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@#AIM: To quantitatively analyze the microcircular and structural changes of the macular and peripapillary area in patients with diabetic kidney disease(DKD), exploring non-invasive effective monitoring indexes that can predict the occurrence and development of diabetic kidney disease used optical coherence tomography angiography(OCTA).<p>METHODS: A cross-sectional study. The diabetic patients(52 cases)and healthy subjects(20 cases)who came to Shanxi Provincial People's Hospital from January 2020 to January 2021 were collected, and the diabetes mellitus(DM)patients were further divided into DKD group(23 cases)(complicated with diabetic kidney disease)and non-DKD group(29 cases)(not complicated with diabetic kidney disease). All patients underwent slit-lamp microscopy, best corrected visual acuity(BCVA), OCTA and fundus color photography. OCTA was used to scan the macula and peripapillary area of all participants, measuring the shallow and deep blood flow density, the area and circumference of the fovea(FAZ), vascular density in the 300μm area around FAZ(FD300), retinal thickness, peripapillary-VD, retinal nerve fiber layer(RNFL)thickness, and ganglion cell complex(GCC)thickness. The correlation between the changes of these parameters in OCTA, DR staging and DKD staging was analyzed. <p>RESULTS: Parafoveal SCP-VD, perifoveal DCP-VD, peripapillary-VD, and FD300 showed a decreasing trend among the healthy group, non-DKD group, and DKD group(<i>P</i><0.05). The foveal DCP-VD was decreased only in the DKD group(<i>P</i><0.05), and there was no significant difference in the SCP-VD of fovea among the three groups(<i>P></i>0.05). FAZ area and GCC thickness were gradually increased among healthy group, non-DKD group and DKD group(<i>P</i><0.05). DR staging was positively correlated with DKD staging(<i>rs</i>=0.648, <i>P</i><0.05). Parafoveal SCP-VD, parafoveal DCP-VD, and perifoveal DCP-VD were negatively correlated with DKD staging(<i>rs</i>= -0.535, <i>P</i>=0.009; <i>rs</i>= -0.712, <i>P</i><0.001; <i>rs</i>= -0.641, <i>P</i>=0.001). Compared with non-DKD group, DKD group had higher SBP, lower eGFR, and higher UACR(<i>P</i><0.05). <p>CONCLUSION: OCTA can detect retinal microcirculation and structural changes in patients with DKD, including decreased vessel density in the macular and peripapillary area, increased FAZ area and GCC thickness. More importantly, we found that retinal vessel density decreased with renal function impairment, suggesting that retinal vessel density may be a noninvasive and effective predictor in the severity of DKD.
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@#Diabetic retinopathy and diabetic nephropathy are the two most common and serious microvascular complications in diabetic patients, and they are the main causes of blindness and end-stage renal disease. Retinal blood vessels are the common damage targets of early diabetes and the only living blood vessels in the human vascular system that can be directly observed in naked eye. The changes in their morphological structure or function directly or indirectly reflect the microvascular lesions caused by diabetes. Especially, in recent years, the development of optical coherence tomography angiography(OCTA), a new and non-invasive technology, has made its breakthroughs in angiography resolution, vascular depth and vascular morphology, and it can provide objective quantitative data. It has certain application value in diabetic microangiopathy. Therefore, the purpose of this paper is to review OCTA and its application in diabetic microangiopathy.
