Fundus screening results and related factors of fundus diseases in 5 307 newborns / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To explore the results of fundus screening in 5 307 newborns and the related factors of fundus diseases.METHODS: A total of 5 307 newborns who underwent fundus screening in our ophthalmology department from January to December 2022 were selected. RetCam III system was used for fundus examination, and abnormal fundus conditions were recorded. The influencing factors of retinal hemorrhage in full-term infants and retinopathy of prematurity(ROP)in preterm infants were analyzed.RESULTS: The incidence of ocular abnormalities in newborns was 27.17%, with the highest incidence of retinal hemorrhage(61.23%), followed by retinal exudation(22.95%), ROP and ROP like retinopathy(10.68%). The incidence of morning glory syndrome(0.21%), albino fundus(0.21%), and permanent fetal vasculature(PFV; 0.28%)was lower. The incidence of eye abnormalities in full-term infants was lower than that in preterm infants(26.30% vs 30.08%, P<0.05), and the incidence of retinal hemorrhage and exudation in full-term infants was higher than that in preterm infants(P<0.05). The incidence of ROP and ROP like retinopathy in preterm infants was higher than that in full-term infants(P<0.05). Natural delivery is a risk factor for retinal hemorrhage in full-term infants(P<0.05). Fetal age(32-34, 30-31 wk), birth weight(1 500-2 499, <1 500 g), milk powder feeding, and oxygen inhalation are risk factors for ROP in premature infants(all P<0.05).CONCLUSION: The incidence of eye abnormalities in newborns at our hospital is relatively high, and early detection of eye abnormalities in newborns can be achieved through fundus screening.

Analysis of influencing factors of community elderly health services by general practitioners from the perspective of social ecology / 中华医院管理杂志

Objective:To identify the influencing factors for community elderly health services provided by general practitioners (GPs) using the social ecological theory, for reference in improving their participation and satisfaction.Methods:According to the social ecological theory, an ecological model for GPs to carry out community elderly health services was constructed from four levels: public policy ecology, community health service ecology, interpersonal relationship ecology, and individual characteristics ecology of general practitioners. A survey questionnaire was designed with six latent variables: public health policy support, public health service and basic medical service supply, doctor-patient relationship, individual participation and individual satisfaction. The questionnaire was distributed to 220 GPs from 11 primary healthcare institutions in Jiangsu province, China, who were randomly selected between October and November 2021. Exploratory and confirmatory analyses of the model were conducted using AMOS 25.0.Results:A total of 207 valid questionnaires were collected, and all the KMO values of the six latent variables were greater than 0.7, while the composite reliability values and average variance extracted values greater than 0.7 and 0.5, respectively. Both the reliability and validity of the data met the analysis requirements. Exploratory analysis revealed that public health policy support had a direct positive effect on both public health service and basic medical service supply (both effect sizes being 0.37). Public health service had a direct positive effect on doctor-patient relationship, individual participation and individual satisfaction (effect sizes being 0.52, 0.22, and 0.31, respectively). The direct effect of basic medical service supply on doctor-patient relationship was not significant (effect size being 0.03), but it had a direct positive effect on public health service (effect size being 0.46). Doctor-patient relationship had a direct positive effect on individual participation (effect size being 0.51), but its direct effect on individual satisfaction was not significant (effect size being 0.06). Individual participation had a direct positive effect on individual satisfaction (effect size being 0.52). Conclusions:By optimizing the public policy ecosystem, community health service ecosystem, and interpersonal relationship ecosystem, the participation and satisfaction of general practitioners can be systematically improved.

