A comparison of visual acuity measured by ETDRS chart and Standard Logarithmic Visual Acuity chart among outpatients

AIM:To compare the results of visual acuity(VA)measured by Early Treatment Diabetic Retinopathy Study(ETDRS)chart,5 m Standard Logarithm Visual Acuity(5 SL)chart,and 2.5 m Standard Logarithm Visual Acuity(2.5 SL)chart in outpatients of age 12-80 y.METHODS:Each patient(totally 2000 outpatients)had both eyes tested with ETDRS chart at 4 m,5 SL chart at 5 m,and 2.5 SL chart at 2.5 m in random order.The VA values of outpatients were categorized by ages.VA values were expressed by log MAR recording method.RESULTS:The mean VA results of ETDRS charts,5 SL,and 2.5 SL chart were 0.52±0.28,0.50±0.30,and 0.46±0.28 log MAR,respectively.There was a statistically significant difference in the three eye charts in the whole group(P<0.001).For all subjects,the correlation of VA tested with three charts was statistically significant(Spearman correlation coefficient=0.944,0.937,0.946,all P<0.001).Bland–Altman analysis shows the 95%limits of agreement between the 5 SL and 2.5 SL chart were-0.182 to 0.210,-0.139 to 0.251,and-0.151 to 0.235 log MAR,respectively.CONCLUSION:The agreement between the three eye charts is not high.The VA measured by 5 SL chart is slightly better than that by ETDRS chart and 5 SL chart would be a suitable alternative when ETDRS chart are not available in the clinical situation.The VA measured by 2.5 SL chart is about 0.5 line better than VA tested with ETDRS chart,which may overestimate VA.     

高血压性脑出血患者的血液流变学和凝血谱的特性变化

目的通过对高血压性脑出血患者的血液流变学和凝血谱有关指标的检测,比较患者与健康对照组的血液流变学和凝血谱指标,为脑出血的预防和临床治疗提供客观依据。方法比较50例高血压性脑出血患者和51名健康对照者的血液流变学和凝血谱有关指标。结果高血压性肭出血患者的红细胞压积、全血粘度、全血还原粘度、血浆粘度、红细胞变形能力、纤维蛋白原浓度、D-二聚体水平、凝血酶时间等指标较健康对照组明显升高。而且血液流变学指标的异常变化幅度和凝血谱的指标异常变化幅度,特别是纤维蛋白原浓度密切相关。结论高血压患者的血液流变学和凝血谱的异常变化可能是导致脑出血发生的重要因素,因此纠正这些异常因素对预防和治疗高血压性脑出血具有一定的意义。     

强化胰岛素正确注射方法教育对减少皮肤并发症的影响分析

目的 探讨强化胰岛素正确注射方法教育联合图表标示减少皮肤并发症发生的临床价值.方法 将239例糖尿病患者按出院顺序分为对照组和观察组,出院后均采用腹部顺时针方向按8个注射点轮换注射胰岛素,要求8d内注射点不重复、注射点距离上次注射点≥2 cm;并要求一针一换和按正确方法消毒等;对观察组患者强化正确注射方法的重要性教育,并将注射部位和注射时间以图表标示.出院后6个月时比较2组患者胰岛素正确注射方法执行的差异、注射部位皮肤并发症发生率差异,并分析未正确执行胰岛素注射方法患者皮肤并发症发生率.结果 2组注射方法除正确排气差异无统计学意义,注射前洗手、部位轮换注射8d为一周期、8d内注射点不重复、注射点距离上次注射点≥2 cm、采用正确的消毒方法、针头做到一次性使用观察组均明显好于对照组;注射部位皮肤并发症发生率观察组明显低于对照组;皮肤并发症发生率以注射部位未按周期轮换、8d内注射点有重复及注射点距离上次注射点＜2 cm最高,其次是针头多次使用和未按正确方法消毒.结论 强化胰岛素正确注射方法教育可以提高患者注射胰岛素的可操作性,降低注射部位皮肤并发症发生率.     

Predictors of readmission after successful electroconvulsive therapy for depression: a chart review study

Objective: The study aimed to identify the predictors for readmission after a successful electroconvulsive therapy (ECT) course.

Methods: Medical charts of patients who received ECT for major depressive episodes were reviewed. Patients’ demographic characteristics and treatment parameters, such as ECT charge, seizure duration, the number of ECT sessions and pharmacotherapy, were extracted. We compared differences between those who were readmitted after successful ECT within 6 and 12 months, versus those not readmitted. We also conducted a multivariate logistic regression analysis to identify the predictors for readmission.

Results: Out of 51 patients who were discharged after ECT, 27 patients met the inclusion criteria and were included in the analysis. Eight patients were readmitted within 6 months after discharge, and four more patients were readmitted during the next 6-month follow up. Comparing patients who were and were not readmitted, we found no significant differences between groups, including ECT parameters such as the number of ECT sessions, average charge and final charge. No predictors for readmission were found through multivariate analysis.

Conclusions: Although patients who require higher ECT charge and more sessions seem to be prone to readmission, our dataset suggested that none of these types of ECT parameters were risk factors for readmission.     

知识体系图在药剂学教学中的应用

探索如何构建药剂学知识体系图,采用流程图、状态图、概念图等使药剂学知识更加系统化、直观化、逻辑化,促使学生深入理解和有效记忆知识,提高解决问题的能力,并有效激发学习兴趣。     

双控法在整建制接管新型冠状病毒肺炎重症隔离病区的应用

目的 探索快速、高效地整建制接管新型冠状病毒肺炎（以下简称“新冠肺炎”）重症隔离病区的方法,为应对重大突发公共卫生事件提供借鉴。 方法 应用清单查检与甘特图相结合的方法,对我院在驰援武汉市整建制接管重症隔离病区过程中需要的人员、设备、物资、制度流程和环境5项管理进行内容控制和时间控制,确保隔离病区各项应急工作顺利开展。 结果 医疗队在2 h内完成人员集结,到达武汉市24 h内整建制接管重症隔离病区,48 h内收满100张床位的重症患者,各项生命支持设备、物资到位,应急预案完成。救治2个月,重症、危重症患者占比超过90%,患者出院、转出超过91%,医疗队队员零感染、零意外。 结论 双控法在整建制接管新冠肺炎重症隔离病区的护理管理和持续改进中发挥了重要的作用,是应对新冠肺炎等重大突发疫情行之有效的护理方法。     

《千金翼方》载录的《辨伤寒》考(上)

孙思邈《千金翼方》卷九、卷十载录的《伤寒论》称《唐本伤寒论》,又称《孙思邈本伤寒论》。犹如《宋本伤寒论》又称《赵开美本伤寒论》一样。《孙思邈本伤寒论》与《赵开美本伤寒论》都来源于一个共同的祖本,即均来自南朝梁阮孝绪《七录》著录的《辨伤寒十卷》。阮孝绪《辨伤寒十卷》与陈延之《小品方》著录的《辨伤寒》相关。《宋本伤寒论》受到世人高度崇信赞佩,关于它的研究已成滔滔江河之势,《唐本伤寒论》直至现在,对它的研究考证仅是涓涓细流,未被医家与学者周知。文章考证《千金翼方》成书时代及其流传,考证《伤寒辨》之特点与结构,比较《辨伤寒》与宋本《伤寒论》之异同。