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Objective:To explore the value of scenario-based learning (SBL) in humanistic education of residents during rotation in department of geriatrics.Methods:Residents who were trained in Department of Geriatrics of Peking University First Hospital from March 5, 2019 to April 6, 2020 were selected as research objects and they were randomly assigned to SBL group and traditional training (TT) group for 4 weeks of humanistic education including humanistic knowledge learning and humanistic spirit cultivation. For humanistic knowledge learning, 56 residents were taught together. For humanistic spirit cultivation, SBL training and traditional training were conducted in the two groups respectively. The SBL group trained the residents through the simulation of such 4 scenarios as daily diagnosis and treatment work, emergency and critical care, diagnosis and treatment of elderly patients with mental disorders and hospice care, while TT group adopted traditional lecturing. After 8 weeks of training, the effects of SBL on the humanistic education were evaluated through simulated doctor-patient consultation scenarios. SPSS 22.0 was used for t test and Mann-Whitney U test. Results:A total of 56 residents participated in the training and complete the assessment. There were no significant differences in gender, age and duration of standardized training, respectively. However, the SEGUE scores of doctor-patient communication ability in SBL group were significantly superior to those of the TT group[(115.80±5.46) points vs. (109.71 ± 5.82), P<0.001]. Further analysis showed that among the 25 items of SEGUE scale, there were significant difference in the scores of 10 items (3rd, 6th, 8th, 12th, 14th, 15th, 18th, 19th, 22nd, 24th) between the two groups ( P<0.05). Conclusion:In humanistic education, SBL plays an important role in improving humanistic qualities of rotation residents in department of geriatrics, which is deserved to promote.
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Objective:To explore the application research of continuity nursing based on the interactive reaching standard theory after heart transplantation.Methods:The clinical data of 104 patients after heart transplantation in Nanjing Hospital Affiliated to Nanjing Medical University (Nanjing First Hospital) from June 2012 to June 2020 were collected for retrospective study. According to the file order, they were divided into the control group and the experimental group with 52 cases in each group. The control group took regular nursing care, and the experimental group took continuation nursing based on the interactive standard theory on the basis of the control group. The intervention continued for 24 weeks. The compliance behavior, psychological state and other indexes were compared between two groups.Results:The scove of Positive and Negative Affect Scale: after 12 weeks and 24 weeks of nursing, the experimental group′s positive emotion scores (27.71 ± 4.42, 35.11 ± 4.19) were higher than those of the control group (24.45 ± 4.03, 28.87 ± 4.36). The negative emotional scores (24.52 ± 3.71, 16.66 ± 2.28) were lower than those of the control group (28.84 ± 4.14, 23.31 ± 3.46), the differences were statistically significant ( t=5.60, 11.57, P<0.05). After 12-week and 24-week nursing, the experimental group′s health knowledge level score (44.12 ± 4.43, 53.64 ± 4.55) , self-care skills score(35.35 ± 4.01, 44.78 ± 4.22) , self-responsibility score (21.15 ± 2.38, 26.11 ± 1.44) , and self-concept score (18.56 ± 6.25, 23.58 ± 2.58) were higher than the control group (37.78 ± 4.52 and 45.56 ± 5.13, 31.11 ± 3.64 and 36.65 ± 3.91, 18.82 ± 2.46 and 22.35 ± 1.29, 15.96 ± 4.10 and 18.12 ± 3.10), the differences were statistically significant ( t values were 2.51-14.03, P<0.05). Conclusions:Continuing care led by the interactive standard theory can improve the health literacy of patients after heart transplantation, relieve negative emotions, promote post-traumatic growth, enhance self-management capabilities, establish compliance behaviors, and improve heart function.
