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AIM: To investigate the clinical efficacy of the compound anisodine combined with retinal laser photocoagulation in the treatment of severe non-proliferative diabetic retinopathy(NPDR). METHODS: According to the retrospective study, totally 120 eyes of patients with severe NPDR who admitted to Daxing Teaching Hospital Affiliated to Capital Medical University from May 2023 to July 2023 were selected. The patients were divided into the observation group and the control group according to treatment methods, with 60 eyes in each group. The observation group was treated with panretinal photocoagulation combined with the compound anisodine injection. The control group was only treated with panretinal photocoagulation. The optical coherence tomography angiography(OCTA)and optical coherence tomography(OCT)were used to quantitatively analyze the fundus retinal structure and blood flow. Furthermore, the best corrected visual acuity(BCVA), superficial vascular density(SVD), deep vascular density(DVD), choroidal blood flow density and central macular foveal retinal thickness(CMT)were compared before treatment and at 1 d, 1 and 2 mo after treatment.RESULTS:At 2 mo postoperatively, the rate of visual improvement and the BCVA in the observation group of patients were significantly better than those of the control group, and the incidence of macular edema in the observation group was significantly lower than the control group(P

AIM: To investigate the clinical value of epalrestat combined with compound anisodine in treatment of non-proliferative diabetic retinopathy(NPDR).METHODS: According to the random remainder method, they were divided into A, B and C three groups. Group A was treated with calcium dobesilate, group B was treated with epalrestat, and group C was treated with epalrestat combined with compound anisodine. All groups were treated for 6mo. The BCVA and fundus color photos, fundus fluorescein angiography(FFA), oscillatory potentials of electroretinogram(ERG-Ops)and optical coherence tomography(OCT)were performed before and after 1mo, 3mo and 6mo of treatment. The therapeutic effect was evaluated. RESULTS: Before treatment, there was no statistical difference among the three groups in BCVA, Ops wave amplitude or central macular thickness(P>0.05). The BCVA was improved, Ops wave amplitude was increased and the central macular thickness was decreased in the three groups after 1mo, 3mo and 6mo of treatment. Compared with the same group before treatment, there were statistically significant differences(PPPPCONCLUSION: Epalrestat combined with compound anisodine is effective in treatment of DR. The combined treatment can significantly improve the visual acuity, relieve macular edema and promote the recovery of retinal function.

Objective: To explore the clinical effect of gliquidone combined with compound anisodine in the treatment of diabetic papillitis. Methods: A total of 100 patients with diabetic papillitis,who were treated in People's Hospital of Xinjiang Uygur Autonomous Region from June 2019 to January 2020, were divided into experimental group and control group (50 cases in each group). The patients in the control group were given compound anisodine only, and the patients in the experimental group were treated with gliquidone on the basis of the control group's therapy. The treatment effect, vision level, average visual field defect degree, adiponectin level, hs-CRP level, vascular endothelial growth factor (VEGF) level, adverse mood and quality of life of the two groups were compared before and after treatment, and the incidence of adverse reactions during treatment was compared. Results: (1) The total effective rate was 98.00 % in the experimental group and 86.00 % in the control group, with significant difference between the two groups (P<0.05). (2) Before treatment, there was no significant difference in visual acuity and visual field average defect degree between the two groups, but after treatment, the visual acuity of the two groups was significantly improved, while the visual field average defect degree of the experimental group was higher than that of the control group (P<0.05). (3) Before treatment, the levels of adiponectin, hs-CRP and VEGF in the two groups were not significantly different (P>0.05), but after treatment, the levels of adiponectin in the experimental group were higher than those in the control group,but hs-CRP and VEGF in the experimental group were lower than those in the control group (P<0.05). (4) Before treatment, the scores of HAMA, HAMD and SF-36 in the two groups were not significantly different (P>0.05), while the scores of HAMA and HAMD in the experimental group were lower than those in the control group (P<0.05), and SF-36 was higher than that in the control group (P<0.05). (5) The total incidence of adverse reactions was 12.00 % in the experimental group and 10.00% in the control group, with little difference between the two groups (P>0.05). Conclusion: Gliquidone combined with compound anisodine has a good therapeutic effect on diabetic papillitis. It can significantly reduce the degree of visual field defect, improve patients' visual acuity, reduce the levels of inflammatory mediators and vascular growth factors, relieve patients' anxiety and depression, and improve patients' quality of life. At the same time, the treatment is safe and worthy of clinical application. [ABSTRACT FROM AUTHOR]

