Objective To investigate the therapeutic effects of subconjunctival verapamil on outcome in an experimental model of traumatic proliferative vitreoretinopathy. Methods An experimental model of traumatic proliferative vitreoretinopathy was induced in pigme nt rabbits,which then were selected randomly to receive either subconjunctival verapamil injection treatment or a placebo injection(control)daily for 3 weeks.Animals were examined by indirect ophthalmoscopy at weekly intervals for 5 weeks. Eyes were enucleated for light microscopy 5 weeks later. Results Fifty-six percent(18 of 32)of the rabbits receiving subconjunctival verapamil injection had developed tractional retinal detachment,whereas eighty-one percent(26 of 32)of control animals had developed tractional retinal detachment(chi;2=4.655,P=0.031).The results of clinical examination and light microscopy didn't show evidence of toxicity between the verapamil treated animals and control animals. Conclusion Subconjunctival verapamil decreased the incidence of tractional retinal detachment due to traumatic proliferative vetreoretinopathy in this rabbit model.Verapamil at the dose used in this model has no evident toxicity on rabbit eyes.Further studies are needed to determine the doseresponse and efficacy of the drug. (Chin J Ocul Fundus Dis,1999,15:69-71)
目的探讨低分子肝素预防下肢静脉曲张术后深静脉血栓形成的临床效果。 方法将2011年1月至2013年12月期间于笔者所在医院行大隐静脉高位结扎＋分段剥脱术＋腔内激光闭合术的513例下肢静脉曲张患者随机分为2组：低分子肝素组238例，下肢静脉曲张术后采用低分子肝素预防性治疗；对照组275例，术后不采用任何抗凝药物。比较2组患者深静脉血栓形成和并发症发生情况。 结果低分子肝素组发生浸透敷料的出血14例（5.9%），切口出血或皮下血肿25例（10.5%），血小板减少1例（0.4%），肝功能异常2例（0.8%），无深静脉血栓形成发生；对照组发生浸透敷料的出血19例（6.9%），切口出血或皮下血肿27例（9.8%），肝功能异常2例（0.7%），深静脉血栓形成7例（2.5%），无血小板减少发生。2组患者浸透敷料的出血、切口出血或皮下血肿、血小板减少及肝功能异常发生率比较差异均无统计学意义（P＞0.05），但低分子肝素组深静脉血栓形成的发生率低于对照组（P＜0.05）。术后获访487例，随访时间为4～12个月，平均10个月。其中低分子肝素组获访225例，对照组获访262例。获访患者随访期间发生下肢静脉曲张复发9例（低分子肝素组4例，对照组5例），隐神经损伤11例（低分子肝素组5例，对照组6例），无远期下肢深静脉血栓形成病例。2组患者的下肢静脉曲张复发率和隐神经损伤发生率比较差异均无统计学意义（P＞0.05）。 结论采用低分子肝素预防下肢静脉曲张术后下肢深静脉血栓形成具有良好的临床效果和安全性，值得临床推广应用。
ObjectiveTo summarize the effects of endovascular intervention and artificial graft bypass for the occlusive superficial femoral artery disease. MethodsThe clinical data of 122 patients (136 limbs) with superficial artery occlusive disease underwent endovascular intervention or artificial graft bypass from January 2008 to April 2011 in this hospital were collected retrospectively. Age, TASCⅡgrading, condition of outflow tract, complications before and after procedures, hospital stay, primary patency rate, rate of amputation, and death rate were recorded. Results①Seventy-four limbs of 64 patients were accepted percutaneous transluminal angioplasty and stent graft (PTA/S group), 62 limbs of 58 patients were accepted femoral popliteal artery artificial graft bypass (artificial graft bypass group). Compared with the artificial graft bypass group, the age was significantly older (P < 0.05), TASCⅡA or B lesions were more (P < 0.05), TASCⅡC or D lesions were less (P < 0.05), the limbs with one or three outflow tracts were more (P < 0.05) in the PTA/S group. The limbs with two outflow tracts, and the patients combined with diabetes or hypertension or diabetes and hypertension had no significant differences between these two groups (P > 0.05).②There was no perioperative mortality in two groups. Compared with the artificial graft bypass group, the average hospital stay was sifnificantly shorter (P < 0.05), the 3-year death rate after procedure was higher (P < 0.05), the rate of postoperative incision infection was lower (P < 0.05), the primary patency rate of 36-month after operation was lower (P < 0.05) in the PTA/S group. The rate of amputation, the primary patency rates of 6-, 12-, and 24-month after operation had no significant differences between these two groups (P > 0.05). ConclusionsManagement of occlusive superficial femoral artery disease with femoral popliteal artery artificial bypass grafting exhibits a higher long term patency as compared with percutaneous stent graft. However, the hospital stay is longer than that in PTA/S group, and postoperative infection also occurres individually in artificial graft bypass group. Percutaneous transluminal angioplasty and stent graft has little trauma, faster recovery, shorter hospital stay, which is an important significance for the patients with too old or weak to accept femoral popliteal artery artificial graft bypass. But its long term patency rate needs to be improved.
