AIM:To observed the variation regularity of corneal endothelial cells in patients with different diabetes duration after phacoemulsification, and investigate the effects of diabetes and its disease duration on corneal endothelial cells.
METHODS: Ninety-seven ( 135 eyes ) cataract patients with diabetes were selected randomly and divided into GroupⅠ( which diabetes duration ≥10a) and GroupII(which diabetes duration <10a) according to their disease duration. Additionally 62 (89 eyes) age-related cataract patients were randomly selected as the control group. The corneal endothelial cell density ( CD ) , proportion of hexagonal cell and coefficient of variation ( CV ) in the three group patients were measured respectively before phacoemulsification and after surgery. And the measurement results were statistically analyzed.
RESULTS:The corneal endothelial CD and proportion of hexagonal cell in the three group were decreased after surgery compared with preoperative. But the CV of corneal endothelial cells was increased on the 1 st wk and in 1st mo after surgery compared with the preoperative. The difference was statistically significant (P<0. 05). The corneal endothelial CD and proportion of hexagonal cell in the two diabetic groups were lower than the control group after surgery. However, the CV of corneal endothelial cells was higher than the control group. The difference was statistically significant ( P < 0.05 ) . There was no significant difference in the corneal endothelial CD, proportion of hexagonal cell and CV between the two diabetic groups before phacoemulsification (P>0. 05). The proportion of hexagonal cell in Group Ⅰ was lower than which in GroupIIafter surgery. While the CV was higher than which in Group II. The difference was statistically significant (P<0. 05).
CONCLUSION: Phacoemulsification has some damage on the corneal endothelial. Since the impact of diabetes on the morphology and function of corneal endothelial cell was related to the diabetic duration. So phacoemulsification has more obvious damage on the corneal endothelial in diabetic patients. And the diabetic duration was longer, the damage on the corneal endothelial in phacoemulsification was more easily.

Patent ductus arteriosus(PDA) is a common condition that primarily occurs in preterm infants who with low birth weight,which closely related to several co-morbidities(intracranial hemorrhage,necrotizing enterocolitis,pulmonary edema/hemorrhage,bron chopulmonary dysplasia,and retinopathy).Although the color Doppler ultrasound assessment can be used as the gold standard to determine the present of PDA,it is still very hard to fully reflect the hemodynamic change occured in PDA case.In recent years,B-type natriuretic peptide (BNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP),two kind of biological markers,were used in the premature infants to assess the present,shunt volume,progress and durg or surgical intervention indication of PDA.In this paper,the corrections of PDA between BNP and NT-proBNP were reviewed briefly.

Objective To investigate the correlation of the initial arterial lactate (Lac) and 6-h lactate clearance rate (LCR) with prognosis in patients with acute paraquat poisoning (APP).Methods The included 132 APP patients (70 males and 62 females,age ranging 15-71,30 (18) [M (IQR)]treated at a single center between January 2009 and December 2013.Patients were divided into two groups:group A,survivors ＞ 28 days after admission (n =64); and group B,those died ≤ 28 days after admission (n =68).The prognostic values of arterial Lac and 6-h LCR during the acute stage of poisoning were evaluated.Results Paraquat dose ranged from 5-200 mL,20 mL (37.25 mL) [M (IQR)].The average time from poisoning to arrival at the emergency department was ranging 4-312 h,6 h (8.75h) [M (IQR)].Total mortality was 51.51％.There were no differences in age,gender,and length of time elapsed from poisoning to diagnosis between two groups.Survivors had a significantly lower dose of paraquat ingested compared with nonsurvivors (P ＜ 0.05).An ROC curve analysis determined that the dose had an area of 0.86 (95％ CI:0.80-0.92) and the volume cut-off point was 27.5 mL to predict the prognosis in patients with acute paraquat poisoning (75％ sensitivity,85.9％ specificity,Youden index 0.609).The initial arterial lactate level was higher in nonsurvivors than that in survivors.The ROC curve analysis indicated that the initial arterial lactate level had an area of 0.99 (95％ CI:0.99-1.00) and the concentration cut-off point was 5.050 mmoL/L to predicti prognosis in patients with acute paraquat poisoning (sensitivity 98.5％,specificity 100％,Youden index 0.985).The 6 h LCR was lower in nonsurvivors than that in survivors.ROC curve analysis showed that the 6-h LCR had an area of 0.99 (95 ％ CI:0.97-1.00) and the concentration cut-off point was 17.28％ to predict prognosis in APP patients (sensitivity 100％,specificity 97.1％,Youden index 0.971).Conclusions In the early stages of APP,initial arterial Lac and 6-h LCR are closely related to prognosis and may serve as prognostic factors.

