OBJECTIVE To investigate the risk factors and prevent meaures of ophthalmic infection after operation. METHODS The factors associated with ophthalmic infection after operation were analyzed. The comprehensive and strict system of washing and sterilization of operative instruments were established. The usage of aseptic implantable articles was strictly managed. The management of operation environment,faculty,patients,and aseptic technique were further strengthened. The samples of the faculty were cultivated routinely and the fulfillment of institution was assured. RESULTS The procedure of peri-operation infection control was bettered. The awareness of infection prevention during ophthalmic operations was improved for the nurse faculty. A safe operation procedure was ascertained. The risk of ophthalmic operation infection was decreased. CONCLUSIONS Scientific and consummate management of ophthalmic operation and its proper fulfillment are key factors to prevent ophthalmic operation infection.

The assessment runs through the diagnosis,treatment and prognosis of chronic obstructive pulmonary disease (COPD).Though there are various methods of assessments,many physicians diagnose patients and prescribe medicine homogeneously according to the lung function or clinical manifestations.Therefore,it is necessary to summarize the measurements of COPD,making it be better known to clinic physicians.On the basis of these measurements,physicians can choose the suitable therapeutic schemes to treat COPD patients.In recent years,pulmonary rehabilitation is growing up gradually,which is one of treatment methods for COPD.To popularize knowledge and form complete treatments of pulmonary rehabilitation is still a long way to go,because of unbalanced development,unpopular and monotherapy in China.In order to benefit patients and improve the patients'life quality,we need to promote actively,intensify constantly and practice the pulmonary rehabilitation one by one.

Post-exercising tachypnea is the main manifestation of chronic obstructive pulmonary disease (COPD).Pulmonary rehabilitation,which is one of non-pharmacotherapy of COPD,can relieve dyspnea,improve exercise tolerance and health-related quality of life.At present,although the pulmonary rehabilitation is developing in China,there is a lack of more emphasis,recognition and unbalance development.Most grass-roots hospitals have not carried out the treatment.Now,there is no unified definition about the prescription of pulmonary rehabilitation for COPD patients.More studies are warranted to standardize the formulation and implementation of the pulmonary rehabilitation program.Therefore,we mainly demonstrate the pulmonary rehabilitation of COPD including assessments and trainings,in order to pay more attention to it.

Objective:To observe the clinical effect of medium and long term visual quality after regional refractive multifocal intraocular lens (MIOL) implantation and compared with that of single focal intraocular lens (SMOL) implantation.Methods:A cohort study was conducted with 108 patients (141 eyes) who had undergone MIOL and SIOL implantation in First Affiliated Hospital of Zhengzhou University from August 2016 to August 2017.According to the implanted IOL, the patients were divided into the MIOL group (55 patients 76 eyes) and the SIOL group (53 patients 65 eyes). At 2 years after operation, the parameters of uncorrected far, intermediate and near vision, as well as corrected distant vision were assessed; the spherical equivalen was checked; the defocus curve of the operation eye was drawn; the high order aberrations (HOAs), Strehl ratio and modulation transfer function (MTF) were measured by i-Trace visual quality analyzer; contrast sensitivity of eyes was evaluated by a CSV-1000 contrast sensitivity instrument; visual quality between the two groups was compared by using the Chinese version of the American questionnaire on quality of Life after MIOL.This study was approved by the Ethics Committee of the First Affiliated Hospital of Zhengzhou University.Written informed consent was obtained from each patient prior to any medical examination. Results:The uncorrected intermediate and near visual acuity in the MIOL group was better than that in the SIOL group, with statistically significant difference(both at P<0.05). Two years after operation, the average defocus curve showed that there were two peaks at 0.0 D and -3.0 D in the MIOL group, and formed a wide platform between 0.0 and -3.0 D, and the downward trend was gentle.Under the pupil diameter of 5 mm, HOAs, coma, trefoil and secondary astigmatism in the MIOL group were higher than those in the SIOL group (all at P<0.05). Strehl ratio in the MIOL group was significantly lower than that in the SIOL group, with statistically significant difference ( P<0.05). Under the pupil diameter of 5 mm, MTF values of spatial frequencies of 5, 10, 15, 20, 25 and 30 c/d in the MIOL group were slightly lower than those in the SIOL group, without statistically significant differences (all at P>0.05). There was no significant difference in contrast sensitivity (3, 6, 12 and 18 c/d) between the two groups under photopic or mesopic conditions and with or without glare (all at P>0.05). The proportion of glasses removed in the MIOL group was 98.18%, which was significantly higher than that in the SIOL group (52.83%) by questionnaire ( χ2=30.37, P<0.01). The incidence of visual interference symptoms, such as glare and halo was 7.27% (4/55) in the MIOL group and 1.89% (1/53) in the SIOL group, respectively, with no statistically significant difference ( χ2=0.76, P=0.382). The satisfaction scores of vision at near distance vision, medium distance vision and overall visual acuity in the MIOL group were higher than that in the SIOL group, with statistically significant differences (all at P<0.05). Conclusions:Compared with SIOL implantation, regional refraction MIOL implantation can provide better and more stable mediate and near vision, a better contrast sensitivity, a lower incidence of optical interference and a higher postoperative satisfaction.