Influencing factors of lower urinary tract symptoms in patients with prostate hyperplasia after transurethral holmium laser enucleation / 中华全科医师杂志

A total of 360 patients with prostate hyperplasia underwent transurethral holmium laser enucleation of the prostate in Department of Urology of Jinhua People′s Hospital from July 2019 to December 2022. Among 360 patients, lower urinary tract symptoms occurred one month after operation in 40 cases with an incidence rate of 11.11%. The age, body mass index (BMI), course of disease, nature of disease, preoperative prostate volume, postoperative prostate volume, preoperative IPSS score, postoperative IPSS score, preoperative maximum urine flow rate, postoperative maximum urine flow rate, preoperative residual urine volume, postoperative residual urine volume, postoperative urinary tract infection, operative time, postoperative catheter retention time were compared between patients with lower urinary tract symptoms (study group) and those without (control group). There were significant differences in the course of disease, preoperative prostate volume, preoperative IPSS score, preoperative maximum urine flow rate, preoperative residual urine volume, postoperative urinary tract infection and postoperative catheter retention time between two groups ( t=28.01, 6.35, 8.79, 17.92, 34.84, 11.45;all P<0.05). Multivariate logistic analysis showed that the course of disease, preoperative prostate volume, preoperative IPSS score, postoperative urinary tract infection, and postoperative catheter retention time were independent risk factors for postoperative lower urinary tract symptoms ( OR=6.964, 3.442, 1.944, 4.836, 4.225, 4.894; all P<0.05); while the preoperative maximum urinary flow rate was the protective factor( OR=0.043, P<0.05). The incidence of postoperative lower urinary tract symptoms in patients undergoing transurethral holmium laser enucleation of prostate is high. Effective protective measures should be taken based on the risk factors to reduce the incidence of postoperative lower urinary tract symptoms and to promote the early recovery of patients.

Status quo and influencing factors of health self-management ability of scientific and technological workers in Shanxi Province / 中华健康管理学杂志

Objective:To investigate the status quo and influencing factors of health self-management ability of scientific and technological workers in Shanxi Province.Methods:This study was a cross-sectional study. Using the general situation questionnaire and the adult health self-management ability evaluation scale, 467 scientific and technological workers who received physical examination in the First Hospital of Shanxi Medical University from January 2022 to September 2022 were investigated by questionnaire, and their height, weight, body mass index, fasting blood glucose, blood lipids and blood uric acid were collected on the day of physical examination. Multiple linear regression analysis was used to explore the influencing factors of health self-management ability, and Pearson and Spearman correlation analysis was used to analyze the correlation between health self-management ability and examination items.Results:The total score of health self-management ability of 467 scientific and technological workers was (153.7±16.5). The results of multiple linear regression showed that the type of medical insurance, self-assessment of health status, staying up late, and sleep quality were independent influencing factors of health self-management ability ( R2=0.141, adjusted R2=0.120, F=6.771; P<0.001). Health self-management ability was positively correlated with high-density lipoprotein ( r=0.114), behavioral subscale was positively correlated with high-density lipoprotein ( r=0.107), environmental subscale was negatively correlated with uric acid ( r=-0.103), triglyceride ( r=-0.118), and positively correlated with high-density lipoprotein ( r=0.129), and cognitive subscale was negatively correlated with triglyceride ( r=-0.125), all of which were statistically significant ( P<0.05). Conclusions:The ability of health self-management of scientific and technological workers in Shanxi Province belongs to the upper middle level, which is affected by the type of medical insurance, the self-assessment of health status, staying up late, and the quality of sleep. It is suggested that the ability of health self-management of scientific and technological workers can be improved by strengthening their health beliefs, providing a more convenient working environment, reducing the frequency of staying up late, and improving their sleep quality.

Status and influencing factors of enteral nutrition support for preterm infants / 中国小儿急救医学

Premature infants have immature gastrointestinal function and are prone to various comorbidities after birth, which have a great impact on their near and long-term prognosis.Proper nutritional support is the basis of their survival and treatment plan, of which enteral nutrition is the main tool.However, the management of enteral nutrition varies considerably between neonatal facilities worldwide, and the nutritional management of preterm infants varies between physicians.This review summarized and discussed the existing literature on enteral nutrition in preterm infants, to provide a review of the current status of enteral nutrition support in preterm infants in China and abroad and the factors that currently influence the time to achieve adequate enteral nutrition, aiming to provide a reference for improving clinical practice protocols.

