●AIM:To evaluate the effectiveness and safety of scleral buckling for the treatment of rhegmatogenous retinal detachment(RRD)using a novel foldable capsular buckle(FCB).●METHODS:This was a series of case observation...●AIM:To evaluate the effectiveness and safety of scleral buckling for the treatment of rhegmatogenous retinal detachment(RRD)using a novel foldable capsular buckle(FCB).●METHODS:This was a series of case observation studies.Eighteen patients(18 eyes)who visited our ophthalmology department between August 2020 and August 2022 and were treated for RRD with scleral buckling using FCB were included.The procedure was similar to conventional scleral buckling,while a balloon-like FCB was placed onto the retinal break with balanced salt solution filling for a broad,external indentation instead of the silicone buckle.The retinal reattachment rate,best corrected visual acuity(BCVA),intraocular pressure(IOP),refractive dioptre and astigmatism degree,and complications were evaluated and recorded.●RESULTS:There were 7 males and 11 females aged 19-58y.The average time course of RRD was 12d,ranging from 7-20d.The retinal break was located in the superior quadrants in 8 eyes and in the inferior quadrants in 10 eyes,with macula-off detachments in 12 eyes.The patients were followed-up for at least 6mo.The final retinal reattachment rate was 100%.The BCVA was significantly improved compared with the baseline(P<0.05).There was no significant change in refractive dioptre or astigmatism degree at each follow-up(all P>0.05).Three patients had transiently high IOPs within one week after surgery.Mild diplopia occurred in 5 patients after surgery and then disappeared after the balloon fluid was removed.●CONCLUSION:The success rate of FCB scleral buckling for RRD is satisfactory.This procedure can be expected to be applied in new,uncomplicated cases of RRD.展开更多
BACKGROUND Many studies have demonstrated the benefit of complete multivessel revascularization versus culprit-only intervention in patients of ST-segment elevation myocardial infarction(STEMI)and multivessel coronary...BACKGROUND Many studies have demonstrated the benefit of complete multivessel revascularization versus culprit-only intervention in patients of ST-segment elevation myocardial infarction(STEMI)and multivessel coronary artery disease.However,only a few single-center retrospective studies were performed on small Chinese cohorts.Our study aims to demonstrate the advantage of multivessel percutaneous intervention(PCI)strategy on 30-day in-hospital outcomes to patients with STEMI and multivessel disease in larger Chinese population.METHODS From the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome(CCC-ACS)project,5935 patients with STEMI and multivessel disease undergoing PCI and hospitalized for fewer than 30 days were analyzed.After 5:1 propensity score matching,3577 patients with culprit-only PCI and 877 with in-hospital multivessel PCI were included.The primary outcome was major adverse cardiovascular and cerebrovascular event(MACCE),defined as a composite of myocardial infarction,all-cause death,stent thrombosis,heart failure,and stroke.RESULTS Multivariable logistic regression analysis revealed that in-hospital multivessel PCI was associated with lower risk of 30-day MACCE(adjusted OR=0.75,95%CI:0.57-0.98,P=0.032)than culprit-only PCI and conferred no increased risk of allcause death,myocardial infarction,stent thrombosis,stroke,or bleeding.Subgroup analysis showed that MACCE reduction was observed more often from patients with trans-femoral access(OR=0.34,95%CI:0.15-0.74)than with trans-radial access(OR=0.87,95%CI:0.66-1.16,P for interaction=0.017).CONCLUSIONS The in-hospital multivessel PCI strategy was associated with a lower risk of 30-day MACCE than culprit-only PCI in patients with STEMI and multivessel coronary artery disease.展开更多
·AIM: To compare the clinical efficacy and safety of ultrasonic cycloplasty(UCP) vs Ahmed glaucoma drainage valve implantation(ADV) in addition to intravitreal antivascular endothelial growth factor(VEGF) for tre...·AIM: To compare the clinical efficacy and safety of ultrasonic cycloplasty(UCP) vs Ahmed glaucoma drainage valve implantation(ADV) in addition to intravitreal antivascular endothelial growth factor(VEGF) for treatment of fundus disease-related neovascular glaucoma(NVG).