Objective To investigate the duration of the first-fundus-examination and the status of diabetic retinopathy in patients with type 2 diabetes mellitus. Design Questionnaire. Participants 956 patients (1905 eyes) with type 2 diabetes in Tongren Eye Center of Beijing Tongren Hospital. Method Self-designed questionnaire was carried out. Patients were divided into different groups by the du-ration of the first-fundus-examination, degree of diabetic retinopathy, duration of diabetes, education background and living area in the data analysis. Main Outcome Measurements Duration of the first- fundus-examination, degree of diabetic retinopathy. Results Dia-betes patients in shorter duration groups finished the first-fundus-examination earlier than in longer duration groups (all P <0.05). Dif-ferent education background didn't show significant influence on duration of the first fundus examination. Urban patients received earli-er first-fundus-examination than rural patients (all P <0.05). The incidences of vitreous hemorrhage, retinal detachment and retinal pho-tocoagulation were rising with the duration of diabetes. The proportions of vitreous hemorrhage and retinal photocoagulation were higher in primary-school education group than in middle-school and college education groups (all P<0.05). Difference of the incidences of vit-reous hemorrhage and retinal detachment weren't found between in Beijing and non-Beijing patients. The incidences of vitreous hemor-rhage and retinal detachment in urban patients were higher than in rural patients (all P<0.05). Conclusion The most diabetic patients finish the first-fundus-examination much later than requested. Diabetic patients in lower-education-level groups and in rural group are even later, and their conditions are more serious.(Ophthalmol CHN, 2009, 18: 279-282)

Objective　To evaluate the possible role of vascular endothelial growth factor (VEGF) in the pathogenesis of retinal neovascularization resulting from retinal ischemia．　Methods　Retinal vein occlusion of rabbits model was established with argon laser photocoagulation to retinal vein．The VEGF mRNA expression was observed in ischemic retina and retinal neovascular tissue with in situ hybridization technique．　Results　VEGF mRNA expression was detected in inner ischemic retina and retinal neovascular tissue that were corespondent to the distribution of retinal ischemia． The strongest VEGF mRNA expression was detected in retinal neovascular tissue．　Conclusion　VEGF might play an important role in the pathogenesis of vascular proliferative retinopathy．

Purpose:During the malignant transformation, most tuomr cells will become resistant to anoikis (the apoptosis induction upon loss of anchorage), thereby gaining an important growth advantage and providing the basis for tumor spread, growth at distant places, and formation of metastasis.The present study focus on the role of soluble fibronectin, integrin and their signal transduction in the process of tumor cells anoikis apoptosis.Methods:Flow cytometry detected integrin subunits' expression on the human squamous cell carcinoma cell (HSC 3) surface. Establish anoikis induction model. The role of different integrin subunits during anoikis induction were detected by antibody blocking method, p53 and Bcl 2/Bax expression were measured during this anoikis process.Results:There is no or low expression of integrin av on the normal epithelial cells, whilst it expresses relative higher on the surface of HSC 3 cells. The treatment of soluble fibronectin decreased p53 expression, increased the ratio of Bcl 2/Bax and then protected HSC 3 cell from anoikis. Anti integrin ?v blocking antibody resumed the anoikis that was inhibited by soluble fibronectin evidently. Conclusions:We now provide the evidence that the binding of integrin ?v and soluble fibronectin protected HSC 3 cells from anoikis apoptosis, via decreasing the expression of p53, increase the ratio of Bcl 2/Bax.

