Objective To make a survey of the binocular visual acuity, residual visual acuity and the pathogenic factors causing the deficient of the vision handicap student in Blindness-Deaf-Mute school in Guiyang to provide the data for low vision rehabilitation. Methods Through routine examination, we examined the 58 students with vision impairment and further advised them wear the optics visual aids. Results 6 cases of low vision, accounting for 10.3%; 52 cases of blindness, accounting for 89.7%. One case was rectified its visual acuity by means of subjective refraction and rectification of eyesight. Causes of the disease: 35 cases suffered from the deficient due to genetic factors, accounting for 60.3%; among them, the congenital glaucoma was the first (12/35). 23 cases suffered from the deficient due to acquired factors, accounting for 39.7%, among them, the keratomalacia was the first (19/23). Visual aids wearing :visual acuity≥0.3, 3 cases; visual acuity≥0.05, 6 cases. Conclusions Prevention can prevent the genesis of blindness. The students of residual visual acuity should wear visual aids.

Objective To investigate the effectiveness of implantation of homologous cancellous and autologous red marrow under endoscope in the treatment of traumatic bone nonunion or bone defect.MethodsTotally 25 patients with traumatic bone nonunion or bone defect were enrolled in this study.The lesion involved the tibia bone in 9 cases,the femur in 13,and the humerus in 3.The grafts were sized 1 to 6 cm in length(mean,2.7 cm).Before the implantation of the cancellous bones,the scar fibrous tissues within the nonunion were removed completely by endoscopy,and then autologous red marrow obtained from the iliac crest was injected.ResultsAll the patients were followed up for 12 to 36 months(mean,25 months).The surgical wounds healed primarily in all of the cases without injuries to the blood vessels and nerves.Bony union was achieved within 4 to 9 months(mean,5.1 months) in 23 of the patients,the other 2 failed because of breaking and loosing of internal fixators.No patient developed re-nonunion and infection.ConclusionsImplantation of homologous cancellous and autologous red marrow under endoscope is effective for traumatic bone nonunion or bone defect with a low rate of complication and high rate of bony union.Since no need to harvest the ilium bone,the method is minimally invasive for the patients.

To study therapeutic effects of irbesartan combined amiodarone on heart failure (HF) patients with atrial fibrillation (AF) and its influence on cardiac function ,plasma levels of Ang‐Ⅱ,NE and BNP .Methods :A total of 98 HF patients with AF treated in our hospital from Sep 2016 to Sep 2017 were randomly divided into ami‐odarone group (received amiodarone based on routine treatment ) and combined treatment group (received irbesar‐ tan based on amiodarone group).Both group were treated for six months .HR ,BP ,cardiac function indexes ,plas‐ma levels of Ang‐Ⅱ,NE and BNP before and after treatment ,and incidence of adverse reactions were observed and compared between two groups .Results : Compared with before treatment ,after treatment ,there were significant reductions in HR ,BP ,LVEDd ,LVESd ,plasma levels of Ang‐Ⅱ,NE and BNP ,and significant rise in LVEF in two groups , P＜0. 05 or ＜0. 01. Compared with amiodarone group ,after treatment ,there were significant reduc‐tions in HR [(95. 6 ± 13.7) beats／min vs .(81. 4 ± 11. 8) beats／min] ,BP [(145. 7 ± 20.6)／(89.1 ± 11.4) mmHg vs.(132.3 ± 17.5)／(81.3 ± 10.2) mmHg] ,LVEDd [ (58.3 ± 5.2) mm vs.(53.2 ± 4.6) mm] ,LVESd [ (44. 2 ± 5. 1) mm vs.(38.1 ± 4.9) mm] ,plasma levels of Ang‐Ⅱ[(113.27 ± 10.14) pg／ml vs.(98.67 ± 8. 79) pg／ml] , NE [(1.90 ± 0. 31) pg／ml vs.(1.74 ± 0. 28) pg／ml] and BNP [(282.18 ± 54.16) pg／ml vs.(214. 36 ± 41. 25) pg／ml] ,and significant rise in LVEF [(39.8 ± 4.1)% vs.(48.6 ± 5. 5)%] in irbesartan group ,P＜0.01 all.There was no significant difference in incidence rate of adverse reactions during treatment between two groups , P＝ 0.712. Conclusion :Irbesartan combined amiodarone can effectively improve cardiac function ,reduce HR ,BP ,plasma lev‐els of Ang‐Ⅱ,NE and BNP with good safety in HF patients with AF .