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With the emergence of new respiratory virus, it is more apparent for the vulnerability of population to respiratory viral infection.Non-pharmaceutical interventions (NPIs) for respiratory virus infection have become the main way to prevent corona virus disease 2019.Some studies had proven its effectiveness.In addition, the NPIs also significantly reduced the incidence and hospitalization rate of other respiratory disease in children.NPIs for respiratory virus infection in children have its particularity and challenge.In daily life, it is important to guide children how to do the NPIs, so as to protect susceptible children and reduce the disease burden in children′s health system.Therefore, the aerosol transmission, the specificity of the NPIs in children, and the impact on childhood respiratory diseases are described in this article, to improve the prevention of common respiratory diseases in children.
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Objective:To investigate the clinical features of IgD multiple myeloma (MM) and the effect and prognosis of daratumumab-based combination therapy.Methods:The clinicopathological data of a IgD MM patient with disease progression and extramedullary infiltration treated with daratumumab in the Affiliated Hospital of Qingdao University in December 2019 were retrospectively analyzed.Results:The 74-year-old woman was diagnosed as IgD MM by bone marrow aspiration and immunofixation electrophoresis. The patient was given VD (bortezomib, dexamethasone), RD (lenalidomide, dexamethasone) and ID (ixazomib, dexamethasone) regimens. In June 2020, the patient developed multiple subcutaneous nodules, and she was assessed as progressive disease with extensive extramedullary infiltration. After treated with daratumumab-PAD (liposomal doxorubicin, bortezomib, dexamethasone) regimen, the patient's subcutaneous nodules were significantly reduced and partially disappeared, and the general condition was significantly improved. But the patient was in a cachexia state and finally died of the irregular treatment and disease progression.Conclusions:IgD MM has a low incidence and a short survival period, and there is no uniform standard treatment. The early application of daratumumab combined with proteasome inhibitors, immunomodulators, cytotoxic drugs and hematopoietic stem cell transplantation may improve the overall survival of patients.
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Objective:To compare the actual situation and measurement data of human resources deployment in public general hospitals in Pudong New Area, so as to provide a data basis for further optimizing the human resources deployment plan.Methods:The Pudong New Area Health Statistical Information System was used to collect the staffing information and business data of 9 public general hospitals in Pudong New Area, Shanghai in 2019. On such basis, the numbers of officially budgeted positions and actual positions were calculated. Descriptive analyses of the data were performed to compare the theoretical and actual quantities by paired t-test and Wilcoxn signed-rank sum test. Results:The actual number of officially budgeted positions of the 9 hospitals was less than the theoretical number( Z=-2.55, P=0.011), while the actual number of positions was less than that of theoretical number( t=3.36, P=0.010). The proportion of the officially budgeted position shortage at tertiary hospitals(72.77%)was higher than that of secondary hospitals(36.94%). The proportion of position shortage at tertiary hospitals(16.14%)was less than that at secondary hospitals(38.78%). Conclusions:Area-owned general hospitals are in shortage of human resources, while secondary and tertiary hospitals have different needs for human resources. The actual situation of a hospital should be comprehensively considered to develop an optimal deployment plan for human resources.
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The cell cycle inhibitor P21 has been implicated in cell senescence and plays an important role in the injury-repair process following lung injury. Pulmonary fibrosis (PF) is a fibrotic lung disorder characterized by cell senescence in lung alveolar epithelial cells. In this study, we report that P21 expression was increased in alveolar epithelial type 2 cells (AEC2s) in a time-dependent manner following multiple bleomycin-induced PF. Repeated injury of AEC2s resulted in telomere shortening and triggered P21-dependent cell senescence. AEC2s with elevated expression of P21 lost their self-renewal and differentiation abilities. In particular, elevated P21 not only induced cell cycle arrest in AEC2s but also bound to P300 and β-catenin and inhibited AEC2 differentiation by disturbing the P300-β-catenin interaction. Meanwhile, senescent AEC2s triggered myofibroblast activation by releasing profibrotic cytokines. Knockdown of P21 restored AEC2-mediated lung alveolar regeneration in mice with chronic PF. The results of our study reveal a mechanism of P21-mediated lung regeneration failure during PF development, which suggests a potential strategy for the treatment of fibrotic lung diseases.
