Results of intravitreal ranibizumab treatment for retinopathy of prematurity in infants

Purpose: To assess the results of intravitreal ranibizumab treatment for retinopathy of prematurity (ROP) in infants.

Methods: A single-institution, retrospective consecutive case series.

Results: Thirty-one patients who received ranibizumab treatment for ROP were evaluated in this study. The mean follow-up time was 14?±?1.37?months. Vascularization of the peripheral retina had completed with delay in the majority of cases and also avascular areas were present in the peripheral retinas of five infants at one year of age. Although recurrence of ROP developed in 14 infants after single-dose ranibizumab treatment, only four infants received additional treatment due to recurrence of ROP requiring treatment. No serious ocular complications were reported, but, two infants died in this series.

Conclusion: Even so ranibizumab treatment is an effective therapy for ROP in early period, close monitoring after injection is necessary due to the high incidence of recurrence. In addition, questions remain regarding the systemic safety of ranibizumab. Further studies are needed to study the systemic and ocular side effects of ranibizumab.     

广域眼底成像在早产儿视网膜病变激光治疗中的应用

目的观察广域眼底成像在早产儿视网膜病变( ROP)激光治疗中的应用价值。方法选取 2017年 2月至 2020年 8月在安徽省妇幼保健院确诊为 ROP的 33例 60眼纳入研究。 60眼 ROP均在间接眼底镜下接受了初始激光光凝治疗,治疗后立即通过广域眼底成像识别所有的无血管区和激光遗漏区,并对遗漏区域补充光凝。治疗后 1周内复查,平均随访 5.5个月。随访期间主要观察光凝范围、光凝有无遗漏及病变是否消退或进展。结果激光治疗 60眼中共发现 9个激光遗漏区,主要分布在嵴周或颞侧,对遗漏区及时补充光凝。术后 1周复查,未发现光凝遗漏区,术后远期复查所有病变均消退。结论广域眼底成像实现了视网膜的可视化,准确识别初始激光可能遗漏的区域,及时补充光凝以减少 ROP因光凝不足需再次治疗的可能性。     

早产儿视网膜病变的影响因素分析

摘要： 目的 观察早产儿视网膜病变 （ROP） 的发病情况, 分析与重度 ROP 有关的高危因素。方法 分析 2011 年 7 月—2014 年 7 月常州市妇幼保健院新生儿科收治的 703 例符合 ROP 筛查标准的患儿, 于生后 4～6 周或矫正胎龄 32 周开始统一由眼科医师使用双目间接检眼镜进行检查, 根据 ROP 检查结果决定是否治疗。收集患儿资料,比较不同胎龄、 不同出生体质量患儿的重度 ROP 检出情况。结果 703 例患儿中轻度 ROP 37 例, 检出率为 5.26%,重度 ROP 6 例, 检出率为 0.85%。胎龄<28 周和出生体质量 500~1 000 g 的患儿, 重度 ROP 患病风险明显增高, 差异均有统计学意义。结论 出生胎龄小和出生体质量低是发生重度 ROP 的危险因素, 早发现、 早治疗可预防 ROP 致盲。     

视网膜激光光凝术治疗非增殖性糖尿病视网膜病变的效果观察

目的探讨视网膜激光光凝术治疗非增殖性糖尿病视网膜病变的临床效果。方法选取我院2010～2012年间行视网膜激光光凝术治疗的非增殖性糖尿病视网膜病变患者74例为研究对象。回顾患者治疗过程并对治疗效果进行统计学分析。结果经过激光光凝治疗后3个月复诊查看患者视网膜恢复情况,有效患者70例,无效患者4例,有效率为94.59%。129颗患病眼中,视力提高51颗,视力维持不变63颗,视力下降15颗,视力恢复率88.37%。另外,有20颗眼出现眼内压升高,发生率15.50%;14颗眼出现视网膜出血,发生率为10.85%;10颗眼出现黄斑水肿,发生率为7.75%。74例患者中,共有发生并发症患者11例,并发症发生率为14.86%。部分患者行2次治疗,治疗效果得到提高。结论视网膜激光光凝术治疗非增殖性糖尿病视网膜病变,临床效果安全有效。     

Intravitreal anti-VEGF treatment for retinopathy of prematurity in infants with active adenoviral keratoconjunctivitis

Purpose: To evaluate the results of intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment for retinopathy of prematurity (ROP) in infants with active adenoviral keratoconjunctivitis (AKC).

