Objective To investigate the correlation of ascorbic acid distribution and retinal susceptibility to iron toxicity of the retina.Methods Autoclaved iron particles of 5 mg and 15 mg were implanted into the vitreous cavities of 32 Spragu-Dawley (SD) rats and 9 rabbits, respectively. The retinal sections of rats and rabbits were examined after hemotoxylin-eosin (HE) staining. Apoptos is of rabbits′retinal neurons was investigated by TdT-mediated dUTP-biotin nick-end labeling (TUNEL). Chinoy′s method was used to observe the distribution of as corbic acid in the retinae of the 2 kinds of animals.Results In rats, histological and structural densification was observed only in the photoreceptor cells after implantation of the iron particles. In rabbits, however, histological and structural destruction as well as TUNEL-positive nuclei were observed in all neuronal layers of the retina 3 days after the implantation of the iron particles. Silver granules reduced by ascorbic acid from silver nitrate were observed only in the outer nuclear layer in normal rats retinae, while they were observed evenly throu ghout all layers of rabbits′retinae. Conclusions The suscept ibility of retina to iron toxicity is correlated to the distribution of ascorbic acid in retina. (Chin J Ocul Fundus Dis，2003，19：269-332)
Objective A short-term observation study of ocular surgery with or without systemic chemotherapy to treat retinoblastoma (RB). Method The clinical data of 66 RB cases treated at Beijing Tongren Hospital from August 2006 to September 2007 were retrospective reviewed.All patients received ultrasound (B scan/CDI), radiology examination (CT scan/MRI) and RetCam retina examination, and classified according to the International Intraocular Retinoblastoma Classification (IIRC) method. Focal therapies (include laser and cryotherapy) were applied to Group A, systemic chemotherapy (CCTV protocol, Cyclosporine, Carboplatin, Teneposide and Vincrinstine) plus ocular surgery (include focal therapy, enucleation and orbital exenteration) to Group B, C, D and E. Patients were followedup for more than 6 months. Result Of 66 cases (36 male/30 female), 16/66 cases were bilateral RB and 50/66 were unilateral. Follow up period was from 6 to 13 months (mean time 8.6 month). According to IIRC, there were 5 eyes in Group A, 6 eyes in Group B, 5 eyes in Group C, 15 eyes in Group D and 51 eyes in Group E( include extraocular disease). 22/82 eyes were conserved at the end of follow up, including 5/5(100%) of group A, 6/6(100%) of group B, 5/5(100%) of Group C, 4/15(26.7%) of Group D and 2/51(3.9%) of Group E. 5/66 (7.6%) patients died during this period, they all were in Group E. Conclusion Ocular surgery combined with systemic chemotherapy is an effective method to treat retinoblastoma. The consequences depends on the classification with higher conservative rate of eyeballs in early and middle stage (Group A, B, C), and lower rate in late stage (Group D and E).
ObjectiveTo evaluate the efficacy of intra-arterial chemotherapy (IAC) for advanced retinoblastoma (RB) after failure of intravenous chemotherapy (IVC).
MethodsFifteen eyes of 13 patients with advanced RB were treated with IAC (1-5 cycles) after failure of IVC (2-8 cycles). The patients included 10 boys and 3 girls, with the mean age of (15.67±8.16) months. Six patients had bilateral RB and 7 patients had unilateral RB. There were 14 eyes (93.33%) in stage D, 1 eye (6.67%) in stage E according to the International Classification of intraocular retinoblastoma. The main reasons for failure of IVC were recurrent primary tumor in 3 eyes (20.00%), subretinal seeds recurrence in 9 eyes (60.00%), viable vitreous seeds in 2 eyes (13.33%) and poor response of primary tumor in 1 eye (6.67%). The mean interval between IVC completion and IAC start was 3 months. The mean follow-up was 19 months (ranged from 3 to 52 months).
ResultsAfter IVC and secondary IAC, the retinoblastoma and seeds were regressed in 12 eyes (80.00%). Three eyes required enucleation for severe vitreous seeds, subretinal seeds recurrence and primary tumor recurrence. There was no evidence of metastasis in any case.
