0.05).Patients in both group had accepted PCI successfully.The ratio of patients achieved TMPGⅡor TMPG Ⅲ after PCI was significant higher that in the early group(P

Objective To evaluate the long-term results of vitreoretinal surgery without use of intraocular silicone oil or gas in patients with diabetic tractional retinal detachment (DTRD).Methods The clinical interventional case series study included 104 patients (112 eyes) with DTRD,who were consecutively treated by pars plana vitrectomy without use of intraocular silicone oil or gas.Among the eyes,there were 6 eyes with iris neovascularization (INV),1 eye with neovascular glaucoma (NVG) and 50 eyes with macular retinal detachment.There were no pre-existing retinal holes or breaks prior to surgery nor any iatrogenie retinal breaks developed during vitrectomy.Cataract removal combined with intraoeular lens implant surgeries were performed on 15 eyes.Follow-up duration varied from 12 to 65 months (mean: 29 months).Results Subretinal fluid was completely absorbed within 2 months after surgery.In 107 eyes (95.54%),the retina reattached after surgery and remained attached till the end of follow-up period.Best corrected visual acuity (BCVA) improved in 79 eyes (70.53%),remained unchanged in 14 eyes (12.500%) and got worse in 19 eyes (16.79%).The BCVA improving rate was lower in the macular detached group (33 eyes/50 eyes,66.00% Vs 46 eyes/62 eyes,74.19%,χ2=0.89,P=0.344).No obviously aggravated opacity of lens was observed after vitreoretinal surgeries in the eyes without cataract surgeries.Seven (6.25%) eyes showed INV (5 new onset eyes),and none of them developed into NVG.In multivariate logistic regression,factors associated with postoperative rubeosis iridis were pre-existing rubeosis iridis I-adjusted odds ratio (OR)= 10.2],low preoperative BCVA (OR= 11.1) and low postoperative BCVA (OR = 16.7).Conclusions Vitreoretinal surgery for DTRD may not necessarily be combined with silicone oil or gas tamponade if there are no preoperative or intraoperative retinal breaks,and only using irrigation fluid could access a good long-term prognosis result.

Objective To observe the change of diffusion upper limit of macromolecules through pathological retina and the difference between the layers of retina. Methods Retinal edema was emulated by establishing branch retinal vein occlusion(RVO)model in miniature pig eyes under photodynamic method.Two days later,the retinas of both eyeballs were peeled off.The diffusion test apparatus was designed by ourselves.FITC-dextrans of various molecular weights(4.4,9.3,19.6,38.9,71.2 and 150 kDa)and Carboxyfluorescein(376 Da)were dissolved in RPMI-1640 solutions and diffused through inner or outer surface of retina.The rate of transretinal diffusion was determined with a spectrophotometer.Theoretical maximum size of molecule(MSM)was calculated by extrapolating the trend-linear relationship with the diffusion rate.In separate experiments to determine the sites of barrier tO diffusion,FITC-dextrans were applied to either the inner or outer retinal surface,processed as frozen sections.and viewed with a fluorescence microscope. Results FITC-dextrans applying tO inner retinal surface,4.4 kDa dextrans were largely blocked by inner nuclear layer(INL);19.6-71.2 kDa dextrans were blocked by the nerve fiber layer(NFL)and inner plexiform layer;150 kDa dextrans were blocked by NFL.FITC-dextrans applying to outer retinal surface,most dextrans with various molecular weights were blocked before outer nuclear layer(ONL).No matter applying to the inner or outer surface,Carboxyfluorescein can diffuse through the whole retina and aggregate at INL and ONL.After RVO,the inner part of retina became edema and cystoid,loosing the barrier function.Compared with the normal retina,the MSM in RVO tissues increased(6.5±0.39nm Vs 6.18±0.54nm,t=4.143,P=0.0001). Conclusions After RVO,the barrier function of inner part of retinal is destroyed and the upper limit of diffusion macromolecule size increased.which is nevertheless limited.ONL acts as bottle-neck barriers to diffusion,if the outer part of retina is damaged,the change of the diffusion upper limit will be prominent.

Objective To observe the clinical characteristics of polypoidal choroidal vasculopathy (PCV).Methods Two hundreds fifty-four PCV patients (306 eyes) were enrolled in this study.All the patients were examined for corrected visual acuity (BCVA) testing,slit-lamp microscope,indirect ophthalmoscopy,fundus photography,fluorescein angiography,indocyanine green angiography and optic coherence tomography.Results The patients included 152 males (59.8％) and 102 females (40.2％) ; the age was from 38 to 91 years,with a mean age of (65.4±8.9) years.Bilateral lesions were observed in 52 patients (20.5％) and unilateral lesions were observed in 202 patients (79.5％).BCVA varied from nonlight perception to 1.2.BCVA was lower than ＜0.1 in 167 eyes (54.6％),≥0.1 but ＜0.3 in 92 eyes(30.1％) and ≥0.3 in 47 eyes (15.4％).Vitreous hemorrhage was observed in 61 eyes (19.9％).In 202 patients with unilateral PCV lesions,drusen can be observed in the contralateral eyes of 68 patients (33.7％),exudative age-related macular degeneration changes in the contralateral eyes of 24 patients (11.9 ％),and central serous chorioretinopathy history was positive in the contralateral eyes in nine patients (4.5％).In 306 eyes,there were 43 eyes (14.1％) with high permeable choroid.PCV lesions located at macula area in 199 eyes (65.0％),under the temporal retinal vascular arcade in 49 eyes (16.0％),and peripapillary in 15 eyes (4.9％).PCV lesion formation was single in 110 eyes (35.9％),cluster in 176 eyes (57.5％),string in three eyes (1.0％),branch in four eyes (1.3％),and both single and cluster polyps in 13 eyes (4.2％).There were 125 eyes (40.8％) with sub-neuroretinal fluid,121 eyes (39.5％) with hemorrhagic pigment epithelium detachment,and 73 eyes (22.9％) with serous pigment epithelium detachment.Conclusion PCV patients have higher bilateral incidence and female prevalence,and lower rate of peripapillary lesions.

