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Minimally invasive glaucoma surgery (MIGS) has been successfully incorporated in clinical practice in recent years.Increasing evidence shows that it also plays an important role in the treatment of primary angle-closure glaucoma (PACG). Goniosynechialysis (GSL) is a key surgical procedure used by MIGS for PACG, which involves separating the peripheral anterior synechia and reopening the angle.However, there is still a lack of uniform standards for indications and surgical procedures.Therefore, it is necessary to formulate a detailed and complete expert consensus on surgical procedures to standardize the application of clinicians in the treatment.
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Gastroesophageal reflux disease （GERD） is a frequently and commonly occurring disease in clinic. In recent decades， with the development in pathophysiology and drug researches， modern medicine has achieved remarkable progress and results in diagnosis and treatment. However， the treatments for non-erosive reflux disease， refractory gastroesophageal reflux disease， proton pump inhibitor resistance， overlap of disease symptoms， and extraesophageal symptoms are limited and ineffective. Traditional Chinese medicine （TCM） was widely used in clinical practice， which has been proved effective in relieving symptoms and improving the quality of life. Sponsored by China Association of Chinese Medicine （CACM） and undertaken by the Spleen and Stomach Disease Branch of CACM， "the 12th Youth Salon of Clinical Predominance Disease Series （GERD）" invited 18 authoritative digestive experts of TCM and western medicine to discuss "the difficulties of clinical diagnosis and treatment of GERD and TCM advantages". The focus issues such as modern medical diagnosis and treatment achievements and contributions， improvement and maintenance of symptoms， response to overlapping disease symptoms， reduction and withdrawal of acid suppressors， and treatment of extra-esophageal symptoms were discussed in depth. TCM and western medicine exchanged and complemented each other's strengths， combing the difficulties of modern medical diagnosis and treatment， which clarified the positioning and advantages of TCM and provided guidance for clinical and scientific research.
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Objective:To evaluate the preliminary effectiveness and safety of surgical peripheral iridectomy (SPI) combined with goniosynechilysis (GSL) and goniotomy (GT) in the treatment of advanced primary angle-closure glaucoma (PACG).Methods:A multicenter observational case series study was performed.Thirty-five eyes of 27 patients with advanced PACG, who underwent SPI+ GSL+ GT with a follow-up of at least 6 months, were included from August 2021 to January 2022 at Zhongshan Ophthalmic Center, Handan City Eye Hospital, Shijiazhuang People's Hospital, West China Hospital of Sichuan University, and the Third Affiliated Hospital of Chongqing Medical University.The mean follow-up time was 9(7, 10) months.Pre- and post-operative best corrected visual acuity (BCVA) and intraocular pressure (IOP) were measured with an ETDRS chart and a Goldmann applanation tonometer, respectively.The number of anti-glaucoma medications applied before and after surgery was recorded, and the complications after surgery were analyzed.Success rate of surgery was calculated.Complete surgical success was defined as an IOP of 5-18 mmHg (1 mmHg=0.133 kPa) and 20% reduction from baseline without anti-glaucoma medication or reoperation.Qualified success was defined as achieving criterion of complete success under anti-glaucoma medications.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Zhongshan Ophthalmic Center, Sun Yat-sen University (No.2021KYPJ177). Written informed consent was obtained from each subject.Results:The mean preoperative IOP was (30.83±8.87)mmHg, which was significantly decreased to (15.69±3.70)mmHg at 6 months after the surgery ( t=8.588, P<0.001), with a 44.00% (34.78%, 60.00%) decline of 13.00(8.00, 21.00)mmHg.The median number of anti-glaucoma medications was significantly reduced from 2(0, 3) preoperatively to 0 (0, 1) postoperatively ( Z=-3.659, P<0.001). The mean preoperative and postoperative 6-month BCVA were 0.80(0.63, 1.00) and 0.80(0.60, 1.00), respectively, showing no significant difference ( Z=-0.283, P=0.777). Complete surgical success rate was 62.86%(22/35), and the qualified success rate was 91.43%(32/35). Surgical complications mainly included hyphema (6/35), IOP spike (3/35), and shallow anterior chamber (4/35). There was no vision-threatening complication. Conclusions:SPI+ GSL+ GT is preliminarily effective and safe in the treatment of advanced PACG, which provides a new option for PACG.
