Could Labor Be Considered Outside of a Medical Environment in Africa? Case of the Maternity Hospital in Yopougon Attié/Abidjan/Ivory Coast/West Africa

Introduction: Developing countries are characterized by a high maternal mortality rate, particulary related to the management of childbirth. The author describes in this work 588 childbirth labors that took place without any medical supervision. Method: All patients who reached the hospital with a full cervix dilation were included in the study. The outcomes of those childbirth labors without medical supervision were evaluated at the maternal and neonatal level. Results and Discussion: The average age of the patients was 28.1 ± 13 years with 47% nulliparous and 30% pauciparous. These patients represented 14% of all births;59% of the patients had had three and five prenatal consultations. 71% of them came straight from home and had meconium-stained amniotic fluid. The APGAR score was greater than 6 in 94% of newborns, and 66.7 of them weighed between 2500 and 3500 g. Only 0.9% of patients coming from home needed a caesarean section. Conclusion: Home birth is not yet possible in Africa because it is not supervised by professionals who know the risks of childbirth, its complications and recognize the warning signs;however, the results of this preliminary study show that the issue of home childbirth in Côte d’Ivoire can be reconsidered subject to greater involvement of medical staffs.

A review and comparison of common maternal positions during the second-stage of labor

The second-stage of labor is the most stressful part of childbirth process and the proper maternal position during this period is paramount for women's safe vaginal birth.Midwives play a pivotal role in managing maternal positions during the second-stage of labor.However,there is limited evidence to support an ideal maternal position during the second-stage of labor.Further,the difference between different maternal positions might not be apparent.This paper aims to review and compare the benefits and risks of common maternal positions during the second-stage of labor,thereby to provide midwives evidence-based practical guidelines.

Matched or nonmatched interventions based on the transtheoretical model to promote physical activity.A meta-analysis of randomized controlled trials

Purpose: The aim of this study was to examine whether the efficacy of transtheoretical model(TTM)-based interventions on physical activity(PA)varied according to the following criteria:(1) interventions targeted the actual stages of change(SOCs) or did not;(2) participants were selected according to their SOC or were not; and(3) its theoretical constructs(decisional balance, temptation, self-efficacy, processes of change).Methods: Thirty-three randomized controlled trials assessing TTM-based interventions promoting PA in adults were systematically identified.Results: The between-group heterogeneity statistic(Qb) did not reveal any differential efficacy either in interventions targeting the actual SOC compared with those that did not(Qb = 1.48, p = 0.22) or in interventions selecting participants according to their SOC compared with those that did not(Qb = 0.01, p = 0.91). TTM-based interventions enhanced PA behavior whether they targeted the actual SOC(Cohen's d = 0.36; 95%confidence interval(CI): 0.22–0.49) or not(d = 0.23; 95%CI: 0.09–0.38) and whether they selected their participants according to their SOC(d = 0.33; 95%CI: 0.13–0.53) or not(d = 0.32; 95%CI: 0.19–0.44). The moderators of the efficacy of TTM-based interventions were the number of theoretical constructs used to tailor the intervention(Qb = 8.82, p = 0.003), the use of self-efficacy(Qb = 6.09, p = 0.01), and the processes of change(Qb = 3.51, p = 0.06).Conclusion: TTM-based interventions significantly improved PA behavior, and their efficacy was not moderated by SOC but by the TTM theoretical constructs.

Evaluating the Role of Measuring the Perineal Length as a Predictor of Progress of Labor and Obstetrical Trauma

Objective: Evaluating the effect of perineal length on the duration of the second stage of labor, the mode of delivery, the need for episiotomy and the possibility of perineal and vaginal tears needing repair. Participants and Methods: It is a prospective hospital-based observational study done on 483 parturient women in a university hospital. Personal, medical and obstetric data together with the measurement of perineal length were recorded in the first stage of labor. We followed up the progress of labor until delivery. Regression models were used to consider possible risk factors of episiotomy or tears needed repair. Results: The mean duration of the second stage of labor was significantly longer among women with a perineum of ≥4 cm length when compared with those with a perineal length of Conclusion: Longer perineum is associated with increase in the duration of the second stage of labor. Obstetricians should expect the need of episiotomy when confronted with circumcised primigravida with long perineum. However, if the perineum is short they should not be deceived, short perineum is more probably torn.

