To observe the incidence of high intraocular pressure ( lOP ) and its risk factors in the early stage (within 7d) after 23 - gauge sutureless microincisional vitrectomy.
●METHODS: Retrospective case series study. Totally 98 patients ( 98 eyes ) who had undergone 23 - gauge sutureless microincisional vitrectomy were enrolled. lOP was measured by non-contact tonometry. High lOP was defined as an lOP > 25mmHg at any time within 7d after surgery. The influence of age, sex, side of operation, course of disease, primary disease pre - operation, reoperation, surgical options, type of tamponade, status of lens, surgical time on postoperative high lOP were analyzed.
● RESULTS: High lOP was found in 33 eyes ( 33. 7%) within 7d after surgery. High lOP was found in 8 eyes on postoperative 1d, the incidence was 24. 2% (8 / 33), and 25 eyes was found on postoperative 3d, the incidence was 75. 8% (25 / 33). The incidence of high lOP of male and female were 32. 8% ( 20 / 61 ) and 35. 1% ( 13 / 37 ) respectively. The incidence of high lOP of right and left eye were 36. 8% (21 / 57) and 29. 3% (12 / 41) respectively. There were no significant differences comparing age (Z =-0. 22), sex( χ2 = 0. 057), side of operation( χ2 = 0. 612), course of disease (Z= -0.079) and surgical time (Z= -0. 553) between patients with high lOP and those without it (P>0. 05). Similarly, no statistical significance was found between eyes with gas tamponade and silicone oil tamponade (χ2 = 1. 04), traumatic eyes and non traumatic eyes(χ2 = 0. 044), and retinal detachment eyes and without retinal detachment eyes ( χ2 = 2. 282, P > 0. 05 ). The incidence of high lOP in eyes with several operations was higher than that in eyes with the first operation ( χ2 =5. 211,P< 0. 05), in eyes with combined operations eyes was significantly higher than that in eyes with pure vitrectomy (χ2 = 4. 57,P< 0. 05), and in eyes with aphakic eye was higher than that in eyes with phakic eyes ( χ2 =4. 224,P<0. 05).
●CONCLUSlON:High lOP occurs commonly in 3d after 23- gauge sutureless microincisional vitrectomy. The risk factors of high lOP are reoperation, combined operations and aphakic eye.

OBJECTIVETo investigate the apoptosis effect of diffuse large B-cell lymphoma cell line (DLBCL) SUDHL-4 induced by IL-21 and its related mechanism.

METHODSSUDHL-4 cells were treated with IL-21 at different concentration (1000 ng/ml, 100 ng/ml, 10 ng/ml, 1 ng/ml) for 24 h, 48 h, 72 h, respectively. The inhibitory rate of cell proliferation was detected by CCK-8 assay. The cell growth curves were drawn and half inhibitory concentration (IC(50)) values were calculated. The cell apoptosis were detected by flow cytometry (FCM), the expression of the caspase-9, caspase-3, cleaved caspase-3, Bcl-2, Bcl-XL, Bid, Bax and c-myc protein in SUDHL-4 cells treated with IL-21 by western blot, the mRNA expression of Bcl-2, Bcl-XL, Bid, Bax, c-myc by Survivin gene with RT-PCR.

RESULTSIL-21 markedly inhibited SUDHL-4 cell growth in a time- and dose-dependent manner. The 48 hIC(50) was 140.9ng/ml; The FCM showed that the apoptosis proportion of SUDHL-4 cells treated with 100 ng/ml of IL-21 apoptosis (AnnexinV-FITC(+) positive cells) gradually increased (48 h: 19.7 ± 2.3%). The protein expression of caspase-9, caspase-3, Bcl-2 and Bcl-XL decreased in a time-dependent manner. The Bax and c-myc protein markedly increased, but the Bid protein level did not change. IL-21 up regulated c-myc and Bax gene expression, however down regulated Bcl-2 and BCL-XL gene expression, but the gene expression of Bid and Survivin hadn't been changed significantly.

CONCLUSIONSIL-21 can inhibit proliferation and induce apoptosis of SUDHL-4 cell. The mechanism may involve in endogenous mitochondrial pathway mediated by the c-myc and the Bcl-2 genes.

