Objective To explore the clinical significance of changes of serum IL-1,IL-6 and TGF-β1 in pa-tients with Knee osteoarthritis(KOA).Methods Serum IL-1,IL-6 and TGF-β1 levels were measured by ELISA in 100 patients with KOA and 100 health control .Results The KOA group serum IL-1 and IL-6 levels were higher than those of the healthy control group (t=71.132,t=78.503,all P<0.01),while the level of TGF-β1 was converse(t=36.165,P<0.01);The levels of serum IL-1 and IL-6 increased gradually with the increase of the severity ,while.the level of TGF-β1 was decreased;the serum level of TGF-β1 was negative correlation with the level of IL-6,IL-8 in patients with KOA(r=-0.633,r=-0.615,all P<0.05),the serum level of IL-1 was positive correlation with the level of IL-6(r=0.730,P<0.01).Conclusion The serum IL-6,IL-8 and TGF-β1 reflect situation of patients and extent of Joint injury ,which is close relationship between the clinical process of KOA and has significance value to evaluate the pathogenetic condition and prognosis .

Objective To observe the effects of intravitreal injection of conbercept for aggressive posterior retinopathy of prematurity (AP-ROP).Methods It is a retrospective case study.Twenty-one patients (40 eyes) with AP-ROP were enrolled in this study.There were 9 males (18 eyes) and 12 females (22 eyes),with the mean gestational age of (28.30±1.79) weeks and the mean birth weight of (1 021.40±316.70) g.All the lesions of 40 eyes were located in posterior zone,with 24 eyes in zone Ⅰ and 16 eyes in zone Ⅱ.All the eyes were treated with intravitreal injection of conbercept 0.025 ml (0.25 mg).During follow-up,nonresponders or patients with deterioration were retreated with intravitreal injection of conbercept or photocoagulation;patients with progressive deterioration to stage 4 had received vitrectomy.At the 1,2,4,8,12,16,20,24 weeks after treatments,the disappearance or decrease of retinal vessel tortuosity and neovascularization,and the growth of the normal retinal vessels toward the peripheral retina were evaluated.Results Thirty-six eyes were cured for only one injection,the cured rate was 90.00％.However,2 eyes (5.00％) had progressed to stage 4 with contractive retinal detachment,which underwent vitrectomy.Two eyes (5.00％) had received twice injections,whose remaining avascular zone area treated by photocoagulation.No major systemic or ocular complications after injection appeared.All lens remained transparent and no iatrogenic retinal hole was occurred during the follow-up.Conclusion Intravitreal injection ofconbercept is effective in the treatment of AP-ROP.

Objective To evaluate the therapeutic effects of treatments of eye-retaining and enucleation for choroidal melanomas. Methods The clinical data of 44 patients (44 eyes) with choroidal melanomas after eye-retaining treatments and enucleation surgery were retrospectively analyzed. The metastasis, retention rate of eyeball after eye-retaining treatment, and visual acuity prognosis were observed and analyzed. In 44 eyes treated by eye-retaining therapy, transpupillary thermotherapy (TTT) was performed primaryly on 7 (15.9%),~ 106 Ru brachytherapy on 25 (56.8%), and local resection of tumor combined with ~ 106 Ru brachytherapy on 12 (27.3%).The average follow-up period was 13.3 months. Results Forty-four patients had no melanoma metastasis during the follow-up period. In 39 patients (88.6%) who had their eyes retained successfully, the retention rate of eyeball was 100%, 92.9%, and 83.3% in 6, 14, and 24 eyes with small, middle, and large tumor, respectively. In the patients treated by eye-retaining therapy, the visual acuity was ≥0.3 in 11 (28.2%), ≥0.05-

