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As digital data undergo explosive growth, deoxyribonucleic acid (DNA) has emerged as a promising storage medium due to its high density, longevity, and ease of replication, offering vast potential in data storage solutions. This study focuses on the protection and retrieval of data during the DNA storage process, developing a technique that employs flow cytometry sorting (FCS) to segregate multicolored fluorescent DNA microparticles encoded with data and facilitating efficient random access. Moreover, the encapsulated fluorescent DNA microparticles, formed through layer-by-layer self-assembly, preserve structural and sequence integrity even under harsh conditions while also supporting a high-density DNA payload. Experimental results have shown that the encoded data can still be successfully recovered from encapsulated DNA microparticles following de-encapsulation. We also successfully demonstrated the automated encapsulation process of fluorescent DNA microparticles using a microfluidic chip. This research provides an innovative approach to the long-term stability and random readability of DNA data storage.
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ADN , Citometría de Flujo , ADN/química , Colorantes Fluorescentes/química , Almacenamiento y Recuperación de la InformaciónRESUMEN
Behçet uveitis poses significant management challenges, owing to its intricate pathogenesis and the severe prognosis it harbors, frequently culminating in irreversible visual impairment and an elevated risk of blindness. This review synthesizes contemporary insights into personalized immunosuppressive strategies for Behçet uveitis, emphasizing the necessity for a customized approach in recognition of the disease's heterogeneity and the variable responsiveness to treatment. This discourse elaborates on the application, efficacy, and safety profiles of traditional immunosuppressants, highlighting a paradigm shift toward integrative combination therapies aimed at diminishing reliance on glucocorticoids and mitigating their associated adverse effects. This thorough evaluation seeks to enlighten clinical practices and spearhead future investigations aimed at refining the management of Behçet uveitis, championing a personalized, multidisciplinary strategy to amplify therapeutic efficacy and enhance patient quality of life.
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Síndrome de Behçet , Inmunosupresores , Uveítis , Humanos , Síndrome de Behçet/tratamiento farmacológico , Síndrome de Behçet/terapia , Síndrome de Behçet/inmunología , Uveítis/inmunología , Uveítis/tratamiento farmacológico , Uveítis/terapia , Inmunosupresores/uso terapéutico , Medicina de Precisión/métodos , Calidad de VidaRESUMEN
DNA-based molecular amplifiers offer significant promise for molecular-level disease diagnosis and treatment, yet tailoring their activation for precise timing and localization remains a challenge. Herein, we've pioneered a dual activation strategy harnessing external light and internal ATP to create a highly controlled DNA logic amplifier (FDLA) for accurate miRNA monitoring in cancer cells. The FDLA was constructed by tethered the two functionalized catalytic hairpin assembly (CHA) hairpin modules (ATP aptamer sealed hairpin aH1 and photocleavable (PC-linker) sites modified hairpin pH2) to DNA tetrahedron (DTN). The FDLA system incorporates ATP aptamers and PC-linkers as logic control units, allowing them to respond to both exogenous UV light and endogenous ATP present within cancer cells. This response triggers the release of CHA hairpin modules, enabling amplified FRET miRNA imaging through an AND-AND gate. The DTN structure could improve the stability of FDLA and accelerate the kinetics of the strand displacement reaction. It is noteworthy that the UV and ATP co-gated DNA circuit can control the DNA bio-computing at specific time and location, offering spatial and temporal capabilities that can be harnessed for miRNA imaging. Furthermore, the miRNA-sensing FDLA amplifier demonstrates reliable imaging of intracellular miRNA with minimal background noise and false-positive signals. This highlights the feasibility of utilizing both exogenous and endogenous regulatory strategies to achieve spatial and temporal control of DNA molecular circuits within living cancer cells. Such advancements hold immense potential for unraveling the correlation between miRNA and associated diseases.
