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Objective:To observe the changes of macular morphology and blood flow after minimally invasive vitrectomy (PPV) in patients with severe non-proliferative diabetic retinopathy (sNPDR).Methods:A prospective clinical study. From January 2020 to April 2021, 17 consecutive sNPDR patients with 17 eyes who were diagnosed and received PPV treatment at the Zhongshan Ophthalmic Center of Sun Yat-sen University were included in the study. There were 12 males with 12 eyes and 5 females with 5 eyes; the average age was 55 years old; the average duration of diabetes was 11 years; the average glycosylated hemoglobin was 7.9%. Before the operation and 1, 3, and 6 months after the operation, all the affected eyes underwent best corrected visual acuity (BCVA), standard 7-field fundus color photography, and optical coherence tomography angiography (OCTA). An OCTA instrument was used to scan the macular area of the affected eye with in the range of 3 mm×3 mm to measure the central subfoveal thickness (CST), the thickness of the ganglion cell complex (GCC) in the macular area, the thickness of the retinal nerve fiber layer (RNFL), and the superficial capillary plexus (SCP) vessel density and perfusion density in the macular area, macular avascular zone (FAZ) area, a-circularity index (AI). Before the operation and 6 months after the operation, the least significant difference test was used for the pairwise comparison.Results:Before the operation, 1, 3, and 6 months after the operation, the FAZ area of the macular area were 0.34±0.14, 0.35±0.10, 0.37±0.10, 0.36±0.13 mm 2, respectively; AI were 0.52±0.13, 0.54±0.11, 0.57±0.10, 0.60±0.11; CST was 282.6±66.7, 290.4±70.9, 287.2±67.5, 273.2± 49.6 μm; GCC thickness were 77.1±15.5, 74.3±13.9, 72.6±16.2, 78.5±18.3 μm; the thickness of RNFL was 97.9±13.8, 101.3±14.6, 97.7±12.0, 96.1±11.4 μm, respectively. The overall blood flow density of SCP in the macula were (16.79±1.43)%, (16.71±1.82)%, (17.30±2.25)%, (17.35±1.22)%; the overall perfusion density were 0.32±0.02, 0.32±0.03, 0.33±0.03, 0.33±0.02, respectively. After the operation, the CST increased first and then decreased; the thickness of RNFL increased 1 month after the operation, and then gradually decreased. Comparison of the parameters before and 6 months after the operation showed that the AI improved, and the difference was statistically significant ( P=0.049); the difference in FAZ area and the thickness of CST, GCC, and RNFL was not statistically significant ( P=0.600, 0.694, 0.802, 0.712); There was no statistically significant difference in the retina SCP blood flow density and perfusion density in the macular area ( P=0.347, 0.361). Conclusion:Compared with before surgery, there is no significant change in macular structure and blood flow density in sNPDR patients within 6 months after minimally invasive PPV.
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Objective To investigate the correlation of suicidal ideation with social support and quality of life among only-child loss people.Methods Totally 320 only-child loss people were collected by using stratified cluster random sampling method.Social support rating scale(SSRS) and general quality of life inventory(GQOLI) were used to investigate the suicidal ideation status.The association of suicidal ideation with social support and quality of life was analyzed by Pearson correlation analysis.Results The suicidal risk rate of only-child loss people was 45.0％.Compared with control group((4.87±2.32),(35.50±9.33),(139.46±37.80)),only-child loss group had lower scores in suicidal ideation,SSRS,GQOLI ((8.94±3.99),(29.97±9.15),(29.97±9.15) respectively,t=1.997-15.009,P＜0.05 or P＜0.01).The suicidal ideation total score was negatively correlated with scores of SSRS and all its 4 items,GQOLI,physical function,psychological function(r=-0.121--0.270,P＜0.05 or P＜0.01).The score of suicidal ideation in the past year was positively correlated with scores of material function (r=0.135,P＜ 0.05).Regression analysis showed that age,marriage,objective support,subjective support and GQOLI were the influencing factors(t=-3.251-3.160,P＜ 0.01 or P＜0.05).Conclusion Only-child loss people have higher suicidal risks,which is negatively correlated with lower social support and quality of life,and influenced by age,marriage,SSRS and GQOLI factors.
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Objective To explore the characteristics of community empty-nesters sleep quality and psychological defense mechanism,and the correlation between them.Methods 230 empty-nest elderly and 181 nonempty nesters were assessed with Pittsburgh sleep quality index (PSQI) and Defense style questionnaire (DSQ).Results PSQI score of empty-nest ehlerly was (14.33±2.48),higher than that of non-empty nesters(t=17.857,P＜0.01).Factor score of immature psychological defense style in DSQ was (3.92± 1.20),for the mediate defense style was (4.49± 1.11),for the wrapping factor was (3.38± 1.92).All of them were higher than the scores for nonempty nesters,and the differences were statistically significant (t=4.463,6.937,5.404,P＜0.01).Factor score for mature psychological defense style in DSQ was (3.96±1.45),and lower than the score for non-empty nesters(t=7.472,P＜0.01).hnmature defense mechanism of empty-nest elderly was positively related with subjective sleep quality,sleep continuity,sleep disorders,using sleep medicine,dysfunction in the daytime,and the total score in PSQ1 (r=0.533,0.145,0.605,0.521,0.497,0.734).Mature defense mechanism was negative related with sleep latency,sleep continuity,and the total score in PSQI (r=-0.129,-0.542,-0.104).The mediate defense meehanism was positively related with subjective sleep quality,sleep latency and the total score in PSQI (r=0.186,0.294,0.131),while negative related with sleep efficiency(r=-0.188).The wrapping factor had a positive correlation with subjective sleep quality,using sleep medicine and the total score in PSQI (r=0.440,0.431,0.564).Conclusion Empty-nesters tend to adopt immature defense styles,and most of them have a poor sleeping,which are closely related with each other.
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Objective To investigate the effects of serum levels of leptin, IGF-1, BDNF and inflammatory markers in patients with post-stroke depression(PSD). Methods By using Hamilton rating scale for depression (HAMD) ,46 patients with post-stroke depression were recruited and 50 patients without depression as the control group. Two weeks after the onset of stroke, serum levels of leptin, insulin growth factor(IGF-1), hs-CRP, intracellular adhesion molecule (ICAM-1) and brain-derived neurotrophic factors (BDNF) were measured by enzymelinked immunosorbent assay(ELISA). Results The levels of leptin and IGF-1 in patients with PSD were significantly higher than that of the control group (( 57.4 ± 14.32) ng/ml vs (17.53 ± 11.62) ng/ml, P = 0. 002;(120.86 ±28.66) ng/ml vs (66.5 ± 17.51) ng/ml, P=0. 004 respectively). The serum levels of leptin and IGFI were positively correlated with the HAMD score(r=0. 724, P＜0. 01; r=0. 641, P＜0. 01 respectively). There was no significant differences in the levels of hs-CRP((2.3 ±0.42) mg/dl vs (2.2 ± 0.28) mg/dl, P= 0. 767),ICAM-1 (( 182.6 ± 50.27) ng/ml vs (178.7 ± 51.14) ng/ml, P = 0. 812) and BDNF(( 25.8 ± 8.35) ng/ml vs (24.2 ±7.48)ng/ml, P = 0.580)in the two groups. Conclusion The serum levels of leptin and IGF-1 may be associated with post-stroke depression and may be the markers of PSD in the old stroke patients.