With the advent of new diagnostic equipment OCT and treatment modalities PDT as well as refined vitrectomy technique, our capability to manage subfovel CNV and retinal detachment induced by macular hole in high myopic eye is improved. More important is that these developments help us to detect new macular pathology in high myopia, such as posterior retinal detachment without macular hole and foveoschisis, which are unrecognized before. The progresses not only enrich our knowledge but also increase our ability to manage maculopathies in pathologic myopia in recent years.

BACKGROUND:Traditionaly repairing single vertebral thoracolumbar fracture often uses of cross-vertebral 4 screw fixation. Because of “paralelogram effect” and the “suspension effect”, it is prone to have internal fixation failure, reset height and correction angle loss, and other complications. However, these complications can be avoided or reduced by fractured vertebra pedicle screw fixation. OBJECTIVE:To investigate the feasibility evaluation of pedicle screw fixation for repairing thoracolumbar fracturevia fractured vertebrae. METHODS:A total of 23 patients with single segment thoracolumbar fractures treated at the First Hospital of Lanzhou University between January 2013 and June 2014 were retrospectively analyzed. The fractured segments were between T11 to L2, the patient’s average age was 47.8 years old. Al the patients received the posterior pedicle screws and adjacent and up and down six pedicle screw internal fixation within 10 days after injury. The repair effect was observed, including short-term postoperative complications, vertebral height ratio, Cobb angle and the recovery of spinal neurological function. RESULTS AND CONCLUSION:Twenty-three cases were folowed up for 4 to 15 months. Al patients had no severe complications in the short term (4 to 15 months) after treatment. There was no screw rod breakage or internal fixation loosening at the last folow-up. The vertebral height ratios and Cobb angle which were measured in postoperative and final folow-up were significantly improved compared with the preoperative data (P < 0.05). The two indicators had a slight rebound in the last folow-up compared with that after treatment, but the difference was not significant (P> 0.05). The spinal neurological functions of most patients were partialy recovered at the last folow-up. These results suggest that pedicle screw embedding fixation repairing thoracolumbar fractureviafractured vertebrae can effectively restore vertebral height and correct kyphosis, and maintain correction effect. The advantages are obvious with a low occurrence rate of pedicle screw fracture.

Objective To analyse the effect of vitrectomy in diagnosing and treating endogenous endophthalmitis. Methods The effects of treatment, prognosis and the final follow-up visual acuity of 22 patients (30 eyes) with endogenous endophthalmitis diagnosed in our hospital from Jan 2000 to Dec 2003 were retrospectively reviewed. Results In 21 patients who underwent blood or vitreous body smear and culture, 18 (86%) had a positive result, including bacteria in 6, fungi in 11, and mixed infection in 1. In 16 patients who had complete follow-up data, successful vitrectomy were performed on 13 (81.3%) including 6 with functional success. Conclusion Vitrectomy may improve the positive rate of culture and vision prognosis in patients with endogenous endophthalmitis.

Objective To evaluate the clinical features and treatment outcomes of ocular posteriorsegment syphilis.Methods The clinical data of 24 patients with active ocular syphilis wereretrospectively reviewed.The diagnosis was made first in eye clinic,and verified by treponema pallidumparticle agglutination(TPPA)and rapid plasma reagin(RPR).The patients,17 males and 7 females,aged from 30 to 63 years with an average of 47.6 years.The duration of symptoms ranged from 3 days to2 years with an average of 5.8 months(≤1 month,7 cases;1-3 month,5 cases;3-6 months,5 cases;>6 months,7 cases).There were 18 bilateral cases and 6 unilateral cases.The result of humanimmunodeficiency virus(HIV)test was negative for all cases.Twenty-three patients received systemicpenicillin therapy and 1 patient was treated with oral erythromycin due to penicillin allergy.Beforetreatment,the mean visual acuity was 0.17±0.1 9,the mean titer of RPR was 1:84.The follow-up periodwas half a year.Results The major ocular manifestations included bilateral(16 cases)or unilateral(1case)chorioretinitis,unilateral retinal vasculitis(2 cases),unilateral neuroretinitis(2 cases),andbilateral(2 cases)or unilateral(1 case)optic neuritis.The mean follow-up visual acuity was 0.60±0.29,the mean follow-up titer of RPR was 1:18.8.Some patients had got the diagnosis and prompt treatment atthe early stage of the disease and their visual acuity recoveried very well.Conclusions The majormanifestion of ocular posterior segment syphilis is chorioretinitis.It is important tO consider the possibilityof syphilis when patients have inflammation of posterior segment.Prompt serology examination andpenicillin treatment are the keys to cure ocular syphilis.

In recent years,there are more and more cases of retinal infectious diseases in China,however,the diagnosis and management of those patients are still big challenges for our ophthalmicclinicians.It is our top priority to improve their capacity of early diagnosis for those diseases.We need toknow the relationship between retinal infectious diseases and systemic infections,their predisposingfactors.We also need to be familiar with the typical as well as atypical clinical features of those diseases.Vitreoretinal surgery already becomes a powerful tool to make diagnosis of retinal infectious diseases now;we need to make full use of this tool combined with modern technologies of microbiology,cytology,immunology and molecular biology to provide objective scientific evidences for the early diagnosis of retinalinfectious diseases.

