Objective:To study the risk factors for diabetic retinopathy(DR)in patients with coronary artery disease(CAD).Methods:353 patients with diabetes mellitus hospitalized at Beijing Anzhen Hospital between 2013 and 2015 were enrolled, including 96 patients with coronary artery disease(27%)and 156 patients with DR(44%).Medical history and examination/laboratory results of all patients were collected for analysis.Coronary artery disease was diagnosed according to coronary angiography.DR was diagnosed via ophthalmological examinations.The clinical characteristics of patients with and without DR were compared and contrasted between the groups.Results:Compared with patients without DR, patients with DR had a longer duration of diabetes, [15 years(10, 20) vs.8 years(4, 13), P<0.001]and a higher urine albumin/creatine ratio(UACR)[12.1 mg/g(3.2, 71.9) vs.4.8 mg/g(2.2, 3.5), P<0.001].Logistic regression analysis suggested that duration of diabetes( OR=1.107, 95% CI: 1.063~1.153, P<0.001)and UACR( OR=0.003, 95% CI: 1.001~1.006, P=0.008)were independent risk factors for DR.ROC curves revealed that a duration of diabetes >9.5 years or UACR>7.1 mg/g was significantly associated with DR.Also, of all patients with CAD, those with DR had a longer duration of diabetes[15 years(10, 20) vs.10 years(6, 15), P=0.002]and a higher percentage with hypertension(88.1% vs.67.6%, P=0.014).Hypertension history( OR=4.049, 95% CI: 1.099~14.925, P=0.036)and duration of diabetes( OR=1.159, 95% CI: 1.044~1.287, P=0.005)were independent risk factors for DR in patients with CAD.History of hypertension or a duration of diabetes>11.5 years was significantly associated with DR. Conclusions:In patients with coronary heart disease, hypertension history or a long duration of diabetes is significantly associated with an increased risk of DR.

Objective:To evaluate the effect and safety of monoclonal antibodies to calcitonin gene-related peptide and its receptor (CGRP-mAbs) on migraine.Methods:Database of PubMed, Embase, Cochrane, CNKI, Wangfang digital journals were searched for randomized controlled trials (RCTs) of CGRP-mAbs in treatment of migraine. Quality of enrolled literature was assessed by the software of Review Manager 5.3 and software of StataMP14 was employed to conduct meta analysis.Results:A total of 13 RCTs were included, including 6 218 adult migraine patients (experimental group: 2 679 patients, placebo group: 3 539 patients). Meta analysis suggested that CGRP-mAbs for preventive treatment of migraine significantly reduced the monthly migraine days from baseline (standardized mean difference (SMD)=-0.35, 95% CI-0.4--0.3) and monthly acute migraine-specific medication consumption from baseline (SMD=-0.38, 95% CI-0.43--0.32), as compared with placebo group. CGRP-mAbs for preventive treatment of migraine significantly increased the ≥50% reduction from baseline in migraine days per month ( RR=1.65, 95% CI 1.54-1.76). The adverse events were similar between the CGRP-mAbs group and placebo group ( RR=1.06, 95% CI 1.01-1.10). Conclusion:CGRP-mAbs are effective and safe for preventive treatment of migraine.

Objective To evaluate the effects of different doses of dexmedetomidine on the median effective concentration (EC50) of propofol given by target-controlled infusion (TCI) at loss of consciousness (LOC).Methods Eighty ASA Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,with body mass index ≤25 kg/m2,scheduled for operations under general anesthesia,were randomly allocated to one of four groups(n=20 each): control group (group C) and dexmedetomidine 0.4 μg/kg group (group D1),dexmedetomidine 0.5 μg/kg group (group D2) and dexmedetomidine 0.6 μg/kg group (group D3).Dexmedetomidine 0.4,0.5 and 0.6 μg/kg were infused intravenously over 10 min in groups D1-3,while the equal volume of normal saline was given instead of dexmedetomidine in group C.Propofol was then given by TCI and the EC50 was determined by up-and-down sequential trial.The target plasma concentration was set at 2.0μg/ml in the first patient in each group.The ratio of the target plasma concentration between the two consecutive patients was 1.1.Loss of response to eyelash stimulation and verbal command (2 times) was considered to be signs of LOC.The EC50 and 95％ confidence interval (CI) of propofol causing LOC were calculated.Complications such as bradycardia,hypotension and respiratory depression were recorded.Results The EC50 (95％ CI) of propofol causing LOC was 2.59 (2.51-2.67),2.09 (2.02-2.16),1.82 (1.70-1.95) and 1.60 (1.49-1.72) μg/ml in groups C and D1.3 respectively.The EC50 of propofol causing LOC was significantly lower in groups D1-3 than in group C.Dexmedetomidine significantly decreased the EC50 of propofol required for causing LOC in a dose-dependent manner in groups D1-3 (P ＜ 0.05).The incidences of bradycardia and hypotension were significantly lower in groups D1.3 than in group C (P ＜ 0.05).Compared with group D1,the incidence of bradycardia was increased in groups D2,3 and the incidence of hypotension was increased in group D3 (P ＜ 0.05),There was no significant difference in the incidences of bradycardia and hypotension between groups D2 and D3 (P ＞ 0.05).No patients developed respiratory depression.Conclusion The optimum dose for dexmedetomidine infused intravenously when combined with propofol given by TCI is 0.4 μg/kg and it can decrease the EC50 of propofol administered by TCI at LOC with no adverse reactions.