Material and methods: A retrospective analysis was performed using the medical records of all infants treated with intravitreal injections of anti-VEGF agents during an AKC outbreak previously reported in the literature at a tertiary center for treatment of ROP. The infants were divided into two groups. Group 1 included nine infants (18 eyes) with AKC, while Group 2 included 13 infants (26 eyes) without AKC.

Results: During the AKC outbreak, 22 infants were treated with anti-VEGF agents for treatment-requiring ROP. In all patients in both groups, the ROP and plus disease displayed a significant regression within 2 days after the intravitreal injections. Moreover, no serious complications such as endophthalmitis, retinal detachment, cataract or intravitreal hemorrhage were observed after the treatment and there were no statistically significant differences between the groups in terms of postoperative complications.

Conclusion: Immediate and appropriate intervention is very important in cases of treatment-requiring ROP otherwise it can result in blindness. However, laser treatment for ROP is technically difficult in infants with active AKC. The results of this study showed that favorable outcomes without serious ocular complications could be obtained via intravitreal injections of anti-VEGF agents in infants with active AKC.     

半导体532激光治疗糖尿病视网膜病变的临床观察

目的：观察半导体532激光光凝术治疗糖尿病视网膜病变（ DR）的临床疗效。方法采用半导体532激光对50例（95只眼）非增殖性和增殖性DR患者进行局限性视网膜光凝、格栅样视网膜光凝或全视网膜光凝治疗。观察治疗前后视力、裂隙灯、眼底、眼压、眼底血管荧光造影及眼底OCT的变化,光凝术后随访6个月。结果光凝术后36眼（37．9％）视力提高,视力无变化52眼（54．7％）,视力下降7眼（7．4％）,总有效88眼（92．6％）。伴黄斑水肿者26眼,经光凝后黄斑水肿完全或部分消退,未出现新的黄斑水肿。结论半导体532激光光凝术治疗DR安全有效。     

多波长氪激光治疗糖尿病视网膜病变的疗效观察

目的：观察多波长氪离子激光对糖尿病视网膜病变（diabetic retinopathy,DR）的疗效。方法：根据DRPSG（Diabetic Retinopathy Photocoagulation Study Group）制订的治疗技术规定,采用多波长氪离子激光对160例283眼[分别为增殖前期糖尿病视网膜病变（PPDR）、增殖期糖尿病视网膜病变（PDR）]行全视网膜光凝治疗（PRP）,根据病变性质、部位和屈光间质情况选择不同波长激光进行视网膜光凝。术前行视力、裂隙灯、检眼镜、眼压、眼B型超声、视野和荧光素眼底血管造影检查,术后随访6～24个月。结果：PPDR视力提高和不变占75眼（78.11%）,PDR视力提高和不变占153眼（81.18%）,其间未见严重并发症。结论：用多波长氪离子激光治疗DR操作方便,使部分患者视力提高,是治疗DR的有效方法,可依实际需要组合使用不同波长治疗糖尿病视网膜病变,扩大了治疗DR的适应证。     

