AIM: To observe the clinical efficiency of intravitreal conbercept on diabetic macular edema(DME).METHODS: This was a single arm, open-babel prospective study.Twenty eyes from 20 patients (12 males and 8 females) with DME diagnosed by fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) were enrolled.Before the injection, best-corrected visual acuity (BCVA) of early treatment of diabetic retinopathy study (ETDRS), non-contact tonometer, ophthalmoscope, fundus photography, fundus fluoresein angiograph (FFA), and OCT were examined.All affected eyes were treated with intravitreal conbercept 0.05mL (10mg/mL).Patients were followed up for 6 to 11mo, with a mean duration of 8.55±1.96mo.Post-treatment BCVA, CMT, leakage of macular edema and complications were compared with baseline using repeat analysis.RESULTS: The initial average visual acuity (ETDRS letters) were 43.35±17.45, range from 9 to 70.The initial average central macular thickness (CMT) was 576.30±167.92μm, range from 337 to 987μm.The mean BCVA showed significant improvement during 1, 3, 6mo post-treatment and the latest follow up, with a mean increase of 11.2±5.9, 13.8±7.9, 15.7±6.8 and 14.7±8.6, respectively (P<0.01).The changes of BCVA between before and at 1mo after treatment were different compared with the changes between before and at 6mo (P<0.01).During the latest follow up, the mean BCVA was obviously improved in 10 eyes (50%), improved in 7 eyes (35%), stable in 3 eyes (15%).Likewise, the mean CMT significantly decreased during the follow-up period with a mean CMT reduction of 183.8±159.5, 292.9±169.0, 271.4±167.2 and 286.4±166.9μm respectively (P<0.001).The CMT at 1mo were different with that 3, 6mo and final follow-up (P<0.01).During the latest follow up, macula lutea leakage disappeared in 6 eyes (30%), decreased in 12 eyes (60%) and increased in 2 eyes (10%).No adverse events such as secondary retinal detachment or endophthalmitis were found during the follow-up.CONCLUSION: Intravitreal conbercept significantly improve visual acuity and macular edema exudation.

Objective:To describe the prevalence of depression of internal and Chinese traditional medicine outpatient departments in different levels of general hospitals in Shenyang.Methods:Stratified multi-stage cluster randomization was used to identify 23 general hospitals for investigation, a total 7448 outpatients above 15 years of age in internal and Chinese traditional medicine outpatient departments have been investigated.Investigator used expanded version of General Health Questionnaire (GHQ-12) as a screen instrument to identify subgroups of the sample at high, moderate and low risk, then psychiatrists determined their diagnosis by using structured clinical interview for DSM-IV Axis I Disorders-Patient Edition(SCID-I/P) for 100% of high-risk and 40% of moderate-risk and 10% of low-risk subjects.Results:At the internal department, the overall current rate of any depressive disorders was 11.01%(95%CI: 10.05%-12.06%), and at the Chinese tradition medicine department, the overall current rate of any depression was higher (16.22%, 95%CI: 13.23%-19.87%).Conclusion:The prevalence of depression of outpatients in the Chinese tradition medicine departments of general hospitals was higher than that of outpatients in the internal medicine department.We should pay attention to depressive disorder in Chinese tradition medicine department than internal medicine department.

Objective To explore the relationship of serum parathyriod hormone ( PTH) level with renal ane-mia in patients with chronic kidney disease (CKD).Methods Serum levels of PTH,Hb,Hct,BUN,Cr were observed in 126 patients with CKD at stages 3-5,the changes of 42 patients in maintenance hemodialysis(MHD) with recombi-nant human erythropoietin (rhEPO) and calcitriol-1.25(OH)2D3 treatment for three months were determined. Results The serum PTH level was significantly increased in CKD patients at stage 3 and more in CKD patients at stage 4 and 5.There were positive relationship between blood PTH and BUN ,Cr(P<0.01),but a negative relation-ship between PTH and Ccr,Hb(P <0.01).42 patients of MHD treated with rhEPO,1.25(OH)2D3 after three months,according to the changes of HCT ,the effective rate was 73.8% and the ineffective rate was 26.2%.The PTH,Hb,HCT of the effective group had statistically significant differences compared with the ineffective group ( all P<0.01).Hb and Hct significantly increased and PTH significantly decreased in the effective group .Conclusion CKD patients had decreased renal function ,elevated blood PTH .High serum PTH might aggravate renal anemia and fail to respond to rhEPO.The high serum PTH corrected by using 1.25(OH)2D3 might improve renal anemia,with high plasma PTH correcting .

