Objective To evaluate ocular surface changes following minimal vitreoretinal surgery in postmenopausal women patients with proliferative diabetic retinopathy (PDR).Methods Sixty-one women PDR patients (61 eyes) underwent vitreous microsurgery were recruited in this prospective study,including 31 postmenopausal women (PMW group) and 30 non-postmenopausal women (non-PMW group).The contralateral eyes were considered as the control group.Corneal fluorescein (FL) staining,tear break-up time (TBUT),Schirmer I test (SIT),central corneal sensitivity and ocular surface disease index (OSDI) were estimated.All tests were carried out 1 day preoperatively and 1 day,10 days,1 month and 3 months postoperatively.The student's t test or Mann-Whitney U and ANOVA for repeat measurements test were used.Results Preoperatively,TBUT of surgery and non-surgery eyes in PMW were shorter than non-PMW (t=-2.115,-2.035;P＜0.05),but higher OSDI scores were found in PMW (t=2.482,2.208;P＜ 0.05).TBUT reduction rate (Z=-2.771,-1.993;P＜0.05) and OSDI rising rate (Z=2.539,2.157;P＜0.05) of surgery eyes in PMW were higher than non-PMW 1 day and 10 days postoperatively.The lower SIT of surgery eyes in PMW were observed at 1 day and 10 days (t=-2.403,-2.029;P＜0.05) after surgery.At 10 days after surgery,FL and OSDI scores of surgery eyes in non-PMW returned to preoperative level (Z=-0.447,-0.513;P＞0.05),but in PMW,the recovery process experienced 1 month (Z=-1.500,-0.853;P＞0.05).TBUT and SIT of surgery eyes in two groups both reached preoperative level at 1 month following surgery (Z=-0.715,-1.266,-1.531,-0.522;P＞ 0.05).Conclnsions PMW with PDR had ocular surface dysfunction,which resulted in aggravated dry eye after minimal vitreoretinal surgery.

Objective:By comparing the clinical outcome of the modified triple tube method and the traditional three-tube method in the treatment of thoracic internal fistula after esophageal cancer surgery, in order to provide a basis for the clinical treatment of thoracic fistula after esophageal cancer surgery.Methods:The traditional three-tube method for the treatment of thoracic fistula after esophageal cancer surgery was the traditional group, and the modified three-tube method was the modified group. There was no spillover of the contrast agent during the above gastrointestinal angiography and the patient could eat normally as the standard of cure. In this study, we collected the data of thoracic fistula patients after esophageal cancer surgery who were treated with two kinds of treatment methods in our hospital in different time period(the traditional group: 10 patients from February 2008 to June 2014; the modified group: 36 patients from January 2012 to December 2019). Retrospective analysis of the two groups of patients in terms of general data(sex, age, etiology and other factors), time to cure and other indicators, compare the pros and cons of these two methods in the treatment of postoperative thoracic fistula.Results:There was no significant difference in general data such as sex, age, and cure time between the two groups, but there was significant difference in the cure time( P<0.01). The average cure time of the modified group was(38.08±11.97) days, which was significantly better than that of the traditional group(95.60 ± 7.79) days. Conclusion:Compared with the traditional three-tube method, the modified three-tube method can significantly shorten the treatment time when treating patients with thoracic fistula after esophageal cancer surgery.

Objective To investigate the proportion of different types, distribution of genders, ages as well as the relative factors in inpatient with glaucoma. Design Retrospective case series. Participants 5058 cases of inpatients in Xingtai Eye Hospital, Hebei province from June 2004 to May 2009 were included. Methods Statistical analysis was conducted for 5058 cases of inpatients with glausoma. Main outcome Measures The type of glaucoma, age, gender and their percentages. Results In all 5058 cases, the patients with primary glaucoma, secondary glaucoma and congenital glaucoma accounted for 59.07%, 37.92% and 3.01% respectively. Primary angle-closure glaucoma (PACG) accounted for 88.65% in primary glaucoma, and primary open angle glaucoma (POAG) accounted for 11.35%. In PACG, acute PACG accounted for 53.15%, chronic PACG 46.85%;The female over forty accounted for 69.54%, male 26.95%. In POAG, the female over forty accounted for 69.54%, male 28.02%. From June 2004 to May 2005, POAG accounted for 11.32% in primary glaucoma, 12.44% from June 2008 to May 2009. There was no statistically significant difference. Conclusion In the central part of China, the majority of inpatients with glaucoma was PACG. It may relate to the regional,economic and cultural conditions.

