中国不同民族中小学生视力保健行为与近视患病的关联

探讨中国不同民族中小学生的近视患病情况及视力保健行为的差异,分析视力保健行为与近视患病率之间的关联性,为青少年近视的防控提供理论依据.方法 采用分层抽样的方法,抽取全国12个省市43 771名在校中小学生,使用“中小学生视力保健行为评定问卷”进行无记名问卷调查,通过x2检验和方差分析,比较不同民族、不同年级中小学生近视患病率和持续用眼行为、饮食习惯及户外活动评分,以及近视与非近视学生视力保健行为的差异.结果 我国中小学生近视标化患病率汉族为33.5%,维吾尔族为20.6%,回族为25.9%,其他民族为20.1%;各民族不同年级组学生的近视患病率均为七~九年级组>四~六年级组>一~三年级组,差异具有统计学意义(P值均<0.01).一~三年级,四~六年级,七~九年级中小学生持续用眼行为、饮食习惯及户外活动情况等视力保健行为的民族间差异均具有统计学意义(P值均<0.05),三个年级组近视与非近视学生的视力保健行为除四~六年级组饮食习惯和户外活动外,差异均有统计学意义(P值均<0.05).结论 我国中小学生近视患病率较高,不同民族学生的近视患病率和视力保健行为存在较大差异,视力保健行为与近视患病情况存在生态学一致性.应加强学生对近视的认识,规范对学生视力保健行为的指导.     

中小学生视力保健行为评定问卷编制及其信效度评价

编制中小学生视力保健行为评定问卷并进行信、效度评价,为开展学生预防近视工作提供测评工具.方法 通过循证复习相关文献、专家咨询,构建包含57条项目的初始问卷.使用初始问卷对我国12个省市的47 951名中小学生进行问卷调查,使用两独立样本t检验、相关分析和因子分析等多种统计方法进行项目分析和信、效度评价.结果 “中小学生视力保健行为评定问卷”由一~三年级问卷(40个项目)、四~六年级问卷(43个项目)和初中问卷(43个项目)3份问卷组成,每份问卷包括10个维度;3份问卷的分半系数分别为0.847,0.874和0.863,Cronbachα系数分别为0.761,0.804和0.792;问卷具有较好的内容效度,探索性因子分析结果与理论构想基本一致.反应度分析结果显示,一年级、四年级及初一年级学生总问卷得分和高分项目选项数分别高于三年级、六年级及初三年级学生,差异均具有统计学意义(P值均<0.05).结论 “中小学生视力保健行为评定问卷”具有比较可靠的信度和效度,符合心理测量学要求,可用作中小学生预防近视工作的测评工具.     

广西上林县2014年中小学生视力不良分析

目的了解上林县中小学生视力不良的现况,为科学防治视力不良提供依据。方法对上林县2014年中小学生的视力检测结果进行统计分析,按性别、年级分层比较视力不良率的差异。结果上林县中小学生平均视力不良率为58.04%。小学低年级男、女生视力不良率差异无统计学意义(P0.05);小学高年级女生视力不良率为73.33%,高于男生的62.13%(P0.01)。初中女生视力不良率为78.13%,高于男生的57.46%(P0.01)。结论上林县中小学生视力不良率随着年级的升高而上升,女生视力不良率高于同级别的男生。     

四川省2015年中小学生视力不良现状与影响因素分析

了解四川省中小学生视力现况及其影响因素,为中小学生视力不良防控提供科学依据.方法 采用分层随机抽样的方法,于2015年收集四川省14 306名7~18岁中小学生视力数据.分析不同年龄、性别、地区的学生视力的差异以及可能的影响因素.结果 学生视力不良率为52.3%,平均视力为(4.79±0.37).不同年龄组学生视力不良率与平均视力差异均有统计学意义(P值均<0.01);女生视力不良率(55.8%)高于男生(48.8%) (x2=70.190,P<0.01),平均视力(4.77)低于男生(4.82)(t=7.143,P<0.01);城市学生视力不良率(59.6%)高于农村学生(44.5%) (x2=326.403,P<0.01),平均视力(4.74)低于农村学生(4.85)(t=18.047,P<0.01).10~ 12,12~ 13,14~ 15,15 ~ 16,17~ 18岁年龄段学生平均视角扩大速度约为7%~23%.结论 随着学生年龄增长,视力不良率不断升高,伴随视力不断下降;小学高年级、初中三年级、高中三年级学生视力下降幅度较大,需重点关注.     