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Adenosina Trifosfato , Aptámeros de Nucleótidos , Técnicas Biosensibles , ADN , MicroARNs , MicroARNs/análisis , Humanos , Técnicas Biosensibles/métodos , Adenosina Trifosfato/análisis , Aptámeros de Nucleótidos/química , ADN/química , ADN/genética , Transferencia Resonante de Energía de Fluorescencia/métodos , Rayos UltravioletaRESUMEN
Most patients with myopia have dry eye, which has been shown to adversely affect ocular symptoms, myopia progression, and quality of life in patients with myopia. Needle prickling has been shown to be effective in providing symptom relief in patients with myopia and dry eye. Press needle is a long-lasting, easy-to-operate, and inexpensive traditional Chinese medicine treatment. The standard practice of needle insertion is very important for the treatment of myopia and dry eye. The specific steps include selecting the appropriate acupoints, piercing them with appropriate needles, and fixing them in the skin or subcutaneously at the acupoints, burying them for 2 days, resting for 1 day; the course of treatment lasts for 2 weeks. Specifically, the following indicators were assessed: uncorrected visual acuity and the ocular surface disease index. This article will explain how to standardize the operation of a press needle in the treatment of myopia and dry eye.
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Terapia por Acupuntura , Síndromes de Ojo Seco , Medicina Tradicional China , Miopía , Humanos , Síndromes de Ojo Seco/terapia , Miopía/terapia , Medicina Tradicional China/métodos , Terapia por Acupuntura/métodos , Terapia por Acupuntura/instrumentación , AgujasRESUMEN
Glycolysis-dominant metabolic pathway in cancer cells can promote their therapeutic resistance against radiotherapy (RT). Carbon monoxide (CO) as a glycolysis inhibitor can enhance the efficiency of RT. Herein, an X-ray responsive CO-releasing nanocomposite (HA@AuNC@CO) based on strong host-guest interactions between the radiosensitizer and CO donor for enhanced RT is developed. The encapsulated gold nanoclusters (CD-AuNCs) can effectively generate cytotoxic reactive oxygen species (ROS) under X-ray radiation, which not only directly inactivate cancer cells but also induce in situ CO gas generation from adamantane modified metal carbonyl (Ada-CO) for glycolysis inhibition. Both in vitro and in vivo results demonstrate that HA@AuNC@CO exhibits active targeting toward CD44 overexpressed cancer cells, along with excellent inhibition of glycolysis and efficient RT against cancer. This study offers a new strategy for the combination of gas therapy and RT in tumor treatment.
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Monóxido de Carbono , Glucólisis , Oro , Nanopartículas del Metal , Especies Reactivas de Oxígeno , Oro/química , Monóxido de Carbono/química , Humanos , Animales , Nanopartículas del Metal/química , Especies Reactivas de Oxígeno/metabolismo , Línea Celular Tumoral , Rayos X , Glucólisis/efectos de los fármacos , Ratones , Neoplasias/tratamiento farmacológico , Neoplasias/terapia , Neoplasias/metabolismo , Fármacos Sensibilizantes a Radiaciones/química , Fármacos Sensibilizantes a Radiaciones/farmacologíaRESUMEN
Macrophages form a crucial component of the innate immune system, and their activation is indispensable for various aspects of immune and inflammatory processes, tissue repair, and maintenance of the balance of the body's state. Macrophages are found in all ocular tissues, spanning from the front surface, including the cornea, to the posterior pole, represented by the choroid/sclera. The neural retina is also populated by specialised resident macrophages called microglia. The plasticity of microglia/macrophages allows them to adopt different activation states in response to changes in the tissue microenvironment. When exposed to various factors, microglia/macrophages polarise into distinct phenotypes, each exhibiting unique characteristics and roles. Furthermore, extensive research has indicated a close association between microglia/macrophage polarisation and the development and reversal of various intraocular diseases. The present article provides a review of the recent findings on the association between microglia/macrophage polarisation and ocular pathological processes (including autoimmune uveitis, optic neuritis, sympathetic ophthalmia, retinitis pigmentosa, glaucoma, proliferative vitreoretinopathy, subretinal fibrosis, uveal melanoma, ischaemic optic neuropathy, retinopathy of prematurity and choroidal neovascularization). The paradoxical role of microglia/macrophage polarisation in retinopathy of prematurity is also discussed. Several studies have shown that microglia/macrophages are involved in the pathology of ocular diseases. However, it is required to further explore the relevant mechanisms and regulatory processes. The relationship between the functional diversity displayed by microglia/macrophage polarisation and intraocular diseases may provide a new direction for the treatment of intraocular diseases.
