AIM: To determine whether the 23 - gauge ( 23G ) vitrecomy cutter could replace scissors in conventional 20-gauge ( 20G ) pars plana vitrectomy for treating severe proliferative diabetic retinopathy ( PDR) .
METHODS:Non-comparative interventional case series. Totally 27 eyes of 27 patients with PDR stageⅥ confirmed by funduscopy and B-ultrasound scan were enrolled. They underwent 20G vitrectomy, in which 23G vitrectomy cutter replaced scissors to remove neuvascular membrane. All 27 eyes received complete panretinal photocoagulation, 17 eyes received no tamponade, 6 eyes were 12% C3 F8 tamponade, 4 eyes were filled with silicone oil. The follow up time was 3mo. The operation duration time, iatrogenic retinal tear and retinal bleeding need electric coagulation, best corrected visual acuity ( BCVA) , retinal reattachment were analyzed.
RESULTS: The operative time was 35- 120 ( average 79-19±29. 82) min; intraoperative iatrogenic retinal breaks were detected in 2 eyes (7%). At the end of 3mo follow up, BCVA>0. 1 were in 9 eyes, from 0. 05-0. 1 in 10 eyes,<0. 05 in 8 eyes. Retinal reattached in 25 eyes (93%), still detached in other 2 eyes with silicone oil.
CONCLUSION: The 23G vitrectomy cutter could replace scissors in conventional 20G pars plana vitrectomy for treating severe PDR.

● AIM: To investigate the sequential changes of HIF-1 α Protein and mRNA in hypoxic bovine retinal microvessel endothelial cells.● METHODS: The bovine retinal microvessel endothelial cells were cultured in normoxic and CoCl2-induced hypoxic conditions respectively. Expressions of HIF-1 α Protein were measured with immunohistochemical staining, and RT-PCR was used to determine the HIF-1 α mRNA.● RESULTS: HIF-1 α began to increase 1h after hypoxia,and reached the peak at 4h. After 16h, it declined significantly. Compared with the normoxic group, the expression of HIF-1 α protein in the hypoxic groups had significant difference (P＜0.01), and HIF-1 α mRNA expression was unchanged under hypoxia.● CONCLUSION: HIF-1 α participates in the hypoxic procedures in retinal microvessel endothelial cells, and hypoxia induce time-dependent changes of HIF-1 α protein expression, which is not modulated on the transcription level. Analysis of HIF-1 α expression revealed a temporal and spatial changes with regard to the hyperoxic repression, indicating that HIF-1 may play a major role in the development of retinopathy of prematurity and other ischemic retinal disorders such as diabetic retinopathy.

Adolescent ; Adult ; Aged ; Humans ; Middle Aged ; Pupil Disorders ; diagnosis ; etiology ; Refraction, Ocular ; Retina ; physiopathology ; Retinal Detachment ; surgery ; Scleral Buckling ; Visual Acuity ; Vitreoretinopathy, Proliferative ; surgery

Objective To evaluate the theraputic effect of transcatheter arterial chemoembolization (TACE)for hepatocellular carcinoma with tumor thrombosis of portal vein.Methods One hundred and six patients of hepatocellular carcinoma with tumor thrombosis of portal vein under treament of TACE were observed before and after the procedure.Results After TACE tumor size reduced＞50% in 23 patients,＜50% in 25, no significant change in 44.The size of tumor enlarged in 12.The disappearance of portal vein tumor thrombosis accessed in 14,with reduction in 39,and no significant change in 51.Two patients died within one week.Conclusion TACE provides good therapeutic effect on hepatocellular carcinoma with tumor thrombosis of portal vein.

OBJECTIVE: To discuss the cause of disease, treatment and therapeutic effect in patients with rhegmatogenous retina detachment (RRD) combined with non-secondary glaucoma. METHODS: Clinical data of 28 patients with RRD combined with primary or congenital glaucoma were retrospectively analyzed. RESULTS: Twenty-five out of the 28 patients succeeded with one operation (89.3%). The intraocular pressure of post-operation:on the 1st day was 10 approximately 46 (28.1+/-6.5) mmHg, on the 7th day was (18.9+/-7.2) mmHg, and on the last re-examination day was (17.6+/-6.2) mmHg. Anti-glaucoma operation was performed in 10 patients after the retinal operation. Chroidal hemorrhage was found in 2 patients and 2 chroidal exudations were found after the retinal operation. CONCLUSION The proportion of primary open angle glaucoma is higher than that of primary angle closure glaucoma, and trauma or surgery before the retinal operation is an important cause in glaucoma patients with RRD. There is no obvious difference in the ratio of surgical success between non-secondary glaucoma with RRD and those RRD patients without glaucoma. Vitreotomy+ silicon oil injection or drainage of subretinal fluid+air injection+cryocoagulation+explants is recommended. Chroid is easily involved. It is important to control the intraocular pressure during and after the surgery. The final visual acuity is rather poor, which may be related to the glaucoma and intraocular pressure.
Adolescent ; Adult ; Aged ; Child ; Female ; Glaucoma ; complications ; surgery ; Humans ; Male ; Middle Aged ; Retinal Detachment ; complications ; surgery ; Retrospective Studies ; Visual Acuity ; Vitrectomy

A 16-year-old female patient with systemic lupus erythematosus (SLE) presented with abdominal pain and oliguria, after one month of hospital treatment with methylprednisolone and cyclophosphamide. Computed tomography of the abdomen revealed the calcification of bilateral superior segmental ureteral wall. Computed tomography urography revealed stenosis of bilateral ureters. This calcification may be associated with lupus-induced inflammatory reaction of ureteral endomembrane. By receiving the ureteral catheters, her abdominal pain and oliguria had been completely resolved. After discharge, she underwent the surgery of cutaneous ureterostomy in the local hospital. During two years follow-up, her condition is stable without any symptom of the urinary system.
Adolescent ; Calcinosis ; diagnosis ; etiology ; Female ; Humans ; Lupus Erythematosus, Systemic ; complications ; Ureter ; pathology

OBJECTIVETo determine the concentrations of interleukin-18 (IL-18), IL-6, IL-8, and prostaglandin E2 (PGE2) in the synovial fluid in patients with osteoarthritis (OA), and explore the role of IL-18 in the pathogenesis of OA.

