Research progress on commonly used visual acuity charts for preschool children / 国际眼科杂志(Guoji Yanke Zazhi)

Preschool age(3-6 years old)is a critical period for visual development, and it is crucial to detect and treat visual problems in preschool children as early as possible. Visual acuity charts are important tools for screening visual issues in children. In China, the commonly used charts are the standard logarithmic visual acuity chart and the pediatric optotype chart, while overseas, the Lea, HOTV, and ETDRS visual acuity charts are frequently employed. Numerous studies have reported the measurability, repeatability, and sensitivity of these three charts in diagnosing visual-related problems in children. However, the application of these three charts is relatively limited in China. This article provides a comprehensive review of the design principles, clinical applications, and characteristics of these three visual acuity charts, so as to better understand their applicability and limitations in preschool children, and provide reference for the selection and improvement of vision examination methods in the future.

Comparison of curative effect and cost between domestic and imported covered stents in the treatment of non-complex Stanford type B aortic dissection / 国际外科学杂志

Objective:To compare the curative effect and cost of domestic and imported covered stents in the treatment of non-complex Stanford type B aortic dissection.Methods:A retrospective case-control study was used to analyze the clinical data of 93 patients with non-complex Stanford B aortic dissection who underwent thoracic endovascular aortic repair (TEVAR) in Taizhou Second People's Hospital from September 2016 to September 2021.Ninty-three patients were divided into two groups according to the use of different covered stents during the operation, of which 47 patients were treated with domestic covered stents (observation group) and 46 patients were treated with imported covered stents (control group). Overall response rate, rate of complication, treatment cost and cost-effectiveness ratio of the two groups were compared and sensitivity analysis was performed in the two groups.The measurement datas conforming to the normal distribution were expressed as mean ± standard deviation( ± s), and the inter-group comparison was conducted by t test.The comparison of counting datas between groups was conducted by Chi-square test or Fisher exact probability method. Results:The overall response rate of the observation group and the control group were 93.62% and 97.83%, with no significant difference ( P>0.05); The incidence of complications was 6.38% and 2.17%, with no significant difference ( P>0.05). The cost of covered stent [(62 155.49±10 231.08) yuan] and the total cost of treatment [(95 063.66±20 042.34) yuan] in the observation group were lower than those in the control group [(93 825.37±16 577.04) yuan and (126 035.89±26 186.18) yuan]( P<0.05). There was no significant difference in other direct costs between the observation group [(32 908.17±9 811.26) yuan] and the control group [(32 210.52±9 609.14) yuan] ( P >0.05). The cost-effectiveness ratio of the observation group and the control group were 1 015.42 and 1 288.31, and the incremental cost-effectiveness ratio of the control group was 7 356.82. After the cost-effectiveness sensitivity analysis and adjusting the cost of the covered stent to decrease by 10% of the two groups, the cost-effectiveness ratio of the observation group and the control group were 949.03 and 1 192.41, and the incremental cost-effectiveness ratio of control group was 6 604.61. Conclusions:Both domestic and imported covered stents are effective in the treatment of non-complex Stanford type B aortic dissection with fewer complications. Compared with the imported covered stent, the domestic covered stent has lower treatment cost and more advantages of cost-effectiveness, which is more in line with diagnosis related groups reform.

Research on the motivation of young patients′ medical electronic word-of-mouth sharing on internet platforms / 中华医院管理杂志

Objective:To explore the facilitating and inhibitory factors influencing the behavior of young patients to share medical electronic word-of-mouth (eWOM) on internet platforms, so as to provide insights for the improvement of healthcare quality.Methods:In May 2022, 271 undergraduate students from universities in Zhejiang province were selected by convenient sampling to survey their motivations to share eWOM with a self-designed questionnaire. Multiple regression analysis was used to examine the impact of different motivational factors on the sharing intention of young patients.Results:Only 16 respondents (5.9%) had previously published medical eWOM. Egoistic motivation, altruistic motivation, medical experience, and comment habits were significant factors that promoted patients to share eWOM, with egoistic motivation ( β=0.212, P<0.001) having the greatest impact and comment habit ( β=0.139, P=0.003) having the least impact. Distrust, low self-efficacy and involvement, perceived reluctance, and perceived uselessness were significant factors inhibiting patients from publishing eWOM. Of them, distrust ( β=-0.161, P<0.001) and perceived reluctance ( β=-0.161, P=0.001) had the greatest impact, and low self-efficacy and involvement had the least impact ( β=-0.134, P=0.003). Conclusions:To enhance the positive attitude of young patients towards sharing eWOM, it is important to focus on their personal benefits and provide high-quality healthcare experiences. Building trust among patients in the platform is crucial, and efforts should be made to reduce operational barriers. Additionally, educating and raising awareness among young patients regarding the significance and influence of healthcare reviews is important.