Objective To observe clinical efficacy of atorvastatin combined with clopidogrel for treatment of patients with unstable angina and its influences on hypersensitive C-reactive protein (hs-CRP) and prognosis of such patients. Methods Data of four hundred and thirty patients with unstable angina pectoris admitted to Tangshan Worker's Hospital from January 2013 to December 2017 were collected, and according to difference in drug application, they were divided into control group and observation group, with 215 patients in each group. Both groups were treated with routine western therapy; the patients in the control group were subjected to enteric-coated aspirin (the initial dose was 300 mg and the maintenance dose 100 mg/d) atorvastatin therapy (20 mg orally taken, once a day) on the basis of conventional therapy, subcutaneous injection of 4.1 kU low molecular weight heparin calcium every 12 hours once time for 7 days; the patients in the observation group were subjected toatorvastatin therapy (similar dosage used in the control group) and clopidogrel therapy (the initial dose was 30 mg and the maintenance dose was 75 mg/d) on the basis of conventional treatment. After both groups were treated for 6 months, their clinical efficacies were evaluated. The differences of cholesterol (TC), triacylglycerol (TG), hs-CRP were compared before and after treatment between the two groups, and the clinical curative effect, and drug adverse reaction were observed in the two groups. Results After treatment, the total effective rate of the observation group was significantly higher than that of the control group [92.56% (199/215) vs. 73.48% (158/215), P < 0.05, P < 0.05]. After treatment, the levels of TC, TG and hs-CRP in the two groups were lower than those before treatment, and the above indexes in the observation group were significantly lower than those in the control group [TC (mmol/L): 2.28±0.29 vs. 3.81±1.33, TG (mmol/L): 4.35±0.32 vs. 7.77±0.24, hs-CRP (mg/L): 5.41±2.26 vs. 7.15±3.22, all P < 0.05].There was no significant difference in the incidence of adverse reactions between the observation group and the control group [7.91% (17/215) vs. 10.25% (22/215), P > 0.05]. Conclusion Atorvastatin combined with clopidogrel for treatment of unstable angina pectoris can effectively lower the level of hs-CRP,and it has important significance for improving the prognosis of such patients.

Objective:To retrospectively evaluate the effects of lung-protective ventilation strategies on postoperative pulmonary complications in the patients undergoing long-time neurosurgery.Methods:Based on the duration of anesthesia>8 h, the clinical data from patients underwent elective first craniotomy under general anesthesia from January 1, 2019 to December 31, 2021 were retrospectively collected. Patients were divided into lung-protective ventilation group (group L) and conventional mechanical ventilation group (group C) according to whether lung-protective ventilation was performed during operation. The baseline characteristics, intraoperative condition, postoperative pulmonary complications and hospitalization of patients in the two groups were recorded.Results:Compared with group C, the tidal volume was significantly decreased, positive end-expiratory pressure and respiratory rate were increased, the incidence of intraoperative hypoxemia was decreased, the number of patients with grade 1 according to the severity grade of postoperative pulmonary complications was significantly increased, and the length of hospital stay was shortened in group L ( P<0.05). There were no statistically significant differences in the baseline characteristics, incidence of postoperative pulmonary complications at 7 days after surgery and other parameters between group L and group C ( P>0.05). Conclusions:Lung-protective ventilation strategies can reduce the severity of postoperative pulmonary complications in the patients undergoing long-time neurosurgery.

Objective:To explore the relationship between psychological distress and intimacy in stroke patients and the mediating effect of different dyadic coping style, to provide theoretical guidance for improving the intimate relationship of stroke patients.Methods:A convenient sampling method was used to select 203 patients with stroke who visited the General Hospital of Ningxia Medical University, the People's Hospital of Ningxia Hui Autonomous Region and the Department of Neurology of Yinchuan First People's Hospital from December 2020 to July 2021 as the survey objects. The general information questionnaire, Kessler Psychological Distress Scale, Quality of Relationship Index and Dyadic Coping Inventory were used to investigate patients.Results:The scores of psychological distress, intimate relationship, positive dyadic coping and negative dyadic coping were 19.33 ± 7.46, 32.75 ± 6.79, 86.25 ± 13.22, and 16.46 ± 4.08, respectively. Correlation analysis showed that psychological distress was negatively correlated with intimate relationship and positive dyadic coping ( r=-0.195, -0.204, both P<0.01), psychological distress was positively correlated with negative dyadic coping ( r=0.229, P<0.01). The mediating effect of positive dyadic coping and negative dyadic coping on psychological distress and intimate relationship was 35.87% and 53.26%, respectively. Conclusions:The psychological distress indirectly affects the intimate relationship of stroke patients through positive dyadic coping and negative dyadic coping. Health care workers can guide patients to actively cope with the disease and encourage couples to strengthen communication, so as to enhance the intimacy of couples and promote their physical and mental health development.

