目的 探讨追踪护理模式对中青年保留神经宫颈癌根治术后膀胱功能恢复的影响效果。方法 按住院先后顺序将82例患者分为对照组40例、实验组42例,对照组给予常规护理,实验组实施追踪护理模式,3个月后对两组患者的尿失禁、尿潴留发生率,膀胱功能恢复情况及尿失禁严重程度进行测评。结果 实验组尿失禁、尿潴留的发生率分别为2%、4% ,膀胱功能Ⅰ级、Ⅱ级达100%,68%患者无尿失禁,与对照组比较差异均有统计学意义(P>0.05)。结论 对中青年保留神经宫颈癌根治术实施追踪护理模式,可提高患者膀胱功能锻炼的有效性,促进膀胱功能的早日恢复,改善其生活质量。

Objective To explore the effect of follow-up nursing on the recovery of bladder function in young and middle-aged patients with cervical cancer after radical operation. Methods 82 patients were divided into control group (n = 40) and experimental group (n=42). The control group was given routine nursing care, experimental group to implement the follow-up nursing model. After 3 months, the incidence of urinary incontinence and urinary retention were observed in the two groups, including bladder function recovery and severity of urinary incontinence. Results The incidence of urinary incontinence and urinary retention in the experimental group were 2% and 4%, respectively. Bladder function level I and II reached 100%. There was no urinary incontinence in 68% patients. Compared with the control group, the difference was statistically significant (P>0.05). Conclusion It may improve the effectiveness of bladder function training, promote the early recovery of bladder function and improve the quality of life of young and middle-aged patients with cervical cancer.

目的 观察尝试采用激素替代疗法(hormonereplace menttherapy,HRT)治疗更年期疾病的干眼症的临床疗效。方法 将80例(160眼)干眼症患者随机分成2组,治疗组40例(80眼)在滴人工泪液的基础上采用激素替代疗法(HRT)口服治疗。对照组40例(80眼)单纯采用人工泪液滴眼液滴双眼。两组同时给予综合护理。3个月后观察疗效。结果 治疗组总有效率82.5%,对照组总有效率60%,两组总有效率比较差异有统计学意义(P<0.05),治疗组疗效优于对照组。结论 在人工泪液滴眼液滴双眼的基础上尝试采用激素替代疗法(HRT)治疗更年期疾病的干眼症患者,效果优于单纯应用人工泪液点眼。

Objective To investigate the role of hormone replace menttherapy (HRT) in treating xerophthalmia among patients with climacteric disease. Methods Eighty xerophthalmia patients (160 eyes) were randomly divided into two groups. Forty patients in the treatment group (80 eyes) were treated using combined HRT and artificial drops. Forty patients in the control group (80 eyes) were treated using artificial drops alone. All patients were provided comprehensive nursing. The evaluation of clinical effects was performed after 3 months of treatment. Results The total effective rate of both groups was 82.5% in the treatment group and 60% in the control group, respectively (P<0.05). Conclusion Combined HRT and artificial drops is more effective in treating climacteric disease-related xerophthalmia than using artificial drops only.

目的 探讨康复护理路径早期功能训练对桡骨远端骨折LCP(锁定加压接骨板locking compression plate, LCP)内固定术后患者腕关节功能康复的影响。方法 对2014年5月—2016年6月住院80例桡骨远端骨折LCP 内固定术后患者分为对照组和观察组,每组各40例,对照组按桡骨远端LCP内固定术后护理措施进行护理,观察组患者在此护理基础上,制定术后功能康复护理路径,按功能康复护理路径对术后患者实施早期功能康复训练,随访评价两组患者患肢的组织肿胀、疼痛、骨折复位和腕关节功能康复效果。结果 疼痛评分:对照组在术后第3天~14天疼痛评分均高于观察组(P＜0.005);肿胀程度评分:对照组在术后第3天~7天肿胀程度评分均高于观察组,消肿速度比观察组慢(P＜0.001);腕关节的屈伸活动范围、握力和捏力比较观察组优于对照组(P＜0.001);腕关节复位优良率观察组95%高于对照组87.5%(P＜0.001)。结论 应用康复护理路径对桡骨远端骨折的LCP内固定术后患者进行早期腕关节功能康复训练,能减轻患者疼痛和局部软组织肿胀,减少并发症,提高术后患者康复质量。

