·AIM: To determine whether a combined scleral buckle and pars plana vitrectomy, as a primary surgery, owns any advantage over a single scleral buckling in pseudophakic and aphakic retinal detachments.·METHODS: Thirty consecutive pseudophakic/aphakic retinal deachments were included in this retrospective study. Each patient underwent combined scleral buckle and pars plana vitrectomy, and was followed up for 3 to 14 months. Patients were examined with respect to anatomic reattachment, visual acuity improvement, and surgical complications.·RESULTS: All eyes were anatomically reattached after the first operation. All patients had an increase in their visual acuity, and there were no complications attributable to the vitrectomy procedure.·CONCLUSION: A combined surgery for primary pseudophakic/aphakic retinal detachments offers significant benefits to scleral buckling alone. The improved uccess rate is contributing to the function of vitrectomy, which improves peripheral visibility and reduces the occurrence of proliferative vitreoretinopathy (PVR).

AIM: To investigate the characteristics and surgical management of retinal detachment (RD) after laser-assisted in situ keratomileusis (LASIK) in myopia.METHODS: Documents of patients with RD observed in 18342 eyes (9 598 patients) who underwent LASIK were retrospectively reviewed. None of the patients had history of corneal or other diseases before LASIK and preoperative fundus examination was performed. Patients were followed for a mean of 20 months and the clinical features of the eyes which developed RD after LASIK were investigated.RESULTS: Six patients including 2 males and 4 females developed RD, and the incidence of RD after LASIK was 0.33‰. Mean pre-LASIK myopia in these 6 eyes was 9.33D.None of these eyes had prophylactic treatment history of any retinal lesions. Mean time interval between LASIK and RD development was 9.2 months. All RDs happened spontaneously and were managed with vitrectomy and other techniques.Retinal reattachment was achieved at the first retinal detachment surgery in all 6 eyes (100%) at mean follow-up of 9.3months.CONCLUSION: RD after LASIK is not common. The study suggests no cause-effect relationship between RD and LASIK procedure in myopic eyes. However, clinicians should still be aware of retinal pathology in patients undergoing LASIK.

AIM: To assess the efficacy and safety of prophylactic laser photocoagulation for retinal breaks before laser in situ keratomileusis (LASIK) in myopic eyes.METHODS: From April 2000 to April 2004, totally 1 845 eyes ( 1 233 patients ) requesting LASIK had a fundus examination with indirect ophthalmoscopy before the surgery. They were divided into two groups according to the presence (Group 1) or absence of retinal breaks (Group 2). All patients with retinal breaks, though they were asymptomatic, underwent prophylactic laser photocoagulation to seal the breaks before LASIK.RESULTS: Patient age ranged from 18 to 43 ( 25.3±5.7) yaers old. Mean preoperative spherical equivalent refraction (PSER) was -7.44± 2.13 D (range, -1.50 to -14.50 D). Retinal breaks were identified and treated in 37eyes (2.05%) of 32 patients;1 808 eyes of 1 201 patients had no retinal breaks. No statistical difference was found in age ( P ＞0.05) or gender (P ＞0.05) between the two groups. Significant difference of PSER was noted between Group 1 (-9.41± 4.15D) and Group 2 (-7.52±3.71D) (P＜0.05). During a mean 14mo follow-up, none of the patients developed retinal detachment.CONCLUSION: The efficacy and safety of prophylactic laser photocoagulation for retinal breaks was confirmed.Retinal breaks should be identified and treated by photocoagulation in eyes before LASIK for myopia.

· AIM: To report the clinical results of vitrectomy for Terson syndrome.· METHODS: Twenty-one eyes of 15 patients with Terson syndrome underwent vitreous surgery with the mean follow-up of 19.1mo.· RESULTS: Incomplete posterior vitreous detachment(PVD) was found in 15 eyes (71.4 %), epiretinal membrane was formed in 7 eyes (33.3 %), and retinal detachment occurred in 4 eyes (19.0 %). Significant visual improvement occurred in all eyes after vitrectomy: visual acuity of 20/40 or better was achieved in 17 eyes (80.9 %)and 4 eyes (19.0 %) developed lens opacity.· CONCLUSION: Vitrectomy for Terson syndrome can provide good visual recovery, with low complication rate,including that of cataract.

