OBJECTIVE:To provide reference for suitable selection of antibacterial ophthalmic preparation in the clinic. METHODS:The application of antibacterial ophthalmic preparation in a hospital during Jan. 2013-Dec. 2016 were summarized and analyzed to calculate DDDs. The results of bacterial culture and identification,drug sensitivity test were collected. The correlation of DDDs of antibacterial ophthalmic preparation with resistance rates of bacteria was analyzed by using Pearson test. RESULTS:During 2013-2016,there were 7 categories of antibacterial ophthalmic preparations used in this hospital,involving 10 types. To-tal DDDs showed an upward trend with average annual growth rate of 26.16％. DDDs of Tobramycin (dexamethasone) eye drops were the highest for consecutive 3 years (2013-2015). Gatifloxacin eye drops/eye gel and Ofloxacin eye drops/eye oint-ment ranged 2nd-4th place in the list of DDDs. A total of 26143 ocular specimens were examined,and 21 kinds of bacteria were detected,involving 6221 strains with detection rate of 23.80％. Top 3 bacteria in the list of detection rate were Staphylo-coccus epidermidis (3067 strains),Streptococcus pneumoniae (470 strains) and Staphylococcus aureus (321 strains). Resistance rates of above 3 kinds of bacteria to erythromycin were all higher than 70％,while they were sensitive to rifampicin,chlorampheni-col,gentamicin and levofloxacin,etc. Compared to previous year,the average resistance rates of rifampicin(in 2015),gentamicin (in 2015,2016),tetracycline(in 2015),ofloxacin(in 2014,2015),levofloxacin(in 2016)and gatifloxacin(in 2016)had statisti-cally significant differences(P<0.05). DDDs of tetracycline was positively associated with its average resistance rate(r=1.000,P<0.05),and DDDs of other antibacterials had nothing to do with resistance rate(P>0.05). CONCLUSIONS:The main ocular infec-tions were S. epidermidis,S. pneumoniae and S. aureus. DDDs of tetracycline is certainly associated with resistant rates. Regulating clinical use of antibacterial ophthalmic preparation is important for delaying the development of bacterial resistance.

Objective To review retrospectively the experience of surgical treatment of Ebstein anomaly in 45 adult patients.Methods Between January 2008 and December 2011,45 adult patients underwent surgery for Ebstein anomaly.There were 14 male and 31 female patients aged 18 to 61 years (mean,39 years).The main symptoms included chest tightness,shortness of breath,palpitation.25 patients had cyanosis,while 6 patients with Wolff-Parkinson-White syndrome.Preoperative echocardiography: The septal downward from 2.5 cm to 7.5 cm,average 4.2 cm; the posterior leaflet downward 3.0 cm to 8.0cm,average 5.1 cm.Tricuspid incompetence was moderate in 6 patients and severe in 29.According to Carpentier classification,5 cases of type A,30 type B,type C in 6 cases.Preoperative New York Heart Association(NYHA) functional class Ⅱin 14 cases,Ⅲ 30 cases,Ⅳ in 1 cases.Surgical procedures included modified Danielson's in 15 patients,modified Carpentier's in 23,and 7 patients underwent tricuspid valve replacement(incloud 4 secondary operations).The ratio of tricuspid valve repair was 84.4％.Autologous pericardium patch was used to reconstruct the septal and posterior leaflets in 5 cases.Intraoperative use of annuloplasty rings in 21 cases.Results There were 2 hospital deaths with a postoperative mortality of 4.4％.The main causes of death were low cardiac output and right heart failure.Operation to discharge time was (8.0 ± 3.8)days.The follow up time was 2 to 46 months.Echocardiography examination: Within the 32 patients of severe tricuspid regurgitation before tricuspid valve plasty,16 patients’ tricuspid regurgitation disappeared,13 patients with mild regurgitation,3 moderate regurgitation.Within 5 patients of moderate tricuspid regurgitation before tricuspid valve plasty,4 cases tricuspid regurgitation disappeared after operation,1 case tricuspid valve mild regurgitation.Tricuspid valve leaflets were at normal levels,the atrialized portion of the ventricular disappeared.The heart function improved to be NYHA class Ⅰ to Ⅱ in 95 ％ of the survived patients.Conclusion Operative method of Ebstein anomaly sould be selected according to the type of pathoanatomies.Tricuspid valve repair should be performed to the best of our ability.

Potassium metabolism in young adult men exercising in the heat for six consecutive days and the effect of potassium deficiency in mice and rats induced by low potassium diet during heat exposure were observed. Increased potassium loss in sweat and lower potassium intake resulted in negative potassium balance. Individuals with a negative potassium balance had lower se- rum potassium levels and higher body temperature after exercise. Potassium deficient mice accomplished less work done (2.372 vs 4.253 Kg.M) but exih-ibited a markedly greater rate of heat gain (1.36 vs 0.87℃/Kg.M) as compared to the controls. The survival rate and cellular energy metabolism also decreasedThese observations suggest that prevention from potassium deficiency must be emphasized during prolonged physical activity under hot environments. According to the linear regression equations between potassium intake and balance, it is proposed that the potassium requirements in mild and medium physical activity in the heat are 40 and 60 mEq/day respectively, and the allowance of potassium in the latter may be 70-80 mEq/day.

