AIM: To evaluate the relationship between intravitreal bevacizumab(IVB) treatment and the levels of vitreous vascular endothelial growth factor(VEGF), basic fibroblast growth factor(b FGF) and vitreous-retina surface ...AIM: To evaluate the relationship between intravitreal bevacizumab(IVB) treatment and the levels of vitreous vascular endothelial growth factor(VEGF), basic fibroblast growth factor(b FGF) and vitreous-retina surface fibrosis in patients with proliferative diabetic retinopathy(PDR).·METHODS: This study was a prospective, open-label,controlled, randomized clinical trial. Sixty-eight eyes of PDR patients(n =53) and macular hole patients(n =15)were enrolled in this study. Thirty-four eyes of the PDR patients received IVB before vitrectomy. Twenty-three of the 34 PDR patients received IVB treatment 5d before vitrectomy(subgroup a), and 11 of the 34 PDR patients received IVB treatment greater than 2wk prior to vitrectomy(subgroup b). Nineteen of the PDR patients did not receive IVB treatment at any time prior to vitrectomy. The levels of b FGF and VEGF in vitreous samples were measured using enzyme-linked immunosorbent assay(ELISA) and the degree of vitreoretinal fibrosis was characterized using clinical data and data obtained intra-operatively.·RESULTS: In PDR patients, VEGF and b FGF levels were significantly increased compared to non-PDR(control) subject's eyes(P <0.01). In PDR patients,vitreous VEGF levels were significantly decreased following IVB treatment compared to PDR patients that did not receive IVB treatment(P <0.01). The degree of vitreoretinal fibrosis was significantly increased in subgroup b compared to subgroup a(P <0.05) and to patients that did not receive IVB(P <0.05). Vitreous b FGF levels were significantly greater in subgroup b than subgroup a(P <0.01) or in patients who did not receive IVB treatment(P <0.05). A Spearman's rank correlationtest indicated that higher levels of vitreous b FGF, but not VEGF, correlated with the degree of vitreoretinal fibrosis.·CONCLUSION: We found that b FGF levels increase in PDR patient's vitreous after IVB treatment longer than two weeks prior to vitrectomy and correlated with the degree of fibrosis after IVB treatment. These findings suggest vitreous fibrosis is increased in PDR patients after IVB treatment may be due to increased levels of b FGF.展开更多
BACKGROUND Hypertensive cerebral hemorrhage(HICH)is the rupture and bleeding of vessels of the cerebral parenchyma caused by continuously elevated or violently fluctuating blood pressure.The condition is characterized...BACKGROUND Hypertensive cerebral hemorrhage(HICH)is the rupture and bleeding of vessels of the cerebral parenchyma caused by continuously elevated or violently fluctuating blood pressure.The condition is characterized by high disability and high mortality.Hematoma formation and resulting space-occupying effects following intracerebral hemorrhage are among the key causes of impaired neurological function and disability.Consequently,minimally invasive clearance of the hematoma is undertaken for the treatment of HICH because it can effectively relieve intracranial hypertension.Therefore,special attention should be given to the quality of medical and nursing interventions in the convalescent period after minimally invasive hematoma clearance.AIM The study aim was to determine the value of intensive intervention,including doctors,nurses,and patient families,for the prevention of rebleeding in elderly patients with HICH during the first hospitalization for rehabilitation after the ictal event METHODS A total of 150 elderly HICH patients with minimally invasive hematoma evacuation in our hospital between May 2018 and May 2020 were selected and equally divided into two groups of 75 each by their planned intervention.The control group was given conventional nursing intervention and the observation group was given tripartite intensive intervention.The length of hospital stay,cost,complication rate,satisfaction rate,and rebleeding rate during hospitalization were recorded.Changes in cerebral blood flow indicators were recorded in both groups.Changes in the National Institutes of Health Stroke Scale(NIHSS)score,quality of life index(QLI)score,and health behavior score were evaluated at the National Institutes of Health.RESULTS Duration of hospitalization was shorter in the in the observation group than in the control group,the hospitalization cost was less than in the control group,and the rate of rebleeding during hospitalization was lower than in the control group(all P<0.05).There were no significant differences between the two groups before treatment(all P>0.05).The mean flow rate(Qmean)and mean velocity(Vmean)of the two groups increased(P<0.05),and the dynamic resistance and peripheral resistance decreased(P<0.05).The Qmean and Vmean in the intervention group were higher than those in the control group(P<0.05).Moreover,the dynamic resistance and peripheral resistance of the blood vessels were also lower in the intervention group than in the control group(P<0.05).The difference in health behavior scores between the two groups before treatment was not significant(P>0.05).In both groups,the scores for healthy behaviors such as emotion control,medication adherence,dietary management,exercise management,and selfmonitoring were higher after than before treatment(P<0.05),and the scores of healthy behaviors in the intervention group were