AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a tota...AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.展开更多
AIM:To evaluate the trend of glaucoma internal filtration surgeries for inpatients between 2015 and 2021 at the Eye Hospital of Wenzhou Medical University.METHODS:A review of the medical records of inpatients who had ...AIM:To evaluate the trend of glaucoma internal filtration surgeries for inpatients between 2015 and 2021 at the Eye Hospital of Wenzhou Medical University.METHODS:A review of the medical records of inpatients who had been diagnosed with glaucoma and received antiglaucoma surgery between January 1,2015 and December 31,2021 was conducted.The glaucoma diagnosis in this study included primary open angle glaucoma,primary angleclosure glaucoma,secondary glaucoma,and paediatric glaucoma.The types of surgeries were categorised as internal filtration,external filtration,and cyclodestruction surgery based on the pathway of aqueous humor outflow.The trend of these glaucoma surgeries in the sample of patients with different types of glaucoma was then analysed.RESULTS:The number of patients hospitalised for glaucoma surgery increased yearly,from 752 in 2015 to 1373 in 2021,at the Eye Hospital of Wenzhou Medical University.Regarding the patients diagnosed with primary open angle glaucoma,internal filtration surgery increased from 27.40%of the sample to 54.40%of the sample,while external filtration surgery decreased from 71.50%to 44.20%between 2015 and 2021.For paediatric glaucoma,internal filtration surgery increased from 37.50%in 2015 to 88.20%in 2021.Whilst different types of surgeries were performed on the sample of patients with secondary glaucoma,the proportion of internal filtration surgery also showed an increase from 18.20%in 2015 to 40.90%in 2021.Meanwhile,internal filtration surgery in the patient sample with primary angle-closure glaucoma already accounted for over 70.00%in 2015,and showed a small increase by 2021.CONCLUSION:As surgical technology and surgical experience continue to elevate and improve,the range of glaucoma surgeries are correspondingly evolving.This study find that internal filtration surgeries accounted for an increasing proportion of treatments in the surgical management of glaucoma between 2015 and 2021.展开更多
AIM:To describe the outcome of using low-dose laser cycloplasty(LCP)in chronic angle-closure glaucoma(CACG).METHODS:A retrospective case series.Medical charts of CACG patients who underwent LCP in the Eye Hospital of ...AIM:To describe the outcome of using low-dose laser cycloplasty(LCP)in chronic angle-closure glaucoma(CACG).METHODS:A retrospective case series.Medical charts of CACG patients who underwent LCP in the Eye Hospital of Wenzhou Medical University were reviewed.The main outcomes included intraocular pressure(IOP),the number of glaucoma medication,anterior segment parameters and surgery-related complications.RESULTS:A total of 7 eyes of 7 CACG patients(age 38.9±11.0y)underwent LCP with a mean follow-up of 27.1±13.7mo(range 16-48mo).Following LCP,mean IOP and glaucoma medications decreased from 26.1±6.1 mm Hg with 3.1±1.1 glaucoma medications pre-treatment to 14.9±3.1 mm Hg(P=0.027)with 0.4±1.1 glaucoma medications(P=0.001)at final follow-up.The anterior chamber depth(ACD),angle opening distance500 and trabecular-iris angle increased from 1.65±0.33 mm,0.05 mm(range 0-0.30 mm)and 5.1°(range,0-31.97°)at baseline to 1.98±0.43 mm(P=0.073),0.53 mm(range 0.42-0.91 mm,P=0.015),45.9°(range,40.2°-59.4°),(P=0.015)in the long-term follow-up,respectively.The deepening of ACD and reopening of anterior chamber angle(ACA)was observed in 6 eyes(85.7%).CONCLUSION:LCP is a promising treatment option for patients with CACG via reducing IOP and glaucoma medication without serious complications.In addition,LCP can bring a significant deepening in ACD and reopening of ACA.展开更多
