Objective To evaluation clinical efficacy and complications characteristics of vitrectomy on type 1 diabetes of diabetic retinopathy.Methods This was a retrospective review study.From January 2010 to January 2016,18 cases (28 eyes) under the age of 30 diagnosed as type 1 diabetes of diabetic retinopathy were treated in our hospital.All the patients were performed vitrectomy.The postoperative visual acuity and complications in and after operation were observed.Results The follow-upperiod was 6-72 months with the average of 43.0 months.Postoperative visual acuity improved or remained unchanged in 23 eyes (82.1％),and decreased in 5 eyes(17.9％).Our primary anatomic success rate was 92.3％.Complication in operation was iatrogenic retinal tear in 3 eyes.Postoperative complications consisted of anterior chamber fibrin exudation in 9 eyes,hyphema in 5 eyes,recurrent vitreous hemorrhage in 2 eyes,retinal detachment in 3 eyes,rubeosis of iris in 5 eyes and neovascular glaucoma in 4 eye.Conclusion For young patients of type 1 proliferative diabetic retinopathy,vitrectomy can restore retinal anatomical structure and function.Panrentinal photocoagulation and preoperative anti-VEGF injections in vitreous is necessary with serious neovascularization-related complications.

OBJECTIVE:To study the effects of rAd-p53 injection on the proliferation,apoptosis and autophagy of nephroblas-toma cells. METHODS:Nephroblastoma cells were respectively cultured 20 h with high,medium,low concentration(1×109,1× 108,1×107 VP/mL)of Recombinant human rAd-p53 injection,cells with no injection were the blank control. Cell proliferation,cy-cle,apoptosis and related gene p21,Bax protein expressions were detected,and autophagy gene LC-3,Atg7,Atg12 expressions and number of autophagosomes were also detected. RESULTS:The proliferation inhibition rates of high,medium,low concentra-tion of Recombinant human rAd-p53 injection to nephroblastoma cells were(42.86±3.18)%,(33.64±7.25)%,(16.26±9.07)%;apoptotic rates were (53.85 ± 9.36)%,(37.35 ± 9.64)%,(23.64 ± 10.65)%,respectively. Compared with blank control,cells at period G0/G1 were increased under high,medium,low concentration Recombinant human rAd-p53 injection,effects were relatively obvious under high,medium concentration (P<0.05 or P<0.01);p21,Bax protein and LC-3,Atg7,Atg12 gene expressions were enhanced under high concentration,the number of autophagosomes was increased(P<0.01);Bax protein expression was en-hanced under medium concentration(P<0.05),the other indicators had no obvious changed(P>0.05). CONCLUSIONS:Recom-binant human rAd-p53 injection can inhibit the cell proliferation of nephroblastoma,and induce its apoptosis and autophagy.

Objective To investigate the validity and reliability of Item Erectile Function Scale (I-EF) for neurogenic erectile dysfunc-tion (ED). Methods 104 patients with spinal cord injury were assessed with I-EF. They were measured with pudendal somatosensory ner-vous evoked potential (SEP), bulbocavernosus reflex potential time (BCR) and nocturnal penile tumescence (NPT) detection. 34 patients ac-cepted medicine for ED, and were assessed with I-EF after treatment. 21 patients with medium ED were assessed by 2 testers, and retested 2-4 weeks later. Results The patients who recorded their potential of SEP and BCR got the scores of Q1, Q2 above 7, and the absence with the scores of 3. Those found NPT 1-3 times got the score of Q3 above 7, and the absence with the scores of 3. The incidence of reflex erec-tions and NPT were more in complete suprasacral ones than in complete sacral ones (P<0.05). There was significant improvement after med-ication in patients with mild to medium ED (P<0.05). The interclass correlation coefficient (ICC) was 0.93 between testers and 0.90 between test-retest. Conclusion I-EF can be used to assess neurogenic erectile dysfunction for rehabilitation.