AIM:To explore the influence of compound anisodine combined with triamcinolone acetonide on the oxygen saturation of retinal vessels and serum Apelin in patients with diabetic retinopathy(DR). METHODS:Totally 58 cases of patients(60 eyes)with diabetic retinopathy from June 2014 to December 2016 in our hospital were selected as the research object. All of them were randomly divided into control group(29 cases, 30 eyes)and observation group(29 cases, 30 eyes). The control group received panretinal photocoagulation; the observation group was given intravitreal injection of triamcinolone acetonide before panretinal photocoagulation combined with compound anisodine after panretinal photocoagulation. After treatment, the postoperative visual recovery and the complications were recorded. The oxygen saturation of retinal vessels and the serum levels of Apelin of the two groups were analyzed and compared as well. RESULTS:After the treatment, the visual acuity of the two groups increased significantly, the proportion of vision improvement in the observation group(90%)was significantly higher than that in the control group(67%, PPPPP=0.109). CONCLUSION:The implementation of intravitreal injection of triamcinolone acetonide combined with the injection of compound anisodine via temporal subcutaneous tissue for patients with diabetic retinopathy is significantly effective, it can effectively reduce the level of the Apelin to inhibit the proliferation of retinal vessels, relieve the ischemic and hypoxia injury, which benefits the postoperative vision recovery with high safety.

AIM: To evaluate the efficacy and safety of compound anisodine injection combined with anti-VEGF therapy in treatment of macular edema of branch retinal vein occlusion.METHODS: Sixty patients with retinal vein occlusion were randomly divided into the combined group and the control group. The control group was treated with a conventional anti-VEGF injection. The combined group was treated with compound anisodine and anti-VEGF injection. Treatment of compound anisodine: one injection per day, after 14d of injections pause for 14d, a total of 28 injections. Compare the therapeutic effects and safety of the two groups.RESULTS:After anti-VEGF combined with compound anisodine and VEGF treatment, the visual acuity of the two groups were significantly increased(Ftime=185.05, PtimeFgroup=3.34, Pgroup=0.025); The CRT of the two groups were significantly decreased after treatment(Ftime=286.2, PtimeFgroup=12.46, Pgroupth day of treatment.CONCLUSION: Compound anisodine combined with anti-VEGF therapy can improve the therapeutic effect in patients with retinal vein occlusion.

AIM: To explore the clinical effect of Tongzhihuoluo Granules combined with compound anisodine on the acquired ophthalmoplegia in the middle-aged and elderly. METHODS:We selected 81 patients(81 eyes)with acquired ophthalmoplegia in the middle-aged and elderly who were diagnosed and treated in our hospital from January 2015 to October 2017. All patients were divided into observation group(n=40)and control group(n=41)by treatment methods. The control group was given subcutaneous injection of compound anisodine 2mL near the superficial temporal artery of the affected side. The observation group was combined with Tongzhihuoluo Granules. The clinical efficacy and diplopia distance were compared between the two groups. The pulsatility index and blood flow velocity of the basilar artery before and after treatment were compared between the two groups. RESULTS: The effective rate of ophthalmoplegia in the observation group was 92%(37/40), which was significantly higher than that in the control group(73%, 30/41; PPPPPPPCONCLUSION: The clinical therapeutic effect of Tongzhihuoluo Granules combined with compound anisodine on the acquired ophthalmoplegia in middle-aged and elderly patients is significantly better than that of compound anisodine, which can effectively improve the blood flow of vertebral-basal artery and has high clinical efficacy.

Background: Compound anisodine (CA) is a compound preparation made from hydrobromide anisodine and procaine hydrochloride. The former is an M-choline receptor blocker with the function of regulating the vegetative nervous system, improving microcirculation, and so on. The latter is an antioxidant with the activities of neuroprotection. This study aimed to investigate the potential neuroprotection of CA, which affects the degeneration of the retinal ganglion cells (RGCs) in an animal model with chronic ocular hypertension. Methods: Female C57BL/6J mice (n = 24) were divided randomly into four groups: normal control group without any treatment (Group A, n = 6); CA control group with feeding the CA solution (Group B, n = 6); microbeads (MBs) control group with injecting MB into the anterior chamber (Group C, n = 6); CA study group with MB injection and with feeding the CA solution (Group D, n = 6). Intraocular pressure (IOP) was measured every 3 days after MB injection. At the 21st day, neurons were retrograde-labeled by Fluoro-Gold (FG). Animals were sacrificed on the 27th day. Retinal flat mounts were stained immunohistologically by α2-III-tubulin. FG-retrograde-labeled RGCs, α2-III-tubulin-positive RGCs, and α2-III-tubulin-positive nerve fibers were quantified. Results: Mice of Groups C and D expressed the incidence of consistent IOP elevation, which is above the IOP level of Group A with the normal one. There is no significant difference in IOP between Groups A and B (P > 0.05). On the 27th day, there were distinct loss in stained RGCs and nerve fibers from Groups C and D compared with Group A (allP < 0.001). The quantity was significantly higher in Group D as compared to Group C (allP < 0.001) but lower than Group A (allP > 0.001). There was no significant difference in the quantity of RGCs and nerve fibers between Groups A and B (allP > 0.05). Conclusions: These findings suggest that CA plays an importantly neuroprotective role on RGCs in a mouse model with chronic ocular hypertension.

