Objective To analyze the characteristic and temporal trend in mortality and disease burden of Alzheimer’s disease (AD) and other forms of dementia in Guangzhou from 2008 to 2019, and estimate the disease burden attributable to smoking to provide evidence for promoting local health policy of prevention and intervention of dementia. Methods Based on the data of Guangzhou surveillance point of the National Mortality Surveillance System (NMSS), the crude mortality, standardized mortality, years of life lost (YLL) of AD and other dementia were calculated. The indirect method was used to estimate years lived with disability (YLD) and disability-adjusted life-years (DALY).The distribution and changing trends of the index rates were compared from 2008 to 2019 using Joinpoint Regression Program.Based on the data of Guangzhou Chronic Disease and Risk Factors Monitoring System in 2013, the indexes of disease burden of AD and other forms of dementia attributable to smoking in 2018 was calculated. Results The standardized mortality rate, YLL rate, YLD rate and DALY rate of AD and other forms of dementia in Guangzhou increased from 0.45/100 000, 0.05‰, 0.02‰ and 0.07 ‰ in 2008 to 1.28/100 000, 0.15‰, 0.07‰ and 0.22‰ in 2019, respectively. The average annual changing trend was statistically significant (AAPC=11.30%, 13.09%, 13.09%, 13.09%, P<0.001）. In most years, the mortality and disease burden of women were higher than those of men, but men had higher growing trend than women in standardized mortality rate, YLL rate, YLD rate and DALY rate from 2008 to 2019, with a slower growing speed after the year 2012.The disease burden of dementia attributable to smoking in men was significantly higher than that in women. Conclusion The mortality and disease burden of AD and other forms of dementia in Guangzhou have dramatically increased over the past twelve years. Intervention against modifiable factors such as smoking, and prevention and screening for dementia in key populations should be strengthened. Support policies for dementia care management should be adopted to reduce the disease burden caused by premature death and disability.
Objective To observe the application and effectiveness of bevacizumab intravitreal injection as adjunctive treatment for laser coagulation to treat retinopathy of prematurity (ROP). MethodsFrom March 2008 to October 2010, 17 infants (31 eyes) with ROP received bevacizumab intravitreal injection and were analyzed. Ten infants were male (18 eyes) and 7 were female (13 eyes).Their gestational age was from 24.7 to 31.0 weeks, with a mean of (28.2±1.9) weeks. Their birth weight was from 750 to 1600 grams, with a mean of (1150±264) grams. The indications for treatment included poor papillary dilation and refractive media opacity precluding complete laser coagulation and that ROP could not be controlled after complete laser coagulation treatment. The duration of followup was 1.4 to 40.8 months, with a mean of (20.8±13.2) months. It was noted whether the diseases were completely controlled or not, unfavourable structural outcome occurred or not and if there were complications regarding treatment. Results During the follow-up of all 31 eyes, ROP of 27 eyes (87.0%) was controlled by bevacizumab intravitreal injection as adjunctive treatment for laser coagulation. Increasing neovascularization and traction retinal detachment occurred in 2 eyes (6.5%). These 2 eyes underwent vitreoretinal surgery. The posterior retinal structure returned to normal in 1 eye and posterior vitreoretinal traction occurred in 1 eye. After bevacizumab intravitreal injection ROP continued progressing and traction retina detachment occurred in 2 eyes. The overall health of this infant remained good during and after operation. No systemic adverse drug reactions were found. No endophthalmitis occurred. No ocular complications such as corneal burn, cataract, and anterior segmental ischemia were found. Conclusions During the follow-up，the effectiveness of bevacizumab intravitreal injection as adjunctive treatment for laser coagulation to treat ROP was positive. No complications regarding the treatment were found.
Objective To investigate the incidence of retinopathy of prematurity (ROP) in extremely low birth weight infants and to explore their risk factors. Methods ROP screening was carried out in Shenzhen Eye Hospital from July 2006 to October 2011. One hundred and fortyfive infants with a birth weight less than 1000 grams were respectively analyzed. There were 93 males and 52 females. Their average gestational age was (28.5±2.0) weeks and average birth weight was (923.0±85.0) grams. The more advanced ROP stages during the follow up or between the 2 eyes of bilateral patients were recorded and analyzed in this study. All infants were first divided into ROP group or non-ROP group. All the ROP cases were further divided into mild ROP group and severe ROP group. Mild group included infants with stage 1, stage 2 and nonthreshold stage 3 ROP. Severe group included infants with pre-threshold type 1, threshold, aggressive posterior ROP and stage 4/5 ROP. Gestational age (less than or equal to 28 weeks or more than 28 weeks), birth weight (less than 750 grams or more than or equal to 750 grams), fetus number in one birth (single or multiple fetus), mode of delivery (normal or cesarean section delivery) and gender were analyzed as risk factors according to reference. SPSS 13.0 was used to do the statistical analysis. Results96/145 infants developed ROP with an incidence of 66.21%. There were 59 (40.69%) severe ROP infants who underwent laser coagulation, bevacizumab intravitreal injection or vitreoretinal surgery. The difference of gestational age, fetus number in one birth, mode of delivery between ROP group and non-ROP group was statistically significant (P＜0.05). The difference of gestational age between mild ROP group and severe ROP group was statistically significant (χ2=7.588,P=0.006).Logistic regression analysis showed that only gestational age related to ROP occurence［Exp（B）=0.328 07,P=0.005 19］. Conclusions The incidence of ROP and severe ROP are very high in extremely low birth weigh infants. ROP risk factors are various and mainly include gestational age less than or equal to 28 weeks, multiple fetus and normal delivery.