Intravitreal bevacizumab and Ahmed glaucoma valve implantation in patients with neovascular glaucoma

AIM:To explore the efficacy of preoperative intravitreal bevacizumab(IVB) injection combined with Ahmed glaucoma valve(AGV) implantation in the treatment of neovascular glaucoma(NVG).METHODS:This retrospective study included 35 eyes from 35 patients who underwent preoperative IVB and AGV implantation for treatment of NVG. Findings such as intraocular pressure(IOP) number of anti-glaucoma medications, visual acuity(VA), surgical success rates,and complications were recorded.RESULTS:AfterAGVimplantation,IOPwas18.2±4.0mmHg,15.5±3.3 mm Hg and 9.8±2.6 mm Hg at 6, 12 and 36 mo,significantly decreased compared with pre-IOP(P 【0.01).The number of anti-glaucoma medications was 0.9 ±0.5,0.8 ±0.9 and 0.8 ±0.6 at 6, 12 and 36 mo, significantly decreased compared to pre-treatment(P 【0.01). At last visit, there were 19 eyes with stable VA, 4 with VA improvement, 12 with diminished VA and 3 with complete loss light perception. There were 7 cases that failed during 3-year fellow up period. Cumulative probabilities of valve survival by Kaplan-Meier analysis were 82.9%,74.1% and 71.0% at 12, 24 and 36 mo, respectively. Cox stepwise regression analysis found that the survival time was significant associated with the pre-visual acuity 【2/400(P 【0.05). Post-operative complications occurred in 8eyes, of which hyphema presented in 2 eyes, choroidal effusion in 2 eyes.CONCLUSION:The procedure of preoperative IVB andAGV implantation should be one of treatments for NVG because of its safety and effectiveness.

A temporary self-expanding metallic stent for malignant colorectal obstruction

AIM:To investigate the clinical safety and efficacy of a temporary self-expanding metallic stent(SEMS) for malignant colorectal obstruction.METHODS:From September 2007 to June 2012,33 patients with malignant colorectal obstruction were treated with a temporary SEMS.The stent had a tubular configuration with a retrieval lasso attached inside the proximal end of the stent to facilitate its removal.The SEMS was removed one week after placement.Clinical examination,abdominal X-ray and a contrast study were prospectively performed and both initial and follow-up data before and at 1 d,1 wk,and 1 mo,3 mo,6 mo and 12 mo after stent placement were obtained.Data collected on the technical and clinical success of the procedures,complications,need for reinsertion and survival were analyzed.RESULTS:Stent placement and removal were technically successful in all patients with no procedurerelated complications.Post-procedural complications included stent migration(n = 2) and anal pain(n = 2).Clinical success was achieved in 31(93.9%) of 33 patients with resolution of bowel obstruction within 3 d of stent removal.Eleven of the 33 patients died 73.81 ± 23.66 d(range 42-121 d) after removal of the stent without colonic re-obstruction.Clinical success was achieved in another 8 patients without symptoms of obstruction during the follow-up period.Reinsertion of the stent was performed in the remaining 12 patients with re-obstruction after 84.33 ± 51.80 d of follow-up.The mean and median periods of relief of obstructive symptoms were 97.25 ± 9.56 d and 105 ± 17.43 d,respectively,using Kaplan-Meier analysis.CONCLUSION:Temporary SEMS is a safe and effective approach in patients with malignant colorectal obstruction due to low complication rates and good medium-term outcomes.

α-Pyrone Derivatives from a Streptomyces Strain Resensitize Tamoxifen Resistance in Breast Cancer Cells

Tamoxifen resistance(TamR)is the underlying cause of treatment failure in many breast cancer patients receiving tamoxifen.In order to look for noncytotoxic natural products with the ability to reverse TamR,an extract from strain Streptomyces sp.KIB-H0495 was detected to be active.Subsequent large scale fermentation and isolation led to the isolation of four a-pyrone derivatives including two new compounds,violapyrones J(2)and K(3),and two known analogues,violapyrones B(1)and I(4).Further bioactivity assays indicated that only 1 and 3 exerted potent resensitization effects on MCF-7/TamR cells at a concentration of 1 lM.Owing to the simple structures of 1 and 3,these two compounds might have potential for further investigation as novel tamoxifen resensitization agent in breast cancer chemotherapy.

Dramatic thinning of Alaskan river ice and its climatic controls

River ice thickness(RIT)directly influences human activities,such as rural transportation and subsistence activities,in addition to ecosystem and hydrology processes in the Arctic.Knowledge of RIT response to the rapid Arctic warming is very limited or essentially lacking.The scientific objective of this study is to investigate changes and variations in RIT and their response to rapid Arctic warming.We used ground-based measurements of 45 river gauge sites from 1961 through 2015 spanning 12 river basins across Alaska.The results indicate that the long-term mean maximum river ice thickness(MRIT)ranged from 40.3±12.7 cm in the southeast to 187.3±31.9 cm in northwest Alaska.MRIT decreased dramatically from 1961 to 2015,on average,at a rate of−0.26±0.17 cm per year,and RIT declined significantly in all months from October through March,and more rapidly in winter than in autumn and spring.The impacts of air temperature and snowfall on MRIT change were analysed,and their relative influences were 74%and 26%,respectively.Specifically,an increase in air temperature was the primary factor contributing to MRIT decrease,while increasing snowfall,and snow on river ice enhanced MRIT decline.Seasonally,snowfall was the primary regulator for thickness change and higher air temperature resulted in RIT declining in autumn,while ice thickness decrease was mostly driven by warming in spring.However,neither air temperature nor snowfall is the primary control factor for declining RIT in winter,and further work needs to be done to detect the reason.