Objective:To investigate the feasibility of rectus muscle insertion measurement with anterior segment optical coherence tomography (AS-OCT) after corrective surgery of concomitant exotropia.Methods:A cross-sectional study was performed.Twenty-five eyes of 25 patients with concomitant exotropia were included in Shenyang Aier Eye Hospital from March 2018 to February 2019, and all patients received concomitant exotropic corrective surgery.The distance of limbus to rectus muscle insertion was measured before operation, at the beginning and at the end of operation with a caliper and at postoperative 2 weeks, 1 month, 3 months and 6 months with AS-OCT, respectively.Degree of strabismus was examined by the alternate prism cover test at 33 cm.The research followed the Declaration of Helsinki and the protocol was approved by a Medical Ethics Committee of Shenyang Aier Eye Hospital (No.2017KJB005). Written informed consent was obtained from the patients/custodians prior to any medical examination and treatment.Results:A total of 44 rectus muscles of 25 eyes with concomitant exotropia were measured, including 25 lateral rectus muscles and 19 medial rectus muscles.The detection rate of the muscle insertion by AS-OCT was low at 2 weeks and 1 month after surgery.The mean distance of limbus to lateral rectus muscle insertions was (12.30±1.40), (11.72±1.45) and (11.84±1.27)mm at the end of operation and postoperative 3 and 6 months, respectively, showing a significant difference among them (F=4.085, P=0.023), and the distance measured at the end of operation was significantly larger than that at postoperative 3 months (P=0.018). The mean distance of limbus tomedial rectus muscle insertion was (5.12±0.42), (5.56±0.61) and (5.28±0.57)mm at the end of operation, postoperative 3 and 6 months, respectively, and there was no significant difference among the three time points (F=3.912, P=0.055). The degree of strabismus of the patients at various time points after surgery were significantly reduced in comparison with that before surgery (all at P<0.05).Conclusions:AS-OCT can track the position of extraocular muscle insertions after concomitant exotropic corrective surgery.

Crohn's disease (CD) is a chronic nonspecific inflammatory disease.CD can affect any location in the digestive tract,and it also affect other organs,including the eyes,skin,liver and joints,which are termed extraintestinal manifestations (EIMs).The cutaneous manifestations of CD are common and occur in about one-third of patients.EIMs of CD have been divided into 3 categories.(1) Specific lesion,cutaneous manifestations of CD were the same as histopathologic findings of underlying gastrointestinal lesion.(2) Reactive lesion,it was also inflammatory lesion which was usually accompanied by underlying gastrointestinal disease while inflammatory injury was different from histopathologic findings of gastrointestinal lesion.(3) Associated lesion,it was caused by sequelae of human leucocyte antigen and chronic inflammation.In the current era of ever-expanding therapeutic options for CD,some investigators have proposed a fourth category of EIMs,namely those that are therapy-related lesion.The therapy-related lesion is closely related to disease-associated conditions in light of certain skin findings,and there is potential overlap between them.

The shape and structure of granules are controlled by the granulation process, which is one of the main factors to determine the nature of the solid dosage forms. In this article, three kinds of granules of a traditional Chinese medicine for improving appetite and promoting digestion, namely, Jianwei Granules, were prepared using granulation technologies as pendular granulation, high speed stirring granulation, and fluidized bed granulation and the powder properties of them were investigated. Meanwhile, synchrotron radiation X-ray computed micro tomography (SR-µCT) was applied to quantitatively determine the irregular internal structures of the granules. The three-dimensional (3D) structure models were obtained by 3D reconstruction, which were more accurately to characterize the three-dimensional structures of the particles through the quantitative data. The models were also used to quantitatively compare the structural differences of granules prepared by different granulation processes with the same formula, so as to characterize how the production process plays a role in the pharmaceutical behaviors of the granules. To focus on the irregularity of the particle structure, the box counting method was used to calculate the fractal dimensions of the granules. The results showed that the fractal dimension is more sensitive to reflect the minor differences in the structure features than the conventional parameters, and capable to specifically distinct granules in structure. It is proved that the fractal dimension could quantitatively characterize the structural information of irregular granules. It is the first time suggested by our research that the fractal dimension difference (Df,c) between two fractal dimension parameters, namely, the volume matrix fractal dimension and the surface matrix fractal dimension, is a new index to characterize granules with irregular structures and evaluate the effects of production processes on the structures of granules as a new indicator for the granulating process control and optimization.