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Microglía , Retinopatía de la Prematuridad , Recién Nacido , Humanos , Microglía/patología , Retinopatía de la Prematuridad/patología , Retina/patología , Macrófagos , FenotipoRESUMEN
BACKGROUND Myopia results when light rays focus before reaching the retina, causing blurred vision. High myopia (HM), defined by a refractive error of ≤-6 diopters (D) or an axial length of ≥26 mm, is an extreme form of this condition. The progression from HM to pathological myopia (PM) is marked by extensive ocular axis elongation. The rise in myopia has escalated concerns for HM due to its potential progression to pathological myopia. The covert progression of HM calls for thorough analysis of its current research landscape. MATERIAL AND METHODS HM-related publications from 2003-2022 were retrieved from the Web of Science database. Using VOSviewer and Citespace software, we conducted a bibliometric and visualized analysis to create document co-citation network maps. These maps detailed authors, institutions, countries, key terms, and significant literature. RESULTS From 9,079 articles, 8,241 were reviewed. An increasing trend in publications was observed, with Kyoko Ohno-Matsui identified as a top contributor. The Journal of Cataract and Refractive Surgery was the primary publication outlet. Chinese researchers and institutions were notably active. The document citation network identified five focal areas: refractive surgery, clinical manifestations/treatment, prevention/control, genetics, and open angle glaucoma. CONCLUSIONS Research emphasis in HM has shifted from refractive surgery for visual acuity enhancement to the diagnosis, classification, prevention, and control of HM complications. Proposals for early myopia intervention to prevent HM are gaining attention. Genetics and HM's link with open angle glaucoma, though smaller in focus, significantly enhance our understanding of HM.
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Catarata , Glaucoma de Ángulo Abierto , Miopía Degenerativa , Humanos , Miopía Degenerativa/complicaciones , Miopía Degenerativa/diagnóstico , Glaucoma de Ángulo Abierto/complicaciones , Retina , Trastornos de la VisiónRESUMEN
Photodynamic therapy (PDT) has the characteristics of being simple and non-invasive, and with on-demand light control. However, most photosensitizers exhibit strong hydrophobicity, low quantum yields in water and low tumor selectivity. In this study, carbon network-hosted porphyrins (CPs) with high biocompatibility and efficient singlet oxygen (1O2) generation were developed to reduce the biotoxicity of photosensitizers and avoid quenching caused by hydrophobic aggregation for enhanced PDT. The CPs were prepared by a simple solid-phase synthesis method using porphyrin, green non-toxic citric acid and urea as the raw materials. The CPs exhibited excellent water solubility and high biocompatibility. Even when the concentration reached 1.5 mg mL-1, cells still had good biological activity. By separately fixing the porphyrins in the carbon network, the CPs avoided aggregation-induced inactivation and had high generation efficiency of 1O2. Furthermore, in order to improve the PDT effect, the CPs were modified with the upper nuclear targeting peptide TAT (T-CPs), which was used to target the nucleus and generate 1O2in situ to directly destroy genetic material. The proposed strategy provides a simple and green path to prepare nanophotosensitizers with high biocompatibility and efficient 1O2 generation for PDT.
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Fotoquimioterapia , Porfirinas , Fármacos Fotosensibilizantes/química , Porfirinas/química , Fotoquimioterapia/métodos , Carbono , AguaRESUMEN
Behçet's uveitis (BU) is a debilitating manifestation of Behçet's disease, often requiring prompt and aggressive treatment to prevent vision loss. Glucocorticoids (GCS) serve as a first-line therapy for BU; however, their long-term, high-dose use can result in significant adverse effects. This review summarizes the efficacy, adverse effects, and advances in combination therapy involving GCS for the management of BU. We discuss the benefits and drawbacks of various GCS administration routes, including periocular and intravitreal injections, intravitreal sustained-release devices, and systemic therapy, highlighting the role of fluocinolone acetonide and dexamethasone as primary sustained-release formulations. Moreover, we underscore the importance of combining GCS with immunosuppressive drugs and biological agents to minimize adverse reactions and optimize therapeutic outcomes. The review concludes that, while GCS remain a crucial component of BU treatment, careful consideration of their administration and combination with other therapies is essential to achieve long-term remission and improved visual outcomes for patients with BU.