芪明颗粒联合视网膜激光治疗糖尿病性黄斑水肿的疗效分析

目的 观察芪明颗粒联合激光治疗对糖尿病性黄斑水肿的疗效.方法 将患者随机分为2组,治疗组28例50眼,对照组26例48眼.2组均行光凝治疗,治疗组同时加服芪明颗粒.结果 治疗组和对照组患者治疗1个月、2个月时视力的变化差异无统计学意义(1个月时U=0.2785,P>0.05;2个月时U=0.2869,P>0.05).3个月时2组视力变化差异有统计学意义(U=2.2412,P<0.05).2组患者于治疗后3个月黄斑水肿消退情况,2组比较差异有统计学意义(3个月时U=2.1775,P<0.05).激光治疗3个月后2组患者1~2环(黄斑区)mfERG比较,与治疗前相比,2组患者a波、b波的振幅密度均增加,差异均有统计学意义(P<0.05),治疗后2组之间比较,1环a波的振幅密度治疗组优于对照组,差异有统计学意义(P<0.05),2组治疗前后1~2环(黄斑区)a波、b波的潜伏期与治疗前相比无明显变化(P>0.05).结论 芪明颗粒联合激光治疗可更有效地减轻糖尿病性黄斑水肿,改善患者视力.     

A new laser pain threshold model detects a faster onset of action from a liquid formulation of 1 g paracetamol than an equivalent tablet formulation

AIMS: To discover whether a new infra-red laser method could detect a change in pain threshold after as mild an analgesic as paracetamol and whether an effervescent liquid formulation produced a faster onset of action than tablets. METHODS: This double-blind, placebo controlled randomized study used a portable, infra-red laser to measure "first pain" thresholds on the nondominant forearm in 12 normal volunteers before and after 1 g of paracetamol or placebo. The mean of six recordings was determined three times before dosing, the first being used as a familiarization procedure, and 14 times after dosing. RESULTS: We detected a small (2%), statistically significant difference in pain threshold between a liquid formulation of paracetamol and placebo at 30 and 60 min (P = 0.004 and P = 0.001), but not between tablets and placebo. Liquid also increased the threshold significantly compared with tablets at 60 min (P = 0.01). CONCLUSIONS: To detect such a small increase in pain threshold requires a highly consistent measure and the coefficient of variation was 2% for the study overall, surprisingly low for a subjective phenomenon. The reasons for this include minimizing reflectance by blacking the skin, using a nonhairy site, averaging six data points at each sample time and controlling closely the ambient conditions and the subjects' preparation for studies.     

泛昔洛韦联合半导体激光治疗带状疱疹的临床研究

目的：观察泛昔洛韦联合半导体激光治疗带状疱疹的疗效。方法：将94例患者随机分为试验组和对照组，两组均口服泛昔洛韦250mg，每日3次，共7天，试验组加用半导体激光照射神经根和疼痛最明显区域，每日照射2次，每次10分钟，共7天。结果：试验组痊愈率85．41％，对照组痊愈率65．21％，痊愈率差异有显著性（P〈0．01）。两组总有效率相当，无统计学意义，试验组在水疱停止出现时间、水疱干涸时间、疼痛缓解时间、完全结痂时间均优于对照组，差异有显著性（P〈0．01）。试验组后遗神经痛的发生率低，差异有显著性（P〈0．05）。结论：泛昔洛韦联合半导体激光治疗带状疱疹疗效好，安全，降低了后遗神经痛的发生率。     

血栓通联合眼底激光对糖尿病视网膜病变黄斑水肿患者血清 NOS、VEGF 和 IL－6的影响

目的：研究血栓通联合激光对糖尿病视网膜病变黄斑水肿患者血清 NOS、VEGF、IL－6的影响。方法选取2014年10月至2015年10月接诊的100例糖尿病视网膜病变黄斑水肿患者作为本次研究对象,按随机数表法分为观察组和对照组,对照组采用眼科激光机进行激光治疗,观察组在对照组的治疗上,每7天加服血栓通胶囊进行治疗。观察2组患者治疗后血清一氧化氮合成酶（nitric oxide synthase,NOS）、血管内皮生长因子（vascular endothelial growth factor,VEGF）、白细胞介素－6（interleukin－6, IL－6）水平、治疗后眼部情况、治疗后眼部黄斑荧光和出血面积、治疗后临床疗效。结果治疗后,观察组 NOS（109．40±16．42） U／ml 优于对照组（68．47±10．02） U／ml;VEGF、IL－6（95．60±57．02、16．93±5．70） pg／ml 小于对照组（235．97±70．01、32．68±9．60） pg／ml,差异有统计学意义（ P ＜0．05）;观察组视力（0．70±0．16）优于对照组（0．56±0．26）,微血管瘤数（10．63±2．12）小于对照组（15．78±3．68）,差异有统计学意义（ P ＜0．05）;观察组黄斑区荧光面积、眼底出血面积（0．61±0．16、0．46±0．11）均小于对照组（0．70±0．20、0．59±0．16）,差异有统计学意义（ P ＜0．05）;观察组临床疗效94．00％（47／50）优于对照组62．00％（31／50）差异具有统计学意义（ P ＜0．05）。结论血栓通胶囊对糖尿病视网膜病变黄斑水肿疗效显著,能够有效的改善 NOS、IL－6和 VEGF 水平。值得临床推广。     

