Sub-threshold micro-pulse diode laser treatment in diabetic macular edema: A Meta-analysis of randomized controlled trials.

AIM: To examine possible differences in clinical outcomes between sub-threshold micro-pulse diode laser photocoagulation (SDM) and traditional modified Early Treatment Diabetic Retinopathy Study (mETDRS) treatment protocol in diabetic macular edema (DME). METHODS: A comprehensive literature search using the Cochrane Collaboration methodology to identify RCTs comparing SDM with mETDRS for DME. The participants were type I or type II diabetes mellitus with clinically significant macular edema treated by SDM from previously reported randomized controlled trials (RCTs). The primary outcome measures were the changes in the best corrected visual acuity (BCVA) and the central macular thickness (CMT) as measured by optical coherence tomography (OCT). The secondary outcomes were the contrast sensitivity and the damages of the retina. RESULTS: Seven studies were identified and analyzed for comparing SDM (215 eyes) with mETDRS (210 eyes) for DME. There were no statistical differences in the BCVA after treatment between the SDM and mETDRS based on the follow-up: 3mo (MD, -0.02; 95% CI, -0.12 to 0.09; P=0.77), 6mo (MD, -0.02; 95% CI, -0.12 to 0.09; P=0.75), 12mo (MD, -0.05; 95% CI, -0.17 to 0.07; P=0.40). Likewise, there were no statistical differences in the CMT after treatment between the SDM and mETDRS in 3mo (MD, -9.92; 95% CI, -28.69 to 8.85; P=0.30), 6mo (MD, -11.37; 95% CI, -29.65 to 6.91; P=0.22), 12mo (MD, 8.44; 95% CI, -29.89 to 46.77; P=0.67). Three RCTs suggested that SDM laser results in good preservation of contrast sensitivity as mETDRS, in two different follow-up evaluations: 3mo (MD, 0.05; 95% CI, 0 to 0.09; P=0.04) and 6mo (MD, 0.02; 95% CI, -0.10 to 0.14; P=0.78). Two RCTs showed that the SDM laser treatment did less retinal damage than that mETDRS did (OR, 0.05; 95% CI, 0.02 to 0.13; P<0.01). CONCLUSION: SDM laser photocoagulation shows an equally good effect on visual acuity, contrast sensitivity, and reduction of DME as compared to conventional mETDRS protocol with less retinal damage.

Leptin enhances the release of cytokines by peripheral blood mononuclear cells from acute multiple sclerosis patients.

Objective To explore the effect of leptin on cytokine production by PBMCs obtained from MS patients either in acute (relapse) or in stable (nonrelapse) phase of disease. Methods PBMCs were collected from 25 untreated acute MS patients, 11 stable MS patients and 20 healthy controls. PBMCs were cultured either with RPMI-1640 alone or with leptin (1.25 nmol/ml), phytohemagglutinin (PHA) (100 mug/ml), and leptin + PHA. 72 h later the supernate of the culture medium were collected and stored at -70 degrees C. The pro-inflammatory cytokine (IFN-gamma) concentration were determined using an enzyme-linked immunosorbent assay ( ELISA), and the anti-inflammatory cytokine (IL-4) concentration were investigated by radioimmunity methods. Results Our data showed that leptin induced IFN-gamma production by PBMCs of patients in an acute phase of disease but not in a stable phase or in healthy controls. Moreover, we found that PHA induced IL-4 production by PBMCs of patients in an acute phase of disease, but leptin inhibited this ability of PHA. Conclusion Leptin can affect on pro- and anti-inflammatory cytokine production by PBMCs collected from MS patients, may be this connected with leptin increase the susceptiveness of MS.

[Inhibition of 8-OH-DPAT on spontaneous unit discharges of 5-hydroxytryptamine inhibitory unit in rat primary somatosensory cortex].

AIM: To investigate the effect of 5-hydroxytryptamine (5-HT) on spontaneous unit discharges of primary somatosensory cortex (SI-SUD) and the role of 5-HT1A receptor in 5-HT inhibitory effect on SI-SUD in rat. METHODS: The SI-SUD was recorded before and during microiontophoresis of 5-HT and 8-OH-DPAT (the selective agonist for 5-HT1A receptor. The changes of mean of interspike interval (MISI) of SI-SUD were analysed and handled with the statistics. RESULTS: (1) Effects of 5-HT on SI-SUD may be inhibitory (48/96), excitatory (26/96) or non-responsive (22/96), and the major effect is inhibitory. (2) In 20 of 5-HT inhibited units, 17 are also inhibited with microiontophoresis of 8-OH-DPAT, but 3 have no obvious response to 8-OH-DPAT. CONCLUSION: The major effect of 5-HT on SI-SUD is inhibitory. In majority of 5-HT inhibited units, 5-HT1A receptor may be existence, which may involve in the inhibition of 5-HT on SI-SUD.