Objective To investigate the correlation of ascorbic acid distribution and retinal susceptibility to iron toxicity of the retina.Methods Autoclaved iron particles of 5 mg and 15 mg were implanted into the vitreous cavities of 32 Spragu-Dawley (SD) rats and 9 rabbits, respectively. The retinal sections of rats and rabbits were examined after hemotoxylin-eosin (HE) staining. Apoptos is of rabbits′retinal neurons was investigated by TdT-mediated dUTP-biotin nick-end labeling (TUNEL). Chinoy′s method was used to observe the distribution of as corbic acid in the retinae of the 2 kinds of animals.Results In rats, histological and structural densification was observed only in the photoreceptor cells after implantation of the iron particles. In rabbits, however, histological and structural destruction as well as TUNEL-positive nuclei were observed in all neuronal layers of the retina 3 days after the implantation of the iron particles. Silver granules reduced by ascorbic acid from silver nitrate were observed only in the outer nuclear layer in normal rats retinae, while they were observed evenly throu ghout all layers of rabbits′retinae. Conclusions The suscept ibility of retina to iron toxicity is correlated to the distribution of ascorbic acid in retina. (Chin J Ocul Fundus Dis，2003，19：269-332)
Objective A short-term observation study of ocular surgery with or without systemic chemotherapy to treat retinoblastoma (RB). Method The clinical data of 66 RB cases treated at Beijing Tongren Hospital from August 2006 to September 2007 were retrospective reviewed.All patients received ultrasound (B scan/CDI), radiology examination (CT scan/MRI) and RetCam retina examination, and classified according to the International Intraocular Retinoblastoma Classification (IIRC) method. Focal therapies (include laser and cryotherapy) were applied to Group A, systemic chemotherapy (CCTV protocol, Cyclosporine, Carboplatin, Teneposide and Vincrinstine) plus ocular surgery (include focal therapy, enucleation and orbital exenteration) to Group B, C, D and E. Patients were followedup for more than 6 months. Result Of 66 cases (36 male/30 female), 16/66 cases were bilateral RB and 50/66 were unilateral. Follow up period was from 6 to 13 months (mean time 8.6 month). According to IIRC, there were 5 eyes in Group A, 6 eyes in Group B, 5 eyes in Group C, 15 eyes in Group D and 51 eyes in Group E( include extraocular disease). 22/82 eyes were conserved at the end of follow up, including 5/5(100%) of group A, 6/6(100%) of group B, 5/5(100%) of Group C, 4/15(26.7%) of Group D and 2/51(3.9%) of Group E. 5/66 (7.6%) patients died during this period, they all were in Group E. Conclusion Ocular surgery combined with systemic chemotherapy is an effective method to treat retinoblastoma. The consequences depends on the classification with higher conservative rate of eyeballs in early and middle stage (Group A, B, C), and lower rate in late stage (Group D and E).
ObjectiveTo evaluate the efficacy of intra-arterial chemotherapy (IAC) for advanced retinoblastoma (RB) after failure of intravenous chemotherapy (IVC). MethodsFifteen eyes of 13 patients with advanced RB were treated with IAC (1-5 cycles) after failure of IVC (2-8 cycles). The patients included 10 boys and 3 girls, with the mean age of (15.67±8.16) months. Six patients had bilateral RB and 7 patients had unilateral RB. There were 14 eyes (93.33%) in stage D, 1 eye (6.67%) in stage E according to the International Classification of intraocular retinoblastoma. The main reasons for failure of IVC were recurrent primary tumor in 3 eyes (20.00%), subretinal seeds recurrence in 9 eyes (60.00%), viable vitreous seeds in 2 eyes (13.33%) and poor response of primary tumor in 1 eye (6.67%). The mean interval between IVC completion and IAC start was 3 months. The mean follow-up was 19 months (ranged from 3 to 52 months). ResultsAfter IVC and secondary IAC, the retinoblastoma and seeds were regressed in 12 eyes (80.00%). Three eyes required enucleation for severe vitreous seeds, subretinal seeds recurrence and primary tumor recurrence. There was no evidence of metastasis in any case. ConclusionIAC can achieve high global salvage rate (80.00%) for patients with advanced retinoblastoma after failure of IVC.
Medical ethics must be considered for protecting the fights and interests of patients in clinical trials. Now the fights of the subjects are more and more emphasised, but there are some problems. It is evidence-based medicine (EBM) and emphasis of evidence that need the high-quality clinical trials, yet it violates the principle of ethics in some degree. It will be helpful for the administrators to supervise the clinical trials on drugs well from the point of ethical views.
To observe the pathologic changes of normal tissue in nude mice after peritoneal perfusion with hyperthermia, hyper-osmolar solution and mitomycin C (MMC). Fifty BALB/c nunu mices (7-10 weeks old) bearing HT-2 lines were chosen for the study, and were randomly divided into five groups: isotonic solution (control group), hyperosmolar solution (HOS group), HOS plus MMC group, hyperthermia (HT group) and HOS plus HT plus MMC group. After continuous hyperthermic peritoneal perfusion (42℃/30min) with 7.5% NaCl and 5μg/ml MMC, the liver, spleen, small intestine and kidney were examined by light microscopy. Results: ①In HOS and HOS plus MMC groups, no changes of liver, spleen and kidney were found. ②In HT and HOS plus HT plus MMC groups, slight degeneration of liver, hyperemia of spleen, swelling of kidney tubule cells and small intestine were found. ③In HOS plus HT plus MMC group, partial loss of small intestinal villi were also observed. Conclusioin: After continuous hyperthermic perfusion conbined with hyper-osmolar solutions and mitomycin C, a slight injury was showed in normal tissue of nude mice.