higher than those in the control group(P<0.05).There was no significant difference in the NIHSS and QLI scores between the two groups before treatment(P>0.05).The QLI scores of the two groups increased(P<0.05),and the NIHSS scores decreased(P<0.05).The QLI scores of the intervention group were higher than those of the control group(P<0.05),and the NIHSS score was correspondingly lower than that of the control group(P<0.05).The incidence of respiratory infections,pressure sores,central hyperpyrexia,and deep venous thrombosis was lower in the intervention group than in the control group.Accordingly,the satisfaction rate was higher in the treatment group than that in the control group(P<0.05).CONCLUSION Intensive intervention by doctors,nurses,and families of elderly patients with HICH reduced the rate of rebleeding during hospitalization.It also reduced the incidence of complications,promoted rehabilitation,improved the quality of life,and enhanced nerve function.Additionally,it improved satisfaction and promoted healthy behaviors.展开更多
AIM:To evaluate the clinical factors related to chronic rhegmatogenous retinal detachment (RRD).· METHODS:A retrospective case-control study.A total of 103 consecutive patients (103 eyes) with primary RRD were st...AIM:To evaluate the clinical factors related to chronic rhegmatogenous retinal detachment (RRD).· METHODS:A retrospective case-control study.A total of 103 consecutive patients (103 eyes) with primary RRD were studied to evaluate the clinical factors related to chronic RRD.· RESULTS:Chi-square test was used to sift out the following associated factors with chronic RRD:younger patients(P =0.0028),better preoperative best corrected visual acuity (BCVA,P =0.0316),atrophic retinal break (P <0.0001),inferior retinal break (P <0.0001),smaller break (P =0.0005);then the independent risk factors related to chronic RRD was determined by stepwise logistic regression analysis as following:atrophic retinal break (odds ratio (OR)=7.997,P =0.007),inferior retinal break (OR=14.127,P <0.0001) and better preoperative BCVA (OR=1.636 P <0.0722).· CONCLUSION:Atrophic retinal break,inferior retinal break and better preoperative BCVA are the independent risk factors related to chronic RRD.展开更多
AIM:To evaluate predictive factors for postoperative visual function of primary chronic rhegmatgenous retinal detachment(RRD) after sclera buckling(SB).METHODS:Totally 48 patients(51 eyes) with primary chronic RRD wer...AIM:To evaluate predictive factors for postoperative visual function of primary chronic rhegmatgenous retinal detachment(RRD) after sclera buckling(SB).METHODS:Totally 48 patients(51 eyes) with primary chronic RRD were included in this prospective interventional clinical cases study,which underwent SB alone from June 2008 to December 2014.Age,sex,symptoms duration,detached extension,retinal hole position,size,type,fovea on/off,proliferative vitreoretinopathy(PVR),posterior vitreous detachment(PVD),baseline best corrected visual acuity(BCVA),operative duration,follow up duration,final BCVA were measured.Pearson correlation analysis,Spearman correlation analysis and multivariate linear stepwise regression were used to confirm predictive factors for better final visual acuity.Student's /-test,Wilcoxon twosample test,Chi-square test and logistic stepwise regression were used to confirm predictive factors for better vision improvement.RESULTS:Baseline BCVA was 0.8313±0.6911 logMAR and final BCVA was 0.4761±0.4956 logMAR.Primary surgical success rate was 92.16%(47/51).Correlation analyses revealed shorter symptoms duration(r=0.3850,P=0.0053),less detached area(P=0.5489,P<0.0001),fovea(P=0.4605,P=0.0007),no PVR(P=0.3138,P=0.0250),better baseline BCVA(P=0.7291,P<0.0001),shorter operative duration(P=0.3233,P=0.0207) and longer follow up(r=-0.3358,P=0.0160) were related with better final BCVA,while independent predictive factors were better baseline BCVA[partial R-square(PR^2)=0.5316,P<0.0001],shorter symptoms duration(PR^2=0.0609,P=0.0101),longer follow up duration(PR^2=0.0278,P=0.0477) and shorter operative duration(PR^2=0.0338,P=0.0350).Patients with vision improvement took up 49.02%(25/51).Univariate and multivariate analyses both revealed predictive factors for better vision improvement were better baseline vision[odds ratio(OR)=50.369,P=0.0041]and longer follow up duration(OR=1.144,P=0.0067).CONCLUSION:Independent predictive factors for better visual outcome of primary chronic RRD after SB are better baseline BCVA,shorter symptoms duration,shorter operative duration and longer follow up duration,while independent predictive factors for better vision improvement after operation are better baseline vision and longer follow up duration.展开更多
基金Supported by Public Interest Research on Social Development Projects in Zhejiang Province (No.2011c23019)
