Triamcinolone Acetonide combined with Aflibercept in the treatment of wet age-related macular degeneration with poor response to Ranibizumab / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the efficacy and safety of intravitreal injection of aflibercept combined with posterior sub-fascial injection of triamcinolone acetonide in the treatment of wet age-related macular degeneration(ARMD)with poor response to anti-vascular endothelial growth factor drugs.METHODS: Retrospective cohort study. From June 2018 to May 2020, a total of 60 patients(60 eyes)with refractory ARMD who had poor response to the treatment of anti VEGF drug ranibizumab were randomly divided into the control group of aflibercept and the observation group of triamcinolone acetonide combined with aflibercept, with 30 patients(30 eyes)in each group. Once a month, the patients in the two groups received intravitreal injection of aflibercept alone or intravitreal injection of aflibercept combined with posterior sub-fascial injection of triamcinolone acetonide for three consecutive times. The changes of best corrected visual acuity(BCVA), central macular thickness(CMT)and intraocular pressure were reviewed before injection and 1, 3 and 6mo after the third injection.RESULTS: The BCVA and CMT of the two groups were significantly improved 1, 3 and 6mo after the injection of the drug(P<0.05). The mean intraocular pressure in the combined group was higher at 1mo after treatment than before, but it still within the normal range. There was a significant difference in intraocular pressure between the two groups(17.50±4.60 vs. 18.30±3.73mmHg, P<0.05).CONCLUSION: Triamcinolone acetonide injection under the posterior fascia of the eyeball combined with intravitreal injection of aflibercept in the treatment of wet ARMD can effectively reduce macular edema and improve vision, which is more safe and reliable.

Progress of CX3CL1 (Fractalkine) and its receptor CX3CR1 in regulating central nervous system disease / 医学研究生学报

In recent years, researches constituted to show that the occurrence of central nervous system diseases such as Parkinson′s disease, Alzheimer′s disease and multiple sclerosis may have association with the inflammation of central nervous system. The chemokine CX3CL1 is mainly produced by neurons and acts on the central nervous system. After binding to the receptor CX3CR1, by inhibiting the calcium influx induced by NMDA in neurons, it can promote the activation of protein kinase and activate nuclear transcription factor kappa B, reduce the release of inflammatory factors, and stabilize the status of microglia, thus suppress the inflammatory response of the central nervous system and reduce neuronal death, which play a certain role in neuroprotective effect. Therefore, the interaction between CX3CL1 and CX3CR1 is expected to be a new target in the treatment of central nervous system diseases. In this paper, the structure of CX3CL1 and its receptor CX3CR1, the interaction of signal axis and their research progress on central nervous system diseases are reviewed.

Study on therapeutic mechanism of Rehmanniae Radix Praeparata- Corni Fructus in sequelae of ischemic stroke based on network pharmacology technology / 中国中药杂志

In ischemic stroke sequela phase, Rehmanniae Radix Praeparata-Corni Fructus drug pair has the effect in protecting damaged neurons, but its mechanism has not been clear. In this study, network pharmacology was used to predict the mechanism of Rehmanniae Radix Praeparata-Corni Fructus in the treatment of ischemic stroke sequela. Through database search and literature retrie-val, 40 active ingredients of Rehmanniae Radix Praeparata and Corni Fructus were obtained, and their targets were obtained through STITCH and TCMSP databases. The targets of ischemic stroke sequela were obtained through OMIM,GAD,TTD and DrugBank databases. By screening the intersections of active ingredients targets and stroke treatment targets, 21 potential targets were obtained. The DAVID database was used for GO enrichment analysis and KEGG pathway analysis of potential targets. GO enrichment analysis showed that Rehmanniae Radix Praeparata-Corni Fructus were mainly involved in regulation of blood pressure, negative regulation of extrinsic apoptotic signaling and positive regulation of angiogenesis. KEGG pathway analysis showed that Rehmanniae Radix Praeparata-Corni Fructus could inhibit inflammatory response and apoptosis signaling pathway by regulating HIF-VEGFA signaling pathway in neural stem cell proliferation, TNF signaling pathway and NF-kappaB signaling pathway. Molecular docking technique was used to verify that Rehmanniae Radix Praeparata-Corni Fructus component has a good binding activity with potential targets. The results showed that in ischemic stroke sequela phase, Rehmanniae Radix Praeparata-Corni Fructus drug pair could play an important role in recovering neural function, promoting the proliferation of neural stem cells, angiogenesis, preventing neural cells apoptosis and regulating inflammatory factors.

