Background Primary iris stromal cysts is a rare clinical disease.In recent years,the pathological findings of primary iris stromal cysts are different from previous literature reports.It is very important to understand the pathological characteristics of primary iris stromal cysts for illuminating its pathogenesis and accurate treatment.Objective This study was to analyze the pathological types and clinical manifestations of primary iris stromal cysts.Methods Histopathological sections of 14 patients with primary iris stromal cysts from January 1979 to December 2012 in Tianjin Eye Hospital were retrospectively analyzed.The primary iris stromal cysts were typed based on the hematoxylin-eosin staining,periodic acid-Schiff (PAS) staining and immunochemistry, and the clinical chacteristics upon different types were evaluated.Results In 14 specimens of primary iris stromal cysts,squamous epithelial type was found in 9 specimens,lens epithelial type in 3 specimens and ciliary body epithelial type in 2 specimens.The primary iris stromal cysts of squamous epithelial type were constituted of non-cuticular stratified squamous epithelium cells,and sporadic goblet cells were found in some specimens.The primary iris stromal cysts of lens epithelial type were consisted of lens epithelium cells and lens capsular analogic tissue and the cysts were tightly adherent to the lens.Crystalline lens dysplasia were seen in 2 specimens.The primary iris stromal cysts of ciliary body epithelial type showed single or stratified ciliary body like epithelium cells.Iris-ciliary dysplasia or anterior chamber angle abnormality was displayed in 1 specimen in this type of cysts.Under the slit lamp microscope,superior-temporal clear cysts were often seen in the primary iris stromal cysts of squamous epithelial type, and translucent cysts or diffuse swelling cysts were exhibited in the lens epithelial type and might be accompanied with lens dysplasia and cataract.Diffuse swelling was found in the cysts of ciliary body epithelial type which were often associated with chamber dysplasia and infantile glaucoma.Conclusions Primary iris stromal cysts are pathologically classified into squamous epithelial type, lens epithelial type and ciliary body epithelial type and present with different clinical appearances.

Background Persistent hyperplastic primary vitreous (PHPV) is a congenital eye disease of children,because its clinical manifestations are nonspecific,it is easy to be misdiagnosed as congenital cataract and the prognosis is poor.There has been more researches on PHPV clinical characteristics than its histopathological feature and immunochemistry.Objective This study was to investigate the clinical characteristics of PHPV and the pathological characteristics of retrolental membranes secondary to PHPV.Methods The clinical data of 6 PHPV eyes from 6 patients during May 2005 to December 2014 were retrospectively analyzed.All the PHPV eyes received a combinating procedure of cataract extraction and anterior vitrectomy.The retrolental membranes were collected during surgery for the histopathological examination by hematoxylin & eosin staining and periodic acid-Schiff (PAS)staining.Immunochemistry was used to detect the expression of Vimentin,smooth muscle actin (SMA),S-100,glial fibrillary acidic protein (GFAP),neuron specific enolase (NSE),epithelial membrane antigen (EMA),CD34 and proliferating cell nuclear antigen (PCNA) in the retrolental membranes.Results Monocular PHPV was found in 6 cases since born,with the main clinical manifestation of similar to congenital cataract.The ocular axial was shorter in 5 PHPV eyes than that of the contralateral eye by A-sonography,and 1 eye accompanied by eye nystagmus,strabismus and small cornea.The retrolental membranes were seen during the surgery in all cases,and the white band through the vitreous in 2 eyes.Pathological examination showed that the retrolental membrane was mainly composed of loose or myxoid connective tissue fibers,the capillaries and small veins.PAS positive tissue,residual transparent artery and differentiated adipocytes were exhibited in some specimens.Immunohistochemistry indicated that spindle-shape cells in the retrolental membranes presented the characteristics of mesenchymal cells,and some cells appeared the myofibroblast characteristics with the low proliferation activity.The development of the lens and the ciliary body was abnormal because of the stretching of retrolental membranes into the lens capsule in 1 PHPV eye.The follow-up was performed for 6-9 years in 4 eyes,with the best corrected visual acuity (BCVA) for 0.06,light perception,0.05 and 0.07 respectively.The intraocular pressure was normal in all the eyes.Conclusions PHPV is usually misdiagnosed as congenital cataract and shows a poor postoperative BCVA.PHPV occurs mainly due to an incomplete regression of the embryonic vitreous and hyaloid vasculature and eventual abnormality of lens.

