Abstract Objective：To explore the application of refined nursing models to improve the quality and efficiency of resuscitation in patients undergoing ophthalmic general anesthesia surgery under laryngeal mask ventilation.Methods: From January 2020 to December 2023, a total of 56064 patients in our hospital who underwent ophthalmic general anesthesia and were resuscitated in PACU with a laryngeal mask were subjected to a refined nursing model, including PACU preparation, PACU patient reception process, PACU nursing observation points, timely removal of the laryngeal mask, as well as nursing care for some special patients, such as infants at low months of age, preoperative crying and restless children, and elderly patients with underlying diseases. Results： All 56064 patients did not experience major complications and safely passed the anesthesia recovery period. They returned to the ward safely and shortened the observation time of the PACU, improving the utilization rate of PACU beds. Conclusions: By providing refined nursing care for a large number of patients undergoing ophthalmic laryngeal mask ventilation general anesthesia surgery, incorporating predictive care into the observation of the patient's condition during the recovery period, timely preventing and cooperating with doctors to handle various complications, shortening the observation time of patients in the PACU, enabling them to wake up safely and reach the standard of leaving the PACU as soon as possible, and improving the bed utilization rate of the PACU.
Spaceflight associated Neuro-Ocular Syndrome (SANS) refers to a series of ocular, neurological and neuroimaging manifestations observed by astronauts during and after long-term space flight, which may cause short-term or long-term vision changes, cognitive effects or other harmful health effects on pilots. Therefore, clarifying the pathogenesis of SANS, conducting effective ground simulation experiments and formulating corresponding mitigation countermeasures are of great significance for deeper and longer space flight in the future. This article outlines the relevant advancements domestically and internationally.
objective: to observe the effect of dexmedetomidine combined with esmolamine on the rapid recovery of pediatric ophthalmic surgery. Methods: 150 children who underwent ophthalmology surgery in Kaifeng Central Hospital from April 2022 to August 2023 were randomly divided into three groups: group M (n = 48), group S (n = 53) and group Y (n = 49). The hemodynamic parameters, mean arterial pressure (MAP), heart rate (HR) and respiratory rate (RR) were monitored and recorded, and the intraocular pressure (IOP), laryngeal mask removal time, awakening time, cognitive function recovery time, orientation recovery time and postoperative hospital stay were recorded in the early morning of operation and after anesthesia induction. Results: there was no significant difference in sex ratio, age, weight, height and type of operation among the three groups, MAP and HR at T1~T4 time point in group M were significantly lower than those at T0 time point in MAP and HR group, MAP and HR were significantly increased in group S at T1~T4 time point, while MAP and HR were not significantly changed in group Y at T1~T4 time point. There was no significant difference in MAP and HR among the three groups at T0 time point, but there were significant differences in MAP and HR among the three groups at T1, T2, T3 and T4 time points. The MAP and HR of T1~T4 in M group were significantly lower than those in S group and Y group, while those in S group were higher than those in Y group. Compared with T0 time point in RR group, the RR of S group and Y group at T1~T4 time point decreased significantly (P < 0 05). There was no significant difference in RR at T0~T4 time point between group S and group Y (P > 0.05). Compared with the early morning of the operation day, the intraocular pressure in group M decreased after anesthesia induction, while the intraocular pressure in group S and Y increased (P < 0.05). There was no significant difference in intraocular pressure among the three groups in the early morning of operation (P > 0.05), but there was significant difference in intraocular pressure among the three groups after anesthesia induction (P < 0.05). The intraocular pressure in group M was significantly lower than that in group S and group Y, and that in group S was higher than that in group Y (P < 0.05). Laryngeal mask removal and awakening time: the laryngeal mask removal time and awakening time in group M and S were significantly higher than those in group Y (P < 0.05). There were also significant differences in cognitive function, directional ability recovery time and hospital stay among the three groups (P < 0.05). The cognitive function recovery time, orientation recovery time and postoperative hospital stay in group M and group S were longer than those in group Y (P < 0.05). Conclusion: dexmetomidine combined with esmolamine has a good anesthetic effect in pediatric ophthalmic daytime surgery. it can be safely and effectively used in pediatric ophthalmic daytime surgery and promote the rapid recovery of children.
