Objective The popularization of gastroenteroscopy and the introduction of comfortable medical care have further promoted the growth of people's demand,especially the demand for painless endoscopy.This cross-sectio...Objective The popularization of gastroenteroscopy and the introduction of comfortable medical care have further promoted the growth of people's demand,especially the demand for painless endoscopy.This cross-sectional study aims to investigate the current situation and change in county people's demand for endoscopy to promote the development of endoscopy centers in county hospitals in southeast China.Methods From October to December 2021,patients and their family members who came to the Gastroenterology Department in Suichang County People's Hospital of Zhejiang Province were randomly selected to complete the questionnaire.A total of 838 valid questionnaires were collected.Additionally,the original software data of the Endoscopy Center were sampled and retrieved(from October to December every year from 2018 to 2021)for statistical analysis of real-world data.Those who would choose painless endoscopy the next time in the valid questionnaires were included in the painless endoscopy group,while those who would choose ordinary endoscopy the next time were included in the ordinary endoscopy group.Results The stepwise forward binary logistic regression model analysis showed that,patients with“secondhand smoke exposure”were more willing to choose painless endoscopy(OR=1.459,95%CI:1.050-2.028,p=0.025).However,patients with an education level of“primary and below”and“junior high school”,and patients who are suffering from“currently experiencing abdominal distension”,were more willing to choose ordinary endoscopy(OR=0.270,95%CI:0.149-0.488,p<0.001;OR=0.528,95%CI:0.330-0.845,p=0.008;OR=0.536,95%CI:0.334-0.861,p=0.010).Patients with previous experience in painless endoscopy tended to choose painless endoscopy the next time,while patients with previous experience in ordinary endoscopy tended to choose ordinary endoscopy the next time(χ^(2)=140.97,p<0.001).From 2018 to 2021,the proportion of painless endoscopy has increased yearly(p<0.001).Most patients indicated that they would“regularly review gastroenteroscopy”(477/838,56.9%).Conclusions With Suichang County of Zhejiang Province as the representative,the demand for painless endoscopy for people's gastrointestinal cancer detection in southeast China has been increasing yearly.The development of endoscopy centers in county-level hospitals can basically meet the demand growth.Meanwhile,advanced concepts such as comfortable medical care and regular follow-up are gradually popularized at the grassroots level in southeast China.展开更多
目的:探讨健康儿童青少年经光学相干断层成像(OCT)测得的黄斑区以及视盘区相关参数的正常值范围,并分析个体因素对OCT主要参数的可能影响。方法:横断面研究。本研究为爱尔儿童青少年屈光发育队列研究的一部分内容,在2019年3─6月期间,使...目的:探讨健康儿童青少年经光学相干断层成像(OCT)测得的黄斑区以及视盘区相关参数的正常值范围,并分析个体因素对OCT主要参数的可能影响。方法:横断面研究。本研究为爱尔儿童青少年屈光发育队列研究的一部分内容,在2019年3─6月期间,使用OCT对湖南醴陵市及湖北宜昌市3所学校的913名中小学生(5~15岁)眼球黄斑区及视盘区进行扫描,以OCT自带软件导出视盘形态学指标、视盘及黄斑区视网膜厚度和神经纤维层厚度(RNFL),分别以P2.5~P97.5及均值±1.96标准差定义其正常值范围,并通过Spearman相关和多元线性回归模型分析年龄、性别、屈光度和眼轴长度对OCT主要参数的影响。结果:糖尿病早期治疗研究小组黄斑部格子分区(EDTRS)中,黄斑中心区视网膜厚度及RNFL的正常值范围分别为193.72~262.68μm和0.67~8.18μm。内环区视网膜厚度依次为上方(288.07~340.29μm)>鼻侧(283.89~340.53μm)及下方(283.85~337.21μm)>颞侧(275.32~326.32μm),RNFL依次为下方(24.40~33.01μm)及上方(24.52~33.24μm)>鼻侧(20.89~28.35μm)>颞侧(20.54~24.45μm);外环区视网膜厚度依次为鼻侧(266.97~323.27μm)>上方(254.81~305.03μm)>下方(241.54~292.42μm)>颞侧(238.45~286.59μm),RNFL依次为鼻侧(42.38~63.03μm)>下方(36.35~53.74μm)及上方(36.19~53.64μm)>颞侧(21.37~26.52μm)。