ABSTRACT
Objective:To observe the efficacy and safety of individual dose of intravitreal conbercept (IVC) in the treatment of retinopathy of prematurity (ROP) before type 1 threshold.Methods:A retrospective case study. From January to July, 2019, 23 cases (46 eyes) of children with type 1 pre-threshold ROP were included in the study. Among them, 14 cases (28 eyes) were male and 9 cases (18 eyes) were female. The mean gestational age at birth was 28.06±1.73 weeks. The average birth weight was 1.14±0.19 kg. The mean corrected gestational age was 34.38±1.41 weeks at the time of first intravitreal injection of IVC. The axial length (AL) of children was measured by A-mode ultrasound before IVC for the first time. According to the calculation of AL, the corresponding injection dose range was 14.23-16.19, 16.20-17.57, 17.58-18.63 mm and the injection dose of IVC was 0.015, 0.020, 0.025 ml (including IVC was 0.15, 0.20, 0.25 mg, respectively). The first IVC dose was 0.015 ml. On the first day before IVC and on the first and seventh days after IVC, 2 ml of arterial blood was taken from children, serum vascular endothelial growth factor (VEGF) concentration was detected. The follow-up time after treatment was ≥1 year. After one year of follow-up, the effective rate and recurrence rate of IVC for the first time were tested by χ2 tests. The short-term changes of injection times, injection intervals, retinal vascularization time and serum VEGF concentration in children were tested by t test. Results:Retinal neovascularization subsided and vascular buckling decreased in all eyes. Iris neovascularization subsided, 1-3 weeks after IVC for the first time. Within one year after the first IVC, 16 eyes underwent IVC twice with or without new blood vessels at the junction of the vascular area. The average corrected gestational age was 40.56±3.81 weeks. The injection dose of IVC was 0.015 ml and 0.020 ml for 2 eyes and 14 eyes, respectively.The mean interval from IVC for the first time was 40.89±8.99 days. Of the 16 eyes who underwent IVC twice, 8 eyes showed neovascularization again in the retinal area with or without blood vessels. The average corrected gestational age was 43.00±1.41 weeks. The injection dose of IVC was 0.020 ml and 0.025 ml for 3 eyes and 5 eyes, respectively. The mean interval of the second IVC was 28.60±6.07 days. The mean interval from the first IVC was 69.20±12.40 days. At the end of follow-up, all eyes were treated effectively (100%, 46/46). The mean time of retinal vascularization was 46.31±3.42 weeks. The average number of injections was 1.52±0.76. On the first day before IVC and on the first and seventh days after IVC, the average serum VEGF concentrations were 111.21±148.71, 25.60±27.71 and 42.99±38.01 pg/ml, respectively. Serum VEGF concentration was significantly lower than that before IVC on the 1st and 7th day after IVC ( Z=-4.054, -2.779; P<0.05). Serum VEGF concentration was higher 7 days after IVC than 1 day after IVC, and the difference was statistically significant ( Z=-2.505, P<0.05). All eyes were not treated by laser photocoagulation or vitrectomy. No eye complications such as lens opacification, endophthalmitis and retinal detachment related to drugs or treatment methods were found in all patients. Conclusion:Intravitreal injection of individualized dose of IVC is effective in the treatment of type 1 pre-threshold ROP. Seven days after treatment, serum VEGF concentration of patients’serum decreases.
ABSTRACT
Accompanied by the rapid improvement of clinical diagnosis and treatment technology and the needs of scientific research, the training of higher professional talents represented by breast surgery postgraduates is facing many challenges. Based on the above background, this study puts forward the new teaching mode combining online and offline, involving evidence-based medicine guidelines, strengthening the aesthetic concept and humanistic teaching quality into the breast surgery teaching system to improve the teaching concept and teaching mode. Through the intuitive information teaching means and clinical case analysis, the students' independent learning and thinking ability can be cultivated. Finally, we look forward to improving the scientific research level and the cultivation of breast surgeons with outstanding comprehensive ability and medical humanistic quality from the optimization of teaching modes.
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ObjectiveTo validate the feasibility and accuracy of right ventricular (RV) volume and systolic function with single cardiac cycle real-time three-dimensional (3D) echocardiography. MethodsThree-dimensional images of RV and left ventricle (LV) were obtained in 122 healthy adults by 3D matrix array transducer. The end systolic volume (ESV), end diastolic volume (EDV), stroke volume (SV) and ejection fraction (EF) were measured by RV analysis and LV analysis software. To validate the reliability of measurement of right ventricle by real-time three-dimensional echocardiography, the correlations of RV functional parameters and multiple parameters (such as age, gender and body surface area) were analyzed. And the correlation and difference between different modalities of left ventricle and right ventricle were compared.Results3D-RVEF was (55.66±13.97)%, 3D-RVEDV was (68.24±40.19) ml, 3D-RVESV was (30.09±19.14) ml and 3D-RVSV was (38.30±26.10) mL. RVSV and RVEF of normal men were larger than those of normal women, but no statistical difference were found [(40.15±26.15) mlvs (36.11±25.60) ml, (55.69±14.57)%vs (55.62±13.36)%, bothP>0.05]. RV related function parameters had no relevant correlation with age (P>0.05). Body surface area was weakly related to RVEDV, RVESV and RVSV (r=0.236, 0.247 and 0.178, allP<0.05). BSA had no correlation with RVEF. 3D-RVSV and 3D-RVEDV were weakly positively correlated with 3D-LVSV and 3D-LVEDV (r=0.215 and 0.201, bothP<0.05). 3D-RVEF and 3D-RVESV were not correlate with 3D-LVEF and 3D-LVESV.ConclusionThe single cardiac cycle real-time three-dimensional echocardiography is a simple and feasible method for assessment of right ventricular function and can quantify right ventricular contractive function precisely.