The idiopathic macular hole ( lMH ) is research priority associated with the regenerate quickly of vitrectomy. The unaided visual acuity and the best corrected visual acuity is partial for the visual acuity of the patient with lMH. The mechanism and clinical significance of modern visual function measurements associated with lMH, including contrast sensitivity, visual field, multifocal electroretinogram, and stereoscopic vision, have been introduced. These measurements could be of great value in early diagnosis of lMH, assessment of surgical indication and evaluation of visual performance after vitrectomy. They would also be helpful to the analysis of postoperative impaired visual function and its management. Having an adequate understanding of the contents and significance of visual function is helpful to the improvement of lMH surgery techniques and postoperative visual acuity.

Objective To determine the risk factors related to venous thromboembolism after knee arthroscopy. Methods A retrospective study including patients from Feb 2012 to Mar 2016 was carried out to analyze the risk factors of venous thromboembolism after knee arthroscopy. A 1 : 2 matched control group was generated according to the surgeon and the date. Preoperative and perioperative data were collected with respect to age, gender, body mass index, smoking, blood fat, surgical procedure, the time length of ligating tourniquet, anesthesia methods, surgery time and Caprini evaluation. Univariate and multivariate analyses were performed. Results 29 cases of venous thromboembolic events (VTEs) occurred, resulting in an incidence rate of 1.17%. Factors associated with an elevated risk of postoperative VTEs included age OR^ =1.09, 95%CI (1.03, 1.16) and Caprini evaluation OR^ =2.97, 95% CI (1.39, 6.32). Conclusions In this study, VTEs occurred infrequently. Considering the serious result of VTEs, it is important to prevent it. Age and Caprini are associated with elevated risk of postoperative VTEs. It is essential to target those at high risk for VTEs and appropriately treat those patients.

The DNA structures could be altered or even damaged by exogeous or endogenous factors during cell proliferation. Failure of effective and timely repair will lead to cell cycle arrest or apoptosis. By taking the advantage of the quick proliferation of cancer cells, DNA damage induction, cell cycle arrest and apoptosis promotion have become important strategies for ant-cancer chemotherapy. Previous reports showed that an array of natural compounds inhibit cancer cell proliferation by inducing DNA damage, which have therapeutic potentials for anti-cancer drug research and development.
Animals ; Biological Products ; pharmacology ; therapeutic use ; DNA Damage ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Neoplasms ; drug therapy

Objective To study the indications and clinical outcome of the upper cervical spine via the high anterior cervical retropharyngeal approach in treatment of upper cervical spine injuries. Methods There were 41 patients including 32 males and 9 females, at age of 12-67 years. Of all patients, there were 21 patients with Hangman fractures, two with fracture of C2 vertebral body, 12 with irreducible atlantoaxial dislocation secondary to os odontoideum, four with C1,2 tuberculosis and two with C2 gaint cell tumor. All patients underwent the high anterior cervical retropharyngeal approach to expose C1C3. C2,3 fusion followed by self-locking plate was performed for Hangman fractures and C2 fractures. Ventral reduction plud posterior aflantoaxial fusion was done for irreducible atlantoaxial dislocation secondary to os odontoideum. Lesion was cleared for tuberculosis and the tumor was resected and reconstructed. The neurological funcation was evaluated according to the ASIA criteria, the JOA score and Odom' s criteria. Results Successful exposure of arch of atlas to C3 was achived in all 41 patients, with satisfactory reducation, decompression, fusion, lesion resection and reconstruction. The trauma patients with normal neurological function showed no neurological deficit postoperatively, but those with quadriparesis had partial recovery. While the patients with illness obtained marked recovery of neurological function, with the JOA score from preoperative 8.9 to 12.5 at final follow-up. The clinical success rate (excellent/good/fair) reached 94. % according to Odom' s Criteria. Hypoglossal symptom was found in three patients and facial nerve symptom in two, without wound infection. Conclusions Via the high anterior cervical retropharyngeal approach, the upper cervical spine can be thoroughly exposed to facilitate reduction, decompression and reconstruction and maximally restore physiological function of the cervical spine in treatment of the upper cervical spine injuries.

