影响儿童屈光不正性弱视治疗效果相关因素观察

目的探讨影响儿童屈光不正性弱视治疗效果的相关因素,为临床诊治提供参考。方法选择2011年1月-2014年12月期间屈光不正性弱视患儿144例(224眼),男70例,女74例。患儿根据依从性及弱视程度等因素分别应用遮盖、综合疗法等治疗方法矫正治疗,并分别对不同年龄、弱视类型、治疗方法、依从性等因素评价患者治疗效果。结果 224眼治疗总有效率为89.29%,治疗前平均视力为0.41±0.12,治疗后平均视力为0.74±0.22,治疗前后比较,差异有统计学意义(t=19.708,P=0.000)。年龄≤5岁、6~8岁、8岁治疗有效率分别为95.83%、88.24%、69.44%,年龄越小治疗有效率越高,各组间对比差异有统计学意义(H=14.254,P=0.000);综合治疗、屈光矫正、压抑矫正治疗有效率分别为95.31%、84.38%、75.00%,综合治疗有效率最高,3组间对比差异有统计学意义(H=15.544,P=0.000);远视、近视、散光治疗有效率分别为95.77%、80.65%、70.00%,远视治疗有效率最高,3组间对比差异有统计学意义(H=13.656,P=0.000);依从性好、依从性差治疗有效率分别为96.23%、73.68%,组间对比差异有统计学意义(χ~2=5.254,P=0.004)。结论早期采用综合疗法有利于屈光不正性弱视患儿取得较好的治疗效果,远视性弱视患儿治疗效果优于其他弱视类型。     

儿童屈光性弱视的疗效分析

目的比较各类屈光不正性儿童弱视的疗效.方法大连市幼儿园及小学生通过散瞳验光确诊的520例976眼屈光不正性弱视,包括远视性弱视857眼、近视性弱视39眼,以及混合散光性弱视80眼,并将各类弱视分为轻、中、重3组进行疗效比较.结果远视性弱视组治愈686眼(80%),混合散光性弱视组治愈66眼(82%),两组疗效较好且相近,近视性弱视组治愈26眼(66%),疗效较差(P＜0.05).结论儿童屈光性弱视的疗效与屈光不正性质有关,其中以远视性和混合散光性弱视的疗效较佳.     

122例脑瘫患儿屈光状态和斜弱视临床分析

目的了解脑瘫患儿屈光状态和斜弱视情况及特点,制定多学科的综合康复计划,促进患儿的视力能康复。方法对4~14岁的122例(244眼)脑瘫患儿进行眼部常规检查,眼位检查,散瞳验光等检查,并记录详细的既往病史。结果本组脑瘫患儿中屈光不正220眼,发生率90.2%,其中80%经屈光矫正视力提高2行及以上,并以复性远视散光、远视和混合散光为主。屈光不正状态在痉挛型和其他类型脑瘫患儿间差异无统计学意义(P0.05)。脑瘫患儿中斜弱视发生率13.1%,其中痉挛型脑瘫占50%,主要病因是早产及低出生体重。结论重视脑瘫患儿的屈光矫正,特别是复性远视散光和混合散光。痉挛型是斜弱视脑瘫患儿最主要的脑瘫类型。     

同量治疗下双眼屈光不正性弱视主视眼与非主视眼疗效对比分析

目的探讨同量治疗下对双眼屈光不正性弱视患儿主视眼、非主视眼治疗效果。方法治疗前准确检查主视眼组、非主视眼组双眼屈光不正性弱视患儿视力(国际标准视力表)并记录,根据患儿实际情况提供针对性的治疗方案,记录各组不同时间治疗效果。结果两组双眼屈光不正性弱视患儿经同量治疗1个月后,主视眼组临床总有效率(71.11%)显著优于非主视眼组(31.11%,P0.05);治疗3个月、6个月和1年后主视眼组、非主视眼组患儿临床总有效率对比并无显著差异(P0.05);随着治疗时间的延长,对照组临床总有效率随之显著提高(P0.05)。结论应用同量治疗双眼屈光不正性弱视主视眼、非主视眼短期疗效对比虽具有一定差异,但经中长期同量治疗双眼屈光不正性弱视主视眼、非主视眼均可获得理想疗效,有利于保障患儿生活质量及身心健康。     

南京地区285例3～12岁弱视儿童屈光状态及疗效分析

【目的】分析3~12岁儿童弱视屈光状态、视功能发育的特点、临床治疗情况等因素对弱视发病的影响,为临床防治提供可靠的依据。【方法】选择2007年12月—2009年4月间就诊的南京地区3~12岁弱视儿童285例全部进行远视力,常规眼前节及眼底检查,排除眼部器质性病变,角膜映光法检查眼位。用1%阿托品眼膏散瞳检影验光,进行屈光状态检查,并将所有患儿综合治疗后观察疗效并分析。【结果】285例弱视儿童483只视力低下眼中,远视性屈光不正439眼(90.89%);以双眼的复性远视顺规散光为主。3~7岁组患儿200例384眼,双眼屈光不正性弱视占总眼数的63.98%,斜视性弱视占11.09%;8~12岁组患儿85例99眼,单眼弱视多见,原因依次为单眼的高度远视伴散光占总眼数的23.69%,单眼斜视占4.85%,眼部先天性疾病及外伤占3.96%。综合疗法治疗效果3~7岁组优于8~12岁组(P0.05)。【结论】3~7岁组学龄前儿童弱视主要是远视性屈光不正和斜视,8~12岁组以单眼弱视多见。弱视发现越早,程度越轻治疗效果越好。早期发现、及时治疗是挽救视力、减少儿童和青少年弱视的关键。     