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Minimally invasive glaucoma surgery (MIGS) has been successfully incorporated in clinical practice in recent years.Increasing evidence shows that MIGS also plays an increasingly important role in the treatment of primary angle-closure glaucoma (PACG). Surgical peripheral iridectomy (SPI) plus goniosynechialysis (GSL) and goniotomy (GT), as a new procedure, has been proven to be safe and effective in the treatment of PACG with no or mild cataracts.However, there is still a lack of uniform standards for indications, surgical procedures, and perioperative medication.Therefore, it is necessary to formulate a detailed and complete expert recommendations on surgical procedures to standardize the application of combined SPI+ GSL+ GT in the treatment.Some experts in glaucoma treatment and management in China have discussed the current problems and developing trend in MIGS for PACG and put forward the expert recommendations of standard process, including indications, anaesthetic methods, surgical site, operating procedure and rational administration of drugs in perioperation, in order to standardize the medical process of clinicians using combined SPI+ GSL+ GT in PACG treatment and lay a foundation for better evaluation of the efficacy of MIGS.
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With high incidence, high disability rate and serious impact on patients' quality of life, advanced primary angle-closure glaucoma (PACG) with cataract is a severe eye disease in China and its main treatment method is surgery.Phacoemulsification cataract extraction and intraocular lens implantation (PEI) combined with trabeculectomy has been used to treat advanced PACG with cataract, but there are many postoperative complications.Recently, combined PEI, goniosynechialysis (GSL) and goniotomy (GT) has been proven to be a safe and effective surgical treatment for advanced PACG with cataract.At present, the combined PEI+ GSL+ GT surgery has been widely applied, but there is still a lack of uniform standards for its clinical application.Therefore, it is necessary to formulate a detailed and complete recommendation of the surgical procedures for PEI+ GSL+ GT, to standardize its application in clinical practice.Based on the analysis of the existing problems, some glaucoma experts in China have formulated detailed and complete operation norms, as well as expert recommendations on surgical indications and contraindications, anesthetic methods, surgical techniques and perioperative medication to standardize the application process of PEI+ GSL+ GT in clinical practice.
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Primary angle-closure glaucoma (PACG) is a common subtype of glaucoma and one of the leading causes of blindness in Asia.Trabeculectomy has been recognized as an effective filtering surgery for PACG and is widely used in clinical practice, but its high risk of postoperative complications, especially bleb scarring over time can not be ignored.Nowadays, non-bleb-based minimally invasive glaucoma surgeries (MIGS) have attracted much attention.Surgeries opening, restoring, or expanding Schlemm canal to reconstruct aqueous humor outflow pathway is one of the MIGS and able to achieve moderate intraocular pressure (IOP) reduction, which has been widely used in the treatment of primary open-angle glaucoma (POAG) for a long time.However, based on the pathogenesis of PACG and its similar pathological changes in Schlemm canal to POAG, some retrospective studies and prospective single-arm studies discovered that Schlemm canal surgery combined with phacoemulsification and/or goniosynechialysis appears to lower IOP well and safe in PACG eyes in recent years.Whether Schlemm canal surgery is also suitable or effective for PACG is getting some attention and is still controversial up to now, mostly due to some differences in pathogenesis between PACG and POAG, it is necessary to perform randomized controlled trials to confirm the efficacy of Schlemm canal surgery for PACG and upgrade the therapeutic strategy of PACG.
