[A multicenter survey of antibiotic use in very and extremely low birth weight infants in Hunan Province].

OBJECTIVE: To investigate the current status of antibiotic use for very and extremely low birth weight (VLBW/ELBW) infants in neonatal intensive care units (NICUs) of Hunan Province. METHODS: The use of antibiotics was investigated in multiple level 3 NICUs of Hunan Province for VLBW and ELBW infants born between January, 2017 and December, 2017. RESULTS: The clinical data of 1 442 VLBW/ELBW infants were collected from 24 NICUs in 2017. The median antibiotic use duration was 17 days (range: 0-86 days), accounting for 53.0% of the total length of hospital stay. The highest duration of antibiotic use was up to 91.4% of the total length of hospital stay, with the lowest at 14.6%. In 16 out of 24 NICUs, the antibiotic use duration was accounted for more than 50.0% of the hospitalization days. There were 113 cases with positive bacterial culture grown in blood or cerebrospinal fluid, making the positive rate of overall bacterial culture as 7.84%. The positive rate of bacterial culture in different NICUs was significantly different from 0% to 14.9%. The common isolated bacterial pathogens Klebsiella pneumoniae was 29 cases (25.7%); Escherichia coli 12 cases (10.6%); Staphylococcus aureus 3 cases (2.7%). The most commonly used antibiotics were third-generation of cephalosporins, accounting for 41.00% of the total antibiotics, followed by penicillins, accounting for 32.10%, and followed by carbapenems, accounting for 13.15%. The proportion of antibiotic use time was negatively correlated with birth weight Z-score and the change in weight Z-score between birth and hospital discharge (rs=-0.095, -0.151 respectively, P<0.01), positively correlated with death/withdrawal of care (rs=0.196, P<0.01). CONCLUSIONS: Antibiotics used for VLBW/ELBW infants in NICUs of Hunan Province are obviously prolonged in many NICUs. The proportion of routine use of third-generation of cephalosporins and carbapenems antibiotics is high among the NICUs.

Veronicastrum axillare Alleviates Ethanol-Induced Injury on Gastric Epithelial Cells via Downregulation of the NF-kB Signaling Pathway.

We used human gastric epithelial cells (GES-1) line in an ethanol-induced cell damage model to study the protective effect of Veronicastrum axillare and its modulation to NF-κB signal pathway. The goal was to probe the molecular mechanism of V. axillare decoction in the prevention of gastric ulcer and therefore provide guidance in the clinical application of V. axillare on treating injuries from chronic nephritis, pleural effusion, gastric ulcer, and other ailments. The effects of V. axillare-loaded serums on cell viability were detected by MTT assays. Enzyme-linked immunosorbent assay (ELISA) and Real-Time PCR methods were used to analyze the protein and mRNA expression of TNF-α, NF-κB, IκBα, and IKKß. The results showed that V. axillare-loaded serum partially reversed the damaging effects of ethanol and NF-κB activator (phorbol-12-myristate-13-acetate: PMA) and increased cell viability. The protein and mRNA expressions of TNF-α, NF-κB, IκBα, and IKKß were significantly upregulated by ethanol and PMA while they were downregulated by V. axillare-loaded serum. In summary, V. axillare-loaded serum has significantly protective effect on GES-1 against ethanol-induced injury. The protective effect was likely linked to downregulation of TNF-α based NF-κB signal pathway.

[Impact factors analysis of standardized perioperative antibiotic application on nosocomial infection and drug-resistance bacteria].

