1.Comparison of effects of 25G+and 27G+pars plana vitrectomy in the treatment of vitreous hemorrhage
Zhengze LI ; Junkai MA ; Gaoen MA
Journal of Xinxiang Medical College 2024;41(8):732-736
Objective To compare the clinical effects of 25G+and 27G+pars plana vitrectomy(PPV)for vitreous hemorrhage.Methods Fifty patients(50 eyes)with vitreous hemorrhage treated in the Third Affiliated Hospital of Xinxiang Medical University from December 2019 to August 2022 were selected as the research subjects.The patients were divided into a 25G+group and a 27G+group according to different surgical methods.Patients in the 25G+group underwent 25G+PPV treatment,and patients in the 27G+group underwent 27G+PPV treatment.The operation time and the incidence of intraoperative complications were compared between the two groups.Before surgery and 3 months after surgery,the visual acuity of patients in the 2 groups was examined by using the standard visual acuity chart of early treatment of diabetic retinopathy study(ETDRS)group,and the intraocular pressure of patients in the 2 groups was measured by using the Callon non-contact tonometer.Postoperative complications and subconjunctival hemorrhage scope of patients in the 2 groups were compared.Results There were no significant differences in gender,age,preoperative visual acuity and intraocular pressure of patients between the 25 G+group and the 27G+group(P<0.05).The operation time of patients in the 25G+group was significantly shorter than that in the 27G+group(P<0.05).At 1 day after surgery,the subconjunctival hemorrhage scope of patients in the 27G+group was significantly smaller than that in the 25 G+group(P<0.05).Patients in both the 25 G+and 27 G+groups had significantly better ETDRS visual acuity at 1 day,1 week,1 month and 3 months after surgery compared with before surgery(P<0.05).There was no statistically significant differencein the ETDRS visual acuity of patients between the two groups at 1 day,1 week,1 month and 3 months after surgery(P>0.05).The intraocular pressure of patients in the 25G+group was significantly lower than that in the 27 G+group at 1 day after surgery(P<0.05).There was no significant difference in intraocular pressure of patients between the 25G+group and the 27G+group at 1 week,1 month and 3 months after surgery(P>0.05).At 1 day after surgery,transient hypotonia was observed in 3 patients in the 25 G+group,while no hypotonia was observed in the 27 G+group.In the 25G+group,13 eyes(52.0%)underwent incision suture due to incision seepage when the scleral puncture cannulae were removed,while in the 27G+group,no scleral incision suture was performed.No iatrogenic injury occurred during the operation in both groups.During the 3-month follow-up,no intraocular infection or choroidal detachment was found in both groups.Conclusion Both 25G+PPV and 27G+PPV can achieve better clinical efficacy in treating vitreous hemorrhage,and the operation is safe and reliable.Compared with 25G+PPV,27G+PPV can significantly reduce subconjunctival hemorrhage and edema and stabilize intraocular pressure of patients.
2.Expression and significance of SHP2 in retinal tissues of mice with oxygen-induced retinopathy
Jin CHEN ; Xiangling LIU ; Shaobo SU ; Gaoen MA
Journal of Xinxiang Medical College 2024;41(11):1016-1021
Objective To investigate the expression and significance of Src homology 2 domain-containing protein tyrosine phosphatase 2(SHP2)and phosphorylated SHP2(P-SHP2)in oxygen-induced retinopathy(OIR).Methods Twenty clean-grade C57BL/6J(B6)7-day-old neonatal mice were randomly divided into normal control group and OIR group,with 10 mice in each group.The mice in the normal control group and the nursing mother mice were fed together in a normal oxygen and room temperature environment.Mice in the OIR group were placed in an oxygen chamber with a temperature of 22-25 ℃,humidity of(60±10)%and oxygen volume fraction stable at(75±5)%for five days together with the nursing mother mice,and then transferred to a normal oxygen environment.At 12,14,17 days of age,three mice were selected from the normal con-trol group and the OIR group,respectively;and the expressions of SHP2 and P-SHP2 proteins in the retinal tissues of mice in the two groups were detected by Western blot.Two 17-day-old mice were randomly selected from the normal control group and the OIR group,respectively;and the retinal histopathology of mice was observed by hematoxylin-eosin staining.Results In the normal control group,the cell structure in all layers of the retinal tissue of 17-day-old mice was orderly,the inner limiting mem-brane and endothelial nucleus were intact,and the shape was normal.In the OIR group,the intercellular structure in all layers of the retinal tissue of 17-day-old mice was disordered,and the vascular endothelial nucleus was seen to break through the reti-nal inner limiting membrane.There was no statistically significant difference in the relative expression of SHP2 protein in the retinal tissues of mice at different ages in the normal control group(F=2.052,P>0.05).The relative expression level of P-SHP2 protein in the retinal tissues of mice at 14,17 days of age in the normal control group was significantly lower than that at 12 days of age(P<0.05),and the relative expression level of P-SHP2 protein in the retinal tissues of mice at 17 days of age was significantly lower than that at 14 days of age(P<0.05).The relative expression level of SHP2 protein in the retinal tissues of mice at 14 days of age in the OIR group was significantly higher than that at 12,17 days of age(P<0.05).There was no statistically significant difference in the relative expression level of SHP2 protein in the retinal tissues between 17-day-old mice and 12-day-old mice in the OIR group(P>0.05).The relative expression level of P-SHP2 protein in the retinal tissues of mice at 14 days of age in the OIR group was significantly higher than that at 12,17 days of age(P<0.05).There was no statistically significant difference in the relative expression level of P-SHP2 protein in the retinal tissues between 17-day-old mice and 12-day-old mice in the OIR group(P>0.05).The relative expression level of SHP2 protein in the retinal tissues of mice at 12,17 days of age in the OIR group was significantly lower than that in the normal control group(P<0.05).There was no statistically significant difference in the relative expression level of SHP2 protein in the retinal tissues of mice at 14 days of age between the two groups(P>0.05).The relative expression level of P-SHP2 protein in the retinal tissues of 12-day-old mice in the OIR group was significantly lower than that in the normal control group(P<0.05),while the relative expression level of P-SHP2 protein in the retinal tissues of 17-day-old mice was significantly higher than that in the normal control group(P<0.05).There was no statistically significant difference in the relative expression level of P-SHP2 protein in the retinal tissues of mice between the two groups at 14 days of age(P>0.05).Conclusion SHP2 and P-SHP2 are expressed with tem-poral fluctuations in OIR.Hypoxia may promote conformational changes of SHP2 in OIR mice,and play an active role in phos-phorylation;and participate in and promote the occurrence and development of OIR.
