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Intravitreal therapy for the management of diabetic retinopathy:A concise review
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作者 Atul Arora Arvind K Morya +3 位作者 Parul C Gupta Nitin K Menia Prateek Nishant Vishali Gupta 《World Journal of Experimental Medicine》 2024年第4期104-119,共16页
Diabetic retinopathy(DR)is a serious microvascular complication of diabetes mellitus and may result in irreversible visual loss.Laser treatment has been the gold standard treatment for diabetic macular edema and proli... Diabetic retinopathy(DR)is a serious microvascular complication of diabetes mellitus and may result in irreversible visual loss.Laser treatment has been the gold standard treatment for diabetic macular edema and proliferative diabetic retinopathy for many years.Of late,intravitreal therapy has emerged as a cornerstone in the management of DR.Among the diverse pharmacotherapeutic options,anti-vascular endothelial growth factor agents have demonstrated remarkable efficacy by attenuating neovascularization and reducing macular edema,thus preserving visual acuity in DR patients. 展开更多
关键词 diabetic retinopathy Intravitreal therapy Anti-vascular endothelial growth factor Macular edema Proliferative diabetic-retinopathy
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Key genes and regulatory networks for diabetic retinopathy based on hypoxia-related genes:a bioinformatics analysis
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作者 Cai-Han Yu Cai-Xia Wu +3 位作者 Dai Li Lan-Lan Gong Xu-Dong Lyu Jie Yang 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2024年第8期1411-1417,共7页
AIM:To prevent neovascularization in diabetic retinopathy(DR)patients and partially control disease progression.METHODS:Hypoxia-related differentially expressed genes(DEGs)were identified from the GSE60436 and GSE1024... AIM:To prevent neovascularization in diabetic retinopathy(DR)patients and partially control disease progression.METHODS:Hypoxia-related differentially expressed genes(DEGs)were identified from the GSE60436 and GSE102485 datasets,followed by gene ontology(GO)functional annotation and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis.Potential candidate drugs were screened using the CMap database.Subsequently,a protein-protein interaction(PPI)network was constructed to identify hypoxia-related hub genes.A nomogram was generated using the rms R package,and the correlation of hub genes was analyzed using the Hmisc R package.The clinical significance of hub genes was validated by comparing their expression levels between disease and normal groups and constructing receiver operating characteristic curve(ROC)curves.Finally,a hypoxia-related miRNA-transcription factor(TF)-Hub gene network was constructed using the NetworkAnalyst online tool.RESULTS:Totally 48 hypoxia-related DEGs and screened 10 potential candidate drugs with interaction relationships to upregulated hypoxia-related genes were identified,such as ruxolitinib,meprylcaine,and deferiprone.In addition,8 hub genes were also identified:glycogen phosphorylase muscle associated(PYGM),glyceraldehyde-3-phosphate dehydrogenase spermatogenic(GAPDHS),enolase 3(ENO3),aldolase fructose-bisphosphate C(ALDOC),phosphoglucomutase 2(PGM2),enolase 2(ENO2),phosphoglycerate mutase 2(PGAM2),and 6-phosphofructo-2-kinase/fructose-2,6-biphosphatase 3(PFKFB3).Based on hub gene predictions,the miRNA-TF-Hub gene network revealed complex interactions between 163 miRNAs,77 TFs,and hub genes.The results of ROC showed that the except for GAPDHS,the area under curve(AUC)values of the other 7 hub genes were greater than 0.758,indicating their favorable diagnostic performance.CONCLUSION:PYGM,GAPDHS,ENO3,ALDOC,PGM2,ENO2,PGAM2,and PFKFB3 are hub genes in DR,and hypoxia-related hub genes exhibited favorable diagnostic performance. 展开更多
关键词 diabetic retinopathy hypoxia-related genes hub genes miRNA-TF-Hub gene drug prediction
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Association between glucose-lowering drugs and circulating insulin antibodies induced by insulin therapy in patients with type 2 diabetes
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作者 Peng Zhang Qing Jiang +3 位作者 Bo Ding Reng-Na Yan Yun Hu Jian-Hua Ma 《World Journal of Diabetes》 SCIE 2024年第7期1489-1498,共10页
