Objective The purpose of our study is to analyze the effects of different ways of anesthesia on the prognosis of these patients.Methods Our study was a retrospective study,enrolling elderly patients (≥65 years)undergoing pheochromocytoma resection surgery from Jan 2004 to Feb 201 5 in our hospital.We recorded perioperative data including demography,primary disease,com-bined disease,preoperative management,anesthesiology,surgery,and prognosis.Then we divided the patients into two groups,general anesthesia (group G)and general anesthesia combined with epi-dural anesthesia (group GE),to make further statistical analysis.Results There were 33 patients en-rolled,totally undergoing 35 cases of surgery accounting for 13.4% of pheochromocytoma resection surgery in the same period in our hospital.The maintenance of analgesia during surgery by using remifentanyl (18.2% vs 79.2%,P = 0.001 )and sufentanyl (45.5% vs 79.2%,P = 0.046 )were significantly lower in group of general anesthesia combined with epidural anesthesia.However hemo-dynamic parameters didn’t show statistical difference between groups.There were no patients dead during perioperative period.In group GE,the duration of mechanical ventilation (P =0.039),post-operative hospital stay (P =0.013)and total hospital stay (P =0.01 5)were much shorter than those in group G.Multivariable Cox model analysis showed that general anesthesia combined with epidural anesthesia was an independent protective factor for shorter postoperative hospital stay (RR=0.245, 95% CI 0.106-0.564,P =0.001),and combination of vasopressors during operation were the inde-pendent predictors of longer postoperative hospital stay (RR= 4.184,95% CI 1.146-1 5.281,P =0.030).Conclusion During pheochromocytoma resection surgery in elderly patients,general anesthe-sia combined with epidural anesthesia had lower rate of using intravenous analgesic drugs,shorter du-ration of mechanical ventilation,postoperative hospital stay and total hospital stay.

Objective To investigate the memory monitoring ability in patients with idiopathic generalized epilepsy (IGE) and explore the mechanism of the memory impairment.Methods The feeling of knowing (FOK) paradigm of episodic memory (EM) and semantic memory (SM) were established and subsequently administered in 31 patients with IGE (IGE group) and 30 healthy controls (HC group) participants who were matched in age,sex and educational level.Results Compared with HC group (feeling of knowing of episodic memory (FOK-EM) FOK accuracy (85.29± 16.84) ％;feeling of knowing of sematic memory (FOK-SM) recall (76.61± 18.66) ％),the FOK-EM FOK accuracy ((64.03± 22.10) ％) and FOK-SM recall ((53.27±26.91) ％) in IGE group were significantly decreased(t=-4.215,P＜0.01;t=-3.677,P＜0.01).The correct judgment and correct recognition of FOK-EM ((51.16±32.93) ％) and the false judgment and correct recognition ((21.07±24.38) ％) of FOK-EM in the IGE group were significantly different with the HC group (the correct judgment and correct recognition of FOK-EM:(79.34±27.26)％ and the false judgment and correct recognition of FOK-EM:(2.45±5.38) ％;t=-3.634,P＜0.01;t=4.149,P＜0.01).Most importantly,the false judgment and correct recognition of FOK-EM were correlated with the Digital Span Test,Vocabulary Fluency Test and the Stroop effect in IGE group (r=-0.309,P＜0.05;r=-0.355,P＜0.01;r=-0.354,P＜0.05;r=0.602,P＜0.01).Conclusion The results show that the IGE group made less accurate metamemory monitoring than the HC group by underestimating their memoU performance on FOK-EM,whereas the semantic metamemory monitoring is not impaired in IGE group.More importantly,the impairment of memory monitoring was correlated with the deficit of executive function,indicating that this mechanism can be an influential factor of memory disorder in IGE.It also indicates that the episodic and semantic metamemory monitoring depend on different neural networks.

