Effect of orbital decompression on choroidal thickness in patients with thyroid associated ophthalmopathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the effect of orbital decompression on the central macular choroidal thickness(CMCT)in patients with thyroid-associated ophthalmopathy(TAO).METHOD: Prospective clinical studies. A total of 29 TAO patients(42 eyes)treated in our department from January 2021 to January 2022 were analyzed, and they were divided into 20 cases(30 eyes)in the moderate and severe group and 9 cases(12 eyes)in the extremely severe group. Both groups of patients received orbital decompression, and the changes of CMCT, visual acuity, intraocular pressure, exophthalmos, and clinical activity score(CAS)at 3 and 6mo before and after surgery were compared between the two groups.RESULTS: All patients completed follow-up. The CMCT, exophthalmos, intraocular pressure, and CAS of the extremely severe group at 3 and 6mo were 355.13±15.59 and 339.61±13.17μm, 19.33±2.23 and 17.83±1.70mm, 18.86±3.05 and 18.09±1.37mmHg, 3.75±0.87 and 2.42±1.00 points, respectively. The moderate and severe group was 325.00±10.48 and 321.04±11.34μm, 16.07±1.74 and 15.6±1.98mm, 16.65±2.04 and 16.03±2.3mmHg, 1.50±0.51 and 1.43±0.50 points, and there was differences with those before operation(extremely severe group: 396.46±17.61μm, 22.00±2.3mm, 21.85±2.82mmHg, 5.33±1.44 points; moderate and severe group: 335.77±11.60μm, 19.07±1.84mm, 18.89±3.06mmHg, 1.63±0.49 points; all P<0.001). The best corrected visual acuity(LogMAR)before surgery was 0.64±0.22 in the extremely severe group, and 0.43±0.20 and 0.34±0.15 at 3 and 6mo after operation, respectively, which were different from those before surgery(all P<0.001)CONCLUSION: Orbital decompression can effectively reduce CMCT, intraocular pressure and exophthalmos in TAO patients, relieve orbital vein stasis, and effectively improve vision and reduce mobility in patients with extremely severe disease.

Expert consensus on clinical application of GBE50 Dispersible Tablets for ischemic cardiovascular and cerebrovascular diseases / 中国中药杂志

Ginkgo biloba Extract( GBE50) Dispersible Tablets is a new standardized prescription,which is widely used in the treatment of ischemic cardiovascular and cerebrovascular diseases. However,there are still many problems in its clinical application.Rational and safe use of GBE50 Dispersible Tablets is pivotal to the medication safety and clinical prognosis of patients. This consensus has been jointly formulated by clinical experts of traditional Chinese medicine and western medicine in cardiovascular and cerebrovascular diseases and followed the Manual for the Clinical Experts Consensus of Chinese Patent Medicine published by the China Association of Chinese Medicine. The present study identified clinical problems based on clinical investigation,searched the research papers according to PICO clinical problems,carried out evidence evaluation,classification,and recommendation by GRADE system,and reached the expert consensus with nominal group technique. The consensus combines evidence with expert experience. Sufficient evidence of clinical problems corresponds to " recommendations",while insufficient evidence to " suggestions". Safety issues of GBE50 Dispersible Tablets,such as indications,usage and dosage,and medication for special populations,are defined to improve clinical efficacy,promote rational medication,and reduce drug risks. This consensus needs to be revised based on emerging clinical issues and evidencebased updates in practical applications in the future.

Meta-analysis for clinical efficacy of traditional Chinese medicine in treating resistant hypertension / 中国中药杂志

To systematically evaluate the efficacy and safety of traditional Chinese medicine in treating patients with resistant hypertension. CNKI, Wanfang, VIP, CBM, PubMed, Web of Science, Cochrane Library, EMbase and other databases were retrieved by computers to screen out the randomized controlled trial of traditional Chinese medicine in treating resistant hypertension. Cochrane Handbook was used to evaluate the quality of the included literature, RevMan 5.3 and Stata 12.0 was used for Meta-analysis. Finally, 11 literatures meeting the criteria were included, involving 1 023 patients. The results of Meta-analysis showed that the combined therapy of standard triple antihypertensive regimen with traditional Chinese medicine could further reduce systolic blood pressure of patients with resistant hypertension(MD=-16.69, 95%CI[-22.21,-11.16], P<0.000 01), reduce diastolic blood pressure(MD=-7.51, 95%CI[-8.26,-6.76], P<0.000 01), improve the effective rate of anti-hypertension(OR=5.16, 95%CI[3.01, 8.84], P<0.000 01), improve the up-to-standard rate of blood pressure(OR=3.01, 95%CI[1.49, 6.09], P=0.002), and improve the effectiveness of clinical symptoms(OR=4.48, 95%CI[2.31, 8.68], P<0.000 01), with no significant effect on creatinine level(MD=-2.51, 95%CI[-6.91, 1.89], P=0.26). The results of this study indicated that the combined therapy of standard triple antihypertensive regimen with traditional Chinese medicine could further improve the clinical efficacy in patients with resistant hypertension with a good safety, but more high-quality clinical studies are still needed to verify this conclusion.