BACKGROUND:Retinoic acid is the most promising inducer for neuroblastoma minimal residual lesion, and it can induce cel differentiationin vivo, accompanied by reducing tumor cel proliferation.
OBJECTIVE:To study the effect of nanoparticle labeling on biological characteristics of neuroblastoma stem cels, and the role of 13-cis retinoic acid to induce differentiation of neuroblastoma stem cels.
METHODS:Neuroblastoma stem cels were isolated and culturedin vitro using serum-free suspension culture method, labeled with polylysine-modified γ-Fe2O3 nanoparticles and induced in culture medium containing 13-cis retinoic acid. RT-PCR was used to detect the expression of Oct-4 before and after labeling as wel as before and after induction. Immunofluorescence method was used to detect the expression of nestin before and after labeling as wel as before and after induction.
RESULTS AND CONCLUSION:Neuroblastoma stem cels were successfuly cultured in the bone marrow samples from 5 of 20 cases. Polylysine-modified γ-Fe2O3 nanoparticle labeling did no influence the viability and proliferation ability of neuroblastoma stem cels, and also had no effect on Oct-4 mRNA and nestin expression. After cultured in the culture medium containing 13-cis retinoic acid, the cel shape changed and the growth rate slowed down. Moreover, the expression of Oct-4 mRNA and nestin was gradualy reduced. These findings indicate that polylysine-modified gamma-Fe2O3 nanoparticles can be used to label neuroblastoma stem cels, and 13-cis retinoic acid can induce the differentiation of neuroblastoma stem cels.

Objective To evaluate the effectiveness and safety of Botulinum toxin-A (BTX-A) injection into detrusor to treat neurogenic detrusor overactivity in patients with spinal cord injury (SCI).Methods A total of 78 patients with SCI were treated with transurethral injection of BTX-A (300 IU dissolved in 15 ml of saline) into 30 different points of detrusor with 15 ml in every patients. Urodynamic parameters and voiding diary were assessed at baseline and 3 weeks and 3 months after the injections. Adverse events were recorded after the injection if present.Results After the first injection, 78 patients showed that the mean frequencies of incontinence decreased from 13.5 to 2.7 times per day, the mean volume of intermittent catheterization (IC) increased from 131 ml to 389 ml per time, the mean volume of incontinence decreased from 1 690 ml to 281 ml per day, the mean getting effect time was 7.6 days. 10 patients received second injection at 8.9 months after first injection, the results showed that the mean frequencies of incontinence decreased from 9.7 to 3.7 times per day, the mean IC volume increased from 108 ml to 387 ml. 6 patients received third injection at 5.8 months after second injection, the results showed that the mean frequencies of incontinence decreased from 9.2 to 3.9 times per day, the mean IC volume increased from 116 ml to 364 ml. No side effects were observed during the follow-up.Conclusion BTX-A injection into detrusor to treat neurogenic detrusor overactivity in patients with SCI seems to be an effective, safe and miniinvasive solution.

Purpose To investigate the prognosis and influencing factor of hematoma complicated from ultrasonography-guided EnCor vacuum-assisted breast biopsy system in minimally invasive surgery for breast lesions, and to provide reference for clinical treatment. Materials and Methods 280 female patients with 486 benign breast lesions underwent minimally invasive excision using a ultrasonography-guided EnCor vacuum-assisted device, occurrence and the inlfuence factors of hematoma complicated from the operation was observed. Results All the 486 lesions were completely excised with EnCor system, hematoma (≥1cm) were found in 47 cases after 24 hours and almost disappeared in 6 months. After analysis of the occurrence of hematoma, it was found that the following situations would lead to a higher incidence of hematoma, which included lumps ≥ 2.5 cm, more than two lesions removed at one time, lumps locating deep inside the areola or the edge of breasts, bigger and less dense breasts, operation in menstrual period, pressure bandaging after operation less than 12 hours and operation without using adrenaline (P<0.05 or P<0.01). Conclusion Benign lesions breast can be effectively excised using ultrasonography-guided EnCor vacuum device, and the factors listed below could affect the occurance of hematoma complicated from the surgery, including the size, location and number of the resected nodules, breast shape, surgery during menstrual period, postoperative pressure bandaging and the use of hemostatics.

