Retinal vein occlusion (RVO) is a common retinal venous disorder that causes vision loss. No specific therapy has been developed. Controversy exists regarding two treatments: intravitreal ...dexamethasone implants and anti-vascular endothelial growth factor (VEGF). The goal of this study is to compare the effectiveness and safety of dexamethasone implants and anti-VEGF treatment for RVO.
The PubMed, Embase, and Cochrane Library databases were searched for studies comparing dexamethasone implants with anti-VEGF in patients with RVO. Best-corrected visual acuity (BCVA), central subfield thickness (CST), intraocular pressure changes, conjunctival haemorrhage, reduced VA, and macular oedema were extracted from the final included studies. RevMan 5.3 was used to conduct the quantitative analysis and bias assessment.
Four randomised controlled trials assessing 969 eyes were included. The anti-VEGF treatment showed better BCVA improvement (mean difference MD = - 10.59, P < 0.00001) and more CST decrease (MD = - 86.71 μm, P = 0.02) than the dexamethasone implants. However, the dexamethasone implants required fewer injections. As for adverse effects, the dexamethasone implants showed significantly higher intraocular pressure (IOP) and more cataracts than the anti-VEGF treatment. No significant differences were found in conjunctival haemorrhage, reduced VA, and macular oedema.
Anti-VEGF treatment showed better functional and anatomical improvement with less risk of IOP elevation and cataract formation compared to dexamethasone implants. Thus, anti-VEGF treatment is the first choice for treating RVO patients.
A 59‐year‐old patient presented with 4‐day acute painless bilateral visual loss, MRI results showed dura enhancement of the frontal, anterior cranial fossa. The patient was considered to have ...idiopathic hypertrophic cranial pachymeningitis based on laboratory tests and MRI data. After treatment with hormones, the visual acuity obviously improved.
We reported a patient presented with 4‐day acute painless bilateral visual loss, who was diagnosed to have idiopathic hypertrophic cranial pachymeningitis based on laboratory tests and MRI data, the visual acuity obviously improved after timely treatment. Therefore, Intracranial changes should be considered in patients with a sharp decline in visual acuity but with no obviously positive signs of the eye fundus.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
A previous study reported that intravitreal injection of αA-crystallin inhibits glial scar formation after optic nerve traumatic injury. The purpose of this study was to investigate the effect of ...αA-crystallin on optic nerve astrocytes induced by oxygen glucose deprivation (OGD) in vitro.
Optic nerve astrocytes from newborn Long Evans rats were cultured with αA-crystallin (10−4 g/l) to detect the effects of αA-crystallin on astrocytes. Using a scratch assay, the effect of αA-crystallin treatment on astrocyte migration was assessed. Astrocytes were exposed to OGD and glucose reintroduction/reoxygenation culture for 24 h and 48 h. The expression of glial fibrillary acidic protein (GFAP) and neurocan were subsequently evaluated via immunocytochemistry and western blot. BMP2/4, BMPRIa/Ib and Smad1/5/8 mRNA expression levels were detected by RT-PCR.
The results showed that αA-crystallin slowed the migration of astrocytes in filling the scratch gaps. GFAP and neurocan expression in astrocytes was increased after OGD. However, after treatment with αA-crystallin, GFAP and neurocan expression levels clearly decreased. Furthermore, RT-PCR showed that BMP2 and BMP4 mRNA expression levels decreased significantly.
These results suggest that αA-crystallin inhibits the activation of astrocytes after OGD injury in vitro. Inhibition of the BMP/Smad signaling pathway might be the mechanism underlying this effect.
