Objective To investigate problems in applying clinical epidemiology and evidence-based medicine in the field of dentistry in China. Method In early April of 2001, about 200 copies of a questionnaire were sent to chief editors of dental journals, directors and famous experts of the university dental schools and/or dental departments of the provincial/metropolitan hospitals located in the mainland of China. The sent back questionnaires were summarized and analysized. Results At the end of June, 2001, 40 replies from the experts of 12 universities and one metropolitan dental hospital were received. The main points are summarized as following: EBM in China is at starting stage of "anti-illiteracy" campaign. There are 6 out of 12 universities having delivered clinical epidemiology courses to postgraduates (2 to undergraduates), only 3 added lectures on evidence-based medicine to dental students and/or professionals, only one university held intensive training courses on EBM to clinicians. In dental practice there are still scram dentists making decisions simply by experiences. In the research practice some dentists are eager for quick success, and instant benefits, ignoring, scientific design aid quality control of the studies. Randomized controlled clinical trials are seldom appeared in Chinese dental journals. To popularize EBM in all dental clinicians is important for them to use and produce the best evidences. Conclusions EBM in dental field of China is at starling stage. Collection and dissemination of best dental evidences in dental professionals is a key to raise the dental care levels in China.
Polypoidal choroidal vasculopathy (PCV) is one of the exudative maculopathy, which is characterized by retinal pigment epithelium detachment, subretinal hemorrhages and sensory retinal detachment. The prevalence of polypoidal choroidal vasculopathy (PCV) reached 33.5% in neovascular age related macular degeneration (AMD) for Chinese population. Indocyanine green angiography showed a single or multiple focal nodular areas of hyperfluorescence arising from the choroidal circulation and currently is recognized a gold standard for diagnosis of PCV. The histopathologic findings indicated that hyalinization of choroidal vessels, like arteriosclerosis. Up to now there is no reliable evidence to demonstrate the difference in genetic study. The study of environment factor showed hypertension is associated with PCV closely than with AMD. PCV and AMD is different genotype or different phenotype as well as difference in pathogenesis need further studies.
Objective To investigate the causes of blindness and low vision of the people over 50 years old in Binhu Area of Wuxi City. Methods Cluster sampling was used in randomly selected individuals over 50 years old in 28 villages. The oculopathy related to blindness and low vision of the people over 50 years old were analyzed. The vision acuity lt;0.05 was defined as blindness, while 0.05-0.3 was defined as low vision. SPSS 17.0 software was used to analyze the data. Results Totally 6150 individuals were examined. The bilateral blindness and low vision was found in 47 and 84 individuals, unilateral blindness and low vision was found in 201 and 214 individuals. Among 201 unilateral blindness individuals, there were 55 individuals have low vision in the other eye. In the 295 blind eyes, there are 116 eyes (39.32%) with cataract, 31 eyes (10.51%) with high myopia macular degeneration, and 28 (9.49%) eyes with atrophy eyeballs. In the 437 low vision eyes, there are 223 eyes (51.03%) with cataract, 41 (9.38%) eyes with high myopia macular degeneration, and 41 (9.38%) eyes with age-related macular degeneration. Conclusion Cataract is the first cause leading to blindness and low vision, followed by age-related macular degeneration, high myopia macular degeneration and atrophy eyeballs.
Objective To estimate the prevalence of diabetic retinopathy (DR) in residents at the age of ge; 60 years in Beixinjing blocks, Shanghai, and to analyze the changes and risk factors of the occurrence of DR while comparing with the previous epidemiology study in the same blocks in 2003.Methods With the help of an established resident health data,a epidemiology study was performed on all of the old residents (ge; 60 years old) with diabetes mellitus from November 2007 to April 2008.The epidemiology data included resident common information, health check, examination of visual acuity,slitlamp biomicroscopy, direct ophthalmoscopy, and photography of 2 pictures covering 450 posterior ocular fundus area acquired by digital nonmydriasis fundus camera. The diagnosis of DR was drawn according to the international DR classification (2002). The DR grade was compared in 254 residents who were involved in both of the two epidemiology studies in 2003 and 2007.Chisquare method was used to analyze the risk factors of DR and stepwise logistic analysis was used for identifying the independent factors.Results A total of 483 diabetic residents was included in this study with the inclusion rate of 91.30%, in whom 121 DR patients was found with the DR prevalence of 25.05％. The prevalence of non-proliferative DR and proliferative DR was 22.36% and 2.69%, respectively. The duration of diabetes was confirmed as the independent risk factor of DR prevalence, and no risk factor was found to affect the different ratio of non-proliferative and proliferative DR. Comparing to the results of the study in 2003,the DR grade remained steadily or decreased in 92.52% of the 254 diabetes residents.Conclusion The prevalence of DR is high in the diabetic residents at the age of ge; 60 years.The intervention work of DR prevention in Beixinjing blocks is effective.
