近视遗传吗

一般而言,近视可分为单纯性近视和高度近视两类。单纯性近视是指屈光度在600度以下者,有的伴有散光,但眼部无其他器质性病变,配戴合适的眼镜可以将视力矫正。青少年学生近视大多属于此类。高度近视往往在人的儿童时期或青少年时期发病,病情发展较快,屈光度一般在600度以上,眼底或眼睛其他部位容易产生病变,即使戴上眼镜也很难把视力     

探索角膜塑形镜对青少年近视度数增长的抑制作用

目的:观察角膜塑形镜在抑制青少年近视度数增长中的作用。方法:随机抽取2011年8月到2012年10月在我院眼科门诊及欧普康视配镜中心(A组)配框架眼镜和(B组)佩戴角膜塑形镜的青少年各21名,年龄8¹4岁,近视度数-1.50D14岁,近视度数-1.50D^-4.00D,散光度<-1.50D,对比其戴镜前后屈光度的变化。结果:1年以后A组比B组屈光度进展明显,经t检验,P<0.05差异显著,有统计学意义。结论:角膜塑形镜对青少年近视度数增长有明显的抑制作用。     

青少年护眼二注意

由于彩电、电脑等电器的日渐普及,患上近视的青少年越来越多。专家提醒,在治疗和防治青少年近视上,应注意以下三点:一不宜戴隐形眼镜刚上小学三年级的毛毛一个假期下来患了近视,跟着母亲到医院查视力,医生建议配框架眼镜。但毛毛觉得框架眼镜“不美”,希望配一副隐形眼镜。但在听了医师的建议后,最终断了这个念头。医师告诉他,隐形眼镜虽有不少优点,但不是人人都可以配戴。处于生长发育期的孩子,由于眼镜屈光度变化较大,就不应该配戴。即使对成年人,配戴隐形眼镜也有一定要求。配戴者必须在仔细检查眼睛,正确验光,听取医生意见后,再做决定。…     

硬性透氧性角膜塑形镜矫正中、低度青少年近视的临床疗效观察

目的:观察硬性透氧性角膜塑形镜矫正中、低度青少年近视的临床效果.方法:选取2012年6月至2013年6月在我院就诊患者62人,共116只眼,年龄8~16岁,平均12.32±3.25岁,性别不限;等效球镜度数-1.00~-6.00D,顺规散光-1.75D,角膜曲率范围在37.0-52.0D,配戴夜戴型硬性透氧性角膜塑形镜,戴镜时间8~10h,并按照近视度数分为低度近视组和中度近视组,观察戴镜后第1d、1周、2周、1月、3月、6月后患者视力、屈光度、角膜曲率变化情况并进行比较.结果:所有戴镜者白天视力都基本恢复正常(视力达1.0),其中低度近视组在戴镜后2周、中度近视组在戴镜后1个月视力恢复最佳并稳定;所有患者角膜曲率都降低,并在戴镜后1个月稳定,结论:硬性透氧性角膜塑形镜是矫正青少年中、低度近视的有效方法.     

多焦点眼镜与青少年近视防治

近年来,关于各种多焦眼镜延缓青少年近视进展的报道逐渐增多,观点也各有所见.本文主要就多焦点眼镜的类型、应用于近视控制的研究进展、及其作用机制,以及调节在近视中的作用作一综述.     

德国倡导科学用眼少年近视少

德国,作为医疗大国,青少年的近视率不足15%,这必须归功于德国青少年眼睛保护协会和教育部门科学和到位的预防工作。首先,他们成立了专门防治近视眼的机构,定期检查学生的视力,建立视力档案,一发现某学生出现了视力降低的情况,就及时进行检查矫正。其次,近视150度以上要戴眼镜。协会认为,目前配戴合适的眼镜是矫正真性近视的主要方法。很多父母不希望孩子戴眼镜,结果导致他们总眯眼看东西,反而加深了近视度数。所以,如果孩子近视在150度以上,就要考虑戴足度眼镜。预防胜过治疗德国青少年眼睛保护协会的提醒:1分的预防胜过10分的治疗。多吃明…     