Clinical analysis of 21 cases of pregnancy complicated with systemic lupus erythematosus / 第二军医大学学报

Objective To analyze and summarize the clinical characteristics and pregnancy outcomes of systemic lupus erythematosus (SLE) patients with pregnancy. Methods We retrospectively analyzed the clinical characteristics and pregnancy outcomes of 21 pregnant SLE patients in the Department of Obstetrics and Gynecology of Changhai Hospital of Navy Medical University (Second Military Medical University) from Jan. 2010 to Jun. 2017. Results Of 21 patients, 2 were diagnosed during pregnancy, and 9 out of 19 patients diagnosed before pregnancy were deteriorated and changed to active phase. Among the 21 patients, 13 cases (61.90%) received regular pregnancy examination, 17 cases (80.95%) gave birth, and 4 cases (19.05%) had induced labour. There were 6 cases (28.57%) having preeclampsia, 6 cases (28.57%) having premature birth, 5 cases (23.81%) having fetal intrauterine growth restriction, and 6 cases (28.57%) having fetal distress in uterus. Conclusion SLE patients have considerable risk of pregnancy, and pregnancy can induce SLE or aggravate the condition. SLE may cause serious maternal complications. Only at a stable condition can SLE patients start a pregnancy, and finish their pregnancy and puerperium under the joint monitoring of obstetricians and rheumatologists.

Detection of early gastric cancer and analysis of its endoscopic characteristics (43 cases) / 中国内镜杂志

Objective To investigate and analyze the detection of early gastric cancer (ECG) and explore the endoscopic and pathological characteristics. Methods Clinical data of patients underwent gastroscopy in 2016 were retrospectively collected for the screening and statistics of the detection rate of ECG (detected in examination and confirmed by pathology). In addition, the clinical data of 43 detected patients with ECG (47 lesions) were retrospectively summarized. Endoscopic characteristics under a white light endoscope and a magnifying endoscope with narrow band imaging (NBI) as well as pathological characteristics of ECG were compared. Results The overall detection rate of ECG was 0.23% (43/18,534), accounting for 24.71% (43/174) in the total detected cases of gastric cancer. This study revealed that ECG was the most commonly detected in the gastric antrum (36.17%, 17/47), lesion size >1.0 cm was the most common (68.09%, 32/47), and 0-IIc type were the most common under the endoscope, accounting for 55.32% (26/47). Under the white light endoscope, 35 (74.47%, 35/47) lesions showed mucosal redness, 43 (91.49%, 43/47) lesions presented clear boundaries, 42 (89.36%, 42/47) lesions exhibited irregular surface, 39 (82.98%, 39/47) lesions demonstrated mucosal atrophy and (or) intestinal metaplasia, 17 (36.17%, 17/47) lesions presented edge burrs, 8 (17.02%, 8/47) lesions showed WOS, 13 (27.66%, 13/47) lesions had superficial ulcers, and 21 (44.68%, 21/47) lesions demonstrated spontaneous bleeding. Magnifying endoscopy with NBI was conducted in 30 lesions, revealing clear boundaries in 86.67% (26/30) lesions, irregular or disappeared submucosal microvasculature in 96.67% (29/30) lesions, and irregular or disappeared epithelial microstructure and pit pattern in 90.00% (27/30) lesions. Differentiated pathological type was dominant (89.36%, 42/47). Conclusion ECG mainly occurs in the gastric antrum and 0-IIc type are dominant. Careful observation of the changes and characteristics of the local tone of gastric mucosa under a white light endoscope as well as the changes in lesion boundaries, submucosal microvasculature, epithelial microstructure and pit pattern under a magnifying endoscope with NBI is helpful to improve the diagnosis rate of ECG.