BACKGROUND Insulin antibodies(IAs)affect blood glucose control in patients receiving insulin therapy.AIM To investigate the relationship between different hypoglycemic treatments and IAs in patients with type 2 diabet... BACKGROUND Insulin antibodies(IAs)affect blood glucose control in patients receiving insulin therapy.AIM To investigate the relationship between different hypoglycemic treatments and IAs in patients with type 2 diabetes mellitus(T2DM).METHODS This cross-sectional,retrospective study included 1863 patients with T2DM who were receiving exogenous insulin therapy.All patients received stable antidiabetic therapy in the last 3 months and IA levels were measured using an iodine-125 array.RESULTS A total of 1863 patients were enrolled.There were 902(48.4%)patients who had positive IAs(IA level>5%),with a mean IA level of 11.06%(10.39%-11.72%).IA levels were positively correlated with high fasting blood glucose(odds ratio=1.069,P<0.001).The proportion of positive IAs was lowest in patients using glargine only(31.9%)and highest in patients using human insulin only(70.3%),P<0.001.The IA levels in patients using sulfonylureas/glinides(8.3%),metformin(9.6%),and dipeptidyl peptidase-4 inhibitors(8.2%)were all lower than in patients without these drugs(all P<0.05).CONCLUSION Nearly half of patients on insulin therapy have positive IA antibodies,and IA antibody levels are associated with blood glucose control.Insulin glargine and a combination of oral glucose-lowering drugs were correlated with lower IA levels. 展开更多
关键词 Insulin antibodies Insulin therapy Glucose-lowering drugs GLARGINE Type 2 diabetes
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Research Progress of Drug Therapy for Diabetes
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作者 Yuhang Li Chunhui Zhang Hui Gao 《Expert Review of Chinese Medical》 2024年第1期6-9,共4页
Diabetes is mainly a series of symptoms of glucose metabolism disorder caused by relative or absolute insufficiencies of insulin.Most patients are accompanied by protein,fat,water and electrolyte disorders,including d... Diabetes is mainly a series of symptoms of glucose metabolism disorder caused by relative or absolute insufficiencies of insulin.Most patients are accompanied by protein,fat,water and electrolyte disorders,including diabetes type 1 and diabetes type 2,of which diabetes type 2 accounts for more than 90%.The incidence rate of diabetes is high,the course of disease is long,and it is difficult to cure.Most patients need long-term medication.This study analyzed the clinical manifestations and predisposing factors of diabetes,and explored the progress of drug treatment of diabetes,which is summarized as follows. 展开更多
关键词 diabetES drug therapy research progress
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Inflammation in diabetic retinopathy: possible roles in pathogenesis and potential implications for therapy 被引量:28
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作者 Lei Tang Guo-Tong Xu Jing-Fa Zhang 《Neural Regeneration Research》 SCIE CAS CSCD 2023年第5期976-982,共7页
Diabetic retinopathy, characterized as a microangiopathy and neurodegenerative disease, is the leading cause of visual impairment in diabetic patients. Many clinical features observed in diabetic retinopathy, such as ... Diabetic retinopathy, characterized as a microangiopathy and neurodegenerative disease, is the leading cause of visual impairment in diabetic patients. Many clinical features observed in diabetic retinopathy, such as capillary occlusion, acellular capillaries and retinal non-perfusion, aggregate retinal ischemia and represent relatively late events in diabetic retinopathy. In fact, retinal microvascular injury is an early event in diabetic retinopathy involving multiple biochemical alterations, and is manifested by changes to the retinal neurovascular unit and its cellular components. Currently, intravitreal anti-vascular endothelial growth factor therapy is the firstline treatment for diabetic macular edema, and benefits the patient by decreasing the edema and improving visual acuity. However, a significant proportion of patients respond poorly to anti-vascular endothelial growth factor treatments, indicating that factors other than vascular endothelial growth factor are involved in the pathogenesis of diabetic macular edema. Accumulating evidence confirms that low-grade inflammation plays a critical role in the pathogenesis and development of diabetic retinopathy as multiple inflammatory factors, such as interleukin-1β, monocyte chemotactic protein-1 and tumor necrosis factor-α, are increased in the vitreous and retina of diabetic retinopathy patients. These inflammatory factors, together with growth factors such as vascular endothelial growth factor, contribute to blood-retinal barrier breakdown, vascular damage and neuroinflammation, as well as pathological