ObjectiveTo observe the changes of blood flow density in the macular area of normal eyes, and to analyze its correlation with age. MethodsA cross-sectional study. Two hundred and fifty normal healthy subjects (125 males and 125 females, aged 44.76±14.77) in routine ophthalmologic examination at the Department of Ophtalmology of Guangdong Provincial People’s Hospital during June 2017 to June 2018 were enrolled. Among them, 20 to 29, 30 to 39, 40 to 49, 50 to 59, and ≥ 60 years old were 50 subjects (50 eyes) in each. BCVA, slit lamp microscope, indirect ophthalmoscope, OCT angiography (OCTA) examinations were conducted for all eyes. The subjects were examined by both eyes, and the data of 1 eye was selected by EXCEL to generate random numbers, including 126 right eyes and 124 left eyes. The range of 6 mm × 6 mm in the macular area was scanned using a frequency domain OCTA instrument. The software automatically divides it into three concentric circles centered on the macular fovea, which were foveal area with a diameter of 1 mm, parafoveal area of 1 to 3 mm, and foveal peripheral area of 3 to 6 mm. The blood flow density of superficial capillary vessel, deep capillary vessel and foveal avascular area (FAZ) within a 300 μm width (FD-300), FAZ area, perimeter (PERIM), non-circularity index, center retinal thickness (CRT) were measured. The relationship between the blood flow density in macula, CRT, FAZ and age was analyzed by Pearson correlation analysis. ResultsThe mean blood flow density of superficial capillary vessel and deep capillary vessel were (51.61±2.54)% and (54.04±5.46)%, respectively. The average FD-300, CRT, PERIM and non-circularity index were (285.55±12.13) μm, (2.150±0.367) mm, 1.10±0.04, respectively. The relevance of the results showed that the age was negatively correlated with the blood flow density of whole area (r=−0.335, −0.279; P＜0.01), parafoveal area (r=−0.255, −0.368; P＜0.01), foveal peripheral area (r=−0.330, −0.269; P＜0.01) in superficial capillary vessel and deep capillary vessel as well as FD-300 (r=−0.311, P＜0.01), but not correlated with the blood flow density of foveal area (r=−0.071, −0.118; P=0.264, 0.064). There was no relationship between the age and the FAZ area, PERIM, non-circularity index (r=−0.070, −0.055, 0.074; P=0.267, 0.385, 0.142). The age was negatively correlated with the average CRT (r=−0.217, P＜0.01), but not correlated with the CRT in foveal area (r=0.115, P=0.068). The CRT was positively correlated with the blood flow density of superficial capillary vessel and deep capillary vessel in foveal area (r=0.715, 0.653; P＜0.01), but negatively correlated with the FAZ area (r=−0.669, P＜0.01). ConclusionThe capillary blood flow density of macular area in the normal eyes decreases with age.
Objective To verifying the characteristics of optical coherence tomography(OCT) in exudative age-related macular degeneration (AMD). Methods The patients being investigated in this series included 16 cases (19 eyes) of exudative age-related macular degeneration diagnosed by FFA and OCT examinations, among them 4 cases (6 eyes) were examined with ICGA. The color photographs of ocular fundi, FFA, ICGA and OCT were investigated by contrasting each other. Results As compared with the FFA and ICGA examinations, the characteristic findings found in OCT in patients with exudative AMD in this series were as the following:①serous detachment of neurosensory epithelium in 11 eyes,②retinal hemorrhage in 2 eyes,③serous detachment of retinal pigment epithelium in 5 eyes,④hemorrhagic detachment of retinal pigment epithelium in 10 eyes,⑤disciform scar in 4 eyes,⑥fibrovascular pigment epithelial detachment and occult CNV in 12 eyes. Conclusion OCT can supply a comprehensive survey of exudative AMD, in making the diagnosis as an important complementary examination of FFA and ICGA. (Chin J Ocul Fundus Dis,2000,16:220-223)
Age-related macular degeneration (AMD) is an age-related neurodegenerative eye disease characterized by degeneration and progressive death of retinal pigment epithelium (RPE) and photoreceptor cells. In recent years, as a new treatment for AMD, stem cell therapy has attracted wide attention in the field of AMD, and has become a current research hotspot. Although stem cell therapy carries risks such as increased incidence of cancer and immune rejection, it significantly promotes damaged photoreceptor cells and retinal cells by differentiating into RPE cells and other retinal cell types, as well as secreting neurotrophic factors and extracellular vesicles. In particular, the development of embryonic stem cell-derived RPE cells, its cryopreservation technology and the advancement of plasmid, adeno-associated virus, Sendai virus and other delivery technologies have laid a solid foundation for stem cell therapy of AMD. As a new method to prevent retinal damage and photoreceptor degeneration, stem cell neuroprotective therapy has shown great potential, and with the continuous maturity and improvement of these technologies, stem cell therapy is expected to provide new ideas for the prevention and treatment of AMD in the future.
