AIM: To investigate the differences in varying stages of non-proliferative diabetic retinopathy(NPDR)using optical coherence tomography angiography(OCTA).METHODS: Cross-sectional study. A total of 77 cases(77 eyes)of diabetic patients were included, and they were divided into non-diabetic retinopathy(NDR; 23 eyes)and non-proliferative diabetic retinopathy(NPDR; 54 eyes)groups, further subdivided into mild NPDR(20 eyes), moderate NPDR(20 eyes), and severe NPDR(14 eyes). Foveal avascular zone(FAZ)area, superficial and deep capillary plexus densities(SSP and DSP), and visual acuity(LogMAR)were compared between NDR and NPDR groups. Furthermore, the visual acuity, FAZ area and levels of SSP and DSP were compared in different degrees of NPDR. Correlation analysis were conducted to elucidate relationships between FAZ area, visual acuity, SSP, DSP, and severity of the disease.RESULTS: Compared with the NDR group, the visual acuity(LogMAR)and macular FAZ area increased, while SSP and DSP were decreased in the NPDR group(P<0.05); there were significant differences in visual acuity, FAZ area and SSP and DSP levels in different degrees of NPDR(P<0.05). Visual acuity(LogMAR)and FAZ area displayed a positive correlation with the severity of disease, while SSP and DSP showed a negative correlation.CONCLUSION: With the progression of NPDR, the visual acuity(LogMAR)and FAZ area increased, and the SSP and DSP decreased.

Objective To investigate the efficacy of Jianpiwenyang Gel(SSWYG)for treating chronic diarrhea and explore its therapeutic mechanism.Methods Eighty patients with chronic diarrhea of spleen and stomach weakness type were randomized into two groups for interventions with lifestyle adjustment and treatment with bifid triple viable capsules(control group,n=40)or naval application with SSWYG(treatment group,n=40)for one week,after which symptoms of chronic diarrhea were evaluated.The Chinese medicine system pharmacology analysis platform(TCMSP),GeneCards,NCBI,OMIM database and GEO database(GSE14841)were used to obtain the active ingredients and target proteins of SSWYG and chronic diarrhea-related targets.The key targets were obtained by topological analysis for Gene Ontology(GO)and KEGG analyses.The affinity and binding characteristics of SSWYG for specific targets were verified by molecular docking using AutoDock software.Results In both groups,gastrointestinal symptom rating scale(GSRS),Bristol Scale and TCM syndrome scores significantly improved after the treatments(P<0.05),and better effects were observed in the treatment group(P<0.05).Sixty-eight targets of SSWYG in treating chronic diarrhea were obtained,and 33 most probable ones were screened out by topological analysis.GO and KEGG analyses identified several chronic diarrhea-related pathways including the TNF and IL-17 pathways.Molecular docking study showed good affinity of the core components of SSWYG for the key targets CASP3,JNK,IL1B,IL6,and AKT1.JUN and CASP3 had the lowest binding energy and the highest stable binding energy with multiple major active ingredients of SSWYG.Conclusion SSWYG can significantly improve clinical symptoms of chronic diarrhea possibly by regulating the TNF and IL-17 as well as other pathways via CASP3 and JUN,suggesting a complex therapeutic mechanism of SSWYG involving multiple ingredients and targets and coordinated regulation of multiple pathways.

ObjectiveTo compare the air disinfection effects of different human-machine coexistence disinfection methods in the high-risk areas of airborne diseases in medical and healthcare institutions, and to provide a reference for the prevention and control of airborne diseases in medical and healthcare institutions. MethodsField trials were conducted in the fever clinic, the infection disease department, and dental clinics of a tertiary hospital in Shanghai, respectively. The existing air disinfection methods (plasma air disinfection machine, circulating air ultraviolet disinfection machine or negative pressure ventilation system), upper-room 222 nm ultraviolet germicidal system, and the combination of the existing air disinfection methods and upper-room 222 nm ultraviolet germicidal system were all used in each location in the experiment group. The control group did not adopt specific air disinfection methods. Air sampling was conducted by the six-level sieve hole microbial sampler or the flat slab exposure method. The daily air sampling time was from 8:00 a.m. to 16:00 p.m., with one sample per hour, and a total of 9 samples were taken. The disinfection effects were compared by calculating the total number of airborne bacteria colonies and the sterilization rate for each disinfection method. ResultsThe total numbers of airborne bacteria colonies in the fever outpatient infusion room, the ward and nurse station of infection disease department of 222 nm group were lower than that in the control group (P=0.005, P<0.001, P<0.001). The total numbers of airborne bacteria colonies in the fever outpatient infusion room and the dental examination room of 222 nm group were lower than that in the control group or plasma air disinfection machine group (P=0.022, P=0.014). The total numbers of airborne bacteria colonies in the nucleic acid sampling room of plasma air disinfection machine group combined with 222 nm group were lower than that in plasma air disinfection machine group (P=0.019). The total numbers of airborne bacteria colonies in the CT examination room of fever clinic of the 222 nm group were lower than that in the circulating air ultraviolet disinfection machine group (P=0.002). The total numbers of airborne bacteria colonies in the CT examination room of 222 nm group combined with circulating air ultraviolet disinfection machine were lower than that of circulating air ultraviolet disinfection machine group and the control group (P=0.008, P<0.001). The air sterilization rate of upper-room 222 nm ultraviolet germicidal system ranged from 48.04% to 73.74%. The air sterilization rate of plasma air/circulating air ultraviolet disinfection machine combined with the upper-room 222 nm ultraviolet germicidal system ranged from 6.86% to 73.77%. ConclusionUpper-room 222 nm ultraviolet germicidal system could effectively reduce airborne colonies in the air and improve air hygiene quality in both clinic and ward environments with high airborne transmission risks.