OBJECTIVE: To investigate the impact factors and clinical significance of standardized perioperative antibiotic application on nosocomial infection and drug-resistant bacteria strains in eye hospital. METHODS: It was a retrospective series case study. The inpatients underwent ophthalmologic operation of one year before standardized application (from Sep. 2009 to Aug. 2010) and one year after standardized application (from Sep. 2010 to Aug. 2011) in Tianjin Eye Hospital were selected and the incidence rate of nosocomial infection and types of drug-resistant strains in these two years were analyzed. RESULTS: From Sep. 2009 to Aug. 2010, the prophylactic antibiotics application rate for type I incisional surgeries was 80.29% (12937/16 111), the nosocomial infection rate was 0.011% (2/17 563). From Sep. 2010 to Aug. 2011, the same values were 44.50% (7968/17 905) and 0.005% (1/19 441). There was a significant decrease of prophylactic antibiotics application comparing these two years (χ(2) = 4587.78, P < 0.05). However, there was no significant difference in nosocomial infection rate (χ(2) = 0.44, P > 0.05). Average antibiotics application rate for inpatient (type I-IV incisional surgeries) was 76.69% (13 469/17 563) from Sep. 2009 to Aug. 2010, and 49.40% (9604/19 441) from Sep. 2010 to Aug. 2011. There was a significant decrease over these two years (χ(2) = 2927.19, P < 0.05). The results of isolation and cultivation of bacteria in these two years showed that staphylococcus epidermidis predominated in gram-positive bacteria, pseudomonas aeruginosa predominated in gram-negative bacteria. Drug resistance rate of staphylococcus was 42.86% (33/77) from Sep. 2009 to Aug. 2010 and 39.19% (39/74) from Sep. 2010 to Aug. 2011. Drug resistance rate of pseudomonas aeruginosa was 2/11 from Sep. 2009 to Aug. 2010 and 2/13 from Sep. 2010 to Aug. 2011. There were no significant differences in drug resistance rate of staphylococcus and pseudomonas aeruginosa between these two years (χ(2) = 0.09, P > 0.05, χ(2) = 0.03, P > 0.05). CONCLUSIONS: By standardizing the perioperative antibiotics application in eye hospital, the rate of systemic administration of antibiotics declined gradually. The Choices and the administrative mode of antibiotics were more rational than before. In the meanwhile, the rate of nosocomial infection and drug-resistance did not increase. Therefore, avoiding the drug abuse ensured the medical safety, which was worthy of further study.

[Characters of multifocal electroretinogram in different grades of diabetic macular edema].

OBJECTIVE: To investigate the characters of multifocal electroretinogram (mfERG) in different grades of diabetic macular edema defined by optical coherence tomography (OCT). METHODS: MfERG and OCT were performed in 57 eyes of diabetic macular edema (DME) patients and 35 eyes of the control group. According to the macular thickness measured by OCT, eyes with DME were divided into three groups: mild, moderate and severe DMEs. RESULTS: In mild DME, the response densities of N(1) were attenuated in ring 4[(14.67 ± 4.91) nV×deg(-2)] to ring 5 [(11.65 ± 3.89) nV×deg(-2)] respectively (t = 2.179, 2.529; P < 0.05). The latencies of P(1) was prolonged significantly in ring 3 [(40.61 ± 4.10) ms] (t = -2.133, P < 0.05). In moderate DME, the response densities of P(1) and N(1) were attenuated in ring 1 [(149.50 ± 29.01) nV×deg(-2)], ring 2 [(59.33 ± 25.96) nV×deg(-2)], ring 3 [(41.83 ± 9.78) nV×deg(-2)], and ring 5 [(22.00 ± 5.52) nV×deg(-2)] respectively (t = 3.610, 2.168, 2.627, 3.445; P < 0.05). The latencies of P(1) and N(1) were prolonged significantly in ring 3 [(42.86 ± 4.72) ms], ring 4 [(44.33 ± 5.56) ms], ring 5 [(46.31 ± 4.72) ms] (t = -3.150, -3.210, -3.968; P < 0.05) and ring 3 [(23.05 ± 3.06) ms], ring 4 [(22.41 ± 3.36) ms] (t = -2.845, -2.098; P < 0.05) respectively. In severe DME. The response densities of P(1) and N(1) were attenuated in ring 1 [(110.00 ± 20.68) nV×deg(-2)], ring 2 [(62.40 ± 27.90) nV×deg(-2)], ring 3[(39.20 ± 19.65) nV×deg(-2)], ring 5 [(21.60 ± 11.12) nV×deg(-2)] (t = 7.135, 1.782, 2.214, 2.609; P < 0.05) and ring 1 [(41.63 ± 39.17) nV×deg(-2)], ring 3 [(16.63 ± 5.81) nV×deg(-2)], ring 4 [(11.20 ± 7.42) nV×deg(-2)], ring 5 [(9.05 ± 4.63) nV×deg(-2)] (t = 2.714, 2.282, 2.736, 2.858; P < 0.05) respectively. The latencies of P(1) and N(1) were prolonged significantly in ring 1 [(35.12 ± 8.44) ms], ring 3 [(40.44 ± 2.10) ms], ring 4 [(42.80 ± 3.74) ms] (t = 3.426, -2.710, -3.120; P < 0.05) and ring 4 [(23.36 ± 4.05) ms] (t = -2.572; P < 0.05) respectively. CONCLUSION: As the progress of DME, the thickness of macular fovea had significant correlation with responses of multifocal electroretinogram in patients with moderate or severe DME. MfERG combined with OCT can evaluate the changes of morphology and local retinal function in macula area objectively and quantitatively.