Objective To investigate the characteristics of pathogens and risk factors of the catheterassociated infection (CAI) in emergency ICU (EICU) in order to design an appropriately therapeutic strategy for the future.Methods From January 2008 to December 2010,a total of 1363 patients were enrolled for this retrospective study.Blood sample taken from the vein with indwelling catheterization and the tips of catheters cut in 5 cm after withdrawn from the veins in 1363 patients were collected for bacterial culture.Results Of 1363 catheters,pathogens were found in 147 (10.79％) after venous catheterization.The daily occurrences of CAI were 3.05 ones per 1000 catheters.Of 147 cases of infection,46.94％ pathogens were gram-negative bacilli,40.14％ gram-positive cocci,and 12.92％ fungi.Unconditional Logistic regression analysis suggested that repeated catheterization,femoral vein catheterization,the application of multi-lumen catheter and long-term indwelling catheterization were the independent risk factors responsible for CAI.Conclusions The risk factors responsible for catheter related infections should be controlled to prevent the occurrence of nosocomial infection.

Objective To investigate the effect of mild therapeutic hypothermia for different lengths of time on cerebral edema and hypoxia-inducible factor 1 α (HIF-1α),vascular endothelial growth factor (VEGF) expressions following intracerebral hemorrhage (ICH) so as to explore possible mechanism for better application of mild hypothermia.Methods ICH models were made in rats by stereotaxically injecting autologous artery blood into right caudate nucleus.Forty male Sprague-Dawley (SD) rats were randomly (random number) divided into 5 groups (n =8 each):sham-operated (sham),normothermic (NT),hypothermic-1 hour (MH1),hypothermic-2 hours (MH2),hypothermic-4 hours (MH3).Normothermic and sham-operated animals were kept at (37.0-± 0.2) ℃ of body temperature.Animals in the hypothermic groups received immediately and rapid cooling after ICH and kept at (33.0 ± 0.5) ℃ of body temperature for 1,2 and 4 hours respectively.Rats were sacrificed at 48 hours after cerebral hemorrhage.Then brain water content and BBB permeability were determined.Quantitative real-time PCR and Western blot were used to analyze the expression of HIF-1α and VEGF.Results The content of brain water,Evans blue concentration in brain,and the mRNA expression and protein levels of HIF-1α and VEGF were noticeably higher in NT group than those in sham group (P ＜0.01).There were statistically significant difference in the expression of HIF-lα mRNA and protein but little difference in other indicators between MH1 group and NT group.Compared with NT group,MH2 group and MH3 group brought about an improvement in BBB permeability and remarkable down-regulation of protein levels and expression of HIF-1 α and VEGF mRNA,whereas there were no statistically significant difference in expression of indicators between the two groups.Conclusions Mild therapeutic hypothermia induced rapidly and immediately after ICH could limit the development of brain edema in rats by down-regulating expression and protein levels of HIF-1 α mRNA,and in turn suppressing the evaluation of VEGF mRNA and protein expression.The brain edema was effectively reduced in animals treated with hypothermia for 2 hours' or 4 hours ' duration with little difference in magnitude of reduction in brain edema between these two modalities of hypothermia.

Objective To discuss the value of echocardiography for the assessment of structure and function of right heart in normal Chinese adults Methods The structure and function of right heart was assessed by echocardiography according to 2010 guideline of American Society of Echocardiography (ASE). The echocardiographic data of right heart of 130 normal Chinese adults were analyzed to acquire the normal reference values of echocardiographic parameters and evaluate the differences of these results among different age groups. Results There were significant differences among different age groups for some of the parameters. Right atrium (RA) transverse diameter was greater in the middle-aged group than that in the young-aged group [(36.90±5.10) mm vs (33.90±5.20) mm, t=-2.79, P=0.006]. RA longitudinal diameter (RAL) and RA area (RAA) were smaller in the young-aged group than those in the middle-aged and old-aged groups [(40.10±5.10) mm vs (42.90±5.10) mm, (43.40±5.60) mm, t=-2.51 and-2.91, P=0.013 and 0.004;(11.90±3.20) mm2 vs (13.40±2.90) mm2, (13.90±3.60) mm2, t=-2.24 and-2.90, P=0.027 and 0.004]. Parasternal long-axis right ventricule outflow tract (PLAX RVOT), parasternal short-axis right ventricule outflow tract (PSAX RVOT) and pulmonary artery diameter (PAD) were smaller in the young-aged group than those in the middle-aged and old-aged groups [(24.20±3.00) mm vs (26.20±2.30) mm, (25.90±2.90) mm, t=-2.80 and-2.32, P=0.006 and 0.022;(24.70±3.00) mm vs (27.20±2.50) mm, (26.90±2.60) mm, t=-4.40 and -3.84, P=0.000 and 0.000; (20.60±2.00) mm vs (22.10±2.70) mm, (21.90±2.10) mm, t=-3.12 and-2.67, P=0.002 and 0.008]. RV lateral wall thickness was smaller in the young-aged group than that in the middle-aged and old-aged groups [(5.10±0.60) mm vs (5.60±0.60) mm, (5.40±0.70) mm, t=-3.12 and-2.22, P=0.02 and 0.028];DTI e wave was greater in the young-aged group than that in the middle-aged and old-aged groups [(14.90±3.70) cm/s vs (10.90±3.10) cm/s, (11.10±2.60) cm/s, t=5.82 and 5.49, P=0.000 and 0.000]. DTI a wave was smaller in the young-aged group than that in the middle-aged and old-aged groups [(12.50±3.90) cm/s vs (14.60±3.70) cm/s, (16.60±3.60) cm/s, t=-2.79 and -5.04, P=0.007 and 0.000] and DTI a wave was smaller in the middle-aged group than that in the old-aged group (t=-2.26, P=0.02). Tricuspid E wave was greater in the young-aged group than that in the middle-aged and old-aged groups [(0.61±0.11) m/s vs (0.51±0.11) m/s, (0.48±0.08) m/s, t=4.58 and 5.44, P=0.000 and 0.000]. E/A was greater in the young-aged group than that in the middle-aged and old-aged groups (1.45±0.30 vs 1.12±0.33, 1.10±0.27, t=4.58 and 5.44, P=0.000 and 0.000). No significant differences were found among different age groups in RV systolic function parameters, whereas a trend of decrease in RV diastolic function was detected. Conclusion Echocardiography can be useful in assessing the structure and function of right heart quantitatively.