Cognition disorders is one of the most important factors affecting the elderly. Impaired cognitive function caused by the elderly daily self-care ability decreased, the elderly in China cause serious social, psychological and economic burden. The purpose of this review is to summarize the current evidence on main air pollutants(SO₂, NO₂, CO, PM_2.5 and PM₁₀, black carbon)and cognitive function in elderly. The study found that exposure to air pollution, especially particulate matter, is associated with cognitive disorders n in the elderly. However, the existence of such correlations requires reasonable physiological mechanisms. Future studies also require a large number of longitudinal cohorts to investigate air pollution in association with cognitive impairment . There is a need for parallel toxicological and epidemiological studies to elucidate mechanisms and pathways of action.

Objective: To investigate the association of ambient fine particulate matters (PM_2.5) exposure with anxiety in middle-aged and elderly people in China. Methods: Using a stratified random sampling method, 5 997 middle-aged and elderly people (aged 40-89) who resided in the region for more than 2 years and had no hearing or language impairment were selected from 32 districts/counties in the key areas for air pollution prevention and control in China from October 10^th, 2017 to February 7^th, 2018. Information about demographic characteristics, socioeconomic factors and health status were collected by questionnaire survey and physical examination. The anxiety symptoms were assessed by 7-item Generalized Anxiety Disorder Scales. Three-year moving average concentrations of PM_2.5 were calculated to estimate exposure level. The multivariate logistic regression model was conducted to assess the association between PM_2.5 exposure and anxiety. The interaction of age, gender, overweight, education, smoking, drinking and chronic diseases was also analyzed by likelihood ratio test. Results: There were 2 995 (49.94%) males subjects, 4 092 (68.23%) subjects with education of secondary school or above and 2 576 (42.95%) subjects with self-reported chronic diseases among the 5 997 middle-aged and elder participants. The prevalence of anxiety was 6.64% (n=398). The mean±SD of 3-year moving average concentrations of PM_2.5, O₃ and SO₂ were (53.50±13.38), (90.58±13.26) and (40.29±12.56) μg/m³, respectively. PM_2.5 had significantly association with anxiety, and the corresponding OR value was 1.17 (95%CI: 1.05,1.31) with a 10 μg/m³ increment of 3-year moving average concentrations of PM_2.5. Compared with female (OR (95%CI)=1.07 (0.93,1.23)), those with no chronic diseases (OR (95%CI)=1.06 (0.93,1.20)) and those with primary school degree or below (OR (95% CI)=0.90 (0.75,1.09)), the association between PM_2.5 and anxiety was stronger among male (OR (95%CI)=1.35 (1.12,1.63)) and those with chronic diseases (OR (95%CI)=1.77 (1.31,2.38)), middle school education (OR (95%CI)=1.43 (1.22,1.67)), college education and above (OR (95%CI)=1.68 (1.05, 2.67)), all the P interaction values were <0.05. Conclusion PM_2.5 exposure has significantly positive association with anxiety. The associations are stronger in male, people with higher educational qualifications and patients with chronic diseases.