AIM To study mechanism of endothelin (ET) on canine pulmonary veins. METHODS The isometric tension of pulmonary venous strips was recorded. RESULTS ET 3 and IRL1640 produced contraction in pulmonary venous strips. ET 3 induced contraction was markedly suppressed by BQ123 (P

Objective To investigate the impact factors for temperature of cornea(TOC) and analyse the relationship between TOC and evaporative dry eye. Methods Two hundred and fifty-seven patients(405 eyes) with normal lacrimal secretion received dry eye tests.Patients were divided into positive group and negative group according to the results,and were randomly subdivided into 4 groups with different environment temperature(T) and relative humidity(RH).For all eyes,TOC,body surface temperature(TBS) of forehead and center corneal thickness(CCT) were measured right after blinking.The impact factors for TOC and the differences in TOC between positive group and negative group were analysed.Results TOC was positively correlated with TBS(r=0.89),T(r=0.75) and RH(r=0.60)(P

Objective 　To evaluate the clinical measurement of cerebral perfusion by dynamic CT. Methods　 Thirteen normal adults were examined by dynamic CT for the measurement of cerebral blood flow (CBF). Another dynamic CT scans with the measurement of CBF were performed separately to rule out cerebral ischemia in 5 cases and secondary Parkinson disease in 2. Results　 Normal cerebral cortical perfusion was measured at 59.3～96.8 ml*min-1*100g-1 with the　mean value 76.2 ml*min-1*100g-1. Normal white matter perfusion was measured at 27.1～43.1 ml*min-1*100g-1 with the mean value 33.9 ml*min-1*100g-1. In 5 cases of suspending cerebral ischemia, one showed increase of CBF and 4 presented decrease of CBF. In 2 cases of suspending secondary Parkinson disease, one appeared decrease of CBF and other one was normal. Conclusion　 Dynamic CT scan with the measurement of CBF can demonstrate the hemodynamic status of normal brain and pathological lesion. Combined with routine CT scan, measurement of cerebral perfusion by dynamic CT is an ideal method to show the morphological and functional changes of brain tissue simultaneously.

Objective To investigate the related risk factors and neonatal outcomes in early preterm birth by analysis of 198 cases of early-to-moderate preterm birth. Methods Retrospective analysis was conducted on 198 pregnant women hospitalized during January 2004 to September 2006 with early-to-moderate preterm birth who delivered at 28 to 33+6 weeks of gestational age and their preterm infants.All of them were divided into two groups: early preterm birth group,28 to 3l+6 weeks of gestational age,n=90 for the pregnant women and n= 99 for the preterm infants;moderate preterm birth group,32 to 33+6 weeks of gestational age,n=108 for the pregnant women and n=122 for the preterm infants(fatal birth defects were excepted).The risk factors for preterm birth and neonatal outcomes were compared between the two groups. Results Various factors contributed to the occurrence of preterm birth.Systemic antenatal care and weight gain during pregnancy were significantly less found in the early preterm birth group than the moderate preterm birth group(P

AIM: To report a case of wet age-related macular degeneration (AMD) treat with multiple transpupillary themotherapy (TTT) and choroidal neovascularization (CNV) disappeared but retinal pigment epithelial(PRE) and choroidal atrophy occurred with a low vision at the end point.METHODS: Clinical data including fundus hotographs, fundus fluorescein angiography (FFA), indocyanine angiography (ICGA) and optical coherence tomography(OCT) was reviewed.RESULTS: A 72-year-old man complained about blurred vision of his left eye and FFA revealed polypoidal choroidal vasculopathy (PCV) in the macula. His left eye had stable vision of 0.1 for 6 years without any treatment of CNV. About 2 years later, his right eye presented a piece of CNV. During the period of 3 years, the lesion remained more (3×5 PD) and less (1×2PD) in size with remarkable exudates and bleeding, and 7 sessions of TTT were applied with 80-280mW, 2mm of spot, and 60 seconds exposure and with the interval of 3 months or more. The CNV lesion finally disappeared, but there left a white area in the macula and vision decreased from 0.3 to 0.04.CONCLUSION: Although CNV lesion can be eliminated by TTT, obvious atrophy of RPE cells and the choroids can happen and this may not be of help for patient vision. It suggests that the parameters of TTT will be lower than 120 mW/mm and limited less two sessions if applicable, especially for Asia people.