MicroRNAs(miRNAs), which play a role in tumorigenesis, may also serve as diagnostic or prognostic biomarkers. However, studies on human miRNA profiles in plasma from nasopharyngeal carcinoma(NPC) patients are in their...MicroRNAs(miRNAs), which play a role in tumorigenesis, may also serve as diagnostic or prognostic biomarkers. However, studies on human miRNA profiles in plasma from nasopharyngeal carcinoma(NPC) patients are in their infancy. Here, we used microarrays to perform systematic profiling of human miRNAs in plasma from NPC patients. We subsequently used real-time quantitative polymerase chain reaction(Q-PCR) to validate miRNAs with aberrant expression that could serve as potential biomarkers. By comparing the plasma miRNA profiles of 31 NPC patients and 19 controls, 39 of 887 human miRNAs were found to be aberrantly expressed. Considering the fold change and P value, miR-548q and miR-483-5p were validated in 132 samples from 82 NPC patients and 50 controls. Moreover, high expression of miR-548q and miR-483-5p was further found in 3 NPC cell lines and clinical biopsy tissues from 54 NPC patients and 22 controls. Our results revealed that miR-548q and miR-483-5p are potential biomarkers of NPC. Combining the receiver operating characteristic(ROC) analyses of these 2 miRNAs, an area under the ROC curve(AUC) of 0.737 with 67.1% sensitivity and 68.0% specificity were obtained, showing the preliminary diagnostic value of plasma miRNAs. Moreover, most NPC patients with a poor outcome exhibited high expression(> median) of miR-548q(70.6%) and miR-483-5p(64.7%) in tissue samples, indicating their prognostic value. The high expression levels of miR-548q and miR-483-5p in plasma, cell lines, and clinical tissues of NPC patients indicate that their roles in NPC should be explored in the future.展开更多
AIM:To investigate the risk factor of primary open angle glaucoma(POAG),which is the leading cause of irreversible blindness worldwide.An abnormally high level of endogenous formaldehyde(FA) has recently been found co...AIM:To investigate the risk factor of primary open angle glaucoma(POAG),which is the leading cause of irreversible blindness worldwide.An abnormally high level of endogenous formaldehyde(FA) has recently been found correlated with cell death and neurodegenerative disease,raising the possibility of a putative correlation of abnormal endogenous FA with POAG.· METHODS:Thirty-four elderly patients with POAG and sixteen healthy controls were enrolled.Glaucomatous visual defects were present at both the functional(visual field) and structural[retinal nerve fiber layer(RNFL)thickness]levels.Morning urine samples were obtained and were analyzed by high-performance liquid chromatography(HPLC) to detect the endogenous FA level in a double blind manner.· RESULTS:Patients with POAG(P <0.05) had significantly higher urine FA levels.The urine FA level of patients with severe visual field defects[mean deviation(MD)≥12 dB]was significantly(P<0.001) greater than that of patients with mild to moderate defects(MD<12 dB).By optical coherence tomography(OCT),the superior and inferior RNFL thickness of POAG group was significantly(P<0.001) thinner than in controls.Furthermore,the superior and inferior thinning of the RNFL was correlated with the elevation of urine FA concentration.CONCLUSION:Endogenous FA level is positively correlated with the neuronal defects of POAG.展开更多
AIM:To compare the effectiveness and safety between bevacizumab and ranibizumab in the treatment of agerelated macular degeneration(AMD)through a systematic review and meta-analysis.METHODS:We performed a comprehensiv...AIM:To compare the effectiveness and safety between bevacizumab and ranibizumab in the treatment of agerelated macular degeneration(AMD)through a systematic review and meta-analysis.METHODS:We performed a comprehensive search of randomized controlled trials(RCTs),non-RCTs,casecontrol and cohort studies that compared bevacizumab and ranibizumab using PubMed and the Cochrane Library.After the related data were extracted by two investigators independently,pooled weighted mean differences(WMDs)and risk ratios(RRs)with 95%confidence intervals(CIs)were estimated using a random-effects or a fixed-effects model.RESULTS:A total of four RCTs involving 1927 patients and eleven retrospective case series involving 2296patients were included.For the primary outcomes,no significant differences were found between ranibizumab group and bevacizumab group in visual acuity(WMD:-0.04;95%CI:-0.08 to 0.00;P=0.06),best corrected visual acuity(WMD:-0.05;95%CI:-0.10 to 0.00;P=0.05),retina thickness(WMD:-4.69;95%CI:-13.15 to 3.76;P=0.86)and foveal thickness(WMD:10.91;95%CI:-14.73 to36.56;P=0.40).The pooled analyses in the evaluation of safety showed that compared to bevacizumab,ranibizumab was associated with decreased risks of ocular inflammation(RR:0.45;95%CI:0.23 to 0.89;P=0.02)and venous thrombotic events(RR:0.27;95%CI:0.08 to 0.89;P=0.03).However,there were no significant differences observed in deaths(P=0.69)and arterialthromboembolic events(P=0.71)between the two groups.CONCLUSION:With equal clinical efficacy,ranibizumab was found to be associated with less adverse events compared to bevacizumab,indicating that ranibizumab might be a safer management.展开更多