Clinical observation of orthokeratology controlling monocular myopia in adolescents / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the change of axial length in anisometropia myopia with simple eye receiving orthokeratology treated.<p>METHODS: Totally 56 cases(112 eyes)with anisometropia myopia receiving monocular orthokeratology treated were divided into two groups. For every case, eye wearing orthokeratology was assigned to the experimental group and another eye to the control group. The refraction, corneal curvature and axial length were measured at pre-wear and 1mo discontinuation after wearing orthokeratology 1y.<p>RESULTS: The statistically significant changes(<i>t</i>=2.8631, <i>P</i><0.001)of increase in refraction were(0.29±0.15D),(0.76±0.41D)for the experimental and control group respectively. The horizontal corneal curvature was(0.27±0.11D)and(0.20±0.14D)for two groups, and there was no statistically significant difference(<i>t</i>=0.8204, <i>P</i>>0.05). The increase of axial length was(0.14±0.10)mm and(0.32±0.14)mm for the experimental and control group, respectively, and the increase was statistically significant(<i>t</i>=2.7518,<i>P</i><0.001).<p>CONCLUSION: Orthokeratology can slow down myopia progression by reducing axial length to control myopia increase.

Clinical observation of external rectus muscle amputation in the treatment of divergence insufficiency / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the clinical effect of external rectus muscle amputation in the treatment of divergence insufficiency. <p>METHODS: A retrospective analysis of 37 cases of insufficiency in our hospital from February 2011 to October 2017. The clinical manifestations were hyperopic esotropia with ipsilateral diplopia, myopia implicit esotropia without diplopia, and the monocular and binocular movements were normal. Preoperative refractive, strabismus, near stereopsis, negative fusion force examination, and then single or double external rectus muscle surgery.<p>RESULTS: Double vision disappeared after all cases, and there was no recurrence in diplopia after one year of follow-up. The preoperative long-term internal strabismus was +15△-+28△, with an average of 18.4△±5.7△, the near-internal strabismus was +5△-+16△, the average was 10.3△±3.6△, The difference value of long distance and short distance strabismus was 8.1△±2.3△; one week after surgery, the distance strabismus was -5.4△±1.5△, the near-distance squint was -7.2△±1.6△, the difference value was 1.8△±0.6△; the one year postoperative strabismus was -1.9△±1.2△, the close squint was -3.4△±1.4△, the difference value was 1.5△±0.8△. The long-distance strabismus one week after operation and one year after operation was significantly lower than that before operation(<i>P</i><0.05). The difference of distance and strabismus between one week and one year after operation was statistically significant. Preoperative the difference between near and far squint one week and one year after operation was statistically significant(<i>P</i><0.05). The difference was statistically significant between the preoperative and postoperative one week. The difference was statistically significant 1 week after surgery and 1 year after surgery. The long-distance negative fusion force before surgery was 3△-9△, with an average of 5.1△±1.8△, and the near-negative fusion force was 15△-24△, with an average of 19.4△±3.2△. The long-near negative fusion force was 10.1△±3.3△, 19.7△±4.1△ at 1wk after operation, and the long-distance negative fusion force was 11.2△±3.6△, 20.2△±4.8△ for one year after operation. There was a statistically significant difference between the patients with preoperative and one week postoperative negative fusion(<i>q</i>=4.551, <i>P</i>=0.013). There was no significant difference between the one week and one year after surgery(<i>q</i>=0.713, <i>P</i>=0.115).There was no significant difference in the patients' brachytherapy before and after one week and one year after operation(<i>P</i>>0.05).<p>CONCLUSION: Divergence insufficiency of external rectus muscle surgery can effectively reduce the difference of long-distance strabismus after surgery, eliminate the symptoms of diplopia in patients, and improve the near stereoscopic sharpness and long-distance negative fusion force.