ObjectiveTo explore the feasibility and efficacy of hyperbaric oxygen (HBO) therapy combined with mild hypothermi on severe craniocerebral injury (SCI).MethodsAll 80 SCI patients were randomly divided into therapeutic group (52 cases) and control group (28 cases). All patients received general synthesis treatment; while the hyperbaric oxygen combined with mild hypothermia treatment was added to the therapeutic group. Changes of Vm, Vs and PI of middle cerebral artery (MCA) in systolic stage were detected by transcranial-Doppler (TCD) before and after treatment. The plasma level of endothelin (ET) was also tested and prognosis of patients was analyzed.ResultsVm, Vs and PI of MCA in systolic stage improved obviously and ET reduced greatly in therapeutic group compared with those in the control group (P<0.01), and prognosis was also superior to control group.ConclusionHyperbaric oxygen combined with mild hypothermia can improve the consciousness state and prognosis of SCI patients as a result of the relaxation of the cerebral vascular spasm and the reduction of ET, which may contribute to the abatement of the cerebral ischemia and hypoxia.

Key trial activities include: development of the trial protocol;development of standard operating procedures;development of support systems and tools;generation and approval of trial information documents;selection of trial sites and the selection of properly qualified,trained,and experienced investigators and study personnel;ethics committee review and approval of the protocol;review and approval by applicable regulatory authorities;enrollment of subjects into the study: recruitment,eligibility,and informed consent;the investigational product(s): quality,handling,and accounting;trial data acquisition: conducting the trial;trial data acquisition: conducting the trial; safety management and reporting;monitoring the trial;managing trial data;quality assurance of the trial performance and data;reporting the trial.

BackgroundDry eye is a multi-factorial-induced tear film and ocular surface disorder.Immunoinflammation plays a key role in the pathogenesis of dry eye.As inhibitor of the cyclo-oxygenase pathway,nonsteroidal anti-inflammatory drugs play an anti-inflammatory and anti-hypersensitivity role,and it can be a potential treatment for dry eyes.ObjectiveThis study was to investigate the effectiveness of nonsteroidal anti-inflammatory drugs (0.1％topical pranoprofen) on moderate to severe dry eyes and its mechanism.MethodsThis was a small sample of randomized controlled clinical trial.Thirty right eyes of 30 patients with moderate to severe dry eyes were included in the study according to the diagnosis criteria and randomized into two groups.The patients of the trial group received topical administration of 0.1％ pranoprofen plus 0.1％ sodium hyaluronate,and those of the control group received the topical 0.1％ sodium hyaluronate only.Ocular surface inflammation index scores (OSDI) and ocular surface fluorescine staining (OSS) scores were measured under the slit lamp,and tear film break-up time (BUT),Schirmer Ⅰ test values were evaluated.The expression of human leucocyte antigen-DR (HLA-DR) and CD11b in conjunctiva epithelial cells were detected by impression cytology and flow cytometry (FCM).All the indexes were compared between the two groups before and after treatment.Informed consent was obtained from all patients.ResultsThere were no significant differences in terms of age and gender and their baseline values between the trial group and control group (t=0.412,P=0.684;x2=0.240,P=0.624),and so were all the indexes (P＞0.05).Compared with the control group,the OSDI,OSS scores and cells positive for HLA-DR were lowered but the BUT was delayed in the trial group on day 15 ( t=2.43,P=0.03;t=2.83,P=0.01;t=3.29,P=0.00;t=3.23,P=0.00 ).No significant differences were found in the Schirmer Ⅰ test value and CD11b expression between these two groups (t=0.17,P=0.87;t=0.28,P=0.79).The OSDI,OSS scores and BUT were significantly improved,and the number of cells positive for HLA-DR were reduced 15 days after administration of drugs in comparison with before treatment in the trial group ( t =12.30,10.70,6.10,7.92,P =0.00 ).However,there were no comparable alteration seen in these indexes before and after the usage of drugs in the control group ( P＞0.05).Positive correlations were found in HLADR expression with OSDI and OSS ( r =0.601,P =0.018 ; r =0.586,P =0.022 ) and a negative correlation in HLADR expression with BUT (r=-0.697,P=0.004) on day 15 in the trial group.ConclusionsTopical usage of 0.1％ pranoprofen is beneficial for remitting the ocular signs and symptoms in moderate to severe dry eyes.This study illustrates that topical usage of 0.1％ pranoprofen can down-regulate the expression of inflammatory markers in conjunctival epithelial cells.