文摘AIM: To evaluate the relationship between intravitreal bevacizumab(IVB) treatment and the levels of vitreous vascular endothelial growth factor(VEGF), basic fibroblast growth factor(b FGF) and vitreous-retina surface fibrosis in patients with proliferative diabetic retinopathy(PDR).·METHODS: This study was a prospective, open-label,controlled, randomized clinical trial. Sixty-eight eyes of PDR patients(n =53) and macular hole patients(n =15)were enrolled in this study. Thirty-four eyes of the PDR patients received IVB before vitrectomy. Twenty-three of the 34 PDR patients received IVB treatment 5d before vitrectomy(subgroup a), and 11 of the 34 PDR patients received IVB treatment greater than 2wk prior to vitrectomy(subgroup b). Nineteen of the PDR patients did not receive IVB treatment at any time prior to vitrectomy. The levels of b FGF and VEGF in vitreous samples were measured using enzyme-linked immunosorbent assay(ELISA) and the degree of vitreoretinal fibrosis was characterized using clinical data and data obtained intra-operatively.·RESULTS: In PDR patients, VEGF and b FGF levels were significantly increased compared to non-PDR(control) subject's eyes(P <0.01). In PDR patients,vitreous VEGF levels were significantly decreased following IVB treatment compared to PDR patients that did not receive IVB treatment(P <0.01). The degree of vitreoretinal fibrosis was significantly increased in subgroup b compared to subgroup a(P <0.05) and to patients that did not receive IVB(P <0.05). Vitreous b FGF levels were significantly greater in subgroup b than subgroup a(P <0.01) or in patients who did not receive IVB treatment(P <0.05). A Spearman's rank correlationtest indicated that higher levels of vitreous b FGF, but not VEGF, correlated with the degree of vitreoretinal fibrosis.·CONCLUSION: We found that b FGF levels increase in PDR patient's vitreous after IVB treatment longer than two weeks prior to vitrectomy and correlated with the degree of fibrosis after IVB treatment. These findings suggest vitreous fibrosis is increased in PDR patients after IVB treatment may be due to increased levels of b FGF.
文摘BACKGROUND Hypertensive cerebral hemorrhage(HICH)is the rupture and bleeding of vessels of the cerebral parenchyma caused by continuously elevated or violently fluctuating blood pressure.The condition is characterized by high disability and high mortality.Hematoma formation and resulting space-occupying effects following intracerebral hemorrhage are among the key causes of impaired neurological function and disability.Consequently,minimally invasive clearance of the hematoma is undertaken for the treatment of HICH because it can effectively relieve intracranial hypertension.Therefore,special attention should be given to the quality of medical and nursing interventions in the convalescent period after minimally invasive hematoma clearance.AIM The study aim was to determine the value of intensive intervention,including doctors,nurses,and patient families,for the prevention of rebleeding in elderly patients with HICH during the first hospitalization for rehabilitation after the ictal event METHODS A total of 150 elderly HICH patients with minimally invasive hematoma evacuation in our hospital between May 2018 and May 2020 were selected and equally divided into two groups of 75 each by their planned intervention.The control group was given conventional nursing intervention and the observation group was given tripartite intensive intervention.The length of hospital stay,cost,complication rate,satisfaction rate,and rebleeding rate during hospitalization were recorded.Changes in cerebral blood flow indicators were recorded in both groups.Changes in the National Institutes of Health Stroke Scale(NIHSS)score,quality of life index(QLI)score,and health behavior score were evaluated at the National Institutes of Health.RESULTS Duration of hospitalization was shorter in the in the observation group than in the control group,the hospitalization cost was less than in the control group,and the rate of rebleeding during hospitalization was lower than in the control group(all P<0.05).There were no significant differences between the two groups before treatment(all P>0.05).The mean flow rate(Qmean)and mean velocity(Vmean)of the two groups increased(P<0.05),and the dynamic resistance and peripheral resistance decreased(P<0.05).The Qmean and Vmean in the intervention group were higher than those in the control group(P<0.05).Moreover,the dynamic resistance and peripheral resistance of the blood vessels were also lower in the intervention group than in the control group(P<0.05).The difference in health behavior scores between the two groups before treatment was not significant(P>0.05).In both groups,the scores for healthy behaviors such as emotion control,medication adherence,dietary management,exercise management,and selfmonitoring were higher after than before treatment(P<0.05),and the scores of healthy behaviors in the intervention group were higher than those in the control group(P<0.05).There was no significant difference in the NIHSS and QLI scores between the two groups before treatment(P>0.05).The QLI scores of the two groups increased(P<0.05),and the NIHSS scores decreased(P<0.05).The QLI scores of the intervention group were higher than those of the control group(P<0.05),and the NIHSS score was correspondingly lower than that of the control group(P<0.05).The incidence of respiratory infections,pressure sores,central hyperpyrexia,and deep venous thrombosis was lower in the intervention group than in the control group.Accordingly,the satisfaction rate was higher in the treatment group than that in the control group(P<0.05).CONCLUSION Intensive intervention by doctors,nurses,and families of elderly patients with HICH reduced the rate of rebleeding during hospitalization.It also reduced the incidence of complications,promoted rehabilitation,improved the quality of life,and enhanced nerve function.Additionally,it improved satisfaction and promoted healthy behaviors.
