Objective:To explore the effect of phacoemulsification through corneoscleral incision on cataract patients with type 2 diabetes mellitus.Methods:A prospective case-control study was conducted to collect cataract patients with type 2 diabetes who were admitted to the First Hospital of Hebei Medical University from January 2018 to June 2019. All patients were treated with phacoemulsification. They were randomly divided into three groups: 40 cases (68 eyes) of corneoscleral incision, 40 cases (66 eyes) of upper transparent corneal incision and 40 cases (70 eyes) of temporal transparent corneal incision. The dry eye symptom scale score, corneal fluorescein staining (FL) score, tear rupture time (BUT) and Schirmer I test (SIt) were compared in three groups; The levels of interleukin-6 (IL-6) and interleukin-8 (IL-8) in aqueous humor were compared among the three groups before and 7 days after operation.Results:⑴ The levels of IL-6 and IL-8 in aqueous humor of the three groups were significantly lower than those before operation, especially in group A ( P<0.05), but there was no significant difference in the levels of IL-6 and IL-8 in aqueous humor of group B and C ( P>0.05); ⑵ The scores of dry eye symptoms in group B were significantly higher than those in group A at 1 and 7 days after operation ( P<0.05); The scores of dry eye symptoms in group C were significantly higher than those in group A and B at 1, 7 and 30 days after operation ( P<0.05); The dry eye symptom score in group A and B decreased to the preoperative level 30 days after operation ( P>0.05), and that in group C decreased to the preoperative level 90 days after operation ( P>0.05); ⑶ The postoperative 1, 7 and 30 d BUT in group A and C were significantly higher than those in group B ( P<0.05), and the level of SIt was significantly lower than that in group B ( P<0.05); At 1 and 7 days after operation, SIt in group A was significantly lower than that in group C ( P<0.05); the FLS score in group A and C was significantly lower than that in group B at 1 and 7 days after operation ( P<0.05). Conclusions:The incision of corneoscleral margin has little effect on tear film stability and ocular surface function of cataract patients with type 2 diabetes mellitus treated by phacoemulsification, which is worthy of clinical recommendation.

Objective:To compare and study the clinical efficacy of three different phacoemulsification incisions for cataract patients with type 2 diabetes mellitus.Methods:A retrospective analysis was performed in 120 patients (198 eyes) with type 2 diabetes cataract who underwent cataract extraction and intraocular lens implantation from January 2018 to June 2019 in the First hospital of Hebei Medical University. According to the surgical incision, the patients were divided into three groups: A group (the cornea scleral marginal incision, 40 cases, 72 eyes), B group (the clear corneal incision at the top , 40 cases, 66 eyes), C group (underwent temporal clear corneal incision, 40 cases, 60 eyes). The corneal perception, dry eye symptoms, basic tear secretion test (SIt), tear film rupture time (BUT), corneal fluorescein staining (FL) and complications were compared among the three groups before and after treatment.Results:The corneal perception of B group and C group was lower than that of A group on 1 d, 7 d and 30 d after operation ( P<0.05); The scores of dry eye symptoms in C group were higher than those in A group and B group on 1 d, 7 d and 30 d after operation ( P<0.05), and the scores of dry eye symptoms in B group were higher than those in A group on 1 d and 7 d after operation ( P<0.05); The SIt value of C group was lower than that of A group on 1 d, 7 d and 30 d after operation ( P<0.05), and that of B group was lower than that of A group and group C on 1 d, 7 d and 30 d after operation ( P<0.05); The BUT value of C group was lower than that of A group at 1 d and 7 d after operation ( P<0.05), and the BUT value of B group was lower than that of A group and C group at 1 d, 7 d and 30 d after operation ( P<0.05); The FL value between A group and C group at 1 d, 7 d, 30 d and 90 d after treatment was not significant ( P>0.05). The FL value of B group returned to the level before treatment at 30 d after operation, and the FL value of B group was higher than that of A group and C group at 1 d and 7 d after operation ( P<0.05); There was little difference in the incidence of complications among the three groups ( P>0.05). Conclusions:The cornea scleral marginal incision can reduce the tear secretion, maintain the stability of tear film, and is more suitable for cataract patients with type 2 diabetes mellitus. It is worthy of further promotion in clinic.