Objective: To investigate the influence factors of survival outcome among elderly aged ≥80 years old. Methods: In baseline survey in 2009, 930 participants aged ≥80 years old were enrolled from 7 longevity areas, to collect the information of socioeconomic factors, life style, cognitive function, activities of daily living and diseases, as well as physical examination to test biomarkers of blood and urine. The survival status was followed up at 2012 and 2014 survey. Stepwise Cox proportional hazards models were used to screen influence factors of 5-year survival. Results: During 5 years of follow-up, 571 participants died, 133 participants were lost to follow up, and the all-cause mortality was 63.4%. In stepwise Cox proportional hazards models, male, unmarried, self-reported poor life quality, disability in daily life, cognitive impairment, cardiovascular and cerebrovascular diseases, chronic kidney diseases were risk factors for elderly survival outcome, with the HR (95%CI) at 1.75 (1.40-2.12), 1.49 (1.10-2.03), 1.40 (1.16-1.69), 1.37 (1.11-1.70), 1.51 (1.22-1.88), 1.62 (1.18-2.23) and 1.48 (1.23-1.77) respectively. Each 1 year increase in age corresponded to 4% increase in mortality risk (HR (95%CI)=1.04 (1.02-1.05)); each 1 kg/m² increase in BMI corresponded to 5% increase in mortality risk (HR (95%CI)=0.95 (0.93-0.98)); each 1.0×10⁹/L increase in total lymphocyte count (TLC) corresponded to 13% increase in mortality risk (HR (95%CI)=0.87 (0.76-0.99)). Additionally, the mortality risk decreased 19% (HR (95%CI)=0.81 (0.66-0.98)) in participants with regularly physical exercise compared to those without; and the mortality risk decreased 41% (HR (95% CI)=0.59 (0.40-0.88)) in participants with elevated triglycerides (TG, ≥2.26 mmol/L) compared to those without. Conclusion In Chinese longevity areas, some nutritional and immune indices such as relatively higher level of BMI, TLC and TG were independent protective factors for 5-year survival outcome, which was different from general adults and younger elderly.

As a relatively new procedure, femtosecond laser small incision lenticule extraction (SMIIE) is still in its initial stage.Despite the safety, efficacy, predictability and stability it has showed in refractive error correction, there are still reports of intraoperative complications resulting in different clinical outcomes in SMILE.SMILE includes the production of lenticule by femtosecond laser, the separation and extraction of lenticule, and intraoperative complications may occur in every step.The production of the lenticule is completely dependent on the femtosecond laser, so complications related to femtosecond lasers are inevitable, such as suction loss, opaque bubble layer and black spots.Separation and extraction of the lenticule relies on the experience and surgical skills of surgeon, during which, torn corneal cap, difficult lenticule extraction, lenticule remnants, bleeding and lenticule decentration may occur.In this article, the categories, reasons, management and effects of intraoperative complications on outcome in SMILE were summarized to improve the ability of ophthalmologists to handle intraoperative incidents and enhance surgical safety.

In China, the level of ambient fine particulate matter (PM 2.5 ) pollution far exceeds the air quality standards recommended by the World Health Organization. Moreover, the health effects of PM 2.5 exposure have become a major public health issue. More than half of PM 2.5 -related excess deaths are caused by cardiopulmonary disease, which has become a major health risk associated with PM 2.5 pollution. In this review, we discussed the latest epidemiological advances relating to the health effects of PM 2.5 on cardiopulmonary diseases in China, including studies relating to the effects of PM 2.5 on mortality, morbidity, and risk factors for cardiovascular and respiratory diseases. These data provided important evidence to highlight the cardiopulmonary risk associated with PM 2.5 across the world. In the future, further studies need to be carried out to investigate the specific relationship between the constituents and sources of PM 2.5 and cardiopulmonary disease. These studies provided scientific evidence for precise reduction measurement of pollution sources and public health risks. It is also necessary to identify effective biomarkers and elucidate the biological mechanisms and pathways involved; this may help us to take steps to reduce PM 2.5 pollution and reduce the incidence of cardiopulmonary disease.
Humans ; Particulate Matter/analysis* ; Air Pollution/adverse effects* ; Risk Factors ; Respiratory Tract Diseases ; China/epidemiology* ; Environmental Exposure/adverse effects*

Refractive surgery is one of the important methods for refractive error correction, which include corneal refractive surgery and intraocular refractive surgery.In recent years, refractive surgery has a rapid development, and there is still development space and potential market demand.The clinical application of various new technologies has brought the refractive surgery to a new stage.The ultimate aim of refractive surgery is to pursue safer minimally invasive approaches and more customized correction for better visual quality.The new approaches including the guidance of corneal topography and wavefront aberration, the Q-value adjustment, Kappa angle adjustment, and customized corneal cross-linking during the surgery have been developed.The integration of various surgical approaches and research is also a new development direction.The combination with intelligent operation to improve the efficiency and accuracy of treatment seems to be one new direction, too.Ophthalmologists should pay attention to the current development and the possible future directions and trends of refractive surgery in China.