Objective To investigate the efficacy of Jianpiwenyang Gel(SSWYG)for treating chronic diarrhea and explore its therapeutic mechanism.Methods Eighty patients with chronic diarrhea of spleen and stomach weakness type were randomized into two groups for interventions with lifestyle adjustment and treatment with bifid triple viable capsules(control group,n=40)or naval application with SSWYG(treatment group,n=40)for one week,after which symptoms of chronic diarrhea were evaluated.The Chinese medicine system pharmacology analysis platform(TCMSP),GeneCards,NCBI,OMIM database and GEO database(GSE14841)were used to obtain the active ingredients and target proteins of SSWYG and chronic diarrhea-related targets.The key targets were obtained by topological analysis for Gene Ontology(GO)and KEGG analyses.The affinity and binding characteristics of SSWYG for specific targets were verified by molecular docking using AutoDock software.Results In both groups,gastrointestinal symptom rating scale(GSRS),Bristol Scale and TCM syndrome scores significantly improved after the treatments(P<0.05),and better effects were observed in the treatment group(P<0.05).Sixty-eight targets of SSWYG in treating chronic diarrhea were obtained,and 33 most probable ones were screened out by topological analysis.GO and KEGG analyses identified several chronic diarrhea-related pathways including the TNF and IL-17 pathways.Molecular docking study showed good affinity of the core components of SSWYG for the key targets CASP3,JNK,IL1B,IL6,and AKT1.JUN and CASP3 had the lowest binding energy and the highest stable binding energy with multiple major active ingredients of SSWYG.Conclusion SSWYG can significantly improve clinical symptoms of chronic diarrhea possibly by regulating the TNF and IL-17 as well as other pathways via CASP3 and JUN,suggesting a complex therapeutic mechanism of SSWYG involving multiple ingredients and targets and coordinated regulation of multiple pathways.

Objective:To investigate the alteration of glymphatic system based on diffusion tensor image-analysis along the perivascular space(DTI-ALPS)in bipolar disorder Ⅰ(BD-Ⅰ).Methods:A total of 44 BD-Ⅰ patients(BD-Ⅰ group) admitted to the Affiliated Brain Hospital of Guangzhou Medical University from January 2012 to December 2017 were selected.In addition, totally 30 healthy controls (HC group) were recruited. The diffusion tensor image data were analyzed retrospectively, and along the perivascular space (ALPS) index was calculated. Hamilton anxiety scale (HAMA), 17-item Hamilton depression rating scale (HAMD-17), Young mania rating scale (YMRS) and global assessment function (GAF) were used to evaluate the severity of anxiety, depression, mania and social function respectively. SPSS 25.0 software was used for t-test, Z-test and chi-square test, and the differences in clinical data and DTI-ALPS index between the two groups were compared. The partial correlation test was used to analyze the correlations between DTI-ALPS index and the clinical indicators such as HAMA, HAMD-17, YMRS and GAF. Results:The DTI-ALPS indexes in left(1.69±0.17), right(1.44±0.15) and bilateral cerebral hemispheres(1.56±0.15) of BD-Ⅰ group were lower than those in HC group ((1.71±0.15), (1.46±0.13) and (1.58±0.12)), but the differences were not statistically significant ( t=-0.441, -0.545, -0.556, all P>0.05). After controlling for gender, age, years of education and course of disease, there were significant negative correlations between bilateral average DTI-ALPS index and somatic anxiety ( r=-0.334, P=0.038), as well as between right DTI-ALPS index and somatic anxiety( r=-0.349, P=0.030) in BD-Ⅰ group. Conclusion:The dysfunction of cerebral glymphatic system is not obvious in BD-Ⅰ patients, but their anxiety may be related to dysfunction cerebral glymphatic system.