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Síndrome de Behçet , Uveítis , Humanos , Síndrome de Behçet/complicaciones , Síndrome de Behçet/tratamiento farmacológico , Glucocorticoides , Preparaciones de Acción Retardada/uso terapéutico , Uveítis/tratamiento farmacológico , Uveítis/etiología , Inmunosupresores/uso terapéuticoRESUMEN
Behçet's uveitis (BU), a vision-threatening manifestation of Behçet's disease, poses substantial management challenges due to its chronic, relapsing nature and potential for vision loss. This review explores the role of biologic therapies in the treatment of BU, providing a comprehensive overview of their effectiveness, drawbacks, and future possibilities. Traditionally, management has relied heavily on corticosteroids and conventional immunosuppressants. However, their long-term use is frequently associated with systemic side effects and insufficient control of ocular inflammation. Biologic therapies, particularly TNF-alpha inhibitors like infliximab and adalimumab, have emerged as effective alternatives, offering better disease control and a more favorable safety profile. We critically evaluated these agents, noting their clinical efficacy in reducing inflammatory flares and preserving visual acuity. Despite their benefits, several issues remain. Accessibility, cost, and lack of long-term safety data limit their widespread use. Additionally, individual variability in treatment response necessitates personalized therapeutic strategies. Recent research has shown promise in addressing these challenges, with the emergence of novel biologic agents and personalized medicine approaches. In summary, biologic therapies represent a paradigm shift in BU management, contributing to better patient outcomes. Yet, there are significant challenges to be overcome. As we move forward, continued research, development of novel biologic agents, and a precision medicine approach will shape the future landscape of BU treatment.
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Pioneering advancements in optical coherence tomography (OCT) have facilitated the discernment of peripapillary hyper-reflective ovoid mass-like structures (PHOMS), prevalent neuro-ophthalmological findings associated with an array of ophthalmic conditions, such as optic disc drusen (ODD), papilledema, myopic/tilted optic discs, non-arteritic anterior ischemic optic neuropathy (NA-AION), and optic neuritis. Despite an expanding corpus of research, numerous inquiries persist concerning their clinical significance, correlations with ocular afflictions, and prognostic implications. This comprehensive review endeavors to impart an in-depth comprehension of PHOMS, encompassing facets like conceptualization, detection, pathogenesis, and associations with diverse ophthalmic conditions. Furthermore, we underscore several unresolved quandaries and suggest prospective avenues for future exploration.
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Pancreatic cancer (PC) is one of the most common malignant tumors with a poor prognosis and high mortality. Surgical resection is the most effective treatment for PC; however, only a minority of patients have resectable tumors. Chemotherapy is the primary treatment for PC. Curcumin is a natural chemical substance obtained from plants with a wide range of pharmacological activities. Research evidence suggests that curcumin can influence PC development through multiple molecular mechanisms. The synthesis of novel curcumin analogs and preparation of curcumin nano-formulations are effective strategies to overcome the low bioavailability of curcumin in the treatment of PC. This review aims to summarize the mechanisms of action of curcumin in preclinical and clinical studies on PC and research progress in enhancing its bioavailability.
