[Existence forms of Tiantian Capsules and its raw material Aloe in rats].

This study explored the existence forms(original constituents and metabolites) of Tiantian Capsules, Aloe, and Tiantian Capsules without Aloe in rats for the first time, aiming to clarify the contribution of Aloe to the existence form of Tiantian Capsules. Rats were administrated with corresponding drugs by gavage once a day for seven consecutive days. All urine and feces samples were collected during the seven days of administration, and blood samples were collected 0.5, 1, and 1.5 h after the last administration. UHPLC-Q-TOF-MS was employed to detect and identify the original constituents and metabolites in the samples. A total of 34, 28, and 2 original constituents and 64, 94, and 0 metabolites were identified in the samples of rats administrated with Aloe, Tiantian Capsules, and Tiantian Capsules without Aloe, respectively. The main metabolic reactions were methylation, hydrogenation, hydroxylation, dehydroxylation, glucuronidation, and sulfation. This study clarified for the first time the existence forms and partial metabolic pathways of Aloe, Tiantian Capsules, and Tiantian Capsules without Aloe in rats, laying a foundation for revealing their effective forms. The findings are of great significance to the research on the functioning mechanism and quality control of Aloe and Tiantian Capsules.

Separation and purification of pyrroloquinoline quinone from Gluconobacter oxydans fermentation broth using supramolecular solvent complex extraction.

In this paper, new supramolecular extractants, which contained surfactant, alkane and alkanol, were designed and used to separate PQQ. After a series of tests, the optimal extractant composition was determined as benzalkalonium (C8-C16) chloride (BC): n-hexane:n-pentanol, and the highest extraction rate could reach 98%. The extraction equilibrium could be reached in five minutes. The mechanism of the extraction selectivity was inferred as an ion-pair and π-π complexation interaction between PQQ and BC, which was indicated by UV and fluorescence quenching experiments. To recycle the organic extractant, the extract was back-extracted with sodium chloride solution. After extraction, back extraction and crystallization, an isolated product with a purity of 97.5% was obtained from G. oxydans fermentation broth. The product was identified as PQQ by HPLC analysis and MS. Above all, the present research developed a simple and efficient method for the separation of PQQ from fermentation broth.

[Transpupillary thermotherapy for circumscribed choroidal hemangiomas].

OBJECTIVE: To study the effects of transpupillary thermotherapy (TTT) on circumscribed choroidal hemangiomas (CCH). METHODS: It was a retrospective cases series study. One hundred and fourteen cases (114 eyes) in out-patient department were enrolled in the study with 80 male cases and 34 female cases. The age ranged from 16 to 71 yrs with an average at 44 years. Single eye was affected in all cases. Indirect ophthalmoscope, fundus fluorescein angiography (FFA), ultrasound (B) were used for the examination. Treatment was delivered via slit lamp by using an 810 nm diode laser (Irises) with spots or composed spots (larger tumor) covering the whole tumor. If the tumor was located or partly located in the fovea, laser spot should be avoided in the fovea and papillo-macular bundle. The laser power should be lesser (light gray color) in parafovea area. Routine laser spot (gray-white color) was used in perifovea area. A width of 200 µm out of disk border should not be placed by laser spot in paradisk tumor cases. RESULTS: The visual acuity (VA) ≥ 0.5 of pre-and post-treatment was 17 eyes (14.9%) and 27 eyes (23.7%), respectively. Pre-treatment, the retinal detachment extended in the inferior part in 27 cases (23.7%) except on the tumor surface. The tumor was located at macular area in 67 cases (58.8%), around the disc in 35 cases (30.7%), at the temporal arcuate in 12 cases (10.5%). In our cases, VA maintenance with fluid absorption was noted in 76 cases (66.7%) after the treatment. VA improvement with fluid absorption in 28 case (24.6%). Both VA maintenance and improvement (rate of efficiency) with fluid absorption were 91.2%. Fluid non-absorption or VA decline was regarded as unsuccessful in 10 cases (8.8%). The average thickness of 32 cases tumor pre- and post-treatment was (3.90 ± 1.15) mm and (2.41 ± 1.30) mm. Twenty seven cases were followed up for ≥ 1 year (mean 22.8 months) with rate of efficiency at 81.5%. The complications (9 eyes, 7.9%) contained minor macular hemorrhage in 2 eyes, macular pucker in 3 eyes, macular edema and cystoid macular edema in 2 eyes, retinal branch occlusion in 1 eye, and arcuate scotoma in 1 eye. CONCLUSIONS: The treatment of TTT on CCH, whether the tumor located around-disc or in foveal area with exudative fluid could get successful in the majority of cases. TTT is one of the treatments worth doing owing to fewer complications, less expenses and easy-doing with definite and persistent effect.