Lipid metabolism disorders contribute to hyperlipidemia and hepatic steatosis. It is ideal to develop drugs simultaneous improving both hyperlipidemia and hepatic steatosis. Nitazoxanide is an FDA-approved oral antiprotozoal drug with excellent pharmacokinetic and safety profile. We found that nitazoxanide and its metabolite tizoxanide induced mild mitochondrial uncoupling and subsequently activated AMPK in HepG2 cells. Gavage administration of nitazoxanide inhibited high-fat diet (HFD)-induced increases of liver weight, blood and liver lipids, and ameliorated HFD-induced renal lipid accumulation in hamsters. Nitazoxanide significantly improved HFD-induced histopathologic changes of hamster livers. In the hamsters with pre-existing hyperlipidemia and hepatic steatosis, nitazoxanide also showed therapeutic effect. Gavage administration of nitazoxanide improved HFD-induced hepatic steatosis in C57BL/6J mice and western diet (WD)-induced hepatic steatosis in Apoe ^-/- mice. The present study suggests that repurposing nitazoxanide as a drug for hyperlipidemia and hepatic steatosis treatment is promising.

Objective:To compare the visual quality of patients with astigmatic multifocus intraocular lens (ART IOL) and astigmatic monofocus IOL (Toric IOL) after implantation.Methods:A prospective, non-randomized, controlled study was conducted to include 72 eyes of 72 cataract patients with corneal astigmatism (1.0-2.5 D) who were scheduled to receive phacoemulsification combined with IOL implantation in Chaoju Eye Hospital of Inner Mongolia from July 2017 to October 2018.Patients were divided into ART IOL group (37 eyes) and Toric IOL group (35 eyes) according to different IOLs implanted.All patients were followed up for 1 year after surgery.The main and secondary outcome indicators were compared.The main outcome indicators included distance (5 m), intermediate (80 cm), and near (40 cm) uncorrected visual acuity and best corrected visual acuity, defocus curve, contrast sensitivity, postoperative IOL rotation and residual astigmatism, while the secondary outcome indicators included visual subjective symptoms and spectacle independence rate.The above outcome indicators were compared between the two groups.This study followed the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Chaoju Eye Hospital of Inner Mongolia (No.CJYKLL202012).Written informed consent was obtained from each patient before surgery.Results:There was no statistically significant difference between the two groups in average uncorrected distance visual acuity and best corrected distance, intermediate and near visual acuity (all at P>0.05).The average intermediate and near visual acuity in the ART IOL group was significantly higher than that in the Toric IOL group, showing statistically significant differences (both at P<0.05).The defocus curve of the ART IOL group presented a double peak, which reached the peak at the far focus (0.0 D) and near focus (-2.5 D), respectively.The visual acuity range from 1.5 to-3.0 D was above 0.2 logarithm of the minimum angle of resolution (LogMAR), and the focus depth range was 4.5 D (1.5 to -3.0 D).The defocus curve of the Toric IOL group had only one crest, which was located at best corrected visual acuity (0.0 D).The visual acuity reached 0.2 LogMAR or above were from 1.0 to -1.0 D, and the focal depth range was 2.0 D (1.0 to -1.0 D).There was no statistically significant difference in contrast sensitivity at different spatial frequencies between the two groups in bright light, bright flashing light and dark light (all at P>0.05), while the contrast sensitivity of the ART IOL group at high dark flashing light frequency was lower than that of the Toric IOL group, showing statistically significant difference ( P<0.05).In the ART IOL group and the Toric IOL group, the average residual astigmatism after surgery was (-0.47±0.51)D and (-0.49±0.42)D, respectively, with no statistically significant difference ( t=0.408, P>0.05).There was no significant difference in postoperative IOL rotation between the two groups ( t=1.906, P>0.05).The total postoperative spectacle independence rate in the ART IOL group was 97.30%(36/37), which was higher than that in the Toric IOL group (17.14%, 6/35), showing statistically significant difference ( χ2=15.320, P<0.05). Conclusions:Both Toric IOL and ART IOL can better correct corneal astigmatism and improve patients' distance visual acuity, but ART IOL implantation can provide better distance, intermediate and near visual acuity, and higher spectacle independence rate.

