1.Related factors of postvitrectomy vitreous hemorrhage in proliferative diabetic retinopathy
Yenan, WANG ; Hai, LU ; Dachuan, LIU
Chinese Journal of Experimental Ophthalmology 2013;32(11):1021-1024
Background Vitrectomy is an effective method to proliferative diabetic retinopathy (PDR) in type 2 diabetic patients.Postoperative vitreous hemorrhage is a major cause of vision loss.Objective This study was to analyze the related factors of vitreous hemorrhage after vitrectomy in proliferative retinopathy with type 2 diabetes.Methods Three hundred and five eyes of 305 cases who received vitrectomy for PDR from type 2 diabetes were retrospectively investigated.The clinical data of 14 eyes with vitreous hemorrhage after vitrectomy were analyzed.Results Vitreous hemorrhage after vitrectomy occurred in 14 eyes with the incidence 4.6%.The PDR was grade ⅣV in 3 eyes,grade Ⅴ in 4 eyes and grade Ⅵ in 7 eyes.Pars plana vitrectomy with intraocular laser photocoagulation was performed on all the 14 eyes,and 1 eye accepted scleral condensation and 8 eyes accepted silicone oil tamponade.Visual acuity was improved in 6 eyes,unchanged in 4 eyes and worsen in 4 eyes after initial surgery.Vitreous hemorrhage appeared in postoperative 1-7 days in 9 eyes,8 days-3 months in 1 eye,3-6 months in 2 eyes and over 6 months in 2 eyes.The cause for postoperative vitreous hemorrhage included residual neovascular membrane,insufficient photocoagulation range and intensity,neovascularization and instable blood glucose level.Vitreous hemorrhage disappeared in 5 eyes after medicine therapy,and reoperation in 9 eyes.In the end of the follow up,visual acuity improved in 9 eyes,unchanged in 2 eyes and worsen in 3 eyes.Retinas reattached in 13 eyes.However,the retina was still detached in 1 eye with silicone oil tamponade.Conclusions Postoperative vitreous hemorrhage usually occurs within 1 week.The main related factors are residual retinal neovascular membrane,inadequate intraocular laser photocoagulation and unstable blood glucose level.Medicine therapy is effective for postoperative vitreous hemorrhage in type 2 diabetic patients,but re-vitrectomy is needed for excessive vitreous bleeding.
2.Clinical Study of Sanqi Granules in Treating Chronic Glomerulonephritis
Lixin WANG ; Youqing CAI ; Yenan MO ; Qiong SU ; Xusheng LIU ; Nizhi YANG
Journal of Guangzhou University of Traditional Chinese Medicine 2017;34(3):321-325
Objective To evaluate the efficacy and safety of Sanqi Granules (SG) for the treatment of chronic glomerulonephritis(CGN).Methods A prospective randomized controlled trial was carried out in 60 CGN patients with qi deficiency and blood stasis syndrome.The included patients were assigned into SG group,losartan group,and SG plus losartan group,20 cases in each group.The course of intervention was 24 weeks.Before and after treatment,24-hour urine protein quantity,serum creatinine (SCr),estimated glomerular filtration rate (eGFR) and the scores of traditional Chinese medical syndromes were observed.The clinical efficacy of Chinese medicine and western medicine,and the safety was evaluated after treatment.Results (1) After treatment for 12 and 24 weeks,the scores of traditional Chinese medical syndromes in the three groups were markedly improved (P < 0.05),and the improvement in SG group and SG plus losartan group was superior to that in losartan group (P < 0.05).(2) After treatment for 24 weeks,24-hour urine protein quantity in losartan group was significantly decreased (P <0.05),while SG group and SG plus losartan group only showed a decreasing trend(P > 0.05).(3) After treatment for 24 weeks,renal function indexes of SCr and eGFR in SG group and SG plus losartan group were improved to some degrees,and the difference of eGFR in SG group was significant (P < 0.05 compared with that before treatment),while the renal function injury in losartan group showed a deteriorative trend.SG group and SG plus losartan group had better effect on improving SCr and eGFR than losartan group (P < 0.05).(4) After treatment for 24 weeks,the total effective rate of Chinese medicine in losartan group,SG group,SG plus losartan group was 50.00%,90.00%,84.21%,and the total effective rate of western medicine was 88.89%,75.00%,63.16%,respectively.SG group and SG plus losartan group had better clinical efficacy of Chinese medicine than losartan group (P < 0.05),while the difference of clinical efficacy of western medicine among the three groups was insignificant (P > 0.05).(5) During the follow-up,no severe adverse events were shown in the three groups.Conclusion SG exert certain therapeutic effect on improving the scores of traditional Chinese medical syndromes and protecting renal function,while have no obvious effect on decreasing urine protein.
