Since January 2020, as ophthalmologists working at the center of the novel coronavirus pneumonia (NCP) outbreak in Wuhan, China, we found 3 cases in 30 NCP patients with binocular conjunctivitis. Of them, one case visited for conjunctivitis as a first symptom and then diagnosed as NCP, and two cases visited for binocular conjunctivitis during the NCP onset. In 3 patients, conjunctivitis was manifested as signs of viral conjunctivitis from mild to moderate. Their symptoms of two patients disappeared after treatment with antiviral eyedrops for 7 to 10 days and another patient died of NCP. Interestingly,although we detected positive viral nucleic acid in the conjunctiva sacs of 2 of other 27 NCP patients by using swabs and RT-PCR technology, no conjunctivitis occurred in these two patients.

Objective: To evaluate the disinfection efficacy of peracetic acid disinfectant (type Ⅲ ) on gastrointestinal endoscopy. Methods: Endoscopes were disinfected respectively by 2% glutaraldehyde (GA group) and peracetic acid disinfectant (type Ⅲ ) (PAA group) according to the process by the 2016 version of "Regulation for cleaning and disinfection technique of flexible endoscope" , and then samples were collected through biopsy channel at the specified steps. The bacterial count and pathogenic bacteria of these samples were detected. Hepatitis B virus surface antigen (HBsAg), hepatitis C virus (HCV) antibody and Treponemia pallidum antibody (TP-Ab) were detected by chemiluminesent microparticle immunoassay (CMIA) in the PAA group. The PAA group were continuously sampled for 5 days. Results: A total of 56 gastroscopes and 16 colonoscopes were disinfected in the GA group, and 46 gastroscopes and 15 colonoscopes were disinfected in the PAA group. Compared with pre-disinfection, the bacterial count was both significantly reduced in the two groups after disinfection (P<0.05). The qualified rate of gastroscopes disinfection and total qualified rate of the PAA group were higher than those of the GA group [the qualified rate of gastroscopes: 97.83% (45/46) VS 92.86% (52/56), P>0.05; total qualified rate: 98.36% (60/61) VS 94.44% (68/72), P>0.05]. The qualified rate of colonoscopes in the two groups were both 100.00% (15/15, 16/16). After disinfecting by peracetic acid disinfectant (Type Ⅲ), HBsAg, anti-HCV and TP-Ab were negative. There were no significant differences on colonies number at different steps in a 5-day continuous sampling (P>0.05). Conclusion Peracetic acid disinfectant (type Ⅲ) can provide a satisfied disinfectant effect, and be applied in clinic to meet the requests of high-level disinfection for gastrointestinal endoscopy.

Objective The aim of the study was to investigate the protective effect of probucol on oxidative stress injury in rats with ischemia-reperfusion injury(IRI)and its mechanism. Methods Thirty male Sprague-Dawley rats were randomly di-vided into sham operation group(S group),ischemia-reperfusion group(IR group),and probucol treatment group(probucol+IR group,P+IR group).Rats in the S and IR groups were fed with warm water every day,and rats in P+IR group were treated with probucol.After 1 week,rat model of renal ischemia and reperfusion was established.Right kidneys of the rats were re-moved.In IR and P+ IR groups,the left renal artery was clamped with a non-invasive artery clamp,and after 30 minutes the blood vessels restored patency by loosening the clamp.After reperfusion,the S and IR groups were perfused with warm water every day,and the P+IR group was treated with probucol for 1 week.After 1 week,all the rats were sacrificed and the blood and kidney tissue specimens were taken.The blood biochemical indexes of the rats were measured,and the pathological changes of the kidneys were observed.Results The levels of blood urea nitrogen(BUN),serum creatinine(SCr)and blood lipids in P+ IR group were significantly lower than those in IR group(all P<0.05);in P+IR group,the level of superoxide dismutase(SOD)in serum and renal tissue was increased significantly(all P<0.05),meanwhile,the levels of malondialdehyde(MDA)were significantly decreased (P<0.05).In P+IR group,the pathological damage of kidney tissue was reduced,and renal index was significantly improved(P<0.05).Conclusion Probucol can increase the activity of SOD in blood and kidney of rats with IRI,improve renal function,reduce the level of blood lipids,reduce the pathological injury of renal tissue,and play a role in renal protection.