•We observed the inhibition of αA-crystallin in astrocyte activation in vitro.•αA-crystallin inhibited the migration of astrocytes in scratch assay.•αA-crystallin inhibited astrocyte GFAP and neurocan expression after oxygen glucose deprivation.•αA-crystallin inhibited astrocyte BMPs mRNA expression after oxygen glucose deprivation.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Abstract Type I photodynamic therapy (PDT) generates reactive oxygen species (ROS) through oxygen‐independent photoreactions, making it a promising method for treating hypoxic tumors. However, the ...superoxide anion (O 2 ∙ – ) generated usually exhibits a low oxidation capacity, restricting the antitumor efficacy of PDT in clinical practice. Herein, a photoactivated self‐assembled nanoreactor ( 1 ‐NBS@CeO 2 ) is designed through integration of type I PDT and cerium oxide (CeO 2 ) nanozymes for inducing cascade‐amplified oxidative stress in hypoxic tumors. The nanoreactor is constructed though co‐assembly of an amphiphilic peptide ( 1 ‐NBS) and CeO 2 , giving well‐dispersed spherical nanoparticles with enhanced superoxide dismutase (SOD)‐like and peroxidase (POD)‐like activities. Following light irradiation, 1 ‐NBS@CeO 2 undergoes type I photoreactions to generated O 2 ∙ – , which is further catalyzed by the nanoreactors, ultimately forming hypertoxic hydroxyl radical (∙OH) through cascade‐amplified reactions. The PDT treatment using 1 ‐NBS@CeO 2 results in elevation of intracellular ROS and depletion of GSH content in A375 cells, thereby inducing mitochondrial dysfunction and triggering apoptosis and ferroptosis of tumor cells. Importantly, intravenous administration of 1 ‐NBS@CeO 2 alongside light irradiation showcases enhances antitumor efficacy and satisfactory biocompatibility in vivo. Together, the self‐assembled nanoreactor facilitates cascade‐amplified photoreactions for achieving efficacious type I PDT, which holds great promise in developing therapeutic modules towards hypoxic tumors.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Currently, the use of assisted reproductive technology (ART) is increasing. Because of the poor prognosis of retinopathy of prematurity (ROP), the association between ART and the ROP has been ...explored in several studies, but the result was still inconclusive. Conducting a meta-analysis, we evaluated the risk of ROP in relation to the ART. Subgroup analysis as well as groups with different embryo numbers and different ROP stages was further analyzed. The PubMed, Embase, and Cochrane Library databases were searched for studies recording data about both the use of ART and ROP occurrence simultaneously. Odds ratios (ORs) and 95% confidence interval (95%CI) were calculated to analyze the association by using random- or fixed-effect models based on heterogeneity test. In total 15 observational studies containing 10392 ART cases and 39474 spontaneous conception cases were included. Results showed that there was a significant association between the use of ART and ROP occurrence in the offspring (OR = 1.34, 95% CI: 1.05 to 1.73, P = 0.02). With subgroup analysis, we found that the influence actually came from a subgroup of ART, the in vitro fertilization (IVF). Moreover, there was a significant association between ART and ROP in singletons. Though insignificant, the ORs were larger than 1 in the analysis between ART and stage 1 and 2 ROP. But ART showed significant association with stage 3 ROP. Our study preliminarily indicated that the use of IVF was associated with higher risk of ROP occurrence. And ART is more likely to result in severe ROP and ROP in singletons. Further specific, high-quality studies with large sample size are still needed to draw more precise conclusion.
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DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
博士
國立成功大學
工業與資訊管理學系
102
From a health policy perspective, ideal resource allocation in health care should be concerned with the combination of inputs required to produce these services at the lowest ...costs, given that resources are limited. To accomplish this goal, procedural equity must accurately assess the fairness of health care services delivery.
Taiwan implemented a National Health Insurance (NHI) program in 1995 so as to reduce financial barriers for all citizens using a universal health care system. Horizontal equity, an explicit goal of the NHI system, is to guarantee equal opportunity of access to health care. However, due to a severe financial deficit, a global budget was introduced to replace the original payment system in 2002.
At the macro level, measuring equity and efficiency of resource allocation in hospital-based health care services is a complex issue concerning multi-criteria decision making (MCDM). Two methods of MCDM are illustrated and analyzed in this study:grey Incidence Analysis (GIA) is used to measure the static resource allocation in NHI system to address the equity in health care services between urban and rural in Taiwan; and data envelopment analysis (DEA) is applied to measure the efficiency of health care resource allocation and further to explore the impacts of global budgeting scheme in Taiwan’s NHI system.
