目的 研究羽毛球颠球运动对低年级小学生近视的改善效果,为制定儿童青少年近视干预方案提供依据。方法 采用方便抽样方法,抽取广州市1个城区1所小学三年级4个班共182名学生作为研究对象。基线调查完成后,以班为单位,采用随机数字表法将4个班分为干预组(2个班,91例)和对照组(2个班,91例),干预组安排羽毛球颠球项目体育活动,对照组按原教学计划安排非球类常规体育活动。比较两组干预前后筛查性近视率、视力不良率和近视进展程度。结果 干预前两组的年龄、性别、筛查性近视率、视力不良率及近视分级比较,差异均无统计学意义(P>0.05)。两组干预后的等效球镜度数(SE)比较,差异无统计学意义(P>0.05);对照组干预后的裸眼远视力(UDVA)低于干预组,△UDVA、△SE均高于干预组,差异均有统计学意义(P<0.05)。对照组新发筛查性近视率29.13%、累积筛查性近视率49.45%、累积视力不良率68.13%及近视进展程度,均高于干预组新发筛查性近视率7.69%、累积筛查性近视率34.07%、累积视力不良率52.74%及近视进展程度,差异均有统计学意义(P<0.05)。结论 羽毛球颠球运动能降低低年级小学生视力不良进展速度,减少近视的发生率及近视程度,学校可结合引起近视的因素进行灵活应用,以预防近视的发生发展。
Objective To study the impact of badminton juggling on the myopia of lower-grade primary school students and to provide a basis for developing myopia intervention strategies for children and adolescents.Methods By using the convenience sampling method,182 third-grade students from four classes in a primary school in a district of Guangzhou were selected as subjects.After completing the baseline survey,the four classes were divided into an intervention group(2 classes,91 students)and a control group(2 classes,91 students)using a random number table.The intervention group was arranged to participate in badminton juggling sports activities,while the control group followed the original teaching plan without ball games.The study compared the screening rate of myopia,the rate of poor vision,and the degree of myopia progression before and after the study in both groups.Results On baseline,there were no statistically significant differences between the two groups in terms of age,gender,rate of screening myopia,poor vision,and myopia grading(P>0.05).After 12 months,there was no statistically significant difference in the spherical equivalent(SE) comparison between the two groups(P>0.05).However,the uncorrected distance visual acuity(UDVA) of the control group after 12 months was significantly lower than that of the intervention group,and both △UDVA and △SE were significantly higher than those of the intervention group,with all differences being statistically significant(P<0.05).Incidence of screening myopia in the control group (29.13%),the cumulative rate of screening myopia(49.45%),the cumulative rate of poor vision (68.13%),and the degree of myopia progression was significantly higher than those in the intervention group,which had incidence of screening myopia at 7.69%,the cumulative rate of screening myopia at 34.07%,cumulative rate of poor vision at 52.74%.All these differences were statistically significant(P<0.05).Conclusions Badminton juggling can slow down vision deterioration,reduce the incidence and severity of myopia in lower grade primary school students.Schools can flexibly apply these findings in conjunction with factors that contribute to myopia to prevent its occurrence and development.
目的 探讨眼底豹纹斑密度(FTD)及视盘旁萎缩弧(PPA)与眼轴长(AL)的相关性,为眼底定量化在儿童近视防控的应用提供科学依据。方法 本研究随机抽取广州市荔湾区两所小学三年级学生作为研究对象,在校园视力筛查的过程中同时采集AL、CR和眼底彩照。使用AI软件对眼底彩照进行量化分析,量化指标包括不同区域和范围的FTD及PPA面积大小,根据眼轴长度分为三组:A组(AL<23 mm);B组(23 mm≤AL<24 mm);C组(24 mm≤AL)。结果 共有398例右眼被纳入统计分析,年龄范围8~11岁,中位数是9岁,男性人数占55.1%。三组组间AL、AL/CR和SE比较均有统计学差异(P<0.05)。A组与B组相比,FTD在后极部整体范围、黄斑中心3 mm区域、黄斑中心3 mm区域上方区域具有统计学差异(P<0.05),C组与B组相比,PPA面积及FTD在后极部整体范围、视盘为中心4.5 mm范围、黄斑为中心直径3 mm和6 mm范围均具有统计学差异(P<0.05),Spearman相关性分析表明,AL与PPA(r=0.443)和FTD(r=0.322)呈正相关(P<0.001)。亚组相关性分析表明,A组仅黄斑为中心直径3 mm上方范围FTD与AL呈正相关(P=0.028),B组PPA、黄斑中心直径3 mm及其上方范围FTD与AL呈正相关(P<0.05),C组仅PPA与AL呈正相关(P=0.005)。结论 眼底定量对于儿童近视防控具有潜在价值,PPA和FTD与AL呈正相关性,不同区域和范围FTD与AL相关性具有一定差异性,黄斑中心直径3 mm范围及其上方范围与眼轴相关性最强。FTD在短眼轴阶段就可以作为生物标记物预测近视严重程度,而PPA主要在长眼轴阶段体现生物标记物的作用。
Objective To investigate the correlation between fundus tessellated density(FTD)and peripapillary atrophy(PPA)with axial length(AL), providing a scientific basis for the application of fundus quantification in the prevention and control of myopia in children. Methods This study randomly selected third-grade students from two primary schools in Liwan District, Guangzhou City, as research subjects. Axial length(AL), corneal radius(CR), and fundus color photographs were collected simultaneously during the school vision screening process. AI software was utilized to perform quantitative analysis on the fundus color photographs, with quantification indicators including the area size of PPA and FTD in different regions and ranges. Subjects were divided into three groups based on axial length:Group A(AL<23 mm); Group B(23 mm≤AL<24 mm); Group C(AL≥24 mm). Results A total of 398 right eyes were included in the statistical analysis, with an age range of 8 to 11, a median age of 9, and 55.1% were male. There were significant statistical differences in AL, AL/CR, and spherical equivalent(SE)among the three groups(P<0.05). Compared with Group B, Group A showed significant statistical