BACKGROUND: Capsule opacification is a common complication following implantation of intraocular lenses for a long period. Scholars are looking for an ideal intraocular lens so as to reduce the incidence of capsule opacification. OBJECTIVE: To study the effects of three intraocular optic materials with sharp optic edge on anterior and posterior capsule opacification as well as capsulorrhexis contraction. DESIGN, TIME AND SETTING: A randomized controlled study was performed at the Department of Ophthalmology, Affiliated Hospital of Chengde Medical College from May 2005 to December 2006. PARTICIPANTS: A total of 135 patients (148 eyes) with age-related cataract, including 73 males (80 eyes) and 62 females (68 eyes) and aging 52-81 years with the mean age of (71.44 ?6.83) years, were collected in this study. METHODS: All patients were performed with phacoemulsification combining with implantation of foldable intraocular lenses which were characterized by sharp optic edges. Thereafter, they were randomly divided into three groups: lyophobic material group (n=43, 49 eyes), who were implanted with lyophobic acrylic acid intraocular lens; hydrophilic material group (n=42, 46 eyes), who were implanted with hydrophilic acrylic acid intraocular lens; lyophobic/hydrophilic material group (n=50, 53 eyes), who were implanted with lyophobic/hydrophilic acrylic acid intraocular lens. MAIN OUTCOME MEASURES: Anterior and posterior capsule opacification as well as capculorhexis contraction were quantitatively evaluated 1 year postoperatively. RESULTS: At one year postoperatively, incidences of posterior capsule opacification were 8.3% in the lyophobic material group, 26.7% in the hydrophilic material group, and 15.3% in the lyophobic/hydrophilic material group, respectively, and there was significant difference (P 0.05). CONCLUSION: The optic intraocular lens of sharp optic edge does not have any effects on anterior capsule opacification or capsulorrhexis contraction, but has effects on formation of posterior capsule opacification; in particular, lyophobic acrylic acid can reduce the incidence to posterior capsule opacification.

Objective To evaluate the effectiveness and safety of the combination of dexmedetomidine and propofol for sedation in pediatrics undergoing regional anesthesia.Methods Forty-eight children aged 2 -6 years old,scheduled for elective surgery under regional anesthesia,were randomly divided into the two groups.The dexme-detomidine plus propofol group(group DP,n=24)received an infusion over 10 minutes of dexmedetomidine 0.7μg/kg and propofol 1.0 to 2.5 mg/kg bolus for induction,then an infusion of dexmedetomidine 0.5μg·kg-1·h-1 and propofol 100-300μg·kg-1·min-1 for maintenance.The propofol group(group P,n=24)received a propofol 1.0 to 2.5mg/kg bolus for induction,then an infusion of propofol 150 -300μg·kg-1 ·min-1 for maintenance.If body movement was detected during surgery,a bolus of propofol 1 .0mg/kg was administered in both groups,and if there was another body movement within three minutes of the propofol bolus,a bolus of ketamine 1 .0mg/kg was adminis-tered.Hemodynamic data,respiratory rate,and oxygen saturation were recorded by researchers blinded to the study drugs.Recovery time and the primary outcome were evaluated by a modified Aldrete score.The occurrence of adverse events and the amount of supplemental ketamine used were also recorded.Results The consumption of propofol in the group DP was (149.00 ±24.93)μg·kg-1·min-1,and in the group P was (217.00 ±17.90)μg·kg-1· min-1.The propofol consumption was significant lower that in group DP(t=117.94,P=0.00).The needs for sup-plemental ketamine bolus in the group DP was 0.50(1.00)/case,and it was 2.00(1.00)/case in group P.The need for supplemental ketamine was less in group DP(Z=-4.48,P=0.00).Hypopnea occurred in 5 cases in group P, and 0 in group DP.The incidence of hypopnea was more in group P(χ2 =5.58,P=0.03).In group DP,the mean arterial pressure and heart rate at discharge were respectively (74.96 ±5.69)mmHg and (101.17 ±9.65)bpm,and their baseline values were (81.13 ±7.23)mmHg and (112.00 ±13.65)bpm.Both mean arterial pressure and heart rate in the group DP remained decreased at discharge(t=10.78,P=0.00;t=10.08,P=0.00;respectively).The discharge time of the group DP was (40.91 ±10.90)min and it was(39.67 ±14.95)min in group P.There was no significant difference in the discharge time(t=0.11,P=0.74).Conclusion The combination of dexmedetomidine and propofol can provide appropriate depth of sedation in pediatric patients undergoing regional anesthesia.