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Curcumina , Neoplasias Pancreáticas , Disponibilidad Biológica , Curcumina/química , Curcumina/farmacología , Curcumina/uso terapéutico , Humanos , Neoplasias Pancreáticas/tratamiento farmacológico , Neoplasias PancreáticasRESUMEN
Purpose: To establish a high-glucose (HG) stressed cell model and study the expression of main components of the Dll4/Notch-VEGF signaling pathway under high-glucose stimulation. Methods: A model of HG-conditioned cells (human umbilical vein endothelial cells, HUVECs) was first established, and then the expression of Dll4, Notch1, Notch4 and VEGF in HG-stressed cells with or without Notch pathway blockage was analyzed by RT-PCR and Western blot. To observe cell migration, we also evaluated the Transwell assay. Results: HUVECs stimulated with 30mmol/L HG was selected as a cell model. RT-PCR and Western blot results showed that HG stimulation induced the expression of Dll4, Notch1 and VEGF and downregulated Notch4. The expressions were reversed after Notch pathway blockage; meanwhile, the blockage of Notch pathway inhibited cell migration under HG condition. Conclusion: The function of Notch4 in responses to HG stimulation deserves further researching. Combination therapy by blocking Dll4/Notch and VEGF pathways may provide us with a new way for anti-neovascularization.
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Oxidative stress alters cellular microenvironment, facilitating cell apoptosis and inflammatory response, and oxidation of lens constituents may ultimately result in cataracts. Astragaloside IV (AS-IV) exhibits a variety of pharmacological activities, such as antioxidative and anti-inflammatory activity via regulating various signaling pathways. However, the effect of AS-IV on lens epithelial cells and its potential therapeutic role in cataracts remained to be investigated. In this study, AS-IV prevented H2 O2 -induced injury and inflammatory response in human lens epithelial cell line HLE-B3 through inhibiting NLRP3 inflammasome in a mitogen-activated protein kinase-dependent pathway, providing a potential novel therapeutic strategy for cataracts.
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Catarata , Inflamasomas , Catarata/tratamiento farmacológico , Catarata/metabolismo , Células Epiteliales , Humanos , Inflamasomas/metabolismo , Proteína con Dominio Pirina 3 de la Familia NLR/metabolismo , Estrés Oxidativo , Saponinas , TriterpenosRESUMEN
BACKGROUND: This study aims to explore a case of exophytic nasal papilloma with acute dacryocystitis as the first symptom. CASE PRESENTATION: A 72-year-old male patient complaining of "a 10-year history of tearing and purulent discharge from the right eye, with subsequent redness and pain in the inner canthus for three days" was initially diagnosed with acute dacryocystitis of the right eye. The patient was treated with anti-inflammatory therapy. However, the redness and swelling of the inner canthus continued to increase. An endoscopic dacryocystorhinostomy of the right eye was performed under general anesthesia. A large amount of purulent secretion was drained during the operation. As a result, the swelling of the inner canthus was significantly reduced. A routine intra-operative biopsy of the wall of the lacrimal sac revealed an exophytic nasal papilloma. A second biopsy, 1 week after the surgery, revealed the same result. The patient was advised to undergo a dacryocystectomy once the swelling had subsided. However, the patient was reluctant to undergo this surgery and remains under clinical observation. CONCLUSION: It is rare for an exophytic nasal papilloma, which is a benign tumor in the lacrimal sac, which has the potential for recurrence and malignant transformation, to manifest with acute dacryocystitis as the first symptom. Therefore, this case report could provide a reference for the future clinical diagnosis of this disease.
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Dacriocistitis , Dacriocistorrinostomía , Enfermedades del Aparato Lagrimal , Conducto Nasolagrimal , Papiloma , Anciano , Dacriocistitis/diagnóstico , Dacriocistitis/cirugía , Humanos , Enfermedades del Aparato Lagrimal/cirugía , Masculino , Conducto Nasolagrimal/cirugía , Papiloma/diagnóstico , Papiloma/cirugíaRESUMEN
OBJECTIVE: This study aimed to systematically review the relationship between dry eye disease (DED) and asthma based on published population-based studies. DATA SOURCES: PubMed, EMBASE and ISI Web of Science from their inception were searched up to October 2019. STUDY SELECTION: Observational studies addressing the association between asthma and DED will be eligible. DATA EXTRACTION AND SYNTHESIS: Two reviewers independently conducted the data extraction and quality assessment. We used a random-effects model for all analyses. Subgroup analysis according to ethnicity was performed to test the influence of ethnicity on the association. MAIN OUTCOMES AND MEASURES: Six independent studies (a total of 45 215 patients with asthma and 232 864 control subjects) were included in this review and had an average of seven stars by the Newcastle-Ottawa Scale. Our current findings suggest that the prevalence of DED was higher in the asthma group than in the control group (Z=7.42, p<0.00001; OR 1.29, 95% CI 1.20 to 1.38). In the subgroup analysis by ethnicity, Australian, Caucasian and Asian patients with asthma showed an increased risk of DED.