Influencing Factor Analysis of Coronary Slow Flow in Relevant Patients / 中国循环杂志

Objective:To investigate the influencing factors of coronary slow flow (CSF) in relevant patients.Methods:A total of 1 530 patients received coronary angiography (CAG) in our hospital from 2008-01 to 2010-09 were retrospectively studied.According to corrected TIMI frame counts,2 groups were established:CSF group,n=139 patients without obvious coronary artery stenosis but with CSF and Control group,n=232 patients without obvious coronary artery stenosis and with normal coronary blood flow.Basic clinical condition,risk factors and routine laboratory tests were compared between 2 groups;the influencing factors of CSF were evaluated by multivariate Logistic regression analysis.Results:① The following parameters were different between 2 groups:age,gender,histories of smoking and diabetes;red blood cells (RBC),hemoglobin,mean hemoglobin concentration,hematocrit (HCT),mean RBC volume,RBC distribution width;neutrophils,monocytes,basophilic granulocyte,the ratios of lymphocytes/monocytes (LMR),neutrophils/monocytes (NMR),neutrophils/lymphocytes (NLR) and platelet/lymphocytes (PLR);glutamic oxalacetic transaminase,creatine kinase and total bile acid,P＜0.05.② Correlation analysis showed that RBC (r=0.191,P＜0.01),hemoglobin (r=0.184,P＜0.01),neutrophils (r=0.218,P＜0.01),mean hemoglobin concentration (r=0.151,P＜0.01),mean RBC volume (r=-0.138,P＜0.01),total bile acid (r=-0.172,P＜0.01),NLR (r=0.231,P＜0.01),LMR (r=-0.157,P＜0.01) and NMR (r=0.121,P＜0.01)were related to 3-branch mean flow frame.③ Multivariate Logistic regression analysis indicated that total bile acid (partial regression coefficient=-0.102,P＜0.01),LMR (partial regression coefficient =-0.381,P＜0.01) and NMR (partial regression coefficient =0.489,P＜0.01) were the independent influencing factors of coronary slow flow.Conclusion:Total bile acids,LMR and NMR were the influencing factors of coronary slow flow in relevant patients.

Influencing Factor Analysis of Coronary Slow Flow in Relevant Patients / 中国循环杂志

Objective:To investigate the influencing factors of coronary slow flow (CSF) in relevant patients.Methods:A total of 1 530 patients received coronary angiography (CAG) in our hospital from 2008-01 to 2010-09 were retrospectively studied.According to corrected TIMI frame counts,2 groups were established:CSF group,n=139 patients without obvious coronary artery stenosis but with CSF and Control group,n=232 patients without obvious coronary artery stenosis and with normal coronary blood flow.Basic clinical condition,risk factors and routine laboratory tests were compared between 2 groups;the influencing factors of CSF were evaluated by multivariate Logistic regression analysis.Results:① The following parameters were different between 2 groups:age,gender,histories of smoking and diabetes;red blood cells (RBC),hemoglobin,mean hemoglobin concentration,hematocrit (HCT),mean RBC volume,RBC distribution width;neutrophils,monocytes,basophilic granulocyte,the ratios of lymphocytes/monocytes (LMR),neutrophils/monocytes (NMR),neutrophils/lymphocytes (NLR) and platelet/lymphocytes (PLR);glutamic oxalacetic transaminase,creatine kinase and total bile acid,P＜0.05.② Correlation analysis showed that RBC (r=0.191,P＜0.01),hemoglobin (r=0.184,P＜0.01),neutrophils (r=0.218,P＜0.01),mean hemoglobin concentration (r=0.151,P＜0.01),mean RBC volume (r=-0.138,P＜0.01),total bile acid (r=-0.172,P＜0.01),NLR (r=0.231,P＜0.01),LMR (r=-0.157,P＜0.01) and NMR (r=0.121,P＜0.01)were related to 3-branch mean flow frame.③ Multivariate Logistic regression analysis indicated that total bile acid (partial regression coefficient=-0.102,P＜0.01),LMR (partial regression coefficient =-0.381,P＜0.01) and NMR (partial regression coefficient =0.489,P＜0.01) were the independent influencing factors of coronary slow flow.Conclusion:Total bile acids,LMR and NMR were the influencing factors of coronary slow flow in relevant patients.