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OBJECTIVE@#To observe the efficacy difference between -needle radiofrequency guided by meridians-muscles theory and oral administration of medication for knee osteoarthritis (KOA).@*METHODS@#One hundred patients with KOA were randomly divided into an acupuncture group and a medication group, 50 cases in each one. The patients in the acupuncture group were treated with -needle radiofrequency guided by meridians-muscles theory at tendon nodes around knee joints ( points), 4 points per treatment, once every two weeks and two treatments were given. The patients in the medication group were treated with oral administration of celecoxib capsules, 1 capsule every day for 4 weeks. The visual analogue scale (VAS) and Western Ontario and McMaster Universities (WOMAC) in the two groups were observed before treatment, after treatment and during 4-week follow-up visit. The clinical efficacy was evaluated.@*RESULTS@#Compared before treatment, the VAS was reduced in the two groups after treatment and during 4-week follow-up visit (all <0.05), and the VAS score in the acupuncture group was lower than that in the medication group (both <0.05). Compared before treatment, the pain score, stiffness score, activity function score and total score of WOMAC were reduced in the two groups after treatment and during 4-week follow-up visit (all <0.05), and the scores in the acupuncture group were lower than those in the medication group (all <0.05). After treatment, the total effective rate was 80.0% (40/50) in the acupuncture group, which was superior to 56.0% (28/50) in the medication group (<0.05). During 4-week follow-up visit, the total effective rate was 76.0% (38/50) in the acupuncture group, which was superior to 40.0% (20/50) in the medication group (<0.05).@*CONCLUSION@#The efficacy of -needle radiofrequency guided by meridians-muscles theory is superior to oral administration of celecoxib capsules for KOA, which could relieve joint pain and stiffness, improve joint mobility, and has long effective duration.
Subject(s)
Humans , Acupuncture Points , Acupuncture Therapy , Knee Joint , Meridians , Needles , Osteoarthritis, Knee , Therapeutics , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To assess the efficacy of tendons of minimally invasive therapy (TMIT) combined drug therapy by comparing it with treatment by drug therapy alone on patients with knee osteoarthritis (KOA).</p><p><b>METHODS</b>Totally 60 KOA patients were assigned to the treatment group and the control group according to random digit table, 30 in each group. Patients in the control group took Hydrochloric Acid Glucosamine Capsule and Celecoxib Capsule. Patients in the treatment group additionally received TMIT. The treatment course for all was 4 weeks. Scores for visual analogue scale (VAS) and the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index were observed and recorded at week 1 and 4 after treatment by acupotomology mirror.</p><p><b>RESULTS</b>Compared with before treatment, improvement was shown in VAS score, pain and stiffness degrees, activities and functions, and WOMAC scores at week 1 and 4 after treatment in all patients with statistical difference (P < 0.05). Besides, better effect was shown in the treatment group (P < 0.05).</p><p><b>CONCLUSIONS</b>TMIT combined drug therapy could relieve KOA patients' pain, stiffness and joint activities, elevate the overall efficacy. TMIT was easily operated with less injury.</p>
Subject(s)
Humans , Celecoxib , Drug Therapy, Combination , Methods , Knee Joint , Osteoarthritis, Knee , Drug Therapy , Pain , Pain Measurement , Tendons , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of Bushen Zhuanggu Granule (BZG) on the gonadal hormone, blood lipids, serum level of nitric oxide (NO) and free oxygen radical (FOR) in climacteric women.</p><p><b>METHODS</b>Climacteric women were randomized according the digital table into the CM group (188 cases) and the WM group (189 cases). They were treated by BZG and Premarin plus Depogeston respectively for 2 years. The therapeutic effect on patients' symptoms and changes of blood lipids, gonadal hormones, NO, superoxide dismutase (SOD) and malonaldehyde (MDA) were observed.</p><p><b>RESULTS</b>There were 53 women in the CM group and 96 in the WM group dropping out in the 2-year follow-up period, the difference between them was significant (P < 0.01). The obvious and effective rates in the CM group were 36.30% (49/135), 82.96% (112/135), and in WM were 30.11% (28/93), 73.12% (68/93), the difference between the two group was significant (P < 0.05). The score of complaint was significantly lower in both groups (P < 0.05, P < 0.01), and the effect was more obvious in the CM group (P < 0.01). Effects on gonadal hormones and blood lipids were significantly improved in both groups after treatment (P < 0.05); comparison between groups showed the superiority of WM in increasing estrogen (P < 0.05), Blood levels of NO and SOD increased and MDA decreased in both groups after 1- and 2-year treatment (P < 0.05 or P < 0.01), showing no significant inter-group difference (P > 0.05). No evident adverse reaction was found in the routine tests on blood, urine and stool, hepatic and renal functions and electrocardiogram examined once every 6 months.</p><p><b>CONCLUSION</b>BZG can effectively restore the disordered indices of gonadal hormones, blood lipids, NO, and SOD in climacteric women, with the efficacy equivalent to the effect of hormone replacement therapy, but it is more safe and inexpensive.</p>