Background Tongxinluo capsule is a new drug for cardio- cerebral vascular diseases on the national essential drug list of China, and the second-class award of National Science and Technology Development of China, 2001. Objective This review aims to assess the effect (harms and benefits) of Tongxinluo capsule for unstable angina. Search strategy electronic searchs The Cochrane Heart Review Group specialised trials register,The Cochrane Controlled Trials Register, published in the latest issue of the Cochrane Library, MEDLINE, EMBASE, CBM, Chinese Cochrane Centre Controlled Trials Register, Current Controlled Trials (www. controlled-trials. com), The National Research Register Handsearchs We will search 83 journals of Chinese traditional medicine. Inclusion riteria We will include randomised controlled trials of Tonxinluo capsule versus placebo or other current phamarcotherapy or other Chinese medicinal herbs in the participants with unstable angina pectoris. Studies will report mortality (sudden death from acute myocardial infarction), severity of angina pectoris, frequency of acute attack angina, ECG improvement, rate of dosage reducing or taking frequency of nitroglycerine and symptom improvement, etc. Data analysis Data will be included in a meta-analysis if they are available, of sufficient quality and sufficiently similar.
Objective To observe the clinical manifestations, therapeutic efficacy and results of bacterial culture of seven patients of scleral buckle (SB) infection after scleral bulking surgery. Methods Seven patients (seven eyes) underwent SB removal for SB infections were enrolled in this study. The patients included four males (four eyes) and three females (three eyes). The patients aged from 12 to 69 years, with a mean age of 42.7 years. There were four right eyes and three left eyes. The duration (interval between primary surgery and SB removal) ranged from two weeks to ten years, with a mean of 47.5 months. Six patients were concurrent with systemic disease. All the patients were examined for visual acuity, slit lamp microscope and indirect ophthalmoscope examination. Some patients also received external eye examination and fundus photography. Whether SB exposure or not and the clinical manifestations were observed. SB removal was performed in all the patients and the SB were sent to the laboratory for bacterial culture. The follow-up time ranged from two weeks to eight months, with a mean of 3.2 months. Whether infections recurrence and retinal detachment or not were observed. Results SB exposure was in three eyes. Obvious ocular pain and swelling, conjunctival hyperemia and visible yellow-white discharge in the conjunctival sac were presented in two eyes; irritation and discharge were in one eye. No SB exposure was in four eyes. Ocular pain and swelling, conjunctival hyperemia and visible yellow-white discharge in the conjunctival sac were presented in two eyes. Repeated subconjunctival hemorrhage and diplopia were presented in one eye. Visual acuity decline, conjunctival sac discharge and total retinal detachment were in one eye. All patients had no intraocular inflammation. The infection was controlled after SB removal and the retina was attached during the follow-up. The bacterial culture were all positive, which included Staphylococcus aureus, Staphylcoccus epidermidis and Erysipelothrix rhusiopathiae, Gram positive corynebacterium, Aspergillus flavus, Kocuria roseus, Streptococcus oralis, Maxwell Corynebacterium. Conclusions The clinical manifestations of SB infection and the pathogenic microorganisms are variable. SB removal can control the infection.
Objective To observe the relationship between the suturing patterns to close the scleral incision and postoperative intraocular pressure (IOP) in 23G minimally invasive vitrectomy. Methods Eighty eyes of 80 patients with vitreoretinal diseases, who were treated with primary 23G minimally invasive vitrectomy, were enrolled in this prospective clinical study. Patients with poor closed scleral incision which need suturing were excluded from this study. The corrected visual acuity ranged from hand movement to 0.2. The IOP ranged from 7.9 to 19.8 mm Hg (1 mm Hg=0.133 kPa), with the mean of (13.9plusmn;1.8) mm Hg. The eyes were randomly divided into three groups: group A (20 eyes), suturing all three scleral puncture after vitrectomy; group B (20 eyes), suturing only two upper scleral puncture, but not the lower infusion puncture after vitrectomy; group C (40 eyes), no suturing for all 3 scleral puncture after vitrectomy. All patients underwent 23G vitrectomy only. The corrected visual acuity and IOP were observed after surgery. Results The corrected visual acuity were 0.1 -0.3, 0.2- 0.5, 0.3 -0.8 in one, seven and 14 days after surgery, respectively. No one in group A, B experienced hypotony in one, three, seven and 14 days after surgery. Thirteen (32.5%), five (12.5 %), two eyes (5.0%) in group C experienced hypotony in one, three and seven days after surgery. Seven eyes (17.5%) experienced severe hypotony (＜5 mm Hg) in 14 day after surgery in group C. The difference was statistically significant compared the incidence of hypotony in group C with group A, B respectively at different time points after surgery (chi;2= 16.82,P=0.007). The difference was statistically significant compared the incidence of hypotony in group C at different time points after surgery (chi;2=11.64,P=0.003). The difference was no significant compared the IOP between group A and B at different time points after surgery (F=1.618,P=0.205). Compared the IOP of group C to group A and B, the difference was statistically significant in one and three days after vitrectomy (F=9.351,P=0.000); but not statistically significant in seven and 14 days after vitrectomy(F=0.460,P=0.633). Conclusions Whether or not suturing the scleral punctures is closely related to postoperative hypotony in 23G vitrectomy. Suturing only the two upper scleral punctures can reduce the occurrence of postoperative hypotony.