Adult ; Humans ; Male ; Occupational Diseases ; Pulmonary Aspergillosis

Objective:To investigate the role of clinical pharmacists in the process of chemotherapy for a patient with intracranial glioma. Methods:Usage and dosage of antitumor drugs, drug interactions, adverse drug reactions and medication education after dis-charged as the breakthrough points, clinical pharmacists and clinicians explored options for the patient treatment and adjusted the medi-cation timely according to the condition. Results:There were no serious adverse drug reactions in the adjusted therapeutic regimen and the treatment results of the patient were satisfactory. Conclusion:Clinical pharmacists provide pharmaceutical care can play an impor-tant role in improving the safety and effectiveness of drug use.

Psychiatric professional talents are specially needed in China.Attention should be paid to the cultivation of clinical thinking ability in the process of cultivating professional master degree postgraduate majoring in mental health and psychiatry.Following measures can be taken such as using problem-based leaming(PBL) interactive teaching,organizing symposium,urging students to reviewing the language knowledge and logic knowledge,implementing specialized training to promote students' rigorous logical thinking ability,the ability to get information and interpersonal communication ability,strengthening the clinical practice teaching and paying close attention to the analysis and summary after the failure.

Background Pseudoexfoliation syndrome (PEX) has a high incidence in Uygur population and usually leads to secondary glaucoma and complicated cataract.The abnormal change of lens tissue and degeneration of zonular fibers bring a lot of difficulties for phacoemulsification (phaco) with intraocular lens implantation,especially stop-and-chop phaco technique.Prechop technique is a new choping technology,but its application in PEX with cataract is less.Objective This study was to compare the efficacy and safety of pre chop phaco technique and stop-and-chop phaco technique for PEX combined cataract.Methods A randomized controlled Clinical trial was designed.Forty-one eyes of 41 patients with PEX combined cataract of Ⅲ degree of nucleus were enrolled in People's Hospital of Hetian District from March 2015 to January 2016.The patients were randomized into the prechop group and stop-and-chop group according to random nubmer table,and cystotome-assisted prechop phaco surgery and stop-and-chop phaco surgery were performed in different groups,respectively.The effective phaco duration,corneal endothelium loss rate,cornea edema eye number after operation,vision outcomes and complications were compared between the two groups.Results The mean effective phaco duration was 14.0 (13.0,16.5) minutes and 18.5 (16.5,24.0) minutes in the prechop group and stop-and-chop group,with a significant difference between them (Z =17.354,P ＜ 0.01).The corneal endothelial cells were (2 101.90 ± 209.08)/mm in the prechop group,and the number was similar to (2 002.30 ± 207.04)/mm of the stop-and-chop group (t =-1.530,P =0.134).Corneal endothelial cell lossing rate was (8.27±2.23)％ in the prechop group,which was lower than (13.09±4.26)％ in the stop-and-chop group (t =3.810,P =0.001).The BCVA was better in the prechop group than that in the stop-and-chop group in postoperative day 3 (P =0.044),and the corneal edema degree was not signigicantly different in postoperative day 1 and day 3 between the two groups (P=0.221,0.446).Intraoperative complication was rapture of zonule and occurred in 1 eye and 2 eyes in the prechop group and stop-and-chop group,respectively.Conclusions Compared with the stop-and-chop phaco technique,the prechop phaco tequnique can decrease intraoperative complication,lighten the postoperative damage of corneal endothelial cells and accelerate visual rehabilitation in PEX combined with cataract patients.