Objective:To observe the multimodal imaging features of retinal diseases associated with COVID-19.Methods:A retrospective case study. Sixteen patients (30 eyes) of retinal diseases associated with COVID-19 admitted to the Ophthalmology Department of the Second People's Hospital of Zhengzhou in December 2022 were included in the study. There were 5 males and 11 females, with the mean age of (26.69±9.88) years; 14 patients were bilateral and 2 patients were unilateral. The time of ocular symptoms after the diagnosis of COVID-19 was (2.63±0.89) days. All patients underwent the examinations of best corrtected visual acuity (BCVA), fundus color photography (FP), infrared fundus photography (IR), optical coherence tomography (OCT). Fluorescein fundus angiography (FFA) was performed in 2 patients (4 eyes). There were 20 eyes with acute macular neuroretinopathy (AMN), including 6 eyes with cotton wool spots; 10 eyes with Purtscher-like retinopathy (PLR). The BCVA of the patients was 0.1-1.0. No obvious abnormality was found in anterior segment examination. The features of FP, IR and OCT were analyzed retrospectively.Results:In 20 eyes of AMN, irregular reddish brown lesions in the central or paracentral area of the macula in 14 eyes; FP showed no obvious abnormality in 6 eyes; IR showed irregular map like low reflection in the central or paracentral area of macular in all eyes; OCT showed hyperreflectivity in outer plexiform layer and outer nuclear layer, hyporeflectivity in the ellipsoid zone and photoreceptor layers in all eyes; no abnormal fluorecence was observed in 2 eyes examined by FFA. In 10 eyes with PLR, cotton wool spots and retinal hemorrhage were observed in the posterior pole and/or peripapillary area, and the peripheral retina was generally normal, Purtscher spot was found in 5 eyes and macular edema in 4 eyes; OCT showed strong reflex signal in neuroepithelial layers, edema in neuroepithelial layers in 6 eyes; in the 2 eyes examined by FFA, fluorescein leakage from the retinal vein wall was observed, the posterior pole and peripapillary area retinal arteriole occlusions showed patchy hypofluorescence, the fluorescence was obscured by retinal hemorrhage below at inferior retina.Conclusions:For AMN associated with COVID-19, IR can show the lesion contour, OCT shows lesions in the outer retina. PLR associated with COVID-19 are usually at the posterior pole and/or peripapillary area in FP, OCT shows neurocortical edema.

Objective: To observe and explore the therapeutic efficacy of hyperbaric oxygen (HBO) in the treatment of non-arteritic anterior ischemic optic neuropathy (NAION). Methods: A total of 139 NAION patients were randomly divided into a control group of 72 and a hyperbaric oxygen group of 67. Both groups were given conventional drugs including prednisolone, mecobalamin and compound anisodine, while the hyperbaric oxygen group was additionally provided with hyperbaric oxygen treatment at a pressure of 0.2MPa once a day for 30 days. Each day′s treatment lasted for 110 minutes, including 20 minutes at increasing pressure, 20 minutes decreasing and 60 minutes with the pressure stable at 0.2MPa. Before and after the 30-day treatment, the visual acuity and visual mean sensitivity (MS) of the two groups were observed and compared. Results: There was no significant difference between the control group and the hyperbaric oxygen group in terms of average visual acuity or visual MS before the treatment. Afterward the average visual acuity (4.88±0.25) and visual MS (16.68±1.19) of the hyperbaric oxygen group were significantly higher than before the treatment and significantly better than those of the control group. The total effective rate of the hyperbaric oxygen group was 91%, significantly higher than that of the control group (75%). Conclusions Conventional treatment combined with hyperbaric oxygen therapy can significantly promote the visual acuity and visual MS of NAION patients.

Currently, single-cell multi-omics technologies including single-cell DNA sequencing (scDNA-seq) and single-cell RNA sequencing (scRNA-seq) have been used to reveal the heterogeneity of malignant tumor cells, elucidate their pathogenesis, drug resistance and recurrence mechanisms, which provide new strategies for the diagnosis and prognostic assessment of malignant tumors. This article reviews the application of single-cell sequencing technology in the diagnosis and prognostic assessment of acute leukemia based on the progress reported at the 65th American Society of Hematology Annual Meeting.

