新型视力自动测试仪的研制

介绍了一种新研制成功的视力自动测试仪,被检者通过操作手持遥控器判别视标的开口方向,系统自动检测并判别其正误,最后打印出检测报告.系统测定的视力范围从对数视力3.0到5.3,同时,系统带有红外超声自动测距功能,以保证测量结果的准确性.     

射阳县合兴乡学生视力调查分析

为积极开展学生视力保护工作,射阳县合兴乡卫生院于１９９８年９月对全乡１５所小学、３所初中４５７７名学生进行了视力调查,现将调查结果报告如下。１调查对象及方法１．１调查对象与方法采用Ｅ字标准对数灯光视力表箱,由专业人员对全乡１５所小学,３所初级中学所有在校学生进行检测。１．２判断标准以有一眼裸眼视力低于５．０的为视力不良。视力不良程度分为三度,４．９为轻度,４．６～４．８为中度,４．５以下为重度;双眼视力不良的以差的一眼划分不良程度。２结果视力不良情况,４５７７名中小学生中,视力不良的占１７．５％…     

霍乱弧菌三种试验的诊断效果比较

应用纯培养菌制备标本，以生理盐水为空白对照，共检测１１７例，并试验了实际标本的处理方法。从ＰＣＲ法、菌培养、凝集试验入选判别模型的顺序、真实性评价及ＲＯＣ曲线面积大小比较３个诊断试验的判别能力的大小。结果表明，３个诊断试验均入选判别模型，它们对诊断霍乱的判别能力均显著，３个指标的入选顺序为：ＰＣＲ试验→菌培养→凝集试验，第一个入选的指标是Ｘ１（ＰＣＲ），其对判别函数的贡献最大，判别能力也最大，其次是菌培养，最后是凝集试验；以判别函数为标准，ＰＣＲ试验的灵敏度及特异度均可达到１００％，细菌培养灵敏度为１００％，特异度为９６．５５％，假阳性率为３．４５％；凝集试验灵敏度为６４．７７％，特异度为９６．５５％，假阳性率为３．４５％，假阴性率为３５．２３％，３种试验的真实性评价表明ＰＣＲ试验的真实性高于其他两个试验；３种试验的ＲＯＣ曲线面积由大到小顺序是：ＰＣＲ试验（０．９６１７）＞菌培养（０．９５９６）＞凝集试验（０．６３３４），故诊断霍乱的判别能力由大到小的顺序是：ＰＣＲ试验＞菌培养＞凝集试验。ＰＣＲ试验的判别能力大于菌培养、凝集试验     

自操作式视力测定仪

本文介绍一种自操作式视力测定仪。在标准视力表面每一视标下方安装发光二极管,通过发光二极管的发光与否来指定某一视标供受检者判别。受检者通过键盘输入自己对视标开口方向的判别。判别信号的鉴别,视标换行及同一行视标的随机选择由数字电路实现。所测定的视力由数码管显示。经试用与人工视力检查对照,相关系数R=0.87(P<0.001)。     

鹤壁市高中学生戴镜情况分析

鹤壁市高中学生戴镜情况分析王淑琴１徐俊娥２王惠２１对象、内容与方法１．１对象是鹤壁市高中一至三年级视力低下佩戴眼镜的４９２名男、女学生。１．２调查内容：视力低下眼的屈光度数、裸眼视力、矫正视力、眼孔距离、眼镜的光学中心、中心距、屈光度数。１．３视力检...     

幼儿视力3年监测结果分析

为了在幼儿期尽早筛出斜视、弱视和近视，进行视力和眼位的检查非常重要。我所儿保科连续３年对辖区内的重棉一厂幼儿园的儿童进行视力和眼位检查，检查结果如下。１对象和方法 １９９５～１９９７年，每年６月下旬对幼儿园的全体儿童进行视力和眼位检查。３年共查６５７人次，其中３～岁组１８５人，４～岁组 ２２７人， ５～岁组 ２４５人， ９９％是城市儿童， ９８％为独生子女。用有标准照明的视力箱进行远视力检查。用遮盖－去遮盖试验、交替遮盖试验筛查眼位。２结果２．１３年远视力检查结果比较通过３年的筛查，幼儿左、右眼远视力…     

浅谈如何做好儿童视力检查

浅谈如何做好儿童视力检查大庆市大同医院张今贵视力检查是眼科诊断与治疗的重要环节，为早期掌握儿童视力情况，依据儿童年龄与发育不同而采用不同的检查方法是非常必要的。现将本科对不同年龄组儿童视力检查方法介绍如下：１．３岁以下儿童视力检查：采用大小不等的玻璃...     

