1.Comparative efficacy of phacoemulsification using clear corneal incisions of different lengths in age-related cataract patients
Zhenggang WANG ; Hui XIONG ; Guangxiu LIU ; Xiaojiao WAN
International Eye Science 2026;26(10):1787-1792
AIM:To compare the clinical efficacy of phacoemulsification with 2.2 mm versus 3.0 mm clear corneal incisions in patients with age-related cataract(ARC).
METHODS: ARC patients treated in the Ophthalmology Department of the hospital from January 2025 to November 2025 were retrospectively enrolled and divided into two groups according to the corneal incision size: the observation group underwent 2.2 mm clear corneal incision, while the control group underwent 3.0 mm clear corneal incision. The two groups were compared in terms of intraoperative parameters, pre- and postoperstive best-corrected visual acuity(BCVA), surgically induced astigmatism(SIA)at 1 wk, 1 and 3 mo postoperatively, inflammatory response(anterior chamber flare value and anterior chamber inflammatory cell count)at 1 and 3 d postoperatively, corneal endothelial cell parameters \〖corneal endothelial cell density(CECD), hexagonal cell ratio(HEX), coefficient of variation(CV)of cell area, and corneal endothelial cell loss rate\〗 measured preoperatively and at 3 mo postoperatively, and the incidence of complications within 3 mo after surgery.
RESULTS:A total of 120 ARC patients(120 eyes for patients with bilateral eyes meeting the inclusion criteria, only the right eye was enrolled)were enrolled, with 60 patients(60 eyes)in the observation group(31 males and 29 females, mean 68.93±6.01 y)and 60 patients(60 eyes)in the control group(28 males and 32 females, mean 69.25±5.73 y). No statistically significant differences were observed in preoperative baseline data between the two groups(all P>0.05). The mean intraoperative ultrasound time, mean phacoemulsification energy, cumulative dissipated energy, and volume of irrigation fluid used in the observation group were significantly lower than those in the control group(all P<0.01. At 1 d and 1 wk postoperatively, BCVA in the observation group was significantly better than that in the control group(both P<0.05). At 1 and 3 mo postoperatively, there was no statistically significant difference in BCVA between the two groups(both P>0.01). At 1 wk, 1 and 3 mo postoperatively, SIA in the observation group was significantly lower than that in the control group, and the change in astigmatism axis at 3 mo postoperatively was also significantly smaller in the observation group(P<0.01). At 1 and 3 d postoperatively, the anterior chamber flare value and inflammatory cell count in the observation group were significantly lower than those in the control group(all P<0.05). At 3 mo postoperatively, CECD and HEX in the observation group were significantly higher than those in the control group, while CV and endothelial cell loss rate were significantly lower(all P<0.05). The total incidence of postoperative complications in the observation group was 11.7%, which was significantly lower than that in the control group(26.7%, P<0.05).
CONCLUSION:Compared with the 3.0 mm clear corneal incision, the 2.2 mm clear corneal incision phacoemulsification for ARC can significantly improve phacoemulsification efficiency, reduce early postoperative inflammatory response and SIA, accelerate visual recovery, better preserve the morphology and function of corneal endothelial cells in the short term, and lower the incidence of complications.
2.Establishment and application of clinical pharmaceutical pathway of anti-infective treatment for high-risk populations of antibiotic-associated encephalopathy
Chunhui DU ; Yongli WAN ; Xiaojiao YANG ; Jin ZHOU ; Jianbo WANG ; Zhenyu ZHAO
China Pharmacy 2024;35(21):2690-2696
OBJECTIVE To establish a clinical pharmaceutical pathway of anti-infective therapy for high-risk populations of antibiotic-associated encephalopathy (AAE), and analyze its application effects. METHODS Clinical pharmacists developed the “AAE High-Risk Population Screening Form” and “Antibiotic AAE Risk Comparison Form” based on literature and expert opinions, and established the “Clinical Pharmaceutical Pathway of Anti-infective Treatment for AAE High-Risk Population” in our hospital. A prospective, non-randomized controlled study was conducted from May 2023 to April 2024, including 50 cases in the observation group and 50 cases in the control group among patients with pulmonary infections admitted to the Dept. of Internal Medicine in our hospital. The observation group was involved in the development of an anti-infective treatment following the clinical pharmaceutical pathway by clinical pharmacists, while the control group received routine anti-infective treatment by clinical physicians. The occurrence of AAE, the rational antibiotic drug use, and the effectiveness of initial anti-infective treatment in the two groups were observed, and the intervention measures and outcomes of AAE cases were summarized. RESULTS The anti-infective treatment clinical pharmaceutical pathway for AAE high-risk population was preliminarily established in our hospital. The analysis of the application effects showed that there was 1 case of AAE in the observation group and 8 cases in the control group, with a significantly lower incidence of AAE in the observation group than in the control group; the rational antibiotic drug use and the effectiveness of initial anti-infective treatment in the observation group were both significantly superior to those in the control group (P<0.05). Drug withdrawal and dressing change were the preferred effective intervention measures for AAE, and encephalopathy treatment drugs could be used as auxiliary measures for symptom relief. Timely and effective intervention was conducive to rapid symptom relief, with a total improvement rate of AAE of 88.89%. CONCLUSIONS The anti-infective treatment clinical pharmaceutical pathway for AAE high-risk population can effectively prevent the occurrence of AAE as well as contribute to promoting rational drug use and the effectiveness of initial anti-infection plans and strengthening treatment outcomes.
3.Evaluation of the high-quality development of tertiary public hospitals in C city based on entropy weight TOPSIS combined with RSR method
Zhihan LIU ; Xiaojiao HE ; Hanchun WEI ; Sheng WAN
Chinese Journal of Hospital Administration 2022;38(9):679-684
Objective:To comprehensively evaluate the high-quality development of some tertiary public hospitals in C city, and explore the high-quality development path of municipal public hospitals, so as to provide a basis for the formulation of relevant policies.Methods:Based on the relevant policy documents of the evaluation indicators for the high-quality development of public hospitals, and around the four dimensions of medical quality, economic efficiency, sustainable development and satisfaction, the entropy weight TOPSIS-RSR method was adopted to comprehensively evaluate the high-quality development of some tertiary public hospitals in C city in 2019 and 2020. It included all five municipal comprehensive tertiary public hospitals in C city, and included one provincial and two county-level tertiary public hospitals for comparative study.Results:In 2019 and 2020, the number of medical cooperation, the surplus of income and expenditure, and the entropy weight of scientific research project funding per 100 health technicians were large, which were the key indicators to evaluate the high-quality development of public hospitals, with the values of 0.096 and 0.109, 0.119 and 0.141, 0.123 and 0.124, respectively. According to the best classification principle, the provincial, municipal and county-level public hospitals in C city could be divided into three levels of " good" , " medium" and " poor" , and the development gap between these levels was large.Conclusions:The development of municipal public hospitals in C city has achieved remarkable results, but there are still such problems as uneven distribution of medical resources, insufficient motivation for talent training, relatively lagging discipline construction, and insufficient advantages and characteristics. In this regard, we should further optimize the allocation of medical resources, improve the operation and management system, clarify the social functions of public hospitals, and scientifically allocate core resources.

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