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Objective:To evaluate the effectiveness and safety of phacoemulsification cataract extraction combined with intraocular lens implantation (PEI) plus goniosynechilysis (GSL) and goniotomy (GT) for advanced primary angle-closure glaucoma (PACG).Methods:An observational case series study was performed.Fifty eyes of 50 patients with advanced PACG were enrolled in Zhongshan Ophthalmic Center from August 2020 to June 2021.All the patients received PEI+ GSL+ GT and were followed up for over 6 months, with a mean follow-up of 7.5 (6, 10) months.Intraocular pressure (IOP) was measured with a Goldmann applanation tonometer.Best corrected visual acuity (BCVA) was examined with an ETDRS chart and converted to logarithm of the minimum angle of resolution (LogMAR) units for analysis.Types and number of anti-glaucoma medications applied before and after surgery, and the surgical complications were collected.Success rate of surgery was calculated.Complete surgical success was defined as an IOP of 5-18 mmHg (1 mmHg=0.133 kPa) with a reduction of 20% from baseline without anti-glaucoma medication, no vision-threatening complications, no loss of light perception, and no reoperation.Qualified success was defined as an IOP of 5-18 mmHg with a reduction of 20% from baseline with or without anti-glaucoma medication, no vision-threatening complications, no loss of light perception, and no reoperation.This study adhered to the Declaration of Helsinki.This research protocol was approved by an Ethics Committee of Zhongshan Ophthalmic Center (No.2021KYPJ177). Written informed consent was obtained from each subject before entering the cohort.Results:The mean preoperative IOP was (28.81±7.81)mmHg, and the IOP at the end of follow-up was (13.41±4.10)mmHg, showing a statistically significant decrease ( t=12.260, P<0.001). The postoperative IOP was decreased by 13.80 (9.10, 19.40)mmHg, with a percentage decrease of 51.1% (38.6%, 67.1%). The mean preoperative and postoperative BCVA was (0.92±0.11) LogMAR and (0.88±0.10) LogMAR, respectively, and no significant difference was found ( t=-0.560, P=0.580). The number of anti-glaucoma medications was reduced from 2 (1, 3) before operation to 0 (0, 0) after operation.The complete success rate of surgery was 80% (40/50), and the qualified success rate was 94% (47/50). Surgical complications mainly included hyphema in 7 eyes, IOP spike in 7 eyes, and corneal edema in 3 eyes.No vision-threatening complication occurred. Conclusions:PEI+ GSL+ GT is preliminarily effective and safe for advanced PACG by reducing IOP and application of anti-glaucoma medications with few complications.
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Cataract surgeries are mainly used in the management of glaucoma in two circumstances:first,lens extraction to improve visual acuity in patients with controlled glaucoma and coexisting cataract;second,lens extraction to control glaucoma and other related complications.This article introduces the application of eight cataract surgical techniques in the management of glaucoma,which is even more challenging.To have a successful outcome after cataract surgeries,it is crucial to have comprehensive evaluation of patients,carefully analyze the optimal timing and indications of surgeries,and improve surgical techniques.
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Cataract surgeries are mainly used in the management of glaucoma in two circumstances: first, lens extraction to improve visual acuity in patients with controlled glaucoma and coexisting cataract; second, lens extraction to control glaucoma and other related complications.This article introduces the application of eight cataract surgical techniques in the management of glaucoma, which is even more challenging.To have a successful outcome after cataract surgeries, it is crucial to have comprehensive evaluation of patients, carefully analyze the optimal timing and indications of surgeries, and improve surgical techniques.
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Elevation of intraocular pressure (IOP) is the most eminent risk factor for the presence and progression of glaucoma,which leads to optic nerve damages ultimately.With the advance of ocular imaging technology,several new structural and functional risk factors have been identified.The introduction of in vivo IOP measuring devices enables the real-time monitoring the IOP fluctuation.New anti-glaucoma drugs and surgical methodshave made more options for glaucoma treatment.Gene therapy and stem cell therapy have potential futures for glaucoma.Incorporation of imaging and deep learning techniques could enhance early detection and diagnosis of glaucoma.There were progresses in optic protection and regeneration.More studies are warrant to investigate the joint mechanism of gene,environment,anatomy and other factors,to develop new imaging techniques and artificial intelligence-assisted diagnostic software platform based on big data,to find new antihypertensive drugs based on different targets,and to assess the efficacy and safety of optic protection and regeneration therapies.
