Diabetic retinopathy (DR) is one of the most significant microvascular complications of diabetes,and its incidence increases with the prolongation of DM;meanwhile,it can lead to severe vision loss.Recently,the pathogenesis of DR has been one of the focuses both at home and abroad,but the basic mechanisms are not fully elucidated.More and more scholars believe that DR may be a chronic and low degree of inflammatory response.Moreover,it is well established that microglia is a monocyte-macrophage,with antigen-presenting function.Especially in the retina,as microglia is activated,followed by the release of a large number of inflammatory factors,microglia involves in DR inflammatory response.Understanding the activation mechanism of microglia can provide a new perspective for the prevention and treatment of DR.Therefore,recent advances in activation of microglia in diabetic retinopathy and its intervention mechanism will be reviewed in the article.

Adult ; Female ; Hemoperfusion ; Humans ; Male ; Neurotoxicity Syndromes ; etiology ; therapy ; Organophosphate Poisoning ; Pesticides ; poisoning ; Retrospective Studies ; Treatment Outcome

Objective To investigate the prognostic risk factors for surgery in patients with cirrhotic portal hypertension.Methods One hundred and sixty one patients with cirrhotic portal hypertension who received surgery in our hospital in the past 10 years were studied.The data were entered into a pre-designed form.24 predictors including patients′ age,sex,degree of liver atrophy,ChildPugh classification,coagulation profile,splenic size,renal function,blood pH,base excess (BE),operative time,volume of ascites,and intraoperative and postoperative hemorrhage were recorded and analyzed.For each of the predictors,2-3 subgroups were compared.Results Seven predictors were clearly related to surgical prognosis:postoperative bleeding within 30h (B0.356,P＜0.001) and a bleeding volume ＞2 L were awarded 3 points; liver volume (B-0.160,P＜0.001) and severe liver atrophy (antero-posterior diameter of the left liver lobe ≤55 mm,oblique diameter of the right lobe ≤110 mm) were awarded three points; blood pH (B0.141,P＜0.001),pH＜7.35 was awarded 2 points; BE (B-0.123,P＜0.001),BE＜-3 (mmol/L) was awarded 2 points; decrease in PLT (B0.065,P =0.015),PLT＜ 3 (T/L) was awarded 2 points; intraoperative bleeding (B0.062,P=0.014),bleeding volume ＞2 L was awarded 2 points; decrease in RBC (B0.053,P=0.024),＜3(G/L) was awarded 1 point.Of the 147 patients who recovered from surgery,all had ≤3 points,except one who had 4 points.Of the 14 patients who died,all had ≥5 points except one who had 4 points.Conclusions Postoperative bleeding (＞2 L),severe liver atrophy (antero-posterior diameter of the left live lobe ≤55 mm,oblique diameter of the right lobe ≤110 mm),blood PH＜7.35,BE ＜-3 (mmol/L),PLT＜30 000(T/L),intraoperative major bleeding (＞2 L) and RBC＜3 (G/L) were significant prognostic risk factors for surgery.For patients who had a score of 5-6 points; death was likely following surgery.A score ≥8 points should be considered as a contraindication to surgery.To reduce operative mortality,active treatment should be given before surgery to keep the score to be 4 points or less.

Objective To investigate the diagnostic value comparatively of CT and radiography in pneumoconiosis.Methods Chest radiographic and CT images were analyzed retrospectively in 52 cases with pneumoconiosis.Results The pulmonary disseminated small shadowes (diameter 10 mm),13 cases and 9 cases were detected by CT and radiography respectively.20 cases (5 pneumonia,3 pulmonary tuberculosis,1 lung cancer,6 pneumothorax,4 pulmonary emphysema) and 10 cases (1 pneumonia,1 pulmonary tuberculosis,6 pneumothorax,2 pulmonary emphysema) with complications were showed by CT and radiography respectively.Conclusion CT is not superior to radiography in diagnosis of simple pneumoconiosis,but CT is superior to radiography detecting the big shadow of lung and complications,and it can help radiologists to avoid mistakes.