Apoptosis ; drug effects ; Caspase 3 ; metabolism ; Caspase 9 ; metabolism ; Cell Line, Tumor ; Humans ; Interleukins ; administration & dosage ; pharmacology ; Lymphoma, Large B-Cell, Diffuse ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; bcl-X Protein ; metabolism

This study was aimed to investigate the impact of specific siRNA on survivin gene in transfected lymphoma cell line and provide experimental evidences for future treatment of mantle cell lymphoma. The small interfering RNA (siRNA) targeted survivin mRNA was synthesized in vitro and was transfected into Jeko-1 that showed high survivin expression in mRNA level. The levels of survivin mRNA and protein expression were detected by quantitative reverse transcription polymerase chain reaction (RT-PCR) and Western blot respectively. The apoptosis effect was examined by calculating the ratio of Annexin V-FITC/PI positive cells using flow cytometry. The inhibition of cell proliferation was assayed with CCK-8 reagent after transfection. The results showed that expression of survivin mRNA was markedly suppressed by the siRNA. The relative expression levels were 0.49 ± 0.03, 0.38 ± 0.02 and 0.17 ± 0.02 at time points of 24, 48 and 72 h respectively, compared with the control group; the inhibitive rates of cell proliferation were (31.2 ± 2.1)%, (43.3 ± 3.4)% and (52.6 ± 2.5)%; the apoptotic rates of cells were (6.3 ± 0.5)%, (13.5 ± 1.1)% and (23.6 ± 1.6)% respectively; survivin protein expression levels were gradually reduced. It is concluded that the siRNA targeting survivin down-regulates the expressions of survivin mRNA and protein evidently. The siRNA of survivin displays the potent ability to inhibit the proliferation of lymphoma cell line Jeko-1; survivin may become a potential molecular target for the therapy of lymphoma in the future.
Cell Line, Tumor ; Cell Proliferation ; Gene Silencing ; Humans ; Inhibitor of Apoptosis Proteins ; genetics ; RNA, Messenger ; genetics ; RNA, Small Interfering ; genetics ; Transfection

Objective To obtain scientific data for control of iodine deficiency disorders(IDD) by reviewing the surveillance information of school children intelligence quotient(IQ) after the implementation of universal salt iodization. Methods One thousand five hundred and eighty children were selected from 11 primary school in Dalian city of Liaoning province during 2006 to 2009. IQ was measured by Combined Raven Test-C2(CRT-C2) in China. Groups of IQ were classified as outstanding(≥ 130), excellent (120- 129), above average (110- 119), average (90 - 109), below average(80 - 89), margin(70 - 79), low(≤69). Urinary samples of children were collected randomly. Urinary iodine were determined by As-Ce catalytic spectrophotometry. The growth characteristics of IQ were analyzed according to surveillance year and born year. Results The average IQ of children aged 8-10 were 110.4 ± 14.0,112.5 ± 12.4,117.2 ± 11.4,116.2 ± 12.6, respectively, increased year by year from 2006 to 2009. Its average annual increase from 2007 to 2009 were 2.1,3.4,1,9 compared with the IQ in 2006 respectively. The medians of urinary iodine were 224.7,266.7,222.1 μg/L from the year 2007 to 2009, respectively, which were all between 200 - 300 μg/L and can be classified as more than adequate level. The average IQ of children born during the year of 1994 to 2000 were 106.7 ± 13.0,108.1 ± 13.9,108.5 ± 13.4,111.3 ± 14.3,113.6 ± 12.5,115.3 ± 12.3,119.8 ± 11.2, respectively. Its average annual increase from 1995 - 2000 were 1.4,0.9,1.5,1.7,1.7,2.2 compared with the IQ born in 1994 respectively. The ratio of IQ in margin group and low group were all below 2% ; the ratio was increasing in excellent group and outstanding group and decreasing in average group and below average group significantly year after year(x2 = 52.471,34.329,66.483,11.148, all P<0.01). Conclusions Universal salt iodization improves IQ scores. IQ index should be brought into the surveillance project and put in use in IDD control.

