AIM:To examine the efficacy and safety of cryotherapy in the management of Fusarium corneal ulcer.
METHODS: Retrospective contract analysis of the clinical data of 41 patients ( 41 eyes ) who infected with Fusarium corneal ulcer. All of them underwent focal lesion keratectomy combined with amniotic membrane transplantation between January 2010 and May 2013. The cryotherapy treatment group of 22 cases (22 eyes), non-cryotherapy group of 19 cases ( 19 eyes ) . All the cases were followed up for 3 ~12mo. We analyzed the healing of corneal ulcer, corneal neovascularization, postoperative visual acuity, complications and ulcer recurrences.
RESULTS: There were no significant difference for the two groups at the cure rate and the recovery rate, the corneal neovascularization and postoperative visual acuity (P>0. 05). The total effective rate and corneal healing time in cryotherapy group was significantly higher than that in non - cryotherapy group ( P < 0. 05 ). The postoperative visual acuity of two group were higher than that of preoperatively ( P < 0. 05 ). There was no complication occurred in cryotherapy group while there was 1 patient of secondary glaucoma in non-cryotherapy group.
CONCLUSION: Cryotherapy is an effective and safe method for the treatment of Fusarium corneal ulcer.

Objective To analyze the relationship between HBsAg level and HBV DNA level as well as illness severity in patients with HBV-related acute-on-chronic liver failure (ACLF).Methods One hundred and nineteen patients with chronic hepatitis B (CHB group) and 98 patients with ACLF(ACLF group) were enrolled.HBsAg and HBeAg were assayed with Roche electrochemical luminescence method.HBV DNA was quantified using a real-time polymerase chain reaction (PCR) assay.HBsAg and HBV DNA levels were compared between two groups and between HBeAg-positive and HBeAg-negative patients in ACLF group respectively,also the correlationbetween HBsAg and HBV DNA was studied.Results The proportions of HBeAg-negative patients were 68.4％(67/98) and 42.9％(51/119) in ACLF group and CHB group respectively,and there was significant difference between two groups (P ＜0.01).There was no significant difference in HBV DNA between two groups (P ＞ 0.05).HBV DNA in HBeAg-positive patients was higher than that in HBeAg-negative patients in two groups(P ＜ 0.05).There was no significant difference in HBsAg between HBeAg-positive patients and HBeAg-negative patients in ACLF group (P ＞ 0.05 ),but they were higher than that in HBeAg-positive patients in CHB group (P＜ 0.05).HBsAg was correlated to ALT,AST in HBeAg-positive patients (P ＜ 0.05).No significant correlation was found among HBsAg and HBV DNA as well as biochemical changes (P＞ 0.05).There was no significant difference in the ratio of different HBsAg levels among the patients of different HBV DNA in ACLF group (P＞ 0.05).Conclusion The level of HBsAg does not directly correlate with serum HBV DNA level,and has no directly correlation with the severity of the disease in patients with HBV-related ACLF.

OBJECTIVE To investigate the prevalence of the antimicrobial and disinfectant-resistant genes from the clinical isolates of meticillin-resistant Staphylococcus aureus(MRSA) and meticillin-resistant Staphylococcus haemolyticus(MRSH).METHODS The identification and antimicrobial susceptibility test of MRSA and MRSH isolates were determined by MicroScan auto SCAN4.PCR was used for detecting antimicrobial and disinfectant-resistant genes.The minimal inhibitory concentration(MIC)and minimal bactericidal concentration(MBC)of benzalkonium bromide to staphylococci that carried qacA/B gene were determined by broth dilution method.RESULTS The positive rates of qacA/B,aac(6′)/aph(2″),aph(3′)-Ⅲ,ant(4′,4″),TEM,erm,and tetM from 24 MRSH strains were 37.5%,87.5%,33.3%,29.2%,95.8%,and 94.4%;and 91.7%.respectively,and 30.6%,91.7%,72.2%,8.3%,100%,94.4% and 91.7%,respectively.The MIC of benzalkonium bromide for MRSH and MRSA were both 32-128 mg/L,MBC for MRSH was 256-512 mg/L and for MRSA was 512-1024 mg/L.The MIC and MBC of benzalkonium bromide for standard strain ATCC25923 were 16 mg/L and 32mg/L,respectively.CONCLUSIONS Antimicrobial and disinfectant-resistant genes are commonly prevalent in MRSA and MRSH isolates.