Objective To explore the histopathological changes of the pigs′ eyes in vivo after radial optic neurotomy (RON), and provide the experimental foundation for the safety of RON. Methods A total of 12 healthy miniature pigs were used in the experiment, in whom 8 were executed at the 1~st , 3~rd , 7~th , and 48~th day respectively after underwent RON in both eyes, and 4 were executed at the 120~th day after underwent RON unilaterally (the other eye was as the control in 2 and underwent single vitrectomy in 2). All the enucleated eyes were cut in sections routinely and embeded in paraffin. The sections were stained by HE, Masson trichrome staining or Luxol fast blue staining and the different sections of optic nerve were observed by light microscope. Results No damages of the major vessel wall were found and the cerebral pia mater of orbital optic nerves kept integrated. At the 1~st day after the operation, the incisions came into being and local hemorrhages infiltrated into the circumambience and backside. The vacuole-like change induced by the demyelination of optic nerve fiber located at the incisions. At the 3~rd day, the vacuole-like changes widened. At the 7~th day, the fibroblasts aggregated at the incision, with hyperplastic neuroglia cells and dispersed pigmented granules. Lymphocytes and monocytes were the major infiltrated inflammatory cells. At the 48~th day, collagen filled in the incisions and aggregated neuroglia cells of the rear optic nerves behind the incision were found, which showed weak staining with obvious boundary which was somewhat beyond the midline of optic nerves. At the 120~th day, localized atrophy of optic nerve occurred under the incision. No abnormal pathological findings were found in the normal eyes and the eyes undergo vitrectomy. Conclusions Localized atrophy of optic nerves comes into being after the normal pig eyes in vivo underwent RON. The surgery is safe to some extent.

Objective To evaluate curative effects of percutaneous laser disc decompression(PLDD) in the treatment of discogenic low back pain.Methods A total of 36 patients with discogenic low back pain was included in the study.The PLDD was performed by using the DIOMED semiconductor laser treatment,with a power of 15 W,1 s-pulse duration,1 s-interval,and an energy of radiation of 800~1 200 J.Curative outcomes were evaluated based on the Visual Analog Scale(VAS) criteria. Results The operation time was 15~60 min(mean,30 min).The pain provocation was observed in 32 patients.Follow-up examinations were conducted in the 36 patients for 6~36 months(mean,11 months).The postoperative VAS scores were improved by ≥ 3 points in 18 patients and ≥ 2 points in 14 patients.Results revealed that 32 patients(88.9%) reported a good response and 4(11.1%) reported no response. Conclusions Percutaneous laser disc decompression is a safe,effective,and minimally invasive procedure that can be used for patients with discogenic low back pain.

Objective To compare differential diagnostic value of narrow-band imaging (NBI) magnifying endoscopy and magnifying chromoendoscopy.Methods A total of 92 lesions from 75 patients were examined with conventional colonoscopy,NBI magnifying endoscopy and magnifying chromoendoscopy to evaluate pit patterns and vascular morphology patterns.Endoscopic findings were compared with the pathological results.Results The detection rate of conventional endoscopy,NBI magnifying endoscopy and magnifying chromoendoscopy were 94.6％ (87/92),97.8％ (90/92) and 100.0％ (92/92),respectively.NBI magnifying endoscopy was superior to the magnifying chromoendoscopy (P =0.000) in the the lesion contour and microvessels pattern detection,but there was no difference in the pit patterns detected with the two techniques (P =0.394).Consistency,sensitivity,and specificity of NBI magnifying endoscopy in diagnosis of colorectal neoplastic lesions were 91.3％ (84/92),83.9％ (26/31),95.1％ (58/61),respectively,while these variables of magnifying chromoendoscopy were 89.1％ (82/92),80.6％ (25/31),93.4％(57/61),which were not statistically significant (P ＞ 0.05).Conclusion Differential diagnostic value of NBI magnifying endoscopy and magnifying chromoendoscopy for colorectal neoplastic and non-neoplastic lesions was similar,but NBI magnifying endoscopy displays the lesion contours and microvessels clearlier,and is easy to manipulate.

