Platelet aggregation test (PAgT), platelet adhesion test (PAdT), thromboplastic activity of factor Ⅷ (FⅧ∶c), antithrombin Ⅲ activity (AT-Ⅲ∶a), antithrombin Ⅲ antigen (AT-Ⅲ∶Ag), von willebrand factor (vWF) and fibrinogen (Fg) were measured in 33 patients with biliary tract diseases and 24 normal individuals. The results showed that there was no significant difference in PAgT, PAdT, AT-Ⅲ∶a and AT-Ⅲ∶Ag between the two groups (Ｐ＞0.05). Fg increased more significantly in biliary tract disease than in the controls (Ｐ＜0.01). FⅧ∶c increased more significantly in patients with obstructive jaundice than in that of nonjaundiced and the controls (Ｐ＜0.01). The levels of vWF increased higher and higher in the sequence of patients with no jaundice, obstructive jaundice due to benign diseases and obstructive jaundice due to malignancy(Ｐ＜0.01). In conclusion, Fg, FⅧ∶c and vWF increased in patients with biliary tract disease.
Objective To assess the efficacy and safety of Zhiling decoction for vascular dementia. Methods The Specialized Register of the Cochrane Dementia and Cognitive Improvement Group was searched in Feb. 2004 using the term Zhiling. In addition, we handsearched 83 traditional Chinese medicine journals （1993 to 2004 ）. We included all randomized controlled trials（RCTs）of Zhiling decoction treating people with vascular dementia. We also evaluated the internal validity of the RCTs . If all included RCTs were of high quality and homogeneity, then the meta-analysis was conducted. Results Only one RCT was identified. The outcomes were listed as the followings ： ① The Hasegawa＇ s dementia scale scoring （ HDS ） scores of the patients in Zhiling decoction group were improved significantly from baseline after 8 weeks course of treatment and there was no significant difference in the control group. The HDS scores improvement was greater than control group（P 〈0.01 ）o ② The latency of P3 was shorter in both groups after treatment, and there was a significant treatment effect in Zhiling group （t = -52. 09, 95% CI -69.79 to -34.39, P 〈0. 000 01 ）. The amplitude of 173 increased in both groups after treatment, and there was a non-sigmficant treatment effect in Zhiling group for change from baseline （t =1.40, 95% CI -0.02 to 2.82, P =0.05）. ③ Brain electrical activity monitoring （BEAM） showed that benefits in those treated by Zhiling decoction were higher than those treated by Naofukang with OR9.90 （ 95% CI 3.34 to 29.38）. ④In the Zhiling group serum cholesterol （P 〈0.01 ） , serum triglyceride （P 〈0.01 ） and LPO（P 〉0. 01 ） decreased after treatment. There was an increase in the level of high density lipoprotein （HDL） and superoxide dismutase （SOD） in red blood cells compared with baseline for Zhiling groups （P 〈0.01 ）. ⑤ The cerebral blood flow decreased in both groups after treatment, and there was a significant treatment effect in favour of Zhiling （treatment effect t = -1.03, 95% CI -1.26 to -0.80, P 〈0. 00001 ）.⑥ No side effects on heart, liver or renal function were reported in Zhiling decoction group. Conclusions The currendy available evidence is insufficient to assess the potential efficacy for Zhiling decoction in the treatment of vascular dementia. Just one RCT concerning the management of Zhifing decoction versus Naofukang suggests that Zhiling decoction may be effective in treating vascular dementia. Further randomised, double-blind, placebo-controlled trials are urgendy needed .
