AIM: To assess the repeatability and agreement of higher-order aberration obtained by adaptive optics visual simulator(VAO)compared with OPD-Scan Ⅲ.METHODS: A cross-sectional study was conducted from August to September 2023, including a total of 204 patients(204 eyes)with myopia whose right eyes were measured. The examinations were performed by the same skilled examiner using both devices separately. The VAO device was used to measure higher order aberrations of orders 3 to 6 at a pupil diameter of 4.5 mm, while both the VAO and OPD-Scan Ⅲ devices were utilized to measure total higher-order aberration(tHOA), spherical aberration(SA), coma aberration(Coma), and trefoil aberration(Trefoil)of the entire eye at pupil diameters ranging from 3 to 6 mm. Furthermore, the repeatability of whole eye aberration measurements obtained with the VAO device was evaluated and the agreement of the two devices was assessed.RESULTS: The whole-eye higher-order aberrations measured by VAO demonstrated excellent repeatability(0.767≤ICC≤0.941, Sw<0.01 μm, TRT<0.1 μm). There was no statistically significant difference in Coma measured by VAO or OPD-Scan Ⅲ for pupil diameters ranging from 4 to 6 mm(P>0.05), while a statistically significant difference was observed in whole-eye tHOA of other pupil diameters(all P<0.05). The agreement of aberration measurements for each order between VAO and OPD-Scan Ⅲ for 3 mm pupil diameters, SA at 4 and 5 mm pupil diameter and Coma at 4 mm pupil diameter showed a 95% limit of agreement(LoA)<0.1, indicating good agreement; however, poor agreement was found for the remaining aberration measurements at different pupil diameters, with a 95%LoA>0.1, and there were significant differences in higher-order aberrations measured by two devices under a pupil diameter of 3 mm(r=0.218-0.317, P<0.01), 4 mm(r=0.406-0.672, P<0.01), 5 mm(r=0.538-0.839, P<0.01 and r=0.030-0.109, P>0.01)and 6 mm(r=0.369-0.766, P<0.01).CONCLUSION: The VAO demonstrates favorable repeatability when assessing whole-eye higher order aberration under pupil diameters of 3-6 mm. However, there is inadequate agreement and interchangeability in whole-eye higher order aberration at 3-6 mm pupil diameter between VAO and OPD-Scan Ⅲ for clinical purposes.

Objective:To construct a set of quality evaluation index system of "Internet + nursing" with clear evaluation criteria with the service objects as the evaluation subject and Service Quality model as the theoretical framework, and to provide an objective basis for the quality evaluation of "Internet + nursing".Methods:CNKI, Wanfang databases, VIP, PubMed, and Web of Science were searched from establishment to November 2021. The article determined the quality evaluation items of "Internet + nursing" based on the perspective of service objects by means of literature analysis, field research and Delphi expert inquiries. Analytic hierarchy process was used to confirm the weight of each indicator.Results:In this study, 22 experts were consulted for 2 rounds.The effective recovery rate of the two rounds of questionnaires were 100%. The judgment basis coefficient was 0.936, familiarity coefficient was 0.945 and authority coefficient was 0.941; in the first round, the Kendall harmony coefficients assigned to the importance of the first and second level indicators were 0.187 and 0.122, and the Kendall harmony coefficients assigned to the feasibility were 0.183 and 0.125; in the second round, the Kendall harmony coefficients assigned to the importance of the first and second level indicators were 0.241 and 0.190, and the Kendall harmony coefficients assigned to the feasibility were 0.218 and 0.166 (both P<0.01). The final evaluation index system for the "Internet + nursing" based on the perspective of service objects included 7 first-class indicators and 33 second-class indicators. Conclusions:The "Internet + nursing" quality evaluation index system constructed in this study based on the perspective of service objects is scientific, reliable and practical, which can be used as an evaluation tool for the current "Internet + nursing" quality evaluation and strategy optimization.

Objective:To investigate the method and effect of correcting upper eyelid depression with released orbital diaphragmatic fat.Methods:From January 2017 to June 2020, there were 26 female patients with upper eyelid depression in this department of Hebei Chengde Stomatological Hospital. The patients aged 22-54 years, with average 43 years. An external mass orbital diaphragm fat release reverse folding repositioning with fat placement in the upper lid depression was performed in 26 patients. An incision about 4 mm long was made in the middle and lateral of the orbital diaphragm to ensure the integrity of the orbital diaphragm as far as possible. The photos of beauty seekers before and 6 months after operation were compared to observe the correction effect of upper eyelid depression and the shape of upper eyelid.Results:All 26 patients had one-stage healing of the surgical incision without infection, with inconspicuous incisional scarring. At 6 months postoperatively, 18 patients had satisfactory results; 1 patient had improved results due to insufficient fat; and 1 patient had poor results due to too little fat and poor filler placement, which was later improved by autologous fat grafting.Conclusions:External mass orbital fat release reverse folding repositioning for correction of upper eyelid depressions is a surgical procedure with obvious results, little trauma, and following the principle of anatomical recovery, which is worthy of clinical application.

