RESUMEN
Objective@#To explore the effect of puberty on refractive development of children and adolescents and its interaction with outdoor activities, near work and the use of electronic products, so as to provide a reference for strategies for intervening myopia.@*Methods@#Cluster sampling method was used to select 776 students aged 7-13 from a nine year consistent school in Shanghai to participate and were followed up for 2 years. All participants underwent cycloplegic refraction and ocular axial length measurement once a year, as well as pubertal development, average daily outdoor time, near work time and time of electronic products usage. The influencing factors and interaction effects of refractive parameters in different puberty stages were analyzed by generalized estimation equation.@*Results@#At baseline, 634 children participated in cycloplegic refraction, of which 350 were myopic (55.2%). There were significant differences in axial length, average daily outdoor time, near work time and time of using electronic products at different stages of puberty ( F = 4.10 ，4.24，5.54，9.20， P <0.05). There was interaction between puberty and outdoor time on axial length development ( β =0.133, P < 0.05), and the interaction between puberty and the time of near work or using electronic products was not statistically significant ( P >0.05).@*Conclusion@#Puberty may play a regulatory role in the relationship between outdoor time and refractive development among Chinese children and adolescents.
RESUMEN
Objective:To analyze and compare difference of ultrasonic blood flow of left internal mammary artery(LIMA) and right internal mammary artery(RIMA)as graft to left anterior descending artery(LAD) in patients undergoing off-pump coronary artery bypass grafting(OPCABG).Methods:From October 2017 to October 2019, a total of 363 patients who underwent OPCAB including 329 patients in LIMA-LAD group and 34 patients in RIMA-LAD group, were included in this study. Transthoracic ultrasound examination on IMA was performed before OPCABG. The blood flow , the value of PI(pulsation index) and diastolic flow(DF) of LIMA and RIMA to left anterior descending were measured and recorded by intraoperative TTFM. Patients underwent coronary artery CT examinations at 1 week after OPCABG to discover the patency of grafts.Results:The pre-operative diameter of RIMA was larger and the blood flow and pulsation index of RIMA was better than that of LIMA before OPCABG( P<0.001). But there was no significant difference in the flow, pulsation index and DF value of graft between the two groups after IMA were anastomosed to LAD( P>0.05). In situ skeletonized graft of RIMA did not show the advantage of increased blood flow. Compared with the preoperative parameters of flow of internal mammary artery, both the left and right grafts of IMA were significantly better in blood flow and pulsation index( P<0.001). Considering the remarkable difference in age between the two groups, Flow, PI and DF were compared again after propensity score matching, and there was still no statistical difference between the two groups( P>0.05). A total of 313 patients in LIMA-LAD group completed coronary CTA examination one week after surgery, among which 4 grafts had different degrees of problems. A total of 34 patients in RIMA-LAD group completed coronary CTA examination, one case indicated that the CTA imaging in distal segment was not clear, and the other results had no obvious abnormality. There was no significant difference in postoperative rate of coronary CTA completion( P=0.381) and rate of graft failure( P=0.405) between the two groups. Conclusion:Compared with the preoperative parameters of blood flow of internal mammary artery, both the left and right IMA grafts are significantly better in flow and pulsation index. The pre-operative diameter of RIMA is larger and the blood flow and pulsation index of RIMA is better than that of LIMA before OPCABG. But there is no significant difference in the flow, pulsation index and DF value of graft between the two groups after IMA are anastomosed to LAD. In situ skeletonized graft of RIMA do not show the advantage of increased blood flow.
RESUMEN
Objective:To observate the changing trend of flow of in-situ bilateral internal mammary artery as grafts during perioperative period in patients undergoing coronary artery bypass grafting(CABG), and to compare the parameters of flow between LIMA and RIMA.Methods:A total of 57 patients , 50 males and 7 femails, mean aged(57.8±10.1) years, underwent bilateral IMA CABG in our hospital from August 2016 to January 2019. Transthoracic ultrasound of IMA examination was performed before CABG. The blood flow, the PI(pulsation index) and other parameters were measured and recorded by intraoperative TTFM.Results:There was no significant difference of the average diameter and PI between LIMA and RIMA, but the preoperative flow of RIMA is higher( P=0.026) in our study. There was no significant difference of the average flow and PI between LIMA and RIMA recorded by TTFM( P>0.05), but the higher diastolic flow(DF) in LIMA grafts( P=0.022) compared with RIMA grafts may be associated with the different target sites( P<0.05). Compared with the preoperative flow and PI of IMA, the intraoperative flow and PI of both LIMA and RIMA grafts were better( P<0.001). Conclusion:Compared with the preoperative flow of IMA, both flow of LIMA and RIMA are better. In spite of the targets exist difference , there are no significant difference of the average flow and PI between LIMA graft and RIMA graft recorded by TTFM.