angiogenesis in diabetic retinopathy, complicated by diabetic macular edema and proliferative diabetic retinopathy. In addition, retinal cell types including microglia, Müller glia, astrocytes, retinal pigment epithelial cells, and others are activated, to secrete inflammatory mediators, aggravating cell apoptosis and subsequent vascular leakage. New therapies, targeting these inflammatory molecules or related signaling pathways, have the potential to inhibit retinal inflammation and prevent diabetic retinopathy progression. Here, we review the relevant literature to date, summarize the inflammatory mechanisms underlying the pathogenesis of diabetic retinopathy, and propose inflammation-based treatments for diabetic retinopathy and diabetic macular edema. 展开更多
关键词 anti-inflammation therapy anti-vascular endothelial growth factor diabetic retinopathy hyperreflectivity foci INFLAMMATION inflammatory cells inflammatory cytokines leukostasis MICROGLIA Müller cells
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Global trends in diabetic eye disease research from 2012 to 2021
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作者 Yuan Yuan Shangli Ji +4 位作者 Yali Song Zhaodi Che Lu Xiao Shibo Tang Jia Xiao 《Neural Regeneration Research》 SCIE CAS CSCD 2024年第10期2310-2320,共11页
Diabetic eye disease refers to a group of eye complications that occur in diabetic patients and include diabetic retinopathy, diabetic macular edema, diabetic cataracts, and diabetic glaucoma. However, the global epid... Diabetic eye disease refers to a group of eye complications that occur in diabetic patients and include diabetic retinopathy, diabetic macular edema, diabetic cataracts, and diabetic glaucoma. However, the global epidemiology of these conditions has not been well characterized. In this study, we collected information on diabetic eye disease-related research grants from seven representative countries––the United States, China, Japan, the United Kingdom, Spain, Germany, and France––by searching for all global diabetic eye disease journal articles in the Web of Science and Pub Med databases, all global registered clinical trials in the Clinical Trials database, and new drugs approved by the United States, China, Japan, and EU agencies from 2012 to 2021. During this time period, diabetic retinopathy accounted for the vast majority(89.53%) of the 2288 government research grants that were funded to investigate diabetic eye disease, followed by diabetic macular edema(9.27%). The United States granted the most research funding for diabetic eye disease out of the seven countries assessed. The research objectives of grants focusing on diabetic retinopathy and diabetic macular edema differed by country. Additionally, the United States was dominant in terms of research output, publishing 17.53% of global papers about diabetic eye disease and receiving 22.58% of total citations. The United States and the United Kingdom led international collaborations in research into diabetic eye disease. Of the 415 clinical trials that we identified, diabetic macular edema was the major disease that was targeted for drug development(58.19%). Approximately half of the trials(49.13%) pertained to angiogenesis. However, few drugs were approved for ophthalmic(40 out of 1830;2.19%) and diabetic eye disease(3 out of 1830;0.02%) applications. Our findings show that basic and translational research related to diabetic eye disease in the past decade has not been highly active, and has yielded few new treatment methods and newly approved drugs. 展开更多
关键词 clinical trials diabetic cataracts diabetic eye disease diabetic glaucoma diabetic macular edema diabetic retinopathy drug development global research PUBLICATION research grant
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Advances in the Pathogenesis and Pharmacologic Treatment of Diabetic Cataracts
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作者 Xin Kou 《Journal of Clinical and Nursing Research》 2024年第7期173-177,共5页
Diabetic cataract(DC)is a common complication prior to diabetes mellitus,which is a metabolic disease with pathogenesis including abnormal metabolism of polyphenol pathway(PP)and non-enzymatic glycosylation(NEG)of pro... Diabetic cataract(DC)is a common complication prior to diabetes mellitus,which is a metabolic disease with pathogenesis including abnormal metabolism of polyphenol pathway(PP)and non-enzymatic glycosylation(NEG)of proteins,etc.The therapeutic drugs are mainly aldose reductase inhibitors(ARIs)and glycosylation inhibitors.The therapeutic regimens for DC are becoming more and more diversified due to the development of biological testing and clinical research technology,thus improving its clinical efficacy.With the development of biological testing and clinical research technology,the treatment options for DC have become increasingly diversified and the treatment specificity has been improved,improving its clinical efficacy.In order to comprehensively analyze the pathogenesis and pharmacological treatment of this disease,the following review is made. 展开更多
