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AIM:To systematically evaluate the efficacy and safety of intravitreal ranibizumab combined with compound trabeculectomy and panretinal photocoagulation(PRP)compared with compound trabeculectomy combined with PRP in the treatment of neovascular glaucoma(NVG).METHODS: Databases including Wanfang database, China National Knowledge Infrastructure(CNKI), PubMed, EMbase, China Biomedical Document Service System(CBM), Clinicalkey, and Cochrane Library were retrieved. Literatures about intravitreal ranibizumab combined with compound trabeculectomy and PRP in the treatment of NVG in the experimental group and compound trabeculectomy and PRP in the treatment of NVG in the control group from creation of database to July 20, 2022 were searched. At the same time, relevant reference were consulted. The best corrected visual acuity, intraocular pressure, occurrence of complications and the success rate of the surgery were systematically evaluated.RESULTS: A total of 8 clinical studies were included, with 864 patients(864 eyes)with NVG. Meta-analysis showed that the intraocular pressure of patients in the experimental group was lower than that in the control group at 1wk, 1 and 3mo after surgery(1wk: MD=-4.00, 95%CI: -4.62～-3.38, P<0.05; 1mo: MD=-4.11, 95%CI: -4.66～-3.56, P<0.05; 3mo: MD=-4.58, 95%CI: -5.61～-3.55, P<0.05). The best corrected visual acuity of the experimental group was better than that of the control group at 1mo after surgery(MD=0.17, 95%CI: 0.11～0.23, P<0.05), but there was no significant difference at 1wk after surgery(MD=0.08, 95%CI: -0.13～0.29, P=0.47). The patients in the experimental group had fewer complications(OR=0.30, 95%CI: 0.18～0.52, P<0.05)and higher surgical success rate(OR=5.15, 95%CI: 2.78～9.53, P<0.05).CONCLUSION:With decreased intraocular pressure, improved visual acuity and surgical success rate, intravitreal ranibizumab combined with compound trabeculectomy and PRP was better than the compound trabeculectomy and PRP in the treatment of NVG.
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Objective To investigate the effects of overexpression of nuclear factor E2 related factor 2 (Nrf2) protein on placental oxidative stress and fetal cardiac function in pregnant mice with gestational diabetes mellitus. Methods Thirty-six pregnant mice were randomly divided into four groups: control group, model group, pcDNA group and Nrf2 group. Pregnant mouse model of gestational diabetes was establish by intraperitoneal injection of streptozotocin (STZ); mice in each group were transfected with corresponding adenovirus or saline. RT-PCR and Western blotting were performed to detect the expression levels of Nrf2 mRNA and protein in the placenta of pregnant mice. Fasting blood glucose was measured, uterine index, total number of fetuses and abortion rate were calculated. The placental superoxide dismutase (SOD) activity, contents of reduced glutathione (GSH) and malondialdehyde (MDA) in pregnant mice were detected. HE staining was used to observe the pathological changes of liver and kidney tissue of pregnant mice. The protein expression level of Nrf2 in the heart tissue of offspring mice was detected by Western blotting. The heart rate (HR), left ventricular systolic pressure (LVSP), left ventricular ejection fraction (LVEF) and shortening fraction (FS) of offspring mice were measured; ELISA was performed to detect the serum contents of creatine kinase isoenzyme (CK-MB), cardiac troponin I (cTnI) and myoglobin (MB) of offspring mice. HE staining was used to observe the pathological changes of myocardium in offspring mice. Results Compared with the control group, the Nrf2 mRNA level, Nrf2 protein expression level, SOD activity and GSH content, as well as the HR, LVSP, LVEF and FS of the offspring mice were obviously reduced in model group and pcDNA group (P<0.05); the fasting blood glucose, abortion rate and MDA content in pregnant mice, as well as the contents of CK-MB, MB and cTnI in offspring mice increased, while the uterine index and total fetal number decreased significantly (P<0.05); while the above indicators showed no significant difference in Nrf2 group. Compared with the model group, the Nrf2 mRNA level and protein expression level, SOD activity, GSH content, as well as the HR, LVSP, LVEF and FS of offspring increased significantly in Nrf2 group; the fasting blood glucose, abortion rate and MDA content in pregnant mice, as well as the contents of CK-MB, MB and cTnI in offspring mice decreased, while the uterine index and total fetal number increased significantly (P<0.05); while the above indicators showed no significant difference in pcDNA group. In addition, HE staining results showed that Nrf2 overexpression reduced the pathological damage of liver and kidney tissues of diabetic pregnant mice and the myocardial damage of the offspring mice. Conclusion Over-expression of Nrf2 protein can alleviate placental oxidative stress in gestational diabetic pregnant mice and maintain the cardiac function of the offspring mice.
