血管性认知功能障碍患者测定可溶性CD40配体、同型半胱氨酸和内皮素-1临床意义

目的观察血管性认知功能障碍（VCI）患者血清可溶性CD40配体（sCD40L）、同型半胱氨酸（Hcy）和内皮素1（ET-1）的临床意义。方法选取2011年6月至2012年8月在我院连续住院的脑梗死患者279例,依据脑卒中后6个月的认知评定结果分为血管性痴呆（VD）组75例,血管性非痴呆认知障碍（VCIND）组123例和认知正常组（对照组）81例。观察各组血清sCD40L,ET-1、Hcy水平和简易精神状态评价量表（MMSE）评分的变化,及其与VCI严重程度的关系。结果 VD组和VCIND组的MMSE评分比对照组明显降低（P〈0.01）;sCD40L,ET-1和Hcy水平较对照组明显增高（P〈0.01）,MMSE评分（19.58±2.67）分、（25.94±1.68）分vs（28.46±1.56）分,sCD40L（7.45±2.24）μg/L、（5.98±1.94）μg/L vs（3.46±0.76）μg/L,ET-1（88.35±3.64）ng/L、（81.65±4.35）ng/L vs（65.24±5.64）ng/L,Hcy（25.67±4.25）mmol/L、（18.54±3.24）mmol/L vs（10.25±2.68）mmol/L;而VD组的增高水平较VCIND组更为明显（P〈0.01）。MMSE评分、sCD40L、ET-1和Hcy水平随着VCI严重程度的增高而增高（P〈0.05或〈0.01）。结论 sCD40L,ET-1和Hcy参与了VCI疾病的发生、发展过程,血浆sCD40L、ET-1和Hcy水平与VCI严重程度呈正相关,可以作为VCI疾病严重程度的重要指标。     

阻塞性睡眠呼吸暂停患者血清Chemerin水平与血管内皮功能的关系

目的 探讨男性阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清Chemerin水平与血管内皮功能的关系.方法 选择OSAHS患者80例和健康对照组40例,分别使用酶联免疫吸附法测定所有受试者血清Chemerin因子、内皮素1(ET-1)、血管性血友病因子(vWF)水平,应用硝酸盐还原酶法测定一氧化氮(NO)水平,同时使用多普勒彩色超声测定肱动脉内径变化率.结果 与对照组比较,OSAHS组血清Chemerin(0.51±0.09)ng/L vs(0.35±0.05)ng/L、ET-1(62.36±20.14) ng/Lvs (33.79±11.91) ng/L和vWF(30.35±12.67)μg/L vs(22.44±9.91) μg/L水平明显高于对照组(均P＜0.01).血清NO(36.33±11.89)μmol/L vs(41.19±14.56)μmol/L和肱动脉内径变化率(△D％8.95±4.15 vs 14.08±3.79)明显低于对照组(均P＜0.01).Chemerin、ET-1和vWF水平与呼吸紊乱指数(AHI)呈正相关(r =0.641、0.552和0.469,均P＜0.01),与最低血氧饱和度(LSaO2)均负相关(r =-0.551、-0.439和-0.528,均P＜0.01).Chemerin与△D％呈负相关(r=-0.496,P＜0.01).NO水平和△D％与AHI呈显著负相关(r=-0.536、-0.491,P＜0.01),与LSaO2正相关(r=0.621、0.583,P＜0.01).△D％与. AHI、MSaO2和血清Chemerin水平呈线性回归关系.结论 OSAHS患者存在着血清Chemerin升高和血管内皮功能损害,与患者严重程度和低氧密切相关;Chemerin是导致血管内皮功能损害的重要因素.     

