Current status of surgery for portal hypertension in China: a national multi-center survey analysis / 中华器官移植杂志

Objective:To explore the current status of surgery for portal hypertension to grasp current status and future development of surgery in China.Methods:This study is jointly sponsored by China Hepatobiliary & Pancreatic Specialist Alliance & Portal Hypertension Alliance in China (CHESS).Comprehensive surveying is conducted for basic domestic situations of surgery for portal hypertension, including case load, surgical approaches, management of postoperative complications, primary effects, existing confusion and obstacles, liver transplantation(LT), laparoscopic procedures and transjugular intrahepatic portosystemic shunt(TIPS), etc.Results:A total of 8 512 cases of portal hypertension surgery are performed at 378 hospitals nationwide in 2021.Splenectomy plus devascularization predominated(53.0%)and laparoscopy accounted for 76.1%.Primary goal is preventing rebleeding(67.0%) and 72.8% of hospitals used preventive anticoagulants after conventional surgery.And 80.7% of teams believe that the formation of postoperative portal vein thrombosis is a surgical dilemma and 65.3% of hospitals practiced both laparoscopy and TIPS.The major reasons for patients with portal hypertension not receiving LT are due to a lack of qualifications for LT(69.3%)and economic factors(69.0%).Conclusions:Surgery is an integral part of management of portal hypertension in China.However, it is imperative to further standardize the grasp of surgical indications, the handling of surgical operation and the management of postoperative complications.Moreover, prospective, multi-center randomized controlled clinical studies should be performed.

Efficacy analysis of elective nodal irradiation and involved field irradiation combined with chemotherapy in treatment of esophageal cancer / 肿瘤研究与临床

Objective:To explore the efficacy of elective nodal irradiation (ENI) and involved field irradiation (IFI) combined with chemotherapy in treatment of esophageal cancer.Methods:A total of 104 patients with esophageal cancer in Affiliated Hospital of Jiangnan University from May 2018 to May 2020 were selected as subjects for prospective study. All patients were randomly divided into observation group and control group by lottery method with 52 cases in each group. The target volume of observation group was delineated with IFI, and the control group was delineated with ENI. The curative effects, the levels of serum tumor markers [carbohydrate antigen 50 (CA50), squamous cell carcinoma (SCC) and carcinoembryonic antigen (CEA)] before and after treatment, the 1-year overall survival (OS) rate, the incidence of adverse reactions and the scores of various dimensions of health survey summary (SF-36) after treatment were compared between the two groups.Results:The total effective rate in the observation group was 90.38% (47/52), the total effective rate in the control group was 84.62% (44/52), and the difference was not statistically significant ( χ2 = 0.79, P =0.374). There was no statistical difference in CA50, CEA, SCC levels between the two groups before and after treatment (all P > 0.05). After treatment, the CA50, CEA and SCC levels in the two groups were lower than those before treatment, and the differences were statistically significant (all P < 0.05). The 1-year OS rate of the observation group was 94.23%, the control group was 90.38%, and the difference in OS between the two groups was not statistically significant ( χ2 = 0.54, P = 0.462). The incidence of acute radiation esophagitis in the observation group was lower than that in the control group, and the difference was statistically significant ( P < 0.001). There was no statistical difference between the two groups in SF-36 scale scores of physical functioning, role-physical, bodily pain, mental health, vitality, social functioning, role-emotional, and general health after treatment (all P > 0.05). Conclusions:Both ENI and IFI are effective treatments for patients with esophageal cancer. There is no significant difference in the quality of life of patients between the two delineation methods, but the incidence of acute radiation esophagitis is lower in patients with IFI regimen.

Blood biochemical indicators, IgM and IgG antibodies in 56 confirmed and suspected COVID-19 cases / 上海预防医学