AIM: To determine the aqueous, vitreous, serum levels of pigment epithelium-derived factor (PEDF)and vascular endothelial growth factor(VEGF)in patients with proliferative diabetic retinopathy(PDR), and to speculate on the source of the change in concentration and to discuss its clinical significance.METHODS:Forty-one eyes withproliferative diabetic retinopathy were included in the study, 16 of which were complicated by neovascularization of iris (NVI).Twenty-one eyes with idiopathic macular hole (MH)were as controls. The aqueous, vitreous, serum levels of PEDF and VEGF of all the groups were determined with ELISA. PEDF, VEGF and the levels in the three groups were compared with analysis of variance (ANOVA). The PEDF, VEGF concentrations in aqueous,vitreous and serum were analyzed with Pearson correlation test,and the correlation of PEDF and VEGF levels was also analyzed with Pearson correlation test.RESULTS:The aqueous levels of PEDF decreased significantly in sequence in groups of control, PDR without NVI, PDR with NVI. VEGF levels increased coordinately. The similar findings existed in vitreous samples. The PEDF,VEGF levels in aqueous were not correlated significantly with those in serum,but correlated positively with those in vitreous. The intraocular levels of PEDF had a negative correlation to those of VEGF.CONCLUSION:The reduction of intraocular PEDF level and elevation of intraocular VEGF level may play an important role in the occurrence and progression of PDR. In the development of PDR, the PEDF,VEGF levels in aqueous may be mainly effected by local pathological changes, as anti-angiogenic and pro-angiogenic factors, their unbalanced intraocular distribution may promote the angiogenesis of the iris and retina.

With the improvement of clinical and scientific research level of pediatric retinal diseases in China,teaching in pediatric retinal diseases for medical students and residents has become increasingly important.Because infants cannot cooperate in ophthalmic examinations,this part becomes a difficult point in clinical teaching and practice.By using the RetCam,a wide-field retinal imaging system,infant's retinal images can display in real time on screen and images and videos can be recorded and reviewed after examination finished.By setting up teaching target reasonably,arranging teaching contents scientifically,and using teaching method properly,we applied multimedia-assisted instruction in teaching pediatric retinal diseases based on RetCam and enhanced teaching effect.

Objective To evaluate the clinical results of phacoemulsification combined with pars plana vitrectomy for eyes with cataract and proliferative diabetic retinopathy. Design Non-controlled retrospective case series study. Participants 123 eyes with proliferative diabetic retinopathy (PDR) and cataract. Methods Phacoemulsification,posterior chamber intraocular lens (PCIOL) implantation combined with pars plana vitrectomy were done in 123 eyes with proliferative diabetic retinopathy (PDR) and cataract. Postoperative vision,number of secondary procedures and surgical complications were analyzed. Main Outcome Measures Postoperative visual improvement and associated complications. Results All 123 eyes underwent combined surgery. The average follow-up was 10 months. 99 eyes (81%) experienced postoperative vision improvement of varying degrees. Vision improved by 2 lines or more in 93 eyes (76%). No apparent corneal edema or corneal decompensation were encountered. One patient with type 1 diabetes developed neovascular glaucoma 6 months after surgery. Retinal detachment occurred in 1 eye and reoperated. Vitreous hemorrhage requiring secondary procedure happened in 4 eyes. All 24 eyes (19%) without vision improvement were found to be with diabetic maculopathy. Conclusions Phacoemulsification combined with pars plana vitrectomy can be used as an effective surgical tool to improve visions in patients with PDR and cataract. Diabetic maculopathy is the major cause of poor visual improvement. (Ophthalmol CHN ,2006,15: 198-201)

Open ocular trauma in children is one of the main causes of non-congenital monocular blindness in children. Children’s psychological and daily activities are different from those of adults; the eye tissue structure is not maturely enough, and the characteristics of high response to injury and incompatibility with various diagnostic and treatment methods determine the factors that cause injuries and injuries in children with open ocular trauma. The environment, diagnosis and treatment, and prognosis of children are more complicated than adults. For the emergency of first and second stage on diagnosis and treatment of children with open ocular trauma, it should follow the principles of adult open ocular trauma management, combined with the children's characteristics, clarifying the anatomical location of the ocular trauma before surgery, and closing the wound during the first-stage operation. At the same time, the disturbance of intraocular tissue should be minimized, the timing of the second stage operation and the individualization of the operation design, and the medication and care after the operation should also be combined with the characteristics of children. Prevention of ocular trauma in children is the focus of attention. In the new information era, clinical research and public information platforms should be fully utilized to advance the epidemiological study of children's ocular trauma and guide the construction of the prevention and treatment system for children's ocular trauma more scientifically.

