对远视性儿童弱视几个新认识

我们22年来,对儿童弱视临床治疗的实践,和公开发表的14篇论文对儿童弱视未知领域探讨进行总结,有如下几个新认识:1.提出远视性儿童弱视愈后脱镜指标和进一步补充与修正;2.儿童弱视愈后复发概念与分期;3.儿童弱视痊愈或脱镜后近视化;4.治疗年龄限制;5.结束治疗。

远视性儿童弱视临床研究报告

目的:对儿童弱视临床治疗中1) 远视性儿童弱视愈后脫镜指标。2) 儿童弱视愈后复发概念与分期。3)儿童弱视痊愈或脫镜后近视化。4) 治疗年龄限制。5) 结束治疗等。很少有人涉及,报道也很少的这五个方面问题进行研究探讨。方法:弱视儿童就诊后,散瞳验光配戴合适的矫治眼镜、遮盖疗法、使用家庭弱视治疗仪、1个月定期复查,痊愈后,按:(1) 双眼裸眼远近视力≥1.0(国际标准视力表)半年以上者(年龄在3~5岁儿童视力的正常值下限为0.5,6岁及以上儿童视力的正常值下限为0.7),(2) 眼位正常或斜视性弱视治愈后残余斜视度P Objective: Clinical treatment of amblyopia in children, 1) The index of disconnection after amblyopia recovery in hyperopic children. 2) The concept and stage of amblyopia recurrence in children. 3) Children & apos;samblyopia recovered or became myopic after taking off glasses. 4) Age limit of treatment. 5) End treatment. Very few people are involved, The report also very few of these five aspects of the study. Methods: after the amblyopia children went to the doctor, they wore suitable corrective glasses, covered therapy, used the family amblyopia therapeutic instrument, and reexamined regularly for 1 month, note: (1) binocular naked near and far vision ≥ 1.0 (International Standard Visual Acuity Chart) for more than half a year (the lower limit of normal vision for children aged 3~5 years is 0.5, and the lower limit of normal vision for children aged 6 years and over is 0.7), (2) residual strabismus < 5˚, (3) hyperopic dioptre ≤ 1.00 ds (3 years ≤ + 2.00 ds, 4~5 years ≤ + 1.50 ds) and (4) hyperopic astigmatism ≤ + 0.50 DC. Decided to take off the lens. Results: 1) The younger the age at first diagnosis, the better the curative effect: 2.5~6 years old, 24.17%, 40.44%, 24.83%, 89.44%, all higher than other age groups, 2) The mild amblyopia at first diagnosis (0.8~0.6), 20.57%, 24.83%, 89.44%, the recovery rate was 75.18% (95.75%), significantly higher than that of the moderate amblyopia (0.5~0.2) (22.26%) , the recovery rate was 32.75% , the basic recovery rate was 27.16%, the total recovery rate was 82.17%, the severe amblyopia (0.1 or less) was 14.17%, the recovery rate was 7.58%, the basic cure rate was 48.76% and the total cure rate was 71.05%. 3) The initial diopter of low diopter (spherical lens ≤ 3.00 d, cylindrical lens ≤ 1.00 d) was 17.52%, the cure rate was 57.18%, the basic cure rate was 16.06%, the total rate was 90.76%, higher than moderate (3.25~4.75 D for spherical lens, 1.25~1.50 D for cylindrical lens), 26.17%, 24.00%, 30.06%, 80.23% and 19.28% for height (5.00 d for spherical lens, 1.75 D for cylindrical lens), the cure rate was 17.69%, the basic cure rate was 30.06%, the total cure rate was 72.08%, 4) At the first diagnosis, the simple hyperopia was 23.34%, the basic cure rate was 39.68%, the basic cure rate was 35.11%, the total cure rate was 87.10%, which was higher than the simple hyperopia astigmatism, the removal of mirror was 12.38%, the total cure rate was 37.13%, the cure rate was 25.25%, 74.76% in total, and 10.80%, 36.21%, 25.08%, 72.09% in total 5) The relationship between treatment time and curative effect: From Table 5, it can be seen that after 3 years treatment, 21.77% of the patients were out of mirror, 49.10% were cured, 20.87% were basically cured, 91.74% in total, 26.02% of the patients were out of mirror, 47.37% were cured, the cure rate was 18.95% (92.34%) , 29.35% (29.35%), 49.74% (49.74%), 15.4% (94.73%), 29.30% (29.30%), 58.06% (58.06%), 9.68% (94.73%), respectively, the total rate of 97.04% was higher than that of the following three years (p < 0.05). Conclusion: 1) The corrected index of amblyopia in hyperopic children should be: (1) binocular naked near-far Vision 1.0 (International Standard Visual Acuity chart) more than half a year (the lower limit of normal vision for children aged 3~5 years is 0.5, for children aged 4~5 years less than 0.6, and for children aged 6 years and over is 0.7), (2) if the eye position is normal or the residual strabismus degree is less than 5˚, after the strabismus amblyopia is cured, (3) hyperopia dioptre ≤1.00 ds (3 years ≤ + 2.00 ds, 4~5 years + 1.50 ds), (4) hyperopic Astigmatism + 0.50 DC, 4 indexes. 2) The concept of recurrent amblyopia, We Believe: Amblyopia recurrence is after treatment amblyopia, Corrected vision was improved to ≥ 0.9 (International Standard Vision) Or the naked eye vision improved to ≥ 1.0, His eyesight is failing again, after mydriasis optometry with compound tropicamide or atropine, it was proved that the diopter was obviously increased, that is, the recurrence of amblyopia. Stages of amblyopia recurrence: we believe that according to the different stages of treatment of amblyopia in children, Amblyopia recurrence should be divided into three stages, namely: After basic cure, amblyopia recurred, Amblyopia recurred after recovery and after lens removal. 3) The problem of myopia after amblyopia recovery or lens removal in children, we advocate early detection and prompt treatment of pseudomyopia, Prevent the formation of true myopia. 4) Treatment of the problem of age limitation we believe that: Amblyopia treatment can be started at the age of 21/2, the best age is 2~6, 7~12 is the right age, but 13~18-year-old children amblyopia do not easily give up treatment. 5) The problem of ending treatment, we Believe: The treatment of hyperopic amblyopia in children is the safest after taking off lens. The rate of vision regression was lowest. And myopic amblyopia, basic cure or after cure can end treatment.

