ObjectiveTo compare the effects of fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) on classifications and locations of choroidal neovascularization (CNV) located under subretinal hemorrhage in age-related macular degeneration, and on the areameasuring of subretinal hemorrhage.MethodsThe medical record of 177 patients with subretinal hemorrhage associated with AMD confirmed by photochrome of ocular fundus, FFA and ICGA examinations were retrospectively reviewed. The locations and classifications of CNV on the images of FFA and ICGA in the 177 patients and the area of subretinal hemorrhage of 30 patients randomly selected from the 177 patients were analyzed and measured. ResultsOn the images of FFA, the locations and classifications of CNV could be defined in 160 patients (90.4%), and CNV was considered eligible for laser therapy in 24 patients (13.6%). On the images of ICGA, the locations and classifications of CNV could be defined in 175 patients （98.9%），and CNV was considered eligible for laser therapy in 51 patients (28.8%). There was no statistical difference of the locations（Z=-0.383，P=0.701） and classifications （ χ2=2.993，P=0.810） of CNV on the images of FFA and ICGA. The areas of blocked fluorescence measured on the images of FFA (x-=26.610 mm2 and M=13.548 mm2) were larger than those of ICGA (x-=24.714 mm2，M=12.875 mm2) with statistical differences （Z=-3.000，P=0.003） between FFA and ICGA. ConclusionsICGA is beneficial for imaging CNV located under subretinal hemorrhage, and may increase the number of the patients who are considered eligible for laser treatment. The effect of measurement of the area of subretinal hemorrhage in AMD evaluated by FFA is better. (Chin J Ocul Fundus Dis,2003,19:149-151)
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 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.
ObjectiveTo compare the short-term effectiveness of medial unicompartmental knee arthroplasty (UKA) between patients younger or older than 60 years of age, and to investigate the impact of age on the effectiveness. Methods The clinical data of 182 patients (182 knees) who underwent medial UKA between July 2016 and June 2018 were retrospectively analyzed, of which 72 patients were less than 60 years old (group A) and 110 patients were more than 60 years old (group B). There was a significant difference in age between groups (t=−20.198, P<0.001). No significant difference was found in gender, body mass index, surgical sides, Kellgren-Lawrence grading, disease duration, and preoperative Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score between groups (P>0.05). The postoperative hospital stay and complications were recorded, and the WOMAC score, satisfaction score, and prosthesis revision were compared between groups. Results The length of postoperative hospital stay was (4.50±1.09) days in group A, and (4.46±1.29) days in group B, with no significant difference between groups (t=0.198, P=0.844). All incisions healed by first intention. The incidences of early postoperative complications in groups A and B were 5.6% and 3.6%, respectively, and the difference was not significant (χ2=0.061, P=0.804). All patients were followed up. The follow-up time were 28-50 months (mean, 36 months) in group A and 28-50 months (mean, 35 months) in group B. At last follow-up, the WOMAC scores of both groups significantly improved when compared with those before operation (P<0.05), and there was no significant difference between groups (P>0.05) in the difference before and after operation. The satisfaction scores were 6.6±1.7 in group A and 6.9±1.6 in group B, with no significant difference between groups (t=−1.326, P=0.186). There was no revision surgery in both groups during follow-up period. ConclusionAge has no significant effect on the prognosis of medial UKA, and patients younger than 60 years of age can also obtain good short-term effectiveness.
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.
Objective To explore the accuracy and practicability of bone age assessment for the diagnosis of idiopathic precocious puberty (IPP). Methods According to the “Gold Standard”, we selected 55 girls with IPP for the study group, and 83 normal girls for the control group. We retrospectively analyzed the first left hand-wrist radiographs at the first visit. Bone ages were assessed by using a single-blind method according to the RUS (Radius Ulna and Short bones), carpale and 20 bones method (TW2). Each had 5 decision thresholds (gt;97th percentile, gt;90th percentile, gt;75th percentile, gt;50th percentile and ≤50th percentile). The diagnostic values from RUS, carpale and 20 bones methods assessing bone age were analyzed to identify the best decision threshold. Results ① Both sensitivity and specificity of the four decision thresholds were relatively higher, including gt;90th percentile of RUS (sensitivity 0.836, specificity 0.916), gt;90th percentile of carpale (sensitivity 0.746, specificity 0.916), gt;90th and gt;75th percentile of 20 bone (sensitivity 0.746, specificity 0.964 and sensitivity 0.982, specificity 0.783, respectively). ② Area under receiver operator characteristic curve (AUR): AUR of RUS 0.939 ± 0.019 (95%CI 0.902 to 0.977), AUR of carpale 0.899 ± 0.028 (95%CI 0.845 to 0.954), AUR of 20 bone 0.958 ± 0.014 (95%CI 0.930 to 0.986). No significant difference was found (F=2.03, P=0.13). ③ Agreement assessment within-observer reliability was 89.28%, and between-observer reliability was 80.3% (Kappa 0.68, u=6.87, P＜0.01). Conclusions RUS and 20 bones methods have high accuracy for the diagnosis of idiopathic precocious puberty. Considering sensitivity and specificity, we think that ＞90th percentile of RUS is the best decision threshold.
Objective To evaluate the efficacy of pulmonary surfactant (PS) on severe acute respiratory distress syndrome (ARDS) in different age baby with congenital heart disease. Methods We divided 43 baby patients into two separate groups including a little baby group (12 patients with age less than 3 months) and an infants group (31 patients with age of 3 months to one year). Both groups of patients were treated with intratracheal PS at the same time. The clinical data were collected and analyzed. Results The little baby group had lower body weight. There was no statistical difference in the cardiopulmonary bypass (CPB) time, operation blocking time, mechanical ventilation time, ICU stay time between the two groups (P>0.05). Before treatment, arterial partial presurre of oxygen (PaO2), fractional oxygen concentration in inspire gas (FiO2), the ratio of arterial PO2 to the inspired oxygen fraction (P/F) and arterial-alveolar N2 difference or gradient (a/A) had no difference between the two groups (P>0.05). After treatment, PaO2 and P/F of both groups were significantly lower than before (P<0.05), and FiO2 and P/F were significantly higher than before (P<0.05). After 24 h of treatment, PaO2 and P/F of the little baby group was significantly higher than that of the infants group (P<0.05), and FiO2 and P/F were significantly lower than those of the infants group (P<0.05). Conclusion PS treating severe ARDS in little baby with congenital heart disease has better effect than infants.
The severe visual impairment caused by neovascular age-related macular degeneration (nAMD) is associated with macular neovascularization (MNV) invasion and subretinal fibrosis (SF). Excessive SF can lead to subretinal scarring, irreversible damage to photoreceptors, retinal pigment epithelium, and choroid tissue, resulting in permanent visual impairment in nAMD patients. The pathogenesis of SF is complex, involving many pathological processes such as tissue repair after injury, inflammation, and related signaling pathways and cytokine complex. Current experimental treatments for SF only target inhibition of a single cytokine. Timely and effective inhibition of the formation and progression of MNV and early identification of risk factors for SF are crucial to improving the prognosis of nAMD patients.
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)