[Clinical analysis of occult macular dystrophy].

OBJECTIVE: To report the clinical features of occult macular dystrophy (OMD). METHODS: It was a retrospective case series study. 9 cases (14 eyes) with 3 males, 6 females, mean age 36 (7 to 53) years, were examined with vision acuity, fundus ophthalmoscope, fundus fluorescein angiography (FFA), electroretinogram (ERG), visual evoked potential (VEP), multifocal electroretinogram (mfERG) and optical coherence tomography (OCT). In mf ERG, the amplitude density and implicit time of P1 ring1 and ring2 of the affected eyes were compared with the normal control eyes. The correlation between the implicit time & amplitude density of P1 ring1 & ring2 of the affected eyes and visual acuity were examined. RESULTS: 9 eyes VA were 0.05 to 0.2, 4 eyes were 0.3 to 0.6 and 1 eye it was ≥0.7. All of the 9 cases possessed their unique clinical features, including progressive visual decline, normal fundus, FFA, and F-ERG. Macular function impairment was showed only by mfERG. In mfERG, the results of comparison between the affected eyes and normal control eyes were as follows:On implicit time of P1 ring1, average figure of the affected eye group was (27.67±1.07) ms, the control group was (26.28±1.88) ms. The parameters were significant difference between 2 groups (t=-2.308, P<0.05). On ring1 amplitude density, average figure of the affected eye group was (42.71±15.48) nv/deg2, average figure of the control group was (66.79±14.87) nv/deg2, there was also a significant difference between two groups (t=5.259, P<0.05). On implicit time of ring2, average figure of the affected eye group was (27.80±1.20) ms, average figure of the control group was (26.91±0.82) ms, the results from the 2 groups showed significant difference (t=-2.275, P<0.05). On ring2 amplitude density, average figure of the affected eye group was (24.99±8.49) nv/deg2, average figure of the control group was (39.20±6.47) nv/deg2, there was significant difference between two groups (t=4.943, P<0.05). No correlation was found between the implicit time (r=-0.329, -0.369) & amplitude density (r=0.053, 0.057) of P1 ring1 & ring2 of the affected eyes and visual acuity (P>0.05). CONCLUSIONS: The major signs of OMD are visual acuity decline with normal fundus, FFA and F-ERG, macular function impairment manifested only by mfERG. It's probably a type of cone dystrophy.

[Clinical features and treatment of choroidal metastasis].