·METHODS: A total of 43 patients(45 eyes) with NVG secondary to fundus diseases underwent anti-VEGF combined with UCP or ADV from August 2020 to March 2022 were enrolled in this retrospective cohort study. Of them, 14 patients(15 eyes) were treated with both UCP and anti-VEGF as the UCP group and 29 patients(30 eyes) treated with both ADV and anti-VEGF as the ADV group. The success of the treatment was defined as intraocular pressure(IOP) between 11-20 mm Hg with or without using IOP-lowering drugs. IOP measurement, IOP lowering drugs at baseline and follow-ups period and complications were recorded.·RESULTS: The average age was 63.03±9.95 and 52.27±12.89y in ADV and UCP groups, respectively(P=1.947). The fundus pathology included proliferative diabetic retinopathy in 42 eyes and retinal vein occlusion in 3 eyes. All eyes in both groups achieved successful treatment at 3mo. While the success rate was 90.0%(27/30) in the ADV group and 86.7%(13/15) in the UCP group at the last follow-up of 6mo(P>0.05). IOP was significantly lower with reduction of drug use than the baseline in both groups(both P<0.05). And the ADV group needed fewer anti-glaucoma drops than the UCP group from 1d to 3mo. The comfort scores of patients in the ADV group were significantly lower than those in the UCP group in the first week after the operation(P<0.05).·CONCLUSION: UCP is an alternative to the ADV with the same efficacy but non-invasive for the treatment of NVG.展开更多
BACKGROUND Catheter ablation for atrial fibrillation(AF)is commonly performed worldwide.However,the clinical charac-teristics of hospitalized patients with AF and national trends in catheter ablation at tertiary hospi...BACKGROUND Catheter ablation for atrial fibrillation(AF)is commonly performed worldwide.However,the clinical charac-teristics of hospitalized patients with AF and national trends in catheter ablation at tertiary hospitals in China remain unreported.METHODS This study used the Chinese national database(Hospital Quality Monitoring System)from 2013 to 2016,which is a mandatory database that collects the front page of patients’medical records for hospital accreditation,to describe the clinical cha-racteristics of patients with AF as an overall cohort and as subgroups divided by catheter ablation and sex.RESULTS Of 597,919 AF patients first admitted,57,983 patients underwent catheter ablation[56,384 cases(97.2%)of radiofre-quency ablation and 1599 cases(2.8%)of cryoablation]at 746 tertiary hospitals.Nearly 10%of patients hospitalized with AF at ter-tiary hospitals in China underwent catheter ablation,and the percentage of patients undergoing catheter ablation was on the rise bet-ween 2013 and 2016,and the number of cases increased by 2.5 times.Compared with AF patients who did not undergo catheter ablation,those who did were younger,more frequently male,and had fewer baseline comorbidities.Although the overall CHA_(2)DS_(2)-VASc score revealed over half of the patients were high-risk,patients who underwent catheter ablation were mostly low-risk(71.2%of males and 59.1%of females).Considering in-hospital adverse events,the overall pericardial tamponade and all-cause death incidences were 0.2%(0.6%in the ablation group)and 1.2%(0.1%in the ablation group),respectively;both of which were higher in females than males.CONCLUSIONS In this study,AF patients who underwent catheter ablation were relatively young,had a low thrombosis risk,and had few comorbidities and adverse events.Females were older and experienced more complications than males.展开更多
BACKGROUND Arterial stiffness,as assessed by aortic ultrasound and pulse wave velocity,is associated with incident hypertension.However,there is still no consensus on whether the augmentation index(AI)affects new onse...BACKGROUND Arterial stiffness,as assessed by aortic ultrasound and pulse wave velocity,is associated with incident hypertension.However,there is still no consensus on whether the augmentation index(AI)affects new onset of hypertension.This study investigated the relationship of radial AI(r AI)and incident hypertension in a Chinese community-based population without hypertension at baseline.METHOD A total of 1,615 Chinese non-hypertensive participants from an atherosclerosis cohort in Beijing,China were included in our analysis.Baseline r AI normalized to heart rate of 75 beats/min(r AIp75)was obtained using HEM-9000 AI.New-onset hypertension was defined as blood pressure≥140/90 mm Hg or self-reported hypertension or taking anti-hypertensive medications at the follow up survey.Multivariate regression models were used to evaluate the impact of r AIp75 on the risk of new-onset hypertension.RESULTS After a mean 2.35-year follow-up,213(13.19%)participants developed incident hypertension.No significant relation between r AIp75 and incident hypertension was observed in the whole population after adjustment for possible confounders(adjusted odds ratio(OR)and 95%confidence interval(CI):1.09[0.95-1.27];P=0.2260).However,r AIp75 was significantly associated with incident hypertension in women,but not in men(adjusted OR and 95%CI:1.29[1.06-1.56],P=0.0113 for women;0.91[0.72-1.15],P=0.4244 for men;P for interaction=0.0133).CONCLUSIONS Sex modified the effect of the r AI on incident hypertension in a Chinese,community-based,non-hypertensive population.Screening of the r AI could be considered in women with a high risk of hypertension for the purpose of primary intervention.展开更多