AIM: To observe the effect of compound anisodine injection combined with yi-qi-tong-luo acupuncture, hot compress and massage for blepharospasm. METHODS: Selected in our hospital, 60 cases(78 eyes)with blepharospasm were randomly divided into two groups, 30 cases 39 eyes in each group. The observation group were treated with compound anisodine injection combined with yi-qi-tong-luo acupuncture treatment, and supplemented by hot compress and massage, while the control group only with compound anisodine injection. We compared the treatment effect of the two groups. RESULTS: In the observation group, 38 eyes were clinically effective, 1 eye was invalid, 35 eyes marked, the total effective rate was 97%, the markedly effective rate was 90%; in control group, 32 eyes were the clinically effective, 7 eyes invalid, 23 eyes marked, the total effective rate was 82%, the markedly effective rate was 59%; the total effective rate and markedly effective rate of observation group were higher than those of the control group with statistical difference(PPCONCLUSION: The compound anisodine injection combined with yi-qi-tong-luo acupuncture, hot compress and massage for blepharospasm, can significantly improve the efficiency of treatment, with higher effective rate and lower recurrence rate, compared with using compound anisodine alone.

AIM:To evaluate the clinical efficacy of mouse nerve growth factor combined with compound anisodine on the treatment of nonarteritic anterior ischemic optic neuropathy(NAION).METHODS: Clinical case series study was applied. One hundred and twenty-two patients with monocular onset NAION were randomly divided into three groups. Routine treatment was given to all of patients. Control group A(40 patients with 40 eyes)were undergone subcutaneous injection of compound anisodine besides superficial temporal artery, 2mL each time, twice per day; control group B(41 patients with 41 eyes)were given intramuscular injection of mouse nerve growth factor, 30μg each time, once per day; and the combined group(41 patients with 41 eyes)received compound anisodine and mouse nerve growth factor for four consecutive weeks. Visual acuity and fundus were observed every day during the treatment period. When the treatment finished, the best corrected visual acuity(BCVA), visual field and OCT were checked and recorded. The results were analyzed. RESULTS: The recovery of visual acuity and visual field in the combined group was better than those of two control groups(PP<0.05). Visual acuity, visual field and retinal nerve fiber layer had no statistical differences between control group A and control group B(P>0.05). The effective rates of the three groups were respectively 70%(control group A), 65.9%(control group B), 92.7%(the combined group). The overall effective rate of patients in the combined group was significantly higher than that of two control groups(PP>0.05).CONCLUSION: Mouse nerve growth factor combined with compound anisodine has a remarkable effect on the treatment of NAION.

