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@#AIM: To analyze the effectiveness and influencing factors of phacoemulsification combined with intraocular lens(IOL)implantation in the treatment of primary angle-closure glaucoma(PACG). <p>METHODS: Clinical data of 75 patients(75 eyes)with PACG who received phacoemulsification and IOL implantation in our hospital from January 2017 to December 2018 were retrospectively analyzed. Postoperative intraocular pressure(IOP), best-corrected visual acuity(BCVA), changes of anterior segment and incidence of complications were counted. The patients were grouped by efficacy, and multivariate Logistic regression analysis was performed to analyze the risk factors influencing the effectiveness of phacoemulsification and IOL implantation in patients with PACG. <p>RESULTS: Postoperative IOP of patients with PACG was decreased while BCVA was increased, and there were statistically significant differences compared with those before operation(<i>P</i><0.05). Central anterior chamber depth(ACD), angle opening distance(AOD500), trabecular iris angle(TIA500)and angle recess area(ARA)were increased significantly compared with those before operation(<i>P</i><0.05). Multivariate Logistic regression analysis showed that chronic PACG and preoperative IOP were independent risk factors for efficacy of phacoemulsification and IOL implantation in patients with PACG(<i>P</i><0.05). <p>CONCLUSION: Phacoemulsification combined with IOL implantation has good efficacy and safety in the treatment of PACG. However, it is necessary to pay attention to preoperative IOP control. What's more, it should be carefully considered whether this operation is necessary for patients with chronic PACG.
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@#AIM: To explore the effect of phacoemulsification and intraocular lens implantation on corneal endothelial cells(CECs)in patients with glaucoma and cataract. <p>METHODS: The clinical data of 107 patients(113 affected eyes)with glaucoma and cataract who were treated in the hospital during the period from October 2016 to October 2018 were retrospectively analyzed. Patients treated with trabeculectomy or phacoemulsification combined with intraocular lens implantation were included in the control group(<i>n</i>=52, 54 affected eyes)and the study group(<i>n</i>=55, 59 affected eyes). The changes in visual acuity, anterior chamber depth and intraocular pressure before and after surgery, CECs related indexes and incidence of postoperative complications were compared between the two groups. <p>RESULTS: There was no significant difference in visual acuity between the two groups before surgery(<i>P</i>>0.05). The visual acuity of both groups were significantly improved after surgery(<i>P</i><0.05), and the improvement in study group was better than that in control group(<i>P</i><0.05).The anterior chamber depth in both groups increased, while intraocular pressure decreased after surgery(<i>P</i><0.05). After surgery, anterior chamber depth in study group was significantly larger than that in control group(<i>P</i><0.05), but there was no significant difference in intraocular pressure between the two groups(<i>P</i>>0.05). The cell area variation coefficient, hexagonal cell ratio, average cell area and corneal center thickness in control group increased significantly, while CECs density decreased significantly after surgery(<i>P</i><0.05). However, there was no significant difference in CECs related indexes in study group before and after surgery(<i>P</i>>0.05). After surgery, changes levels of CECs related indexes in study group were significantly lower than those in control group(<i>P</i><0.05). The incidence rates of postoperative complications in study group and control group were 5.1% and 20.4%, respectively(<i>P</i><0.05).<p>CONCLUSION: The application of phacoemulsification and intraocular lens implantation in the treatment of glaucoma with cataract can improve the visual acuity and intraocular pressure of patients, maintain structural integrity of CECs, with safety.
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@#AIM: To investigate the effect of long-term application of prostaglandin analogue eye drops on conjunctival flora in glaucoma patients.<p>METHODS: Totally 69 patients(113 eyes)with glaucoma treated with latanoprostaglandin from June 2016 to June 2017 were selected, and the sensitivity of conjunctival flora and staphylococcus epidermidis to antibiotics was examined after admission, 3mo and 1a.<p>RESULTS: The number of bacterial eyes detected at admission, 3mo and 1a were 63, 66 and 67 respectively(χ<sup>2</sup>=2.496, <i>P</i>=0.287). There was no difference in the detection rates of staphylococcus epidermidis, streptococcus, staphylococcus aureus, staphylococcus hominis, staphylococcus hemolyticus and moraxella at the time of admission, 3mo and 1a(<i>P</i>>0.05). The ratio of MRSE at 3mo was higher than that at entry(χ<sup>2</sup>=3.063, <i>P</i>=0.062). The ratio of MRSE at 1a was higher than that at 3mo(χ<sup>2</sup>=38.945, 24.984, all <i>P</i><0.001). The susceptibility of staphylococcus epidermidis to levofloxacin, gatifloxacin, moxifloxacin, ceftazidime, tobramycin, cefmethime and erythromycin at 3mo was lower than that at the time of admission, but there was no difference(<i>P</i>>0.0167), while the susceptibility of staphylococcus epidermidis to chloramphenicol at 3mo was lower than that at entry(<i>P</i><0.0167). The sensitivity of staphylococcus epidermidis to levofloxacin, gatifloxacin, moxifloxacin, ceftazidime, cefmethime, tobramycin, chloramphenicol and erythromycin at 1a was lower than that at 3mo(<i>P</i><0.0167).<p>CONCLUSION: The long-term application of latanoprostaglandin will not affect the detection rate of conjunctival flora, but can increase the incidence of MRSE. Clinically, patients who need long-term application of latanoprostaglandin should be considered comprehensively to prevent the emergence of drug-resistant strains in order to prevent uncontrollable infection.
