AIM: To investigate the changes of intraocular pressure (IOP) and associated factors of IOP elevation after 4mg intravitreal injection of triamcinolone acetonide (IVTA) in treatment of macular edema.METHODS: The study is prospective, consecutive, and non-comparative interventional case series including 93 eyes with macular edema associated with retinal vein occlusion (n=54 eyes) or diabetic retinopathy (n=39 eyes), which received 4mg IVTA injection. The change in IOP was followed for all cases at pre-operation and 14 days, 1, 2, 3, 4, 5, and 6 months post-operation. Associated factors of IOP elevation were examined regarding baseline IOP, causal disease, age and gender.RESULTS: IOP increased significantly (P＜0.001) at 14 days 16.02± 2.45mmHg after injection and peaked at 18.80± 6.20 at 2 months post-injection (P＜0.001) from 14.85 ± 2.55 mmHg preoperatively. An IOP rise to the value higher than 21mmHg was observed in 2 (2.2%) eyes 14 days after injection and which was observed in 14 (15.1%), 18(19.5%),9(9.6%), 4(4.3%), 0, and 0 eyes respectively at 1, 2, 3, 4, 5,and 6 months after injection. One eye (0.01%) showed pressure elevation of over 5mmHg than baseline 14 days after injection and IOP peaked to 22 mmHg (23.7%) at 2 months after injection. Five (5.3%) eyes had an increase of 10mmHg at 1 month and IOP peaked to 12mmHg (12.9%) at 2 months after injection. The rise in IOP was statistically associated with younger age (correlation coefficient -0.18- -0.29, P ＜0.05), high baseline IOP (correlation coefficient 0.52-0.79, all P ＜0.001),and the presence of diabetes mellitus (correlation coefficient 023, P＜0.001) but independent of gender (correlation coefficient -0.002-0.04, all P ＞0.05). In all eyes, IOP could be lowered to the normal range with topical medication, without development of glaucomatous optic nerve head changes.CONCLUSION: Elevated IOP after 4mg IVTA injection is common and patients should be monitored beyond 6 months post-injection. In all the cases, IOP can be normalized by topical medication. Patients with high baseline IOP, diabetic retinopathy, and younger age should be carefully monitored for an elevated IOP.

OBJECTIVE To study the isolation and resistance tendency of Acinetobacter calcoaceticus-baumannii to antimicrobial agents from 1998 to 2004 to provide valuable data for infection prevention and therapy. METHODS We reviewed the isolation rates,distribution in clinical specimens and wards,and the resistance rates of(A.calcoaceticus-baumannii)to 14 kinds of antimicrobial agents from 1998 to 2004. RESULTS There was an increasing tendency of isolation rates of A.calcoaceticus-baumannii every year,which was 0.18% in 1998 but 1.48% in 2004.In the seven years,there was the highest isolation rate of 70.58% in specimens from respiratory tract,the next was from the urine(9.42%),and blood(4.63%).Concerning the wards distribution,ICU had the highest rate of 47.28%.In 1998,A.calcoaceticus-baumannii had resistance rates more than 50% only to one kind of antimicrobial agents(aztreonam),but in 2004,it had increased to thirteen kinds(except cefoperazone/sulbactam).About the fourteen kinds of antimicrobial agents we inspected,that were increased in their resistance rate.The highest increasing of resistance rate was ceftazidime from 11.1% in 1998 to 88.9% in 2004,the imipenem was second for 0.0% to 64.8%,and the third was sulfamethoxazole/trimethoprim form 0.0% to 64.0%,while there still was an increasing resistance tendency to them. CONCLUSIONS The clinical isolation rate of A.calcoaceticus-baumannii is increasing,and it has higher resistance rates to many antimicrobial agents as well as an increasing resistance tendency to relatively susceptive antimicrobial agents every year.So physicians should prescribe on the basis of antimicrobial agents susceptibility tests in vitro.

OBJECTIVETo explore the clinical effect of low dose pituitrin in children with septic shock.

METHODSA total of 48 pediatric cases with septic shock, in whom 6 hours, conventional treatment could not reverse shock from January 2008 to December 2010, were selected for this study. The patients were divided into two groups randomly (completely random design) (control group 24, remedial group 24). The conventional treatment included antibiotics/fluid resuscitation/correcting acid-base imbalance, glucocorticoid, organ (heart/lung) support, dopamine 1 - 15 µg/(kg·min) and norepinephrine 0.5 - 2 µg/(kg·min) pumped in continuously in the control group. In initial 6 hours the same treatment was given to the remedial group, while low dose pituitrin (0.01 - 0.03 U/min) was pumped additionally during the rest of time. The therapeutic effect on correcting shock was evaluated in both groups.

