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.
ObjectiveTo explore the application of PDCA cycle in the examination of medical quality of Tibetan area hospitals. MethodsIn the October 2014, PDCA cycle theory was introduced into the examination of Tibetan hospital medical quality. We collected quality problems existing in the medical activities actively, analyzed the reason and influencing factors and made corresponding plans. Then we implemented the plans and measures strictly, surveyed the results, found out and analyzed the problems, summarized the results of the examination, and turned the unsolved problems to the next PDCA circulation. Continuous follow-up was performed until the results were satisfactory. Based on Sichuan Province Secondary Comprehensive Hospital Evaluation Standard, we analyzed the medical quality of the hospital before PDCA application (July to September 2014) and after PDCA application (October to December 2014). ResultsThe incidence of medical nursing documents writing defects decreased from 12.4% to 5.9%. Hospital infection management defect rate declined from 13.5% to 5.3% and drug safety management defect rate declined from 11.8% to 2.5%, and all the differences were statistically significant (P<0.05). ConclusionPDCA cycle in the Tibetan hospital for medical quality examination has greatly improved the medical quality of Tibetan hospitals.
ObjectiveTo investigate the effect of arthroscopic debridement combined with oral glucosamine hydrochloride tablets in the treatment of knee osteoarthritis. MethodsSixty-two patients with knee osteoarthritis treated between January 2013 and April 2015 were chosen to be our research subjects. They were randomly divided into trial group (n=31) and control group (n=31). The control group was treated with arthroscopic debridement, and the trial group was given glucosamine hydrochloride tablets for treatment, apart from arthroscopic debridement. We evaluated the clinical effects by visual analogue scale (VAS) score and Lysholm knee joint function score before, and 1 week, 4 weeks, 3 months and 6 months after surgery. ResultsOne week after surgery, the VAS score and Lysholm knee joint function score were not significantly different between the two groups (P>0.05). Four weeks, 3 months and 6 months after surgery, the VAS score of the trial group was respectively 3.08±0.91, 2.46±0.87, and 1.45±0.66, and was 5.47±1.02, 3.55±1.20, and 2.37±0.53 in the control group; the Lysholm score of the trial group was 80.55±2.24, 85.35±1.79, and 89.74±4.58, respectively, and of the control group was 72.55±4.47, 74.68±2.94, and 76.69±5.63. The VAS score and the Lysholm score of the trial group were both better than those of the control group (P<0.05). ConclusionArthroscopic debridement can alleviate the symptoms of knee osteoarthritis, and oral administration of glucosamine hydrochloride tablets after surgery has obvious effects.
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.