AIM: To report the outcomes of penetrating canaloplasty for corticosteroid-induced glaucoma in a case series.METHODS: Penetrating canaloplasty is a blebindependent filtering surger y unifying canaloplasty and trabecul...AIM: To report the outcomes of penetrating canaloplasty for corticosteroid-induced glaucoma in a case series.METHODS: Penetrating canaloplasty is a blebindependent filtering surger y unifying canaloplasty and trabeculectomy. In this study, the surger y was performed to restore the natural outflow through surgically expanded Schlemm’s canal and generated trabeculum ostium. A total of 10 eyes of 8 patients were treated with penetrating canaloplasty for corticosteroid-induced glaucoma. Intraocular pressure(IOP) and the number of glaucoma medications at postoperative 3, 6, 12, 18, 24,36, and 48mo were documented as primary endpoint.Complications after the surgery were recorded as secondary endpoint.RESULTS: Penetrating canaloplasty was accomplished successfully for all 10 eyes, with a mean follow-up of 20.4±13.0mo(range 6-48mo). The mean preoperative IOP and number of anti-glaucoma medications were 45.1±6.5 mm Hg and 3.3±0.5 respectively. The mean post-operative IOP at 3, 6, 12, 18, 24, 36, and 48mo were 15.8±6.0, 14.7±3.3,15.3±2.0, 15.6±2.6, 17.5±1.8, 16.5±4.9, and 14.0 mm Hg.The number of anti-glaucoma medications at these time points were all 0. This surgery failed to control the IOP in 1 eye at 1mo after surgery. Hyphaema occurred in 3 eyes on the first day after surgery. Postoperative transient IOP increasing was encountered with in two eyes from 1wk to 1mo after surgery. Choroidal detachment developed in one eye but responded well to conservative treatment.CONCLUSION: Penetrating canaloplasty is effective for corticosteroid-induced glaucoma without serious complications, making it a viable or preferred alternative option.展开更多
Through expounding the theory of phlegm-turbidity and the development of epilepsy,this paper presents the new theoretical basis for the treatment of epilepsy.The authors calculate that phlegm and turbidity are differe...Through expounding the theory of phlegm-turbidity and the development of epilepsy,this paper presents the new theoretical basis for the treatment of epilepsy.The authors calculate that phlegm and turbidity are different in the formation and pathogenic effects.Therefore,it is necessary to expound the formation of the phlegm and turbidity.It is also necessary to explain the pathogenesis of the phlegm and turbidity in the epilepsy.Phlegm is caused by the invasion of external evil,emotional disorders,or Qi deficiency and decline,resulting in Qi and blood disorder in the body;the accumulation of phlegm and heat for a long time will lead to the accumulation of turbidity;further with the failure of Qi and fluid circulation,it will lead to brain damage and epileptic seizures.Therefore,the treatment needs to distinguish the severity of phlegm and turbidity,based on which,use different herbs for the treatment of epilepsy.展开更多
Background:Tissue specimens for nasopharyngeal carcinoma(NPC)research are scarce because of sampling dif-ficulties.Previous studies have suggested non-invasive nasopharyngeal brushing as an effective sampling method f...Background:Tissue specimens for nasopharyngeal carcinoma(NPC)research are scarce because of sampling dif-ficulties.Previous studies have suggested non-invasive nasopharyngeal brushing as an effective sampling method for NPC diagnosis.The present study aimed to evaluate the feasibility of nasopharyngeal brushing in the acquisition of NPC nucleic acids for research.Methods:Nasopharyngeal brushing samples were acquired from 24 healthy individuals and 48 NPC patients.Tissues from 48 NPC and 18 nasopharyngitis patients were collected by endoscopic biopsy.The expression levels of tumor suppressor genes(TSGs)and Epstein-Barr virus(EBV)-encoded microRNAs as well as EBV DNA copy number were measured by quantitative polymerase chain reaction in both types of samples.Results:Among six TSGs examined,the expression levels of two genes were significantly decreased in nasopharyn-geal brushing and tissue samples from NPC patients as compared with those from healthy/nasopharyngitis indi-viduals.Four EBV-encoded microRNAs,mir-bart1-5p,mir-bart5,mir-bart6-5p,and mir-bart17-5p,were significantly up-regulated in both NPC brushing and tissue samples compared with those from healthy/nasopharyngitis controls(P<0.001).EBV DNA was significantly increased in both nasopharyngeal brushing samples(P<0.001)and tissue sam-ples(P<0.001)from NPC patients in comparison with those from healthy controls.Conclusions:Nasopharyngeal brushing can obtain sufficient tumoral materials for the analysis of viral nucleic acid,including EBV-encoded microRNAs and EBV DNA.For the detection of TSG expression,nasopharyngeal brushings was feasible but inferior to tissue samples.This study confirms nasopharyngeal brushing as an applicable sampling method that can aid in nucleic acid-based NPC research.展开更多