objective: to observe the effect of dexmedetomidine combined with esmolamine on the rapid recovery of pediatric ophthalmic surgery. Methods: 150 children who underwent ophthalmology surgery in Kaifeng Central Hospital from April 2022 to August 2023 were randomly divided into three groups: group M (n = 48), group S (n = 53) and group Y (n = 49). The hemodynamic parameters, mean arterial pressure (MAP), heart rate (HR) and respiratory rate (RR) were monitored and recorded, and the intraocular pressure (IOP), laryngeal mask removal time, awakening time, cognitive function recovery time, orientation recovery time and postoperative hospital stay were recorded in the early morning of operation and after anesthesia induction. Results: there was no significant difference in sex ratio, age, weight, height and type of operation among the three groups, MAP and HR at T1~T4 time point in group M were significantly lower than those at T0 time point in MAP and HR group, MAP and HR were significantly increased in group S at T1~T4 time point, while MAP and HR were not significantly changed in group Y at T1~T4 time point. There was no significant difference in MAP and HR among the three groups at T0 time point, but there were significant differences in MAP and HR among the three groups at T1, T2, T3 and T4 time points. The MAP and HR of T1~T4 in M group were significantly lower than those in S group and Y group, while those in S group were higher than those in Y group. Compared with T0 time point in RR group, the RR of S group and Y group at T1~T4 time point decreased significantly (P < 0 05). There was no significant difference in RR at T0~T4 time point between group S and group Y (P > 0.05). Compared with the early morning of the operation day, the intraocular pressure in group M decreased after anesthesia induction, while the intraocular pressure in group S and Y increased (P < 0.05). There was no significant difference in intraocular pressure among the three groups in the early morning of operation (P > 0.05), but there was significant difference in intraocular pressure among the three groups after anesthesia induction (P < 0.05). The intraocular pressure in group M was significantly lower than that in group S and group Y, and that in group S was higher than that in group Y (P < 0.05). Laryngeal mask removal and awakening time: the laryngeal mask removal time and awakening time in group M and S were significantly higher than those in group Y (P < 0.05). There were also significant differences in cognitive function, directional ability recovery time and hospital stay among the three groups (P < 0.05). The cognitive function recovery time, orientation recovery time and postoperative hospital stay in group M and group S were longer than those in group Y (P < 0.05). Conclusion: dexmetomidine combined with esmolamine has a good anesthetic effect in pediatric ophthalmic daytime surgery. it can be safely and effectively used in pediatric ophthalmic daytime surgery and promote the rapid recovery of children.
Objective: To explore the imaging characteristics and clinical application of autofluorescence in multiple evanescent white-dot syndrome. Methods :Choose 18 cases (18 eyes)of patients of multiple evanescent syndrome white-dot diagnosed in the second people’s hospital of yunnan province .All patients underwent fundus color photography, autofluorescence, fluorescence fundus angiography, indocyanine green angiography, ultra-wide-angle fundus color photography, and ultra-wide-angle fundus autofluorescence. Follow-up all the patients. in the follow-up process mainly take ultra-wide-angle fundus color photography, and ultra-wide-angle fundus autofluorescence. Analysis the characteristics of fundus color photography, FFA, ICGA, and ultra-wide-angle fundus color photography, and compares with autofluorescence and analysis the clinical application advantage of autofluorescence in multiple evanescent white-dot syndrome(MEWDS)in the diagnosis, follow-up and observe prognosis .Results :In the disease, some white dots that cannot be found in fundus color photography can be clearly shown in the autofluorescence,the dots shown in the fundus autofluorescence or ultra-wide-angle autofluorescence are clear and more than the dots shown in the fundus photography or the ultra-wide-angle fundus photography .The number of dots in autofluorescence is more than that in FFA, which is basically the same as that in ICGA. During the follow-up, with the improvement of the patient's condition, the autofluorescence of the dots gradually decreased, and the number gradually decreased, until the fundus autofluorescence was completely normal. Conclusion: Fundus autofluorescence can clearly show the lesion’s characteristics of multiple evanescent white-dot syndrome(MEWDS) the number of lesions showed better than that of the fundus color photography and FFA and ICGA lesions seen in the basic corresponding number, its charactenstics of non-contact and repeatability, have a great advantage in the diagnosis, follow-up and evaluation of multiple evanescent white-dot syndrome.