Long-Term Statistics of Extreme Tsunami Height at Crescent City

Historically, Crescent City is one of the most vulnerable communities impacted by tsunamis along the west coast of the United States, largely attributed to its offshore geography. Trans-ocean tsunamis usually produce large wave runup at Crescent Harbor resulting in catastrophic damages, property loss and human death. How to determine the return values of tsunami height using relatively short-term observation data is of great significance to assess the tsunami hazards and improve engineering design along the coast of Crescent City. In the present study, the extreme tsunami heights observed along the coast of Crescent City from 1938 to 2015 are fitted using six different probabilistic distributions, namely, the Gumbel distribution, the Weibull distribution, the maximum entropy distribution, the lognormal distribution, the generalized extreme value distribution and the generalized Pareto distribution. The maximum likelihood method is applied to estimate the parameters of all above distributions. Both Kolmogorov-Smirnov test and root mean square error method are utilized for goodness-of-fit test and the better fitting distribution is selected. Assuming that the occurrence frequency of tsunami in each year follows the Poisson distribution, the Poisson compound extreme value distribution can be used to fit the annual maximum tsunami amplitude, and then the point and interval estimations of return tsunami heights are calculated for structural design. The results show that the Poisson compound extreme value distribution fits tsunami heights very well and is suitable to determine the return tsunami heights for coastal disaster prevention.

A predictive model for early recurrence of colorectal-cancer liver metastases based on clinical parameters

Background:The prognosis for patients with colorectal-cancer liver metastases(CRLM)after curative surgery remains poor and shows great heterogeneity.Early recurrence,defined as tumor recurrence within 6 months of curative surgery,is associated with poor survival,requiring earlier detection and intervention.This study aimed to develop and validate a bedside model based on clinical parameters to predict early recurrence in CRLM patients and provide insight into post-operative surveillance strategies.Material and methods:A total of 202 consecutive CRLM patients undergoing curative surgeries between 2012 and 2019 were retrospectively enrolled and randomly assigned to the training(n=150)and validation(n=52)sets.Baseline information and radiological,pathological,and laboratory findings were extracted from medical records.Predictive factors for early recurrence were identified via a multivariate logistic-regression model to develop a predictive nomogram,which was validated for discrimination,calibration,and clinical application.Results:Liver-metastases number,lymph-node suspicion,neurovascular invasion,colon/rectum location,albumin and post-operative carcinoembryonic antigen,and carbohydrate antigen 19–9 levels(CA19–9)were independent predictive factors and were used to construct the nomogramfor early recurrence after curative surgery.The area under the curve was 0.866 and 0.792 for internal and external validation,respectively.The model significantly outperformed the clinical risk score and Beppu’s model in our data set.In the lift curve,the nomogram boosted the detection rate in post-operative surveillance by two-fold in the top 30%high-risk patients.Conclusion:Our model for early recurrence in CRLM patients after curative surgeries showed superior performance and could aid in the decision-making for selective follow-up strategies.