急性脑梗死的颈动脉内中膜厚度与血清高敏C反应蛋白、纤维蛋白原和同型半胱氨酸关系

目的观察急性脑梗死的颈动脉粥样硬化与血清高敏C反应蛋白(hsCRP),纤维蛋白原(Fbg)和同型半胱氨酸(Hcy)关系。方法在我院就诊住院的急性脑梗死患者165例,和同期在我院健康体检患者20例为健康对照组。观察急性脑梗死和健康对照组的Fbg,Hcy和hsCRP水平变化,观察Fbg,Hcy和hsCRP水平与颈动脉粥样硬化及颈动脉斑块严重程度的关系。结果急性脑梗死组的hsCRP,Fbg,Hcy和颈动脉内膜-中膜厚度(IMT)水平较健康对照组明显升高,(15.8±2.94)mg/L vs(2.74±0.96)mg/L,(4.67±1.18)g/L vs(2.36±0.82)g/L,(24.3±6.83)μmol/L vs(6.83±1.83)μmol/L vs(1.37±0.32)mm vs(0.76±0.16)mm(P0.01)。急性脑梗死患者动脉粥样硬化根据IMT划分为:IMT1.0mm为26例,1.0mm≤IMT1.2mm为43例和IMT≥1.2mm为96例。随着颈动脉粥样硬化严重程度的加重,急性脑梗死患者的hsCRP,Fbg和Hcy水平出现明显升高,(7.98±1.76)mg/L vs(12.87±2.87)mg/L vs(19.28±3.13)mg/L,Fbg(2.45±0.97)g/L vs(4.58±1.04)g/L vs(5.31±1.25)g/L and Hcy(10.87±2.76)μmol/L vs(22.94±6.28)μmol/L vs(28.68±7.03)μmol/L(P0.05或0.01)。急性脑梗死组根据动脉粥样硬化斑块形成的严重程度分为Ⅰ级29例,Ⅱ级35例和Ⅲ级32例。随着急性脑梗死颈动脉斑块严重程度的增加,血清hsCRP(14.65±2.97)mg/L vs(19.43±3.26)mg/L vs(23.31±3.02)mg/L,Fbg(4.41±1.18)g/L vs(5.33±1.21)g/L vs(6.10±1.32)g/L和Hcy(22.87±5.87)μmol/L vs(28.47±6.92)μmol/L vs(34.18±7.12)μmol/L水平出现明显升高(P0.05或0.01)。结论急性脑梗死患者血清hsCRP,Fbg和Hcy水平高于健康对照组,与颈动脉粥样硬化和动脉斑块具有明显的相关性。     

冠心病患者血清氧化低密度脂蛋白、肿瘤坏死因子α与冠状动脉病变程度的相关性研究

目的 氧化低密度脂蛋白(ox-LDL)及肿瘤坏死因子α(TNF-α)在冠心病(CHD)的发生、发展过程中均发挥着重要作用,本研究旨在探讨ox-LDL、TNF-α与冠状动脉病变程度的关系.方法 170例行冠状动脉造影(CAG)患者根据造影结果分为对照组66例和(CHD)组104例.收集空腹静脉血,用酶联免疫吸附测定(ELISA)法检测ox-LDL水平,用放射免疫测定法检测TNF-α水平.CHD组患者分急性心肌梗死(AMI)、不稳定型心绞痛(UA)及稳定型心绞痛(SA)组;单支、双支及多支病变组;轻度、中度及重度狭窄组.结果 CHD组ox-LDL水平较对照组明显升高,(559.58±113.80) μg/L vs (461.01±115.91)(P＜0.01);AMI组ox-LDL水平高于UA组及SA组,(609.75±127.35) μg/L vs (543.03±92.07) μg/L,(515.07±111.81) μg/L(P＜0.01);重度狭窄组ox-LDL水平较轻度狭窄组和中度狭窄组均明显升高,(597.45±113.93) μg/L vs (522.43±75.25) μg/L,(538.84±123.64) μg/L(P＜0.01 或 ＜0.05).CHD组TNF-α水平组较对照组明显升高,(10.06±2.78) ng/L vs (8.07±4.81) ng/L(P＜0.01);AMI组、UA组TNF-α水平高于对照组,(10.68±2.45) ng/L,(9.83±2.64) ng/L vs (8.07±4.81) ng/L(P＜0.01 或＜0.05).结论 ox-LDL水平及TNF-α水平与冠心病病变严重程度呈一定相关性.     

