Giving up treatment in ophthalmology is common in our country. Financial difficulty is the main reason of abandoning treatment in ophthalmology. We should make every effort to deal with some patients with ocular diseases who had no light perception at all. Misdiagnosis and wrong therapy ought to be avoided as much as possible in our clinical practice. The giving up treatment of retinoblastoma is relatively common in our country at present time and its early diagnosis and early treatment is very important. Therapeutic giving up treatment is a new concept and eye doctors can make use of it in some special situations in that the disease can be treated effectively.

Background The enhance of differentiation of orbital preadipocyte is a main factor for pathogenesis of thyroid associated ophthalmopathy(TAO).Experiment has proved that orbital preadipocyte can differentiate into mature adipocyte expressing resistin,and resistin is a adipocyte factor with biological activity.Objective The present study is to investigate the effects of recombinant human resistin on differentiation of orbital preadipocytes derived from TAO patients orbital tissues.Methods Orbital adipose tissue was obtained from 10 eyes with TAO during the orbital decompression surgery.Orbital adipose tissue of the normal group was obtained from 5 removed eyes during the surgery due to different reasons.Preadipocytes were isolated and cultured using expand culture method.The 2-5 generations of preadipocytes were identified by oil red O staining under the light microscope.0,10,25,50,100ng/mL of recombinant human resistin were added into medium in the first day after differentiation of cells.The expression of PPARγ mRNA in differentiated adipocytes were detected by reverse trancripaton PCR(RT PCR).Results The differentiation of preadipocyte presented the similar procedure and outcome between the TAO group and normal group.Differentiated adipocyte was stained into the jacinth by oil red O.The expression of PPARγ mRNA in differentiated cells was gradually declined with the increase of concentration of recombinant human resistin (F=241.341,P＜0.01).A dose dependent inhibitory effect was detected in the expression of PPARγ mRNA.The weakest expression of PPARγ mRNA in differentiated cells was 100ng/mL resistin group.Conclusion The recombinant human resistin has an inhibitory effect on the differentiation of orbital preadipocytes by reducing the expression of adipose related genes.Resistin is probably a new research approach to treatment of TAO.

Objective To observe the clinical manifestations and the effect factors of thyroid-associated ophthalmopath (TAO) with optic neuropathy. Methods The clinical data of 62 cases (120 eyes) of TAO with optic neuropathy diagnosed in 1994-2001 were retrospectively analyzed. Results The incidence of TAO with optic neuropathy was 18.3% in all the simultaneous TAO inpatients, and was more frequently found in the male than in the female ones. The incidence of TAO with optic neuropathy was correlated with orbitono-increase, ocular myopathy, hypertension, hyperlipemia, diabetes, and cardiopathy (P0.05). In 62 patients with the methylprednisolone pulse therapy, the visual acuity improved in 33 (29 0%), improved while the treatment but decreased after stop treating in 29 (24.2%), and no changes in 58 (46.8%). In 63 eyes undergone orbital decompression with methylprednisolone pulse therapy, 59 (93.7%) had better visual acuity. Conclusion The incidence of TAO with optic neuropathy was correlated with orbitono-increase, ocular myopathy, hypertension, hyperlipemia, diabetes, and cardiopathy. Methylprednisolone pulse therapy and orbital decompression are the effective measures for TAO with optic neuropathy.

Objective To evaluate the role of the cell cycle related genes cyclinD1 and Bcl-2 protein expression in the pathogenesis and infiltration of the uveal melanoma. Methods Using immunohistochemistry to detect the cyclinD1 and bcl-2 protein expression in 96 cases of uveal melanoma. Results The expression content of bcl-2 was high in uveal melanoma, and there wasnt any relationship between bcl-2 cell positivity and tumor cell type and extrascleral extension. In contrast, cyclinD1 expression was higher in epithelial cell uveal melanoma than mix cell and spindle cell varieties. There was a positive correlation between cyclinD1 cell positivity and extrascleral extension. Conclusion The expression of bcl-2 protein is important for the survival of the uveal melanoma. CyclinD1 may serve as a sensitive index of its malignancy.

Objective To investigate the role of anti apoptosis gene bcl 2 in the survival of cultured uveal melanoma UM cells. Methods Antisense oligodeoxynucleotides (AS ODN) bcl 2 were delivered with cationic lipid to primary cultured UM cells. The inhibitory effect of AS ODN bcl 2 on proliferation of UM cells was examined by 3, 4,5 Dimethyliazol 2,5 diphenyl tetrazolium bromide (MTT) method. Using DNA ladder to determine if the UM cells had been apoptotic. Bcl 2 expression was detected by RT PCR and Westernblot technics. Results The effect of AS ODN bcl 2 in inhibiting the proliferation of cultured UM cells had opposite relation to dosage. It down regulated the mRNA and protein level of bcl 2 gene, and the sense ODN didn′t have this effect. Conclusion AS ODN bcl 2 can down regulate bcl 2 expression, inhibits UM cells proliferation and induces apoptosis.