Dear Editor,Nasopharyngeal carcinoma(NPC)is a common malignancy in East and Southeast Asia,especially in South China.The etiology of NPC has been linked to genetic susceptibility,Epstein-Barr virus(EBV)infection,and e...Dear Editor,Nasopharyngeal carcinoma(NPC)is a common malignancy in East and Southeast Asia,especially in South China.The etiology of NPC has been linked to genetic susceptibility,Epstein-Barr virus(EBV)infection,and environmental factors.Accumulated evidence including multiple genome-wide association studies(GWASs)has revealed robust genetic predisposition of NPC.However,GWAS-identified genetic variants collectively account for only 8.2%of NPC heritability[1].The underlying inherited predisposition is largely undetermined.The strongest genetic signal for NPC consistently hits the human leukocyte antigen(HLA)region on 6p21[2].However,the highly polymorphic nature and complicated long-range linkage disequilibrium(LD)in the HLA region particularly obscure the causal variants driving the association.In addition,most genetic variants located in introns or intergenic regions.The causal genes mediating genetic effects on NPC risk have rarely been ascertained by GWAS alone.展开更多
基金Supported by the Key Innovation and Guidance Program of the Eye Hospital,School of Ophthalmology&Optometry,Wenzhou Medical University(No.YNZD2201903)the Scientific Research Foundation of the Eye Hospital,School of Ophthalmology&Optometry,Wenzhou Medical University(No.KYQD20180306)the Nursing Project of the Eye Hospital of Wenzhou Medical University(No.YNHL2201908).
文摘AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.
基金Supported by the National Key Research and Development Project of China(No.2020YFC2008200)the Program for Zhejiang Leading Talent of S&T Innovation(No.2021R52012)+1 种基金Key Research and Development Projects of Zhejiang Province(No.2022C03112)the Zhejiang Provincial Program for the Cultivation of Leading Talents in Colleges and Universities(No.2020099)。
文摘AIM:To evaluate the trend of glaucoma internal filtration surgeries for inpatients between 2015 and 2021 at the Eye Hospital of Wenzhou Medical University.METHODS:A review of the medical records of inpatients who had been diagnosed with glaucoma and received antiglaucoma surgery between January 1,2015 and December 31,2021 was conducted.The glaucoma diagnosis in this study included primary open angle glaucoma,primary angleclosure glaucoma,secondary glaucoma,and paediatric glaucoma.The types of surgeries were categorised as internal filtration,external filtration,and cyclodestruction surgery based on the pathway of aqueous humor outflow.The trend of these glaucoma surgeries in the sample of patients with different types of glaucoma was then analysed.RESULTS:The number of patients hospitalised for glaucoma surgery increased yearly,from 752 in 2015 to 1373 in 2021,at the Eye Hospital of Wenzhou Medical University.Regarding the patients diagnosed with primary open angle glaucoma,internal filtration surgery increased from 27.40%of the sample to 54.40%of the sample,while external filtration surgery decreased from 71.50%to 44.20%between 2015 and 2021.For paediatric glaucoma,internal filtration surgery increased from 37.50%in 2015 to 88.20%in 2021.Whilst different types of surgeries were performed on the sample of patients with secondary glaucoma,the proportion of internal filtration surgery also showed an increase from 18.20%in 2015 to 40.90%in 2021.Meanwhile,internal filtration surgery in the patient sample with primary angle-closure glaucoma already accounted for over 70.00%in 2015,and showed a small increase by 2021.CONCLUSION:As surgical technology and surgical experience continue to elevate and improve,the range of glaucoma surgeries are correspondingly evolving.This study find that internal filtration surgeries accounted for an increasing proportion of treatments in the surgical management of glaucoma between 2015 and 2021.
