Study On Combination Use Of Ultra-shortwave And Compound Anisodine In The Treatment Of Anterior Ischemic Ophthalmopathy And The Regulation Of MAPK Signal Pathways

Objective:1. High-frequency electromagnetic radiation therapy plays important roles in expanding the blood vessels, promoting local blood circulation and nutrition metabolism in organizations by clinical studies. After clinical treatment of high-frequency electromagnetic waves based on its mechanism, changes of visual function and hemodynamics of ophthalmic artery in anterior ischemic optic neuropathy patients were observed. Compared with treatment of compound anisodine injection, we investigate the clinical characteristics and rules.of high frequency electromagnetic radiation treatment for anterior ischemic optic neuropathy. New clinical methods and theoretical basis for anterior ischemic optic neuropathy were investigated in our study. 2. To study the regulatory effect of p44/42 MAPK pathway on the differentiation of MC3T3-E1 pre-osteoblast. Methods: 1. Forty-two cases (57 eyes) with anterior ischemic optic neuropathy were randomly divided into treatment group and the control group, 20 cases (27 eyes) and 22 cases (30 eyes) respectively. In control group, patients were treated by compound anisodine subcutaneous injection adjacent to superficial temporal artery; high-frequency electromagnetic radiation combining with compound anisodine injection were used in treatment group. Before and after treatment, changes of visual acuity and visual field of all subjects were observed. And changes of hemodynamic parameters, including peak systolic velocity (PSV), end diastolic velocity (EDV) and time average maximum velocity (TAMX), pulsatility index (PI) and resistance index (RI) in ophthalmic artery, central retinal artery and short posterior ciliary arteries were examined by color Doppler ultrasound instrument. 2. The activation of the p44/42 MAPK pathway was continuously suppressed with a specific MEK-1 inhibitor PD98059. The Alkaline Phosphatase activity and calcium deposition of MC3T3-E1 preosteoblasts were examined by histochemical staining. The expression of some osteoblast marker genes was evaluated by Semiquantitative Reverse Transcription Polymerase Chain Reaction (RT-PCR). The transcriptional activity of CBFA1 gene promoter was explored by Luciferase assay.Results: 1. Two weeks after treatment of compound anisodine injection and combination treatment of high-frequency electromagnetic radiation and compound anisodine injection respectively, visual acuity of all subjects were increased in both groups and was significantly higher than the levels before treatment (P <0.01). Compared with the control group, visual acuity of subjects in treatment group was improved significant (P <0.05). Results of visual field examination showed that percentages of visual field defect were decreased significantly after treatment (P <0.05), for all subjects of both groups. Compared with the controls, the percentages of visual field defect of combination treated subjects were reduced significantly (P <0.01).By color Doppler examination, results of ocular artery hemodynamics showed that hemodynamic parameters in central retinal artery had been improved significantly after treatment (P <0.05), both by simple treatment of compound anisodine injection and combination treatment of high-frequency electromagnetic radiation and compound anisodine injection. Compared with the control group, PSV, EDV and TAMX were improved significant (P <0.05) in combination treatment group, but no difference were found in the assay for RI and PI. In control group, PSV and EDV were significantly increased after treatment (P <0.05), but no significant difference were found on TAMX, RI and PI., Except for PI, all the other hemodynamic parameters of ophthalmic artery were improved significantly (P <0.05) in the combination treatment group. Results of PSV, EDV and TAMX examination were higher in combination treatment group than those of control group, and the difference was statistically significant. For hemodynamic parameters of short posterior ciliary artery, PSV and TAMX were increased significantly (P <0.01) after treatment in control group; PSV, EDV and TAMX were also increased significantly (P <0.01) after treatment in combination treatment group and were significant higher than those of control group (P <0.05).2. PD98059 not only increased the Alkaline Phosphatase activity of MC3T3-E1 but also promoted calcium depostition and the expression of some osteoblast marker genes in MC3T3-E1 cells. The treatment of PD98059 significantly increased the Cbfa1 gene promoter activity.Conclusion: 1. Combination treatment of high-frequency electromagnetic radiation and compound anisodine injection can significantly increase visual acuity, improve visual field defect scope in anterior ischemic optic neuropathy patients, levels of improvement are better than that of compound anisodine injection alone. Its treatment mechanisms are increasing peak systolic velocity, end diastolic velocity and average peak flow velocity and improving the ocular blood supply in the ophthalmic artery, central retinal artery and short posterior ciliary artery, for the treatment of anterior ischemic optic neuropathy.2. Continuous suppression of the p44/42 MAPK pathway promotes the differentiation of MC3T3-E1 pre-osteoblasts.