Meta-analysis of the efficacy of intravitreal Ranibizumab combined with compound trabeculectomy and panretinal photocoagulation in the treatment of neovascular glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To systematically evaluate the efficacy and safety of intravitreal ranibizumab combined with compound trabeculectomy and panretinal photocoagulation(PRP)compared with compound trabeculectomy combined with PRP in the treatment of neovascular glaucoma(NVG).METHODS: Databases including Wanfang database, China National Knowledge Infrastructure(CNKI), PubMed, EMbase, China Biomedical Document Service System(CBM), Clinicalkey, and Cochrane Library were retrieved. Literatures about intravitreal ranibizumab combined with compound trabeculectomy and PRP in the treatment of NVG in the experimental group and compound trabeculectomy and PRP in the treatment of NVG in the control group from creation of database to July 20, 2022 were searched. At the same time, relevant reference were consulted. The best corrected visual acuity, intraocular pressure, occurrence of complications and the success rate of the surgery were systematically evaluated.RESULTS: A total of 8 clinical studies were included, with 864 patients(864 eyes)with NVG. Meta-analysis showed that the intraocular pressure of patients in the experimental group was lower than that in the control group at 1wk, 1 and 3mo after surgery(1wk: MD=-4.00, 95%CI: -4.62～-3.38, P<0.05; 1mo: MD=-4.11, 95%CI: -4.66～-3.56, P<0.05; 3mo: MD=-4.58, 95%CI: -5.61～-3.55, P<0.05). The best corrected visual acuity of the experimental group was better than that of the control group at 1mo after surgery(MD=0.17, 95%CI: 0.11～0.23, P<0.05), but there was no significant difference at 1wk after surgery(MD=0.08, 95%CI: -0.13～0.29, P=0.47). The patients in the experimental group had fewer complications(OR=0.30, 95%CI: 0.18～0.52, P<0.05)and higher surgical success rate(OR=5.15, 95%CI: 2.78～9.53, P<0.05).CONCLUSION:With decreased intraocular pressure, improved visual acuity and surgical success rate, intravitreal ranibizumab combined with compound trabeculectomy and PRP was better than the compound trabeculectomy and PRP in the treatment of NVG.

The correlation of body mass index with clinical factors in patients with first-episode depression.

Depression is one of the major disease burdens worldwide. Few studies have addressed body mass index (BMI) in Chinese depression patients. This current study aimed to investigate the BMI in patients with depression and the correlation with clinical factors. A total of 211 inpatients with first-episode depression were enrolled. General and clinical data were collected by standardized questionnaires and the levels of hemoglobin, fasting blood glucose, uric acid, and blood lipid were measured. In total, 24-item Hamilton Depression Scale (HAMD) and 14-item Hamilton Anxiety Scale (HAMA) were rated for all the patients. The BMI of 211 patients with depression was 37 (17.5%) in the underweight group, 117 (55.5%) in the normal-weight group, 43 (20.4%) in the overweight group, and 14 (6.6%) in the obesity group. Multivariate logistic analysis showed that uric acid was the only risk factor for BMI. The ordered logit model showed that the risk of elevated uric acid increased with BMI grade. And the risk of severe depression was significantly greater in patients with underweight than those in normal-weight. The level of uric acid in patients with first-episode depression is positively correlated with BMI, and the score of depressive symptoms is higher in patients with underweight.

Analysis of psychological state and clinical psychological intervention model of patients with COVID-19

BackgroundPatients with the 2019 coronavirus disease (COVID-19) have different degrees of psychological pain, such as anxiety and depression, which may related to their prognosis. Psychological intervention can be conducted in different ways to improve psychological pain and improve the treatment effect. ObjectiveThe present study aimed to investigate and analyze the psychological status of patients with COVID-19 during the course of illness, and to evaluate the effect and influencing factors of psychological crisis intervention, so as to explore the effective mode of clinical psychological intervention in acute patients under isolation environment. MethodsA total of 143 persons participated in the study, including 26 patients diagnosed with COVID-19 in the isolation ward (COVID-19 group), 87 patients with general pneumonia in the observation ward (General Pneumonia group) and 30 healthy volunteers (Normal group). All the patients in the ward received comprehensive psychological intervention, including telephone psychological counseling (active and passive), self-adjustment of written materials and one-to-one psychological crisis intervention. Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA) were used to evaluate the mental health status of all patients on the day of admission and 1 week after treatment. ResultsThe scores of HAMA and HAMD of all patients (including isolation ward and observation ward) were significantly higher than the healthy volunteers at the time of admission. The total score of HAMA and HAMD in CVOID-19 group were both higher than that General Pneumonia group. After 1 weeks hospitalization with comprehensive psychological intervention, the scores of HAMA and HAMD in CVOID-19 group were significantly decreased. ConclusionPatients those who diagnosed with COVID-19 in the isolation ward and/or general pneumonia in observation ward have different degrees of anxiety, depression and sleep problems. While receiving antiviral treatment, patients also need psychological intervention. Comprehensive psychological intervention model has been proved to be effective.

