先天性上睑下垂患者100例弱视致病原因的探讨

目的:评估先天性上睑下垂患者的弱视发病情况。方法:在本横断面研究中,包括1岁以上的先天性上睑下垂患者100例(114眼)。最佳矫正视力小于10/10或两眼之间至少相差2/10者定义为弱视。年幼患者不能进行斯内伦视力表检测者,观察其注视情况。不同弱视患者的类型:1)屈光参差性弱视:散光性屈光参差≥1.00D;远视性球镜屈光参差≥1.00D,近视性球镜屈光参差≥-3.00D(睫状肌麻痹);2)斜视性弱视,3)形觉剥夺性弱视(SDA)。观察弱视的总发病率及类型,并对单侧和双侧上睑下垂患者进行比较。结果:弱视的发生率在上睑下垂患者为39/114(34.2%),其具体原因:屈光参差性弱视占29.8%,SDA占10.5%,斜视性弱视4.3%,严重的上睑下垂患者弱视发病率更高,视轴遮盖者(OA)占76%,而视轴未遮盖者只占22%。在视轴遮盖的单侧眼睑下垂患者,散光屈光参差性弱视发生率更高,在双侧眼睑下垂至少1眼视轴遮盖者,球镜屈光参差性弱视发生率更高。无论单侧和双侧上睑下垂,如果有视轴遮盖,则SDA比较多见。结论:由于屈光参差性弱视比SDA发生率更高,关注导致的弱视所有原因对于预防儿童上睑下垂所致的弱视极其重要。     

Topical effectiveness of kiwifruit versus fibrinolysin ointment on removal of necrotic tissue of full‐thickness burns in male rats

Formation of necrotic tissues is a major issue affecting treatment of full‐thickness burns. This study was designed to compare topical effectiveness of applying kiwifruit versus fibrinolysin on removal of necrotic tissue of burns. Ten adult male Wistar rats were randomly assigned to three groups. For group 1, the right‐side wounds were treated with kiwifruit and the other side with fibrinolysin. For group 2, the wounds on the right side were treated with kiwifruit or fibrinolysin, and the left sides were kept as control group 2. All wounds in group 3 were considered as control group 1. The control wounds were left to heal naturally. In each group and for each wound, the time of debridement were noted. The results indicated that for the wounds where kiwifruit was applied, the average time for removal of dead tissue was 5.7 days, which is significantly shorter than the average 18.5 days it took for treatment with fibrinolysin (p = 0.02). However, there were no significant differences between control wounds 1 and 2. Findings of the present study can open new horizons and provide a new treatment modality for patients with deep burns.     

Frequent incidence of double minute chromosomes in cancers, with special up-to-date reference to leukemia

Double minute chromosomes (DMs) are small chromatin bodies consisting of gene amplification in an extrachromosomal location. Although found in an variety of human tumor cells, their presence in hematologic malignancies is rare and their role in leukemogenesis is controversial. However, they are thought to be involved in tumorigenesis and in drug resistance, representing a mechanism for upregulated oncogene expression generally associated with a poor prognosis. The presence of DMs has been associated with a rapid disease course, low response rate, and short survival. Little knowledge is, however, available on DMs in leukemias. To elucidate this issue, a web-based search for all types of articles published was initiated using MEDLINE/PubMed, the Mitelman database and other pertinent references on websites. We found that DMs have the highest frequency in adrenal carcinoma (28.6%), and lowest rate noted as 2.6% for large intestine. The large Mitelman database and other web based pertinent reports provide novel knowledge of DMs and their association in the wide field of cancers.     

Effect of tirofiban on percutaneous coronary intervention-induced endothelial dysfunction in patients with stable coronary artery disease