Objective To explore the incidence and distribution features of neonatal phenylketonuria(PKU) and congenital hypothyroidism(CH) in Lianyungang area.Methods The heel blood samples dried on filter paper was collected from newborns after 72 hours.As the screening indicators,PKU was detected through serum phenylalanine concentration(Phe) detection by Guthrie′s bacterial inhibition assay and CH was detected through serum thyroid stimulating hormone(TSH) levels detection by time-resolved fluorometry(TRFIA) or enzyme linked immunosorbent assay(ELISA).Results Sixty-four children with CH were diagnosed and the rate of CH was 1∶2423,41 patients were examined by thyroid gland nuclein kinescope picture,among which there were 23 patients whose thyroid glands were unusal.These patients lived in 45 towns(streets),which had no difference between men and women,city and country side.A couple of twins were screened for CH;15 cases of PKU was detected with an incidence of 1∶10 339.These patients′ parents were neither consanguineous marriage nor dominance hereditary family history.Their physical and mental development were similar to the same age children after interventive treatment.Conclusions The distribution of CH and PKU is diffuse in Lianyungang.Neonatal screening is the only valid means to find patients with CH and PKU.

ObjectiveTo evaluate the effectiveness of transcatheter Amplatzer device closure on patent ductus arteriosus(PDA),and to give some evidences for the clinical application.MethodsAll studies in the world regard to the controlled trials(CT) about transcatheter Amplatzer device closure and cardiac surgery on PDA were searched and made synthetic evaluation by means of Meta-analysis.RevMan 4.2.2 software was used for statistical analysis.Cases relative risk(RR)and its 95% confidence interval(CI)of procedure failure,the incidence of complication and residual shunt were calculated.ResultsTotally 5 studies including 349 cases were analyzed.Operation failure of Amplatzer device occlusion was higher than cardiac surgery [5 CT,349 cases,3.0% vs 0,RR=4.29,95%CI(0.77,23.95)](P=0.10).Incidence of complication of Amplatzer device occlusion was lower than cardiac surgery[5 CT,343 cases,3.1% vs 38.0%,RR=0.11,95%CI(0.05,0.23)](P

Objective To investigate the characteristics of common causes of acute pancreatitis (AP) in China and to evaluate the association of the aetiology with the severity of disease.Methods The relevant literature was searched from the China National Knowledge Infrastructure (CNKI) database (1989.1-2015.3),WANFANG database (1999.1-2015.3),VIP database (1994.1-2015.3),and China Academic Journal Network Publishing Database (CAJD).To collect related literature about aetiology and the severity of acute pancreatitis,Meta analysis was performed for gallstone,alcohol,hyperlipidemia and other AP from the aspects of the severity of disease in the literature which reaches the criteria.Results The Meta analysis included 24 clinical articles which were accordance with the criteria,totally 17359 patients,including 8673 cases of biliary AP [6690 cases of mild acute pancreatitis (MAP),1983 cases of acute necrotizing pancreatitis (ANP)],1408 cases of alcoholic AP (1022 cases of MAP,386 cases of ANP),1753 cases of hyperlipidemia AP (1107 cases of MAP,646 cases of ANP),and 5525 cases of other aetiology (4179 cases of MAP,1346 cases of ANP).The Meta analysis showed that among the common causes which was developed to AP,there was significant difference between biliary AP and alcohol AP (OR =0.65,95％ CI:0.45 ～0.93,P ＜ 0.05).There was significant difference between biliary AP and hyperlipidemia AP (OR =0.51,95％ CI:0.33 ～0.79,P ＜0.05).However,there was no significant difference between alcoholic AP with hyperlipidemia AP (OR =0.70,OR =0.70,95％ CI:0.46 ～ 1.05,P ＞ 0.05).Conclusions There is difference in the severity of AP caused by different reasons in China.There is more likely that hyperlipidemia AP and alcohol AP easily developed into ANP than biliary AP.However,further investigation and large-scale clinical trials will be needed to confirm this conclusion.

