AIM: To investigate the association between dyslipidemia and macular hard exudates(HEs)in non-proliferative diabetic retinopathy(NPDR)secondary to type 2 diabetes mellitus(T2DM).METHODS: NPDR patients attending the outpatient ophthalmology clinic from January 2021 to December 2023 were selected and divided into three groups according to the severity of macular HEs. Group A: None or minimal HEs; Group B: Definite HEs; Group C: Prominent HEs. Total cholesterol(TC), triglycerides(TG), low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C), lipoprotein(a)[Lp(a)] levels and other lipid-related indicators were routinely measured. The correlation between these indicators and HEs was analyzed.RESULTS:Group A(24 eyes)consisted of 9 males and 15 females with the mean age of 54.71±6.15 y, group B(52 eyes)consisted of 20 males and 32 females with the mean age of 55.08±6.27 y, group C(14 eyes)consisted of 9 males and 5 females with the mean age of 53.93±6.08 y. The concentration of TC, TG, LDL-C and Lp(a)was highest in group C, followed by group B and lowest in group A with statistically significant differences(P<0.001). There were no statistically significant differences between the three groups for fasting plasma glucose(FPG), glycated hemoglobin A1c(HbA1c), creatinine(Cr), and HDL-C(P>0.05). The results of multivariate Logistic regression analysis showed that elevated levels of TC, TG, LDL-C, and Lp(a)were associated with the presence of macular HEs. Receiver operating characteristiccurve analysis showed that the area under the curve(AUC)for TC, TG, LDL-C, Lp(a), and their combination in predicting macular HEs in NPDR were 0.785, 0.718, 0.784, 0.742, and 0.911, respectively, with the combined model demonstrating the highest predictive performance.CONCLUSION: Dyslipidemia is closely associated with the development and progression of macular HEs in patients with NPDR and T2DM. The levels of TC, TG, LDL-C, and Lp(a)were correlated with the severity of macular HEs, suggesting that dyslipidemia may be involved in the pathological process of macular HEs formation.

Objective:To explore the effects of contingency theory-based health education in patients with diabetes mellitus.Methods:Totally 112 diabetic patients admitted into Affiliated Hospital of Shaoxing University from January 2017 to December 2018 were selected by convenient sampling and randomized divided into the control group and the intervention group, with 56 patients in each group. Patients in the control group received routine care, while patients in the observation group received contingency theory-based health education. The health knowledge level, self-care ability, self-efficacy and quality of life of the two groups before and after intervention were compared.Results:The health knowledge level of the intervention group after intervention was higher than that of the control group [ (17.15±2.28) vs. (13.20±2.94) ], and the difference was statistically significant ( P<0.01) . The scores of self-care ability, self-efficacy and quality of life of the intervention group were higher than those of the control group, and the differences were statistically significant ( P<0.01) . Conclusions:The contingency theory-based health education can improve the disease knowledge, self-care ability, self-efficacy and quality of life of diabetic patients, which is worth promoting in clinical practice.

Objective To study the clinical efficacy and effects on CRP levels of ambroxol in treatment of pulmonary infections.Methods 68 patients with pulmonary infection were selected and divided into the observation group(n =34)and control group by using the random number table method(n =34).The observation group was treated with ammonia bromine atomization inhalation treatment,while the control group was treated with alpha chymo-trypsin atomization inhalation therapy.The clinical effect and duration of symptoms and signs disappeared of the two groups were compared,and serum CRP level changes in the two groups before and after treatment were also compared. Results After treatment,the clinical total effective rate was 91.2% of the observation group.And the total effective rate was 70.6% in control group,the comparison between the two groups had statistically significant difference (χ2 =4.316,P <0.05).Compared with the control group,the observation group patients symptoms disappear time(3.1 ± 0.5)d,pulmonary symptoms disappear time(4.1 ±1.7)d,body temperature returned to normal time(4.1 ±1.6)d and hospital stay(8.4 ±2.8)d were significantly shortened,the differences were statistically significant (t =2.879, 2.918,3.025,3.972,all P <0.05 ).The serum CRP levels in patients of the observation group was (22.45 ± 9.27)mg/L,which of the control group was (33.45 ±14.67 )mg/L,both were significantly lower than before treatment,the difference was statistically significant (t =6.314,5.126,all P <0.05).The lower degree of serum CRP level in the observation group was obviously better than tha in the control group,the difference was statistically significant (t =6.263,P <0.05).Conclusion The ambroxol can achieve significant clinical effect on treatment of pulmonary infections,which can significantly shorten the patientˊs symptoms and lung signs disappear time and length of hospital stay,etc.It can reduce the serum CRP level,and is worth popularization and application in clinic.