Takayasu arteritis (TA) is a primary, chronic, non-specific, inflammatory disease of the aorta and its larger branches. The pulmonary artery trunk and its branches could be impacted by TA, which could cause stenosis or occlusion of lesion vessels. TA also affects the normal function of the aortic valve and other heart valves, mainly due to valvular insufficiency. Aortic regurgitation caused by TA is mainly treated by surgical operation. In this review, the examination technique, operation timing, operation method and prognosis of aortic valve involved in TA are discussed systematically.
Objective To observe the clinical characteristics of non arteritic anterior ischemic optic neuropathy (NAION) in patients of different genders. MethodsA retrospective clinical analysis. A total of 183 cases (246 eyes) of NAION with complete diagnosis and treatment confirmed by Departments of Neuro-ophthalmology/Acupuncture and Moxibustion of Eye Hospital, China Academy of Chinese Medical Sciences from June 2018 to December 2023 were included. Among them, 101 cases (138 eyes) were male and 82 cases (108 eyes) were female. Their age was (59.2±9.8) years. The number of right and left eyes were 120 and 126, respectively. The patient's gender, age, disease course, history of hypertension, history of diabetes, history of hyperlipidemia, history of smoking and drinking, best corrected visual acuity (BCVA), intraocular pressure, and peripapillary Retinal Nerve Fiber Layer (pRNFL) thickness were recorded in detail. Visual field defects were classified into diffuse defects, ring scotoma, fan-shaped or wedge-shaped defects, upper and lower half defects, arcuate scotoma, and quadrantanopia. Logistic regression analysis was utilized to determine whether gender was an independent factor affecting the degree of visual field impairment in NAION. ResultsCompared with female patients, male patients showed earlier onset age, a shorter interval between binocular onsets, a higher morbidity rate of hyperlipidemia, and a higher proportion with history of smoking and drinking, with statistically significant differences (P＜0.05). There was no statistically significant difference in disease duration, intraocular pressure, pRNFL thickness, and intraocular perfusion pressure between patients of different genders (P＞0.05). Female patients exhibited better BCVA than male patients, but the difference was not statistically significant (P＞0.05). The degree of visual field impairment in female patients was significantly better than that in males. Males' visual field defects were mostly in the lower half, while females' defects were mostly of arcuate scotoma, with statistically significant differences (P＜0.05). The results of multiple logistic regression analysis showed that the gender of male was an independent risk factor for severe visual field impairment in NAION patients (odds ratio=2.936, 95% confidence interval 1.275-6.763, P=0.011). ConclusionsMale NAION patients have an earlier onset age and a shorter interval between the initial and contralateral eye onset. Male patients exhibit a more severe degree of visual field impairment, which is mostly manifested as lower half visual field defect. While female patients tend to develop arcuate scotoma. After adjusting for other influencing factors, the gender of male remains an independent risk factor for severe visual impairment in NAION patients.
目的 总结盐酸沙格雷酯治疗周围动脉炎性疾病的初步疗效。方法 2009年10月至2012年3月期间我院共收治32例周围动脉炎性疾病患者，其中血栓闭塞性脉管炎（TAO） 18例，雷诺综合征14例，经患者知情同意的情况下给予盐酸沙格雷酯治疗，给予西络他唑100mg/d以及必须的强的松治疗后加服盐酸沙格雷酯100mg，3次/d口服，治疗后3个月观察疗效。结果 18例TAO患者中有10例服用了盐酸沙格雷酯，治疗后其间歇性跛行距离〔（362±127） m〕较治疗前 〔（224±86） m〕延长；8例静息痛患者中7例症状消失，1例改善；4例溃疡患者中3例愈合，1例未愈合。8例未加服盐酸沙格雷酯患者，有6例间歇性跛行消失，2例改善；5例静息痛患者中3例症状消失，2例改善；2例溃疡患者中1例愈合，1例未愈合。14例雷诺综合征患者中8例加服盐酸沙格雷酯，雷诺症状7例消失，1例改善；3例溃疡患者完全愈合。6例未加服盐酸沙格雷酯患者雷诺症状4例消失，2例改善；1例溃疡患者未愈合。结论 从本组有限病例资料看，盐酸沙格雷酯对于治疗周围动脉炎性疾病是有效的。
ObjectiveTo investigate the relationship between the level of stromal cell-derived factor-1 (SDF-1), internal carotid artery stiffness index, and non-arteritic anterior ischemic optic neuropathy (NAION) with macular edema (ME). MethodsA retrospective study. A total of 202 patients with NAION diagnosed by ophthalmic examination in Department of Ophthalmology, The Second Affiliated Hospital of Jiamusi University from January 2023 to January 2025 were included in the study. Based on the presence or absence of ME, the patients were divided into the NAION+ME group and the NAION group, with 94 and 108 cases respectively. A prediction model was constructed based on the influencing factors. To comprehensively evaluate the predictive value of SDF-1 level and carotid artery stiffness index for NAION with ME, a multidimensional analytical approach was employed. The diagnostic performance of individual and combined markers was assessed by constructing receiver operating characteristic (ROC) curves and calculating the area under the curve (AUC). Multivariate logistic regression analysis was performed to determine their independent predictive value. Stratified subgroup analyses were conducted to explore predictive differences across various populations. Cox proportional hazards regression models were established to evaluate long-term predictive