Objective:To investigate the changes in the nerve fiber layer of the cornea in patients with demyelinating optic neuritis (DON) and its correlation with visual acuity.Methods:A cross-sectional study. From March 2021 to July 2022, 27 cases (39 eyes) of DON patients diagnosed in the Department of Neurology and Ophthalmology of Beijing Tongren Hospital Affiliated to Capital Medical University were enrolled in this study. According to the serological test results, the patients were divided into aquaporin 4 antibody associated optic neuritis (AQP4-ON group) and myelin oligodendrocyte glycoprotein antibody associated optic neuritis (MOG-ON group), with 15 cases (19 eyes) and 12 cases (20 eyes) respectively. According to previous history of glucocorticoid treatment, the patients were divided into glucocorticoid treated group and non-glucocorticoid treated group, with 17 cases (27 eyes) and 10 cases (12 eyes) respectively. Twenty healthy volunteers (20 eyes) with age- and gender-matched were selected as the control group. All eyes underwent best corrected visual acuity (BCVA) and in vivo confocal microscopy (IVCM) examinations. BCVA was performed using Snellen's standard logarithmic visual acuity chart, which was converted into logarithmic minimum angle resolution (logMAR) visual acuity during statistics. The corneal nerve fiber length (CNFL), corneal nerve fiber density (CNFD), corneal nerve fiber branch length (CNBL), corneal nerve fiber branch density (CNBD) and the density of corneal dendritic cells (DC) were detected by IVCM examination. Parameter comparison between groups by t-test and Kruskal-Wallis rank sum test. The correlation between logMAR BCVA and pamameters of corneal nerve fibers were analyzed using Spearman analysis. Results:The CNFL, CNFD, and CNBL of the DON group and the control group were (10.67±2.55) mm/mm 2, (57.78±12.35) root/mm 2, (3.27±1.34) mm/mm 2, and (13.74±3.05) mm/mm 2, (70.95±13.14) root/mm 2, and (4.22±1.03) mm/mm 2, respectively; the difference in CNFL, CNFD, and CNBL between the two groups were statistically significant ( t=4.089, 3.795, 2.773; P<0.05). The CNFL, CNBL, and CNBD of the affected eyes in the MOG-ON group and AQP4-ON group were (12.02±2.13) mm/mm 2, (3.80±1.19) mm/mm 2, (47.97±8.86) fibers/mm 2, and (9.25±2.19) mm/mm 2, (2.72±1.19) mm/mm 2, (39.43±13.86) fibers/mm 2, respectively; the differences in CNFL, CNBL, and CNBD between the two groups were statistically significant ( t=-4.002, -2.706, -2.306; P<0.05). The corneal DC density of the patients in the hormone treated group and the non-hormone treated group was (24.43±8.32) and (41.22±9.86) cells/mm 2, respectively. The difference in corneal DC density between the two subgroups was statistically significant ( P<0.001). Correlation analysis showed that there was a significant negative correlation between logMAR BCVA and CNBL and CNFL in patients with DON ( r=-0.422, -0.456; P<0.05). Conclusions:There are different degrees of corneal nerve fiber damage in patients with different types of DON. There was a negative correlation between BCVA and the length of corneal nerve fibers.

Objective:To retrieve, evaluate and integrate the best evidence of the operation related to the measurement of intra-abdominal pressure by bladder pressure sensor in adult emergency and critically ill patients.Methods:The "6S" pyramid model was used to retrieve the evidence of internal abdominal pressure measurement at home and abroad, including guidelines, best practices, evidence summary, systematic evaluation, expert consensus and so on. The retrieval time limit was from the establishment of the database to February 12, 2022. Two researchers independently evaluated the quality of the article, extracted data from the included article and graded the evidence according to Joanna Briggs Institute (JBI) evidence pre-grading system (2014 version) .Results:A total of 9 articles were included, including 1 clinical decision, 4 guidelines, 1 expert consensus and 3 quasi-experimental studies. A total of 23 pieces of best evidence were summarized from 10 aspects, including starting time, precautions, patient position, elimination of interference factors, infection control, zero calibration and measurement, data reading, monitoring frequency, equipment management, personnel education and training.Conclusions:This study integrates the best evidence of the operation related to the measurement of intra-abdominal pressure by bladder pressure sensor in adult emergency and critically ill patients, and provides evidence-based basis for standardizing clinical practice and accurately measuring intra-abdominal pressure in adult emergency and critically ill patients.