Study on Influencing Factors of Artificial Hip Joint Test Quality Based on ISO/IEC 17025 and GLP / 中国医疗器械杂志

OBJECTIVE@#Taking artificial hip joint test as the object, integrating ISO/IEC 17025 and GLP, and establishing a new set of management requirements for test influence factors.@*METHODS@#The requirements of ISO/IEC 17025 and GLP regulations for influencing factors were compared and analyzed, the similarities and differences were found, and the two were integrated to formulate new management requirements for each influencing factor.@*RESULTS@#From the personnel, equipment, materials, methods, reports, filing and other factors, a set of management requirements in line with ISO/IEC 17025 and GLP was formulated, so that the laboratory can provide the objective, real and accurate test data for medical equipment manufacturers and regulatory authorities.@*CONCLUSIONS@#It can improve the test quality of the laboratory and ensure the authenticity and reliability of the test data and conclusions.

Clinicopathological analysis of superior mediastinal lymph node metastases in medullary thyroid carcinoma / 中华肿瘤杂志

Objective: To investigate the clinicopathological characteristics of superior mediastinal lymph node metastases (sMLNM) in medullary thyroid carcinoma (MTC). Methods: This retrospective analysis enrolled the patients who were treated for sMLNM of MTC in our hospital from May 2012 to January 2021. All patients were suspected of sMLNM due to preoperative imaging. According to the pathological results, the patients were divided into two groups named sMLNM group and the negative superior-mediastinal-lymph-node group. We collected and analyzed the clinical features, pathological features, pre- and post-operative calcitonin (Ctn), and carcinoembryonic antigen (CEA) levels of the two groups. Logistic regression analysis was used to analyze risk factors, and receiver operation characteristic (ROC) curves were drawn to determine the optimal cut-off values of preoperative Ctn and preoperative CEA for predicting sMLNM. Results: Among the 94 patients, 69 cases were in the sMLNM group and 25 cases were in the non-SMLNM group. Preoperative Ctn level (P=0.003), preoperative CEA level (P=0.010), distant metastasis (P=0.022), extracapsular lymph node invasion (P=0.013), the number of central lymph node metastases (P=0.002) were related to sMLNM, but the multivariate analysis did not find any independent risk factors. The optimal threshold for predicting sMLNM by pre-operative Ctn is 1500 pg/ml and AUC is 0.759 (95% CI: 0.646, 0.872). The sensitivity, specificity, positive predictive value, and negative predictive value of diagnosis are 61.2%, 77.3%, 89.1%, 39.5%, respectively. In patients who underwent mediastinal lymph node dissection through transsternal approach, the metastatic possibility of different levels from high to low were level 2R (82.3%, 28/34), level 2L (58.8%, 20/34), level 4R (58.8%, 20/34), level 3 (23.5%, 8/34), level 4L (11.8%, 4/34). Postoperative complications occurred in 41 cases (43.6%), and there was no perioperative death in all cases. 14.8% (12/81) of the patients achieved biochemical complete response (Ctn≤12 pg/ml) one month after surgery, 5 of these patients were in sMLNM group. Conclusions: For patients who have highly suspicious sMLNM through imaging, combining with preoperative Ctn diagnosis can improve the accuracy of diagnosis, especially for patients with preoperative Ctn over 1 500 pg/ml. The superior mediastinal lymph node dissection for the primary sternotomy should include at least the superior mediastinal levels 2-4 to avoid residual lesions. The strategy of surgery needs to be cautiously performed. Although the probability of biochemical cure in sMLNM cases is low, nearly 40% of patients can still benefit from the operation at the biochemical level.