To evaluate the efficacy of heparin combined with low molecular heparin against early thrombosis in chronic patients after native arteriovenous fistula ( AVF) . Methods: A total of 299 patients were enrolled in the study from January 2012 to December 2014 and randomly divided into two groups. The control group received 5000IU low molecular heparin after the operation for 7 days and the trial group received 3 000u heparin additionally through free arterial end and venous terminal during the operation. The thrombosis formation rate and adverse drug reactions ( ADR ) of one week and 4 weeks after the operation were observed in the two groups. Results:One week after the operation, the thrombosis formation rate in the control group and the trial group was 3. 4% and 0, respectively, and four week after the operation, that was 4. 8% and 0. 67%, respectively. The incidence of ADR showed no statistical-ly difference between the two groups (P>0. 05), and no severe ADR appeared in both groups. Conclusion:Heparin combined with low molecular heparin may be more effective and safer in the prevention of primary thrombosis in the patients after AVF.

Objective To investigate the effects and underlying mechanism of the scavenger receptor CD36 in high glucose-induced rat glomerular mesangial cells apoptosis.Methods The mesangial cells of rats were divided into 4 groups:control group (5.6 mmol/L glucose),mannitol group (24.2 mmol/L mannitol+5.6 mmo]/L glucose),high glucose group (30 mmol/L glucose),CD36 monoantibody group (30 mmol/L glucose+CD36 mono-antibody).The intracellular ROS level was detected by confocal microscopy with fluorescent probe CM-H2DCFDA.MDA,GSH-PX,8-OHDGA in cell supernatant were detected.Apoptosis was determined by flow cytometry followed by Annexin V-FITC/PI double stains.The expression of CD36,Bax and Bcl-2 were detected by RT-PCR and Western blotting.Results The expression of CD36 was detected in glomerular mesangial cells.The highest level was found in high glucose group in 24 hours.There was no significant difference found between control group and mannitol group with respect to intracellular ROS generation,MDA,8-OHDG,GSH-PX level,apoptosis rate,expression of CD36,Bax and Bcl-2 (all P ＞ 0.05).There was no significant difference in the expression of CD36 between CD36 mono-antibody group and high glucose group (P ＞ 0.05).Compared to control group,the intracellular ROS generation,MDA and 8-OHDG levels,apoptosis rate,the expression of CD36 and Bax were significantly increased,the GSH-PX level and the expression of Bcl-2 were significantly lower in high glucose group (all P ＜ 0.05).Compared to the high glucose group,the intracellular ROS generation,MDA and 8-OHDG levels,apoptosis rate,the expression of Bax were suppressed but the GSH-PX level and the expression of Bcl-2 increased in CD36 mono-antibody group (all P ＜ 0.05).The intracellular ROS level was positively correlated with apoptosis rate,protein expression of CD36 and Bax gene,was negatively correlated with Bcl-2 protein expression.Conclusions CD36 was involved in the high glucose induced apoptosis of mesangial cells which was potentially mediated by an increased level of oxidative stress.

Objective To investigate the effect of quality control circle (QCC) in the health education for chronic renal disease patients.Methods Totals of 200 chronic renal disease patients were randomly enrolled in the study from January to December,2013.The patients,enrolled from January to June,received traditional health education (Group A,n =100),and the patients,enrolled from July to December received QCC health education (Group B,n =100).Patients' health education quality and twenty primary nurses' comprehensive qualities were evaluated.Results The number of emotional stability,good compliance,mastering relevant knowledge,active consultation,changing bad health behavior,satisfaction to nursing service was 98,98,97,99,98,95,respectively,after QCC,and 80,61,69,57,60,85,respectively,before QCC,and the differences were significant (x2 =16.547,42.000,27.782,51.399,43.520,5.556,respectively; P ＜ 0.05).Primary nurses' comprehensive qualities advanced notably with the application of QCC (t =-30.357,-45.768,-55.969,-50.567,-24.182,-42.354,-32.931,-30.427,respectively; P ＜ 0.01).Conclusions QCC can improve the quality of health education in chronic renal disease patients and enhance nursing quality.