Manual Uterine Fundal Pressure in the Spontaneous Delivery during the Second Stage of Labor: A Pilot Case-Control Study Following an Analysis of Questionnaire Survey

Background: Recent obstetrical practice tends to avoid the use of manual uterine fundal pressure (MUFP);however, data showed that MUFP is actually employed. We here attempted 1) to determine the obstetricians’ attitudes towards MUFP via questionnaire, and 2) to examine whether MUFP shortens the 2nd stage of labor, with the latter tested as a pilot study. Methods: A questionnaire-based study was carried out (n = 122) at meetings of Obstetrics on May 5, 2017. Then, we conducted a pilot case-control study from August 23 to September 6, 2020. Participants (n = 29) were divided into two groups;women who did and did not want MUFP;i.e., MUFP (n = 14) vs. (Non-MUFP) group (n = 15). Results: Of 122 doctors, 99.18% (121/122) used MUFP at cesarean section. 95.90% (117/122) of institutions used MUFP in spontaneous delivery. 95.08% (116/122) obstetricians considered MUFP effective and helpful. 85.24% (104/122) considered that MUFP should be employed after station +3. In the case control study, MUFP vs. Non-MUFP group showed the second-stage-duration of 58.5 (50.25 - 71.25) vs. 48 (39 - 59) minutes, without statistical significance (P = 0.101). However, importantly, MUFP, compared with Non-MUFP group, showed a significantly shorter duration from head visible on introitus (apparition) to delivery;i.e., 21.26 ± 7.32 vs. 30.13 ± 10.61 minutes (P = 0.014). Conclusions: MUFP is still used widely and MUFP shortened the duration of head apparition to delivery time. Larger-sample studies are needed to confirm the efficacy and safety of MUFP.

Psychological and Emotional Responses during Different Stages of the COVID-19 Pandemic Based on a Survey of a Mental Health Hotline

Background:The coronavirus(COVID-19)outbreak in 2019 triggered psychological and emotional responses.This research investigates the psychological status and emotional problems of those who sought psychological assistance during the epidemic period by calling a mental health hotline.Methods:This study aims to combine qualitative and quantitative research.Descriptive analysis was used for undertaking qualitative research.We ana-lyzed the data from group 1(n=706),in which the people used the mental health hotline from 25 January 2020 to 23 June 2020.A self-designed questionnaire was developed in accordance with the classification and sum-marized items from group 1’s psychological problems and emotional status.To implement the quantitative research,we conducted a cross-sectional descriptive survey and used the self-compiled scale and HADS to inves-tigate group 2(n=553)from May 2020 to June 2020.Results:Descriptive statistics and comparative analysis revealed that:①Visitors mainly reported behavior,emotional,family relationship problems and sleep disorders.②Anxiety,comorbidities,sleep disorders and coping problems were the most frequently reported problems.③There were significant differences in the number of visitors experiencing various problems or exhibiting harmful behaviors(sorrow,worry,fear,depression,sleep disorders,self-harm or suicide,and coping problems,anxiety,hypochondria,and comorbidity)in the four stages of the epidemic.④More than a quarter of participants still suffered from anxiety or depression in the later stages of the epidemic.Conclusion:Different problems manifested at different stages of the epidemic,and psychological interventions and assistance should be tailored to reflect this.

Effect of upright and ambulant positions versus lying down during the active first stage of labor on birth outcomes among nulliparous women:randomized controlled clinical trial

Objective:To examine the effect of upright and ambulant positions versus lying down during the active first stage of labor on birth outcomes for nulliparous women.Methods:This is a randomized controlled clinical trial conducted at the delivery department of Damanhour Educational Institute,El Behira Governorate,Egypt.The study sample involved 150 parturient women equally divided into intervention and control groups using randomization block technique.The researchers used four tools for data collection:Demographic data interview schedule,World Health Organization Partograph,Apgar’s score,to evaluate neonatal outcomes,and visual analogue pain intensity scale.For the study group,the parturient women were encouraged to assume one of the upright positions or ambulating around the bed so as to maintain the pelvis in vertical plane as far as possible for 20-25 min for every 1 h.The control group received routine hospital care,which includes lying down in bed.IBM SPSS 23.0 was used to analyze the data.Results:Significant differences(P<0.05)were observed between the study and control groups in relation to cervical dilation,fetal head descent,uterine contractions interval,and frequency.The duration of the first stage of labor significantly reduced(P=0.018)in the intervention group compared with control group.No significant differences(P>0.05)were observed between both groups in term of emergency cesarean birth rates,oxytocin use,and neonatal outcomes.Conclusions:This study proves that upright and ambulant positions significantly enhance uterine contractility,cervical dilatation,and fetal head descent and reduce the first stage duration.

