AIM: To evaluate the effectiveness of ab-externo microcatheter-assisted trabeculotomy(MAT)in moderate and advanced primary congenital glaucoma(PCG).METHODS: A retrospective study. A total of 20 children(22 eyes)with PCG who were admitted to Xi'an Fourth Hospital from August 2018 to November 2019 underwent ab-externo MAT. The follow-up is 12mo. The intraocular pressure(IOP), numbers of IOP-lowering drugs, corneal diameter, the cup/disk ratio(C/D ratio)of optic nerve and postoperative complications were observed.RESULTS: The mean preoperative IOP was 33.4±9.1mmHg, while it was 14.4±5.2mmHg at the last follow-up(P<0.001).The median of IOP-lowering drugs used before surgery was 2(2, 4), and it was 0(0, 2)at 12mo after surgery(P<0.001). The preoperative corneal diameter was 13.34±0.89mm, and it was 13.27±0.78mm at 12mo after surgery(P>0.05). The preoperative C/D ratio of optic nerve was 0.85±0.17, and it was 0.84±0.16 at 12mo after surgery(P>0.05). There were no severe complications occurred in all patients.CONCLUSION: Ab-externo MAT is effective and safe in the treatment of moderate and advanced PCG.

AIM: To analyze the role of preoperative telephone interview in the cancellation rate for ophthalmic daytime surgery.

METHODS: A prospective, single center study was conducted to compare and analyze the cancellation of daytime surgery in two time periods. The control group was from June 2018 to June 2019, only routine nursing and health education were implemented. The patient in the intervention group were from October 2019 to October 2020, add the telephone interview of the day before operation was added by the nurses in the ophthalmic operating room.

RESULTS: The main reasons for canceling the operation included upper respiratory tract infection, abnormal blood glucose, abnormal blood pressure and physiological period, abnormal preoperative examination results, and patients didn't follow the doctor's advice to use preoperative eye drops. In the control group, there were 16 974 cases scheduled for daytime operation, 16 332 cases actually operated, and the cancellation rate of operation was 3.78%(642 cases cancelled). In the intervention group, 17 694 cases were scheduled for daytime operation, and 17 296 cases were actually operated, with the cancellation rate of 2.25%(398 cases cancelled). The disease distribution and cancellation reasons of the two groups were statistically significant(P<0.05).

CONCLUSION: Telephone interview can effectively reduce the cancellation rate of ophthalmic daytime operation, provide targeted and personalized pre-hospital guidance for patients, improve the compliance of patients and their families to complete preoperative preparation, reduce the psychological anxiety of patients before operation, and improve the medical experience of patients.

Objective:To investigate the risk factors of acute kidney injury (AKI) in patients with severe drug eruption.Methods:Clinical data including basic information (gender, age, body mass index), type of severe drug eruption, allergenic drugs, co-existing diseases, first laboratory findings after admission, renal function during hospitalization, etc. in patients with severe drug eruption admitted to Department of Dermatology, Guangdong Provincial People′s Hospital from January 2014 to December 2020 were collected and analyzed retrospectively. Patients were divided into AKI group and non-AKI group and the clinical data were compared between the 2 groups. The risk factors of AKI in patients with severe drug eruption were analyzed by a binary logistic regression model and the odds ratio ( OR) and its 95% confidence interval ( CI) were calculated. Results:A total of 91 patients were enrolled in the study, including 50 males and 41 females, aged 54 (40, 65) years with a range of 9-85 years. The drugs that induced severe drug eruptions were allopurinol in 48 patients, antiepileptic drugs in 23 patients, antibacterial drugs in 6 patients, and other drugs in 14 patients. There were 21 patients (AKI incidence: 23.1%) in the AKI group and 70 patients in the non-AKI group. The proportion of patients sensitized to antiepileptic drugs, baseline estimated glomerular filtration rate, levels of serum albumin and hemoglobin in the AKI group were lower than those in the non-AKI group [0 (0/21) vs. 32.9% (23/70), (70±12) ml/(min·1.73 m 2) vs. (103±6) ml/(min·1.73 m 2), 26(23, 30) g/L vs. 36(34, 38) g/L, (116±17) g/L vs. (129±15) g/L], the proportions of patients sensitized to allopurinol, with diabetes mellitus, and with chronic kidney diseases, baseline serum urea nitrogen level, serum creatinine level, and proportion of urinary albumin positive patients were all higher than those in the non-AKI group [81.0%(17/21) vs. 44.3%(31/70), 28.6%(6/21) vs. 7.1%(5/70), 28.6%(6/21) vs. 5.7%(4/70), 7.2 (4.6, 12.2) mmol/L vs. 5.0 (3.8, 6.4) mmol/L, 103 (63, 134) μmol/L vs. 67 (56, 79) μmol/L, 47.6%(10/21) vs. 17.1%(12/70)], and the differences were statistically significant (all P<0.05). Binary logistic regression analysis showed that allopurinol sensitization ( OR=6.588, 95 %CI: 1.006-43.123, P=0.049) was the independent risk factor for AKI in patients with severe drug eruption and serum albumin ( OR=0.595, 95 %CI: 0.471-0.752, P<0.001) was a protective factor. Conclusions:Allopurinol sensitization was the independent risk factor for AKI in patients with severe drug eruption. Patients with low serum albumin were more likely to develop AKI.