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OBJECTIVE：To investigate the clini cal features of thrombocytopenia induced by antidepressants ，and to provide reference for the rational use of clinical drugs. METHODS ：Retrieved from CNKI ，Wanfang database ，VIP，PubMed and Web of Science，during Jan. 1st in 1985 to Aug. 31st in 2020，case reports about antidepressants-induced thrombocytopenia was collected and analyzed descriptively in terms of demographic characteristics ，medication，clinical manifestations ，treatment and outcome. RESULTS：A total of 17 literatures were retrieved ，and 19 patients were included ，involving 10 male and 9 female，aged from 5 to 95 years old ，with an average of （48±24）years old. Nine kinds of drugs were involved ，including 4 cases of escitalopram ，3 cases of citalopram ，3 cases of fluoxetine ，3 cases of mirtazapine ，2 cases of amitriptyline ，1 case of sertraline ，1 case of paroxetine，1 case of mianserin and 1 case of imipramine. There were 9 cases of single drug and 10 cases of drug combination. All 19 patients suffered from thrombocytopenia at 3 d-10 years after medication ，14 of them had hemorrhage tendency. Main clinical manifestations included mucocutaneous hemorrhage ，gingival bleeding ，black stool ，hematochezia，vaginal bleeding ，ocular hemorrhage，alveolar hemorrhage. No bleeding was found in 5 cases. After drug withdrawal/changing drugs and other symptomatic treatment， platelet count of 19 patients recovered to normal ， and bleeding symptoms disappeared. CONCLUSIONS ： Thrombocytopenia caused by antidepressants has no obvious clinical features and is not easy to be found ，but it may lead to severe； bleeding symptoms if it is not found in time. The changes of platelet count should be closely monitored in clinical application of such drugs to ensure the safety of drug use.
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Objective:To investigate the effect of lithium chloride (LiCl) on the gap junctional intercellular communication (GJIC) in human Tenon capsule fibroblasts (HTFs) and its underlying mechanism.Methods:The Tenon capsule tissue of a patient who underwent strabismus surgery in Dezhou People's Hospital in April 2019 was collected and cut into tissue blocks of dimensions 1 mm×1 mm×1 mm.Primary culture and subculture were carried out, and the 4th-generation HTFs were taken for experiment.HTFs were divided into the control group and LiCl treatment group and were cultured with cell medium without or with 80 mmol/L LiCl for another 48 hours according to grouping.The cell scratch and dye labeling technique were used to label the coupling index and evaluate the GJIC function.The expression and localization of Cx43 in HTFs were detected by immunofluorescence staining.The expression levels of Cx43 mRNA and protein were detected by real-time fluorescence quantitative PCR and Western blot, respectively.The study protocol was approved by an Ethics Committee of Dezhou People's Hospital (No.2019-023). Written informed consent was obtained from the subject.Results:The cultured spindle-shaped HTFs grew adhering to the wall showing radial monolayer or vortexlike, and the cytoplasm was vimentin positive.Results of dye tracer experiment of cell scratch showed that the cell coupling index of LiCl treatment group was 9.04±0.53, which was significantly higher than 4.94±0.39 of the control group ( t=-18.79, P<0.01). Immunofluorescence staining showed that the Cx43 fluorescence was dotted in the cell membrane between adjacent cells in the control group, and Cx43 staining was obviously enhanced in the LiCl treatment group.The results of real-time fluorescence quantitative PCR showed that with relative expression level of Cx43 mRNA in the control group set to 1, the relative expression level of Cx43 in the LiCl treatment group was significantly increased to 1.97±0.23, showing a statistical significance between them ( t=-14.426, P<0.01). Western blot showed that the relative expression level of Cx43 protein was 0.871±0.057 in the LiCl treatment group, which was significantly higher than 0.446±0.028 in the control group ( t=-11.682, P<0.01). Conclusions:LiCl can enhance the GJIC function between HTFs by upregulating the expression levels of Cx43 mRNA and protein, suggesting that the enhanced GJIC function by LiCl may be one of the mechanisms of its inhibition on HTFs proliferation.