关键词 diabetic cataract PATHOGENESIS drug therapy
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Are proton pump inhibitors a new antidiabetic drug? A cross sectional study 被引量:7
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作者 Diana Boj-Carceller Pilar Bocos-Terraz +3 位作者 Miguel Moreno-Vernis Alejandro Sanz-Paris Pablo Trincado-Aznar Ramón Albero-Gamboa 《World Journal of Diabetes》 SCIE CAS 2011年第12期217-220,共4页
AIM: To investigate the effect of proton pump inhibitors (PPIs) on glycemic control (HbA1c) in type 2 diabetic patients. METHODS: A crosssectional study of consecutive in-patients admitted to hospital in any departmen... AIM: To investigate the effect of proton pump inhibitors (PPIs) on glycemic control (HbA1c) in type 2 diabetic patients. METHODS: A crosssectional study of consecutive in-patients admitted to hospital in any department during the fi rst semester of the year 2010 who had a recent HbA1c measurement. The study excluded those with a diagnosis of hyperglycemic decompensation, diabetic onset or pregnancy. It compared HbA1c levels of those taking PPIs and those not. RESULTS: A total of 97 patients were recruited. The average HbA1C level was 7.0% ± 1.2%. Overall PPI consumption was 55.7%. HbA1c was signif icantly lower in individuals who took PPIs: -0.6%, 95% CI: -0.12 to-0.83. People who used PPIs with some type of insulin therapy had a HbA1c reduction by -0.8%, 95% CI: -0.12 to -1.48. For the rest of subgroup analysis based on the antidiabetic drug used, PPI consumption always exhibited lower HbA1c levels. CONCLUSION: PPIs seems to be consistently associated with better glycemic control in type 2 diabetes. HbA1c reduction observed is similar to incretin-based therapies. 展开更多
关键词 PROTON PUMP INHIBITORS diabetes MELLITUS drug therapy HYPOGLYCEMIC agents INCRETINS
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Diabetic macular edema:New promising therapies 被引量:4
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作者 Hanan N Al Shamsi Jluwi S Masaud Nicola G Ghazi 《World Journal of Diabetes》 SCIE CAS 2013年第6期324-338,共15页
The treatment of diabetic macular edema is rapidly evolving.The era of laser therapy is being quickly replaced by an era of pharmacotherapy.Several pharmacotherapies have been recently developed for the treatment of r... The treatment of diabetic macular edema is rapidly evolving.The era of laser therapy is being quickly replaced by an era of pharmacotherapy.Several pharmacotherapies have been recently developed for the treatment of retinal vascular diseases such as diabetic macular edema.Several intravitreal injections or sustained delivery devices have undergone phase 3 testing while others are currently being evaluated.The results of clinical trials have shown the superiority of some of these agents to laser therapy.However,with the availability of several of these newer agents,it may be difficult to individualize treatment options especially those patients respond differently to various therapies.As such,more effort is still needed in order to determine the best treatment regimen for a given patient.In this article,we briefly summarize the major new therapeutic additions for the treatment of diabetic macular edema and allude to some future promising therapies. 展开更多
关键词 diabetic MACULAR edema diabetic retinopathy INTRAVITREAL injection Laser PHOTOCOAGULATION PHARMACOtherapy Sustained release drug delivery devices VITRECTOMY
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Visualizing the intellectual structure and recent research trends of diabetic retinopathy 被引量:1
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作者 Li Xiao Yi-Jing Yang +3 位作者 Qi Liu Jun Peng Jun-Feng Yan Qing-Hua Peng 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2021年第8期1248-1259,共12页