Antineoplastic Agents ; administration & dosage ; therapeutic use ; Child ; Female ; Humans ; Injections, Intralesional ; Interferon-alpha ; administration & dosage ; therapeutic use ; Male ; Neoplasms ; drug therapy ; Recombinant Proteins ; Treatment Outcome

[Summary] An analysis of clinical data was performed in 6 patients diagnosed as adefovir dipivoxil (ADV)-induced nephropathy in recent 14 months.The results showed that all of six patients suffered from pain over multiple joints after taking ADV 10-20 mg/d for 2-3 years,along with hypophosphatemia,hypouricemia,and raised osteogenesis index.One case had increased serum creatinine,5 cases had hypokalemia,renal glycosuria,and4 cases had albuminuria.Imageological examination showed osteoporosis,osteomalacia,and pseudo fracture.After discontinuance of ADV treatment,joint pain was obviously relieved within 3-6 weeks,blood uric acid level returned to normal within 1-2.5 months,and renal glycosuria and albuminuria disappeared by 1-2 months.The results suggest that after taking ADV for more than two years,attention should be paid to the nephropathy induced by ADV and regular monitoring of renal function,blood electrolyte,and urine should be mandatory.Hypouricemia is a reliable index of diagnosis and treatment in this event.

Aged ; Female ; Humans ; Leiomyosarcoma ; Thyroid Neoplasms

Objective To investigate the relationship between adiponectin and the first-phase of pancreatic P-cell insulin secretion in subjects with different statuses of glucose tolerance. Methods Thirty-seven patients with newly diagnosed type 2 diabetes mellitus (DM) , 30 patients with abnormal glucose tolerance (IGR) , and 40 normal control subjects (NGT) underwent intravenous glucose tolerance test (IVGTT). Fasting adiponectin and proinsulin (PI) was assayed by EL1SA. Fasting free fatty acid ( FFA) was measured by colorimetry. Insulin area under the curve ( AUC ) , incremental AUC (iAUC) from 0 min to 10 min, AIR3-5, homeostasis model assessment for insnlin resistance (HOMA-IR) , and for β cell function ( HOMA-p) were calculated. The relationship between adiponectin and AUC, iAUC, AIR3-5, proinsulin, FFA, and HOMA-IR was explored. Results (1) The levels of AUC, iAUC, AIR3-5, and adiponectin in DM group and IGR group were significantly lower than those in NGT group (P<0.05), reduced in DM group than those in IGR group(P<0.05). (2) The levels of PI in DM group and IGR group were significantly higher than that in NGT (P<0.05). (3) Adiponectin was positively correlated with HOMA-p,AUC,iAUC,AIR3-5, and HDL-C,while negatively correlated with proinsulin, HOMA-IR, and LDL-C. (4) Proinsulin was positively correlated with HOMA-IR. (5 ) Multiple regression stepwise analysis showed that adiponectin was independently associated with AUC. Conclusions Adiponectin was an independent factor affecting the first phase of pancreatic p-cell insulin secretion. Low adiponectin level could predict the dysfunction of the first phase pancreatic p-cell secretion as well as insulin resistance in patients with type 2 diabetes.