AIM: To evaluate the safety and efficacy of Ahmed glaucoma valve implantation for refractory glaucoma after sequential failed trabeculectomy.
METHODS: Thirty - six patients (36 eyes) with prior failed sequential trabeculectomy who underwent Ahmed glaucoma valve implantation were included. The intraocular pressure ( IOP), best corrected visual acuity (BCVA) and complications were ovserved and all the patients were followed up at least for 12mo.
RESULTS: Mean preoperative IOP was 35. 20±7. 28mmHg and reduced to 10. 15±3. 34, 11. 23±3. 56, 15. 63±5. 72, 17. 17±5. 47, 17. 73±6. 23,19. 76±5. 43mmHg at 1, 2wk, 1, 3, 6 and 12mo after surgery, which was significant different from the preoperative level (t = 12. 643, 11. 837, 10. 324, 8. 839, 8. 462, 8. 046, all P < 0. 05 ). Visual acuity was not significantly different between pre - operation and 12mo post- operation ( Z = - 0. 420, P > 0. 05). At 12mo after operation, the complete success rate reached 78% and the conditional success rate reached 92%. There were 5 eyes complicated with shallow anterior chamber, 3 eye complicated with anterior chamber hemorrhage, which all recovered after additional treatments. Late complications included valve exposure and encapsulated cystic blebs around the plate. Severe corneal endothelium loss occurred in 1 patient.
CONCLUSION: Ahmed glaucoma valve implantation is effective in reducing IOP at 1-year follow-up in refractory glaucoma patients with prior sequential failed trabeculectomy, but we should fully understand and attach great importance to all kinds of complications that may occur.

Aged ; Aged, 80 and over ; Coronary Artery Disease ; complications ; therapy ; Coronary Stenosis ; complications ; therapy ; Female ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention

Taking application of some isolation and purification technologies, such as solvent extraction, preliminary solvent isolation, column chromatographies over silica gel and Sephadex LH-20 gel and preparative HPLC, 10 compounds were obtained from Gynura nepalensis cultivated in the suburban area of Beijing. Their structures were identified by spectroscopic methods and comparison with literature as (3R) -3-hydroxy-β-ionone (1), (3S,5R, 6S, 7E) -5, 6-epoxy-3-hydroxy-7-megastigmen-9-one (2), (+) -boscialin (3), 3, 6-trans-3-hydroxy-α-ionone (4), 3, 6-cis-3-hydroxy-α-ionone (5), 3, 4-cis-3, 4-dihydroxy-β-ionone (6), ethyl caffeate (7), loliolide (8), 1H-indole-3-carbaldehyde (9), and 3-(hydroxyacetyl)indole (10), respectively. All compounds were isolated from the title plant for the first time, and with compounds 1, 2, 4-7, 9 and 10 being isolated from Gynura species for the first time. Structurally, the above compounds 1-6 belong to C13 nor-sesquiterpenoids, sharing the same carbon skeleton of megastigmane. According to this study, they are one of major kinds of chemical constituents of Gynura nepalensis and have important reference value for the investigation on phytotaxonomy of this species.
Asteraceae ; chemistry ; Caffeic Acids ; chemistry ; Cyclohexanones ; Drugs, Chinese Herbal ; chemistry ; Glucosides ; Indoles ; chemistry ; Mass Spectrometry ; Molecular Structure ; Norisoprenoids ; chemistry

AIM: To investigate the therapeutic effects of panretinal photocoagulation(PRP)with multiple wavelength and multispot pattern scan laser combined with conbercept for proliferative diabetic retinopathy.

METHODS: Retrospective case control study. A total of 102 eyes of 80 cases with proliferative diabetic retinopathy without proliferative fiber membrane from retinal or vitreous hemorrhage were recorded. The eyes were divided into two groups according to the therapeutic methods: group A included 60 eyes of 48 cases received only PRP; group B included 42 eyes of 32 cases received intravitreal injection of 0.5mg conbercept before PRP. All patients were given PRP with multiple wavelength and multispot pattern scan laser(NIDEK MC-500VIXI)and completed in twice with the interval time 3-7d. The patients were received supplementary laser therapy after 3mo according to fundus fluorescein angiography(FFA)results. The therapeutic effect and related complications were observed in two groups, the best corrected visual acuity(BCVA)of 3mo after PRP was recorded and the changes of central macular thickness(CMT)were compared. All patients were followed up for at least 3mo.

RESULTS: Incidence rate of vitreous hemorrhage and macular edema happened or became worse in group A was obviously higher than group B, the difference was statistically significant(P<0.05). The effective rate was 73.33% in group A and 90.48% in group B at 3mo after PRP and the difference was statistically significant(P<0.05). The CMT values at different time points after treatment in the two group showed a significant difference(P<0.05).

CONCLUSION: Intravitreal injection of conbercept combined with PRP with multiple wavelength and multispot pattern scan laser as a treatment for early proliferative diabetic retinopathy can reduce vitreous hemorrhage in the process of PRP and macular edema, and is more effective with better visual acuity recovery compared with only PRP.

