AIM: To analyze the effects of two kinds of anti-vascular endothelial growth factor (VEGF) drugs, conbercept and ranibizumab, on proliferative diabetic retinopathy (PDR) patients as pre-treatment for pars plana vitrectomy (PPV).METHODS: From June 2016 to December 2016, 62 patients (64 eyes) aged 41-59 years old diagnosed with PDR with nonclearing vitreous hemorrhage (VH) and/or tractional retinal detachment (TRD) requiring PPV were enrolled in our study.Patients were treated with intravitreal injection of anti-VEGF drugs 0.50mg (0.05mL) 3d before PPV.Then the standard 23G minimally invasive sclera three-channel vitrectomy was performed where there were no significant complications after the injection of anti-VEGF drugs.The operation time, intraoperative bleeding, iatrogenic retinal breaks, the use of endodiathermy and silicone oil, and postoperative complications were recorded and analyzed.We compared and analyzed the visual acuity and macular thickness before and 1mo after the surgery with the preoperative data.RESULTS: Both conbercept and ranibizumab could improve the postoperative visual acuity and reduce the postoperative macular thickness of PPV.There was no significant difference between the impacts of two kinds of anti-VEGF drug pre-treatment on operation time, intraoperative bleeding, iatrogenic retinal breaks, the use of endodiathermy, silicone oil filling and postoperative vitreous secondary hemorrhage.CONCLUSION: The effects of conbercept and ranibizumab pre-treatment were similar.PPV combined with anti-VEGF pre-treatment could improve postoperative visual acuity and macular edema.The choice of conbercept or ranibizumab should be made flexibly according to the actual situation of patients.

Objective To discuss the intraoperative and postoperative effects of conbercept combined with pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR) patients.Methods From January 2016 to December 2016,123 PDR patients (149 eyes) aged 41-65 years old with nonclearing vitreous hemorrhage (VH) and/or tractional retinal detachment (TRD) were enrolled in this study.According to whether preoperative intravitreal injection conbercept,the patients were divided into two groups:Conbercept group (64 cases,78 eyes),Control group (59 cases,71 eyes).Conbercept group was treated with intravitreal injection of Conbercept 0.50 mg (0.05 mL) at 3 days before PPV.Then the standard 23G minimally invasive sclera three-channel vitrectomy was performed if no significant complications after the injection of conbercept.The operation time,intraoperative bleeding,iatrogenic retinal hole,use of endodiathermy and silicone oil,and postoperative complications were recorded and analyzed.The visual acuity and macuiar thickness were compared before and 1 month after the surgery.Results Two groups had no difference on age,sex,HbA1 C,duration,VH ≥ three degree(56/78,45/71),TRD.Conbercept pretreatment could significantly reduce the bleeding during PPV (43/78,49/71),the probability of iatrogeuic retinal holes (11/78,21/71),reduce intraocular electrocoagulation using (57/78,62/71) and silicone oil (43/78,51/71),and then shorten the operation time (58.63 ± 21.66)s and (72.69 ± 22.48)s,and it could significantly improve the postoperative visual acuity (0.23 ± 0.15,0.16 ± 0.11) and macular edema thickness (260.95 ± 27.44) μm and (330.81 ± 36.62)μm,while reduce the incidence of second bleeding (3/78,10/71).Conclusion Conbercept pre-treatment combined with PPV for PDR is a positive and effective treatment,which has good clinical application significance.

This study evaluated the efficacy and safety of "J"-shaped uterine incision for caesarean section for patients diagnosed with placenta previa. A total of 55 consecutive cases of placenta previa treated in Union Hospital were retrospectively analyzed over a period of two years and 10 months. The subjects were divided into two groups with respect to the uterine incision. Twenty-four pregnant women with placenta previa who were indicated for caesarean section underwent the procedure using a new "J"-shaped uterine incision and 31 pregnant women with placenta previa received caesarean section that used the traditional transverse incision. The two groups were compared in terms of operation time, estimated blood loss, infant expulsion time, exhaust time and postoperative recovery. Meanwhile, comparison was also made in neonatal clinical data between the two groups. Compared with the "J"-shaped incision group, the traditional incision group had a lower Apgar scores (P<0.05). However, there existed no statistically significant differences in the overall time of operation and postoperative period of breaking wind (P>0.05). It is concluded that, with caesarean section for placenta previa patients, the "J"-shaped uterine incision significantly decreases intraoperative blood loss and facilitates the fetal delivery.

