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RESUMEN Fundamento: la degeneración macular relacionada con la edad está entre las causas más comunes de pérdida visual severa e irreversible en pacientes mayores de 60 años en el mundo industrializado. Es considerado el aumento de la esperanza de vida en la población de los adultos mayores, la necesidad de un diagnóstico temprano y oportuno, es obvio para esta enfermedad que constituye un problema de salud a resolver. Objetivo: describir los resultados de la cicatrización con el uso del bevacizumab en la degeneración macular relacionada con la edad húmeda. Métodos: se realizó un estudio descriptivo, longitudinal en pacientes con el diagnóstico de degeneración macular relacionada con la edad húmeda. La población la conformaron 25 pacientes que acudieron a la consulta de retina en el periodo de octubre 2018 a abril 2019 y que cumplieron con los criterios de selección. Se les aplicó una encuesta y se estudiaron variables como: edad, sexo, antecedentes patológicos personales, número de inyecciones intravitreas colocadas a cada paciente, complicaciones post inyección y cicatrización de la lesión macular. BMMEM Resultados: según el comportamiento de los grupos de edades y el sexo, se encontró que la edad entre 60 y 69 fue de diez pacientes y el sexo femenino 15 pacientes fueron los más frecuentes. La hipertensión ocular fue la complicación que predominó. El antecedente patológico personal más frecuente fue la hipertensión arterial con cuatro pacientes. La mayor cantidad de ojos cicatrizaron con la administración de una y dos dosis del medicamento. Conclusiones: predominó el grupo de edad de 60 a 69 años y el sexo femenino. La hipertensión ocular fue la complicación más frecuente. Se constató la hipertensión arterial como el antecedente patológico personal más habitual. La cicatrización de los ojos ocurrió con la administración entre una y dos dosis.
ABSTRACT Background: the age-related macular degeneration is among the most common causes of harsh and irreversible visual loss in patient elders of 60 years in the industrialized world. Considering the increase of life expectancy and the rise in population of the senior citizens, the need of an early and opportune diagnosis, it is obvious for this disease that constitutes a health problem we have to solve. Objective: to describe the results of the cicatrization with the use of the bevacizumab in the age-related humid macular degeneration. Methods: a descriptive, longitudinal study in patients with the diagnosis of age-related humid macular degeneration was carried out. 25 patients that attended the retinal consultation in the period October, 2018 to April, 2019 and who fulfilled the criteria constituted the population of selection. They were applied an opinion poll and they studied variables were: Age, sex, pathological personal background, number of intravitreous injections placed to each patient, complications after injection and cicatrization of the macular injury. B Results: according to the age groups and the sex, it was shown that the age between 60 and 69, ten patients and the feminine sex 15 patients were the most frequent. The ocular hypertension was the complication that predominated with four patients. The greatest amount of eyes healed with the administration of one and two doses of the medication. Conclusions: the age group from 60 to 69 years and the feminine sex predominated. The ocular hypertension was the most frequent complication. It was verified high blood pressure as the most frequent pathological antecedent. The cicatrization of the eyes happened with the administration between one and two doses.
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Abstract Objective To compare two different treatments—the use of highly purified anhydrous (HPA) lanolin and expressed breast milk—for women with pain and nipple trauma during the breastfeeding process. Method A total of 180 puerperal women were randomly assigned to 2 groups: one was treated with HPA lanolin and the other with their own expressed breast milk. All of the participants received the same breastfeeding technique instructions and therapeutic care standard. Three assessments were performed: at the time of inclusion in the study (after randomization); after 48 hours; and after 7 days. At each interval, data was collected in relation to pain and trauma. A numerical/verbal category scale was used for the pain variable, and the nipple trauma score for the trauma variable. The results were subjected to statistical analysis using the chi-squared test, the Fisher exact test, the student t-test, and the Kolmogorov-Smirnov test. Generalized estimating equations were calculated using the STATA 12 statistical software package (StataCorp LLC, College Station, TX, USA) and IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp, Armonk, NY, USA). Results There was pain improvement from the second to the third assessment in the group that used HPA lanolin, while the pain remained unchanged between these two periods (p< 0.001) in the breast milk group. In terms of trauma, improvement was identified in its extension and depth from the first to the third assessment, and it was higher in the HPA lanolin group than in the breast milk group (p= 0.025). Conclusion The treatment of pain and nipple trauma with HPA lanolin achieved better results than the one with breast milk, based on a 7-day treatment period.
