1.Overview of systematic evaluation of anti-VEGF drugs in the treatment of diabetic macular oedema
Jingnan GUAN ; ZONGYONGYANGCUO ; Juan LING ; Xianyan SHEN ; Menghan LI ; Xufan CHEN ; Yonglin LIANG ; Dinghua ZHANG
China Pharmacy 2025;36(8):996-1000
OBJECTIVE To re-evaluate the use of systematic evaluation/meta-analysis of anti-VEGF drugs in the treatment of diabetic macular oedema (DME), aiming to provide evidence-based support for the clinical application of this medication. METHODS A comprehensive search was conducted across a range of databases, including CNKI, Wanfang data, VIP, CBM, PubMed, Web of Science, Embase, and Cochrane Library. The objective was to identify systematic evaluation/meta-analysis of anti- VEGF drugs for DME, with search time from the inception of the databases to March 2024. The report quality, methodological quality, and evidence quality were assessed by using PRISMA2020 statement, AMSTAR2 scale and GRADE tool. A comprehensive analysis of systematic evaluation/meta-analysis results was also conducted. RESULTS A total of 22 articles were included. According to the PRISMA2020 statement evaluation, 13 studies provided relatively complete information (≥21 points), while 9 studies had information deficiencies (18-<21 points). The AMSTAR 2 scale evaluation revealed that 21 studies had very low methodological quality, and one study had low methodological quality. The GRADE tool evaluation showed that out of 89 outcome indicators, 28( 31.46%) were classified as high-quality evidence, 34( 38.20%) as moderate-quality evidence, 24( 26.97%) as low- quality evidence, and 3 (3.37%) as very low-quality evidence. The comprehensive quality analysis results demonstrated that, compared with laser photocoagulation, anti-VEGF drugs significantly enhanced the improvement in best-corrected visual acuity (BCVA), as well as significant change in retinal thickness at 1 and 6 months, and 1 and 2 years post-treatment, and also in BCVA and retinal thickness at 1, 3, and 6 months post-treatment (P<0.05). Compared with placebo, patients treated with anti-VEGF drugs showed significant improvement in BCVA after 1 year of treatment (P<0.05). However, when compared with corticosteroid drugs, patients treated with anti-VEGF drugs exhibited a significant increase in retinal thickness after 6 months of treatment (P<0.05). Compared with corticosteroid drugs, the incidence of adverse events related to the eyes, cataract formation and intraocular pressure were significantly decreased in patients treated with anti-VEGF drugs (P<0.05). Compared with laser photocoagulation, the incidence of ocular adverse events was significantly decreased in patients treated with anti-VEGF drugs, while the incidence of fatal adverse events was significantly increased (P<0.05). CONCLUSIONS Anti-VEGF therapy for DME may possess certain advantages in terms of efficacy and safety, but it is associated with a higher risk of fatal adverse events; the evidence included in systematic reviews/meta-analyses is of moderate to high quality.
2.Clinicopathologic characteristics of Epstein-Barr virus-positive inflammatory follicular dendritic cell sarcoma:report of nine cases
Qianqian CHEN ; Wenwen LUO ; Jiexia GUAN ; Qiong LIANG
Chinese Journal of Clinical and Experimental Pathology 2024;40(1):56-59,65
Purpose To explore the clinicopathologic fea-tures of Epstein-Barr virus-positive inflammatory follicular den-dritic cell sarcoma(EBV+IFDCS).Methods The clinico-pathologic features of 9 cases of EBV+IFDCS were retrospective-ly analyzed and followed up.Results The age of 9 patients with EBV+IFDCS ranged from 22 to 78 years(mean 44.7 years).7 cases occurred in the liver and 2 in the spleen.Fi-brinoid degeneration and hyaline degeneration in the vessel walls(6/9),eosinophilic infiltration(3/9),and epithelioid granulo-mas(2/9)were seen in some cases.The tumor cells expressed CD21(7/9),CD23(8/9)and CD35(9/9),partially ex-pressed SMA(6/9)and D2-40(1/9).It was noteworthy that 2 cases from the spleen accompanied by high expression of IgG4 plasma cells(80-135/10 HPF),and in the liver(0-36/10 HPF).All cases were followed up for 3-84 months,with 6 pa-tients disease-free,2 patients underwent metastasis,1 patient lost of follow-up.Conclusion EBV+IFDCS is a rare low-grade malignant tumor.EBER in situ hybridization and immunohisto-chemical detection play important roles in the diagnosis and dif-ferential diagnosis of EBV+IFDCS.Surgical resection is the main therapeutic intervention for EBV+IFDCS,and patients re-quire long-term post-surgical follow-up.
