ABSTRACT
Objective:To compare the efficacy of pars plana vitrectomy (PPV) combined with human amniotic membrane (hAM) plugging technique or internal limiting membrane (ILM) flap insertion technique for high myopia macular hole retinal detachment (MHRD).Methods:A non-randomized controlled clinical study was performed.Sixteen eyes of 15 patients with high myopia MHRD treated in the Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine from July 2020 to August 2021 were included.All patients underwent PPV and were divided into hAM plug group (7 eyes of 7 patients) and the ILM insertion group (9 eyes of 8 patients) based on the different plugging materials.The best corrected visual acuity (BCVA) and intraocular pressure were measured before surgery and at 1 week, 1, 3, and 6 months postoperative, respectively.Slit-lamp microscopy combined with lenses, scanning laser ophthalmoscope and optical coherence tomography (OCT) were used to examine the fundus, the macular hole closure and retinal reposition.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (No.SH9H-2021-T322-2). Written informed consent was obtained from each subject.Results:The retinal reattachment was achieved in 6 eyes in the hAM plug group and all 9 eyes in the ILM insertion group after initial surgery.The macular hole closure was observed in 5 eyes in the hAM plug group and 8 eyes in the ILM insertion group after initial surgery, and there was no statistical difference in the macular hole closure rate between the two groups ( P>0.05). There were significant differences in the overall comparison of BCVA between the two groups over time ( Ftime=4.420, P<0.05). Postoperative BCVA at different time points was better than preoperative BCVA in each group, but the differences were not significant (all at P>0.05). There was no significant difference in the overall comparison of BCVA between the two groups ( Fgroup=0.183, P>0.05). Two eyes in the hAM plug group and 4 eyes in the ILM insertion group developed transient ocular hypertension, which returned to normal after 1 week of treatment. Conclusions:Both PPV combined with hAM plugging technique and ILM insertion technique are safe and effective for the treatment of MHRD in high myopia.The hAM plugging technique can not only achieve anatomical reduction but also functional recovery of the retina even in complicated fundus conditions.
ABSTRACT
ObjectiveTo investigate the anti-inflammatory effect of the component compatibility of Gentianae Macrophyllae Radix and Clematidis Radix et Rhizoma on the rat model of rheumatoid arthritis (RA) and the mechanism. MethodSeventy-two SPF-grade SD rats (male and female) aged 5 to 6 weeks were selected. Except the blank group, the rat model of collagen-induced arthritis (CIA) was replicated by the type Ⅱ collagen induction method. The 64 rats after successfully modeling were randomly divided into model group, methotrexate group (0.375 mg·kg-1), gentianoside with magnoflorine group (150.454 1 mg·kg-1+5.061 8 mg·kg-1), gentianoside with clematichinenoside AR group (150.454 1 mg·kg-1+16.433 1 mg·kg-1), sweroside with magnoflorine group (3.455 8 mg·kg-1+5.061 8 mg·kg-1), sweroside with clematichinenoside AR group (3.455 8 mg·kg-1+16.433 1 mg·kg-1), swertiamarin with magnoflorine group (9.303 2 mg·kg-1+5.061 8 mg·kg-1), and swertiamarin with clematichinenoside AR group (9.303 2 mg·kg-1+16.433 1 mg·kg-1), with 8 rats in each group. Each group was given the corresponding medicinal solution or normal saline by gavage for 15 d. During the experiment, the general status, of rats in each group were observed and recorded. Tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), rheumatoid factor (RF), C reactive protein (CRP), prostaglandin E2 (PGE2), and anti-cyclic peptide containing citrulline antibody (anti-CCP Ab) in the serum of rats were measured by enzyme-linked immunosorbent assay (ELISA). The histopathological changes in rat ankle joints were observed by hematoxylin-eosin (HE) staining. Immunohistochemistry (IHC) and Western blot were used to detect the protein expression of nuclear factor-κB (NF-κB) and vascular endothelial growth factor (VEGF) in rat ankle joints. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was used to detect the mRNA expression of NF-κB and VEGF in rat ankle joints. ResultCompared with those in the blank group, rats in the model group were in poor general conditions with significant foot-plantar swelling, and the content of CRP, anti-CCP Ab, and IL-1β in the rat serum was significantly increased (P<0.01). In the model group, the tissue structure of the ankle joint was severely damaged, and the protein and mRNA expression of NF-κB and VEGF in the rat ankle joints were significantly up-regulated (P<0.01). As compared with the model group, the general status of rats in each administration group was significantly improved. The levels of serum TNF-α, IL-1β, RF, CRP, PGE2, and anti-CCP Ab were reduced to different degrees in these administration groups, among which the effects of the gentianoside with clematichinenoside AR group on down-regulating serum TNF-α and IL-1β, the gentianoside with magnoflorine group on down-regulating serum RF and CRP, the sweroside with magnoflorine group on down-regulating serum PGE2, and the swertiamarin with clematichinenoside AR group on lowering serum anti-CCP Ab were better than those of administration groups. The histopathological changes in the ankle joint were improved to different degrees. The protein and mRNA expression of NF-κB and VEGF in rat ankle joints in the administration groups was significantly down-regulated (P<0.05, P<0.01), and the swertiamarin paired with clematichinenoside AR group had the most significant effect. ConclusionThe component compatibility of Gentianae Macrophyllae Radix and Clematidis Radix et Rhizoma exerts a good therapeutic effect on the rat model of RA, and the compatibility of components from the two medicines has a multi-channel, multi-target, and synergistic effect. The five component compatibility patterns, namely gentiobioside with magnoflorine, gentiobioside with clematichinenoside AR, sweroside with clematichinenoside AR, swertiamarin with magnoflorine, and swertiamarin with clematichinenoside AR, all have potential advantages. The mechanism may be related to the reduction of inflammatory factor secretion and the inhibition of abnormal protein and mRNA expression of NF-κB and VEGF.
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Objective To investigate the mechanism of anti-aging effect of Yangyan Quban particles on the aging skin. Methods With the dose of D-galactose 1000 mg/(kg?d) by sc administration to the female mice for 42 days, the aging model was established. The mice received Yangyan Quban particles (6.68, 3.34, 1.67 g/kg) by ig administration at the same time of injecting D-galactose. Forty-two days later, the dorsal skin samples were collected to determine glutathione peroxidase (GSH-Px) activity and serum estradiol (E2) contents, and the influence on uterus, ovary, skin dry and wet weight and the amount of water intake were studied. Results Compared with the aged model mice, the GSH-Px activity and E2 contents in the mice treated with Yangyan Quban particles were increased remarkably, especially the medium is the best dose (P