Primary pulmonary mucinous adenocarcinoma with a low incidence,a subtype of lung adeno-carcinoma,occurs in adult males because of its no significant clinical specificity,likely to cause misdiagnosis,and patients with adverse prognosis.Thus,we need further to understand this disease and early diagnosis through a va-riety of methods as soon as possible.Surgical treatment is still the preferred mode of this disease.With addition to resecting lesions,it is also further pathological diagnosis,gene testing,tumor staging and prognosis as well as prep-aration for following-up chemotherapy.In recent years,with the continuous development of genetic technology and innovation,the occurrence of this disease has been found to be related to KRAS gene mutation,ALK gene re-arrangement and its related signal pathway.Related gene mutations and signaling pathways can serve as a target for the treatment of this disease,which provides a variety of ideas for the development of new targeted drugs.How-ever,there are still many problems that need further study,including standard chemotherapy for primary pulmona-ry mucinous adenocarcinoma,drug resistance to targeted drugs, and the development of new KRAS inhibitors.This article reviews the definition of primary pulmonary mucinous adenocarcinoma and pathogenesis,diagnosis and some of the latest treatment methods.

Objective:To evaluate the value of dual-energy CT (DECT) mixed images CT in predicting hemorrhagic transformation (HT) after endovascular therapy (EVT) of acute ischemic stroke (AIS).Methods:From October 2018 to January 2020, the immediate dual-energy CT images of intracranial high attenuation (HA) regions in patients with AIS after endovascular treatment in Wuhan No.1 Hospital were retrospectively analyzed. According to the diagnostic criteria of CT or diffusion weighted image in 72 hours of follow-up, they were classified into HT group and non-HT group. The CT value of mixed images, contrast media, and virtual non-enhancement (VNC) and iodine concentration in the highest attenuation areas were measured. Intragroup correlation coefficient was used to evaluate the consistency among the readers; Mann-Whitney U test was used to compare the difference between the two groups of quantitative parameters; Spearman correlation analysis was uesd for evaluating correlation between mixed images CT value and contrast media CT value, VNC CT value, and iodine concentration. The receiver operating characteristic curve was used to analyze the quantitative parameters to predict the diagnostic efficacy of HT. Results:A total of 154 cases were enrolled, with 65 cases in the HT group and 89 cases in the non-HT group. The intraclass correlation coefficient of CT values of mixed images was 0.861 ( P<0.05). Comparing the non-HT group and the HT group,the CT value of mixed images [59.40(54.84, 63.05) HU vs 100.10(79.90, 122.40) HU, Z=-10.87, P<0.001],contrast agent CT value [24.90(20.75, 30.05) HU vs 66.60(47.10, 84.15) HU, Z=-10.85, P<0.001] and iodine concentration [1.10(1.00, 1.30) mg/ml vs 2.90(2.05, 3.65) mg/ml, Z=-10.85, P<0.001] both increased in the HT group, but there was no significant difference in VNC CT values between the two groups [33.60(31.80, 35.70) HU vs 34.30(30.90, 38.00) HU, Z=-0.50, P=0.62]. There was a highly significant correlation between the CT value of mixed images and iodine concentration ( r=0.99, P<0.01). Using CT value>72.60 HU as the diagnostic cutoff value for predicting HT, the sensitivity and specificity were 89.23% and 95.51%, respectively. Conclusions:The CT value of DECT mixed images after EVT can be used to predict HT within 72 hours. When DECT was not available, conventional CT scan′s intracranial HA density over 72.60 HU can be selected as the cutoff value for predicting HT.

