ObjectiveTo investigate the correlation of visual sensitivity, best corrected visual acuity (BCVA) and central retinal thickness (CRT) in diabetic macular edema (DME).MethodsA retrospectives study. Forty-five eyes of 30 patients in DME were included. There were 20 eyes of 16 males, 25 eyes of 14 females, with an average age of 54.49±7.45 years. All the patients had type 2 diabetes; the average duration of diabetes was over 10 years. The BCVA examination was performed using the international standard visual acuity chart, which was converted into logarithmic logarithm (logMAR) visual acuity. The following parameters provided by the MAIA microperimetric device were evaluated, including average threshold (AT), macular integrity index (MI), fixation indexes (P1 and P2), bivariate contour ellipse area (BCEA) for 63% and 95% of points, and horizontal and vertical axes of the ellipse of fixation (H63, H95, V63, V95). The CRT was measured and the integrity of the ellipsoidal band was observed by optical coherence tomography (OCT). The integrity of the ellipsoid band was divided into continuous smooth (group A): fully visible; part of the light band was interrupted (B group): not completely visible; missing light band (C group): completely invisible. Pearson correlation analysis was used to analyze the correlation between the factors; non-parametric tests were used to compare the logMAR BCVA, AT, and CRT between the different ellipsoid zone integrity groups; multiple linear regression analysis was used to analyze factors related to AT.ResultsPearson correlation analysis showed that the logMAR BCVA was positively correlated with MI (r=0.303, P=0.04) and CRT (r=0.342, P=0.02), negatively correlated with AT (r=−0.59, P=0.00) and P1 (r=−0.38, P=0.01). There was negative correlation between AT and MI (r=−0.55, P=0.00). The result of multivariate linear regression analysis showed that the logMAR BCVA is inversely correlated with AT (t=−3.53, P=0.001). Group A, B and C were 23, 17 and 5 eyes in the 45 eyes, respectively. There were significant differences in logMAR BCVA, AT, and CRT between the three groups of eyes (P=0.045, 0.049, 0.018).ConclusionsIn DME patients, the logMAR BCVA was positively correlated with CRT, negatively correlated with AT and P1. The logMAR BCVA is inversely correlated with AT. Microperimetry combined with OCT and visual acuity can be used to assess the visual function of patients with DME.
ObjectiveUse information technology to establish an “Internet+” chronic disease management model to provide patients with a full process, seamless, and convenient services. Explore a new model of “Internet+” chronic disease management and care services in the region. Methods Patients with chronic diseases treated in Mianyang Central Hospital from May 2018 to April 2019 were selected. The patients were randomly divided into intervention group and control group according to the single and even number at the end of hospitalization number. The control group adopted the traditional chronic disease management mode, and the intervention group adopted the “Internet+” chronic disease management mode based on the patients’ needs. And select the nursing experts who provide “Internet+” online nursing services. Compared with the effective management before and after the implementation of “Internet+” chronic disease management, the number of patients with chronic diseases, clinical outcome indicators, the number of health education readings, the number of Internet nursing services, and the sense of professional benefit of nurses and other indicators, etc. Results A total of 143 patients were included, including 78 in the control group and 65 in the intervention group. A total of 28 nursing experts were investigated. The effective management rate of patients with chronic diseases was 78.7%. The WeChat public account “Slow Disease Window” has read nearly 90 000 person-times, and the Internet Hospital “Nursing Professional Online” has nearly 2 000 online nursing services. After participating in “Internet+” chronic disease management, the disease activity and functional status of chronic disease patients were significantly improved (P<0.05). Nursing professionals have a strong sense of professional benefits (P<0.05). Conclusions With the development of “Internet+” chronic disease management, a new mode of chronic disease management was explored to promote the management of chronic disease more convenient and efficient, so that the health education work can be homogenized, the clinical outcome of the patients was effectively improved. At the same time the career planning of nursing staff can be broadened.