3.The role of BCR/ABL isoforms in the presentations and outcome of Philadelphia-positive acute lymphoblastic leukemia in adult patients
Yenan LI ; Dehui ZOU ; Min GU ; Yingchang MI ; Jianxiang WANG ; Lugui QIU
Chinese Journal of Internal Medicine 2009;(6):481-484
Objective To investigate the difference of clinical characteristics and outcomes between different isoforms of BCR/ABL in adults with Philadelphia-positive acute lymphoblastic leukemia (ALL).Methods The data of 106 adults with Ph+ALL diagnosed in our hospital from January 1, 1996 to December 31, 2007 were reviewed. The difference of clinical characteristics between different subgroups of BCR/ABL was compared and their relation with outcomes was studied. Results The median age of the 106 patients was 34 years and the median white blood cell count at baseline was 28. 5 × 109/L. Comparative analysis demonstrated that patients in p210 group had an older age, higher blood platelet count (BPC) and more frequent occurrence of splenomegaly. Referring to the outcomes, the complete remission (CR) rate of the two groups were 92. 2% and 93.9%, respectively. The median overall survival (OS) and relapse free survival (RFS) in p190 group were 13 months and 10 months, the 1,3-year estimated OS were (54. 7±6. 7)% and (5.5±5.2)%, and the 1,3-year estimated RFS were (40. 2±6. 8)% and (7. 8±6. 7)%,while in p210 group, the median OS and RFS were 15 months and 10 months, respectively, the 1,3-year estimated OS were (65.8±8. 9)% and (14. 5±7.4)%, and the 1,3-year estimated RFS were (48. 3±9. 4)% and (12. 9±7. 7)%. All of the above data had no statistic significance between the two groups.Conclusion Majority of the adults with Ph+ALL is p190 positive and patients with p210 have older age, higher BPC and more frequent occurrence of splenomegaly, while there is no significant difference between p190 group and p210 group in CR rate, RFS and OS.
4.Clinical etiological analysis of severe vitreous hemorrhage in venerable age patients
Yenan WANG ; Yuntao HU ; Zhizhong MA ; Changguan WANG ; Hongliang DOU ; Xuefeng FENG ; Yimin XU ; Xizhe WANG
Chinese Journal of Experimental Ophthalmology 2018;36(10):780-784
Objective To analyze the etiologies of severe vitreous hemorrhage in venerable age patients.Methods A retrospective series case study was adopted.Medical records of 30 cases 30 eyes severe vitreous hemorrhage venerable age patients were analyzed in Xuanwu Hospital Capital Medical University,Peking University Third Hospital and Beijing Tsinghua Chang Gung Hospital from July in 1999 to June in 2015.Visual acuity,intraocular pressure,anterior segment slit lamp microscopy,mydriasis funduscopy and ophthalmic B type ultrasound examination were used to evaluate 30 cases 30 eyes.Thirty eyes were all treated with pars plans vitrectomy (PPV).Results Mydriasis funduscopy examination showed that vitreous hemorrhage was so dense in 30 eyes that the fundus cannot be observed.The initial visual acuity examination showed that 8 eyes were count finger,5 eyes were hand move,16 eyes were light perception,and 1 eye was no light perception.There were dense light spots or clusters of high echoes in vitreous cavities,complete/incomplete posterior vitreous detachment (PVD) of all eyes;retinal detachment with different degrees in 5 eyes;proliferating cord adhesion to the wall of eyeball in 3 eyes.The etiologies included retinal vein occlusion (RVO) in 10 eyes (33.33%),retinal tear or retinal detachment in 7 eyes (23.33%),polypoidal choroidal vasculopathy (PCV) in 7 eyes (23.33%),proliferative diabetic retinopathy (PDR) in 4 eyes (13.33%).The above 4 etiologies were in 28 eyes,accounting for 93.33%.The others were ocular trauma in 2 eyes (6.67%).Conclusions The main cause to severe vitreous hemorrhage venerable age patients is RVO,followed by retinal tear or retinal detachment,PCV and PDR.Ocular trauma is rare.Vitrectomy is a diagnostic treatment,which can remove vitreous hemorrhage,improve the visual acuity of the patients,and determine the etiologies of the vitreous hemorrhage.