Objective To observe the clinical effect of minimally invasive vitreoretinal (MIV) surgery combined with a modified suprachoroidal drainage surgery for retinal detachment associated with choroidal detachment (RRDCD).Methods A prospective clinical study.A total of 27 patients (27eyes) diagnosed as RRDCD were recruited in this study.There were 16 males and 11 females,with an average of (53.67± 14.82) years.The mean intraocular pressure (IOP) was (8.2± 2.1) mmHg (1 mmHg=0.133 kPa) and best corrected visual acuity (BCVA) of minimum resolution angle logarithm (logMAR) was 1.87±0.58.All subjects underwent 23G MIV combined a modified suprachoroidal drainage surgery,which 23G stab knife and 1 ml syringe needle were used for surgery.The visual outcome,IOP,rate of retinal reattachment and complications were comparatively analyzed preoperatively and postoperatively.Results At 1 day,10 days,1 month and 3 months after surgery,the average of logMAR BCVA were 1.62 ± 0.67,1.51 ± 0.63,1.39 ± 0.54,1.32± 0.56 and the mean of IOP were (13.47 ± 5.06),(14.43 ± 4.09),(14.89 ± 4.30),(15.38 ± 3.37) mmHg,respectively.There were significant differences of logMAR BCVA and IOP between before and after surgery (F=6.19,15.21;P＜0.05).Retinal reattachments were achieved in 27 eyes (100％) at 1 day and 10 days after surgery.At 1 month and 3 months after surgery,the rate of retinal reattachment were 88.89％ (24 eyes) and 85.19％ (23 eyes),respectively.No severe complications such as endophthalmitis and choroidal hemorrhage were found at follow-up visits.Conclusion MIV combined with a modified suprachoroidal drainage surgery is an effective and safe treatment for RRDCD,which can promote retina tear closure,improve visual acuity.

Objective To investigate the risk factors of postoperative vitreous hemorrhage after minimal vitrectomy without endotamponade for proliferative diabetic retinopathy (PDR).Methods From June 2015 to June 2017,103 eyes of 103 patients with PDR diagnosed and underwent minimalvitrectomy in Henan Provincial People's Hospital were enrolled in the study.There were 58 males and 45 females,with the average age of 58.37± 10.14 years and diabetes duration of 8.7± 7.2 years.Baseline systemic parameters including sex,age,diabetes duration,hypertension,HbA1c,creatinine,whether received anticoagulants,ocular parameters including whether combined with vitreous hemorrhage,whether finished panretinal photocoagulation (PRP),whether received treatment of anti-VEGF,whether combined with iris neovascularization (NVI),lens status preoperatively,whether hypotony postoperatively and intraoperative parameters including whether disc neovascularization (NVD) bleeding,whether fibrovascular membrane (FVM) residual,laser points,whether combined with cataract phacoemulsification were identified by multivariate logistic regression analysis.Results Twenty-nine of 103 eyes (28.15％) developed PVH in 1 day to 6 months after surgery,with self absorption of 18 eyes and reoperation of 11 eyes.Univariate analysis showed there were significant differences in age (t=2.124,P=0.036),anti-VEGF(x2=7.105,P=0.008),NVD bleeding (x2=10.158,P=0.001) and FVM residual(x2=8.445,P=0.004) between patients with and without postoperative vitreous hemorrhage.Sex (x2=0.021,P=0.884),diabetes duration (t=0.87,P=0.386),hypertension (x2=2.004,P=0.157),HbA1c (t=1.211,P=0.229),creatinine (t=0.851,P=0.397),preoperative oral anticoagulants (x2=0.985,P=0.321),preoperative vitreous hemorrhage (x2=0.369,P=0.544),PRP (X2=1.122,P=0.727),NVI (x2=2.635,P=0.105),lens status (x2=0.172,P=0.679),hypotony postoperatively (x2=1.503,P=0.220),laser points (x2=1.391,P=0.238) and combined phacoemulsification surgery (x2=0.458,P=0.499) were not associated with PVH.Multivariate logistic regression analysis revealed the more PVH appeared in younger (OR=1.065,P=0.009) and NVD bleeding (OR=6.048,P=0.001) patients.Conclusion Younger age and NVD bleeding are the important risk factors for PVH after minimal vitrectomy without endotamponade in PDR.