3.Perception of high-quality Party branches construction in public hospitals:a case study of selected hos-pitals in Jiangmen,Guangdong
Pengfei LI ; Jianchao CHEN ; Qunxing ZHONG ; Qunsheng LIANG ; Meishuang GUAN ; Ping DAI
Modern Hospital 2024;24(8):1178-1181
Strengthening Party building within public hospitals is crucial for their healthy development in accordance with the Party's objectives.The party branch,as the grassroots organizational unit,is essential for bridging the gap between its con-struction level and the demands of practical tasks,a matter of significant interest to hospital administrators.This study delves into the current perceptions of high-quality construction among grassroots party branches in certain public hospitals in Jiangmen City,Guangdong Province.Suggestions and measures for high-quality construction of party branches are tailored,integrating the local context.The goal is to enhance the effectiveness of Party building,steering the hospitals towards high-quality development and fortifying the Party's grassroots governance foundation.
4.Analysis and comparison of health education on respiratory infectious diseases at home and abroad
Yan GUAN ; Xili CHEN ; Wenxi WANG ; Ming LI ; Yueming SU ; Zhenyu LIANG ; Dongying ZHANG
Chinese Journal of Health Management 2024;18(11):869-875
Objective:To analyze and compare the health education efforts of respiratory infectious diseases at home and abroad.Methods:The literature related to health education and popular science of respiratory infectious diseases included in the databases of China National Knowledge Infrastructure (CNKI) and Web of Science (WOS) from January 1, 2003 to December 31, 2023 was searched. A total of 4 686 articles were retrieved in CNKI, 1 540 articles unrelated to the theme were excluded, and 3 146 Chinese articles were obtained. In the WOS database, 7 724 articles were retrieved, 3 685 articles about the clinical mechanism of diseases, pharmacology, and other research topics were excluded, and 4 039 English articles were obtained. The information of annual publications, institutions, authors and keywords was analyzed by using CiteSpace visualization software, and the publication status, research hotspots and development trends of health education related to respiratory infectious diseases at home and abroad were analyzed.Results:Since 2003, the number of publications in health education on respiratory infectious diseases at home and abroad had shown a fluctuating growth trend, and in 2020, the field showed a sharp growth trend at home and abroad. There was no core author group in this field in China, and the network density of domestic authors was 0.006 5, and the network density of foreign authors was 0.009 6. The domestic institutions were mainly the Center for Disease Control and Prevention and medical institutions, including Guangzhou Chest Hospital (29 articles) and the Chinese Center for Disease Control and Prevention (10 articles); Foreign research institutions were mainly higher education institutions, including the University of London (91 articles) and Harvard University (67 articles). The network density of domestic was 0.001 3, and the network density of foreign publishing institutions was 0.026 3, the network density was greater than that of Chinese publishing institutions. The emergence of "COVID-19" "Avian influenza" "Knowledge, Attitude, Practice" and "mental health" in China had strong burst (burst intensity: 46.41, 12.12, 10.33, 8.5); "Coronavirus" "coverage" "Avian influenza" and "COVID-19 vaccine" in foreign countries had strong burst (burst intensity: 14.34, 11.06, 10.73, 10.02).Conclusions:At present, the health education of respiratory infectious diseases at home and abroad has received great attention. But the cooperation between domestic authors and research institutions is loose, and the close collaboration needs to be strengthened. There are differences in the research focus of health education on respiratory infectious diseases at home and abroad.