Objective:To investigate the effect of enalapril on plasma homocysteine(Hcy) levels and the association of methylenetetrahydrofolate reductase(MTHFR) C677T polymorphism with the changes of Hcy levels in response to en...Objective:To investigate the effect of enalapril on plasma homocysteine(Hcy) levels and the association of methylenetetrahydrofolate reductase(MTHFR) C677T polymorphism with the changes of Hcy levels in response to enalapril among patients with essential hypertension.Methods:A total of 130 patients with mild-to-moderate essential hypertension were enrolled and enalapril was orally administered at a dose of 10 mg/d for eight weeks.Plasma Hcy levels were measured by denaturing high-performance liquid chromatography(DHPLC) at baseline and after eight weeks of treatment.Genotyping of MTHFR C677T polymorphism was performed by TaqMan probe technique.Results:Compared with baseline,plasma Hcy levels did not change significantly after eight weeks(P=0.81).Stratified by baseline Hcy levels,a significant increase in plasma Hcy levels(P=0.02) among those with Hcy <10 μmol/L was observed,in contrast to no significant changes in plasma Hcy levels(P=0.54) among those with Hcy ≥10 μmol/L.No significant association was observed between MTHFR C677T polymorphism and changes in Hcy levels in response to enalapril.Conclusions:Enalapril may cause an increase in plasma Hcy levels among the hypertensives with low baseline Hcy levels.There was no significant association between MTHFR C677T genotypes and changes in Hcy levels in response to enalapril among subjects with essential hypertension.展开更多
基金Supported by Xuzhou Health Outstanding Talents Project(No.XWJC001)Critical Special Project for Social Development of Xuzhou(No.KC21153)+1 种基金Science and Technology Innovation Project of Xuzhou Municipal Health Commission(No.XWKYHT20230039)Applied Basic Research Project of Xuzhou(No.KC23016).
文摘●AIM:To evaluate the effectiveness and safety of scleral buckling for the treatment of rhegmatogenous retinal detachment(RRD)using a novel foldable capsular buckle(FCB).●METHODS:This was a series of case observation studies.Eighteen patients(18 eyes)who visited our ophthalmology department between August 2020 and August 2022 and were treated for RRD with scleral buckling using FCB were included.The procedure was similar to conventional scleral buckling,while a balloon-like FCB was placed onto the retinal break with balanced salt solution filling for a broad,external indentation instead of the silicone buckle.The retinal reattachment rate,best corrected visual acuity(BCVA),intraocular pressure(IOP),refractive dioptre and astigmatism degree,and complications were evaluated and recorded.●RESULTS:There were 7 males and 11 females aged 19-58y.The average time course of RRD was 12d,ranging from 7-20d.The retinal break was located in the superior quadrants in 8 eyes and in the inferior quadrants in 10 eyes,with macula-off detachments in 12 eyes.The patients were followed-up for at least 6mo.The final retinal reattachment rate was 100%.The BCVA was significantly improved compared with the baseline(P<0.05).There was no significant change in refractive dioptre or astigmatism degree at each follow-up(all P>0.05).Three patients had transiently high IOPs within one week after surgery.Mild diplopia occurred in 5 patients after surgery and then disappeared after the balloon fluid was removed.●CONCLUSION:The success rate of FCB scleral buckling for RRD is satisfactory.This procedure can be expected to be applied in new,uncomplicated cases of RRD.
基金We thank all hospitals and staff participating in the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome(CCC-ACS)project.The CCC-ACS Project is a collaborative project of the American Heart Association and the Chinese Society of Cardiology.The American Heart Association received funding from Pfizer through an independent grant for learning and change and AstraZeneca as a quality improvement initiative.
