ABSTRACT
@#AIM: To evaluate the clinical efficacy of heads-up 3D vision system in surgery for proliferative diabetic retinopathy with traction retinal detachment. <p>METHODS: We retrospectively reviewed 32 patients(38 eyes)of PDR complicated with local TRD(no traction retinal hole)who underwent 25G minimally invasive vitrectomy in our hospital from August 2018 to March 2019. The patients were divided into two groups according to the observation system during the operation. 19 eyes of 16 patients in the experimental group were operated with heads-up 3D vision system, and 19 eyes of 16 patients in the control group were operated with traditional microscope. The operation time, iatrogenic retinal hole and silicone oil injection were recorded in the two groups. The patients were followed up for at least 6mo to observe the best corrected visual acuity and the occurrence of postoperative complications. <p>RESULTS: In the experimental group, iatrogenic retinal hole and silicone oil injection occurred in 1 eye during operation. The retina was completely reattached after operation. One day after operation, vitreous hemorrhage occurred in 4 eyes, which was self-absorbed after 2-4wk. Intraocular hypertension occurred in 6 eyes in postoperative 2wk, which could be controlled by drug treatment. Vitreous hemorrhage occurred in 2 eyes after 6wk and the best corrected visual acuity of 6mo was more than 0.3 in 15 eyes. In the control group, iatrogenic retinal hole occurred in 4 eyes, silicone oil was injected in 5 eyes during operation. The retina was completely reattached after operation. One day after operation, vitreous hemorrhage occurred in 6 eyes, which was self-absorbed after 2-4wk. Intraocular hypertension occurred in 5 eyes in postoperative 2wk, which could be controlled by drug treatment. Vitreous hemorrhage occurred in 3 eyes after 6wk, and the best corrected visual acuity of 6mo was more than 0.3 in 14 eyes. The operation of all patients was completed successfully, and no serious complications such as endophthalmitis occurred, but the operation time of the experimental group was significantly shorter than that of the control group(37.3±4.8min <i>vs</i> 41.2±5.1min, <i>P</i>=0.020).<p>CONCLUSION:Application of heads-up 3D vision system in PDR combined with TRD vitrectomy can shorten the operation time and improve the operation efficiency.
ABSTRACT
<p><b>BACKGROUND</b>Tong-xin-luo capsule (TXL), used as a traditional Chinese herb, offeres a therapeutic potential for treatment of cardiovascular diseases. It has been shown to exert a variety of pharmacological effects, including antihypertensive effects, and is able to improve ventricular remodeling. However, the mechanisms of its action are not completely understood. The aim of this study was to evaluate the molecular mechanisms of Tong-xin-luo capsule on left ventricular remodeling in spontaneously hypertensive rats (SHR).</p><p><b>METHODS</b>Sixteen eight-week-old SHRs were randomized into an SHR group (n = 8) and a TXL group (n = 8) that were given Tong-xin-luo capsule (1.5 mg x kg(-1) x d(-1)). Eight Wistar Kyoto (WKY) rats fed with 0.9% NaCl served as the control group (WKY group). Systolic blood pressure (BP), body weight and heart rate were monitored once every two weeks. Ventricular remodeling was detected by histopathological examination. Nuclear factor kappa B P65 (NF-kappaB P65) and peroxisome proliferators activated receptor gamma (PPAR-gamma) protein and phosphorylated inhibitor kappa alpha (IkappaBalpha) protein were detected by immunohistochemistry and western blot respectively. The physical interaction of the P65-P50 heterodimer with IkappaBalpha and NF-kappaB were measured by co-immunoprecipitation. PPAR-gamma mRNA, collagen I mRNA and collagen III mRNA were measured by real-time PCR.</p><p><b>RESULTS</b>TXL inhibited NF-kappaB P65 expression and ventricular remodeling and suppressed the activation of NF-kappaB compared with the SHR group (P < 0.01, P < 0.05). TXL reduced IkappaBalpha phosphorylation, increased expression of PPAR-gamma protein and enhanced the physical interaction of the P65-P50 heterodimer with IkappaBalpha. The mRNA expression of PPAR-gamma was enhanced but the mRNA expression of collagen I mRNA and collagen I mRNA were suppressed by TXL.</p><p><b>CONCLUSIONS</b>In spontaneously hypertensive rats, TXL could inhibit ventricular remodeling induced by hypertension, and the inhibitory effect might be associated with the process of TXL increasing the expression of PPAR-gamma that could result in the inhibition of the activation of NF-kappaB.</p>