Objective To investigate the early functional training of rehabilitation nursing path to the effects of distal radius fracture LCP (locking compression plate LCP) in patients after internal fixation of wrist joint function rehabilitation. Methods From May 2014 to June 2016, 80 patients with distal radius fractures were divided into control group and observation group(n=LCP), each with 40 cases. The control group was treated with nursing care of patients with distal radius LCP internal fixation. On the basis of nursing, the patients in the observation group were given rehabilitation nursing pathway, and the patients were followed up according to the rehabilitation path including evaluation of two groups of patients with fracture limb swelling, pain, fracture reduction and wrist joint function rehabilitation. Results Pain score: in the third days to fourteenth days pain score of the control group was higher than the observation group (P<0.005); Swelling degree score: swelling scores of the control group for the third days to seventh days after were higher than those in the observation group, the swelling reduced slowly (P<0.001); The wrist flexion range, grip and pinch strength compared to the observation group was better than the control group (P<0.001); The good rate of wrist joint reduction in the observation group (95%) was higher than that in the control group[(87.5%) (P<0.001)]. Conclusion The application of rehabilitation nursing path for patients with distal radius fracture after LCP internal fixation for early rehabilitation of wrist function may reduce the pain and local soft tissue swelling, reduce complications and improve the quality of postoperative rehabilitation.

目的 探讨个体化健康管理对超高龄结直肠癌患者希望水平的影响效果。方法 对66例超高龄结直肠癌患者实施个体化健康管理,3个月后对患者进行希望水平、肛门括约肌功能、生活质量的测评。结果 3个月后患者排便功能恢复良好的达90.91%,与出院前比较差异有统计学意义(P＜0.01);3个月后患者HHI各维度和SF-36各维度的得分明显提高,与干预前比较差异均有统计学意义(P＜0.01)。结论 对超高龄结直肠癌患者实施个体化健康管理,可提高其生存希望水平,改善生活质量。

Objective To explore the effect of individualized health management on the hope level of patients with advanced colorectal cancer. Methods Using individualized health management for 66 elderly patients with colorectal cancer for 3 months, the level of hope, anal sphincter function and quality of life were evaluated. Results After 3 months, the defecation function of the patients recovered well to reach 90.91%, and the difference was statistically significant (P<0.01); After 3 months, the scores of each dimension of Herth Hope Index (HHI) and SF-36 were significantly improved, and the difference was statistically significant (P<0.01). Conclusion The implementation of individualized health management for the elderly patients with colorectal cancer may improve the survival level and improve the quality of life.

目的 探讨阳性强化法对社区门诊静脉输液患儿穿刺疼痛及依从性的影响。方法 选取社区门诊2014年4月—2016年4月收治的100例行静脉输液治疗的患儿作为研究对象,采取随机数字表法将其分成两组,每组50例。观察组患儿给予阳性强化法干预,对照组给予常规护理干预,对比两组患儿穿刺疼痛相关指标、穿刺效果、患儿静脉输液依从性及患儿家长的满意度。结果 观察组患儿疼痛面容持续时间明显短于对照组,穿刺后心率明显慢于对照组,啼哭时间>30s的患儿占比明显低于对照组(P<0.01)。观察组一次穿刺成功率、穿刺耗时>5min占比分别为94.00%、24.00%,对照组分别为74.00%、62.00%,观察组一次穿刺成功率明显高于对照组,穿刺耗时>5min占比明显低于对照组(P<0.01)。观察组患儿静脉输液依从率为90.00%,与对照组的66.00%对比有明显上升(P<0.01)。观察组患儿家长满意度为96.00%,与对照组的80.00%对比有明显上升(P<0.05)。结论 对社区门诊静脉输液患儿实施阳性强化法干预可有效减轻穿刺疼痛,提高患儿的输液依从性,患儿家长满意度高。