Objective:To evaluate the clinical efficacy of Sini-Jia-Huanglian Decoction on chronic heart failure (CHF) with qi deficiency and blood stasis syndrome. Methods:A total of 100 patients with CHF and qi deficiency and blood stasis syndrome in Handan Mingren hospital from January 2018 to June 2019 who met the inclusion criteria were divided into two groups according to the random number table method, 50 cases in each group. The control group was treated with conventional western medicine therapy, and the treatment group was treated with Sini-Jia-Huanglian Decoction on the basis of the control group. Both groups were treated for 30 days. TCM syndrome score was performed before and after treatment. The level of N-terminal-pro-B-type natriuretic peptide (NT-proBNP) was detected by radioimmunoassay. The levels of peptide and galectin 3 (Gal-3) were detected by ELISA. The exercise tolerance was measured by 6-minute walking test, the clinical efficacy was tevaluated. Results:The total effective rate of the treatment group was 92.0% (46/50), and the control group was 76.0% (38/50), there was significant difference between the two groups ( χ2=4.762, P=0.029). After treatment, the scores of shortness of breath, palpitation, dyspnea, dizziness, chest pain and total scores in the treatment group were significantly lower than those in the control group ( t values were 4.257, 8.493, 8.211, 4.481, 5.500, 6.977, respectively, all Ps<0.01). After treatment, the levels of NT-proBNP (2 349.61 ± 683.50 ng/L vs. 3 026.27 ± 714.35 ng/L, t=4.840), and peptide (12.16 ± 3.43 ng/L vs. 17.52 ± 3.98 ng/L, t=7.214) and Gal-3 (3.01 ± 0.82 μg/L vs. 3.94 ± 0.93 μg/L, t=5.304) in the treatment group were significantly lower than those in the control group ( P<0.01), and the walking distance of 6 minutes (450.66 ± 79.25 m vs. 384.49 ± 70.16 m, t=4.421) was significantly longer than that of the control group ( P<0.01). Conclusions:The Sini-Jia-Huanglian Decoction can improve the heart function and clinical symptoms of CHF patients with qi deficiency and blood stasis syndrome, and improve the clinical efficacy.