Dental Offices ; organization & administration ; standards ; Private Practice ; organization & administration ; standards ; Quality of Health Care

Objective To use numerical simulation for analying hemodynamic changes in intracranial aneurysm with elastic wall, and to analyze the effect of mechanical properties of the aneurysm wall on the hemodynamic changes. Methods Based on the DSA images of a patient with multi-intracranial aneurysm, the numerical simulation of the hemodynamics of the elastic intracinal aneurysm was processed using a software of finite element method of computational fluid dynamics (CFD) and the computational fluid-structure interaction analyses. We also investigated the effect of the coupling of hemodynamics and aneurysm wall movement. Results The morphology of the elastic aneurysm underwent deformation, and the angle between aneurysm and parent artery also changed, affecting the inflow jet dispersed into the flow field of aneurysm and the distribution of wall shear stress on the surface of aneurysm. Conclusion The numerical simulation of CFD can directly reflect the hemodynamic characteristics of aneurysms. More accurate elastic wall aneurysm model is needed to improve the quantitative analysis of the hemodynamics of intracranial aneurysms.

Objective To observe the effect of Sini decoction on inflammatory response and immune function in septic rats and to discuss its possible mechanism.Methods 66 Sprague-Dawley (SD) rats were randomly divided into normal control group (n=6),model group (n=30),and Sini decoction group (n=30).Septic model was reproduced by intraperitoneal injection of lipopolysaccharide (LPS,5 mg/kg).After the reproduction of sepsis,rats in Sini decoction group received Sini decoction (5 g/kg) by gavage,while those in model group were given equal dose of normal saline in the same way.Rats in normal control group did not receive any treatment.Blood was collected via eye sockets at 2,12,24,48,72 hours after LPS administration,then the rats were sacrificed.The concentrations of inflammatory mediators,such as interleukin (IL-1,IL-6,IL-10),tumor necrosis factor-α (TNF-α),and the expression level of monocyte human leukocyte antigen-DR (HLA-DR) were determined with enzyme linked immunosorbent assay (ELISA),and the pathological changes in intestinal mucosa were observed under electron microscope.Results The concentration of IL-1 (ng/L) at 2 hours in model group was gradually increased and peaked at 48 hours (4.07 ± 0.10),and then gradually decreased,while the IL-1 level in Sini decoction group peaked at 12 hours (2.98 ± 0.12) followed by a gradual decrease.IL-6 (ng/L) in model and Sini decoction groups peaked twice at 12 hours (91.39 ± 1.55,73.00 ± 2.38) and 48 hours (82.51 ± 1.49,64.68 ± 1.68) respectively.IL-10 (ng/L) in model group gradually decreased after peaking at 2 hours (86.66 ± 6.12),and that in Sini decoction decreased at 12 hours (71.61 ± 2.35) followed by an increasing tendency,and approached normal level at 48 hours (109.09 ±4.77 vs.124.01 ± 7.89,P＞0.05).TNF-α (ng/L) in model group was gradually increased and peaked at 48 hours (83.37 ±3.79),and that in Sini decoction peaked at 12 hours (48.52 ± 1.21),and decreased to normal level at 72 hours (18.59 ± 1.97 vs.15.50 ± 2.68,P＞0.05).During the course of the experiment,as compared with those of the model group,level of IL-1,IL-6,and TNF-α were significantly lower at all time points in Sini decoction group,and IL-10was significantly higher.The expression level of HLA-DR (μg/L) in model and Sini decoction groups peaked at 2 hours (4.86 ± 0.15,4.85 ± 0.17),and then gradually lowered.HLA-DR expression μg/L) at 48 hours and 72 hours in Sini decoction group was significantly lower than that in model group (48 hours:4.21 ± 0.12 vs.2.74 ± 0.16,72 hours:3.80 ± 0.09 vs.2.27 ± 0.12,both P＜0.01).Pathological study of intestinal mucosa showed that the intestinal mucosa were infiltrated significandy by inflammatory cells,and villi were damaged severely in both model group and Sini decoction group at 2 hours after LPS challenge.Infiltration of inflammatory cells in Sini decoction group was less intense after 12 hours,and the intestine villi repair was more obvious compared with model group.Conclusion Sini decoction could regulate systemic inflammatory response,and promote the repair of intestinal mucosa,the intestinal function and the immune status of septic rats.