AIM:To analyze the intellectual structure and recent research trends in diabetic retinopathy(DR)and unearth potential knowledge.METHODS:English DR publication included in this study was exported from the Web of Scienc... AIM:To analyze the intellectual structure and recent research trends in diabetic retinopathy(DR)and unearth potential knowledge.METHODS:English DR publication included in this study was exported from the Web of Science Core Collection,and Chinese DR publication was exported from China National Knowledge Infrastructure from the establishment time of the database to 2019.CiteSpace and Microsoft Excel were used to visually analyze DR research,including analysis of the number of publications,highly cited publication analysis,spatial distribution analysis,and keyword co-occurrence analysis.RESULTS:A total of 23795 English studies and 11577 Chinese studies,including 2089 studies related to traditional Chinese medicine(TCM),were obtained.The data suggested the following:1)The number of English and Chinese DR publications increased over time,and the growth rate of English publications was relatively fast.2)The distribution of international scholars and institutions was close,while the distribution was scattered in China.Shanghai Jiao Tong University has the largest number of publications.Tien-Yin Wong was the core author with the largest number of publications.England and the United States are the core of international DR research cooperation.3)Optical coherence tomography and risk factors are recent international research hot spots and trends.The difference is that TCM is a recent research trend under DR in China.CONCLUSION:DR has drawn an increasing amount of attention worldwide.The focus of research in this field has shifted from tertiary type DR treatment to secondary prevention strategies which focus on the screening and monitoring of disease progression.The advantages of TCM in the prevention of DR have attracted attention,and it is worth incorporating this with Western medicine to address this challenge. 展开更多
关键词 diabetic retinopathy diabetes mellitus retinopathy complementary therapies BIBLIOMETRICS
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Clinical evidence and potential mechanisms of Chinese medicines for the treatment of diabetic retinopathy 被引量:1
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作者 Jian Huo Ke-Yu Zhu +2 位作者 Qian Yang Wen Liu Jun-Guo Duan 《Traditional Medicine Research》 2018年第2期42-53,共12页
Diabetic retinopathy is one of the main causes of visual impairment and blindness on a global scale. At present, thelimitations of anti-vascular endothelial growth factor agents, steroids, laser photocoagulation, and ... Diabetic retinopathy is one of the main causes of visual impairment and blindness on a global scale. At present, thelimitations of anti-vascular endothelial growth factor agents, steroids, laser photocoagulation, and vitreous surgery haveled to a growing awareness of the role of Chinese medicines in the treatment of diabetic retinopathy. This review firstdescribes the ingredients and characteristics of the formulae including Chinese herbal formulaes, Chinese patent drugsand ancient processed drugs and summarizes the application of Chinese medicines and their mechanisms of action in thetreatment of diabetic retinopathy. Due to the complexity of Chinese medicines, in-depth mechanisms, side effects of herb,and drug interactions need to be elaborated in future research. Chinese medicines have the potencial to protect theresidual eyesight and delay the progression of disease, thereby offering a beneficial, exploitable option in thetreatment/prevention of diabetic retinopathy. 展开更多
关键词 diabetic retinopathy Chinese medicines FORMULA Chinese patent drugs
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Type 2 Diabetes Mellitus in Children and Adolescents: Early Prevention and Non-Drug Therapy 被引量:1
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作者 Lunan Zhao Ting Long +3 位作者 Amy Leung Hui Ruozhi Zhao Shaohua Long Wen Peng 《Journal of Diabetes Mellitus》 2017年第3期121-141,共21页
The global rate of type 2 diabetes mellitus (T2DM) in youth has increased dramatically in the last 30 years. This increase mirrors the global epidemic of childhood obesity. Studies show that, compared to adults who de... The global rate of type 2 diabetes mellitus (T2DM) in youth has increased dramatically in the last 30 years. This increase mirrors the global epidemic of childhood obesity. Studies show that, compared to adults who develop T2DM, youth with T2DM ultimately suffer from more harmful symptoms. The prevalence of T2DM and obesity in youth signals a significant public health issue that financially burdens governments, families, and individuals. Since evidence suggests that T2DM in youth is different from both type 1 and type 2 diabetes in adults, researchers and clinicians face many difficulties in developing new treatments. Most treatment efforts have relied on drugs;however, recent studies suggest that non-drug therapy also effectively reduces obesity and diabetic symptoms. Healthier eating, increased physical exercise, and positive mental health, are often underappreciated factors towards managing obesity. Yet these lifestyle changes empower both young and older patients to independently fight diseases and attain better health. To manage the global health risk of obesity, further research addressing the prevention and nondrug early intervention of T2DM and obesity in youth is urgently needed. The present review focuses on the latest updates in the field. 展开更多
