Research progress of anti-vascular endothelial growth factor in cataract surgery for diabetic retinopathy / 中华眼底病杂志

Diabetic retinopathy (DR) is a common ocular complication in diabetic patients, which is chronic and progressive and seriously impairs visual acuity. The rapid occurrence and progress of cataract in diabetic patients is also one of the important reasons for visual impairment in DR patients. Compared with non-diabetic patients, diabetic patients have higher risk of complications after cataract surgery. Studies have shown that anti-vascular endothelial growth factor (VEGF) therapy after cataract surgery can prevent the aggravation of diabetic macular edema in DR patients. However, due to the lack of systematic review of the clinical effect of anti-VEGF drugs in DR patients undergoing cataract surgery, the use of anti-VEGF drugs is relatively conservative in clinic. It is believed that with the deepening of research and the progress of clinical trials, the wide application of anti-VEGF drugs in clinical practice is expected to provide more accurate and effective treatment for DR patients in the future.

Clinical study on the relationship between coronary artery lesion and cardiac function in patients with coronary heart disease / 重庆医学

Objective To investigate the relationship between coronary artery lesion and cardiac function in coronary atherosclerotic heart disease (CHD) patients.Methods Ninty cases of patients with CHD who were hospitalized for chest pain in Air Force PLA General Hospital and scheduled for coronary angiography were selected.Noninvasive hemodynamie testing was performed before coronary angiography.According to the results of coronary angiography,74 patients with coronary artery stenosis were selected as disease group,persons with an additional angiography showed no coronary artery stenosis and excluded from other systemic diseases in physical examination center(30 cases) were chosed as control group.According to the results of coronary angiography,the Gensini score system was used to quantify the degree of coronary artery disease,the patients were divided into two groups according to the score.:high score group (Gensini score＞ 20 points,40 cases) and low score group (Gensini score≤20).And the relationship between coronary artery stenosis and cardiac function was analyzed by comparing the two groups of noninvasive hemodynamics cardiac function indexes,BNP and LVEF values.Results The levels of C,SV,CO,CI,HI and LVEF in the disease group were significantly lower than those in the control group (P＜0.05),Q-B/B-X was significantly higher than that in the control group (P＜0.05);There were statistically significant of BNP and LVEF between Gensini high score and low score group (P＜0.05).The Pearson correlation analysis showed there was significantly negatively correlated between Gensini score and C,SV,CO,CI,HI,LVEF,and significantly positively correlated btween Gensini score and Q-B/B-X,BNP.Conclusion The degree of coronary artery lesion was negatively correlated with cardiac function,and the worse the disease,the worse the heart function.

Recovery of cardiac function in patients with frequent premature ventricular contraction after radiofrequcency catheter ablation by noninvasive hemodynamic detection technique / 军事医学

Objective To explore the change in cardiac function in patients with idiopathic frequent premature ventricular contraction(PVC) after radiofrequency catheter ablation(RFCA) and drug control by ultrasound Doppler and noninvasive hemodynamic detection technique.Methods Forty-eight patients with idiopathic frequent PVC were selected as the test group with a total of(16 391.03±10 873.01)beats per day.Another 55 healthy subjects were selected as the control group.Heart ultrasound Doppler and noninvasive hemodynamic detection technique were used in the two groups.Twenty-five patients were selected from the PVC group to receive RFCA,while noninvasive hemodynamic detection technique was adopted 3 days after operation.Results by ultrasound Doppler and noninvasive hemodynamic detection technique were compared between the two groups before and after operation.Results There was no significant difference in left ventricular ejection fraction(LVEF),left ventricular end-diastolic dimension(LVEDD),left ventricular end-systolic dimension (LVESD),left atrial diameter(LA)and the ratios of the peak mitral flow velocity in early diastole (E) to the peak atrial kick velocity (A) between the two groups.HI,SI,CI and C in PVC group were significantly lower than those in control group(P<0.01),but WA,O,WA/C and O/C were significantly higher than those in control group(P<0.01).HI,SI,CI and C obviously increased 3 days after operation(P<0.01),but WA,O,WA/C and O/C significantly decreased (P<0.01).Conclusion The cardiac functio of idiopathic PVC patients in the early stage may have been damaged,and RECA can reverse or delay the damaged cardiac function due to frequent PVC.