Objective:To analyze the clinical adverse events of the first carbon ion therapy system in radiotherapy for cancer patients in China.Methods:A retrospective analysis was conducted on the clinical trial monitoring data of the carbon ion therapy system obtained by the Pharmacovigilance Center of Gansu Province. A descriptive study was conducted on the demographic characteristics, radiotherapy techniques, irradiation site and dose parameters, postoperative follow-up, and adverse event information of 46 tumor patients who received carbon ion therapy and participated in the clinical trial in Wuwei Cancer Hospital, Gansu Province from November 2018 to February 2019. Frequency and percentage were used to describe and analyze the occurrence of adverse events after carbon ion therapy for cancer patients in different groups. All subjects who received radiotherapy were grouped according to the treatment dose and fractionation method.Results:The median age of the 46 patients was 47 years old, and the male to female ratio was 30∶16. There were 15, 5, 8, 9, and 9 patients with head and neck, chest, abdomen, pelvic cavity, and limb spinal tumors, respectively. The total duration of radiotherapy was 2-4 weeks for 10-16 times. There were 246 adverse events in 45 cases, with an incidence of 98%. No severe adverse events occurred. The adverse events definitely related to carbon ion devices accounted for 19.1%, and no severe adverse events related to carbon ion devices occurred. According to the evaluation criteria of common terminology criteria for adverse events (CTCAE), the main adverse events were CTCAE grade 2 and below, with only 1 (2%) head and neck tumor patient (nasopharyngeal malignant tumor) experienced CTCAE grade 3 adverse events after treatment. In addition, 43 patients developed acute adverse reactions, with an incidence of 93%, mainly involving the skin, mucosa, eyes, ears, pharynx and esophagus, upper gastrointestinal tract, lower gastrointestinal tract (including pelvic cavity), lung, genitourinary tract, heart, central nervous system and hematology (white blood cells, platelets and neutrophils), etc. Conclusion:The adverse reactions of patients treated with the first carbon ion therapy system are mainly CTCAE grade 2 and below, and the clinical adverse events are mild and controllable.

Objective To analyze the correlation between inspiratory muscle strength and pulmonary ventilation function in chronic obstructive pulmonary disease (COPD) patients.Methods A total of 41 COPD patients admitted in the Second Xiangya Hospital from January to September 2018 were screened.The inspiratory muscle strength (MIP) and peak inspiratory flow (PIF) of patients were measured by using POWER breathe K-5 tester.The MIP was also calculated as a percentage of the predicted value.A pulmonary function detector was used to measure the forced vital capacity (FVC),forced expiratory volume in 1 second (FEV1 ％),FEV1 as a percentage of FVC (FEV1/FVC％),peak expiratory flow (PEF),forced expiratory flow as a percentage of the predicted value (FEF 50％) at 50％ of vital capacity and forced expiratory flow rate as a percentage of the predicted value (FEF 75％) at 75％ of vital capacity.According to the Gobal Inistiative for chronic Obstructive Lung Disease (GOLD) classification method of COPD patients,the corresponding MIP value and PIF value of the patients were divided into 4 groups and conducted the comparison between groups.Pearson correlation was used to analyze the correlation between the above-mentioned inspiratory muscle strength test values and lung ventilation function test values,and a scatter diagram was drawn for the ones that had a correlation.Results Among the 41 patients,39 (95.1％) had a decrease in inspiratory muscle strength.According to the GOLD classification,the mean MIP value has a difference among the 4 groups.The mean MIP of grade Ⅲ was [(47.09 ± 29.42) cmH2O],which was higher than that of grade Ⅳ of [(24.72 ± 7.66) cmH2 O] (P ＜ 0.05).There was no difference between PIF.The MIP was positively correlated with FVC (P ＜0.05).There was no correlation between MIP and FEV1 ％,FEV1/FVC％,PEF,FEF50％ and FEF75％ (P ＞0.05).The MIP as a percentage of the predicted value had a weak positive correlation with FVC and FEV1％ (P ＜0.05).There was no significant correlation between MIP as a percentage of the predicted value and FEV1/FVC％,PEF,FEF50％ and FEF75％ (P ＞0.05).PIF had a weak positive correlation with FVC,PEF,FEF50％ and FEF75％,with statistically significant difference (P ＜ 0.05).There was no significant correlation between PIF and FEV1 ％ and FEV1/FVC％ (P ＞0.05).Conclusions Inspiratory muscle dysfunction was common in patients with COPD.There was a difference in MIP among different GOLD lung function classification in COPD patients.Some values of the inspiratory muscle strength and lung ventilation function had a weak-moderate correlation,while some values had no correlation.Therefore,inspiratory muscle strength test cannot replace the lung ventilation function test in COPD patients.

