Different doses of verteporfin photodynamic therapy for central exudative chorioretinopathy / 中华实验眼科杂志

Background The dosage of verteporfin photodynamic therapy (PDT) for central exudative chorioretinopathy(CEC) depends on the calculation formula of Treatment of Age-related Macular Degeneration with Photodynamic Therapy Study Group(TAP)and Verteporfin in Photodynamic Therapy Study Group(VIP).Some local adverse responses or normal tissue damage have been noted under the standard dose of verteporfin during the treatment of CEC.So it is necessary to explore an appropriate therapeutic dosage of verteporfin.Objective This clinical study aimed to observe and compare the clinical efficacy and safety of different doses of verteporfin PDT for CEC.Methods Ninety eyes of 90 patients with CEC were enrolled in this study with the approval of the Ethic Commission of Affiliated Second Hospital of Nanchang University.Written informed consent was obtained before PDT.The patients were randomly divided into standard dose group,half dose group and 1/3 dose group.All of the patients received PDT.Standard dose(6 mg/m2),3 mg/m2 or 2 mg/m2 of verteporfin was applied in the three groups respectively,with the laser intensity 50 J/cm2.The patients were followed-up for 3 months.Repeat treating regimen was performed in the same way in the patient with fundus fluorescein leakage after initial PDT.Results The BCVA(logMAR) value was 0.44±0.36 after PDT in the standard dose group.Visual acuity improved in 20 patients (66.67％),stabilized in 8 patients(26.67％)and decreased in 2 patients (6.67％).The BCVA showed a significant difference between the preoperative and postoperative BCVA (t =6.719,P =0.000).CNV disappeared in 19 patients (63.33％),obviously improved in 7 patients (23.33％),partially disappeared in 3 patients (10.00％) and unchanged in 1 patient (3.33％).The central fovea thickness (CFT)value was significantly declined in postoperation compared with preoperation (t =5.758,P =0.000).Eight patients received secondary PDT with the recurrence rate 26.67％.In the half dose group,visual acuity improved in 18 patients(60.00％),stabilized in 11 patients(36.67％)and decreased in 1 patient (3.33％).CNV disappeared in 16 patients (53.33％),obviously improved in 8 patients (26.67％),partially disappeared in 5 patients (16.67％) and unchanged in 1 patient (3.33 ％).Significant difference was seen between the preoperative BCVA and postoperative BCVA(t=8.294,P =0.000).The decrease of C FT was significant in postoperation(t =8.493,P =0.000).Ten patients received secondary treatment with the recurrence rate 33.33％.In 1/3 dose group,visual acuity improved in 8 patients (26.67 ％),stabilized in 12 patients (40.00％),decreased in 10 patient (33.3％).CNV disappeared in 8 patients (26.67％),obviously improved in 8 patients (26.67％),partially disappeared in 6 patients (20.00％) and unchanged in 8 patient (26.67％).There was no significant difference between the preoperative BCVA and postoperative BCVA (t =0.536,P =0.596).The difference between preoperative CFT and postoperative CFT was insignificant(t =0.942,P=0.354).Fourteen patients received secondary PDT and 8 patients received three times with the recurrence rate 73.33％.Conclusions 3 mg/m2 verteporfin PDT for CEC shows a similar clinical efficiency and safety to 6 mg/m2 verteporfin.3 mg/m2 verteporfin PDT can decrease cost,but the effect of 2 mg/m2verteporfin PDT is not satisfacted.

The treatment of central exudative chorioretinopathy / 中华实验眼科杂志

Central exudative chorioretinopathy( CEC),also known as idiopathic choroidal neovascularization (ICN),was more common in middle-aged,appearing the isolated macular choroidal neovascularization lesions ( CNV ).CNV can cause macular hemorrhage,exudativeing and scarring and therefore affect the patient' s central vision.The etiology of CEC is below understanding,and the treatment aimed at CNV.The clinical management of CEC include photodynamic therapy ( PDT),the administration of antibody of vascular epithelial growth factor ( VEGF ),adrenal glucocorticoid drug,combined therapy,transpupillary thermotherapy (TTT),laser photocoagulation,ratiotherapy,surgery,Chinese traditional medicine and gene therapy.The various treating approaches and their mechanisms were reviewed.