基金Supported by the Program for Zhejiang Leading Talent of S&T Innovation(No.2021R52012)Key Research and Development Projects of Zhejiang Province(No.2022C03112)the Basic Scientific Research Program of Wenzhou(No.Y2020365).
文摘AIM:To describe the outcome of using low-dose laser cycloplasty(LCP)in chronic angle-closure glaucoma(CACG).METHODS:A retrospective case series.Medical charts of CACG patients who underwent LCP in the Eye Hospital of Wenzhou Medical University were reviewed.The main outcomes included intraocular pressure(IOP),the number of glaucoma medication,anterior segment parameters and surgery-related complications.RESULTS:A total of 7 eyes of 7 CACG patients(age 38.9±11.0y)underwent LCP with a mean follow-up of 27.1±13.7mo(range 16-48mo).Following LCP,mean IOP and glaucoma medications decreased from 26.1±6.1 mm Hg with 3.1±1.1 glaucoma medications pre-treatment to 14.9±3.1 mm Hg(P=0.027)with 0.4±1.1 glaucoma medications(P=0.001)at final follow-up.The anterior chamber depth(ACD),angle opening distance500 and trabecular-iris angle increased from 1.65±0.33 mm,0.05 mm(range 0-0.30 mm)and 5.1°(range,0-31.97°)at baseline to 1.98±0.43 mm(P=0.073),0.53 mm(range 0.42-0.91 mm,P=0.015),45.9°(range,40.2°-59.4°),(P=0.015)in the long-term follow-up,respectively.The deepening of ACD and reopening of anterior chamber angle(ACA)was observed in 6 eyes(85.7%).CONCLUSION:LCP is a promising treatment option for patients with CACG via reducing IOP and glaucoma medication without serious complications.In addition,LCP can bring a significant deepening in ACD and reopening of ACA.
基金supported by the National Basic Research Program of China (2011CB504303)the Ministry of Science and Technology of China (2011ZX11307)the Natural Science Foundation of Guangdong Province (9151008004000002)
文摘MicroRNAs(miRNAs), which play a role in tumorigenesis, may also serve as diagnostic or prognostic biomarkers. However, studies on human miRNA profiles in plasma from nasopharyngeal carcinoma(NPC) patients are in their infancy. Here, we used microarrays to perform systematic profiling of human miRNAs in plasma from NPC patients. We subsequently used real-time quantitative polymerase chain reaction(Q-PCR) to validate miRNAs with aberrant expression that could serve as potential biomarkers. By comparing the plasma miRNA profiles of 31 NPC patients and 19 controls, 39 of 887 human miRNAs were found to be aberrantly expressed. Considering the fold change and P value, miR-548q and miR-483-5p were validated in 132 samples from 82 NPC patients and 50 controls. Moreover, high expression of miR-548q and miR-483-5p was further found in 3 NPC cell lines and clinical biopsy tissues from 54 NPC patients and 22 controls. Our results revealed that miR-548q and miR-483-5p are potential biomarkers of NPC. Combining the receiver operating characteristic(ROC) analyses of these 2 miRNAs, an area under the ROC curve(AUC) of 0.737 with 67.1% sensitivity and 68.0% specificity were obtained, showing the preliminary diagnostic value of plasma miRNAs. Moreover, most NPC patients with a poor outcome exhibited high expression(> median) of miR-548q(70.6%) and miR-483-5p(64.7%) in tissue samples, indicating their prognostic value. The high expression levels of miR-548q and miR-483-5p in plasma, cell lines, and clinical tissues of NPC patients indicate that their roles in NPC should be explored in the future.
基金Supported by National Basic Research Program of China(973 Program,No.2012CB911004)the National Natural Science Foundation of China(No. 81041008No.30772376)
文摘AIM:To investigate the risk factor of primary open angle glaucoma(POAG),which is the leading cause of irreversible blindness worldwide.An abnormally high level of endogenous formaldehyde(FA) has recently been found correlated with cell death and neurodegenerative disease,raising the possibility of a putative correlation of abnormal endogenous FA with POAG.· METHODS:Thirty-four elderly patients with POAG and sixteen healthy controls were enrolled.Glaucomatous visual defects were present at both the functional(visual field) and structural[retinal nerve fiber layer(RNFL)thickness]levels.Morning urine samples were obtained and were analyzed by high-performance liquid chromatography(HPLC) to detect the endogenous FA level in a double blind manner.· RESULTS:Patients with POAG(P <0.05) had significantly higher urine FA levels.The urine FA level of patients with severe visual field defects[mean deviation(MD)≥12 dB]was significantly(P<0.001) greater than that of patients with mild to moderate defects(MD<12 dB).By optical coherence tomography(OCT),the superior and inferior RNFL thickness of POAG group was significantly(P<0.001) thinner than in controls.Furthermore,the superior and inferior thinning of the RNFL was correlated with the elevation of urine FA concentration.CONCLUSION:Endogenous FA level is positively correlated with the neuronal defects of POAG.