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Advances in artificial intelligence (AI) have led to innovation and revolution in many different research fields.AI-assisted diagnostic reading of medical images has achieved substantial progress,whose accuracy has been close to human experts.Glaucoma is the leading reason for irreversible blindness in the world.Early diagnosis and treatment of glaucoma would remarkably improve prognosis.However,early diagnosis of glaucoma is difficult because it depends on comprehensive assessment of intraocular pressure,visual field,changes of retinal nerve fiber layer,etc.Thus,development of AI which could assist diagnosis of glaucoma is faced with great challenges and difficulties.In the future,invention of AI-assisted diagnostic platform of glaucoma based on accumulation of labeled clinical data and training computers to read multimodule test results will create huge social economic benefit and revolutionize diagnosis of glaucoma.
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Background The aqueous flare is obvious in uveitic glaucomatous eye due to the damage of blood-aqueous barrier,especially following intraocular surgery.How to quantitatively determine the aqueous flare is important for us to understand the severity of inflammatory response.Objective This study was to assess inflammatory response following Ahmed glaucoma valve implantation in uveitic glaucomatous eye.Methods A nonrandomized controlled study was carried out under the approval of Ethic Committee of Zhongshan Ophthalmic Center of Sun Yat-sen University.Twenty-nine eyes of 29 subjects with refractory glaucoma were enrolled this hospital from October 2011 through July 2012.The patients were divided into the uveitic glaucoma group (10 eyes) and the other refractory glaucoma group (19 eyes) with the matched demography,and Ahmed glaucoma valve implantation was performed on all the eyes under the informed consent of each patient.The aqueous flare value was determined with FC-2000 flare-cell photometry and intraocular pressure (IOP) was measured with Goldmann tonometer before surgery and 1 day,3 days,1 week,2 weeks,1 month and 3 months after surgery.The outcomes were compared between the two groups,and the correlation of aqueous flare value with IOP was analyzed.Results In the uveitic glaucoma group,the aqueous flare values were 21.10 (10.50,38.58) photoparticles/ms,88.00 (23.55,168.63) photoparticles/ms and 29.90 (8.90,65.18)photoparticles/ms 1 day,3 days and 1 week after surgery,which were significantly higher than 13.53 (7.60,24.00) photoparticles/ms before surgery (all at P＜0.01).The same trend was found in the other refractory glaucoma group.In addition,the aqueous flare value was higher in the uveitic glaucoma group than that in the other refractory glaucoma group in 3 months after surgery (q=-3.445,P＜0.01).No significant differences were seen in IOP between the two groups at various time points (all at P＞0.05).Also,no significant correlations were seen between IOP and aqueous flare value in all patients at various time points (preoperation:rs =0.136,P =0.481; postoperative 1 day:rs =0.019,P =0.922 ; postoperative 3 days:rs =-0.035,P =0.858 ; postoperative 1 week:rs =0.317,P=0.094; postoperative 2 weeks:rs =0.034,P =0.861 ; postoperative 1 month:rs =-0.094,P =0.628 ; postoperative 3 months:rs =0.065,P =0.738).Conclusions FC-2000 flare-cell photometry can reflect the inflammatory reaction of the anterior chamber following Ahmed glaucoma valve implantation in various types of refractory glaucomatous eyes.The postoperative inflammatory response is more serious and lasting in uveitic glaucomatous eye.
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Ex-PRESS miniature implantation is a new alternative of anti-glaucoma surgeries due to its advantages,such as simpler operation,similar efficacy to trabeculectomy and less complications.Could Ex-PRESS miniature implantation replace the trabeculectomy? Studies showed that Ex-PRESS implantation has more significant advantages to those patients with high risk for trabeculectomy but dose not has dominant benefits to those prone to failure of trabeculectomy from bleb scarring.The Ex-PRESS implantation requires a relative wide angle so as to have enough space to avoid the device accessing to corneal endothelium,iris or lens.So it is unsuitable for angle-closure glaucoma with higher incidence in China.In addition,the cost-effect for Ex-PRESS implantation should also be fully considered when this method could be put into practice in the near future in China.Ex-PRESS implantation seems to be unable to displace trabeculectomy.The merits and demerits for Chinese patients still need to verify by Chinese own evidence-based studies.