LASEK治疗中、高度近视临床分析

目的:探讨应用LASEK治疗中、高度近视疗效。方法:激光角膜上皮瓣下磨镶术(lsaer epithelid keretmileusis,LASEK)原理是通过在角膜上皮分离出一个角膜瓣,然后用激光进行切削,最后角膜上皮瓣复位,并配戴角膜接触镜3d。本文对在我院接受LASEK治疗的中、高度近视患者21例(42眼)进行随访,年龄22.3±4.0岁,平均术前等球镜为-8.57D±2.15D(-5.00D~-11.0D),平均角膜厚度496μm(462~530μm),平均随访时间6.5月;术后常规观察视力、屈光度、角膜混浊程度、眼压、角膜地形图等情况。结果:1.术后角膜上皮混浊haze采用Fantes标准分级,21例中19例术后3个月时角膜上皮下混浊为0级,2例术后3个月时角膜上皮下混浊为0.5级,但无屈光回退。2.术后屈光度及裸眼视力均在6个月内趋于稳定,术后6个月裸眼视力达到和超过矫正视力的20例,占总例数的95.2%。1例比术前最佳矫正视力下降二行,占总例数的4.8%。3.术后屈光状态:术后10d时平均屈光度为 0.52±0.87D,术后3个月为 0.37±1.21D,术后6个月为 0.12±0.87D者20例,占95.2%。4.本组观察:角膜上皮瓣的厚度有差异,上皮瓣的厚薄与是否配戴接触镜有关,与配戴接触镜时间长短有关,配戴10年以上接触镜者角膜上皮明显变薄。结论:LASEK治疗中、高度近视疗效确切、安全。高度近视术后haze发病率低,无明显屈光回退发生,本组病例较少,有待于更多样本、更长时间临床观察和随访。     

人文关怀教育对实习护生关怀能力的影响研究

目的:探讨人文关怀教育对实习护生关怀能力的影响.方法:40名本科护理实习学生随机均分为实验组和对照组.实验组每周采用自传体记忆、患者病痛叙事、反思等叙事教育方法进行一次人文关怀辅导课.对照组每周进行一次医院组织的常规人文关怀讲座.结果:辅导前,两组学生关怀能力总分相仿[(127.96±24.04)分VS.(128.05±22.17)分](P0.05).实习2个月后,实验组护生关怀能力和共情能力测评得分明显高于对照组[(171.92±16.69)分VS.(139.1±21.71)分和(63.44±11.07)分VS.(55.82±12.11)分](P0.05).结论:人文关怀教育能有效提高实习护生的关怀能力.     

近视与周边视网膜屈光状态研究进展

近视是目前全球发生率最高的屈光不正,已成为全球性的公共卫生和社会问题,世界卫生组织已将近视防治列入全球防盲计划.以往对近视眼病因的研究大部分仅集中在黄斑中心凹处,近年来,越来越多学者认为仅考虑黄斑中心凹的成像质量是不全面的,周边视网膜相对中心凹一定的离焦状态也会影响近视的发生与发展.研究周边视网膜屈光还可以指导屈光不正的矫正,特别是处于近视进展期的青少年患者.     

浅析微信平台、强化实践能力相结合的翻转课堂在骨科临床实习教学中的应用价值

目的 :探究骨科临床实习教学过程中采用微信平台与强化实践能力相结合的翻转课堂的应用价值。方法 :2018年1月～2019年1月,针对我院骨科实习的学生118名,随机分为对照组(常规带教模式)与观察组(微信平台与强化实践能力相结合的翻转课堂)各59名,对比两组实习结束时的出科考试成绩与学生的满意情况。结果 :观察组模拟病例分析成绩[(41.36±2.69)分]、理论考核成绩[(46.53±2.28)分]以及总成绩[(86.61±12.65)分]均优于对照组[(36.51±3.85)分]、[(40.69±1.61)分]、[(79.51±11.28)分],P均<0.05。结论 :该教学方式运用于骨科临床实习效果显著,具有较高应用价值,值得推广。     

