红景天苷对近视豚鼠脉络膜厚度及HIF-1α和多巴胺及其受体表达的影响

目的:探讨红景天苷(SA)对透镜诱导型近视(LIM)豚鼠脉络膜厚度及缺氧诱导因子-1α(HIF-1α)、多巴胺及其D1受体表达的影响。方法:将18只2周龄豚鼠随机分为正常对照(NC)组、LIM组和透镜诱导型近视+红景天苷(LIM+SA)组,每组6只。NC组正常饲养,给予2mL/d生理盐水灌胃;LIM组豚鼠右眼前配戴-5D透镜,建立近视模型,给予2mL/d生理盐水灌胃;LIM+SA组豚鼠右眼前配戴-5D透镜同时给予2mL/d红景天苷(100mg/kg)灌胃。造模4wk后测量各组豚鼠右眼屈光度、眼轴长度及脉络膜厚度,通过实时荧光定量PCR(qPCR)和免疫组织化学(IHC)检测各组豚鼠右眼脉络膜视网膜HIF-1α mRNA及蛋白表达量,通过酶联免疫吸附实验(ELISA)和Western blot法检测多巴胺浓度及其D1受体表达量。结果:造模4wk后,与NC组比较,LIM组和LIM+SA组豚鼠右眼屈光度均负向增加,眼轴均延长,脉络膜厚度均减小,脉络膜视网膜HIF-1α mRNA和蛋白表达量均增加,多巴胺浓度及其D1受体表达量均降低;与LIM组比较,LIM+SA组豚鼠右眼近视屈光度明显减小,眼轴长度较短,脉络膜厚度增加,脉络膜视网膜HIF-1α mRNA和蛋白表达量均降低,多巴胺浓度及其D1受体表达量均增加。结论:红景天苷干预近视豚鼠可通过影响脉络膜厚度及HIF-1α、多巴胺及其D1受体的表达延缓近视进展。

曲伏前列素与噻吗洛尔治疗原发性开角型青光眼疗效的Meta分析

目的:系统评价曲伏前列素滴眼液与噻吗洛尔滴眼液治疗中国成人原发性开角型青光眼(POAG)的血流动力学、散光度及细胞因子的变化。方法:检索PubMed,EMbase,Cochrane Library,Web of Science,中国期刊全文数据库(CNKI),中国生物医学文献数据库(CBM),维普数据库及万方数据库2015-01-01/2020-12-31收录的有关曲伏前列素与噻吗洛尔治疗中国成人POAG的随机对照试验(RCTs)和回顾性队列研究。按照纳入与排除标准筛选文献,用Cochrane风险评估工具对RCTs进行质量评价,用NOS量表对回顾性队列研究进行质量评价。采用Review Manager 5.4软件进行Meta分析并生成加权均数差(WMD)为效应量对比曲伏前列素与噻吗洛尔在视网膜中央动脉(CRA)和睫状后短动脉(PCA)的收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)及血管阻力指数(RI)、散光度、血浆内皮素-1(ET-1)、血清基质金属蛋白酶(MMP)、房水基质金属蛋白酶抑制因子-2(TIMP-2)、血清TIMP-2中的差异。结果:共纳入8项RCTs,4项回顾性队列研究,合计1192例患者。Meta分析结果显示:曲伏前列素组较噻吗洛尔组更能提高CRA和PCA的PSV(WMD=2.40,95CI:2.12~2.68,P<0.00001;WMD=3.76,95%CI:3.30~4.22,P<0.00001)、EDV(WMD=0.81,95%CI:0.70~0.91,P<0.00001;WMD=0.90,95%CI:0.72~1.09,P<0.00001)以及降低CRA和PCA的RI(WMD=-0.07,95%CI:-0.10~-0.04,P<0.00001;WMD=-0.07,95%CI:-0.08~-0.05,P<0.00001);曲伏前列素降低散光度(WMD=-1.34,95%CI:-1.62~-1.06,P<0.00001)效果更优;曲伏前列素较噻吗洛尔更能降低血浆ET-1(WMD=-5.14,95%CI:-7.08~-3.20,P<0.00001)、血清MMP(WMD=-12.48,95%CI:-24.27~-0.69,P=0.04),而对房水TIMP-2(WMD=-1.40,95%CI:-5.51~2.71,P=0.51)、血清TIMP-2(WMD=1.69,95%CI:-30.03~33.41,P=0.92)的影响差异不明显。结论:曲伏前列素治疗POAG较噻吗洛尔在改善血流动力学指标以及降低散光度方面更具优势。