Objective To estimate the prevalence rate and risk factors of diabetic retinopathy (DR) in rural residents in Shandong．Methods A total of 16 330 residents in 8 counties in Shandong province underwent the screening of diabetes by multistage randomized clustersampling; while the standard of diagnosis of diabetes was in accordance with the WHO standard (1990). Diabetes was diagnosed in 707 residents who then underwent questionnaire survey and examinations of fasting bloodglucose，urine protein, visual acuity, slitlamp microscope, and direct opthalmoscope. The standard of DR screening was drawn according to the international DR classification (2002). The data were statistically analyzed with SPSS 11.5 software. Results In 16 330 residents,707 were with diabetes (4.33%), 26.30% of them (181 cases) had DR (1.11% of all the residents). Multivariable analysis showed that kidney damage, hypertension and high blood glucose were the risk factors for DR; while the age, sex, and family history were not related much to DR. Conclusion The prevalence rate of DR in rural residents of Shandong is high. Kidney involvement, hypertension and high blood glucose are the risk factors of DR.
Objective To estimate the prevalence rate and risk factors of diabetic retinopathy (DR) in rural residents in Changzhi. Methods With the help of an established resident health data, a epidemiology study was performed on 63 409 residents (ge;15 years old) in the rural area of Changzhi; while the standard of diagnosis of diabetes was in accordance with the standard made by WHO in 1997. Diabetes was diagnosed in 2632 residents, and these patients underwent the investigation and examination including the disease history, glycosylated hemoglobin (HbA1c), fasting blood glucose, visual acuity, ocular diseases and intraocular pressure. The standard of DR was drawn according to the diagnosis standard made by Chinese Ocular Fundus Diseases Society, Chinese Ophthalmological Society, Chinese Medical Association in 1985. The data was statistically analyzed by SPSS 13.0 software. Results A total of 57 500 residents underwent the examination with the participating rate of 90.68%; 2632(4.58%) were diagnosed as with diabetes, in whom 986 were with DR (with DR prevalence of 37.46%). The duration of diabetes was the independent risk factor of DR (r=0.210,P＜0.001). The duration of diabetes and combined with hypertension were the influence factors of the development of DR. The visual acuity in residents with or without DR differed significantly（P＜0.01）. The level of HbA1c was positively related to DR. Conclusions The incidence of DR is high in residents with diabetes in eastern countryside area of Changzhi. The duration of diabetes and combined with hypertension were the influence factors of the development of DR. The level of HbA1c may be the important indicator which can monitor the occurrence and development of DR in patients with diabetes.
Eye and nervous system are anatomically and physiologically very close. About 40% of the nerve fibers in brain are correlated with visual function. Seven of twelve cranial nerves are straightly correlated with visual afferent or eye movement. Neurological diseases can affect eye in many different ways. Furthermore, systemic disorders can cause secondary neurological lesions or even primary neurological disorders, which sequentially show ocular symptoms a nd signs. Better understanding of the close relationship between eye and brain, together with intimate cooperation between ophthalmologists, neurologists, neuro surgeons and other specialties, are the key point to improve our neuro-ophthalm ology service in China. (Chin J Ocul Fundus Dis,2008,24:82-85)
Objective To determine the incidence of and risk fact ors for retino pathy of prematurity (ROP) among preterm infants in Beijing after implementation of the ROP guidelines. Methods The preterm infants with birth weight le; 2000 g or gestational age le; 3 4 weeks who were admitted to the neonatal intensive care units in 6 hospitals in Beijing from Jan. 1, 2005 to Dec. 31, 2005 were screened. Ophthalmologic examin ations started 3-4 weeks after birth and ROP was classified by the revised Inte r national Classification. Maternal and perinatal risk factors of occurrence of R OP were analyzed. Results In the 639 infants who had been scre ened in the 6 ho spitals, ROP was detected in 69 (10.8%), in whom 23 infants (39 eyes) (3.6%) had type 1 ROP and underwent photocoagulation. The lower the birth weight and small er the gestational age was, the higher the incidence of ROP was. Logistic regres sion analysis indicated that low birth weight, apnea gt;20 seconds, anemia, hypoxic-ischemic encephalopathy and placenta abruption were the high risk factor of R O P.Conclusion In Beijing the incidence of ROP is 10.8% after i mplementation of the ROP guidelines. Low birth weight, apnea gt;20 seconds, anemia, hypoxicischem ic encephalopathy and placenta abruption were the high risk factor of ROP.
