Parks切口眼外肌调整缝线术治疗间歇性外斜视

目的 观察Parks切口眼外肌调整缝线术治疗间歇性外斜视的临床效果.方法 采用Parks结膜切口(近穹隆部结膜切口)联合眼外肌后徙调整缝线术治疗间歇性外斜视37例,术后随访3～8个月.结果 (1)眼位:37例患者中11例术后未达到预期效果、眼位不正,欠矫2例,过矫9例,术后24h内表麻下采用调整缝线术进行眼位调整,11例均将眼位调整至预期效果.最终随访眼位结果:未调整者欠矫2例,分别欠矫-15Δ、-20Δ,过矫15Δ1例.调整眼位者欠矫3例,分别欠矫-12Δ、-15Δ、-25Δ.余31例正位.(2)结膜切口愈合情况:所有患者结膜切口均于术后5～8d完全愈合,睑裂部无明显瘢痕.(3)并发症:5例患者调整缝线结对应的结膜面局部结节状隆起水肿,给予0.1%氟美瞳眼水点眼后消退.未见切口感染、缝穿巩膜、肌肉滑脱等并发症.结论 采用Parks结膜切口眼外肌后徙调整缝线术可于24h内对间歇性外斜视术后眼位不正者进行有效眼位调整,避免了角膜缘梯形结膜切口的缺点.     

调整Parks法治疗有代偿头位的先天性眼球震颤

目的 观察采用调整Parks法手术量治疗有代偿头位(compensatory head posture,CHP)的先天性眼球震颤(congenital nystagmus,CN)的临床效果.方法 对28例伴有CHP的CN患者,采用调整Parks方法的手术量行中间带移位术,当代偿头位为15°～25°、25°～30°、30°～40、＞40时,从慢相侧到快相侧4条水平直肌手术量分别为7050 mm、6446mm、7557 mm、7658 mm.对比观察术前、术后视力及CHP情况.结果 与术前相比,术后单眼或双眼同时注视时的最佳矫正视力和第一眼位视力均有显著提高.CHP基本消除者(CHP＜10°)21例,明显改善者(CHP＞10°)6例,无变化者1例,与术前相比疗效显著.3例伴水平斜视者全部矫正为正位.结论 调整Parks法手术量适用于治疗各种大小CHP的CN患者.     

改良Parks切口与直肌线状折叠术联合应用治疗成人共同性斜视

目的:探究改良Parks切口与直肌线状折叠术联合应用治疗成人共同性斜视疗效及对术后视功能恢复及眼部美观度的影响。方法:以2019-06/2021-06成人共同性水平斜视患者160例为研究对象,根据手术方法的不同分为观察组(改良Parks切口与直肌线状折叠术联合应用,89例)及对照组(角膜缘梯形结膜瓣切口与直肌线状折叠术联合应用,71例)。比较两组临床疗效及手术相关指标;观察两组患者手术前后角膜荧光染色积分、标准干眼症状评估问卷(SPEED)及术后视觉模拟评分法(VAS)、温哥华瘢痕量表(VSS)评分变化情况,并于术后1mo统计患者结膜愈合不良、散光等并发症发生情况。结果:观察组手术总有效率高于对照组,手术切口长度短于对照组(均P<0.05);观察组术后角膜荧光染色积分、干眼症状评分均低于对照组,术后1wk的VAS评分低于对照组(均P<0.05);观察组术后开散性融合范围及视近33cm、视远5m斜视角大于对照组,辐辏性融合范围小于对照组,视近33cm、视远5m立体视低于对照组(均P<0.05);观察组术后泪膜破裂时间长于对照组,泪液分泌量多于对照组,角膜表面规则性指数(...     

An immunological study of nine proteins in CSF and serum of a group of epileptic patients.