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<p><b>OBJECTIVE</b>To evaluate effects of Tongnao Huoluo acupuncture therapy (THAT) on Bcl-2 and Caspase-3 rats with acute cerebral infarction (ACI).</p><p><b>METHODS</b>Totally 264 SD rats were randomly divided into 5 groups, i.e. the THAT group (n =72), the thrombolysis group (n =72), the body acupuncture group (n =72), the ischemia control group (n =24), and the sham-operation group (n =24). Successfully modeled rats were recruited in all groups except the sham-operation group. Rats in the THAT group, the thrombolysis group, and the body acupuncture group were divided into 3 subgroups according to the disease occurrence time, i.e., < or = 1.5 h THAT group, 1.5+ -2 h THAT group, and 2+ -3 h THAT group. The neuroethological scores were assessed at 6, 24, and 72 h after treatment. The expressions of Bcl-2 and Caspase-3 were detected using immunohistochemical staining at 24 and 72 h respectively.</p><p><b>RESULTS</b>In aspect of improving scores of neurological functions: At 6 h after treatment within 2 h after the disease occurrence, the neuroethological scores were lowered more obviously in the thrombolysis group than in the THAT group (P <0.05). There was statistical difference at 24 and 72 h within 2 - 3 h after the,disease occurrence between the THAT group and the thrombolysis group (P <0.05). Compared with before treatment, there was statistical difference at 24 and 72 h within 3 h after the disease occurrence (P <0. 05, P <0.01). In aspect of lowering the expression of Caspase-3 and elevating the expression of Bcl-2: There was statistical difference in lowering the expression of Caspase-3 and elevating the expression of Bcl-2 between the THAT group and the thrombolysis group at 72 h within 2 -3 after the disease occurrence (P <0.05, P < 0.01).</p><p><b>CONCLUSION</b>THAT showed favorable effects in lowering neuroethological scores, lowering expression of Caspase-3, and elevating the expression of Bcl-2 of ACI rats.</p>
Subject(s)
Animals , Male , Rats , Acupuncture Therapy , Caspase 3 , Metabolism , Cerebral Infarction , Metabolism , Therapeutics , Proto-Oncogene Proteins c-bcl-2 , Metabolism , Rats, Sprague-DawleyABSTRACT
<p><b>OBJECTIVE</b>To evaluate the effect of Tongnao Huoluo Acupuncture (THA) therapy on acute cerebral infarction (ACI).</p><p><b>METHODS</b>Adopting multi-centered, randomized and controlled method, 397 ACI patients from 10 hospitals subjected to the study were treated according to the initiating time (IT) of disease during hospitalization: the 138 patients of stage-1 with IT < or =6 h, were randomly assigned to three groups, treated respectively with THA (Group A), thrombolysis with urokinase (Group B) and Batroxobin (Group C); the 140 patients of stage-2 with IT within 6-48 h, and 119 patients of stage-3 with IT within 48 h-14 d were randomly assigned to three groups, treated respectively with THA (Group D) body acupuncture (Group E), and conventional treatment (Group F). Therapeutic effect was evaluated by NIHSS scores estimated at the day 1, 3, 7, 14, 28 and 90 of treatment, and the Barthel Index (BI) measured at day 14, 28 and 90.</p><p><b>RESULTS</b>Effect in Group A was insignificantly different from that in Group B (P > 0.05), but was different from that in Group C significantly (P < 0.01). At day 90, the percentage of patients with high BI (HBI%, patients with BI >95%) was insignificantly different in Group A vs. B (P > 0.05), but was significantly different in Group A vs. C (P < 0.01). Comparisons between Group D, E and F showed that the therapeutic effect in Group D was equivalent to that in Group E (P < 0.05), but better than that in Group F (P < 0.01), and HBI% in Group D was superior than that in the other two groups (P < 0.01).</p><p><b>CONCLUSIONS</b>THA therapy shows favorable effects in reducing the crippling rate and improving the living capacity of ACI patients.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Acupuncture Therapy , Methods , Cerebral Infarction , Therapeutics , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of Tongnao Huoluo acupuncture (TNHLA) therapy in treating acute cerebral infarction at ultra-early stage (within 6 hrs after attack) or acute stage (within 6-48 hrs after attack).</p><p><b>METHODS</b>The effect of TNHLA in the two stages was observed separately (treated group) and compared with the effect treated with immediate thrombolysis by intravenously given urokinase 12 million units in ultra-early stage or simple body acupuncture in acute stage (control group), and with those treated with intravenous dripping of normal saline (placebo group). In the meantime, all groups treated with low molecular dextran injection for 14 days, cytidine diphosphate choline and entric soluble aspirin for 28 days.</p><p><b>RESULTS</b>Effect of TNHLA in the treated group was insignificantly different to that after thrombolysis of the control group in the ultra-early stage, but significantly higher than that of body acupuncture in acute stage. The intracranial hemorrhage rates in the treated, control, and placebo group were 3.3%, 4.0%, and 8.0% respectively.</p><p><b>CONCLUSION</b>TNHLA is effective and safe in treating acute cerebral infarction at ultra-early stage or acute stage.</p>