Neuromyelitis optica spectrum disorder (NMOSD) is a kind of demyelinating disease of central nervous system which mainly affect optic nerve and spinal cord. Because of its serious blindness and disability, how to effectively prevent relapse has become the focus of ophthalmologists. With the deep understanding of the pathogenesis and the progress of scientific and technological means, more and more monoclonal antibodies(mAb) continue to enter clinical trials. B cell surface antigen CD20 blocker, rituximab, has become a first-line drug for the treatment of NMOSD. CD19 blocker, inebilizumab, can reduce the recurrence and disability of NMOSD patients. The addition of interleukin 6 receptor blocker, satralizumab, and complement C5 inhibitor, eculizumab, reduce the recurrence. Some mAbs such as natalizumab and alemtuzumab may not be effective for the treatment of NMOSD. The expansion of mAb treatment indications and the launch of new drugs still require more clinical trials which are large-scale and international cooperation. At the same time, its potential adverse events and cost issues cannot be ignored.

Endothelial progenitor cells(EPC),which have the capacity to differentiate into mature endothelial cells,have been found to home to and incorporate into the angiogenic vasculature of growing tumors with high specificity once mobilized into the circulation.Yet the mechanism still remains unclear.EPC have potential as spatial-specific delivery vehicles.Thus,further studies on the mechanisms of tumor neovascularization and tumor therapy in glioma using genetically engineered EPC as angiogenesis-selective vectors will be of help to explore the potential in the basic and clinical application of EPC in(glioma.)

OBJECTIVE To investigate the distribution and resistance of fungi isolated from hemopathy patients,and to provide the laboratorial data in order to prevent and treat infection caused by fungi more effectively.METHODS Strains were isolated from the upper respiratory tract,lower respiratory tract,genitourinary tract,alimentary tract;and perianal region,perineum,and the soft tissue and skin wounds.Antimicrobial susceptibility of clinical isolates was tested by broth microdilution susceptibility test.RESULTS Candida albicans,Aspergillus,tropicalis,C.krusei,and C.glabrata were the main fungi of total 3104 detected isolates.The resistance rates of C.albicans and C.tropicalis to fluconazole,itraconazole and 5-flucytosine were no more than 1.4%.The MIC50-MIC90 range of C.tropicalis for itraconazole was narrow(0.25-0.5 mg/L),but that was wide for fluconazole(0.25-4.0 mg/L).CONCLUSIONS C.albicans,Aspergillus,C.tropicalis,C.krusei,and C.glabrata are possibly the most common pathogens causing endogenous and exogenous fungi infection.The main infection sites of Aspergillus are the upper respiratory tract and lower respiratory tract,which may be associated possibly with ward's air quality.The MIC50to MIC90 range of C.tropicalis is wider for fluconazole than for itraconazole,which is possibly correlated with overexpression of CtMDR1 in C.tropicalis caused by the widely application of fluconazole in therapy.

AIM: To investigate the effects of anisodamine on the sodium current (I_(Na)) in left ventricular myocytes of rabbit heart undergoing ischemia/reperfusion, so as to explore the cellular (ionic) basis of anisodamine treatment for antiarrhythmia. METHODS: Forty-five rabbits were randomly divided into three groups: ischemic/reperfusion group (I/R), anisodamine intervention group (Ani+I/R) and sham-operated control group (CON). Anesthetized rabbits were subjected to 30 min ischemia by ligation of the left anterior descending coronary artery and 60 min reperfusion. The animals in Ani group were injected with anisodamine at a dose of 5 mg/kg via femoral vein 1 min before operation. The incidence of ventricular arrhythmia was observed. Single ventricular myocytes were isolated enzymatically from the epicardial zone of the infracted region derived from the hearts in I/R, Ani+I/R group and the same anatomy region in CON. Whole cell patch clamp technique was used to record I_(Na). RESULTS: Anisodamine intervention decreased the incidence and duration of ventricular arrhythmia by reperfusion compared to I/R group, resulting in significant decrease in the scores of arrhythmia (2.6±0.7 vs 3.6±0.8, P<0.05). The peak I_(Na) current density (at-30 mV) was significantly decreased in I/R group (-22.46±5.32 pA/pF, n=12) compared to CON (-42.78±5.48 pA/pF, n=16, P<0.01), while it was significantly increased in Ani+I/R group (-38.89±5.24 pA/pF, n=13) compared to I/R group (P<0.01). CONCLUSION: Anisodamine has the ability to reduce the occurrence of ventricular arrhythmia. Ischemia-reperfusion induces significant down-regulation of I_(Na), while pretreatment with anisodamine attenuates this change, suggesting that anisodamine reverses this electrical remodeling, which may be partly responsible for its antiarrhythmia effects.

