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find Keyword "治疗应用" 292 results
  • 微波干扰素结合中药熏洗治疗肛周尖锐湿疣疗效观察

    摘要:目的:观察采用微波、干扰素结合自拟消疣汤熏洗中西医结合方法治疗肛周尖锐湿疣的疗效。方法:采用微波、干扰素结合自拟消疣汤(板蓝根、大青叶、紫草、蒲公英、野菊花、马齿苋、黄柏、土茯苓、苦参、薏苡仁、赤芍)熏洗的中西医结合方法治疗本病30例,并设对照组进行对照。结果: 治疗组复发率为10%,治愈率为90%,创面感染率为0,对照组复发率为37.9%,治愈率为62.1%,并有2例并发感染。结论:本治疗方法对肛周尖锐湿疣有提高治愈率,降低复发率并能有效地防止继发感染之功效。

    Release date:2016-08-26 03:57 Export PDF Favorites Scan
  • Development, problems and prospects of the treatment of diabetic macular edema

    Diabetic macular edema (DME) is a common ocular complication of diabetes patients. It mainly involve macular which is closely related with visual function, thus DME is one of the major reasons causing visual impairment or blindness for diabetes patients. How to reduce the visual damage of DME is always a big challenge in the ophthalmic practice. In the past three decades, there are tremendous developments in DME treatments, from laser photocoagulation, antiinflammation drugs to antivascular endothelial growth factor therapy. However, the mechanism of DME development is not yet completely clear; every existing treatment has its own advantages and weaknesses. Therefore DME treatment still challenges us to explore further to reduce the DME damages.

    Release date:2016-09-02 05:18 Export PDF Favorites Scan
  • Effects of dual targets intervention on the expression of vascular endothelial growth factor and connective tissue growth factor in diabetic rat retina

    Objective To observe the effects of dual targets intervention on the expression of vascular endothelial growth factor (VEGF) and connective tissue growth factor (CTGF) in diabetic rat retina. Methods Forty-eight Sprague -Dawley rats were randomly divided into control group (CON1 group) and diabetes mellitus group (DM group). The rats of DM group were induced with streptozotocin injection creating a diabetic model. Retinas were obtained at eight, 10, 12 weeks after DM induction from both groups. CTGF and VEGF mRNA levels were examined by realtime reverse transcriptionpolymerase chain reaction (RT-PCR). Based on the results of above experiments, 60 rats with same conditions were selected. Fifty rats were induced with streptozotocin injection creating a diabetic model, and 10 rats comprised the control group (CON2 group). Then the 50 diabetic rats were randomly divided into ranibizumab and CTGF shRNA dual targets intervention group, ranibizumab singletarget intervention group, CTGF shRNA singletarget intervention group and nonintervention group. Retinas were obtained at one week after intervention from all the groups. CTGF and VEGF mRNA levels were examined by RT-PCR. Results The levels of CTGF mRNA were significantly higher in DM group than that in CON1 group at the 8th weeks after DM induction, and this upregulation was maintained through the 12th week (t=-2.49, -2.67, -2.42;P<0.05). There was no difference on VEGF mRNA levels between DM group and CON1 group at the 8th weeks after DM induction(t=-0.443,P=0.669). VEGF mRNA levels of DM group started to be significantly elevated over those in the CON1 group at the 10th week, and remained to be higher at the 12th week (t=-2.35, -2.57;P<0.05). The VEGF mRNA of ranibizumab single-target intervention group was significantly lower than that in non-intervention group (t=-3.44,P=0.014), which was similar to CON2 group (t=-1.37,P>0.05); however, the CTGF mRNA level was significantly increased as compared to the nonintervention group (t=2.48,P<0.05). In the CTGF shRNA single-target intervention group, the levels of CTGF and VEGF mRNA were decreased as compared to the non-intervention group (t=0.23, -2.92;P<0.05). In the ranibizumab and CTGF shRNA dual targets intervention group, the levels of CTGF and VEGF mRNA were decreased as compared to the non-intervention group (t=-6.09, -5.11;P<0.001), which was similar to CON2 group (t=-1.16, 1.139; P>0.05). Conclusions Both CTGF and VEGF gene expression are up-regulated in early diabetic rat retina, and the level of CTGF increased earlier than VEGF. Ranibizumab combined with CTGF shRNA could simultaneously reduce the level of CTGF and VEGF mRNA in diabetic rat retina.