血栓素A2、前列环素与阻塞性睡眠呼吸暂停低通气综合征及其合并高血压的相关性研究

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)及其合并高血压患者血浆血栓素B2(TXB2)、6-酮前列腺素F1α(6-Keto-PGF1α)水平的变化.方法检测OSAHS及其合并高血压患者血浆TXB2、6-Keto-PGF1α水平并与正常人进行对照,将检测结果与睡眠呼吸监测指标进行相关性分析.结果 OSAHS患者血浆TXB2及TXB2/ 6-Keto-PGF1α(T/P)比值明显高于正常对照组[(77.37±20.13) ng/L vs (47.97±12.05) ng/L,(5.47±3.83) vs (1.73±0.99)](P<0.01),6-Keto-PGF1α浓度明显低于正常对照组[(20.07±12.11) ng/L vs (31.27±9.41) ng/L](P<0.01),且OSAHS合并高血压组与单纯OSAHS组比较血浆TXB2及T/P比值比较差异有统计学意义[(141.78±21.66) ng/L vs (77.37±20.13) ng/L,(11.06±6.97) vs (5.47±3.83)](P<0.01);血浆TXB2、6-Keto-PGF1α水平与OSAHS的病情严重程度有相关性.结论 OSAHS及其合并高血压患者存在TXA2与PGI2的失衡,这种变化在OSAHS合并高血压患者中更为明显.     

贝那普利、地尔硫(艹卓)对心脏X综合征患者内皮功能的影响

目的 研究应用贝那普利、地尔硫(艹卓)对心脏X综合征(CSX)患者内皮功能的影响.方法 将40例CSX患者随机接受贝那普利(20例,贝那普利组)或地尔硫(艹卓)(20例,地尔硫(艹卓)组)治疗,并设20例健康人为对照组,比较治疗前及治疗12周后对一氧化氮(NO)、内皮素-1(ET-1)及对肱动脉内皮依赖性舒张功能的影响.结果 与正常对照组相比,CSX患者NO水平明显降低,ET-1水平明显升高,血管内皮依赖性舒张功能受损(均P＜0.01).用药后贝那普利组较用药前NO明显升高(54.15±19.48)μmol/L vs(70.25±17.46)μmol/L(P＜0.01),地尔硫(艹卓)组用药后NO明显升高(55.69±16.32)μmol/L vs(59.17±14.92)μmol/L(P＜0.05).ET-1明显降低(70.61±6.22)ng/Lvs(55.18±4.71)ng/L(P＜0.01),血管内皮依赖性舒张功能改善(4.60±2.40)%vs(10.60±2.50)%(P＜0.01),地尔硫(艹卓)组较用药前ET-1明显降低(69.37±7.85)ng/L vs(62.94±6.38)ng/L(P＜0.05),血管内皮依赖性舒张功能改善(4.70±2.30)%vs(6.40±1.90)%(P＜0.05).结论 CSX患者存在血管内皮功能障碍,贝那普利与地尔硫(艹卓)均能改善CSX患者的内皮功能,且较地尔硫(艹卓)更为有效.     

肝硬化患者血浆内皮素-1和血清转化生长因子-α、转化生长因子β1的变化及意义

目的 探讨肝硬化患者血浆内皮素-1(ET-1)和血清转化生长因子-α(TGF-α)、转化生长因子β1(TGF-β1)含量的变化及其意义.方法 应用放射免疫分析法和酶联法对66例肝硬化患者(其中30例伴腹水,36例无腹水)(肝硬化组)进行血浆ET-1和血清TGF-α、TGF-β1含量测定,并与35名健康者(健康对照组)作比较.结果 肝硬化组患者血浆ET-1含量[肝硬化无腹水组(36.2±5.0)ng/L、肝硬化伴腹水组(20.8±3.2)ng/L]显著低于健康对照组[(55.2±8.4)ng/L](P＜0.01),而TGF-α[肝硬化无腹水组(20.5±5.6)ng/L,肝硬化伴腹水组(31.2±6.7)ng/L]、TGF-β1含量[肝硬化无腹水组(44.5±12.6)ng/L,肝硬化伴腹水组(66.8±25.2)ng/L]又显著地高于健康对照组[分别为(5.2±1.8)、(33.4±12.5)ng/L](P均＜0.01),尤以肝硬化伴腹水组为甚.肝硬化组患者血浆ET-1含量与TGF-α、TGF-β1含量呈明显负相关(r值分别为-0.4782、-0.5014,P均＜0.01).结论 肝硬化患者血浆ET-1和血清TGF-α、TGF-β1含量的变化对了解病情和预后具有重要的临床价值.     