As a Traditional Chinese Medicine, compound anisodine (CA) has previously been shown to regulate the vegetative nervous system, improve microcirculation and scavenge reactive oxygen species, and has been commonly utilized as a neuroprotective agent to treat ischemic optic neuropathy and choroidoretinopathy. The present study aimed to investigate the neuroprotective effects of CA on the proliferation and calcium overload of hypoxia-induced rat retinal progenitor cells (RPCs) and brain neural stem cells (BNSCs) harvested from neonatal Sprague-Dawley rats. Cells were treated with CA at 0.126, 0.252, 0.505 or 1.010 g/l for four hours prior to or after hypoxia (<1% oxygen) for four h, followed by re-oxygenation for four hours; a normal control group and a CA-untreated hypoxia model group were also included. An MTT assay demonstrated that the cell viability was markedly improved following treatment with 0.126-1.010 g/l CA, compared with that in the hypoxia model group (P<0.05). Bromodeoxyuridine (BrdU) immunocytochemical staining and flow cytometry indicated that after culture in hypoxia for 4 h, the number of BrdU+ RPCs and BNSCs was significant decreased, as well as the cell population in S+G2 phase of the cell cycle, which was significantly attenuated by treatment with 1.010 g/l CA for 4 h prior to hypoxia (P<0.05). Furthermore, laser scanning confocal microscopy showed that the intracellular calcium concentration in hypoxia-cultured RPCs and BNSCs was markedly increased, which was attenuated by 0.126-1.010 g/l CA in a concentration-dependent manner (P<0.05). Furthermore, western blot analysis demonstrated that after hypoxia, the protein levels of hypoxia-inducible factor (HIF)-1α and vascular endothelial growth factor (VEGF) were upregulated in RPCs and BNSCs, whereas phosphorylated extracellular signal-regulated kinase (phospho-ERK 1/2Thr202/Tyr204) and Cyclin D1 were downregulated; of note, treatment with 1.010 g/l CA significantly attenuated these changes (P<0.05). The results of the present study suggested that CA may improve the proliferation and inhibit calcium overload in hypoxia-induced RPCs and BNSCs by altering the protein levels of Cyclin D1 as well as signaling through the p-ERK1/2/HIF-1α/VEGF pathway. [ABSTRACT FROM AUTHOR]

OBJECTIVE:To observe the clinical effects of compound anisodine injections combined with vitamin B12 injections in treatment of primary and secondary ischemic optic neuropathy. METHODS： 141 cases (group A) of primary ischemic optic neuropathy and 108 cases ( group B ) of secondary ischemic optic neuropathy admitted into Zhengzhou the Second People’s Hospital from Jan. 2013 to Oct，in order to facilitate，for binocular ION patients，chose one eye with worse vision into the study. 2015 were extracted. Group A were divided into control group A，observation group A1，observation group A2 via the random number table，with 47 cases. Group B were divided into control group B， observation group B1，observation group B2 via the random number table， with 36 cases. Based on the conventional treatment，control group A and observation group B were treated with compound anisodine injections in compound anisodine 2ml subcutaneous injection beside the affected side arteriae temporalis superficial; observation group A1，observation group B1 were given were treated with compound anisodine subcutaneous injection beside the affected side arteriae temporalis superficialis with vitamin B。intramuscular injection，once a day. Observation group A2，observation group B2 were given mixture of the compound anisodine and vitamin B12 subcutaneous injection beside the affected side arteriae temporalis superficialis，once a day. The period of treatment of the both groups was three courses (two weeks as one course). Visual acuity changes and visual field defect of each group were compared before and after treatment，changes of eyesight and vision were set as the efficacy indicators. RESULTS： After treatment，the recovery of eyesight and vision and total effective rate were significantly higher than those of control group % and observation group A2 % observation group B2 were respectively higher than those of observation group A1 and observation group B1 % with statistical significance ( P < 0. 05 )； There were no sever adverse drug reactions in all patients during treatment. CONCLUSIONS： The efficacy of compound anisodine injections combined with vitamin B12 injections in treatment of primary and secondary ischemic optic neuropathy is remarkable，with high safety. [ABSTRACT FROM AUTHOR]

AIM: To observe thediabetic retinopathy panretinal photocoagulation with compound anisodine para temporal superficial artery injection and simple retinal photocoagulation, and whether there are differences in the improvement of patients' diabetic retinopathy vision and retinopathy.METHODS: A retrospective analysis of patients with diabetic retinopathy diagnosed in our hospital, divided into two groups according to the treatment method.Group A of panretinal photocoagulation after compound anisodine para temporal superficial artery injection of 66 cases of 109 eyes. Group B was treated with panretinal photocoagulation in 54 cases of 71 eyes. RESULTS:Group A after treatment for 3mo, the visual acuity improved rate was 66.1%, the visual acuity improved in group B was 46.5%, statistically different in two groups(χ2=6.78, Pχ2=6.89, Pχ2=8.37, PCONCLUSION:The patients with diabetic retinopathy panretinal photocoagulation combined with compound anisodine para temporal superficial artery injection and simple retinal photocoagulation can better restore vision and improve diabetic retinopat.