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Asma , Síndromes de Ojo Seco , Asma/epidemiología , Australia , Síndromes de Ojo Seco/epidemiología , Humanos , PrevalenciaRESUMEN
BACKGROUND: The Compound Danshen Dripping Pills have been widely used in the treatment of diabetic retinopathy (DR), but there is a lack of systematic review of reports on this topic. To explore the efficacy of Compound Danshen Dripping Pills combined with western medicine in the treatment of diabetic retinopathy, we conducted a meta-analysis. METHODS: Randomized controlled trials published in the Chinese Medical Literature Database (CBM), Embase, PubMed, and Medline databases from January 2010 to August 2021 were searched. After screening the qualified literature, literature quality was evaluated by the Cochrane Handbook for Systematic Reviews of Interventions. Meta-analysis was performed on outcome measures including effective rate, visual field gray value, hemangioma volume, hemorrhagic plaque area, and visual acuity after diabetic retinopathy treatment with Compound Danshen Dripping Pills using Revman 5.3 analysis software to comprehensively evaluate the utility of Compound Danshen Dripping Pills. RESULTS: A total of 167 documents were preliminarily searched, and 8 studies involving 524 patients were included for meta-analysis. Meta-analysis showed that the statistical value of the effective rate of diabetic retinopathy treatment in the intervention group and control group was OR =5.00, 95% CI: 2.84, 8.83, P<0.0001. The statistical value of visual field gray value comparison was MD =-0.93, 95% CI: -0.98, -0.89, P<0.00001. The statistical value of hemangioma volume was MD =-3.16, 95% CI: -3.48, -2.84, P<0.00001. The statistical value of hemorrhagic plaque area comparison was MD =-0.65, 95% CI: -0.97, -0.32, P<0.0001. The statistical value of visual acuity comparison was MD =0.15, 95% CI: 0.10, 0.19, P<0.00001. DISCUSSION: The Compound Danshen Dripping Pills combined with western medicine are effective and safe in the treatment of diabetic retinopathy.
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Diabetes Mellitus , Retinopatía Diabética , Medicamentos Herbarios Chinos , Canfanos , Retinopatía Diabética/tratamiento farmacológico , Medicamentos Herbarios Chinos/uso terapéutico , Humanos , Panax notoginseng , Ensayos Clínicos Controlados Aleatorios como Asunto , Salvia miltiorrhizaRESUMEN
INTRODUCTION: Primary retinitis pigmentosa (RP) is a common hereditary retinal disease in ophthalmology that has a considerable impact on quality of life, but there are few effective therapeutic strategies. This trial aims to determine the efficacy and safety of acupuncture versus sham acupuncture (SA) for RP. METHODS AND ANALYSIS: This is a study protocol for a randomised, participant-blind, sham-controlled trial. 64 eligible patients with RP will randomly be divided into acupuncture group and SA group. All groups will receive 48 sessions over 3 months. Participants will complete the trial by visiting the research centre in month 6/9 for a follow-up assessment. The primary outcome is visual field mean sensitivity and visual field mean deviation at month 3/6/9 compared with baseline. Secondary outcomes include the best-corrected visual acuity, central macular thickness, subfoveal choroidal thicknes, traditional Chinese medicine syndrome score and the scale of life quality for diseases with visual impairment at month 3/6/9 compared with baseline. Adverse events and safety indexes will be recorded throughout the study. SPSS V.25.0 statistical software was used for analysis, and measurement data were expressed as mean±SD. ETHICS AND DISSEMINATION: Ethics approval was obtained from the Ethics Committee of the Chinese Clinical Trial Registry (approval no: ChiECRCT20200460). The results of this study will be published in a peer-reviewed journal, and trial participants will be informed via email and/or phone calls. TRIAL REGISTRATION NUMBER: ChiCTR2000041090.
