Randomized clinical trial of surodex steroid drug delivery system for cataract surgery: Anterior versus posterior placement of two surodex in the eye

OBJECTIVE: To evaluate safety and antiinflammatory efficacy of placing two Surodex (Oculex Pharmaceuticals, Inc., Sunnyvale, CA) in the eye after cataract surgery in comparison with steroid eyedrops and to compare anterior versus posterior chamber placement. DESIGN: Randomized, masked, controlled trial. PARTICIPANTS: One hundred four eyes of 104 Asian patients undergoing extracapsular cataract extraction with intraocular lens implantation were examined. Of these, 33 eyes of 33 patients served as control eyes (group A). INTERVENTION: Two Surodex pellets were inserted in the anterior chamber (AC) of 35 eyes (group B), and two Surodex pellets were inserted in the ciliary sulcus of 36 eyes (group C) at the conclusion of surgery. Control eyes received neither Surodex nor a placebo implant, but were prescribed conventional 0.1% dexamethasone eyedrops four times daily for 4 weeks. MAIN OUTCOME MEASURES: Anterior chamber flare and cells were graded clinically at the slit lamp. Anterior chamber flare was assessed objectively with the Kowa FC500 Laser Flare Meter (Kowa Co. Ltd, Tokyo, Japan). Intraocular pressure and corneal endothelial specular microscopy with morphometric cell analysis were performed for up to 1 year after surgery. RESULTS: Lower flare meter readings occurred in both Surodex groups at all postoperative visits, as compared with the dexamethasone eyedrop group, with statistical significance at days 4 (P = 0.001), 8 (P = 0.001), and 15 (P = 0.02). No difference in flare occurred between AC and ciliary sulcus placement. Clinical slit-lamp assessment of anterior chamber flare and cells showed no difference between Surodex-treated eyes and dexamethasone-treated eyes. Nine of 33 eyes (27.3%) in group A required steroid augmentation, as opposed to 4 of 71 eyes (5.6%) in groups B and C. Inflammatory symptoms were reduced in the Surodex-treated eyes, with statistical significance for ocular discomfort (P = 0.001), photophobia (P = 0.04), and lacrimation (P = 0.01). No complications occurred with Surodex-treated eyes, and no significant difference in endothelial cell loss was noted between Surodex-treated eyes and dexamethasone-treated eyes up to 1 year after surgery. CONCLUSIONS: Intraocular placement of two Surodex is a safe and effective treatment method to reduce intraocular inflammation after cataract surgery and clearly is superior to eyedrops in reducing inflammatory symptoms and aqueous flare as measured with the laser flare meter. No difference in efficacy between AC placement and ciliary sulcus placement of Surodex was detected in this study.     

缬沙坦在老年高血压疾病临床治疗中的应用

目的：观察缬沙坦治疗老年高血压的疗效.方法：将112例老年高血压患者分为对照54例和治疗组58例,两组患者均接受利尿剂、钙通道阻滞剂（CCB）、β受体阻滞剂、血管紧张素转换酶抑制剂（ACEI）类药等常规降压药物治疗;治疗组患者在接受常规治疗的基础上加用缬沙坦,每日一次,每次40～80 mg,,比较两组患者在治疗前后收缩压（SBP）、舒张压（DBP）、脉压（PP）水平.结果：与治疗前相比,两组患者的SBP均得到了明显改善,其中,治疗组的总有效率为96.55%,明显高于对照组的87.03%,且P＜0.05 差异具有统计学意义.结论：缬沙坦在老年高血压的治疗中表现出了良好的治疗效果,并且副作用较小,是一种理想的老年高血压降压药物,可以在临床中进行推广和应用.     

现代康复理论在脑卒中偏瘫针灸取穴中的运用

目的：探讨黄连温胆汤治疗痰热扰心型失眠症的疗效并研究其作用机制。方法：将66例痰热扰心型失眠症患者随机分为治疗组和对照组各33例,治疗组给予黄连温胆汤治疗,每次20g,水冲服,晚上睡前服用。对照组给予鸟灵胶囊,每粒0．33g,每次3粒,每日3次。两组均服药30天为1疗程。观察病人治疗前、治疗第30天、治疗后第60天匹兹堡睡眠质量量表（PSQI）、临床疗效和不良事件（TESS）量表评定疗效和副作用。结果：黄连温胆汤组的总有效率为90．32％,显效率70．97％;鸟灵胶囊组分别为65．62％和40．63％。黄连温胆汤组有效率高于对照组（P〈0．01）。黄连温胆汤组无副作用出现。结论：黄连温胆汤组治疗痰热扰心型失眠症疗效满意,安全性与依从性好,具有广阔的应用前景和开发价值。     

Gastroprotective and ulcer healing effects of essential oil from Hyptis spicigera Lam. (Lamiaceae)

Aim of the study

Tanshinone IIA (Tan IIA) is one of the key components of Salvia miltiorrhiza Bunge that has been widely used for various cardiovascular and cerebrovascular disorders in Asian countries. Many studies have reported that Tan IIA has antioxidative properties, but whether Tan IIA can rescue neurons from oxidative insult has never been reported. The present study was undertaken to evaluate the possible neuroprotective effects of Tan IIA on hydrogen peroxide (H₂O₂)-induced oxidative stress in rats.