Objective To evaluate clinical use of tigecycline in hospital patients. Methods Basic diseases, pathologic examinations, concurrent medication, therapeutic efficacy and side effects of 40 patients in Lishui Central Hospital of Zhejiang Province from January 2012 to December 2014 were analyzed retrospectively. Results The effective rate of patients using tigecycline for anti-infection treatment in hospital was 42. 5%. The rates of rational use, basically rational use and irrational use were 17. 5%, 77. 5% and 5. 0%, respectively. Adverse drug reactions occurred in 6 cases of tigecycline use (15. 0%). Conclusion Clinical use of tigecycline in inpatients was basically reasonable in this hospital. The clinical curative effect of tigecycline was good in a variety of infections caused by sensitive bacteria. However, the incidence of adverse drug reactions was high. Attentions should be paid in clinical application.

Objective To explore the influence of the protection motivation theory (PMT) on the self-nursing ability of high-risk diabetic foot (DF) patients. Methods The outpatients in our hospital were selected with high-risk DF between January 2013 and May 2014, randomly divided into the control group and PMT group, 52 cases in each group. Guided under the protection motivation theory, PMT group received a six-month health education and management; and the control group accepted conventional health education of diabetes. Before and after the intervention, some observation indexes of the two groups respectively were evaluated including the ability of diabetic foot self-nursing, foot condition, fasting blood sugar, 2 h postprandial blood glucose. Result After six months, the scores of the self-care ability of diabetic foot and foot condition from the patients of PMT group were higher than that of PMT group before the intervention and that of control group after intervention (P<0.05). Conclusion PMT can help patients with high-risk DF enhance their foot self-care ability, improve their foot condition, control their blood sugar, and prevent the DF onset.

Objective To investigate the effects of simvastatin on membrane ionic currents in left ventricular myocytes after acutemyocardial infarction(AML.so as to explore the ionic mechanism of statin treatment for antiarrhythmia.Methods Fourty-five NewZeland rabbits were randomly divided into three groups:AMI group,simvastatin intervention group(statin group)and sham-operatedcontrol group (CON).Rabbits were infarcted by ligation of the left anterior descending coronary artery after administration of oralisolated enzymatically from the epicardial zone of the infractcd region.Whole cell patch clamp technique was used to record mmbranewas significantly decreased in AMI group(-23.26+5.1 8)compared with CON(-42.78±5.48,P＜0.05),while it was significantlyincreased in Stating roup(-39.23±5.45)compared with AMI group(P＜0.01);The peak Ica-L current density(at 0 mV) was significantlydecreased in AMI group(-3.23±0.91)compared with CON(-4.56±1.01,P＜0.05),while it was significantly increased in Statin group(-4.18±0.95)compared with AMI group(P＜0.05);The Ito current density(at+60 mV)was significantly decreased in AMI group(10.41±1.93)compared with CON(17.41±3.13,P＜0.01),while it was significantly increased in Statin group(16.21±2.42)compared withattenuate this change without lowering the serum cholesterol level,suggesting that simvastatin reverse this electrical remodeling thuscontributing to the ionic mechanism of statin treatment for antiarrhythmia.

