Anatomical study of the adductor canal: three-dimensional micro-computed tomography, histological, and immunofluorescence findings relevant to neural blockade / 대한마취과학회지

Background@#A precise anatomical understanding of the adductor canal (AC) and its neural components is essential for discerning the action mechanism of the AC block. We therefore aimed to clarify the detailed anatomy of the AC using micro-computed tomography (micro-CT), histological evaluation, and immunofluorescence (IF) assays. @*Methods@#Gross dissections of 39 thighs provided morphometric data relevant to injection landmarks. Serial sectional images of the AC were defined using micro-CT and ultrasonography. The fascial and neural structures of the AC proper were histologically evaluated using Masson’s trichrome and Verhoeff-Van Gieson staining, and double IF staining using choline acetyltransferase (ChAT) and neurofilament 200 antibodies. @*Results@#The posteromedial branch insertion of the nerve to vastus medialis (NVM) into the lateral border of the AC proper was lower (14.5 ± 2.4 cm [mean ± SD] above the base of the patella) than the origin of the proximal AC. The AC consists of a thin subsartorial fascia in the proximal region and a thick aponeurosis-like vastoadductor membrane in the distal region. In the proximal AC, the posteromedial branch of the NVM (pmNVM) consistently contained both sensory and motor fibers, and more ChAT-positive fibers were observed than in the saphenous nerve (27.5 ± 11.2 / 104 vs. 4.2 ± 2.6 / 104 [counts/µm2], P < 0.001). @*Conclusions@#Anatomical differences in fascial structures between the proximal and distal AC and a mixed neural component of the neighboring pmNVM have been visualized using micro-CT images, histological evaluation, and IF assays.

Related factors of treatment zone diameter after Paragon CRT orthokeratology / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To explore the influence factors of the treatment zone diameter(TZD)and its correlation with axial length growth(ALG)after Paragon CRT orthokeratology.METHODS: Retrospective clinical study. The data of 226 myopic patients(226 eyes)wearing Paragon CRT orthokeratology from April 2020 to September 2022 were collect. The correlated factors of TZD after wearing lens for 1mo, and the relationship between the overlapping treatment zone/ pupil area ratio and the ALG after wearing lens for 1a were analyzed.RESULTS: After wearing lens for 1mo, the TZD was negatively correlated with central corneal thickness(CCT)and positively correlated with the flat corneal eccentricity. After wearing lens for 1a, the ALG of the small TZD group(0.25±0.18mm)was significantly smaller than that of the large TZD group(0.34±0.24mm, P=0.002), and the ALG of the small area ratio group(0.24±0.19mm)was significantly smaller than that of the large area ratio group(0.35±0.23mm,P&#x003C;0.001). Age and overlapping treatment zone area/pupil area ratio were significantly associated with the ALG in multivariate linear regression(all P&#x003C;0.05).CONCLUSION: The wearers with thicker CCT and smaller flat corneal eccentricity usually had smaller TZD, and both the TZD and the overlapping treatment zone area/pupil area ratio were correlated with the ALG.

Building on the backbone of CD47-based therapy in cancer: Combination strategies, mechanisms, and future perspectives

Described as a "don't eat me" signal, CD47 becomes a vital immune checkpoint in cancer. Its interaction with signal regulatory protein alpha (SIRPα) prevents macrophage phagocytosis. In recent years, a growing body of evidences have unveiled that CD47-based combination therapy exhibits a superior anti-cancer effect. Latest clinical trials about CD47 have adopted the regimen of collaborating with other therapies or developing CD47-directed bispecific antibodies, indicating the combination strategy as a general trend of the future. In this review, clinical and preclinical cases about the current combination strategies targeting CD47 are collected, their underlying mechanisms of action are discussed, and ideas from future perspectives are shared.

