Objective To observe the changes of circumpapillary retinal nerve fiber layer (CP-RNFL)thickness and optic disk parameters in retinitis pigmentosa (RP) eyes.Methods Prospective clinical case-control study.A total of 25 patients (42 eyes) with RP were in the RP group,and 42 age matched healthy subjects (84 eyes) in the control group.All subjects underwent optical coherence tomography (OCT) examination,in which 37 eyes with 3D optic disk scanning and 5 eyes with circle optic disk scanning.The parameters included average thickness of entire CP-RNFL,thickness of nasal,superior,temporal and inferior quadrant of CP-RNFL,disc area,disc cup area,rim area,cup/disc (C/D) area ratio,C/D horizontal diameter ratio,C/D vertical diameter ratio,disc cup volume and disc rim volume.Results The average thickness and the thickness of temporal and nasal quadrants of CP-RNFL in RP group were significantly thicker than the control group (t=2.27,3.73,6.44;P=0.027,0.00,0.00),while the thickness of inferior and superior areas were the same as control group(t=-1.49,-1.19;P=0.14,0.24).The disc area,disc cup area,C/D area ratio,C/D horizontal diameter ratio,C/D vertical diameter ratio,disc cup volume in RP group were significantly bigger than control group (P＜0.05),while rim area and rim volume were not significant differences (t=1.75,0.40;P=0.08,0.59).Conclusion In comparison with the healthy subjects,the average thickness and temporal and nasal areas of CP-RNFL in RP eyes were thicker,and the disc area,disc cup area,C/D area ratio,C/D horizontal diameter ratio,C/D vertical diameter ratio,disc cup volume in RP eyes were bigger.

Objective To determine the long-term changes in optic disc parameter and the thickness of circumpapillary retinal nerve fiber layer (CP-RNFL) and macular retina after acute primary angle closure.Methods Prospective clinical case-control study.A total of 26 patients (30 eyes) with acute primary angleclosure glaucoma (APACG) were in the APACG group,whose intraocular pressure were control after a single episode acute primary angle closure;30 age-and sex-matched healthy subjects (30 eyes) in the control group.All subjects underwent three dimensional optical coherence tomography (3D-OCT) examination with 3D optic disk scanning or circle optic disk scanning and 6 mm× 6 mm macular scanning.The parameters included average thickness of entire CP-RNFL,thickness of nasal,superior,temporal and inferior quadrant of CP-RNFL,disc area,disc cup area,rim area,cup/disc (C/D) area ratio,C/D horizontal diameter ratio and C/D vertical diameter ratio.The foveal retinal thickness,center retinal thickness (≤ 1 mm from the fovea),4 quadrants of macular inner-ring (＞ 1 mm but ≤3 mm from the fovea) retinal thickness,4 quadrants of macular outer-ring (＞3 mm but ≤6 mm from the fovea) retinal thickness,average thickness of macular retinal thickness and macular volume were measured and analyzed.Results The disc area,disc cup area,C/D area ratio,C/D horizontal diameter ratio and C/D vertical diameter ratio in APACG group were significantly bigger than the control group (t=3.22,4.12,3.90,3.00,3.23;P＜0.05),rim area was smaller than the control group (t=-2.63,P＜0.05).The average thickness (t=-6.68) and the thickness of superior (t =-5.90),temporal (t =-11.64) and inferior (t =-5.06) quadrants of CP-RNFL,center retinal thickness (t=-2.50),4 quadrants of macular inner-ring retinal thickness (t=-4.91,-4.88,-2.83,-3.59),nasal (t=-2.13) and superior (t=-2.49) quadrants of macular outerring retinal thickness as well as average thickness of macular retinal thickness (t=-2.65) were significantly thinner than the control group (P＜0.05),and the macular volume (t=-2.69) was significantly smaller than the control group (P＜0.05).There was no statistically difference at nasal CP-RNFL (t=-0.11),foveal retinal thickness (t=-0.59),temporal (t=-0.67) and inferior (t=-1.02) quadrants of macular outer-ring retinal thickness between two groups (P＞0.05).Conclusions In comparison with the healthy subjects,the disc area,disc cup area,C/D area ratio,C/D horizontal diameter ratio,C/D vertical diameter ratio in APACG eyes were bigger,while rim area was smaller;the CP-RNFL and macular retinal thickness were thinner except nasal CP-RNFL,fovea,temporal and inferior quadrants of macular outer-ring retinal.

