To investigate long-term anatomic and functional results of extended silicone oil (SO) tamponade in primary vitrectomy for patients with proliferative diabetic retinopathy (PDR) and complex retinal ...detachment (RD).
From January 1999 to June 2005, clinical records of consecutive patients with PDR who underwent primary vitrectomy with extended SO tamponade for complex RD were retrospectively reviewed. Main outcome measures included anatomic outcome, functional outcome, and postoperative complications. Statistical analyses were used to determine factors affecting anatomic and functional outcomes and to evaluate the potential adverse effects on vision from long-term oil tamponade.
Fifty-four eyes of 45 patients (18 male and 27 female) were included in this series. All patients underwent follow-up >or= 12 months (28.2+/-15.1 months; range: 12 to 69 months). Anatomic success was achieved in 85.2% at the third month postoperatively and 83.3% at last followup. Breaks with adjacent unreleased traction was identified as the only variable associated with final anatomic success (OR=0.173, p=0.024). Best-corrected visual acuity (BCVA) improved or remained unchanged in 89% at the third month postoperatively and in 78% at last follow-up. Ambulatory vision was achieved in 41% at the third month postoperative and 44% at last follow-up. Preoperative BCVA was identified as the only variable statistically associated with final BCVA (p<0.001) (multivariate analysis). The change of BCVA from the third month to last follow-up has no correlation with follow-up duration in the 45 eyes with final anatomic success (Pearson correlation coefficient = -0.022, p=0.888). Postoperative complications included peri-silicone oil proliferation in 4 eyes, neovascular glaucoma in 4 eyes, oil migration into anterior chamber in 9 eyes, and pupillary-block induced IOP elevation in 5 eyes.
Prolonged SO tamponade may provide anatomic success and functional stability after primary diabetic vitrectomy. Significant complications compromising visual prognosis were uncommon with prolonged SO tamponade.
Abstract We describe in this paper the current status of ophthalmic plastic and orbital surgery in Taiwan. Data were collected from the Bureau of National Health Insurance of Taiwan, the Bulletin of ...the Taiwan Ophthalmic Plastic and Reconstructive Society, and the Statistics Yearbook of Practicing Physicians and Health Care Organizations in Taiwan by the Taiwan Medical Association. We ascertained that 94 ophthalmologists were oculoplastic surgeons and accounted for 5.8% of 1621 ophthalmologists in Taiwan. They had their fellowship training abroad (most ophthalmologists trained in the United States of America) or in Taiwan. All ophthalmologists were well trained and capable of performing major oculoplastic surgeries. The payment rates by our National Health Insurance for oculoplastic and orbital surgeries are relatively low, compared to Medicare payments in the United States. Ophthalmologists should promote the concept that oculoplastic surgeons specialize in periorbital plastic and aesthetic surgeries. However, general ophthalmologists should receive more educational courses on oculoplastic and cosmetic surgery.
In non-high-risk individuals, risk-category-based atherosclerotic cardiovascular disease (ASCVD) screening strategies may be more cost-effective than one-size-fits-all approaches. However, current ...decisions are constrained by a lack of research evidence. We aimed to explore appropriate risk-category-based screening interval strategies for non-high-risk individuals in ASCVD primary prevention in the Chinese population.
We used data from 28,624 participants in the China Kadoorie Biobank (CKB) who had completed at least two field surveys. The risk assessment tools were the 10-year ASCVD risk prediction models developed based on the CKB cohort. We constructed multistate Markov models to model disease progression and estimate transition probabilities between different risk categories. The total person-years spent unidentified in the high-risk state over a 10-year period were calculated for each screening interval protocol. We also estimated the number of ASCVD events prevented, quality-adjusted life years (QALYs) gained, and costs saved when compared to the 3-yearly screening protocol.
When compared to the uniform 3-yearly protocol, most risk-category-based screening interval protocols would identify more high-risk individuals timely, thus preventing more ASCVD events and gaining QALYs. A few of them would reduce total health-care costs. The protocol, which used 6-year, 3-year, and 2-year screening intervals for low-risk, intermediate-low-risk, and intermediate-high risk individuals, was optimal, and would reduce the person-years spent unidentified in the high-risk category by 17.9% (95% CI: 13.1%–21.9%), thus preventing an estimated 113 thousand (95% CI: 83–138) hard ASCVD events for Chinese adults aged 30–79 over a 10-year period. When using a lower cost of statin therapy, more screening protocols would gain QALYs while saving costs.
For the primary prevention of ASCVD, risk-category-based screening protocols outperformed the one-size-fits-all approach in the Chinese population.
This work was supported by National Natural Science Foundation of China (82192904, 82388102, 82192900) and grants (2023YFC2509400) from the National Key R&D Program of China. The CKB baseline survey and the first re-survey were supported by a grant from the Kadoorie Charitable Foundation in Hong Kong. The long-term follow-up is supported by grants from the UK Wellcome Trust (212946/Z/18/Z, 202922/Z/16/Z, 104085/Z/14/Z, 088158/Z/09/Z), grants (2016YFC0900500) from the National Key R&D Program of China, National Natural Science Foundation of China (81390540, 91846303, 81941018), and Chinese Ministry of Science and Technology (2011BAI09B01).
