AIM: To investigate the efficacy and safety of intense pulsed light(IPL)combined with meibomian gland massage and tobramycin and dexamethasone ophthalmic ointment in treating dry eye(DE)with meibomian gland dysfunction after phacoemulsification(PHACO).METHODS: A total of 100 cases(100 eyes)of DE patients with meibomian gland dysfunction after receiving PHACO in our hospital from January 2022 to December 2023 were selected and divided into control group(receiving meibomian gland massage + eye ointment)and observation group(receiving IPL + meibomian gland massage + eye cream treatment)according to different treatment methods, with 50 cases(50 eyes)in each group. The score of meibomian gland secretion, tear film break-up time(BUT), clinical efficacy and safety were compared between the two groups.RESULTS: After treatment, the scores of the meibomian gland secretion status decreased in both groups, and the observation group had lower scores(all P<0.05). After treatment, the BUT increased in both groups, and the observation group had higher BUT(P<0.05). The clinical efficacy of the observation group(98%)was higher than that of the control group(84%; P<0.05). In addition, the incidence of adverse reactions in the observation group(6%)was lower than that in the control group(20%; P<0.05).CONCLUSION: IPL combined with meibomian gland massage and tobramycin and dexamethasone ophthalmic ointment can effectively improve the clinical efficacy of DE patients after PHACO surgery, reduce adverse reactions, and have high safety.

The new cultural construction of high-quality development of public hospitals proposes a patient-oriented ap-proach.People with disabilities,represented by the hearing-impaired community,faces many difficulties in the process of seeking medical care,and their needs have not been adequately addressed.This inadequacy adversely affects the development of harmoni-ous doctor-patient relationships and the patient medical experience.This study takes the deaf assistance outpatient clinic,first es-tablished by Shanghai East Hospital as an example to elaborate the practice of cultural brand construction under the leadership of Party building.Medical social workers,healthcare professionals,and volunteers work together to build a cultural brand through institutional guarantees,detailed care,and the establishment of a full process service system.This is expected to provide refer-ences for the construction of hospital cultural brands..

The new cultural construction of high-quality development of public hospitals proposes a patient-oriented ap-proach.People with disabilities,represented by the hearing-impaired community,faces many difficulties in the process of seeking medical care,and their needs have not been adequately addressed.This inadequacy adversely affects the development of harmoni-ous doctor-patient relationships and the patient medical experience.This study takes the deaf assistance outpatient clinic,first es-tablished by Shanghai East Hospital as an example to elaborate the practice of cultural brand construction under the leadership of Party building.Medical social workers,healthcare professionals,and volunteers work together to build a cultural brand through institutional guarantees,detailed care,and the establishment of a full process service system.This is expected to provide refer-ences for the construction of hospital cultural brands..

Objective:To systematically review the factors related to the aggressive behavior of hospitalized patients with schizophrenia in China.Methods:CNKI,Wanfang,VIP,China Biomedical Literature Database,PubMed,Cochrane Library,and Embase databases were searched to collect case-control studies on factors related to aggression in hospitalized patients with schizophrenia in China from its inception to June 2023.Analysis was per-formed using ReviewManager 5.3 to calculate pooled OR(95％CI)values.Results:Thirty-three studies were in-cluded.Medical staff coercive measures(OR=3.86,95％CI:2.75-5.43),unemployment(OR=1.44,95％CI:1.14-1.81),positive family history(OR=2.97,95％CI:2.29-3.87),poor medication compliance(OR=4.37,95％CI:3.36-5.69),young age(OR=3.13,95％CI:2.66-3.69),involuntary hospitalization(OR=3.34,95％CI:2.81-3.97),depression(OR=2.11,95％CI:1.68-2.66),emotional abuse(OR=1.13,95％CI:1.04-1.23),male(OR=2.70,95％CI:2.20-3.31),delusions(OR=2.14,95％CI:1.69-2.71),auditory hallucina-tions(OR=2.23,95％CI:1.70-2.94),and major life events(OR=3.21,95％CI:1.90-5.42)and previous history of aggressive behavior(OR=2.20,95％CI:2.06-2.34)were risk factors associated with aggressive be-havior in Chinese patients with schizophrenia,and social support(OR=0.46,95％CI:0.31-0.67)was a protec-tive factor.Conclusion:There are various factors related to aggressive behavior in hospitalized Chinese patients with schizophrenia,and medical staff should identify high-risk groups early according to the relevant factors,and effec-tively intervene in controllable factors to reduce the occurrence of aggressive behavior.