Polypoidal choroidal vasculopathy (PCV) is originally defined as a separate disease, but with the development of imaging techniques, it has now been included in the spectrum of neovascularization. In the Asian population, the prevalence of PCV is high, and with the deepening of clinical studies, the pathological characteristics, pathogenesis and clinical manifestations of PCV have been more deeply understood. Through dynamic observation and histopathological study of PCV lesions during operation, it can be confirmed that the lesions are mainly located between the retinal pigment epithelium and the Bruch membrane, rather than originating from the choroidal circulation, which is of great significance for understanding the origin and natural course of PCV. It is worth noting that although a theoretical bridge has been established between age-related macular degeneration (AMD)/PCV, there is a lack of intuitive clinical data on the ultrastructural and molecular manifestations of the cells/stroma in the local lesions of the eye, especially the progression of AMD/PCV from early/middle stage to exudative stage. It is precisely because of this that highly attractive research topics and exploration space are proposed for the future.
Age-related macular degeneration (AMD) is one of the leading irreversible causes of blindness in China. The pathogenesis of AMD is not fully understood at present. Under various stress conditions, cellular senescence is activated, characterized by telomere shortening, mitochondrial dysfunction, DNA damage, and the release of various senescence-related secretory phenotype factors. Senescence is implicated in the pathogenesis of AMD through multiple pathways, contributing to chronic inflammation and the onset and progression of AMD. Mechanisms such as oxidative stress, lipofuscin, β amyloid protein and the membrane attack complex have become hotspots of study in the pathogenesis of AMD. The cyclic guanosine phosphate - adenosine synthase - interferon stimulating factor synthase-stimulator of interferon gene pathway has emerged as a critical signaling pathway in the early development of AMD, providing direction for further research on AMD. Currently, senolytics, selective agents targeting the induction of senescent cell apoptosis, show significant potential in the treatment of AMD. The integration of new technologies with cellular senescence may offer a novel approach to AMD treatment, and intervening in the AMD treatment through anti-cellular senescence pathways holds promising prospects.
Objective To investigate the impact of peripheral artery disease (PAD) on the short-term prognosis after coronary artery bypass grafting (CABG) in patients of different age groups. MethodsRetrospective inclusion of patients who underwent CABG at Tongji Medical College Affiliated Union Hospital of Huazhong University of Science and Technology from 2016 to 2020. Divided into four groups by age (<50 years, 50-60 years, 60-70 years, >70 years). Propensity score matching (PSM) was used to balance the baseline characteristics of PAD and non PAD patients across different age groups. The primary endpoint of the study was all-cause mortality, and the secondary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE) during the perioperative period. ResultsTotally, 1 516 patients were enrolled, including the GroupⅠ (<50 years, n=167), Group Ⅱ (50-60 years, n=477), Group Ⅲ (60-70 years, n=688), and Group Ⅳ (>70 years, n=184). After PSM treatment, a total of 375 pairs of patients (75.2% male) were successfully matched. Only in the age group of 60-70 years, the in-hospital mortality rate (7.73% vs. 1.45%, P＜0.01) and MACCE incidence rate (21.26% vs. 13.04%, P=0.02) of PAD patients were significantly higher than those of the non PAD group. Further multivariate analysis suggests that PAD is an independent risk factor for in-hospital mortality (OR=3.96, P＜0.01) and MACCE (OR=1.58, P=0.04) in this group, while there is no statistically significant difference in other age groups. Conclusion: PAD significantly increases the risk of recent mortality and MACCE in CABG patients aged 60-70 years, and perioperative management needs to be optimized for this population.
Objective To analyze the incidence and mortality of asthma in China from 1990 to 2019, and to explore the influence of age, period and cohort on the incidence and mortality of asthma. Methods Using the Global Burden of Disease (GBD) 2019 database, the incidence and mortality of asthma in China from 1990 to 2019 were analyzed, and the time variation trend of age-standardized incidence and mortality was analyzed by using Joinpoint software, and the average annual variation percentage was calculated. The age-period-cohort model was constructed to analyze the influence of age, period and birth cohort on the incidence and mortality trend of asthma. Results In 2019, the incidence of asthma in China was 264.44/100 000, and the mortality rate was 1.74/100 000. The incidence rate of asthma in males (300.94/100 000) and mortality rate (1.99/100 000) were higher than those in females (226.51/100 000 and 1.49/100 000). From 1990 to 2019, the age-standardized incidence of asthma in China showed a downward trend, but the trend was not statistically significant (P>0. 05), and the age-standardized mortality showed a downward trend, with an average annual decrease of 4.90%, with a statistically significant trend (P<0.05). The results of age effect showed that the incidence of asthma in China showed a downward trend, and the death first showed a downward trend, and then increased in the age group of 55-59. The results of period effect show that the risk of asthma is decreasing, and then it is increasing from 2015 to 2019, and the risk of asthma mortality is decreasing. The results of cohort effect show that the later people are born, the lower the risk of asthma onset and death. The death of asthma is attributed to behavioral risk, high body mass index and tobacco, and the occupational risk tends to decrease. ConclusionsFrom 1990 to 2019, the incidence and mortality of asthma in China showed a decreasing trend, and the incidence and mortality of men were higher than that of women. The risk factors of behavioral risk, high body mass index and tobacco were still on the rise, so corresponding measures should be taken to carry out early screening, early detection, and early treatment for key populations.