Preparation of anti-salbutamol antibody based on a new designed immunogen and development of a heterologous indirect ELISA for detection of salbutamol residue / 药学学报

To synthesize salbutamol immunogen and develop an enzyme immunoassay (ELISA), a new salbutamol immunogen was synthesized using 4-aminobenzoic acid as a linker to connect hapten with carrier protein. An enzyme immunoassay based on the antibody prepared was developed and applied to detect salbutamol residue spiked in swine liver. An unusual coating antigen, clenbuterol-ovalbumin (OVA) conjugate instead of salbutamol-OVA conjugate, was used in the immunoassay and the results were discussed based on the structures of related compounds. The antibodies showed high sensitivity in the heterologous assay when using clenbuterol-OVA as a coating antigen, with an IC50 value of 8.97 ng mL(-1) toward salbutamol. The antibodies prepared showed high cross-reactivity with clenbuterol (107%) and were promising for the simultaneous determination of salbutamol and clenbuterol residues in food and food products. Recovery rates from the salbutamol-spiked swine liver samples were in the range of 70%-99%, while the intra-assay and inter-assay coefficients of variation were <13.3% and <14.3%, respectively. In summary, the antibodies of salbutamol have been successfully prepared. Sensitive and stable analysis for the detection of salbutamol residues in swine liver was obtained based on the competitive ELISA methods developed in this study.

Cigarette smoking and primary liver cancer risk: a nested case-control study in Shanghai / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the association between cigarette smoking and risk of primary liver cancer (PLC) among middle-aged and elderly men in urban Shanghai.</p><p><b>METHODS</b>A nested case-control study was conducted based on a cohort of 18,244 men who were 45-64 years of age in 1986-1989 and had no history of cancer at recruitment in Shanghai. As of 31 Dec 2000, a total of 213 incident cases of PLC were identified. 1094 matched controls were randomly selected among the cohort subjects who were free of cancer and alive at the time of cancer diagnosis of the index case. The matching criteria were date of birth (within 2 years), date of biospsy specimen collection (within 1 month), and neighborhood of residence at recruitment. Conditional logistic regression models were used to estimate adjusted odds ratios (ORs) and their corresponding 95% confidence intervals (CIs).</p><p><b>RESULTS</b>After controlling for potential confounders, cigarette smoking (ever vs. never) was associated with risk of PLC (OR = 1.91; 95% CI: 1.28-2.86). Risk of PLC increased with increasing number of cigarettes smoked per day, as well as duration of cigarette smoking, pack-years of cigarettes consumed over lifetime and earlier age started smoking. The ORs were 2.16 (95% CI = 1.37-3.40), 2.14 (95% CI = 1.18-3.87), 2.12 (95% CI = 1.21-3.74) and 2.57 (95% CI = 1.50-4.40) for men who smoked 20 cigarettes or more daily, smoked for 40 or more years, consumed more than 37 pack-years of cigarettes, and began smoking before 20 years of age, respectively.</p><p><b>CONCLUSION</b>This study confirms that cigarette smoking is an independent risk factor for primary liver cancer among males in Shanghai.</p>

Comparison of two criteria for evaluating severity of community-acquired pneumonia in China / 中华全科医师杂志

Objectives To understand current status of the admission and treatment for the patients with community-acquired pneumonia (CAP) in central hospitals of Shanghai area,and to evaluate the severity of patients admitted to the hospital with CAP by the criteria set in the Guidelines for Diagnosis and Treatment for CAP developed by the Chinese Medical Association in 2006 and provide evidence for its popularization and application throughout the country.Methods Medical records of 137 patients with CAP admitted to the hospital from January 1,2005 to September 30,2006 were retrospectively studied and analyzed with SPSS 10.0 software.Chi-square test and ANOVA were used to evaluate the severity of the patients with CAP by the criteria set in the Guidelines and to correlate it with pneumonia severity index (PSI).Statistical analysis was performed for the difference between length of hospitalization,cost,length of intravenous use of antibiotics,the number of risk factors,and fatality during hospitalization between three groups of patients categorized based on the severity criteria in the Guidelines.Results There existed a good relationship between the criteria for severity of CAP by the Guidelines and PSI,with a Pearson's coefficient of correlation of 0.577,P