Objective:To evaluate the effect of electroacupuncture preconditioning on cellular immune function in the patients undergoing thyroid surgery.Methods:Sixty-six patients of either sex, aged 30-55 yr, with body mass index of 18.5-23.9 kg/m 2, of American Society of Anesthesiologists Physical Status classification ⅠorⅡ, were selected and divided into electroacupuncture preconditioning group (group D) and control group (group C) by a random number table method, with 33 cases in each group. Patients in both groups received combined intravenous-inhalational anesthesia. Before anesthesia induction, both Hegu and Neiguan acupoints were stimulated for 30 min using a continuous wave at a frequency of 2/100 Hz, and the stimulation intensity was subjected to patient tolerance in group D. Group C received sham electroacupuncture for 30 min without stimulation. Venous blood samples were collected at 30 min before anesthesia induction (T 0) and 12, 24 and 48 h after anesthesia (T 1-3). The percentages of T lymphocyte subsets (CD3 +, CD4 +, CD8 +, CD4 + /CD8 + ) and natural killer cells and concentrations of interleukin-6 and tumor necrosis factor-alpha in the serum were measured by flow cytometry. Results:Compared with group C, the percentage of CD3 +, CD4 + and natural killer cells and ratio of CD4 + /CD8 + were significantly increased at T 1, 2, and the concentrations of interleukin-6 and tumor necrosis factor-alpha in the serum were decreased at T 1-3 in group D ( P<0.05). Conclusions:Electroacupuncture preconditioning can improve cellular immune function in the patients undergoing thyroid surgery.

Objective:To evaluate the effect of electroacupuncture preconditioning on emergence agitation in the patients undergoing total laparoscopic hysterectomy.Methods:This was a randomized controlled trial. Ninety American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ patients, aged 40-60 yr, with a body mass index of 50-70 kg, scheduled for elective total laparoscopic hysterectomy, were divided into control group (C group) and electroacupuncture preconditioning group (E group) using a random number table method, with 45 patients in each group. At 30 min before anesthesia induction, Zusanli and Neiguan acupoints were stimulated for 30 min with disperse-dense waves at a frequency of 2 Hz/100 Hz, an intensity of 3 mA, in group E. Group C did not receive electroacupuncture treatment. The occurrence of emergence agitation, usage of vasoactive drugs and rescue analgesia were recorded in two groups. Peripheral venous blood samples from the upper extremity were obtained before electroacupuncture stimulation (T 0) and at 2 h after operation (T 1) for determination of the plasma concentrations of C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α) and interleukin-10 (IL-10) by enzyme-linked immunosorbent assay. Results:The plasma CRP and TNF-α concentrations in group C and plasma IL-10 concentrations in group E were significantly higher at T 1 than at T 0 ( P<0.05). Compared with group C, the usage rate of vasoactive drugs, rate of rescue analgesia, and incidence of emergence agitation were significantly decreased, and the plasma concentrations of CRP and TNF-α were decreased and the plasma IL-10 concentrations were increased at T 1 in group E ( P<0.05). Conclusions:Electroacupuncture preconditioning can decrease the occurrence of emergence agitation in the patients undergoing total laparoscopic hysterectomy, which may be related to inhibiting inflammatory responses.

OBJECTIVE To evaluate the influence of pharmaceutical quality control on the efficiency and outcomes of standardized medication therapy management （MTM） services for patients with coronary heart disease by using Economic， Clinical and Humanistic Outcomes （ECHO） model. METHODS This study collected case data of coronary heart disease patients who received MTM services during January-March 2023 （pre-quality control implementation group， n＝96） and June-August 2023 （post-quality control implementation group， n＝164）. Using propensity score matching analysis， 80 patients were selected from each group. The study subsequently compared the economic， clinical， and humanistic outcome indicators of pharmaceutical services between the two matched groups. RESULTS There were no statistically significant differences in baseline data between the two groups after matching （P＞0.05）. Compared with pre-quality control implementation group， the daily treatment cost （16.26 yuan vs. 24.40 yuan， P＜0.001）， cost-effectiveness ratio [23.12 yuan/quality-adjusted life year （QALY） vs. 32.32 yuan/QALY， P＜0.001]， and the incidence of general adverse drug reactions （2.50% vs. 10.00%， P＝0.049） of post-quality control implementation group were decreased significantly； the utility value of the EuroQol Five-Dimensional Questionnaire （0.74± 0.06 vs. 0.71±0.07， P＝0.003）， the reduction in the number of medication related problems （1.0 vs. 0.5， P＜0.001）， the medication adherence score （[ 6.32±0.48） points vs. （6.10±0.37） points， P＝0.001]， and the satisfaction score （[ 92.56±1.52） points vs. （91.95±1.56） points， P＝0.013] all showed significant improvements. Neither group experienced serious adverse drug reactions. There was no statistically significant difference in the incidence of new adverse reactions between the two groups （1.25% vs. 3.75%， P＝0.310）. CONCLUSIONS Pharmaceutical quality control can improve the quality of pharmaceutical care， and the ECHO model can quantitatively evaluate the effect of MTM services， making pharmaceutical care better priced and more adaptable to social needs， thus being worthy of promotion.