ScanningElectronMicroscopy/EnergyDispersionSpectrum(SEM/EDS),ElectronProbe Microanalysis ( EPMA ) and Optical Microscopy ( OM ) are the traditional methods for inclusion type identifying at present. The disadvantages such as inconvenient sample preprocessing, low sensitivity and time consuming limited their application. Laser-Induced Breakdown Spectroscopy ( LIBS) is not only performing in bulk analysis field but also in elemental distribution and depth profile information field, so it causes great concern in material science. In this paper, 34CrNiMo6 steel and heavy railway steel samples were analyzed by LIBS in scanning mode to characterize the inclusion type. For 34CrNiMo6 steel, 2D intensity distribution and channel combination revealed the spectra line intensity of Mn and S were abnormal high simultaneously at some region, which indicated there were some MnS inclusion existed in these samples. And for heavy railway steel, 2D distribution and channel combination revealed the spectra line intensity of Si, Ca, Mg and Al were abnormal high simultaneously at some region, showed the existence of Si-Al-Ca-Mg inclusion in these samples. The SEM/EDS analysis result of above-mentioned samples showed agreed well with LIBS.

This investigation was to assess the prevalence and risk factors of hypertension in 35 to 70 years old adults living in Xicheng District of Beijing. Cluster sampling was conducted in 2230 adults, and only 1958 individuals agreed to enter into the study. Written informed consents were obtained before questionnaire and physical examination. A total of 1889 data were used for analysis. The prevalence rate of hypertension was 47.8% (n=902). The age-standardized prevalence rate was 40. 1%. Hypertension was seen in 368 men (53.0%) and 534 women (44.7%) (P=0.0005). The rates of disease awareness, treatment, and control were 47.5%, 38.5%, and 24.1%, respectively. The prevalence of hypertension increased with age (P<0.0001). Linear trend was found between body mass index (BMI) and systolic blood pressure (P<0.0001). In multiple logistic model analysis, the hypertension risk for men was 1.33 times that of women (95% CI, 1.08-1.64), for participants with obesity was 2.81 times that of those with normal weight (95%CI, 2.00-3.97). Hypertension has become one of the most concerned public health problems in the district. Middle-aged people should pay attention to changed blood pressure, especial for overweight men. Health promotion should be needed for hypertension prevention. More attention should be paid to substantial increase in hypertension.

The release behavior of single pellet was investigated by LC/MS/MS method with tamsulosin hydrochloride (TSH) as the model drug of the research and then the pellets were divided into four groups according to the drug loading. Comparison of dissolution profiles of each group and capsule were performed using f1 and f2 factor methods to study the difference and similarity. The release profiles of single pellet, each group and capsule were analyzed using principle component analysis (PCA). The particle system was built through Matlab to get the target release profile. The result of this research demonstrated the release behavior of single pellet correlated well with the drug loading. While the dissolution profile of capsule as a reference, the similarity factor of dissolution profiles of the lower drug loading groups were 62.2, 67.1, 53.9, respectively and, 43.3 for highest drug loading group. The particle systems with different pellet distribution and same release profiles were built through release behavior of single pellet. It is of significance to investigate the release behavior of single pellets for studying the release regularity of multiple-unit drug delivery system.

Objective To explore the relationship between gastric juice pH and hospital-acquired pneumonia ( HAP) , the gastric bacterial colonization and etiology of HAP in neurologic intensive care unit patients by monitoring gastric juice pH value.Methods From October 2014 to May 2015, consecutive seventy-two tube feeding patients admitted in the Department of Neurology Intensive Care Unit in Xijing Hospital were enrolled in this research.The type and concentration of pathogens from gastric contents were collected, while samples from upper respiratory tract and pharynx were detected dynamically at the same time.Results (1)The group with new onset HAP was higher in gastric juice pH (6.4(5.4,6.4) vs 5.4 (2.5, 6.4), Z=-2.37, P=0.01); (2) The isolation rate of colonized bacteria in gastric cavity was associated with the pH of gastric juice , achieving 60.8% ( 42/69 ) in HAP group; ( 3 ) When the gastric juice pH was >4, the isolation rate of Gram-negative bacilli in gastric cavity obviously increased (63.6%(28/44) vs 35.7%(10/28),χ2 =5.323, P=0.021); (4)The same pathogens were found in stomach-pharynx-upper respiratory tract in 7 cases ( 17.5%) of the total 40 HAP patients.Conclusion Increased gastric juice pH was associated with gastric colonization , especially Gram-negative bacilli , and may lead to a higher incidence of new onset HAP in patients on enteral feeding.