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Asthma is the most common chronic respiratory disease in children.Currently, asthma symptoms can be well controlled under initial treatment.For moderate and severe asthma that cannot be controlled by initial treatment, biological therapy is a new option.Among them, the anti-IgE antibody (Omalizumab) is the earliest biological agent to be marketed for the treatment of asthma, followed by a large number of novel monoclonal antibodies targeting different sites.In this paper, the immune mechanism, classification and the development history of biological therapy of asthma were summarized, and the trends of biological therapy of asthma were prospected.
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Pulmonary fibrosis (PF) is a chronic, progressive, fatal interstitial lung disease with limited available therapeutic strategies. We recently reported that the protein kinase glycogen synthase kinase-3
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OBJECTIVE：To investigate the correlation between CYP2C19 gene polymorphisms and antiplatelet reactivity of clopidogrel in Xinjiang Uygur patients with acute coronary syndrome （ACS）. METHODS ：Totally 90 Uygur patients with ACS who were admitted to the cardiovascular department of Xinjiang Kashi Second People ’s Hospital from Jan. 2018 to Jan. 2019 were selected as the study subjects. They were given anti-platelet therapy of asprin+clopidogrel ，and received the treatment continuously for one year after discharge. The platelet aggregation inhibition （DPAI）rate of the patients were determined ，and the response to clopidogrel was evaluated. PCR-fluorescence probe method was used to detect genotype of CYP2C19*2 and * 3，and PCR-direct sequencing method was used to detect genotype of * 17. Multivariate Logistic regression analysis was adopted to investigate the correlation of gene and non-gene factors with DPAI of patients. RESULTS ：Among 90 patients，there were 10 patients with clopidogrel resistance （CR）and 80 patients with non-CR. There were 58，28 and 4 patients with CYP2C19*2 G/G，G/A，A/A genotype，respectively；there were 88 and 2 patients with CYP2C19*3 G/G，G/A genotype ，respectively；there were 64 and 26 patients with CYP2C19*17 C/C，C/T genotype ，respectively；the genotype frequency of each genotype was consistent with Hardy-Weinberg equilibrium （P＞0.05）. After treatment ，DAPIs of patients with CYP2C19*2 G/A，A/A genotype were decreased significantly，while those of the patients with A/A genotype were significantly lower than patients with G/A genotype patients （P＜ 0.05）. DAPIs of patients with CYP2C19*17 C/T genotype were increased significantly ，compared with C/C genotype 2016D01C087） patients （P＜0.05）. There was no statistical significance in @fudan.edu.cn DAPIs between CYP2C19*3 G/A and A/A genotype patients （P＞0.05）. Multivariate Logistic regression analysis showed 85775264@qq.com that CYP2C19 gene pol ymorphism was independently related to DPAI in Xinjiang Uygur patients with ACS [OR ＝2.314，95％CI（1.569，3.144），P＝0.009]，while age ，gender，smoking and other non-gene factors were not related to DPAI （P＞0.05）. CONCLUSIONS ：CYP2C19 gene polymorphism is associated with antiplatelet reactivity of clopidogrel in Xinjiang Uygur patients with ACS. * 2 wild type patients may have higher DPAI ，while * 17 wild type patients may have lower DPAI.