视盘视网膜厚度依次为上方(286.13~378.29μm)及下方(283.20~375.82μm)>颞侧(256.90~325.30μm)>鼻侧(235.40~309.79μm),RNFL依次为下方(122.07~193.79μm)>上方(113.48~188.28μm)>颞侧(71.51~146.15μm)>鼻侧(45.99~112.26μm)。视盘面积(DA)、盘沿面积(RA)、视杯容积(CV)、杯盘面积比(CDAR)、线性杯盘比(LCDR)、垂直杯盘比(VCDR)分别为1.37~3.16 mm 2、0.79~2.64 mm 2、0.01~0.51mm 3、0.03~0.64、0.17~0.80、0.15~0.78。多元线性回归分析显示等效球镜度与黄斑中心区、黄斑外环鼻侧、视盘鼻侧及视盘下方RNFL厚度和DA、CV、VCDR具有相关性(r=-0.197、-0.317、4.458、1.633、0.069、0.020、0.040,均P<0.05),年龄与黄斑中心区RNFL及DA、CV、VCDR呈负相关(r=-0.099、-0.020、-0.005、-0.007,均P<0.05),与黄斑外环鼻侧RNFL呈正相关(r=0.141,P=0.046),眼轴与CV、VCDR、黄斑中心区及外环鼻侧RNFL呈正相关(r=0.022、0.045、0.414,1.486,均P<0.05),与视盘下方呈负相关(r=-2.192,P=0.012),仅黄斑外环鼻侧RNFL与性别有相关性(r=-1.066,P=0.002)。结论:本研究提供了健康儿童青少年人群黄斑区以及视盘区相关参数正常范围,同时发现性别、年龄、屈光度以及眼轴均会对OCT的检查结果产生一定的影响,提示临床中应用OCT评估及诊治儿童青少年眼底病变时,应考虑这些因素的影响。展开更多
基金supported by the National Natural Science Foundation of China(82073160).
文摘Objective The popularization of gastroenteroscopy and the introduction of comfortable medical care have further promoted the growth of people's demand,especially the demand for painless endoscopy.This cross-sectional study aims to investigate the current situation and change in county people's demand for endoscopy to promote the development of endoscopy centers in county hospitals in southeast China.Methods From October to December 2021,patients and their family members who came to the Gastroenterology Department in Suichang County People's Hospital of Zhejiang Province were randomly selected to complete the questionnaire.A total of 838 valid questionnaires were collected.Additionally,the original software data of the Endoscopy Center were sampled and retrieved(from October to December every year from 2018 to 2021)for statistical analysis of real-world data.Those who would choose painless endoscopy the next time in the valid questionnaires were included in the painless endoscopy group,while those who would choose ordinary endoscopy the next time were included in the ordinary endoscopy group.Results The stepwise forward binary logistic regression model analysis showed that,patients with“secondhand smoke exposure”were more willing to choose painless endoscopy(OR=1.459,95%CI:1.050-2.028,p=0.025).However,patients with an education level of“primary and below”and“junior high school”,and patients who are suffering from“currently experiencing abdominal distension”,were more willing to choose ordinary endoscopy(OR=0.270,95%CI:0.149-0.488,p<0.001;OR=0.528,95%CI:0.330-0.845,p=0.008;OR=0.536,95%CI:0.334-0.861,p=0.010).Patients with previous experience in painless endoscopy tended to choose painless endoscopy the next time,while patients with previous experience in ordinary endoscopy tended to choose ordinary endoscopy the next time(χ^(2)=140.97,p<0.001).From 2018 to 2021,the proportion of painless endoscopy has increased yearly(p<0.001).Most patients indicated that they would“regularly review gastroenteroscopy”(477/838,56.9%).Conclusions With Suichang County of Zhejiang Province as the representative,the demand for painless endoscopy for people's gastrointestinal cancer detection in southeast China has been increasing yearly.The development of endoscopy centers in county-level hospitals can basically meet the demand growth.Meanwhile,advanced concepts such as comfortable medical care and regular follow-up are gradually popularized at the grassroots level in southeast China.