OBJECTIVE: To formulate a limit of occupational benzoquinone in the air of workplace. METHODS: According to GBZ/T 210. 1-2008 Guide for Establishing Occupational Health Standards--Part 1: Occupational Exposure Limits for Airborne Chemicals in the Workplace,the relevant literatures on toxicology,epidemiology and foreign occupational exposure limit for benzoquinone were collected and analyzed. A benzoquinone production enterprise was selected as the research subject. Occupational hygiene investigation and occupational epidemiological investigation were carried out. The occupational exposure limit of benzoquinone in the air of workplace was assessed. RESULTS: The literature data analysis results showed that benzoquinone is a highly toxic substance,has strong stimulated effect on human respiratory tract,eyes and skin. The occupational exposure limit of benzoquinone in the workplace air in the United States of America,Germany and Australian is 0. 400 mg/m~3. In the benzoquinone production enterprise,the median of concentration-time weighted average of benzoquinone exposed workers( exposure group) was 0. 100 mg/m~3. The median of concentration-short term exposure limit in the workplace air was 0. 160 mg/m~3. There was no significant difference on the abnormal detection rate of conjunctivitis,dermatitis,and abnormal liver B type and abnormal kidney B type ultrasound between the exposure group and the control group( P > 0. 05). There was no significant difference on the serum liver function and renal function indexes between the two groups( P > 0. 05). The results of blood routine examination in the two groups were within the normal reference range. CONCLUSION: It is suggested that the permissible concentration-time weighted average of benzoquinone in the workplace air should be set at 0. 400 mg/m~3 in China.

Diabetic nephropathy （DN） is one of the serious and common microvascular complications of diabetes mellitus （DM） and the main cause of end-stage renal disease （ESRD）. Endoplasmic reticulum stress （ERS） is a common stress defense mechanism in eukaryotic cells. In the ERS state， cells activate the unfolded protein response （UPR） to enhance the folding of unfolded proteins and the degradation of misfolded proteins， so as to restore the normal physiological function of the endoplasmic reticulum and avoid cell damage. However， excessive or chronic persistent ERS can induce apoptosis， inflammation， oxidative stress and other pathways to eventually cause cell damage. In recent years， a large number of studies have confirmed that ERS is closely associated with the occurrence and development of DN. In the case of DN， ERS is involved in the damage or protection of podocytes， glomerular mesangial cells， renal tubular epithelial cells， and glomerular endothelial cells. The regulation of ERS has become one of the hotspots in the prevention and treatment of DN and has received extensive attention in the field of traditional Chinese medicine. This paper systematically expounds the role of ERS in the occurrence and development of DN and summarizes the ERS-targeted regulation of DN by traditional Chinese medicine， with a view to providing certain research ideas for the prevention and control of DN with traditional Chinese medicine.

Objective:To evaluate the efficacy and safety of oral anisodine hydrobromide tablets in the treatment of nonarteritic anterior ischemic optic neuropathy (NAION).Methods:A multicenter nonrandomized controlled trial was conducted.A total of 282 acute NAION patients (282 eyes) were recruited from 16 hospitals in China from July 2020 to May 2021.Patients were divided into two groups according to treatment methods, which were control group (124 cases, 124 eyes) receiving regular treatment including citicoline sodium plus Ginkgo biloba leaf liquid extract or Ginkgo biloba leaf extract tablets plus mecobalamin, and experimental group (158 cases, 158 eyes) receiving treatment in control group plus oral anisodine hydrobromide tablets 1 mg, twice daily for 2 to 3 months.Best corrected visual acuity (BCVA), visual field index (VFI), peripapillary retinal nerve fiber layer (pRNFL) and radial peripapillary capillary vessel density (RPC) were assessed at 1, 2, 3, and 6 months after enrollment using the standard decimal visual acuity chart, 750i Humphery visual field analyzer, Cirrus HD-OCT 4000/Cirrus HD-OCT 5000, RTVue-XR optical coherence tomography respectively.The primary outcomes were BCVA and VFI, and the secondary outcomes were pRNFL, RPC, and the side effects during the follow-up.The study adhered to the Declaration of Helsinki.All patients were fully informed about the treatment and purpose of this study and voluntarily signed the informed consent form.The study protocol was approved by Chinese PLA General Hospital (No.S2020-021-01). Results:In all, 242 patients (242 eyes) completed the follow-up of BCVA, and 98 patients (98 eyes) completed the VFI follow-up.In terms of visual function, BCVA and VFI improved significantly over time in the two groups, and BCVA and VFI were better in experimental group than in control group at various follow-up time points (all at P<0.05). In terms of structure, pRNFL gradually decreased in both groups with the extension of treatment, and pRNFL was significanthy thinner in experimental group than in control group at various follow-up time points (all at P<0.05). There was no significant difference in RPC between the two groups at the last follow-up ( P>0.05). There were two cases with side effects and one case was discontinued due to side effects 25 days after enrollment. Conclusions:Oral anisodine hydrobromide can improve visual acuity and visual field in NAION and accelerate the regression of optic disc edema, with good safety.