Materials and methods

H₂O₂-induced cytotoxicity was evaluated by the cellular 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) assay and flow cytometry with PI staining. Calcium imaging experiments were carried out to measure intracellular free calcium concentration. Western blotting was used to determine the expression of Bax and Bcl-2 protein. Electrophysiological studies in hippocampal slices were performed to investigate the effect of Tan IIA on synaptic function and cognitive impairment caused by H₂O₂.

Results

It was found that pretreatment with Tan IIA protected primary rat cortical neurons against H₂O₂-induced cytotoxicity. Furthermore, Tan IIA markedly reduced the elevation of [Ca²⁺]_i evoked by H₂O₂. Western blot analysis indicated that pretreatment with Tan IIA prevented the increase in Bax/Bcl-2 ratio induced by H₂O₂. In addition, preincubation of Tan IIA 20 min prior to H₂O₂ exposure could reverse H₂O₂-induced hippocampal LTP impairment, but without significant alteration in basal synaptic transmission and LTP induction.

Conclusions

These findings demonstrate that Tan IIA might serve as a novel promising therapeutic agent for oxidative stress injury in neurodegenerative diseases.     

《坛经》与心理治疗浅谈

从心理治疗角度对《坛经》做一解读。《坛经》重视人的终极关怀,强调每个个体都具有无穷的智慧,不能彼此代替;它主张消泯人与人之间的差别,肯定经典和语言是体悟人生必要的工具,但更重要的是用我们的心灵去领悟。《坛经》超越了宗教,超越了心理治疗,在某些方面又与心理治疗不谋而合,如能融入心理治疗中,无疑对维护人的心身健康有着很大益处。     

瘫复康口服液对脑缺血的保护作用

本研究证实瘫复康口服液对急性脑缺血运物具有明显的保护作用，能够减少脑组织的缺血性损伤；增加脑血流量，改善脑组织的缺血缺氧状况；并能改善血瘀运物的脑膜微循环障碍，实验结果提示该药对脑缺血的保护作用可能是治疗缺血性中风的作用途径之一。     

二甲基亚砜对原代培养大鼠肝细胞醋氨酚损伤的影响

醋氨酚（ＡＡＰ）引起肝细胞损伤时，肝细胞还原型谷胱甘肽（６ＳＨ）含量下降，胞浆游离Ｃａ２＋浓度（［Ｃａ２＋］）升高二甲亚砜（ＤＭＳＯ）对ＡＡＰ肝细胞损伤有明显的保护作用。对轻度损伤能完全拮抗，ＤＭＳＯ对ＧＳＨ含量下降有明显的拮抗作用，当ＧＳＮ维持在一定水平时，ＡＡＰ不引起［Ｃａ２＋］升高。提示ＤＭＳＯ可能通过保护ＧＳＨ等巯基物质而发挥拮抗ＡＡＰ肝细胞损伤的作用     

上海交通大学医学院附属新华医院发表论文的计量分析

以文献计量学方法对上海交通大学医学院附属新华医院1995-2004年发表的论文文献量进行分析，探讨文献量变化与重点学科、非重点学科之间的关系。旨在为各学科的进一步发展和领导决策提供科学依据。     

Intraoperative Ketamine in Total Knee Arthroplasty Does Not Decrease Pain and Narcotic Consumption: A Prospective Randomized Controlled Trial

BackgroundMultiple studies have demonstrated that ketamine, a glutamate receptor blocker, may decrease postoperative pain in abdominal and orthopedic surgeries. However, its role with spinal anesthesia and total knee arthroplasty (TKA) remains unknown. The purpose of this study is to determine the efficacy of subanesthetic dosing of ketamine during TKA on postoperative pain and narcotic consumption.MethodsIn this prospective, randomized, double-blinded clinical trial, we enrolled 91 patients undergoing primary TKA with spinal anesthesia in a single institution from 2017 to 2018. Patients were randomized to receive intraoperative ketamine infusion at a rate of 6 mcg/kg/min for 75 minutes or a saline placebo. All patients received spinal anesthesia and otherwise identical surgical approaches, pain management, and rehabilitation protocols. Patient-reported visual analog pain scores were calculated preoperatively, postoperative days (POD) 0-7, and 2 weeks. Narcotic consumption was evaluated on POD 0 and 1.ResultsThere was no difference in average pain between ketamine and placebo at all time points except for at PODs 1 (45 vs 56, P = .041) and 4 (39 vs 49, P = .040). For least pain experienced, patients administered with ketamine experienced a reduction in pain only at POD 4 (22 vs 35, P = .011). There was no difference in maximum pain cohorts at all time points of the study or in-hospital morphine equivalents between the 2 cohorts.ConclusionAs part of multimodal pain management protocol, intraoperative ketamine does not result in a clinically significant improvement in pain and narcotic consumption following TKA.