关键词 diabetES YOUTH PREVENTION Non-drug therapy
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Hyperbaric Oxygen Treatment for Diabetic Retinopathy and Neuropathy in a Streptozotocin Induced Diabetic Rat Model
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作者 Jesper G. Madsen Martin N. Skov +4 位作者 Kasper Hansen Christoffer Laustsen Niels Ejskjær Henning Andersen Michael Pedersen 《Journal of Biomedical Science and Engineering》 2021年第12期391-401,共11页
<strong>Aim:</strong> Diabetes Mellitus is a global public health challenge with major and potentially devastating complications, and concomitant complications include retinopathy and neuropathy due to hyp... <strong>Aim:</strong> Diabetes Mellitus is a global public health challenge with major and potentially devastating complications, and concomitant complications include retinopathy and neuropathy due to hypoxia and microvascular dysfunction. In this study, we investigated the effect of hyperbaric oxygen therapy as a method to transiently improve tissue oxygenation on diabetic retinopathy and neuropathy in a streptozotocin induced type-1 diabetic rat model (Wistar). <strong>Methods:</strong> Streptozotocin induced type-1 diabetic rats received 10 sessions of 2-h hyperbaric oxygen exposures (pO<sub>2</sub> = 309 kPa) over 2 weeks. Animals were exposed to light stimuli to produce light evoked potentials to estimate the effect of oxygen treatment on diabetic retinopathy. Sciatic nerves were exposed and stimulated to produce muscle evoked potential, which were recorded in the muscles of the foot and subsequently used to evaluate the effect of oxygen treatment on diabetic neuropathy. <strong>Results:</strong> We found significantly shorter light evoked potential latency and increased amplitude in hyperbaric oxygen treated animals. No change was found in nerve conduction. <strong>Conclusions:</strong> This study showed that hyperbaric oxygen therapy is a potentially effective treatment for diabetic retinopathy, improving both latency and amplitude of light evoked potentials. 展开更多
关键词 diabetic Neuropathy diabetic retinopathy Hyperbaric Oxygen therapy
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Drug Therapy Monitoring in Patients with Type 2 Diabetes and Hypertension
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作者 Jose Francisco Castro Bolivar Femando Martinez-Martinez Monica Ferrit-Martin 《Journal of Pharmacy and Pharmacology》 2017年第4期169-178,共10页
The aim of this paper is to detect, prevent and resolve DRP (drug-related problems) and NOM (negative outcomes associated with medication) in hospitalized patients with DM2 (type 2 diabetes) with HTN (hypertens... The aim of this paper is to detect, prevent and resolve DRP (drug-related problems) and NOM (negative outcomes associated with medication) in hospitalized patients with DM2 (type 2 diabetes) with HTN (hypertension) in a tertiary care clinic. Descriptive cross-sectional interventional study is used. DTM (drug therapy monitoring) was conducted in 73 patients using data obtained from clinical histories and interviews. NOM were detected based on symptoms and laboratory test results. The statistical significance was 0.05. It can be found that 23 DRP were detected, primarily in the category "likelihood of adverse effects" (30.43%) causing NOM in the "non-quantitative safety problem" category. The NOM detected were related to safety (62%), effectiveness (24.5%) and necessity (13.5%). Of the 68.57% of pharmacist interventions accepted, 48.57% were resolved and 20% were not resolved. A simple linear correlation (r = -0.34) analysis indicated a weak association between patient age and severity ofNOM. DTM made it'possible to detect suspected DRP and NOM, which were then prevented or resolved, improving the control of HTN and DM2 and helping ensure better drug therapy outcomes for patients. 展开更多
关键词 drug therapy monitoring type 2 diabetes mellitus HYPERTENSION pharmacist intervention.