    Release date:2016-09-02 05:18 Export PDF Favorites Scan
  • 新一代抗血管内皮生长因子药物阿柏西普基础及临床研究现状

    血管内皮生长因子(VEGF)是新生血管性及血管性眼底疾病的重要治疗靶点。阿柏西普(Aflibercept,眼用制药VEGF Trap-Eye,商品名Eylea)是继哌加他尼钠(Pegaptanib,商品名Macugen)、雷珠单抗(Ranibizumab,商品名Lucentis)之后的新一代抗VEGF药物,可直接或间接作用于VEGF家族所有成员,减少新生血管形成,降低血管通透性。VEGF Trap-Eye尤与VEGF-A亲和力高,作用时间持久,在临床前实验中展现出较好的抗新生血管作用和降低血管通透性作用;玻璃体腔注射治疗老年性黄斑变性可取得与Ranibizumab相似的疗效,且延长注射间隔并不降低疗效;治疗糖尿病黄斑水肿疗效明显优于激光光凝治疗,且不同给药间隔可取得相似疗效;在提高视网膜静脉阻塞患者视力和减轻水肿方面亦有一定作用。用于治疗病理性近视继发脉络膜新生血管等其他疾病的疗效尚在临床观察中。VEGF Trap-Eye治疗新生血管性及血管性眼底疾病要进一步全面评价有效性和安全性还需要进行更长期的临床观察。

    Release date:2016-09-02 05:21 Export PDF Favorites Scan
  • Efficacy of internal limiting membrane peeling and silicone oil tamponade for highly myopic macular hole retinal detachment

    Objective To observe the effect of pars plana vitrectomy (PPV) with epiretinal membrane peeling (ERMP) and (or) internal limiting membrane peeling (ILMP) and silicone oil tamponade for highly myopic macular hole retinal detachment (MHRD) with posterior staphyloma. Methods Eighty-five highly myopic MHRD patients (85 eyes) were enrolled in this study. All the patients were examined for corrected visual acuity (CVA), slit lamp microscope and preset lens, indirect ophthalmoscope, A/B ultrasound, optical coherence tomography (OCT) and intraocular pressure examination. The average axial length was (29.1plusmn;1.8) mm. There were 24 eyes with diffuse choroid atrophy and 61 eyes with partial choroid atrophy. The CVA was converted into a logarithm of the minimal angle of resolution (logMAR) for statistical analysis. The average logMAR CVA was 1.93plusmn;0.37. All the patients were treated with PPV and triamcinolone acetonide or indocyanine green (ICG) assisted ILMP and (or) ERMP and silicone oil tamponade. TA assisted ERMP was performed in 21 eyes; with ICG assisted ILMP in 56 eyes and TA assisted ILMP in eight eyes. The duration of silicone oil tamponade was (6.2plusmn;1.6) months. CVA, retina and macular hole status and complications were observed postoperatively. Differences between preoperative and postoperative CVA were evaluated by the t test and correlation analysis. Multiple logistic regression analysis was performed to assess the influence of individual preoperative factors on the initial anatomical success. Differences in the macular hole closure rate between eyes with or without macular schisis were evaluated for statistical significance using corrected chi-square. Results The mean logMAR CVA was 1.34plusmn;0.48 after surgery, which significantly improved compared to that before surgery (t=39.38, P<0.01). The CVA after surgery was independent of axial length (r=0.142, P>0.05), choroid atrophy (t=0.23, -0.165,P>0.05) and macular hole closure (t=0.12, -0.005, P>0.05). The retina reattached in 79 eyes (92.9%) and recurrence of retinal detachment occurred in six eyes (7.1%). Multiple logistic regression analysis indicated that recurrence of retinal detachment was independent of choroid detachment, proliferative vitroretinopathy, axial length, choroid atrophy and ILMP (OR=1.428, 5.039, 0.815, 2.578, 0.432; P>0.05). Of these 85 eyes, macular hole closed in ten eyes (11.8%), macular hole did not close in 75 eyes (88.2%). There were 24 eyes (28.2%) experienced high intraocular pressure during the first 2 weeks after surgery, all of them were under control with drugs. There were 12 eyes (14.1%) presented with high intraocular pressure before the silicone oil removal, all of them were under control only by silicone oil removal. Conclusion For the treatment of MHRD with posterior staphyloma, PPV combined with ERMP and (or) ILMP and silicone oil tamponade show a high retinal reattachment rate.

    Release date:2016-09-02 05:21 Export PDF Favorites Scan
  • Efficacy of C3F8 versus silicone oil intraocular tamponade for severe highly myopic macular hole retinal detachment