ObjectiveTo determine the retinal thickness of normal children 3-6 years old and its relationship with the age and gender. MethodsIn a cross-sectional study, 480 eyes of 240 normal preschool children including 115 male and 125 female, ages 3 to 6 years in the urban of Beijing, China were included. The average age was (4.93±0.77) years old. The visual acuity, slit-lamp microscopy and frequency domain optical coherence tomography (FD-OCT, Optvue, Inc. USA) were examined. The retinal thickness of the macular fovea and 500, 750, 1500 μm from temporal and nasal side around the fovea were measured. 32 eyes were excluded from the study because they couldn't cooperate. Pearson correlation analysis was used to determine the correlation between age and macular retinal thickness. Independent samples group t-test was used to compare the differences between boys and girls. ResultsThe mean thickness of macular fovea was (169.10±20.587) μm. The mean macular thickness of boys was significantly higher than girls (t=-4.549, -6.167, -5.492, -5.163, -6.749, -7.494, -6.874; P≤0.001). The mean thickness of 500 μm and 750 μm from nasal side of macular fovea were significantly higher than temporal side (t=5.594, 15.778, 7.678, 18.180; P < 0.001). There was no significant relevance between macular thickness and age. ConclusionsThe mean macular thickness of boys is significantly higher than girls in normal children in the urban of Beijing. There is no significant relevance between macular thickness and age.
ObjectiveTo analyze the risk factors of new-onset postoperative atrial fibrillation (POAF) after coronary artery bypass grafting (CABG).MethodsFrom September 2011 to October 2013, 1 614 consecutive patients underwent elective coronary artery bypass grafting in Fuwai Hospital. There were 1 281 males and 333 females at average age of 60.3±8.4 years. Holter data recorded for 5 days after operation were collected and analyzed. The risk factors associated with POAF were assessed according to the baseline and intraoperative data, and the positive variables were stratified.ResultsA total of 314 patients (19.5%) developed new-onset POAF. The rate of POAF was elevating with the increase of age (P<0.001).ConclusionAge was an independent risk factor for POAF in patients undergoing elective CABG alone.
Objective To investigate the early and long-outcomes of coronary artery bypass grafting(CABG) in acute myocardial infarction (AMI) patients with coronary artery disease(CAD)(age≤45 years). Methods Data of 596 adult CAD patients (include AMI and Angina) who underwent CABG in our hospital were collected retrospectively from May 2010 to October 2018. In an AMI group, 234 were male patients with an average age of 41.59±3.79 years; 26 were female patients with an average age of 41.64±3.03 years. In an angina group, 280 were male patients with an average age of 42.19±2.90 years; 56 were female patients with an average age of 41.54±3.52 years. Preoperative baseline variables, perioperative mortality, major adverse cardiac and cerebrovascular events (MACCE) were compared between two group. Results There was no significant difference in all preoperative variables. Seven patients were died and the hospital mortality rate was 1.23% (1.54% vs. 0.89%, P=0.477). The complications including reoperation for bleeding, cerebral infarction, renal failure and atrial fibrillation arrhythmia were without significant difference between two group (P>0.05). The intensive care unit stay duration (30.66±27.46 h vs. 23.96±15.11 h), intubation duration (22.54±22.31 h vs. 18.64±11.81 h) and hospitalization costs (97 186±33 741¥ vs. 90 081±24 537¥, P=0.003) were greater in the AMI group. The hospital mortality rate and complications rate were without significant difference between STEMI (ST segment elevated myocardial infarction) and NSTEMI (non-ST-segment elevated myocardial infarction) subgroups (P>0.05). The follow-up rate was 92.6% (546 patients) and the follow-up time was 4 (0.5 to 8.5) years. All cause-mortality rate was 3.85% (21 patients), and freedom MACCE was 72.2%. The freedom from MACCE, recurred angina and cerebral infarction were without significant difference, but AMI was associated with higher rate of PCI procedure. Conclusion CABG procedure in CAD patients under 45 years accompanied AMI is safety and reliable both in early and the long-term outcomes.