【Objective】 To develop an assay to determine β-lactam antibiotics using microcolumn gels and to study the β-lactam antibiotics present in the blood of patients and their clinical significances. 【Methods】 446 patients with a history of taking β-lactam antibiotics from January 2019 to June 2019 were randomly selected from Trauma Emergency Center, Department of Arthrosis, Department of Spine and Department of Bone Oncology of our hospital, and 4 mL(per capita) venous blood was collected. Irregular antibody screening, anti-globulin detection and drug antibody determination were performed by microcolumn gel method. The data of gender, age, disease, blood transfusion history and medication were collected. The test results and clinical data were retrospective analyzed. 【Results】 The yielding rate of antibody was 0.45%(2/446) in patients with a history of taking β -lactam antibiotics. 16.38%(73/446) of the samples were positive in direct antiglobulin test, and 64.38%(47/73) of them did not agglutinate with RBCs treated with drugs. The yielding rate of specific antibodies against drug was 4.93%(22/446), and the titer ranged from 2 to 128(8). 1 case of auto-IgM antibody, 1 case of blood group related antibody and 2 cases of non-specific protein adsorption were detected. The yielding rate of drug antibody in patients with blood transfusion history reached to 12.10 %(22/124), so it was also high in patients with bone tumor. 【Conclusion】 Direct antiglobulin assay is helpful for the detection of β-lactam antibodies. The negative results of antibody screening cannot completely exclude the presence of drug antibodies. The yielding rate of drug antibody can be greatly improved by specific drug antibody detection, and it was higher in transfused patients relative to non-transfused one.

Objective:To explore the difference of constituents and contents of volatile oil in Perilla leaf and Perilla stem.Methods:The volatile oils of Perillaleaf and Perillastems were extracted with steam distillation method. Gas chromatography-mass spectrometry (GC-MS) technique was used to detect the chemical constituents of volatile oil from different parts of Perilla frutescens. The relative percentage content of each component was determined by peakarea normalization method, and the differences of the components and contents of volatile oils from different parts of Perilla frutescens were compared.Results:A total of 24 volatile oil components were identified in perilla leaves and 19 volatile oil components in Perilla stems. The most components in Perilla leaf and Perilla stems was 2-Hexanoyl furan. The content of 2-Hexanoyl furan in the oil of Perilla leaf reached 67.493%. The content of 2-Hexanoyl furan in the oil of Perilla stem reached 70.473%.Conclusions:The composition and content of volatile oil in different parts of Perillafrutescens are different.

Objective: To provide the basis for the popularization and application of QCC,we investigate the operation status of nursing quality control circle (QCC) in Shandong Province, and analyze the existing problems. Methods: A self-designed questionnaire which Cronbach’s α=0.905, was used to the attendees of the annual meeting of the Nursing Committee of Shandong Hospital Quality Management Alliance by convenience sampling. The questionnaire was filled out online by mobile phone scanning. SPSS 23.0 software was used to analyze the data. Results: Among 224 respondents,score of GSES was 27.71±5.58, 96.0% thought it was necessary to continue the QCC, 91.1% thought that it could solve the problems of quality management and has applicability. The worst mastery of QCC knowledge was "development and review of countermeasures" , accounting for only 6.7%. The "calculation of target value" was the best for 45.1%, the best which "QCC report and evaluation" was 32.1%(72/224) in the promotion and management of hospital-level QCC, and the worst which "standardization approval" was only 4.0%(9/224). The main obstacle factors include personnel, skills and in-hospital support. Conclusions Hospital departments should establish effective quality control circle training management methods, strengthen promotion and supervision; nursing managers should pay attention to the training of QCC activities, pay attention to the unity and cooperation of different departments and doctors, and further promote the clinical application of quality management methods.