Retinal function and morphology of severe non-proliferative diabetic retinopathy before and after retinal photocoagulation.

PURPOSE: The purpose of this project was to investigate the changes in macular function and macular morphology of severe non-proliferative diabetic retinopathy (NPDR), due to photocoagulation, using the multifocal electroretinogram (mfERG) and optical coherence tomography (OCT). METHODS: Thirty-five volunteers were in the control group, with one eye per person examined with the mfERG. Both the mfERG and OCT were conducted on 30 patients with diabetes who had severe NPDR before, and two, seven and 14 days after, treatment with photocoagulation. RESULTS: Compared with the control group, the P1 and N1 response densities in the patients with NPDR appeared to decrease significantly at rings 2-3 and rings 3-4, respectively, whereas no difference was seen in the implicit times. At two days after photocoagulation, the P1 and N1 response densities decreased significantly in ring 1 and they were still lower than the pre-photocoagulation values at 14 days after photocoagulation. In addition, no change was found in the implicit times before and after photocoagulation. There was no obvious difference in the macular thickness after treatment. At two days after treatment, the P1 response density in ring 1 negatively correlated with the corresponding macular thickness. CONCLUSION: The para-macular function was significantly impaired in those patients with severe NPDR and photocoagulation reduced the central macular function. Even after 14 days, the central macular function had not returned to pre-photocoagulation levels.

Effect of CO(2) laser sclerectomy with iridectomy on ocular hypertension in rabbits.

AIM: To evaluate the efficiency and safety of an optimized CO(2) Laser glaucoma surgery system for laser sclerectomy with iridectomy. METHODS: Rabbit trials were performed to evaluate the efficiency and safety. RESULTS: IOP was significantly decreased in laser group compared with trabeculectomy group(P<0.05) from 7(th) postoperative day to 60(th) day. Compared with trabeculectomy group, histopathology studies confirmed fewer complications and better effects were found in laser group. CONCLUSION: CO(2) laser sclerectomy with iridectomy is effective and safe in terms of IOP lowering.

F-heparin modified intraocular lenses in Rhesus monkeys.

AIM: In order to improve the biocompatibility of intraocular lenses (IOL), the polymethylmethacrylate (PMMA) IOL was modified with F-heparin. METHODS: The PMMA IOL was modified with F ions and heparin by the technique of ion beam combined with low temperature and low pressure plasma. The monkeys (20 eyes) with cataract partly were randomly classified into 2 groups and implanted with PMMA IOL and modified IOL respectively for 180 days. All of the eyes were examined by slit-lamp microscope at postoperative 15, 30, 60, 90, 180 days. The extracted IOL was analyzed with computer image analysis, light microscope (LM) and scanning electron microscope (SEM) at postoperative 180 days. RESULTS: The early inflammatory reactions postoperatively include anterior chamber exudation and aqueous cell count. The modified IOL group showed less than the non-modified IOL group. The late foreign body cell reaction that adhered to the surface of non-modified IOL was more predominant. The morphologic and pathological changes of posterior capsule opacification (PCO) in monkeys' eyes included fibrosis-type, pearl-type and soemmerring's ring. There was a significant difference between the two groups. CONCLUSION: F-heparin modified IOL has good uveal and capsular biocompatibility.