ConclusionIAC can achieve high global salvage rate (80.00%) for patients with advanced retinoblastoma after failure of IVC.
Medical ethics must be considered for protecting the fights and interests of patients in clinical trials. Now the fights of the subjects are more and more emphasised, but there are some problems. It is evidence-based medicine (EBM) and emphasis of evidence that need the high-quality clinical trials, yet it violates the principle of ethics in some degree. It will be helpful for the administrators to supervise the clinical trials on drugs well from the point of ethical views.
To observe the pathologic changes of normal tissue in nude mice after peritoneal perfusion with hyperthermia, hyper-osmolar solution and mitomycin C (MMC). Fifty BALB/c nunu mices (7-10 weeks old) bearing HT-2 lines were chosen for the study, and were randomly divided into five groups: isotonic solution (control group), hyperosmolar solution (HOS group), HOS plus MMC group, hyperthermia (HT group) and HOS plus HT plus MMC group. After continuous hyperthermic peritoneal perfusion (42℃/30min) with 7.5% NaCl and 5μg/ml MMC, the liver, spleen, small intestine and kidney were examined by light microscopy. Results: ①In HOS and HOS plus MMC groups, no changes of liver, spleen and kidney were found. ②In HT and HOS plus HT plus MMC groups, slight degeneration of liver, hyperemia of spleen, swelling of kidney tubule cells and small intestine were found. ③In HOS plus HT plus MMC group, partial loss of small intestinal villi were also observed. Conclusioin: After continuous hyperthermic perfusion conbined with hyper-osmolar solutions and mitomycin C, a slight injury was showed in normal tissue of nude mice.
Objective
To observe the clinical effect of intravenous thrombolytic therapy for central retinal artery occlusion (CRAO) with poor effect after the treatment of arterial thrombolytic therapy.
Methods
Twenty-four CRAO patients (24 eyes) with poor effect after the treatment of arterial thrombolytic therapy were enrolled in this study. There were 11 males and 13 females. The age was ranged from 35 to 80 years, with the mean age of (56.7±15.6) years. There were 11 right eyes and 13 left eyes. The visual acuity was tested by standard visual acuity chart. The arm-retinal circulation time (A-Rct) and the filling time of retinal artery and its branches (FT) were detected by fluorescein fundus angiography (FFA). The visual acuity was ranged from light sensation to 0.5, with the average of 0.04±0.012. The A-Rct was ranged from 18.0 s to 35.0 s, with the mean of (29.7±5.8) s. The FT was ranged from 4.0 s to 16.0 s, with the mean of (12.9±2.3) s. All patients were treated with urokinase intravenous thrombolytic therapy. The dosage of urokinase was 3000 U/kg, 2 times/d, adding 250 ml of 0.9% sodium chloride intravenous drip, 2 times between 8 - 10 h, and continuous treatment of FFA after 5 days. Comparative analysis was performed on the visual acuity of the patients before and after treatment, and the changes of A-Rct and FT.
Results
After intravenous thrombolytic therapy, the A-Rct was ranged from 16.0 s to 34.0 s, with the mean of (22.4±5.5) s. Among 24 eyes, the A-Rct was 27.0 - 34.0 s in 4 eyes (16.67%), 18.0 - 26.0 s in 11 eyes (45.83%); 16.0 - 17.0 s in 9 eyes (37.50%). The FT was ranged from 2.4 s to 16.0 s, with the mean of (7.4±2.6) s. Compared with before intravenous thrombolytic therapy, the A-Rct was shortened by 7.3 s and the FT was shortened by 5.5 s with the significant differences (χ2=24.6, 24.9; P＜0.01). After intravenous thrombolytic therapy, the visual acuity was ranged from light sensation to 0.6, with the average of 0.08±0.011. There were 1 eye with vision of light perception (4.17%), 8 eyes with hand movement/20 cm (33.33%), 11 eyes with 0.02 - 0.05 (45.83%), 2 eyes with 0.1 - 0.2 (8.33%), 1 eye with 0.5 (4.17%) and 1 eye with 0.6 (4.17%). The visual acuity was improved in 19 eyes (79.17%). The difference of visual acuity before and after intravenous thrombolytic therapy was significant (χ2=7.99, P＜0.05). There was no local and systemic adverse effects during and after treatment.