Objective To observe the clinical effect of small gauge vitrectomy (SGV) treatment for proliferative diabetic tractional (PDR) with retinal detachment (TRD).Methods The data of 42 patients (50 eyes) with PDR combined with TRD who had received SGV treatment were retrospectively analyzed.There were 22 males and 20 females,with an average age of (44.5±11.2) years.There were 16 eyes with TRD involving the macular area,34 eyes without TRD involving the macular area.The eyes with rhegmatogenous retinal detachment or retinal hole were excluded.The best corrected visual acuity (BCVA) was worse than finger counting in 18 eyes,worse than 0.1 in 15 eyes,0.1-0.3 in 16 eyes and better than or equal to 0.3 in 1 eye.Post operative tamponade was delivered for patients with iatrogenic retinal breaks,including 5 eyes with long acting gas and 7 eyes with silicone oil.The mean follow-up time was 9.7 months.The visual outcome,rate of retinal reattachment and complications were analyzed.Results The visual acuity improved in 34 eyes (68.0％),unchanged in 12 eyes (24.0％) and decreased in 4 eyes (8.0％).The difference of visual acuity before and after surgery was statistically significant (t=7.087,P＜0.01).The total rate of retinal reattachment was 96％,and 84％ of eyes achieved anatomic reattachment after single surgery.The rate of retinal reattachment was 89.5％ (34/38) for these eyes without iatrogenic retinal breaks,4/38 eyes without iatrogenic retinal breaks still had retinal detachment in 3 months after surgery and received tamponade of long-acting gas or silicone oil.The rate of retinal reattachment was 66.7 ％ (8/12) for these eyes with iatrogenic retinal breaks and received post-operative tamponade.There were 17 eyes experienced postoperative vitreous hemorrhage,which were treated with anti-vascular endothelial growth factor (VEGF) antibodies or vitreous cavity lavage.There were 9 eyes with transient ocular hypertension,and 4 eyes with neovascular glaucoma (NVG).Among 4 eyes with NVG,2 of which were controlled through anti VEGF treatment or laser treatment,and 2 eyes of 2 patients refused to have further treatment.Conclusion SGV is safe and effective treatment for PDR combined with TRD,and intraocular tamponade is not necessary in the absence of iatrogenic retinal break.

Objective To evaluate the anatomic outcome after lens-sparing vitrectomy (LSV) or scleral buckle (SB) for stage 4 retinopathy of prematurity (ROP).Methods The clinical data of 39 infants (50 eyes) with 4a (20 eyes) or 4b (30 eyes) were retrospectively analyzed.The age ranged from two to 18 months,with a mean of (6.0±3.4) months.The gestational age ranged from 26 to 33 weeks,with a mean of (30.0±1.6) weeks.The birth weight ranged from 800 to 1900 g,with a mean of (1404.5±237.6) g.Nineteen eyes underwent SB and 31 eyes underwent LSV.Follow-up ranged from 6 to 84 months,with a mean of (26.0±21.7) months.The anatomical and refractive results were reviewed at the final follow-up.Results The anatomic success of SB was 100.0％ (19 of 19 eyes) and that of LSV was 87.1％ (27 of 31eyes).Among the patients in whom treatment failed,4 were in the LSV group (4/31,12.9％).The buckles of 5 eyes (5/19,26.3％) were removed.At the end of the follow-up,the mean myopic refraction was (-4.46±2.49) diopters (ranging from -1.25 to 11.00 diopters) in the LSV group,and ( -3.21±1.96) diopters (ranging from -1.25 to 9.25 diopters) in the SB group.There was no significant difference between two groups (F=2.76,P=0.103).Conclusion The anatomic outcome after LSV or SB for stage 4 ROP was excellent.

Objective To compare the efficacy and safety of laser photocoagulation and intravitreal injection of bevacizumab for stage 3 retinopathy of prematurity (ROP).Methods The study included 38eyes of 19 infants with stage 3 ROP (18 eyes of 9 infants in zone Ⅰ,20 eyes of 10 infants in zone Ⅱ ).All the patients were examined by indirect ophthalmoscope and photographed by wide-angle digital retinal imaging system (RetCam Ⅱ ). The fundus lesions in both eyes were the same. Patients received laser photocoagulation in one eye (laser group) and intravitreal injection of 0.03 ml bevacizumab (25 mg/ml) in the fellow eyes (bevacizumab group) during treatment.Follow-up ranged from 12 to 66 weeks,with an average of 33 weeks. The regression time of neovascular ridges and plus-diseases in two groups were compared.Results For 18 eyes with stage 3 ROP in zone Ⅰ,the regression time of neovascular ridges and plus-diseases were (2.25 ±0.46) and (2.11 ±0.60) weeks respectively in bevacizumab group,and both were (3.75 ± 1.75) weeks in laser group.The differences between those two groups were statistically significant (F=18.29,15.56；P＜0.05).For 20 eyes with stage 3 ROP in zone Ⅱ,the regression time of neovascular ridges and plus-diseases were (3.1 ±1.72) and (2.1 ± 0.56) weeks respectively in bevacizumab group,and were (3.50± 1.90) and (2.50± 1.35) weeks respectively in laser group.The differences between those two groups were not statistically significant (F =0.38,2.62 ; P＞ 0.05).There were more fibrous membrane proliferations on the retinal surface in 8 eyes,including 6 eyes in laser group and 2 eyes in bevacizumab group. There was no treatment-related endophthalmitis,cataract,retinal tears and other complications during the follow-up.Conclusion The laser photocoagulation and intravitreal injection of bevacizumab were both safe and effective in treating stage 3 ROP.