Objective:To investigate the application of critical flicker fusion frequency (CFF) in non-arteritic anterior ischemic optic neuropathy (NAION).Methods:A cross-sectional study. From January 2021 to September 2021, a total of 58 NAION patients (105 eyes) (NAION group) and 33 cases (63 eyes) in the healthy control (HC) group were included from Department of Ophthalmology of First Medical Center, PLA General Hospital. Patients underwent best-corrected visual acuity (BCVA), optical coherence tomography (OCT), visual field, CFF and flash visual evoked potential (F-VEP) examinations. BCVA examination was performed using a Snellen decimal visual acuity chart and was converted to logarithm of the minimum angle of resolution visual acuity. In the affected eyes group, there were 56 cases (72 eyes), 31 cases (43 eyes) male and 25 cases (29 eyes) female, with an average age of 49.28±11.42 years old. And the affected eyes were divided into 4 groups: <1, 1-<3, 3-<6 and >6 months according to the time interval from onset to CFF examination, which were 20(27.8%), 26 (36.1%), 17 (23.6%) and 9 (12.5%) eyes, respectively. According to the BCVA ≥0.5, 0.1-0.5, <0.1 in CFF examination, the affected eyes were divided into a mild, moderate, and severe degree, 33 (45.8%), 32(44.4%) and 7 (9.8%) eyes, respectively. Sixty-three eyes of 33 cases were in the HC group. There were 17 cases(31 eyes) males and 16 cases (32 eyes) females, with an average age of 35.18±10.96 years. Hand-held CFF detector type 2 (Japan, NEITZ company) was used for the CFF examination. The thickness of peripheral retinal nerve fiber layer (pRNFL), macular inner limiting membrane retinal pigment epithelium (mILM-RPE), F-VEP peak time and peak value and mean visual field defect (MD) values were recorded within 1 week of CFF examination. The CFF value of the above subgroups was analyzed in order using one-way ANOVA. Pearson correlation analysis was used for the correlation between CFF and F-VEP peak time, peak value, BCVA and MD. The correlations between BCVA, visual field, F-VEP, and CFF were analyzed.Results:The trichromatic values of red, green and yellow in NAION affected eyes were 22.56±10.30, 24.10±11.51, 24.81±11.41 Hz, respectively, which was significantly reduced compared with the HC group ( t=-10.53,-11.11,-11.36; P<0.05). There was no significant difference in CFF-red, green, and yellow values at different time points after the onset of the disease ( F=2.075, 1.893, 2.073; P>0.05). Compared CFF-red, green, and yellow values in NAION-affected eyes with different degrees, the difference was statistically significant ( F=31.579, 27.332, 32.055; P<0.05). The results of correlation analysis showed that the peak time of F-VEP ( r=-0.362, -0.379,-0.357; P<0.05), BCVA ( r=-0.705,-0.695,-0.714; P<0.05), and which was negatively correlated with CFF three color. MD and CFF were positively correlated ( r=0.486, 0.435, 0.450; P<0.05). Conclusion:The CFF value of the affected eye is decreased significantly in NAION-affected eyes, and CFF is more sensitive than F-VEP in reflecting visual impairment, and has a good correlation with visual function and latency of F-VEP.

Objective:To evaluate the occurrence of nocturnal hypotension (NHP) in nonarteritic anterior ischemic optic neuropathy (NAION).Methods:A evidence-based medicine study. Chinese and English as search terms for NAION and NHP was used to search literature in PubMed of National Library of Medicine, Embase, Web of science, Cochrane Library, Clinical Trials, Wanfang, and China National Knowledge Infrastructure and China Biology Medicine disc. Incomplete or irrelevant literature and review literature were excluded. The literature was meta-analyzed using Review Manager 5.4 and STATA 15.0. The 95% confidence interval ( CI) were selected as the estimated value of effect size, the occurrence of NHP in NAION was calculated, and sensitivity analysis and publication bias analysis were also performed to assess the robustness of pooled outcomes. Results:According to the search strategy, 159 articles were initially retrieved, and 8 articles were finally included for meta-analysis, three prospective studies and five retrospective studies. The occurrence of NHP in NAION was 43% (95% CI, 0.36-0.50). Sensitivity analyses confirmed that the evidence was robust. Subgroup analyses showed that the occurrence of NHP in NAION nearly the same in White patients (47%, 95% CI 0.39-0.55) and Chinese patients (41%, 95% CI 0.32-0.51). The occurrence of NHP in NAION was higher in using night mean artery pressure (45%, 95% CI 0.31-0.60) as the diagnostic criteria than using night systolic blood pressure & night diastolic blood pressure (40%, 95% CI 0.32-0.50). Conclusions:The occurrence of NHP in NAION was 43%; the occurrence was similar in patients of different ethnicities. The diagnosis rate could be improved by using nMAP < 70 mm Hg (1 mm Hg=0.133 kPa) as a diagnostic criterion for NHP. Careful intervention should be taken for the blood pressure of patients with NAION and NHP.

