Mitomycin C application after photorefractive keratectomy in high,moderate, or low myopia: Systematic review and meta-analysis

Photorefractive keratectomy (PRK) is considered a safe approach laser procedure with a clinical significance in correcting myopia results. PRK requires removing the whole superficial epithelium. The integrity of the epithelial basement membrane and the deposition of abnormal extracellular matrix can put the cornea in a probable situation for corneal haze formation. Mitomycin C (MMC) is applied after excimer laser ablation as a primary modulator for wound healing, limiting corneal haze formation. We aim to summarize the outcomes of MMC application after laser ablation. We searched Scopus, PubMed, Cochrane CENTRAL, and Web of Science till December 2020 using relevant keywords. The data were extracted and pooled as mean difference (MD) or risk ratio (RR) with a 95% confidence interval (CI), using Review Manager software (version 5.4). Our analysis demonstrated a statistically significant result for MMC application over the control group in terms of corneal haze formation postoperatively (RR = 0.29, 95% CI: [0.19, 0.45], P < 0.00001). Regarding corrected distance visual acuity (CDVA), no significant difference was observed between the MMC group and the control group (MD = 0.02; 95% CI: [-0.04, 0.07]; P = 0.56). Regarding the uncorrected distance visual acuity (UDVA), the analysis favored the MMC application with (MD -0.03, 95% CI: [-0.06, -0.00]; P = 0.05). There was no statistically significant increase in complications with MMC. In conclusion, MMC application after PRK is associated with a lower incidence of corneal haze formation with no statistically significant side effects. The long term effect can show improvement regarding UDVA favoring MMC. However, there is no significant effect of MMCs application regarding CDVA, and SE.     

Identification of novel helper epitope peptides of Survivin cancer-associated antigen applicable to developing helper/killer-hybrid epitope long peptide cancer vaccine

We identified novel helper epitope peptides of Survivin cancer antigen, which are presented to both HLA-DRB1*01:01 and DQB1*06:01. The helper epitope also contained three distinct Survivin-killer epitopes presented to HLA-A*02:01 and A*24:02. This 19 amino-acids epitope peptide (SU18) induced weak responses of Survivin-specific CD4⁺ and CD8⁺ T cells though it contained both helper and killer epitopes. To enhance the vaccine efficacy, we synthesized a long peptide by conjugating SU18 peptide and another DR53-restricted helper epitope peptide (SU22; 12 amino-acids) using glycine-linker. We designated this artificial 40 amino-acids long peptide containing two helper and three killer epitopes as Survivin-helper/killer-hybrid epitope long peptide (Survivin-H/K-HELP). Survivin-H/K-HELP allowed superior activation of IFN-γ-producing CD4⁺ Th1 cells and CD8⁺ Tc1 cells compared with the mixture of its component peptides (SU18 and SU22) in the presence of OK-432-treated monocyte-derived DC (Mo-DC). Survivin-H/K-HELP-pulsed Mo-DC pretreated with OK-432 also exhibited sustained antigen-presentation capability of stimulating Survivin-specific Th1 cells compared with Mo-DC pulsed with a mixture of SU18 and SU22 short peptides. Moreover, we demonstrated that Survivin-H/K-HELP induced a complete response in a breast cancer patient with the induction of cellular and humoral immune responses. Thus, we believe that an artificially synthesized Survivin-H/K-HELP will become an innovative cancer vaccine.     

TP与MVP方案治疗晚期非小细胞肺癌疗效比较

目的观察比较泰素加顺铂与丝裂霉素加顺铂及西艾克治疗晚期非小细胞肺癌的近期疗效及不良反应。方法58例晚期非小细胞肺癌患者随机分为Taxol DDP组(A组)及MMC VDS DDP组(B组),治疗2个周期后进行疗效及不良反应评估。结果A组30例,有效率46.7%;B组28例,有效率42.9%。A组的骨髓抑制与周围神经炎较B组为轻。结论TP与MVP方案在治疗晚期非小细胞肺癌方面均有较好疗效,但TP方案不良反应较轻,可作为首选方案。     

非穿透小梁切除术联合MMC及羊膜植入治疗开角型青光眼远期效果观察

目的 观察非穿透性小梁手术(NPTS) 联合丝裂霉素C(MMC)及羊膜植入治疗开角型青光眼的远期临床效果.方法 对21例(30只眼)28～51岁开角型青光眼患者进行非穿透性小梁手术联合MMC及羊膜植入治疗.术后随访6～18个月,观察患者视力、眼压及滤过泡情况.结果 患者术后眼压控制良好,视力较术前无明显变化.患者术前平均眼压与术后平均眼压相比,差异有显著意义(P＜0.01).随访期间有3只眼需药物治疗,14例有功能性的滤过泡.5例滤过泡苍白局限化,呈贫血状态.结论 NPTS联合MMC及羊膜植入能有效降低眼压,远期效果良好.     