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<p><b>Background</b>Obesity induces dyslipidemia, hypertension, glucose intolerance, and inflammatory state, which results in atherogenic processes, diabetes, and cardiovascular disease. We usually use body composition indices, such as body mass index (BMI), body fat percentage (BFP), waist circumference-height ratio (WHtR), and waist-hip ratio (WHR) to reflect the obesity. The aim of this large population-based cross-sectional study was to investigate the associations between body composition indices and metabolic parameters in Chinese adults.</p><p><b>Methods</b>A total of 12,018 Chinese adults were included. Body composition indices, such as BMI, BFP, WHtR, and WHR, and metabolic parameters, such as systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triglyceride (TG), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), fasting blood glucose (FBG), 2 h postprandial blood glucose (2h PBG), glycosylated hemoglobin (HbA1c), fasting insulin (FINS), insulin resistance index (HOMA-IR), high-sensitivity C-reactive protein (hs-CRP), and white blood cell count (WBC), were measured and analyzed. All analyses were stratified by gender.</p><p><b>Results</b>All body composition indices and metabolic parameters except 2h PBG differed significantly between males and females (all P < 0.001). BMI was positively associated with SBP, DBP, LDL-C, TC, TG, FBG, 2h PBG, HbA1c, FINS, HOMA-IR, hs-CRP, and WBC, and inversely associated with HDL-C; similar relationships were identified between the metabolic parameters and BFP, WHtR, and WHR. In the multivariate analysis, the odds of impaired glucose regulation, dyslipidemia, insulin resistance, and increased hs-CRP were 1.36, 1.92, 3.44, and 1.27 times greater in the overweight group than those in the normal weight group, respectively, and 1.66, 3.26, 7.53, and 1.70 times greater in the obese group than those in the normal weight group, respectively. The odds of dyslipidemia and hs-CRP were 1.29 and 1.38 times greater in the BFP ≥28.0% group than in the BFP <28.0% group, respectively. The odds of dyslipidemia, HOMA-IR, and hs-CRP were 1.55, 1.26, and 1.48 times greater in the WHtR ≥0.96 group than in the WHtR <0.96 group, respectively. Among males, the odds of HOMA-IR were 1.46 times greater in the WHR ≥0.54 group than in the WHR <0.54 group. Similar results were observed in females.</p><p><b>Conclusions</b>This study identified positive associations between all evaluated body composition indices and metabolic parameters in Chinese adults. Among the body composition indices, BMI predicted four of the five evaluated metabolic disorders in both gender groups.</p>
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<p><b>BACKGROUND</b>Patient characteristics may be an internal factor influencing patient complaints, but in China patient characterization is restricted to patient satisfaction surveys, and few studies have considered the relationship between patient characteristics and patient complaints. The aim of this research was to determine the reasons for complaints.</p><p><b>METHODS</b>In this study, we analyzed the characteristics of hospitalized patients and explored their relationship with medical complaints.</p><p><b>RESULTS</b>The significant factors were age (P = 0.045), hospital cost (P = 0.003), household nature (P < 0.001), and education (P < 0.001). The complaint rate decreased when the patients' age increased (regression coefficient, -0.606; OR, 0.545, and 95%CI, 0.301 - 0.987). The complaint rate increased with an increase in hospital cost (regression coefficient, 0.818; OR, 2.266; and 95%CI, 1.320 - 3.889). Patients from non-agricultural households had a higher complaint rate (regression coefficient, 1.051; OR, 2.861; and 95%CI, 1.611 - 5.082). Patients with higher education levels had lower complaint rates (regression coefficient, -0.944; OR, 0.389; and 95%CI, 0.234 - 0.647).</p><p><b>CONCLUSION</b>The survey confirms that older patients and patients with higher education levels had lower complaint rates, while non-agricultural population and patients with higher hospital expenses had higher complaint rates.</p>