儿童屈光性弱视的疗效分析

目的 :比较各类屈光不正性儿童弱视的疗效。方法 :大连市幼儿园及小学生通过散瞳验光确诊的 5 2 0例 976眼屈光不正性弱视 ,包括远视性弱视 85 7眼、近视性弱视 39眼 ,以及混合散光性弱视 80眼 ,并将各类弱视分为轻、中、重 3组进行疗效比较。结果 :远视性弱视组治愈 6 86眼 ( 80 % ) ,混合散光性弱视组治愈 6 6眼 ( 82 % ) ,两组疗效较好且相近 ,近视性弱视组治愈 2 6眼 ( 6 6 % ) ,疗效较差 ( P<0 .0 5 )。结论 :儿童屈光性弱视的疗效与屈光不正性质有关 ,其中以远视性和混合散光性弱视的疗效较佳。     

睫状肌麻痹状态下不同程度的屈光矫正对远视性弱视儿童眼球正视化过程的影响

目的分析在睫状肌麻痹状态不同程度的屈光矫正对远视性弱视儿童眼球正视化过程的影响,促进视觉功能的恢复,更有利于患眼正视化。方法选取屈光不正视儿童120例(169眼)采用阿托品散瞳检影验光,在散瞳状态下配镜,根据球镜度减低不同分为配镜度数不同的Ⅰ、Ⅱ、Ⅲ组,Ⅰ组儿童球镜减验光度数的3/4,Ⅱ组儿童减验光度数的1/2,Ⅲ组儿童减验光度数的2/3;之后每6个月进行散瞳检影验光,观察3年,比较患儿治疗情况。结果Ⅰ组儿童治疗后总有效率为68.85%,Ⅱ组儿童为86.21%,Ⅲ组儿童为84.00%,I组与Ⅱ组差异有统计学意义(P0.05),Ⅱ组与Ⅲ组差异有统计学意义(P0.05)。各组患儿远视度数明显减低,其中I组患儿平均每年递减度数明显低于Ⅱ组,其差异有统计学意义(P0.05);Ⅱ、Ⅲ组平均递减度数差异无统计学意义(P0.05)。眼轴变化I、Ⅱ组差异无统计学意义(P0.05),Ⅱ、Ⅲ组差异有统计学意义(P0.05);其中Ⅰ组治愈时间明显长于Ⅱ组,差异有统计学意义(P0.05),Ⅱ、Ⅲ组差异无统计学意义(P0.05)。结论给予不同程度的屈光矫正能够影响患儿治疗效果,对远视性弱视儿童眼球正视化有一定的影响,在睫状肌麻痹状态下能够暴露出完全的真实屈光度进行配镜,保留1/3的远视性光学离焦不仅达到屈光矫正的效果,并且更有利于患眼正视化。     

江门市3～6岁异常视力儿童屈光状态分析

目的了解江门市异常视力儿童屈光状态。方法对江门市幼儿园的8510名3～6岁儿童进行视力普查。对单眼裸眼视力<0.9者(1116例2232只眼)的屈光状态及弱视患儿的屈光状态进行了分析。结果屈光不正总患病率为13.01%;远视、混合散光、近视患病率依次为9.85%、2.36%、0.80%(P<0.05);轻、中、重度屈光不正患病率依次为7.34%、3.96%、1.70%(P<0.05);屈光不正有年龄特点(4岁组患病率高于其他年龄组);弱视患病率为3.74%;弱视首次检出率为88.23%。结论远视性屈光不正是导致弱视的主要原因。     

同量综合弱视治疗学龄前儿童屈光不正性弱视效果观察

目的 研究同量综合弱视治疗学龄前儿童屈光不正性弱视对眼调节微波动变化及视力的影响。 方法 选择台州恩泽医疗中心(集团)恩泽医院2016年1月—2018年1月收治的学龄前儿童屈光不正性弱视患儿130例纳入研究,采用屈光矫正治疗方式的65例患儿作为屈光治疗组,采用同量综合弱视治疗的65例患儿作为同量综合治疗组,比较两组患儿的眼调节微波动变化及视力。 结果 治疗后6、12个月同量综合治疗组治疗总有效率分别为84.6%、92.3%,均高于屈光治疗组的67.7%、76.9%,组间比较差异均有统计学意义(P＜0.05)。治疗前两组患儿的矫正视力和屈光度比较差异无统计学意义(P＞0.05),治疗后6、12个月同量综合治疗组患儿矫正视力和屈光度均优于屈光治疗组(P＜0.05)。治疗前两组患儿的眼调节功能的调节幅度、调节滞后量、调节灵敏度间差异均无统计学意义(P＞0.05),治疗后6、12个月两组患儿的以上各指标有所改善,但组间比较差异均无统计学意义(P＞0.05)。 结论 同量综合弱视治疗学龄前儿童屈光不正性弱视临床效果显著,能够改善患儿眼调节微波动,有利于促进视觉发育,提高患儿视力。     

1 660例视力低常儿童屈光状态分析

目的：探索视力低常儿童屈光状态及分布规律，屈光不正与弱视的关系，力争在儿童视觉发育敏感期及时治疗。方法：用国际标准视力表查视力，裸眼视力≤0．8为视力低常，给予0．5％阿托品眼药水散瞳验光。结果：（1）远视居首位占85．10％，混合散光占10．92％，近视占3．98％。（2）轻度屈光不正占75．72％，中度占21．44％，高度占2．68％，正视占0．15％，（3）远视屈光不正弱视构成比最大占68．9％。（4）远视性屈光不正程度及屈光参差程度愈高或屈光不正性弱视的散光程度愈高，中度以上弱视所占比例愈大。结论：学龄前儿童屈光状态与弱视的形成密切相关，合理矫正幼儿屈光不正是防治弱视的关键。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.