Objective To evaluate the clinical outcome of artificial cervical disc replacement and cage fusion in the treatment of multi-segmental cervical disc herniation. Methods A total of 39 patients with multi-level cervical disc herniation were treated with disc replacement and adjacent segment cage fusion at one stage. There were 29 patients with two level cervical disc herniation, nine with three level cervical disc herniation and one with four level cervical disc herniation. Of the patients, there were 17 male and 22 female, aged between 35 and 63 years ( mean age 47 years). The herniated disc was located at C3-4 and C4-5 in two patients, C4-5 and C5-6 in 15, C5-6 and C6-7 in nine, C4-5 and C6-7 in three, C3-4,C4-5 and C5-6 in four, C4-5, C5-6 and C6-7 in five and C3-4, C4-8 , C5-6 and C6-7 in one. There were 18 patients with myelopathy and 21 with radieulopathy. The stabilization and the range of motion of implanted disc,the fusion of cage and the displacement of cage were observed on dynamic radiograph postoperatively. The clinical symptom and the neurological function were evaluated according to JOA score and odom' s criteria. Postoperative clinical symptoms and daily function were evaluated by using neck disability index (NDI) scale. Results Twenty-nine patients with bi-level cervical disc herniation underwent single level disc replacement and cage fusion on adjacent segment. Nine patients with three level disc herniation underwent single level disc replacement in seven and level cage fusion on adjacent segment in two. Twopatients underwent two level disc replacement and one level cage fusion. One patient with four level disc herniation was treated with two level disc replacement and two level cage fusion. The patients were followed up for from 6 moths to 3 years, which showed that definite stabilization was achieved for all disc with average range of motion for 9.3 degrees postoperatively. Solid fusion was achieved in all cage, with no subsidence or displacement of cage. The JOA score was increased from 9.1 to 13.2 at final follow up and the NDI (neck disability index) score decreased from 41.8 reduced to 29.5 at final follow up. The clinical success rate (excellent/good/fair) according to Odom' s Criteria was 85%. Conclusion Cervical disc replacement and cage fusion can attain definite stabilization and satisfactory mobility and provide a new effective treatment for cervical disc herniation. The long-term outcome needs further clinical followup.

Objective To measure the phase values of the deep gray nuclei by using susceptibility weighted imaging(SWI) in underage brains,and to investigate the correlation between the phase value and age.Methods A total of 105 healthy juveniles were examined in this study by using MRI conventional sequence and SWI.Their ages ranged from 0 to 18 years(0-＜ 1 year,60 cases; 1-＜3 years,10 cases; 3-7 years,10 cases; 7-12 years,10 cases; 12-18 years,15 cases).Phase values of deep gray nuclei were measured.The correlation between phase value and age was analyzed by Spearman correlation method.Results During 0-3 years,the phase value of caudate nucleus was the lowest within the same age group (0-＜ 1 year:left-0.0433 ± 0.0291,right-0.0369 ± 0.0215 ; 1-＜ 3 years:left-0.0369 ± 0.0215,right-0.0384 ± 0.0259),whereas the phase value of red nucleus was the highest (0-＜ 1 year:left 0.0286-0.0380,right 0.0254 ±0.0361 ; 1-＜3 years:left 0.0325 ±0.0237,right 0.0395 ±0.0270).After 3 years old,the phase value of globus pallidus was the lowest within the same age group (3-＜7 years:left-0.0967 ± 0.0656,right-0.0953 ± 0.0617; 7-＜ 12 years:left-0.1870 ± 0.0531,right-0.1724 ±0.0547; 12-＜ 18 years:left-0.2037 ±0.0492,right-0.1849-±0.0324),whereas the phase value of thalamus was the highest (3-＜ 7 years:left-0.0019 ± 0.0225,right -0.0007 ± 0.0167 ; 7-＜ 12 years:left-0.0067 ± 0.0104,right-0.0064 ± 0.0118 ; 12-＜ 18 years:left-0.0204 ± 0.0181,right-0.0172 ± 0.0133).During 0-18 years,a moderate negative correlation between phase values of bilateral caudate nucleus,globus pallidus,red nucleus,substantia nigra and age were observed (rs =-0.483,-0.497,-0.67,-0.621,-0.489,-0.43,-0.552,-0.58 respectively) A low negative correlation between phase values of bilateral putamen,thalamus and age were observed (rs =-0.272,-0.213,-0.382,-0.366 respectively).Conclusions There is a negative correlation between phase value and age in the deep gray nuclei of underage brains.And the phase value may be a useful index in the diagnosis of iron deposition related diseases.