Objective To provide reliable indicators for effective prevention and control of COVID-19, we examined the biochemical indicators as well as anti-SARS-CoV-2 IgM and IgG antibodies in confirmed and suspected COVID-19 patients. Methods A total of 56 confirmed and suspected COVID-19 cases quarantined during January-March, 2020 in Gansu Provincial People′s Hospital and People′s Hospital of Xigu District, Gansu Province were included.Based on the results of nucleic acid testing and CT scan finding, they were divided into three groups: positive in both nucleic acid testing and CT scan finding; positive in nucleic acid testing but negative in CT scan finding; negative in both nucleic acid testing and CT scan finding.COVID-19 viral nucleic acid was detected and chest CT scan was performed.The following biochemical indicators were examined: total protein, albumin, total bilirubin, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, γ-glutamyltranspeptidase, creatine kinase and lactate dehydrogenase.SPSS 22.0 statistical software was used to analyze the differences in the biochemical indicators among these three groups, as well as the temporal trend of IgM and IgG antibodies at different points of time. Results There were significant differences in the mean values of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and lactate dehydrogenase between these three groups (P < 0.05), whereas no significant difference in the mean value of total protein and albumin (P>0.05).ROC curve indicated that aspartate aminotransferase had the largest maximum area under the curve (AUC, 0.834), whereas alanine aminotransferase had the highest sensitivity (1.0) and total bilirubin had the highest specificity (0.927).Thus, aspartate transaminase provided the best prediction for the diagnosis of COVID-19, with sensitivity of 0.786, specificity of 0.854, and the maximum AUC of 0.834.In 12 of 16 confirmed COVID-19 patients tested IgG positive after 10 days of diagnosis, and 10 of 10 confirmed COVID-19 patients tested IgG positive after 14 days of diagnosis. Conclusion Aspartate aminotransferase may be the most useful indicator in the diagnosis of COVID-19.

Research Progress on Biopharmaceutics of Active Ingredients in Chinese Materia Medica Under Multi-component System / 中国实验方剂学杂志

The biopharmaceutical properties (solubility, permeability, etc.) of active pharmaceutical ingredients are playing an important role in understanding of disposition of drugs in the body, screening of drugs and evaluation of drug delivery system. The active ingredients of Chinese materia medica (CMM) are various and complex, the research on biopharmaceutics provides a train of thought and practical method for the prediction and research on the process of active ingredients from CMM in vivo. The multi-components system is one of the main differences between CMM and chemical medicine, and the study on biopharmaceutics of active ingredients in CMM under multi-components system has become a hot topic. The progress on biopharmaceutics of active ingredients in CMM under multi-components system was reviewed in this article, which may provide the reference for data integration, theoretical induction and system construction in this field, and provide new train of thought for the research on CMM theories and the development of CMM in the perspective of biopharmaceutics.

Mechanism and safety of triptolide in treatment of rheumatoid arthritis / 中草药

Objective: To explore the mechanism of triptolide in the treatment of rheumatoid arthritis (RA) and analyze its safety. Methods: A total of 60 rats were randomly divided into control group, model group, methotrexate (MTX) group and triptolide (TP) low, medium and high dose groups with 10 rats in each group. In addition to the control group, the rats in the other groups were established type II collagen-induced RA model. After the successful establishment of the model, rats in MTX group were given 0.4 mg/kg MTX by gavage from the 3rd week. Rats in TP high, middle, and low dose groups were given 0.1, 0.2, and 0.4 mg/kg TP by gavage. Rats in control group and model group were given equal volume distilled water once a day for 4 weeks. The paw swelling of rats in each group was compared. The percentage of CD4+CD25+and CD4+Foxp3+ Treg was detected by flow cytometry. The levels of IL-10, IL-17, TNF-α, VEGF, IFN-γ, TGF-β, ALT, and AST in the serum were detected. The pathological morphology of ankle joint was observed under microscope. The expression levels of IL-10, IL-17, TNF-alpha, VEGF, IFN-γ, and TGF-β were detected by immunohistochemistry. Results: Pathological sections showed that synovial cells were proliferated significantly in the ankle joint of rats in the model group, with infiltration of a large number of inflammatory cells such as monocytes and lymphocytes, new capillaries, thinning of bone trabeculae and serious erosion of cartilage surface. The degree of pathological changes in other groups was significantly less than that in model group. After treatment, the degree of joint swelling and arthritis index in MTX and TP groups were significantly decreased compared with those before treatment (P 0.05). There was no significant difference between MTX group and TP high dose group (P > 0.05). Conclusion: TP is effective in treating type II collagen-induced arthritis in rats, which can significantly improve joint swelling. Its mechanism is related to promoting the expression of IL-10 and TGF-β, increasing the proportion of Treg cells, inhibiting the expression of IL-17, TNF-α, VEGF and IFN-γ, and has no obvious hepatotoxicity.