RESULTSThe total effective rate was 76.2% in the remedial group and 40.0% in the control group; the mortality was 33.3% and 60% respectively. The difference between both groups was significant (P = 0.025).

CONCLUSIONLow dose pituitrin could improve the clinical effect significantly in children with septic shock in whom 6 hours conventional treatment failed to correct shock, shorten the total periods of treatment, and decrease mortality.

Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Norepinephrine ; therapeutic use ; Pituitary Hormones, Posterior ; administration & dosage ; therapeutic use ; Shock, Septic ; drug therapy ; Treatment Outcome ; Vasoconstrictor Agents ; therapeutic use

This study aimed to explore the mechanism of a novel mutation (p.Lys38Glu) in apolipoprotein H (APOH) gene causing hereditary beta2-glycoprotein Ⅰ (β2GPI) deficiency and thrombosis in a proband with thrombophilia.The plasma level of β2GPI was measured by ELISA and Western blotting,and anti-β2GPI antibody by ELISA.Lupus anticoagulant (LA) was assayed using the dilute Russell viper venom time.Deficiency of the major natural anticoagulants including protein C (PC),protein S (PS),antithrombin (AT) and thrombomodulin (TM) was excluded from the proband.A mutation analysis was performed by amplification and sequencing of the APOH gene.Wild type and mutant (c.112A＞G) APOH expression plasmids were constructed and transfected into HEK293T cells.The results showed that the thrombin generation capacity of the proband was higher than that of the other family members.Missense mutation p.Lys38Glu in APOH gene and LA coexisted in the proband.The mutation led to β2GPI deficiency and thrombosis by impairing the protein production and inhibiting the platelet aggregation.It was concluded that the recurrent thrombosis of the proband is associated with the coexistence ofp.Lys38Glu mutation in APOH gene and LA in plasma.

Aim To observe the effect of interventional therapy of 5-fluorouracil(5-Fu), mitomycin C (MMC) and adriamycin (ADM) on solid malignant turmors in association with aterial infusion of NaHCO3.Methods Patients were randomly divided into two groups.With Seldinger technique,through the femoral atery to tumor atery.The patients in the control group were infused by anticarcinoma agents simply ,and patients in the treatment group were initially infused by NaHCO3,and then by NS 30 ml and anticarcinoma agents seperately. Results Partial remission (PR) in the group treated with NaHCO3 and anticarcinoma agents was significantly higher than in the group treated simply with anticarcinoma agents.Conclusion Aterial infusion of NaHCO3 into malignant tumors can increase the efficacy of ADM,MMC and 5-Fu.

OBJECTIVETo compare the clinical efficacy of SS syrup, a Chinese medicine, and pilocarpine in treating patients with xerostomia.

METHODSThirty-eight patients conformed to the inclusive criteria were randomly divided into two groups, they were treated by SS syrup (SS group) and pilocarpine (control group) respectively. Three indexes, i.e. questionnaire of dryness in mouth, total static salivary flow and dynamic salivary flow, before treatment, 1, 2 and 4 weeks after treatment were recorded and statistically analyzed.

RESULTSSignificant difference was shown in the 3 indexes in the SS group between before treatment and 1, 2 and 4 weeks after treatment (P < 0.05), while in the control group significant difference was shown between before treatment and 1, 2, and 4 weeks after treatment except for total dynamic salivary flow after I weck treatment (P < 0.05).

CONCLUSIONSS syrup, which has no adverse reaction, no contraindication, could be taken chronically, and shows good efficacy in improving the symptoms of xerostomia.

Adult ; Aged ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Xerostomia ; drug therapy

BACKGROUNDGlaucoma is mainly characterized by the loss of retinal ganglion cells. Ciliary neurotrophic factor (CNTF) is believed to stimulate the regeneration of axons of retinal ganglion cells. The objective of our study was to detect the expression of CNTF in the retina of a rat glaucoma model with increased intraocular pressure (IOP).

METHODSThe rat glaucoma model was set up by electrocoagulating at least three episcleral and limbal veins. The location and the expression level of CNTF were detected at 1, 3, 7, 14, and 28 days post-surgery by immunohistochemistry, semiquantitative reverse-transcription polymerase chain reaction (RT-PCR), and Western blot analysis.

RESULTSThe rat glaucoma model with chronic, moderately elevated IOP was successfully produced. A minimum expression of CNTF was found in the ganglion cell layer of the retinas of the control group, and temporally increased expression and intensity of CNTF were found in the experimental retinas.

CONCLUSIONThe expression of endogenous CNTF in the rat retina was found altered after the induction of ocular hypertension.

