电脑验光、检影验光与综合验光仪主觉验光在成人近视验光中的临床应用价值

目的比较成人近视患者自动电脑验光、视网膜检影验光和综合验光仪主觉验光三者球镜屈光度、柱镜屈光度和散光轴位的差异,探讨其在成人近视验光中的准确性和临床应用价值.方法对164例(328只眼)成人近视患者进行电脑验光、检影验光和综合验光仪主觉验光,将三种验光方法测得的球镜屈光度、柱镜屈光度和散光轴位等数据采用SPSS11.0统计软件进行配时t检验和单因素方差分析,P<0.05认为差异有显著性.结果电脑验光测得的球镜屈光度(-5.2104±2.1450)分别与检影验光和主觉验光测得的球镜屈光度(分别为-3.0122±1.9984和-2.9604±2.0285)比较,差异有显著性(p<0.05);电脑验光测得的柱镜屈光度(-1.0888±0.8182)和散光轴位(148.2895±49.9303)分别与检影验光和主觉验光测得的柱镜屈光度(分别为-1.1250±0.8221和-1.0592±0.8030)和散光轴位(分别为149.5395±50.2074和149.7368±50.1258)比较,差异无显著性(p>0.05).检影验光测得的球镜屈光度、柱镜屈光度和散光轴位与主觉验光测得的比较,差异也无显著性(p>0.05).结论在成人近视验光中.电脑验光只能提供大致的屈光不正范围,而医学检影联合综合验光仪主觉精调才是最准确、最可靠的验光方法.     

验光配镜对因屈光不正造成调节性视疲劳的影响观察

目的 观察分析验光配镜对因屈光不正造成调节性视疲劳的影响.方法 对2013年12月～2014年12月我院眼科收治的45例视疲劳患者的临床资料进行研究,通过医学验光配镜进行治疗,观察验光配镜对因屈光不正造成调节性视疲劳的影响.结果 45例患者中,治愈27例,有效16例,无效2例,治疗总有效率为95.6％.结论 医学验光配镜对因屈光不正造成调节性视疲劳的治疗效果较好.     

儿童睫状肌麻痹散瞳验光的必要性对比分析

目的　了解托品酰胺滴眼液和 1%阿托品眼膏散瞳对不同年龄屈光不正儿童的影响 .方法　对 5 98例屈光不正儿童先液散瞳验光 ;再眼膏 ,散瞳验光 ,比较分析屈光度变化 .结果　①各年龄组用眼液与用眼膏散瞳前后球面镜、柱镜、等效球镜的屈光度比较眼膏散瞳后屈光度均高于眼液散瞳 (p<0 .0 5 ) ;②不同年龄组两种方法散瞳后的两两比较显示用眼膏散瞳验光比用眼液更能反映球镜、柱镜度数的真实变化 .结论　①用眼膏散瞳后验光的多项屈光指标均有显著性变化 ,球面镜度数绝大多数增高 ,等效球镜屈光度也增大 ;②在 11岁以内年龄组 ,用眼膏散瞳后验光可以提高屈光不正的检出率 ,减低漏诊率 ,减少验光度数的误差     

儿童睫状肌麻痹散瞳验光的必要性对比分析

目的了解托品酰胺滴眼液和1%阿托品眼膏散瞳对不同年龄屈光不正儿童的影响.方法对598例屈光不正儿童先液散瞳验光;再眼膏,散瞳验光,比较分析屈光度变化.结果①各年龄组用眼液与用眼膏散瞳前后球面镜、柱镜、等效球镜的屈光度比较眼膏散瞳后屈光度均高于眼液散瞳(p<0.05);②不同年龄组两种方法散瞳后的两两比较显示用眼膏散瞳验光比用眼液更能反映球镜、柱镜度数的真实变化.结论①用眼膏散瞳后验光的多项屈光指标均有显著性变化,球面镜度数绝大多数增高,等效球镜屈光度也增大;②在11岁以内年龄组,用眼膏散瞳后验光可以提高屈光不正的检出率,减低漏诊率,减少验光度数的误差.     