【Objective】 To observe the inactivation effect of a new low-temperature plasma air disinfector on microorganisms in the natural environment and artificial contaminated environment so as to further determine the minimum effective processing parameters. 【Methods】 First， in 0.5 m³ of super clean workbench and 1.05 m³ airtight organic glass cavity in the body， the new low-temperature plasma air disinfector developed was used to inactivate the natural bacteria in the air under different parameters. Then in 1.05 m³ airtight organic glass cavity in the body， the new low-temperature plasma air disinfector was used to treat the Staphylococcus aureus and Escherichia coli under the condition of artificial bacteria spraying. Last， the plate counting method was used to evaluate the inactivation effect of the disinfector on natural bacteria and artificial bacteria in the air. 【Results】 For the low-temperature plasma air disinfector in 0.5 m³ and 1.05 m³ confined space， the lowest effective treatment parameters for inactivated natural bacteria were 13 kV， 5 min or 12 kV， 10 min. For the low-temperature plasma air disinfection machine in 13 kV discharge voltage treatment of different time， compared with before treatment， the killing rate of Escherichia coli and Staphylococcus aureus increased significantly after treatment for 20 min （P<0.000 1）. Both could meet the requirements of disinfection specifications ［100%， （99.98±0.01）%≥99.90%］. 【Conclusion】 The inactivation of natural bacteria and artificial bacteria by the new low-temperature plasma air disinfector has reached the qualified standard of disinfection stipulated in Technical Specifications for Disinfection.

Objective: Explore the feasibility of POL intervention based on life skills in young students at high-risk of AIDS, and to provide reference for POL intervention. Methods: Nine potential POLs were recruited from young students at high risk of AIDS in Xi’an, and received life-skill-based interventions from May to October in 2017. A unified approach was adopted before the intervention. The effect of intervention was evaluated at 1 month and 3 months after the intervention. Results: The difference in POLs peer status and psychosocial ability scores was not significant after the intervention. The scores of persistence efficacy dimension of condom use efficacy before, 1-month and 3-month after the intervention were (10.56±1.88)(11.11±2.21)(12.89±2.09)(F=6.84, P<0.05) respectively. No significant changes were found in AIDS-related knowledge and behavior before and after the intervention. POL has increased from 108 students before intervention to 216 publicity coverage after three months intervention, however, the difference was not statistically significant. Feasibility analysis of the POL intervention showed that 8 of the POLs considered to be "very useful". Conclusion Life skill-based POL intervention for young students at high-risk of AIDS has a wide coverage and reasonable acceptance, as well as condom use adherence. The long-term effectiveness still needs to be verified.

Objective? To explore the status quo of nursing masters' core competence and to analyze its influencing factors. Methods? Totally 350 full-time schooling nursing masters from 7 universities from Shandong Province, Guangxi Zhuang Automatous Region, Jilin Province, Yunnan Province, Xinjiang Uygur Automatous Region, Tianjin Municipality and Liaoning Province and 140 nursing teachers from 5 teaching hospitals for nursing masters were selected by convenient sampling between March and October 2018. Nursing masters were investigated with the Core Competence Self-rating Scale for Nursing Masters (CCSRS-NM), while nursing teachers were investigated with the Nurse Master-administered Rating Scale (NMARS). A total of 350 questionnaires were distributed to the master of nursing, 332 valid questionnaires were obtained, 140 questionnaires were distributed to the teachers, and 128 valid questionnaires were obtained. SPSS 17.0 was used for statistical analyses. Multivariate linear regression analysis was employed to explore the influencing factors. Results? The CCSRS-NM score of 332 nursing masters totaled (174.67±23.45); the total NMARS score of 128 nursing teachers was (203.10±26.85). Univariate analysis showed that there were statistical differences in CCSRS-NM scores between nursing masters with different sex, grade, frequent presence at seminars, type of training, time of theoretical learning, published papers or not, attitude to nursing and guidance of supervisors (F/t=2.024, 7.306, 2.375, 2.534, -4.780, 3.792, 11.983, 7.454; P＜0.05); there were statistical differences in NMARS scores between nursing teachers with different age, length of service, professional title, educational background and qualified as supervisors or not (F/t=4.305, 4.696, 6.307, 2.330, -2.226;P＜0.05). According to multivariate analysis, nursing masters' attitude to nursing, time of theoretical learning, guidance of supervisors, sex, published papers or not and grade were the factors influencing nursing masters' core competence (P＜ 0.05); Length of service, professional title and qualified as supervisors or not were the influencing factors to nursing teachers' NMARS scores (P＜ 0.01). Conclusions? The core competence of nursing masters stands at an intermediate level, and nursing teachers' evaluation is higher than nursing masters' self-evaluation. Nursing masters' core competence may be enhanced by strengthening professional attitude education, increasing time of theoretical learning, intensifying supervisors' guidance, encouraging male candidates to study as a nursing major and encouraging nursing masters to publish papers, and reinforcing the communication and exchange between students at different grades. Evaluation of nursing masters' core competence should involve teachers and supervisors with different length of service and professional title.