differences in FTD in the overall posterior pole, the 3 mm diameter area centered on the fovea, and the superior area of the 3 mm foveal center(P<0.05). Compared with Group B, Group C showed significant differences in PPA area and FTD in the overall posterior pole, the 4.5 mm diameter area centered on the optic disc, and the 3 mm and 6 mm diameter areas centered on the fovea(P<0.05). Spearman correlation analysis indicated that AL was significantly positively correlated with PPA(r=0.443)and FTD(r=0.322)(P<0.001). Subgroup correlation analysis showed that in Group A, only the FTD in the superior area of the 3 mm diameter centered on the fovea was significantly positively correlated with AL(P=0.028). In Group B, PPA and FTD in the 3 mm diameter and superior area centered on the fovea were significantly positively correlated with AL(P<0.05). In Group C, only PPA was significantly positively correlated with AL(P=0.005). Conclusions Fundus quantification holds potential value for the prevention and control of myopia in children. PPA and FTD show significant positive correlations with AL, with varying degrees of correlation in different regions and ranges of FTD with AL. The 3 mm diameter area centered on the fovea and its superior area have the strongest correlation with the eye axis. FTD can serve as a biomarker to predict the severity of myopia in the early stages of eye axis elongation, while PPA primarily manifests as a biomarker in the later stages of elongation.
近视是一种常见的屈光不正状态,也是全球范围内普遍存在的视觉健康问题,其特征是在眼部调节放松的状态下,平行光线经眼的屈光系统折射后聚焦在视网膜前,导致视远模糊。近视通常在儿童期发生和发展,但在成年期仍可继续发生和发展。本综述对已发表的关于成年人近视发生和进展的文献进行总结,描述成年人近视的流行病学特征,包括近视率、近视发病率、近视进展率及其近视特征(屈光度及眼轴),总结成年人近视发病和进展的危险因素。了解成年人近视的发展特点和管理方式对于近视防控实践具有重要意义。
Myopia is a common refractive error and a universal visual health problem in the world. It is characterized by the fact that parallel light rays refract through the refractive system of the eye and focus in front of the retina when the eye accommodatior is relaxed, resulting in distant blurred vision. Myopia usually occurs and develops in childhood, but can continue to occur and develop in adulthood. This review summarizes the published literature on the occurrence and progression of myopia in adults, describes the epidemiological characteristics of myopia in adults, including myopia rate, myopia incidence rate, myopia progression rate, and myopia characteristics(diopter and ocular axis) ; and summarizes the risk factors for the occurrence and progression of myopia in adults. Understanding the developmental characteristics and management methods of adult myopia is of great significance for myopia prevention and control practice.
近几十年来,全球近视患病率不断上升,已成为全世界主要的公共卫生问题之一。众多研究表明户外活动能有效控制近视的发生和发展。本文综述了户外活动对近视防控作用的研究进展及其作用机制,以期为近视防控提供新的思路。
In recent decades, the prevalence of myopia has been increasing globally, becoming one of the major public health issues worldwide. Numerous studies indicate that outdoor activities can effectively control the onset and progression of myopia. This article reviews the research progress on prevention and control effect and mechanism of outdoor activities on myopia, hoping to provide new insights for myopia prevention and control.
乳酸以往被视为不具备生物学功能的代谢废物。随着人们对乳酸的深入研究,发现乳酸有多种作用。乳酸化修饰是近期发现一种与乳酸有关的蛋白质翻译后修饰过程。乳酸化修饰主要有两种,一种是与乳酸相关的直接修饰,另外一种是与丙酮酸相关的间接修饰。这两种乳酸化修饰均可能受到糖酵解、乳酸转运与堆积、蛋白质串扰以及神经系统等多方面的调控。乳酸化修饰可以通过直接或间接修饰组蛋白或非组蛋白,从而在肿瘤组织的代谢重编程、增殖、迁移及免疫逃逸中发挥着重要作用。乳酸化修饰的深入研究,有望为肿瘤的诊断和治疗开辟新的路径。因此,为了明确乳酸化修饰在肿瘤方面的研究进展,本文就蛋白乳酸化修饰的分子机制及其在肿瘤中作用的研究进展作一综述。
Lactic acid was previously regarded as a metabolic waste product with no biological function. As lactic acid has been intensively studied, it has been found to have multiple roles. Lactation modification is a recently discovered protein post-translational modification process related to lactic acid. There are two main types of lactation modification:one is direct modification related to lactic acid and the other is indirect modification related to pyruvate. Both types of lactation modification may be regulated by various aspects such as glycolysis, lactate transport and accumulation, protein crosstalk, and the nervous system. Lactation modification can play an important role in metabolic reprogramming, proliferation, migration, and immune escape of tumor tissues by directly or indirectly modifying histones or non-histone proteins. The in-depth study of lactation modification is expected to find new pathways for tumor diagnosis and treatment. Therefore, in order to clarify the research progress of lactation modification in tumors, this paper presents a review on the molecular mechanism of protein lactation modification and the research progress of its role in tumors.
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.