Objective:To investigate the risk factors of acute kidney injury (AKI) in patients with severe drug eruption.Methods:Clinical data including basic information (gender, age, body mass index), type of severe drug eruption, allergenic drugs, co-existing diseases, first laboratory findings after admission, renal function during hospitalization, etc. in patients with severe drug eruption admitted to Department of Dermatology, Guangdong Provincial People′s Hospital from January 2014 to December 2020 were collected and analyzed retrospectively. Patients were divided into AKI group and non-AKI group and the clinical data were compared between the 2 groups. The risk factors of AKI in patients with severe drug eruption were analyzed by a binary logistic regression model and the odds ratio ( OR) and its 95% confidence interval ( CI) were calculated. Results:A total of 91 patients were enrolled in the study, including 50 males and 41 females, aged 54 (40, 65) years with a range of 9-85 years. The drugs that induced severe drug eruptions were allopurinol in 48 patients, antiepileptic drugs in 23 patients, antibacterial drugs in 6 patients, and other drugs in 14 patients. There were 21 patients (AKI incidence: 23.1%) in the AKI group and 70 patients in the non-AKI group. The proportion of patients sensitized to antiepileptic drugs, baseline estimated glomerular filtration rate, levels of serum albumin and hemoglobin in the AKI group were lower than those in the non-AKI group [0 (0/21) vs. 32.9% (23/70), (70±12) ml/(min·1.73 m 2) vs. (103±6) ml/(min·1.73 m 2), 26(23, 30) g/L vs. 36(34, 38) g/L, (116±17) g/L vs. (129±15) g/L], the proportions of patients sensitized to allopurinol, with diabetes mellitus, and with chronic kidney diseases, baseline serum urea nitrogen level, serum creatinine level, and proportion of urinary albumin positive patients were all higher than those in the non-AKI group [81.0%(17/21) vs. 44.3%(31/70), 28.6%(6/21) vs. 7.1%(5/70), 28.6%(6/21) vs. 5.7%(4/70), 7.2 (4.6, 12.2) mmol/L vs. 5.0 (3.8, 6.4) mmol/L, 103 (63, 134) μmol/L vs. 67 (56, 79) μmol/L, 47.6%(10/21) vs. 17.1%(12/70)], and the differences were statistically significant (all P<0.05). Binary logistic regression analysis showed that allopurinol sensitization ( OR=6.588, 95 %CI: 1.006-43.123, P=0.049) was the independent risk factor for AKI in patients with severe drug eruption and serum albumin ( OR=0.595, 95 %CI: 0.471-0.752, P<0.001) was a protective factor. Conclusions:Allopurinol sensitization was the independent risk factor for AKI in patients with severe drug eruption. Patients with low serum albumin were more likely to develop AKI.

Objective To investigate the clinical data of patients with hepatocellular carcinoma in Ningxia Hui Autonomous Region through questionnaire survey,explore the association between the risk factors of liver cancer and the onset age of disease in this area and provide evidence for prevention and treatment of liver diseases.Methods A retrospectively analysis was conducted in 250 patients with primary hepatocellular carcinoma by using their clinical data collected through questionnaire survey to understand the relationship between gender,smoking,alcohol use,hypertension,diabetes mellitus,hyperlipidemia,family history of liver cancer,liver cirrhosis,HBV infection,eating fish history and other factors and the incidence of hepatocellular carcinoma by univariate and logistic multivariate regression models.Results Univariate regression analysis showed that hypertension,diabetes mellitus,hyperlipidemia and family history of liver cancer,HBV infection,cirrhosis,smoking,eating fish history were risk factors for the early onset of liver cancer,t=4.150,P＜0.05;t=3.752,P＜0.05;t=5.676,P＜0.05;t=9.731,P＜0.05;t=15.824,P＜0.001;t=5.724,P＜0.05;t=11.662,P＜0.01;t=4.472,P＜0.05,respectively,but logistic multivariate regression model analysis indicated that smoking,HBV infection were independent risk factors,OR=3.211(95％CI:1.134-4.642),OR =7.31 (95％CI:4.312-21.072).Conclusions The risk factors affecting the age of liver cancer onset vary with area diet pattern alcohol use did not influenced the age of liver cancer onset,but smoking and HBV infection were the independent risk factors for early onset of liver cancer.It is necessary to strengthen the HBV infection prevention and control and advise people to quit smoking.

