目的:探讨耳穴贴压联合视功能训练对弱视患儿矫正视力的改善效果及其协同作用机制。方法:采用随机对照试验设计,纳入2023年6月至2024年6月就诊于汕头大学·香港中文大学联合汕头国际眼科中心的105例弱视患儿。通过随机数字表法分为...目的:探讨耳穴贴压联合视功能训练对弱视患儿矫正视力的改善效果及其协同作用机制。方法:采用随机对照试验设计,纳入2023年6月至2024年6月就诊于汕头大学·香港中文大学联合汕头国际眼科中心的105例弱视患儿。通过随机数字表法分为干预组(耳穴贴压联合视功能训练,n=53)和对照组(视功能训练联合安慰剂贴压,n=52)。两组均接受标准化视功能训练,干预组加用耳穴贴压(取眼穴、肝穴、脾穴、肾穴等穴位),每日按压3次,持续3个月。主要观察指标为最佳矫正视力(以LogMAR表示)及其改善幅度(ΔLogMAR=基线LogMAR-治疗后LogMAR)。采用逐步多元线性回归分析ΔLogMAR的影响因素。结果:两组基线特征均衡(P>0.05)。干预3个月后,干预组最佳矫正视力(LogMAR)优于对照组(0.28±0.16 vs. 0.35±0.18,P=0.039),ΔLogMAR改善幅度更高(0.19±0.14 vs. 0.10±0.15,P=0.027)。多元线性回归显示:基线矫正视力(b=-0.619)、弱视程度(以中度作为参照:轻度b=0.584;重度b=-0.800)、联合耳穴贴压干预(b=0.075)、日均遮盖时长(b=0.098)均为ΔLogMAR的独立预测因子(均P<0.05)。结论:耳穴贴压联合视功能训练可促进弱视患儿视力改善,疗效优于单纯视功能训练。展开更多
AIM:To investigate the causal effect of obesity on cataract risk and explores the potential mediating roles of metabolites using Mendelian randomization(MR).METHODS:Summary-level data from large-scale genome-wide asso...AIM:To investigate the causal effect of obesity on cataract risk and explores the potential mediating roles of metabolites using Mendelian randomization(MR).METHODS:Summary-level data from large-scale genome-wide association studies to examine the relationship between obesity and cataract were utilized.Obesity-related traits,including body mass index(BMI),waist-to-hip ratio(WHR),and waist circumference(WC).A two-sample MR approach was employed to assess the causal effect of obesity on cataract risk,while potential mediators were identified from suitable genome-wide association studies(GWAS)datasets.Additionally,a metabolic pathway analysis was conducted.RESULTS:An increase of 1 standard deviation(SD)in BMI,WHR,and WC was associated with a significantly higher risk of cataract(BMI:odds ratio(OR)1.0017,95%confidence interval(CI):1.0001-1.0032,P=0.0320;WHR:OR 1.0029,95%CI:1.0006-1.0051,P=0.0129;WC:OR 1.0020,95%CI:1.0001-1.0038,P=0.0390].These associations remained robust after adjusting for confounding factors in multivariable MR analysis.Furthermore,a two-step MR analysis identified eight potential metabolic mediators,with one mediator showing a significant causal role in the relationship between obesity and cataract.CONCLUSION:This work highlights the importance of addressing obesity as a modifiable risk factor for cataracts,particularly through metabolic pathways.展开更多
文摘目的:探讨耳穴贴压联合视功能训练对弱视患儿矫正视力的改善效果及其协同作用机制。方法:采用随机对照试验设计,纳入2023年6月至2024年6月就诊于汕头大学·香港中文大学联合汕头国际眼科中心的105例弱视患儿。通过随机数字表法分为干预组(耳穴贴压联合视功能训练,n=53)和对照组(视功能训练联合安慰剂贴压,n=52)。两组均接受标准化视功能训练,干预组加用耳穴贴压(取眼穴、肝穴、脾穴、肾穴等穴位),每日按压3次,持续3个月。主要观察指标为最佳矫正视力(以LogMAR表示)及其改善幅度(ΔLogMAR=基线LogMAR-治疗后LogMAR)。采用逐步多元线性回归分析ΔLogMAR的影响因素。结果:两组基线特征均衡(P>0.05)。干预3个月后,干预组最佳矫正视力(LogMAR)优于对照组(0.28±0.16 vs. 0.35±0.18,P=0.039),ΔLogMAR改善幅度更高(0.19±0.14 vs. 0.10±0.15,P=0.027)。多元线性回归显示:基线矫正视力(b=-0.619)、弱视程度(以中度作为参照:轻度b=0.584;重度b=-0.800)、联合耳穴贴压干预(b=0.075)、日均遮盖时长(b=0.098)均为ΔLogMAR的独立预测因子(均P<0.05)。结论:耳穴贴压联合视功能训练可促进弱视患儿视力改善,疗效优于单纯视功能训练。
基金Supported by the National Natural Science Foundation of China(No.82501261)Medical Research Projects of the Jiangsu Provincial Health Commission(No.M2024041).
文摘AIM:To investigate the causal effect of obesity on cataract risk and explores the potential mediating roles of metabolites using Mendelian randomization(MR).METHODS:Summary-level data from large-scale genome-wide association studies to examine the relationship between obesity and cataract were utilized.Obesity-related traits,including body mass index(BMI),waist-to-hip ratio(WHR),and waist circumference(WC).A two-sample MR approach was employed to assess the causal effect of obesity on cataract risk,while potential mediators were identified from suitable genome-wide association studies(GWAS)datasets.Additionally,a metabolic pathway analysis was conducted.RESULTS:An increase of 1 standard deviation(SD)in BMI,WHR,and WC was associated with a significantly higher risk of cataract(BMI:odds ratio(OR)1.0017,95%confidence interval(CI):1.0001-1.0032,P=0.0320;WHR:OR 1.0029,95%CI:1.0006-1.0051,P=0.0129;WC:OR 1.0020,95%CI:1.0001-1.0038,P=0.0390].These associations remained robust after adjusting for confounding factors in multivariable MR analysis.Furthermore,a two-step MR analysis identified eight potential metabolic mediators,with one mediator showing a significant causal role in the relationship between obesity and cataract.CONCLUSION:This work highlights the importance of addressing obesity as a modifiable risk factor for cataracts,particularly through metabolic pathways.