Effect of intervention treatment from different stages on prognosis in children with central coordination disturbance

BACKGROUND： Central coordination disturbance is regarded as the early-stage symptom of brain injury-induced cerebral palsy. This disease manifests itself as motor disorder, abnormal attitudinal reflex and muscular tension. Early intervention may improve its prognosis. OBJECTIVE： To observe the effects of intervention treatment from different stages on the prognosis of central coordination disturbance following brain injury in children patients. DESIGN： A contrast observation experiment SETTING： Department of Neurology and Rehabilitation, Urumqi Children＇s Hospital PARTICIPANTS ： Totally 151 children who were diagnosed as central coordination disturbance from January 2002 to December 2003 in the Department of Neurology and Rehabilitation of Urumqi Children＇s Hospital were recruited. All the children patients, including 101 male and 50 female, aged from 3 months to 1 year old, met the diagnosis criteria of central coordination disturbance from Vojta. They were divided into slight, moderate and severe abnormity according to Vojta attitudinal reflex. All 151 patients were divided into 2 groups according to their age at diagnosis： 3-6 months old group （n=74）, 62 severe, 10 moderate and 2 slight; 7-12 months old group （n=77）, 66 severe, 7 moderate and 4 slight. All the relatives of children patients were informed of the experiment. METHODS： ① Both groups received physical training （PT） as the main treatment; Hand training was given if necessary. All of the patients received additional hyperbaric oxygen therapy, bioelectric therapy, scalp acupuncture, drug treatment and family training. The importance of integration of hospital and family based rehabilitation was stressed. Those who did not catch up with the normal development or had abnormal reflexes continued to receive treatment. ② Around the age of 2 years old, all children did a final evaluation using Bayley Scales of Infant Development （BSID）. Mental development index （MDI） and physical development index （PDI） were taken as evaluative criteria. Children with scores 80 and above on MDI and PDI were considered to have normal motor and mental development; 79 and below were considered delayers. The Diagnostic Criteria of Cerebral Palsy and Infantecondary School Social Adaptation Scale were used in the final evaluation[scores ≤5 was extremely severe （extremely severe cerebral palsy）, 6 was severe（severe cerebral palsy）, 7 was moderate（moderate cerebral palsy）, 8 was slight（slight cerebral palsy）, 9 was borderline（slight cerebral palsy）, 10 was normal, 11 was above average, 12 was excellent and ≥13 was extremely excellent]. ③ Final evaluative results of 2 groups were compared. And u test was used for the comparison of Bayley development index and Chi-square test for the comparison of normalization rate. MAIN OUTCOME MEASURES： BSID MDI and PDI as well as the normalization rate of motor function and mental behavior of children patients at 2 years old. RESULTS： Totally 151 children patients entered the stage of result analysis. ①Two groups of children patients were given integrated rehabilitation therapy , and evaluated at 2 years old . The 3-6 months old group had higher MDI and PDI than the 7-12 months old group （91.81＋19.99 vs 71.93＋18.98;91.55＋23.61 vs 68.95＋23.51, u=6.265,5.894,P 〈 0.01 ）.②After being given integrated rehabilitation therapy, children patients of 3-6 months old group had significantly higher normalization rate of motor function and mental behavior than 7-12 months old group （73% ,27%,X2=29.723 9,P 〈 0.01 ）. ③Six slight and 17 moderate central coordination disturbance children of 2 groups all completely recovered; After intervention treatment, among 128 severe central coordination disturbance children, 52 recovered and 76 were still abnormal, in which, 43 slight cerebral palsy, 18 moderate cerebral palsy, 5 severe cerebral palsy and 10 extremely severe cerebral palsy. CONCLUSION： To perform integrated intervention treatment before 6 months old can better improve and promote mental and physical development levels of children patients with central coordination disturbance after brain injury than 6 months later.