Objective To explore positive reinforcement on pain and compliance of puncture to children in community outpatients with intravenous infusion. Methods Select 100 cases of children who receive intravenous infusion in community outpatients from April 2014 to April 2016 as research objectives and divide them into two groups randomly with each group of 50 cases. Provide positive reinforcement to observation group while provide routine nursing to control group. Compare two groups' puncture pain relevant indicator, puncture effect, children's intravenous infusion compliance and parents' satisfaction. Results Children in observation had less duration of pain face expression, lower heart rate after puncture and less children crying >30s than those in control group (P<0.01). Observation group's first puncture success rate, puncture time duration >5mins rate were 94.00% and 24.00% respectively while control group's data were 74.00% and 62.00%. Observation group's first success rate was significant higher than that of control group. Observation group's puncture time duration >5mins rate was significant lower than that of control group (P<0.01). Children's intravenous infusion compliance rate in observation group was 90.00% which was significant higher than control group's 66.00% (P<0.01). Parents satisfaction rate in observation groups was 96.00% which was significant higher than control group's 80.00% (P<0.05). Conclusion Implementing positive reinforcement on children in community outpatient may help to relieve puncture pain, improve children's compliance to intravenous infusion and increase parents' satisfaction.

目的 本研究旨在探讨老年肾功能不全继发脑血管疾病患者肾功能与头颅MR特征性改变的相关性以及患者头颅MR信号改变的影响因素。方法 选择2015年4月—2016年4月我科住院的老年脑血管病患者103例,依据简化MDRD方程计算eGFR水平将患者进行分组,通过比较分析肾功能不全患者与对照组头颅MR腔隙灶、脑白质高信号的差异性,应用统计学分析方法,探讨老年脑小血管疾病MR病变程度与肾功能、年龄、血压等的相关性,从而推测肾功能不全患者继发脑血管疾病的危险因素。结果 本研究患者的平均年龄(84.23±4.92)a,按eGFR<60 mL·min^-1·1.73 m^-2定义为肾功能不全组52例,肾功能正常组51例。组间患者腔隙灶数目、脑白质高信号评分、混合病变与否差异有统计学意义(P<0.05)。Logistic回归分析头颅MRI发生混合病变与年龄、高血压基础病、肾功能不全与否存在相关关系,且均为正相关。结论 ①肾功能不全与头颅MRI的混合病变及严重脑白质高信号改变呈正相关,肾功能不全可反映头颅MRI的混合病变及脑白质高信号的严重程度。②年龄、高血压是脑小血管病的危险因素。

Objective To investigate the correlation of cranial MRI with renal insufficiency in elderly CVD patients, and find the risk factor of CVD. Methods 103 elderly patients with cerebrovascular disorder between April 2015 and April 2016 were identified in Guangzhou first people's hospital. Participants were grouped by the simplified MDRD equation based on eGFR levels, to confirm imaging results by detailed examination of cranial MRI. Lacunar lesions and White-matter hyperintensity were accessed and compared between renal dysfunction group and controlled group to identify the differences. Through statistical analysis, risk factors to cerebrovacular disease were considered. Results In the 103 elderly patients, the mean age of (84.23±4.92),had being divided into two groups according to eGFR< 60 ml·min^-1·1.73 m^-2:renal insufficiency group (n=52) and normal renal function group (n=51).There were statistical significance in the number of lacunar lesions,score of white-matter hyperintensity,mixed lesions between groups(P<0.05). Logistic regression analysis showed a positive correlation between age, hypertension and renal insufficiency. Conclusion ①Renal insufficiency is positively correlated with the mixed lesions and severe white-matter hyperintensity in cranial MRI,and could reflect its severity. ②Age and hypertension were risk factors for cerebral small vessel diseases.

目的 探讨小骨窗显微手术不同手术时机对高血压脑出血患者疗效及神经功能的影响。方法 选取我院2014年5月—2016年5月收治的80例高血压脑出血患者作为研究对象,脑出血量约30～40 mL,根据出血到手术时间不同分为两组,每组40例。从出血到手术时间<6 h者为超早期作为观察组,出血到手术时间处于6~24 h间者为早期作为对照组,比较两组患者治疗后1个月GOS(格拉斯哥预后)优良率,治疗后3周、6周的斯堪的纳维亚(SSS)评分,治疗后3个月、6个月的生存质量评分及治疗后的生存情况、再出血情况。结果 观察组治疗后1个月GOS优良率为77.50%,相对于对照组明显上升(P<0.05);观察组治疗后3周、6周的SSS评分较对照组明显降低(P<0.01);观察组治疗后3个月、6个月的生存质量评分较对照组明显升高(P<0.01);两组治疗后的生存率差异有统计学意义(P<0.05),再出血率差异无统计学意义(P>0.05)。结论 对高血压脑出血患者在超早期行小骨窗显微手术可提高疗效,明显改善患者神经功能,提高生活质量及生存率,值得临床推广。