Astragaloside IV prevents lipopolysaccharide-induced injury in H9C2 cardiomyocytes / 中国天然药物

This study aimed to investigate the protective effects of astragaloside IV (AS IV) on lipopolysaccharide (LPS)-induced injury in H9C2 cardiomyocytes. H9C2 Cardiomyocytes were cultured with LPS (10 μg·mL(-1)) for 4 h and treated with AS IV at 50, 100, and 150 μmol·L(-1) for various durations. Cell viability was determined by MTT. The content of released TNF-α and IL-6 from cardiomyocytes were evaluated by enzyme-linked immunosorbent assay (ELISA). The levels of superoxidase dismutase (SOD), malondialdehyde (MDA), lactate dehydrogenase (LDH), and creatine phosphate kinase (CK) were measured by using commercial available kits. The mRNA and protein expression levels of NF-κB p65 were measured by RT-PCR and Western blotting, respectively. And the NF-κB p65 activity was measured by ELISA. Our results demonstrated that AS IV at 50, 100, and 150 μmol·L(-1) markedly inhibited the release of TNF-α and IL-6 and decreased NF-κB expression, compared with the model group. Moreover, the improved SOD activity and decreased MDA, LDH and CK levels were detected after AS IV treatment. In summary, AS IV could increase the activities of antioxidant enzymes, inhibite lipid peroxidation, and down-regulate the inflammatory mediators involved in the inflammatory responses. These results demonstrated that AS IV could prevent LPS-induced injury in cardiomyocytes.

Content determination of twelve major components in Tibetan medicine Zuozhu Daxi by UPLC / 中国中药杂志

A quantitative analytical method of ultra-high performance liquid chromatography (UPLC) was developed for simultaneously determining twelve components in Tibetan medicine Zuozhu Daxi. SIMPCA 12.0 software was used a principal component analysis PCA) and partial small squares analysis (PLSD-DA) on the twelve components in 10 batches from four pharmaceutical factories. Acquity UPLC BEH C15 column (2.1 mm x 100 mm, 1.7 µm) was adopted at the column temperature of 35 °C and eluted with acetonitrile (A) -0.05% phosphate acid solution (B) as the mobile phase with a flow rate of 0. 3 mL · min(-1). The injection volume was 1 µL. The detection wavelengths were set at 210 nm for alantolactone, isoalantolactone and oleanolic; 260 nm for trychnine and brucine; 288 nm for protopine; 306 nm for protopine, resveratrol and piperine; 370 nm for quercetin and isorhamnetin. The results showed a good separation among index components, with a good linearity relationship (R2 = 0.999 6) within the selected concentration range. The average sample recovery rates ranged between 99.44%-101.8%, with RSD between 0.37%-1.7%, indicating the method is rapid and accurate with a good repeatability and stability. The PCA and PLSD-DA analysis on the sample determination results revealed a great difference among samples from different pharmaceutical factories. The twelve components included in this study contributed significantly to the quantitative determination of intrinsic quality of Zuozhu Daxi. The UPLC established for to the quantitative determination of the twelve components can provide scientific basis for the comprehensive quality evaluation of Zuozhu Daxi.

Simultaneous determination of 11 components in Zhizi Jinhua Pill by UPLC / 中草药

Objective: To establish a UPLC method for the simultaneous determination of 11 components, such as chlorogenic acid, geniposide, baicalin, berberine, wogonoside, baicalein, aloe-emodin, wogonin, emodin, chrysophanol, and physcion in Zhizi Jinhua Pill (ZJP). Methods: The chromatographic separation was achieved on an Acquity UPLC BEH C18 column (100 mm × 2.1 mm, 1.7 μm) with acetonitrile (A)-0.1% phosphate acid solution (B) as mobile phase at the flow rate of 0.4 mL/min for gradient elution; The column temperature was 35°C. The determination wavelengths were 324 nm for chlorogenic acid, 238 nm for geniposide, 345 nm for berberine, 276 nm for baicalin, wogonoside, baicalein, and wogonin, and 254 nm for aloe-emodin, emodin, chrysophanol, and physcion. Results: The 11 compounds were well separated. The RSD values of precision and reproducibility were all less than 2%. The stability was good in 24 h. The linear relationship between the concentration and peak areas of the 11 compounds was all linear (r ≥ 0.9995). The average recoveries were between 98.68%-100.47% and the RSD values were all less than 1.5%. Conclusion: The method is simple, reliable, and accurate, and could be used for the quality control of ZJP.