Objective:To investigate the changes of refraction power and higher-order aberrations under mesopic and photopic vision conditions.Methods:A cross-sectional study was performed.Seventy-one eyes of 71 patients with myopia or myopic astigmatism were enrolled in Tianjin Eye Hospital from February 6 to 28 in 2017.Spherical diopter, cylindrical diopter and higher-order aberrations were examined with NIDEK OPD Scan-Ⅲ.The pupil size, refractive power, total higher-order aberrations and Zernike aberration coefficients were compared between mesopic and photopic conditions.The study protocol was approved by an Ethics Committee of Tianjin Eye Hospital.Written informed consent was obtained from each subject prior to any medical examination.Results:The mean pupil diameter of the photopic conditions was significantly smaller than that of mesopic condition ( t=-66.730, P<0.001). The mean spherical equivalent (SE) were (-6.85±2.75)D and (-6.50±2.38)D under mesopic and photopic conditions, and mean cylindrical diopter were (-1.27±0.91)D and (-0.84±0.76)D, respectively, with statistically significant differences between the two conditions (both at P<0.001). There was no significant difference in spherical diopter between photopic and mesopic conditions ( P=0.212). The root mean square (RMS) values of total higher order aberration, total trefoil, total coma and total spherical aberration under mesopic condition were significantly higher than those under photopic condition (all at P<0.001), and the RMS values of Zernike aberration coefficients were significantly increased in mesopic condition compared with the photopic condition (all at P<0.001). Conclusions:Both refractive power and higher-order aberrations in photopic condition are higher than those in mesopic condition.

Objective: To investigate the relationship of plasma albumin and hypersensitive C-reactive protein (Hs-CRP) with 5-year all-cause mortality among Chinese older adults aged 65 and older. Method: Data was collected in 8 longevity areas of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) study conducted by Chinese Center for Disease Control and Prevention and Peking University at baseline survey in 2012 and 2014, the participants enrolled in 2012 was followed-up in 2014 and 2017, the participants enrolled in 2014 was followed-up in 2017 only. Finally, 3 118 older adults aged 65 and older with complete information on albumin, Hs-CRP and body mass index (BMI) were included in this study. Plasma samples of older adults were collected for the detection of albumin and Hs-CRP at baseline survey. Survival status and follow-up time was recorded for all participants. All older adults were divided into 4 groups according to the levels of plasma albumin and Hs-CRP, and Cox proportional hazard models were constructed to assess their influence on the risk of all-cause mortality. Results: Among 3 118 older adults included, the prevalence of hypoalbuminemia was 10.1% (316/3 118), and was 22.8% (711/3 118) for elevated Hs-CRP. During 10 132 person-years of follow-up, 1 212 participants died. Participants with hypoalbuminemia had increased risk of all-cause mortality, with an hazard ratio (HR) and 95% confidential interval (CI) of 1.18 (1.01-1.38), compared to participants with normal plasma albuminemia; participants with elevated Hs-CRP had increased risk of all-cause mortality, with an HR (95%CI) of 1.18 (1.04-1.35), compared to participants with normal plasma Hs-CRP. Participants with normal plasma albumin and elevated Hs-CRP, with hypoalbuminemia and normal Hs-CRP, with hypoalbuminemia and elevated Hs-CRP also had increased risk of all-cause mortality when compared to those with normal plasma albumin and normal Hs-CRP, the HR (95%CI) were 1.16 (1.01-1.34), 1.11 (0.91-1.37) and 1.43 (1.11-1.83), respectively. Conclusion Hypoalbuminemia and elevated Hs-CRP were responsible for increased risk of 5-year all-cause mortality among Chinese older adults from 8 longevity areas.