Objective To investigate the curative effects of microsurgical treatment with small bone flap craniotomy in patients with hypertensive cerebral hemorrhage and on their nerve function in different timing of surgery. Methods To select 80 cases of hypertensive cerebral hemorrhage in our hospital from May 2014 to May 2016 as the research object. The amount of cerebral hemorrhage of the patients was about 30-40 mL. According to the different time of bleeding, they were divided into two groups, 40 cases in each group. The super early period that the time from bleeding to operation was less than 6 h was regarded as the observation group, and the early period that the time from bleeding to operation is during 6~24 h was regarded as the control group. To compare the GOS (Glasgow outcome) excellent rate of patients in two groups in 1 month after treatment, the Scandinavia (SSS) score in 3 weeks and 6 weeks after treatment, and the quality of life score and survival and re-bleeding condition after treatment in 3 months and 6 months. Results Compared with the control group, the GOS excellent rate in the observation group in 1 month after treatment was 77.50% which increased significantly (P<0.05); the SSS score in the observation group in 3 weeks and 6 weeks after treatment was significantly lower than that in the control group (P<0.01); The quality of life score in the observation group in 3 months and 6 months after treatment was significantly higher than that in the control group (P<0.01); There was statistically significant difference in survival rate between the two groups after treatment (P<0.05), and the re-bleeding rate showed no significant difference (P>0.05). Conclusion The curative effects of microsurgical treatment with small bone flap craniotomy on patients with hypertensive cerebral hemorrhage is significant, which can improve the patients' neurological function, the life quality and survival rate, thus it is worthy of clinical promotion.

目的 探讨加味六君子汤联合经口营养补充对COPD稳定期伴营养不良患者营养状况和肺功能的影响。方法 收集呼吸内科COPD稳定期并伴营养不良的患者40例,分为试验组和对照组各20例。试验组在对照组基础上再给予加味六君子汤和经口营养补充,观察治疗前、治疗后3月的营养相关指标和肺功能指标,然后进行统计分析。结果 ①治疗后3月,试验组的体质量、白蛋白、前白蛋白和肺功能指标较治疗前均明显改善(P<0.05)。②与对照组比较,试验组的白蛋白、前白蛋白、血红蛋白均明显升高(P<0.05),肺功能亦有显著改善(P<0.05)。③上臂肌围(MAMC)、三头肌皮褶厚度(TSF)在治疗后的组内及组间比较差异均无统计学意义(P>0.05)。结论 加味六君子汤联合经口营养补充有助于COPD稳定期伴营养不良患者体质量增加、蛋白升高,营养状况好转,从而增加呼吸肌储备,改善患者肺功能。

Objective To observe the influence of modified-liujunzi-decoction combined with Oral nutritional supplements(ONS) on the nutrition status and lung function in patients with chronic obstructive pulmonary disease(COPD). Methods 40 patients of COPD stable phase with malnutrition were divided into two groups and each group with 20 cases. On the basis of the control group, the experimental group was given again modified-liujunzi-decoction and ONS. All cases were tested before and 3 months after treatment, for detecting the nutrition related index and lung function index; T-test was used for data statistical analysis. Results ①3 months after treatment, the body weight, serum albumin, prealbumin and lung function index of the experimental group were significantly improved compared with those before treatment (P<0.05). ②Compared with the control group, the serum albumin, prealbumin and hemoglobin were significantly increased in the experimental group (P<0.05), and lung function was also significantly improved (P<0.05). ③After treatment, the mid-arm muscle circumference (MAMC), triceps skinfold thickness (TSF) comparison of intra group and intra group differences were not statistically significant(P>0.05). Conclusion Modified-liujunzi -decoction combined with oral nutritional supplements help to increase body weight, protein, and improve nutritional status in patients of COPD stable phase with malnutrition, thereby increasing their respiratory muscle reserve and improving lung function.

