Objective:To investigate the changes of ocular surface microbiota in obese patients before and after dietary intervention.Methods:From November 1, 2020 to May 1, 2021, 35 obese patients in the obesity management center of the Department of Endocrinology and Metabolic Diseases of Henan Provincial People′s Hospital were selected for a 4-week low-calorie dietary intervention of 1 600-1 800 kcal/day. The body weight, body mass index(BMI), body composition(body fat, body fat percentage, visceral fat grade, total body water, and skeletal muscle) were observed before and after dietary intervention. The characteristics of ocular surface flora in obese patients before and after intervention were analyzed by 16S rRNA sequencing.Results:The body weight, BMI, body fat, percentage of body fat, visceral fat grade and total body water decreased significantly after 4 weeks( P<0.05), while there was no significant difference in skeletal muscle( P>0.05). There was no significant difference of ocular surface flora α and β in diversity( P>0.05). Opportunistic pathogens Pseudomonas and Cutibacterium decreased significantly, while Faecalibacterium, Lachnospiraceae NK4A136 group, Oscillospiraceae UCG 002, and Blautia, which producing short chain fatty acids, increased significantly( P<0.05). Functional prediction analysis showed that the metabolic pathways such as degradation related pathways and insulin signaling pathways of volatile organic compounds(VOCs) were significantly enriched. Conclusion:After dietary intervention, opportunistic pathogenic bacteria decreased and short chain fatty acid producing bacteria increased in obese patients. The altered ocular surface flora may be related to the degradation of VOCs and the improvement of insulin sensitivity.

In order to solve the problem of poor communication, low efficiency of consultation, and even affecting self-confidence caused by unskilled skills and insufficient cooperation with patients in the real clinic, and to solve the problem during the clinical thinking training that beginners do not know how to organize effective information and complete the process of diagnosis and differential diagnosis more efficiently. By applying the artificial intelligence (AI) virtual patient (VP) system to the process of teaching diagnostic knowledge and clinical thinking training. It provides the students with the experience of simulating the diagnosis and treatment of the clinical real scene. Let the students talk with the VP system for inquiry training and then go to the clinic to give the real patients inquiry and by simulating the process of treating the real patients, let the students take the initiative to complete the collection of medical records and clinical decision-making under the simulated scene to train the clinical thinking. This can not only solve the shortcomings of the previous simulation teaching and clinical teaching, but also stimulate students' interest in learning. According to the results of the questionnaire, students have a high acceptance of VP system simulation teaching. Through the results of homework and assessment and evaluation, the teaching results are better than before, and this teaching method should be further popularized.

OBJECTIVE To evaluate the safety and clinical efficacy of cefoperazone/sulbactam in the treatment of biliary tract infections.METHODS In this prospective multicenter study,159 hospitalized patients with biliary tract infections received cefoperazone/sulbactam,and the clinical and bacteriological efficacy as well as the side effects were evaluated.RESULTS The clinical effective rate of cefoperazone/sulbactam in the treatment of biliary tract infections was 86.78%.After treatment,the body temperature reduced to normal rapidly,the average time of defervescence was 3.09?1.81 days.Pathogen eradication rate was 85.71%.No adverse reactions were reported during the study period.CONCLUSIONS Cefoperazone/sulbactam can be used as one of antibiotics of choice in the initial empirical therapy for biliary tract infections.