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Quzhou, China

PURPOSE:: To evaluate the relative efficacy of subthreshold micropulse diode laser versus conventional laser photocoagulation for the treatment of diabetic macular edema. METHODS:: A comprehensive literature search was conducted to find relevant randomized controlled trials (RCTs). Efficacy estimates were determined by comparing weighted mean differences of the mean change of best-corrected visual acuity and central macular thickness from baseline. RESULTS:: Six RCTs were selected for this meta-analysis, including 398 eyes (203 eyes in the subthreshold micropulse diode laser group and 195 eyes in the conventional laser group). Subthreshold micropulse diode laser was superior to conventional laser in terms of mean change of logMAR best-corrected visual acuity at 3, 9, and 12 months after treatment (P = 0.02; P = 0.04, and P = 0.03, respectively), and it showed a similar trend at 6 months (P = 0.05). Although, there was no significant difference in terms of mean change in central macular thickness from baseline to 3, 6, 9, or 12 months (P = 0.80; P = 0.20; P = 0.88, and P = 0.86, respectively). CONCLUSION:: Subthreshold micropulse diode laser treatment resulted in better visual acuity compared with conventional laser, although the differences before 12 months are likely to be too small to be of clinical relevance and may be dependent on baseline best-corrected visual acuity. The two types of treatment seem to have similar anatomical outcome. © 2016 by Ophthalmic Communications Society, Inc. Source


Ye Z.,Quzhou Peoples Hospital
Zhongguo gu shang = China journal of orthopaedics and traumatology | Year: 2011

To investigate the therapeutic effectes of vacuum sealing drainage (VSD) technique and reattachment of avulsed skin in treating avulsion injuries of limbs. A retrospective analysis was done on 25 patients suffering from avulsion injuries of limbs, who were treated with vacuum sealing drainage and reattachment of the avulsed skin. Among the patients, 19 patients were male and 6 patients were female, ranging in age from 21 years to 57 years, with an average of 41 years. After debridement, the patients got reattachment of skin graft with subdermal vascular network or split-thickness skin graft, and the wound surface was covered with polyvinyl sponge. VSD was removed after 7 to 14 days. The color, survival rate and sensory function of the skin were observed after operation. All the wounds infection was controlled with VSD. The skin survival rate was more than 96% in 16 cases, more than 90% in 7 cases, and skin edge of 2 cases had little necrosis but rehabilitated after dress-changing. The reattached skins had almost normal skin color, soft and abrasion resistant, satisfactory sensory function, and no compression ulcer was observed after 4 weeks. VSD combined with graft with subdermal vascular network or split-thickness skin graft helps to promote wound drainage, reattachment of skin, and decrease infection. It is an effective method in treating avulsion injuries of limbs. Source


Chen G.,Quzhou Peoples Hospital | Li W.,Xiamen University | Tzekov R.,Roskamp Institute | Tzekov R.,University of South Florida | And 3 more authors.
Retina | Year: 2015

PURPOSE:: To evaluate the relative efficacy and safety of bevacizumab versus ranibizumab for the treatment of the neovascular form of age-related macular degeneration. METHODS:: A comprehensive literature search using the Cochrane Methodology Register to identify randomized controlled trials comparing bevacizumab with ranibizumab in patients with neovascular age-related macular degeneration. Efficacy estimates were determined by comparing weighted mean differences in the change of best-corrected visual acuity and central macular thickness from baseline. Safety estimates were determined by calculating the risk ratio for rates of death, arteriothrombotic events, venous thrombotic events, and at least 1 serious systemic adverse event. Statistical analysis was performed using the RevMan 5.1 software. RESULTS:: A total of 6 randomized controlled trials were selected for this meta-analysis, including 2,612 patients (1,292 patients in the bevacizumab group and 1,320 patients in the ranibizumab group). There were no significant differences between bevacizumab and ranibizumab in best-corrected visual acuity mean change at 1 year or 2 years (weighted mean difference = -0.40, 95% confidence interval [CI], -1.48 to 0.69, P = 0.47 and weighted mean difference = -1.16, 95% CI, -2.82 to 0.51, P = 0.17, respectively). Ranibizumab was found to be more efficacious in reducing central macular thickness at 1 year (weighted mean difference = 4.35, 95% CI, 0.92-7.78, P = 0.01). The pooled risk ratios comparing the rates of serious systemic adverse events at 1 year and 2 years were slightly in favor of ranibizumab (risk ratio = 1.24, 95% CI, 1.04-1.48, P = 0.02 and risk ratio = 1.20, 95% CI, 1.05-1.37, P = 0.008, respectively), whereas the rates of death, arteriothrombotic events, and venous thrombotic events did not differ statistically. CONCLUSION:: Bevacizumab and ranibizumab had equivalent efficacy for best-corrected visual acuity in the treatment of neovascular age-related macular degeneration. Ranibizumab tended to have a better anatomical outcome. There were no differences between drugs in rates of death, arteriothrombotic events or venous thrombotic events, and differences in rates of serious systemic adverse events that require further study. Copyright © by Ophthamic Communications Society. Source