Starting effect of highly active antiretroviral therapy on the incidence of anemia in HIV-infected patients / 上海预防医学

ObjectiveTo investigate the risk factors of anemia in HIV-infected patients receiving highly active antiretroviral therapy （HAART） in the Pudong New Area. MethodsA retrospective cohort study was conducted among HIV-infected patients who started HAART from 2005 to 2020 in Pudong New Area. Cox proportional hazards model was used to analyze the risk factors of anemia， moderate or severe anemia， and chronic anemia. The piecewise linear mixed-effect model was used to analyze the association between initial HAART classes and hemoglobin change in the follow-up. ResultsA total of 2 403 HIV-infected patients were included in the analysis. Among them， there were 357 cases of new onset anemia， 86 cases of chronic anemia and 102 cases of moderate or severe anemia， with the incidence density of 4.41/100 person years， 0.89/100 person years and 0.96/100 person years respectively. Multifactorial Cox regression analysis results showed that female， age >45 years， baseline CD4+ T lymphocyte count （CD4） <200 cells‧μL-1， opportunistic infections， glomerular filtration rate （eGFR） <60 mL‧min-1‧（1.73 m2）-1， and zidovudine （AZT） or protease inhibitor （PIs） based regimens were associated factors for the development of anemia. Female， age >45 years， CD4 <200 cells‧μL-1， opportunistic infections， and AZT-based regimens were associated with the development of chronic anemia. Mild anemia at baseline and AZT-based regimens were associated with the development of moderate or severe anemia. Linear mixed-effects model showed that the use of AZT （-7.87 g‧L-1， 95%CI： -9.42 to -6.32） or PIs （-3.43 g‧L-1， 95%CI： -5.57 to -1.30） was associated with lower Hb at follow-up. ConclusionInitial use of AZT and PIs is associated with progression to anemia and a lower follow-up hemoglobin level. Increased hemoglobin monitoring in users of AZT and PIs may be beneficial， especially during the first 6 months after initiation of HAART.

Research progress on bile acid metabolism mediated by uridine diphosphate glucuronic acid transferase and its endogenous and exogenous influencing factors / 中国临床药理学与治疗学

Uridine diphosphate glucuronic acid transferase (UDP-glucuronosyltransferases, UGT) is an important Ⅱmetabolic enzymes in the body. It is invovled in the metabolism of exogenous compounds, and also in endogenous substances such as bile acid metabolism and regulation. Parsing uridine diphosphate glucuronic acid transferase mediated bile acid metabolism and its influence factors can help enhance related disease treatment and prevention. Studies have shown that the interaction between UGT and bile acids is influenced by many endogenous and exogenous factors. This paper will focus on the effects of internal and exogenous factors such as nuclear receptors, genetic factors, xenobiotics and liver-related diseases on the action of UGT enzyme, and discuss the potential mechanism of bile acid balance intervention.

Research progress in antitumor and immunoregulation of fucoidan / 国际生物医学工程杂志

Fucoidan is a kind of sulfated polysaccharide with various biological activities that mainly exists in the cell walls of brown algae. It is also found in marine invertebrates such as sea cucumbers and sea urchins. Fucoidan has received a lot of attention due to its tumor-killing and immune-boosting properties. Moreover, the combination of fucoidan with chemotherapeutic drugs not only improves antitumor efficacy but also reduces the side effects of these drugs. The function of fucoidan is closely correlated with its structure, molecular weight, degree of sulfation, monosaccharide component, algae source, and time of collection. In this review, the antitumor and immunomodulatory effects of fucoidan are reviewed from the aspects of promoting cell apoptosis, inducing cell cycle arrest, inhibiting angiogenesis and cell migration, and activating immune cells, to provide theoretical guidance for the development and clinical application of fucoidan.