Objective To analyze the relationship of human leukocyte antigen alleles (HLA-A/B, HLA-DRB/DQB) polymorphism and Eales disease, tuberculosis infection in a Han population in Zunyi city of China. Methods The subjects were analyzed by case control study, which consisted of three groups including Eales disease group (47 patients), pulmonary tuberculosis group (36 patients) and normal control group (100 healthy people). Thirty-nine patients in Eales disease group who had complete history were divided into 4 subgroups according to the history and tuberculin PPD test. Twelve patients with past or present pulmonary tuberculosis were in group A, 27 patients without pulmonary tuberculosis were in group B, 27 patients with positive PPD test were in group C, and 12 patients with negative PPD test were in group D. Fifty-nine alleles of HLA-A/B and HLA-DRB/DQB were analyzed by polymerase chain reaction with sequencespecific primers (PCR-SSP) in all subjects. Odds ratios between each group (OR) and 95% confidence interval (CI) were calculated; Frequency distribution of HLA-A02 gene were analyzed for the group A and the TB group. Results The frequency distribution of HLA-A02 （OR=9.719, OR95% CI:4.377-21.580,P=0.000）and HLA-B07 （OR=11.605, OR95% CI:2.397-56.191,P=0.001）alleles in Eales disease group were obviously higher than that in normal control group, but frequency distribution of HLA-A11（OR=0.495, OR95% CI:0.245-1.000,P=0.048）in Eales disease group was obviously lower than that in normal control group. There was no significant difference in frequency distribution of HLA-A02, HLA-A11 and HLA-B07 alleles between groups A and B, and between groups C and D (P＞0.05). The distribution frequency of HLA-A02, HLA-A24, HLA-B07 and HLA-DRB16 alleles among Eales disease group, pulmonary tuberculosis group and control group was statistically different (P＜0.05). The frequency distribution of HLA-A24 alleles in pulmonary tuberculosis group was lower than that in Eales disease group （chi;2=7.289,P=0.007）, but the frequency distribution of HLA-A02 alleles had no significant difference (OR=0.515,P=0.202) between two groups. Conclusions The alleles of HLA-A02 and HLA-B07 may be genetic predisposing genes of Eales disease, but HLA-A11 alleles may be protective gene in population of Han nationality from Zunyi city. The alleles of HLA-DRB16 and HLA-A02 may be genetic predisposing genes of pulmonay tuberculosis. The alleles of HLA-A02 may be a common susceptible gene for Eales disease and pulmonary tuberculosis. HLA-A11 and HLA-A24 alleles were protective genes of Eales disease and pulmonary tuberculosis respectively.
ObjectiveTo investigate the efficacy of Quality Control Circles (QCC) in reducing the emergency application times of maintenance hemodialysis. MethodsIn December, 2012, the quality circle was formed by eight nurses and a physician, through brainstorming. The group finally selected "Reducing emergency maintenance dialysis times" as the theme. With the help of questionnaire, interview, and comparative study, we analyzed the emergency situation of maintenance hemodialysis patients, and regulate and implement related policies. ResultsBy QCC practices, the times of hemodialysis declined from 11.7 to 5.3 cases per month, which exceeded our expectations largely. As to the circle members, their problem-solving skills, responsibility, communication skills, self-confidence, motivation and QCC techniques were also improved. ConclusionQCC can not only reduce the times of maintenance dialysis, but also improve the team cohesion, harmony and quality management capabilities.
Objective To optimize the in vitro culture system of C57/BL6 marrow mesenchymal stem cells (MSCs) and to investigate the effect of alcohol and acetaldehyde on MSCs. Methods The MSCs were isolated from the femur marrow of C57/BL6 mice and were cultured in the optimized system, so that highlypurified MSCs were harvested and identified by immunohistochemistry. Then, MSCs were cultured in the medium containing alcohol or its metabolic product acetaldehyde, with the following concentration groups: alcohol 5.7，17.0，50.0，100.0 and 150.0 mmol/L; acetaldehyde 4.5, 0.9, 0.18, 0.036, 0.007 2, 0.001 44 , 0.000 28 mmol/L. MSCs were cultured with α-MEM as the control group. After 3 days, their proliferation activity was measured by the MTT method. Results MSCs within 6 passages had a good stability and a high proliferation activity. They were identified to express CD90 but no CD34. The MTT assay showed that alcohol at the concentration greater than 100.0 mmol/L and acetaldehyde at the concentration greater than 4.5 mmol/L could inhibit proliferation of MSCs(P＜0.05) . But the proliferation activity might rise with an increase in the acetaldehyde concentration smaller than 0.18 mmol/L(P＜0.05) . Conclusion Theoptimized culture system can effectively isolate and culture MSCs. Both alcoholand acetaldehyde can inhibit proliferation of MSCs but toxicity of acetaldehydeis more serious.