Background The aim of this study was to assess the retinal and choroidal microvasculature features using optical coherence tomography angiography (OCTA) in patients with retinitis pigmentosa (RP). Methods This study was a meta-analysis of relevant published studies that were included after a comprehensive search of PubMed, Embase, Cochrane Library, and Web of Science databases. Mean difference (MD) with a 95% confidence interval was used to assess continuous variable outcomes. Heterogeneity was evaluated using the chi-squared test based on the values of P and I2. Results Seven studies were included in this meta-analysis. The vessel density values measured in the superficial and deep foveal zones of RP patients using OCTA were significantly lower than the recorded values in the control groups (MD = −3.58, P=0.04; MD = −4.93, P=0.02, respectively). The superficial and deep parafoveal vessel density values measured with OCTA were also significantly lower in RP patients than in control groups (MD = −9.09, P < 0.00001; MD = −10.74, P < 0.00001, respectively); for choriocapillaris vessel density, there was no statistically significant difference between RP patients and controls (MD = −1.33, P=0.09). The deep foveal avascular zone (FAZ) was significantly larger in RP patients than in controls (MD = 0.15, P=0.01), whereas there was no significant difference in the superficial foveal avascular zones in the two groups (MD = 0.08, P=0.11). Conclusions We showed that retinal and choroidal vessels were attenuated in RP patients. Additionally, we revealed that the FAZ was larger in RP patients, especially the deep FAZ. OCTA may become a useful modality in the diagnosis and monitoring of patients with RP.

Background The optimal use of vancomycin in the elderly requires information about the drug’s pharmacokinetics and the influence of various factors on the drug’s disposition. However, because of sampling restrictions, it is often difficult to perform traditional pharmacokinetic studies in elderly patients. Objective This study was conducted to estimate the population pharmacokinetics of vancomycin in Chinese geriatric patients (age ≥ 65 years) with pulmonary infections and to explore the clinical application of this information for vancomycin dose individualization. Methods The steady-state trough concentrations were retrospectively collected from January 2011 to December 2016 and were analyzed using the nonlinear mixed-effect model software. The final model was evaluated using the bootstrap method, goodness-of-fit plots and the normalized prediction distribution error method. Main Outcome Measure Model parameters and prediction error. Results A total of 125 steady-state trough concentrations from 70 patients were retrospectively collected. A one-compartment model was established. The final model was depicted as clearance (CL) [L/h] = 2.45 × (CL CR /56.28) × 0.542; volume of distribution ( V d ) [L] = 154. The creatinine clearance (CL CR ) was identified as the most significant covariate in the final model. The typical values of CL and V d in the final model were 2.45 L/h and 154 L, respectively. Model validation outcomes showed that the final model was stable and had satisfactory prediction performance. Conclusion A population pharmacokinetic model was established to estimate the pharmacokinetics characteristics of Chinese geriatric patients with pulmonary infections, and this model can be used to develop an initial vancomycin dosing regimen for geriatric patients.

Background. The aim of this meta-analysis was to compare morphological and functional outcomes between vitrectomy with the inverted internal limiting membrane (ILM) flap technique and vitrectomy with internal limiting membrane peeling in highly myopic eyes with macular hole- (MH-) induced retinal detachment (MHRD). Methods. The PubMed, Web of Science, Embase, and Cochrane Library databases were comprehensively searched from inception to November 10, 2019, for published studies comparing the two techniques for the treatment of MHRD. The outcomes in the collected articles included the postoperative MH closure rate, retinal reattachment rate, and best-corrected visual acuity (BCVA). Review Manager (version 5.3) was used for analyses. Results. In total, seven retrospective studies comparing the inverted ILM flap technique with ILM peeling for the treatment of MHRD were included. The MH closure rate was significantly higher in the inverted ILM flap group than in the ILM peeling group at 6 and 12 months after initial surgery (OR = 15.39; 95% CI: 6.68 to 35.43;P<0.00001 and OR = 12.58, 95% CI: 3.51 to 45.08; P=0.0001), while the retinal reattachment rate was similar in both groups at 6 months after initial surgery (OR = 2.40; 95% CI: 0.89 to 6.50; P=0.08). Besides, the postoperative BCVA was significantly better in the inverted ILM flap group than in the ILM peeling group at 12 months after initial surgery (MD = −0.35; 95% CI: −0.52 to −0.18; P<0.0001). Conclusions. Thus, the MH closure rate and postoperative BCVA may be better with the inverted ILM flap technique than with ILM peeling for myopic MHRD, while the postoperative retinal reattachment rate appears to be similar with both techniques. Therefore, in the future, vitrectomy with the inverted ILM flap technique should be preferred over standard ILM peeling technique for the treatment of MHRD in highly myopic eyes.

BackgroundInfantile purulent meningitis (PM) is a commonly severe intracranial infectious disease in infants under age 1 year. In recent years, several diagnostic and treatment methods were reported, but in these cases the neurological complications and sequel were often observed, among which subdural effusion (SE) is the most common complication in PM. Timely diagnosis and early intervention are vital for better outcomes. In this study, the surgical treatments for infantile PM complicated by SE were investigated.Material/MethodsPatients who had PM complicated by SE in the Children’s Hospital of Hebei Province from June 2000 to June 2012 were retrospectively analyzed and 170 patients were enrolled in the study. Surgical treatment for each patient was adopted according to producing effusion time, leucocyte count, protein content, intracranial pressure, and bacteria culture, coupled with cranial ultrasound examination, CT, and MRI scans.ResultsNearly, 15 patients were cured using serial taps, with a 50% cure rate. Seventeen out of 30 (56.6%) patients receiving subcutaneous reservoir drainage had better outcome. Nearly 80% of patients (55/69) who underwent minimally invasive trepanation and drainage were positive. Surgical procedure of minimally invasive trepanation and drainage combined with drug douche was effective in 63% of patients (19/30). In addition, 6 patients were cured with subdural-peritoneal shunt. Only 1 patient died, after the recurrence of meningitis, and the remaining 4 patients were cured by craniotomy.ConclusionsFor infantile PM complicated with SE, treatment needs be chosen according to the specific situation. Surgical procedure of minimally invasive trepanation and drainage is a very effective treatment in curing PM complicated by SE. The treatment was highly effective with the use of drug douche. Subdural-peritoneal shunt and craniotomy were as effective as in refractory cases.