Construction and Evaluation of Metastatic Risk Model in Left and Right Colorectal Cancer / 肿瘤防治研究

Objective To identify the influence factors and construct a predicted model for liver, lung, bone, or brain metastasis among patients with left or right colorectal cancer. Methods Patients with colorectal cancer with information on liver, lung, bone, and brain metastasis were retrospectively filtered and analyzed from 2010 to 2018 from the SEER database. These patients were divided into three groups based on their primary tumor location. Multivariate logistic regression analysis was conducted to identify the influence factors on metastasis. A nomogram that could predict metastasis was established and further validated by the AUC of ROC curves. Results A total of 49335 eligible patients were chosen from the SEER database. N stage and CEA were identified as risk factors for all metastases, which were unrelated to primary tumor location. By contrast, race had varying effects on liver metastasis between different groups (P < 0.05). The nomogram model predicting liver metastasis was successfully established, and the AUCs based on the three groups were 0.821 (95%CI: 0.813-0.830), 0.841 (95%CI: 0.833-0.848), and 0.796 (95%CI: 0.782-0.811), respectively. Conclusion The influence factors and predictive models on liver metastasis were different in patients with colorectal cancer and different primary tumor locations.

Analysis of occurrence relationship and its influencing factors on body composition and determinants of gestational diabetes mellitus / 中国综合临床

Objective:To analyze the body composition and determinants of gestational diabetes mellitus(GDM), so that to provide basic data for prevent and control GDM further.Methods:All 1 553 pregnant women with GDM (GDM group) at 24-28 weeks of gestation were selected, and 1 298 pregnant women with normal glucose tolerance (NGT) at the same pregnancy were taken as the control group. The general data, body composition test data and 75 g oral glucose tolerance test results of the two groups were collected for statistical analysis. T-test was used for comparison between normal distribution measurement data groups, and counting data were compared χ 2 inspection. Results:The age of GDM group (31.30±4.63) years, the body mass index before pregnancy (21.78±3.11) kg/m 2, and the proportion of body fat content (30.77±5.26)% were all higher than that of NGT Group ((28.42±4.01) years, (20.74±3.04) kg/m 2, (27.76±5.56)%). The proportion of water content (50.46±4.11)%, protein content (13.91±1.27)%, and inorganic salt content (4.90±1.99)%, were lower than that of NGT Group ((52.11±3.97)%, (14.47±1.18)%, (5.71±2.26)%), and there were significant differences between the two groups (t values were 17.84, 9.03, 6.41, 8.67, 7.14 and 5.94, respectively; all P<0.001). The detection rates of advanced age 25.4%(394/1 553), family history of diabetes 23.1%(359/1 553), history of GDM 4.3%(67/1 553), history of polycystic ovary syndrome 0.6%(9/1 553) in GDM group were higher than those in NGT group (7.4%(96/1 298), 11.4%(148/1 298), 0.3%(4/1 298), 0.1%(1/1 298)). There were statistically significant differences between the two groups(χ 2 values were 160.49, 66.36, 46.73 and 5.11, respectively; all P<0.05). The proportion of lean, normal, overweight and obese people in GDM group was 11.5%(179/1 553), 65.8%(1 022/1 553), 18.5%(287/1 553), 4.2%(65/1 553), and 22.6%(293/1 298), 63.0%(818/1 298), 11.4%(148/1 298), 3.0%(39/1 298), respectively. The body fat content in GDM group was 1.9%(30/1 553), 45.5%(707/1 553), 52.6%(817/1 553), and 8.1%(105/1 298), 54.0%(701/1 298), and 37.9%(492/1 298), respectively. The protein content in GDM group was 95.9%(1 489/1 553), 4.1%(64/1 553), 0(0/1 553), and 89.5%(1 162/1 298), 10.5%(136/1 298), 0(0/1 298), respectively. The low, normal and high water content in GDM group were 36.3%(564/1 553), 54.3%(843/1 553), 9.4%(146/1 553), and 22.5%(292/1 298), 58.8%(763/1 298), 18.7%(243/1 298), respectively. There were statistically significant differences in the overall distribution of body mass index before pregnancy and the contents of body water, body fat and protein between the two groups (statistical values were 78.89, 100.21, 43.80 and 92.54, all P<0.001). Logistic analysis showed that old age ( OR=3.462, 95% CI=2.737-4.380), overweight before pregnancy ( OR=1.296, 95% CI=1.031-1.628), family history of diabetes ( OR=2.061, 95% CI=1.676-2.535), history of GDM ( OR=12.688, 95% CI=4.577-35.169), high body fat content ( OR=1.607, 95% CI=1.234-2.092), low water content ( OR=1.493, 95% CI=1.025-2.175) were the risk factors of GDM (all P<0.05). Low body fat content ( OR=0.341, 95% CI=0.151-0.768) was the protective factor of GDM ( P<0.05). Conclusions:In addition to the traditional risk factors such as body mass index before pregnancy, old age, family history of diabetes, and history of GDM, the contents of body water and body fat also played an important role in the occurrence of GDM.