Severe acute respiratory syndrome coronavirus 2 infection in renal transplant recipients: A case report / 北京大学学报(医学版)

The novel coronavirus is a newly discovered pathogen in late December 2019, and its source is currently unknown, which can lead to asymptomatic infection, new coronavirus pneumonia or serious complications, such as acute respiratory failure. Corona virus disease 2019 (COVID-19) is a new type of respiratory disease that is currently spreading all over the world and caused by this coronavirus. Its common symptoms are highly similar to those of other viruses, such as fever, cough and dyspnea. There is currently no vaccine or treatment for COVID-19. Everyone is susceptible to infection with this disease, and owing to the long-term use of immunosuppressants, the immunity of kidney transplant recipients is suppressed, and it is more likely to be infected with the disease. At present, its impact on kidney transplant recipients is unclear. This article reports the clinical features and therapeutic course of novel coronavirus infection in a patient after renal transplantation. A 37-year-old female patient who received a kidney transplant 6 months before was diagnosed with novel coronavirus pneumonia. The patient's symptoms (such as fever, chills, dry cough, muscle aches), laboratory tests (such as decreased white blood cell count, elevated liver enzymes and D-dimer, positive viral nucleic acid test), and chest CT (multiple left lower lung plaque ground glass shadow) were similar to those of non-transplanted novel coronavirus pneumonia patients. In terms of treatment, because the immunity of kidney transplant recipients has been suppressed for a long time, it is a very common strategy to suspend the use of immunosuppressive agents. Therefore, the patient immediately discontinued the immunosuppressive agent after admission, so that she could restore immunity against infection in a short time. At the same time, the use of glucocorticoids was also very important. Its immunosuppressive and anti-inflammatory effects played a large role in the treatment process.In addition, prophylactic antibiotics was needed, and nephrotoxic drugs should be used with caution. Finally, following discounting the use of immunosuppressant and a low-dose glucocorticoid-based treatment regimen, COVID-19 in this renal transplant recipient was successfully cured. The cure of this case was of great significance, and this adjuvant nonspecific antiviral therapy could provide a template for the treatment of other such patients.

Effect of Electroacupuncture on Blood-brain Barrier in SAMP8 Mice / 中国康复理论与实践

Objective:To investigate the effects of electroacupuncture on blood-brain barrier to promote intake of drugs into brain of SAMP8 mice. Methods:The male SAMP8 mice (30-week-old) were randomly divided into model group (n = 7), drug group (n = 7), acupuncture group (n = 7) and combined group (n = 7). Other SAMR1 mice were as control group (n = 7). The acupuncture group and the combined group accepted electroacupuncture at Baihui (DU20) and Yintang (EX-HN3), the drug group and the combined group accepted Donepezil, for four weeks. They were observed hippocampus tight junction (TJ) under transmission electron microscope. The activities of acetylcholinesterase (AChE) in hippocampus were detected with immunohistochemistry. The mRNA expression of ZO-1, Claudin-5 and Occludin was detected with real-time quantitative polymerase chain reaction. Results:TJ and basement membrane in the control group, the acupuncture group and the combined group were better than those in the model group and the drug group. AChE was the most in the combined group, and then the drug group and the control group, the acupuncture group and the model group (P < 0.001). The expression of mRNA of ZO-1, Claudin-5 and Occludin was more in the acupuncture group and the combined group than in the drug group (P < 0.01). Conclusion:Electroacupuncture could ameliorate blood-brain barrier disruption and promote drug to enter the brain in SAMP8 mice, which may relate to the adjustion of ZO-1, Claudin-5 and Occludin.