复方血栓通胶囊治疗糖尿病视网膜病变的成本效果分析

目的:评价复方血栓通胶囊治疗糖尿病视网膜病变(DR)的经济性。方法:检索中国知网数据库,筛选符合复方血栓通胶囊联合羟苯磺酸钙治疗DR的疗效与单独使用羟苯磺酸钙治疗DR的疗效对比的文献,及符合复方血栓通胶囊联合激光治疗DR的疗效与单独使用激光治疗DR的疗效对比的文献,提取治疗效果数据,成本数据来源于真实临床花费数据,构建决策树模型,从付费者的角度出发,进行成本-效果分析。结果:复方血栓通胶囊联合激光治疗DR有效率为89.78%,总费用为7 153.10元,单独使用激光治疗DR有效率为75.56%,总费用为8 096.99元。复方血栓通胶囊联合羟苯磺酸钙治疗DR有效率为87.37%,总费用为7 126.86元,单独使用羟苯磺酸钙治疗DR有效率为65.27%,总费用为10 511.24元。复方血栓通胶囊联合羟苯磺酸钙或激光治疗DR的有效率更高,成本更低。结论:复方血栓通胶囊联合羟苯磺酸钙或者联合激光治疗DR与单独使用羟苯磺酸钙或者激光治疗DR具有明显成本效果优势,值得推广应用。     

丁苯酞软胶囊治疗急性期后循环缺血的疗效

目的观察dl-3-正丁基苯酞软胶囊治疗急性期轻中度后循环缺血的疗效。方法入选86例患者,随机分为治疗组43例和对照组43例。对照组给予长春西汀注射液静滴,每日1次;治疗组在此基础上给予丁苯酞软胶囊口服,疗程为2周。评价两组患者在治疗前及治疗第7天、第14天的神经功能。结果两组患者治疗前的一般情况及美国国立卫生研究院脑卒中量表(NIHSS)、临床神经功能缺损程度评分差异均无统计学意义,具有可比性;治疗第7天和第14天的NIHSS评分和临床神经功能缺损程度评分较治疗前均显著降低(P<0.05)。结论dl-3-正丁基苯酞软胶囊对轻中度后循环缺血急性期的治疗具有显著效果。     

YAG激光联合氩激光治疗伴虹膜后粘连人工晶体前膜的疗效

目的 评估人工晶体(IOL)植入术后YAG激光联合氩激光治疗伴虹膜后粘连人工晶体前膜的疗效。方法 对人工晶体前膜伴虹膜粘连患者55例(59眼),使用Nd:YAG激光联合氩激光方法切除人工晶体前表面机化膜,对合并虹膜粘连者予以松解,观察治疗后患者视力提高情况、一次性激光治疗成功率、人工晶体的损伤、术后人工晶体前膜再发率及术后并发症。结果 57眼一次性激光治疗后前膜全部切除且解除虹膜与人工晶体间粘连,2眼因前房炎症反应较重复发,行第二次激光治疗后痊愈,激光治疗一次成功率达96.6%。无严重并发症发生。随访6个月所有患者瞳孔区人工晶体前膜完全切除,虹膜粘连松解。视力稳定提高≥3级者51眼(86.4%)。结论 YAG激光联合氩激光切除人工晶体前膜、松解虹膜后粘连的方法安全有效,并发症少,可及早恢复视力。     