The effect of different stent oversize on lumen remodeling of endovascular repair of type B aortic dissection / 中华普通外科杂志

Objective:To investigate the effect of different stent oversize in thoracic endovascular aortic repair (TEVAR) on lumen remodeling of type B aortic dissection (TBAD).Methods:The clinical and follow-up data of 89 TBAD patients receiving TEVAR from Nov 2010 to Jun 2020 at Yantai Yuhuangding Hospital were retrospectively analyzed. According to the difference of proximal stent oversize, 89 patients were divided into: low oversize group (<10%, 47 cases) and high oversize group (≥10%, 42 cases). The changes of the normal vessel diameter and area at the proximal end of the stent and the long diameter, short diameter and area of the true/false lumen at the distal end of the stent at 3, 6, and 12 months after surgery and postoperative complications were analyzed.Results:The change of proximal vessel diameter with time in the low oversize group is smaller than that in the high oversize group ( P<0.05),and the change of the distal false lumen area of the stent in the low oversize group was greater than that in the high oversize group ( P<0.05). The high oversize group was prone to retrograde type A aortic dissection (RTAD) ( P<0.05). Conclusion:Low oversize stents are more conducive to the remodeling of the aortic lumen in the early and mid-term after TEVAR in TBAD patients.

c-MYC-mediated TRIB3/P62+ aggresomes accumulation triggers paraptosis upon the combination of everolimus and ginsenoside Rh2

The mammalian target of rapamycin (mTOR) pathway is abnormally activated in lung cancer. However, the anti-lung cancer effect of mTOR inhibitors as monotherapy is modest. Here, we identified that ginsenoside Rh2, an active component of Panax ginseng C. A. Mey., enhanced the anti-cancer effect of the mTOR inhibitor everolimus both in vitro and in vivo. Moreover, ginsenoside Rh2 alleviated the hepatic fat accumulation caused by everolimus in xenograft nude mice models. The combination of everolimus and ginsenoside Rh2 (labeled Eve-Rh2) induced caspase-independent cell death and cytoplasmic vacuolation in lung cancer cells, indicating that Eve-Rh2 prevented tumor progression by triggering paraptosis. Eve-Rh2 up-regulated the expression of c-MYC in cancer cells as well as tumor tissues. The increased c-MYC mediated the accumulation of tribbles homolog 3 (TRIB3)/P62+ aggresomes and consequently triggered paraptosis, bypassing the classical c-MYC/MAX pathway. Our study offers a potential effective and safe strategy for the treatment of lung cancer. Moreover, we have identified a new mechanism of TRIB3/P62+ aggresomes-triggered paraptosis and revealed a unique function of c-MYC.

Value of plasma Epstein-Barr virus DNA detection in the screening of nasopharyngeal carcinoma and its clinical application in non-high-risk areas / 中华检验医学杂志

Objective:To investigate the value of plasma Epstein-Barr virus (EBV) DNA detection in the screening of nasopharyngeal carcinoma (NPC) and its clinical application in non-high-risk areas.Methods:Plasma EBV DNA results in 1 153 newly diagnosed nasopharyngeal carcinoma patients who were treated in Sichuan Cancer Hospital from 2015 to 2020 and 244 healthy control cases with matched sex and age were retrospectively analyzed. EBV DNA were detected by quantitative real-time PCR. Positive rate of EBV DNA was determined by the cutoff value of 400 (≥400 copies/ml as positive) and optimization threshold method (presence of S amplification curve as positive). Further analyses were conducted to compare EBV DNA load in different clinical stage, TNM stage and regions distribution characteristics. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic value of the cutoff value of 400 and optimization threshold method for NPC.Results:Compared with healthy controls, EBV DNA increased significantly in newly diagnosed NPC patients ( P<0.001). Both evaluation methods revealed that the EBV DNA positive percentage increased with TNM and clinical stage ( P<0.001). With 400 copies/ml as cutoff value, the diagnostic sensitivity and specificity were 40.85% and 100%, respectively. The area under the curve was 0.704 (95% CI 0.676-0.733, P<0.001). Evaluated by the optimization threshold method, the sensitivity and specificity could improve to 82.0% and 99.2%, respectively, and the area under the curve reached 0.910 (95% CI 0.894-0.924, P<0.001). Conclusions:In the low prevalence area of nasopharyngeal carcinoma, the sensitivity for diagnosis of nasopharyngeal carcinoma is only 40.9% by the 400 copies/ml cutoff value method. The optimization threshold method is a better choice to improve the diagnostic sensitivity without lowering the diagnostic specificity.