目的 观察手术前静滴不同剂量复方麝香注射液对老年患者全麻术后早期轻度认知障碍(MCI)发生的影响。方法 选择下肢与下腹部手术全麻患者120例(ASA Ⅰ-Ⅱ级),将其随机分为4组,组Ⅰ(n=30,对照),采用质量浓度为9 g/L的生理盐水100 mL静脉滴注;组II(n=30):应用低剂量复方麝香注射液(0.1 mL/kg,加入质量浓度为9 g/L的生理盐水100 mL)手术开始前0.5 h静脉滴注,其速率为200 mL/h;组Ⅲ(n=30): 应用中剂量复方麝香注射液(0.2 mL/kg), 药物配伍、治疗时间和注射速度与组Ⅱ相同;组Ⅳ(n=30):高剂量复方麝香注射液(0.3 mL/kg),用药方法同组Ⅱ。各组术前用药、麻醉诱导、术中麻醉深度、麻醉苏醒等用药与方法相同;观察各组患者术前、术后第1天、3天、7天的CCSE、FAQ、MMSE评分等。结果 4组患者手术时间、麻醉时间、术中出血量、苏醒时间基本相同(P>0.05),4组手术后第1天、3天及7天CCSE、FAQ、MMSE认知功能评分均减少, 组Ⅱ、组Ⅲ、组Ⅳ下降的变化幅度较小,得分高于组Ⅰ(P<0.05),组Ⅱ、组Ⅲ、组Ⅳ组间比较差异无统计学意义(P﹥0.05);术后第1天、3天、7天MCI发生率,组Ⅰ分别为66.7%、33.3%和16.7%;组Ⅱ为50.0%、16.7%和6.7%;组Ⅲ为50.0%、16.7%和6.7%。组Ⅳ为46.7%、20.0%和10.0%,用药组比组Ⅰ降低(P<0.05),但组Ⅱ、组Ⅲ、组Ⅳ之间无明显差异(P﹥0.05);4组术后不良反应组间比较差异无统计学意义。结论 术前静脉滴注复方麝香注射液0.1 mL/kg可有效降低老年患者全麻术后MCI的发生,增加麝香注射液剂量(0.2 mL/kg、0.3 mL/kg)对于老年手术患者MCI未见增效作用,临床选用静滴的剂量0.1 mL/kg即可。

Objective To observe the effect of different doses of compound musk injection before operation on early mild cognitive impairment (MCI) in elderly patients after general anesthesia. Methods We selected 120 cases of lower limb and lower abdominal surgery general anesthesia (ASA level Ⅰ-Ⅱ),and divided them randomly into 4 groups: Group Ⅰ (n=30,control): 0.9% saline 100mL intravenous infusion; Group Ⅱ (n=30): low dose compound musk injection (0.1 mL/kg,add 0.9% saline 100 mL), 0.5h before the start of surgery, intravenous drip, the rate was 200 mL/h; Group Ⅲ (n=30): medium dose compound musk injection (0.2 mL/kg), the same as group Ⅱ in drug compatibility,treatment time and injection rate; Group Ⅳ (n=30): high dose compound musk injection (0.3 mL/kg), the same as group Ⅱ in drug compatibility, treatment time and injection rate. Each premedication, induction of anesthesia, anesthesia depth,intraoperative awake and anesthesia medication were the same. And we observed each group about preoperative and postoperative CCSE,FAQ and MMSE(mini-mental state examination) score of the 1st days,3rd days and 7th days. Results In the 4 groups of patients,the operation time,anesthesia time,intraoperative blood loss,recovery time were basically the same (P>0.05); CCSE,FAQ,MMSE cognitive function scores of 4 groups were reduced after operation on the first day,the third day and the seventh day; group Ⅱ,group Ⅲ,group Ⅳ decreased slightly.The scores were higher than group Ⅰ (P<0.05),and there were no significant differences between group Ⅱ,group Ⅲ and group Ⅳ (P>0.05); The incidence of MCI in first days, third day and seventh day after operation respectively was: group Ⅰ 66.7%,33.3% and 16.7%; group Ⅱ 50%,16.7% and 6.7%; group Ⅲ 50%,16.7% and 6.7%; group Ⅳ 46.7%,20% and 10%.Those of the drug groups were lower than group Ⅰ (P<0.05), but there was no significant difference between group Ⅱ, group Ⅲ and group Ⅳ (P>0.05).There were no significant differences in the 4 groups in postoperative adverse reactions. Conclusion Preoperative intravenous infusion of compound musk injection 0.1 ml/kg, may effectively reduce the incidence of MCI in elderly patients after general anesthesia. Increasing musk injection dose (0.2 ml/kg,0.3 ml/kg and 0.4 mg/kg) was no synergistic effect on MCI in elderly patients,0.1ml/kg is enough.