From the findings of this empirical study, health care resources tend to be clustered in the metropolitan areas, like New Taipei City, Taipei City, Taichung City, Tainan City and Kaohsiung City. Not only equity but also efficiency in Taipei City has the highest ranking, which implies that health care resources in Taipei City are well utilized without wasting health care resources. Although Penghu County has a lower ranking in regards to equity, it has better resource allocation in overall efficiency and allocative efficiency.
Due to supply exceeding demand, Hsinchu County and Hsinchu City have excess supply in hospital-based health care services. DMUs Yilan County, Changhua County, Nantou County and Chiayi City, where demand exceeds supply (excess demand) in hospital-based health care services, it is advisable that a better system of location-selection for new hospitals be implemented in the future. Hence, policy maker should draw attention to improving resource allocation of health care services for the equity in areas such as Yilan County, Hsinchu County, Changhua County, Nantou County, Hsinchu City and Chiayi City.
Diabetic wound healing still faces great challenges due to the excessive inflammation, easy infection, and impaired angiogenesis in wound beds. The immunoregulation of macrophages polarization toward ...M2 phenotype that facilitates the transition from inflammation to proliferation phase has been proved to be an effective way to improve diabetic wound healing. Herein, an M2 phenotype‐enabled anti‐inflammatory, antioxidant, and antibacterial conductive hydrogel scaffolds (GDFE) for producing rapid angiogenesis and diabetic wound repair are reported. The GDFE scaffolds are fabricated facilely through the dynamic crosslinking between polypeptide and polydopamine and graphene oxide. The GDFE scaffolds possess thermosensitivity, self‐healing behavior, injectability, broad‐spectrum antibacterial activity, antioxidant and anti‐inflammatory ability, and electronic conductivity. GDFE effectively activates the polarization of macrophages toward M2 phenotype and significantly promotes the proliferation of dermal fibroblasts, the migration, and in vitro angiogenesis of endothelial cells through paracrine mechanisms. The in vivo results from a full‐thickness diabetic wound model demonstrate that GDFE can rapidly promote the diabetic wound repair and skin regeneration, through fast anti‐inflammation and angiogenesis and M2 macrophage polarization. This study provides highly efficient strategy for treating diabetic wound repair through designing the M2 polarization‐enabled anti‐inflammatory, antioxidant, and antibacterial bioactive materials.
A thermosensitive injectable self‐healing antibacterial antioxidant conductive polydopamine/polypeptide‐graphene oxide hydrogel (GDFE) with robust M2 polarization capacity is reported for promoting diabetic wound tissue repair. The hydrogel promotes diabetic wound repair through regulating the inflammatory microenvironment by stimulating the polarization of macrophages toward M2, subsequently promoting the neovascularization and anti‐inflammatory effect for skin repair.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Intervertebral disc degeneration (IDD) is a complicated pathological condition blamed for low back pain. Mitochondrion is of vital importance for cellular homeostasis, and mitochondrial dysfunction ...is considered to be one of the major causes of cellular damage. Mitophagy is a cellular process to eliminate impaired mitochondria and showed protective effects in various diseases; however, its role in IDD is still not clear. Here, we explore the role of Parkin-mediated mitophagy in IDD. In this study, we found that Parkin was upregulated in degenerative nucleus pulposus (NP) tissues in vivo as well as in TNF-α stimulated NP cells in vitro. Knockdown of Parkin by siRNA showed that Parkin is crucial for apoptosis and mitochondrion homeostasis in NP cells. Further study showed that upregulation of Parkin by salidroside may eliminate impaired mitochondria and promote the survival of NP cells through activation of mitophagy in vitro. In in vivo study, we found that salidroside could inhibit the apoptosis of NP cells and ameliorate the progression of IDD. These results suggested that Parkin is involved in the pathogenesis of IDD and may be a potential therapeutic target for IDD.
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