眼后段疾病相关青光眼的临床分析

目的：探讨与眼后段疾病相关的青光眼的病因及相应治疗措施。方法：对74例与眼后段疾病相关的青光眼患者的临床资料行回顾性分析。结果：74例患者中硅油继发青光眼39例，经手术及药物治疗，眼压可控制正常。新生血管性青光眼(Neovascular glaucoma,NVG)29例，多数行视网膜周边冷冻联合视网膜光凝等抗增殖手术，治愈率为15％，有效率为60％。6例行玻璃体切割、内眼激光、周边视网膜冷冻(或联合硅油填充)术，3例术后眼压正常，5例新生血管消退。外伤性晶体脱位、玻璃体嵌顿、视网膜脱离继发青光眼4例，因眼后段疾患行多次手术引起瞳孔闭锁继发青光眼2例，手术治疗后眼压正常。结论：硅油继发青光眼、外伤性品体脱位、玻璃体嵌顿继发青光眼、瞳孔闭锁继发青光眼等经药物及手术治疗眼压可控制正常，预后较好，而NVG仍是治疗的难题，抗增殖手术如玻璃体切割、内眼激光、周边视网膜冷冻联合硅油填充术可能会成为治疗NVG的一种有效手段，但需进一步探讨。     

延续性护理模式在椎动脉型颈椎病患者中的应用效果分析

目的:观察延续性护理模式在椎动脉型颈椎病患者中的应用效果。方法:将100例椎动脉型颈椎病患者随机分为观察组、对照组各50例。观察组采用延续性护理模式配合优质护理服务进行临床护理,对照组采用常规护理模式进行护理。观察2组颈椎功能障碍指数,自我护理能力及遵医嘱情况。结果:颈椎功能障碍指数出院后3个月、出院时与入院时2组组内比较,差异有统计学意义(P0.05);出院后3个月与出院时2组组内比较,差异有统计学意义(P0.05);出院时、出院后3个月时2组组间比较,差异有统计学意义(P0.05)。自我护理能力2组比较差异有统计学意义(P0.05);遵医嘱情况2组比较,差异有统计学意义(P0.05)。结论:延续性护理模式能缓解患者的临床症状,提高患者的自我护理能力,促提高患者的遵医情况。     

痰湿证睡眠呼吸暂停患者CPAP压力水平研究

目的:对痰湿证睡眠呼吸暂停(OSA)患者运用持续正压通气(CPAP)治疗,探讨呼吸机压力水平和BMI、颈围、最低血氧、AHI、鼾声指数的关系,推导相关压力值计算公式,方便临床应用。方法:对54例痰湿证OSA患者行呼吸机压力滴定,分析呼吸机压力水平和BMI、颈围、最低血氧、AHI、鼾声指数的相关性,得出平均压力的多元线性回归方程,用于临床参考。结果:(1)CPAP治疗前后AHI指数和鼾声指数有显著差异(P0.01),CPAP治疗疗效显著。(2)BMI、颈围、最低血氧、AHI、鼾声指数均和平均压力直线相关(P0.01)。(3)根据多元线性逐步回归,得出平均压力=0.220×颈围+0.036×AHI+0.001×鼾声指数-3.746。结论:OSA患者BMI、颈围、最低血氧、AHI、鼾声指数均与CPAP平均压力显著相关,通过回归方程计算得出相关压力水平。     

老参地、农田地改造,连续栽培人参、西洋参

人参、西洋参不能重茬、连作，导致人参产业和林业之间的矛盾日显突出。作者提出了一种农田地、老参地连续栽培人参方法，是一项具新型实用配套技术，适用于老参地、农田地连续播种、移栽人参和西洋参，且成品参的产量质量与新林地对照没有显著差异。     

Combining CGM and an Online Peer Support Community for Hispanic Adults with T2D: A Feasibility Study