A comprehensive depiction of long-term health impacts of marital status is lacking.
Sex-stratified phenome-wide association analyses (PheWAS) of marital status (living with vs. without a spouse) were ...performed using baseline (2004–2008) and follow-up information (ICD10-coded events till Dec 31, 2017) from the China Kadoorie Biobank (CKB). We estimated adjusted hazard ratios (aHRs) to evaluate the associations of marital status with morbidity risks of phenome-wide significant diseases or sex-specific top-10 death causes in China documented in 2017. Additionally, the association between marital status and mortality risks among participants with major chronic diseases at baseline was assessed.
During up to 11.1 years of the median follow-up period, 1,946,380 incident health events were recorded among 210,202 men and 302,521 women aged 30–79. Marital status was found to have phenome-wide significant associations with thirteen diseases among men (p < 9.92 × 10−5) and nine diseases among women (p < 9.33 × 10−5), respectively. After adjusting for all disease-specific covariates in the final model, participants living without a spouse showed increased risks of schizophrenia, schizotypal and delusional disorders (aHR 95% CI: 2.55, 1.83–3.56 for men; 1.49, 1.13–1.97 for women) compared with their counterparts. Additional higher risks in overall mental and behavioural disorder (1.31, 1.13–1.53), cardiovascular disease (1.07, 1.04–1.10) and cancer (1.06, 1.00–1.12) were only observed among men without a spouse, whereas women living without a spouse were at lower risks of developing genitourinary diseases (0.89, 0.85–0.93) and injury & poisoning (0.93, 0.88–0.97). Among 282,810 participants with major chronic diseases at baseline, 39,166 deaths were recorded. Increased mortality risks for those without a spouse were observed in 12 of 21 diseases among male patients and one of 23 among female patients. For patients with any self-reported disease at baseline, compared with those living with a spouse, the aHRs (95% CIs) of mortality risk were 1.29 (1.24–1.34) and 1.04 (1.00–1.07) among men and women without a spouse (pinteraction<0.0001), respectively.
Long-term associations of marital status with morbidity and mortality risks are diverse among middle-aged Chinese adults, and the adverse impacts due to living without a spouse are more profound among men. Marital status may be an influential factor for health needs.
The National Natural Science Foundation of China, the Kadoorie Charitable Foundation, the National Key R&D Program of China, the Chinese Ministry of Science and Technology.
Previous observational studies established a positive relationship between snoring and stroke. We aimed to investigate the causal effect of snoring on stroke.
Based on 82,339 unrelated individuals ...with qualified genotyping data of Asian descent from the China Kadoorie Biobank (CKB), we conducted a Mendelian randomization (MR) analysis of snoring and stroke. Genetic variants identified in the genome-wide association analysis (GWAS) of snoring in CKB and UK Biobank (UKB) were selected for constructing genetic risk scores (GRS). A two-stage method was applied to estimate the associations of the genetically predicted snoring with stroke and its subtypes. Besides, MR analysis among the non-obese group (body mass index, BMI <24.0 kg/m2), as well as multivariable MR (MVMR), were performed to control for potential pleiotropy from BMI. In addition, the inverse-variance weighted (IVW) method was applied to estimate the causal association with genetic variants identified in CKB GWAS.
Positive associations were found between snoring and total stroke, hemorrhagic stroke (HS), and ischemic stroke (IS). With GRS of CKB, the corresponding HRs (95% CIs) were 1.56 (1.15, 2.12), 1.50 (0.84, 2.69), 2.02 (1.36, 3.01), and the corresponding HRs (95% CIs) using GRS of UKB were 1.78 (1.30, 2.43), 1.94 (1.07, 3.52), and 1.74 (1.16, 2.61). The associations remained stable in the MR among the non-obese group, MVMR analysis, and MR analysis using the IVW method.
This study suggests that, among Chinese adults, genetically predicted snoring could increase the risk of total stroke, IS, and HS, and the causal effect was independent of BMI.
National Natural Science Foundation of China, Kadoorie Charitable Foundation Hong Kong, UK Wellcome Trust, National Key R&D Program of China, Chinese Ministry of Science and Technology.
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The effects of preheat treatments on the microstructures and mechanical properties of tungsten inert gas （TIG）-welded AZ61 magnesium alloy joints were studied by microstructural observations, ...microhardness tests and tensile tests. The results showed that the vol- ume fraction of the lamellar β-Mg17（Al,Zn）12 intermetallic compound of in fusion zone （FZ） increased from 15% to 66% with an increase in preheat temperature. Moreover, the microhardness of the FZ and the ultimate tensile strength of the welded joints reached their maximum values when the preheat temperature was 300℃ because more lamellar β-Mg17（Al,Zn）12 intermetallic compounds were distributed at the α-Mg grain boundaries and no cracks and pores formed in the FZ of the welded joint.
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