Recent studies demonstrated that glycoprotein (GP) IIb/IIIa receptor antagonists improve endothelial dysfunction of forearm resistance vessels in patients with stable coronary artery disease. However, it remains unclear whether these findings can be extended to the conductance vessel level. In this study, we aimed to evaluate the acute effect of tirofiban on endothelial function of arterial conductance vessels in patients undergoing percutaneous coronary intervention (PCI). Endothelial function was examined by ultrasonographic measurement of flow-mediated vasodilation (FMD) of the brachial artery. Endothelium-independent vasodilation was determined in response to nitroglycerin. Sixty-six patients who underwent PCI were included in the study. Thirty-three patients received a bolus of 10 microg/kg body weight of tirofiban, whereas 33 patients who did not receive tirofiban served as the control group. FMD was measured in all patients before and 30 minutes after PCI. Tirofiban significantly improved FMD (6.0 +/- 0.4% before vs 7.8 +/- 0.5% after PCI, p <0.0001), whereas FMD deteriorated in patients in the control group (6.1 +/- 0.6% before vs 4.7 +/- 0.7% after PCI, p = 0.006). Nitroglycerin-induced dilation remained unaltered in response to PCI. In another group of 11 patients with coronary artery disease, FMD did not change after coronary angiography without coronary intervention. In conclusion, PCI induces endothelial dysfunction in forearm conductance vessels that can be reversed with tirofiban.     

Employing hydrogels in tissue engineering approaches to boost conventional cancer-based research and therapies

Cancer is a complicated disease that involves the efforts of researchers to introduce and investigate novel successful treatments. Traditional cancer therapy approaches, especially chemotherapy, are prone to possible systemic side effects, such as the dysfunction of liver or kidney, neurological side effects and a decrease of bone marrow activity. Hydrogels, along with tissue engineering techniques, provide tremendous potential for scientists to overcome these issues through the release of drugs at the site of tumor. Hydrogels demonstrated competency as potent and stimulus-sensitive drug delivery systems for tumor removal, which is attributed to their unique features, including high water content, biocompatibility, and biodegradability. In addition, hydrogels have gained more attention as 3D models for easier and faster screening of cancer and tumors due to their potential in mimicking the extracellular matrix. Hydrogels as a reservoir can be loaded by an effective dosage of chemotherapeutic agents, and then deliver them to targets. In comparison to conventional procedures, hydrogels considerably decreased the total cost, duration of research, and treatment time. This study provides a general look into the potential role of hydrogels as a powerful tool to augment cancer studies for better analysis of cancerous cell functions, cell survival, angiogenesis, metastasis, and drug screening. Moreover, the upstanding application of drug delivery systems related to the hydrogel in order to sustain the release of desired drugs in the tumor cell-site were explored.

Hydrogels and tissue engineering showed their potential in facinating research and developement in cancer therapy.     

Role of frailty in prediction of hospitalized older adult patient’s outcomes: a prospective study

Background/aim Frailty is associated with an increased risk of negative short-term and long-term hospital outcomes. This study aimed to evaluate the role of frailty in predicting readmission, length of stay, and quality of life in the hospitalized older adults.Materials and methods This observational study was conducted at Ziaiyan Hospital, Tehran, Iran. In total, 304 participants (65–85 years), were enrolled through the inclusion criteria from August to December 2019. The frailty index (FI) was assessed by the minimum data set-home care. Readmission was obtained through telephone interviews. The length of stay was gathered by the patient’s hospital records, and the EuroQol questionnaire was used for assessing the quality of life. Data were collected by a researcher nurse at the admission time, 30, 60, and 90 days after discharge. The logistic regression model and repeated measures ANOVA were employed to analyze the association between frailty and outcomes.ResultsAccording to FI, 102 (33.55%) participants were pre-frail, whereas 35 (11.51%) were frail. In the fully-adjusted model for readmission, the pre-frail participants had a higher risk of readmission at the hospital in comparison with the nonfrail and frail groups (OR = 1.88, 95% CI = 1.90–3.26), and also for GP visits, frail patients showed nearly significant differences (OR = 2.45, 95% CI = 0.99–6.06) but there were no differences between frail and pre-frail patients in readmissions in the emergency ward. In a fully-adjusted prolonged stay model, pre-frail patients had a higher probability to stay longer in hospital (OR = 2.28, 95% CI: 1.24–4.18). The fully-adjusted model for QoL showed, frail patients were more prone to the declined levels of QoL in comparison with pre-frail patients (OR = 10.77, 95% CI: 3.97–29.18).ConclusionsThe findings indicated that frailty worsened negative outcomes and declined QoL. Early diagnosis in hospital settings could be beneficial for designing optimal care plans for the frail and pre-frail patients.