Objective To investigate the therapeutic effects of vitre ctomy for primary retinal detachment due to macular hole in high myopic eyes. Methods Consecutive patients with primary retinal detachment due to macular hole who went to our hospital from March 1996 to March 2004 were retrospectively analyzed. The condition of the patients must accord with the previous refractive error of ge;6.00 D or the axial length of ge;26 mm without peripheral retinal hole; and with primary retinal detachment due to macular hole which had undergone vitrectomy. Results In 83 patients (85 eyes) including 63 females and 20 males with an average age of 54.1 years, preoperative visual acuity was light perception to counting finger in 49 eyes, 0.01-0.1 in 33, and 0.12-0.2 in 3 eyes; the extent of retinal detachment was only in the macular area in 15 eyes, in 1-2 quadrants in 11 eyes, and in 3-4 quadrants in 59 eyes; extraction of the lens or phako fragmentation was simultaneously performed during the operation in 62 eyes (72.9%), macular epiretinal membrane was removed in 37 eyes, and C3F8 or silicone oil was injected intravitreously in 29 (34.1%) and 56 (65.9%) eyes, respectively; the retina was reattached postop eratively in 77 eyes (90.6%) and failed to reattach in 8; visual acuity improved in 47 eyes (55.3%), remained unchanged in 25 (29.4%), and decreased in 13 (15.3%) after operation. Conclusions Primary retinal detachment due to macular hole often occurs in elder female patients with high myopic eyes.Simultaneous vitrectomy procedures including removal of posterior vitreous cortex, macular epiretinal membrane, cataractous lens and internal tamponade may usu ally beneficial to improve or preserve. The visual acuity improves or remains still in most of the affected eyes after the surgery. （Chin J Ocul Fundus Dis, 2006, 22: 287-290)
To explore the feasibility of mesenchymal stem cells (MSCs) acting as seed cells in tissue engineering, we isolated human bone marrow MSCs and differentiated them into vascular endothelial-like cells (ELCs) in vitro. Bone marrow mononuclear cells (BMSCs) were isolated by the method of percoll density centrifugation, and seeded in Dulbecco Modified Eagle Medium supplemented with 10% fetal bovine serum. MSCs were purified through multiple adherent cultures, and differentiated into ELCs induced by endothelial cell growth medium-2 (EBM-2) medium containing vascular endothelial growth factor (VEGF), human fibroblast growth factor (hFGF), insulin like growth factors 1 (IGF-1), and human epidermal growth factor (hEGF). The relative biologic characteristics of ELCs including cell morphology and phenotype were studied by inverted microscope and flow cytometry. The induced cells were identified by immunofluorescence with CD31 and Von Willebrand factor (vWF). The results showed that the morphology of MSCs was long-spindle and vortex-like growth. After induction of differentiation, the cells were round, and similar to vascular endothelial cells (ECs). Flow cytometric analysis revealed that ELCs expressed ECs specific surface markers of CD31 and vascular endothelial cadherin (VE-cadherin), but not CD133. Immunofluorescence results also confirmed that ELCs expressed CD31 and vWF. The results suggested that ELCs possed similar cell biological characteristics with ECs. In one word, human MSCs derived from bone marrow have the potential to differentiate into ECs in vitro,and show clinical feasibility acting as ideal donor cells of vascular tissue engineering.
ObjectiveTo systematically review the efficacy between key hole approach versus large trauma craniotomy for patients with hypertensive intracerebral hemorrhage. MethodsSuch databases as The Cochrane Library (Issue 3, 2013), PubMed, EMbase, WangFang Data, CNKI and VIP was searched to identify randomized controlled trials (RCTs) on key hole approach versus large trauma craniotomy for patients with hypertensive intracerebral hemorrhage from January 2005 to June 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Then meta-analysis was performed using RevMan 5.2. ResultsA total of 13 studies involving 1 324 patients was included. The results of meta-analysis showed that, key hole approach was superior to large trauma craniotomy with significant differences in the fatality rate (OR=0.29, 95%CI 0.19 to 0.45, P < 0.000 01), incidence of postoperative complications (OR=0.35, 95%CI 0.21 to 0.57, P < 0.000 1), recovery time of consciousness (MD=-4.52, 95%CI-5.84 to-3.20, P < 0.000 01), neurologic impairment score after 1-month treatment (MD=-12.63, 95%CI-16.36 to-8.90, P < 0.000 01), total effectiveness (OR=3.79, 95%CI 2.54 to 5.66, P < 0.000 01), and postoperative living ability (ADL Grade I, Ⅱ). ConclusionKey hole approach is better than large trauma craniotomy for patients with hypertensive intracerebral hemorrhage. Due to limited quality and quantity of the included studies, the abovementioned conclusion still needs to be verified by conducting more high quality studies, especially conducting multicenter blinding RCTs with large sample-size.