Electroacupuncture improves locomotor function by regulating expression of inflammation and oxidative stress-related proteins in mice with spinal cord injury / 针刺研究

OBJECTIVE: To observe the effect of electroacupuncture (EA) on the expression of apolipoprotein E (ApoE) and related proteins of inflammation and anti-oxidative stress in spinal cord in mice with spinal cord injury (SCI), so as to explore its mechanisms underlying function repair. METHODS: Thirty-six female C57BL/6 mice were equally randomized into 3 groups: sham operation, model and EA. The SCI model was established by clamping the spinal cord for 25 s with a serrefine after laminectomy of the 1st lumbar vertebra (L1). EA (1.5 Hz/7.5 Hz, 1.0 mA) was applied to bila-teral "Zusanli" (ST36) and "Sanyinjiao" (SP6) for 10 min, once a day for 7 days. The hindlimb locomotor function was assessed according to the state of the range of motion, coordination, claw gesture of the hind leg ankle-joint, trunk stabi-lity and the tail posture by using Basso Mouse Scale(BMS). The histopathological changes of the injured area of the spinal cord were determined by H.E. staining. The expression levels of ApoE, phosphorylated nuclear transcription factor-κB(p-NF-κB), interleukin 1 beta(IL-1β), phosphorylated extracellular regulatory protein kinase(p-ERK1/2), extracellular regulatory protein kinase(ERK1/2), nuclear factor erythroid 2-related factor 2(Nrf2) and heme oxidase-1(HO-1) in the spinal cord were detected by Western blot, and the glial fibrillary acidic protein (GFAP)-positive astrocytes were displayed by immunofluorescence staining. RESULTS: After modeling, the BMS scores were significantly decreased in the model group compared with the sham operation group (P<0.05). Following EA, the BMS scores were markedly increased in the EA group relevant to the model group (P<0.05), suggesting an improvement of the hindlimb locomotor function. H.E. stain showed structural disorder with lots of cavities, severe inflammatory infiltration with large quantity of inflammatory cells, and apparent reduction of normal neurons in the injured spinal cord tissue of model group, which was milder in the EA group. The expression levels of ApoE, p-NF-κB, IL-1β, p-ERK1/2 (not ERK1/2), Nrf2 and HO-1 were significantly increased in the model group than those in the sham operation group (P<0.05). Compared with the model group, the expression levels of ApoE, p-ERK1/2, Nrf2 and HO-1 were further notably up-regulated (P<0.05), and those of p-NF-κB and IL-1β proteins obviously down-regulated in the EA group (P<0.05). Immunoflorescence staining showed that the number of GFAP-positive cells was apparently increased in the model group compared with the sham operation group and observably decreased in the EA group relevant to the model group (P<0.05). CONCLUSION: EA can significantly improve locomotor function in SCI mice, which is associated with its effects in reducing inflammation, oxi-dative stress reactions and reactive astrocyte proliferation via up-regulating expression of ApoE, p-ERK1/2, and Nrf2/HO-1 (antioxidant pathway) and inhibiting IL-1β and NF-κB expression.

[Effects of intermittent and continuous thermochemotherapeutic intra artery infusion on adriamycin concentration in rabbit VX-2 tumor].