Investigate the thyroid function of radiation workers and analysis of influence factors / 中华劳动卫生职业病杂志

Objective: To analyze the thyroid condition and influencing factors of radiation workers, and to provide scientific basis for radiation protection management. Methods: In April 2020, 4308 radiation workers from October 1, 2017 to September 30, 2019 were collected for occupational health examination in Hangzhou Occupational Disease Prevention and Treatment Hospital, the data included basic information, Thyroid hormone level and thyroid color doppler ultrasound results. The thyroid status of radiation workers in different subgroups was compared. The influencing factors of Thyroid nodule were analyzed by multiple logistic regression. Results: 616 radiation workers had abnormal thyroid gland (14.3%, 616/4308) . The main manifestations of thyroid gland abnormality were abnormal Thyroid nodule (5.1%, 220/4308) and abnormal TSH level (7.1%, 308/4308) . Compared with the male radiation workers, the abnormal rate of Thyroid nodule, T3 and Tsh in female radiation workers was higher (P<0.05) , and the abnormal rate of Thyroid nodule, T3 and T4 increased with the increase of working age (P<0.05) . Radiation Workers in non-rated medical institutions and private medical institutions had the highest detection rate of Thyroid nodule (P<0.05) , and there was no significant difference in thyroid abnormalities among Workers (P<0.05) . By multiple logistic regression analysis, Sex (female) , age and institution type (private) were all independent risk factors for Thyroid nodule (95% CI: 1.548~2.763、1.002~1.030, P<0.05) . Conclusion: Ionizing radiation can cause thyroid damage in radiation workers, so we should pay more attention to the radiation protection management of female, high age, private and district medical organizations, so as to protect the health of radiation workers.

Analysis of the epidemic characteristics of diarrhea cases with Vibrio parahaemolyticus infection in Shanghai from 2017 to 2018 / 上海预防医学

Objective To analyze the infection status and epidemic characteristics of Vibrio parahaemolyticus diarrhea cases in Shanghai in recent years， and to explore its influencing factors and provide a basis for the prevention and control of Vibrio parahaemolyticus infection. Methods Food-borne disease surveillance data in Shanghai from 2017 to 2018 was collected， and the infection status and epidemic characteristics of Vibrio parahaemolyticus were analyzed. χ 2 test and multivariate unconditional logistic regression were used to analyze the factors of Vibrio parahaemolyticus infection. Results Among the food-borne surveillance cases in Shanghai from 2017 to 2018， the positive detection rate of Vibrio parahaemolyticus reached 5.1%， and the positive cases were concentrated in July， August， and September. Those working in the catering industry， migrant workers and workers， and the young and middle-aged people （19‒59 years old） have a high incidence. The results of multivariate analysis showed that dining in Qingpu， Songjiang or Minhang District， occupations of migrant workers and workers， age over 19 years old， the third quarter of a year， and the consumption of aquatic animals and related foods are risk factors for Vibrio parahaemolyticus infection. Conclusion The infection of Vibrio parahaemolyticus in Shanghai is still one of the food-borne diseases that warrant our attention. Strengthening food safety management and supervision， and promoting publicity and education for key populations are important for reducing the risk of infection by this pathogen. At the same time， long-term monitoring of infectious diarrhea cases in this city is necessary to dynamically understand the infection and epidemic characteristics of Vibrio parahaemolyticus ， and adjust the annual prevention and control measures in time.