    Objective To compare the outcome of C3F8 versus silicone oil intraocular tamponade after pars plana vitrectomy (PPV) for the treatment of severe highly myopic macular hole retinal detachment (MHRD). Methods Thirty-two highly myopic MHRD patients (32 eyes) with extreme long axial lengths (ge;29.0 mm), quot;severequot; retina pigment epithelium (RPE) and chorioretinal atrophy, and posterior staphyloma who underwent PPV, were enrolled in this study. The patients were divided into two groups according to different intraocular tamponade agents: C3F8 (group A, 15 eyes) and silicone oil (group B, 17 eyes). The patients with retinal re-detachment after surgery received PPV again. The differences of sex (P=1.000), age (t=0.444, P=0.660), best-corrected visual acuity (t=0.084, P=0.934), diopter (t=0.449, P=0.978), lens state (P=1.000), time of the symptoms (t=0.375, P=0.710) and degree of retinal detachment (chi;2=0.014, P=0.907) between group A and B were not statistically significant. The anatomic reattachment of the retina, macular hole closure, and vision acuity were observed at one week, one, three, six and 12 months after surgery. Results The rates of retinal reattachment and macular hole closure were 60.00% and 13.33 % in group A, 82.35% and 29.41% in group B in the first time of surgery. There was no difference in rates of retinal reattachment and macular hole closure between two groups (P=0.243, 0.402). The rates of retinal reattachment and macular hole closure were 86.67% and 20.00% in group A, 94.12% and 29.41% in group B in the second time of surgery. There was no difference in rates of retinal reattachment and macular hole closure between two groups (P=0.589, 0.691). Twelve months after surgery, the vision acuity improved in five eyes, unchanged in seven eyes , and decreased in three eyes in group A; the vision acuity improved in seven eyes , unchanged in eight eyes , and decreased in two eyes in group B. The differences of vision result was not statistically significant between two groups (chi;2=0.209, P=0.647). Conclusion The rates of retinal reattachment and macular hole closure with silicone oil tamponade was higher than that with C3F8 tamponade in eyes with severe highly myopic MHRD, but the differences are not statistically significant.

    Release date:2016-09-02 05:21 Export PDF Favorites Scan
  • Effect of tetramethypyrazine on hypoxia-related factors expression in human umbilical vein endothelial cells

    Objective To observe the effect of tetramethypyrazine (TMP) on the expression of hypoxia-related factors in human umbilical vein endothelial cells (HUVECs). Methods The second to fifth passage cultured HUVECs were divided into five groups: control group, CoCl2induced hypoxic group and 50, 100, 200 mu;mol/L TMP treatment groups. HUVECs in control group were not treated. HUVECs inCoCl2induced hypoxic group were treated with 150 mu;mol/LCoCl2for four hours. HUVECs in 50, 100, 200 mu;mol/L TMP treated groups were pretreated with 150 mu;mol/LCoCl2 for four hours, followed by treatment with 50, 100, 200 mu;mol/L TMP for eight hours. Real-time reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the mRNA levels of prolyl hydroxylase 2 (PHD2), hypoxia-induced factor-1alpha;(HIF-1alpha;) and vascular endothelial growth factor (VEGF). Protein levels of PHD2, HIF-1alpha;, and VEGF were detected using Western blot. Results Compared with the control group, theCoCl2 induced hypoxic group showed decreased mRNA and protein levels of PHD2 (t=3.734, 3.122;P<0.05), while those of HIF-1alpha; and VEGF increased (HIF-1alpha; mRNA:t=4.589,P<0.05; HIF-1alpha; protein:t=3.778,P<0.05. VEGF mRNA:t=3.926,P<0.05; VEGF protein:t=3.257,P<0.05). Compared with theCoCl2 induced hypoxic group, 50, 100, 200 mu;mol/L TMP treated groups showed increased mRNA and protein levels of PHD2 (PHD2 mRNA: t=3.286, 3.617, 3.886;P<0.05. PHD2 protein: t=2.813, 3.026, 3.078; P<0.05); while those of VEGF decreased (VEGF mRNA: 50 mu;mol/L TMP: t=1.696,P>0.05; 100 mu;mol/L TMP:t=2.974,P<0.05; 200 mu;mol/L TMP: t=3.492,P<0.05; VEGF protein: 50 mu;mol/L TMP: t=1.986,P>0.05; 100 mu;mol/L TMP: t=2.976,P<0.05; 200 mu;mol/L TMP:t=3.136,P<0.05); although changes in HIF-1alpha;mRNA levels were not statistically significant (t=1.025, 0.726, -1.386;P>0.05), showed a decrease in HIF-1alpha;protein levels (50 mu;mol/L TMP: t=2.056,P>0.05; 100 mu;mol/L TMP:t=3.058,P<0.05; 200 mu;mol/L TMP:t=3.828,P<0.05). ConclusionIn HUVECs, TMP can upregulate the mRNA and protein expression of PHD2, while down regulating HIF-1alpha; protein expression and VEGF mRNA and protein expression under acute hypoxic conditions.