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Objective To investigate the inhibitory effect of rapamycin,an mammalian target of rapamycin (mTOR) pathway inhibitor,on the proliferation,migration and fibrosis of human pterygium fibroblasts (PFBs).Methods Pterygium tissues were collected from patients with primary pterygium who underwent surgical excision in Shenyang Fourth People's Hospital from May to July 2015.The tissues were cultured in vitro and the PFBs were identified by anti-human vimentin immunofluorescence assay.The 3 to 5 generation cells were used for the experiments.The viability of cells treated with different concentrations of rapamycin was detected by methyl thiazolyl tetrazolium (MTT).The cells were divided into normal control group and rapamycin group,and the scratch wound healing test was used to evaluate migration of the PFBs.The expressions of MKI67,α-smooth muscle actin (α-SMA),fibronectin,caspase3,mammalian target of rapamycin (mTOR) and LC3B mRNA were detected by real-time quantitative PCR.Results The cultured cells showed morphology of long spindle and were vimentin immunopositive.The cell viability in rapamycin treated PFBs demonstrated a dose-dependent decrease.At 24 hours after culture,The cell viability in 30 μmol/L rapamycin group was (76.67±8.84)％ of that in 0 μmol/L rapamycin group (P＜0.001).The relative residual scratch width in 30 μ mol/L rapamycin group was (35.40±11.62) ％ 48 hours after scratch,which was significantly greater than (2.45±0.76) ％ in the normal control group (P＜0.05).Real-time quantitative PCR showed that the mRNA expressions of MKI67,α-SMA,fibronectin and mTOR in rapamycin group were significantly decreased when compared with those in normal control group (all at P＜0.05).The expression of LC3B mRNA in rapamycin group was significantly higher than that in normal control group (P＜0.05).The mRNA expression of caspase3 was not significantly different between the two groups (P=0.861).Conclusions Rapamycin can effectively inhibit the proliferation,migration and fibrosis of PFBs without affecting the cell survival.Detailed mechanism remains to be further studied.Rapamycin may serve as an anti-fibrosis agent to prevent the progression and recurrence of pterygium in the future.
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Data were collected from national health statistics reports and grassroots health comprehensive reform monitoring reports to survey the workload, service efficiency and regional medical coordination in community health service centers in Shanghai Pudong New Area.The efficiency of basic medical services and basic public health services in Pudong New Area increased yearly from 2010 to 2016. The improved capacity of community health service institutions included: mutual recognition of investigation with superior hospitals, the sharing of test results and test equipment in the region, and achieving remote consultation with superior hospitals. With the continuous improvement, more medical services can be provided in community health centers in Shanghai Pudong New Area, resulting in the increased workload of medical staff. The coordination of regional institutions further promotes the implementation of tiered medical service system.
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Quality control of biotech drugs has attracted increasing attentions in recent years. Deamidation reaction is one of the major concerns in quality control of biotech drugs, due to the generation of isoaspartic acid(isoAsp) . This paper describes the deamidation of asparagine(Asn) residues and its effects on the biological drugs. The detection methods currently used in China and overeas for this reaction, including pretreatment protocols and instrumental analysis were described. The identification and determination of isoaspartyl sites were also described in detail, along with the positive impact on the development of biotech drugs in China by the studies on deamidation reactions.