Relationship between X-ray injury cross-complementary protein 1 gene polymorphism and prognosis of triple-negative breast cancer / 中国医师进修杂志

Objective To investigate the relationship between X-ray injury cross-complementing protein 1 (XRCC1) gene polymorphism and prognosis in patients with triple-negative breast cancer (TNBC). Methods Patients with primary triple-negative breast cancer (TNBC) diagnosed in the Ninth People′s Hospital, Shanghai Jiaotong University School of Medicine from January 2013 to January 2015 were selected. Patients were selected for genotyping (XRCC1 gene Arg280His, Arg399Gln and Arg194Trp) and divided into survival group and death group according to the prognosis of patients. Logistic regression was used to analyze the relationship between XRCC1 genotype and prognosis. Results A total of 130 patients were enrolled in the study, with an average age of (50.4 ± 6.3) years. The mean follow-up time was (45 ± 13) months, including 62 patients with breast cancer-related deaths and 68 patients with survival. The patients in death group was older than those in the survival group [(52.6 ± 6.7) years vs. (48.3 ± 5.2) years, P < 0.01), and and the lymph node metastasis rate was higher [88.7%(55/62) vs.73.5%(50/68), P＝0.028]. The frequency of XRCC1 gene Arg399Gln genotype in the survival and death group was GG: 61.8% vs. 38.7%; GA: 32.4% vs. 41.5%; AA: 5.9% vs. 19.4%, P＝0.011.There were also statistical differences between the two groups in the frequency of allele, and the frequency of A allele was significantly higher in the death group than in the survival group (40.4% vs. 22.0%, P<0.01). For the additive model of the Arg399Gln polymorphism A allele, for each additional copy of the A allele, the risk was 1.443 times that before the increase (95% CI 1.174-1.793, P<0.01). After adjusting for age and lymph node metastasis, the A allele still significantly increased the risk of death ( OR＝1.533, 95% CI 1.254-1.903, P < 0.01). Conclusions The XRCC1 gene Arg399Gln polymorphism is associated with the prognosis of TNBC, and patients with the A allele have a poor prognosis.

Cross-sectional study on clinic behavior and therapeutic status of patients with psoriatic arthritis in multi-center / 北京大学学报(医学版)

OBJECTIVE@#To investigate and analyse the features of treatment behavior and standardized therapeutic status of patients with psoriatic arthritis (PsA).@*METHODS@#Out patients diagnosed with PsA in People's Hospital of Peking University, Haidian Hospital, People's Hospital of Jianyang City, Central Hospital of Xinxiang City, Integrated Traditional Chinese and Western Medicine Hospital of Cangzhou City, The Third Hospital of Hebei Medical University from February to June 2018 were enrolled in this investigation. The data including gender, age of onset, course of disease, site of first consulting department, time of the first visit and definite diagnosis, follow-up interval, and use of conventional disease modifying anti-rheumatic drugs (cDMARDs) and biological DMARDs (BioDMARDs) were collected and analyzed.@*RESULTS@#In the cross-sectional study, 133 PsA patients were investigated. The mean age of onset was (47±11) years, the male to female ratio was 1.3:1, and mean disease duration was (16±8) years. Rheumatology department was the most common site of first hospital visit (37.6%, 50/133). Orthopedics department and dermatological department were visited by 24.1% (32/133) and 23.3% (31/133), respectively. Ratio of definite diagnosis was the highest in rheumatology department which was 78% (39/50). The ratio of definite diagnosis of dermatological department was the second highest, which was 19.4% (6/31). The mean definite diagnosed time was 7.6 months since the first visit of PsA patients, and diagnosed time was the shortest in rheumatology department, which had statistical significance. 37% PsA patients were treated appropriately in 3 months, 17.3% PsA patients were treated in 3-6 months and 40.2% patients with PsA visited their doctor more than once a year. 48.8% patients hadn't received standardized treatment before visit, and one third patients never received the therapy of DMARDs. Methotrexate was the most commonly used cDMARDs (58.3%), followed by leflunomide (20.5%) and BioDMARDs (19.7%), and biologicals were tumor necrosis factor antagonists.@*CONCLUSION@#In this multi-center study, the first visit department of PsA patients was widely distributed, and most patients were definitely diagnosed in Rheumatology Department. The time of their first visit and definite diagnosis were delayed due to multi factors. Nearly half of the patients did not receive standardized treatment.

Research progress on clinical diagnosis and treatment for external snapping hip / 中国骨伤

External snapping hip(ESH) is a vague term used to describe palpable or auditory snapping with hip movements with or without pain. The pathogenesis of ESH is related to the specific anatomical structure and friction factor. The clinical symptom is auditory snapping during activities, physical examination, X-ray, magnetic resonance imaging(MRI), dynamic ultrasound and other imaging techniques can be used to diagnose. Conservative medical management includes rest, avoidance of aggravating activities, and antiinflammatory medications. Treatment Patients with mild symptoms can achieve good results by medication, rest and physiotherapy. Surgical treatment for patients with ineffective conservative treatment was performed. All kinds of open surgery method can achieve good clinical curative effect, arthroscopic surgery is gradually been promoted due to small trauma, less complications. Besides, there are some reports that traditional treatments such as massage, acupuncture and acupotomology have achieved good clinical results, which deserve further study and promotion.