Analysis of the epidemic characteristics of diarrhea cases with Vibrio parahaemolyticus infection in Shanghai from 2017 to 2018 / 上海预防医学

Objective To analyze the infection status and epidemic characteristics of Vibrio parahaemolyticus diarrhea cases in Shanghai in recent years， and to explore its influencing factors and provide a basis for the prevention and control of Vibrio parahaemolyticus infection. Methods Food-borne disease surveillance data in Shanghai from 2017 to 2018 was collected， and the infection status and epidemic characteristics of Vibrio parahaemolyticus were analyzed. χ 2 test and multivariate unconditional logistic regression were used to analyze the factors of Vibrio parahaemolyticus infection. Results Among the food-borne surveillance cases in Shanghai from 2017 to 2018， the positive detection rate of Vibrio parahaemolyticus reached 5.1%， and the positive cases were concentrated in July， August， and September. Those working in the catering industry， migrant workers and workers， and the young and middle-aged people （19‒59 years old） have a high incidence. The results of multivariate analysis showed that dining in Qingpu， Songjiang or Minhang District， occupations of migrant workers and workers， age over 19 years old， the third quarter of a year， and the consumption of aquatic animals and related foods are risk factors for Vibrio parahaemolyticus infection. Conclusion The infection of Vibrio parahaemolyticus in Shanghai is still one of the food-borne diseases that warrant our attention. Strengthening food safety management and supervision， and promoting publicity and education for key populations are important for reducing the risk of infection by this pathogen. At the same time， long-term monitoring of infectious diarrhea cases in this city is necessary to dynamically understand the infection and epidemic characteristics of Vibrio parahaemolyticus ， and adjust the annual prevention and control measures in time.

Research progress of visual quality after SMILE / 国际眼科杂志(Guoji Yanke Zazhi)

Femtosecond laser small incision lenticule extraction(SMILE)is one of the most advanced corneal refractive operations at present. Different from other traditional corneal refractive operations, SMILE achieves minimally invasive and valveless operation. Therefore, the evaluation of postoperative visual quality of SMILE also has its own characteristics, at present, the latest research at home and abroad has confirmed that the naked eye vision can be significantly improved and the refractive status is stable after SMILE. However, there are different understandings of the objective visual quality indexes and their influencing factors, such as higher-order aberration, modulation transfer function cut off(MTF cut off)and objective scatter index(OSI)after SMILE. This paper reviews the postoperative visual quality and its influencing factors after SMILE to provide clinical help.

Study on Influencing Factors of Environmental Testing Quality of Medical Device Manufacturers Clean Workshops / 中国医疗器械杂志

OBJECTIVE@#Improve the quality of testing in medical device manufacturers clean workshops to ensure the authenticity and reliability of testing data.@*METHODS@#Analyze the problems and influencing factors found in the process of testing of medical device manufacturers clean workshops from 2016 to 2020, and put forward reasonable suggestions to ensure the quality of testing.@*RESULTS@#In the process of testing, there are six factors that affect the quality of testing, including testing personnel, instruments and equipment, testing consumables, testing methods, testing environment and actual operation.@*CONCLUSIONS@#To improve the quality of testing, should strengthen the training of testing personnel, continuously improve the testing quality management system, establish an effective information communication mechanism, find out the influencing factors in time, provide objective, real and effective testing data for medical device manufacturing enterprises, and provide technical support for the production and supervision of medical devices.