文摘AIM:To compare the effectiveness and safety between bevacizumab and ranibizumab in the treatment of agerelated macular degeneration(AMD)through a systematic review and meta-analysis.METHODS:We performed a comprehensive search of randomized controlled trials(RCTs),non-RCTs,casecontrol and cohort studies that compared bevacizumab and ranibizumab using PubMed and the Cochrane Library.After the related data were extracted by two investigators independently,pooled weighted mean differences(WMDs)and risk ratios(RRs)with 95%confidence intervals(CIs)were estimated using a random-effects or a fixed-effects model.RESULTS:A total of four RCTs involving 1927 patients and eleven retrospective case series involving 2296patients were included.For the primary outcomes,no significant differences were found between ranibizumab group and bevacizumab group in visual acuity(WMD:-0.04;95%CI:-0.08 to 0.00;P=0.06),best corrected visual acuity(WMD:-0.05;95%CI:-0.10 to 0.00;P=0.05),retina thickness(WMD:-4.69;95%CI:-13.15 to 3.76;P=0.86)and foveal thickness(WMD:10.91;95%CI:-14.73 to36.56;P=0.40).The pooled analyses in the evaluation of safety showed that compared to bevacizumab,ranibizumab was associated with decreased risks of ocular inflammation(RR:0.45;95%CI:0.23 to 0.89;P=0.02)and venous thrombotic events(RR:0.27;95%CI:0.08 to 0.89;P=0.03).However,there were no significant differences observed in deaths(P=0.69)and arterialthromboembolic events(P=0.71)between the two groups.CONCLUSION:With equal clinical efficacy,ranibizumab was found to be associated with less adverse events compared to bevacizumab,indicating that ranibizumab might be a safer management.
基金Supported by National Key Research and Development Project of China (No.2020YFC2008200)Program for Zhejiang Leading Talent of S&T Innovation (No.2021R52012)+1 种基金Key Research and Development Projects of Zhejiang Province (No.2022C03112)Zhejiang Provincial Program for the Cultivation of Leading Talents in Colleges and Universities (No.2020099)。
文摘AIM: To report the outcomes of penetrating canaloplasty for corticosteroid-induced glaucoma in a case series.METHODS: Penetrating canaloplasty is a blebindependent filtering surger y unifying canaloplasty and trabeculectomy. In this study, the surger y was performed to restore the natural outflow through surgically expanded Schlemm’s canal and generated trabeculum ostium. A total of 10 eyes of 8 patients were treated with penetrating canaloplasty for corticosteroid-induced glaucoma. Intraocular pressure(IOP) and the number of glaucoma medications at postoperative 3, 6, 12, 18, 24,36, and 48mo were documented as primary endpoint.Complications after the surgery were recorded as secondary endpoint.RESULTS: Penetrating canaloplasty was accomplished successfully for all 10 eyes, with a mean follow-up of 20.4±13.0mo(range 6-48mo). The mean preoperative IOP and number of anti-glaucoma medications were 45.1±6.5 mm Hg and 3.3±0.5 respectively. The mean post-operative IOP at 3, 6, 12, 18, 24, 36, and 48mo were 15.8±6.0, 14.7±3.3,15.3±2.0, 15.6±2.6, 17.5±1.8, 16.5±4.9, and 14.0 mm Hg.The number of anti-glaucoma medications at these time points were all 0. This surgery failed to control the IOP in 1 eye at 1mo after surgery. Hyphaema occurred in 3 eyes on the first day after surgery. Postoperative transient IOP increasing was encountered with in two eyes from 1wk to 1mo after surgery. Choroidal detachment developed in one eye but responded well to conservative treatment.CONCLUSION: Penetrating canaloplasty is effective for corticosteroid-induced glaucoma without serious complications, making it a viable or preferred alternative option.