数字显示验光仪的研制

本文介绍了一种能直接用数字显示人眼屈光状态的医用电子－光学仪器，它是利用凸透镜离眼愈远，对眼的屈光作用愈强的光学原理，籍两块异号镜片距离的变动，得出不同的球面屈光度来作为人眼球面屈光状态的主觉检查，并用两块同号圆柱镜片，按其相关的角度民各种不同的球面屈光度及散光屈光度作为人眼散光测定，本验光仪是根据上述原理设计一个非线性的位移量和一个角度量转换成数字量，从而显示人眼球面屈光和非对称折射，是一种便于携带的多功能验光仪。     

电脑验光仪辅助YAG激光断线控制小切口非超乳白内障术后散光

目的 分析电脑验光仪辅助下YAG激光拆除角膜缝线控制小切口非超乳白内障摘除术后散光的临床效果.方法 对102例小切口非超乳白内障摘除术后的患者,进行4周的随访观察,经电脑验光仪检查发现存在明显角膜散光,根据其散光程度及轴向作散光调整,予YAG激光拆除相应的角膜缝线,拆线后随访4周.结果 小切口非超乳白内障摘除术后因切口缝线引起的角膜散光,在拆除角膜缝线后,角膜散光均值较拆线前相比明显减小(P<0.05).结论 电脑验光仪辅助下YAG激光拆除角膜缝线可有效的控制小切口非超乳白内障摘除术后的角膜散光.     

近视患者50例医学验光分析

目的 观察近视眼在散瞳前后验光中屈光状态的变化.方法 将50例(96只眼)近视患者散瞳前进行检影验光,在滴复方托品酰胺眼水,散瞳后进行检影验光,分析比较验光结果.结果 ①散瞳前后及复查时患者平均等效球镜度(AESLD)较散瞳前差异均有统计学意义(P＜0.05).②各年龄段散瞳前后及复查时有统计学意义(P＜0.05).③既往有配镜史者和无配镜史者两组散瞳前后AESLD差异均有统计学意义(P＜0.05).结论 对16岁以下的近视患者必须进行医学验光,给予精确矫正.     

加强基层医院眼科在青少年屈光矫治中的作用

青少年的屈光矫治主要有近视、远视、散光的光学矫正,包括儿童的弱视治疗,青少年近视的预防与保健.但由于种种原因,这项工作主要由眼镜店来担负,验光方式主要为主观验光或电脑验光,而基层医院眼科主要担负眼科常见病、多发病的诊治工作,但随着社会的发展,屈光不正患者在眼科疾病比例中的增加,青少年屈光不正患者在光学矫正中存在的问题越来越突出,本文就基层医院眼科开展和加强青少年的屈光矫正的必要性和可行性做些探讨.     

普洱市城区学龄前儿童视力与弱视调查

目的 了解我市学龄前儿童的视力情况及弱视患病率,及早发现异常,及早诊断.方法 视力检查用国际标准视力表检查.屈光不正者经视力检查后,进行眼底、眼位、视功能检查,再做散瞳验光.弱视筛查:经散瞳验光后,矫正视为≦0.8,眼部无器质性病变者.结果 2142名儿童中,按眼数统计,视力低常者839只眼,屈光不正者:远视814只眼,近视10只眼,混合性散光15只眼.结论 本次调查视力低常主要原因是远视,屈光不正引起,弱视患病4.29%.     