1997—2011年承德市双桥区城区中小学生视力不良情况分析

目的了解承德市双桥区城区中小学生视力不良的发展规律和动向,为青少年近视防治工作提供科学依据。方法对承德市双桥区城区1997—2011年中小学生视力不良检查资料进行统计分析。结果中小学生视力不良率总体呈上升趋势;中小学生视力不良率女生高于男生;视力不良率与年级成正比,随着年级的增高,视力不良率随之增高;中学生视力不良率高于小学生,差异均有统计学意义(P<0.01)。结论中小学生视力不良率呈明显上升,应引起社会高度重视,采取综合性措施,社会、学校、家长、学生就要相互配合。     

龙海市2016-2017学年中小学生视力状况分析

目的探讨龙海市中小学生视力状况,为改善本地区中小学生视力保健水平提供理论依据。方法对该市2016-2017学年中小学生体检资料的视力检查结果进行统计分析。结果 (1)龙海市2016-2017学年中小学生视力不良率为55.6%,轻、中、重度分别为:18.3%、32.5%、49.2%;小学生视力不良率小于初中和高中视力不良率,差异有统计学意义(χ~2=311.19,P0.05)。(2)性别比较:小学、初中、高中女生视力不良率均高于男生,差异有统计学意义(χ~2=58.55,P0.05;χ~2=130.30,P0.05;χ~2=57.74,P0.05)。(3)城乡比较:小学、初中、高中城镇学生视力不良率均高于农村学生,差异有统计学意义(χ~2=17.67,P0.05;χ~2=5.82,P0.05;χ~2=15.17,P0.05)。结论龙海市中小学生视力不良问题严峻,不同学习阶段、性别、城乡差异明显,应引起有关部门重视。     

铜陵市中小学生视力减退进展情况分析

目的 了解铜陵市中小学生视力不良发生发展的趋势及规律,为开展学生视力保护工作提供参考.方法 以2004-2008年铜陵市中小学生为研究对象,按<全国学生体质健康状况调查研究实施方案>要求,每年对全市中小学在校学生视力状况进行横断面调查,并追踪观测学生个体视力的减退进展状况.结果 2004-2008年铜陵市中小学生总体视力不良率为55.93%～73.03%,男、女生视力不良率分别为57.78%和66.32%,城男、乡男、城女、乡女视力不良率分别为61.15%,50.90%,69.11%,60.59%.学生视力不良率在小学二、三年级下降之后逐年级升高,高中阶段视力不良率高达80%以上,小学五、六年级和初二至高一年级视力不良率有较大升幅.追踪观测显示.小学二至四年级和六年级视力减退率有较大升幅.结论 小学二至四年级和六年级是预防和遏制视力减退进展的重点阶段;在小学低年级阶段培养学生保持正确的学习姿势和用眼习惯是预防近视的重要措施.     

沈阳市1984-2009年小学新生和中小学毕业生视力不良情况分析

目的了解沈阳市小学一年级和中小学毕业生视力不良情况及动态变化趋势,为开展视力不良的干预工作提供参考依据。方法利用沈阳市1984-2009年中小学生体检资料,对小学一年级、六年级和初三、高三学生视力不良情况进行比较。结果 1984-2009年沈阳市小学一年级、六年级和初三、高三学生的视力不良增长率分别为3.50%,31.04%,36.83%和34.12%。随着年级的升高,学生视力不良率不断上升;城市学生视力不良率显著高于农村学生,女生高于男生。结论学生视力不良的防控工作刻不容缓,应采取有效的防治策略和措施,加强各部门协作,改善学生的视力状况。     