个体化护理在经尿道前列腺电切术全程的应用研究

目的：探讨个体化护理对经尿道前列腺电切术患者临床疗效的影响.方法：122例前列腺电切患者随机分为对照组和观察组,每组61例,对照组给予常规护理,观察组给予个体化护理.观察比较两组患者的并发症、舒适度和护理满意度和住院时间.结果：观察组患者的术后并发症较对照组减少,患者的治疗舒适度和护理满意度明显高于对照组（P＜0.05）,住院时间缩短（7.2±0.8 d VS9.9 ±1.2 d,P＜0.05）.结论：个体化护理应用于前列腺电切患者能提高护理满意度,减少术后并发症和促进术后康复,该模式值得推广.     

In Plain Sight: Reading Outcomes of Providing Eyeglasses to Disadvantaged Children

ABSTRACT

Many disadvantaged students with refractive errors, such as myopia (nearsightedness) and hyperopia (farsightedness), do not have eyeglasses, and their reduced vision may impact reading proficiency. Providing eyeglasses may increase their reading success. This article reports the findings of a study in Baltimore City in which disadvantaged second and third graders were assessed for vision problems. Of 317 students, 182 were given glasses. Those who needed glasses were given two pairs, one for home and one for school, as well as replacements if glasses were lost or broken. School staff assisted in ensuring that students wore their glasses, storing them safely, and replacing glasses when necessary. Students who received glasses improved more on Woodcock reading measures than those who never needed glasses (ES = +0.16, p < .03). The study demonstrates the potential of providing eyeglasses to disadvantaged students who need them to improve their reading performance.     

腹腔镜辅助进展期胃癌根治术的临床体会

目的：探讨进展期胃癌行腹腔镜辅助手术的安全性和可行性并评价临床近期疗效。方法：选择2011年1月至2013年6月30例进展期胃癌患者行腹腔镜辅助胃癌根治术患者（腹腔镜组）,与同期28例行传统开腹胃癌根治手术的患者（开腹组）比较两组患者的手术时间、出血量、清扫淋巴结数目、术后胃肠道功能恢复情况、并发症发生率、住院平均时间等情况。结果：腹腔镜组手术时间长于开腹组,两组间差异有统计学意义（t=4.635,P〈0.05）;腹腔镜组术中出血量、肛门首次排气时间、术后住院时间明显优于开腹组;腹腔镜组淋巴结清扫数量为（25.5±8.5）枚,开腹组为（20.6±7.8）枚,两组比较差异无统计学意义（P〉0.05）。腹腔镜组术后并发症发生率（6.7%）及死亡率（0）均低于开腹组,但差异无统计学意义。患者随访时间6个月,两组患者总体生存率差异无统计学意义（P〉0.05）。结论：腹腔镜辅助进展期胃癌根治术不仅创伤小,恢复快,具有安全性,而且能够达到与开腹手术相同的根治水平,其近期生存率与传统开腹手术无差别。     

Computed tomography angiography-guided percutaneous coronary intervention in chronic total occlusion