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Current status in diabetic macular edema treatments 被引量:7
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作者 Pedro Romero-Aroca 《World Journal of Diabetes》 SCIE CAS 2013年第5期165-169,共5页
Diabetes is a serious chronic condition,which increase the risk of cardiovascular diseases,kidney failure and nerve damage leading to amputation.Furthermore the ocular complications include diabetic macular edema,is t... Diabetes is a serious chronic condition,which increase the risk of cardiovascular diseases,kidney failure and nerve damage leading to amputation.Furthermore the ocular complications include diabetic macular edema,is the leading cause of blindness among adults in the industrialized countries.Today,blindness from diabetic macular edema is largely preventable with timely detection and appropriate interventional therapy.The treatment should include an optimized control of glycemia,arterial tension,lipids and renal status.The photocoagulation laser is currently restricted to focal macular edema in some countries,but due the high cost of intravitreal drugs,the use of laser treatment for focal and diffuse diabetic macular edema(DME),can be valid as gold standard in many countries.The intravitreal anti vascular endothelial growth factor drugs(ranibizumab and bevacizumab),are indicated in the treatment of all types of DME,but the correct protocol for administration should be defined for the different Retina Scientific Societies.The corticosteroids for diffuse DME,has a place in pseudophakic patients,but its complications restricted the use of these drugs for some patients.Finally the intravitreal interface plays an important role and its exploration is mandatory in all DME patients. 展开更多
关键词 diabetic MACULAR edema diabetic retinopathy Laser Anti-vascular endothelial growth factor drugs INTRAVITREAL dexamethasone TRIAMCINOLONE VITRECTOMY
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A comparative study on the transplantation of different concentrations of human umbilical mesenchymal cells into diabetic rats 被引量:9
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作者 Jia-Hui Kong Dan Zheng +4 位作者 Song Chen Hong-Tao Duan Yue-Xin Wang Meng Dong Jian Song 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2015年第2期257-262,共6页
AIM: To observe the effects of intravitreal injections of different concentrations of human umbilical mesenchymal stem cells on retinopathy in rats with diabetes mellitus.METHODS: Healthy and adult male Sprague-Dawley... AIM: To observe the effects of intravitreal injections of different concentrations of human umbilical mesenchymal stem cells on retinopathy in rats with diabetes mellitus.METHODS: Healthy and adult male Sprague-Dawley(SD) rats were randomly assigned to a normal control group(group A), a diabetic retinopathy(DR) blank control group(group B), a high-concentration transplantation group(group C), a low-concentration transplantation group(group D) and a placebo transplantation group(group E). The expression of nerve growth factor(NGF)protein in the retinal layers was detected by immunohistochemical staining at 2, 4, 6 and 8wk.RESULTS: The expression of NGF was positive in group A and most positive in the retinal ganglion cell layer. In groups B and E, the expression of NGF was positive 2wk after transplantation and showed an increase in all layers. However, the level of expression had decreased in all layers at 4wk and was significantly reduced at 8wk. In groups C and D, the expression of NGF had increased at 2wk and continued to increase up to 8wk. The level of expression in group C was much higher than that in group D.CONCLUSION: DR can be improved by intravitreal injection of human umbilical mesenchymal stem cells.High concentrations of human umbilical mesenchymal stem cells confer a better protective effect on DR than low concentrations. 展开更多
关键词 diabetic retinopathy human umbilical mesenchymal stem cells nerve growth factor stem cell therapy
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Diabetic macular edema:Current management 2013 被引量:5
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作者 J Fernando Arevalo 《World Journal of Diabetes》 SCIE CAS 2013年第6期231-233,共3页
Diabetic retinopathy(DR)is the leading cause of vision loss of working-age adults,and diabetic macular edema(DME)is the most frequent cause of vision loss related to diabetes.The Wisconsin Epidemiologic Study of Diabe... Diabetic retinopathy(DR)is the leading cause of vision loss of working-age adults,and diabetic macular edema(DME)is the most frequent cause of vision loss related to diabetes.The Wisconsin Epidemiologic Study of Diabetic Retinopathy found the 14-year incidence of DME in type 1 diabetics to be 26%.Similarly the Diabetes Control and Complications Trial reported that 27% of type 1 diabetic patients develop DME within9 years of onset.The most common type of diabetes,type 2,is strongly associated with obesity and a sedentary lifestyle.An even higher incidence of macular edema has been reported in older patients with type 2diabetes.Within the last 5 years,the use of intravitreal corticosteroids and intravitreal anti-vascular endothelial growth factor(VEGF)agents have come into clinical practice for the management of DME and several recent randomized clinical trials have shown improved effectiveness of ranibizumab compared to focal/grid laser.In this theme issue,we discuss the classification of DR and the treatment options currently available for the treatment of DME including corticosteroids,anti-VEGF agents,combined therapy,enzymatic vitrectomy(vitreolysis),and new therapies. 展开更多