Changes of Labor Education in the Past 70 Years Since the Founding of the People’s Republic of China

Throughout the development of labor education in the past 70 years since the founding of the People’s Republic of China,its development characteristics are different along with the varying stages of economic development.The development of labor education has an important relationship with the political system,economic policy,and cultural foundation.This article reviews the development process of labor education in the past 70 years since the founding of the People’s Republic of China,analyzes the characteristics of labor education in each period,and proposes suggestions to promote the development of labor education in China,whereby the development of labor education should follow the basic rules of education development,grasp the characteristics of the times of labor education,and build a new system of labor education;adhere to people-oriented education and establish proper educational orientation;innovate the labor education system and build a labor education model with Chinese characteristics;improve the support and guarantee system of labor education and earnestly promote the implementation of labor education;enhance the internationalization of labor education and the international competitiveness of labor education.

Clinical Effects and Mechanism of Chanlibao in Accelerating Second Stage of Labor

To observe the clinical effects and the mechanism of Chanlibao (CLB, a preparation of Chinese herbal medicine) in accelerating second stage of labor, primiparae were divided into 3 groups at random. CLB or oxytocin (OTC) was given to the CLB group ( n =80) and the OTC group ( n =52) respectively. The third group served as controls ( n =29). The control group consisted of women experiencing natural labor and to whom no drug was given. The time of second stage of labor and prognosis of mother and newborn of different groups were observed and compared. And intrauterine pressure and fetal heart rate were monitored by means of electronic monitoring. Isolated uterine muscular tissue was used to observe the reactivity to CLB. The results showed that the time of second stage of labor and postpartum hemorrhage in the CLB group were less than those in the control group and the average intrauterine pressure in the former was higher than that in latter, so was the contraction strength of isolated uterine muscle, but with no difference as compared with the OTC group. No side effect of CLB was found. It is concluded that CLB could obviously strengthen uterine contraction and accelerate second stage of labor. Moreover, it is inexpensive, convenient and free of side effect. It can be used as a new, safe and effective alternative for improving prognosis of mother and newborn, especially those not indicated for oxytocin or profuse infusion.

Introduction of a New Concept of Pain Management during Labor and a Novel Technique for Pain Free Labor

Traditional labor epidural techniques have not been proven to be sufficient to cover the second stage of labor. We have developed a new concept of pain management during labor and a new technique that provides sufficient analgesia for second stage of labor. Combined Spinal Epidural with long lasting saddle block (with hyperbaric tetracaine) was used. Potentially pain free labor could be achieved by using this method. Utilizing hyperbaric Tetracaine intrathecally may provide a long lasting sensory sacral blockade. Primary outcome measure was absence of pain during pushing (2nd stage of labor). Patients received additional comfort during 1st stage of labor. Sample size included all patients that requested labor epidurals since 12/22/11 when this new technique was introduced.

Uterotonic drugs use for post partum hemorrhage: An audit of the third stage of labor management

Objectives: Worldwide the use of uterotonic drugs has significantly reduced maternal mortality from postpartum hemorrhage. The objective is to audit the use of uterotonics in the active management of the third and fourth stages of labor. Methods: Personal data, diagnostic clinical information, blood loss and uterotonics administered were extracted from a cohort of 634 consecutive parturient. Trend in Shock Index (Pulse Rate/Systolic Blood Pressure) and 48 hours hematocrit changes were computed and analyzed. Results: There were 422 vagina deliveries and 212 caesarean sections. Primiparous mothers were 141 (34.2%), while grand multiparous mothers were 14 (3.4%). The mean visually estimated postpartum blood loss 165.9 ± 80 ml. There was no significant difference in the mean blood loss between the three parity groups of parturient [P = 0.09]. Fourteen parturient (3.44%) had blood loss ≥500 ml. The value of Shock Index (Pulse Rate/Systolic Blood Pressure) in the study ranged between 0.43 and 1.38. Logistic regression analysis of the variables associated with the switch between the three regimens of uterotonic drugs, showed a significant positive correlation between VEBL and uterotonic drugs administered [Pearson correlation = 0.130, P-value = 0.008]. In addition, there was a significant negative correlation between uterotonic drugs administered and Shock Index at 30 minutes and 2 hours postpartum. The correlation coefficient between VEBL and regimens of uterotonic drugs used was positive and significant (P = 0.019). Conclusion: Visually estimated blood loss, with shock are the main Triggers involved in switching between uterotonic drugs regimens used in active management of PPH. Shock index calculation is vital in management decision. We advocate training of all birth attendants on VEBL.