Objective To investigate the incidence of retinopathy of prematuri ty (ROP) in the area of Shanghai, and to provide the preliminary data for the ev aluation of present criteria for ROP screening. Methods Record s of 289 prematur e infants who had undergone ROP screening from the four NICU in Shanghai between February 2004 and January 2005 were analyzed. Screening criteria included prete rm infants or low birth weight (LBW) infants with BW of 2000g or less. The first examination starts at 4 to 6 weeks chronologic age or 32 weeks post conceptual age. Results In the 289 screened infants, 19 had developed acu te ROP. There we re 3 threshold ROP, 7 prethreshold ROP and 9 developed ROP less than prethreshol d. The incidence of ROP was 6.6%. According to the British recommended guideline s（BWle;1500 g or GAle;31 weeks）, only 119 out of 289 needed screening and one ca se of stage 1 ROP was missed; the incidence of ROP was 15.1% (18/119). When lowered sc reening criteria to the American guidelines（BWle;1500g or GAle;28 weeks）, t here were only 83 infants needed screening, and we missed 2 stage 1 and 1 prethreshold ROP and the incidence of ROP was 19.3% (16/83). Conclusions The i ncidence of ROP i s 6.6% according to our study. It is lower than other reports and it has somethi ng to do with our present screening guideline. Further epidemiological data are needed to modify the guideline accordingly.
Objective To learn the screening results of retinopathy o f prematur ity (ROP) of the preterm infants in three hospitals in Shenzhen. Metho ds From Jan. 2004 to Jan. 2007, 1372 preterm infants (2744 eyes) with birth weight lt;200 0 g or but the ones having severe systemic disease in Shenzhen People's Hospita l, Shenzhen Maternity and Child Healthcare Hospital and Shenzhen Eye Hospital we re screened for ROP with binocular indirect ophthalmoscope and (or) widefield digital pediatric retinal imaging system (RetCamII). Cryotherapy or laser photoco agulation was performed if threshold or pre-threshold type I ROP was found. All preterm infants were followed up until retina is completely vascularized or the disease regressed. Results In all the infants, 218 cases (436 eyes) (15.9％) developed ROP, including 190 eyes (6.9％) suffering from threshold or pre-threshold type 1 ROP, 16 eyes (0.6％) from stage 4 or stage 5, and 230 eyes (8.4％) from stages below threshold or pre-threshold type 1 ROP. There were 435 infants ( 870 eyes) (31.7%) with BW of 1500g or less, in which 236 eyes (27.1％) developed ROP, including 126 eyes (14.5％) suffering from threshold or pre-threshold type 1 ROP, 10 eyes (1.1％) from stage 4 or stage 5, and 100 eyes (11.5％) from stages below threshold or pre-threshold type 1 ROP. There were 137 infants 274 eyes (10%) with BW of 1250g or less, in which 108 eyes (39.4％) developed ROP, including 60 eyes (21.9％) suffering from th reshold or pre-threshold type 1 ROP, 4 eyes (1.4％) from stage 4 or stage 5, and 44 eyes (16％) from stages below threshold or pre-threshold type 1 ROP. Th eincidence of ROP（chi;2=60.43，Plt;0.001）, the incidence of threshold or pre-threshold type 1 ROP（chi;2=46.82，Plt;0.001）and the incidence of below threshold or pre-threshold type 1 ROP （chi;2=10.71，P=0.005）among the total group, BWle;1500g group and BWle;1250g group had statistical differences. Conclusions The incidence of ROP in the three hospitals in Shenzhen was lower. However, the incidence of severe ROP (threshold or pre-threshold type 1 ROP) was higher. Birth weight is an important factor to affect ROP incidence.