北京市3—6岁异常视力儿童屈光状态分析

目的 了解北京市３－６岁异常视力儿童屈光状态。方法 采用分层随机整群抽样的方法，对北京市３－６岁儿童（５５８６名）的视功能进行调查，本文仅就单眼裸眼视力〈０．９者（３７０例〉７４０只眼）的屈光状态及伴斜视、弱视患儿的屈光状态进行了分析。结果屈光不正总患率为６．５３％，远视、混合散光、近视患病率依次为：４．７６％、１．５６％、０．３０％、；轻、中、重度屈光不正患病率依次为３．６８％、２．０５％、０．     

深圳市865例学龄前儿童视功能普查

为了解深圳市学龄前儿童视功能（视力、光觉、色觉、立体视觉等多种功能）状况，我们采用自行设计方法，对深圳市８６５例学龄前儿童进行视功能普查。结果显示：我市学龄前儿童视功能较差，视力正常者仅为４４．８６％，色觉和三级功能异常者分别为１．８５％和４．５１％；弱视发病率为３．４７％，斜视发病率为３．００％，近视和其他眼病发病率分别为０．３５％和１．７３％，发病率较低，考虑与本次普查的年龄组有关；４、５、６岁年龄组视力正常比例分别为１０．３１％、３９．４３％、５０．２５％，有显著性差异（Ｐ＜０．０１），视…     

217名小学生视力追踪观察

１９９０～１９９５年对张掖、高台３所小学２１７名小学生进行了连续６年视力动态追踪观察。现将观察情况报告如下。对象与方法（１）选择对象：城区３所小学新入学的７～９岁男女一年级小学生,双眼远、近视力在５．０以上的视力正常者为观察对象。剔除留级、转学,追踪...     

Evaluation of the cost-effectiveness of an automated multiphasic health testing system

We present an evaluation of the cost-effectiveness of an automated multiphasic health testing system (AMHTS) compared with a manual system for providing comprehensive health examinations of large populations. The automated technology was found to be more economical (50–75% less/examinee) than the traditional system in performing each phase of the comprehensive screening and overall battery at a certain examinee load per month. Direct costs had a larger effect on cost per examinee than indirect costs and equipment depreciation. Highly automated phases (tests) were relatively more cost-effective than phases requiring more time and participation of physicians or trained personnel. This study demonstrates that an AMHTS can be utilized (within its parent medical care delivery organization) as an efficient, economical, and convenient method for conducting large-scale multiphasic screening.     

CT受检者体表屏蔽防护存在的问题与对策

CT非检查区域体表屏蔽防护是降低受检者辐射剂量简单而有效的方法，也是国家行业标准规定的基本要求。一些调查报道回顾显示，在我国的不同的地区和不同级别的医疗机构CT受检者个人放射防护用品配置合理性欠缺、使用率不高、穿戴方法不当、日常维护不到位以及医务人员、公众或受检者对放射防护的基本知识认知不足等问题不同程度地存在，需要不断改进。     

The Diagnosis of Urinary Tract Infection in Young Children (DUTY) Study Clinical Rule: Economic Evaluation

Objective

To estimate the cost-effectiveness of a two-step clinical rule using symptoms, signs and dipstick testing to guide the diagnosis and antibiotic treatment of urinary tract infection (UTI) in acutely unwell young children presenting to primary care.

Criteria and modalities of assessment of work fitness for jobs in food industry]

Current legislation establishes the general methods and standards of judgement concerning fitness of workers to perform particular jobs. The object of this study was to verify particular criteria and methods that, in observance of the law, allow the physician to maintain in productive activity workers with chronic disease or permanent consequences of industrial accidents in Apulia, Southern Italy. In accordance with the law, 156 workers and their work environment are regularly under surveillance. In the last few years it was possible to accurately diagnose all diseases that may be involved in particular work fitness checks. 3 workers suffered the permanent consequences of very serious labour accidents amputation of II, III, IV fingers of the right hand; a slight post-traumatic shortening (shrinkage) of the right femur; tympanic membrane perforation). 7 workers suffered from non-work related disease (substitution of aortic valve, allergic asthma, virus B chronic hepatitis, chronic glomerulonephritis, replacement of right knee, rheumatoid arthritis, thrombosis of the retinal central vein without a vision reduction). The criteria for an "fitness judgement" are: an accurate diagnosis and evaluation of residual functional ability, analysis of the original job, with an investigation in the field, and break down into the single operations in order to assess all work-related risks (concerning health, safety and physical resources), and evaluation of work organization per job. It was thus possible to define particular adjustments to the original job, so as to be compatible with the current physical conditions the workers. Workers, factory directors and union officers accepted these particular criteria and standard of "work fitness judgement, which made it possible to apply them in practice with consequent reinstatement of workers in productive activity.     

Exposure as Part of a Systems Approach for Assessing Risk

Background

The U.S. Environmental Protection Agency is facing large challenges in managing environmental chemicals with increasingly complex requirements for assessing risk that push the limits of our current approaches. To address some of these challenges, the National Research Council (NRC) developed a new vision for toxicity testing. Although the report focused only on toxicity testing, it recognized that exposure science will play a crucial role in a new risk-based framework.