Objective To explore the effect of child's interest guidance mode on improving the negative emotion and compliance in children with pneumonia.Methods From January 2020 to December 2021,90 children with bronchopneumonia admitted to Nantong Maternal and Child Health Care Hospital were conveniently selected and assigned(1∶1)to study group or control group by random number table method.The control group was received routine cluster care.The study group was received child's interest guidance nursing on the basis.The lung function and comfort level on the day after admission and at discharge were compared between the 2 groups.The recovery time of all indicators in the 2 groups was recorded.Results There were no significant differences in the indicators related to lung function or the comfort between the 2 groups before the intervention(P>0.05).The forced vital capacity(FVC),forced expiration volume in one second 1(FEV1),peak expiratory flow(PEF)and comfort level in the study group were significantly higher than those in the control group after the intervention(P<0.05).The time to symptom improvement in the study group was significantly shorter than that in the control group(P<0.05).Conclusion The nursing mode of child's interest guidance can improve lung function and shorten recovery time in children with bronchopneumonia during hospitalization,making it worthy of clinical application.

Objective:To conduct a quantitative and qualitative analysis of the issues found in quality management, establish a risk-based whole-process quality management model, and improve the quality of clinical trials.Methods:Based on the risk-based quality management theory, the issues found in the quality control of drug clinical trials in Beijing Cancer Hospital in 2020 were structured and classified by severity (mild to moderate to severe) and 10 categories, and the risk matrix was graded by a semi-quantitative method. Targeted quality control strategies for different levels of risk were carried out according to visual analysis of the informative quality analysis platform. Chi-square tests of the severity of quality control issues in our hospital in 2020 and 2021 and non-parametric tests of the number of issues per capita in each category were used to evaluate the effectiveness of the management model.Results:A risk matrix was established according to the severity and frequency of the issues found in the quality control in 2020. The issues with severe risks were categorized as protocol compliance and serious adverse events, and categories with moderate risks included informed consent, biological sample related, original records, and investigator folders. After using visual analysis and adopting the risk-based quality control strategy, the proportion of severe issues found in quality control in our hospital in 2021 was 0.92%, lower than that of 1.39% in 2020, and the difference was statistically significant. The average number of issues detected per capita in each category for each trial in 2021 was lower than that in 2020 with a statistical difference, indicating that the management model was effective.Conclusions:Using information technology to adopt risk-based quality management is helpful to improve the quality of hospital clinical trials.

Panax ginseng is a traditional Chinese medicine with significant pharmaceutical effects and wide application. Through orientational modification and transformation of ginsenoside glycosyl, rare ginsenosides with high antitumor activities can be generated. Traditional chemical methods cannot be applied in clinic. because of extremely complex preparation technologies and very high cost Transformations using microorganisms and their enzymatic systems provide the most feasible methods for solving the main problems. At present, the key problems in enzymatic synthesis of ginsenosides include low specific enzyme activities, identity of enzymes involved in the enzymatic synthesis, and their catalytic mechanisms, as well as nonsystematic studies on structural bioinformatics; specificity of enzymatic hydrolysis for saponin glycosyl has been rarely studied. Many reviews have been reported on glycosidase molecular recognition, immobilization, and biotransformation in ionic liquids (ILs), whereas ginsenoside transformation and application have not been systematically studied. To evaluate theoretical and applied studies on ginsenoside-oriented biotransformation, by reviewing the latest developments in related fields and evaluating the widely applied biocatalytic strategy, this review aims to evaluate the ginsenoside-oriented transformation method with improved product specificity, increased biocatalytic efficiency, and industrial application prospect based on the designed transformations of enzyme and solvent engineering of ILs. Therefore, useful theoretical and experimental evidence can be obtained for the development of ginsenoside anticancer drugs, large-scale preparation, and clinical applications in cancer therapy.
Biocatalysis ; Ginsenosides ; Glycoside Hydrolases ; Panax ; Saponins