膀胱内不同药物灌注预防浅表性膀胱癌术后复发的临床研究

目的研究吡柔比星（THP）、丝裂霉素C（MMC）和THP与MMC交替灌注预防膀胱癌术后复发的疗效。方法2002年1月至2007年9月对72例浅表膀胱癌患者在经尿道绿激光汽化或膀胱部分切除术后,随机分为A、B、C3组,每组各24例,A、B和C组分别为THP、MMC和THP与MMC交替膀胱灌注,手术后第一周开始,每周1次共8次,以后每两周1次共8次,再以后每月1次共两年。结果72例患者均随访两年以上A组3例复发（12．5％）,B组6例复发（20．6oA）,C组1例复发（4．16％）（P〈0．05）。结论THP与MMC交替膀胱灌注预防膀胱癌手术后复发作用优于单用THP或MMC。     

丝裂霉素C联合自体角膜缘干细胞移植治疗翼状胬肉

目的观察翼状胬肉切除联合术中应用丝裂霉素C（MMC）＋自体角膜缘干细胞移植治疗翼状胬肉的临床疗效。方法对48例51只眼翼状胬肉患者,行翼状胬肉切除,同时术中应用0.02%MMC联合自体角膜缘干细胞移植,术后随访胬肉复发情况。结果术后随访6～18个月,角膜创面愈合良好,视力均有不同程度提高,胬肉复发3眼（复发率5.88%）。结论翼状胬肉切除联合术中应用MMC＋自体角膜缘干细胞移植治疗翼状胬肉,能明显降低术后复发率。     

丝裂霉素C防止LASEK术后角膜雾状混浊的临床研究

目的探讨准分子激光上皮瓣下角膜磨镶术（LASEK）术中应用丝裂霉素C（MMC）抑制术后角膜上皮下雾状混浊（Haze）的疗效。方法108例216眼行LASEK术的近视患者随机分为两组：MMC组56例112眼及对照组52例104眼。MMC组在激光切削完毕后用浸有0．02％MMC的棉片覆于角膜切削区1-1．5min;对照组采用常规LASEK手术。术后早期观察眼部刺激症状及角膜上皮愈合情况;1、3、6、12个月复查视力、屈光度、角膜Haze及角膜地形图。结果两组上皮愈合时间差异无统计学意义（P＞0,05）;术后1、3、12个月,MMC组Haze发生率明显低于对照组（P＜0．01）,未出现2级及2级以上的Haze;术后1年两组达最佳矫正视力者差异无统计学意义（P＞0.05）。但MMC组中高于及低于最佳矫正视力1行的眼数与对照组相比,差异有统计学意义（P＜0．05）;MMC组术后1个月与1年的角膜曲率差异无统计学意义,而对照组差异有统计学意义（P＜0．05）。结论LASEK术中应用低浓度MMC能有效抑制LASEK术后角膜Haze的产生,防止屈光状态回退,有助于视力的提高。     

联合抗代谢药物预防兔后发性白内障的研究

目的 探讨联合抗代谢药物在预防兔后发性白内障（PCO）中的作用及其机制.方法 40只新西兰白兔随机分为两组。在兔晶状体超声乳化吸出术后，实验组右眼晶状体囊袋内注入含有02mg／ml丝裂霉素及12．5mg/ml 5-氟尿嘧啶的甲基纤维素，左眼晶状体囊袋内仪注入甲基纤维素设置空白对照组；对照组右眼晶状体囊袋内注入含有0．2mg/ml丝裂霉素的甲基纤维素，左眼晶状体囊袋内注入含有12．5mg/ml 5-氟尿嘧啶的甲基纤维素。部分动物囊袋内植入人工晶体。手术后对动物进行1～12个月临床观察，对不同阶段进行晶状体囊膜组织和人工晶体病理学检查、晶状体囊膜平片检查及人工晶体电镜扫描。结果 空白对照组在手术后2周出现后囊膜混浊，随着术后时间的延长，PCO明显加重；对照组在术后1个月发生不同程度PCO，而实验组观察12个月，未见PCO发生。结论 晶状体囊袋内联合抗肿瘤药物能有效杀伤晶状体上皮细胞（LEC）、晶状体赤道部生发区细胞，较单一抗肿瘤药物更可靠预防PCO的发生。晶状体囊袋内联合抗肿瘤药物可能为解决预防人类PCO提供一条新途径。