关键词 diabetic macular edema diabetic retinopathy diabetic macular edema Enzymatic vitrectomy (vitreolysis) Focal/grid laser Intravitreal anti-vascular endothelial growth factor Intravitreal corticosteroids New therapies
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Continuing episodes of pain in recurrent acute pancreatitis: Prospective follow up on a standardised protocol with drugs and pancreatic endotherapy 被引量:2
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作者 C Ganesh Pai M Ganesh Kamath +1 位作者 Mamatha V Shetty Annamma Kurien 《World Journal of Gastroenterology》 SCIE CAS 2017年第19期3538-3545,共8页
AIM To assess the outcomes of drug therapy(DT)followed by pancreatic endotherapy for continuing painful episodes in recurrent acute pancreatitis.METHODS DT comprised of pancreatic enzymes and antioxidants failing whic... AIM To assess the outcomes of drug therapy(DT)followed by pancreatic endotherapy for continuing painful episodes in recurrent acute pancreatitis.METHODS DT comprised of pancreatic enzymes and antioxidants failing which,endotherapy(ET;pancreatic sphincterotomy and stent placement)was done.The frequency of pain,its visual analogue score(VAS),quality of life(Qo L),serum C peptide and faecal elastase were compared between baseline and after 1 year of follow up in all patients and in the two subgroups on DT and ET.Response was defined as at least 50%reduction in the severity of pain to below a score of 5.RESULTS Of the thirty nine patients analysed,21(53.9%)responded to DT and 18(46.1%)underwent ET.The VAS for pain(7.0±2.0 vs 1.3±2.5,P<0.001)and the number of days with pain per month decreased[1.0(1.0,2.0)vs 1.0(0.0,1.0),P<0.001],and the Qo L scores[55.0(44.0,66.0)vs 38.0(32.00,51.00),P<0.01]improved significantly during follow up.Similar significant improvements were seen in patients in the subgroups of DT and ET except for Qo L in ET.The serum C-peptide(P=0.001)and FE(P<0.001)levels improved significantly in the entire group and in the two subgroups of patients except for the C peptide levels in patients on DT.CONCLUSION A standardised protocol of DT,followed by ET decreased the intensity and frequency of pain in recurrent acute pancreatitis,enhanced Qo L and improved pancreatic function. 展开更多
关键词 drug therapy Endoscopy Exocrine insufficiency Pancreatic diabetes Pancreatic duct stents Quality of life Recurrent acute pancreatitis Surgery
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Qi-Promoting and Phlegm-Resolving Method for Treatment of Diabetic Microvascular Complications 被引量:1
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作者 高渌纹 《Journal of Traditional Chinese Medicine》 SCIE CAS CSCD 2000年第2期104-109,共6页
OBJECTIVE: To evaluate the effects of qi-promoting and phlegm-resolving approach in treatment of diabetic microvascular complications. METHODOLOGY: Clinical observation of cases given modified Wen Dan Tang ([symbol: s... OBJECTIVE: To evaluate the effects of qi-promoting and phlegm-resolving approach in treatment of diabetic microvascular complications. METHODOLOGY: Clinical observation of cases given modified Wen Dan Tang ([symbol: see text] Gallbladder-warming Decoction). RESULT: Favorable results obtained in cases of diabetic microvascular complications of the type of stagnancy of qi and phlegm (diabetic retinopathy, diabetic nephropathy and diabetic foot). CONCLUSION: Wen Dan Tang is effective for diabetic microvascular complications of the type of stagnancy of qi and phlegm. 展开更多
关键词 diabetic Angiopathies diabetic Foot diabetic retinopathy drugs Chinese Herbal FEMALE Humans MALE Middle Aged
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Twenty-eight Cases of Diabetic Foot Ulcer and Gangrene Treated with the Chinese Herbal Medicine Combined with Injection of Ahylsantinfarctase 被引量:1
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作者 王凡 王友京 《Journal of Traditional Chinese Medicine》 SCIE CAS CSCD 2002年第1期3-4,共2页
  Since 1995, the Chinese herbal medicine for supplementing qi and activating blood circulation combined with injection of ahylsantinfarctase into the femoral artery has been used in 28 cases of diabetes complicated...   Since 1995, the Chinese herbal medicine for supplementing qi and activating blood circulation combined with injection of ahylsantinfarctase into the femoral artery has been used in 28 cases of diabetes complicated with gangrene and ulcer of the foot, with quite good therapeutic effects as reported in the following.…… 展开更多
关键词 Aged Astragalus Plant diabetes Mellitus Type 2 diabetic Foot drug Combinations drug therapy Combination drugs Chinese Herbal Female Femoral Artery GANGRENE Humans INJECTIONS Injections Intra-Arterial Male
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