Comparison of contrast sensitivity after regional refraction multifocal intraocular lens implantation / 局解手术学杂志

Objective To compare the sensitivity of regional refraction multifocal intraocular lens implantation with other methods. Methods A total of 78 patients with simple cataract treated by visual acuity in our hospital from February 2016 to June 2017 were selected as subjects.The patients were divided into SBL-3 group (26 cases),SN6AD1 group (26 cases) and ZMB00 group (26 cases) according to the different intraocular lens.The contrast sensitivity value of patients in 3 groups under clear light(85 cd/m2),dark light(3 cd/m2),clear and glare light(45 Lux),dark and glare light(28 Lux) with different spatial frequencies (3,6,12,18 c/d) by the United States CSV-1000E contrast sensitivity tester after surgery.Results In terms of sensitivity index as clear light,dark light,clear and glare light,and dark and glare,the SBL-3 group were better than those of ZMB00 group and SN6AD1 group,the difference was significant(P<0.05);there were no significant differences between ZMB00 group and SN6AD1 group of each index sensitivity(P>0.05).Conclusion The postoperative sensi-tivity of refractive multifocal intraocular lens implantation of SBL-3 is significantly better than the apodized diffractive multifocal intraocular lens implantation of SN6AD1 and alll optical diffractive multifocal intraocular lens implantation of ZMB00,which is worthy of widely use for simple cataract.

AppIication of poIymer interbody fusion cages / 中国组织工程研究

BACKGROUND: Interbody fusion is an effective approach in the spinal surgery which is traditionally performed via auto/allogenic bone grafting,and it has a number of shortcomings as well as specific therapeutic effects. In the past few years, polymer interbody fusion cages have been gradually applied in clinical practice, which provides more options for spinal surgeons. OBJECTIVE: To introduce the advantages and disadvantages of degradable/non-degradable polymer materials respectively by analyzing their materialogy characteristics, and to further predict their application prospects. METHODS: PubMed, Ovid and CNKI were searched by computer to retrieve articles concerning the materialogy characteristics and application situation of common biomedical polymer materials in the spinal surgery. The key words were "spinal surgery, fusion cage, engineering plastic, degradable high polymer material" in Chinese and English, respectively. RESULTS AND CONCLUSION: Up to now, a variety of polymer materials, especially degradable polymer materials, are still at the stage of exploring and primary research, and their in-depth studies, including animal and biomechanics experiments, are still expected to be done gradually. Except for PEEK interbody fusion cages, some polymer materials are still lack of large sample and multi-center clinical trials before further application.

The effect of Chinese yam extract combined with tegafur on the cytotoxicity of HT-29 cell line in vivo and in vitro / 天津医药

Objective To study the inhibitory effects of Chinese yam combined with tegafu on colon cancer HT-29 cells in vivo and in vitro.Methods The changes of cell morphology were observed by the method of adopting 2×2 factorial designs,after HT-29 colon cancer cells were treated with physiological saline containing dimethyl sulfoxide(blank control), tegafur(36 mg/L)and Chinese yam(125 mg/L).MTT method was used to detect the proliferation of tumor cells,and flow cytometry was used to detect the expression of tumor stem cells(CD133+cells).The nude mouse model of colon cancer HT-29 cells was established. The treatment was given in the above method, and the tumor inhibition rate was calculated. The VEGF positive rate of the tumor was detected by immunohistochemistry. Results The inhibited proliferation of colon cancer HT-29 cells was significantly higher in the synergistic group than that in Chinese yam group and tegafur group,and the inhibitory rates were higher in the three treatment groups than that of blank control group.The proportion of CD133+cells was significantly lower in HT-29 cells in the synergistic group compared with that of the Chinese yam group and the tegafur group,and which was lower in these three groups than that of the blank control group.After the treatment in three treatment groups,the tumor quality and VEGF positive rate were significantly lower than those of the blank control group,and which was lower in the tegafur+Chinese yam group than that of Chinese yam group and the tegafur group. Conclusion Chinese yam combined with tegafu can inhibit the proliferation of colon cancer HT-29 cells and their stem cells.