Background Small incision lenticule extraction (SMILE) is increasingly used for myopia.However,the size of the incision varied in different operators.The influence of 2 mm micro-incision SMILE on postoperative diopter and aberrations is not clear yet.Objective The aim of the current study was to perform a clinical analysis of the efficacy,safety,stability and predictability of 2 mm micro-incision SMILE and investigate the influence of preoperative sphere and cylinder power on postoperative aberrations.Methods A serial cases observational study was carried out under the approval of Ethic Committee of Tianjin Eye Hospital and informed consent of each patient.Fifty-five eyes of 31 subjects with myopia and myopic astigmatism were enrolled in this study in Tianjin Eye Hospital from January to April 2013 and a 2 mm micro-incision SMILE was performed on the eyes.Follow-up visits were performed at 1 week,1 month and 6 months after operation.Uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),manifest and cycloplegic refraction were examined at each postoperative time points to evaluate the efficacy,safety,stability and predictability of 2 mm micro-incision SMILE.Wave-front aberrations were measured by WaveScan aberrometer.Repeated measurement analysis of variance was used for the comparison of the differences of aberrations before and after the surgery.And the differences between various follow-up visits were compared with LSD-t test.The relationship between preoperative sphere or cylinder power and aberrations postoperatively were analyzed by Spearman rank correlation.Results At 1 week,1 month and 6 months postoperatively,the effective index was 1.2,and the safety indexes were 1.2,1.2 and 1.5 respectively.The spherical equivalent remained 0.00 D at each postoperative time point.And 96.4％ and 97.8％ of eyes were within ±0.5 D of intend correction and 100％ were within ± 1.0 D of the intend correction at 1 month and 6 months postoperatively.Vertical coma (Z7) and spherical aberration (Z12) were significantly raised at 1 week,1 month and 6 months after surgery compared with the values preoperatively (Z7:t =9.668,10.607,9.772,all at P ＜ 0.001 ;Z 12:t =-6.227,-6.923,-7.441,all at P＜0.001).The Zernike coefficients were relatively symmetrical between various time points postoperatively (all at P＞0.05).Third-order to sixth-order aberrations and higher order abberration (HOA) showed significant increase at various time points after the surgery compared with the values before surgery (all at P＜0.05),and no significant differences were seen between various follow-up visits (all at P＞0.05).Positive correlations were found between preoperative sphere and S3,S4 and HOA at 1 week,1 month and 6 months postoperatively (P＜0.05).Negative correlations were found between preoperative cylinder and S3,S4 and HOA at postoperatively various time points (all at P＜0.05).In addition,significant positive correlations were seen between Z7 and preoperative cylinder as well as between Z12 and sphere preoperatively,and negative correlations also were observed between Z7 and preoperative sphere as well as between Z12 and cylinder preoperatively at each follow-up visits(all at P＜0.05).Conclusions SMILE with 2 mm micro-incision is a safe,effective,stable and predictable procedure for myopic and myopic astigmatism eyes.The aberrations and Zernike terms remain stable after surgery until 6 months although these parameters present elevation to a certain extent.Preoperative SE and astigmatism power affect postoperative aberrations.

The myelodysplastic syndrome (MDS) is a clonal disorder characterized by inefficient haematopoiesis,dysplasia of hematopoietic cells in bone marrow and unable production of mature cells with normal differentiation resulting in peripheral cytopenias.The incidence of MDS is increased with the increasing age,suggesting that the accumulation of genetic or epigenetic changes lead to DNA mutations in hematopoietic stem cell,activation of oncogenes and inactivation of tumor suppressor genes,increasing limitless self-proliferation,and eventually resulting in aberrant clonal hematopoiesis and the occurrence of MDS.About thirty percentage of patients with MDS will transform into acute myeloid leukemia (AML) at last.MDS is always not sensitive to cytotoxic drugs,but targeted drugs maybe help to improve the prognosis.

Objective To investigate the experience of combined laparoscopic-endoscopic procedure for colon tumor . Methods Clinical data of 32 cases of colon tumor receiving combined laparoscopic-endoscopic procedure from January 2011 to June 2014 were analyzed retrospectively , including 25 cases of endoscopic assisted laparoscopic operation ( laparoscopic resection of colon segment or laparoscopic radical resection of colon cancer with positioning of colonic lesions by endoscopy ) and 7 cases of laparoscopic assisted endoscopic operation ( intraoperative endoscopic resection under the monitor of laparoscopy ) . Results Twenty-five cases were performed endoscopic-assisted laparoscopic surgery , including endoscopic-assisted laparoscopic radical resection for colon cancer in 20 cases and endoscopic-assisted laparoscopic segmental resection of colon in 5 cases.The combined procedure contained endoscopic-assisted positioning lesions , laparoscopic bowel resection and reconstruction , and lymph node dissection .The success rate of endoscopic-assisted positioning was 100%(25/25).No conversion to laparotomy was required .No surgical complications occurred . Follow-up for 6 -48 months ( median, 30 months ) in 25 cases found no signs of recurrence and metastasis .One patient died of myocardial infarction and the remaining 24 patients survived .Seven cases were performed laparoscopic-assisted endoscopic surgery , including laparoscopic-assisted endoscopic submucosal dissection colon ( ESD) in 3 cases, laparoscopic-assisted endoscopic mucosal resection ( EMR) in 2 cases, and laparoscopic-assisted endoscopic polypectomy in 2 cases.Intestinal perforation occurred during the operation in 1 case of ESD, which was given a laparoscopic colon perforation repair .Follow-up for 9 -36 months ( median, 24 months) in 7 cases showed no deaths or signs of recurrence and metastasis . Conclusion Combined laparoscopic-endoscopic procedure has advantages of both laparoscopy and endoscopy to improve surgical safety , on the basis of good cooperation of laparoscopic and endoscopic teams .