Animals ; Ciliary Neurotrophic Factor ; analysis ; genetics ; Densitometry ; Immunoblotting ; Immunohistochemistry ; Male ; Ocular Hypertension ; metabolism ; pathology ; Rats ; Rats, Sprague-Dawley ; Retina ; metabolism ; ultrastructure ; Reverse Transcriptase Polymerase Chain Reaction

The ubiquitin-proteasome pathway is the principal mechanism for the degradation of short-lived proteins in eukaryotic cells. Recently, proteasome inhibitors have been shown to induce apoptosis in many kinds of human malignant cells. In this study, the mechanism of apoptosis induced by proteasome inhibitor in leukemic cells was examined. Evaluated by MTT assay, treatment of leukemic cells with Z-LLL-CHO, a reversible proteasome inhibitor, induced cell death in a dose-dependent manner. Appearance of the sub G(0)/G(1) fraction of cell cycle observed in flow cytometry assay suggested the induction of apoptosis, which was further proved by typical DNA ladder and morphological study. Western blot displayed the cleavage of bcl-2 into a shortened 22 kD fragment and the decrease in the levels of caspase-3 precursor. A highly sensitive colorimetric assay was employed and the elevation of caspase-3 activity was detected in both cell lines after treatment with Z-LLL-CHO. By comparison, these results showed that the leukemic cell line M-07e and KG-1a, which both express bcl-2 at a relative high level, had different susceptibility to undergo apoptosis induced by Z-LLL-CHO, which possibly due to their different levels of expression and activation of caspase-3 precursor, as well as their different degree of bcl-2 cleavage after treated by Z-LLL-CHO.

OBJECTIVETo investigate over-expression of wild-type alpha-synuclein inducing the aberrant aggregation of alpha-synuclein in HEK293 cell in vitro.

METHODSThe cDNA encoding the human alpha-synuclein without the stop code was cloned into PGEM T-easy vector. Using enzyme map and DNA sequencing analyzed and determined the recombinant plasmid, and then sub-clone the alpha-synuclein cDNA fragment into pEGFP-N1 vector. The recombinant plasmids alpha-synuclein-pEGFP were transfected into HEK293 cells by lipofectamin 2000. The aberrant aggregation of alpha-synuclein was measured by EGFP fluorescence, anti-alpha-synuclein immunocytochemistry. The inclusions in the cultured cells were identified with HE staining.

RESULTSThe restriction enzyme map suggested that eukaryotic expression vector for human wild-type alpha-synuclein gene was constructed successfully. By EGFP fluorescence, anti-alpha-synuclein immunocytochemistry, it could be observed that the alpha-synuclein protein could aggregate in cytoplasm and the Lewy body-like inclusions found in cytoplasm of cultured cells.

CONCLUSIONThe over-expression of wild-type alpha-synuclein can induce protein aberrant aggregation and Lewy body-like inclusions formation in cytoplasm of HEK293 cell in vitro.

Cells, Cultured ; Gene Expression ; Humans ; Immunohistochemistry ; Inclusion Bodies ; metabolism ; Lewy Bodies ; metabolism ; Parkinson Disease ; genetics ; metabolism ; alpha-Synuclein ; genetics ; metabolism

OBJECTIVEEvidence suggests that type 2 diabetes (T2DM) is associated with an increased risk of dementia and that glucose variability is an independent risk factor for diabetic complications. This study investigated the relationship between glucose excursion and cognitive function in aged T2DM patients.

METHODSA total of 248 aged T2DM patients wore a continuous glucose monitoring system (CGMS) for 3 days in order to evaluate glucose excursion, including mean amplitude of glycemic excursions (MAGE) and mean of daily difference (MODD). All subjects were evaluated with a number of accepted cognitive function tests, including the mini-mental status examination (MMSE). The relationship between MAGE and MODD and performance on these cognitive tests was assessed.

RESULTSThe MAGE and MMSE score were negatively correlated, likewise with the correlation between MODD and MMSE. Liner multivariate regression analysis showed that MAGE and MODD were also negatively related to MMSE independent of age, sex, glycemic control, hypertension, smoking, or coronary heart disease history.

CONCLUSIONGlucose excursion is related to cognitive function in aged T2DM patients. Elevated glucose excursion decreased the MMSE score, which reflects general cognitive function. Thus, therapy aimed at controlling glucose excursion may be beneficial for maintaining cognitive function in aged T2DM patients.

Aged ; Aged, 80 and over ; Blood Glucose ; metabolism ; Cognition ; Diabetes Mellitus, Type 2 ; blood ; psychology ; Female ; Humans ; Linear Models ; Male ; Multivariate Analysis