玻璃体内注射曲安奈德联合激光光凝治疗糖尿病黄斑水肿的疗效和安全性的Meta分析

目的系统评价黄斑光凝(Laser)联合曲安奈德玻璃体内注射(IVTA)和单纯应用IVTA治疗糖尿病黄斑水肿的疗效和差异。方法通过PubMed,Web of science,Google scholar,CNKI全文数据库检索有关IVTA联合Laser和单用IVTA两种不同的方法治疗糖尿病黄斑水肿的临床对照研究文献资料。采用Cochrane系统评价的方法,文献质量采用Jadad量表评分,使用RevMan5.2软件进行Meta分析。结果经检索筛选后最终可纳入5篇(253眼)相关文献且结果显示,在减轻中央黄斑厚度(CMT)方面,IVTA+Laser组和单纯IVTA组比较,随访3个月后降低幅度差异为:-0.3μm(95%CI:-8.68⁸.09);6个月后为:-65.96μm(95%CI:-161.58,29.66),两组差异无统计学意义;在提高最佳矫正视力(BCVA)方面,随访3、6个月后提高幅度的差异分别为-0.04(95%CI:-0.248.09);6个月后为:-65.96μm(95%CI:-161.58,29.66),两组差异无统计学意义;在提高最佳矫正视力(BCVA)方面,随访3、6个月后提高幅度的差异分别为-0.04(95%CI:-0.24⁰.17),-0.11(95%CI:-0.290.17),-0.11(95%CI:-0.29⁰.07),P=0.22,两者差异仍无统计学意义。两组并发白内障及眼压升高的概率无差别。结论两组方案治疗糖尿病黄斑水肿疗效和安全性相仿,但尚需更多前瞻性多中心大样本的临床随机对照试验数据对其验证。     

曲安奈德对实验性视网膜静脉阻塞血管内皮生长因子表达的影响

目的:研究曲安奈德(TA)对视网膜静脉阻塞(RVO)大鼠视网膜组织中血管内皮生长因子(VEGF)表达的影响.方法:SD大鼠48只,随机分成3组:空白组(平衡盐液),对照组(模型+平衡盐液),实验组(模型+TA),观察对照组和实验组模型眼底情况.每组分别于玻璃体腔注射平衡盐液或TA后第3、第5、第7、第14天随机处死4只大鼠,分别用免疫荧光组织化学和酶联免疫吸附试验(ELISA)测定VEGF的表达.结果:在RVO的2组模型眼中,实验组眼底病变改善显著,与对照组差异有统计学意义.免疫组织化学图像定量分析和ELISA测定显示在模型眼中VEGF的表达显著增加,与空白组比较差异有统计学意义;实验组VEGF表达在各个时间点上均显著低于对照组.结论:TA明显改善RVO模型眼底病变的作用可能是通过TA下调了视网膜组织中VEGF的表达.     

醋酸曲安奈德及液氮冷冻联合疤痕软膏治疗瘢痕疙瘩疗效观察

目的观察醋酸曲安奈德及液氮冷冻联合疤痕软膏治疗瘢痕疙瘩的临床疗效。方法将2013年7月—2016年5月三峡大学仁和医院皮肤科收治的84例瘢痕疙瘩患者随机分为3组,Ⅰ组(32例)患者采用醋酸曲安奈德及液氮冷冻联合疤痕软膏治疗,Ⅱ组(28例)患者采用醋酸曲安奈德联合液氮冷冻治疗,Ⅲ组(24例)患者单纯应刚醋酸曲安奈德治疗,对比观察3组患者的临床疗效。结果 1组患者有效率达93.8%,明显高于Ⅱ组患者的82.1%和Ⅲ组患者的83.3%,P均0.05,差异具有统计学意义。结论醋酸曲安奈德及液氮冷冻联合疤痕软膏治疗瘢痕疙瘩,疗效显著,值得临床推广应用。     

Drug reflux during posterior subtenon infusion of triamcinolone acetonide in diffuse diabetic macular edema not only brings insufficient reduction but also causes elevation of intraocular pressure

Background  At the time of posterior subtenon infusion of triamcinolone acetonide (STI-TA) in patients with diabetic macular edema (DME), drug reflux of TA has sometimes been observed from the conjunctival incision site. We investigated the influence of this reflux on regression of DME and postoperative intraocular pressure (IOP). Methods  STI-TA was performed on one hundred and twenty-four eyes of 88 consecutive patients with DME. Eligible eyes were divided into two groups: those with observed drug reflux of TA and those without observed drug reflux of TA. Visual acuity (VA), foveal thickness (FT) and IOP were monitored in each eye for up to 12 weeks after STI-TA. Results  STI-TA with drug reflux was observed in ten individual eyes of seven patients. These patients were significantly younger than those patients without observed drug reflux. After STI-TA, both improvement of VA and regression of FT in reflux(+) eyes were less than in reflux(-) eyes. Postoperative IOP elevation in reflux(+) eyes was much higher, and four of the ten eyes needed anti-glaucoma therapy. This was in contrast to three of the 118 eyes without drug reflux that required anti-glaucoma therapy. Conclusions  At the time of STI-TA in DME, drug reflux of TA is a risk factor not only for insufficient reduction of edema, but also for postoperative IOP elevation. Proprietary Interest None.     

中西医结合治疗肛周湿疹45例临床观察

目的:观察中西医结合治疗肛周疹湿患者的临床疗效。方法:选择90例肛周湿疹患者,随机数字表法分成对照组和观察组各45例,对照组给予常规西药,观察组在对照组基础上给予马应龙麝香痔疮膏及中药方剂治疗,观察两组临床疗效及复发率,分别于用药前后进行临床症状积分评价,对比两组治疗结果。结果:用药前两组的瘙痒、分泌物增多、渗出、皮损评分相比差异无统计学意义(P>0.05),用药后两组各项评分均明显降低,但对照组各项评分均高于观察组(P<0.05)。对照组总有效率77.78%,低于观察组91.11%(P<0.05);对照组复发率20.00%,高于观察组6.67%(P<0.05)。结论:中西医结合治疗肛周湿疹疗效较好,能够快速减轻相关症状,值得临床推广。