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 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.

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 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 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.

BACKGROUND: Bone implant materials have been previously reported to be not coincident between inducing velocity of new bone formation and degradation velocity itself; therefore, the materials could not be completely degraded but formed into foreign substances. A novel artificial bone implant material, characterizing by well biocompatibUity, biodegradation, and biomechanics, is focused in biomaterials field recently.OBJECTIVE: To study the biodegredation of a novel bionic scaffold with nanostructure, i.e., poly (3-hydroxybutyrate-co-3-hydroxyvalerata)/sol gel bioactive glass (PHBV/SGBG), in vivo. DESIGN, TIME AND SETTING: A controlled animal experiment was performed at Animal Experimental Center of the Third Hospital affiliated to Sun Yat-sen University from May 2005 to October 2006. MATERIALS: PHBV/SGBG was provided by Materials Institute of South China University of Technology, and ethylene oxide was sterilized for preparation.METHODS: Eight hybrid dogs were used to make models of Ubia diaphyseal defect, having two defects on both left and right sides. The tibia diaphyseal defects at proximal part were considered as the control group, and those were not performed with any treatment; while, the tibia diaphyseal defects at distal part were considered as the experimental group, and PHBV/SGBG was fully implanted into the defect regions. Every two dogs were sacrificed at different time points of 2, 4, 8, and 12 weeks, respectively. MAIN OUTCOME MEASURES: In vivo biodogradation and osteogenesis were monitored under optic microscopy and electron microscope.RESULTS: The PHBV/SGBG scaffold had well biodegradation and rapid degradation velocity, and it began to degrade at two weeks after operation. The PHBV/SGBG scaffold was almost replaced by new bone tissues at 8 weeks after operation and completely degraded at 12 weeks after operation. In addition, the PHBV/SGBG scaffold had a good ability to induce new bone formation from edge to center. Whereas, surface depression in the defect region was still visible in the control group, cortical bone was not formed in embedded region of soft tissue; furthermore, electron microscopy demonstrated that calcium salt deposition was increased in the bone defect region, and the structure was tight; however, the defect was not completely repaired, and some voids were still visualized.CONCLUSION: The novel bionic scaffold, PHBV/SGBG, degrades fast in vivo to generate new bone tissues. The new bone regenerate accompanied by a fitting degradation of the novel bionic scaffold that achieve complete repair.

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 visual field outcome and refractive status of patients with retinopathy of prematurity (ROP) treated by laser photocoagulation.Method The data of 39 ROP patients (73 eyes) who received laser photocoagulation were retrospectively analyzed and compared with 13 normal control subjects (25 eyes) whose age and sex were matched with ROP group.There were 24 males (45 eyes) and 15 females (28 eyes) in ROP group,with an average age of (7.0± 1.28) years.The first laser treatment was carried out at postnatal age (PA) of (38.74±3.82) weeks,the birth weight (BW) of (1402.33 ±369.61) g and the number of laser burns was (517.86 ± 277.40).The control group included 7 females (13 eyes) and 6 males (12 eyes),with an average age of (7.17 ± 0.96) years.The age (t=0.691) and gender (x2=1.425) were comparable between the two groups (P=0.491,0.233).The data of patients and controls were retrospectively analyzed including best corrected visual acuity,refractive examination,automated perimetry test.The differences of the mean deviation (MD) of visual field and the spherical equivalent (SE) between these two groups were comparatively observed.ROP patients were divided into no VF loss group (MD≤2 dB) and VF loss group (MD＞2 dB),mild VF loss group (MD ≤ 6 dB) and moderate VF loss group (MD ＞6 dB) according to the results of automated perimetry test,the differences of gestational age (GA),PA,BW,number of laser burns and SE between these groups were comparatively observed.Results The MD in ROP group and control group were 4.87±5.12 dB and 1.27 ± 3.34 dB,respectively;the difference between the two groups was statistically significant (t=-4.01,P＜ 0.001).The subgroup analysis showed that BW,number of laser burns,and SE were significantly different between no VF loss group and VF loss group (t=2.074,-1.996,-2.162;P=0.042,0.026,0.034);while the GA was not significantly different between these two groups (t=1.973,P=0.052).The difference of PA was not statistical significant different between mild VF loss group and moderate VF loss group (t=2.03,P=0.051) and SE was significantly different between the above two groups (t=3.283,P=0.002).For refractive outcomes,the BW and ROP stage correlated with SE significantly (r=-0.304,-0.387;P=0.015,0.002).The mean BCVA in ROP group was 0.84±0.23,and 59 eyes (91.2％) with BCVA better than 0.5.Conclusion Laser treatment for ROP tends to have less effect on long term refractive status and VF loss,with good visual outcome.