Resumo Objetivo Comparar dois tratamentos distintos—o uso de lanolina anidra altamente purificada (HPA, na sigla em inglês) e o próprio leite materno—para mulheres com dor e trauma mamilar durante o processo de amamentação. Métodos Participaram do estudo 180 puérperas randomizadas para 2 grupos: um utilizou tratamento com lanolina HPA e o outro o próprio leite materno. Todas receberam a mesma orientação quanto à técnica de amamentação e rigor terapêutico e foram avaliadas em três momentos: na inclusão no estudo (após a randomização), em 48 horas e em 7 dias. Em todos os momentos, foram colhidos dados em relação à dor e ao trauma. Para a variável dor, utilizou-se escala de categoria numérica/nerbal e, para a variável trauma, a pontuação de traumas mamilares. Os testes estatísticos utilizados foram: Qui-quadrado, teste exato de Fisher, t de Student, e Kolmogorov-Smirnov, sendo que os modelos de equações de estimação generalizadas foram calculados por meio dos pacotes STATA 12 (StataCorp LLC, College Station, TX, EUA) e IBM SPSS Statistics for Windows, Versão 20.0 (IBM Corp, Armonk, NY, EUA). Resultados Houve melhora da dor da segunda para a terceira avaliação no grupo que utilizou a lanolina HPA, enquanto que no grupo que usou leite materno a dor permaneceu inalterada entre esses dois momentos (p< 0,001). Quanto ao trauma, foi identificada melhora em sua extensão e profundidade, da primeira para a terceira avaliação, e a melhora foi maior no grupo tratado com lanolina HPA do que no grupo tratado com leite materno (p= 0,025). Conclusão O tratamento da dor e do trauma mamilar com lanolina HPA teve melhor resultado comparado com o leite materno, com base em um período de tratamento de 7 dias.
Subject(s)
Humans , Female , Adolescent , Adult , Young Adult , Pain Management/methods , Lanolin/therapeutic use , Milk, Human , Nipples/injuries , Pain/etiology , Breast Feeding/adverse effects , Middle AgedABSTRACT
Background Interleukin-6 (IL-6) is a pleiotropic cytokine involving in inflammation and wound healing.Previous report found that IL-6 increases phosphorylated STAT3 (p-STAT3) level and promotes corneal epithelial wound healing by stimulating migration.However,the essential role of IL-6 in corneal epithelial wound healing and the expression changes in diabetic mellitus remains unknown.Objective This study was to explore the roles of IL-6 in corneal epithelial proliferation and wound healing in both normal and diabetic mice.Methods Fifty-two normal C57BL/6 mice were randomized into normal control group (32 mice) and diabetic group (20 mice).Type 1 diabetic mellitus was induced by intraperitoneal injections of 50 mg/kg streptozotocin once per day for consecutive 5 days in the mice of the diabetic group.Whole corneal epithelium was scraped in all mice,and the corneal epithelial defect area was examined by fluorescein staining in 24,48 and 72 hours after corneal epithelium removal.Recombinant mouse IL-6 or anti-IL-6 blocking antibody of 5 μl were subconjunctivally injected according to the grouping and contrasted with PBS injection group or isotype control antibody group,respectively.TKE2 cells,a mouse corneal epithelial stem/progenitor cell line,were trypsinized and incubated in the KSFM with different concentrations of IL-6 or without IL-6,and colony formation efficency (CFE) was examined by crystal violet staining.The expressions of △NP63 and Ki67,specific makers of stem cells,were detected by immunofluorescine technology.The expressions of △NP63,Ki67 and p-STAT3 proteins were assayed in the cells by Western blot,respectively.The expression of IL-6 mRNA and protein in the regenerated corneal epithelium was detected by real time quantitative PCR and ELISA.The use and care of the mice complied with the Statement of Association for Research in Vision and Ophthalmology.Results The percentage of residual corneal epithelium defect area with initial detect area was gradually shrinked over time after PBS and IL-6 injection in both normal control mice and diabetic mice,and the percentage of residual corneal epithelium defect area was significantly reduced in the IL-6 injected group compared with the PBS injected group (normal control group:Fgroup =19.982,P ＜ 0.01;Ftime =589.350,P ＜ 0.01;Diabetic group:Fgroup =25.411,P＜0.01;Ftime =334.807,P＜0.01).The CFE was (13.23± 1.12)％,(15.87± 1.30)％,(21.69±1.62)％,(25.33±1.28)％ and (18.67±1.54)％ in the blank control group and 10,20,50,100 ng/ml IL-6-treated groups,respectively,showing a gradual increase of CFE dependent upon IL-6 concetrations (F =35.547,P＜0.01).The expressions of △NP63,Ki67,p-STAT3 proteins in the cells were gradually increased over time after 50 ng/ml IL-6 treated for 5,10,15,30 and 60 minutes,and the relative expression level of the cytokines was significnatly higher in the IL-6 cultured groups than that without IL-6 culture group (all at P＜0.05).The relative expression of IL-6 mRNA in the regenerated corneal epithelilum was 0.45±0.21 and 1.00±0.16 in the diabetic group and normal control group,respectively,and compared with the normal control group,the expression of IL-6 mRNA reduced by 56％ (t=3.42,P=0.03).The content of IL-6 protein in regenerated corneal epithelium of the diabetic group was (257±12) ng/μl,which was significantly lower than (323 ± 17) ng/μl of the normal control group (t =5.60,P＜0.01).Conclusions IL-6 promotes the proliferation and regeneration of corneal limbal stem cells to repair defected corneal epithelium by activating STAT3 signaling pathway in both normal and diabetic mice,while the blocking of endogenous IL-6 impairs the corneal epithelial cell activation and wound healing.
