京沪妇女保健人员素质适宜程度比较

目的分析2000—2017年京沪妇女保健人员素质不足严重程度及孕产妇死亡率的变化趋势,明确两地差异,探讨妇女保健人员素质适宜程度。方法收集1995—2017年所有涉及京沪妇女保健资源问题的文献,系统筛选涉及妇女保健人员素质主题的有关文献,进而计算妇女保健人员素质不足严重程度评分。上海纳入165篇文献,北京纳入147篇。运用Spearman相关、线性回归等方法分析妇女保健人员素质不足严重程度与孕产妇死亡率的关系。结果北京妇女保健人员素质不足严重程度从2000年的3.53分降至2017年的3.12分,上海则由3.70分降至2.12分。上海孕产妇死亡率与妇女保健人员素质不足严重程度相关有统计学意义(r=0.758,P<0.01)。上海的回归方程有统计学意义(P<0.01)。结论京沪两地妇女保健人员素质不断提高,上海妇女保健人员素质在孕产妇死亡率降低中发挥更大作用,但人员专业能力仍需进一步提升;适宜的妇女保健体系应"人员能力胜任工作需要";验证了量化妇女保健人员素质的可行性。     

“互联网+”居家养老服务需求意愿及影响因素研究

目的:以合肥市为例,基于老年人自身角度,对“互联网+”居家养老服务需求程度及影响因素进行探究方法;采用描述性统计方法探究老年人“互联网+”居家养老服务需求及接受现状;采用多元有序logistic模型从个体特征、社会环境特征、“互联网+”认知特征等三方面分析不同特征老人“互联网+”居家养老服务需求影响因素。结果:①老年人对于智能化养老需求意愿较高,但实际接受程度仍偏低。②年龄、文化程度、享受养老保险类型、“互联网+”居家养老服务认识了解程度,智能设备使用简易程度等会正向促进居家养老服务需求程度的提高。而户口所在地、当前养老现状满意程度、信息化养老服务费用等会负向影响居家养老服务需求程度的提高。结论:促进老年人生活质量进一步提高,应从增强“互联网+”居家养老服务模式普及率,尊重社区居民养老服务需求,坚持政府主导与市场融合,构建完善基础信息技术系统等方面入手。     

重庆市高等级公路交通事故回顾性调查

目的 旨在通过对重庆市高等级公路交通事故的回故性调查,分析重庆市高等级公路交通事故的发生特点及规律。方法 调查重庆市２１０高等级公路交通管理大队自１９９５年至１９９７年间一般事故以上的道路交通事故。结果 其间共性生产道路事故８４３起,人员伤亡事故２０９起,事故数逐年增加;其中重大事故４９起、一般事故７９４志,共造成３１４人伤亡,其中死亡４７人,重伤１４９人和轻伤１１８人;在人员重伤和死亡中大多数为     

Retrograde intubation dacryocystorhinostomy for proximal and midcanalicular obstruction

Objective

Retrograde intubation of canaliculi during dacryocystorhinostomy can restore canalicular patency in cases otherwise managed with bypass tubes. The surgical technique and success for this procedure are discussed.

Relationship between corneal thickness and measured intraocular pressure in a general ophthalmology clinic

OBJECTIVE: To assess whether central corneal thickness (CCT) is a confounding factor in the classification of patients attending for glaucoma assessment in a district general hospital. DESIGN: Cross-sectional study by a single observer. PARTICIPANTS: Patients attending a general ophthalmic clinic: 235 clinically normal eyes, 52 eyes with normal-tension glaucoma (NTG), 335 eyes with primary open-angle glaucoma (POAG), 12 eyes with pseudoexfoliative glaucoma (PXE), 42 eyes with chronic angle closure glaucoma (CACG), and 232 glaucoma suspect (GS) eyes. INTERVENTION: Central corneal thickness was measured using ultrasonic pachymetry. MAIN OUTCOME MEASURE: Correlation of CCT and diagnosis. RESULTS: Mean CCT was 553.9 microm (95% confidence intervals [CI] for the mean, 549.0-558.8 microm) in the clinically normal eyes, 550.1 microm (95% CI, 546.6-553.7 microm) in the POAG eyes, 514.0 microm (95% CI, 504.8-523.3 microm) in the NTG eyes, 530.7 microm (95% CI, 511.2-550.1 microm) in the PXE eyes, 559.9 microm (95% CI, 546.8-573.0 microm) in the CACG eyes, and 579.5 microm (95% CI, 574.8-584.1 microm) in the GS eyes. The differences of mean CCT between the groups were highly significant (P< 0.001 analysis of variance). Eighty-five percent of eyes with NTG and only 36% of eyes with POAG had a mean CCT of 540 microm or less. Thirteen percent of eyes with POAG and 42% of GS eyes had a mean CCT greater than 585 microm. CONCLUSIONS: The CCT measurement is desirable in patients attending for glaucoma assessment in a district general hospital to avoid misclassification resulting from the relationship between CCT and tonometric pressure. Central corneal thickness alone is not an accurate predictor for the clinical diagnosis in this group of eyes. However, many eyes diagnosed as having NTG have thin corneas, which would tend to lower the tonometrically recorded intraocular pressure (IOP), so the finding of a less-than-normal thickness cornea introduces some doubt as to the diagnosis of NTG. For the GS eyes, most eyes had thick corneas, which would tend to increase the tonometrically recorded IOP. Thus, GS eyes with modest elevation of IOP and a thick cornea may be at low risk of progressing to POAG. Thus, many patients with "high IOPs" and a thick CCT do not necessarily have high IOPs and may not need to be followed as GS eyes.     

Amacrine cells,bipolar cells and ganglion cells of the cat retina: A Golgi study

Neuronal types contributing to the inner plexiform layer of the cat retina are described based primarily on light microscopy of Golgi-impregnated retinal whole-mounts. Cells have been characterized on morphological criteria that include dendritic branching patterns, dendritic tree sizes, cell body sizes and stratification of processes in the inner plexiform layer. Nine different types of bipolar cell, 22 different types of amacrine cell and 23 different types of ganglion cell can be distinguished using one or more of these morphological criteria. The significance of the different morphological types of cells is discussed, particularly in relationship to the functional bisublamination of the cat inner plexiform layer.     

Exercise and heart disease. Epidemiology of the "exercise hypothesis"

The "exercise hypothesis" states that exercise protects against coronary heart disease. Reviewed herein is the epidemiologic evidence for and against the "exercise hypothesis." The weight of evidence supports the view that exercisers have a lower risk of coronary disease, but that vigorous exercise cannot always prevent progression of coronary atherosclerosis and does increase the risk of sudden death in persons with advanced coronary atherosclerosis. It is concluded that the "exercise hypothesis" is plausible, even likely, but still unproved.