Clinical Study on ModifiedYigongsan Formula Combined with Aidi-injection in the Treatment of Advanced Gastric Cancer / 中国中医药信息杂志

Objective To observe the clinical efficacy of ModifiedYigongsan Formula combined with Aidi-injection on advanced gastric cancer.Methods Totally 64 cases of patients with advanced gastric cancer were randomly divided into treatment group and control group with 32 cases in each group. Both groups were treated with Aidi-injection for intravenous drip, continuous infusion for 2 weeks. The treatment group was treated with Modified Yigongsan Formula, daily 1 agent, oral administration after lunch, for 4 weeks continuously; the control group did not take other medicine. The tumor markers (CEA, CA199), TCM syndrome score and physical condition score of the patients before and after treatment were observed.ResultsAfter treatment, the TCM syndrome score in the treatment group was significantly improved than that in the control group; the total effective rate was 84.38% (27/32) in the treatment group, and 43.75% (14/32) in the control group; the treatment group was significantly higher than that in the control group (P0.05). Conclusion ModifiedYigongsan Formula combined with Aidi-injection on advanced gastric cancer tumor marker improvement was not obvious, but the improvement of TCM syndrome and physical condition of patients is very obvious.

Glycogen synthase kinase-3: a key kinase in retinal neuron apoptosis in early diabetic retinopathy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Diabetes-related pathogenic factors can cause retinal ganglion cell (RGC) apoptosis, but the specific mechanism is not very clear. The aim of this study is to investigate the correlation between glycogen synthase kinase-3 (GSK-3) activation and retinal neuron apoptosis.</p><p><b>METHODS</b>In an in vitro experiment, the number of apoptotic RGC-5 cells differentiated by staurosporine was evaluated via flow cytometry and nuclei staining using Hoechst 33258. GSK-3 phosphorylation and caspase-3 activation in RGC-5 cells after serum deprivation were determined using Western blotting. Mitochondrial membrane potential was detected using the dye 5, 5', 6, 6'tetrachloro-1, 1', 3, 3'-tetrethyl benzimidalyl carbocyanine iodide, and reactive oxygen species (ROS) levels were measured with dihydroethidium. In an in vivo experiment, the number of apoptotic retinal neurons was evaluated via terminal transferase dUTP nick-end labeling (TUNEL), and GSK-3 phosphorylation was determined using Western blotting, in the retinal nerve epithelial tissue of rats in which diabetes was induced by intravenous tail-vein injection of streptozotocin for 4 weeks.</p><p><b>RESULTS</b>The levels of phosphorylated Ser21/9 in GSK-3α/β and p-T308/S473-AKT were lower and the cleaved caspase-3 levels were higher in the serum-deprived model (P < 0.05). Lithium chloride treatment was associated with a slower rate of apoptosis, increased mitochondrial membrane potential, and decreased ROS levels in differentiated RGC-5 cells (P < 0.05). The level of blood glucose and the number of TUNEL-positive cells in the whole-mounted retinas were higher (P < 0.01), and the levels of phosphorylated Ser21/9 in GSK-3α/β and body weight were lower (P < 0.05). However, the thickness of the retinal nerve epithelial layer was not significantly less in diabetic rats compared with control group. Lithium chloride intravitreal injection increased the levels of phosphorylated Ser21/9 in GSK-3α/β and decreased TUNEL-positive cells in the whole-mounted retinas.</p><p><b>CONCLUSION</b>GSK-3 kinase is closely related to retinal neuron apoptosis, and the application of the GSK-3 inhibitor lithium chloride can reduce retinal neuron apoptosis in early diabetic retinopathy.</p>

Comparison of fundus fluorescein angiography and indocyanine green angiography for imaging of subretinal hemorrhage in age-related macular degeneration / 中华眼底病杂志

Objective To compare the effects of fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) on classifications and locations of choroidal neovascularization (CNV) located under subretinal hemorrhage in age-related macular degeneration, and on the area-measuring of subretinal hemorrhage. Methods The medical record of 177 patients with subretinal hemorrhage associated with AMD confirmed by photochrome of ocular fundus, FFA and ICGA examinations were retrospectively reviewed. The locations and classifications of CNV on the images of FFA and ICGA in the 177 patients and the area of subretinal hemorrhage of 30 patients randomly selected from the 177 patients were analyzed and measured. Results On the images of FFA, the locations and classifications of CNV could be defined in 160 patients (90.4%), and CNV was considered eligible for laser therapy in 24 patients (13.6%). On the images of ICGA, the locations and classifications of CNV could be defined in 175 patients (98.9%),and CNV was considered eligible for laser therapy in 51 patients (28.8%). There was no statistical difference of the locations (Z=-0.383,P=0.701) and classifications (?2=2.993,P=0.810) of CNV on the images of FFA and ICGA. The areas of blocked fluorescence measured on the images of FFA (=26.610 mm2 and M= 13.548 mm2) were larger than those of ICGA (=24.714 mm2, M=12.875 mm2) with statistical differences (Z=-3.000,P=0.003) between FFA and ICGA. Conclusions ICGA is beneficial for imaging CNV located under subretinal hemorrhage, and may increase the number of the patients who are considered eligible for laser treatment. The effect of measurement of the area of subretinal hemorrhage in AMD evaluated by FFA is better.