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<p><b>BACKGROUND</b>Neovascular glaucoma is a refractory disease, and difficult to manage. The aim of this study was to evaluate the clinical outcomes of Ahmed glaucoma valve implantation (AGVI) in neovascular glaucoma (NVG) and non-NVG patients.</p><p><b>METHODS</b>This prospective, non-randomized study included 55 eyes of 55 patients with refractory glaucoma; 27 had NVG (NVG group) and 28 had non-NVG (non-NVG group). All of the patients underwent AGVI. The NVG group was adjunctively injected with intravitreal ranibizumab/bevacizumab (IVR/IVB) before AGVI. Intraocular pressure (IOP) was the primary outcome measure in this study. Surgical success rate, number of antiglaucoma medications used, best corrected visual acuity (BCVA), and postoperative complications were analyzed between the groups.</p><p><b>RESULTS</b>All of the patients completed the study (follow-up of 12 months). Kaplan-Meier survival curve analysis indicated that the qualified success rates in the NVG and non-NVG groups at 12 months were 70.5% and 92.9%, respectively; this difference was significant (P = 0.036). The complete success rates in the NVG and non-NVG groups at 12 months were 66.7% and 89.3%, respectively (P = 0.049). Compared with preoperative examinations, the postoperative mean IOP and use of medications were significantly lower at all follow-up time points in both groups (all P < 0.05). There were significant differences in BCVA between the two groups at the 12-month follow-up (χ(2) = 9.86, P = 0.020). Cox proportional hazards regression showed NVG as a risk factor for surgical failure (RR = 15.08, P = 0.033). Postoperative complications were similar between the two groups.</p><p><b>CONCLUSIONS</b>AGVI is a safe and effective procedure in refractory glaucoma, but the success rate of surgery was related to the type of refractory glaucoma. The complete and qualified success rates of NVG patient adjunctive anti-vascular endothelial growth factor treatment are still lower than those of non-NVG patients.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Glaucoma , General Surgery , Glaucoma Drainage Implants , Glaucoma, Neovascular , General Surgery , Proportional Hazards Models , Prospective StudiesABSTRACT
<p><b>BACKGROUND</b>Glaucoma secondary to systemic lupus erythematosus (SLE) is an uncommon but serious complication that threatens vision and therefore cannot be neglected. A few cases of secondary glaucoma resulting from lupus-induced or iatrogenic ocular impairments have been reported in association with SLE. However, a systematic analysis of the diagnosis and treatment of glaucoma secondary to SLE has not been reported in the literature. The aim of this study is to further investigate the relationship between glaucoma and SLE.</p><p><b>METHODS</b>In this study, we reviewed nine eyes of five patients diagnosed with secondary glaucoma associated with SLE, including one case of neovascular glaucoma and four cases of steroid-induced glaucoma.</p><p><b>RESULTS</b>Neovascular glaucoma was successfully treated by Ahmed glaucoma valve implantation surgery with adjunctive ranibizumab intravitreal injection, followed by panretinal photocoagulation (PRP). The steroid-induced glaucoma in eight eyes of four cases were controlled by trabeculectomy along with antiproliferative agents.</p><p><b>CONCLUSION</b>Regular follow-up ocular examinations should be conducted to ensure early diagnosis and treatment of secondary glaucoma in SLE patients to improve the prognosis of vision.</p>
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Adult , Female , Humans , Young Adult , Antibodies, Monoclonal, Humanized , Therapeutic Uses , Glaucoma , Diagnosis , Drug Therapy , Lupus Erythematosus, Systemic , Diagnosis , Drug Therapy , Ranibizumab , Retrospective StudiesABSTRACT
