ObjectiveTo investigate the effect of “noncycloplegic retinoscopy for screening myopia + subsequent wearing orthokeratology lens” process for primary and secondary school students based on physical examination center.MethodsA total of 172 primary and secondary school students undergoing vision examination in the Health Management Department (i.e. physical examination center) of the Second Affiliated Hospital of Xi’an Jiaotong University between January 2017 and December 2018 were selected as the research objects. After examination by noncycloplegic retinoscopy in the health management department, they were examined by mydriatic retinoscopy in the ophthalmology department, and then the consistency of the results of the two methods was analyzed. Then 93 students with myopia diagnosed by both methods were randomly divided into control group (n=46) and trial group (n=47), wearing frame glasses and orthokeratology lenses respectively. The diopter, eye axial length, corneal curvature and vitreous cavity depth before wearing glasses, as well as the increment of the above indicators at 3, 6 and 12 months after wearing glasses/lenses were compared between the two groups, and the incidence of complications of the two groups were compared.ResultsCompared with mydriatic retinoscopy, the positive predictive value of noncycloplegic retinoscopy was 88.6%, the sensitivity was 96.9% and the specificity was 84.2%, and the consistency kappa coefficient was 0.821 (P<0.001). Before wearing glasses/lenses, there was no significant difference in diopter, eye axial length, corneal curvature or vitreous cavity depth of both eyes between the two groups (P>0.05); at 3, 6 and 12 months after wearing glasses/lenses, the diopter increment and eye axial increment of both eyes of the trial group were less than those of the control group [left eye diopter increment: (0.48±0.07) vs. (0.73±0.08) D, (0.69±0.13) vs. (1.04±0.11) D, (0.88±0.11) vs. (1.13±0.11) D; left eye axial increment: (0.18±0.05) vs. (0.26±0.04)mm, (0.22±0.04) vs. (0.36±0.04) mm, (0.27±0.05) vs. (0.40±0.05) mm; right eye diopter increment: (0.46±0.10) vs. (0.73±0.09) D, (0.71±0.12) vs. (1.04±0.10) D, (0.90±0.10) vs. (1.17±0.11) D; right eye axial increment: (0.17±0.04) vs. (0.24±0.04) mm, (0.23±0.04) vs. (0.37±0.04) mm, (0.26±0.05) vs. (0.42±0.05) mm] (P<0.05). At 3, 6 and 12 months after wearing glasses/lenses, the changing trends of corneal curvature and vitreous cavity depth in both eyes of the trial group were different from those of the control group (PInteraction<0.05), and the corneal curvature of both eyes at each time point was lower than that before wearing lenses and that of the control group (P<0.05), while the vitreous cavity depth of both eyes was not statistically different from that before wearing lenses (P>0.05) but lower than that of the control group (P<0.05). There was no statistical difference in the incidence of common complications between the two groups (P>0.05).ConclusionIn the physical examination center, the accuracy of noncycloplegic retinoscopy for general survey of myopia in primary and secondary school students is high, and then after the diagnosis by mydriatic retinoscopy in the special department, the use of orthokeratology lens can effectively control the progress of myopia, so the process of “noncycloplegic retinoscopy for screening myopia in physical examination center + subsequent wearing orthokeratology lens in specialty” is feasible.
【摘要】 目的 考察用乌头碱水解物、新乌头碱水解物、次乌头碱水解物的含量作为附片水煎剂及附片质量控制指标的可行性。 方法 采用高效液相色谱分析法，色谱柱为Shimpack CLC-ODS，以甲醇-乙酸铵溶液（0.2 mol/L）（200︰210）为流动相，流速1.0 mL/min，检测波长为241 nm，对乌头碱新，乌头碱、次乌头碱水解物的含量测定进行研究。 结果 3种水解物检测方法测得水解物在进样范围有良好线性关系，重现性好，稳定性好，生药提取时间宜选定为40 min，不同批号的附片中3种水解物含量差别较大。 结论 此方法简便，使用新乌头碱、乌头碱、次乌头碱的水解物作为含附片制剂的质量控制指标是可行的。【Abstract】 Objective To examine the feasibility of regarding the hydrolyzate from aconitine, new aconitine, and hypaconitine to be the decoction of radix aconite and the quality control index. Methods High performance liquid chromatographic method (HPLC) method was adopted. Shimpack CLC-ODS column with UV detection at 241 nm was used. The mobile phase consisted of (200∶210), and the flow rate was 1.0 mL/min. Results The content of the hydrolysis objects in the water decoction and toxicity were correlated with each other, and the contents of hydrolysis were significantly different among different groups of radix aconiti. Conclusion This method is simple, accurate and effective for content research of hydrolyzate from aconitine-type alkaloids in Monkshoo decoction of Radix Aconiti, and it is feasible to take it as the quality control index.