Effects of salvianolic acid and notoginseng triterpenes on angiogenesis in EA-hy926 cells in vitro / 中国天然药物

AIM@#To investigate the different effects of salvianolic acid and notoginseng triterpenes on proliferation, angiogenesis and expression of vascular endothelial growth factor in EA-hy926 cells in vitro.@*METHODS@#EA-hy926 cells were cultured in vitro. Salvianolic acid and notoginseng triterpenes at concentrations of 0.4, 0.8 and 1.2 mg·L(-1) were used to culture EA-hy926 cells. EA-hy926 cells in a blank control group were grown in culture solution only. Viability of cells was assessed by CCK-8, and after treated for 12 h, capillary-like structures were examined. After 24 h culture, the expression of VEGF was detected by real-time PCR.@*RESULTS@#Salvianolic acid at 0.4, 0.8 mg·L(-1), the same as notoginseng triterpenes, increased VEGF content in EA-hy926 cells. Expression of VEGF protein in the salvianolic acid at 1.2 mg·L(-1) group, was up-regulated as compared with notoginseng triterpenes group (P < 0.05).@*CONCLUSION@#Salvianolic acid and notoginseng triterpenes can promote EA-hy926 cell proliferation, angiogenesis and expression of VEGF protein. This analysis also provided evidence that salvianolic acid had the better effects as compared with notoginseng triterpenes.

Effect of clinical pathways based on integrative medicine for patients with chronic heart failure: a multi-center research / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To assess a multi-center study effectiveness of clinical pathways based on integrative medicine (IM) for chronic heart failure (CHF) patients.</p><p><b>METHODS</b>A combined method of historical control study and clinical study on concurrent control was used. After the standard management for clinical pathways was carried out in four hospitals at home, the effects on hospitalization days, medical expenses, clinical efficacy, patient satisfaction, and quality of life were assessed.</p><p><b>RESULTS</b>Results of non-concurrent historical control study showed that: the hospital stay was significantly shorter in the pathways group than in the retrospective group (12.59 days vs 18.44 days), and the total cost of hospitalization was significantly reduced in the pathways group (yen 9 051.90 vs yen 11 978.40), showing statistical difference (P < 0.01). Moreover, the effect on the heart function was better in the pathways group than in the retrospective group (the markedly effective rate: 45.60% vs 21.90%; the total effective rate: 96.80% vs 86.10%), showing statistical difference (P < 0.01). Results of clinical study on concurrent control showed that the hospital stay was significantly shorter in the pathways group than in the control group (11.19 days vs 13.21 days), showing statistical difference (P < 0.05). The average total cost of hospitalization was significantly lower in the pathways group than in the control group (yen 8 656.80 vs yen 11 609.70), showing statistical difference (P < 0.01). As for clinical efficacy of Chinese medical syndrome, the total effective rate was higher in the pathways group than in the control group (97.10% vs 93.62%), showing statistical difference (P < 0.05). The markedly effective rate of heart function was better in the pathways group than in the control group, showing statistical difference (49.30% vs 38.30%, P < 0.05). The overall satisfaction was higher in the pathways group than in the conventional group (P < 0.01). There was no statistical difference in the mortality within 3 months after discharge from hospital, and the readmission rate due to heart failure between the two groups (P > 0.05). But there was statistical difference in the quality of life (P < 0.05).</p><p><b>CONCLUSION</b>The pathway could shorten the hospitalization time, decrease the cost of hospitalization, improve the clinical efficacy, improve patients' quality of life and satisfaction, therefore, it could be spread nationwide.</p>

Effect of the regulation of adiponectin on the expression of nitric oxide synthase in the retinas of diabetic rats / 中华实验眼科杂志

Background Diabetic retinopathy (DR) is a common complication of diabetic mellitus,but its pathogenesis is still unclear.Adiponectin may restrain inflammatory reaction and reduce adhesion of vascular endothelial cell to influence diabetic microangiopathy.Relation between adiponectin and nitric oxide synthase (NOS)is less reported.Objective This study was to observe the effect of adiponectin on the expression of NOS in the retinas of diabetic rats.Methods Forty 8-10 weeks Sprague-Dawley (SD) female rats were collected.The rats were randomized into the normal control group (10 rats),adiponectin group (15 rats) and diabetic model control group (15 rats) using the random number table method.Tetraoxypyrimidine was intraperitoneally injected to establish the diabetic model in the rats of the adiponectin group and diabetic model control group,and 10 μg/kg of adiponectin was then injected into the rats of the adiponectin group.Western blot was used to detect the expression of the adiponectin protein in the rat retinas,and the expression of NOS in rat retina was located by immunochemistry.The use of the animals complied with the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results The relative amount of adiponectin (adiponectin/β-actin)in the retinas was 0.85 ± 0.21,0.79 ± 0.17 and 0.42 ± 0.08,respectively,in the normal control group,adiponectin group and diabetic model control group,with significant differences among the 3 groups (F =4.236,P =0.000).The adiponectin/β-actin ratio in the retinas of the diabetic model control group was significantly declined in comparison with the normal control group and adiponectin group (q =6.615,P =0.000 ; q =6.026,P =0.000).The NOS levels (A value) in the retinas were 0.244 ± 0.035,0.262 ± 0.032 and 0.367 ± 0.066,respectively,in the normal control group,adiponectin group and diabetic model control group,showing a significant difference among them (F =3.752,P =0.001).The A value of NOS in the diabetic model control group was significantly increased in comparison with the normal control group and adiponectin group (q =3.488,P =0.002 ; q =3.079,P =0.005).NOS expression was localized to the inner nuclear layer and retinal ganglion cell layer.Conclusions Adiponectin reduces NO content in diabetic rat retinas by regulating NOS expression.