Background Intracranial vascular malformation causes different neurophthalmological symptoms and signs due to oppressing visual-related tissue and cranial nerves after hemorrhage.However,there is no availably systematic clinical research on this disease up to now.Objective This retrospective cases analysis was to explore the neurophthalmological features of intracranial vascular malformation.Methods The clinical datas were collected from 100 cases with intracranial vascular malformation in Affiliated Third Hospital of Sun Yat-sen University from June,2007 to June,2013.The neurophthalmological clinical features including general condition,initial symptom,concomitant symptoms and image results were retrospectively surveyed.Results Neurophthalmological symptoms and signs were found in 20 patients with intracranial vascular malformation by CT and MRI with the detectability 20％ (20/100).The main neurophthalmological symptoms were visual field defect (50％,10/20) and vision loss (45％,9/20).The neurophthalmological signs were pupil abnormalities (35％,7/20).Other neurophthalmological features included optic nerve atrophy (5 ％,1/20),papilloedema (5 ％,1/20) and oculomotor nerve palsy (5 ％,1/20),etc.The relevant cranial diseases included cerebral arteriovenous malformation in 60％ patients (12/20),cavernous angiomas in 35％ (7/20) and venous malformation with cavernous angiomas (1/20).The lesions of cerebral arteriovenous malformation were located in occipital lobe (4 cases),parietal-occipital area (3 cases),temporal lobe (3 cases) and frontal lobe (1 case),midbrain area (1 case) ; while those of cavernous angiomas were located in parietal lobe (1 case),occipital lobe (1 case),gyrus cingulated area occipital lobe (1 case),carvenous sinus (1 case),temporal lobe (1 case),parietal-temporal area (1 case) and pons area (1 case).Intracranial hemorrhage occurred in 14 patients in subarachnoid space (6 cases) and brain (8 cases).Conclusions The patients with intracranial vascular malformation have different neurophthalmological symptoms and signs.Sufficient attention should be paid to the patients with neurophthalmological symptoms and signs.
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Objective To evaluate the feasibility and safety of mediastinum examination with flexible endoscope via suprasternal fossa.Methods A total of 20 healthy pigs were enrolled.Mediastinocosopy was performed via a tunnel to thoracix through a 1.5 cm incision on suprastemal fossa.Mediastinum was observed and complications were recorded.Results Mediastinocosopy was successfully achieved in all pigs.No severe bleeding or death occurred during the procedure.Five pigs got fever after the procedure with elevated white blood cell count.Four pigs had pneumothorax and three of them died in 1-6 days.Conclusion Mediastinocosopy with flexible endoscope through suprastemal fossa is feasible to diagnose mediastinal diseases,which can be important experimental evidence for the mini-invasive therapy of mediastimum diseases.
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Background The research field of optic neuritis has developed rapidly and become more complex in recent years.It is very important for the reseachers and clinicians to known its status and the future trend.Objective This survey was to learn the distribution pattern,subject domain knowledge and worldwide research tendency of optic neuritis based on literatures in PubMed database.Methods Literatures on optic neuritis published in January 2000 to July 2012 were identified in PubMed database.The analytic dimention of an article included journal,published year,author,country and language.After core Mesh terms had been characterised by bibliographic item co-occurrence mining system (BICOMS),the co-occurrence matrix was built.Cluster analysis and multiple diamensional analysis were finished by SPSS 17.0.Then visualized network was drawn using ucinet 6.0.Results Totally 2 191 literatures were included,the number of articles increased from 105 in 2000 to 282 in 2011.The United States,England,Germany,Netherlands and Japan together accounted for 73.71％ of articles.There were 52 high-frequency subjects and hot topics were clustered into 9 categories.The visualized domain knowledge map was successfully built.The immunologic research was fully developed.The topic on etiology and diagnostic research,pathologic research,physiologic research and neuromyelitis optica (NMO) research had become core domain,while the studies of medication therapy,non-central nervous system idiopathetic demyelinating optic neuritis,epidemiology and genetics were not developed well.Conclusions Global optic neuritis publications display a continuous growth in the new millennium.The Big 5 in scientific literature on optic neuritis are the United States,England,Germany,Netherlands and Japan.The international main research focus includes 9 fields,which may provide reference or scholars both in scientific research and clinical research.
