Choroidal neovascularization (CNV) ithe leading cause of vision disordecaused by variouretinal diseases.Apresent,many therapeutimethodare employed clinically,such aphotodynamitherapy (PDT),anti-vasculaendothelial growth facto(anti-VEGF) and transpupillary thermotherapy (TTT).However,none of them can cure CNV thoroughly and repeated treatmenirequired usually.The reason forecurrenCNV istill unclear.Choroidal hypoperfusion associated with Pdmay be one of the reasons.The purpose of thireview ito discusthe problem of choroidal hypoperfusion associated with PDfoCNV awell aitimpacon the eye and possible solutions.Thipapepresentevidenceof choroidal hypoperfusion aftePDand itrelationship with clinical outcomes.Meanwhile,the effecof combination therapy iassessed.Finally,low-fluence Pdirecommended apotential method to reduce choroidal hypoperfusion.

Blood Cells ; immunology ; pathology ; Bone Marrow Cells ; immunology ; pathology ; Child, Preschool ; Diagnosis, Differential ; Female ; Humans ; Immunophenotyping ; Leukemoid Reaction ; diagnosis

BACKGROUNDMediastinoscopy has experienced a renaissance due to the introduction of neoadjuvant treatment protocols and recognition of the limitations of noninvasive mediastinal staging of lung cancer by CT and PET. The aim of this study is to determine the value of video-mediastinoscopy in mediastinal staging of lung cancer.

METHODSA total of 60 patients who underwent video-mediastinoscopy for known or suspected lung cancer were retrospectively reviewed. There were 52 cervical mediastinoscopies, 2 parasternal mediastinoscopies and 6 combined procedures. All the patients were found to have enlarged mediastinal lymph nodes on radiographic examination of the chest (more than 1.0cm on its shortest axis).

RESULTSOf the 60 patients, 42 patients were found with N2 or N3 disease on video-mediastinoscopy and then were confirmed pathologically. The other 18 mediastinoscopy-negative patients underwent thoracotomy for pulmonary resection and mediastinal lymph node dissection in the same operative session, in which thoracotomy-proven N0 was found in 17 patients, and N2 in 1 patient (false-negative result by video-mediastinoscopy). The sensitivity, specificity, and accuracy of video-mediastinoscopy for mediastinal staging of lung cancer were 97.7%, 100% and 98.3%, respectively. In the entire group of 60 patients, there was 1 complication (1.7%) , and no perioperative death.

CONCLUSIONSVideo-mediastinoscopy is a highly effective and safe procedure. It can be used routinely in mediastinal staging of lung cancer.

Objective To analyze the results of distal tibial pilon fractures treated with delayed open reduction and internal fixation. Methods From September 1997 to May 2001, 26 pilon fractures were stabilized temporarily by application of plaster splint, bandage, calcaneal traction (closed fracture) or unilateral external fixations (open fracture) immediately after injury. There were 19 males and 7 females with an average age of 37.6 years ( 15 to 58 years). Of 26 cases, 6 were open fractures and 20 close fractures, 18 of which were associated with fibular fracture. According to Ruedi-Allgower classification, the fractures were classified as typeⅠin 2, typeⅡin 15, and typeⅢ in 9. The conditions of soft tissue were divided into mild close injury without tension vesicle in 8, and severe injury with tension vesicle or open wound in 18. The definitive internal fixations were performed on an average of 10.2 days (range, 7 to 15 days) after injury as soon as the soft tissue recovered. The final outcomes of treatment were evaluated based on clinical rating and radiographic results. Results All patients were available for follow-up at an average of 3.8 years (range, 2 to 5.5 years) after surgery. All fractures healed at an average of 12.7 weeks (range, 8 to 29 weeks) postoperatively. There were 9 excellent(34.6%), 12 good (46.2%), 3 fair (11.5%), and 2 poor (7.7%) results according the ankle score of Teeny and Wiss. The results were significantly affected by the type of fracture and the severity of soft tissue injury, the excellent and good rate was 88.2% in typeⅠandⅡ, and 66.7% in typeⅢ; the total excellent and good rate was 100% in the patients with mild soft tissue injury, and 72.2% in the patients with severe soft tissue injury. The complications including 2 wound superficial infection and 1 skin necrosis, occurred in 3 patients(11.5%), which were successfully treated by local dressing changes. The incidence of osteoarthritis were found in 16 patients (61.5%) showed by X-ray films, but the radiographic manifestations did not correspond well with the clinical score. Conclusion This two-stage treatment protocol for pilon fracture has some advantages of fewer complications and good function.