同型半胱氨酸与舒张性心力衰竭的相关性

目的 研究血浆同型半胱氨酸(Hcy)与舒张性心力衰竭(DHF)的相关性.方法 选择DHF患者70例以及同一年龄段的健康对照组70例,检测两组的Hcy、N-末端脑钠素前体(NT pro-BNP)的水平以及左心室射血分数(LVEF)的变化情况.结果 与健康对照组比较,DHF患者血浆NT pro-BNP及Hcy明显增高(1 795.02±981.65) ng/L vs (67.54±24.55) ng/L,(15.00±2.11) μmol/L vs (10.46±1.38) μmol/L(P<0.05),两组间LVEF差异无统计学意义(P>0.05);DHF患者中,随着纽约心脏协会(NYHA)心功能分级增加,血浆Hcy浓度以及NT pro-BNP水平逐渐增高(P<0.05),在NYHA心功能Ⅱ级与Ⅲ级、Ⅲ级与Ⅳ级之间比较差异均有统计学意义(P<0.05);DHF患者中,NT pro-BNP与血浆Hcy浓度呈明显正相关(r=0.936,P<0.05).结论 Hcy参与了DHF的病理生理过程,可能成为DHF的治疗靶点以及诊断标志物.     

血管紧张素受体Ⅱ拮抗剂对腹膜透析患者微炎症反应的影响

目的 观察血管紧张素Ⅱ受体拮抗剂(ARB)药物对腹膜透析惠者微炎症反应的影响.方法 选择持续不卧床腹膜透析患者43例,随机分为ARB治疗组(21例)和对照组(22例),ARB治疗组给以缬沙坦80 mg,每日1次,共16周.监测治疗前后患者炎症因子高敏C反应蛋白(hsCRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)和营养学指标的变化.结果 ARB治疗16周,与对照组比较,ARB治疗组hsCRP、IL-8、TNF-α含量明显减少(16.67±21.08)mg/L vs(5.08±3.61)mg/L,(42.56±38.49)ng/L vs(12.64±13.54)ng/L,(114.64±12.62)ng/L vs(56.87±11.80)ng/L(P＜0.05),血浆白蛋白、血红蛋白明显升高(28.6±1.2)g/L VS(38.6±0.9)g/L,(68.8±1.4)g/L vs(75.2±1.2)g/L(P＜0.01);而对照组CRP、IL-6、TNF-α含量较前升高,血浆白蛋白水平下降.治疗组与对照组比较差异有统计学意义(P＜0.05或0.01).结论 ARB治疗可以显著抑制腹膜透析患者微炎症反应、改善营养状态.     

血清同型半胱氨酸及白细胞介素-6和超敏C-反应蛋白在急性脑卒中病程中的变化及其意义

目的 观察血清同型半胱氨酸(Hcy)及白细胞介素-6(IL-6)、超敏C-反应蛋白(hs-CRP)在不同病情程度急性脑卒中(AS)患者中的差异.方法 选择AS患者126例.按临床神经功能缺损程度评分标准进行病情程度及预后分组.分别测定发病后第3、14、28天血清Hcy、IL-6、hs-CRP浓度.选择同期健康体检者108名作为对照组.结果 ①AS组血清Hcy、IL-6和hs-CRP水平明显高于健康对照组[(58.24±9.86)、(17.12±4.23)μmol/L,(59.64±13.82)、(18.46±4.62)ng/L,(19.78±6.12)、(2.28±0.82)mg/L,t值分别为2.623、2.761、3.746,P均＜0.01];②发病第3天重、中、轻型AS组血清Hcy、IL-6、hs-CRP水平均高于健康对照组(P均＜0.01),且重型组、中型组高于轻型组(P均＜0.01);发病第14天重型组与中型组高于轻型组及健康对照组(P均＜0.01);发病第28天重型组高于中、轻型组及健康对照组(P均＜0.01).③发病第28天基本治愈组与显著进步组较无变化组的血清Hcy、IL-6、hs-CRP水平明显降低[(16.12±4.74)、(18.42±5.02)、(48.69±7.89)μmol/L,(19.52±5.67)、(20.74±6.13)、(51.26±11.66)ng/L,(3.21±1.36)、(3.24±2.51)、(8.86±1.32)mg/L,P均＜0.01].结论 血清Hcy、IL-6、hs-CRP是临床评价AS严重程度和预后的重要生物学指标.     