Objective: To assess the clinical efficacy of Xuebijing injection in the prevention of postoperative systemic inflammatory response syndrome (SIRS) in the patients with ureteral stones and urinary tract infection during the perioperative period of ureteroscopy.Methods: Totally 64 cases with ureteral stones complicated with urinary tract infection treated with ureteroscopy were selected as the subjects and divided into two groups according to the digital method.The 32 cases in the control group were given the conventional antibiotics during the perioperative period for preventing the incidence of SIRS, and the observation group was given 500ml Xuebijing added to 100ml normal saline for intravenous drip additionally.The incidence of SIRS and the laboratory indicators after the operation were observed and compared between the groups.Results: The incidence of postoperative SIRS of the observation group was 9.38% , which was lower than that of the control group (34.38% , P <0.05);the incidence of sepsis of the observation group was 0%, while there was no statisticcally difference bettween the two groups(P＞0.05).The C-reactive protein (CRP), procalcitonin (PCT), leucocyte count and endotoxin in the observation group on the 2nd, 4th and 6th day after the operation were better than those in the control group, and the difference was statistically significant (P＜0.05).Conclusion: Xuebijing injection combined with antibiotics has significant clinical effect on the incidence of SIRS after ureteroscopy in the patients with ureteral stones and urinary tract infection, which can effectively improve the clinical indicators and reduce the incidence of sepsis, and is worthy of clinical promoted application.

AIM:To investigate the effects and mechanism of anti-vascular endothelial growth factor ( VEGF) assisted pars plana vitrectomy ( PPV) in the treatment of proliferative diabetic retinopathy ( PDR) . ·METHODS: A total of 92 patients ( 92 eyes ) with PDR treated by PPV were divided into the simple PPV group (41 patients with 41 affected eyes) and the combined treatment group ( 51 patients with 51 affected eyes ) according to whether the patient underwent intravitreal injection of Ranibizumab ( IVR) . The combined treatment group was treated with IVR at 5-7d before PPV. The surgical time, times of electrocoagulation, silicone oil filling rate, the incidence of postoperative complications, LogMAR BCVA of affected eyes, levels of VEGF and pigment epithelium derived factor ( PEDF ) in aqueous humor and vitreous body were compared between the two groups. ·RESULTS:The surgical time was shorter, the times of electrocoagulation was less, the silicone oil filling rate and the incidence rates of iatrogenic retinal hole and vitreous body hematocele were lower in the combined treatment group than in the simple PPV group (P<0. 05). Levels of VEGF and PEDF in aqueous humor and vitreous body of the combined treatment group during PPV were lower than those in the simple PPV group (P<0. 05). The LogMAR BCVA of the affected eyes of the combined treatment group in 3mo after surgery was better than that of the simple PPV group (P<0. 05). ·CONCLUSION:IVR combined with PPV can reduce the perioperative levels of VEGF and PEDF, reduce the times of electrocoagulation and the incidence of iatrogenic retinal hole and vitreous body hematocele, and improve the visual acuity of patients with PDR.

Objective To discuss the clinical management and significance of the prenatal diagnosis of Fetal Choroid Plexus Cysts(CPC).Methods From May 2004 to March 2007,55 cases of fetal CPC diagnosed by B-ultrasound during second trimester were prospectively studied.Each case was studied regarding fetal chromosome karyotype,disappearance weeks of the cyst,the clinical outcome and follow-up results respectively.Result The cases were diagnosed during 16-25 gestational weeks.The diameters of the cysts varied from 0.2 cm to 2.4 cm.There were 25 cases of bilateral cysts and 30 cases of unilateral or 50 cases of isolated CPC and 5 cases of complicated CPC.The cysts of all cases who continued pregnancy disappeared before 28 weeks.Fetal chromosome karyotypes were obtained in 50 cases.Among them,two cases were 18-trisomy,and one case was 21-trisomy.Five cases were terminated pregnancy because of abnormal chromosome karyotype or malformation during second trimester.One neonate was diagnosed as ventricular septal defect among 50 cases of follow up.Among these six cases,three were from advanced-age pregnant women,five cases were with abnormal fetal structure and five cases were with the diameter of bilateral or unilateral cysts more than 1.0 cm.Conclusion(1)Fetal CPC can be diagnosed during second trimester,and the majority disappear before 28 gestational weeks.(2)High risk factors for fetal abnormal chromosome karyotype may be:advanced-age pregnant women,abnormal structure of fetus,and the diameter of bilateral or unilateral cyst more than 1.0 cm.It is suggested that fetal CPC with the high risks should receive fetal chromosome karyotype test during pregnancy.