The aim of the present study was to observe the clinical efficacy and safety of recombinant tissue plasminogen activator (rt-PA) combined with compound anisodine in treating central retinal artery occlusion (CRAO). Forty-eight patients diagnosed with CRAO were randomly divided into a treatment group (24 cases) and a control group (24 cases). For the control group, nitroglycerin, 654-2, methazolamide, puerarin and compound anisodine were used for the treatment, along with oxygen, massage and other conventional treatments. Besides conventional therapy, the treatment group was also given intravenous rt-PA thrombolysis. Visual acuity, fundus oculi, visual field changes were taken as indicators for efficacy evaluation. It was found that the total effective rate of the control group was 70.83%, while that for the treatment group was 91.67%, and the comparative difference between the two groups was of statistical significance (p<0.05). The visual field defect of the control group after treatment was approximately 74.26±12.91%, and the visual field defect of the treatment group after treatment approximately 35.08±16.33%; thus, the comparative difference was statistically significant (p<0.01). The comparative difference of the original contents of fibrous protein in blood in the treatment group before and after treatment was statistically significant (p<0.01). In conclusion, the result show that intravenous thrombolysis with rt-PA combined with compound anisodine is safe and effective in treating CRAO, which can significantly improve the prognosis of patients. [ABSTRACT FROM AUTHOR]

As a Traditional Chinese Medicine, compound anisodine (CA) has previously been shown to regulate the vegetative nervous system, improve microcirculation and scavenge reactive oxygen species, and has been commonly utilized as a neuroprotective agent to treat ischemic optic neuropathy and choroidoretinopathy. The present study aimed to investigate the neuroprotective effects of CA on the proliferation and calcium overload of hypoxia-induced rat retinal progenitor cells (RPCs) and brain neural stem cells (BNSCs) harvested from neonatal Sprague-Dawley rats. Cells were treated with CA at 0.126, 0.252, 0.505 or 1.010 g/l for four hours prior to or after hypoxia (<1% oxygen) for four h, followed by re-oxygenation for four hours; a normal control group and a CA-untreated hypoxia model group were also included. An MTT assay demonstrated that the cell viability was markedly improved following treatment with 0.126-1.010 g/l CA, compared with that in the hypoxia model group (P<0.05). Bromodeoxyuridine (BrdU) immunocytochemical staining and flow cytometry indicated that after culture in hypoxia for 4 h, the number of BrdU + RPCs and BNSCs was significant decreased, as well as the cell population in S+G2 phase of the cell cycle, which was significantly attenuated by treatment with 1.010 g/l CA for 4 h prior to hypoxia (P<0.05). Furthermore, laser scanning confocal microscopy showed that the intracellular calcium concentration in hypoxia-cultured RPCs and BNSCs was markedly increased, which was attenuated by 0.126-1.010 g/l CA in a concentration-dependent manner (P<0.05). Furthermore, western blot analysis demonstrated that after hypoxia, the protein levels of hypoxia-inducible factor (HIF)-1α and vascular endothelial growth factor (VEGF) were upregulated in RPCs and BNSCs, whereas phosphorylated extracellular signal-regulated kinase (phospho-ERK 1/2 Thr202/Tyr204 ) and Cyclin D1 were downregulated; of note, treatment with 1.010 g/l CA significantly attenuated these changes (P<0.05). The results of the present study suggested that CA may improve the proliferation and inhibit calcium overload in hypoxia-induced RPCs and BNSCs by altering the protein levels of Cyclin D1 as well as signaling through the p-ERK1/2/HIF-1α/VEGF pathway.

The aim of the present study was to observe the clinical efficacy and safety of recombinant tissue plasminogen activator (rt-PA) combined with compound anisodine in treating central retinal artery occlusion (CRAO). Forty-eight patients diagnosed with CRAO were randomly divided into a treatment group (24 cases) and a control group (24 cases). For the control group, nitroglycerin, 654-2, methazolamide, puerarin and compound anisodine were used for the treatment, along with oxygen, massage and other conventional treatments. Besides conventional therapy, the treatment group was also given intravenous rt-PA thrombolysis. Visual acuity, fundus oculi, visual field changes were taken as indicators for efficacy evaluation. It was found that the total effective rate of the control group was 70.83%, while that for the treatment group was 91.67%, and the comparative difference between the two groups was of statistical significance (p<0.05). The visual field defect of the control group after treatment was approximately 74.26±12.91%, and the visual field defect of the treatment group after treatment approximately 35.08±16.33%; thus, the comparative difference was statistically significant (p<0.01). The comparative difference of the original contents of fibrous protein in blood in the treatment group before and after treatment was statistically significant (p<0.01). In conclusion, the result show that intravenous thrombolysis with rt-PA combined with compound anisodine is safe and effective in treating CRAO, which can significantly improve the prognosis of patients.