Objective:To investigate the electrocardiographic characteristics of left and right ventricles origin of premature ventricular contractions(PVCs) during V3 transition of precordial leads, right ventricular outflow tract (RVOT) anterior septum and right coronary sinus (RCC), and RVOT middle-posterior septum and left coronary sinus (LCC).Methods:From January 2017 to September 2019, 91 patients with ventricular extrasystole of outflow tract who had V3 transition in precordial lead and had successful radiofrequency ablation in RVOT anterior septum, middle posterior septum, LCC and RCC were selected for retrospective case control study.The electrocardiography measurements of PVCs were compared between the anteroseptal RVOT group and RCC group, as well as the middle-posterior septal RVOT group and the LCC group, respectively.The measurements included the R-wave amplitude in lead Ⅰ, Ⅱ, Ⅲ and aVF, R amplitude ratio in leads Ⅲ to Ⅱ, Q-wave amplitude in lead aVL and aVR, Q amplitude ratio in leads aVL to aVR, R-wave and S-wave amplitude from leads V1 to V3, the V2S/V3R index, the transition zone index, and the V2 transition ratio.Results:Thirty-six cases originated from the anteroseptal RVOT, and 11 from the LCC.Lead I R-wave amplitude in anterior septal RVOT was higher than LCC group((0.22±0.25) mV vs.(-0.17±0.33) mV; P=0.003). R-wave amplitude in lead Ⅱ was lower than that in the LCC group((1.59±0.35) mV vs.(1.76±0.27) mV; P=0.035). R-wave amplitude in lead aVF was lower compared with the LCC group((1.53±0.35) mV vs.(1.78±0.39) mV; P=0.050). The V2S/V3R index showed a significant difference between these two groups(1.99±0.66 vs.0.76±0.38; P<0.001). The V2 transition ratio also appeared a significant difference between the two groups(0.69±0.43 vs.1.05±0.35; P=0.005). PVCs arose from the middle-posterior septal RVOT in 32 cases, and from the RCC in 12 cases.Compared with RCC group, lead Ⅰ R-wave amplitude showed lower ((0.25±0.31) mV vs.(0.57±0.12) mV; P<0.001); R amplitude ratio in leads Ⅲ to Ⅱ higher (0.89±0.14 vs.0.72±0.18; P=0.002); Q amplitude in lead aVL((0.72±0.24) mV vs.(0.51±0.16) mV; P=0.002)higher, and Q amplitude ratio in leads aVL to aVR higher in the middle-posterior septal RVOT(0.76±0.23 vs.0.50±0.21; P=0.002). Conclusion:Among the cases with lead V3 transition, PVCs originated from the anteroseptal RVOT show significantly different R wave in lead Ⅰ, Ⅱ, aVF, V2S/V3R index, and the V2 transition ratio compared with those from the LCC.The PVCs from the middle-posterior septal RVOT and the RCC have different R wave in lead Ⅰ, R amplitude ratio in leads Ⅱ and Ⅲ, Q amplitude ratio in leads aVL and aVR.Combined with its different characteristics, it can help to identify the origin of left and right ventricles.

Objective:To construct the nursing quality evaluation index system for Intensive Care Unit (ICU) aspiration prevention so as to provide a scientific basis for the monitoring and evaluation of nursing quality of ICU inpatients aspiration prevention.Methods:We initially constructed an item pool of quality evaluation index and a questionnaire by taking "structure-process-outcome" three-dimensional quality model as the framework and combining literature retrieval, semi-structured interviews and group discussions. We also used Delphi method combined with analytic hierarchy process to determine the index system and its weight.Results:In two rounds of questionnaires, the response rates were 100% and 96%, and the authority coefficients were 0.894 and 0.912, and the judgment coefficients were 0.960 and 0.964, and the familiarity coefficients were 0.828 and 0.860, and the Kendall's W were 0.072 and 0.189 respectively. The nursing quality evaluation index system for ICU aspiration prevention included 3 first-level indicators (structural indicators, process indicators, and outcome indicators) , 12 second-level indicators and 48 third-level indicators. Conclusions:The nursing quality evaluation index system for ICU aspiration prevention is scientific, reliable and instructive, which provides a scientific decision-making basis for the clinical practice of ICU nurses and improves the ICU nursing quality and guarantees patient safety.