北京市中小学生排尿行为习惯现状

了解北京市九城区中小学生排尿行为现状,为开展科普宣传提供依据.方法 采用方便抽样方法,从北京市9个城区中方便抽取24 339名6~18岁中小学生进行问卷调查.结果 北京市中小学生每日排尿6次.城区中小学生经常故意减少排尿次数的比例低于远郊县区(11.8%,12.8%,x2=3.92,P=0.05).男生憋尿、经常故意减少排尿次数的比例(9.8%,11.7%)低于女生(10.7%,13.4%)(x2值分别为4.94,16.23,P值均<0.05),上课有尿意经常举手示意排尿、无尿意也主动排尿、控制排尿速度的比例(22.4%,34.9%,13.7%)高于女生(17.1%,32.3%,9.1%)(x2值分别为106.75,19.04,130.00,P值均<0.01).男生尿液颜色为较深黄色的比例低于女生(3.6%,4.4%,x2=8.12,P=0.00).城区中小学生因担心上课时有尿意而减少饮水的比例低于远郊县区(21.2%,23.0%),男生低于女生(21.7%,23.4%),高年级学生低于低年级学生(一~三年级29.9%,四~六年级22.4%,七~九年级18.2%,十~十二年级17.8%)(x2值分别为658.88,10.77,258.97,P值均<0.01).结论 北京市城区有一定比例中小学生存在不健康排尿行为,需进行科普宣教.     

唐山市曹妃甸区2018-2019年中小学生视力不良调查结果分析

目的 了解曹妃甸区中小学生视力不良的发生率及其严重程度,为中小学校实施学生常见病干预措施和健康促进工作提供科学依据.方法 抽取唐山市曹妃甸区6所城市和7所农村中小学校,各学校的每个年级随机抽取2-3个班,共计抽取5 985名学生进行了裸眼远视力调查.结果 曹妃甸区中小学生总体视力不良率为66.82％,其中轻、中、重度视力不良率分别为14.07％、24.64％和28.10％.小学生、初中生、高中生的视力不良率分别为50.76％、78.15％、89.15％,差异有统计学意义(x2= 729.964,P＜0.001);男生视力不良率(61.04％)低于女生(72.57％),差异有统计学意义(x2 = 89.689,P＜0.001);寄宿制初中学生的视力不良率(81.13％)高于非寄宿制初中学生(77.04％),差异无统计学意义(x2= 3.409,P= 0.065);城市初中和小学的学生视力不良率(66.17％)高于农村(57.38％),差异有统计学意义(x2 = 36.862,P＜0.001).结论 曹妃甸区中小学生视力不良发生率较高,随年级增加而上升,应加强中小学生视力不良防控工作.     

Oxygène, stress oxydant et supplémentations antioxydantes ou un aspect différent de la nutrition dans les maladies respiratoires

Dioxygen is an element essential to our survival, our life, our development, our capacity of adaptation. Nevertheless, dioxygen is also at the origin of toxicity, acidity, deterioration, degeneration. Indeed, when the metabolism of dioxygen is altered, as in the respiratory diseases, an “oxidative stress” can appeared and induced metabolic anomalies associated with important consequences. Oxidative stress is defined as an imbalance between pro-oxidant (reactive oxygen species) and antioxidant factors, in favour of the former. The genomic, metabolic and functional modifications induced by oxidative stress were implied in the development of various degenerative diseases. Antioxidant treatments, in a nutritional or pharmacological way, appeared consequently as new potent therapies. In this review, the role of dioxygen in the cellular metabolism, and in the production of the reactive oxygen species is discussed. The negative effects of the oxidative stress on the organism are reported. Finally, the results of the studies on the nutritional antioxidant treatment firstly in the degenerative diseases, secondly in a chronic respiratory disease, the chronic obstructive pulmonary disease, are discussed in a last part.     

Nutrition parentérale à domicile : prise en charge et suivi des incidents ; mise en œuvre des vigilances. Enquête sur la France métropolitaine

For Home Parenteral Nutrition (HPN), pharmacy had to deliver some medical devices and drugs. It comes up the following and taking care of incidents that's occurring at home with those products. The aim of the survey was making and inventory on vigilance's organization, incident's management and assessment, about HPN in France. A questionnaire was send to the main characters of HPN (by law authorized centres, services providers, custom-made makers, laboratories.) They were asked to describe their organization and to grade incidents according to their frequency. Organizations are varied and specific to each centre. The data process shows that the most registered incidents are: blended tubing of infusion sets, problems linked to industrial sets, occlusion or air bubble alarms with pumps. There are very few internal medical devices vigilance reports. An improved management would be done with generalization of a patient declaration form, a patient's practice assessment and a permanent quality improvement.     

