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

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 investigate the relationship among a 50 Hz magnetic field (MF)-induced epidermal growth factor receptor (EGFR) clustering,lipid rafts and acid sphingomyelinase (ASM), and to explore its possible mechanism.

METHODSHuman amnion FL cells were exposed to 50 Hz, 0.4 mT MF for 15 min. EGF treatment was used as positive control. Nystatin was employed to study lipid rafts since it could disrupt lipid rafts structure.The EGF receptors, ASM and lipid rafts were labeled with polyclonal anti-EGFR antibody, anti-ASM antibody and FITC-Cholera toxin B, respectively. The images were observed by laser confocal scanning microscope.

RESULTBoth EGF treatment and 50 Hz MF exposure could induce EGFR clustering; however, nystatin pretreatment disrupted this effect. MF exposure turned ASM (labeled with Cy3) from a diffused state in the sham exposure group to a concentrated state on the cell membrane, which co-localized with lipid rafts (labeled with FITC).

CONCLUSIONThe results suggest that the EGFR clustering induced by 50 Hz MF depends on intact lipid rafts on cellular membrane, and the ASM might participate in the process of EGFR clustering.

Cell Membrane ; radiation effects ; Cells, Cultured ; Electromagnetic Fields ; Epidermal Growth Factor ; metabolism ; Humans ; Membrane Microdomains ; radiation effects ; Receptor, Epidermal Growth Factor ; metabolism ; radiation effects ; Signal Transduction ; physiology ; radiation effects ; Sphingomyelin Phosphodiesterase ; metabolism

Adult ; Female ; Humans ; Lupus Erythematosus, Systemic ; drug therapy ; Methylprednisolone ; therapeutic use ; Mycophenolic Acid ; analogs & derivatives ; therapeutic use ; Neuromyelitis Optica ; drug therapy ; Prednisone ; therapeutic use ; Young Adult

OBJECTIVETo investigate CT and MRI characteristics of primary spinal large B cell lymphoma.

METHODSCT and MRI data of 23 patients with primary spinal large B cell lymphoma confirmed by histopathology were retrospectively analyzed from March 2011 to August 2015. Among them, including 14 males and 9 females aged from 28 to 70 years old with an average of 53.4 years old. The clinical manifestation mainly focus on pain around spinal and minority peripheral nerve symptom. The courses of disease ranged from 2 weeks to 3 months with an average of 9 weeks. Nine patients underwent CT plain scan, 8 patients underwent plain and enhanced CT; 21 patients underwent MRI plain scan and enhanced; 15 patients underwent CT and MRI examination. The location, bone changes, shape, density, signal intensity and enhancement characteristics of lesions were observed and compared with pathology.

RESULTSLocation and size of lesion showed cervical vertebrae in 1 case, thoracic vertebrae in 16 cases, lumbar vertebrae in 2 cases, and sacral vertebrae in 4 cases. Mass was larger, the largest cross-sectional size of group was up to 73 mm× 125 mm. CT examination showed that 11 cases with "cloud and mist" shape change, 6 cases with compression fractures, and with "floating ice" shape change, 9 cases with "oversleeve" shape change, 11 cases with spinal stenosis; enhancement scan showed obvious reinforcement. MRI showed slightly low signal on T1WI and T2WI were slightly high signal, and signal was uneven, and enhancement scan showed obvious reinforcement, 13 of 16 cases with spinal canal stenosis changed like "oversleeve", intervertebral space showed no significant stenosis. Comparison of CT and MRI showed the manifestation of bone destruction by CT was superior than that of MRI, but the range of lesion, and related surrounding structures were not better than MRI. MRI displayed the range of lesion usually bigger than CT. Pathology results showed that 23 patients were all primary spinal large B cell lymphoma.

CONCLUSIONSPrimary spinal large B cell lymphoma has certain features in age, location and imaging findings. The "cloud and mist", "floating ice" and "oversleeve" shape bony destruction by CT and MRI has certain significance to diagnosis of primary spinal large B cell lymphoma.

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