The concentrations of nine proteins, alpha-1-acid glycoprotein, antitrypsin, prealbumin, transferrin, albumin, IgG, ceruloplasmin, IgA and alpha-2-macroglobulin, have been determined in the serum and CSF of two groups of patients, one control and one experimental, by an immunological method. The experimental group were patients suffering from grand mal epilepsy. The control group showed no detectable neurological disorder. In the group of grand mal epileptics, only prealbumin showed a significant elevation in CSF when compared with the control group. In contrast, the rest of the proteins are decreased with respect to the controls except for alpha 1-acid glycoprotein and transferrin. The results from this study also suggest that something more than an ultrafiltration process dependent upon molecular weight, is important in determining the concentration of some serum proteins in the CSF.     

Positive HABITATS for physical activity: Examining use of parks and its contribution to physical activity levels in mid-to older-aged adults

Studies of parks and physical activity rarely identify the actual spaces participants use. Using data from the HABITAT project, a longitudinal cohort of mid-to older-aged (40–70 years) respondents (n = 11,036) living in Brisbane Australia, this study examined (1) the demographic characteristics of users and non-users of parks; (2) the park used and the characteristics and features of the most popular reported spaces; and (3) the level of physical activity undertaken in the reported parks and whether users had higher total physical activity levels than non-users. Park use was significantly higher (p < 0.01) among dog walkers, couples (over 40) living with children, and those living in least disadvantaged areas. Regular park use was significantly higher among users of larger-sized neighbourhood and district-catchment parks. Park users were 35% more likely to meet the physical activity guidelines (OR = 1.35, 95%CI 1.21–1.50, p < 0.001) compared with those who indicated they did nto regularly use a park. The size of the park used was positively associated with participation in physical activity. Users of larger-sized parks spent more time doing vigorous activity and engaged in more activity sessions than non-users. Future data obtained from large populations, including spatial examination of the actual parks used and their characteristics, are essential to facilitate planning for park provision, optimising the use of these spaces for recreation and physical activity by mid-to older-aged adults, and creating healthy communities.     

Public open space,physical activity,urban design and public health: Concepts,methods and research agenda

Public open spaces such as parks and green spaces are key built environment elements within neighbourhoods for encouraging a variety of physical activity behaviours. Over the past decade, there has been a burgeoning number of active living research studies examining the influence of public open space on physical activity. However, the evidence shows mixed associations between different aspects of public open space (e.g., proximity, size, quality) and physical activity. These inconsistencies hinder the development of specific evidence-based guidelines for urban designers and policy-makers for (re)designing public open space to encourage physical activity. This paper aims to move this research agenda forward, by identifying key conceptual and methodological issues that may contribute to inconsistencies in research examining relations between public open space and physical activity.     

Public green spaces and positive mental health – investigating the relationship between access,quantity and types of parks and mental wellbeing

Associations between parks and mental health have typically been investigated in relation to the presence or absence of mental illness. This study uses a validated measure of positive mental health and data from RESIDential Environments (RESIDE) Project to investigate the association between the presence, amount and attributes of public green space in new greenfield neighbourhood developments and the mental health of local residents (n = 492). Both the overall number and total area of public green spaces were significantly associated with greater mental wellbeing, and findings support a dose-response relationship. Positive mental health was not only associated with parks with a nature focus, but also with green spaces characterised by recreational and sporting activity. The study demonstrates that adequate provision of public green space in local neighbourhoods and within walking distance is important for positive mental health.     

腹腔镜Parks手术在早期低位直肠癌治疗中的应用(附15例分析)

目的探讨腹腔镜Parks手术在早期低位直肠癌保肛中的作用及相关手术技巧。方法回顾性分析15例超低位直肠癌患者施行腹腔镜Parks手术的临床资料。结果全组手术过程顺利。平均手术时间260min,平均术中失血量略210ml,胃肠功能恢复时间31.3h,手术器材费用4210元。肿瘤近侧切除肠管长度平均14.7(11～18)cm,远切缘距肿瘤2.6(1.5～4.0)cm。术后发生吻合口漏1例,吻合口出血2例,术后肛门功能基本满意。随访2～45月,局部复发1例。结论腹腔镜Parks手术具有创伤小、出血少、恢复快等优点,在保留肛门的同时可节省部分费用,可作为部分早期低位直肠癌患者保留肛门功能手术的一种新的选择。