种植二期手术同期应用3D打印临时冠在单颗非游离后牙种植修复中的疗效分析

目的分析种植二期手术同期应用3D打印临时冠在单颗非游离后牙种植修复中的疗效。方法本研究为前瞻性随机对照试验。2020年6月至2022年8月在江南大学附属医院口腔科行单颗后牙种植的30例患者为研究对象, 基于随机数字表法分为两组, 3D打印临时冠组15例应用3D打印临时冠, 另15例归入传统Ⅱ期手术组。传统Ⅱ期手术组男、女各8、7例, 年龄25～40(30.35±3.33)岁;3D打印临时冠组男、女各10、5例, 年龄24～41(31.21±3.45)岁。比较两组患者种植修复完成后种植牙的稳定性、食物嵌塞评分、咀嚼效能和并发症发生率的差异。统计学处理方法包括Fisher确切概率法、独立样本t检验。结果在正式种植修复完成后的1、3、6个月, 3D打印临时冠组食物嵌塞评分分别为(2.01±0.33)、(1.01±0.12)、(1.21±0.32)分, 均显著低于传统Ⅱ期手术组(均P<0.01)。正式修复后, 3D打印临时冠组的咬合力与咀嚼效率为(130.11±8.54)lbs、(1.43±0.11), 均显著高于传统Ⅱ期手术组(均P<0.05)。在龋病、牙周炎、牙松动等并发症发生...     

光学相干断层扫描对氩激光治疗糖尿病性黄斑水肿的疗效观察

目的应用光学相干断层扫描观察氩激光治疗糖尿病性黄斑水肿的临床疗效。方法对糖尿病性黄斑水肿患者行氩激光光凝术。在光凝前、光凝后3个月分别进行扫描获取光学相干断层扫描图像,记录黄斑中心凹视网膜厚度,作统计学分析。结果平均随访(3.0±0.6)个月。光凝前及光凝后3个月黄斑中心凹区视网膜厚度平均值分别为(397±102)μm和(204±90)μm,差异有统计学意义。结论光学相干断层扫描检测能较准确定量测算黄斑区视网膜厚度,可对比观察氩激光光凝前后视网膜厚度变化,进而判断氩激光光凝的疗效。     

视网膜激光光凝联合补阳还五汤治疗视网膜浅脱离的临床研究

目的分析氩激光光凝联合补阳还五汤治疗裂孔性视网膜浅脱离的疗效。方法 58例（共58眼）裂孔性视网膜脱离患者,采取氩激光光凝后辅以补阳还五汤治疗,观察疗效。结果进行3-24个月,平均15.23个月的随访。19眼视网膜脱离范围≤1/2 PD,1次光凝治疗后痊愈;32眼视网膜脱离范围〉1/2 PD,但≤1 PD,其中19眼经3次光凝治疗后痊愈,13眼经2次光凝治疗后痊愈;7眼视网膜脱离范围〉1 PD,3眼无效,4眼经3次光凝治疗后痊愈。结论采取氩激光光凝治疗裂孔性视网膜浅脱离,安全有效,辅以补阳还五汤,有助于视网膜下液体吸收。     

Microparticles,not only markers but also a therapeutic target in the early stage of diabetic retinopathy and vascular aging

Introduction: Microparticles (MPs) are small vesicles between 100 and 500 nm, released from different cells including blood, endothelium, smooth muscle, and retina cells. MPs are produced during shedding process in response to some stressing and stimulating factors, as well as during apoptosis. The cellular machinery leading to MP shedding involves the loss of the plasma membrane asymmetry and phosphatidylserine externalization with an increase in cytosolic calcium concentrations. MPs not only transfer membrane proteins from the cells of their origin but also convey phospholipids and microRNA to the distant cells. Some of these macromolecules have neoangiogenetic properties (factor XII, tissue factor or mitogen-activated protein kinases) or participate in modulation of vascular senescence or remodeling (miRNAs).