Objective To investigate the related factors of the prognosis of arterial embolectomy of acute cardiogenic cerebral embolism caused by atrial fibrillation.Methods The clinical data of using vein thrombolysis bridging artery embolectomy or arterial embolectomy alone for the treatment of patients with acute cardiogenic cerebral embolism of cerebral large artery occlusion due to atrial fibrillation were analyzed retrospectively.From January 2015 to December 2016,22 consecutive inpatients with cardioembolic cerebral embolism caused by paroxysmal or persistent atrial fibrillation were enrolled,including 10 patients with the 90-day modified Rankin Scale (mRS) score 0-2 (good recovery group) and 12 patients with mRS scores 3-6 (poor recovery group).The clinical features,imaging data,and treatment of the patients in both groups were compared.The factors such as age,gender,preoperative international standardization ratio (INR),embolism position,whether bridging vein thrombolysis before thrombectomy,National Institutes of Health Stroke Scale (NIHSS) score at the onset,time of onset to reperfusion (TOR),whether using tirofiban,times of thrombectomy,modified Thrombolysis In Cerebral Infarction (mTICI) blood flow grade,and postoperative intracranial symptomatic intracerebral hemorrhage were analyzed.Results There were no significant differences in age,gender,preoperative INR,embolism position,the number of intravenous thrombolysis before thrombectomy,the number of using tirofiban in surgery,the proportion of the above mTICI 2b grade,and the proportion of symptomatic cerebral hemorrhage after surgery of the patients between the two groups (P>0.05).The NIHSS score 15.2±2.0 at the onset in the good recovery group was lower than 22.9±8.4 in the poor recovery group.There was significant difference between the two groups (P<0.05).The TOR time (307±86 min) in the good recovery group was less than that of the poor recovery group (426±145 min).There was significant difference between the two groups (P<0.05).Embolectomy was performed 1.5 (0.5,3.0) times in the good recovery group,which was less than the poor recovery group (4.0 [2.0,7.0] times).There was significant difference between the two groups (P<0.05).Conclusions Shortening the time of reperfusion and reducing the number of embolectomy during operation are the important factors for improving the prognosis of patients when atrial fibrillation causes arterial embolectomy in patients with acute cerebral embolism.However,a study of larger sample is needed for further exploration.

Objective To investigate the effect of Holmium laser urethrotomy under ureteroscopy on urethral stricture.Methods 30 men with urethral stricture who accepted urethrotomy with Holmium laser under ureteroscopy were observed.Results Operation was performed successfully in 21 cases;7 cases underwent 2～3 endoscopic surgical treatments.Endoscopic surgical treatment failed in 2 cases,and open surgery were performed on them.21 cases were followed up for 3～37 months,and 8 of them need urethral dilatation termly.Conclusion Endoscopic surgery with ureteroscopy and Holmium laser may be effective on urethral stricture with slight trauma.

Objective To explore the technique, efficacy and complications of transurethral sphincterotomy with Holmium laser for the treatment of male patients with neurogenic bladder and examine its long-term outcome. Methods 20 male cases who received transurethral sphincterotomy with Holmium laser were included in this retrospective analysis, in which 7 cases injuried at cervical spinal cord, 6 at thoracic spinal cord, 3 at cauda equine; 1 was spinal meningocele, 1 was sacral crack, 1 was ependymoma, and 1 was myelitis sequel. The age was 20~64 years, averaged 45.1 years. They were followed up for 3~95 months (averaged 43.6 months) since the last sphincterotomy. Results The 20 patients significantly improved in symptoms, laboratory examination, imaging demonstration and urodynamic index after the operation.There were 3 patients who required repeated laser surgery during the follow- up. 17 patients were stable. Conclusion Transurethral sphincterotomy with Holmium laser is effective on neurogenic bladder with less bleeding for the appropriately selected patients.

Objective To explore the technique,efficacy and complications of external sphincterotomy with Holmium laser for the treatment of detrusor external sphincter dyssynergia (DSD). Methods 7 male cases with neurogenic DSD who received the procedure were reported. Results All patients got significant improvement after the operation in symptoms,laboratory,imaging and urodynamic index. No one required transfusion. 1 case lost the erection. There was no need of re-operation during the follow-up. Conclusion External sphincterotomy with Holmium laser for the treatment of DSD shows the advantages of less bleeding,safety and good effectiveness for the well selected patients.