中医药治疗年龄相关性黄斑变性的优势（中）

很多患者对年龄相关性黄斑变性（AMD）的发生和发展以及如何治疗有很多疑问．希望更多地了解有关AMD的知识。其实．这对于AMD早期干预和及时治疗都是十分有利的。     

GPR143在年龄相关性黄斑变性中的研究进展

年龄相关性黄斑变性(AMD)是目前世界上不可逆致盲的主要原因之一,AMD在白种入中最常见,其发病风险随年龄增长而增加.AMD发生有种族、遗传易感性和色素生成等相关影响因素,其中最主要的缺陷发生在视网膜色素上皮(RPE)细胞上.RPE具有吸收散射光、循环吞噬脱落光感受器外节盘膜、支持视网膜间物质运输活动等多种功能,对视觉...     

老年性黄斑变性：年龄越大，危险越高

一个人如果没有一个好的视力，生活质量就无从谈起。老年性黄斑变性就是一种对视力产生严重影响的疾病。 老年性黄斑变性又称为年龄相关性黄斑变性，简称AMD，是一种慢性进行性眼病，是与年龄相关的疾病。     

年龄相关性黄斑变性的治疗现状

老年黄斑变性（age2related macular degenerati称AMD或ARMD）又称年龄相关性黄斑变性,常伴有进行性视力损害,严重影响老年人的生存质量,是全世界第三位不可逆性和西方国家老年人首位的致盲眼病,其在亚洲发病率亦呈逐渐增多的趋势。     

年龄性相关性黄斑变性的中医辨证治疗

年龄相关性黄斑变性（age-relatedmaculardegeneration，AMD）是全球性老年人致盲的主要眼病，尤以渗出型AMD致盲率高。且发病率随着年龄增长而增加，中医辨证治疗本病具有明显优势，本病贵在早期发现，早期治疗，预后较好。     

年龄相关性黄斑变性的临床治疗及疗效评估

目的:分析年龄相关性黄斑变性的临床治疗方法以及疗效评估.方法:在2013年7月-2016年5月期间到院进行诊断治疗的年龄相关性黄斑变性患者中抽选66例,征得患者和其家属同意后,等分为对照组和实验组,各组病例数有33例,两组患者均以口服的方式使用维生素E胶丸和维生素C,实验组在此基础上加用舒肝明目丸予以进一步的治疗,对比分析两组患者治疗效果.结果:实验组治疗总有效率(90.9%)和对照组比较明显要高,组间数据对比有统计学意义,P<0.05.结论:在年龄相关性黄斑变性的临床治疗中使用中医,可提高疗效,有使用价值与推广价值.     

当心年龄相关性黄斑变性

日前,有研究机构发起了针对严重的致盲性眼病年龄相关性黄斑变性的公众认知调研,并根据调研结果编撰发布了全国首部基于网络调研的《年龄相关性黄斑变性白皮书》。调研数据显示,虽然在6287名被访者中,有多达4480人表示自己听说过年龄相关性黄斑变性,疾病的知晓率达71%,但却有高达57%的被访者不清楚黄斑是人眼中的一个正常的解剖     

年龄相关性黄斑变性的危险因素与预防

年龄相关性黄斑变性(age-related macular degeneration,AMD)是50岁以上人群中常见的一种不可逆的致盲性慢性眼病,其发生主要与遗传及环境因素有关,并涉及衰老、氧化应激、光毒性损害、局部炎症等多个方面。该文综述了AMD的危险因素及其相关机制。     

光动力治疗后的湿性年龄相关性黄斑变性患者的生存质量研究

目的 评价光动力治疗(PDT)后的湿性年龄相关性黄斑变性(AMD)患者的生存质量.方法 46例典型为主型的AMD患者采用PDT,并随访1年.对治疗前后AMD患者的最佳矫正视力、生存质量进行统计分析.结果 治疗1年后,71.0%的患者视力下降小于3行.治疗后,调查量表中有部分视功能有显著改变.结论 PDT能有效阻止湿性AMD所致的视力严重下降.     