A blood film slide taken from a patient previously diagnosed as vivax malaria in Mojiang County, Yunnan Province, showing atypical forms. The ring forms had multinuclei, and the late trophozoites trended to form band. The schizonts and gametocytes were somewhat alike to Plasmodium vivax. PCR amplification confirmed that the patient was infected by P.knowlesi.

Objective To evaluate the efficacy and value of mediastinoscopy in the diagnosis of superior vena cava obstruction syndrome (SVCOS). Methods 12 patients with SVCOS underwent mediastinoscopy. This group consists of 9 males and 3 females aged 16 to 71 years. 7 cervical mediastinoscopies and 5 parasternal mediastinoscopies were performed. Results In eleven patients, definite pathological diagnosis was obtained, included: primary lung cancer in 8, lymphoma in 3 and invasive thymoma in 1. There were no operative morbidity and mortality. Only in 1 patient with lymphoma the symptom got worse after cervical mediastinoscopy and soon released by chemotherapy. Conclusion Mediastinoscopy is an effective method in the diagnosis of SVCOS.It can be considered as a routine procedure if other methods failed.

AIM: To study the visual quality, dry eye and biomechanical stability of patients with myopia and astigmatism after different corneal refractive surgeries. ·METHODS: A total of 986 patients with myopia and astigmatism were selected as the research object in our hospital from July 2015 to July 2016, according to the operation mode of the selection of the research object, the 986 patients were randomly divided into small incision lenticule extraction ( SMILE) group, femtosecond laser in situ keratomileusis ( FS-LASIK ) group, sub-bowman-keratomileusis ( SBK ) group and laser-assisted in situ keratomileusis ( LASIK ) group. The postoperative visual quality was determined by comparing the diopter, uncorrected visual acuity ( UCVA ) , best corrected visual acuity ( BCVA) and high-order image difference of 25d, 90d. The postoperative dry eye condition was determined by comparing the postoperative tear secretion test ( Schirmer Ⅰ test ) , tear film rupture time ( BUT ) and fluorescence staining ( FS) . The biomechanical stability of the patients was determined by comparing the corneal hysteresis ( CH ) and corneal resistance factor ( CRF ) values of the four groups. ·RESULTS: The diopter, UCVA, BCVA and high-order aberration comparison of FS-LASIK group, SBK group and LASIK group between before and after surgery, showed no significant difference ( P>0. 05 ); on diopter, BCVA, UCVA, there was no significant difference between before and after surgery in SMILE group (P>0. 05), but statistical significance difference on high order aberration (P<0. 05). The BUT and FS value of the four groups decreased obviously after operation, and the difference was statistically significant (P<0. 05). In LASIK group SIt after operation significantly decreased, with statistically significant compared with that before operation ( P <0. 05). After operation, CH and CRF of the four groups decreased with significant differences (P<0. 05). ·CONCLUSION: SMILE, FS-LASIK, SBK and LASIK are equally safe, effective and stable in the treatment of myopia and astigmatism.

The incidence of birth defect in China is still high,which is not only affected by genetic factors,but also affected by heavy metals in surrounding that prejudices foetus' normal development.Heavy metal is a kind of inorganic pollutants with high toxicity.Excessive intake of lead,cadmium,arsenic or mercury,and the insufficient intake of zinc,calcium and copper may both lead to at least 1 kind of birth defect.The interactions between heavy metals also affect the outcomes of pregnancy.This paper reviewed different relationships between heavy metals and birth defect recording to relevant achievements such as animal experimentations and epidemiologic study made by researches from at home and abroad in recent years.It is advised to intake adequate zinc and copper and avoid being exposed to harmful metals to make sure the effective reduction of the incidences of birth defects.This paper will also point out the direction of future research about the relationship among the birth defects and heavy metal.

Inhibitors of epidermal growth factor have played an important role in the treatment of oncology.One of the most common adverse effects is aeneform eruption.This article reviews the incidence,clinical manifestation, mechanism and management for acneform eruption which related to inhibitors of epidermal growth factor.

Cell swelling activates or upregulates a number of anion channels. Of the volume-activated or-regulated anion channels, the volume-sensitive outwardly rectifying anion channel (VSOR) is most prominently activated and ubiquitously expressed. Volume regulated chloride channels play significant roles in a variety of physiological processes including volume regulation, proliferation, differentiation, migration,apoptosis and resistance of tumor cells. Molecular identification and activation mechanisms of VSOR are poorly understood. Many signaling molecules have been shown to regulate VSOR activity in research, playing permissive or modulatory roles. Therefore, VSOR may be a new anticancer target by identifying its signaling molecules and activation mechanisms.