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Background The primary reason to trabeculectomy failure is fibrosis of conjunctiva and episclera because of progressive fibroblast proliferation and collagen deposition of the filtration bleb.Conventional methods of inhibiting bleb scarring was intraoperative application of mitomycin C (MMC),but many complications occured after surgery.Researches showed that bevacizumab was an antifibrotic agent,and whether it can suppress scarring of filtering bleb after trabeculectomy is concerned.Objective The aim of this study was to evaluate the antifibrotic efficacy of bevacizumab after trabeculectomy in rabbits.Methods Forty New Zealand rabbits were randomly divided into four groups.Trabeculectomy was performed on the right eyes of each rabbits.The rabbits received subconjunctival injection of 0.05 ml bevacizumab (25 mg/ml) at the end of operation in the bevacizumab single injection group.The same dose of bevacizumab was respectively injected at the end of operation as well as 3 days and 7 days after operation in the bevacizumab repitition injection group,and 0.05 ml normal saline solution was used in the same way in the normal saline group.In the MMC group,MMC cotton patch with 0.2 mg/ml was placed under the Tenon caplsule and scleral flap for 3 minutes during operation.The intraocular pressure (IOP),bleb area and shape were evaluated during the 28-day period.The animals were sacrificed on postoperative day 14 and 28,respectively for the histopathologic examination of bleb.The expression of CD31 in the bleb was detected by immunohistochemistry for the calculation of microvessels.All experiments were performed in accordance with the ethics code for animal experimentation and approved by the Institutional Review Board of Tianjin Eye Hospital.Results No significant difference was found in the postoperative IOP among the groups (F =0.88,P =0.47).Compared with the bevacizumab single injection group,MMC group and normal saline group,the shape of bleb was higher and much diffuse with sparse vessels 7 days after operation in the bevacizumab repitition injection group.The survival time of bleb was 27 days,19 days and 13 days in the bevacizumab repitition injection group,the bevacizumab single injection group,MMC group and normal saline group,respectively.The percentage of collagen deposition area was (49.18±1.54)％,(26.41±1.23)％,(50.68±1.87)％ and (70.63±1.81)％ at day 14 postoperative in the bevacizumab single injection group,bevacizumab repitition injection group,MMC group and normal saline group,respectively,with the largest area in the normal saline group,and percentage of collagen deposition area was significantly reduced in the bevacizumab repitition injection group compared with the bevacizumab single injection group (all at P＜0.05).The percentage of collagen deposition area was (66.82±1.53)％ at day 28 postoperative in the bevacizumab repitition injection group,while complete scarring was seen in other 3 groups.The number of microvessels was least at postoperative day 14 in the bevacizumab repitition injection group compared with the bevacizumab single injection group,MMC group and normal saline group (all at P ＜ 0.05).The number of microvessels was more in postoperative day 28 in the bevacizumab repitition injection group (3.51 ±0.31) compared with other groups (all at P ＜ 0.05).Conclusions Subconjunctival injection of bevacizumab following trabeculectomy can improve the successful rate of surgery by remaining the survival time of filtering bleb,inhibiting the bleb scarring in rabbits.
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Objective To investigate the antibacterial properties and curative effects of a nanosilver-epidermal growth factor (NanoAg-EGF) sustained-release carrier.Methods First,in accordance with former method,sustained-release carrier of NanoAgEGF was prepared,with the design of the NanoAg-EGF group,NanoAg-alone group,EGF-alone group,control groups of normal saline-alone,and benzylpenicillin sodium.Contrasting detection on antibacterial properties of five kinds of common microbes (staphylococcus aureus,escherichia coli,pseudomonas aeruginosa,candida albicans,and streptococcus pneumonia) in each group was used to confirm their antibacterial properties.Then,wound models of diabetic rats were randomly divided into five groups,with the wound treatments by sustained-release cartier of NanoAg-EGF,combined application of NanoAg + EGF,EGF-alone,NanoAg-alone,and normal saline-alone control group,respectively.The observation on the healing situation of each group in different times was used to ensure the curative effect.Results In the antibacterial experiments,it was found that the NanoAg-EGF and NanoAg had strong antibacterial properties.Their antibacterial properties had no significant difference (P ＞ 0.05).The control group,penicillin sodium only had relatively weak antibacterial properties on staphylococcus aureus and streptococcus pneumoniae,with obviously weaker function compared to the NanoAg-EGF and NanoAg groups (P ＜ 0.05).The control groups,EGF-alone and normal saline-alone had no inhibitor function on each kind of pathogenic microorganisms.In the wound healing experiments on diabetic rats,it was found that NanoAgEGF shortened significantly the wound healing time of diabetic rats (P ＜ 0.05).On the 3rd day,the healing rate of each group had no difference (P ＞ 0.05).On the 7th day and 13th day,the healing rates of NanoAg-EGF [(61.71 ± 8.78)％ and (100 ± 2.60) ％] were significantly higher than the other four groups (P ＜ 0.05).Conclusions NanoAg-EGF not only has good antibacterial properties but also can promote rapidly the wound healing of diabetes.