Unraveling R0: Considerations for Public Health Applications

We assessed public health use of R₀, the basic reproduction number, which estimates the speed at which a disease is capable of spreading in a population. These estimates are of great public health interest, as evidenced during the 2009 influenza A (H1N1) virus pandemic.We reviewed methods commonly used to estimate R₀, examined their practical utility, and assessed how estimates of this epidemiological parameter can inform mitigation strategy decisions.In isolation, R₀ is a suboptimal gauge of infectious disease dynamics across populations; other disease parameters may provide more useful information. Nonetheless, estimation of R₀ for a particular population is useful for understanding transmission in the study population. Considered in the context of other epidemiologically important parameters, the value of R₀ may lie in better understanding an outbreak and in preparing a public health response.During the spring of 2009, the 2009 H1N1 influenza pandemic began in North America and quickly spread around the world, sparking great interest in potential mitigation strategies for the first influenza pandemic in more than 40 years. Research focused on interventions such as social distancing that could be applied before a specific monovalent H1N1 vaccine became available in the fall of 2009. During the initial wave of the 2009 H1N1 outbreak, teams of modelers from around the world gathered available data from Mexico to estimate several of the novel virus’s characteristics.1,2 Efforts focused on the rapid estimation of the basic reproduction number, or R₀, of this virus. R₀ is a theoretical parameter that provides some information regarding the speed at which a disease is capable of spreading in a specific population. First estimates were published online by early May 2009.1,2 Estimates of R₀ continue to be published from other countries and as more data become available.3–11As an indicator of the interest in publications concerning R₀, an early publication on the pandemic potential of the 2009 H1N1 strain by Fraser et al.1 has garnered 654 citations as of February 7, 2013. Although the influenza pandemic explains much of the recent interest in the basic reproduction number, this interest is not limited to the field of influenza. Web of Science searches on the terms “reproduction number” or “reproductive number” revealed that there have been 710 publications on this topic from 2009 through February 7, 2013, across various disciplines, with most articles being published in journals covering infectious diseases and mathematical modeling. Table A (available as a supplement to this article at http://www.ajph.org) shows breakdown by journal. If the search is expanded to include data from previous years, it is clear that there has been exponential growth by calendar year in the number of publications on this topic (Figure 1). Why is there such growing interest in R₀ among the disciplines interested in the dynamics of infectious diseases? To help better understand the interest in the basic reproduction number among public health officials, infectious disease researchers, and theoretical modelers, we reviewed the derivation of R₀ and its history.Open in a separate windowFIGURE 1—The number of publications regarding infectious disease and mathematical modeling as reported by Web of Science.Note. The figure was produced by searching Web of Science on the terms “reproduction number” or “reproductive number” and limiting the results to the fields of infectious diseases, mathematical computational biology, and applied mathematics. Clearly, interest in research regarding the basic reproductive number has risen dramatically since the 1990s. The number of publications in this area currently appears to be growing exponentially.We present a basic epidemiological compartmental model (a susceptible–infected–recovered or SIR model with S, I, and R representing the 3 compartments) described by Kermack and McKendrick.12 In this relatively simple model designed to describe epidemics, individuals start as susceptible to a particular pathogen and then progress to the other 2 compartments if infected. The model is defined by a system of 3 ordinary differential equations (ODEs):in which β is the transmission rate, γ is the recovery rate (or the inverse of the infectious period), and N is the total population size such that N = S + I + R. The standard model in equation 1 assumes no births or deaths. At the beginning of the outbreak or epidemic (t = 0) we assume the population is composed entirely of susceptible individuals and a single infectious individual. With this model, if the transmission rate exceeds the recovery rate (i.e., β/γ > 1), the disease will spread (dI/dt > 0). Alternatively, β/γ is the number of new infections per unit time multiplied by the time period of infectiousness, and describes the number of new infections resulting from the initially infected individual. In the presented case of the simple SIR model, the basic reproduction number (or ratio) equals β/γ.The scientific community largely underappreciated the implications of the Kermack–McKendrick model until the late 1970s, when Anderson and May13 used the model to study strategies for controlling infectious diseases. R₀ is a parameter of importance for gauging the disease dynamics because it indicates when an outbreak might happen based on the threshold value of 1.0. More generally, if the effective reproduction number R_e = R₀ × (S/N) is greater than 1.0, we predict that the disease continues its spread; the effective reproduction reflects the fact that, as proportion of susceptible individuals decreases (S/N), disease transmission slows. From this simple mathematical perspective, epidemiologists frequently consider the basic reproductive number one of the most vital parameters in determining whether an epidemic is “controllable.”14,15 The objective of any public health response during an influenza pandemic, for example, is to slow or stop the spread of the virus by employing mitigation strategies that either (1) reduce R₀ by changing the transmission rate (e.g., via school closure) or the duration of infectiousness (e.g., through antiviral use) or (2) reduce R_e by reducing the number of susceptible individuals (e.g., by vaccination).     