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Objective@#The aim of the present study was to investigate the survival rate and its prognostic factors for patients with biliary tract cancer, and then a prognostic risk prediction model was constructed to predict the survival probability of patients.@*Methods@#A total of 14 005 patients with biliary tract cancer (including gallbladder cancer, extrahepatic bile duct cancer, and ampulla of Vater cancer), who were diagnosed between 2010 and 2015 in the US National Cancer Institute Surveillance, Epidemiology, and End Results Program (SEER) were included in the development cohort. The prognostic risk factors of biliary tract cancer were investigated using multivariate Cox regression models. The predictive nomograms were then constructed to predict the overall survival probability of 1, 3, and 5 years, and the predictive discrimination and calibration ability of the nomograms were further evaluated. Meanwhile, 11 953 patients who were diagnosed during 2004 to 2009 from SEER Program were then selected to validate the external predictive accuracy of the prediction models.@*Results@#The 1, 3 and 5-year cumulative survival rates of patients with biliary tract cancer were 41.9%, 20.4% and 15.3%, respectively, in the development cohort. Age greater than 50 years, African Americans and Native Americans and Alaska Natives, higher T, N and M stage and poor histological differentiation grade were risk factors for death, while married status, Asia-Pacific Islanders, insured status and surgery on primary site were protective factors. Gender was not significantly associated with the overall survival. The C statistic of the prediction model was 0.73 (95%CI: 0.72-0.74), and the calibration curve showed that the interaction curves of predictive and actual survival rates of 1, 3 and 5 years were close to the 45 degree diagonal. Results in the validation cohort were similar with those in the construction cohort, with a C statistic of 0.70 (95%CI: 0.69-0.72), indicating high external applicability of the prediction model. Findings from gallbladder cancer, extrahepatic bile duct cancer, and ampulla of Vater cancer are in consistent with the overall biliary tract cancer.@*Conclusions@#The survival rate of patients with biliary tract cancer is relatively poor, and the survival prediction model based on prognostic factors has high prediction accuracy. In the future, this prognostic prediction model could be applied to clinical practice to guide individualized treatment for patients with biliary tract cancer.
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Objective To explore the value of liver and spleen stiffness in diagnosing esophageal and gastric varices (EGV) and predicting high risk of EGV bleeding in patients with hepatitis B virus (HBV)-related liver cirrhosis.Methods Totally 71 patients with HBV-related liver cirrhosis who had undergone endoscopy were prospectively recruited.Then acoustic radiation force imaging (ARFI) was performed.The severity of EGV was graded and ROCs were drawn on the liver shear wave velocity (LSWV) and spleen shear wave velocity (SSWV) to detect the value of liver and spleen stiffness in diagnosing EGV and predicting the high risk of EGV bleeding.Results There were significant differences of LSWV and SSWV between patients with EGV and without EGV (all P＜0.001).Taking endoscopy results as golden standards,the areas under ROC curve of LSWV and SSWV were 0.877 and 0.910 (both P＜0.001) in diagnosing esophageal varices,and the optimal cut-off values were 2.01 m/s and 2.84 m/s (sensitivity 93.5％ and 76.1％,specificity 76.0％ and 92.0％),respectively.Areas under ROC curve of LSWV and SSWV in predicting the high risk of EGV bleeding were 0.882 and 0.914 (both P＜0.001),and the optimal cut-off values were 2.27 m/s and 2.94 m/s (sensitivity 77.1％ and 85.7％,specificity 83.3％ and 91.7％),respectively.Conclusion Liver and spleen stiffness are useful in diagnosing EGV and predicting the high risk of EGV bleeding in patients with HBV-related liver cirrhosis.
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Objective To evaluate the present family doctors staffing and service capacity building in Changning under the linkage reform of contracting service and health insurance payment . Methods The staffing data of family doctors were collected from the 2013-2015 annual reports ,while the data on their qualifications ,training ,job stress and competence were collected from two follow-up investigations. These data were analyzed with descriptive statistics .Results in 2016 ,the number of family doctors totaled 27000 ,up to 2.75 doctors per 10000 people.Over 97％ of the family doctors were qualification certificated.More than half of the family doctors participated in the standardized training .68.80％ (97/141)of the family doctors complained overwork.More than 80％ of the family doctors have encountered technical problems with medical services .Conclusions The number and quality of family doctors in Changning have been greatly improved to satisfy contracting services of the residents to a minimal extent. However ,more family doctors are needed ,as they still face much work stress. The family doctors call for standardized training ,better payroll and incentive mechanism ,better career development and coordinated support mechanism ,as well as better team building for greater performance .