5.Berberine regulates polarization of macrophages:a mechanistic study based on PI3K/Akt1 signaling pathway
Yushan CHEN ; Tingting WANG ; Zhonghua MENG ; Shasha SHANG ; Junmeng ZHENG ; Yonghua ZONG ; Chunying SI ; Yazhou LIANG ; Huaimin GUAN
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2024;26(6):694-698
Objective To explore the effect and possible mechanism of berberine on the macro-phage polarization of human myeloid leukemia monocytic cell line THP-1 induced by oxidized low-density lipoprotein(ox-LDL).Methods THP-1 cells were induced into macrophages by PMA,and then according to different concentrations of berberine,the cells were divided into con-trol group,and 5,10,20,40 and 50 μmol/L berberine groups.After intervention for 24 or 48 h,CCK8 assay was used to detect cell viability for optimal concentration and time of berberine treat-ment.PMA-induced THP-1 macrophages were assigned into blank group,model group(ox-LDL),berberine group,inhibitor group(phosphatidyl inositol 3-kinase(PI3K)inhibitor LY294002)and berberine+inhibitor group(berberine+LY294002).The contents of inducible nitric oxide syn-thase(iNOS)and TGF-β1 were detected by ELISA.qPCR was employed to measure the mRNA expression of TNF-α,arginase 1(Arg1),PI3K and protein kinase B Akt1,and Western blotting was applied to detect the protein levels of Akt1 and phosphorylated protein kinase B antibody(p-Akt1).Results In 24 h after intervention,the macrophage activity was significantly lower in the 40 and 50 μmol/L berberine groups than the control group(P<0.05),and after 48 h,the ac-tivity in all the 5 doses of berberine groups was obviously lower than that in the control group[(0.89±0.02)%,(0.82±0.03)%,(0.71±0.02)%,(0.62±0.03)%and(0.53±0.02)%vs(1.01±0.01)%,P<0.05].Berberine treatment of 20 μmol/L for 24 h had little effect on cell viability,and the dose and the time were regarded as the best concentration and time.Compared with the blank group,iNOS content and TNF-α mRNA level were increased in the model group,while TGF-β1 content,mRNA levels of Arg1,PI3K and Akt1,and p-Akt1/Akt1 protein levels were de-creased(P<0.05).iNOS content and TNF-α mRNA level were decreased,while TGF-β1 content,mRNA levels of Arg1,PI3K and Akt1 and protein levels of p-Akt1/Akt1s were increased in the berberine group than the model group(P<0.05).Compared with the berberine group,iNOS con-tent and TNF-α mRNA level were increased,while mRNA levels of Arg1,PI3K and Akt1 and protein levels of p-Akt1/Akt1 were decreased in the berberine+inhibitor group(P<0.05).Con-clusion Berberine can inhibit the inflammatory response of THP-1 macrophages induced by ox-LDL by activating PI3K/Akt1 pathway,and inhibit the M1 polarization and promote the M2 polarization of macrophages.
6.Effects of template and pore-forming agent method on the structure and drug delivery of porous maltodextrin
Zhe LI ; Xiao-sui LUO ; Wei-feng ZHU ; Qiong LI ; Yong-mei GUAN ; Zheng-ji JIN ; Li-hua CHEN ; Liang-shan MING
Acta Pharmaceutica Sinica 2024;59(8):2381-2395
This study using maltodextrin as raw material, 1%-5% polyvinylpyrrolidone K30 as template agent, 1%-5% ammonium bicarbonate as pore-forming agent, curcumin and ibuprofen as model drugs. Porous maltodextrin was prepared by template and pore-forming agent methods, respectively. The structure and drug delivery behavior of porous maltodextrin prepared by different technologies were comprehensively characterized. The results showed that the porous maltodextrin prepared by pore-forming agent method had larger specific surface area (6.449 4 m2·g-1) and pore size (32.804 2 nm), which was significantly better than that by template agent method (3.670 2 m2·g-1, 15.278 5 nm). The adsorption kinetics between porous maltodextrin prepared by pore-forming agent method and curcumin were suitable for quasi-first order adsorption kinetic model, and that between porous maltodextrin and ibuprofen were suitable for quasi-second order adsorption kinetic model. While the adsorption kinetics between porous maltodextrin prepared by template agent method and two model drugs were both suitable for the quasi-first order adsorption kinetic model. In addition, the dissolution behavior analysis showed that the porous maltodextrin prepared by the two technologies can significantly improve the dissolution behavior of insoluble drugs, and the drug release was both carried out by diffusion mechanism, which suitable for the Peppas kinetic release model, but the porous maltodextrin prepared by template agent method had a faster release rate. The change of nozzle diameter had no significant effect on the adsorption process and drug release behavior of porous maltodextrin. In conclusion, the porous maltodextrins prepared by two different technologies were both beneficial to the delivery of insoluble drugs, and the template agent method was the best for delivery of insoluble drugs. This study can provide theoretical basis for the preparation of porous particles, promote the application of porous particles in insoluble drugs, and improve the bioavailability of insoluble drugs.