Objective:To evaluate the clinical differences between smokers and non-smokers with chronic obstructive pulmonary disease (COPD).Methods:The clinical data of 5 183 COPD patients, including 3 688 smoking COPD patients and 1 495 non-smoking patients, were collected from the respiratory and critical medicine clinics of 12 Grade-A hospitals in Hunan Province and Guangxi Zhuang Autonomous Prefecture from December 2016 to December 2019. The general condition, clinical symptoms, acute exacerbation history and pulmonary function of the two groups were compared.Results:⑴ Non-smokers were more likely to be female, to be younger and had a lower educational level ( P<0.05). There was no difference of body mass index (BMI) and marriage statue between two groups ( P>0.05). ⑵ Clinical features: the incidence of chest distress in non-smoking COPD patients was higher than that in smoking COPD patients (86.8% and 81.4%, respectively), and the incidence of asthma was also higher than that of smoking COPD patients (86.0% and 83.1%, respectively), with statistically significant difference ( P<0.05). There was no significant difference in the incidence of cough and expectoration between the two groups ( P>0.05). The COPD assessment test (CAT) score of non-smoking COPD patients was significantly higher than that of smoking group (16.2±6.4) and (15.7± 6.5) ( P<0.05). There was no significant difference in the score of dyspnea modified medical research council dyspnea scale (mMRC) and the risk of acute exacerbation between the two groups ( P>0.05). The first second exertional volume as a percentage of predicted value (FEV 1%) and forced vital capacity (FVC) of non-smoking COPD patients were higher than those of smoking COPD patients ( P<0.05). Conclusions:Compared to smokers with COPD, non-smokers more are more likely to be female and have more severe clinical symptoms.

Objective:To observe the clinical characteristics and guideline compliance of chronic obstructive pulmonary disease (COPD) patients with initial triple therapy in real-life world.Methods:This study is a cross-sectional study. The subjects of the study were COPD patients admitted to 13 hospitals in Hunan Province and Guangxi Zhuang Autonomous Region from December 2016 to December 2021. The initial treatment was triple inhaled drugs. The data collected included gender, age, diagnosis, body mass index (BMI), history of acute exacerbation (AE) in the past year, pulmonary function, COPD Assessment Test (CAT) score, modified British Medical Research Council Dyspnea Questionnaire (mMRC), inhaled drugs and other indicators. The characteristics and differences of COPD patients before and after 2020 were analyzed.Results:7 184 patients with COPD were enrolled in this study, including 2 409 COPD patients treated with initial triple therapy, accounting for 33.5%(2 409/7 184). Taking January 1st, 2020 as the cut-off point, 1 825 COPD patients (75.8%) received initial treatment with triple inhaled drugs before 2020 and 584 patients (24.2%) after 2020 were included in this study. Compared with COPD patients before 2020, the COPD patients after 2020 had higher FEV 1% [(40.9±15.5 )% vs (39.3±15.5)%, P=0.040], lower CAT [(15.8±6.5)point vs (17.5±6.2)point, P<0.001], less AE in the past year [1(0, 2)times vs 1(0, 2)times, P=0.001] and higher rate of non-AE [255(43.7%) vs 581(37.1%), P=0.006]. In addition, before 2020, patients with COPD were mainly treated with open triple drugs (1 825/1 825, 100%); after 2020, 306 patients (52.4%) received open triple inhaled drugs, and 278 patients (47.6%) received closed triple inhaled drugs. Conclusions:In real-life world, most of patients with COPD treated with triple therapy have severe lung function, obvious symptoms and high risk of acute exacerbation. The real-world prescribing of triple therapy in patients with COPD does not always reflect recommendations in guidelines and strategies, and overtreatment is common. After 2020, prescribing triple therapy for COPD patients is more positive and worse consistency with guideline.

At present, heavy ion is an ideal radiation for cancer treatment, and carbon ion is used in the treatment of many kinds of cancer due to its higher relative biological effect value. In 2019, Wuwei heavy ion center built the first medical heavy ion accelerator-carbon ion radiotherapy system in China, and obtained the registration license from the National Medical Products Administration, and officially received cancer patients in March 2020. This study introduced the development and application of the first carbon ion radiotherapy system in China.
Carbon ; China ; Heavy Ion Radiotherapy ; Heavy Ions ; Humans ; Neoplasms/radiotherapy*