Objective: To investigate the effect of insulin-like growth factor-Ⅰon osteocalcin secretion in periodontal ligament cells. Methods: Human periodontal ligament cells were cultured by tissue explant in vitro, and the concentration of osteocalcin were determined with radio-immunological method. Results: Under the condition of L-ascorbic acid and β-glycerophosphate in culture medium, human periodontal ligament cells secreted osteocalcin time-dependently and peaked at the third week; IGF-Ⅰ3.125 ng/ml，6.250 ng/ml, 12.500 ng/ml, 25.000 ng/ml could promote the secretion of osteocalcin dose dependently. Conclusion: IGF-Ⅰ can increase the secretion of osteocalcin in human periodontal ligament cells.

AIM: To observe the clinical efficacy and safety of the Ex-press miniature glaucoma device placed under scleral flap combined mitomycin C for the treatment of refractory glaucoma.

METHODS: This retrospective analysis comprised 18 eyes of 18 patients who suffered from refractory glaucoma and treated with Ex-press miniature glaucoma device implantation combined mitomycin C in January 2014 to May 2015 in Jingzhou Central Hospital. All patients were followed at least 12mo. The visual acuity, intraocular pressure(IOP), complications and filtering bleb were recorded and statistically analyzed preoperative and 1d, 1, 2wk, 1, 6 and 12mo after operation.

RESULTS: Average intraocular pressure was 43.83±7.99mmHg preoperative and decreased significantly at every time point postoperative(8.72±3.29, 11.56±1.86, 13.33±2.30, 13.67±2.03, 14.78±3.64, 16.61±7.19mmHg respectively), the difference was statistically significant(t=16.475, 15.324, 14.761, 14.172, 12.140, 11.412, P<0.05). The successful rate was 89% at 12mo after operation, and 3 eyes with improved vision, 12 eyes with unchanged vision, 3 eyes with decreased vision. Early complications were mainly anterior chamber bleeding and postoperative shallow anterior chamber, and late complications were non-functional bleb. There were no serious or unexpected complications in our group of patients.

CONCLUSION:The Ex-press miniature glaucoma device implantation combined mitomycin C in the treatment of refractory glaucoma is a safe and effective method, which has few surgical complications and less damage to eyesight, and make the stability control of postoperative intraocular pressure.

Objective To evaluate the value of reducing radiation dose with ECG-pulsing and image quality in 64-row multi-alice CT coronary angiography.Methods Fifty-nine consecutive patients whose heart rates were less than 80 beat per minute and cardiac rhythm was regular were randomly divided into two groups from October 26, 2007 to March 12, 2008.Conventional technique of CT coronary angiography was employed in group 1, while ECG-pulsing technique was applied in group 2.CT dose index volume (CTDIvol) and dose length product (DLP) were obtained automatically, and then the corresponding effective dose (ED) were calculated.The quality scores were performed on obtained imaging by using double blind method.Student t-test was applied in the comparison of value of CTDIvol, value of ED and quality of imagiugbetween two groups.Results The value of CTDIvol was (70.0±1.1) and (39.0±2.7) mGy, the value of ED was (16.8±2.0) and (9.5±1.7) rosy in group 1 and group 2, respectively, which reached statistically significant differences between the groups(t=57.675,15.346 ,P <0.01, respectively). The quality scores of coronary images were 3.8±0.2 and 3.8±0.1 in the groups, which did not reach the statistical significance (t=-0.222, P 0.05).Conclusions The proper application of ECG-Pulsing technology in 64-slice spiral CT coronary angiography can reduce radiation dose significantly while having no influence on the quality of the imaging.

This study aims to investigate the change of plasma concentration of digoxin (DIG) in rats with ovariectomy. Twelve female SD rats were randomly assigned into ovariectomized group and sham group (n = 6). All rats plasma was collected after a single dose of 2 mg x kg(-1) DIG administrated orally, serum DIG concentration was determined by LC-MS/MS. The level of P-gp in the intestinal was analyzed by Western blotting. Pharmacokinetic calculations were performed on each individual using DAS 2.0 practical pharmacokinetic software. Compared with the sham group, C(max) of ovariectomized group decreased significantly (P < 0.01). There was no significant difference of AUC(0-t), and the level of P-gp was elevated in ovariectomized group. It was found that C(max) of DIG was significantly reduced after ovariectomy, and the change was associated with the decreased level of estrogen, which contributes to the increased level of P-gp.