7.Rigid-body inverse dynamics modelling and analysis of 6RSS parallel bio-inspired masticatory robot
Chen CHENG ; Xiao-Jing YUAN ; Neng-Jun YANG ; Gen-Liang HOU ; Fan-Qi ZENG ; You-Cai WANG ; Wei-Peng LUO ; Guan ZHAO
Chinese Medical Equipment Journal 2024;45(3):16-22
Objective To carry out rigid-body inverse dynamics modelling and analysis of a self-designed 6RSS parallel bio-inspired masticatory robot.Methods Firstly,the functions of kinematic variables including translational/rotational velocities and accelerations were derived for rigid-body inverse dynamics modelling.Secondly,the rigid-body inverse dynamics model was established with the Newton-Euler's law.Finally,the chewing motion trajectories of the oral health volunteers were tracked and numerical calculations were carried out in the case where the robot was subjected to a chewing reaction force.Results Numerical calculations showed that the driving torque and the constraint force of the robot peaked when the chewing reaction force was at its maximum.Conclusion The external force has a large impact on the inverse dynamics of the robot,and theoretical references are provided for the motion control and optimal design of the robot.[Chinese Medical Equipment Journal,2024,45(3):16-22]
8.Application effect of rehabilitation instruction based on resourcefulness theory on exercise behavior implementation intention in patients with first-episode stroke
Yiping QUAN ; Fangfang ZHAO ; Jun SUN ; Wenjuan GUAN ; Haiying HU ; Hui ZHANG ; Fei XIE ; Yu LIANG ; Xia CHEN
Modern Clinical Nursing 2024;23(4):47-53
Objective To investigate the effect of rehabilitation instruction based on resourceful theory on the execution intention of exercise behaviour in patient with the first-episode stroke.Methods From September 2022 to February 2023,a total of 80 inpatients with first-episode stroke from a general hospital in Anhui Province participated in the study.Patients in Wards Ⅰ and Ⅱ were assigned to an intervention group,while those in Wards Ⅲ and Ⅳ were assigned to a control group,with 40 patients per group.The patients in control group received standard interventions,while those in the intervention group were offered with a rehabilitation instruction based on resourceful theory in addition to the standard interventions.Stroke patient rehabilitation exercise behaviour execution intention questionnaire,resourcefulness scale and modified Barthel were employed for assessments before and after the intervention.Results After the intervention,the intervention group showed significantly higher scores inexecutive intention of exercise behaviour,resourcefulness level and daily living activities compared to those in the control group(all P<0.01).Conclusion Rehabilitation instruction based on the theory of resourcefulness can effectively increase the executive intention of exercise behaviour in the patients with first-episode stroke,improve the resourcefulness thinking levels and enhance the daily living activity of the patients.