Objective To analyze the CT and MR manifestations and the diagnosis of primary malignant melanoma in the nasal cavity and paranasal sinuses.Methods CT,MR features and clinical data of 1 6 cases of malignant melanoma in the nasal cavity and paranasal sinuses,which were confirmed by biopsy or surgical pathology and immunohistochemistry were analysed retrospectivelly. CT routine and enhanced scan were performed in all patients,MR routine and enhanced scan were performed in 9 cases.Results CT findings of 1 6 patients were unilateral,in which 8 cases were located in the nasal cavity,4 cases in the paranasal sinuses,and 4 cases were both in the nasal cavity and paranasal sinuses.All lesions were irregular shape with soft tissue densityand without calcification and cystic degeneration and demonstrated invasiveness to the surrounding tissue.Lesions were nonuniformly moderate to severe en-hancement.Among 9 patients with MR examination,lesions were mainly unilateral in which 4 cases were in the nasal cavity,3 cases in the paranasal sinuses,2 cases both in the nasal cavity and paranasal sinuses.Lesions were irregular in 9 cases,in which 1 case had typical high signal on T1 WI,low signal on T2 WI,while 3 cases equal signal on T1 WI,equal or slightly higher signal on T2 WI and 5 cases mixed signal.On MR enhanced scan,unevenly slight-medium enhancement were showed in the lesion and surrounding tissues. Conclusion Primary malignant melanoma of the nasal cavity and paranasal sinuses is lack of specificity on CT imaging.Typical ma-lignant melanoma,a type of rare to finding,has certain characteristics on MR,non-pigment type and mixed type are more common. CT combined with MRI can better show the site of the tumor,and the relation with surrounding tissues and adjacent bones.

Objective To compare the effect of conservative and operative treatment for cervical spinal cord injury without fracture and dislocation (CSCIWFD)and to detect mechanism of injury as well as its relationship to outcome.Methods A retrospective review was conducted on 688 patients with CSCIWFD treated from August 1994 to March 2013.There were 155 patients managed conservatively (conservation group) and 533 surgically (operation group).Neurological function improvement was compared between two groups to detect the correlation of patents' age and treatment methods with outcome.Results The patients were followed up for mean 17.9 months (range,3-36 months).Neurological function was estimated using Japanese Orthopedic Association (JOA) score:(1) the recovery rate of patients aged over 40 years in operation group was better than that in conservation group (P ＜0.05) ; (2) the recovery rate in patients aged under 39 years was unsatisfactory in both groups,with insignificant difference between the two groups (P ＞ 0.05).Conclusions Different age of patients with CSCIWFD has different injury mechanism,injury severity and outcome.Surgery provides better results than conservative treatment for patients aged over 40 years,but both results are poor for patients aged under 39 vears.

Objective To explore the cell metabolism of the bilateral hippocampus effected by the inflammatory factor of blood serum in the development of the depression.Methods Using Proton magnetic resonance spectroscopy 1 H-MRS technology to detect multiple metabolic indices of the bilateral hippocampus of 20 first episode depression patients and 20 healthy persons,and detecting the levels of IL-6,IL-2,IL-10 in blood serum were detected.Finally the correlation between them was analyzed.Results Compared with the healthy group,the values of Glx/Cr and NAA/ Cr were reduced in left hippocampus (Glx/Cr: (0.82±0.48),t=2.69,P＜0.05 ; NAA/Cr: (1.12 ±0.44),t =2.81,P＜ 0.05) and the value of Cho/ Cr was increased in left hippocampus ((2.49± 0.78),t =2.36,P＜0.05),but only the value of Glx/ Cr were reduced in right hippocampus ((0.84 ± 0.47),t =2.43,P＜ 0.05),and the other metabolic indices changed unobvious.The depressive group had the significantly higher levels of IL-6,IL-2 in blood serum(IL-6: (12.47±3.19) ng/L,t=4.53,P＜0.05 ; IL-2: (29.44±5.72) ng/L,t=2.44,P＜0.05),but no significant difference was found in the IL-10 level in blood serum.The Glx/ Cr of bilateral hippocampus level was negatively correlated to the IL-6 and IL-2 level in blood serum(left:(IL-6: r=-0.555,P＜0.05;IL-2: r=-0.624,P＜0.05) ;right:(IL-6: r=-0.575,P＜0.05; IL-2: r=-0.523,P＜0.05)).The NAA/ Cr of left hippocampus level was negatively correlated to the IL-6 and IL-2 level in blood serum(IL-6: r=-0.582,P＜0.05;IL-2: r=-0.607,P＜0.05).The Cho/Cr of left hippocampus level was negatively correlated to the IL-6 and IL-2 level in blood serum(IL-6: r=0.601,P＜0.05; IL-2: r=0.552,P＜0.05).Conclusion The abnormal of glutamic acid system in bilateral hippocampus maybe the important performance and the potential originating link,the changes of the inflammatory cytokines level maybe the factor of these abnormal changes.

Objective Combined with susceptibility weighted imaging (SWI) and proton magnetic resonance spectroscopy (1H-MRS) to study the hippocampus in the first-episode depression patients for exploring the causal relationship.Methods 20 first-episode depression patients and 20 healthy volunteers underwent SWI scanning and hippocampal 1H-MRS image,analysis and comparison the changes between the venous system and metabolism of two groups.Results Proton spectroscopy analysis showed that compared with the control group,bilateral hippocampal NAA/Cr(left hippocampus:depression group 0.95±0.77,control group 1.78±0.82; right hippocampus:depression group 1.12±0.74,control group 1.91 ± 0.80) and Cho/Cr (left hippocampus:depression group 1.08±0.83,control group 1.75±0.73 ; right hippocampus:depression group 0.91±0.68,control group 1.95 ±0.74) in the depression group was significantly lower,the difference was significant(NAA/Cr:t value in left and right were -3.14,-3.49,P＜0.05; Cho/Cr:t value in left and right were-3.25,-3.19,P＜0.05),however MI/Cr had no obvious changes (t value in left and right were 1.24,-1.27,P＞0.05).Magnetic sensitive scan showed depression group compared with the control group was significantly reduced in lateral vein diameter,length and branches (t value were 3.23,4.56,2.66,P＜0.05).Conclusion The SWI sequence and 1H-MRS imaging methods can become a new research idea about the central nucleus,and this idea may explain the causal relationship between the hippocampus in depression patients of vascular abnormalities and hippocampal neuronal metabolic abnormalities.