Retinoic acid, an active metabolite of vitamin A, exerts multiple effects on regulating embryonic development and inducing differentiation, proliferation, apoptosis as well as resistance in various cancer cells. Apart from the classic genomic action (binding to the nuclear receptors to regulate the expression of its downstream target genes), retinoic acids also play important roles in anti-cancer effect through non-genomic pathways (via extranuclear and non-transcriptional effects).
Apoptosis ; Cell Differentiation ; Genomics ; Humans ; Neoplasms ; drug therapy ; Receptors, Retinoic Acid ; Tretinoin

Objective:To analyze the occurrence of early hypotony after the intravitreal injection of anti-vascular endothelial growth factor (VEGF) and its risk factors.Methods:A case-control study was performed.One hundred and twenty-seven eyes of 127 patients with fundus vascular disease who received intravitreal injections of anti-VEGF drugs were enrolled in Henan Provincial People's Hospital from January 2020 to January 2022.Of the 127 patients, there were 71 males and 56 females, with an average age of (61.85±11.53) years and a mean intraocular pressure of (15.28±3.71)mmHg (1 mmHg=0.133 kPa). All subjects were intravitreally injected with 0.05 ml of anti-VEGF drugs, including 56 cases receiving ranibizumab, 38 cases receiving conbercept and 33 cases receiving aflibercept.The intraocular pressure was measured with a non-contact tonometer at 30 minutes, 1 hour and 2 hours after the injection.The cases were grouped as hypotony group or non-hypotony group according to the intraocular pressure of subjects was less than 10 mmHg or not.The differences in sex, age, distribution of left eye and right eye, disease type, intraocular pressure before injection, injection frequency, lens status, drug type, injection timing, injection site, with or without high myopia, with or without a history of glaucoma or ocular hypertension, and with or without a history of vitreoretinal surgery were analyzed to investigate the factors with a P-value <0.05, which were used as the independent variable and the occurrence of hypotony as the dependent variable in logistic regression analysis to explore the risk factors for hypotony.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Henan Eye Hospital (No.HNEEC-2022-42). Results:Hopotony occurred in 8 eyes within 2 hours after the injection.There were significant differences in intraocular pressure at different time points before and after injection between the hypotony and non-hypotony groups ( Fgroup=62.177, P<0.001; Ftime=25.128, P<0.001). The intraocular pressure of the hypotony group at 30 minutes, 1 hour and 2 hours after injection were lower than before injection, and the intraocular pressure of the non-hypotony group was higher at 30 minutes after injection than before injection (all at P<0.05). The average reduction of intraocular pressure of the hypotony group was 7.88, 7.63 and 7.23 mmHg at 30 minutes, 1 hour and 2 hours after the injection, and the intraocular pressure returned to baseline level at 1 day after injection.There was no significant difference in sex, distribution of left and right eyes, disease type, pre-injection intraocular pressure, injection frequency, lens status, drug type, injection timing, injection site, with or without a history of high myopia and with or without a history of glaucoma or ocular hypertension between the two groups.There were significant differences in age and with or without a history of vitreoretinal surgery between the two groups ( t=8.265, P<0.001; χ2=6.907, P=0.035). Multivariate logistic regression analysis showed younger patients and having a history of vitreoretinal surgery were the risk factors for early hypotony after anti-VEGF intravitreal injection (odds ratio=88.563, P<0.001; odds ratio=20.991, P=0.009). Conclusions:Patients with younger age and having a history of vitreoretinal surgery are susceptible to early hypotony after anti-VEGF intravitreal injection.

Cryoablation therapy with explicit anti-tumor mechanisms and histopathological manifestations has a long history.A large number of clinical practice has shown that cryoablation therapy is safe and effective,making it an ideal tumor treatment method in theory.Previously,its efficacy and clinical application were constrained by the limitations of refrigerants and refrigeration equipment.With the development of the new generation of cryoablation equipment represented by argon helium knives,significant progress has been made in refrigeration efficien-cy,ablation range,and precise temperature measurement,greatly promoting the progression of tumor cryoablation technology.This consensus systematically summarizes the mechanism of cryoablation technology,indications for oral mucosal melanoma(OMM)cryotherapy,clinical treatment process,adverse reactions and management,cryotherapy combination therapy,etc.,aiming to provide reference for carrying out the standardized cryoablation therapy of OMM.