现代残疾康复理念、政策与社区康复体系研究

本研究分析了当代残疾康复的理念和理论架构,构建了以国际公约、决议和政策、国内法律和政策以及操作性工具3个层次的康复理论体系;运用包容性发展,分析探讨了当代社区康复的体系和特点;就发展康复事业、为残疾人提供全面系统的康复服务提出相关的政策建议。     

国内外唇腭裂专科护理发展现状的文献研究及分析

目的了解和分析国内唇腭裂专科护理工作发展的现状。方法检索并分析万方医学网、中国知网、Springer Link及PubMed英文数据库近6年有关唇腭裂手术的围术期护理、患儿的喂养、手术安全管理、围术期疼痛研究以及心理护理的相关文献。结果共检索出国内文献89篇(核心期刊20篇)、国外文献22篇,其中围术期护理38篇、患儿的喂养16篇、手术安全管理10篇、围术期疼痛研究10篇、心理护理15篇。结论与国外文献相比,国内论文总结和回顾性居多,应增加研究探讨性论文,从而促进唇腭裂临床护理工作专科化的发展。     

城乡学童个性行为特征调查

目的探讨农村与城市儿童的个性行为特征。方法将97名农村学龄儿童设为农村组,97名城市学龄儿童设为城市组,采用艾森克个性问卷一儿童版和Achenbach’s 行为量表一儿童版进行评定分析。结果两组学龄儿童艾森克个性问卷各维度评分均无显著性差异（P均〉0．05）,且与全国常模相一致（P均〉0．05）;农村组男学童Achenbach’s行为量表违纪行为、攻击行为及外向型因子分均显著高于城市组,女学童退缩、社交问题因子分均显著高于城市组（P〈0．05或0．01）,其他因子分均无显著性差异（P均〉0．05）。结论农村与城市儿童个性无显著差异,而农村儿童存在较多的行为问题,可能与其所受教养和生活方式有关。     

Comparison of short-term and long-term protocols for stabilization and preservation of RNA and DNA of Leishmania, Trypanosoma, and Plasmodium

Molecular tools continue to be important in the prevention and control of parasitic diseases. However, using these techniques directly in the field remains a major challenge. Therefore, the preservation of clinical samples collected from endemic field areas for later analysis remains an important preanalytical process. This study aimed at identifying a suitable protocol for stabilization and preservation of RNA and DNA in bioclinical specimens for Trypanosoma, Leishmania, and Plasmodium research. Both spiked and unspiked blood samples were preserved in 7 protocols (different media; storage temperatures). Samples were evaluated for possible degradation of DNA and RNA along the storage duration up to the 10th week. Nucleic acid targets were assessed as follows: (i) Trypanosoma and Plasmodium RNA analysis was done using real-time nucleic acid sequence-based amplification (RT-NASBA) for 18S rRNA and for stage-specific Pfs25 mRNA, respectively; (ii) Trypanosoma DNA assessment analysis was conducted by using a conventional PCR for 18S rDNA; (iii) Leishmania RNA analysis was performed with a quantitative NASBA for 18S rRNA and Leishmania DNA assessment with an RT-PCR for 18S rDNA. Findings suggested that a newly developed L3™ buffer proved to be reliable and suitable for both short- and long-term preservation of parasite nucleic acid material. This buffer is envisaged to be suitable for utilization in field situations where resources are limited.     

Rates and risks of transmission of smallpox and mechanisms of prevention

In 1980, the World Health Organization declared smallpox eradicated from the world; the last known natural case had occurred in Somalia in 1977, and the United States had stopped routinely vaccinating its citizens in 1972. However, with increasing concerns regarding domestic and international terrorism, smallpox has resurfaced as a potential threat to global health. We review the direct and indirect modes of smallpox transmission and how patterns of transmission vary substantially, depending on the severity of circulating disease, vaccination status, environmental and socioeconomic factors, and the setting of an outbreak. We examine mechanisms for controlling outbreaks of disease and preventing further transmission in the event of an outbreak, with an emphasis on smallpox vaccination.     

History of violence and subjective health of mother and child

Objective: To study the self-reported prevalence of experienced violence among a cohort of women about two years after giving birth, their health during pregnancy, pregnancy outcomes and their experience of their child’s health.

Setting and subjects: In 2011, a total of 657 women participated in phase III of the Childbirth and Health Cohort Study in Icelandic Primary Health Care, 18 to 24 months after delivery. The women had previously participated in phase I around pregnancy week 16 and phase II 5–6 months after delivery. Data were collected by postal questionnaires.

Main outcome measures: Women’s reported history of experienced violence, sociodemographic and obstetric background, self-perceived health, the use of medications and their child’s perceived health.