Objective To investigate the prevalence of feeding intolerance (FI),and to explore the FI within 7 days of ICU admission in association with clinical outcome in critically ill patients.Methods The adult patients from 14 general ICUs in Zhejiang Province with an expected admission to ICU for at least 24h were recruited from March 2014 to August 2014,and all clinical,laboratory,and survival data were prospectively collected.The AGI (acute gastrointestinal injury) grade was daily assessed based on gastrointestinal (GI) symptoms,feeding details and organ dysfunction within the first week of ICU stay.The intra-abdominal pressures (IAP) was measured using AbViser device.Results Of 550 patients enrolled,418 were assessed in GI symptoms and feeding details within 7 days of ICU stay.The mean age and SOFA score were (65.1 ± 18.3) years and (8.96 ±4.10),respectively.Of them,355 patients (84.9％) were under mechanical ventilation support,and 37 (8.85％) received renal replacement therapy.The mean length of time for enteral feeding was (30.8 ±26.2) h,and the prevalence of FI on the 3rd and 7th day of ICU stay accounted for 39.2％ and 25.4％,respectively.Compared to those with FI within 7 days of ICU stay,the patients without FI had higher rate of successively weaning from mechanical ventilation (21.3％ vs.5.7％,P =0.003) and higher rate of withdrawal of vasoactive medication (45.5％ vs.20.0％,P =0.037),as well as lower mortality rate of 28-day (24.4％ vs.38.7％,P =0.004) and 60-day (29.6％ vs.44.3％,P =0.005).In multivariate Cox regression model with adjustment for age,sex,participant center,serum creatinine and lactate,AGI grade on the first day of ICU stay,and comorbidities,the FI within 7 days of ICU stay (x2 ≥ 7.24,P ＜ 0.01) remained to be independent predictors for 60-day mortality.After further adjusted for SOFA score,the FI within 7 days of ICU stay (HR =1.71,95％ CI:1.18-2.49;P =0.006) and AGI grade on the first day of ICU stay (HR =1.33,95 ％ CI:1.07-1.65;P =0.009) could provide independent prognostic values of 60-day mortality.Conclusions There is high rate of FI occurred within 7 days of ICU stay,and is significantly associated with worse outcome.In addition,this study also provides evidence to further support that measurement of gastrointestinal dysfunction could increase value of SOFA score in outcome prediction for the risk of 60-day mortality.

Objective To analysis the related influencing factors and explore the approach of improving the effect of platelet transfusion through compared the posttransfusion effect of matched-type with random platelet transfusion.Methods Analysis the results of platelet antibody screening test and matched-type test in our hospital′s inpatients during July 2013 to June 2014,who applied for platelet transfusion.The influence of sex,blood transfusion history,pregnant history on the antibody were analyzed.The factors of sex,times of blood transfusion,pregnant times,platelet component sorts,storage time,combined with other components,platelet antibody (positive or negative) and transfusion matched-type platelet on the effect of platelet transfusion were analyzed.Application in our clinical blood transfusion intelligent management and evaluation system to evaluate the effect of platelet transfusion.Results Totally 812 patients′ platelet antibody were screened.Then we randomly selected 87 antibody positive inpatients were selected and 1 247 U plateletswere transfused,which including matched-type platelet transfusion for antibody screening positive patients,random platelet transfusion for antibody screening positive patients,random platelet transfusion for antibody screening negative patients,there were statistical difference (P<0.05).With Logistics regresion analysis,the history of blood transfusion was an independent risk factor for platelet antibody production (P<0.05,OR=13.104,95%CI:7.784-22.061).Sex (P<0.05,OR=1.629,95%CI:1.236-2.148),transfusion times,different platelet component sorts (leukocyte-reduced platelets aphaeresis and irradiation leukocyte-reduced platelets aphaeresis),different storage time,transfusion combined with other components (RBC)(P<0.05,OR=2.464,95%CI:1.053-5.765),transfusion matched-type platelet(P<0.05,OR=0.576,95%CI:0.389-0.854) were the risk factors for platelet transfusion.Conclusion Matched-type test should be done to improve efficiency when the platelet antibody screening were positive.Sex,times of blood transfusion,platelet component sorts,storage time,combine with other components,transfusion matched-type platelet couldinfluence the effect of platelet transfusion.

Objective To conduct the statistical analysis on the free carnitine and acylcarnitines levels in 0?6 years old children by detecting the contents of free carnitine and acylcarnitines in dry blood spot to provide the biological reference range for the diagnosis of fatty acid metabolic disorder and organic acidemia.Methods The levels of acylcarnitines of peripheral blood dry blood spot in 263 normal children were detected by using the isotopic dilution non-derived tandem mass spectrometry.All children were divided into male and female groups according to different genders and divided into the groups according to the age,1-28 d(gestational weeks ≥37 weeks),1-12 months old,13 months-3 years old and 4-6 years old.Results The detection results after normality test found that the levels of free carnitine and acylcarnitines in children showed a normality distribution.The free carnitine and various acylcarnitines levels had no statistical difference between male children and female children (t=0.5,P=0.619).The C4,C5,C6,C10,C12 and C18 had equal variance among various age groups(P>0.05) and could conducted the one way variance analysis;C0,C2,C3,C5,OH,C6,C8,C14,C16 and C18 had the variance heterogeneity among different age groups(P<0.05) and could conduct the rank-sum test(P<0.05).The C0,C2,C3,C5,OH,C6,C8,C10,C12,C14,C16 and C18 had statistical differences among different age groups,the reference value ranges were calculated according to different ages.The difference in C4 and C5 had no statistical significance and the reference value range could be calculated by the merged group.Conclusion It is a very important for the diagnosis and treatment of fatty acid metabolic disorder and organic acidemia to establish the reference value ranges of dry blood spot free carnitine and acylcarnitines in children according to different ages.