Objective To explore the clinical effect of remifentanil and ketamine with sevoflurane in pediatric surgery. Methods 80 cases of ASAⅠ～Ⅱ grade line surgery in children, were randomly divided into remifentanil group(A group) and the ketamine group(B group). Intramuscular midazolam 0.3mg/kg basic anesthesia catheter later. A group 2min before skin incision to give 0. 5μg/kg remifentanil infusion pump micro pump remifentanil 30μg(kg/h) add sevoflurane inhalation 3MAC until surgery. B group 2min before skin incision 2mg/kg ketamine infusion then pump ketamine 3mg(kg/h) add sevoflurane inhalation 3MAC until surgery; Record separately the two groups before skin incision in children with 2 min(T0) ,atskin incision(T1),after skin incision 15min(T2) ,when surgery (T3) in children with the mean arterial pressure (MAP),heart rate(HR),respiratory frequency(R)and oxygen saturation (SpO2) ,and record the total number of children with secretions (sputum volume) , awake time and the availability of laryngeal spasm,restlessness,nausea, vomiting and other adverse reactions. Results A group sputum volume was less than B group(P＜0.01) and A Group awake time was shorter than B Group(P＜0.01) ;Two groups of patients R infants had no inter-group differences(P＞0.05) ,two groups of children during quiet sleep,analgesic perfect, no significant respiratory depression,no laryngeal spasm,restlessness and nausea,vomiting and other adverse reactions. Conclusion Remifentanil composite Sevoflurane for surgery in children than ketamine was more stable during the cycle, secretions less quickly after waking up was a safe and reliable method of anesthesia.

BACKGROUND: Poly hydroxybutyrate-hydroxyvalerate (PHBV) has been used to construct bioprosthetic heart valve. It remains unclear whether it can be used as membrane for guided bone regeneration. OBJECTIVE: To investigate the biocompatibility of PHBV membrane and evaluate its efficiency of promoting bone regeneration in vivo. METHODS: Effects of 100%, 75%, 50%, 25% PHBV extract solution on relative growth rate of dog bone marrow mesenchymal stem cells were measured by MTT method and cytotoxicity of the biomaterials was evaluated. Bone defects were made on distal bilateral tibias and treated with PHBV membrane; the proximal bilateral tibias undergoing reduction of periosteal flap and were used as control. RESULTS AND CONCLUSION: The toxicity gradation of PHBV membranes was grade 0-1. That is, they were not toxic to growth and proliferation of bone marrow mesenchymal stem cells. New bone regeneration was observed in the defects covered with PHBV membranes at week 2 post-surgery. The defects covered with PHBV membranes were filled with mature bone at week 12 post-surgery. The bone repair in experimental groups was earlier and better than that in control groups. Results demonstrated that PHBV membrane, which has no cytotoxicity to mesenchymal stem cells in a wide range of extract concentration, could be a promising biopolymer membrane for guided bone regeneration.