Objective: To develop a nursing quality index system for patients with continuous renal replacement therapy (CRRT) in ICU. Methods: Based on evidence-based analysis, semi-structured interview, Delphi method and AHP method were adopted to determine the nursing quality indicator and indicators′weight in CRRT. Results: The index system consisted of 8 first-level indicators, 22 second-level indicators, and 51 third-level indicators. After two rounds expert advisory, the effective response rates were 100.0%, 93.3%; authority coefficients were 0.84, 0.86; coefficients of concordance for first-level, second-level, third-level indicators were 0.686, 0.359, 0.196 at first round, and those were 0.688, 0.454, 0.273 at second round, and P values were all less than 0.01. Conclusion The nursing quality index system are scientific, comprehensive and practical, which can be applied to guarantee the implementation of CRRT treatment and patient safety.

Objective To compare the differences of optic disc parameters and the thickness of circumpapillary retinal nerve fiber layer (CP-RNFL) in acute uveitis Vogt-Koyanagi-Harada (VKH) syndrome with different degrees of optic disc edema. Methods This is a retrospective study including 40 eyes of 23 VKH patients. The eyes were divided into 2 groups according to the results of fluorescein fundus angiography (FFA). The discs with hyperfluorescence but no leakage were in mild optic disc edema group (group A, 13 patients and 25 eyes), and the discs with hyperfluorescence and leakage were in severe optic disc edema group (group B, 10 patients and 15 eyes). The patients were significantly older in group B than in group A (t=-2.17, P<0.05). The differences of gender, diseased time (t=-1.67) and corrected visual acuity (t=-0.76) between 2 groups were not significant (P>0.05). Eighty eyes of 46 normal healthy subjects, matching group A and group B with age and gender, were divided into group C (26 subjects and 50 eyes) and group D (20 subjects and 30 eyes) respectively.All subjects underwent three dimensional optical coherence tomography examinations. The parameters included average thickness of entire circumpapillary retinal nerve fiber layer (CP-RNFL), thickness of nasal, superior, temporal and inferior quadrant of CP-RNFL, disc area, disc cup area, rim area, cup/disc (C/D) area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio. Results The disc area, disc cup area and rim area were bigger, the thickness of mean CP-RNFL and the nasal and temporal quadrants of CP-RNFL were thicker in group A than those in group C (P<0.05). The disc area and rim area were bigger, the thickness of mean CP-RNFL and the nasal, superior, temporal and inferior quadrant of CP-RNFL were thicker, C/D area ratio and C/D diameter ratio were smaller in group B than those in group D (P<0.05). The disc area was bigger, disc cup area, C/D area ratio and C/D diameter ratio were smaller, the thickness of mean CP-RNFL and the nasal , superior and inferior quadrants of CP-RNFL were thicker in group B than those in group A (P<0.05). Conclusions Acute VKH uveitis with mild optic disc edema has thicker CP-RNFL in the nasal and temporal quadrants; with severe optic disc edema has thicker CP-RNFL in all 4 quadrants. Acute VKH uveitis also has smaller C/D area ratio and C/D diameter ratio.

Objective To translate The Pressure Ulcer Risk Primary or Secondary Evaluation Tool (PURPOSE-T) into Chinese,and assess its reliability and validity in Chinese hospitalized patients. Methods The original PURPOSE-T was translated into Chinese and back translated and modified for cultural adaptation according to guidelines.The reliability and validity of the Chinese version of PURPOSE-T were tested in 230 hospitalized patients. Results The Chinese version of PURPOSE-T consists of three parts and contains 25 entries. The inter-rater consistency Kappa coefficient was 0.798, the weighted Kappa coefficient was 0.843. The evaluation results were compared with binary variables with a Kappa coefficient of 0.745. The test-retest reliability Kappa coefficient and the weighted Kappa coefficient were 0.863 and 0.892. Two classified assessment Kappa coefficient was 0.857. The item content validity index ranged from 0.83 to 1.00, and the scale content validity index was 0.98. The phi correlation coefficient of PURPOSE-T and Braden scale was 0.781; the phi correlation coefficient of Waterlow Scale evaluation result was 0.777. The correlation coefficient between Chinese PURPOSE-T items and Braden scale items ranged from 0.605 to 0.877 (P<0.01), and the Waterlow Scale items ranged from 0.599 to 0.887 (P<0.01). Conclusions The Chinese version of PURPOSE-T appears to possess adequate validity, test-retest reliability and internal consistency. The newly translated Chinese version of PURPOSE-T may be used to assess the risk of pressure injury in inpatients in China.