Observations on the Therapeutic Effect of"Neck Seven Needles"on Cervical Spondylotic Radiculopathy / 上海针灸杂志

Objective To investigate the clinical efficacy of Zhu's "neck seven needles" in treating cervical spondylotic radiculopathy. Method Ninety-six patients with cervical spondylotic radiculopathy were randomized to two groups. The treatment group received Zhu's "neck seven needles" therapy and the control group, cervical vertebra traction therapy. Both groups were treated once every other day, for a total of 10 days. The symptoms were scored using the Short-form McGill Pain Questionnaire (SF-MPQ-2) before and after treatment. Result The SF-MPQ-2 score decreased significantly in both groups of patients after treatment compared with before. It decreased more in the treatment group than in the control group and the difference was statistically significant (P<0.01). The total efficacy rate was significantly higher in the treatment group than in the control group (P<0.01). Conclusion Zhu's "neck seven needles" is clinically more effective than conventional cervical vertebra traction in treating cervical spondylotic radiculopathy.

Ahmed glaucoma valve implantation treatment of traumatic angle recession glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To study the influence of Ahmed glaucoma valve implantation on eyesight, intraocular pressure and corneal endothelial cell density of patients with traumatic angle recession glaucoma. ·METHODS: Totally 33 cases (35 eyes) of patients with traumatic angle recession glaucoma admitted to our hospital since June 2014 to June 2016 were selected and treated with Ahmed glaucoma valve implantation. The clinical data of all patients were retrospectively analyzed, so as to evaluated to success rate of surgery. Non-contact tonometer was applied to surveying intraocular pressure before treatment and at 1wk, 1,3,6mo and 1a post treatment. Specular microscope was adopted to examine and calculate the corneal endothelial cell density before treatment and at 1wk, 1, 3, 6mo and 1a post treatment. All affected eyes were compared for visual acuity before surgery and in 1a after surgery, moreover, patients were followed - up, received the further consultations and the complications were recorded. ·RESULTS: As for 35 affected eyes, the absolute success rate of surgery was 54% , while the relative success rate was 40% , and the total successful rate and failure rate were 94% and 6% respectively. In terms of the number of people who had no light sensation before surgery, or who had light sensation, ≤0. 01, 0. 01-0. 10 or >0. 10-0. 20, there was no significant difference (Z=-0. 132, P=0. 362). The intraocular pressure before treatment was 43. 43 ± 3. 65mmHg, at 1wk after surgery was 13. 50 ± 2. 54mmHg, at 1mo was 15. 93 ± 2. 61mmHg, at 6mo was 16. 00 ± 2. 18mmHg and at 1a was 16. 45 ± 2. 21mmHg, and the difference among different time points had statistical significance (F= 887. 82, P<0. 01). After treatment the intraocular press decreased compared to before treatment (P<0. 05); those after treatment had no difference with each other ( P> 0. 05 ). Before treatment, the corneal endothelial cell density was 2443. 35 ± 343. 12 pieces/mm2, in 1wk after the surgery was 2231.67±334.45 pieces /mm2, in 1mo after the surgery was 2065. 47 ± 336. 45 pieces /mm2, in 3mo after surgery was 2031. 47 ± 345. 76 pieces/mm2, in 6mo was 2001. 72±337. 18 pieces /mm2and in 1a after the surgery was 1979. 65 ± 301. 32 pieces /mm2, and the difference among different time points had statistical significance ( F = 13. 49, P<0. 01 ). After treatment the corneal endothelial cell density decreased compared to before treatment (P<0. 05); those after treatment had no difference with each other (P>0. 05). After surgery, there were 4 cases (4 eyes) of ocular hypotension, 3 cases (3 eyes) of hyphema, 2 cases ( 2 eyes) of drainage tube plugging and 2 cases ( 2 eyes ) of intraocular hypertension, which were all quickly relieved after basic intervention treatment. · CONCLUSION: Treating traumatic angle recession glaucoma with Ahmed glaucoma valve implantation can dramatically optimize the state of intraocular hypertension and protect the retaining visual acuity, and visual acuity can be optimized in some cases. It causes little complication that can be relieved with basic prognosis, but postoperative corneal endothelial cell loss exists in some cases.