Objective To probe the significance of application of ultrasound biomicroscopy (UBM) in the diagnosis and management of the iris and ciliary tumors. Methods UBM (Mode 840, Humphrey, 50 MHz 5 mm?5 mm) was done in 34 cases (35 eyes) of iris and ciliary body tumors, and some of the affected eyes underwent B scan or Doppler ultrasound and CT scan. Histopathological examination of the resected tumor tissues was performed in 21 eyes of the operation. Results Among this series of 35 eyes with iris and ciliary body tumors detected by UBM, the characteristics of locality and solidity of the tumors, i,e., anterior chamber in plantation cyst, cyst behind the iris, and solid tumors of iris and ciliary body, of 21 eyes undergone surgical treatment revealed the same results both in UBM and histopathological examinations. Conclusion UBM can supply precise informations in diagnosis and treatment of tumors of iris and ciliary body.

Objective To evaluate color Doppler ultrasonography(CDU) in the diagnosis of intraocular tumor. Methods Two hundred seventy-three cases(301 eye) of intraocular space-occupying lesions were examinated by high-resolution CDU to observe the two-dimensional gray-scale image and vasculature of intraocular tumors. Results Intratumor calcifying spot could be detected in 138 cases(149 eye) of 153 cases(178 eye) with retinoblastoma,and intratumor blood flow with branchy pattern could be found in 152(177 eye) of 153 cases(178 eye) with retinoblastoma. In 4 Coats disease and 2 persistent hyperplastic primary vitreous and 3 retinopathy of prematurity, intratumor calcifying spot couldn′t be detected,and the band blood flow of the detached retinal vessels could be detected. Intratumor blood flow with branchy pattern could be detected in all 66 choroidal melanomas and 4 melanomas of ciliary body with infiltrated choroid and 15 of 19 choroidal metastases. Intratumor blood flow with “simulating vessel pool” or conglomerate sparkled pattern could be found in 12 choroidal hemangioma. No intrinsic flow was detected in 8 choroidal hemorrhages or subretinal hemorrhages and 2 teratoid medulloepitheliomas. Conclusions CDU is of significance in the diagnosis and differention of intraocular tumors.

Objective To evaluate the methods and efficacy of microsurgical treatment for the premalignant and malignant lesions of the conjunctiva. Methods Forty-seven patients witn premalignant and malignant lesions of the conjuncitva were managed by microsurgical, these patients include 12 melanoma, 26 squamous cell carcinoma, 6 Bowen’ diseases, 3 primary acquired melanosis. The surgical method differs with limbal tumors, extralimbal tumors, and primary acquired melanosis. Results In all 47 patients, the tumor was completely removed in in one procedure. After follow-up for 4~60 months(mean 17 months), these were no tumor recurrence. Conclusion It is effective methods that premalignant and malignant lesions of the conjunctiva are managed by microsurgical resection, alcohol application, and supplemental cryotherapy. Careful propeirativa clinical evaluation of patient with a conjunctiva neoplasm is important in making the correct diagnosis and planning the surgical approach.

AIM: To understand the effect of the RB1 gene mutation on the function of pRB (the protein product of the RB1 gene) in the patients with retinoblastoma (RB). METHODS: The genomic DNA from retinoblastoma patients was extracted. After amplification, the promoter and all 27 exons were screened by SSCP-heteroduplex method. The mutation was cloned and identified by sequencing. The effect of the mutation product on the function of pRB was analyzed. RESULTS: One missense mutations of the exon 4 of the RB1 gene was identified in the genomic DNA from RB patients. This mutation was outside the large pocket of the pRB. No mutation of the RB1 gene was found in the genome DNA of the patient's parents. This is the fourth report that there was a genome mutation located outside the large pocket of pRB in the RB patients. CONCLUSION: The amino-terminus of the pRB may be essential for growth suppression.

Objective To probe the relationship between the patients′ prognosis and the gene of multidrugs and drug resistance in uveal melanoma. Methods The gene expression of cyclin D1, epithelial growth factor receptor (EGFR), non metastasis gene 23 (nm 23), P glucose protein (P gp), multidrug resistance relation protein (MRP) and lung resistance protein (LRP) expression in 96 cases of uveal melanoma were detected by depigment immunohistochemistry. The patients with complete anamnesis data were observed continuously, and the follow up results were classified. Results Among the 96 cases of uveal melanoma, the epithelioid cell type was in 21, the mixed cell type in 56, and the spindle cell type in 19; including 76 at intraocular stage and 20 at extraocular stage. As the level of metastasis suppress gene nm 23 expression decreased and the level of cyclin D1 and EGFR expression increased, the expression level of drug resistance genes increased. The levels of LRP and MRP had negative correlation to the expressions of nm 23 and postive correlation to the expressions of nm 23, Cyclin D1 and EGFR. In 58 patients′ who were observed continuously, 19 died in 5 years and 26 survived over 5 years. Conclusion There are significant association between patients′ prognosis and multidrug and drug resistance gene in uveal melanoma.