3.Comparison of 25G+and 27G+pars plana vitrectomy in the treatment of idiopathic epiretinal membrane
Junkai MA ; Qing ZHANG ; Xiaoxiao MA ; Yidan MA ; Shaobo SU ; Qiong YAN ; Zixuan CAO ; Gaoen MA
Journal of Xinxiang Medical College 2024;41(2):122-127
Objective To compare the clinical efficacy of 25G+and 27G+pars plana vitrectomy(PPV)in the treat-ment of idiopathic epiretinal membrane(iERM).Methods A total of 50 iERM patients(50 eyes)who were admitted to the Third Affiliated Hospital of Xinxiang Medical University from December 2019 to August 2022 were selected as the research subjects.These patients were divided into the control group and observation group based on different surgical methods,with 25 patients(25 eyes)in each group.Patients in the control group received 25G+PPV treatment,while patients in the observation group received 27G+PPV treatment.The surgical duration and postoperative 1-day incision subconjunctival hemorrhage and e-dema of patients in two groups were compared;central macular thickness(CMT)was measured by optical coherence tomo-graphy before surgery,1 day,1 week,1 month,and 3 months postoperatively in the two groups.Visual acuity of patients in both groups was assessed according to the early treatment diabetic retinopathy study(ETDRS)visual acuity chart.Intraocular pressure was measured by using a non-contact Callon tonometer.Complications,such as intraoperative macular injury,retinal hole,postoperative choroidal detachment,retinal hemorrhage,retinal detachment,and intraocular infection,were observed in both groups.Results The surgical duration of patients in the observation group was significantly shorter than that in the control group(t=2.314,P<0.05).The extent of subconjunctival hemorrhage and edema of patients in the observation group was significantly smaller than that in the control group(t=13.706,P<0.01).The ETDRS visual acuity of patients at 1 day,1 week,1 month,and 3 months after surgery in both groups was significantly higher than that before surgery(P<0.05).There was no signifi-cant difference in ETDRS visual acuity of patients between the two groups at 1 day,1 week,1 month,and 3 months postoperatively(P>0.05).At 1 day after surgery,the intraocular pressure of patients in the observation group was significantly higher than that in the control group(P<0.05).At 1 week,1 month,and 3 months after surgery,there was no significant difference in intraocular pressure of patients between the two groups(P>0.05).Two patients in the control group experienced transient ocular hypotension 1 day after surgery,while no such complication was observed in the observation group.Patients in both groups presented with varying degrees of retinal nerve epithelial layer traction,retinal edema,thickening,and vascular distortion before surgery.At 1 day after surgery,epiretinal membrane traction was relieved in both groups,and there was a significant improvement in the anatomical structure of the macular area compared to preoperative conditions.At 1 day,1 week,1 month,and 3 months after surgery,the CMT of patients in both groups was reduced compared to preoperative values(P<0.05);there was no significant difference in CMT of patients between the two groups at 1 day,1 week,1 month,and 3 months after surgery(P>0.05).In the control group,18 eyes(72.0%)were sutured at the scleral puncture sites due to leakage,while no suturing was performed in the observation group.Patients in both groups completed the surgery successfully,without any intraoperative complications such as macular injury or retinal hole.During the 3-month follow-up,no postoperative complications such as choroidal detachment,retinal hemorrhage,retinal detachment,or intraocular infection were observed in both groups.Conclusion Both 27G+PPV and 25G+PPV have good clinical effects and high surgical safety in the treatment of iERM.Compared with 25G+PPV,27G+PPV can shorten the surgical duration,better maintain postoperative intraocular pressure stability,and reduce the range of subconjunctival bleeding and edema.