Effects of midwife-led psychological intervention on delivery outcomes:a meta-analysis

Objective:To systematically review the influence of psychological intervention of midwives on the delivery mode and outcomes.Methods:Databases including Cochrane Library,PubMed,Medline,EMBASE,CINAHL,CNKI,Wangfang,and VIP were searched for randomized controlled trials studying the effects of midwife-led psychological nursing on puerpera.Two evaluators independently searched and screened the papers,extracted relevant data,and quality assessment of the included studies,followed by a meta-analysis of the papers using RevMan 5.3 software.Results:12 studies with 1,395 patients were included.The results of the meta-analysis showed that compared to conventional nursing,midwife-led psychological intervention can improve the number of people who choose natural delivery[Z=7.53,95%CI(2.07,3.45),P<0.001],shorten the duration of the first stage of delivery[Z=45.10,95%CI(-4.43,-4.06),P<0.001),reduce postpartum hemorrhage after delivery for two hours[Z=21.68,95%CI(-63.92,-53.32),P<0.001];these differences were statistically significant.Conclusion:Psychological interventions led by midwives can improve the natural delivery rate of pregnant women,shorten the duration of the first stage of delivery,and decrease postpartum hemorrhage after delivery for two hours;thus,it can be popularized for clinical use.

Effect of prolonged second stage of labor on maternal and neonatal outcomes

Objective:To discuss the effect of prolonged second stage of labor on maternal and neonatal outcomes.Methods:A total of 101 primiparas with the length of second stage of labor longer than 2 h were selected and pregnant women with the length less than 2 h served as control.The maternal and neonatal outcomes of two groups were observed and compared.Results:A total of 62.1%(18/11) with the length of second stage of labor between 120 min and 180 min,46.7%(28/32) between 181 min and 240 min and 12 longer than 241 min underwent vaginal delivery.The longer the length of second stage of labor,the lower score of Apgar scale for infants in 1 min,and the higher the incidence of asphyxia.But there was no difference in scale in 5 min.As second stage of labor prolonged,the incidences of cesarean section and of postpartum hemorrhage increased. Conclusions:Almost half of puerperas with the length of second stage of labor longer than 2 h underwent vaginal delivery.The prolonged second stage of labor can decrease the score of Apgar scale in 1 min,increase the incidence of asphyxia,but has no effect on scale in 5 min.It still need more evidence from evidence medicine to definition of time and treatment of second stage of labor.

Interventional treatment for unresectable hepatocellular carcinoma

Hepatocellular carcinoma(HCC) is the sixth most common cancer and third leading cause of cancer-related death in the world. The Barcelona clinic liver cancer classification is the current standard classification system for the clinical management of patients with HCC and suggests that patients with intermediate-stage HCC benefit from transcatheter arterial chemoembolization(TACE). Interventional treatments such as TACE, balloon-occluded TACE, drug-eluting bead embolization, radioembolization, and combined therapies including TACE and radiofrequency ablation, continue to evolve, resulting in improved patient prognosis. However, patients with advanced-stage HCC typically receive only chemotherapy with sorafenib, a multi-kinase inhibitor, or palliative and conservative therapy. Most patients receive palliative or conservative therapy only, and approximately 50% of patients with HCC are candidatesfor systemic therapy. However, these patients require therapy that is more effective than sorafenib or conservative treatment. Several researchers try to perform more effective therapies, such as combined therapies(TACE with radiotherapy and sorafenib with TACE), modified TACE for HCC with arterioportal or arteriohepatic vein shunts, TACE based on hepatic hemodynamics, and isolated hepatic perfusion. This review summarizes the published data and data on important ongoing studies concerning interventional treatments for unresectable HCC and discusses the technical improvements in these interventions, particularly for advanced-stage HCC.

Association between Fetal Heart Rate Monitoring during Labor and Neonatal Acidosis in Full-Term Newborns: A Retrospective Multicenter Cohort Study