Objective T o observe the efficacy and safety of intravitreal injection of ranibizumab (Lucentis) for 12 consecutive months treating exudative age-related macular degeneration (EAMD). Methods This is an open and prospective study without control trial. Twenty-two eyes from 22 patients (18 males and 4 females) with EAMD diagnosed by fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were enrolled in this study. The patients aged from 46 to 79 years with the mean of 68.2plusmn;9.3 years. All of the patients received intravitreal injection of ranibizumab (0.5 mg, 0.05 ml) once a month for 12 consecutive months. The best-corrected visual acuity (BCVA) was obtained using the international standard visual acuity chart (converted into logMAR for statistical analysis). Central retinal thickness (CRT) was measured by optical coherence tomography (OCT) before and after each monthly treatment. Intraocular pressure (IOP) was measured using non-contact tonometry before treatment and 1 hour and 1 day after treatment. FFA and ICGA were performed every 3 months. The BCVA was 0.01 -0.9 with the average of 0.26plusmn;0.22. The average logMAR BCVA was 0.76plusmn;0.44, the CRT was 182-559 mu;m with the mean of (302.62plusmn;90.18) mu;m, and the IOP was normal before treatment. Only 13 of 22 patients completed 12 months of follow-up. The BCVA, CRT and IOP after treatment were compared with baseline using paired t test. Results Of all the 22 patients, the mean logMAR BCVA at 1 and 3 months after treatment were 0.52plusmn;0.32 and 0.37plusmn;0.27 respectively, both of which were significantly different compared with before treatment (t=4.518, 6.237;P＜0.05). Of the 13 patients, the mean logMAR BCVA at 1, 3 and 12 months after treatment was 0.51plusmn;0.34, 0.35plusmn;0.26, 0.34plusmn;0.30 respectively. All of these measures were significantly different compared with 0.74plusmn;0.37 before treatment (t=3.443, 5.438, 4.756;P＜0.05) . The mean CRT at 1, 3 and 12 months after treatment were (228.85plusmn;54.93), (231.00plusmn;38.94) and (262.92plusmn;70.48) mu;m. There were significant differences among before and 1, 3 months after treatment (t=2.914, 3.199;P＜0.05), but not between before and 12 months after treatment (t=1.408, P＞0.05). The first 3 injections contributed to the most BCVA gain with 6 patientsprime; BCVA increasing from 0.1- 0.5 to 0.5 or above. The greatest CRT reduction was obtained at 1 month after the first injection. IOP increased 1 hour after treatment and recovered within 1 day. No intravitreal injection-related side effects such as endophthalmitis were observed during the follow-up period. Conclusions Monthly intravitreal injections of ranibizumab may improve BCVA and macular edema. There was no adverse event during the follow-up duration.
ObjectiveTo evaluate the effect of percutaneous mechanical thrombectomy (PMT) with AngioJet mechanical thrombus aspiration system for the acute deep venous thrombosis (DVT) of lower extremities. MethodsThe clinical data of 72 patients (72 limbs) with acute DVT who underwent PMT with AngioJet system from December 2015 to June 2018 in our hospital were analyzed retrospectively. ResultsOf the 72 cases, 30 cases underwent PMT alone, while 42 cases underwent PMT combined with catheter directed thrombolysis (CDT). Thrombus clearance rate of grade Ⅲ was obtained in 49 cases (68.05%), grade Ⅱ in 20 cases (27.78%), and grade Ⅰ in 3 cases (4.17%). Thirty-five cases were found with May-Thurner syndrome, and 34 cases were treated with stenting while 1 case complicated with iliac bleeding. The rates of PTS were 1.41% (1/71), 3.57% (2/56), 4.55% (2/44), and 20.00% (3/15) at 3-month, 6-month, 1-year, and 2-year after intervention, respectively. The deep vein patency rates were 86.36% (38/44) and 80.00% (12/15) at 1-year and 2-year after intervention, respectively. The iliac stent patency rates were 100% (23/23) and 87.50% (7/8) at 1-year and 2-year after intervention, respectively. ConclusionThe effect of PMT assisted with CDT for the acute DVT of lower extremities is satisfactory, but its long-term efficacy needs to be further observed.