METHODSThe synovial fluid was collected from 30 patients with knee OA, and the concentrations of IL-18 and the other cytokines were measured using enzyme-linked immunosorbent assay (ELISA). A linear regression was performed between IL-18 and the other cytokines.

RESULTSThe average IL-18 and PGE2 concentrations were 220-/+304 pg/ml and 89-/+104 pg/ml in the synovial fluid, respectively, and the two cytokines showed a positive correlation in the synovial fluid (r=0.628, P=0.001). The IL-18 concentration was also correlated to the concentrations of IL-6 (1200-/+1587 pg/ml, n=22; r=0.590, P=0.008) and IL-8 (5190-/+6024 pg/ml, n=9; r=0.776, P=0.014).

CONCLUSIONIL-18 can promote PGE2 production, which causes cartilage degradation in OA, thus therapies targeting this cytokine may prove an effective approach to early OA treatment.

Aged ; Dinoprostone ; biosynthesis ; Female ; Humans ; Interleukin-18 ; metabolism ; Male ; Middle Aged ; Osteoarthritis ; metabolism ; Synovial Fluid ; metabolism

OBJECTIVETo determine the contents of thymidine phosphorylase (TP) and dihydropyrimidine dehydrogenase (DPD) in pancreatic cancer to provide a basis for the clinical use of capecitabine in pancreatic cancer patients.

METHODSThe contents of TP and DPD in pancreatic cancer and adjacent normal tissues from 20 patients were determined by ELISA and the TP to DPD ratios in the cancer and adjacent normal tissue were compared.

RESULTSTP content was 5- to 283-fold higher in tumor tissue (mean 74-fold) than in the adjacent normal tissue (P < 0.01). DPD in the cancer tissue increased significantly. So did the TP to DPD ratio, when compared to that in normal pancreatic tissue (P < 0.01).

CONCLUSIONThe increased TP to DPD ratio in pancreatic cancer suggests that capecitabine could be activated by the cancer, these capable of selectively kill the tumor cells.

Dihydrouracil Dehydrogenase (NADP) ; metabolism ; Enzyme-Linked Immunosorbent Assay ; Humans ; Pancreas ; enzymology ; Pancreatectomy ; Pancreatic Neoplasms ; enzymology ; surgery ; Thymidine Phosphorylase ; metabolism

BACKGROUNDBrain-derived neurotrophic factor (BDNF) is a stress-responsive intercellular messenger modifying hypothalamic-pituitary-adrenal (HPA) axis activity. The interaction between stress and age in BDNF expression is currently not fully understood. This study was conducted to observe unpredictable stress effect on behavior and BDNF expression in CA3 subfield (CA3) and dentate gyrus of hippocampus in different aged rats.

METHODSForty-eight Wistar rats of two different ages (2 months and 15 months) were randomly assigned to six groups: two control groups and four stress groups. The rats in the stress group received three weeks of unpredictable mild stress. The depression state and the stress level of the animals were determined by sucrose preference test and observation of exploratory behavior in an open field (OF) test. The expressions of BDNF in CA3 and dentate gyrus of the hippocampus were measured using immunohistochemistry.

RESULTSAge and stress had different effects on the behavior of different aged animals (age: F = 6.173, P < 0.05, stress: F = 6.056, P < 0.05). Stress was the main factor affecting sucrose preference (F = 123.608, P < 0.05). Decreased sucrose preference and suppressed behavior emerged directly following stress, lasting to at least the eighth day after stress in young animals (P < 0.05). The older stress rats showed a lower sucrose preference than young stress rats (P < 0.05). Older control rats behaved differently from the younger control animals in the OF test, spending more time in the central square (P < 0.05), exhibiting fewer vertical movements (P < 0.05) and less grooming (P < 0.05). Following exposure to stress, older-aged rats showed no obvious changes in vertical movement and grooming. This indicates that aged rats were in an unexcited state before the stress period, and responded less to stressful stimuli than younger rats. There was significantly lower BDNF expression in the CA3 and dentate gyrus regions of the hippocampus following stress in both age groups (P < 0.05), a reduction that was still present at the eighth day after stress (P < 0.05). Stress and age were the main factors affecting the expression of BDNF (F = 9.408, P < 0.05; F = 106.303, P < 0.05). The aged stress group showed lower BDNF expression compared to the young stressed group at every testing time point.

CONCLUSIONStress has age-dependent effects on behavioral responses and hippocampal BDNF expression in rats.

Age Factors ; Animals ; Behavior, Animal ; Brain-Derived Neurotrophic Factor ; analysis ; genetics ; Chronic Disease ; Dentate Gyrus ; chemistry ; Exploratory Behavior ; Hippocampus ; chemistry ; Immunohistochemistry ; Rats ; Rats, Wistar ; Stress, Psychological ; metabolism ; psychology ; Sucrose ; administration & dosage

Glycoproteins ; genetics ; metabolism ; Herpesviridae ; genetics ; metabolism ; Viral Proteins ; genetics ; metabolism