Background:Previous research has identified that people with type 2 diabetes (T2D) within the Hispanic community would benefit from an online peer support community (OPSC) and continuous glucose monitoring (CGM) data to facilitate diabetes self-management.Methods:A mixed-methods feasibility study enrolled Hispanic, Spanish-speaking adults with T2D, not on insulin. Participants were provided with CGM and access to an OPSC for 12 weeks. Feasibility was assessed by number of eligible participants who enrolled, attrition, quantity of CGM data, validated clinical measures of self-efficacy, quality of life and adverse events. Engagement in the OPSC was measured using objective metrics on the online platform. Qualitative interviews were conducted upon conclusion of the intervention to assess feasibility, acceptability, participant satisfaction, and key recommendations for improvement.Results:Of 46 participants screened, 39 were eligible and 26 completed the study. Participants significantly improved self-efficacy scores. Posts in the OPSC related to goal setting had the highest engagement followed by mid-week and end of week check-in posts respectively. Participant interviews described challenges accessing the OPSC platform as a barrier to engagement. Despite this, all participants were satisfied with the intervention. Key recommendations for improvement included providing greater variety of and individualized education and the use of a peer support platform that is easily accessible.Conclusions:The CGM + OPSC intervention tailored to the Hispanic community with T2D was feasible, acceptable and satisfactory and improved participant self-efficacy for diabetes management which may lead to improved clinical outcomes.     

Spanish Translation and Linguistic Validation of the Glucose Monitoring Experiences Questionnaire (GME-Q) in Continuous Glucose Monitoring Users

Background and Aims:The use of continuous glucose monitoring (CGM) has become standard practice in people with type 1 diabetes. The evaluation of user satisfaction is crucial. The Glucose Monitoring Experiences questionnaire (GME-Q) includes 23 items with a 5-point Likert scale to produce a total satisfaction score and three subscale scores. The study aimed to translate the GME-Q from English into Spanish and to validate its use in Spanish-speaking CGM users with type 1 diabetes.Methods:The linguistic translation and validation process of the GME-Q was established. T1D CGM users were asked to complete the produced Spanish version of the GME-Q and interviewed about difficulties or misunderstandings. Total satisfaction, effectiveness, convenience and intrusiveness subscales and internal consistency reliability were computed.Results:Forward and backward translations and cognitive debriefing produced a final version of the GME-Q in Spanish. Ninety-eight subjects with type 1 diabetes were selected (age: 40 ± 12 years, 63% females, Hb1c: 7.2 ± 0.9% (55 ± 10 mmol/l), pump users: 78%, CGM use: 3.7 ± 2.6 years). The completion rate was 99% and the Cronbach’s alpha coefficient was 0.8. The total satisfaction score was 3.9 ± 0.4 (effectiveness: 4.1 ± 0.6, convenience: 3.8 ± 0.6, intrusiveness: 2.2 ± 0.7).Conclusion:The GME-Q was translated into Spanish and validated for Spanish-speaking CGM users with type 1 diabetes.     

Investigation of the Thermodynamic Transformation and Rare Earth Microalloying of a Medium Carbon-Medium Alloy Steel for Large Ball Mill Liners

The medium carbon-medium alloy steel was developed for the manufacture of large ball mill liners and sports equipment. In this study, the continuous cooling transformation curve of a novel type of medium carbon-medium alloy steel was measured with a thermal simulation machine; based on this curve, the hardening and tempering processes were optimized. The steel was then complex modified with alkaline earth and rare earth alloys. The mechanical properties of the treated steel were tested. The microstructure of the steel was analyzed by metallographic microscopy, X-ray diffraction, scanning electron microscopy and transmission electron microscopy, and the wear surface of the steel was analyzed by a three-dimensional morphometer. After high-temperature tempering, the microstructure transformed into tempered sorbite, which possesses good mechanical properties and can adapt to working conditions that require high strength and toughness. Rare earth or alkaline earth modification of the medium carbon-medium alloy steel promoted microstructural uniformity and grain refinement and improved the mechanical and anti-wear properties.     

