Objective To assess the effectiveness and safety of fructose 1,6-diphosphate （FDP） in the treatment of hypoxic ischemic encephalopathy （HIE）patients. Methods Biomedical databases, including MEDLINE （1977 -2004 ）, EMBASE（1989- 2004） ,Cochrane Injuries Group trials register, Cochrane Controlled Trials Register, CBMdisk and CNKI （1994- 2005 ）were searched. Chnical trials were collecte＆Quality assessments of chnical trials were carried out. Randomized controlled trials （RCTs） with mortality and the incidence of cerebral palsy, epilepsy and mental defect were selected for meta-analysis. Results Nine RCTs were included, and all were done in China. None of the 9 RCTs described the method of randomization or allocation concealment. None of the 9 RCTs mentioned wether blindness was use＆ In Jadad score, 5 trials were scored by 2 and 4 trials were 1. Seven trials were included in the meta-analysis of death, which showed that the obsolute risk （OR） [95% confidence interval （CI）] of death following FDP administration was 0. 50 （95% CI 0. 21 to 1.16）. Five RCTs reported the results of follow-up. When intention to treat （ITT） analysis was adopted, the OR of FDP on cerebral palsy was 0. 36 （95% CI 0. 19 to 0. 89）, on epilepsy was 0.74 （95% CI 0. 29 to 1.88）, and on dementia was 0. 21 （95% CI 0. 06 to 0.70）. We didn＇t conduct sensitivity analysis because no RCTs were of high quality. We didn＇t identify clinical trials compared with adverse reactions between the two groups. Conclusions The quality of RCTs on FDP for HIE is poor. Because there were no RCTs of high quality available, we can＇t draw a conlusion. Well-designed RCTs with economic evaluation are urgently needed to evaluate the value of FDP in the treatment of HIE.
ObjectiveTo observe and analyze changes in macular ganglion cell complex (GCC) parameters after trabeculectomy in primary open-angle glaucoma (POAG) patients and their relationship with visual function. MethodsA retrospective clinical study. From January 2022 to June 2024, 105 POAG patients (105 eyes) diagnosed and undergoing trabeculectomy at Department of Ophthalmology, Daqing Longnan Hospital were included. All patients underwent examinations including uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), visual field, and optical coherence tomography (OCT). The patients were divided into the mild group, the moderate group and the severe group according to the degree of optic nerve damage, with 36, 42 and 27 cases respectively. According to the BCVA 3 months after the operation, the patients were divided into the good visual recovery group and the poor visual recovery group, with 63 and 42 cases respectively. OCT was used to measure the average GCC thickness in the overall macular area (GCC-Avg), superior hemisphere (GCC-Sup), and inferior hemisphere (GCC-Inf). Generalized linear mixed-effects models and restricted cubic splines (RCS) were used to analyze the relationship between GCC thickness and optic nerve damage severity. Multiple linear regression analyzed the relationship between GCC parameter changes and visual acuity recovery. Stepwise regression assessed the impact of optic nerve damage severity and GCC parameter changes on visual acuity recovery. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were used to evaluate the predictive value of GCC parameter changes for postoperative visual recovery in patients with different nerve damage severities. A mediating effect model was constructed to analyze the mediating effect of GCC thickness between optic nerve damage severity and postoperative visual recovery. ResultsSignificant differences were found in GCC-Avg, GCC-Sup, and GCC-Inf thicknesses among the different optic nerve damage severity groups (F=5.761, 18.199, 7.529; P＜0.05). Generalized linear mixed-effects models and RCS analysis revealed a significant nonlinear dose-response relationship between GCC thickness and severe nerve damage (nonlinear test P＜0.05). Significant differences were observed between the good and poor recovery groups in preoperative and postoperative intraocular pressure (t=2.839, 3.979) and optic nerve damage severity (χ2=15.418) (P＜0.05). Preoperatively, and at 1 week and 1 month postoperatively, the poor recovery group had significantly lower GCC-Avg (t=5.089, 5.983, 6.321), GCC-Sup (t=7.513, 9.342, 9.81), GCC-Inf (t=5.499, 6.279, 7.698) thicknesses, UCVA (t=15.194, 14.852, 18.758), and BCVA (t=16.129, 16.167, 21.798) compared to the good recovery group (P＜0.05). UCVA and BCVA improved significantly at 1 week, 1 month, and 3 months postoperatively in the good recovery group (P＜0.05). Multiple linear regression showed that GCC-Avg, GCC-Sup, and GCC-Inf thicknesses were positively correlated with UCVA and BCVA in patients with different nerve damage severities (P＜0.05). Optic nerve damage severity was positively correlated with visual recovery (P＜0.05), while GCC-Avg, GCC-Sup, and GCC-Inf were negatively correlated with visual recovery (P＜0.05). ROC curve analysis showed that GCC-Avg, GCC-Sup, and GCC-Inf thicknesses had AUC ＞0.7 for predicting postoperative visual recovery in POAG patients. The combined prediction using all three parameters yielded higher AUC, sensitivity, and specificity than any single parameter, indicating superior predictive performance. ConclusionVisual recovery after trabeculectomy in patients with open-angle glaucoma correlates with the extent of optic nerve damage and the thickness of the ganglion cell complex in the macula, and ganglion cell complex thickness mediates the modulation between the extent of optic nerve damage and postoperative visual recovery.
ObjectiveTo analyze pathogenic factors and etiological characteristics of suppurative endophthalmitis.MethodsA total of 531 consecutive patients (531 eyes) with suppurative endophthalmitis who were hospitalized in Qingdao Eye Hospital of Shandong Eye Institute from January 2006 to December 2015 were included in the study. Among them, 410 patients with 410 eyes were males (77.2%), 121 patients with 121 eyes were females (22.8%). The average age of the patients was 38.62±15.36 years. The relevant medical records were collected to analyze the pathogenic factors. Samples of aqueous humor, vitreous or other intraocular samples were taken under aseptic conditions for bacterial and fungal culture and in vitro drug sensitivity test.ResultsOcular trauma was the primary pathogenic factor of suppurative endophthalmitis (60.1%), other factors included postoperative endophthalmitis (19.0%), suppurative keratitis-related endophthalmitis (17.1%) and endogenous endophthalmitis (3.8%). Postoperative endophthalmitis mainly occured after cataract surgery. A total of 224 strains of organisms were isolated, among which the predominant organisms isolated were gram-positive bacteria (54.0%) and staphylococcus epidermidis was the most common (25.0%). The other pathogenic organisms were fungi (29.5%) and gram-negative bacteria (16.5%). Among the fungi, aspergillus (10.7%) was the dominant genus, followed by fusarium (9.8%). For gram-positive organisms, susceptibilities were vancomycin 97.4%, gatifloxacin 91.8%, fusidate acid 77.9% and levofloxacin 54.6%. For gram-negative organisms, susceptibilities were gatifloxacin 85.7%, levofloxacin 77.8%, tobramycin 71.4% and ceftazidime 62.5%. For fungal isolates, sensitivities were voriconazole 88.2% and amphotericin B 84.8%.ConclusionsOcular trauma is the main pathogenic factor of suppurative endophthalmitis, followed by postoperative endophthalmitis and suppurative keratitis-related endophthalmitis. Gram-positive bacteria are the major pathogenic organisms, especially staphylococcus epidermidis followed by fungal species, among which aspergillus and fusarium were the dominating pathogenic genus.