Objective: To analyze the influencing factors of refusal of vitrectomy in patients with proliferative diabetic retinopathy (PDR).Methods: A total of 517 patients with PDR who underwent vitrectomy in Xingtai City from January 2021 to August 2022 were selected and divided into two groups according to whether they underwent surgical treatment.The personal and disease characteristics of the patients were collected. Logistic regression was used to analyze the influencing factors of non-vitrectomy.Results: 126 patients (24%) did not undergo vitrectomy. There were statistically significant differences in the proportion of patients received retinal photocoagulation, combined with other serious systemic diseases, and preoperative visual acuity improvement between the two groups (P<0.05).Multivariate analysis showed that no previous retinal photocoagulation treatment(OR=0.414,95% CI0.236-0.724, p=0.002), combined with other serious systemic diseases(OR=11.812,95% CI6.446-21.646, p<0.001), and preoperative visual acuity improvement(OR=21.317,95% CI11.756-38.653, p<0.001) were the influencing factors for patients who did not undergo vitrectomy.Conclusions:Previously not receiving retinal photocoagulation treatment, combined with other serious systemic diseases, and preoperative visual acuity improvement are the influencing factors for patients not undergoing vitrectomy. Early knowledge popularization should be strengthened, targeted communication with patients should be carried out, and patients' confidence in surgery should be established.
Abstract Objective To investigate the ocular manifestations, diagnosis, treatment and prognosis of chronic myeloid leukemia (CML), a case with binocular fundus hemorrhage is reported. Method Detailed records were recorded of a middle-aged woman who was admitted to the Ophthalmology clinic of Chengdu First People's Hospital on November 19, 2023 due to "ocular fundus hemorrhage". The fundus examination and systemic blood routine examination showed abnormalities, and our department suspected blood tumor-related diseases. The patient was then actively transferred to the hematology department for treatment. Through bone marrow imaging, chromosome karyotype analysis of bone marrow cells, BCR/ABL1 fusion gene qualitative test results, the final diagnosis of "chronic granulocytic leukocyte"; Our department of follow-up observation for more than 1 month, with the stability of hematology, the patient's fundus hemorrhage lesions also subsided. In this paper, all the reports of this case in China were searched so far, and the foreign literature was analyzed and summarized. Results This case is very rare, so far only 19 cases have been reported abroad and only 3 cases in China. Results This case is very rare, so far only19 cases have been reported abroad and only 3 cases in China. Conclusion Fundus change is a non-specific manifestation of CML patients and is only reported as a case in the literature，Meanwhile, leukemic retinopathy has certain clinical reference value for the diagnosis and prognosis of CML.
Abstract Objective: To explore the association between high myopia and anxiety and depression. Methods: Clinical data were collected from 149 patients with high myopia, and their anxiety and depression were assessed using the Hospital Anxiety and Depression Scale HADS. The correlation between high myopia and anxiety and depression was explored using statistical analysis. Results: Among the study population, the percentage of anxious patients was 19.46% and the percentage of depressed patients was 29.53%. No association was found between cataract surgery and anxiety depression in highly myopic patients. There was an independent correlation between anxiety and depression scores of highly myopic patients and gender and educational level, which was statistically significant. CONCLUSIONS: Between 19% and 29% of patients with high myopia were likely to suffer from depression and anxiety disorders, and males and highly educated patients with high myopia had a higher risk of anxiety and depression.