Protective effect of Icariin against TGF-β1-induced injury of rat Leydig cells / 中华男科学杂志

<p><b>Objective</b>To study the effect of Icariin on rat Leydig cells with TGF-β1-induced injury.</p><p><b>METHODS</b>We determined the optimal concentration of Icariin for protecting primarily cultured Leydig cells against TGF-β1-induced injury by methyl thiazolyl tetrazolium assay. We detected the effects of Icariin on the secretion of estradiol (E2) and activity of aromatase in the injured Leydig cells by radioimmunoassay and Tritium water release experiment and its effect on the gap junctional intercellular communication (GJIC) between the Leydig cells by fluorescence distribution after photobleaching.</p><p><b>RESULTS</b>Different concentrations of Icariin showed different degrees of protective effect on the TGF-β1-treated Leydig cells, the effect observed at 20 μg/ml and at its optimum at 160 μg/ml. After treatment of the injured Leydig cells with Icariin at 160 μg/ml, significant improvement was observed in the E2 secretion and aromatase activity (P<0.01) as well as in the GJIC between the Leydig cells (P<0.01).</p><p><b>CONCLUSIONS</b>Icariin can effectively protect rat Leydig cells against TGF-β1-induced injury, which is largely attributed to its effects of increasing E2 synthesis, enhancing aromatase activity, and improving GJIC between Leydig cells.</p>

Effects of Shenfu injection on calreticulin expression and neuronal apoptosis in the cerebral cortex of neonatal rats with hypoxic-ischemic brain damage / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To examine the expression of calreticulin (CRT) and the changes of intracellular free calcium and neuronal apoptosis in the cerebral cortex of neonatal rats with hypoxic-ischemic brain damage (HIBD), and to investigate the intervention effects of Shenfu injection.</p><p><b>METHODS</b>Seven-day-old rats were randomly assigned to three groups: control, hypoxic-ischemia (HI) and Shenfu-treated. Each group (n=50) was subdivided into 5 groups sacrificed at 3, 6, 12, 24 and 72 hours. Rat models of HIBD were prepared according to the Rice's method. Rats in the control group only underwent the separation of right common carotidartery. Shenfu injection was administered by intraperitoneal injections right after HI insults and then once daily at a dosage of 10 mL/kg for 3 days in the Shenfu-treated group. The expression of CRT in the cerebral cortex was detected by RT-PCR and Western blot. The free calcium concentrations were determined under a fluorescent microscope. The apoptosis rate was measured by the flow cytometry.</p><p><b>RESULTS</b>Compared with the control group, the expression levels of CRT in the HI and the Shenfu-treated groups were obviously up-regulated (P<0.05), and the expression levels of CRT in the Shenfu-treated group were notably higher than those in the HI group (P<0.05) at all time points. The concentrations of intracellular free calcium and the apoptosis rate of neurons in the cerebral cortex in the Shenfu-treated group were significantly reduced compared with those in the HI group (P<0.05), but increased significantly compared with those in the control group at all time points (P<0.05).</p><p><b>CONCLUSIONS</b>Shenfu injection may have neuroprotective effects against HIBD by up-regulation of CRT expression and relief of calcium overload.</p>