光动力治疗后的湿性年龄相关性黄斑变性患者的生存质量研究

目的评价光动力治疗（PDT）后的湿性年龄相关性黄斑变性（AMD）患者的生存质量。方法46例典型为主型的AMD患者采用PDT，并随访1年。对治疗前后AMD患者的最佳矫正视力、生存质量进行统计分析。结果治疗1年后，71．0％的患者视力下降小于3行。治疗后，调查量表中有部分视功能有显著改变。结论PDT能有效阻止湿性AMD所致的视力严重下降。     

血清叶黄素水平与老年性黄斑变性关系的Meta分析

目的系统评价老年性黄斑变性(age-related macular degeneration,AMD)患者血清叶黄素水平与对照组相比差异有无统计学意义。方法以电子检索结合手工检索及索引检索的方式检索中外数据库中对AMD患者及其对照组进行血清叶黄素水平测定的病例对照研究、队列研究的中英文研究文献,按照纳入及排除标准从中选择符合标准的8篇文献,提取其数据信息,采用专用软件RevMan 5.0完成系统评价过程。结果共纳入8篇临床研究,固定效应模型合并的标准化均差(standard mean difference,SMD)和95%可信区间(95%CI)为-0.15(-0.28～-0.02),表明AMD患者血清叶黄素水平低于正常对照组,且差异有统计学意义。结论初步得出血清叶黄素水平低与AMD发生可能存在一定关联,但需要进行更广泛地研究,确定人体血清叶黄素水平的正常范围,从而为AMD高危人群的筛查和干预提供科学依据。     

Abdominal obesity and age-related macular degeneration

A prospective survey of social mixing patterns relevant to respiratory disease transmission by large droplets (e.g., influenza) or small droplet nuclei (e.g., tuberculosis) was performed in a South African township in 2010. A total of 571 randomly selected participants recorded the numbers, times, and locations of close contacts (physical/nonphysical) and indoor casual contacts met daily. The median number of physical contacts was 12 (interquartile range (IQR), 7-18), the median number of close contacts was 20 (IQR, 13-29), and the total number of indoor contacts was 30 (IQR, 12-54). Physical and close contacts were most frequent and age-associative in youths aged 5-19 years. Numbers of close contacts were 40% higher than in corresponding populations in industrialized countries (P < 0.001). This may put township communities at higher risk for epidemics of acute respiratory illnesses. Simulations of an acute influenza epidemic predominantly involved adolescents and young adults, indicating that control strategies should be directed toward these age groups. Of all contacts, 86.2% occurred indoors with potential exposure to respiratory droplet nuclei, of which 27.2%, 20.1%, 20.0%, and 8.0% were in transport, own household, crèche/school, and work locations, respectively. Indoor contact time was long in households and short during transport. High numbers of indoor contacts and intergenerational mixing in households and transport may contribute to exceptionally high rates of tuberculosis transmission reported in the community.     

Photodynamic therapy in age-related macular degeneration

INTRODUCTION: Exudative form of age-related macular degeneration is the leading cause of legal blindness in elderly. PURPOSE: The purpose of this study is to report 3.5 years experience with photodynamic therapy in this disorder. PATIENTS AND METHODS: Patient files of all patients underwent photodynamic therapy with verteporfin in Department of Ophthalmology, Semmelweis University, Budapest in a 3.5 years period were reviewed. Changes in visual acuity were considered as main outcome variable compared to natural history data. RESULTS: From April, 2000 to September 2003, 302 patients were treated using photodynamic therapy with verteporfin for exudative form of age-related macular degeneration. The mean change of visual acuity were 2.6 and 2,7 lines at 12 and 24 months, respectively, while according to the natural history data 4.2 and 4.5 could have been expected. After 2 years, 83% of the patients had visual acuity better than or equal to 20/200 (this is the level of legal blindness), while only 33% was expected according to natural history data. Visual acuity of 20/80 or better (practical ambulatory vision) was found in 39% of the treated eyes (12% in natural history data). There was no severe adverse event. CONCLUSIONS: Photodynamic therapy was found to reduce the risk of severe visual loss. The authors' results confirm the data from the international trials. To achieve good results, good patient compliance and continuous access to the treatment are indispensible.     