Objective To study the differences of clinical manifestations,etiology and hospitalized outcomes of purulent meningitis in preterm and term infants.Method All preterm and term infants with purulent meningitis hospitalized in the Hospital from 2006 to 2015 were enrolled in this study.The data of neonate's condition,maternal condition,clinical manifestations,complications,etiology,treatment and outcomes of the preterm and term infants groups were compared.Result During the study period,44 preterm infants and 118 term infants were included.The time of onset for purulent meningitis of preterm infants group was statistically earlier than that of term infants group [11.2 (3.2,19.8) d vs.14.3 (5.6,23.9) d,P ＜ 0.05].The prognosis of preterm infants group was statistically worse than that of term infants group (P ＜ 0.05).Among them,the incidences of clinical manifestations in preterm infants group compared to term infants group were:fever (54.5％ vs.78.8％),seizure (11.4％ vs.26.3％),lethargy and poor response (59.1％ vs.38.1％),slow weight gain (9.1％ vs.0％),apnea (45.5％ vs.0.8％) and cyanosis (15.9％ vs.4.2％);all the differences between two groups were significant (P ＜ 0.05).The time of onset for purulent meningitis with complications was statistically earlier than those without complications [9.5 (4.1,20.5) d vs.13.8 (5.9,22.0) d,P＜0.05].The duration of treatment for purulent meningitis with complications was longer than that without complications [(42.2 ± 8.8) d vs.(28.7 ± 7.1) d,P ＜ 0.05],and the positive rate of pathogens was also statistically higher than those without complications (73.8％ vs.26.7％,P ＜0.05).Coagulase-negative staphylococcus was the main pathogen for both preterm and term infants group.Klebsiella pneumoniae was more common in preterm infants group than in term infants group (40.0％ vs.10.4％,P ＜0.05).Conclusion Preterm infants with purulent meningitis had early onset time,atypical clinical manifestations,and poor prognosis.The treatment course for purulent meningitis with complications is prolonged.The pathogens for neonatal purulent meningitis have already changed.The detection rate of conditional pathogens is increasing yearly,for which the clinicians should take note seriously.

Objective To explore the sensibility of the encephalic region affected by the inflammatory factor of cerebrospinal fluid(CSF) and the role of the inflammatory factor in the development of the depression.Methods Based on the evaluation of ethology,forty SD rats were randomly and equally divided into control group and model group which was exposed to chronic unpredictable mild stress for 4 weeks.Using analyzing technology 1 H-MRS to detect prefrontal cortex and hippocampus of each group and detecting the levels of interlukin 6(IL-6),interlukin 2 (IL-2),interlukin 10 (IL-10) in CSF at the beginning and 4 weeks later,and the correlation was analyzed between them.Results Compared with the control group,the values of Glx/ Cr and NAA/ Cr in bilateral prefrontal cortex were reduced which did not reach statistically significance (P ＞ 0.05),and the value of Cho/ Cr had no significant difference.The values of Glx/Cr and NAA/Cr in left hippocampus reduced significantly(Glx/Cr:(1.16 ±0.07),t =2.50,P＜0.05 ;NAA/Cr:(1.30 ±0.09),t=5.94,P＜0.01),and the value of Cho/Cr was increased which did not reach statistically significance(P＞ 0.05).The values of Glx/Cr and NAA/Cr were reduced and the value of Cho/Cr was increased in right hippocampus which did not reach statistical significance(P＞0.05).The depressive group had the significantly higher levels of IL-6,IL-2 in CSF(IL-6:(32.41 ± 3.52),t =11.46,P ＜ 0.01 ; IL-2:(18.89 ± 2.56),t =7.42,P ＜ 0.01),but no significant difference was found in the IL-10 level in CSF.The Glx/Cr of left hippocampus level was negatively correlated to the IL-6 and IL-2 level in CSF (IL-6:r =-0.555,P＜ 0.05 ; IL-2:r=-0.582,P＜ 0.05) ; the NAA/Cr of left hippocampus level was negatively correlated to the IL-6 and IL-2 level in CSF(IL-6:r=-0.582,P＜0.05;IL-2:r=-0.607,P＜0.05).Conclusion The development of inchoate depression has a correlation with the high sensibility of the left hippocampus affected by the inflammatory factor levels.The metabolism of never cells has changed,which maybe constitutes the physiopathology basis of the depression.

Holmium ; Humans ; Kidney ; Lithotripsy, Laser ; Shock, Hemorrhagic ; Ureteroscopy