Chen G.,Quzhou Peoples Hospital | Li W.,Xiamen University | Jiang F.,Quzhou Peoples Hospital | Mao S.,Quzhou Peoples Hospital | Tong Y.,Quzhou Peoples Hospital
PLoS ONE | Year: 2014

Objective: To evaluate the efficacy and safety of Ex-PRESS implantation (Ex-PRESS) compared to trabeculectomy in the treatment of patients with open-angle glaucoma (OAG). Methods: A comprehensive literature search using the Cochrane Methodology Register to identify randomized controlled clinical trials (RCCTs) comparing Ex-PRESS to trabeculectomy in patients with OAG. Efficacy estimates were measured by weighted mean difference (WMD) for the percentage intraocular pressure reduction (IOPR%) from baseline to end-point, and odds ratios (OR) for the complete success rate and postoperative interventions. Safety estimates were measured by OR for postoperative complications. Statistical analysis was performed using the RevMan 5.1 software. Results: A total of four RCCTs were selected for this meta-analysis, including 215 eyes of 200 patients (110 eyes in the Ex-PRESS group, 105 eyes in the trabeculectomy group). There was no significant difference between Ex-PRESS and trabeculectomy in the IOPR% (WMD = 3.15; 95% confidence interval (CI), -6.17-12.47; P = 0.51). The pooled OR comparing Ex-PRESS to trabeculectomy for the complete success rate at one year after surgery were in favor of Ex-PRESS (OR = 2.93; 95% CI, 1.39-6.16; P = 0.005). The Ex-PRESS procedure was found to be associated with lower number of postoperative interventions (OR = 0.23; 95% CI, 0.07-0.81; P = 0.02) and with a significantly lower frequency of hyphema than trabeculectomy (OR = 0.21; 95% CI, 0.05-0.85; P = 0.03), whereas other complications did not differ statistically. Conclusion: In OAG, Ex-PRESS and trabeculectomy provided similar IOP control, but Ex-PRESS was more likely to achieve complete success, with fewer postoperative interventions. Complication rates were similar for the two types of surgery, except for a lower frequency of hyphema in the Ex-PRESS group. © 2014 Chen et al. Source


Chen G.,Quzhou Peoples Hospital | Li W.,Xiamen University | Tzekov R.,Roskamp Institute | Tzekov R.,University of South Florida | And 3 more authors.
PLoS ONE | Year: 2014

Objective: To evaluate the relative efficacy of ranibizumab (RBZ) monotherapy or combined with laser (RBZ + Laser) versus laser monotherapy for the treatment of diabetic macular edema (DME). Methods: A comprehensive literature search using PUBMED, ClinicalTrials.gov, and the Cochrane Library to identify randomized controlled trials (RCTs) comparing RBZ or RBZ + Laser to laser monotherapy in patients with DME. Efficacy estimates were determined by comparing weighted mean differences (WMD) in the change of best corrected visual acuity (BCVA) and central macular thickness (CMT) from baseline, and the risk ratios (RR) for the proportions of patients with at least 15 letters change from baseline. Safety analysis estimated the RR of cardiac disorders at 6 to 12 months in RBZ therapy vs. laser monotherapy. Statistical analysis was performed using the RevMan 5.1 software. Results: Seven RCTs were selected for this meta-analysis, including 1749 patients (394 patients in the RBZ group, 642 patients in the RBZ + Laser group, and 713 patients in the laser group). RBZ and RBZ + Laser were superior to laser monotherapy in the mean change of BCVA and CMT from baseline (WMD=5.65, 95% confidence interval (CI), 4.44-6.87, P<0.00001; WMD =5.02, 95% CI, 3.83-6.20, P<0.00001, and WMD =-57.91, 95% CI, -77.62 to -38.20, P<0.00001; WMD =-56.63, 95% CI, -104.81 to -8.44, P=0.02, respectively). The pooled RR comparing the proportions of patients with at least 15 letters improvement or deterioration were also in favor of RBZ and RBZ + Laser (RR=2.94, 95% CI, 1.82-4.77, P<0.00001; RR=2.04, 95% CI, 1.50-2.78, P<0.00001, and RR=0.21, 95% CI, 0.06-0.71, P=0.01; RR=0.52, 95% CI, 0.29-0.95, P=0.03, respectively). There were no significant differences between RBZ and RBZ + Laser for any of the parameters. There were no difference in the safety profile between RBZ and laser. Conclusion: RBZ and RBZ + Laser had better visual and anatomic outcomes than laser monotherapy in the treatment of DME. RBZ + Laser seemed to be equivalent to RBZ. © 2014 Chen et al. Source

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