OBJECTIVE: To assess the clinical features and management of choroidal metastasis. METHODS: Fundus examination was performed in 49 patients (66 eyes) with choroidal metastasis. Fundus fluorescein angiography (FFA) was performed in 44 cases, combined with indocyanine green angiography (ICGA) examination in 12 cases. B-scan ultrasound examination was performed in 8 cases. Transpupillary thermotherapy (TTT) was performed in 24 eyes, combined with photo-dynamic therapy in one eye. Plaque radio-therapy was used in one eye. The parameters of treatment for TTT were 1.2 - 3 mm spot size, 450 - 1000 mV, 60 s; 2 sessions of TTT in 2 eyes and 3 sessions in 3 eyes. RESULTS: Fourteen cases were male and 35 cases were female. Both eyes were affected in 17 cases (34.7%). Age ranged from 23 - 74 years old with an average of 47 years. The visual acuity was 0.05 or less in 13 eyes; 0.06 - 0.2 in 22 eyes and 0.3 or more in 31 eyes. Primary tumours were found in 40 cases (81.6%) (surgical excision in 25 cases), consisting of breast carcinoma in 16 cases (32.7%), lung carcinoma in 14 cases (28.6%), hepatoma and cholangiocarcinoma in 3 cases, colon and stomach carcinomas in 3 cases, gynecologic appendix carcinoma (including 1 case of ovarian mucous cyst adenocarcinoma) in 2 cases, nasopharyngeal adenocarcinoma in 1 case, vertebra tumor in 1 case, undetected in 5 cases (10.2%) and under detection in 4 cases (8.2%). The fundus had 1 lesion in 58 eyes (58/66 = 87.8%), 2 lesions in 4 eyes (4/66 = 6.0%), 3 or more lesions in 2 eyes (including 7 lesions in 1 eye). According to the location and development status of the lesions, they could be divided into solitary type, 39 eyes (39/66 = 59.1%); diffuse type, 19 eyes (19/66 = 28.8%); and early type, 8 eyes (8/66 = 12.1%). FFA examination: early stage lesions showed hypofluorescence and later stage lesions showed moderate to strong hyperfluorescence. In 8 cases of solitary lesions, the size of the lesion measured by B-scan averaged 11.5 mm x 10.5 mm x 3.6 mm with the maximal height at 4.9 mm. The tumor became flattened and vision remained stable at 3 months after plaque radiotherapy in 1 case. Three cases were followed-up for 2, 3, and 4 months after TTT treatment. The lesions remained stable with vision unchanged or slightly decreased. CONCLUSIONS: The choroidal metastasis has specific clinical features. The classification of metastatic lesions into solitary, diffuse and early types is helpful for the evaluation of the disease process. The primary tumor can be found in 80% of cases. The most common primary cancer is breast carcinoma, followed by lung carcinoma. These two cancers account for 75% of primary tumors. In solitary type and early type lesions, TTT combines with systemic treatment could result in regression of lesions, saving of vision and improvement of the life quality.

Prevalence and associations of epiretinal membranes in a rural Chinese adult population: the Handan Eye Study.

PURPOSE: To determine the prevalence and association of epiretinal membranes (ERMs), as assessed by retinal photography and optical coherence tomography (OCT), in a Chinese population. METHODS: The Handan Eye Study is a population-based study of eye disease in rural Chinese aged 30+ years. Eligible residents underwent a detailed ophthalmic examination including retinal photography and Stratus OCT. ERMs were defined by a combination of retinal photographs and OCT and classified as cellophane macular reflex (CMR) or preretinal macular fibrosis (PMF) based on retinal photographs characteristics. RESULTS: Of the 6830 persons examined, 6565 (96.1%) had gradable retinal photographs and/or OCT. The mean age was 51.7 +/- 11.6 years. ERMs were present in 3.4% (95% CI: 2.9%-3.8%) of participants, bilateral in 20.3% of the cases. CMR was present in 2.2% and PMF in 0.7%, and ERMs were unclassified in 0.5% (detected by OCT only). ERM prevalence was similar in women and men (3.6% vs. 3.1%), strongly associated with increasing age (P for trend < 0.001). After adjustment for age and sex, primary ERM was associated positively with myopia (OR: 1.58, 95% CI: 1.12-2.23) and inversely with current smoking (OR: 0.61, 95% CI: 0.38-0.97, versus never smoked). Best corrected visual acuity was significantly worse in eyes with primary ERMs (mean LogMAR score lower by 0.07, 95% CI: 0.05-0.10) than eyes without ERMs, after adjustment for age, sex, and lens status. CONCLUSIONS: ERMs affect 3.4% of the population 30+ years of age and living in rural China. Idiopathic ERMs were associated with myopia, decreased visual acuity, and inversely associated with smoking.

[The study of clinical characteristic of nonischemic central retinal vein occlusion].