Objective To study the feasibility and value of magnetic resonance diffusion tensor imaging (DTI) to monitor non?arteritic anterior ischemic optic neuropathy (NAION). Methods Thirty eight NAION patients (56 eyes) were divided into acute period in 17 eyes, progressive period in 16 eyes and chronic period in 23 eyes at the base of onset time. According to matching principle, 56 eyes in 38 normal controls (NCs) were enrolled. All the patients and NCs underwent MR and DTI scan. The raw data were processed by two experienced radiologists, mean diffusivity (MD), axial diffusivities (λ//), radial diffusivities (λ┴), fractional anisotropy (FA) and Length value were got. The independent sample t test was used for the parameter values between the NAION group and the NCs group. A single factor variance analysis was used to compare the parameters among different stages of NAION group. Results Compared to the NCs group, the values of FA and Length in NAION group were reduced [0.20±0.11 vs 0.31±0.12, (5.85±0.92) vs (65.11± 6.89) mm], and the differences were statistically significant (t=-4.28,-5.25;P<0.05). The values of MD andλ┴were increased [(0.16±0.04)×10-3 vs (0.10±0.04)×10-3 mm2/s, (0.16±0.05)×10-3 vs (0.09±0.03)×10-3 mm2/s] in NAION group and the differences were statistically significant (t=6.83, 7.10;P<0.05). The value of FA and Length in acute period, progressive period and chronic period of the NAION group decreased differently compared to the NCs group. At the same time, the value of MD value and λ┴in the three periods of the NAION group increased compared to the NCs groupand the differences were statistically significant (P<0.05). The value of FA between the acute period, the progressive period, and the chronic period of NAION group were statistically signficant (F=10.88, P<0.05). However, no significant differences were found in the values of MD, λ┴and Length of the NAION group (F=0.23, 0.64, 0.33, 1.38;P=0.79, 0.54, 0.72, 0.27). Conclusion The parameters of DTI can be used to monitor the damage of optic nerve and development in NAION.

The epidemic of coronavirus disease 2019 (COVID-19) puts higher demands on critical care medicine. Lots of studies have been conducted to solve COVID-19-related problems. Therefore, we reviewed the annual progress for COVID-19-related issues including antivirals threapies, respiratory support and immunomodulatory therapies and other critical issues, including the effect of antibiotic on mitochondrial damage and its relationship with sepsis, the goal and direction of antimicrobial de-escalation, drug prophylaxis of constipation, bleeding in gastrointestinal disorders and management of critical illness in the informalization era and so on. We hope to provide reference for clinical and scientific research work of the intensivists.

In order to provide basic information for the utilization and development of famous classical formulas containing Bletillae Rhizoma， this article systematically analyzes the historical evolution of the name， origin， harvesting and processing of Bletillae Rhizoma by reviewing the ancient materia medica， prescription books， medical books and modern literature. The research results showed that Baiji（白及） was the main name， some scholars took Baiji（白芨） as its main name， and there were many other names such as Baiji（白给）， Baigen（白根）， Baiji（白苙）. The mainstream source of Bletillae Rhizoma was the tubers of Bletilla striata， and drying， large， white， solid， root-free and skin removed completely were the good quality standards. With the promotion of wild to cultivated medicinal materials， there were certain differences between their traits， and the quality evaluation indexes should be adjusted accordingly. The origin of records in the past dynasties was widely distributed， with Guizhou and Sichuan having high production and good quality in modern times. The harvesting period is mostly in spring and autumn， and harvested in autumn was better. The processing and processing technology is relatively simple， and it was used fresh or powdered in past dynasties， while it is mainly sliced for raw use in modern times. Based on the results， it is suggested that the tubers of Bletilla striata of Orchidaceae should be used in the famous classical formulas， and it should be uniformly written as Baiji（白及）. And if the original formula indicates the requirement of processing， it should be operated according to the requirement， if the requirement of processing is not indicated， it can be used in raw form as medicine.

【Objective】 To explore the prognostic impact and clinical application value of therapeutic plasma exchange(TPE) intervention timing and liver injury periodization in patients with exertional heat stroke(EHS). 【Methods】 Data of 127 EHS patients from the First Medical Center of the General Hospital of the People′s Liberation Army from January 2011 to December 2023 were collected, then divided into the death group and the survival group based on therapeutic outcomes and into 5 stages according to the dynamic changes of ALT, AST, TBIL and DBIL. According to propensity score matching analysis, 11 patients in the survival group and 12 patients in the death group were included in the statistical analysis, and 20 of them were treated with TPE. The changes in indicators and clinical outcomes before and after TPE were observed, in order to evaluate the impact of intervention timing on prognosis. 【Results】 Among the 23 patients, 14 had no liver injury or could progress to the repair phase, resulting in 3 deaths(with the mortality rate of 21.43%), while 9 patients failed to progress to the repair phase, resulting in 9 deaths(with the mortality rate of 100%), with significant differences(P<0.05). The mortality rate of the first TPE intervention before the third stage of liver injury was 23.08%(3/13), while that of intervention after reaching or exceeding the third stage was 85.71%(6/7), and the difference was statistically significant(P<0.05). 【Conclusion】 TPE should be executed actively in EHS patients combined with liver injury before the third phase to lock its pathological and physiological processes, thereby improving prognosis and reducing mortality.