Objective To investigate the effect of anterior percutaneous endoscopic discectomy (APECD) and open-door laminoplasty (ODLP) through hybrid surgery in the treatment of multisegmental cervical stenosis and giant disc herniation. Methods This study involved 3 patients with multisegmental cervical stenosis and giant disc herniation confirmed by MRI. Among them, there were 2 males and 1 female, with ages from 56-61. All patients showed significant paresthesia or weakness, and were treated between September and November 2016. The surgery was performed by first the ODLP that made spinal cord back shift, and then APECD for the second step. The visual analog scale (VAS) and neck disability index (NDI) were assessed before and after operation. Results The VAS and NDI scores were improved two weeks after operation. No adverse events like spinal cord injury and vascular injury were found during the operation. After operation, no patients were found incision infection, hematoma formation, cerebrospinal fluid leakage, dysphagia, trachyphonia and so on. Conclusion The hybrid surgery of APECD and ODLP for the treatment of the multisegmental cervical stenosis and giant disc herniation can not only decompress the nerve safely and improve the function, but also preserve cervical intervertebral disc and motion segments, therefore delaying the degeneration of adjacent segments with clinical significance.

Objective To evaluate the effect of en bloc open-door laminectomy and pedicle screw fixation for extremely severe cervical ossification of posterior longitudinal ligament (OPLL).Methods From January 2007 to December 2011,16 cases of serious cervical OPLL were treated,in which there were 13 males and 3 females,aged from 45 to 74 years (average,56.5 years).Spinal cord functional deterioration was related to minor activities of the neck,such as sneeze,cough or hyperextension of the neck,in 15 cases.One case suffered from aggravating neurological symptoms without a definite precipitating factor.The average preoperative Japanese Orthopaedic Score (JOA) was 7.1 ±1.8.Preoperative CT scans displayed the average stenotic rate (thickness of OPLL/sagittal diameter of the spinal canal) was 83.7％.All the patients received en bloc laminectomy and pedicle screw fixation of the cervical spine.Results All the patients were followed up for 3 months to 4 years (average,24.4±10 months).The JOA scores at 2 weeks,3 months,and the last follow-up postoperatively were 13.2±1.7,13.5 ±1.6 and 14.1 ±1.5,respectively; the improvement rates were 61.6％,64.6％ and 70.7％,respectively.The operative time ranged from 80 to 150 minutes (average,130 minutes),and blood loss ranged from 150 to 600 ml (range,300 ml).One case of postoperative wound hematoma,1 case of cerebrospinal fluid leakage and 3 cases of trapezius muscle pain occurred in this group.No serious complications,such as deep infection,deterioration of neurological dysfunction,vertebral artery injury and internal fixation failure,were noticed.Conclusion Owing to the minimum interference to the cervical spinal cord,stabilization of the decompressed segments and maintenance of cervical lordosis,en bloc open-door laminectomy and pedicle screw fixation is suitable for extremely severe cervical OPLL.

Objective To study the onset,treatment,prognosis and possible causes of transient quadriplegia shortly after anterior cervical compression and fixation (within four hours postoperatively) in three patients with cervical spondylotic myelopathy who could function well for limbs after anesthesia awakening from the operation. Methods A retrospective study was carried out on medical data of three patients including two males and one females,at age of 41-61 years.Anterior cervical corpectomy,titanium mesh bone fusion and titanic plate fixation were performed under general anesthesia.The decompression segment was C5 in one patient,C6 in one and C5 plus C6/7intervertebral disc in one respectively.Paralysis occurred between 30 minutes and 4 hours postoperatively.Two patients were with complete paralysis and one with incomplete. All the patients received dehydration,neurotrophic drugs and high-dose methylprednisolone therapy immediately after paralysis. Meanwhile,emergent cervical MRI was performed,which showed spinal cord swelling,without obvious spinal cord compression by hematoma.Results The paralysis was alleviated completely in two patients within two hours after early medication without additional surgical compression.The other one patient was recovered incompletely at 24 hours after medicationand then underwent posterior cervical laminoplasty,when tremendous pressure was released from cervical spinal cord.But the spinal function had significant recovery after surgical compression and won complete recovery one week later. Conclusions Besides spinal cord ischemia-reperfusion injury,the transient paralysis after anterior cervical surgery may be associated with cervical spinal cord swelling and limited anterior decompression space.Early diagnosis and early intervention of paralysis may save the spinal cord function and attain a satisfactory prognosis.