ObjectiveTo compare the safety and efficacy of a modified 23G with suturing incision and traditional 23G vitrectomy for silicone oil removal. MethodsA total of 177 patients (180 eyes) who underwent silicon oil removal (the average tamponade period was 4.5 months) were enrolled in this prospective study. The patients included 112 males (113) and 65 female (67). The mean age was (43.8±10.3) years. The corrected vision, indirect ophthalmoscopy, intraocular pressure, B-ultrasound and optical coherence tomography were measured for all patients. All patients had no complete retinal detachment. The patients were randomly divided into modified 23G with suturing incision group (group A, 88 eyes) and traditional 23G vitrectomy (group B, 92 eyes). The differences of sex (χ2=1.596), age, corrected vision (t=0.785), intraocular pressure (t=0.352), primary disease (χ2=1.982) and lens condition (χ2=2.605) were not significant (P>0.05). The operation time, intraocular pressure, silicon oil retention, choroidal detachment, retinal redetachment and endoophthalmitis were recorded at the end of the operation. ResultsThe difference of mean operation time was not significant between group A and B (t=1.950,P>0.05). The differences of mean visual acuity 1 day, 1 week and 3 months after operation were not significant between group A and B (t=0.873, 1.115, 0.141; P>0.05). There was difference of mean intraocular pressure at 1 day after operation (t=2.550,P<0.05), but not at 1 week and 3 months after operation (t=1.451,1.062; P>0.05) between group A and B. There were 25 eyes (28.4%) with intraocular hypotension, 8 eyes (9.1%) with choroidal detachment, 5 eyes (5.7%) with vitreous hemorrhage, 9 eyes (10.2%) with retinal redetachment, and 7 eyes (8.0%) with silicon oil retention in group A. There were 5 eyes (5.4%) with intraocular hypotension, 2 eyes (2.2%) with choroidal detachment, 2 eyes (2.2%) with vitreous hemorrhage, 8 eyes (8.7%) with retinal redetachment, and 1 eye (1.1%) with silicon oil retention in group B. The differences of incidence of intraocular hypotension, choroidal detachment and silicon oil retention were significant (P<0.05). No endoophthalmitis occurred. ConclusionThe safety of modified 23G with suturing incision is better than traditional 23G vitrectomy for silicone oil removal, with decreased incidence of intraocular hypotension, choroidal detachment and silicon oil retention.
ObjectiveTo compare the different effects of ubiquitin(UB) on human umbilical vein endothelial cells (HUVECs) and macrophages under normal circumstances,and analyze whether UB could protect HUVECs from lipopolysaccharide(LPS) induced injury. MethodsThe morphologic changes of HUVECs in vitro with up-rising concentrations of UB interventions were observed. HUVECs and human macrophages in vitro were divided into 4 groups according to UB concentration (0.01 μg/mL,0.1 μg/mL, 1 μg/mL, and 10 μg/mL). Supernatant and cells of each group were collected in 24 h after UB intervention. The levels of TNF-α and VCAM-1 in supernatant were measured by ELISA while NF-κB protein level in cells was detected by Western blot. HUVECs were divided into a LPS group(LPS 10 μg/mL) and an UB+LPS group(UB 0.1 μg/mL,LPS 10 μg/mL). The supernatant of the two groups were collected in 8,16 and 24 h after LPS and UB intervention. The levels of TNF-α and VCAM-1 in supernatant were measured by ELISA. ResultsThe injury of HUVECs got worse with the ascending concentrations of UB.At the concentration of 50 μg/mL,UB induced HUVECs got ballooned and died massively. With the increase of UB concentration,the levels of TNF-α and VCAM-1 in HUVECs' supernatant ascended firstly and then descended,while those in human macrophages' supernatant ascended gradually. zHowever,the tendency of the NF-κB protein level in the two kinds of cells was similar when the concentration of UB increased.At the consentration of 0.1 μg/mL or 1 μg/mL,ubiquitin induced NF-κB protein level obviously increased.At the concentration of 0.01 μg/mL or 10 μg/mL,UB induced the protein level was similar with those of the control group and even decreased slightly. There was no significant difference in TNF-α or VCAM-1 levels at each time point between the LPS group and the UB+LPS group. ConclusionsUB injuries HUVECs obviously at a low concentration but injuires human macrophages at much higher concentraton. UB can not protect HUVECs from LPS-induced injury in vitro.
