Objective lt;brgt;To evaluated the effect of transpupillary thermotherapy (TTT) on age-related macular degeneration (AMD). lt;brgt; lt;brgt;Methods lt;brgt;Sixty-two cases (62 eyes) of exudative AMD were managed with TTT. Before treatment, 58 cases underwent fundus fluorescein angiography(FFA),42 cases underwent simultaneous indocyanine green angiography (ICGA), and 56 cases underwent optic coherence tomography (OCT).TTT was delivered using a 810 nm diode laser with variable spot sizes 0.5-3.0 mm and power range 60-40 mW,60 seconds duration. Sixty-two cases were followed up for 1-10 months with 4.8 months average. lt;brgt; lt;brgt;Results lt;brgt;The visual acuities of last visit were compared with those before the treatment. The visual acuity was unchanged in 43 cases (69.3%), improved in 15 cases (24.2%), and declined in 4 cases (6.5%). OCT was re-done in 51 cases and compared with OCT images before TTT treatment. The height of macular edema was unchanged in 29 cases (56.9%), decreased in 18 cases (35.3%), and increased in 4 cases (7.8%). The amelioration of visual acuity was compatible with that of macular configuration in the majority of cases (74.5%). Only in 13 cases (25.5%) the amelioration of visual acuity lagged behind that of macular configuration. The re-treatment was performed in 18 cases (29.1%), probably due to insufficiency of laser power. No side-effect was found. lt;brgt; lt;brgt;Conclusion lt;brgt;TTT makes most of the cases of exudative AMD retaining or improving their visual acuity. The employment is secured. Further exploration is needed in order to obtain the parameters of the laser treatment. (Chin J Ocul Fundus Dis, 2002, 18: 180-183)
To evaluate the tberapeutlc effect of diode laser photocoagulation trearment on eases of diabetic retinopathy with certain degree of refractive media opacity. METHODS: Diode laser photocoagulation treatment were given to 36 selected cases (40 eyes )of diabetic retinopathy who can not be treated with argon laser because of refractive media opacity, Before and after treatment,visual acuity and fundus were examined and fundus fluorescein angiography and retinal color photographp were taken. The follow-up period was 8~14 months (with an average of 11 months) RESULT:Visual acuity were improved or maintained in 29 eyes(about 73%)of the 34 eyes of proliferative diabetic retinopathy ,retinal new vessels partly or entirely regressed in 25 eyes(about 74%). CONCLUTION ;Tbe effect of diode laser treatment on patients with diabetic retinopatby with certain degree of lens/vitreous opacity is relatively safisfactory. （Chin J Ocul Fundus Dis,1996,12:111- 113）
【Abstract】ObjectiveTo construct a recombinant eukaryotic expression vector for human endostatin in order to study the inhibitory effect of liposome-mediated endostatin gene on the growth of human liver carcinoma in nude mice. MethodsHuman endostatin cDNA including IL-2 secreting peptide was cloned into eukaryotic expression plasmid pcDNA3.0 to construct recombinant plasmid pCD-sEndo. pCD-sEndo plasmid was transferred into hepatocarcinoma cell line SMMC-7721 mediated by liposome Dosper, the expression and secretion of endostatin gene was detected by RTPCR and Western blot analysis. The suspension of SMMC-7721 cells was injected subcutaneously at the back of 32 nude mice to establish the model of human liver carcinoma. The mice were divided into 4 groups randomly, and injected with Dosper+pCD-sEndo, Dosper+pcDNA3.0, Dosper and physiological brine separately. Tumor volume was measured by stages. The mice were executed after the drug had been given for 1 week, then the microvessel density (MVD) of the tumor tissue was detected with immunohistochemical method and apoptotic index of tumor cells was measured by TUNEL-stain. ResultsThe eukaryotic expression vector pCD-sEndo was successfully constructed and was confirmed by enzyme digestion and sequence analysis. Expression of endostatin gene was detected in transfected SMMS-7721 cells by RTPCR in vitro, and endostatin protein was also detected in the supernatant of transfected SMMS-7721 cells by Western blot. In vivo study, the growth of human liver carcinoma was inhibited in the group injected with endostatin gene: the average volume of tumor in this group was significantly smaller than that in other groups （P＜0.05）; the average MVD in this group was 6.2±2.5, significantly less than that in the group injected with physiological brine (32.8±6.4), Dosper （27.8±6.4）, or Dosper+pcDNA3.0 (25.5±5.5), P＜0.05. The average apoptotic index of tumor cells in treatment group, brine group, Dosper group and Desper+pcDNA3.0 group was 24.5±7.3, 7.6±2.5, 9.5±3.0 and 11.2±3.6 respectively, it was evidently higher in the treatment group than in the latter three groups. ConclusionHuman endostatin mediated by cation liposome could decrease the microvessel number of implanted human hepatocarcinoma in nude mice. It could also accelerate apoptosis of tumor cells and inhibit growth of tumor.