Effect of pcDNA3.1- vascular endothelial growth factor 165 recombined vector on vascular buds in rabbit vertebral cartilage endplate / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>This study aimed to investigate the effect of pcDNA3.1-vascular endothelial growth factor (VEGF)165 vector on vertebral cartilage endplate vascular buds and intervertebral discs.</p><p><b>METHODS</b>Rabbits were randomly assigned to the control and experimental groups with 10 in each. In the experimental group, we anesthetized the rabbits and exposed the front vertebral body. Using the mark of the longitudinal ossature of the front vertebral body of the lumbar vertebrae, we advanced a needle at the central point of the front fourth and fifth lumbar intervertebral discs and injected 20 µl pcDNA3.1-VEGF165. Similarly, in the control group, we injected 20 µl pcDNA3.1. At 4 and 8 weeks post-injection, we examined the changes of the vertebral cartilage endplate using X-ray radiograph, histology, and scanning electron microscopy.</p><p><b>RESULTS</b>The vertebral cartilage endplate calcification and degeneration in the experimental group were less than those in the control group at 8 weeks post-operation. The average number and diameter of vascular buds obviously increased in the experimental group at 4 and 8 weeks post-operation. The number of vascular buds and the diameter in the region of the inner annulus increased when compared to those in the area near the nucleus pulposus.</p><p><b>CONCLUSIONS</b>The pcDNA3.1-VEGF165 plasmid can increase the average number and diameter of vascular buds and decelerate intervertebral disc degeneration.</p>

Influence of apolipoprotein E gene polymorphism on the lipid regulation by xuezhikang capsule / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the influence of apolipoprotein E (ApoE) gene polymorphism on the lipid metabolism regulatory effect of Xuezhikang Capsule (XZKC).</p><p><b>METHODS</b>ApoE polymorphism of 74 patients with hyperlipidemia was detected by gene sequencing method, and their plasma levels of total cholesterol (TC), triglyceride (TG), high- and low-density lipoprotein cholesterol (HDL-C and LDL-C) were determined before and after they received a 6-week treatment of XZKC, for analyzing the relationship between ApoE gene polymorphism and the changes of various blood lipids associated indices.</p><p><b>RESULTS</b>The effect of XZKC on reducing TG in the epsilon2 allele (E2/E2 and E2/E3 genotypes) was higher than that in the E3/E3 genotypes and epsilon4 allele (E3/E4 and E4/E4 genotypes), while on increasing HDL-C, it showed more effect in the epsilon4 allele (E3/E4 and E4/E4 genotypes) than that in the epsilon2 allele (E2/E2 and E2/E3 genotypes) and E3/E3 genotypes.</p><p><b>CONCLUSION</b>Patients' ApoE gene polymorphism could influence the lipid regulatory effect of XZKC, embodying mainly by raising HDL-C and reducing TG in patients with different ApoE genotypes to different extents.</p>

Determinants of Augmentation Index in the Elderly / 中华高血压杂志

Objective The Augmentation index(AI)is an indicator of pulse wave reflections.To under- stand the validity of AI in the elderly,we studied the determinants of AI in an elderly population.Methods All subjects older than 70 years living in Zhaoxiang Town,Qingpu District,Shanghai were recruited.Pulse wave a- nalysis at the left radial artery was performed by using Omron HEMg000AI device.The augmentation index (AI)adjusting for a heart rate of 75 beats/min was used for statistical analysis.Results One thousand two hun- dred eighty-six participants included 761(59 %)women,and 815(63 %)hypertensive patients with average age 76.3 years participate the study.Women had a significant higher AI than men(90.3% versus 85.8%,P