Clinical efficacy of botulinum toxin type A on acute acquired comitant esotropia.

AIM: To investigate the effects of micro-injection of botulinum toxin A (BTXA) on acute acquired comitant esotropia (AACE). METHODS: A total of 33 AACE patients who underwent BTXA micro-injection at Renmin Hospital of Wuhan University from September 1st, 2019 to July 1st, 2021 were retrospective analyzed. Esotropia, eye alignment, stereopsis, and complications were examined at baseline (except complications), 1wk, 1, 3, and 6mo after injection. RESULTS: The average angle of deviation before injection was (+20.24±6.80)Δ at near and (+24.76±6.43)Δ at distance, while (+5.15±5.85)Δ at near and (+7.30±6.17)Δ at distance 6mo after treatment (P<0.05). Six months after injection, the stereopsis of patients had improved. The number of patients having no stereopsis (>800 seconds of arc) decreased from 11 to 3. The number of patients having peripheral stereopsis (300-800 seconds of arc), macular stereopsis (70-200 seconds of arc) and central concave stereopsis (≤60 seconds of arc) increased from 10 to 11, 10 to 12, and 2 to 7, respectively. At the follow-ups at 1wk, 1, 3, and 6mo after injection, success rates were 96.97%, 96.97%, 93.94% and 87.88%, respectively. One week after injection, two patients (6.07%) showed subconjunctival hemorrhage; three patients (9.09%) showed limited eye movement and one patient (3.03%) showed mild vertical strabismus. All the symptoms disappeared by the final follow-up. CONCLUSION: Micro-injection of BTXA can reduce diplopia and improve binocular vision function of AACE patients. Furthermore, the operation is relatively safe with few complications, making it an ideal treatment modality for AACE.

Diode laser combined with intradiscal vancomycin for iatrogenic discitis: an experimental study in rabbits.

OBJECTIVE: The purpose of this study was to assess the efficacy of diode laser combined with intradiscal vancomycin for iatrogenic discitis (ID) infected with Staphylococcus aureus. BACKGROUND DATA: In vivo and in vitro studies have reported that diode laser has a potential bactericidal effect on S. aureus. METHODS: The rabbit ID model was induced by injecting S. aureus into the intervertebral discs (IVDs). The animals were classified into the following groups: Group M, model; Group N, non-treatment; Group O, operation; Group V, vancomycin; Group L, laser; and Group C, laser with vancomycin. The rabbits were killed when paraplegia occurred and target IVD regions were removed for histopathological examination. RESULTS: In Group M, MRI findings revealed narrowing of the disc space, with changed T1 and T2 signals. In Group N, pathological examination showed a narrowed disc space, inflammatory changes in disc tissue, extensive erosion and hyperostosis of bony end plates, and an epidural abscess. Narrowed disc space and bone fusion were observed in Group O. In Group V, narrowed disc spaces, focal inflammatory changes of the disc tissue, and focal erosion and hyperostosis of bony end plates were seen. In Groups L and C, cavitation, inflammatory lesions, focal erosion, and hyperostosis of bony endplates were observed. However, in Group C, fibrosis was found in the nucleus region, with a smaller area of cavitation and better preservation of IVD structure than in Group L. The ID score was lowest in Group O, at 9.7 ± 0.95. The ID scores in Groups V and L were 12.2 ± 1.32 and 12.6 ± 0.97, respectively, significantly less than in Group N. The Group C ID score of 10.9 ± 0.99 was significantly less than that of Groups N, V, and L. CONCLUSIONS: High power diode laser combined with intradiscal vancomycin contained the pathological process of ID in this rabbit model.

Sulfasalazine prevents apoptosis in spermatogenic cells after experimental testicular torsion/detorsion.

AIM: To determine whether sulfasalazine can prevent apoptosis in spermatogenic cells by preventing the activation of NF-kappaB in spermatogenic epithelium in experimental testicular torsion. METHODS: Thirty-two adult male Sprague-Dawley rats were subjected to unilateral 720 degree testicular torsion for durations of 0 h and 2 h, then the torsion was relieved. The ischemic/reperfused testes were collected for the detection of NF-kappaB expression with Western blotting and immunohistochemistry techniques, and detection of apoptosis with TUNEL techniques. RESULTS: The NF-kappaB coefficient of spermatogenic epithelium and the apoptosis index of spermatogenic cells were significantly different in the operation and the sham-operation groups after experimental testicular torsion (P<0.01). CONCLUSION: NF-kappaB activation of spermatogenic epithelium is related to apoptosis of spermatogenic cells. Sulfasalazine can prevent apoptosis in spermatogenic cells after the experimental testicular torsion through prevention of NF-kappaB activation.