Background The safety,effectiveness and predictability of laser in situ keratomileusis (LASIK) to correct hyperopia are of a widely clinical concern,but the efficacy of LASIK for hyperopic correction is not satisfied in comparison to that of myopia.Objective The aim of this work was to evaluate the safety,effectiveness and predictability of autologous corneal len inlays to correct hyperopia.Methods Autologous corneal len inlays was performed on the left eye of female patient with the diopter of +3.25 DS.This patient was followed-up for 1 month.Cornea compensatory intraocular pressure (IOPcc) and imitation Goldmann IOP (IOPg) were measured,and the corneal thickness and corneal flap were observed using optical coherence topography (OCT).Corneal topography was examined to check the change of corneal curvature.Ocular response analyzer was used to evaluate the shifts of corneal hysteresis (CH) and corneal resistance factor (CRF).Uncorrected and best corrected visual acuity and refraction were compared between before and after operation.Written informed consent was obtained from the patient prior to the operation.Results No intraoperative and postoperative complications were found.Uncorrected distance visual acuity improved one line 1 day and 1 month after surgery,and near visual acuity progressed to J2 and the spherical equivalent (SE) was-0.125 D 1 month after surgery.OCT exhibited that the cornea was clear and transparent,and the graft was centered in the corneal stroma capsular bag without rejection 1 month after surgery.The IOPcc was 12.4 mmHg before operation and 11.9 mmHg 1 month after operation,and IOPg was 11.9 mmHg before operation and 10.7 mmHg 1 month after operation in the operated eye.The CH was 9.7 mmHg before operation and 8.9 mmHg 1 month after operation,and CRF was 10.9 mmHg before operation and 10.3 mmHg 1 month after operation,without remarkble change in the indexes mentioned above.Conclusions Autologous corneal implantation can be used to correct hyperopic eye with good safety,effectiveness and predictability.

One hundred and eighty three women with high risk of breast cancer identified in Baoding First Central Hospital from June 2007 to June 2014,were enrolled in the study.In these 183 cases,41 received preventive therapy (22.4％),142 did not.Factors associated with acceptance of chemoprevention included older age,menopause,comorbidities,lower level education,being married,higher BMI,having high level hyperplasia of ductal epthelia and counseling to breast specialists (P ＜ O.05);whilenot informed by doctors was the main reason for failed taking preventive agents(95.1％,135/142).Thirteen of 41 women receiving chemoprevention discontinued the therapy (31.7％);no-insurance,no side-effects and higher BMI were related to the discontinuing (P ＜ 0.05).The 1-,2-,3-,and 5-year adherence rates of chemoprevention was 86.1％ (31/36),65.4％ (17/26),59.1％ (13/22),8/13 and 5/10,respectively.The results show that chemoprevention rate is low among Chinese women at high risk of breast cancer,and the long-term adherence to preventive therapy is poor.Corresponding measures should be taken to strengthen the chemoprevention of breast cancer.

Leukemia inhibitory factor (LIF) plays important roles in varieties of biological processes. This factor is highly conserved in mammalian animals and only one heterozygous LIF mutation was reported to cause the infertility of women. A LIF mutation was generated and the evidences were provided that the mutation of mature LIF at the 29th amino acid totally abolished its functions, including stimulation of STAT activation assayed by Luciferase reporter gene expression and EMSA experiments. In addition, the mutated LIF failed to inhibit the proliferation of M1 cells. The data indicated that the mutation of LIF did not have a dominant negative effect but lost the biological functions, suggesting that the 29th amino acid is critical for maintaining the activities of LIF.