Objective To Improve inpatient safety of oral drugs , and reduce risk of medication errors .Methods 1 696 oral-order errors caused by prescription and transcription from July to December 2012 were investigated by Excell.Results 979 cases (57.7%) reduced the efficiency of unit-dose automated dispensing machines and 717 cases (42.3%) affected to inpatients’ medica-tion safety.Conclusion It is very important that pharmacists should check drugs packaged unit -dose with prescription paper .It is also an effect means to prevent medication errors that continuing training pharmacists′skill, intensifying communication with clinics and strengthening information technology systems .

Objective:Explore the efficacy of pulmonary wedge resection in the treatment of non-small cell lung cancer (NSCLC) and risk factors for postoperative recurrence, and construct a risk prediction model.Methods:A retrospective analysis of the clinical data of 126 NSCLC patients were admitted to Mianyang Central Hospital from June 2018 to June 2020. According to different surgical methods, the patients were divided into pulmonary wedge resection group ( n=88) and lobectomy Group ( n=38). Compare the metastasis rate, recurrence rate, and fatality rate at 1 year after the two kinds of operations; according to the recurrence of the lung wedge resection group, the patients are divided into recurrence group ( n=15) and non-recurrence group ( n=73). The general data and preoperative laboratory examination indexes of the two groups of patients were compared; multivariate Logistic analysis of factors affecting postoperative recurrence of patients; a risk scoring model was constructed and its predictive value was evaluated. Enumeration data was expressed by the number of cases and percentage (%), and the comparison between groups was performed by chi-square test. Multivariate Logisitic regression analysis of factors affecting the recurrence of NSCLC patients at 1 year after pulmonary wedge resection; a risk scoring model was constructed according to risk factors, and X-tile software was used to obtain the cutoff value of the score; a calibration curve was used to evaluate the accuracy of the risk prediction model prediction The clinical decision curve evaluates the effectiveness of model predictions. Results:The surgical margin metastasis rate and mortality of patients in the pulmonary wedge resection group were 0 and 6.82%, and the lobectomy group were 13.16% and 21.05%, respectively. The differences between the two groups were statistically significant ( P<0.05); The proportion of patients with smoking history, vascular thrombus cancer, lymph node dissection ≤ 15, carcinoembryonic antigen >5 ng/mL, neutrophil to lymphocyte ratio>2.5, soluble CD105>4 ng/mL, vascular endothelial growth factor >9 ng/mL and matrix metalloproteinase 9 (MMP-9) > 300 μg/L in recurrent group were significantly higher than those in non-recurrent group. All of them were risk factors for recurrence after wedge pneumonectomy ( P<0.05); the above risk factors were incorporated into the risk scoring model, and weights of 22, 38, 25, 33, 20, 27, 36, and 30 were assigned respectively, and patients were classified as medium according to the cut-off value. Risk patients (≤78 points), high-risk patients (>78 points and ≤162 points), and extremely high-risk patients (>162 points). Conclusions:The effect of thoracoscopic wedge resection in the treatment of NSCLC is significantly better than that of thoracoscopic lobectomy. The construction of a risk scoring model for predicting postoperative recurrence of patients is beneficial to early identification of high-risk groups in clinical practice, and to guide medical staff to adopt personalized treatment and nursing care measures.

Objective:To analyze the understanding of "informed consent" in clinical treatment of medical staff in institutions with different nature , understand the current situation of informed consent in clinical treatment and further analyze its progress and deficiency .Methods:Using a self-developed questionnaire , a survey was conduc-ted among 326 medical staff in institutions with different nature in Shanghai .Results:In aspect of informing , the choices of medical staff in specific content of clinical treatment and informed objects differed significantly ( P<0 .05 ) .In aspect of voluntary , the medical staff ' s choices on whether patients or their families could refuse doc-tor's treatment differed significantly (P<0.05).In aspect of decision -making capacity, the medical staff's choices in assessment experience , methods, the necessity of assessment and how to assess differed significantly ( P<0.05).Conclusion:At present, the differences of understanding of medical staff from institutions with different nature towards informed consent were more significant .Although medical staff ' s awareness and understanding of informed consent has increased , but the specific operation mode and process need further training and improve-ment.