Objective To investigate the clinical and pathological features of elderly patients with hepatocellular carcinoma (HCC)and the prognosis after radical resection.Methods From January 2013 to December 2014,98 elderly patients with primary liver cancer were enrolled in this study,with 120 non-elderly patients with primary liver cancer serving as the control group.Comparison was made concerning clinical and pathological characteristics,short term postoperative outcomes and long-term prognosis between the two groups.Results The average age of patients in the elderly group(68.4±3.7)was significantly higher than in the control group(53.6 ±5.3),and the difference was statistically significant(t=23.376,P＜0.001).The positive rate of HBsAg in the elderly group was 38.8 ％,higher than in the control group (70.0 ％),and the difference was statistically significant (x2 =21.341,P＜0.001).The incidence of liver failure in the elderly group was 4.1％,higher than in the control group (0.0 ％),and the difference was statistically significant (xe =4.990,P =0.026).There was no significant difference in survival rate at 6 months,1 year and 2 years between two groups (x2 1.427,2.127,and 0.510,each P＞0.05).There was no significant difference in recurrence rate between the two groups at 1 year and 2 years(x2 =0.205 and 0.706,each P＞0.05).Conclusions Elderly patients with hepatocellular carcinoma present favorable clinical and pathological features and show similar short and long-term outcomes,compared with non-elderly patients.Radical resection is valuable in the treatment of hepatocellular carcinoma in elderly patients.

Objective: To investigate the effects of silk fibroin on the immobilization of thrombin. Methods: The immobilized thrombin was prepared using silk fibroin as the carrier and glutaraldehyde as the crosslinking agent. With activity yield as the index, the process conditions of silk fibroin immobilized thrombin were determined by an orthogonal test. Results:The optimum process con-ditions of immobilized thrombin treated with silk fibroin were as follows:the immobilization time was 6 h, the enzyme dosage was 2 400 NIH·g-1 casein, the temperature was 25℃ and pH was 7. 6. The activity recovery of immobilized thrombin was 67. 22%. Conclu-sion:Silk fibroin has the positive immobilization effect on thrombin.

Objective To assess the environmental contact allergens in patients with allergic contact dermatitis (ACD).Methods Totally,167 patients with ACD were included in this study.All the patients underwent patch test.Results Of these patients,92 (55.1％) were diagnosed as facial ACD,and 148 showed positive patch test results (88.6％).The six most common allergens in a decreasing order were nickel sulfate,fragrance mix,paraphenylenediamine,thimerosal,octanoates and amerchol L 101.Conclusion Patch test may be an efficient way to confirm the cause of ACD.

Objective To investigate the efficacy and safety of long-term intermittent treatment with topical corticosteroids in localized chronic eczema.Methods A total of 129 patients with localized chronic eczema were treated with triamcinolone acetonide and econazole nitrate cream (Pevisone (R)).Those who achieved a clinical cure within 4-week treatment were recruited into the following long-term study and classifled into 2 groups to be intermittently treated with triamcinolone acetonide and econazole nitrate cream or a moisturizing cream for 8 weeks.The cream was applied topically twice a day for 2 days every week.Patients were followed up on week 4 and 8 after the beginning of treatment and on week 12 after the discontinuation of treatment.The severity of eczema in patients was rated according to SCORAD (SCORing atopic dermatitis) score.Results The SCORAD score was significantly lower in patients treated with triamcinolone acetonide and econazole nitrate cream than in those with moisturizing cream on week 8 in the treatment and week 12 after the discontinuation (t=3.076,2.367,both P<0.05).A statistical decrease was also observed in the recurrence rate of eczema in patients treated with triamcinolone acetonide and econazole nitrate cream compared with moisturizing cream.treated patients at the 3 follow-up time points (x2=4.426,7.683,8.199,all P<0.05).The incidence of adverse events was 3.1% during the treatment with triamcinolone acetonide and econazole nitrate cream.No severe adverse reactions were observed.Conclusion Long-term intermittent treatment with topical corticosteroids is effective for the prevention of exacerbation and postponement of recurrence,of eczema.

Based on the discuss of Yin-Yang in classics, five states method is reasoned,in which one of the states is indescribable,without no disbalance between Yin and Yang, and the rest could be named by more or less in Yinqi or Yangqi as pathologic states. To state the pathologic states, Zhang Zhongjing had established a six-disease system named by Yin-Yang which benefited from the Four-Season Model in Neijing Bible as reference. Therefore the general principle of treatments and the six-disease system in Treatise on Febrile Disease, such as “the patients in a state of Autumn unbalance sould be treated with cathartic while that in Summer unbalance treated with diaphoretic”, can be easily understood in the Four-Season Model.