UNLABELLED: OBJECTIVE; To make a comparative study of the clinical characteristics and risk factors of nonischemic central retinal vein occlusion (CRVO) between patients younger and older than the age of 40. METHODS: It was a retrospective case series. Retrospective data analysis (including best corrected visual acuity, color fundus photograph and fundus fluorescein angiography, etc. ) was conducted in patients with nonischemic central retinal vein occlusion who were followed-up for 6 months or longer. RESULTS: The data of 148 cases (151 eyes) were analyzed. The follow-up time was 6 months to 15 years, averaged 17 months. Among them, 39 patients (40 eyes) aged 40 years or younger, their age ranged from 15 to 40 years, averaged 27 years old. There were 20 cases of male patients (20 eyes) and accounted for 51% of total cases. The rest of the patients were above the age of 40 years old. Their age ranged from 41 to 76 years, averaged 57 years old. Male patients (53 cases, 54 eyes) accounted for 49% of total cases. In the younger patients, only 2 of them had a history of hypertension, no other systemic illness was found. In the older patients, more than 40% of them had a history of systemic illness, including hypertension and diabetes mellitus. Initial visual acuity showed no statistically significant difference between these two groups (Pearson, chi2 =0. 087, P = 0.769). There was a significant difference in final visual acuity between these two groups (Pearson, chi2 = 4.692, P = 0.047). Final visual acuity was 20/60 or better in 18 cases (45%) in the younger group, but only 25 cases (23%) in the older group. Final visual acuity was 20/200 or less in 67% of cases in the older group, while 35% in the younger group. Complications occurred more frequently in the older group. The difference of complication rate in these two groups was statistically significant (Pearson, chi = 8.763, P = 0.006). Final vision was statistically correlated with age, initial visual acuity and complications, but not with sex or systemic illness. CONCLUSIONS Systemic illness is a risk factor for the occurrence of CRVO in the older group, but not in the younger group. It does not affect the final visual acuity. Complications occurs less common in the younger group. Although final visual acuity was better in the younger group, but still 35% of them was 20/200 or less. Most of the patients in the older group have severe visual impairment. Active treatment should be given to both groups.

[Comparison of fundus photography and fluorescein angiography in grading diabetic retinopathy].

OBJECTIVE: To study the consistency of the color fundus photography and fluorescein angiography for grading the diabetic retinopathy. METHODS: It was a retrospective case series. The agreement study was conducted in a series of diabetic patients, who were excluded from the mild non-proliferative diabetic retinopathy (NPDR) and the severe proliferative diabetic retinopathy (PDR). Ninety-nine cases (188 eyes) met the selected criteria Five 50 degrees non-stereoscopic photography for each eye were taken in all cases before FFA was performed. The diabetic retinopathy was graded from the fundus photography and FFA images according to international diabetic retinopathy disease severity scale. The kappa value was calculated according to the grading outcomes from the fundus photography and FFA images to estimate the agreement of the grading outcomes. RESULTS: The fundus photography showed 59 moderate NPDR (31.4%), 76 severe NPDR (40.4%) and 53 PDR eyes (28.2%) respectively, FFA showed 50 moderate NPDR (26.6%), 72 severe NPDR (38.3%) and 66 PDR (35.1%) respectively. The agreement for the grading of DR by the fundus photography and FFA was substantial (K = 0.601). In the evaluation whether it was necessary to implement PRP (more serious than NPDR and PDR), there was higher agreement between them (K = 0.652). CONCLUSIONS: Five 50 degrees photography can provides the support of the application of PRP for diabetic patients, FFA may be earlier and relatively accuracy in the diagnose of diabetic retinopathy.

[Analysis of clinical features of choroidal neovascularization].