BACKGROUND & OBJECTIVE: It has been proved that vital signs of organism can be influenced by heat infusion and the thermochemotherapy with Adriamycin (ADM) is more effective than the general chemotherapy in inhibiting extraneous rabbit VX-2 cells. Intermittent thermochemotherapeutic infusion and continuous thermochemotherapeutic infusion with ADM were performed respectively on the rabbits to evaluate the effectiveness and safety of intermittent thermochemotherapeutic intra artery infusion by comparing their respiration rate, heart rate, body temperature, and the ADM concentration in VX-2 carcinoma. METHODS: VX-2 tumor models were established in the hind legs of 30 New Zealand rabbits, and then they were divided into three groups (10 in each group) randomly. 100 ml saline and ADM in room temperature were infused, 100 ml saline and ADM in 60 degrees C were intermittently infused, and 100 ml saline and ADM in 60 degrees C were continuously infused into the tumor nutrient arteries, which were confirmed by DSA, of the rabbits in each group respectively. During the infusion, the 43-45 degrees C lasting time of the tumor tissues in the two 60 degrees C infusion groups was measured. After the infusion,the respiratory rate,heart rate,body temperature,and the concentration of ADM within the tumors were determined. RESULTS: The concentration of ADM was 7.115+/-2.180 microg/ml in the room temperature infusion group,17.213+/-1.657 microg/ml in the 60 degrees C continuous infusion group, and 16.545+/-3.426 microg/ml in the 60 degrees C intermittent infusion group. There was no significant difference between the 60 degrees C intermittent infusion group and the 60 degrees C continuous infusion group (P >0.05), while there was significant difference between the 60 degrees C intermittent infusion groups and the room temperature infusion group,so was between 60 degrees C continuous infusion groups and the room temperature group (P< 0.05). The 43-45 degrees C lasting time was 22.53+/-1.44 minutes in the continuous infusion group and 24.31+/-2.45 minutes in the intermittent infusion group. There was no significant difference between these two groups (P >0.05). There was no significant difference in the respiration rate, heart rate, and body temperature between the 60 degrees C intermittent infusion group and the room temperature infusion group (P >0.05). CONCLUSION: Compared with continuous infusion, intermittent thermochemotherapy intra artery infusion is a more effective and safer interventional thermochemotherapy.

[Adriamycin thermotherapy through hepatic artery for model of VX2 carcinoma in rabbit liver].

BACKGROUND & OBJECTIVE: It was reported that heating can enhance sensitivity of rabbit VX2 cell to adriamycin and increase intracellular concentration of adriamycin. This study was designed to evaluate the anti-tumor effects of interventional hyperthermia and interventional chemotheramotherapy on VX2 carcinoma in rabbit liver. METHODS: VX2 carcinoma cells were surgically implanted into the right liver lobe of 60 male New Zealand white rabbits, which were randomly divided into 4 groups(15 rabbits per group). To inject physiological saline(37 degrees C), adriamycin (37 degrees C), physiological saline(60 degrees C), and adriamycin (60 degrees C) in different groups via hepatic artery of the rabbits with liver cancer. One week later, to observe the volume of tumor, the serum level of aspartate transaminase(AST), and observe the survival period of VX2 rabbits. RESULTS: In group of ADM(60 degrees C), the tumor growth rate (0.53 +/- 0.21)% was significantly lower than group 2(1.09 +/- 0.26)%, group 3(3.32 +/- 1.28)%, and group 4(3.48 +/- 1.17)% (P < 0.05, P < 0.05, P < 0.01, respectively). The survival period of adriamycin (60 degrees C) group (50.0 +/- 2.0)d was significantly higher than the untreated control group (40.5 +/- 3.0)d, (P < 0.05). The serum level of AST of TNP-470 with lipiodol group was not higher than the other treated groups(P > 0.05), but being significantly higher than the untreated control group after treated(P < 0.05). CONCLUSION: Adriamycin (60 degrees C) greatly decreases the tumour growth rate, and prolongs the survival period.

[Effect of interventional chemothermotherapy on vascular permeability of tumor liver tissue and normal liver tissue in VX-2 tumor-bearing rabbits].

BACKGROUND & OBJECTIVE: It was reported that heating could enhance the sensitivity of chemotherapy with Adriamycin and increase the intracellular content of Adriamycin. The aim of this study was to investigate the effect of interventional chemothermotherapy on vascular permeability of tumor liver tissue and normal liver tissue in VX-2 tumor-bearing rabbits. METHODS: Thirty rabbits used as implanted hepatocarcinoma model were randomly divided into 3 groups: non-perfusion group (injected only with 1% Evans blue after catheterization), normothermic perfusion group (the perfusion fluid was 25 degrees C normal solution), and hyperthermic perfusion group(the perfusion fluid was 60 degrees C normal solution). The contents of Evans blue in the tissues of three groups, which were used as the indices of vascular permeability, were calculated by the standard curve and spectrophotometry. RESULTS: The Evans blue contents in tumor liver tissue and normal liver tissue is statistically different (P < 0.05). There was no over difference of the Evans blue contents in two kinds of tissue between normal perfusion group and non-perfusion group. There was overt difference of the Evans blue contents in two kinds of tissue between hyperthermic perfusion group and normothermic perfusion group. CONCLUSION: Interventional chemothermotherapy could increase the vascular permeability of normal liver tissue and tumor liver tissue.