Objective: To evaluate the advantage of perfluorocarbon liquid as a hydrokinetic manipulation tool during complex vitreoretinal surgery. Methods: Forty-two eyes with complicated retinal detachment were treated with vitrectomy and intravitreal perfluorocarbon liquid injection. Postoperative tamponade were obtained with silicon oil or gas. Results: Retinas were successfully reattached in all eyes intraoperatively, after a follow-up period of 3-6 months,34 of the 42 retinas (81%) remain attached . Conclusion: Perfluorocarbon liquid is an ideal hydrokinetic manipulation tool during complex vitreoretinal surgery.

Objective To investigate the effects and complications of the vitrectomy for Eales′ disease with vitreous hemorrhage or traction retinal detachment. Methods Seventy seven eyes of 69 cases undergoing vitrectomy for Eales′ disease with vitreous hemorrhage or traction retinal detachment were analyzed retrospectively. Results (1) The postoperative visual acuity was enhanced significantly. (2) Complications during the operation in 11 eyes (14.3%): iatrogenic retinal break in 7 eyes, bleeding in 3 eyes and lens damage in 1 eye. (3) Postoperative complications in 20 eyes (26.0%): rebleeding in 14 eyes, elevated IOP in 6 eyes, retinal detachment in 5 eyes, hyphema in 2 eyes, and exudative membrane in anterior chamber in 1 eye. (4) The main long term complication was cataract formation (9 eyes) and macular disorder (6 eyes). Conclusion Vitrectomy is an effective method to treat Eales′ disease with vitreous hemorrhage or traction retinal detachment.

Objective To determine whether kringle 4-5 could inhibit choroidal neovascularization (CNV) in mice induced by argon laser photocoagulation. Methods Fundus laser photocoagulation was performed on C57BL/6J mice to induce CNV. In treatment group, 20 ?g (low dosage group) and 50 ?g (high dosage group) kringle 4-5 were injected retrobulbarly after photocoagulation. In control group, equilibrium liquid was injected retrobulbarly. Choroidal neovascularization was evaluated on the 7th and 14th day after photocoagulation by fundus fluorescein angiography. The mice were killed on the 14th day after photocoagulation, the lesions were evaluated histologically and immunohistochemically, and the expression of CD105 was detected. The Expression of VEGF and bFGF was detected by immunohistochemistry on the 4th day after photocoagulation. Results The incidence of CNV was 64.3% in control group, 51.2%(P

Objective To observe the effects of calcitriol on cellular proliferation and apoptosis,and on the expression of transforming growth factor-β1(TGF-β1)-induced α-SMA and extracellular matrix(ECM)synthesis in renal interstitial fibroblasts,so as to illustrate its potential roles and underlying mechanisms in preventing renal interstitial fibrosis. Methods In NRK-49F of cultured rats in vitro,cellular proliferation was detected by MTY.The cellular cycle and apoptosis were assessed by flow eytometry using annexin-V FITC/propidium iodide(PI).Real-time PCR was performed to detect the mRNA expression of α-SMA,CTGF and FN,and Western blot was performed to detect the protein expression of α-SMA and FN. Results Cellular proliferation was inhibited by calcitriol through G1-arrest (P＜0.05).But calcitriol had no effect on cell apoptosis(P＞0.05).Increased expression of α-SMA,CTGF and FN mRNA induced by TGF-β1were significantly suppressed by calcitriol as compared with TGF-β1 treated group (P＜0.05).However,there was no significant difference among the groups with various concentration of calcitrol (P＞0.05).The similar phenomenon of the level of α-SMA and FN protein expression was observed in all groups by Western blot. Conclusion Caleiniol inhibits cellular proliferation of renal interstitial fibroblast by G1-arrest,but has no effect on cell apoptosis,and can prevent renal interstitial fibrosis caused by TGF-β1.

Purpose To investigate the histopathologic changes of macula lutea retinae in the elderly Chinese population,and to provide information for the cause of visiual disturbance in an autopsy study. Methods Two hundred and twelve eyes from 108 consecutive cases of postmortem (mean age of 78.4 years old) sections of the area of macula lutea retinae were studied by histopathology. Results Among the 212 eyes,hard drusen were found in 36.3% of eyes and soft drusen in 19.3% of eyes.The eyes with both of the above mentioned 2 types of drusens were found to be combined with RPE atrophy and RPE detachment;and subretinal neovascularization were found in 5.7% of these eyes and they were associated with obvious RPE atrophy and photoreceptor loss;3.2% eyes had posterior scleral staphyloma showing thinning of the sclera and choroid,RPE atrophy and apparent photoreceptor loss;2.4%eyes showed CME with the history of cataract surgery. Conclusion The macular affections,age related macular degeneration,myopic macular degeneration and post operative cystoid macular edema are varying in number in the above mentioned order successively,in elderly Chinese at an autopsy study.