文摘目的:探讨健康儿童青少年经光学相干断层成像(OCT)测得的黄斑区以及视盘区相关参数的正常值范围,并分析个体因素对OCT主要参数的可能影响。方法:横断面研究。本研究为爱尔儿童青少年屈光发育队列研究的一部分内容,在2019年3─6月期间,使用OCT对湖南醴陵市及湖北宜昌市3所学校的913名中小学生(5~15岁)眼球黄斑区及视盘区进行扫描,以OCT自带软件导出视盘形态学指标、视盘及黄斑区视网膜厚度和神经纤维层厚度(RNFL),分别以P2.5~P97.5及均值±1.96标准差定义其正常值范围,并通过Spearman相关和多元线性回归模型分析年龄、性别、屈光度和眼轴长度对OCT主要参数的影响。结果:糖尿病早期治疗研究小组黄斑部格子分区(EDTRS)中,黄斑中心区视网膜厚度及RNFL的正常值范围分别为193.72~262.68μm和0.67~8.18μm。内环区视网膜厚度依次为上方(288.07~340.29μm)>鼻侧(283.89~340.53μm)及下方(283.85~337.21μm)>颞侧(275.32~326.32μm),RNFL依次为下方(24.40~33.01μm)及上方(24.52~33.24μm)>鼻侧(20.89~28.35μm)>颞侧(20.54~24.45μm);外环区视网膜厚度依次为鼻侧(266.97~323.27μm)>上方(254.81~305.03μm)>下方(241.54~292.42μm)>颞侧(238.45~286.59μm),RNFL依次为鼻侧(42.38~63.03μm)>下方(36.35~53.74μm)及上方(36.19~53.64μm)>颞侧(21.37~26.52μm)。视盘视网膜厚度依次为上方(286.13~378.29μm)及下方(283.20~375.82μm)>颞侧(256.90~325.30μm)>鼻侧(235.40~309.79μm),RNFL依次为下方(122.07~193.79μm)>上方(113.48~188.28μm)>颞侧(71.51~146.15μm)>鼻侧(45.99~112.26μm)。视盘面积(DA)、盘沿面积(RA)、视杯容积(CV)、杯盘面积比(CDAR)、线性杯盘比(LCDR)、垂直杯盘比(VCDR)分别为1.37~3.16 mm 2、0.79~2.64 mm 2、0.01~0.51mm 3、0.03~0.64、0.17~0.80、0.15~0.78。多元线性回归分析显示等效球镜度与黄斑中心区、黄斑外环鼻侧、视盘鼻侧及视盘下方RNFL厚度和DA、CV、VCDR具有相关性(r=-0.197、-0.317、4.458、1.633、0.069、0.020、0.040,均P<0.05),年龄与黄斑中心区RNFL及DA、CV、VCDR呈负相关(r=-0.099、-0.020、-0.005、-0.007,均P<0.05),与黄斑外环鼻侧RNFL呈正相关(r=0.141,P=0.046),眼轴与CV、VCDR、黄斑中心区及外环鼻侧RNFL呈正相关(r=0.022、0.045、0.414,1.486,均P<0.05),与视盘下方呈负相关(r=-2.192,P=0.012),仅黄斑外环鼻侧RNFL与性别有相关性(r=-1.066,P=0.002)。结论:本研究提供了健康儿童青少年人群黄斑区以及视盘区相关参数正常范围,同时发现性别、年龄、屈光度以及眼轴均会对OCT的检查结果产生一定的影响,提示临床中应用OCT评估及诊治儿童青少年眼底病变时,应考虑这些因素的影响。