Objective To investigate the expression of angiotensinⅡ (Ang Ⅱ ) and its type 1 receptor (AT1) in circulation, placenta and kidney of the rots preeclampsia. Methods Preedampsia rat model was developed by inhibitor of nitric oxide synthase (L-NAME). The systolic blood pressure (SBP), 24 h urine protein, hepatic and renal function were compared among the precelampsia group, the normal pregnant group and nonpregnant control group. The kidney tissue was observed by light microscopy. ELISA and radioimmunoassay were used to detect Ang Ⅱ in rat plasma and kidney homogenate respectively. Placental AT1 was measured by Westem blot. The level of kidney AT1 was evaluated by immunohistochemistry and Western blot. Results In preeclampsia rats, SBP and 24 h urine protein were significantly higher compared with control groups. Compared to normal pregnant group, plasma Ang Ⅱ of preeclampsia rats was much higher [(0.706±0.086) ng/L vs (0.540±0.085) ng/L, P＜0.05]; placental AT1 was increased by 46%(P＜ 0.05); kidney Ang Ⅱ was decreased signigicantly [(65.543±40.634) ng/g vs (165.543±33.078) ng/g, P＜0.05]. The expression of ATI in kidney of preeclampsia rats was reduced evidently,which was only 33% of normal pregnancy group and 59% of nonpregnant control greup,respeetively (P＜0.05). Conclusions In preeclampsia rat model, the circulating Ang Ⅱ is increased, the placental RAS isactivated, while the kidney BAS is suppressed. The underlying mechanism of proteinuria and kidney damage associated with this phenomenon in preeclampsia needs further research.

Objective To investigate the relationship between human papilloma virus(HPV)infection and the development of laryngeal squamous cell carcinoma(LSCC).Methods To elucidate the role of HPV in the development of LSCC,we employed polymerase chain reaction(PCR)based on four pairs of primers an4 in situ hybridization(ISH)to screen the HPV infection in 84 ISCC tissues.Results Using HPV L1 general primer amplification,HPV DNA was detected in 23(27.4%)of the 84 LSCC samples.However,when specific primers for HPV-16 or-18 were used to amplify E6 and E7 in all samples,29 cases(34.5%)were positive for HPV-16,while 6 cases(7.1%)were positive for HPV 18.Coinfeetion of HPV-16 and-18 were found in 4cases (4.8%).Overall,HPV type 16 and 18 infections were present in 36.9% of the LSCC samples.In addition,the positive rate of HPV 16 E6 mRNA was 30.9%(26/84)in LSCC by ISH with digoxin-labeled sense probes of HPV 16 E6.Conclusion High-risk HPV-16may be an etiologic factor in the development of laryngeal squamous cell carcinoma, while the complicated molecular mechanism of HPV16 inducedtumorgenesis needs a further study.

OBJECTIVETo analyze the effect of Chinese herbs used by Prof. LI Tao on peripheral blood T subsets in treating multiple sclerosis (MS) by using association rules and statistical methods, thereby providing evidence for optimizing prescriptions.

METHODSData of MS inpatients and outpatients recorded by data collecting system, Xiyuan Hospital, China Academy of Chinese Medical Sciences were resorted. The relationship between Chinese herbs and T cell subsets were analyzed using SPSS17.0 and Aprior module in SPSS Clementine 12.0.

RESULTSRadix bupleuri, Radix Paeoniae alba, Fructus Aurantii, Atractylodes, and Radix Glycyrrhizae were most commonly used herbal combinations.Radix Aconiti lateralis preparata and Rhizoma Smilacis glabrae were often added. Radix Aconiti lateralis preparata was associated with decreased Th1 cells (confidence level 83.78%, supportive level 36.26%). Decreased Th1 cell was associated with Radix Aconiti lateralis preparata (confidence level 71.26%, supportive level 36.26%).Radix Aconiti lateralis preparata was obviously associated with decreased Th1 cells. Radix Bupleuri, Radix Paeoniae alba, bitter orange, Atractylodes , Radix glycyrrhizae, and Radix Aconiti lateralis preparata could reduce peripheral blood Th1 subsets of MS patients and elevate Th2 subsets (all P < 0.01).

CONCLUSIONSThe herbal combination of Radix Bupleuri, Radix Paeoniae alba, Fructus Aurantii, Atractylodes, Radix Glycyrrhizae, Rhizoma Smilacis glabrae, and Radix Aconiti lateralis preparata could lower peripheral blood Th1 cells and elevate Th2 cells, and prevent the relapse of MS possibly by reducing Th1 cells and elevating Th2 cells. Especially Radix Aconiti lateralis preparata played important roles in aforesaid changes of Th1 and Th2.

Aconitum ; chemistry ; Atractylodes ; chemistry ; Bupleurum ; chemistry ; China ; Drugs, Chinese Herbal ; therapeutic use ; Fruit ; chemistry ; Glycyrrhiza ; chemistry ; Humans ; Multiple Sclerosis ; therapy ; Paeonia ; chemistry ; Plant Roots ; chemistry ; Rhizome ; chemistry ; Smilacaceae ; chemistry ; T-Lymphocyte Subsets ; drug effects