3-18岁少年儿童屈光不正1441例分析

目的:了解3～18岁少年儿童屈光不正状态,力争在视觉发育敏感期早发现,早治疗,寻找少年儿童视力不良的病因,为少年儿童视力不良的防治提供依据。方法:将本科2007年1月-2010年1月门诊3～18岁少年儿童视力不良除外屈光不正以外的其他眼疾的情况下在睫状肌麻痹下检影验光后进行统计分析验光者1441例(2826眼)的屈光不正散瞳验光结果进行分析。结果:3～6岁学龄前组远视662眼(55.8%),近视374眼(31.5%),混合散光150眼(12.7%)。7～18岁年龄组近视1186眼(72.3%),远视280眼(17.1%),混合散光174眼(10.6%)。屈光不正程度均以低度为主。结论:学龄前儿童屈光不正以远视居首位,只要每隔0.5～1年散瞳检影验光1次,戴`适的眼镜,及时进行弱视治疗,视力会逐步提高。7～18岁学生组则以近视为主,防治近视应从改善学习环境、调整用眼习惯减少看近或过度调节,加大眼保健知识宣传力度,发现问题及时治疗,降低近视的发病率。     

Pain and Effusion and Quadriceps Activation and Strength

Context:

Quadriceps dysfunction is a common consequence of knee joint injury and disease, yet its causes remain elusive.

Objective:

To determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion affect the magnitude of quadriceps dysfunction.

Design:

Crossover study.

Setting:

University research laboratory.

Patients or Other Participants:

Fourteen (8 men, 6 women; age = 23.6 ± 4.8 years, height = 170.3 ± 9.16 cm, mass = 72.9 ± 11.84 kg) healthy volunteers.

Intervention(s):

All participants were tested under 4 randomized conditions: normal knee, effused knee, painful knee, and effused and painful knee.

Main Outcome Measure(s):

Quadriceps strength (Nm/kg) and activation (central activation ratio) were assessed after each condition was induced.

Results:

Quadriceps strength and activation were highest under the normal knee condition and differed from the 3 experimental knee conditions (P < .05). No differences were noted among the 3 experimental knee conditions for either variable (P > .05).

Conclusions:

Both pain and effusion led to quadriceps dysfunction, but the interaction of the 2 stimuli did not increase the magnitude of the strength or activation deficits. Therefore, pain and effusion can be considered equally potent in eliciting quadriceps inhibition. Given that pain and effusion accompany numerous knee conditions, the prevalence of quadriceps dysfunction is likely high.Key Words: arthrogenic muscle inhibition, central activation failure, voluntary activation, muscles

Key Points

• Knee pain and effusion resulted in arthrogenic muscle inhibition and weakness of the quadriceps.
• The simultaneous presence of pain and effusion did not increase the magnitude of quadriceps dysfunction.
• To reduce arthrogenic muscle inhibition and improve muscle strength, clinicians should employ interventions that target removing both pain and effusion.