Observation of cataract extraction and vitrectomy with gas tamponade for idiopathic macular hole at different stages / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To investigate the visual acuity after cataract extraction and vitrectomy with gas tamponade for idiopathic macular hole (IMH) at different stages. ·METHODS: In this study, 75 IMH patients ( 75 eyes ) treated in our hospital from August 2014 to August 2016 were enrolled and underwent cataract extraction, vitrectomy and C3F8gas tamponade. Patients were divided into stage Ⅱ Group ( 18 cases ), stage Ⅲ ( 36 cases) and stageⅣ(21 cases) according to Gass stages, and macular hole closure at 2 and 4wk postoperatively were compared. The routine visual acuity examination before and after surgery were performed, and the visual acuity in each group were compared. The optical coherence tomography ( OCT) was used to measure the macular thickness before and after surgery. ·RESULTS: The closure rate of macular hole in stage Ⅱwas significantly higher than that of stage Ⅲ and IV at the 1mo after operation, that at the stage Ⅲ was significantly higher than that of stageⅣgroup, and the difference was statistically significant (P<0. 05). There was no significant difference in the rate of closure of macular hole between stage Ⅱ and stage Ⅲ at 3mo after operation (P>0. 05). The proportion of eyes with visual acuity of finger counting, 0. 02-0. 08, 0. 10-0. 20, 0. 25-0. 40 and ≥0. 50 was statistically significant different before and after surgery(P<0. 05). The improvement rate of visual acuity was 94% in stage Ⅱ, which was significantly higher than that in stage Ⅲ (83%) and stage Ⅳ (67%). The macular thickness of the stage Ⅱ and Ⅲ was significantly lower after the surgery, but there was no significant difference in the stage Ⅳ before and after surgery (P>0. 05), the decreasing range of the stage Ⅱ and Ⅲ was not statistically significantly different (P>0. 05), which were significantly higher than that of the stage Ⅳ, the difference was statistically significant (P<0. 05). ·CONCLUSION: Cataract extraction, vitrectomy and C3F8 gas tamponade surgery is conducive to the vision recovery after idiopathic macular hole, but the effects with different Gass staging are different, surgery should be performed as early as possible to improve macular hole closure and eyesight recovery.

Combined treatment of Conbercept and panretinal photocoagulation for neovascular glaucoma after central retinal vein occlusion / 国际眼科杂志(Guoji Yanke Zazhi)

· AIM:To investigate the efficacy of the combined treatment of Conbercept and panretinal photocoagulation (PRP) for neovascular glaucoma (NVG) with central retinal vein occlusion (CRVO).· METHODS:The clinical data of 100 NVG patients with CRVO treated in our hospital from May 2014 to May 2017 were retrospectively analyzed.In those,50 patients treated with glaucoma filtering surgery combined with PRP were selected as control group,and based on this,50 patients treated with intravitreal injection of conbercept were included in the observation group.The best corrected visual acuity (BCVA) before treatment,and after 7d,1,3,and 6mo treatment were compared.The intraocular pressure IOP of each period with the non-contact tonometer were also compared,the effect of surgery was evaluated by slit-lamp examination of neovascularization combined with intraocular pressure,and then recurrence rate and complication was recorded during 6mo follow-up.· RESULTS:No statistically significant difference was found between preoperative and after surgery at each time point (P＞0.05).The intraocular pressure of the two groups was significantly lower than that of before the surgery,the observation group was significantly lower than that of the control group 7d and 1mo after surgery,and the difference was statistically significant (P＜0.05).There was no statistically significant difference on lOP the 3 and 6mo after surgery between two groups (P＞0.05).The operation success rate was 100％ in the observation group and was 92％ in the control group,the difference was statistically significant (P＜ 0.05).The complete success rate of the observation group was 84％,which was significantly higher than 66％ of the control group,the difference was statistically significant (P＜ 0.05).The hyphema and recurrence rate of the observation group were significantly lower than those of the control group,the difference was statistically significant (P＜0.05).There was no significant difference in the incidence of shallow anterior chamber and low intraocular pressure (P＞0.05).· CONCLUSION:Preoperative intravitreal injection of conbercept combined with panretinal photocoagulation for neovascular glaucoma after central retinal vein occlusion make the pressure recovery and neovascularization time shorter with better surgical results,and can control the anterior chamber hemorrhage and reduce the recurrence rate.