value. Restricted cubic spline (RCS) analysis was applied to reveal potential nonlinear dose-response relationships. Mediation effect models were constructed to analyze the mediating role of carotid artery stiffness index in the association between SDF-1 level and NAION with ME. ResultsIn the NAION+ME group, systolic blood pressure (t=6.066), body mass index (t=2.804), disease duration (t=2.552), intraocular pressure (t=2.574), high-density lipoprotein (t=2.729), fasting blood glucose (t=2.022), glycosylated hemoglobin (t=7.235), SDF-1 level (t=14.319), and internal carotid artery stiffness index (t=2.633) were higher than those in the NAION group, while diastolic blood pressure was lower (P＜0.05). ROC curve analysis showed that the AUC of SDF-1 level combined with internal carotid artery stiffness index in predicting the risk of adverse prognosis was 0.894 [95% confidence interval (CI) 0.803-0.945], with a sensitivity of 87.98% and a specificity of 95.69%. Logistic regression analysis demonstrated significant independent correlations between SDF-1 level (OR=1.682, 95%CI 1.156-1.986), internal carotid artery stiffness index (OR=1.826, 95%CI 1.369-2.648), and the risk of ME in NAION patients (P＜0.05). Subgroup analysis revealed that elevated SDF-1 level and internal carotid artery stiffness index were associated with a higher risk of NAION with ME (Pfor trend＜0.05). RCS analysis demonstrated a nonlinear dose-response relationship between the continuous changes in SDF-1 level and internal carotid artery stiffness index and the risk of NAION with ME (P＜0.05). Mediation effect model analysis showed that internal carotid artery stiffness index played a mediating role between SDF-1 level and the risk of NAION with ME. ConclusionsSDF-1 level and internal carotid artery stiffness index are independent risk factors for ME in NAION patients. The combined detection of these two indicators holds significant value in predicting disease progression.
ObjectivesTo explore the changes of some peripheral blood cells related to inflammation in patients with non-arteritis central retinal artery occlusion (NA-CRAO). MethodsA retrospective clinical study. From July 2019 to July 2021, a total of 218 patients with NA-CRAO hospitalized (NA-CRAO group) in Department of Ophthalmology, Xi'an People's Hospital (Xi'an Fourth Hospital) and 218 patients with routine physical examination (control group) during the same period were included in the study. There were no significant differences in age (t=0.60), sex composition ratio (χ2=0.83) and body mass index (t=0.77) between the two groups (P＞0.05). 0.2 ml fasting peripheral blood was collected from the subject, and white blood cells (WBC), neutrophils (NEUT), lymphocytes (LYMPH), red blood cells (RBC), RBC distribution width (RDW), platelets (PLT), mean PLT volume (MPV), and large PLT ratio (PLCR) were detected. The NEUT/LYMPH ratio (NLR) and PLT/LYMPH ratio (PLR) were calculated. t test was used to compare measurement data between groups. Multiple logistic regression analysis was performed for blood cells with P＜0.05. The receiver operating characteristic curve (ROC curve) was used to calculate the area under the curve (AUC) and 95% confidence interval (95%CI) of each inflammatory indicator, and the optimal cutoff value was determined according to the Jorden index (sensitivity+specificity－1). ResultsCompared with control group, WBC, NEUT, NLR, RDW, PLR were increased in NA-CRAO group, while RBC and LYMPH were decreased, with statistical significance (t=9.68, 12.43, 9.47, 3.64, 5.54, 5.18, 0.46; P＜0.001). There was no significant difference in PLT, MPV and PLCR between the two groups (t=0.32, 1.56, 0.84; P＞0.05). Multivariate logistic regression analysis showed that NLR was a possible risk factor for the occurrence of NA-CRAO (odds ratio=2.51, 95%CI 0.780-0.859, P=0.031). ROC curve analysis showed that the AUC predicted by NLR was 0.819, the optimal critical value was 3.05, and the sensitivity and specificity were 59.2% and 92.7%, respectively. ConclusionsIn peripheral blood cells of NA-CRAO patients, NEUT is significantly increased and LYMPH is decreased. NLR is a possible risk factor for NA-CRAO.
ObjectiveTo review and analyze the clinical manifestations of common aortitis in cardiac surgery. MethodsWe screened 41 552 patients who were hospitalized in the Department of Cardiac Surgery of Zhongshan Hospital, Fudan University from 2010 to 2020, analyzed the patients' clinical data, and classified according to the type of diseases. Then we summarized all their clinical manifestations. ResultsIn our center 145 patients were operated for aortitis diseases, including 75 males and 70 females, with the age of 24-76 (45.6±11.3) years. There were 61 patients of Takayasu's arteritis, 51 patients of Behcet's disease, 8 patients of syphilitic aortitis, 8 patients of systemic lupus erythematosus, 2 patients of Kawasaki disease, 4 patients of ankylosing spondylitis, 10 patients of dry syndrome, and 1 patient of scleroderma. ConclusionAortitis is not uncommon in cardiac surgery, and awareness of the disease should be enhanced. So that we can distinguish various types of aortitis and to make proper management to improve patients' prognosis.