Background: Diabetic retinopathy (DR) urgently needs novel and effective therapeutic targets. Integrated analyses of plasma proteomic and genetic markers can clarify the causal relevance of proteins and discover novel targets for diseases, but no systematic screening for DR has been performed.
Methods: Summary statistics of plasma protein quantitative trait loci (pQTL) were derived from two extensive genome-wide analysis study (GWAS) datasets and one systematic review, with over 100 thousand participants covering thousands of plasma proteins. DR data were sourced from the largest FinnGen study, comprising 10,413 DR cases and 308,633 European controls. Genetic instrumental variables were identified using multiple filters. In the two-sample MR analysis, Wald ratio and inverse variance-weighted (IVW) MR were utilized to investigate thecausality of plasma proteins with DR. Bidirectional MR, Bayesian Co-localization, and phenotype scanning were employed to test for potential reverse causality and confounding factors in the main MR analyses. By systemically searching druggable gene lists, the ChEMBL database, DrugBank, and Gene Ontology database, the druggability and relevant functional pathways of the identified proteins were systematically evaluated.
Results: Genetically predicted levels of 24 proteins were significantly associated with DR risk at a false discovery rate <0.05 including 11 with positive associations and 13 with negative associations. For each standard deviation increase in plasm protein levels, the odds ratios (ORs) for DR varied from 0.51 (95% CI: 0.36-0.73; P=2.22×10-5) for tubulin polymerization-promoting protein family member 3 (TPPP3) to 2.02 (95% CI: 1.44-2.83; P=5.01×10-5) for olfactomedin like 3 (OLFML3). Bidirectional MR indicated there was no reverse causality that interfered with the results of the main MR analyses. Four proteins exhibited strong co-localization evidence (PH4 ≥0.8): cytoplasmic tRNA synthetase (WARS), acrosin binding protein(ACRBP), and intercellular adhesion molecule 1 (ICAM1) were negatively associated with DR risk, while neurogenic locus notch homolog protein 2 (NOTCH2) showed a positive association. No confounding factors were detected between pQTLs and DR according to the phenotypic scan. Drugability assessments highlighted 6 proteins already in drug development endeavor and 18 novel drug targets, with metalloproteinase inhibitor 3 (TIMP) currently in phase I clinical trials for DR. GO analysis identified 18 of 24 plasma proteins enriching 22 pathways related to cell differentiation and proliferation regulation.
Conclusions:Twenty-four promising drug targets for DR were identified, including four plasma proteins with particular co-localization evidence. These findings offer new insights into DR's etiology and therapeutic targeting, exemplifying the value of genomic and proteomic data in drug target discovery.
Filamin C (FLNC) is a muscle protein encoded by the FLNC gene, which plays a crucial role as a muscle actin cross-linking center in skeletal and cardiac muscles, essential for maintaining cytoskeleton stability. Dominant autosomal mutations in the FLNC gene have been linked to various types of cardiomyopathies, myofibrillar myopathies (MFMs), and distal myopathies, representing rare, slowly progressive genetic muscle disorders typically starting in middle age. Evaluation of extraocular muscle strength in patients with FLNC gene mutations is relatively limited in current literature, with no clear documentation of its association with extraocular muscle weakness. This article reports a middle-aged male patient with ocular manifestations of incomplete closure of both eyelids, the outward turning of the right eye were completely limited, and the outward and inward turning of the left eye were completely limited. Following genetic testing, the patient was found to have a missense mutation in the FLNC gene (c.7423G>A:p.Val2475Ile). The patient also exhibits systemic manifestations including facial deformity and difficulty in squatting and standing. Combined with genetic testing results, the diagnosis was determined as acquired FLNC gene mutation-induced paralytic strabismus. This case illustrates the diverse phenotypes associated with FLNC variants, highlighting a novel mutation site in FLNC myopathy and the rare presentation of extraocular muscle weakness in the patient, expanding the clinical spectrum of FLNC gene mutation-related muscle disorders. It also emphasizes the importance of assessing the functional status of extraocular muscles during the examination and monitoring of FLNC myopathies.