OBJECTIVE: To investigate the clinical features of choroidal neovascularization (CNV) in different classifications. METHODS: In this retrospective case series, 393 eyes of 312 patients with CNV between May 2005 and March 2007 in our department was classified based on their etiology, location, fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) findings. RESULTS: The relative frequency of various causes in CNV was as follows: there were 153 cases (49.04%) from age-related macular degeneration (AMD) , 94 cases (30.13%) from idiopathic CNV, 37 cases (11.86%) from pathologic myopia, 15 cases (4.81%) from inflammatory disorders, 7 cases (2.24%) from polypoidal choroidal vasculopathy (PCV), 3 cases (0.96%) from angioid streaks and 1 case (0.32%) from either hereditary disease or trauma or tumor, respectively. The majority cases from AMD was male (64.71%), whereas most from pathologic myopia, idiopathic CNV and inflammatory disorders were female (78.38%, 73.40%, 73.33%). The age range of the cases from AMD was 49-95 years (68.73 +/- 8.31), and 98.04% of them were at least 50 years old. Patients with idiopathic CNV aged 13-43 years old (29.86 +/- 6.45), and 84.04% of them were between 20 and 40 years old. The sex (chi2 = 57.17, P<0.05) and age (F=172.57, P< 0.05) had significant difference in each etiological group. FFA showed that CNV in 43.48% from AMD and 66.67% from PCV were occult and non-classic. CNV in 91.67% from pathologic myopia, 76.19% from inflammatory disorders and 95.00% from idiopathic CNV was classic. In each group, most of the CNV was subfoveal type (58.00%-100.00%), followed by juxtafoveal type (0%-35.00%). In the ICGA of 54 eyes with AMD, 11 eyes (20.37%) were occult CNV (plaque, spot and mixed CNV), 17 eyes (31.48%) were CNV fibrosis. CNV was active in most cases. The frequency of active and inactive CNV in AMD was approximately 61.11% and 37.04%, respectively, no lesions were noted in 1 eye (1.85%) in ICGA. CONCLUSIONS: The clinical characteristics and frequency of various types of CNV are different due to different causes. Classification of CNV based on its etiology, FFA and ICGA findings, location, and activity in detail is important for the diagnosis, treatment and prognosis judgment in CNV.

[Long-term follow-up study of nonischemic central retinal vein occlusion].

OBJECTIVE: To explore the clinical characteristic, visual prognosis and related factors of nonischemic central vein occlusion. METHODS: Retrospective data analysis (including visual acuity, color fundus photography and fundus fluorescein angiography) was conducted in patients with nonischemic CRVO who were followed-up for 3 years or longer. RESULTS: The data of 35 cases (37 eyes) were analyzed. The follow-up time was 3 - 15 years, averaged 4.5 years. Age of those patients ranged from 18 to 76 years, averaged 56 years. Thirty cases (32 eyes) were over 40 years old. Two cases had chronic angle closure glaucoma. At the final visit, visual acuity improved in only 2 eyes (5%), remained the same in 11 eyes (30%), and decreased in 24 eyes (65%). Twenty-eight eyes (75%) had a final visual acuity of 20/200 or less. Nine eyes (24%) transformed to the ischemic type, among which neovascular glaucoma occurred in 5 eyes. Macular complications were the major causes of serious visual impairment. The patients with chronic angle closure glaucoma and partial optic nerve atrophy had relatively good final visual acuity. CONCLUSIONS: Nonischemic CRVO can cause severe visual impairment. Macular complications are the major causes of vision loss. Partial optic nerve atrophy may have a protective effect on visual acuity in CRVO.

[Preliminary results of radiosurgery for uveal melanoma].

OBJECTIVE: To evaluate the clinical value of stereotactic radiosurgery (SRS) for uveal melanoma. METHODS: From Jan, 1996 to March, 2004, 16 patients with uveal melanoma were treated with SRS, two by one session (35 Gy, 25 Gy) and fourteen by fractionated SRS (30-55 Gy/2-4F/4-16D). The follow-up period ranged from 3 to 100 months (median: 66 months). RESULTS: All 16 patients were still alive though all were blind in the diseased eye during recent follow-up. Local control rate was 93.4%, 5-year survival rate of 13 patients who have been followed for more than 5 years, was 100% (13/13). However, 7 patients received eyeball enucleation due to corneal ulcer (n = 2), suspicion for uncontrolled tumor (n = 2) and secondary glaucoma (n = 3). One patient developed distant metastasis, though still alive. CONCLUSION: Fractionated radiosurgery is safe and effective for uveal melanoma. It is indicated for lesions of limited size (longest diameter < 20 mm, depth < 15 mm) located in the posterior pole or behind the equator at the back of the eyeball.

[The characteristics of retinitis pigmentosa with retinal vascular occlusion].

