ABSTRACT
Objective@#To analyze the prevalence of poor vision and eyeglass prescription, refractive examination among primary school students of grade 4-6 in Henan, so as to provide scientific basis for precise interventions for student vision health.@*Methods@#A stratified cluster random sampling method was used to investigate a total of 29 187 students of grade 4-6 from 17 cities in Henan Province. Distant vision examination and questionnaire survey were conducted.@*Results@#The overall prevalence of poor vision for grade 4-6 students in Henan was 63.6%, with girls (69.0%) higher than boys (59.0%),urban students (65.3%) higher than suburban students (62.5%)( χ 2=312.6, 23.6, P <0.01). The prevalence of severe poor vision was 28.5%.With the increase of grade, the detection rate of poor vision and severe poor vision increased( χ 2 trend =278.7, 775.4, P <0.01). Totally 13.2% of pupil did not have a visual examination in the past year. The rate of wearing glasses was 27.0% for students with poor eyesight and 3.2% for students with poor monocular eyesight. Totally 46.8% of the students wearing glasses received mydriatic optometry before wearing glasses.@*Conclusion@#The problem of poor vision among students of grade 4-6 in Henan is prominent, so it is necessary to strengthen eyesight monitoring and eye health education.
ABSTRACT
Objective@#To evaluate the application of artery first, combined vascular resection and reconstruction in the treatment of pancreatic head carcinoma.@*Methods@#The clinical data of 13 patients with pancreatic head cancer were retrospectively analyzed from February 2014 to March 2016 in the Affiliated Hospital of Xiamen University. Preoperative computed tomography of high resolution layer or magnetic resonance imaging examination demonstrated pancreatic head carcinoma, as well as close adhesion, stenosis, compression or displacement of superior mesenteric vein or portal vein wall. In the operation, the artery first approach was used and the whole arterial blood supply in the head of the pancreas was fully exposed and interdicted. Finally, en block resection and vascular resection and reconstruction was adopted.@*Results@#12 of 13 patients had pancreatoduodenectomy synchronously with vascular resection and reconstruction; the other patient had these two surgery sequentially. Four patients received blood vessel wedge resection, five had segmental resection combined with end to end suture, and four had segmental resection combined with artificial vascular graft reconstruction. Operation time was (327.2±65.5) minutes, and the amount of blood loss was (472.6±226.4) millilitres. One patient suffered from delayed gastric emptying, and two patients had pancreatic fistula. All patients recovered from postoperative complications by conservative treatment. No patients developed biliary fistula, gastrointestinal fistula, abdominal infection, pulmonary infection, diarrhea, hypoglycemia or other complications, and none died in perioperative period. Postoperative pathological findings confirmed the diagnosis of pancreatic ductal adenocarcinoma. Mean tumor diameter was (4.2±1.5)cm, and (3.8±1.5) metastasis were found in (13.6±2.5) resected lymph nodes. In 11 cases, the tumor cells were found in the outer membrane of blood vessels, 2 cases were found to have tumor invasion in the inner membrane, and all the resection margins were negative. All patients were followed up, and 2 patients died of liver metastasis 11 months and 18 months after operation, respectively. One patient survived with local recurrence of tumor 13 months after surgery. Other patients had no tumor recurrence and metastasis.@*Conclusions@#The artery first approch combined vascular resection and reconstruction is safe effective and feasible in the treatment of pancreatic head carcinoma. It can improve the ablation rate of pancreatoduodenectomy.