Objective To investigate the effect of leukotriene receptor antagonist montelukast on inflammatory factors in children with asthma.Methods Eighty children with moderate asthma who aged 6-14 years old were randomly assigned to 3 treatment groups:5 mg once daily montelukast,or inhaled 100 ?g twice daily budesonide and 5 mg montelukast with inhaled budesonide 100 ?g per day.Each dose group received medicine for 12 weeks.Before starting therapy and 12 months later,clinical effects were observed,and pulmonary function was measured in patients simultaneously;concentrations of serum and sputum eosinophil cationic protein(ECP), IL-5 and TNF-? were measured respectively;also the peripheral blood eosinophil (Eos)was counted.Results Following treatment,clinical evaluation was improved and there were significant increases in pulmonary function in asthmatic children.Compared with control group,the levels of serum ECP,IL-5,TNF-? and blood Eos counting increased significantly in asthmatic children.The blood Eos counting was significantly correlated with ECP concentration in serum of children with asthma(P

Air ; analysis ; Chromatography, Gas ; Propane ; analogs & derivatives ; analysis ; Reproducibility of Results ; Workplace

Objective:To explore the obstacles of the promotion of nursing quality homogenization management under the mode of multiple hospital areas, and to make the best response strategies and management ideas according to the obstacles, so as to achieve the goal of nursing quality management with the same quality and high efficiency.Methods:Based on the theory framework of 5M1E analysis, this study made an interview outline. Through focus group interview and personal interview, 44 nurses of different positions and levels were interviewed. The interview materials were sorted out and analyzed by Colaizzi seven step analysis method, and the themes were extracted to obtain the obstacles to the promotion of nursing quality homogeneity management.Results:The factors that hinder the management of nursing quality homogeneity included: the lack of understanding and thinking on the management of nursing quality homogeneity, the incomplete integration of quality control organization system in different hospital areas, the lack of comprehensiveness of nursing quality management system and standard unification, the differences in the implementation of quality control system, standard and plan, the difference in information system, the disunity of quality control index extraction, the physics of treatment room, etc. There were six aspects of environmental layout differences.Conclusion:The homogenization of nursing quality management under the mode of "one hospital, multiple districts" is of great significance. Hospitals need to formulate feasible countermeasures and development ideas according to the obstacles of homogenization management, so as to promote the development of nursing quality management and provide patients with the same quality of nursing services.

Objective To explore the role of Clara cell secretory protein(CCSP) in asthmatic children and compare the levels of CCSP in sera and induced sputum.Methods Thirty-four children with asthma who were in remission and 25 healthy controls were enrolled.Sera and hypertonic saline-induced sputum were obtained in asthmatic children,and sera alone were obtained in control subjects.The le-(vels) of CCSP were measured in sera and induced sputum by enzyme linked immunosorbent assay.Results Asthmatic children,compared with controls,had significantly lower concentration of CCSP in sera(P