目的 探讨分析氨茶碱治疗早产儿呼吸暂停的临床疗效及其在治疗过程中所出现的不良事件。方法 选取2014年9—2016年3月广州市第一人民医院新生儿科接受住院治疗的胎龄＜34周,生后2 h内入住新生儿科的早产儿42例。随机分为对照组和氨茶碱组,对照组(20例)给予保暖、吸氧、补充能量、保持呼吸道通畅、物理刺激等对症治疗,不使用氨茶碱及其它改善呼吸的药物;氨茶碱组(22例)患儿除给予对照组治疗措施外,同时给予氨茶碱静脉滴注,首剂负荷量5 mg/kg,在20min内完成,12 h后以2～2.5 mg/kg维持量,每隔12 h一次。观察两组的疗效与不良影响。结果 ①两组患儿性别、出生胎龄、出生体重、产前孕母糖皮质激素的应用、受孕方式、分娩方式、多胎妊娠、5min Apgar评分、机械通气及CPAP辅助通气例数、低-中流量吸氧(箱内或头罩给氧)例数等方面差异均无统计学意义(P均＞0.05)。②与对照组相比,氨茶碱组早产儿呼吸暂停(AOP)发生的次数较少,AOP消失所需时间较短,差异均有统计学意义(P＜0.05)。③不良影响方面,氨茶碱组脑白质发育不良发生率(63.6%,14/22例)显著高于对照组(25%,5/20例),差异有统计学意义(P＜0.05);两组患儿在听力检查异常、喂养不耐受、血糖紊乱、血脂代谢紊乱、血红蛋白下降、电解质紊乱、出院时体重及住院时间等方面均无统计学意义(P均＞0.05)。④氨茶碱组视网膜发育不完全的发生率(40.9%,9/22例)明显高于对照组(15.0%,3/20例),但差异无统计学意义(P＞0.05)。结论 小剂量氨茶碱在防治AOP方面的作用是值得肯定的,但它有可能增加早产儿脑白质发育不良的风险与视网膜发育不完全的风险。

Objective To investigate the clinical efficacy and adverse effects of aminophylline in prevention of apnea of prematurity. Methods Forty-two infants with gestational age ＜34 weeks admitted to department of pediatrics, Guangzhou first people's hospital between Sep. 2014 and Mar. 2016 were randomly divided into 2 groups: control group and aminophylline group. Control group(n=20): 20 infants received warming, oxygen inhalation, supplement energy, maintain airway patency, physical stimulation, such as symptomatic treatment, without aminophylline or any other drugs for improving breathing. Aminophylline group(n=22): In addition to the control group treatment measures, 22 infants received a loading dose of 5 mg/kg of aminophylline and then maintained by a dose of 2mg/kg with intravenous drip q 12 h. Then we compared the efficacy and adverse effects of the two groups. Results ①There was no significant difference in gender, gestational age, birth weight, maternal antenatal glucocorticoid application, pregnancy(including multiple pregnancy) and delivery,5 min Apgar score, oxygen therapy, the application of mechanical ventilation, nasal continuous positive airway pressure, and the low-medium flow oxygen inhalation between the 2 groups(all P＞0.05). ② Compared with the control group, the incidence of apnea in aminophylline group were significant lower, and the time needed for apnea to disappear were significant shorter(all P＞0.05). ③ The incidence of cerebral white matter development dysplasia of aminophylline group(63.6%,14/22 cases) were significant higher than the control group(25%,5/20 cases, P＜0.05). There was no statistically significant difference in hearing loss, feeding intolerance, blood glucose disturbance, blood lipid metabolism disorder, hemoglobin decrease, electrolyte disorder, body weight at discharge, the duration and cost of hospitalization between the 2 groups(all P＞0.05). ④ The incidence of retinal incompleted development of aminophylline group(40.9%, 9/22 cases) were higher than control group(15.0%, 3/20 cases), but there was no statistical significance between the 2 groups(P＞0.05). Conclusion Effects of aminophylline in treating apnea of prematurity is positive, but it is likely to increase the risk of premature brain white matter development dysplasia and the risk of retinal incompleted development.