Myricetin inhibits interferon-γ-induced programmed death ligand-1 and indoleamine 2, 3-dioxygenase 1 expression in lung cancer cells / 中国药理学与毒理学杂志

OBJECTIVE Programmed death ligand-1 (PD-L1) and indoleamine 2, 3-dioxygenase 1 (IDO1) are immune checkpoints which can be induced by interferon-γ(IFN-γ) in the tumor microenvironment, leading to immune escape of tumors. Myricetin (MY) is a flavonoid distributed in many edible and medicinal plants. The aim of this study is to clarify the effect and the mechanism of MY on inhibiting IFN-γ-induced PD-L1 and IDO1 in lung cancer cells. METHODS Expressions of PD-L1 and major histocompatibility complex-I (MHC-I) were evaluated by flow cytometry and Western blotting, and the expression of IDO1 was measured by Western blotting. qRT-PCR was used to detect their mRNA levels. The function of T cells was evaluated using a co-culture system consist of lung cancer cells and the Jurkat-PD-1 T cell line that overexpressing PD-1. Molecular docking analysis, Western blotting and immunofluorescence were used for mechanism study. RESULTS MY potently inhibited IFN-γ-induced PD-L1 and IDO1 expression in human lung cancer cells, while didn't show obvious effect on the expression of MHC-I. In addition, MY restored the survival, proliferation, CD69 expression and interleukin-2 (IL-2) secretion of Jurkat-PD-1 T cells suppressed by IFN-γ-treated lung cancer cells in the co-culture system. Mechanistically, IFN-γ up-regulated PD-L1 and IDO1 at the transcriptional level through the JAK-STAT-IRF1 axis, which was targeted and inhibited by MY. CONCLUSION Our research revealed a new insight into the anti-tumor effects of MY which inhibited IFN-γ-induced PD-L1 and IDO1 expression, supporting the potential of MY in anti-tumor immunotherapy.

Nagilactone E increases PD-L1 expression through activation of c-Jun in lung cancer cells / 中国天然药物

Nagilactone E (NLE), a natural product with anticancer activities, is isolated from Podocarpus nagi. In this study, we reported that NLE increased programmed death ligand 1 (PD-L1) expressions at both protein and mRNA levels in human lung cancer cells, and enhanced its localization on the cell membrane. Mechanistically, NLE increased the phosphorylation and expression of c-Jun, and promoted the localization of c-Jun in the nucleus, while silencing of c-Jun by small interfering RNA (siRNA) reduced NLE-induced PD-L1. Further study showed that NLE activated the c-Jun N-terminal kinases (JNK), the upstream of c-Jun, and its inhibitor SP600125 reversed the NLE-increased PD-L1. Moreover, NLE-induced PD-L1 increased the binding intensity of PD-1 on the cell surface. In summary, NLE upregulates the expression of PD-L1 in lung cancer cells through the activation of JNK-c-Jun axis, which has the potential to combine with the PD-1/PD-L1 antibody therapies in lung cancer.

Application of MRI in the studies of female sexual dysfunction / 中华男科学杂志

Female sexual dysfunction (FSD) is a disease associated with various factors such as psychological conditions, age, physical illness, and drugs. Magnetic resonance imaging (MRI) has the advantages for the studies FSD due to its non-invasiveness and high soft-tissue contrast. Brain MRI revealed significant differences in brain function activation sites and signaling between women with FSD and those with normal sexual function. Pelvic MRI found a close relation of the location and size of the clitoris with the sexual function of women, which may help to determine the lesion area of the FSD patient. A comparative analysis of the central nervous system and peripheral reproductive organs in women with normal sexual function and FSD patients by MRI is of great value for exploring the etiology of FSD and its treatment options.

Catheter thrombectomy and catheter-directed thrombolysis for deep venous thrombosis / 中华普通外科杂志

Objective To evaluate catheter thrombectomy,mechanical thromboaspiration and catheter-directed thrombolysis for the treatment of deep venous thrombosis.Methods From January 2015 to February 2016,60 patients with acute deep vein thrombosis were placed the inferior vena cava filter from contralateral femoral vein or right internal jugular vein.A 5 F pigtail catheter was led to the ipsilateral deep vein,bolus urokinase was given and catheter thrombectomy was undertaken and thromboaspiration was carried out using 10-12 F catheter,then through catheter continuous infusion of urokinase.Results 45 cases were cured,8 cases were significantly improved,5 cases were improved,2 cases were judged as ineffective,the effective rate was 96.6％.Before thrombolysis the thigh circumference difference between affected limb and the contralateral limb was (3.6 ± 1.9)cm (P ＜0.05),calf circumference difference was (4.6 ±2.1)cm (P ＜ 0.05);The difference between the affected limb and contralateral thigh circumferences was (0.19±0.90) cm (P ＞ 0.05),calf circumference difference was (0.5 ± 1.0) cm (P ＞ 0.05).Conclusions Catheter thrombectomy,thromboaspiration and catheter-directed thrombolysis for deep venous thrombosis is safe and effective.