Objective:The aim of this study is to investigate if dual-source computed tomography(DSCT) could guide the percutaneous coronary intervention(PCI) of chronic total occlusion(CTO).Methods:We enrolled patients who were confirmed to have at least one native coronary artery CTO by DSCT before they underwent selective PCI in the period from December 2007 to October 2008.A CTO was defined as an obstruction of a native coronary artery with no luminal continuity.The CT-guided PCI procedure involved placing CT and fluoroscopic images side-by-side on the screen.DSCT images were analyzed for location,segment,plaque characteristics,calcification,and proximal lumen diameter of the CTO before PCI.The guidewire was advanced and manipulated under CT guidance.The PCI was carried out and the results were compared.Results:Seventy-four CTOs were assessed.PCI was successful in 57 cases of CTOs(77.0%).According to the results,CTOs were divided into two groups:successful-PCI and failed-PCI.All coronary artery paths of CTOs were clearly recognized by DSCT.In the successful-PCI group,soft plaques were detected much more often than those in the failed-PCI group,but fibrous and calcified plaques were seen more often in the failed-PCI group.Calcification severity in CTO segments showed a significant difference between the groups(P=0.014).Calcified plaques were detected in 20(35.1%) lesions in the successful-PCI group.More than 70% of the failures were calcified plaques,of which there were two arc-calcified and one circular-calcified lesions.Occlusions were longer in the failed-PCI group than those in the successful-PCI group [(38.8±25.0) vs.(18.0±15.3) mm,respectively,P0.01].Fewer guidewires were used in the successful-PCI group compared with the failed-PCI group(1.7±1.0 vs.2.5±0.9,respectively,P0.01).The logistic regression analysis indicated that predictors of recanalization of CTOs included occlusion length(P=0.0035,risk ratio(RR)=0.93) and calcification severity(P=0.05,RR=0.27).Multi-linear trends analysis showed that the factors affecting procedural time were CTO location(P=0.0141) and occlusion length(P=0.0035).Conclusions:DSCT could delineate the path of CTOs and characterize plaques.The outcomes of PCI were related to thrombolysis in myocardial infarction(TIMI) flow grade,CTO characteristics,severity of calcified plaques,and the length of occlusive segments.Occlusion length and calcification severity were independent predictors of CTOs.Occlusion length and CTO segments could also help to estimate the duration of interventional procedures.     

ERAS在单孔法小儿疝囊高位结扎术围手术期护理中的应用

目的探讨ERAS在单孔法小儿疝囊高位结扎术围手术期护理中的临床应用价值。方法选择2017年3月至2018年3月行择期单孔法小儿疝囊高位结扎的120例患儿随机分为ERAS组(60例)和对照组(60例)进行分析对比。对照组患者采用传统的围手术期护理方法进行护理,ERAS组采用快速康复外科理念的护理方法进行干预。比较两组患儿术后麻醉苏醒的时间、切口疼痛程度、肛门排气的时间、术后并发症、住院时间、出院后满意度等,通过对比两组之间的差异来评价ERAS护理的价值。结果ERAS组患儿术后麻醉苏醒时间平均值、切口疼痛评分平均值、术后排气时间平均值均低于对照组,术后并发症发生率降低,住院时间均减少,且患儿家属对护理服务的满意度也优于对照组,差异均具有统计学意义(P<0.05)。结论在单孔法小儿疝囊高位结扎术围手术期中采用ERAS理念可以加速患儿康复,缩短住院时间,减轻患儿疼痛,减少并发症,提高患儿家属满意度及患儿的舒适度。     

新型农药康宽（氯虫苯甲酰胺）对鲤的急性毒性研究

以体长为（10.12±0.76）cm、体质量为（27.06±0.54）g的鲤鱼苗作为试验动物,在水温为（24.1±0.4）℃的条件下,采用静水试验法进行农药康宽对鲤的急性毒性研究.实验结果表明：康宽对鲤鱼幼苗24,48,72,96 h的半致死浓度分别为174.26,155.14,141.57,130.42 mg/L,安全质量浓度为13.04 mg/L.并分析了康宽对鲤鱼幼苗的致毒效应特征,评价了鲤鱼幼苗对康宽的安全质量浓度.     

Progressive collapse analysis of concrete-filled steel tubular frames with semi-rigid connections

A 9-story concrete-filled steel tubular frame model is used to analyze the response of joints due to sudden column loss. Three different models are developed and compared to study the efficiency and feasibility of simulation, which include substructure model, beam element model and solid element model. The comparison results show that the substructure model has a satisfying capability, calculation efficiency and accuracy to predict the concerned joints as well as the overall framework. Based on the substructure model and a kind of semi-rigid connection for concretefilled square hollow section steel column proposed in this paper, the nonlinear dynamic analyses are conducted by the alternate path method. It is found that the removal of the ground inner column brings high-level joint moments and comparatively low-level axial tension forces. The initial stiffness and transmitted ultimate moment of the semi-rigid connection are the main factors that influence the frame behavior, and their lower limit should be guaranteed to resist collapse. Reduced ultimate moment results in drastic displacement and axial force development, which may bring progressive collapse. The higher initial stiffness ensures that the structure has a stronger capacity to resist progressive collapse.     