Prevalence of mild visual impairment in type 2 diabetes patients over 50 years old in Funing County: Jiangsu Diabetic Eye Disease Study / 中华实验眼科杂志

Objective:To investigate the prevalence and influencing factors of mild visual impairment in type 2 diabetic patients aged ≥50 years living in Funing County, Jiangsu Province.Methods:A population-based cross-sectional study was adopted.Cluster sampling was conducted among diabetic patients aged ≥50 years registered in the Chronic Disease Information Center of Funing County Center for Disease Prevention and Control from March 7th to April 20th, 2019.General information of selected patients was collected.Visual and ocular examinations on site were performed by ophthalmologists and technicians.The International Council of Ophthalmology standard for mild visual impairment, 0.3≤best corrected visual acuity<0.8 was adopted.The influencing factors of mild visual impairment were analyzed by logistic regression.This study protocol was approved by the Ethics Committee of Affiliated Hospital of Nantong University (No.2014-071).Results:Among the included 2 067 patients, 1 909 cases completed the investigation, with a response rate of 92.4%.There were 1 146 patients with mild visual impairment in at least one eye, and the prevalence of mild visual impairment was 60.00%.Among the eyes examined, 1 832 eyes were with mild visual impairment, accounting for 47.98%.Cataract (896/1 632), refractive error (515/1 632) and diabetic retinopathy (166/1 632) were the main causes of mild visual impairment in diabetic patients, accounting for 54.90%, 31.61% and 10.19%, respectively.Aging, female gender, low educational attainment, oral hypoglycemic drugs or subcutaneous insulin injection were risk factors for mild visual impairment in both eyes.Higher educational attainment, more sunshine exposure and exercise were protective factors for mild visual impairment in both eyes.Conclusions:The prevalence of mild visual impairment is relatively high in type 2 diabetic patients.Cataract surgery, correction of refractive error may help to improve mild visual impairment.Strengthening blood glucose control, more physical exercise and outdoor activities may slow the progression of mild visual impairment and prevent it from moderate and severe visual impairment.

The Economic Operation and Developing Trend of County-Level Public Hospitals of Traditional Chinese Medicine (TCM) in Guangxi Province / 世界科学技术-中医药现代化

This study aimed at exploring the economic operation and developing trend of county-level public TCM hospitals in Guangxi Province,promoting the comprehensive reform of county-level public hospitals with feasible countermeasures and suggestions.In this study,forty-seven county-level public TCM hospitals were involved in the analysis of their economic operations and benefits by constituent ratio analysis,ratio analysis and trend analysis.As a result,the average gross income of the hospitals exceeded the total expenditure with a slight surplus.Drug income contributed the biggest share of the medical income,while the ratio of Chinese drug income to the medical income was increasing year by year.The debt ratio increased from 38.7％ in 2009 up to 44.6％ in 2013,being over 30％ in this period.In conclusion,it was demonstrated that problems were found in the lack of financial assistance,the low efficiency of economic management and the increasing average medical charges,which should be addressed by increasing investments to TCM hospitals,strengthening the performance appraisal and adjusting the charges of TCM medical services.