文摘BACKGROUND Many studies have demonstrated the benefit of complete multivessel revascularization versus culprit-only intervention in patients of ST-segment elevation myocardial infarction(STEMI)and multivessel coronary artery disease.However,only a few single-center retrospective studies were performed on small Chinese cohorts.Our study aims to demonstrate the advantage of multivessel percutaneous intervention(PCI)strategy on 30-day in-hospital outcomes to patients with STEMI and multivessel disease in larger Chinese population.METHODS From the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome(CCC-ACS)project,5935 patients with STEMI and multivessel disease undergoing PCI and hospitalized for fewer than 30 days were analyzed.After 5:1 propensity score matching,3577 patients with culprit-only PCI and 877 with in-hospital multivessel PCI were included.The primary outcome was major adverse cardiovascular and cerebrovascular event(MACCE),defined as a composite of myocardial infarction,all-cause death,stent thrombosis,heart failure,and stroke.RESULTS Multivariable logistic regression analysis revealed that in-hospital multivessel PCI was associated with lower risk of 30-day MACCE(adjusted OR=0.75,95%CI:0.57-0.98,P=0.032)than culprit-only PCI and conferred no increased risk of allcause death,myocardial infarction,stent thrombosis,stroke,or bleeding.Subgroup analysis showed that MACCE reduction was observed more often from patients with trans-femoral access(OR=0.34,95%CI:0.15-0.74)than with trans-radial access(OR=0.87,95%CI:0.66-1.16,P for interaction=0.017).CONCLUSIONS The in-hospital multivessel PCI strategy was associated with a lower risk of 30-day MACCE than culprit-only PCI in patients with STEMI and multivessel coronary artery disease.
基金Supported by Xuzhou Health Outstanding Talents Project (No.XWJC001)Critical Special Project for Social Development of Xuzhou City (No.KC21153)。
文摘·AIM: To compare the clinical efficacy and safety of ultrasonic cycloplasty(UCP) vs Ahmed glaucoma drainage valve implantation(ADV) in addition to intravitreal antivascular endothelial growth factor(VEGF) for treatment of fundus disease-related neovascular glaucoma(NVG).·METHODS: A total of 43 patients(45 eyes) with NVG secondary to fundus diseases underwent anti-VEGF combined with UCP or ADV from August 2020 to March 2022 were enrolled in this retrospective cohort study. Of them, 14 patients(15 eyes) were treated with both UCP and anti-VEGF as the UCP group and 29 patients(30 eyes) treated with both ADV and anti-VEGF as the ADV group. The success of the treatment was defined as intraocular pressure(IOP) between 11-20 mm Hg with or without using IOP-lowering drugs. IOP measurement, IOP lowering drugs at baseline and follow-ups period and complications were recorded.·RESULTS: The average age was 63.03±9.95 and 52.27±12.89y in ADV and UCP groups, respectively(P=1.947). The fundus pathology included proliferative diabetic retinopathy in 42 eyes and retinal vein occlusion in 3 eyes. All eyes in both groups achieved successful treatment at 3mo. While the success rate was 90.0%(27/30) in the ADV group and 86.7%(13/15) in the UCP group at the last follow-up of 6mo(P>0.05). IOP was significantly lower with reduction of drug use than the baseline in both groups(both P<0.05). And the ADV group needed fewer anti-glaucoma drops than the UCP group from 1d to 3mo. The comfort scores of patients in the ADV group were significantly lower than those in the UCP group in the first week after the operation(P<0.05).·CONCLUSION: UCP is an alternative to the ADV with the same efficacy but non-invasive for the treatment of NVG.
基金supported by the China-WHO Biennial Collaborative Projects 2016–2017(No.2016/648722–0).