Objective To evaluate the rationality of drug treatment for cardiovascular diseases in aged people and the effects of evidence-based practice. Methods Descriptive study was conducted to compare the therapies for the patients suffering from cardiovascular diseases before and after evidence-based practice by investigating drug use during 1998-1999 (211 cases) and 2002-2003 (211 cases). Results Among antihypertensive drugs, the ACEIs and diuretics played a more important role than before. CCBs and ACEIs were still the most frequently used drugs, and drug combination was more common, comparing to that before evidence-based practice. Lipid lowering drugs and ACEIs were used more common in coronary heart disease. Quality of life of patients was more emphasized and combination use of anti-anxiety drugs was adopted. When treating heart failure, β-receptor blockers, aldadinc and ACEIs were more frequently used. Conclusions After evidence-based practice, drug use is much more based on evidence instead of experience and textbook. As a result, the rate of reaching ideal blood pressure is higher than before. The rate of rational drug use before and after evidence-based practice has increased from 42% to 78%, respectively.
Objective To observe the clinical effect of intravenous thrombolytic therapy for central retinal artery occlusion (CRAO) with poor effect after the treatment of arterial thrombolytic therapy. Methods Twenty-four CRAO patients (24 eyes) with poor effect after the treatment of arterial thrombolytic therapy were enrolled in this study. There were 11 males and 13 females. The age was ranged from 35 to 80 years, with the mean age of (56.7±15.6) years. There were 11 right eyes and 13 left eyes. The visual acuity was tested by standard visual acuity chart. The arm-retinal circulation time (A-Rct) and the filling time of retinal artery and its branches (FT) were detected by fluorescein fundus angiography (FFA). The visual acuity was ranged from light sensation to 0.5, with the average of 0.04±0.012. The A-Rct was ranged from 18.0 s to 35.0 s, with the mean of (29.7±5.8) s. The FT was ranged from 4.0 s to 16.0 s, with the mean of (12.9±2.3) s. All patients were treated with urokinase intravenous thrombolytic therapy. The dosage of urokinase was 3000 U/kg, 2 times/d, adding 250 ml of 0.9% sodium chloride intravenous drip, 2 times between 8 - 10 h, and continuous treatment of FFA after 5 days. Comparative analysis was performed on the visual acuity of the patients before and after treatment, and the changes of A-Rct and FT. Results After intravenous thrombolytic therapy, the A-Rct was ranged from 16.0 s to 34.0 s, with the mean of (22.4±5.5) s. Among 24 eyes, the A-Rct was 27.0 - 34.0 s in 4 eyes (16.67%), 18.0 - 26.0 s in 11 eyes (45.83%); 16.0 - 17.0 s in 9 eyes (37.50%). The FT was ranged from 2.4 s to 16.0 s, with the mean of (7.4±2.6) s. Compared with before intravenous thrombolytic therapy, the A-Rct was shortened by 7.3 s and the FT was shortened by 5.5 s with the significant differences (χ2=24.6, 24.9; P＜0.01). After intravenous thrombolytic therapy, the visual acuity was ranged from light sensation to 0.6, with the average of 0.08±0.011. There were 1 eye with vision of light perception (4.17%), 8 eyes with hand movement/20 cm (33.33%), 11 eyes with 0.02 - 0.05 (45.83%), 2 eyes with 0.1 - 0.2 (8.33%), 1 eye with 0.5 (4.17%) and 1 eye with 0.6 (4.17%). The visual acuity was improved in 19 eyes (79.17%). The difference of visual acuity before and after intravenous thrombolytic therapy was significant (χ2=7.99, P＜0.05). There was no local and systemic adverse effects during and after treatment. Conclusion Intravenous thrombolytic therapy for CRAO with poor effect after the treatment of arterial thrombolytic therapy can further improve the circulation of retinal artery and visual acuity.
ObjectiveTo investigate the effect of multidrug resistant (MDR) bacterial infection in clinical course of acute pancreatitis. MethodsThe medical records of 134 patients with a diagnosis of infected pancreatic necrosis in West China Hospital from Jan. 2003 to Jun. 2010 were reviewed. ResultsMDR microorganisms were found in 78 of the 134 patients. MDR group had higher rate of transferred patients than non-MDR group (38.5% vs. 10.7%, P=0.002). The intensive care unit admission rate was significantly higher in patients with MDR bacterial infections (48.7% vs. 26.8%, P=0.01). The mean intensive care unit stay was significantly longer in patients with MDR bacterial infections (20 days vs. 3 days, P<0.001). Mortality and total hospital stay was not significantly different in the patients with MDR infections vs. those without it (20.5% vs. 14.3%, P>0.05; 78 d vs. 55 d, P>0.05). ConclusionClinicians should be aware of the high incidence and impact of MDR infections in patients with acute necrotizing pancreatitis, especially in transferred patients.
Objective To investigate the effects of advanced glycation endproducts (AGEs) on proliferation of pericytes of bovine retinal capillary vessels and expression of transforming growth factor beta;(TGF-beta;). Methods The proliferation of pericytes detected by methyl thiazolyl tetrazolium (MTT) colorimetric assay, cellular cycle of pericytes was analyzed by flow cytometry was used to analyze cell, and TGF-beta; protein expression of pericytes was observed by immunofluorescent staining. Results AGEs inhibited the proliferation of pericytes of bovine retinal capillary vessels, stopped the cellular cycle of pericytes in synthesis phase (S phase), increased the number of apoptotic cells obviously (Plt;0.01), and promoted the expression of TGF-beta; proteinof perycytes. Conclusions AGEs may promote the apoptosis of pericytes by inhibiting the proliferation of pericytes to lead the decrease of pericytes number, and may accelerate diabetic retinopathy by promoting the expression of TGF-beta; protein of pericytes. (Chin J Ocul Fundus Dis, 2006, 22: 20-23)