Objective To investigate the effect of quality control circle on curative compliance in patients with chronic renal disease(CRD).Method One hundred CRD patients received health education by quality control circle.The curative compliance before using quality control circle was compared to that after using it.Results The rate of curative compliance after applying quality control circle(98.0%)was significantly higher that before(61.0%).Conclusion The qualty control circle can improve curative compliance of CRD patients.

Objective To investigate the HBV reactivation status and clinic outcomes in the renal allograft recipients with inactive HBsAg carriers,and explore the preventive measures.Methods A retrospective analysis of clinical manifestation was processed in 88 cases of inactive HBsAg carriers before and after renal transplantation.Preoperative liver function in all cases was normal and serum HBsAg positive,HBV DNA＜106 copies/L.Tacrolimus (or cyclosporine A) + mycophenolate mofetil (MMF) + prednisone were given in prevention of rejection after transplantation.In 88 cases,56 cases were given nucleoside analogues (acid) for prophylactic antiviral therapy,in which 31 cases were given lamivudine (LAM) (LAM group),25 cases were given entecavir (ETV) (ETV group) ; The rest 32 cases were not given prophylactic antiviral therapy,only receiving routine liver-protecting therapy (inosine,glucurolactone) (control group).Incidence of HBV re-activation,liver function,response to treatment and the pathological changes of hepatic tissue were observed.Results During the follow-up period,the incidence of HBV reactivation in LAM group and ETV group was 45.2％ and 28.0％ respectively,significantly lower than in control group (84.4％,P＜ 0.05).In prophylactic treatment groups,HBV reactivation occurred later,liver function damage was milder,and HBV DNA load peak was lower (P＜0.05).In LAM group,HBV reactivation occurred in 14 cases,including 10 cases occurred during administration of LAM,and ETV treatment was given for about 2 months,serum HBV DNA levels in 7 cases were under detection line;in the rest 4 cases,HBV reactivation occurred in patients with treatment less than 1 year and noncompliance,who withdrew medicine blindly.After the original scheme of antiviral therapy was done,serum HBV DNA levels in 3 cases were under detection line,and the effect was not obvious in one case.In control group,HBV reactivation occurred in 27 cases.Fourteen cases therefore accepted nucleoside (acid) analogs antiviral therapy,and HBV DNA levels in 10 cases were under detection line.Histological examination revealed the liver with fibrotic cholestatic hepatitis changes in 9 patients,including 8 cases in control group,and 1 case in LAM group due to blind withdrawal of medicine.Conclus(i)on LAM and ETV prophylactic use may decrease the HBV reactivation rate in inactive HBsAg carriers after renal transplantation,reduce the severity of liver damage and the occurrence of fibrotic cholestatic hepatitis.

Objective To analyze the clinical characteristic of spontaneous bacterial peritonitis (SBP) in patients with severe viral hepatitis, and explore its clinical classification and significance. Methods A retrospective research of 120 cases of SBP associated with severe viral hepatitis was performed, and main clinical symptoms and physical signs appeared at the early onset were classified and explored. Results Clinical manifestations of SBP in patients with severe viral hepatitis included 5 types, which were conventional type(41.7%, 50/120), symptomless type(15.8%, 19/120), hepatic coma type(13.3%, 16/120), refractory aacites type (17.5%, 21/120), and shock type (11.7%, 14/120). The germieuhure positive rate of SBP with hepatic coma type and shock type were relatively high, and the survival rate of these patients were low. Conclusions Clinical manifestations of SBP in patients with severe viral hepatitis may be atypical, and its classification help to enhancing the understanding and early diagnosis of SBP, and decreasing missed diagnosis. The prognosis of SBP in patients with hepatic coma type and shock type was poor, and then it must be taken high into account more than ever before in the clinical practice.