文摘BACKGROUND Catheter ablation for atrial fibrillation(AF)is commonly performed worldwide.However,the clinical charac-teristics of hospitalized patients with AF and national trends in catheter ablation at tertiary hospitals in China remain unreported.METHODS This study used the Chinese national database(Hospital Quality Monitoring System)from 2013 to 2016,which is a mandatory database that collects the front page of patients’medical records for hospital accreditation,to describe the clinical cha-racteristics of patients with AF as an overall cohort and as subgroups divided by catheter ablation and sex.RESULTS Of 597,919 AF patients first admitted,57,983 patients underwent catheter ablation[56,384 cases(97.2%)of radiofre-quency ablation and 1599 cases(2.8%)of cryoablation]at 746 tertiary hospitals.Nearly 10%of patients hospitalized with AF at ter-tiary hospitals in China underwent catheter ablation,and the percentage of patients undergoing catheter ablation was on the rise bet-ween 2013 and 2016,and the number of cases increased by 2.5 times.Compared with AF patients who did not undergo catheter ablation,those who did were younger,more frequently male,and had fewer baseline comorbidities.Although the overall CHA_(2)DS_(2)-VASc score revealed over half of the patients were high-risk,patients who underwent catheter ablation were mostly low-risk(71.2%of males and 59.1%of females).Considering in-hospital adverse events,the overall pericardial tamponade and all-cause death incidences were 0.2%(0.6%in the ablation group)and 1.2%(0.1%in the ablation group),respectively;both of which were higher in females than males.CONCLUSIONS In this study,AF patients who underwent catheter ablation were relatively young,had a low thrombosis risk,and had few comorbidities and adverse events.Females were older and experienced more complications than males.
基金supported by the University of Michigan-Peking University Health Science Centre(UMHS-PUHSC)Joint Institute for Translational and Clinical Research and the Fundamental Research Funds for the Central Universities(grant numbers:BMU20110177 and BMU20160530)the National Key Research and Development Program of China(grant number:2017YFC1307704)+2 种基金the Scientific Research Seed Fund of Peking University First Hospital(grant numbers:2018SF003 and 2018SF071)Projects of the National Natural Science Foundation of China(grant number:81703288)the Key Laboratory of Molecular Cardiovascular Sciences(Peking University),Ministry of Education and NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides。
文摘BACKGROUND Arterial stiffness,as assessed by aortic ultrasound and pulse wave velocity,is associated with incident hypertension.However,there is still no consensus on whether the augmentation index(AI)affects new onset of hypertension.This study investigated the relationship of radial AI(r AI)and incident hypertension in a Chinese community-based population without hypertension at baseline.METHOD A total of 1,615 Chinese non-hypertensive participants from an atherosclerosis cohort in Beijing,China were included in our analysis.Baseline r AI normalized to heart rate of 75 beats/min(r AIp75)was obtained using HEM-9000 AI.New-onset hypertension was defined as blood pressure≥140/90 mm Hg or self-reported hypertension or taking anti-hypertensive medications at the follow up survey.Multivariate regression models were used to evaluate the impact of r AIp75 on the risk of new-onset hypertension.RESULTS After a mean 2.35-year follow-up,213(13.19%)participants developed incident hypertension.No significant relation between r AIp75 and incident hypertension was observed in the whole population after adjustment for possible confounders(adjusted odds ratio(OR)and 95%confidence interval(CI):1.09[0.95-1.27];P=0.2260).However,r AIp75 was significantly associated with incident hypertension in women,but not in men(adjusted OR and 95%CI:1.29[1.06-1.56],P=0.0113 for women;0.91[0.72-1.15],P=0.4244 for men;P for interaction=0.0133).CONCLUSIONS Sex modified the effect of the r AI on incident hypertension in a Chinese,community-based,non-hypertensive population.Screening of the r AI could be considered in women with a high risk of hypertension for the purpose of primary intervention.
文摘Objective:To investigate the effect of enalapril on plasma homocysteine(Hcy) levels and the association of methylenetetrahydrofolate reductase(MTHFR) C677T polymorphism with the changes of Hcy levels in response to enalapril among patients with essential hypertension.Methods:A total of 130 patients with mild-to-moderate essential hypertension were enrolled and enalapril was orally administered at a dose of 10 mg/d for eight weeks.Plasma Hcy levels were measured by denaturing high-performance liquid chromatography(DHPLC) at baseline and after eight weeks of treatment.Genotyping of MTHFR C677T polymorphism was performed by TaqMan probe technique.Results:Compared with baseline,plasma Hcy levels did not change significantly after eight weeks(P=0.81).Stratified by baseline Hcy levels,a significant increase in plasma Hcy levels(P=0.02) among those with Hcy <10 μmol/L was observed,in contrast to no significant changes in plasma Hcy levels(P=0.54) among those with Hcy ≥10 μmol/L.No significant association was observed between MTHFR C677T polymorphism and changes in Hcy levels in response to enalapril.Conclusions:Enalapril may cause an increase in plasma Hcy levels among the hypertensives with low baseline Hcy levels.There was no significant association between MTHFR C677T genotypes and changes in Hcy levels in response to enalapril among subjects with essential hypertension.