Objective To observe the expression of vascular endothelial growth factor A (VEGFA) and its receptors sFlt-1, kinase insert domain receptor (KDR) in lightinjured human retinal pigment epithelial (RPE) cells. Methods Cultured human RPE cells (8th - 12th generations) were divided into normal control group and light damage group. The cells of two groups were exposed to the 18 W cold white light (2200±300) Lux for 12 hours to induce light damage responses, but the cells of normal control group were packed by tinfoil with doubledeck high pressure disinfection. The VEGF-A, sFlt-1 and KDR mRNA and protein expressions were detected by reverse transcriptionpolymerase chain reaction (RT-PCR) and Western blot at 0, 6, 12, 24 hours after light damage. Results The VEGF-A mRNA and protein expressions in light damage group were significantly increased at 6 hours, and reached its peak at 12 hours after light damage which obviously higher than that in normal group (t=2.74, 2.93; P＜0.05), and then went down gradually. The sFlt-1 mRNA and protein expressions in light damage group reached its peak at 12 hours after light damage which obviously higher than that in normal group (t=4.32, P＜0.01), but obviously lower than that in normal group at 24 hours after light damage (t=2.41, P＜0.05). The KDR mRNA and protein expressions in light damage group were obviously higher than that in normal group at 24 hours after light damage （t=2.89, P＜0.05）,but there was no changes at 6, 12 hours after light damage (t=1.84, P＞0.05). Conclusions At 6, 12 hours after light damage, the expressions of VEGF-A and sFlt-1 increases significantly and KDR expression is stable in lightinjured RPE cells. At 24 hours after light damage, the expression of VEGF-A and sFlt-1 decreases, but KDR expression increases in light-injured RPE cells.
Objective To observe the effect of persistent flickering stimulus on the structure and function of retina in guinea pigs during a developmentally sensitive period.Methods Twenty-four two- week-old guinea pigs were randomly divided into flicker light (FL) group and control group, with 12 guinea pigs in each group. Animals in FL group were raised under 500 Lux illumination with a duty diurnal cycle of 50% at a flash rate of 0.5 Hz. Animals in control group were reared under steady 500 Lux illumination. Light emitting diode (LED) lamps were used for lighting under a 12-hour light/12-hour dark cycle. After the collection of fundus photographs and electroretinograms recorded at week 12, eyeballs were taken out, three dimensions were measured, and histopathological changes were examined.Results Compared to control group, tessellated fundus in FL group appeared more prevalent; implicit time of ldquo;ardquo; waves were prolonged in electroretinogram; the eyeballs were increased in horizontal, vertical, axial dimensions by (0.89plusmn;0.30), (0.69plusmn;0.20) and (0.96plusmn;0.30) mm respectively, the differences between two groups were statistically significant (t=12.7,11.9,15.8;P＜0.05). The gap of sclera collagen fiber was slightly widened.The photoreceptor layer was more likely to develop a disordered outer segment, which contained deciduous disc membranes.Conclusion Persistent flickering stimulus is attended by development of excessive ocular enlargement,which could affect the retinal structure and function of photoreceptors.
The introduction of anti-vascular endothelial growth factor (VEGF) therapy represents a landmark in the management of wet age-related macular degeneration (AMD). However, as a new therapy, several problems such as durability of the therapeutic effects, medication side effects, and medication selection have emerged. We should make appoint of improving the therapeutic effect and safety by realizing the limitation of the therapy, monitoring the clinical potential adverse reactions of anti-VEGF agents, and recommending individualized treatment.
Anti-vascular dndothelial growth factor (VEGF) drugs have open up a new treatment channel for ocular neovascular diseases. A lots of clinical data has proved that anti-VEGF drugs are effective and safe. But we should also notice that long-term and excessive usage of anti-VEGF drugs brings some new problems and complications, and even affect the normal ocular physiological process of the angiogenesis and retinal blood flow. So, it is necessary to pay attention to the problems and potential risks of excessive usage of anti-VEGF therapies for ocular neovascular disease.