Objective To study the efficacy and safety of Yi Huo Hua Tan granule in the treatment of stable chronic obstructive pulmonary disease (COPD) patients with a traditional Chinese medicine (TCM) syndrome of Qi deficiency with phlegm and blood stagnation. Methods The stable COPD patients with a TCM syndrome of Qi deficiency with phlegm and blood stagnation who visited the outpatient in the Department of Integrated Traditional and Western Medicine, West China Hospital of Sichuan University between August 2016 and March 2017 were selected. The patients were randomly divided into an experimental group and a control group using a random number table method. Patients in both groups received conventional western medicine, with Yi Huo Hua Tan granule being additionally prescribed in patients in the experimental group. The treatment during was 60 days. The TCM effective rate, TCM syndrome score, COPD Assessment Test (CAT) score, modified Medical Research Council Dyspnea Scale, six minutes walking distance, long-term prognostic indicators, lung function indicators, inflammatory cytokines in serum and induced sputum supernatant were compared between groups. The safety of Yi Huo Hua Tan granule was also observed. Results A total of 69 patients were included, including 34 patients in the experimental group and 35 patients in the control group. After treatment of Yi Huo Hua Tan granule for 2 months , the total effective rate of TCM syndrome was 44.1% and 8.6% in the experimental group and the control group, respectively (P=0.001). There were statistically significant differences at 2 months and 4 months of follow-up visits between groups (P<0.05). After 2 months treatment, TCM syndrome score, CAT score, modified Medical Research Council score, number of acute exacerbations per year, hospitalization per year, and total length of hospital stay per year in the experimental group were lower than those in the control group (P<0.05). The six minutes walking distance, forced vital capacity, forced expiratory volume in one second, forced expiratory volume in one second /predicted value, serum, and the concentrations of interleukin (IL)-6, IL-1β, and IL-10 in induced sputum supernatant between the two groups showed no statistically significant difference (P>0.05). There was no significant change in blood routine, liver and kidney function, electrocardiogram, or urine and urine routine of the patients in the two groups. Conclusion Yi Huo Hua Tan granule improves the clinical symptoms and quality of life in patients with stable COPD, with a good safety.
ObjectiveTo systematically review the clinical effect and safety of traditional Chinese medicine (TCM) in the treatment of cough variant asthma (CVA). MethodsWe searched MEDLINE (Ovid), PubMed, EMbase, The Cochrane Library, VIP, WanFang Data, CNKI and CBM databases to collect randomized controlled trials (RCTs) about TCM for CVA from inception to May 2014. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by RevMan 5.2 software. ResultsA total of 17 RCTs were included. The results of qualitative analysis showed that:in improving cough symptom, three of four RCTs showed that TCM was superior to western medicine alone. In improving airway hyper responsiveness and overall treatment effect, the difference between TCM and western medicine alone remained uncertain. No serious adverse reactions related to TCM was reported in 17 RCTs. ConclusionBased on the current evidence, some trials suggest the TCM is superior to western medicine alone in improving cough symptom, however in the improvement of airway hyper responsiveness and overall efficacy, the difference between TCM and western medicine alone remains uncertain. Due to the variety of TCM and western medicine as well as limited methodological quality and different intervention of the included studies, more high-quality RCTs with large scale are needed to verify the above conclusion.