Objective

In this commentary we expand on the important role of exposure science in a fully integrated system for risk assessment. We also elaborate on the exposure research needed to achieve this vision.

Discussion

Exposure science, when applied in an integrated systems approach for risk assessment, can be used to inform and prioritize toxicity testing, describe risks, and verify the outcomes of testing. Exposure research in several areas will be needed to achieve the NRC vision. For example, models are needed to screen chemicals based on exposure. Exposure, dose–response, and biological pathway models must be developed and linked. Advanced computational approaches are required for dose reconstruction. Monitoring methods are needed that easily measure exposure, internal dose, susceptibility, and biological outcome. Finally, population monitoring studies are needed to interpret toxicity test results in terms of real-world risk.

Conclusion

This commentary is a call for the exposure community to step up to the challenge by developing a predictive science with the knowledge and tools for moving into the 21st century.     

2012年邯郸市高考生体质健康调查分析

目的通过调查邯郸市2012年高考考生体质健康状况,分析邯郸市高考考生引起专业受限的主要原因,以便给予有针对性的干预措施。方法根据《普通高等学校招生体检工作指导意见》的要求,对邯郸市全体高考考生进行体检。结果邯郸市2012年度高考考生身体条件受限主要原因是视力低下,在报考专业受限的学生中视力低下为43863人,视力低下受限率为83．83％,视力低下率占到报考专业受限率的99．60％。结论邯郸市近年来高考考生身体健康存在的主要问题是视力低下,提高高考考生体检合格率关键在于减轻学生课业负担,减少近距离用眼时间,增加户外活动,提倡营养素均衡摄入。     

应用Fuzzy法综合评价住院医师培训考生素质

参考全球医学教育最基本要求的相关标准,采用问卷调查法和专家讨论法建立对参加我院住院医师培训考生综合素质评价的指标体系,确定相应的备选集及权重系数。在此基础上,依据模糊数学法提出了针对住院医师考生综合素质评价的Fuzzy计算模型,并举例对该模型的使用进行了说明。结果认为本模型能够相对全面、客观地对住院医师考生的综合素质做出评价。     

人体失衡性实时测试系统研究

采用测试平台及计算机系统建立了人体失衡性实时测试系统，通过失衡性指数提出评价体系。对不同年龄组４０名受试者进行失衡性动态检测。测试状态包括：睁眼状态、团眼状态、平台倾斜１０度、平台倾斜２０度、平台倾斜３０度、横各视跟踪、纵向视跟踪、矢向视跟踪。结果表明：不同年龄人群在不同状态下表现出失衡的差异。     

Vigabatrin: balancing effectiveness vs. (irreversible) visual field loss as a side effect

The antiepileptic drug vigabatrin causes an asymptotic concentric contraction of the visual field in 30 to 40% of the patients. The visual field loss seems to be correlated with the cumulative dose of vigabatrin and is not reversible. The cause of this field loss is located in the inner retina (the horizontal and/or amacrine cells). The exact mechanism is still unknown. Though abnormalities in electrophysiology and colour vision are found, regular visual field examination remains the cornerstone in detecting visual field loss. A careful judgement has to be made in individual patients before starting or continuing vigabatrin medication.     

The Future Use of in Vitro Data in Risk Assessment to Set Human Exposure Standards: Challenging Problems and Familiar Solutions

Background

The vision of a National Research Council (NRC) committee (the Committee on Toxicity Testing and Assessment of Environmental Agents) for future toxicity testing involves the testing of human cells in in vitro assays for “toxicity pathways”—normal signaling pathways that when perturbed can lead to adverse effects. Risk assessments would eventually be conducted using mathematical models of toxicity pathways (TP models) to estimate exposures that will not cause biologically significant perturbations in these pathways.

Objectives

In this commentary we present our vision of how risk assessment to support exposure standards will be developed once a suitable suite of in vitro assays becomes available.

Discussion

Issues to be faced basing risk assessments on in vitro data are more complex than, but conceptually similar to, those faced currently when applying in vivo data. Absent some unforeseen technical breakthrough, in vitro data will be used in ways similar to current practices that involve applying uncertainty or safety factors to no observed adverse effect levels or benchmark doses. TP models are unlikely to contribute quantitatively to risk assessments for several reasons, including that the statistical variability inherent in such complex models severely limits their usefulness in estimating small changes in response, and that such models will likely continue to involve empirical modeling of dose responses.

Conclusion

The vision of the committee predicts that chemicals will be tested more quickly and cheaply and that animal testing will be reduced or eliminated. Progress toward achieving these goals will be expedited if the issues raised herein are given careful consideration.