Objective To compare the differences of optic nerve head (ONH) parameters and the thickness of circumpapillary retinal nerve fiber layer (CP-RNFL) between acute Vogt-Koyanagi-Harada syndrome (VKH) and acute central serous chorioretinopathy (CSC) patients.Methods Retrospective clinical case control analysis.This study included 38 eyes of 20 acute VKH patients (VKH group) and 37 eyes of 37 acute CSC patients (CSC group).Seventy five eyes of 57 normal healthy subjects,matching patients with age and gender,were collected as control group.The disc RPE angle,the thickness of average CP-RNFL,the nasal,superior,temporal and inferior quadrant CP-RNFL thickness,and ONH parameters including optic disc area,cup area,rim area,C/D area ratio,linear CD ratio (CDR),vertical CDR were measured by 3D-OCT.Analysis of variance was performed for comparison among three groups.Minimum significant difference t test was performed for comparison between two groups.Results The differences of ONH parameters between VKH group and CSC group:29 eyes of VKH group appeared retinal detachment next to disc,only 12 eyes appeared in CSC group.Twenty one eyes of VKH group appeared optic disc hyperemia while none in CSC group.The three groups' disc RPE angles were (138.62± 11.96)°,(154.09±5.85)° and (153.41 ±5.77)°.VKH group were significantly smaller than CSC group (t=-2.05,P=0.00) and control group (t=-1.68,P=0.00),while there was no significant difference between CSC group and control group (t=-1.88,P=0.72).The optic cup area and rim area were significantly bigger in VKH group than in CSC group (t=4.61,2.71;P=0.00,0.01),and the thickness of mean CP-RNFL,all quadrants of CP-RNFL were significantly thicker in VKH group than in CSC group (t=6.25,4.40,3.53,5.48,2.69;P=0.00,0.00,0.00,0.00,0.01).Conclusion Compared with the acute CSC,VKH patients are likely to appear retinal detachment next to disc,their disc RPE angles are smaller,their optic cup area and rim area are bigger,and their CP-RNFL thickness are thicker.

Objective To explore the effect of low concentration 5-fluorouracil combined with triamcinolone acetonide on rabbit ear hypertrophic scar model.Methods White rabbits post-traumatic scars were randomly divided into A,B,C and D groups,each group contained 18 cases.Group A was given triamcinolone acetonide and low concentration 5-fluorouracil,Group B was given low concentration 5-fluorouracil,Group C was given triamcinolone acetonide and Group D was used as the control group.The dynamic changes of the scar were observed by naked eyes,hematoxylin-eosin (HE) staining and van Gieson (VG) staining through microscope.Vascular endothelial growth factor (VEGF) and CD34 were detected and compared within 4 groups by immunohistochemical staining.Results We successfully established a rabbit ear scar model.It was observed that the scars of Groups A,B and C had been shorter and flatter than Group D,close to the normal tissue.In HE and VG staining,the number of fibroblasts,inflammatory cells,blood vessels in groups A,B and C had been decreased,compared with Group D.Immunohistochemical results showed that the positive rates of VEGF and CD34 from the most to the lest were Groups D,B,C and A.The scar proliferation index from the most to the lest were Groups D,B,C and A.Conclusions The effect of low concentration 5-fluorouracil in treatment of the rabbit ear hypertrophic scar is better than that of triamcinolone acetonide.Low concentration 5-fluorouracil combined with triamcinolone acetonide has a synergistic effect in treatment of hypertrophic scar,which has better effect than that of low concentration 5-fluorouracil or triamcinolone acetonide alone.

Objective:To investigate the clinical application of salvianolate for injection in Tongde Hospital of Zhejiang Province and evaluate its rationality of injection.Methods:From March 2018 to November 2018, 560 patients treated with salvianolate for injection in Tongde Hospital of Zhejiang Province were selected by random sampling method.The indications, usage and dosage, route of administration, choice of vehicle, concentration of vehicle, course of treatment, compatibility, contraindications and adverse reactions of salvianolate for injection were analyzed retrospectively.Results:Totally 560 inpatients received salvianolate for injection were collected, about 26.96%(151/560) was consistent with the indication, 99.82%(559/560) with a correct administration dosage and frequency, 100.00%(560/560) with right administration route, 95.00%(532/560) with a right solvent selection, 67.86%(380/560) with correct solvent concentration, 61.07%(342/560) with a correct treatment course, 100.00%(560/560) with a right medicine combination, about 94.46%(529/560) was consistent with coagulation function contraindication, about 90.18%(505/560) was consistent with liver function contraindication.The incidence of adverse reactions was 1.61%(9/560).Conclusion:In the clinical application of salvianolate for injection, a high rate of unreasonable usage is found in indication, treatment course and solvent selection.Because of the serious problems in the use of salvianolate injection, it should be used strictly to ensure clinical medication safety.