粪便菌群检测在治疗小儿腹泻中的应用分析

目的：评价粪便菌群检测在治疗小儿腹泻中的临床意义.方法：通过收集宜春新建医院儿科自2013年6月至2014年1月住院治疗且好转或痊愈出院的腹泻患儿103例,随机分为对照组64例和干预组39例,对照组采用传统治疗方案进行治疗,干预组在传统治疗方案基础上根据粪便菌群检测结果补充相应的微生态制剂,分别对两组对象的住院时间及住院费用进行比较分析.结果：对照组和干预组的平均住院时间分别为5.9 ±2.1d和4.4±1.9d,平均住院费用分别为1661.03±533.17元和1171.5±555.27元,差异均有统计学意义（P＜0.05）.结论：根据粪便菌群检测结果制定小儿腹泻治疗方案进行治疗,可以缩短患儿治疗时间,降低患者治疗费用.     

Qualitative and quantitative analysis of goat ovaries,follicles and oocytes in view of in vitro production of embryos

Goat ovaries were collected from the slaughterhouse and categorized as right, left, corpus luteum （CL）-present and -absent group and evaluated on the basis of weight （g）, length （cm）, width （cm）, number of follicles, follicles aspirated and number and state ofcumulus-oocyte-complexes （COCs）. Comparatively higher weight [（0.66±0.02） vs （0.64±0.02） g], length [（1.17±0.02） vs （1.1 ±0.02） cm] and width [（0.77±0.02） vs （0.74±0.02） cm] were found in right ovaries than those of left. On the other hand significantly （P〈0.05） higher weight [（0.71±0.03） vs （0.64±0.01） g] and width [（0.76±0.03） vs （0.75±0.01） cm] were found in CL-present group than those of CL-absent group of ovaries. The left ovaries contained comparatively higher number of normal COCs [（1.06±0.09） per ovary] than fight ovaries [（1.03±0.10） per ovary] and the similar trend was found in total number of follicles [（4.51±0.25） vs （4.30±0.23） per ovary] and follicles aspirated [（2.55±0.14） vs （2.52±0.12） per ovary]. But the total COCs per ovary was almost similar in both ovaries [right and left： （1.85±0.12） and （1.85±0.11） per ovary, respectively]. Higher number of total COCs [（1.87±0.09） vs （1.76±0.16） per ovary], total number of follicles [（4.45±0.19） vs （4.16±0.37） per ovary], follicles aspirated [（2.55±0.10） vs （2.48±0.21） per ovary] and normal COCs [（1.12±0.07） vs （0.76±0.14） per ovary] were found in CL-absent group than those of CL-present group of ovaries.     

重组人脑利钠肽治疗急性心力衰竭的疗效观察

目的：探讨在监测血清脑钠肽水平下,短期使用注射用重组人脑利钠肽治疗急性心力衰竭或慢性心力衰竭急性发作的临床效果。方法：48例急性心力衰竭患者根据是否使用注射用重组人脑利钠肽分为常规组和注射用重组人脑利钠肽组,对比两组治疗的临床效果和超声心动图情况,并监测BNP水平。结果：治疗7d后,注射用重组人脑利钠肽组临床有效率明显好于常规组（81．7％vs61．6％,P〈0．05）,左室射血分数明显高于常规组（51±6）％vs（46±5）％,（P〈0．01）,且血清脑钠肽水平明显降低（498±209）pg／mL vs（642±318）pg／mL,（P〈0．01）,血清脑钠肽下降水平和左室射血分数提高水平差异有统计学意义（P〈0．05）,有效者治疗后左室射血分数提高及血清脑钠肽下降均强于无效者（P〈0．01）。结论：在血清脑钠肽指导下短期应用注射用重组人脑利钠肽有助于改善急性心力衰竭患者的临床症状和心功能。