Objective:To observe the clinical and imaging characteristics of radiation optic neuropathy (RION).Methods:A retrospective clinical study. A total of 43 patients (69 eyes) who were diagnosed with RION at the Chinese PLA General Hospital from 2010 to 2021 were included in this study. There were 23 males (36 eyes) and 20 females (33 eyes). The age of patients at the time of radiation therapy was 49.54±13.14 years. The main dose of radiotherapy for lesions was 59.83±14.12 Gy. Sixteen patients were treated with combined chemotherapeutic agents. The clinical details of best corrected visual acuity (BCVA) and color photography of the fundus were collected. Forty-six eyes underwent optical coherence tomography (OCT), visual field were examined in 30 eyes, magnetic resonance imaging (MRI) were performed in 40 eyes. The BCVA examination was performed using Snellen visual acuity chart, which was converted to minimum resolution angle logarithm (logMAR) visual acuity during recording. Hyperbaric oxygen therapy (HBOT) was performed in 10 patients (13 eyes), 9 patients (12 eyes) were treated with intravenous methylprednisolone (IVMP), 12 patients (23 eyes) were treated with HBOT combined with IVMP and control group of 12 patients (21 eyes) were only treated with basal treatment. And grouped accordingly. To observe the changes in onset, recovery, and final BCVA of the affected eye as well as thickness changes of the retinal nerve fiber layer (RNFL) of the optic disc and inner limiting membrane-retinal pigment epithelium (ILM-RPE) layer of the macular area, and final outcome of BCVA with different treatment modalities in affected eyes. The RNFL and ILM-RPE layer thicknesses were compared between patients with different disease duration as well as between treatment regimens using independent samples t-test. Results:Of the 43 cases, vision loss was monocular in 17 patients (39.53%, 17/43) and binocular in 26 patients (60.47%, 26/43). The latency from radiotherapy to onset of visual loss was 36.33±30.48 months. The duration of RION ranged from 1 week to 10 years, in which the disease duration of 37 eyes ≤2 months. Subacute visual acuity loss was present in 41 eyes. logMAR BCVA<1.0, 1.0-0.3, >0.3 were 45, 15, and 9 eyes, respectively. Optic disc pallor and optic disc edema were found in 10 (27.03%, 10/37), 3 (8.11%, 3/37) eyes, respectively, within 2 months. The superior RNFL [95% confidence interval ( CI) 2.08-66.56, P=0.038] and the outer circle of the inner limiting membrane to retinal pigment epithelium (ILM-RPE) (95% CI 4.37-45.39, P=0.021) layer thinned significantly during the first month. The center of the ILM-RPE layer thickened (95% CI-32.95--4.20, P=0.015) significantly during the first two months. The inner circle temporal quadrant of the ILM-RPE layer thickened (95% CI -42.22--3.83, P=0.022) significantly from the third to sixth month, and the RNFL except for the temporal quadrants and the average RNFL, inner circle superior quadrant and outer circle of the ILM-RPE layer thinned significantly after 6 months ( P<0.05). Among the 40 eyes that underwent MRI examination, 33 eyes (82.50%, 33/40) were affected by T1 enhancement of optic nerve, including 23 eyes (69.70%, 23/33) in intracranial segment; 12 eyes with thickening and long T2 signal (36.36%, 12/33). After treatment, BCVA was restored in 17 eyes (24.6%, 17/69) and final BCVA improved in 9 eyes (13.0%, 9/69). There was no significant difference between HBOT, IVMP and HBOT combined with IVMP therapy in improving BCVA recovery or final BCVA compared with the control group, respectively ( t=-1.04, 0.61, 1.31,-1.47, -0.42, 0.46; P>0.05). Conclusions:The structural damage of the RNFL and ILM-RPE layer occurred during the first month, the RNFL showed progressive thinning during the follow-up period, while the ILM-RPE layer showed thinning-thickening-thinning. MRI shows T1 enhancement of the optic chiasma and segments of the optic nerve, and the enhanced segments are usually accompanied by thickening and long T2. HBOT and IVMP have no obvious effect on RION.