Computed Tomography Signs for Active Severe Gastrointestinal Bleeding / 中国医学科学院学报

Objective To summarize the positive signs on multi-detector CT angiography (CTA) for active severe gastrointestinal bleeding (GIB).Methods We retrospectively evaluated the clinical records and CT images of 93 patients with active severe GIB confirmed by digital subtraction angiography (DSA),endoscopy or surgery. The positive CT signs indicating the locations and causes of the bleeding were recorded. Results Intraluminal extravasation of contrast material was identified in 44 cases (47.3%),vascular malformation was found in 22 cases (23.7%),gastrointestinal tumor was detected in 18 cases (19.4%),focal or segmental abnormal bowel mucosal enhancement was present in 7 cases (7.5%),and diverticulum with abnormal enhancement was found in 2 cases (2.2%). Conclusion Positive signs for active severe GIB on CT are diverse and thus should be carefully interpreted in clinical setting.

Three-dimensional finite element analysis of unilateral mastication in malocclusion cases using cone-beam computed tomography and a motion capture system

PURPOSE: Stress distribution and mandible distortion during lateral movements are known to be closely linked to bruxism, dental implant placement, and temporomandibular joint disorder. The present study was performed to determine stress distribution and distortion patterns of the mandible during lateral movements in Class I, II, and III relationships. METHODS: Five Korean volunteers (one normal, two Class II, and two Class III occlusion cases) were selected. Finite element (FE) modeling was performed using information from cone-beam computed tomographic (CBCT) scans of the subjects' skulls, scanned images of dental casts, and incisor movement captured by an optical motion-capture system. RESULTS: In the Class I and II cases, maximum stress load occurred at the condyle of the balancing side, but, in the Class III cases, the maximum stress was loaded on the condyle of the working side. Maximum distortion was observed on the menton at the midline in every case, regardless of loading force. The distortion was greatest in Class III cases and smallest in Class II cases. CONCLUSIONS: The stress distribution along and accompanying distortion of a mandible seems to be affected by the anteroposterior position of the mandible. Additionally, 3-D modeling of the craniofacial skeleton using CBCT and an optical laser scanner and reproduction of mandibular movement by way of the optical motion-capture technique used in this study are reliable techniques for investigating the masticatory system.

A competency model of rural general practitioners: theory construction and empirical study / 南方医科大学学报

<p><b>OBJECTIVE</b>To perform theory construction and empirical study of the competency model of rural general practitioners.</p><p><b>METHODS</b>Through literature study, job analysis, interviews, and expert team discussion, the questionnaire of rural general practitioners competency was constructed. A total of 1458 rural general practitioners were surveyed by the questionnaire in 6 central provinces. The common factors were constructed using the principal component method of exploratory factor analysis and confirmatory factor analysis. The influence of the competency characteristics on the working performance was analyzed using regression equation analysis.</p><p><b>RESULTS</b>The Cronbach 's alpha coefficient of the questionnaire was 0.974. The model consisted of 9 dimensions and 59 items. The 9 competency dimensions included basic public health service ability, basic clinical skills, system analysis capability, information management capability, communication and cooperation ability, occupational moral ability, non-medical professional knowledge, personal traits and psychological adaptability. The rate of explained cumulative total variance was 76.855%. The model fitting index were Χ(2)/df 1.88, GFI=0.94, NFI=0.96, NNFI=0.98, PNFI=0.91, RMSEA=0.068, CFI=0.97, IFI=0.97, RFI=0.96, suggesting good model fitting. Regression analysis showed that the competency characteristics had a significant effect on job performance.</p><p><b>CONCLUSIONS</b>The rural general practitioners competency model provides reference for rural doctor training, rural order directional cultivation of medical students, and competency performance management of the rural general practitioners.</p>