Intravitreal injection of Conbercept combined with trabeculectomy and panretinal photocoagulation for the treatment of neovascular glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the clinical efficacy of intravitreal injection of Conbercept combined with trabeculectomy and panretinal photocoagulation for the treatment of neovascular glaucoma (NVG). METHODS: The clinical data of 90 patients with NVG treated in our hospital from June 2014 to June 2016 were analyzed retrospectively. There were 42 patients treated with trabeculectomy and panretinal photocoagulation enrolled as the control group. On the basis of this, 48 patients who received intravitreal injection of conbercept 5-7d preoperatively were enrolled as observation group. The best corrected visual acuity (standard logarithmic visual acuity), intraocular pressure and the regression of neovascularization were observed and compared before treatment,and 1wk,1,3,and 6mo post treatment. Then the clinical efficacy and postoperative complications were observed and recorded. RESULTS: The difference of visual acuity of the two groups was significant before and after treatment,and the best corrected visual acuity of observation group was significantly higher than that of the control group at 1mo after the operation (P<0.05), no difference was found at 1wk,3 and 6mo post treatment (P>0.05). The pre- and postoperative intraocular pressure of the two groups showed significant difference, and the intraocular pressure of the observation group was significantly lower than the control group at 1wk, 1, 3 and 6mo post treatment (P<0. 05). The cure rate in the observation group was significantly higher than that in the control group (77% vs 64%), with statistical significance (P<0 05). The incidence of anterior chamber hemorrhage and shallow anterior chamber in the observation group was significantly lower than that of the control group (P<0.05), with no difference in the incidence of macular degeneration(P>0.05). Moreover, the recurrence rate of neovascularization in the observation group was significantly lower than that of the control group at 6mo after operation (P<0.05). CONCLUSION: The intravitreal injection of conbercept 5-7d before panretinal photocoagulation can significantly reduce intraocular pressure,improve the visual acuity for the treatment of NVG, which also has a higher comprehensive cure rate.

Ocular surface changes after combined surgery of glaucoma and cataract / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To investigate the effect of phacoemulsification intraocular lens implantation combined with trabeculectomy on ocular surface in the treatment of glaucoma and cataract. ·METHODS: Totally 45 cases of patients with glaucoma and cataract in our hospital from February 2016 to February 2017 were enrolled. All the patients had unilateral disease,and the medical records of the patients were analyzed retrospectively. The sicked eyes were set as the observation group and contralateral eyes were set as the control group. The dry eye score, break-up time (BUT), corneal fluorescein staining score (FL), tear secretion test (S I t) and conjunctival epithelium goblet cell density(CIC) was compared between two groups before operation and at 1wk,1 and 3mo after operation. · RESULTS: The preoperative dry eye score of the observation group had no significant difference with that of the control group (P > 0. 05). At 1wk, 1mo after operation,data of the observation group was significantly higher than that of the control group and before operation, with statistical significance (P < 0. 05), no significant difference was shown at postoperative 3mo (P>0.05). Preoperative BUT of the observation group had no significant difference with that of the control group(P>0.05); at 1 wk,1 and 3mo after operation, data of the observation group was significantly lower than that of the control group and before operation, with statistical significance (P<0.05). The preoperative FL score of the observation group was significantly higher than that of the control group, while the postoperative FL score of the observation group at 1wk,1 and 3mo had sharp difference with that before operation(P<0.05),all were significantly higher than that of the control group,there was statistical significance(P<0.05). There was no significant difference in S I t score between the observation group and the control group preoperatively ( P > 0. 05), and the postoperative S I t scores of the observation group at 1wk,1 and 3mo postoperatively was evidently lower than that of the control group and before operation (P<0.05). There was no significant difference in CIC density between the two groups preoperatively. While the postoperative data of the observation group at 1wk, 1 and 3mo postoperatively was significantly lower than that of the control group and before operation,with statistical points (P<0.05). · CONCLUSION: Phacoemulsification intraocular lens implantation combined with trabeculectomy for treatment of glaucoma and cataract can aggravate dry eye symptoms, as well as reduce tear film stability and tear secretion,impair conjunctival epithelium goblet cell.

Comparison of efficacy between Ranibizumab and Conbercept for wet age-related macular degeneration / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare the efficacy between Ranibizumab and Conbercept for wet age-related macular degeneration. <p>METHODS: Totally 78 cases(78 eyes)of wet age-related macular degeneration treated in our hospital from February 2014 to March 2016 were selected and divided into Group A and Group B, each with 39 cases(39 eyes). Patients in two groups were given ranibizumab and conbercept respectively, and were followed up for 12mo. The various data including visual acuity, the macular foveal retinal thickness, choroidal neovascularization(CNV)leakage and complications were compares between two groups. <p>RESULTS: At 1wk, 1 and 3mo after treatment, the uncorrected vision of Group A was higher than that of Group B, the difference was statistical significance(<i>t</i>=14.05, 12.71, 18.27; <i>P</i><0.05). The macular foveal retinal thickness at different time points in Group A was thinner than that of Group B, the difference held statistical meaning(<i>t</i>=2.504, 2.051, 1.991; <i>P</i><0.05). Two groups' total efficiency at 1 and 3mo after operation had no statistical points(<i>χ²</i>=1.076, 0.253; <i>P</i>>0.05). <p>CONCLUSION: The ranibizumab and conbercept shows identical effect in treating CNV leakage of patients wet age-related macular degeneration without any serious complications occurred, but the comparison of the two shows that the improvements of visual acuity and macular foveal retinal thickness are better in ranibizumab treatment than in conbercept treatment.