    Release date:2016-09-02 05:22 Export PDF Favorites Scan
  • 雷珠单抗治疗新生血管性老年性黄斑变性的安全性研究

    随着对血管内皮生长因子(VEGF)的深入研究和抗VEGF药物的研发,新生血管性老年性黄斑变性治疗领域有了突破性进展。抗VEGF药物治疗新生血管性老年性黄斑变性的主要途径是玻璃体腔注射。任何一种新兴疗法的应用都要建立在可靠的安全性研究基础上。抗VEGF药物玻璃体腔注射的不良反应主要分为药物相关和注射相关不良反应。其中,眼部不良反应主要有眼内炎、视网膜脱离、视网膜裂孔、眼压升高、白内障等;全身不良反应主要有心肌梗死、卒中、尿路感染、高血压、鼻咽炎、咽痛、前列腺癌、骨关节炎、腹股沟疝等。与贝伐单抗(bevacizumab,商品名Avastin)比较,雷珠单抗(ranibizumab,商品名Lucentis)具有较低的不良反应发生率,其全身不良反应不明显。基于药物的安全性差异还有待于更大规模临床试验来证实。

    Release date:2016-09-02 05:22 Export PDF Favorites Scan
  • 影响抗血管内皮生成因子治疗渗出型老年性黄斑变性预后的因素

    玻璃体腔注射抗血管内皮生长因子(VEGF)药物是治疗渗出型老年性黄斑变性(AMD)脉络膜新生血管(CNV)的安全有效方法 。但基线视力、年龄、首发症状、开始治疗的时间、对最初3次治疗的反应以及光相干断层扫描、荧光素眼底血管造影、眼底自身荧光检查结果不同的患者,其治疗预后差异较大;除了上述临床特征和指标外,基因及生物学标记物方面的差异对治疗预后也有影响。探讨影响渗出型AMD患者抗VEGF治疗预后众多相关因素中的主要因素并采取相应的对策,对于提升抗VEGF药物治疗效果具有积极意义。

    Release date:2016-09-02 05:22 Export PDF Favorites Scan
  • Effect of photodynamic therapy combined with intravitreal bevacizumab on wet age-related macular degeneration

    Objective To investigate the effect of photodynamic therapy (PDT) combined with intravitreal bevacizumab on wet age-related macular degeneration (AMD). Methods In this retrospective study, 34 eyes (28 cases) diagnosed with wet AMD received PDT combined intravitreal injection of bevacizumab, including 25 eyes with classic CNV and 9 eyes with minimally classic CNV by fluorescein angiography; On optical coherence tomography (OCT), 23 eyes showed intraretinal fluid (IRF) and 11 eyes presented subretinal fluid (SRF). After signing informed consent, all patients underwent initial standard PDT followed by intravitreal bevacizumab (1.25 mg) within succeeding 3 to 7 days. Best corrected visual acuity (BCVA) and OCT with routine eye examinations were evaluated monthly. Additional bevacizumab (1.25 mg) was injected intravitreally if new or increasing fluid appreciated on OCT, or BCVA lowered more than 5 letters even with stabilized fluid. Injection was discontinued if no fluid was showed on OCT (quot;dry macularquot;), or BCVA was stabilized even with fluid after two consecutive injections. BCVA and central retinal thickness (CRT) were analyzed and compared between baseline and 6 month follow-up. The correlation between parameters such as baseline BCVA, greatest linear dimension (GLD), type of CNV, SRF or IRF and posttreatment BCVA will be analyzed. The injection number of bevacizumab and complications were recorded. Results Compared to baseline, BCVA improved (9.4plusmn;10.2) letters and reach 44.9plusmn;21.3 letters (t=5.438,P<0.01) and CRT decreased (184.6plusmn;214.6) mu;m (t=4.810,P<0.01) at 6 month visit. The average of injection number was 1.9plusmn;0.9 (including initial injection of combination therapy). With multiple lineal regression analysis, only baseline BCVA correlated to posttreatment BCVA at 6 month visit (r=0.802.P<0.01). The type of CNV, GLD, SRF or IRF on OCT and CRT at baseline were not associated to post-treatment BCVA (r=0.053, -0.183, 0.139 and 0.053, respectively.P>0.05). BCVA of eyes with SRF (14.7 letters) increased more than eyes with IRF (6.9 letters) on OCT (t=-2.207,P=0.035). The change of BCVA after treatment (t=-0.076), change of CRT (t=-1.028) and number of injections (Z=-1.505) were not different between classic CNV and minimally classic CNV (P>0.05). The change of CRT (t=-0.020) and number of injections (Z=-0.237) did not present difference between SRF and IRF (P>0.05). The change of BCVA (t=1.159) and number of injections (Z=-1.194) were not correlated to whether residual fluid or not at 6 month visit (P>0.05). No severe complications were noticed during follow-up.Conclusion For wet AMD patients, PDT combined intravitreal bevacizumab could improve visual acuity, reduce retinal thickness and control CNV progress in a short-term.

    Release date:2016-09-02 05:22 Export PDF Favorites Scan
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