起搏器用植入材料的细胞毒性研究

目的:对NERC植入式人工心脏起搏器拟用的环氧树脂、钛金属以及硅橡胶等材料进行细胞毒性实验,探讨各材料对L-929细胞的毒性作用情况,为材料在起搏器的应用提供依据。方法:按照GB/T 16886,制备样品及各种材料的浸提液。分别在48h、72h、96h天,对细胞生长状况进行观察,并通过MTT方法,检测各种材料浸提液对成纤维细胞的细胞毒性作用,根据细胞相对增值率,对材料毒性进行分级。结果:成纤维细胞在起搏器相关材料浸提液中生长正常,细胞形态良好,各浓度浸提液对成纤维细胞的相对增殖率均在90%以上,材料毒性分级为0级或一级。结论:选用相关材料细胞相容性良好,基本上无细胞毒性,符合植入式人工心脏起搏器材料细胞毒性要求。     

Interactions gènes–environnement au cours de la bronchopneumopathie chronique obstructive et l'asthme. Relations avec la composition corporelle

Non-reversible pulmonary obstructive pulmonary diseases as COPD or reversible as asthma are mainly environmental driven diseases. In this context, genes–environment interplays through epigenetics play a role in body composition, the level of oxidant stress and the risk to develop an obstructive bronchial pattern. In this way, they are environmental and genetic factors with pleiotropic effects that might explain the close relationships between body composition and respiratory health.     

Nutrition et mucoviscidose chez l'adulte

A good nutritional status is a main parameter involved in the survival improvement rate, the maintaining of the respiratory function and the increased quality of life in patients with cystic fibrosis. With striking advances in pulmonary and nutritional treatments cystic fibrosis has turned into an adult condition. Most of the adult cystic fibrosis centers are currently managed by pulmonologists or internists in collaboration with a dietician team, allowing an adequate dietetic follow up and early intervention for malnourished patients.     

Réhabilitation respiratoire et prise en charge nutritionnelle dans la bronchopneumopathie chronique obstructive

Pulmonary rehabilitation is an effective therapeutic approach in chronic obstructive pulmonary disease (COPD) in term of improvement of the quality of life, dyspnea and exercice performance. It also has economical implications by reducing exacerbations, the number and the duration of the hospitalizations. Pulmonary rehabilitation is currently recommended among COPD patients presenting dyspnea, an impaired exercice performance or a reduction in their daily activity in connection with their disease inspite of an optimal treatment based on nicotinic weaning, bronchodilatators, and prevention of the infections. Pulmonary rehabilitation program may include cycle ergometry and inspiratory muscle training associated with an educational program concerning the disease and the nutritional aspects. It is recommended to carry out a precise nutritional evaluation comprising in addition to the recent weight history, a body mass index measurement (BMI) and a fat-free mass determination by impedancemetry if the BMI is between 21 and 26 kg/m². Smoking cessation, treatment of the bronchial infection and fractionned hypercaloric dietary intake are recommanded during the rehabilitation program. An oral supplementation near to 500 kcal/j, privileging the carbohydrates, is proposed in COPD patients during the rehabilitation program in case of BMI < 21 kg/m². In the litterature, this oral supplementation associated with the rehabilitation is likely to improve the outcome of training and the pronostic of the disease. In combinaison with the exercice training, anabolic steroids may have positive effects on body weight and fat-free mass by improvements in inspiratory muscle strength or exercice capacity. Nevertheless, further research is needed to confirm the effects of this anabolic intervention in term of efficacity and safety.