Objective To make an individualized therapeutic regimen for a patient with stage III relapsed ovarian cancer guided by evidence-based medicine.Methods According to the clinical problems this patient showed and the PICO (patient, intervention, comparison and outcome) principle, the best clinical evidence associated with relapsed ovarian cancer was retrieved and evaluated. Results The current evidence showed that the relapsed ovarian cancer with platinum resistance tended to be treated by pharmacotherapy. Consequently, on the basis of combining the recommended guidelines, randomized controlled trials (RCTs), systematic reviews or meta-analyses on RCTs, clinical experience from doctors and willingness of patient, the regimen of Irinotecan plus Pegylated Liposomal Doxorubicin for interventional chemotherapy was recommended for this patient. After three courses of the treatment, the disease got some relieved; the medical team would like to keep conducting the same regimen for another six to eight courses, and the follow-up visit was undergoing. Conclusion For patients with relapsed ovarian cancer with platinum resistance, an individualized therapeutic regimen under the guidance of evidence-based methods can not only improve the therapeutic efficacy but also guide both doctors and patients to take the indeterminate risk of medicine.
Objective To observe the clinical features, the complications and treatment effects of intermediate uveitis. Methods The clinical data of 36 patients (66 eyes) with intermediate uveitis were retrospectively analyzed，including the clinical features, fundus fluorescein angiography (FFA) features, complications，treatment effects and prognosis. The patients, 21 males and 15 females, aged from 8 to 70 years，with the mean age of 34.8 years. There were 30 cases with bilateral lesions and 6 cases with unilateral lesions. Results The main clinical manifestation were vitreous opacity, peripheral retinal venous lesions, optic disc edema, macular edema and posterior subcapsular cataract. The results of FFA showed that peripheral retinal venous lesions, optic disc hyperfluorescence, cystoid macular edema and retinal vein staining. After the treatment, the visual acuity of 31 cases（60 eyes，90.9%) were improved, 4 cases（5 eyes，7.6%) were stable and 1 case（1 eye，1.5%) was worsening. The main complications were cystoid macular edema, posterior subcapsular cataract and vitreous hemorrhage which leads to visual damage. Conclusions Intermediate uveitis was a common bilateral and chronic progressive intraocular inflammation，the anterior vitritis, pars plana and peripheral retinal vascular changes were mainly involved. Early diagnosis and proper treatment may prevent the permanent visual damage.
Purpose To study the possibility of prevention of proliferative vitreoretinopathy（PVR） by transduction of exogenous gene in vivo． Methods PVR model of rabbits was induced by intravitreal injection of fibroblasts．beta;-galactosidase (lacZ) gene as a reporter gene was transfered into the vitreous of PVR model eyes mediated by retroviral vector, and the expression of the gene in eye tissues was determined ． Gene transfection was done on the 6th day after fibroblasts injection,and the dosage of intravitreal injection of reporter gene was 0．1ml PLXSN/lacZ serum-free supernatant (1．1times;106 cfu/ml)． Results lacZ gene expression was seen in proliferative membranes after gene transfection, and the expression was located maily at the surface of PVR membrane．The reporter gene expression lasted at least more than 30 days．No expression was found in retinal tissues． Conclusions Retrovirus mediated gene can be directionally transducted in PVR membrane,and might possess the feasibility of gene therapy for PVR． (Chin J Ocul Fundus Dis, 2001,17:224-226)
Objective To study the effect of direct bone morphogenetic protein 2 (BMP-2) gene therapy mediated by adenovirus on repairing bone defect. Methods The radial defect models were made on 60 rabbits, which were evenly divided into 4 groups randomly. The 4 groups were treated with different materials: group A, adenovirus carrying BMP-2 gene (AdBMP-2) plus bovine cancellous bone (BCB); group B, reconstructed BMP-2 plus BCB; group C, AdLacz plus BCB; and group D, only BCB scaffolds. The X-ray, histological examination, biomechanics analysis, and immunohistochemical staining were made 4, 8, and 12 weeks after the operation. Results Group A gained better effect in the volume of new bones, the anti-bending intensity of the healing bone, and the expression of BMP-2 than those of group B. The defect in group A was healed. No new bones were observed in group C and group D. Conclusion Direct BMP-2 gene therapy is easy to perform and has veryb osteoinduction ability. It is a good method to repair segmental bone defects.
ObjectiveTo evaluate the effect of neoadjuvant chemotherapy and find the mechanism of multidrug resistance. MethodsTwenty patients with gastric cancer and 31 patients with colorectal cancer underwent neoadjuvant chemotherapy and then operations. The preoperative specimens were stained by immunohistochemical techniques for testing p53,multidrug resistanceassociated protein (MRP), glutathione S transferase（GST）, telomerase. Resection specimens were evaluated for chemotherapy effect by routine histology; at the same time, the postoperative morbidity and mortality were observed. ResultsIn 51 patients, the response rate of neoadjuvant chemotherapy was 27.45%(14/51),so multidrug resistance was a kind of common phenomena in gastrointestinal carcinomas. The postoperative morbidity was 15.69%(8/15), the main operation complication was infection,the mortality was 1.96%(1/51),only one person died from severe infection.The expression rate of p53, MRP, GST, telomerase was 58.0%,51.0%,66.7%,74.0%respectively, the location of p53 was at cell nucleus,location of MRP,GST was at cell memberane and cytoplasm,location of telomerase was at cytoplasm.The response rate had nothing to do with age, sex and metastasis. But it was related with p53 and telomerase expression. ConclusionNeoadjuvant chemotherapy is an effective, safe therapy. But the rate of drug resistance is high in gastrointestinal carcinomas, and the response rate is related to p53, telomerase expression.