Objective To investigate the significance of urine neutrophil gelatinase associated lipocalin (NGAL ) and renal injury molecule-1 (KIM-1) in predicting the acute kidney injury (AKI) in children with congenital heart disease after operation .Methods From April 2014 to December 2015 ,67 cases of cardiopulmonary bypass in children with congenital heart disease were studied in our hospital ,all patients were divided into AKI group (n=24) and non AKI group (n=43) by pRIFLE standard .Serum creatinine , urine NGAL and urine KIM-1 levels were compared between the two groups before and after the operation ,the receiver operating characteristic curve (ROC curve) and the area under the curve (AUC) were used to evaluate the value of NGAL and KIM-1 in pre-dicting the postoperative AKI in children with congenital heart disease .Results There was no significant difference between the two groups in preoperative and postoperative 2 h and 4 h creatinine (P>0 .05) ,but the levels of postoperative 12 ,24 ,48 h creati-nine in the non AKI group were significantly lower than those in the AKI group (P<0 .05) .The NGAL level of postoperative 2 ,4 , 6 ,12 h in non AKI group was significantly lower than that in AKI group (P<0 .05) ,but there was no significant difference in the level of postoperative 24 h urine NGAL between the two groups (P>0 .05) .There was no significant difference between the two groups of patients with postoperative 2 h urinary KIM-1 (P>0 .05) ,postoperative 4 ,6 ,12 ,24 h urinary KIM-1 levels in the non AKI group were significantly lower than those in the AKI group (P<0 .05) .The optimal time point separate detection of urinary NGAL levels to assist in diagnosis of AKI after 12 h ,AUC was 0 .834 (95% CI:0 .631-0 .912);the best time point separately to detect the level of KIM-1 AKI to assist in the diagnosis of AKI after 24 h ,AUC was 0 .871 (95% CI:0 .665-0 .933);combined de-tection of urinary NGAL and KIM-1 levels to assist the best time for the diagnosis of AKI after 24 h ,AUC was 0 .913(95% CI:0 .745-0 .968) .Conclusion Urine NGAL and urine KIM-1 in children with congenital heart disease after operation have important clinical significance in predicting the occurrence of AKI .

Objective To evaluate the levels of total serum bilirubin(TSB),amplitude integrated electroencephalogram(aEEG) monitoring and brainstem auditory evoked potential(BAEP) individually and in combination for the early diagnosis of neonatal acute bilirubin encephalopathy by receiver operating charac-teristic( ROC) curve. Methods Clinical data was retrospectively analyzed. A total of 152 infants were diag-nosed with hyperbilirubinemia,including 119 cases of non-bilirubin encephalopathy group and 33 cases of bil-irubin encephalopathy group. The detection results of peak serum bilirubin,aEEG,BAEP combined with the three methods were determined with ROC curve analysis. Results The areas under ROC curve of TSB lev-el,aEEG,BAEP and in combination were 0. 900,0. 738,0. 767,0. 925,respectively,the corresponding sensi-tivity(specificity) in the cut-off point were 90. 91%(78. 15%),87. 88%(59. 66%),65. 52%(87. 91%), 93. 10%(82. 42%),respectively. It showed that the area under ROC curve of the maximum,the comprehen-sive assessment in diagnostic sensitivity and specificity of the combination of three methods were better than any single detection method by ROC curve. Conclusion The methods of TSB level,aEEG and BAEP play an important role in the diagnosis of neonatal bilirubin encephalopathy,and combination with the three meth-ods can improve the accuracy of diagnosis.