OBJECTIVETo investigate the role of Xuebijing injection(XBJI, traditional Chinese medicine), in inhibiting TLR4--NF-kappaB--IL-1beta pathway of myocardial hypoxia/reoxygenation in rats.

METHODSThirty six male SD rats (280 +/- 30) g were randomly divided into six groups (n = 6): normal group (N group), balanced perfusion group (BP group), model group (M group), low dose XBJI group (XBJI(L) group), middle dose XBJI group (XBJI(M) group), high dose XBJI group (XBJI(H) group). By Langendorff isolated heart perfusion device to establish the model of myocardial hypoxia/reoxygenation in rats. ELISA was used to detect the concentration of interleukin-1beta (IL-1beta); Western blot was used to detect the expression of nuclear factor kappa B p65 (NF-kappaB p65) protein and toll like receptor 4 (TLR4) protein; and RT-PCR to determine the expression of NF-kappaB p65 mRNA and TLR4 mRNA;To observe microstructure changes of hypoxia/reoxygenation myocardial by light microscopy.

RESULTSCompared with M group, the IL-1beta concentration, NF-kappaB p65 and TLR4 protein,NF-kappaB p65 and TLR4 mRNA of XBJIL group, XBJI(M) group, XBJI(H) group expression decreased in varying degrees,and decreased most obviously all in XBJI(M) group (P < 0.05, P < 0.01); Myocardical structural damage was serious in M group, and improved after treatment XBJI, the most obvious was the XBJI(M).

CONCLUSIONDifferent dose of XBJI can inhibit TLR4--NF-kappaB--IL-1beta signal transduction pathway and reduce several inflammatory reaction after myocardial hypoxia/reoxygenation injury, the 4 ml/100 ml of XBJI is the best.

Animals ; Drugs, Chinese Herbal ; pharmacology ; Heart ; drug effects ; Inflammation ; Interleukin-1beta ; metabolism ; Male ; Myocardium ; pathology ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; drug therapy ; Signal Transduction ; Toll-Like Receptor 4 ; metabolism ; Transcription Factor RelA ; metabolism

Adjuvants, Immunologic ; pharmacology ; Animals ; Anti-Inflammatory Agents, Non-Steroidal ; pharmacology ; Antiviral Agents ; pharmacology ; Caffeic Acids ; chemistry ; isolation & purification ; pharmacology ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Echinacea ; chemistry ; classification ; Fatty Acids, Unsaturated ; isolation & purification ; pharmacology ; Molecular Structure ; Plants, Medicinal ; chemistry ; Polyunsaturated Alkamides

OBJECTIVETo study the lipid constituents from Echinacea purpurea.

METHODThe compounds were isolated by chromatography method and the structures were identified on the basis of spectral analyses.

RESULTFive compounds were isolated and identified as, 1 beta, 6 alpha-dihydroxy-4(14)-eudesmene(1), (2E, 4E, 8Z, 10E)-N-isobutyl-2,4,8,10-dodecatetraenamide(2), (2E, 4E, 8Z, 10Z)-N-isobutyl-2,4,8,10-dodecatetraenamide(3), cerotic acid(4), hyxacosyl alcohol(5).

CONCLUSIONCompounds 1,4 and 5 were obtained from the plant for the first time.

Echinacea ; chemistry ; Fatty Acids ; chemistry ; isolation & purification ; Fatty Alcohols ; chemistry ; isolation & purification ; Plants, Medicinal ; chemistry ; Sesquiterpenes ; chemistry ; isolation & purification

OBJECTIVEThe aim of the study was to review the cases of Kawasaki Disease (KD) and analyze the clinical features especially their cardiac complications.

METHODSTotally 283 patients with KD were hospitalized from 1992 to 2002. Their clinical features and factors associated with increased risk of coronary artery aneurysms were reviewed.