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Terapia por Acupuntura , Retinitis Pigmentosa , Humanos , Medicina Tradicional China , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Retinitis Pigmentosa/terapia , Resultado del Tratamiento , Campos VisualesRESUMEN
Background: Patients with noninfectious uveitis (NIU) are at risk of systemic side effects of long-term glucocorticoid therapy and uncontrolled inflammatory complications. In urgent need to identify more aggressive therapies, adalimumab (ADA) may be the right choice. Objectives: To summarize the current evidence from randomized controlled trials (RCTs) regarding the efficacy and safety of ADA in the treatment of NIU. Methods: We searched Pubmed, Embase, Web of Science, Cochrane Library databases, and Clinical Trials Registry for qualifying articles from their inception to November 19, 2020, with no language restriction. Randomized controlled trials comparing ADA with conventional routine treatment in noninfectious uveitis patients of any age, gender, or ethnicity were included. The primary outcome was the time to treatment failure (TF). The secondary outcomes were the change in best-corrected visual acuity (BCVA), change in the anterior chamber (AC) cell grade, change in vitreous haze (VH) grade, and adverse events (AEs). Main results: The six studies comprised 605 participants in all, and the sample size of each study ranged from 16 to 225. The overall pooled results of the primary outcome (HR = 0.51; 95% CI, 0.41 to -0.63) showed that ADA nearly halved the risk of treatment failure compared to placebo for NIU patients. The pooled mean difference of change in BCVA was -0.05 (95% CI, -0.07 to -0.02). The pooled mean difference of change in AC cell grade and VH grade was -0.29 (95% CI, -0.62 to -0.05) and -0.21 (95% CI, -0.32 to -0.11), respectively. The incidence of AEs in the ADA group was numerically higher than that of AEs in the placebo group (2,237 events and 9.40 events per patient-year, equivalent to 1,257 events and 7.79 events per patient-year). Conclusion: This meta-analysis of six RCTs further confirmed that ADA considerably lowered the risk of treatment failure or visual loss, and moderately reduced AC cell grades and VH grades with slightly more AEs, as compared to placebo. ADA is both effective and safe in treating NIU. Systematic Review Registration: [https://clinicaltrials.gov], identifier [CRD42020217909].
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INTRODUCTION: Myopia is the most common cause of avoidable visual impairment worldwide, which causes huge economic burden and social burden. There are several ways to treat and reduce myopia, but all have drawbacks; this reality drives us to search for additional effective and low-risk interventions of treatment for myopia. Acupuncture is an ancient therapy with a history of thousands of years and is now widely used in the medical system. Some randomized controlled trials have reported that acupuncture, as an adjuvant therapy, can effectively improve the diopter and vision in the sense of myopic children. Deqi is a long-standing belief to ensure the efficacy of acupuncture in the treatment of myopia, but this belief has not been confirmed by sufficient evidence of randomized controlled trials. METHODS: This clinical study is a parallel-group, randomized controlled, and single blind study. Three hundred eligible adolescents will randomly be divided into acupuncture Deqi group, acupuncture without Deqi group, and waiting list group. All groups will be given frame glasses for corrective treatment; patients in the acupuncture Deqi group will be treated with acupuncture at acupoints around the eyes and flat puncture to Deqi, while acupuncture without Deqi group will not flat puncture to Deqi. The waiting list group will not receive acupuncture treatment. The primary outcome will be diopter measurement. Adverse events and safety indexes will be recorded throughout the study. DISCUSSION: Our study will compare acupuncture Deqi with acupuncture without Deqi, and place it in a control group for the treatment of myopia. The results of this trial are expected to provide solid evidence for the effectiveness and safety of acupuncture combined with Deqi in the treatment of myopia, and hope to provide a reference for clinical practice. The primary outcome will be diopter measurement of the patients before treatment. TRIAL REGISTRATION: ChiCTR2000037874, registered September 3, 2020.