9.Application value of cervical vascular color Doppler ultrasound combined with serum miR-222-3p and miR-206 in the diagnosis of carotid artery stenosis in patients with cerebral infarction
Hongling DAI ; Cheng GUAN ; Liang CHEN
International Journal of Laboratory Medicine 2024;45(20):2501-2505
Objective To analyze the application value of cervical vascular color Doppler ultrasound com-bined with serum microRNA-222-3p(miR-222-3p)and microRNA-206(miR-206)in the diagnosis of carotid artery stenosis in patients with cerebral infarction.Methods A total of 90 patients with cerebral infarction ad-mitted to this hospital from July 2018 to July 2022 were selected as the study group,and were divided into mild stenosis group(29 cases),moderate stenosis group(35 cases),and severe stenosis group(26 cases)ac-cording to the degree of carotid artery stenosis.In addition,96 healthy people who underwent physical exami-nation in the hospital were selected as the control group.Real-time fluorescence quantitative PCR was used to detect the levels of serum miR-222-3p and miR-206 in each group.All patients with cerebral infarction under-went cervical vascular color Doppler ultrasound examination,and the clinical data of patients with different de-grees of stenosis were analyzed.Multivariate Logistic regression was used to analyze the factors affecting the degree of carotid artery stenosis in patients with cerebral infarction.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of carotid ultrasound indicators,serum miR-222-3p and miR-206 levels for the degree of carotid artery stenosis in patients with cerebral infarction.Results Compared with the control group,the study group had a significant increase in the serum level of miR-222-3p and a sig-nificant reduction in the serum level of miR-206(P<0.05).Compared with the mild stenosis group,the peak systolic velocity(PSV),end diastolic volume(EDV)and serum miR-222-3p level were increased,and the ser-um miR-206 level was decreased in the moderate stenosis group and the severe stenosis group(P<0.05).Compared with moderate stenosis group,EVD,PSV and serum miR-222-3p levels were significantly in-creased,and miR-206 level was decreased in severe stenosis group(P<0.05).EVD,PSV,serum miR-222-3p level were risk factors for carotid artery stenosis in patients with cerebral infarction,and serum miR-206 level was a protective factor for carotid artery stenosis in patients with cerebral infarction(P<0.05).The area un-der the curve of EVD,PSV combined with serum miR-222-3p and miR-206 in diagnosing the degree of carotid artery stenosis in patients with cerebral infarction was 0.991,and the sensitivity and specificity were 98.36%and 93.10%,respectively.It was better than that of EVD,PSV,serum miR-222-3p,and miR-206 alone(Zcombination-EVD=2.927,P=0.003,Z combination-PSV=2.834,P=0.005,Zcombination-miR-222-3p=3.300,P=0.001,Zcombination-miR-206=3.730,P<0.001).Conclusion Cervical vascular color Doppler ultrasound combined with ser-um miR-222-3p and miR-206 has application value in the diagnosis of carotid artery stenosis in patients with cerebral infarction.
10.Randomized controlled study on treatment of intertrochanteric fracture of femur with proximal femoral nail antirotation assisted by robot navigation
Xi-Cong CHEN ; Jian CAI ; Hui-Liang ZENG ; Guo-Cai CHEN ; Guan-Ming ZHOU
Journal of Regional Anatomy and Operative Surgery 2024;33(9):768-772
Objective To investigate the therapeutic effects of proximal femoral nail antirotation(PFNA)assisted by robot navigation and PFNA guided by C-arm X-ray machine for the treatment of intertrochanteric fracture of femur(IFOF).Methods The 100 patients with unilateral IFOF in our hospital were selected as the study subjects.They were divided into the control group(50 cases)and the robot-assisted group(50 cases)according to random number table method.The control group was treated with PFNA internal fixation under C-arm X-ray machine fluoroscopy,and the robot-assisted group was treated with PFNA internal fixation assisted by robot navigation.Surgical indicators,fracture reduction and fracture healing,stress response indexes,hip joint function,quality of life score and incidence of surgery related complications were compared between the two groups.Results The operation time,total fluoroscopy time,nail placement time and fracture healing time of the robot-assisted group were shorter than those of the control group(P<0.05);and the intraoperative blood loss,guide needle adjustment frequency,and fluoroscopy frequency of the robot-assisted group were less than those of the control group(P<0.05).The fracture reduction and fracture healing in the robot-assisted group were better than those in the control group(P<0.05).Two days after operation,the levels of serum norepinephrine(NE),angiotensin Ⅱ(Ang Ⅱ)and superoxide dismutase(SOD)in the two groups were higher than those before operation(P<0.05),and the levels of serum NE,Ang Ⅱ and SOD in the robot-assisted group were lower than those in the control group(P<0.05).The Harris score and 36-item short-form(SF-36)score of patients 7 days and 3 months after surgery in the two groups were higher than those before surgery(P<0.05),and the above scores 3 months after surgery were higher than those 7 days after surgery(P<0.05).Harris score and SF-36 score 7 days and 3 months after operation in the robot-assisted group were higher than those in the control group(P<0.05).The incidence of complications in the robot-assisted group was lower than that in the control group(P<0.05).Conclusion Compared with the C-arm X-ray machine fluoroscopy,the treatment of IFOF with PFNA assisted by robot navigation can further shorten the operation time,reduce the surgical trauma and the incidence of complications,achieve better effect of fracture reduction and healing,reduce stress response of the body,and improve hip joint function and quality of life for patients.

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