Study on the demand of general practitioners'professional skills in Guangxi / 中国基层医药

Objective To study the demand of general doctors'professional skill in Guangxi Zhuang autonomaus region,and to enhance the professional skills and overall quality of general practitioners in Guangxi,thus to improve grassroots'health service capacity.Methods Through self -designed questionnaires and personal interviews,the author investigated the professional skills of general practitioners in rural township hospitals and urban community health service centers in Guangxi.Results The characteristics of the general practitioners in Guangxi were junior college degree,junior titles,youth and middle -aged.Part of the general practitioners thought that working with the guide of community health informationteaching abilityand the corresponding scientific research capabilitiesdid not belong to the scope of the general practitioners'professional skills demand,the percentage of these were 2%, 22%,26%.The teaching ability and the corresponding scientific ability of the general practitioner who were greater than 30 years,junior college degree and middle grade title and above,were better than the practitioners who were 20 -30 years,technical secondary degree,primary title(χ2 =12.886,1.945,57.473,53.276,30.458,29.141,all P <0.05).The general practitioners in Guangxi had a light awareness of teaching,scientific researching and other aspects.Conclusion We must emphasis on continuous medical education;establish and improve the system of general practitioners;establish and improve the two -way referral system.General practitioners must pay more attention on teaching and scientific researching.

Effects of glial cell derived neurotrophic factor on colon glial cells in rats with slow transit constipation / 中华消化杂志

Objective To investigate the effects of exogenous glial cell derived neurotrophic factor (GDNF)on colon glial cells in slow transit constipation (STC ) rats,and to explore the optimal concentration of GDNF in order to provide evidence for intestinal neurotrophic therapy in the treatment of STC.Methods A total of 132 SD rats were divided into STC group and control group,66 rats in each group.STC rats were established by feeding with rhubarb.Six rats were randomly selected from either groups to verify whether STC model was successfully established.And the left 120 rats of two groups were randomly divided into six subgroups:STC group one to group six and control group one to group six,ten rats in each group,which were untreated,injected through tail vein with saline,and 0.001 ,0.010, 0.050,0.100 μg/L GDNF 2 mL respectively for one week.The expression of Sox-8 at protein level of either group were detected by Western blotting.Independent sample t test was performed for statistical analysis.Results After treated with 0.001 μg/L GDNF (STC group three),there was no significant difference in expression level of Sox-8 between STC group three and STC group one (13.38 ±0.70 vs 13.39±0.45 ,t = 0.042,P = 0.969 ).After treated with 0.010 μg/L GDNF (STC group four),the difference in expression level of Sox-8 between STC group four and STC group three was significant (21 .11 ±2.56 vs 13.38±0.70,t=5 .040,P <0.01).After treated with 0.050 μg/mL GDNF (STC group five),the expression level of Sox-8 was higher than that in STC group four (31.86±1.57 vs 21.11±2.56,t=-6.198,P <0.01 ).The Sox-8 expression of untreated,saline treated,0.001 and 0.050 μg/L GDNF treated STC rats (STC group one,two,three and five)were lower than those of the corresponding control groups (t= 3.394,12.103,10.302,- 6.120,all P < 0.05 ).Conclusion Exogenous GDNF could increase Sox-8 expression in colon tissue of STC rats,an increase in the number of colon glial cells could repair enteric nervous system,and 0.050 μg/L was the optimal concentration.

Study on CXCR1/CXCR2 antagonist G31P anti-inflammatory reaction mediated by neutrophils / 中华微生物学和免疫学杂志

Objective To Study on CXCR1/CXCR2 antagonist G31P anti-inflammatory reaction mediated by neutrophils.Methods Detect whether G31P can block chemotaxis of neutrophils induced by human IL-8 and inhibit the release of IL-8 by epithelia of segmental bronchus;establish HEK293 cell line transfected by pcDNA3.0-CXCR1 ,2,4 and detect the chemotaxis of IL-8 for HEK293 ;establish the experi-mental model of pneumonia induced by the P.aeruginosa,take count of the nucleated cells in the bronchoal-veolar lavage fluid(BALF),analyze myeloperoxidase(MPO) of lung tissue and observe the histopathology changing of it.Results G31P can inhibit the chemotaxis for neutrophils and transfected HEK293 cell line,inhibit the A549 releasing of inflammatory mediators;the proportion of neutrophils declines in G31P treat-ment group,pathology examination appears clear discrepancy.Conclusion G31P can block the chemotaxis of chemotactic factor with ELR+ CXC to neutrophils,block the combination of chemotactic factor with its re-ceptor CXCR2,block the CXCR2 on the surface of alveolar epithelia and vascular endothelial cells.Accordingly,neutrophils recruiting to topoinflammation can be prevented.