Objective:To establish rat diabetes and eye disease models by injection of STZ and explore the therapeutic effect of panaxnotoginseng polysaccharides (PNP) on the diabetes and eye diseases of the model rats,and to clarify their mechanisms.Methods:Seventy SD male rats were randomly divided into blank control (n=10) and model groups (n=60), and the rats in model group were fed with high fat diet. 2 weeks later, the rats in model group were intraperitoneally injected with 35 mg·kg-1 STZ to establish the models.And 3 d later, the rats were treated with fasting and water deprivation for 12 h,the fasting blood glucose (FBG)was tested, and the models were assessed to be successful as the FBG>11.1 mmol·L-1.The rats with hyperglycemia were selected and divided into model, melbine(150 mg·kg-1), and low, middle and high doses (75,150 and 300 mg·kg-1) of PNP groups.After orally administration for 5 and 8 weeks, the FBG levels of rats were recorded.And 8 weeks later, the sugar tolerance, hepatic glycogen levels,serum glutathione(GSH) and nitric oxide(NO) levels of the rats were tested.The rat retinas were removed to analyze the expression levels of vascular endothelial growth factor(VEGF) and inducible nitric oxide synthase(iNOS) by using Q-PCR.The pathological changes of retinas were observed by HE staining method.Results:Compared with model group,the FBG level in middle dose of PNP group was decreased 5 weeks after treatment(P<0.05).Eight weeks later, compared with model group, the levels of FBG, sugar tolerance and hepatic glycogen in different doses of PNP groups were all decreased (P<0.05 or P<0.01).Compared with model group, the level of serum GSH in high dose of PNP group was remarkably increased(P<0.01), and the NO level was significantly decreased (P<0.05 or P<0.01).Compared with model group, the expression levels of VEGF and iNOS in high dose of PNP group were significantly decreased (P<0.05).The results of HE staining showed that the neurodeatrophia of the rats in low and middle doses of PNP groups were improved;and the vascular proliferation and neurodeatrophia of the rats in high dose of PNP group were significantly improved.Conclusion:PNP could decrease the blood sugar, increase the levels of GSH and NO, and up-regulate the gene expression levels of VEGF and iNOS, resulting the treatment of diabetes and its related retinopathy.

Objective To study the cytogenetic features of acute myeloid leukemia (AML) and analyze the association with cytogenetic features and early responses after induction therapy.Methods The karyotypes of 395 patients who had been newly diagnosed with AML were analyzed.These patients were divided into three groups (low-risk,intermediate-risk and high-risk),according to the AML NCCN guidelines.The incidence of different karyotypes in these three groups and the complete remission (CR) rate after the first cycle of induction therapy were analyzed.Results The incidence rates of karyotypes in high-risk,intermediate-risk and low-risk groups were 50.56 ％ (180/356),39.89 ％ (142/356),9.55 ％ (34/356),respectively.All patients with t(15;17) who completed induction therapy reached CR.There was significant difference in the CR rates of t(8;21) groups with or without additional karyotypes [92.00 ％(23/25) vs 50.00 ％(11/22)] (x2 =10.317,P =0.001).There was no significant difference in the CR rates between normal and-Y karyotype group [61.90 ％ (39/63) vs 58.82 ％ (10/17)] (x2 =0.054,P =0.817).Complex cytogenetics ascribed to the low-risk group,of which monosomal karyotype was common,nine of ten patients with monosomal karyotype were associated with an inferior CR rate.Conclusion The cytogenetic features of AML are different from previous reports by other centers.The cytogenetic features of AML patients not only influence the long-term survival,but also the CR rates of induction therapy.

Objective To investigate the level of professional commitment of student nurses,and explore the impact of student nurses' role conflict and role ambiguity on their professional commitment.Methods From May to June 2014,totally 320 student nurses from a third-level hospital in Tianjin were recruited in this study.And Role Stress Scale and Nursing Professional Commitment Scale were used in the investigation.Results The total score of role stress of student nurses was (44.29±5.53) scores,and the total score of professional commitment of student nurses was (86.12±14.14) scores.Pearson correlation analysis and multiple linear regression analysis showed that student nurses' role conflict was positively correlated with professional commitment,but their role ambiguity was negatively correlated with professional commitment.Conclusion School and hospital managers should adopt effective measures to relieve student nurses' role ambiguity and guide the correct understanding of role conflict to maintain a stable nursing team.

Objective To establish the risk assessment index system of clinical surgery department and determine the weight of each index,so as to provide reference for hospital performance management department.Methods Delphi method was used to construct the risk assessment index system of clinical surgery department,and the weight of each index was calculated by analytic hierarchy process.Results The risk assessment index system of clinical surgery departments was successfully constructed,including 4 first-level indicators,12 second-level indicators and 33 third-level indicators.Conclusion Clinical surgical department risk evaluation index system can more reasonably and fairly reflect the clinical risk borne by the surgical department,but also can more truly reflect the results of clinical department performance assessment,which is conducive to the reform of the hospital's internal performance appraisal and distribution system is more rational.

Objective To evaluate the application effect of the risk evaluation index system in clinical surgery departments.Methods A questionnaire was designed based on the risk evaluation index system of clinical surgery departments,and the risk evaluation were graded with RSR method.Results Among the risk evaluation of clinical surgery departments in the two hospitals,the results of first hospital were low,medium and high risk departments,and the results of second hospital were low and high risk departments,respectively.The differences among them were statistically significant.Conclusion In the process of clinical performance evaluation,it suggests that the hospital management department refer to the risk evaluation index system of clinical surgery departments as a risk assessment tool to promote more scientific and fairer performance distribution,which has certain social promotion value.