The impact of continuous positive airway pressure on cardiac mechanics: Findings from a meta‐analysis of echocardiographic studies

Current evidence on the effects of continuous positive airway pressure (CPAP) on cardiac mechanics in patients with obstructive sleep apnea (OSA) is based on a few single studies. The authors investigated this topic through a meta‐analysis of speckle tracking echocardiography (STE) studies that provided data on left ventricular (LV) and right ventricular (RV) mechanics as assessed by global longitudinal strain (GLS). The PubMed, OVID‐MEDLINE, and Cochrane library databases were systematically analyzed to search English‐language review papers published from inception to January 31, 2022. Studies were identified by crossing the following terms: “obstructive sleep apnea”, “sleep quality”, “sleep disordered breathing”, “continuous positive airway pressure therapy”, “noninvasive ventilation”, “left ventricular hypertrophy”, “systolic dysfunction”, “global longitudinal strain”, “left ventricular mechanics”, “right ventricular mechanics”, “echocardiography” and “STE echocardiography”. The meta‐analysis, including a total of 337 patients with OSA from nine studies (follow‐up 2–24 months) showed a significant GLS improvement in both LV and RV after CPAP, standard mean difference (SMD) being 0.51±0.08, CI:0.36–0.66, p = .0001 and 0.28±0.07, CI:0.15–0.42, p = .0001), respectively. Corresponding SMD values for LV ejection fraction (LVEF) and tricuspid annular plane systolic excursion (TAPSE) were 0.20±0.06, CI:0.08–0.33, p = .001 and 0.08±0.06, CI: ‐0.04/0.20, p = .21. Our meta‐analysis suggests that: I) CPAP treatment exerts beneficial effects on biventricular function in patients with OSA; II) the assessment of cardiac mechanics by STE should be routinely recommended for monitoring cardiac function in this setting, due to limitations of conventional echocardiography in evaluating biventricular performance.     

A comparative study of the efficacy and safety of high-flow nasal cannula and nasal continuous positive airway pressure in neonatal respiratory distress syndrome: A protocol for systematic review and meta-analysis

Background:When it comes to preterm newborns, respiratory distress syndrome (RDS) is the most frequent respiratory condition. Despite the fact that it is well acknowledged that preterm delivery plays a significant role, the causes of lung damage are still not completely understood. In newborns with extremely low birth weight and neonatal RDS, nasal continuous positive airway pressure has been suggested as the first respiratory assistance for spontaneous breathing. In the current research, we aim to carry out a meta-analysis to assess the effectiveness and safety of high-flow nasal cannula (HFNC) and non-invasive continuous positive airway pressure (nCPAP) in patients with neonatal respiratory distress syndrome (NRDS).Methods:We intend to search the following databases: PubMed, EMBASE, Cochrane Library, Wanfang database, China National Knowledge Infrastructure (CNKI), and Google Scholar, starting from their initial publication until February 2022, to identify randomized controlled trials comparing HFNC to nCPAP in patients with NRDS. The suitable papers will be chosen by 2 writers who will work independently of one another. Using the Cochrane updated technique for risk of bias, each included article will be subjected to an independent data extraction process by the 2 writers who will then independently evaluate the risk of bias. Consequently, a third author will be asked to address any discrepancies that may arise between the writers. It will be necessary to pool the data and do a meta-analysis with the help of the RevMan 5.3 software.Results:In this study, the effectiveness and safety of HFNC will be compared with those of nCPAP in patients with NRDS.Conclusion:If the results of this research are confirmed, they may serve as a summary of the most recent data for non-invasive respiratory assistance in NRDS.Ethics and dissemination:The study will require ethical approval.Registration number:DOI 10.17605/OSF.IO/BKSQ5     

医药电商平台持续使用意愿及影响因素研究

构建医药电商平台持续使用意愿理论模型,采用问卷调查分析用户对医药电商平台持续使用意愿及影响因素,结果表明感知有用性和用户主观规范正向影响用户对平台持续使用意愿,感知风险负向影响持续使用意愿.在此基础上提出平台运营建议,包括设计创新、口碑化宣传、建设生态链等.