Phylogenic Oto-stomatognathic Connection of the Mammalian Jaw: A Novel Hypothesis for Tensor Tympani Muscle and TMD-related Otologic Symptoms / 체질인류학회지

Otologic complaints, including otalgia, tinnitus, vertigo, and hearing loss, are known to be related to temporomandibular disorders (TMDs). There have been several hypotheses regarding the clinical correlation between otologic complaints and TMDs, based on clinical phenomena with corresponding symptoms, the close neurological relationship between otic and masticatory structures, and anatomical features of the tympanic cavity and jaw joint. Function of the tensor tympani muscle seems to be crucial to understanding TMD-related otologic symptoms. The tensor tympani inserts into the handle of the malleus and it modulates sound transduction in situations of excessive noise. This muscle is innervated by the trigeminal nerve, like the masticatory muscles. Voluntary eardrum movement by pathological tensor tympani contraction results in various otologic symptoms. Thus, co-contraction of the tensor tympani with the masticatory muscle could be a possible cause of TMD-related otologic symptoms. The tensor tympani is rather unrelated to the acoustic reflex, in which the stapedius is strongly involved. The tensor tympani seem to be controlled by proprioceptive information from the trigeminal sensory nucleus. The peripheral innervation pattern of the tensor tympani and masticatory muscles is also supposed to be interconnected. The middle ear structure, including the malleus, incus, and tensor tympani, of mammals had been adapted for acoustic function and lacks the masticatory role seen in non-mammalian jawed vertebrates. The tensor tympani in non-mammals is one of the masticatory muscles and plays a role in the modulation of sound transduction and mastication. After the functional differentiation of the mammalian middle ear, the nervous connection of the tensor tympani with other masticatory apparatus still remains. Through this oto-stomatognathic vestige, the tensor tympani seems to contract unnecessarily in some pathological conditions of the TMD in which the masticatory muscles contract excessively. We hypothesized that the phylogenic relationship between the tensor tympani and masticatory apparatus is a significant and logical reason for TMD-related otologic complaints.

Proper Application of Cyber Lecture on Neuroanatomy for Medical Students / 체질인류학회지

Recent development of cyber lecture system has greatly influenced on the medical education especially on anatomy related subjects. Furthermore, the technology associated to the cyber lecture system is now widely used as the evaluation tool for the medical students. The purposes of this study are to evaluate the opinions of students according to the types of cyber lectures which were applied to a basic medical subject (neuroanatomy) and to suggest practical services and applications available for the medical students. In this study, we adopted several teaching strategies such as online lecture system and web assisted instruction to the neuroanatomy class. Medical students of Dankook universitiy were classified into three groups (online lecture group, web assisted instruction group, and cyber lecture non-experienced group) and asked to complete anonymous survey in private. The majority of students had already experienced web-based leaning at least once. The degree of student satisfaction at the cyber lecture contents were relatively high in both online lecture group and web assisted instruction group. Students in all groups slightly preferred classical lecture room lecture but also seem to be familiar to the cyber lecture. Students from all groups suggested parallel progress with lecture room lecture as the proper application of cyber lecture. Growing demands of cyber lectures based on network technology is likely to make new paradigm of medical education in the near future. Practically, application of cyber lecture system to the lab course of sectional neuroanatomy and also to the preparation for the wide scoped examination might be suggested at this time.

Clinical features and prognostic analysis of breast angiosarcoma / 中国肿瘤临床

Objective: Angiosarcoma of the breast is a rare and heterogeneous entity and its overall incidence is reported as 0.04% of primary breast cancer and as 8% of breast sarcoma approximately. To retrospectively analyze the clinical features and prognosis of breast angiosarcoma, 13 patients were identified by mammary pathologists in Tianjin Medical University Cancer Institute and Hospital from October 1975 to June 2009. Methods:Kaplan-Meier method was carried out to analyze different tumor size, tumor margins and histological grade. Prognosis was tested with univariate analysis by Log-rank test. Results: Median and mean age at diagnosis were 48 years and 44 years, respectively. The duration of follow-up ranged from 7 to 98 months (median, 50 months). All patients underwent surgical excision. Two patients received chemotherapy. Eight patients succumbed to recurrence and distant metastasis. Conclusion:Angiosarcoma of the breast has an exceedingly poor prognosis. The median disease-free survival (DFS) and overall survival (OS) were 28 months and 45 months, respectively. Both tumor size and surgical margins were associated with prognosis (P0.05) and a high risk of recurrence and metastasis (P<0.05).