Objective:To investigate the frequency of myeloid dendritic cells (mDC) and plasmacytoid dendritic cells (pDC) in peripheral blood of patients with systemic lupus erythematosus (SLE) and their relationship with renal injury.Methods:The frequency of peripheral mDC and pDC in 102 SLE patients and 10 healthy controls were detected by flow cytometry. The quantitative data were expressed by [ M( P25, P75)]. The measurement data of the two groups with non-normal distribution was analyzed by Mann Whitney U test. The correlation between the two groups was analyzed by Spearman rank correlation analysis and multiple linear regression. Results:The frequency of pDC [14.00%(7.92%, 19.65%) vs 24.55%(19.68%, 32.90%), Z=-3.163, P<0.01] and mDC [21.25%(13.28%, 32.83%) vs 34.85%(24.58%, 41.93%), Z=-2.607, P<0.01] in the peripheral blood of 102 patients with SLE were significantly lower than those of healthy controls. The frequency of pDC [9.09%(7.31%, 17.38%) vs 24.55%(19.68%, 32.90%), Z=-3.033, P=<0.01] and mDC [9.40%(7.88%, 21.60%) vs 34.85%(24.58%, 41.93%), Z=-3.231, P<0.01] in 12 patients with newly diagnosed SLE were also significantly lower than those in healthy controls. After adjustedfor confounding factors, multivariate analysis showed that SLEDAI level was the main factor influencing the frequency of pDC ( P=0.019) and mDC ( P<0.01). In addition, pDC[8.02%(2.25%, 9.97%) vs 16.70%(11.80%, 24.60%), Z=-2.490, P=0.015] and mDC[8.80%(5.99%, 12.80%) vs 20.20%(11.20%, 42.80%), Z=-2.226, P=0.029] in patients with active LN were also significantly lower than that of patients with stable LN. The mDC frequency was positively correlated with the levels of complement C3 ( r=0.455, P<0.01) and C4 ( r= 0.289, P, P<0.01). Conclusion:The frequency of mDC and pDC in SLE patients is significantly abnormal, which is closely related to disease activity. In addition, pDC and mDC may be involved in the occurrence and development of LN.

Objective To investigate the effects of concomitant administration oftryptophan on depression-related and anxiety-like behaviors of fluoxetine treated adult rats.Methods Sixty male Wistar rats were divided into the following groups by randomized block design:control group,L-tryptophan group,fluoxetine group,and experimental group (n=15);9 g/L sodium chloride injection (5 ml/kg),50 mg/kg L-tryptophan,10 mg/kg fluoxetine and both 50 mg/kg L-tryptophan and 10 mg/kg fluoxetine were,respectively,given to the rats in the above four groups via intragastric administration;depression models were established by 21 d-long-term chronic,medium and unpredictable stress stimulation.The modified forced swimming test (FST) was used to detect the times spent in immobility behavior,swimming behavior and climbing behavior;and elevated plus-maze (EPM) was employed to detect the times spent in open arms,closed arms and center area,and ratio of entries into open arms to the total entries;while tryptophan levels in cerebrospinal fluid were measured by high performance liquid chromatography.Results The times spent in immobility behavior,swimming behavior and climbing behavior showed significant differences among the four groups (P＜0.05);both fluoxetine and tryptophan had significant influences in FST results.The times spent in open arms,closed arms and center area showed significant differences among the four groups (P＜0.05);fluoxetine had significant influences in EPM results,and tryptophan had no significant influences in times spent in open arms,closed arms and center area;moreover,there was no significant interaction between tryptophan and fluoxetine treatments in parameters of FST and EPM.Significant difference of tryptophan level was noted among the four groups (F=6.874,P=0.002);that in the experimental group was significantly higher than that in the fluoxetine and control group (P＜0.05).Conclusions Tryptophan can increase depressive-related behavior,but not alter anxiety-like behavior.Fluoxetine can decrease depression-related behavior,but induce anxiety.Concomitant use oftryptophan and fluoxetine does not alter anxiety-like behavior and the antidepressant effect offluoxetine is not enhanced.