ObjectiveTo explore the effects of vitrectomy on neovascular glaucoma combined with vitreous hemorrhage.MethodsSeven eyes of 7 patients with neovascular glaucoma combined with vitreous hemorrhage underwent vitrectomy combined with phacoemulsification, panretinal photocoagulation, and trabeculectomy. The preoperative visual acuity ranged from light perception to 0.2, and the mean preoperative intraocular pressure was 54 mm Hg (38-64 mm Hg)(1 mm Hg=0.133 kPa). The mean follow-up was 8 months (6-15 months).ResultsThe postoperative visual acuity ranged from light perception to 0.4, and the mean postoperative intraocular pressure was 17 mm Hg (10-30 mm Hg) which was significantly lower than preoperative one (Plt;0.05). The postoperative complications mainly included fibrosis exudates in anterior chamber (7 eyes), intraocular pressure elevation 1-2 weeks after the operation (2 eyes), and postoperative suprachoroidcavity hemorrhage (2 eyes).ConclusionVitrectomy combined with phacoemulsification, panretinal photocoagulation, and trabeculectomy may be effective procedures for some cases of neovascular glaucoma combined with vitreous hemorrhage.(Chin J Ocul Fundus Dis, 2005,21:148-149)
Objective To evaluate the efficacy of intravitreal injection with Bevacizumab for iris neovascularization (INV) which caused by proliferative dia betic retinopathy (PDR) or central retinal vein occlusion (CRVO). Methods The clinical data of 39 patients (47 eyes) with INV who undergone intravitreal injection with Bevacizumab from 12,2006 to 3,2007 in Department of Ophthalmology, Peopleprime;s Hospital of Peking University were retrospectively analyzed. The patients (22 males and 17 females, 23 left eyes and 24 right eyes) aged from 28 to 82 years with the average of （57.77plusmn;13.0）years. 26 cases (34 eyes) were PDR and 13 cases (13 eyes) were CRVO. All of patients underwent intravitreal injection with 1.25 mg/0.05 ml Bevacizumab. Follow-up time was 1 day, 3 days, 1 week, 3 week s and 6 weeks after the treatment. The visual acuity, changes of intraocular pre ssure and changes of INV before and after the treatment were observed and analyzed. Results In patients with PDR, the visual acuity was improved in 19 eyes (55.9%), was stable in 15 eyes (44.1%) and none decreased. In patients with CRVO, the visual acuity was improved in 4 eyes (30.8%), was stable in 9 eyes (69.0%) and none decreased. Among neovascular glaucoma (NVG), decreas e of IOP was noticed in 16 eyes with PDR (80%) and 6 eyes with CRVO (667%). Re gression of INV was noticed in 97.1% PDR patients and 84.6% CRVO patients. Conclusions Intravitreal injection with Bevacizumab is very effective in treating INV. Further researches still needs to explore long term efficacy, safety and complications of this t reatment. （Chin J Ocul Fundus Dis，2008，24：176-179）
Objective To investigate the effectiveness of percutaneous transluminal renal artery stenting (PTRAS) in treating atherosclerotic renal artery stenosis (ARAS). Methods A total of 69 patients with severe ARAS were treated with PTRAS between January 2002 and December 2008. There were 47 males and 22 females with an average age of 66.2 years(range, 42-88 years), including 66 cases of unilateral ARAS (single functional kidney, 1 case) and 3 cases of bilateral ARAS. Renal angiography revealed that the degree of renal artery stenosis was 70%-99%. Concomitant diseases included hypertension (67 cases), atherosclerosis obl iterans (69 cases), coronary heart disease (34 cases), diabetes (44 cases), and hyperl ipidemia (36 cases). Blood pressure, serum creatinine (sCr), and patency of the renal artery were measured to assess the effectiveness of PTRAS after 12 months. Results The renal artery stent was successfully implanted in 68 patients and the technical success rate was 98.6%. One patient was converted to il io-renal bypass because of intra-operative acute renal artery occlusion. One patient died of heart failure at 6 months after PTRAS, and 1 patient was lost at 3 months after PTRAS. The other 66 patients were followed up 32 months on average (range, 13-60 months). The blood pressure decreased significantly at 1 month and gained a further decrease at 12 months after PTRAS when compared with the preoperative ones [systol ic blood pressure: (132 ± 24) mm Hg vs (163 ± 34) mm Hg, P lt; 0.05; diastol ic blood pressure: (78 ± 11) mm Hg vs (89 ± 17) mm Hg, P lt; 0.05; 1 mm Hg=0.133 kPa]. Hypertension was cured in 4 cases (6.3%), improved in 52 cases (81.2%), failure in 8 cases (12.5%), and the overall benefit rate was87.5%. The sCr level was stable after 12 months of PTRAS, showing no significant difference when compared with preoperative basel ine [(107.8 ± 35.4) μmol/L vs (104.1 ± 33.8) μmol/L, P gt; 0.05]. Renal function was improved in 9 cases (13.6%), stable in 48 cases (72.8%), deterioration in 9 cases (13.6%), and the overall benefit rate was 86.4%. Instent restenosis found in 2 patients (3.0%) at 12 months after operation. Conclusion PTRAS is a safe and effective method to treat ARAS. It can control the blood pressure and stabil ize the renal function in most ARAS patients. Long-term efficacy needs further investigation.