人工晶状体嵌顿术治疗儿童白内障临床疗效的Meta分析

目的:系统对比分析人工晶状体(IOL)嵌顿术与非嵌顿术治疗儿童白内障的临床疗效。方法:利用计算机检索PubMed、Embase、Cochrane Library、万方、中国知网等数据库,并查阅相关杂志纸质版,检索文献发表时间从2000-01/2021-01。由2名研究人员分别对检索到的文献进行筛选、评价和数据提取,按照Cochrane评价手册和NOS量表进行质量评价后,使用Rev Man 5.4软件完成Meta分析。结果:最终纳入7篇文献,包括受试眼328眼,Meta分析结果显示,两组患者在术后最佳矫正视力(BCVA)>0.5眼数(RR=2.00,95%CI:1.18~3.37,P=0.01)、IOL偏移(RR=0.28,95%CI:0.17~0.46,P<0.00001)和轻度及以上中央视轴混浊(RR=0.35,95%CI:0.19~0.65,P=0.0007)的发生情况上存在明显差异,但在术后虹膜后黏连(RR=0.67,95%CI:0.10~4.33,P=0.67)和极轻度的中央视轴区混浊(RR=1.05,95%CI:0.64~1.73,P=0.84)的发生情况上无差异。结论:IOL嵌顿术治疗儿童白内障能显著提高术后BCVA、减少IOL偏移并可减轻轻度及以上中央视轴区混浊程度,在总体临床疗效上更具优势。然而上述结论尚需进一步开展严格设计的随机双盲对照试验加以验证。

Effects of Yinzhihuang oral liquid and albumin on bilirubin, inflammatory factors, immune indexes and related factors in neonatal pathologic jaundice

Objective: To explore the effects of Yinzhihuang oral liquid and albumin on bilirubin, inflammatory factors, immune indexes and related factors in neonatal pathologic jaundice. Methods: A total of 134 neonates with pathologic jaundice admitted to our hospital from May 2017 to April 2018 were randomly selected as the control group (n=67) and the observation group (n=67), the control group was treated with albumin, the observation group was treated with Yinzhihuang Oral Liquid on the basis of the control group. The bilirubin, inflammatory factors, immune indicators, alpha-fetoprotein (AFP) and transferrin (TRF) were compared and analyzed before and after treatment. Results: After treatment, the levels of TBIL, DBIL and IBIL in both groups were significantly lower than those before treatment (P<0.05), and the levels of TBIL, DBIL and IBIL [(118.60±10.85) μmol/L, (6.95±1.52) μmol/L, (115.30±14.20)μmol/L] in observation group were significantly lower than those in control group;the levels of CRP and IL-6 in both groups were significantly lower than those before treatment (P<0.05), and the levels of CRP and IL-6 [(8.26±2.07) mg/L, (12.69±2.15) pg/mL] in observation group were significantly lower than those in control group (P<0.05);the levels of CD4+, CD4+/CD8+ in both groups were significantly higher than those before treatment (P<0.05), while the levels of CD8+ was significantly lower than that before treatment, the levels of CD4+, CD4+/CD8+ [(47.08±5.70)%, (2.08±0.41)] in observation group were significantly higher than those in control group (P<0.05), and the level of CD8+ [(22.90±2.05)%] was significantly lower than that in control group (P<0.05);the levels of AFP in significantly higher than before treatment (P<0.05), and the levels of AFP [(12.69±3.04)mg/L] in observation group were significantly lower than those in control group (P<0.05), the levels of TRF [(2.02±0.35) g/L] were significantly higher than those in control group (P<0.05). Conclusions: The combination of Yinzhihuang oral liquid and albumin can effectively reduce the bilirubin level in neonatal jaundice, inhibit its inflammatory reaction, enhance the cellular immune function and improve the expression of AFP and TRF, which is of clinical significance.