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Objective To evaluate the motivation effect of family doctors′ contracting service and health insurance compensation mechanism from the perspective of income change and income satisfaction of family doctors .Methods The situation about salary compensation plan reform and the change of income level and structure were learnt from interviews on the management personnel and questionnaire surveys of family doctors in 2013 and 2016 .The data were subject to descriptive statistics .Results The proportion of family doctors earning between 8000 and 10000 yuan in 2016 rose to 67.16％ (90/134 ) from 18.18％ (26/143 ) in 2013.11.72％ (15/128 ) of family doctors′contracting service fee amounted to over 50％ of their income. The number of family doctors who were dissatisfied with their income has fallen by 28.52％ .There were still 51.90％ (68/131)of the family doctors who were not satisfied with their income and 24.64％ (34/138)of them held the incentives of performance appraisal as a failure .Conclusions The income of family doctors has been greatly increased in the last three years.Contracting service fee plays a key role in motivating these doctors , but three risks also need to be prevented in the process of further reform .
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Objective Under the linkage reform of family doctor service and medical insurance payment ,to study the family doctors′ career cognitive and expectations in order to improve the endogenous power of the family doctor system development ,and push forward the reform with sustainable effects .Methods All the family doctors in Changning were surveyed. There were 154 family doctors surveyed in the first phase of 2013 ,and 143 in the second phase of 2016 .The data were subject to descriptive statistics .Results About 80％ of the family doctors had a clear understanding of the family doctor system in 2016 ,with the proportion of family doctors clearly understanding their duties risen from 55.26％ (84/152)in 2013 to 61.27％ (87/142)in 2016 .Self-assessment of their work value and professional reputation were more positive significantly .70％ of them believed their social status as above average. The proportion of family doctors who were very confident/confident" in the development of community health services and family doctor system increased from 31.72％ (46/145) to 47.20％ (59/125)and from 31.72％ (46/145)to 52.42％ (65/124)respectively .Conclusions The occupational cognition and career expectations of family doctors in Changning district have been significantly improved ,which can guide their behavior towards reform objectives and propel the family doctor system progress smoothly .
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Objective To determine the spectrum of conjunctival flora and the antibiotic susceptibility profiles of patients scheduled for penetrating intraocular surgeries.Methods A prospective case control study was performed.A total of 192 patients (192 eyes) scheduled for penetrating intraocular surgeries at the Fourth People's Hospital of Shenyang from February to August 2015 were enrolled.Samples from the conjunctival sac were collected before instillation of any ophthalmic solutions for both aerobic and anaerobic culture.The positive rate and bacterial spectrum were observed.Bacterial isolates were tested for antibiotic susceptibility to 7 commonly used ophthalmic antibiotics using automated drug resistance analyzing system.The research was approved by the Ethics Committee of the Fourth People's Hospital of Shenyang.Results Totally 91 strains were collected from 81 conjunctival samples during aerobic culture,the positive rate was 42.19％.Staphylococcus epidermidis was the most common microorganism (64.84％),followed by Staphylococcus lentus (7.69％) and Staphylococcus aureus (3.30％).Coagulatase negtive Staphylococcus (CNS) accounted for 80.22％ of the positively cultured aerobes.For anaerobic culture,a total of 28 strains were isolated from 28 conjunctival samples,the positive rate was 14.58％ Propionibacterium acnes was the predominant species (71.43％),followed by Finegoldia magna (10.71％).Majority of the CNS were sensitive to gentamycin and vancomycin,with resistance rates lower than 10％,but their resistance rate to erythromycin and ceftazidime was 87.67％ and 63.01％,respectively.Resistance rate of these CNS to levofloxacin,ciprofloxacin,and moxifloxacin was 42.47％,39.73％ and 17.81％,respectively.Multidrug resistance to at least 3 antibiotic classes was present in 38.36％ of the CNS.Conclusions Bacteria in the conjunctiva sac of preoperative patients are resistant to various ophthalmic antibiotics.To follow-up the bacterial distribution and antibiotic resistance is great meaningful in the prophylactic and treatment in ocular surgery-related infections.