A prospective cohort study on body mass index and mortality among middle-aged and elderly men in urban Shanghai / 中华流行病学杂志

<p><b>OBJECTIVE</b>To examine the association between body mass index (BMI) and mortality as well as the effect of age on it among middle-aged and elderly men in urban area of Shanghai.</p><p><b>METHODS</b>A total of 18,244 male subjects aged 45-64 years resided in urban area of Shanghai were enrolled in the study during January 1, 1986 through September 30, 1989, and were actively followed under annual visits. 'Cox proportional hazards model' was used to estimate the relative risks (RR).</p><p><b>RESULTS</b>By the end of the follow-up process in 2002, a total number of 235,762 person-years was accumulated in the cohort, with an average of 12.9 years per subject. A total number of 3365 deaths including 1381 from cancer and 1165 from cardio- and cerebro-vascular diseases (CVD), was identified during the follow-up period. Compared with those under normal BMI (BMI 18.5-23.9), the RRs of death for all causes of death among groups at low BMI (BMI < 18.5), overweight (BMI 24-27.9) and obesity (BMI > or = 28) were 1.20, 1.12 and 1.61, respectively, among non-smokers after adjustment for age, alcohol consumption and level of education. After excluding the numbers observed during the first 5 years of follow-up, the corresponding RRs became 1.01, 1.12, and 1.75, respectively. The risk of deaths from colon cancer or CVD increased along with the increase of BMI, while the risk of non-cancer and non-CVD deaths, mostly deaths from infectious diseases, increased significantly in the group of low BMI. Among those aged > or = 55 years at baseline survey, the risk for all causes of death increased more significantly with those having obesity. However, among those who were younger than 55 years of age, no significant correlation between BMI and overall mortality was noticed.</p><p><b>CONCLUSION</b>A positive relationship between obesity and total mortality was observed in the middle-aged and elderly men in urban Shanghai. The association was more obvious among the elderly while the risk of deaths from colon cancer or CVD rose along with the increase of BMI. The risk of death from infectious disease increased significantly in the group with low BMI.</p>

Cigarette smoking and cancer mortality: a prospective cohort study in urban males in Shanghai / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the association between cigarette smoking and cancer mortality in urban men in Shanghai and its impact when smoking habit changed during the follow-up period.</p><p><b>METHODS</b>A total of 18 244 male residents aged 45 to 64 years in urban Shanghai were enrolled in the study during January 1, 1986 through September 30, 1989, and was actively followed up on annual visits. Cox proportional hazards model was used to estimate relative risks (RR).</p><p><b>RESULTS</b>By the end of follow-up program in 2002, 235 762 person-years, averaged 12.9 years per subject in the cohort was reached. 3365 deaths including 1381 cancer deaths were registered during the follow-up period. The mortality rates for cancers of lung, stomach, liver, pancreas, esophagus, head and neck etc. increased significantly among smokers. Compared with data of nonsmokers at the baseline survey, the adjusted RR was 1.49 for all-causes mortality among current smokers at the baseline survey. After excluding subjects who changed their smoking habit during the follow-up period, the RR became 1.78 compared with lifelong-nonsmokers. The corresponding RRs rose from 2.05 to 2.58 for all cancer deaths and from 6.40 to 8.77 for lung cancer deaths. The age-adjusted all-causes and cancer death rates among current smokers at the baseline survey were 1695.6 and 782.0 per 100 000 person-years, respectively. After exclusion of those with smoking habit changed during the follow-up period, the rates among persistent smokers were 2353.7 and 1144.6 per 100 000 person-years, respectively.</p><p><b>CONCLUSION</b>Cigarette smoking is an important predictor for risk of all-causes of death as well as for cancer deaths. The change of smoking habit during the follow-up period could result in underestimating the deleterious effect of cigarette smoking on health.</p>