Objective To study the risk factors and prognosis of very/extremely low birth weight preterm (VLBW/ELBW) infants with bronchopulmonary dysplasia (BPD) during the first three years of life.Method From January 1st to December 31st,2012,a retrospective study was conducted on the VLBW/ELBW preterm infants with ＞ 28 days of hospitalization in the NICU of our hospital.The infants were assigned into BPD group (FiO2 ＞ 21％) and non-BPD group depending on the oxygen requirement on the 28th day after birth.The incidences of bronchitis,pneumonia,wheezing and re-hospitalization during the first three years of life were analyzed.The pulmonary function tests were performed at one-year-age.Independent-sapmles t test,Kruskal-wallis test and x2 test were used to compare the results between the two groups.Result A total of 72 patients were enrolled into this study.34 patients in the BPD group and 38 in the non-BPD group.The gestational age,birth weight and the use of INSURE technique of BPD group were significantly lower than non-BPD group,while the duration of hospital stays were longer than non-BPD group (P ＜0.05).The ratio of male,neonatal respiratory distress syndrome (RDS),patent ductus arteriosus (PDA),intrauterine infection,mechanical ventilation,nosocomial infection and the inhalation of high concentrations of oxygen were significantly higher in BPD group than non-BPD group (P ＜ 0.05).Incidences of bronchitis and wheezing during 0 ～ 1,1 ～ 2 and 2 ～ 3 years of age in the BPD were significantly higher than non-BPD group,separately.No significant differences existed in the incidences of pneumonia and re-hospitalization between the two groups.Pulmonary function test showed that the respiratory rate (RR) and peak tidal expiratory flow in the BPD group were significantly higher than non-BPD group,while the tidal volume,peak expiratory time and peak expiratory volume were significantly lower in BPD group than non-BPD group (P ＜ 0.05).Conclusion BPD often occurs in preterm infants with gestational age less than 32 weeks.It may cause impaired pulmonary function,characterized by obstruction in small airway,and increases the risk of bronchitis and wheezing during the first three year of life.

Objective To investigate the effect of docetaxel combined capecitabine chemotherapy and psychological intervention after radical mastectomy. Methods 80 cases of radical mastectomy for breast cancer treated in our hospital from January 2015 to January 2017 were treated with docetaxel combined with capecitabine chemotherapy. According to different nursing methods, the patients were divided into 2 groups. The observation group was treated with psychological nursing, while the control group received routine nursing care. The anxiety and depression scores in two groups before and after nursing were observed and compared. Results There were no significant difference in the scores of anxiety and depression between the two groups before and after treatment. After the intervention group, patients in observation group were significantly improved, and better than the control group patients; The nursing satisfaction rate in the observation group was 97.5%,which was significantly higher than that in the control group (72.5%) (P<0.05). Conclusion After radical mastectomy of breast cancer with docetaxel combined with capecitabine chemotherapy and psychological clinical observation of dry pre found in breast cancer resection and chemotherapy as the basis, to patients with psychological intervention can improve the clinical situation of patients, promote their mental status improved, improve nursing satisfaction rate of patients, so it is worthy of reference.

Objective To investigate the diagnostic correlation and sensitivity of amplitude integrated electroencephalogram (aEEG),brainstem auditory evoked potential (BAEP) and cranial magnetic resonance imaging (MRI) for acute bilirubin encephalopathy (ABE) in the newborn.Method Term and near-term neonates (gestational age ≥ 35 weeks) with hyperbilirubinemia (the level of bilirubin over than 95th percentile) of high and intermediate risk group admitted in the neonatal ward of Guangxi Maternal and Child Health Care Hospital from Jan 2014 to Dec 2015 were recruited retrospectively.The infants were assigned to ABE group and non-ABE group according to the diagnostic criteria of ABE.The clinical data of the newborns were collected and the diagnostic correlation between clinical diagnosis and aEEG,BAEP and cranial MRI were analyzed.The receiver operating characteristic (ROC) curve was adopted to assess the diagnostic efficiency of the peak level of serum bilirubin,aEEG,BAEP and cranial MRI on the early diagnosis of ABE.Result A total of 152 newborns with hyperbilirubinemia were recruited,including 33 cases in the ABE group and 119 cases in non-ABE group.(1) The results of aEEG and MRI were marginally positively correlated with clinical diagnosis of ABE (aEEG:r =0.487,P ＜ 0.001;MRI:r =0.220,P=0.018),while the results of BAEP were closely related to the clinical diagnosis of ABE (r =0.593,P ＜ 0.001);(2) The results of BAEP and MRI on the diagnosis of ABE were positively correlated with those of aEEG (BAEP:r =0.424,P ＜ 0.001;MRI:r =0.307,P ＜ 0.001).(3) The area under the ROC curves for predicting the onset of ABE were 0.899 for the peak level of serum bilirubin,0.767 for BAEP,0.738 for aEEG and 0.590 for MRI.Conclusion There was the correlation on the diagnosis of ABE among the methods of aEEG,BAEP and MRI.The combined diagnosis of the three methods could play a complementary role.The aEEG contributed to the early diagnosis of ABE with high sensitivity.