Objective To investigate the unmet needs of thyroid cancer patients undergoing 131Itreatment and their relationship with psychological distress and quality of life.Methods From October 2014 to March 2016,a total of 338 patients (106 males,232 females,average age (35.50±9.98) years) with thyroid cancer who were receiving 131I treatment were enrolled.The 34 items of Supportive Care Needs Survey Short Form (SNCS-SF34) were used to investigate the unmet care needs of patients.Patients' perceptions of distress and main causes of distress were measured by Distress Thermometers (DT) and issue list.The 12-item Short-Form Health Survey (SF-12) was used to measure patients' quality of life.Pearson correlation analysis was used to analyze the data.Results The degrees of patients' unmet care needs from high to low were as following:health information needs (65.38％,221/338),psychological needs (47.93％,162/338),patients' care and support needs (44.08％,149/338),physical and daily needs (36.09％,122/338) and sexual needs (34.32％,116/338).There were 47.93％(162/388) patients with DT score ＞ 4.The top three causes of patients' distress were fears,fatigue and memory deterioration.Degree of unmet needs for patients had positive correlation with the degree of psychological distress (r values:0.232-0.462,all P＜0.01).The unmet physiological and daily needs and psychological needs of patients had negative correlations with several dimensions of quality of life (r values:from-0.367 to-0.202,all P＜ 0.05).Conclusions The unmet care needs of patients with thyroid cancer have correlations with their psychological distress and quality of life.Evaluation of the unmet care needs of patients with thyroid cancer could be beneficial for providing the targeted care.

Objective To analyze the influence of care ability of family caregivers on the readmission of stroke patients.Methods A total of 139 stroke patients and their family caregivers were followed up for 90 d.The information of patients diseases were collected by general questionnaire,and Chinese version of family care ability scale nameed family care test inventory,(FCTI) was used to evaluate the caregivers'ability,and the number of rehospitalization at 30,90 d after discharge was investigated.Results Out of 139 patients with stroke,there were 12 (8.63％) rehospitalized patients at 30 d after discharge,and 22 (15.83％) at 90 d.The scores of family caregivers'care ability in patients who had rehospitalization at 30,90 d were higher than that of non rehospitalized patients (P ＜ 0.05).Conclusion Chinese version of family care ability scale (FCTI) investigation shows that the higher of caregivers ability scores is,the lower care ability is.So stroke patients at 30,90 d in patients with stroke are more inclined to readmission.

Objective To analyze the influence of care ability of family caregivers on the readmission of stroke patients.Methods A total of 139 stroke patients and their family caregivers were followed up for 90 d.The information of patients diseases were collected by general questionnaire,and Chinese version of family care ability scale nameed family care test inventory,(FCTI) was used to evaluate the caregivers'ability,and the number of rehospitalization at 30,90 d after discharge was investigated.Results Out of 139 patients with stroke,there were 12 (8.63％) rehospitalized patients at 30 d after discharge,and 22 (15.83％) at 90 d.The scores of family caregivers'care ability in patients who had rehospitalization at 30,90 d were higher than that of non rehospitalized patients (P ＜ 0.05).Conclusion Chinese version of family care ability scale (FCTI) investigation shows that the higher of caregivers ability scores is,the lower care ability is.So stroke patients at 30,90 d in patients with stroke are more inclined to readmission.

Objective To study application effect of clinical nursing pathway on health ed-ucation in patients with laparoscopic cholecystectomy.Methods A total of 98 patients with laparo-scopic cholecystectomy were randomly divided into control group and pathway group,with 49 pa-tients in each group.Patients in the pathway group received health education according to clinical nursing pathway table while patients in the control group received traditional health education.Re-sults The command condition of health knowledge,compliance of patients and satisfaction to-wards nursing in the observation group were higher than that in the control group (P <0.05). Conclusion Clinical nursing pathway could effectively improve health education in a standardized and scientific way,enhance patients′compliance and maintain harmonious relationship between nurses and patients.

Objective To study application effect of clinical nursing pathway on health ed-ucation in patients with laparoscopic cholecystectomy.Methods A total of 98 patients with laparo-scopic cholecystectomy were randomly divided into control group and pathway group,with 49 pa-tients in each group.Patients in the pathway group received health education according to clinical nursing pathway table while patients in the control group received traditional health education.Re-sults The command condition of health knowledge,compliance of patients and satisfaction to-wards nursing in the observation group were higher than that in the control group (P <0.05). Conclusion Clinical nursing pathway could effectively improve health education in a standardized and scientific way,enhance patients′compliance and maintain harmonious relationship between nurses and patients.