Carotid plaque composition and volume evaluated by multi-detector computed tomography angiography / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the differences of plaquecomposition and volume between symptomatic and asymptomatic patients with carotid artery stenosis by multi-detector computed tomography angiography (MDCTA).@*METHODS@#The consecutive patients with internal carotid artery stenosis≥70% diagnosed by digital subtraction angiography (DSA) were retrospectively analyzed from July 2011 to December 2015 in Peking University China-Japan Friendship School of Clinical Medicine. The symptomatic patients were defined as those who experienced nondisabling ischemic stroke or transient cerebralis chemic symptoms, including hemispheric events oramaurosis fugaxin the last 6 months. Otherwise, the patients were considered as a symptomatic. A total of 78 patients were enrolled in the study. Of these patients, there were 35 asymptomatic patients (44.9%) and 43 symptomatic patients (55.1%). All the patients received MDCTA before DSA. According to the plaque analysis of post processing work station, carotid plaques were divided into lipid-rich necrotic coreplaques (HU≤60), fibrous plaques (60 to 130 HU) and calcified plaques (HU≥130) through the different value sthreshold of HU. The plaque volume and proportion were all calculated. The differences between the two groups were compared by statistical methods.@*RESULTS@#The proportion of calcified plaques in asymptomatic patients was significantly higher than in symptomatic patients (t=2.760, P=0.007).And the proportion of LRNC plaqueswas lower than that in symptomatic patients (Z=2.009, P=0.044). There was statistical significance between the asymptomatic and symptomatic patients. Multivariate analysis showed that there was a positive correlation between the proportion of calcified plaques and asymptomatic carotid artery stenosis (OR=0.949; 95%CI: 0.915 to 0.985; P=0.005). The proportion of LRNC plaques showed a negative correlation with asymptomatic carotid artery stenosis (OR=1.068; 95%CI: 1.021 to 1.117; P=0.004). For the symptomatic patients, when the LRNC plaque proportion was greater than 30.3%, the specificity was 94.3%, and the sensitivity was 37.2%. There was no significant difference in plaque volume and fibrous plaque proportion in both groups.@*CONCLUSION@#Compared with symptomatic carotid plaques, the proportion of asymptomatic calcified plaques increased but the proportion of LRNC plaques decreased. Plaque LRNC 30.3% of the total volume may represent a clinically useful cutoff. For the patients with carotid artery stenosis, MDCTA may help noninvasively risk-stratify patients.

Analysis of the influence of conbercept intraocular injection to vitrectomy on diabetic retinopathy / 药物评价研究

Objective To discuss the influence of conbercept intraocular injection to vitrectomy on diabetic retinopathy.Methods patients (100 cases) with diabetic retinopathy were divided into two groups according to whether use intraocular injection drug or not.The injection group (49 cases) was given conbercept intraocular injection before vitrectomy.The control group (51 cases) was only given vitrectomy.The influence of conbercept intraocular injection to vitrectomy on diabetic retinopathy was evaluated by surgery,prognosis,visual acuity before and after surgery.Results The surgery time of the injection group was shorter than that of the control group (P ＜ 0.05).There were six bleeding cases in the injection group and 20 cases in the control group.The number of bleeding of injection group was shorter than that of the control group (P ＜ 0.05).In addition,the electric coagulation,silicone oil use,iatrogenic macular holes number of injection group was smaller than of that of the control group (P ＜ 0.05).During 1 month follow-up,the number of small bleeding and large bleeding cases of injection group was smaller than of the control group (P ＜ 0.05).There was no statistical significance on vision between two groups.After 1 month surgery,the vision of two groups were increased.And the vision of injection group was significantly higher than that of the control group (P ＜ 0.05).Conclusion In summary,conbercept intraocular injection could help vitrectomy.It could reduce the difficulty of surgery and shorten the surgery time.It could reduce the bleeding symptoms during and after surgery.It could improve the vision of patients.