Objective To explore the clinical application and diagnostic efficiency of two-dimensional shear wave elastography (2D-SWE) in assessing liver fibrosis of patients with viral and non-viral hepatitis. Methood Seventy-three patients with viral hepatitis and sixty with non-viral hepatitis scheduled for liver biopsy in the third Affiliated Hospital, Sun Yat-Sen University from April, 2011 to January, 2013 were enrolled in this study. The Young's modulus in different fibrosis stages, correlation coefficients of liver fibrosis level and area under receiver operating characteristic curve (ROC) were compared between patients with viral and non-viral hepatitis respectively. Results The hepatic Young's modulus of patients with viral and non-viral hepatitis in S0-1, S2-3, S4 were 6.1(4.8-6.6)kPa,7.4(6.0-8.4)kPa,10.3(7.6-14.0)kPa, and 10.7(8.0-13.5)kPa,24.7(17.4-32.1)kPa,26.8(16.5-31.7)kPa, respectively. The difference of Young's modulus between viral and non-viral hepatitis in S0-1 were statistically significant (Z=-3.45, P=0.001), while not in S2-3 and S=4 (Z=-0.40, -0.06, P=0.686, 0.956). Correlation coefficients of liver fibrosis with 2D-SWE in viral and non-viral hepatitis are 0.964,0.817 ( both P=0.000 ) with statistically significant difference (Z=2.42, P=0.015). The area under ROC for S≥2 and S=4 in viral and non-viral hepatitis were 0.964 and 0.930,0.817 and 0.906 respectively. The comparison was significantly different for S≥2 (Z=-2.47, P=0.014), while not for S=4 (Z=-0.502, P=0.616). Conclusion In liver fibrosis assessment, the diagnosis efficiency of 2D-SWE in patients with viral and non-viral hepatitis was different and dependent on fibrosis stage.

Objective To determine the activities of 131I for treating differentiated thyroid carcinoma with diffuse pulmonary metastases ( DTC-DPM ) from the perspective of internal radiation dosimetry.Methods According to Medical Internal Radiation Dosimetry (MIRD) schema, the activity constraint,from which the whole bdy retention at 48 h should not exceed 2.96 GBq (2.96 GBq rule), was converted to dose-rate constraint(DRC) to lungs at 48 h ( DRCLU ·48 h ) in 131I therapy for DTC-DPM. Based on the assumption of DRCLU·48 h at 48 h in lung, the fractions of whole body activities ( F48 ), the effective half times of 131I in lungs ( TLL ) and the remainder of body ( TRB ) were 0.6-0.9, 20- 120 h, and 10- 20 h, respectively. The maximum safe activities of 131I for different human phantoms from the Organ Level Internal Dose Assessment (OLINDA) software were calculated. Results According to MIRD schema and 2.96 GBq rule, DRCLU ·48 h should not exceed 46.4 mGy/h in 131I therapy for DTC-DPM. Depending on varying F48 h,TLL and TRB, the maximum safe activities of 131I were 6.77-81.36, 5.29-56.20, 5.08-55.19 and 3.87-40. 52 GBq for the male adult, female adult, 15-year-old, and 10-year-old patients with DTC-DPM, respec tively. Conclusion Dosimetry-guided 131I therapy for DTC-DPM considers adequately the differences of 131I kinetics in individual patients and can adjust administered activities of 131I on the precondition of avoiding radiological pneumonitis and pulmonary fibrosis.