RESULTS(1) Among the 283 KD patients, 186 were male and 97 were female. The male-female ratio was 1.9:1. Most of them (71%) were younger than 3 years old. Seasonal peak was in spring and summer (from May to Aug). Depending on the criteria of KD, 228 (81%) were diagnosed as typical KD and 55 (19.4%) were atypical KD. All patients had fever, lasting for 6.1 days. The most common clinical features were oral mucosal changes (97.5%) and cervical lymphadenopathy (95.4%), conjunctivitis (91.2%). And changes in the extremities (89.8%) and rash (81.5%) were also noted. (2) Before the treatment, coronary artery abnormalities were seen in 103/279 (36.9%), which occurred within 4 - 30 days of fever onset. Two weeks after intravenous gamma globulin (IVIG) treatment, the new cases of coronary artery abnormalities were 28/211 (13.3%). The prevalence of coronary artery aneurysms (CAA) with KD was 4.7%. The risk factors of CAA were male cases (P < 0.05) and fever lasting longer than 9 days (P < 0.05). Other cardiac abnormalities in acute phase included left atrial and ventricular enlargement (40/279, 14.3%) and changes in ECG (57/274, 20.8%). The pericardial effusions were found in 11 cases (3.9%).

CONCLUSIONSCardiac complications of KD occurred in the early period of KD. The new cases of coronary artery abnormalities were 13.3% after IVIG treatment. The risk factors of CAA included male cases and fever lasting for longer time.

Child, Preschool ; Coronary Aneurysm ; epidemiology ; etiology ; Female ; Heart Diseases ; diagnosis ; etiology ; Humans ; Immunoglobulins, Intravenous ; administration & dosage ; Male ; Mucocutaneous Lymph Node Syndrome ; complications ; diagnosis ; drug therapy ; Prevalence ; Risk Factors

AIMTo study the water-soluble constituents of Echinacea purpurea.

METHODSThe compounds were isolated by chromatography method and their structures were identified on the basis of spectral analyses.

RESULTSFive compounds were identified as 2-(4-hydroxylphenyl)-ethyl-O-alpha-L-rhamnopy-ranoasyl-(1-->6)-beta-D- glucopyranoside, named echipuroside A 1); (6S, 9R)-6-hydroxy-3-one-alpha-inonol-9-O-beta-D-glucopyranoside 2), ampelopsisionoside 3); phenylmethyl-6-O-beta-D-xylopyranosyl(1-->6)-beta-D-glucopyranoside 4) and phyenylmethyl-beta-D-glucopyranoside 5).

CONCLUSIONCompound 1 is a new compound, the others were isolated from this plant for the first time.

Cyclohexanones ; chemistry ; isolation & purification ; Disaccharides ; chemistry ; isolation & purification ; Echinacea ; chemistry ; Glucosides ; chemistry ; isolation & purification ; Molecular Structure ; Plants, Medicinal ; chemistry ; Solubility ; Terpenes ; Water ; chemistry

OBJECTIVETo investigate the effects of ischemic postconditioning (IPostC) on pneumocyte apoptosis after lung ischemia/reperfusion injury in rats.

METHODSAdult male SD rats were randomly divided into 3 groups based upon the intervention (n = 8): control group (C), lung ischemic reperfusion group (LIR), LIR+ IPostC group (IPostC). At the end of the experiment, blood specimens drawn from the arteria carotis were tested for the content of malondialdehyde (MDA), the activity of superoxide dismutase (SOD) and myeloperoxidase (MPO); the pneumocyte apoptosis index (AI) was achieved by tennrminal deoxynucleotidyl transferase mediated dUTP nick end abeling (TUNEL); the expression of Bcl-2, Bax protein in lung tissue was accessed by quantitative immunohistochemistry (MHC) and Bcl-2, Bax mRNA by RT-PCR.

RESULTSIPostC could significantly attenuate the MDA level, MPO activity and improve SOD activity in blood serum which was comparable to I/R and significantly reduced the number of TUNEL-positive cells compared with I/R group, expressed as Al (% total nuclei) from (39.0 +/- 3.46) to (8.0 +/- 0.88) (P < 0.01). The protein and mRNA expression of Bcl-2 and Bax showed that IPO significantly attenuated the ischemia/reperfusion-upregulated expression of Bax protein but improved the expression of Bcl-2 that improved the Bcl-2/Bax ratio (P < 0.01) .

CONCLUSIONIPostC may attenuate pneumocyte apoptosis in LIRI by up-regulating expression of Bcl-2/Bax ratio and by inhibiting oxidant generation and neutrophils filtration.

Alveolar Epithelial Cells ; cytology ; Animals ; Apoptosis ; Ischemic Postconditioning ; Lung ; metabolism ; pathology ; Lung Injury ; physiopathology ; Male ; Malondialdehyde ; metabolism ; Peroxidase ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; physiopathology ; Superoxide Dismutase ; metabolism ; bcl-2-Associated X Protein ; metabolism