ObjectiveTo investigate the risk factors for neovascular glaucoma (NVG) after vitrectomy in proliferative diabetic retinopathy (PDR) patients. MethodsThree hundred and one patients (301 eyes) with PDR who underwent vitrectomy between January 2008 and December 2013 in our hospital were retrospectively evaluated. Risk factors for NVG after vitrectomy were identified by multivariate Logistic regression analysis. ResultsTwelve of 301 patients (4.0%) developed postoperative NVG in 2 to 18 months after vitrectomy. The incidence of postoperative NVG peaked in 2 to 6 months after vitrectomy (7 eyes, 58.3%). Logistic regression analysis showed that postoperative retinal detachment was a significant risk factor for postoperative NVG in eyes with PDR (P < 0.001). Eyes with postoperative retinal detachment were more likely to develop NVG after vitrectomy than those without postoperative retinal detachment (OR=17.826). Gender, age, duration of diabetes, preoperative serum creatinine levels, glycated hemoglobin levels, preoperative intraocular pressure, preoperative lens status, combined phacoemulsification surgery and tamponade were not associated with postoperative NVG (P > 0.05). ConclusionPostoperative retinal detachment is a major risk factor for NVG after vitrectomy in PDR.
Objective To investigate the efficacy and prognostic factors of pars plana vitrectomy (PPV) in the treatment of proliferative diabetic retinopathy (PDR) with chronic renal failure (CRF). MethodsA retrospective study. From January 2016 to June 2021, a total of 82 eyes of 58 patients diagnosed with PDR combined with CRF and treated with PPV in Department of Ophthalmology, The Second Hospital of Hebei Medical University were included in the study. There were 32 cases in males and 26 cases in females. The mean age was (48.45±10.41) years. The course of renal failure was (4.15±3.23) years, and the course of diabetes was (14.45±6.71) years. All patients undergo best-corrected visual acuity (BCVA). The BCVA examination was performed using the international standard Snellen visual acuity chart, which was converted to logarithm of the minimum angle of resolution (logMAR) visual acuity for recording. The mean number of logMAR BCVA was 2.04±0.82 (0.7-2.8). The duration of vitreous hemorrhage averaged (2.65±1.55) months. There were 38 eyes (46.3%, 38/82) with traction retinal detachment; 32 eyes had a history of panretinal photocoagulation (PRP) treatment (39.0%, 32/82). All eyes were treated with 25G PPV. Patients with traction retinal detachment were treated with intravitreal injection of anti-vascular endothelial growth factor (VEGF) 3 days before surgery. Opacification of the lens affected the operation operator combined with phacoemulsification. Biochemical indexes such as hemoglobin, glycosylated hemoglobin, albumin, creatinine, uric acid, and alternative treatment (non-dialysis/hemodialysis/peritoneal dialysis) were collected. Postoperative follow-up time was ≥6 months. χ2 test or Fisher's exact test were used for comparison between groups. A logistic regression model was used for multivariate analysis, and Spearman correlation analysis was used to evaluate the correlations between variables. ResultsAt 6 months after surgery, the mean logMAR BCVA was 1.16±0.57. Compared with logMAR BCVA before surgery, the difference was statistically significant (t=－0.837, P＜0.001); 44 eyes had BCVA ≥0.1 and 38 eyes had BCVA ＜0.1. Postoperative vitreous hemorrhage (PVH) was observed in 17 eyes after surgery (20.7%, 17/82). PVH occurred in 15 (46.9%, 15/32), 1 (2.3%, 1/44), and 1 (16.7%, 1/6) eyes in patients without dialysis, hemodialysis and peritoneal dialysis, respectively. There was significant difference between those without dialysis and those on hemodialysis (χ2=26.506, P＜0.05). There was no significant difference between peritoneal dialysis patients and those without dialysis and hemodialysis patients (χ2=2.694, 2.849; P＞0.05). PVH occurred in 3 (10.0%, 3/30) and 14 (27.0%, 14/52) eyes of vitreous cavity filled with silicone oil and perfusion fluid, respectively. The difference was statistically significant (χ2=3.315, P＜0.05); 1 (33.3%, 1/3) and 10 (71.4%, 10/14) eyes were treated with PPV again, respectively, and the difference was statistically significant (P＜0.05). Neovascular glaucoma (NVG) occurred in 12 eyes (14.6%, 12/82). Logistic regression analysis showed that age [odds ratio (OR) =0.911, P＜0.05], diabetic retinopathy (DR) stage (OR=7.229, P＜0.05), renal failure duration (OR=0.850, P＜0.05), operation time (OR=1.135, P＜0.05) was an independent risk factor for poor vision prognosis. Diabetes duration (OR=1.158, P＜0.05), renal failure duration (OR=1.172, P＜0.05) and alternative therapy were independent factors affecting the occurrence of PVH. Diabetes duration (OR=1.138, P＜0.05) and renal failure duration (OR=1.157, P＜0.05) were independent risk factors for postoperative NVG. Spearman correlation analysis showed that PVH was strongly correlated with post-operative NVG (r=0.469, P＜0.01). There was no significant correlation between blood glucose, hemoglobin, creatinine and blood urea nitrogen and prognosis of postoperative vision, PVH and NVG occurrence (P＞0.05). ConclusionsIn PDR patients with CRF, DR Stage, age, renal failure course and operation duration are correlated with vision prognosis. Compared with those who do not receive alternative therapy, hemodialysis treatment can reduce the occurrence of PVH and NVG after surgery.