Introduction: Fetal heart rate monitoring during labor is used to study fetal well-being and predict neonatal acidosis of newborn. Fetal heart rate monitoring is analyzed by the obstetrical team and categorized according to the FIGO guidelines. An important limitation of this diagnostic tool is an inter- and intra-observer variability, leading to subjective cardiotocography interpretation and classification. Our objective was to study the association between the categories of fetal heart rate analysis (according to FIGO classification) and neonatal acidosis of full-term newborns. Study design: This is a multicenter retrospective cohort study conducted between 2014 and 2018 in the Grand-Est region. We searched and included retrospectively children hospitalized in a pediatric intensive care unit in one of the participating hospitals with an ICD-10 coding type “P91.6” corresponding to “Hypoxic Ischemic Encephalopathy”. Maternal, pregnancy, delivery, and newborn characteristics were collected and compared by univariate logistic regression with multiple imputation. Odds Ratio and 95% confidence intervals (CI) were calculated using the model and presented. Multiple imputation with m = 100 imputations was tested, using Rubin rules to combine the results. Results: 55 patients were included in the study. Fetal heart rate tracings classified in Category 3 as “pathological” according to FIGO guidelines were significantly associated with an increased risk of severe neonatal acidosis. Late decelerations and bradycardia during labor were associated with severe neonatal acidosis. Conclusion: Severe neonatal acidosis may be suspected by interpretation of fetal heart rate during labor. Fetal bradycardia and late decelerations are predictive of the severity of neonatal acidosis. This study emphasizes the need to screen severe neonatal acidosis and allows the identification of populations most at risk. Repeated team training and upgrading of fetal heart rate study would further reduce the incidence of neonatal acidosis.

King达标理论下分阶段康复运动对冠心病PCI术后Tei指数、有氧运动能力的影响

目的:探讨King达标理论下分阶段康复运动对冠心病经皮冠状动脉介入(PCI)术后结合性心肌性能(Tei)指数、有氧运动能力的影响。方法:选取2018年4月—2020年4月我院108例PCI术后冠心病患者,按照建档顺序分组,各54例。对照组采取常规康复护理,观察组基于对照组采取King达标理论下分阶段康复运动,时间为12周。统计2组康复运动依从性、有氧运动能力[无氧代谢阈值耗氧量(VO2AT)、峰值耗氧量(VO2peak)]、护理满意度,对比干预前后运动自我效能(ESES)、国际体力活动量表(IPAQ)、心脏功能[左心室射血分数(LVEF)、Tei指数]、生活质量(Mac-New HRQL)。结果:观察组康复训练依从性高于对照组(P<0.05);干预2周、4周及12周后观察组GSES、IPAQ评分高于对照组(P<0.05);干预2周、4周及12周后观察组LVEF高于对照组,Tei指数低于对照组(P<0.05);干预2周、4周及12周后观察组VO2AT、VO2peak高于对照组(P<0.05);干预12周后观察组生活质量Mac-New HRQL评分高于对照组(P<0.05);观察组反应性、移情性、可靠性、有形性、保证性评分高于对照组(P<0.05)。结论:King达标理论下分阶段康复运动有助于增强PCI术后冠心病患者自我效能感,提高康复运动依从性,定期定量分阶段的康复训练能逐步改善患者心功能,提高有氧运动耐力,对改善生活质量具有重要作用。

Investigating and Promoting the Decision towards Signing an Organ Donation Card

Using the Health Action Process Approach (HAPA) as a theoretical backdrop, the aim of this research, which consists of two studies, was to understand the process of goal setting and deciding to sign an organ donor card. In Study 1 (N = 550), we tested the HAPA’s stages in terms of discontinuity patterns in the variables predicting goal setting for organ donation. As expected, multigroup structural equation modeling revealed discontinuity patterns in terms of different prediction patterns. In Study 2 (N = 389), the efficacy of a planning intervention that aimed to foster the translation of goals into behavior was tested: participants who received the intervention were more likely to order a donor card than those who did not. Contrary to the HAPA’s predictions, within the intenders group the planning intervention did not stimulate behavior more frequently than in the control condition. In general, the stage-specific planning intervention is of practical importance, as it shows that brief and relatively inexpensive communication can enhance organ donation behavior.

重视眼病前期的流行病学调查

流行病学调查是疾病早预防、早干预以及相关政策制定重要的科学依据。疾病前期(predisease)常指在流行病学调查/筛查中发现的机体非正常状态,但还没有达到疾病的诊断标准,是机体由健康状态向疾病状态进展的过渡阶段,如果不干预就会发展为疾病。如大家熟知的癌症前期(癌前病变)、糖尿病前期以及高血压前期等,也包括近视前期、青光眼前期以及糖尿病前期眼部并发症等眼病前期。疾病前期由于处于疾病尚未出现临床表现或者极早期阶段,通过适当的干预可以阻止甚至逆转疾病的发生而广受重视。然而,目前眼科工作者尚未对开展眼病前期流行病学调查足够重视,对如何开展眼病前期的流行病学调查也不甚了解,本文根据以往开展眼病流行病学调查的经验,就目前患病率高、视觉损伤大的几种常见眼病前期流行病学调查的开展进行论述。