Anatomical and Functional Consideration of the Trigemino-Facial Nervous Communication and Facial Expresssion Muscles / 체질인류학회지

The aim of the study is to examine the distribution and communications of the trigeminal nerve (TN) and facial nerve (FN) and considerate their relationship with the anatomy and function of the facial expression muscles (FEMs) by means of the literature study. The TN emerged on the face via various structures of the skull, and received sensation of the skin and muscles on the face. The FN supplied the motor components to the FEMs, as ramifying five branches after running through the stylohyoid foramen. The TN and FN constituted "nervous communication between heterogeneous cranial nerves" on the ocular (supraorbital nerve and temporal branch), zygomatic (zygomatic nerve and temporal/zygomatic branch), infraorbital (infraorbital nerve and zygomatic branch), retromandibular (auriculotemporal nerve and FN trunk), buccal (buccal nerve and buccal/zygomatic branch) and mental areas (mental nerve and buccal/marginal mandibular branch). The exquisite movement of the FEM which was controlled by the facial motor nucleus would be referred by the proprioception from the TN. The motor components from the FN could be delivered to the FEM via the TN as recruiting the heterogeneous nervous communications. The sensation from the FN also could be conveyed to the TN via the communication.

Topography of Superficial Arteries on the Face / 체질인류학회지

The facial artery (FA) and superficial temporal artery (STA) from the external carotid artery and the supraorbital, supra- and infratrochlear arteries from the internal carotid artery are the superficial arteries distributing to the face. It was broadly known that the FA winds on the antegonial notch, ascends superomedially and finally reaches to the medial canthus area as forming the angular artery (AA). However many previous studies reported that the AA was only observed in 4~68% in their studies. The superior labial artery (SLA) from the FA issues the superficial and deep septal artery proceeding superiorly toward the nasal septum. It was reported that the nasal branches were ramified from the FA, after the bifurcation of the SLA in most Korean cadavers, and it seems that the lateral nasal and dorsal nasal arteries are crucial vasculature of the external nose. The branches of the ophthalmic artery distribute the glabellar and forehead, and they form anastomoses each other or are communicated to the AA. The topography of the superficial arteries of face is very important in the reconstructive surgery and non-invasive treatment such as the botulinum neurotoxin type A or dermal filler injection.

Endovascular treatment for closed limb artery trauma: report of 12 cases / 中华普通外科杂志

ObjectiveTo explore the effect of endovascular treatment for closed limb artery trauma. MethodsFrom March 2006 to December 2011,the clinical data of 12 cases treated for closed limb artery trauma were analyzed retrospectively.Catheters sheath were placed by antegrade or retrograde puncture.Catheters was send to the proximal end of the lesion.Intraoperatively through angiography the location and extent of arterial lesions were determined.Catheter with the help of guidewire were sent through the lesion to establish treatment “ pathway,at the lesion site suitable stents were placed to repair damaged arteries. ResultsThe procedure was all successful in 12 patients,there was no mortality nor sever compalications.Postoperatively 2 cases suffered from acute renal failure,and were managed and cured by continuous veno-venous hemofiltration (CWH).Osteofascial compartment incision decompression was carried out in 3 cases due to osteofascial compartment syndrome.One case of them suffered from amputation due to sever muscle necrosis and lost of limb function.Eleven patients were followed-up for 1year.All the arteries were patent.There were no stent break,deformation or stenosis.ConclusionsEndovascular techniques for the treatment of closed limb arterial trauma is safe and effective.

To improve the understanding of risk factors of age-related macular degeneration / 中华实验眼科杂志

Age-related macular degeneration (AMD) has become a leading cause of irreversible visual loss in senior population with serious influence to their ability of living independently.Epidemiological researches have revealed various risk factors of AMD,some of which are not controllable such as age,heredity and race ;while others are modifiable such as lifestyle,eye conditions and other systemic diseases.However,the awareness of AMD risk factors is alarmingly low in public.Meanwhile,the understanding of AMD risk factors among ophthalmologists is also unsatisfactory.Therefore,the risk factors of AMD are reviewed here in order to improve the understanding of the ophthalmologists and better guide the clinical management of AMD.