Objective To compare the diagnostic value of adenosine and exercise stress myocardial perfusion imaging (MPI) for detecting coronary heart disease (CHD) in women. Methods One hundred and thirty-eight patients with CHD were randomly divided into two groups: adenosine stress group (n = 69)and exercise stress group (n = 69). All patients underwent myocardial SPECT evaluation. Coronary angiography (CAG), referred as "gold standard" , was performed in each patient within 1 week before or after MPI. The diagnostic value of the two stress MPI was compared with χ2 test or Fisher's exact test. Results In adenosine stress group, the sensitivity, negative predictive value and accuracy were 88.2% (45/51),72.7% (16/22), 88.4% (61/69), respectively, which were not significantly different from those of the exercise stress group (91.7% (44/48), 66.7% (8/12), 81.2% (52/64); χ2 =0. 571, 0. 714, 0.249, P >0.05). However, the false positive rate of adenosine stress (11.1%, 2/18) was significantly lower than that of exercise stress (50.0%, 8/16), P = 0.023. Conclusions Adenosine and exercise stress MPI have similar value for CHD diagnosis in women, however, adenosine stress MPI may have an advantage of low false positive rate.

OBJECTIVE: To elucidate the correlation between CKLF-like marvel transmembrane domain containing member (CMTM5) gene and the risk of in-stent restenosis (ISR) with coronary artery disease (CAD) patients and to detect the effects and mechanisms of CMTM5-stimulated genes on human vascular endothelial cells (ECs) proliferation and migration. METHODS: A total of 124 hospitalized patients in Shijitan Hospital were enrolled in this study. All the CAD patients were detected with platelet reactivity and grouped into two groups according to platelet reactivity; ISR was conformed by coronary angiography; RT-PCR method was used to detect CMTM5 gene expression; The CMTM5 over expression, reduction and control EC lines were established; Cell count, MTT, Brdu and flow cytometry methods were used to detect the proliferation of ECs, scratch and transwell experiments to test the migration of ECs, Western blot was used to detect signal path expressions. RESULTS: CMTM5 gene expression in HAPR (High on aspirin platelet reactivity) group was 1.72 times compared with No-HAPR group, which was significantly higher than No-HAPR group. HAPR group ISR rate was 25.8% (8 cases), the incidence of No-HAPR ISR group was 9.7% (9 cases), and the results showed that in HAPR group, the incidence of ISR was significantly higher than that in No-HAPR group (P=0.04, OR=0.04, 95%CI=1.16－7.52), which showed that CMTM5 gene was significantly correlated with the risk of ISR. In HAPR group ISR rate was 25.8% (8 cases), the incidence of ISR in No-HAPR group was 9.7% (9 cases), and the results showed that the risk of ISR in HAPR group was significantly higher than that in No-HAPR group. All the results showed that CMTM5 was significantly correlated with the risk of ISR in CAD patients (P < 0.05). CMTM5 overexpression inhibited the proliferation and migration ability of ECs (P < 0.05), PI3K/Akt signaling pathways were involved in the role of regulation on ECs. CONCLUSION Our results revealed that CMTM5 gene was closely related with ISR, CMTM5 overexpression may repress ECs proliferation and migration through regulating PI3K-Akt signaling.
Chemokines ; Coronary Artery Disease/surgery* ; Coronary Restenosis ; Drug-Eluting Stents/adverse effects* ; Endothelial Cells ; Humans ; MARVEL Domain-Containing Proteins ; Phosphatidylinositol 3-Kinases ; Tumor Suppressor Proteins