New treatments for age-related macular degeneration

The estimated increase in life expectancy of the U.S. population will result in a greater incidence of age-related macular degeneration (AMD) in the next few decades. Exudative AMD, which is characterized by choroidal neovascularization, carries a high risk of severe central vision loss and can compromise an individual's independence and quality of life. The increasing burden of AMD has created an acute need for more effective treatments. Results from a recent large-scale study have shown that supplementation with antioxidants and zinc reduces the risk of progression of dry to exudative AMD. Standard thermal laser photocoagulation can reduce the risk of central vision loss in exudative AMD in a limited number of patients. The recent advent of photodynamic laser therapy has increased the number of patients with exudative AMD who can benefit from treatment. This paper summarizes the clinical presentation of AMD and reviews treatments that are currently available, as well as treatments in development.     

Therapeutic modalities of age-related macular degeneration

Age-related macular degeneration has become a leading cause of legal blindness in the industrial countries. Some hundred thousands of people are estimated to be suffering from the disease in Hungary as well. Earlier the different forms were considered as distinct diseases. Since the whole scale and pathomechanism of age-related macular degeneration has been clarified, and at the same time the therapeutic modalities have been developed in a lot of cases, there is good chance of maintaining or even improving visual acuity. The author describes the different forms of the disease, and then writes about the treatment modalities which proved to be effective, or which have been introduced recently in detail. He emphasises the harmful role of smoking among prevention methods. Conservative treatment beside antioxidants includes the so-called metabolic therapy nowadays. Different types of laser treatment are widely used, while irradiation to a smaller extent. The role of traditional surgical intervention is also limited, but the use of anti-vascular endothelial growth factors is very promising. Costs of different methods are also referred to.     

重金属暴露与心血管疾病关系的流行病学研究进展

重金属是重要环境污染物之一,其对心血管系统的损害已备受国内外学者的关注。本文基于重金属人体负荷水平、重金属暴露对心血管系统危害的相关研究成果,综述铅、镉、砷3种常见重金属暴露与心血管疾病关系的流行病学研究进展,并提出应加强全国范围一般人群重金属负荷水平的监测,以利于定量评估重金属暴露所致的心血管疾病风险。     

Using Mendelian randomization to evaluate the causal relationship between serum C-reactive protein levels and age-related macular degeneration

Serum C-reactive protein (CRP), an important inflammatory marker, has been associated with age-related macular degeneration (AMD) in observational studies; however, the findings are inconsistent. It remains unclear whether the association between circulating CRP levels and AMD is causal. We used two-sample Mendelian randomization (MR) to evaluate the potential causal relationship between serum CRP levels and AMD risk. We derived genetic instruments for serum CRP levels in 418,642 participants of European ancestry from UK Biobank, and then conducted a genome-wide association study for 12,711 advanced AMD cases and 14,590 controls of European descent from the International AMD Genomics Consortium. Genetic variants which predicted elevated serum CRP levels were associated with advanced AMD (odds ratio [OR] for per standard deviation increase in serum CRP levels: 1.31, 95% confidence interval [CI]: 1.19–1.44, P = 5.2 × 10−8). The OR for the increase in advanced AMD risk when moving from low (< 3 mg/L) to high (> 3 mg/L) CRP levels is 1.29 (95% CI: 1.17–1.41). Our results were unchanged in sensitivity analyses using MR models which make different modelling assumptions. Our findings were broadly similar across the different forms of AMD (intermediate AMD, choroidal neovascularization, and geographic atrophy). We used multivariable MR to adjust for the effects of other potential AMD risk factors including smoking, body mass index, blood pressure and cholesterol; this did not alter our findings. Our study provides strong genetic evidence that higher circulating CRP levels lead to increases in risk for all forms of AMD. These findings highlight the potential utility for using circulating CRP as a biomarker in future trials aimed at modulating AMD risk via systemic therapies.