Areas covered: The authors summarise recent knowledge about MP biology and pathophysiology. The mechanisms involved in MP release are discussed, and special emphasis is placed on clinical studies, which document their proangiogenic role in diabetic retinopathy and vascular aging.

Expert opinion: The pharmacological control of phospholipid moieties in the plasma membrane and the regulation of the MP shedding remains a challenge in the early stage of diabetic retinopathy and vascular aging.     

2型糖尿病合并终末期肾病外周血 CD3＋4细胞水平的临床研究

目的：分析CD3＋4细胞与糖尿病肾病代谢参数的相关性及其与糖尿病肾病发病的关系。方法选择终末期肾病患者100例,根据是否合并2型糖尿病分为合并糖尿病的终末期肾病组（ n ＝55）,为终末期肾病组（ n ＝45）。糖尿病组（ n ＝50）。同时选取体检中心健康体检者作为健康对照组（ n ＝60）。比较4组三酰甘油（ TG）、胆固醇（TC）、空腹血糖（FPG）、餐后2 h血糖（2 hFPG）、糖化血红蛋白（HbA1c）、CD3＋4细胞／单核细胞值,尿微量白蛋白、肌酐（ Cr）水平测定,肾小球滤过率的差异,以及各指标间的相关性。结果与阴性健康对照组比较,3个试验组CD3＋4细胞在单核细胞中的比值降低（ P ＜0．05）;糖尿病组高于终末期肾病组、糖尿病合并终末期肾病组（ P ＜0．05）。糖尿病合并终末期肾病组外周血 CD3＋4／单核细胞值与 HBA1c、Cr、FPG、微量白蛋白、2 hFPG 呈负相关（ r 值分别为－0．439、－0．241、－0．298、－0．342、－0．447, P ＜0．05）。结论 CD3＋4细胞可能是肾病患者的危险因素,参与肾病的发生,监测CD3＋4细胞水平变化也许能用来预测2型糖尿病患者合并终末期肾病的发生发展,其中糖尿病可能进一步导致CD3＋4细胞数量的下降。     

Pharmacological effects of 3-iodothyronamine (T1AM) in mice include facilitation of memory acquisition and retention and reduction of pain threshold

Background and Purpose

3-Iodothyronamine (T1AM), an endogenous derivative of thyroid hormones, is regarded as a rapid modulator of behaviour and metabolism. To determine whether brain thyroid hormone levels contribute to these effects, we investigated the effect of central administration of T1AM on learning and pain threshold of mice either untreated or pretreated with clorgyline (2.5 mg·kg⁻¹, i.p.), an inhibitor of amine oxidative metabolism.

Experimental Approach

T1AM (0.13, 0.4, 1.32 and 4 μg·kg⁻¹) or vehicle was injected i.c.v. into male mice, and after 30 min their effects on memory acquisition capacity, pain threshold and curiosity were evaluated by the following tests: passive avoidance, licking latency on the hot plate and movements on the hole-board platform. Plasma glycaemia was measured using a glucorefractometer. Brain levels of triiodothyroxine (T3), thyroxine (T4) and T1AM were measured by HPLC coupled to tandem MS. ERK1/2 activation and c-fos expression in different brain regions were evaluated by Western blot analysis.

Results

T1AM improved learning capacity, decreased pain threshold to hot stimuli, enhanced curiosity and raised plasma glycaemia in a dose-dependent way, without modifying T3 and T4 brain concentrations. T1AM effects on learning and pain were abolished or significantly affected by clorgyline, suggesting a role for some metabolite(s), or that T1AM interacts at the rapid desensitizing target(s). T1AM activated ERK in different brain areas at lower doses than those effective on behaviour.

Conclusions And Implications

T1AM is a novel memory enhancer. This feature might have important implications for the treatment of endocrine and neurodegenerative-induced memory disorders.