Conclusion
Intravenous thrombolytic therapy for CRAO with poor effect after the treatment of arterial thrombolytic therapy can further improve the circulation of retinal artery and visual acuity.
Objective
To investigate the effects of advanced glycation endproducts (AGEs) on proliferation of pericytes of bovine retinal capillary vessels and expression of transforming growth factor beta;(TGF-beta;).
Methods
The proliferation of pericytes detected by methyl thiazolyl tetrazolium (MTT) colorimetric assay, cellular cycle of pericytes was analyzed by flow cytometry was used to analyze cell, and TGF-beta; protein expression of pericytes was observed by immunofluorescent staining.
Results
AGEs inhibited the proliferation of pericytes of bovine retinal capillary vessels, stopped the cellular cycle of pericytes in synthesis phase (S phase), increased the number of apoptotic cells obviously (Plt;0.01), and promoted the expression of TGF-beta; proteinof perycytes.
Conclusions
AGEs may promote the apoptosis of pericytes by inhibiting the proliferation of pericytes to lead the decrease of pericytes number, and may accelerate diabetic retinopathy by promoting the expression of TGF-beta; protein of pericytes.
(Chin J Ocul Fundus Dis, 2006, 22: 20-23)
ObjectiveTo evaluate the effect of airway management drugs on the respiratory function and postoperative recovery of patients who had moderate or severe chronic obstructive pulmonary diseases(COPD) undergoing an open chest surgery.
MethodThere were a total of 22 patients suffering from both lung cancer, esophageal cancer or gastroesophageal junction carcinoma and moderate to severe COPD(of which there were 16 males and 6 females; accepting traditional operation 5 cases and minimally-invasive operation 17 cases; lung cancer 16 cases, esophageal cancer 4 cases and gastroesophageal junction carcinoma 2 cases as the observation group). To statistic the respiratory function and arterial blood gas analysis before and after treating with airway management drugs. And compare the postoperative pulmonary complications(PPCs) and hospital-stay with 50 patients who have no COPD(of which there were 34 males and 16 females; accepting traditional operation 17 cases and minimally-invasive operation 33 cases; lung cancer 35 cases, esophageal cancer 11 cases and gastroesophageal junction carcinoma 4 cases as the control group).
ResultThere was a statistical difference of forced expiratory volume in one second(FEV1), forced vital capacity(FVC) and maximal voluntary ventilation(MVV) after the above treatment by 7 to 10 days and comparing with prior treatment(P<0.05). Partial pressure of oxygen(PaO2) increased with no statistical difference(P>0.05) while PaCO2 decreased with a statistical difference(P<0.05）. Comparing with patients without COPD, the incidences of PPCs and postoperative hospital stay were of no statistical difference(P>0.05).
ConclusionPatients with moderate or severe COPD with airway management drugs(antibiotics,glucocorticoids, bronchodilators and phlegm dissolving agent) in perioperative period could improve the respiratory function and operation tolerance effectively, reduce the incidence of PPCs and shorten postoperative hospital stay.
ObjectiveTo systematically review the efficacy and safety of new anti-epileptic drugs in the treatment of epilepsy. MethodsPubMed, EMbase, The Cochrane Library, CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) of new anti-epileptic drugs rufinamide, zonisamide, and perampanel in the treatment of epilepsy from January 2006 to May 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, meta-analysis was performed by using RevMan 5.3 and Stata 16.0 software. ResultsA total of 16 RCTs involving 4 382 patients were included. The results of meta-analysis showed that the effective rate (RR=1.66, 95%CI 1.45 to 1.89, P<0.000 01) and seizure-free rate (RR=2.82, 95%CI 2.01 to 3.96, P<0.000 01) in new anti-epileptic drugs group were higher than those in the control group, while it did not increase the serious adverse events (RR=0.95, 95%CI 0.72 to 1.27, P=0.75). ConclusionCurrent evidence shows that new anti-epileptic drugs have trends of better effectiveness, and their safety is satisfactory. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusion.