Objective To investigate the expression of c-Jun-N-terminal kinase(JNK) in rat brains with chronic fluorosis and try to reveal the molecular mechanism for the neural impairment induced by the disease.Methods The rats were randomly divided into 3 groups, normal control group(drinking water containing less than 0.5 mg/L of sodium fluoride, NaF), lower fluoride exposed group(drinking water containing 5 mg/L NaF) and higher fluoride exposed group(drinking water containing 50 mg/L NaF), 24 in every group. The rats were examined at the sixth month after feeding. The concentration of fluorine in urine and blood was detected by F-ion selective electrode. The expression of JNK in brains was investigated by using Western blotting and immunohitochemistry staining, and analyze the correlation between activating of JNK and the concentration of fluorine in blood. Results The increased concentration of fluorine in urine(control: 0.92 ± 0.30, lower fluoride exposed group: 2.56 ± 0.91,higher fluoride exposed group: 5.73 ± 3.14, P ＜ 0.05) were observed when 6 months after the beginning of the experiment, and the amount of fluorine in blood was also higher in rats with fluorosis(control: 0.12 ± 0.07, lower fluoride exposed group: 0.36 ± 0.14, higher fluoride exposed group: 0.50 ± 0.18, P ＜ 0.05). The expression of phospho-JNK at protein levels were higher in the brains of rats with fluorosis than that of controls (control: 1.00 ± 0.37, lower fluoride exposed group: 1.20 ± 0.28, higher fluoride exposed group: 1.74 ± 0.69, P ＜ 0.05), whereas no change of total-JNK was found(F = 0.046, P ＞ 0.05). Furthermore, the expression of phospho-JNK in the parietal cortex(119.3 ± 14.1), occipital cortex(112.7 ± 5.4), hippocampus CA3(100.6 ± 8.9), dorsal thalamus (117.8 ± 10.4) and olivary nucleus( 112.6 ± 5.9) of rats in higher fluoride exposed group were higher than that in control( 104.1 ± 8.9,106.6 ± 9.6,106.6 ± 9.7,108.9 ± 6.4,100.3 ± 8.4, all P ＜ 0.05) and lower fluoride exposed group(96.7 ± 17.1,102.5 ± 8.3,106.4 ± 6.5,110.2 ± 9.3,102.4 ± 4.7,102.5 ± 9.8, all P＜ 0.05). The positive stained neurons of total-JNK also distributed in the same brain regions of rats, but no difference was detected between the rats with fluorosis and controls(all P ＞ 0.05). The increased level of phospho-JNK was positively correlated with the fluoride contents in blood of the rats with fluorosis (r = 0.677). Conclusions The expression of phospho-JNK in brains of rats with fluorosis was significantly increased with a correlation to fluoride content in blood, which might be connected to the mechanism of neural impairment induced by chronic fluorosis.

Objective To investigate the expression of extraeellular signal-regulated protein kinase (ERK1/2)pathway in rat brains with fluorosis and the effects of fluoride on learning and memory of the rats,and to reveal the mechanisms of damaged nervous system resulted from the toxicity of the ion.Methods Seventy-two SD rats were divided into 3 groups and 24 rats were in each group.Three groups were fed respectively with different concentrations of fluoride(NaF)for 6 months to establish rat models with fluorosis.Controls were fed with tap water (NaF＜0.5 mg/L):lower and higher concentration group were fed with water containing NaF(5,50 ms/L).Animals are sacrificed after 6 months of treatment with fluoride and the dissected brains were kept for analysis.The protein levels of ERK1/2 in rat brains were detected by Western-blotting and the mRNA level by RT-PCR. The spatial learning and memorizing ability was measured by Morris water maze test. Results The ERK1/2 protein in control group,lower and higher concentration group was 0.944±0.10,1.253±0.02,1.953±0.07,the differece being statistieally sighificant between any two groups (P ＜ 0.05). The phospho-ERKl/2 protein in control group,lower and higher concentration group was 0.73±0.08,0.77±0.07,1.28±0.11,the differece being statistieally sighificant between any two groups(P ＜ 0.05);the activation rate of phospho-ERK1/2 in lower and higher concentration group [(68.4± 3.8)%,(64.1±3.2)%] was decreased compared to control group[ (82.3±10.7)%],the differece being significant(P ＜ 0.05). In the navigation trial,longer escape latencies of lower concentration group on the second, the third,the fifth and the sixth day were observed[ (46.0±8.0),(24.0±2.7),(8.9±5.3),(7.4±4.1 )s] compared to the control[ (39.3±6.9),(19.1±9.1 ),(8.3±3.4),(4.8±2.7)s],the differece being significant (P ＜ 0.05 or ＜ 0.01 );the similar results were also observed in the higher concentration group[ (36.9±16.8),(37.7±12.9), (19.7±7.6),(12.2±5.7 )s],and the escape latencies of the higher concentration group on the third,the fifth and the sixth day were longer than that in lower concentration group. In the probe test,the rats took more time to reach the first cross in lower and higher concentration group[(1.17±0.75),(4.18±1.10)s] than control group[ (5.89± 0.56 ) s ],the differece being significant (P ＜ 0.05 or ＜ 0.01 ) ;stayed shorter [ ( 17.05±4.25 ),(18.20±4.57 ) s ] than control [(25.37±5.65 )s ] in platform area (P ＜ 0.01 );the activation rates of ERK1/2 were directly correlated with the time taken to reach the first cross platform located in the probe test(r = 0.364,P ＜ 0.05) and the activation rates were also directly correlated with the escape latencies on the sixth day(r = 0.497,P ＜ 0.05). Conclusion Long-term exposure of excessive fluoride induces the change of expression and activating rate of the ERK1/2 in rat brains,leading to the decreased capacity of learning and memory.