Objective:To investigate the therapeutic effects of aromatherapy combined with Yin-Yang massage on insomnia in patients. Methods:A total of 120 patients with insomnia who received treatment in Zhoushan Hospital of Traditional Chinese Medicine between September 2017 and December 2019 were included in this study. They were randomly assigned to undergo either aromatherapy (control group, n = 60) or aromatherapy combined with Yin-Yang massage (observation group, n = 60) for 7 days. After treatment, response rate and anxiety status were recorded in each group. Before and after treatment, the scores of Pittsburgh Sleep Quality Index, frequency of taking sleeping pills, and the incidence of adverse reactions were compared between the two groups. Results:Response rate in the observation group was significantly higher than that in the control group [90.00% vs. 73.34%, χ2 = 5.57, P < 0.05]. After treatment, Pittsburgh Sleep Quality Index in the observation group was significantly lower than that in the control group [(9.47 ± 3.65) points vs. (12.45 ± 2.17) points, t = 5.44, P < 0.05]. The frequency of taking sleeping pills in the observation group was significantly lower than that in the control group [(1.19 ± 0.41) times vs. (2.07 ± 0.98) times, t = 6.42, P < 0.05]. There were 0, 3 and 57 cases of severe, moderate and mild anxiety in the observation group, and 5, 18 and 37 cases of severe, moderate and mild anxiety in the control group. There was significant difference in anxiety status between the two groups ( Z = 19.78, P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Aromatherapy combined with Yin-Yang massage can effectively alleviate anxiety in patients with insomnia, improve sleep quality and is highly safe.

BACKGROUNDComplete tumour resection is important for improving the prognosis of brain tumour patients. However, extensive resection remains controversial because the tumour margin is difficult to be distinguished from surrounding brain tissue. It has been established that 5-amino-4-oxopentanoic acid (5-aminolevulinic acid, ALA) can be used as a photodynamic diagnostic marker and a photosensitizer for photodynamic therapy in surgical treatment of brain tumours. We investigated the efficacy of ALA photodynamically guided microsurgery and photodynamic therapy on VX(2) brain tumour implanted in a rabbit model.

METHODSEighty New Zealand rabbits implanted with VX(2) brain tumours were randomly assigned to five groups: control, conventional white light microsurgery, a photodynamic therapy group, a photodynamically guided microsurgery group and a group in which guided microsurgery was followed by photodynamic therapy. The VX(2) tumour was resected under a surgical microscope. The tumour resection was confirmed with histological analysis. All animals were examined with MRI for presence of any residual tumour tissue. The survival time of each rabbit was recorded.

RESULTSAll treatment groups showed a significantly extended survival time compared with the control group. Photodynamically guided microsurgery combined with photodynamic therapy significantly prolonged survival time, compared with guided microsurgery alone. MRI and the autopsy results confirmed removal of most of the tumours.

CONCLUSIONSOur results suggest that photodynamically guided surgery and photodynamic therapy significantly reduce or delay local recurrence, increase the effectiveness of radical resection and prolong the survival time of tumour bearing rabbits. Their combination has the potential to be used as a rapid and highly effective treatment of metastatic brain tumours.

Animals ; Brain Neoplasms ; mortality ; pathology ; surgery ; therapy ; Disease Models, Animal ; Magnetic Resonance Imaging ; Microsurgery ; methods ; Photochemotherapy ; methods ; Rabbits ; Random Allocation

Objective To observe the influence of long-term treatment with inhaled corticosteroid on biochemical bone indexes and bone mineral density (BMD) in children with asthma. Methods The design was a randomized, paralleled group study with 3 low dose regiments of 100, 200,300 micrograms of budesonide per day in 45 children with asthma aged 5-8 years old for 12 months. Before inhaled corticosteroid therapy and 6th,12th month,clinical effects were observed and lung function(FEV1) was measured; concentration of serum osteocalcin(OST),insulin-like growth factor-1(IGF-1),bony alkaline phosphatase (BALP) and urinary deoxypyridinolin: creatinine (DPD/Cr) were measured; BMD was examined by dual energy X-ray absorptiometry. Results Clinical evaluation was improved and there was significant increase in FEV1 of asthmatic children. The amount of serum OST was slightly higher,yet no significant compared with that of normal control group. There was significant increase of serum BALP in asthmatic children after treatment; there was significant increase in serum IGF-1 of patients group after treatment compared with in normal children at the same age group; there was significant decrease in urinary DPD/Cr after treatment.There was no significant decrease in BMD before and after treatment at the hip (neck of femur , trochanter of femur ,Ward′s triangle),the lumber area of the spine (L2-4) and forearm (ultradis, distal). Conclusion Long-term treatment with low does corticosteroid dose not restrictedly affect bone metabolism and BMD in children with asthma.