Quadriceps weakness is a common consequence of traumatic knee joint injury^1,2 and chronic degenerative knee joint conditions.^3,4 Arthrogenic muscle inhibition (AMI), a neurologic decline in muscle activation, results in quadriceps weakness and hinders rehabilitation by preventing gains in strength.⁵ The inability to reverse AMI and restore muscle function can lead to decreased physical abilities,⁶ biomechanical deficits,⁷ and possibly reinjury.⁵ Furthermore, researchers^8,9 have suggested that quadriceps weakness resulting from AMI may place patients at risk for developing osteoarthritis in the knee. In light of the substantial influence of quadriceps AMI on these clinically relevant outcomes, we need to improve our understanding of the factors that contribute to this neurologic decline in muscle activity so efforts to target and reverse it can be implemented and gains in strength can be achieved more easily.Joint injury and disease are accompanied by numerous sequelae (ie, pain, swelling, tissue damage, inflammation), so ascertaining which one ultimately leads to neurologic muscle dysfunction is difficult. Whereas a joint effusion can result in AMI,^10–12 the effects of pain are less understood despite many clinicians attributing AMI to pain. Using techniques that introduce knee pain without accompanying injury may provide insights into the role of pain in eliciting AMI.The degree of knee joint damage may play a role in the quantity of AMI that manifests. Hurley et al^13,14 demonstrated that quadriceps AMI, measured using an interpolated-twitch technique, was greater in patients with extensive traumatic knee injury (eg, fractured tibial plateau, ruptured medial collateral ligament, and medial meniscectomy) than patients with isolated joint trauma (ie, isolated anterior cruciate ligament [ACL] rupture). Similarly, patients with more knee joint symptoms (ie, greater number of symptoms and increased severity of symptoms) may present with greater magnitudes of quadriceps inhibition. Recently, investigators¹⁵ have suggested that patients with more pain display less quadriceps strength, supporting this tenet. Given that effusion and pain often present simultaneously with joint injuries and diseases, such as ACL injury and osteoarthritis, examining both the isolated and cumulative effects of these sequelae appears warranted to determine if they influence the magnitude of muscle inhibition.Experimental joint-effusion and pain models are safe and effective experimental methods that allow for the isolated examination of their effects on muscle function. The effusion model, whereby sterile saline is injected directly into the knee joint capsule,⁷ produces a clinically relevant magnitude of the joint effusion that may be present with traumatic injury. Effusion is thought to activate group II afferents responding to stretch or pressure,^16–18 which in turn may facilitate group Ib interneurons and result in quadriceps AMI.⁵ The pain model involves injecting hypertonic saline into the infrapatellar fat pad to produce anteromedial knee pain similar to that described in patients with patellofemoral pain syndrome.¹⁹ Pain is considered to initiate AMI through activation of group III and IV afferents that act as nocioceptors to signal damage or potential damage to joint structures.^16–18 The firing of these afferents then may lead to facilitation of group Ib interneurons, the flexion reflex, or the gamma loop, ultimately resulting in quadriceps inhibition.²⁰ Thus, these models allow us to create symptoms that are associated with knee injury and have the added benefit of providing a way to examine their effects in isolation.Therefore, the purpose of our study was to determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion would affect the magnitude of quadriceps dysfunction. We hypothesized that pain alone would result in quadriceps inhibition and that the magnitude of inhibition would be greater when effusion and pain were present simultaneously.     

即早基因c-fos与脑血管病及学习记忆

即早基因c-fos是广泛存在于原核细胞和真核细胞的高度保守基因.在正常情况下,c-fos基因参与细胞生长、分化、信息传递、学习和记忆等生理过程,而在病理情况下c-fos基因表达及调控变化与多种疾病的发生和发展有关.C-fos在中枢神经系统的某些部位可有基础水平的表达,但表达很低,当受到如脑缺血、脑出血、痫性发作、应激等刺激后,其在数十分钟内做出反应,在对外界刺激-转录耦联的信忠传递过程中起着核内第三信使的重要作用.     

Opportunities and challenges in the prevention and control of cancer and other chronic diseases: children's diet and nutrition and weight and physical activity

OBJECTIVE: The purpose of this article is to review the role of behavioral research in disease prevention and control, with a particular emphasis on lifestyle- and behavior-related cancer and chronic disease risk factors--specifically, relationships among diet and nutrition and weight and physical activity with adult cancer, and tracking developmental origins of these health-promoting and health-compromising behaviors from childhood into adulthood. METHOD: After reviewing the background of the field of cancer prevention and control and establishing plausibility for the role of child health behavior in adult cancer risk, studies selected from the pediatric published literature are reviewed. Articles were retrieved, selected, and summarized to illustrate that results from separate but related fields of study are combinable to yield insights into the prevention and control of cancer and other chronic diseases in adulthood through the conduct of nonintervention and intervention research with children in clinical, public health, and other contexts. RESULTS: As illustrated by the evidence presented in this review, there are numerous reasons (biological, psychological, and social), opportunities (school and community, health care, and family settings), and approaches (nonintervention and intervention) to understand and impact behavior change in children's diet and nutrition and weight and physical activity. CONCLUSIONS: Further development and evaluation of behavioral science intervention protocols conducted with children are necessary to understand the efficacy of these approaches and their public health impact on proximal and distal cancer, cancer-related, and chronic disease outcomes before diffusion. It is clear that more attention should be paid to early life and early developmental phases in cancer prevention.