Objective:To establish the rat diabetic models by introperitoneal injection of streptozotocin (STZ) to observe the expressions of MMP-2 in retina tissue of the diabetic rats at different periods,and to clarify the effect of MMP-2 in the diabetic retiropathy (DR) of the diabetic rats.Methods:The femal SD rats were divded into normal control group (n=24),4-week model group (n=30),6-week model group (n=30) and 8-week model group (n=30).The rats in model groups were intraperitoneally injected with STZ for consecutive 5 d.The rats in normal control group were injected with sodium citrate solution at the same volume.The body weights and blood glucose levels of the rats in each group were measured at 4,6,and 8 weeks.The retina of each rat was removed;RT-PCR and Western blotting methods were used to detect the expression levels of MMP-2 mRNA and protein,and the immunohistochemistry was conducted to observe the morphology.Results:The body weights and blood glucose levels of the rats in each group had no differences (P＞0.05) before modeling.Three rats died in 4-week model group,5 rats died at 6 weeks and 7 rats died at 8 weeks.The body weights of the rats in model group were significantly lower than those in normal control group at the same time (P＜0.05 or P＜0.01),and the fasting blood glucose levels were signifieantly increased (P＜0.05 or P＜0.01).The expression levels of MMP-2 mRNA and protein in the retina tissue of the rats in model group were significantly higher than those in normal control group (P＜0.05).In normal control group,the retinal structure was clear and the cells were arranged in order,and the ganglion cells were arranged in a single layer;in model group,the retinal tissue structure was loose,the number of ganglion cells were significantly reduced,the inner nuclear layer and rod cell layer cell membrane outside were fuzzy.The MMP-2 positive cells were found to be brown yellow granules,especially in the cytoplasm of ganglion cells and vascular endothelial cells.The positive expression levels of MMP-2 in model group were higher than those in normal control group at 4,6,and 8 weeks.Conclusion:MMP-2 can express in the retina tissue of the diabetic rats.

Cytomegalovirus ( CMV) infection continues to be one of the most common infections after hematopoietic stem cell transplantation and solid-organ transplantation( SOT) ,resulting in significant ad-verse outcomes and mortality. Management of CMV infection after hematopoietic stem cell transplantation and solid-organ transplantation is based on early prevention and early treatment, using of effective antiviral treatment regimens ,thus it has significantly improved the prognosis of CMV infection in transplant recipi-ents. This article reviewed the risk factors,diagnosis,standard treatment and emerging treatment of cytomega-lovirus infection after transplantation,in order to improve the understanding of the disease and understand the novel treatment.

Objective:To analyze the clinical characteristics of pertussis cases diagnosed by two pathological detection methods: bacterial culture and real-time polymerase chain reaction (RT-PCR), and to explore the applicable value of two pathological detection methods in the diagnosis of pertussis.Methods:Bilateral nasopharyngeal swabs and clinical information of 165 children suspected of pertussis were collected by Hebei Children′s Hospital from April 2019 to January 2020. The bacterial culture and RT-PCR for nasopharyngeal swab specimens were performed in all cases. Chi-square test was used to analyze the cases of pertussis diagnosed by the above two methods.Results:Based on clinical diagnosis, the sensitivity of bacterial culture and RT-PCR for the diagnosis of pertussis was 61.70% (58/94) and 86.17% (81/94), and the specificity was 92.96% (66/71) and 71.83% (51/71), respectively. The positive rate of RT-PCR in children of all ages, seasons and cough courses is higher than that of bacterial culture. Children with pertussis diagnosed by bacterial culture and RT-PCR were basically similar in age, season, and cough course distribution, with the most common cases ≤3 months old, a high incidence trend in summer and autumn, and the course of coughing in children was mostly within 15-21days. The positive rate of bacterial culture in the diagnosis of pertussis in children is affected by the age of the children, and there are statistical differences between children in different age groups (χ2= 11.929, P=0.036). The positive rate of bacterial culture was the highest in children with >3 years old (51.85% [14/27]), followed by children with ≤3 months old (48.72% [19/39]), and the lowest in children with >6-12 months old (15.00% [3/20]). Moreover, the positive rate of bacterial culture in the diagnosis of pertussis in children is also affected by the cough course of the children, and there are statistical differences between children in different cough course groups (χ2=9.841, P=0.020). The positive rate of bacterial culture was the highest in children with cough course 15-21 days (49.23% [32/65]), followed by 43.59% (17/39) in children with cough course 8-14 days, and the lowest in children with cough course of less than 7 days (22.86% [8/35]). Conclusions:Compared with RT-PCR, bacterial culture has lower sensitivity and higher specificity in the detection of pertussis. These two detection methods have their own advantages and limitations. Medical institutions at all levels should comprehensively analyze different laboratory detection methods. Only by combining the two methods can the diagnostic value and level be effectively improved.