患有发育障碍类疾病的儿童数量庞大，给社会造成了严重的影响。这类疾病难以预防和治愈，同时缺乏特效药物，因此治疗主要依赖于行为和教育干预，药物治疗只是辅助手段。然而，目前临床相关治疗均有一定的不足，如存在不良反应、治疗周期相对较长、专业性要求相对较高等缺点。与之相比，音乐疗法具有操作简便、不良反应少等优势，因此可应用于儿科多种慢性疾病的治疗。文章旨在通过研究现代音乐治疗，探讨结合古代五音疗法、现代知识以及中医理论，为儿童临床治疗提供一定的方法指导。
The number of children suffering from developmental disorders is substantial，causing significant impact on society．These diseases are difficult to prevent and cure，with a lack of specific medications，thus treatment primarily relies on behavioral and educational interventions，with medication being only an auxiliary measure．However，current clinical treatments have certain drawbacks，such as potential toxic side effects，relatively long treatment periods，and high demands for specialization．In contrast，music therapy offers significant advantages such as easy operation and minimal side effects，making it suitable for the treatment of various chronic pediatric disease．This paper aims to explore the integration of ancient pentatonic therapy，modern knowledge，and traditional Chinese medicine theory through the study of modern music therapy，providing guidance for clinical treatment of children．
目的 分析高原地区3～6年级学生屈光状态及屈光参数之间的关系。方法 2023年9月，采用随机抽样方法选取林芝市波密县某两所小学3～6年级535名学生进行校园筛查。计算并记录裸眼远视力（UCVA），非睫状肌麻痹电脑验光下散光及其轴位、等效球镜（SE）、眼轴（AL）、角膜曲率半径（CR）和眼轴/角膜曲率半径轴率比（AL/CR）。采用SPSS 22.00统计软件分析数据。结果 3～6年级学生AL和AL/CR大体趋势为随年级升高而增长，SE随年级升高而降低。3～6年级学生总体筛查性近视患病率为29.91%，且3～6年级筛查性近视患病率分别为20.35%、25.53%、30.53%和51.38%。总体散光患病率为51.59%，其中顺规散光、逆规散光及斜轴散光分别占90.22%、7.61%及2.17%。视力不良者约40.37%。以非睫状肌麻痹验光SE≤-0.50 D同时UCVA＜5.0作为筛查性近视的诊断，AL/CR诊断筛查性近视的灵敏度为0.656、特异度为0.887和Youden指数为0.534，曲线下面积（AUC）为0.802，优于AL评估（AUC=0.764）。结论 高原地区3～6年级学生的筛查性近视患病率随年级升高而快速增长，且散光患病率较高，视力不良者较多。AL／CR值对筛查性近视监测具有一定的临床意义。
Objective To analyze the relationship between refractive status and refractive parameters of students in grades three-six in plateau area．Methods In September，2023，a random sampling method was used to select 535 students from grades three-six of two primary schools in Bomi County，Nyingchi City，for school screening．Distance uncorrected visual acuity（UCVA），astigmatism and its axis position，equivalent spherical（SE），axial length（AL），corneal radius（CR），and axial length/corneal radius ratio（AL/CR）were calculated and recorded．The data was analyzed using the statistical software SPSS 22.00．Results The general trend of AL and AL/CR for grade three-six students was increased with grade increasing，while SE decreased with grade increasing．The overall prevalence of screening myopia was 29.91%，and the prevalence of screening myopia in grades three to six was 20.35%，25.53%，30.53% and 51.38%，respectively．The overall prevalence rate of astigmatism was 51.59%，including 90.22%，7.61% and 2.17% for astigmatism with the rule，astigmatism against the rule and oblique astigmatism，respectively．About 40.37% of the students had poor vision．Screening myopia was diagnosed using non-cycloplegic optometry with SE ≤-0.50 D combined with UCVA＜5.0．The sensitivity and specificity of AL/CR for screening myopia were 0.656 and 0.887，respectively，with a Youden index of 0.534 and an area under the curve（AUC）of 0.802．This was superior to the AL evaluation，which had an AUC of 0.764．Conclusions The prevalence of screening myopia increased rapidly with the increase of grade in grade 3 to 6 in plateau area．And there were high prevalence of astigmatism and more poor vision．AL/CR value has a certain clinical significance in the monitoring of screening myopia．
目的 识别医院在医患沟通、服务态度、医疗服务和医疗质量方面存在的问题，研究提升医院医疗质量与安全的对策。方法 通过收集和整理2024年1-6月某三甲医院医患沟通科处理的医疗诉求数据，包括患者投诉、咨询、建议及求助调查结果，采用定性分析和定量分析相结合的方法，对134件医疗诉求数据进行详细分类和统计，深入分析投诉事由，并结合实际有责投诉量与诊疗总人数，计算投诉千人发生率。投诉千人发生率与2023年同期对照。结果 共处理医疗诉求134件，其中投诉116件（占86.56%）、求助11件（8.21%）、咨询5件（3.73%）、建议2件（1.5%）。投诉中，医患沟通不畅和服务态度问题占42%，医疗服务问题32%，医疗质量问题占26%。实际有责投诉量为63件，投诉千人发生率约为0.12‰。通过对诉求数据的深入分析，识别出医疗服务过程中的薄弱环节和改进点。结论 针对分析结果及同期对照，提出相应的对策建议，包括加强医患沟通培训，改善服务态度，优化医疗服务流程，并对投诉高发科室进行特别关注和改进等措施，以提高患者满意度和医院整体医疗质量。
Objective To identify issues in hospital communication, service attitude medical services, and medical quality and to explore strategies for enhancing hospital medical quality and safety. Methods By collecting and organizing medical appeal data processed by the Medical Communication Department of a tertiary hospital from January to June 2024, including patient complaints, inquiries, suggestions, and requests for help. A combined qualitative and quantitative analysis was conducted on 134 medical appeal cases. Detailed classification and statistics were performed on these cases, and an in-depth analysis of the reasons for complaints was carried out. Furthermore, the actual number of responsible complaints was compared with the total number of treated patients to calculate the complaint rate per thousand people. This complaint rate was then compared with the same period in 2023. Results A total of 134 medical appeals were processed including 116 complaints（accounting for 86. 56%）, 11 requests for help（8. 21%）, 5 inquiries（3. 73%）, and 2 suggestions（1. 5%）. Among the complaints, issues related to poor communication between doctors and patients and service attitude accounted for 42%, medical service issues accounted for 32%, and medical quality issues accounted for 26%. The actual number of responsible complaints was 63, and the complaint rate per thousand people was approximately 0. 12‰. Through in-depth analysis of the appeal data, weak links and improvement points in the medical service process were identified. Conclusions Based on the analysis results and comparisons with the same period, corresponding countermeasures and suggestions are proposed, including strengthening communication training between doctors and patients, improving service attitude, optimizing medical service processes, and paying special attention to and improving departments with high complaint rates in order to improve patient satisfaction and overall hospital medical quality.