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BACKGROUND:It is controversial whether bone marrow mobilization can retain in cardiac injured position in congestive cardiomyopathy or differentiate into cardiomyocytes and vascular endothelial cells. OBJECTIVE:To study the effects of granulocyte colony stimulating factor (G-GSF) on myocardium and angiogenesis in rats with congestive cardiomyopathy. METHODS:Fifty Wistar rats with heart failure caused by adriamycin-induced cardiomyopathy were divided into heart failure group (n=20) treated with normal saline and bone marrow mobilization (n=30) treated with subcutaneous injection of recombinant human G-GSF. Ten rats from the bone marrow mobilization were kil ed at day 6 of mobilization, and myocardial tissue was taken for CD43 immunofluorescent staining. Blood samples were taken from the rat tail in each group before and 5 days after treatment to count total number of white blood cells and percentage of mononuclear cells. Meanwhile, mononuclear cells extracted from the peripheral blood were used for flow cytometry detection. At day 5 after treatment, bromodeoxyuridine (BrdU, 50 mg/kg) was successively given to al rats for 4 weeks before they were sacrificed. Myocardial tissues were taken to determine the homing of mononuclear cells and evaluate differentiation of mononuclear cells into cardiomyocytes and vascular endothelial cells using BrdU staining, BrdU/myosin heavy chain double staining, and BrdU/actin double staining. Hematoxylin-eosin staining was used for determination of blood vessel density. RESULTS AND CONCLUSION:G-CSF mobilization increased the number of mononuclear cells that was significantly higher than before treatment (P<0.05). Flow cytometry showed that the number of CD34-positive mononuclear cells in the peripheral blood was higher in the bone marrow mobilization than in the heart failure group (P<0.05). Myocardial CD34 immunofluorescence showed that the heart failure group was negative and the bone marrow mobilization group was positive. In the bone marrow mobilization group, the myocardial tissue was positive for BrdU staining, BrdU/myosin heavy chain double staining and BrdU/actin double staining, while vascular endothelial cells in the region of myocardial injury was positive for BrdU;conversely, the heart failure group was negative. The density of blood vessels in the bone marrow mobilization group was significantly higher than that in the heart failure group (P<0.001). These findings indicate that bone marrow mobilization increases the number of mononuclear cells, and these cells are homing to myocardial injury, thereby playing a repair role in the myocardium and vascular tissue of heart failure rats with congestive cardiomyopathy.
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A high performance liquid chromatography tandem mass spectrometric ( HPLC-MS/MS ) method was developed for the determination of seven perfluorinated alkyl acidin ( C4-C10 ) and perfluorooctane sulfonate in water. After the particulate was removed by leaching, surrogate standard was added, then the sample was loading to a pre-conditioned WAX cartridge for purification, and then the eluent was concentrated and analyzed by HPLC-MS/MS. Due to the situation that the fluoride polymer was unavoidable to be used in the LC system, a delay column was employed and the perfluorooctanoic acid ( PFOA ) of interference was departed from the PFOA in sample. The method detection limit ( MDL) of PFOA was 0. 8 ng/L, and the lowest quantitative concentration (LQC) was 3. 2 ng/L. For other compounds, the MDL was ranged from 0. 2 to 1. 2 ng/L, and the LQC was 0. 8-4. 8 ng/L. This method also had good reproducibility, for six duplicated samples, the relative standard deviations ( RSD ) of all target compounds were less than 16%. And the recoveries of target compounds at six spiked matrix samples ranged from 87% to 129%, and the RSD were less than 15%. Because of the connection of delay column, the background was well controlled, and a relatively lower MDL were obtained.