文摘Through expounding the theory of phlegm-turbidity and the development of epilepsy,this paper presents the new theoretical basis for the treatment of epilepsy.The authors calculate that phlegm and turbidity are different in the formation and pathogenic effects.Therefore,it is necessary to expound the formation of the phlegm and turbidity.It is also necessary to explain the pathogenesis of the phlegm and turbidity in the epilepsy.Phlegm is caused by the invasion of external evil,emotional disorders,or Qi deficiency and decline,resulting in Qi and blood disorder in the body;the accumulation of phlegm and heat for a long time will lead to the accumulation of turbidity;further with the failure of Qi and fluid circulation,it will lead to brain damage and epileptic seizures.Therefore,the treatment needs to distinguish the severity of phlegm and turbidity,based on which,use different herbs for the treatment of epilepsy.
基金supported by the Major International Cooperation Projects of the National Natural Science Foundation of China(No.81220108022)the National Natural Science Funds for Distinguished Young Scholars(No.81325018)+3 种基金the National Key Research and Development Program(No.2016YFC1302704)Guangdong Special Support Programs for High-level Personnel(No.2014TX01R201)the Science and Technology Project of Guangdong Province(No.2014B050504004)the Health&Medical Collaborative Innovation Project of Guangzhou City(No.201604020003).
文摘Background:Tissue specimens for nasopharyngeal carcinoma(NPC)research are scarce because of sampling dif-ficulties.Previous studies have suggested non-invasive nasopharyngeal brushing as an effective sampling method for NPC diagnosis.The present study aimed to evaluate the feasibility of nasopharyngeal brushing in the acquisition of NPC nucleic acids for research.Methods:Nasopharyngeal brushing samples were acquired from 24 healthy individuals and 48 NPC patients.Tissues from 48 NPC and 18 nasopharyngitis patients were collected by endoscopic biopsy.The expression levels of tumor suppressor genes(TSGs)and Epstein-Barr virus(EBV)-encoded microRNAs as well as EBV DNA copy number were measured by quantitative polymerase chain reaction in both types of samples.Results:Among six TSGs examined,the expression levels of two genes were significantly decreased in nasopharyn-geal brushing and tissue samples from NPC patients as compared with those from healthy/nasopharyngitis indi-viduals.Four EBV-encoded microRNAs,mir-bart1-5p,mir-bart5,mir-bart6-5p,and mir-bart17-5p,were significantly up-regulated in both NPC brushing and tissue samples compared with those from healthy/nasopharyngitis controls(P<0.001).EBV DNA was significantly increased in both nasopharyngeal brushing samples(P<0.001)and tissue sam-ples(P<0.001)from NPC patients in comparison with those from healthy controls.Conclusions:Nasopharyngeal brushing can obtain sufficient tumoral materials for the analysis of viral nucleic acid,including EBV-encoded microRNAs and EBV DNA.For the detection of TSG expression,nasopharyngeal brushings was feasible but inferior to tissue samples.This study confirms nasopharyngeal brushing as an applicable sampling method that can aid in nucleic acid-based NPC research.
基金the National Key Research and Development Program of China(2021YFC2500400)the Basic and Applied Basic Research Foundation of Guangdong Province,China(2021B1515420007)+4 种基金Sino-Sweden Joint Research Programme(81861138006)the Science and Technology Planning Project of Guangzhou,China(201804020094)the Special Support Program for High-level Professionals on Scientific and Technological Innovation of Guangdong Province,China(2014TX01R201)National Natural Science Foundation of China(81973131,81903395,81803319,82003520)National Science Fund for Distinguished Young Scholars of China(81325018).
文摘Dear Editor,Nasopharyngeal carcinoma(NPC)is a common malignancy in East and Southeast Asia,especially in South China.The etiology of NPC has been linked to genetic susceptibility,Epstein-Barr virus(EBV)infection,and environmental factors.Accumulated evidence including multiple genome-wide association studies(GWASs)has revealed robust genetic predisposition of NPC.However,GWAS-identified genetic variants collectively account for only 8.2%of NPC heritability[1].The underlying inherited predisposition is largely undetermined.The strongest genetic signal for NPC consistently hits the human leukocyte antigen(HLA)region on 6p21[2].However,the highly polymorphic nature and complicated long-range linkage disequilibrium(LD)in the HLA region particularly obscure the causal variants driving the association.In addition,most genetic variants located in introns or intergenic regions.The causal genes mediating genetic effects on NPC risk have rarely been ascertained by GWAS alone.