Background Inflammation is one of the most popular aspects in the studies of diabetic retinopathy (DR) mechanisms.Researches showed that S100A8/A9 participate in the inflammatory procedure of many diseases,however,the relationship between S100A8/A9 complex and retinal inflammation of DR needs to be researched.Objective This study was to detect the serum S100A8/A9 level of diabetes mellitus (DM) and DR patients,and explore its role in DM an DR development.Methods A cases-controlled study was carried out.The DR patients,type 2 DM patients without retinal change and heathy controls were enrolled in Shanghai Xuhui Central Hospital from January to June 2014,and 30 patients for each group.The DR patients were subgrouped to non-proliferative DR (NPDR) group and proliferative DR (PDR) group.The periphery blood was collected to isolate the serum,and serum S100A8/A9 complex level was detected by ELISA.Serum high-sensitivity C-reactive protein (hsCRP) and glycosylated hemoglobin A1C (HbAlc) level was assayed by immunity turbidimetry and immune agglutination respectively.Results Serum S100A8/A9 complex levels in the DR group,DM group and normal control group were (9.74±0.59),(11.41 ±0.64) and (6.46 ±0.62) μg/L,respectively,and the serum S100A8/A9 complex level in the DM group and DR group was significantly higher than that in the normal control group,and the serum S100A8/A9 complex level in the DM group raised in compared with the DR group (all at P＜0.01).Serum hsCRP levels in the DR group,DM group and normal control group were (1.40±0.34),(1.27±0.13) and (1.11 ± 0.12)mg/L,respectively,with the highest value in the DR group and the lowest value in the normal control group (all at P=0.00).The serum HbAlc levels were higher in the DR group and DM group than those in the normal control group (both at P =0.00),while no significant difference was found in the serum HbAlc level between DR group and DM group (P =0.12).There was no significant differece in the serum S100A8/A9,hsCRP and HbAlc levels between NPDR group and PDR group (t=-0.10,P =0.92;t =-0.17,P =0.87;t =0.66,P =0.51).A weak positive correlation was seen between serum S100A8/A9 level and serum hsCRP level (r =0.36,P =0.00).Conclusions As an inflammatory marker,S100A8/A9 complex might play an important role in the pathogenesis and development of DR.Intensive control of glycemia can alleviate retinal inflammation in DM patients.

Objective To observe the therapeutic effect of segmental scleral buckling and vitrectomy with/without lensectomy on the retinopathy of prematurity (ROP) stage 4a,4b and 5.Methods One hundred and thirty-four ROP infants (181 eyes) diagnosed as stage 4a,4b and 5,and performed with segmental scleral buckling or vitreous with/without lensectomy were retrospectively analyzed.The operated 4a-,4b-and 5-stage eyes were 40,51 and 90 eyes.The operational method depended on the location and severity of fibrovascular membrane.Of 181 eyes,segmental scleral buckling was referred for 37 eyes which include 23 eyes with 4a stage and 14 eyes with 4b stage;vitrectomy was referred for 50 eyes which include 14 eyes with 4a stage,29 eyes with 4b stage and 7 eyes with 5 stage;vitrectomy with lensectomy was referred for 94 eyes which include 3 eyes with 4a stage,8 eyes with 4b stage and 83 eyes with 5 stage.The effect was classified as success,improved and failure.Failure includes lost eye.Follow-up for 4a,4b and 5 stage patients are 34,31 and 29 months respectively.Results Segmental scleral buckling was referred for 37 eyes,success in 23 eyes (62.16％),improved in 11 eyes (29.73 ％),failure in 3 eyes (8.11 ％).Vitrectomy was referred for 50 eyes,and success in 20 eyes (40.00％),improved in 22 eyes (44.00％),and failure in 8 eyes (16.00％).In the total of 94 eyes underwent vitrectomy with lensectomy,20 eyes was success (21.28％),improved in 17 eyes (18.08％),failure in 57 eyes (60.64％).In 40 stage 4a eyes,33 successes (82.50％),6 improved (15.00％) and 1 failure (2.50％).In 51 stage4b eyes,11 successes (21.57％),30 improved (58.82％) and 10 failures (19.61％).For 90 stage 5 eyes,14 successes (17.50％),19 improved (23.75％) and 57 failures (71.25％).The therapeutic effect of segmental scleral buckling for stage 4a was better than that for stage 5 (x2 =6.707,P=0.035).The difference of therapeutic effect of vitrectomy for different stage was significant (x2=21.010,P =0.000);stage 4a was the best;stage 4b was the second,stage 5 was the worst.The therapeutic effect of vitrectomy with lensectomy for stage 5 was worse than that for stage 4a and 4b (x2=16.066,P=0.003).Conclusion The surgery patterns of ROP was determined based on the disease severity,the surgery effects of stage 4a and 4b were better than stage 5,which had nothing to do with the surgical procedures.