OBJECTIVE: To observe clinical features of Retinitis pigmentosa with retinal vascular occlusion and its prognosis. METHODS: To analyze the clinical Data in 18 cases retrospectively using fundus examination, fundus fluorescein angiography, indocyanine green angiography, electroretinogram, visually evoked potential etc. Gene screening was performed in 3 cases. RESULTS: the major clinical manifestations of the disease were optic atrophy, vascular attenuation to obliteration, widespread retinal pigment epithelium atrophy with depigmentation and/or fine pigment spots, total or nearly total a and b wave were extinct in the examination of electroretinogram. All this manifestations were compatible with that of typical Retinitis Pigmentosa (tapeto-retinal dystrophy). It also had its unique features, such as total or nearly total vascular obliteration, marked optic atrophy in later stage, and choroidal vessels abnormal. Gene mutation was not found in gene encoding area of RHO gene of No: 3 chromosome and of RLBPI gene of No: 15 chromosome. vision loss in this kind retinitis pigmentosa is much faster than that of typical retinitis pigmentosa. CONCLUSION: Retinitis pigmentosa with retinal vascular occlusion may belonged to a kind of tapeto-retinal dystrophy, vascular progressive obliteration was probably its associated disease.

[The image futures of optical coherence tomography in pathologic myopia].

OBJECTIVE: To study the characteristics of optical coherence tomography (OCT) pictures in pathologic myopia. METHODS: 100 cases (195 eyes) of pathologic myopia were examined with OCT. The Age ranges of all the cases was 16-76 years and refraction error was -6.00 - -36.00 diopters. RESULTS: OCT image was normal in 7 eyes (4.3%), the reflectivity band of RPE and chorio-capillaries were uneven and thinning in 147 eyes (90.2%). Full-thickness macular hole was found in 21 eyes (10.8%), of which 10 (5.1%) eyes were associated with retinal detachment; local shallow retinal detachment was found in 24 eyes (12.3%), of which 7 eyes (3.6%) were associated with retinal schisis, 19 eyes (9.7%) with macular choroidal neovascularization (CNV). retinal swelling was often associated with the following diseases: Fuchs spot 9 eyes (4.6%), thick macular hemorrhage 3 eyes, epiretinal macular membrane 18 eyes (9.2%); macular sensory retina thinning in 5 eyes (2.6%). CONCLUSION: Compared with fundus examination including slit lamp with pan-retinoscope, OCT showed unique preference for observation of the changes of retinal pigment epithelium (RPE), chorio-capillary layer, diagnosis macular hole and epiretinal macular membrane, discovery of small sensory retinal detachment, schisis and thinning of sensory retina layer etc. OCT can not either discover a piece of thin macular hemorrhage or differentiation between thick macular hemorrhage and pigment spot.

[Clinical study of laser-induced chorioretinal venous anastomosis].

OBJECTIVE: To test the effectiveness and safety of laser-induced chorioretinal venous anastomosis in the treatment of nonischemic central retinal vein occlusion (CRVO), and also the effectiveness of the preventative measures for complications associated with the treatment. METHODS: Laser-induced chorioretinal venous anastomosis was performed on 34 cases, 35 eyes with nonischemic CRVO. During the treatment, preventative measures for complications were taken as follows: (1) Patients with total retinal papillary nonperfusion area of less than 5 DA were selected to receive the treatment. (2) Treatment sites must be at least 3 PD away from the optic disc and 4 PD away from the macula. (3) At most 2 argon laser shots were attempted over each treatment site, to avoid severe laser damage. (4) Scattered argon laser photocoagulation was done over the drainage area of the vein distal to the treatment site, in order to prevent neovascular complications in case distal vein occlusion occur. RESULTS: During the 3 approximately 12 months (average 6 months) follow-up, successful anastomosis formed in 28 eyes out of 35 eyes (80%) with a mean of 2.4 attempts to create an anastomosis in each eye. With successful anastomosis, retinal hemorrhage started to be absorbed gradually 2 weeks after the treatment, and almost entirely absorbed 1 approximately 2 months later. Retinal edema also alleviated. Visual acuity improved in 20 out of 28 eyes (71%), and remained unchanged in the rest of the patients with successful anastomosis. In comparison with the natural course of the disease, our treatment has improved both the visual prognosis and the retinal damage caused by the disease. No serious complications occurred in these patients with successful anastomosis. Anastomosis failed to form in 7 cases (7 eyes), among which, 2 eyes developed serious neovascular complications. CONCLUSIONS: CRVA treatment is effective in the treatment of non-ischaemic CRVO. With proper preventative measures for complications associated with the treatment, the safety of the treatment can be increased prominently, but serious neovascular complications was not entirely prevented.