Objective To evaluate the efficacy and safety of dexamethasone intravitreal implant (Ozurdex) in the treatment of macular edema (ME) secondary to retinal vein occlusion (RVO). Methods Thirty-nine patients (39 eyes) with ME secondary to RVO were enrolles in this study. Of the patients, 27 were male and 12 were female. The mean age was (41.9±16.3) years. The mean course of disease was (5.0±5.3) months. The best corrected visual acuity (BCVA), intraocular pressure and optical coherence tomography (OCT) were performed. BCVA was measured by Early Treatment Diabetic Retinopathy Study charts. Central macular thickness (CMT) was measured by OCT. The mean BCVA was (13.4±15.3) letters. The mean intraocular pressure (IOP) was (14.1±2.8) mmHg (1 mmHg=0.133 kPa). The mean CMT was (876.1±437.9) μm. Of the 39 eyes, 33 were central RVO, 6 were branch RVO. Patients were categorized into ischemic (18 eyes)/non-ischemic (21 eyes) groups and previous treatment (22 eyes)/treatment naïve (17 eyes) groups. All eyes underwent intravitreal 0.7 mg Ozurdex injections. BCVA, IOP and CMT were assessed at 1, 2, 3, 6, 9, 12 months after injection. Three months after injection, intravitreal injections of Ozurdex, triamcinolone acetonide or ranibizumab could be considered for patients with ME recurrence or poor treatment effects. Change of BCVA, IOP and CMT were evaluated with paired t test. The presence of ocular and systemic adverse events were assessed. Results BCVA, IOP significantly increased and CMT significantly decreased at 1 month after injection compared to baseline in all groups (t=3.70, 3.69, 4.32, 3.08, 4.25, 6.09, 6.25, 4.02, 5.49, 8.18, 6.54, 5.73; P＜0.05). Two months after injection, change of BCVA, IOP and CMT was most significant (t=4.93, 6.80, 6.71, 5.53, 4.97, 5.89, 5.13, 7.68, 7.31, 8.67, 8.31, 5.82; P＜0.05). Twelve months after injection, there was no statistical difference regarding BCVA of ischemic RVO group and previous treatment group, compared to baseline (t=1.86, 0.67; P＞0.05); BCVA of non-ischemic RVO group and treatment naïve group significantly increased compared to baseline (t=2.27, 2.30; P＜0.05); there was no statistical difference regarding IOP in all groups (t=0.30, 0.13, 0.64, 1.53; P＞0.05);however, CMT significantly decreased in all groups (t=4.60, 3.26, 3.00, 4.87; P＜0.05). Twenty-seven eyes (69.2%) experiences ME recurrence (4.5±1.5) months after injection. Most common side-effect was secondary glaucoma. 41.0% eyes had IOP more than 25 mmHg, most of which were lowered to normal range with use of topical IOP lowering drugs. Four eyes (10.3%) presented with significant cataract progression and needed surgical treatment, all were central RVO eyes. No serious ocular or systemic adverse events such as vitreous hemorrhage, retinal detachment or endophthalmitis were noted. Conclusions Intravitreal injection of Ozurdex for patients with ME secondary to RVO is effective in increasing BCVA and lowering CMT in the first few months. Significant treatment effect could be seen at 1 month after injection and was most significant at 2 months after injection. The long-term vision of eyes in non-ischemic RVO group and treatment naïve group are better. 69.2% eyes experience ME recurrence at 4 months after injection. Short term adverse events were mostly secondary glaucoma and long term adverse events are mostly cataract progression.
Objective To investigate the inhibitive effect of E2F decoy oligodeoxynucleotides (E2F decoy ODNs) on cultured human retinal pigment epithelial (HRPE) cells.Methods E2F decoy ODNs or scramble decoy ODNs at varied concentrations were put into the HRPE cells mediated by lipofectamineTM2000. The proliferative activity of HRPE was detected by methythiazolyl-terazollium assay, and the competitive combinative activity of E2F decoy ODNs and transcription factor E2F was detected by electrophoresis mobility-shift assay. Results The proliferation of HRPE was inhibited markedly by E2F decoy ODNs at the concentration of 0.2 μmol/L (P=0.002) in a dose-dependent manner but not by scrambled decoy. The results of electrophoresis mobility-shift assay showed that the combinative activity of transcription factor E2F was abolished completely by E2F decoy ODNs. Conclusions E2F decoy ODNs may sequence-specifically inhibit the combinative activity of transcripti on factor E2F,and inhibit the proliferation of HRPE cells.(Chin J Ocul Fundus Dis，2004，20：182-185)