文摘AIM:To evaluate the clinical factors related to chronic rhegmatogenous retinal detachment (RRD).· METHODS:A retrospective case-control study.A total of 103 consecutive patients (103 eyes) with primary RRD were studied to evaluate the clinical factors related to chronic RRD.· RESULTS:Chi-square test was used to sift out the following associated factors with chronic RRD:younger patients(P =0.0028),better preoperative best corrected visual acuity (BCVA,P =0.0316),atrophic retinal break (P <0.0001),inferior retinal break (P <0.0001),smaller break (P =0.0005);then the independent risk factors related to chronic RRD was determined by stepwise logistic regression analysis as following:atrophic retinal break (odds ratio (OR)=7.997,P =0.007),inferior retinal break (OR=14.127,P <0.0001) and better preoperative BCVA (OR=1.636 P <0.0722).· CONCLUSION:Atrophic retinal break,inferior retinal break and better preoperative BCVA are the independent risk factors related to chronic RRD.
文摘AIM:To evaluate predictive factors for postoperative visual function of primary chronic rhegmatgenous retinal detachment(RRD) after sclera buckling(SB).METHODS:Totally 48 patients(51 eyes) with primary chronic RRD were included in this prospective interventional clinical cases study,which underwent SB alone from June 2008 to December 2014.Age,sex,symptoms duration,detached extension,retinal hole position,size,type,fovea on/off,proliferative vitreoretinopathy(PVR),posterior vitreous detachment(PVD),baseline best corrected visual acuity(BCVA),operative duration,follow up duration,final BCVA were measured.Pearson correlation analysis,Spearman correlation analysis and multivariate linear stepwise regression were used to confirm predictive factors for better final visual acuity.Student's /-test,Wilcoxon twosample test,Chi-square test and logistic stepwise regression were used to confirm predictive factors for better vision improvement.RESULTS:Baseline BCVA was 0.8313±0.6911 logMAR and final BCVA was 0.4761±0.4956 logMAR.Primary surgical success rate was 92.16%(47/51).Correlation analyses revealed shorter symptoms duration(r=0.3850,P=0.0053),less detached area(P=0.5489,P<0.0001),fovea(P=0.4605,P=0.0007),no PVR(P=0.3138,P=0.0250),better baseline BCVA(P=0.7291,P<0.0001),shorter operative duration(P=0.3233,P=0.0207) and longer follow up(r=-0.3358,P=0.0160) were related with better final BCVA,while independent predictive factors were better baseline BCVA[partial R-square(PR^2)=0.5316,P<0.0001],shorter symptoms duration(PR^2=0.0609,P=0.0101),longer follow up duration(PR^2=0.0278,P=0.0477) and shorter operative duration(PR^2=0.0338,P=0.0350).Patients with vision improvement took up 49.02%(25/51).Univariate and multivariate analyses both revealed predictive factors for better vision improvement were better baseline vision[odds ratio(OR)=50.369,P=0.0041]and longer follow up duration(OR=1.144,P=0.0067).CONCLUSION:Independent predictive factors for better visual outcome of primary chronic RRD after SB are better baseline BCVA,shorter symptoms duration,shorter operative duration and longer follow up duration,while independent predictive factors for better vision improvement after operation are better baseline vision and longer follow up duration.
