ABSTRACT
Central serous chorioretinopathy (CSC) is a common macular disease, which can lead to the loss of central vision in young patients. Although the disease is self-limited to some extent, there is no shortage of patients with prolonged course and recurrent attacks, eventually leading to irreversible visual impairment. Therefore, taking reasonable treatment in a certain period is particularly important for the visual prognosis of patients. Although thermal laser photocoagulation of leakage points and photodynamic therapy (PDT) have achieved good effects, there are risks of retinal damage and retinal pigment epithelium atrophy. Subthreshold micropulse laser (SMLP) is a kind of subthreshold short pulse laser, which does not cause visible damage to the retina and is safer. In the era of lack of PDT drugs, SMLP has gradually become an important means of clinical treatment for CSC, especially for patients with no obvious leakage point or subfoveal leakage point. An in-depth understanding of the mechanism of action of SMLP and its efficacy and safety in the treatment of CSC is helpful for the promotion and application of SMLP in the clinical treatment of CSC.
ABSTRACT
Background Cornea astigmatism can be effectively corrected by implanting Toric intraocular lens (IOL) during cataract surgery and therefore improve visual acuity of patients.However,the decentration and rotation position errors were inevitable sometime.What's the difference of effect of position errors on quality of image between spherical IOL and Toric IOL needs further research.Objective This study was to evaluate the optical performance and wavefront with rotation and decentration of Toric IOL.Methods Different decentration for SN60AT IOL(spherical IOL) and Toric IOL in Hwey-Lan Lion model eyes was set with the role as follows:decentration 0.25 mm to 0.75 mm in a 5°-interval from 0° to 90°.Furthermore,Toric IOL was rotated at 5° and 10°,respectively.Then the image performances of SN60AT IOL and Toric IOL at different decentration distances and rotated degrees were evaluated with modulation transfer function (MTF) and value of wavefront aberration under all conditions.Results At the centration,the MTF curves of spherical IOL and Toric IOL were similar under 3,4 and 5 mm pupil diameter at each spatial frequency.Under the condition of 4 mm pupil diameter,when the decentration was 0.25 mm,the MTF values of SN60AT IOL at 6 c/d and 12 c/d were 0.581 087 and 0.411 960,respectively.T3 IOL were 0.454 259 and 0.382 313,T4 IOL were 0.426 020 and 0.360 490,T5 IOL were 0.425 606 and 0.359 877.When the decentration was 0.50 mm,the MTF values of SN60AT at 6 c/d and 12 c/d were 0.573 073 and 0.412 787,respectively.T3 IOL were 0.450943 and 0.379481,T4 IOL were 0.423 153 and 0.356 664,T5 IOL were 0.422 881 and 0.356 230.When the decentration was 0.75 mm,the MTF values of SN60AT at 6 c/d and 12 c/d were 0.560 038 and 0.413 624,respectively.T3 IOL were 0.445 597 and 0.374 322,T4 IOL were 0.418 522 and 0.350 087,T5 IOL were 0.418 468 and 0.349 976.When the IOL decentralized along 0°,5°,10°,90°meridian line,the MTF values were almostly same.The root mean square (RMS) of spherical IOL and Toric IOL was increased when the IOL decentralized from 0 mm to 0.75 mm,with the most increasing level in coma aberration and slight increase in trefoil aberration.When the T4 IOL decentralized from centre to 0.75 mm,the coma increased from 0 to C(3,-1)-0.049 79 μm,C (3,1)-0.037 59 μm and the trefoil aberration increased from 0 to C (3,3) 0.005 72 μm,C (3,-3) 0.004 64 μm.With the increase of rotation degrees (from 5°to 10°) of Toric IOL,the MTF was worse at high spatial frequency.Toric IOL rotation caused the increase of astigmatism and residual astigmatism and spherical error,but not high order aberration.Conclusions The tolerance of Toric IOL to decentration is very close to the spherical IOL,and optical performance is only associated with the amount of decentration but not direction.The aberration caused by Toric IOL decentration is mainly coma.The rotation of Toric IOL causes astigmatism error but not high order aberrations.
ABSTRACT
Objective To evaluate the effect of simulated training on in-service physicians electrocardiogram(ecg) theory and operational learning effect.Methods Sixty resident doctors were randomly divided into experiment group (n=30) and control group(n=30).The experimental group adopted teaching + simulation training mode to implement the theory and operation of ECG in continuing while the control group were taught only by lectures.Training effect of both groups was assessed by electrocardiogram theory and operation examination before and after training respectively,and by questionnaires at the end of the training as well.Data of the examination and questionnaires were analyzed by t test or x2 test.P＜0.05 was considered statistically significant.Results After training,the score of theory examination was (90.87 ± 6.67) points in experiment group and was (85.83 ± 5.5) points in control group,with statistical difference between these two groups(t=3.201,P=0.003).Score of operation examination was(93.40 ± 4.31) points in experiment group and was(77.03 ± 7.96)points in control group,with significant differences(t=10.204,P=0.000).The satisfaction degree of enhancing learning interest,theoretical knowledge and operation skill,and strengthening the concept of humauistic care were significantly better in the experiment group than in the control group (x2=34.737,6.405,42.088,41.713,P=0.000,0.011,0.000,0.000).Conclusions Application of simulated training in the study of electrocardiogram is obviously superior in effect to the traditional teaching model.It can improve the theoretical knowledge and operation skill,which is helpful in elevating the in-service physicians' comprehensive capability.
ABSTRACT
Objective To examine the application effect of intelligent simulator(SimMan) in comprehensive skill training among doctors and nurses.Methods Totally 168 doctors and nurses were chosen as the training object,6 people (4 doctors and 2 nurses) formed a work team.Comprehensive training course was in accordance with 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care science.Real clinical situation was designed by using the third generation SimMan of Norway laerdal company.Trainees were administered two tests before and after training,in which there were two parts containing specialized operation ability and non-technical ability.Overall qualification rate,average mark and treatment time of qualified teams were compared before and after the training.SPSS 16.0 software was used to analyze the data and P ＜0.05 signifies statistically significance.Results Overall qualification rate,average mark and treatment time of qualified teams were 71.43％,(84.70 ± 3.15),and (449.25 ± 77.0) s respectively before training while 100％,(93.55 ± 3.86) and (323.71 ± 42.26) s after training.There were significant differences in results of two groups before and after training (P =0.002,0.000,0.000).Conclusions Application of the third generation intelligent simulator (SimMan) in comprehensive training will obviously improve training effectiveness and cultivate the non-technical ability.