Surgical treatment of massive subretinal hemorrhage and vitreous hemorrhage associated with age-related macular degeneration / 中华眼底病杂志

Objective To investigate the method and the effects of the surgical treatment of massive subretinal hemorrhage and vitreous hemorrhage associated with age related macular degeneration. Methods A retrospective study of 14 consecutive patients underwent a complete pars plana vitrectomy. Retinotomy was carried out for removing subretinal hemorrhage by using balanced salt solution. Complete air fluid exchange and gas or silicone oil tamponade were performed in all patients. The follow up period was within 3～7 months. Results Atrophy of eyeball in 2 eyes (14.3%) postoperatively. Improvement of corrected final visual acuity and anatomical retinal reattachment were achieved in 12 (85.7%) of the 14 eyes postoperatively. Seven days after operation, muddy sand hemorrhage in anterior chamber occurred in 4 (28.6%) of the eyes and paracenteses of anterior chamber were performed for these eyes. Conclusion Surgical intervention should be applied in the eyes with the massive subretinal hemorrhage associated with age related macular degeneration in order to avoid the affected eyes becoming atrophic due to the subsequent complication of vitreous hemorrhage, anterior chamber muddy sand hemorrhage,ghost cell glaucoma or retinal detachment.

Analysis of the correlation factors and vitrectomy of epiretinal macular membrane of 26 patients / 中华眼底病杂志

ObjectiveTo investigate the correlation factors of macular pucker after vitrectomy, and compare the surgical effect between secondary and idiopathic epiretinal macular membrane.MethodsA study of 26 consecutive patients (26 eyes), in which 18 were diagnosed as secondary epiretinal macular membranes and 8 as idiopathic epiretinal macular membranes, underwent par plana vitrectomy, vitreous cortex separation, and peeling off of the epiretinal macular membrane. The follow-up period was within 3~12 months. Preoperative and postoperative examination included visual acuity, fundus photography, and optical coherence tomography in some patients.ResultsAmong the 18 patients with secondary epiretinal macular membranes, 9 (50.0%) were related to vitreous surgery. There was statistical difference between cryoretinopexy to giant retinal tear and endolaser (?2=12.24,P

Construction of specifically expressed vascular endothelial growth factor_(165) gene in retina / 中华眼底病杂志

Objective To construct specifically expressed vascular endothelial growth factor (VEGF) 165 gene in retina. Methods Rho promoter, specifically expressed in retina, was amplified by polymerase chain reaction (PCR) from the genomic DNA of a BLAB/C rat, then it was cut with restriction enzymes and cloned into the plasmid pcDNA 3.1+-VEGF 165 to form recombinant plasmid pcDNA 3.1+-rho-VEGF 165. The correct recombinant plasmid pcDNA 3.1+-rho-VEGF 165 was identified by restriction enzymes and PCR, and was transferred by jetPEI into cultured human navel vein endothelial cells and human retinal pigment epithelial (RPE) cells. The expression of VEGF protein in human navel vein endothelial and RPE cells was detected by immunocytochemical staining and protraction of the growth curve of the cells. Results In human RPE cells, the expression of VEGF protein was more in recombinant plasmid pcDNA 3.1+-rho-VEGF 165 than that in plasmid pcDNA 3.1+-VEGF 165; in human navel vein endothelial cells, no obvious difference of the expression of VEGF protein between recombinant plasmid pcDNA 3.1+-rho-VEGF 165 and plasmid pcDNA 3.1+-VEGF 165 was found. Conclusions The construction of pcDNA 3.1+-rho-VEGF 165 carrier may provide the basic material for the study of the nosogenesis of VEGF in retinal neovascularization, and establish the foundation to set up the model of transgenic mice with VEGF specific expressing in retina.