PURPOSE:To probe the dosage and effect of lasers in panretinal photocoagulation. METHODS:Three kinds of ocular diseases,e, g., neovascular glaucoma(NVG)in 52 eyes ,central retinal vein occlusion(CRVO)in 47 eyes ,and preproliferative and proliferative diabetic retinopathies(PDR)in 231 eyes ,treated with krypton red and argon blue green laser panretinal photocoagulation in ocular clinic of our hospital,were analysed clinically and retropectively. RESULTS:The effetive average numbers of laser burns in panretinal photocoagulation in this series after clinical analysis statistically were found to be 1 500 in NVG,and 1 000 in PDR and CRVO respectively. CONCLUSION:To select the proper laser,its wave length,therapeutic position and volume of laser burns in accordance with the specific circumstances of various retinopthies is of extreme importance in success of laser panretinal photocoagulation. （Chin J Ocul Fundus Dis,1997,13: 195-196）
【摘要】 目的 通过比较遗忘型轻度认知障碍（amnestic mild cognitive impairment，aMCI）和血管性认知障碍非痴呆型（vascular cognitive impairment-no dementia，VCI-ND）患者及正常老年人群在简易智能精神状态检查量表（mini mental state examination，MMSE）、听觉词语学习测验（auditory verbal learning test，AVLT）、画钟试验（clock drawing test，CDT）及临床痴呆评定量表（clinical dementia rating scales，CDR）中的表现，进一步分析aMCI和VCI-ND在认知损害方面的不同特点。 方法 选取首都医科大学宣武医院神经内科门诊收治aMCI患者23例及VCI-ND患者27例（CDR＝0.5分），同时选取40名正常老年人（CDR=0分）作为对照组。每位受试者均进行MMSE、AVLT、CDT及CDR等神经心理学量表测查，分析以上3组被试各项神经心理学测查得分之间的差异。 结果 各组受试者的年龄、性别及受教育程度差异无统计学意义（Pgt;0.05），具有可比性。aMCI和VCI-ND组在MMSE、CDT、即刻记忆、延迟记忆及延迟再认检测中的平均值均低于对照组，且差异均具有统计学意义（Plt;0.05）。aMCI和VCI-ND两组除延迟再认检测外，其余各项测查的平均分均无统计学意义（Pgt;0.05）。在延迟再认检测中，aMCI组（6.65±4.00）较VCI-ND组（8.67±2.76）再认词语数量少，两组延迟再认的得分均低于对照组（12.83±1.77），差异有统计学意义（Plt;0.05）。 结论 aMCI和VCI-ND在记忆力、执行能力和信息处理能力方面较正常老年人均有所损害。由于aMCI和VCI-ND不同的病理改变，导致患者存在不同类型的记忆储存和提取机制。【Abstract】 Objective To investigate the different patterns of cognitive impairment in patients with amnestic mild cognitive impairment (amci), vascular cognitive impairment-no dementia (VCI-ND) and normal elder people. Methods A total of 23 patients with aMCI and 27 patients with VCI-ND (CDR＝0.5) and another 40 healthy elder people (CDR=0) were selected. Each individual underwent the neuropsychological tests, including mini mental state examination (MMSE), auditory verbal learning test (AVLT), clock drawing test (CDT), clinical dementia rating scales (CDR) and hamilton rating scale for depression (HAMD). The differences between the three groups were analyzed. Results The differences in age, sexes, and the education background among the three groups were not significant (Pgt;0.05) which meant comparability. The mean scores of MMSE, CDT, instant memory and delayed awareness in aMCI and VIC-ND group were much lower than that in the control group (Plt;0.05). The differences in all the test items except for delayed awareness between aMCI group and VCI-ND groups were not significant (Pgt;0.05). However, in the recall recognition test, these three groups had significant differences: the score in patients with aMCI (6.65±4.00) was much lower than that in patients with VCI-ND (8.67±2.76; Plt;0.05), and the scores of the two groups were both lower than that in the normal aging group (12.83±1.77; Plt;0.05). Conclusion Compared with normal elder people, the cognition of aMCI and VCI-ND patients is impaired severely. The memory tests suggeste that compared with aMCI patients, VCI-ND patients may have different neuropathological changes leading to different mechanism of memory encoding and retrieval.