Objective To observe the expression of alpha;A-and alpha;B-in retina after blue-light exposure.Methods Forty female Wistar rats were divided randomly into 4 groups:control group,and blue-light exposure for 6,12,and 24 hours groups, with 10 rats in each group. The rats in the control group were not intervened.The other three groups of rats were exposed to blue fluorescent lights for 6,12,and 24 hours respcetively. Then the rats were kept in darkness for 12 hours. The globes were enucleated after anaesthesia.The immunohistochemistry and Western blot were performed to detect the expression of alpha;A and alpha;B-crystallin in retina.Results The absorbance value (A value) of retina alpha;A-crystallin was 1.40573plusmn;0.70748 in the control group, and were 4.317 51plusmn;0.412 97, 7.397 08plusmn;1.947 90, 9.634 32plusmn;2.377 61, respectively in the other 3 groups; the difference among the groups was significant (F=24.569，P＜0.001). The A value of retina alpha;B-crystallin is 0.129 36plusmn;0.033 93 in the control group, and were 0.507 17plusmn;0.117 55, 7.345 43plusmn;2.292 97, 4.042 26plusmn;3.890 23, respectively in the other 3 groups; the difference among the groups was significant（F=40.102，P＜0.001）. The results of Western blot showed that the expression of alpha;A and alpha;B crystallin in groups with bluelight exposure was obviously higher than that in the control group.Conclusions Blue light may up-regulate the expression of alpha;A-and alpha;B-crystallin in ratsprime; retina.
Objective To evaluate the effect of vitreoretinal surgery on tear film.Methods Ninety-seven patients (97 eyes) of retinal detachment undergoing surgical therapy including vitrectomy, scleral buckling or scleral encircling were included in this study. Uncomfortable eye symptoms were inquired and tear break-up time (BUT), Schirmer Ⅰ test (SⅠt), corneal fluorescein staining (CFS), tear meniscus height (TMH) were measured at three days before surgery and at six time-points after surgery (two, 14 days and one, two, three, six months). Thirty patients were randomly chosen to receive impression cytology of conjunctiva at three days before surgery and at four time-points after surgery (one, two, three, six months).Results Comparing with the preoperative results, at the first three time-points after surgery (two, 14 days, one month), uncomfortable symptoms (t=-25.082,-9.966, -4.718,P＜0.01) and CFS scores(t=-6.244,-3.716,-4.683, P＜0.01) increased, tear breakup time (BUT) shortened greatly (t=9.960, 5.627, 4.953; P＜0.01). SⅠt and TMH increased significantly（t=-25.931,-5.839;-25.345,-3.873;P＜0.01） at two and 14 days after surgery. The number of conjunctival goblet cell decreased significantly at one month after surgery（t=2.259, P＜0.05).All those tear film parameters returned to preoperative level at two months after surgery.Conclusion Vitreoretinal surgery influences tear film stability transiently, and the tear film function tends to restore in two months after the operation.
Objective To measure the changes of eye shape and axial length of the eyeball before and after removing the scleral encircling buckles.Methods This is a prospective and controlled study. Twenty eyes (20 patients) with rhegmatogenous retinal detachment and the fellow eyes were enrolled in this study. All patients underwent scleral encircling buckling, and the buckles were removed 2.0-3.5 years after the surgery. The eye shape and axial length of both eyes were measured by three-dimensional computed tomography (3D-CT) before and one,three,six months after the removing surgery. The axial length was also measured by intraocular lens (IOL) Master.Results 3D-CT showed that buckled eyeball depressed at the equator, resulting in a gourd-shaped eyeball. One month after removing the encircling buckle the depression disappeared. By 3D-CT scanning, the axial lengths of buckled eyes were (27.65plusmn;1.22), (27.3plusmn;1.56), (27.29plusmn;1.46) and (27.12plusmn;1.49) mm before and one, three, six months after the removing surgery respectively. The difference between before and after removing surgery was not statistically significant (t=2.89,P=0.723). By IOLMaster, the axial length of operated eyes were (28.32plusmn;1.94), (28.17plusmn;1.87), (28.21plusmn;1.94), (28.25plusmn;1.93） mm respectively. The difference between before and after removing the encircling band was not statistically significant (t=3.304, P=0.93). There was no significant difference in these two measuring modes (t=3.705,P=0.847).Conclusions Encircling buckling can cause eyeball indentation, removing the encircling band can rescue the indentation. There are no changes in the axial length before and after removing the encircling buckles.