Survey and analysis of current situation and influencing factors of self⁃stigma among patients with mental disorders in a district of Shanghai， China / 上海预防医学

Objective To describe the current situation of self-stigma in patients with mental disorders and investigate its related influencing factors. Methods Using cluster sampling method， general situation and self-stigma of 3 926 patients with mental disorders were investigated with a questionnaire. Results The average total score of stigma in patients with mental disorders was 32.81±14.41. There were statistically significant differences between social factors and occupation， economic status， mental symptoms and behavior involving violence， insight， medication compliance， adverse drug reactions， family monitoring， relationship between guardian and patient， and social participation and social function. There were statistically significant differences between ability factors and occupation， education level， marital status， diagnosis， past accidents and dangerous behaviors， mental symptoms involving violence， insight， medication compliance， disability assessment， implementation of guardianship subsidy measures， family guardianship， relationship between guardians and patients， and social participation and social function. There were statistically significant differences between treatment factors and occupation， marriage， diagnosis， mental symptoms involving violence， insight， medication compliance， adverse drug reactions， family supervision， relationship between guardian and patient， and social participation and social function. According to multiple linear stepwise regression analysis， factors with influence on the total score of stigma， in descending order， were adverse drug reactions， family monitoring， mental status and behavior involving violence， employment， medication compliance， and social function and social participation. Conclusion Patients with mental disorders have a high score of self-stigma， which is related to adverse drug reactions， family monitoring， mental status and behavior involving violence， employment， medication compliance， and social function and social participation.

The prevalence of myopic refractive error and its associated risk factors among primary school students in a community in Shanghai / 上海预防医学

Objective To analyze the prevalence of myopic refractive error and its associated risk factors among primary school students in Shanghai Minhang Distict. Methods A total of 11 356 primary school students who participated in the children's refraction screening project in Meilong Community， Minhang District， Shanghai from January 1 to December 31， 2019 were selected for visual inspection and computer optometry Results The detection rate of myopic refractive error among 6-10 year-old students was 45.59%， with a higher rate in girls and older age group. The detection rates of 6-10 year-old students were 22.88% （6 year-old）， 31.77% （7 year-old）， 47.62% （8 year-old）， 60.53% （9 year-old） and 69.84% （10 year-old）， respectively， showing a linear trend（χ 2=1.31， P<0.001）. Multivariate logistic regression revealed that myopic refractive error was statistically significantly associated with gender， age and parents' myopic. Birth weight， preterm birth and body mass index （BMI） had no influence on refractive myopic in primary school students. Conclusion Myopic refractive error is still a major public health problem in primary school students. A combined strategies for myopic refractive error reduction should be called to focus on high risk persons and behaviors.

Psychological status and influential factors of postpartum depression in primiparae after cesarean section / 中国基层医药

Objective:To investigate the psychological status and the influential factors of postpartum depression in primiparae subjected to cesarean section and provide evidence for the prevention and treatment of postpartum depression in primiparae.Methods:A total of 288 primiparae underwent a psychological status survey in Hangzhou Seventh People's Hospital from January 2016 to January 2020 and were included in this study. We evaluated their psychological status using the Self-rating Depression Scale (SDS) and the Edinburgh Postnatal Depression Scale (EPDS). The factors that affect postpartum depression were analyzed.Results:The incidence of depression post-cesarean section was 25.00% in primiparae. The scores of SDS and EPDS were (61.23 ± 7.83) points and (12.47 ± 3.14) points in primiparae with a depressive status, which were significantly higher than those in primiparae without a depressive status [(41.39 ± 3.21) points, (8.39 ± 1.22) points, t1 = 15.30, P < 0.001; t2 = 15.87, P < 0.001). Univariate analysis results showed there was a significant difference in postpartum depressive psychological status in terms of maternal education level, family relationship, mother-in-law and daughter-in-law relationship, mental health education, depressive status during pregnancy, intrapartum psychological status, and spouse's education level (all P < 0.05). Logistic regression analysis results showed that postpartum depressive status in primiparae was related to family relationships, mother-in-law/daughter-in-law relationships, the depressive status during pregnancy, intrapartum psychological status, and spouse's education level are independent risk factors for postpartum depression in primipara after cesarean section ( P < 0.05). Conclusion:The incidence of postpartum depression is high in primiparae subjected to cesarean section. Family relationships and spouse's education level are the influential factors of depression. Family-oriented early psychological intervention should be strengthened to provide more counseling during pregnancy and promote maternal mental health.