Results: In phase III, 16% of women reported experiencing violence. These women felt less support from their current partner (p?p?p?p?p?p?=?0.008).

Conclusions: Our study confirms that a history of violence is common among women. A history of violence is associated with various maternal health problems during and after pregnancy, a higher rate of caesarean sections and maternal reports of health problems in their child 18–24 months after birth.

• KEY POINTS

• Violence is a major concern worldwide. Understanding the impact of violence on human health and developing effective preventive measures are important elements of any public health agenda.

• ??The reported prevalence of experiencing violence was 16% among women attending antenatal care in the primary health care setting in Iceland.

• ??Women with a history of violence reported worse health in general during pregnancy and delivered more often by caesarean section, compared to women with no such history.

• ??Mothers with a history of violence also evaluated the general health of their child as worse than women with no such history.

• ??The findings of this study support the importance of recognizing and addressing experienced violence among women in primary care.

     

我院文职护士管理和培训的实践与体会

目的构建文职护士培训、使用及管理的科学方法。方法通过规范管理、科学施训、作为骨干大胆任用等多种管理方式,使文职护士得到充分的发展。结果文职护士群体成长为医院优秀骨干,首批满3年的文职护士顺利通过续聘考核。结论科学的管理培训是文职护士成长的重要基石,对医院护理管理有着重要作用。     

Prevalence and severity of nausea and vomiting of pregnancy and effect of vitamin supplementation.

OBJECTIVE: Although nausea and vomiting of pregnancy is the most common medical condition during pregnancy, there are many unanswered questions regarding its cause, epidemiologic features and optimal management. The objectives of this study were to ascertain the prevalence of nausea and vomiting in a sample of Canadian women, to characterize the distribution of their severity and to investigate the role of vitamin B6 deficiency in their etiology. DESIGN: Prospective study. SETTING: Antenatal counselling service for pregnant women. PATIENTS: Three cohorts of women: a prospective, population-based cohort of 193 women, to estimate the rate and severity of nausea and vomiting (cohort A); a cohort of 555 women who sought advice for nausea with or without vomiting, to study the correlation between the maximal daily number of episodes of vomiting and maximal weight loss (cohort B); and a prospective cohort of 301 women who reported vomiting, to correlate vitamin supplementation with vomiting (cohort C). INTERVENTIONS: All 3 cohorts were interviewed during the counselling session, and cohort B was followed up prospectively. OUTCOME MEASURES: Frequency of nausea and vomiting, weight loss, maximal number of daily episodes of vomiting, rate of multivitamin supplementation. RESULTS: Overall, 67% of the women in cohort A reported experiencing nausea or vomiting, or both; 22% reported vomiting, and 9% experienced weight loss. In cohort B there was a significant correlation between the maximal number of daily episodes of vomiting and maximal weight loss, although there was wide variation (r2 = 0.25, p < 0.001). There was a highly significant correlation between the number of daily vomiting episodes and mean weight loss (r2 = 0.99). In cohort C, vomiting was significantly associated with lack of supplementation with multivitamins before 6 weeks' gestation (p = 0.002). CONCLUSIONS: The relation between number of daily vomiting episodes and mean weight loss may serve as a clinical tool to assess the severity of nausea and vomiting in pregnancy and the success of anti-emetics and rehydration regimens. Further study is needed to elucidate the biologic basis of the observed association between vomiting and lack of multivitamin supplementation in early pregnancy.     

通用设计原则与产品研发策略

本文介绍了通用设计的概念和设计原则,并阐述了根据此原则实施通用设计的产品研发策略。通用设计惠及的不仅是残疾人,也惠及了包括普通公众在内的广泛人群,以及企业。应将通用设计的原理应融入政府相关政策和未来发展的规划中,为残疾人以及更多人群提供合理便利的通用设计产品。     

糖尿病视网膜病变筛查与防治中存在的问题及对策

目的探讨糖尿病视网膜病变(diabetic retinopathy,DR)患者筛查和防治中存在的问题及对策。方法以76例糖尿病DR患者为对象,调查未能早期接受眼科诊治的原因。结果存在问题主要是患者对DR防治知识不了解、血糖控制不理想、内科医生未建议进行专科检查等。结论眼科医护人员应密切与糖尿病专科的联系,尽早对DM患者进行DR健康教育,并开展社区DR防治工作。