AIM: To observe and analyze the efficacy of Conbercept combined with 577nm yellow subliminal micropulse laser photocoagulation in the treatment of macular edema(ME)secondary to ischemic branch retinal vein occlusion(BRVO).

METHODS: Totally 71 patients(71 eyes)diagnosed as ME secondary to ischemic BRVO during the period from March 2016 to March 2019 were retrospectively included, and they were divided into laser group(n=33, 33 eyes)and combined group(n=38, 38 eyes)according to the different treatment methods. The patients in the laser group all received 577nm yellow subliminal micropulse laser photocoagulation, and the patients in the combined group all received Conbercept combined with 577nm yellow subliminal micropulse laser photocoagulation. The best corrected visual acuity(BCVA), central macular thickness(CMT)and total macular volume(TMV)were compared between the two groups before treatment and at 1, 2, 3, 6, 9 and 12mo after surgery, and the therapeutic efficacy was observed and the occurrence of complications were recorded.

RESULTS:There were statistically significant differences in the BCVA, CMT and TMV between the two groups before and after treatment(P<0.05), and the BCVA, CMT and TMV in the two groups at 1, 2, 3, 6, 9 and 12mo after treatment were significantly lower than those before treatment(P<0.05), and the differences between the two groups were statistically significant(P<0.05). During follow-up, there were 30 eyes with once laser photocoagulation, 7 eyes with twice and 1 eye with 3 times in combined group, and there were 16 eyes with once laser photocoagulation, 14 eyes with twice and 3 eyes with 3 times in laser group(Z=2.670, P<0.05). There were 3 eyes of corneal epithelial exfoliation on the 1d after vitreous injection in combined group, and the symptoms disappeared after symptomatic treatment. All patients did not have serious complications such as persistent intraocular pressure increase, retinal detachment and intraocular inflammation.

CONCLUSION: Conbercept combined with 577nm yellow subliminal micropulse laser photocoagulation has a significant efficacy in the treatment of ME secondary to ischemic BRVO, and it can effectively improve the visual acuity and promote the macular edema absorption, and it is safe and reliable.

Aim To investigate the protective effect of 1, 8-Cineole on the injury of human aortic endothelial cells (HAECs) induced by high glucose (HG) via regulating autophagy. Methods Cells were incubated with different doses of 1, 8-Cineole followed by exposing to HG for 60 h, and MTT assay was used to analyse cell viability, lactate dehydrogenase (LDH) was used to detect cytotoxicity, and Western blot was used to detect Beclin1, LC3-II/I, p62, caspase-3 and caspase-9 expressions. Autophagy inhibitor (chloroquine, CQ) was treated on HAECs, and the expressions of Beclinl, LC3-II/I, p62, caspase-3 and caspase-9 were measured by Western blot. Results 1, 8-Cineole increased cell viability, reduced the content of LDH, activated autophagy and inhibited apoptosis. Compared with control group, the expression of Beclinl, LC3-II/I, p62, caspase-3 and caspase-9 in CQ group increased. Simultaneously, the expression of above-mentioned between CQ + HG group and CQ + HG + CH group. Conclusions 1, 8-Cineole has protective effect on the injury of HAECs induced by high glucose, and its effect is related to improving autophagy flux.

OBJECTIVETo investigate whether myocardial bridging (MB) is independently associated with coronary atherosclerosis proximal to MB in the left anterior descending coronary artery (LAD) identified by computed tomographic coronary angiography (CCTA).

METHODSFrom March 2011 to December 2012, patients (n=9 862) with suspected coronary disease underwent CCTA using dual-source CT scanner. The baseline clinical characteristics (age, gender, smoking history, presence of hypertension, dyslipidemia, diabetes mellitus, family history of heart attack, and body mass index) and the results of CCTA were reviewed. Two radiologists evaluated the coronary artery for MB and coronary atherosclerosis stenosis (CAS) in LAD and made a diagnosis by consensus. Significant independent risk factors for CAS were investigated by multivariate logistic regression analysis.

RESULTSA total of 3 182 (32.3%) cases of MB and 3 359 cases of CAS of LAD were identified. No patient with CAS in the tunneled segment was found. The mean length of bridges and the mean thickness of the overlying myocardium was (17.3±5.2) mm and (1.2±0.9) mm, respectively. There were 1658 MB cases in 3 359 cases of LAD stenosis and 1 524 MB cases in 6 503 cases of no LAD stenosis (χ(2)=681.12, P<0.05). Logistic regression analysis showed that MB in the LAD were significantly associated with CAS in the proximal LAD (OR=3.07, 95%CI=2.81-3.37, P<0.001), and after final adjustment for age, gender, body mass index, family history of heart attack, smoking, hypertension, dyslipidemia, diabetes mellitus, and resting heart rate (OR=2.86, 95% CI=2.60-3.16, P < 0.001).

CONCLUSIONMB in the LAD is independently associated with CAS in the proximal segment to MB.

Adult ; Aged ; Aged, 80 and over ; Coronary Stenosis ; complications ; diagnostic imaging ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Myocardial Bridging ; complications ; diagnostic imaging ; Risk Factors ; Tomography, X-Ray Computed

OBJECTIVETo assess the value of preoperative coronary computed tomographic angiography (CCTA) in the detection of coronary artery disease (CAD) in patients planned to undergo non-cardiac surgery at intermediate or high risk to avoid unnecessary invasive coronary angiography (ICA).

METHODSThe study protocol was approved by our institutional review board and informed consent was given. In this prospective study, 157 consecutive patients who underwent CCTA before undergoing non-cardiac surgery at intermediate or high risk was involved. The non-cardiac surgery included high-risk surgery (17 patients) and intermediate-risk surgery (140 patients). Follow-up was performed in 6-11 months to define cardiac events described as acute coronary syndrome (ACS) or death secondary to ASC, arrhythmias, cardiac revascularization, or cardiac failure. χ(2) test was performed to compare the differences in incidence of cardiac events among patients who had undergone or who had not undergone preoperative ICA.

RESULTSCCTA was of diagnostic value in 145 of 157 patients. Thirty-seven of 145 had no CAD, and 88 of 145 had no significant CAD (<50% stenosis), and non-cardiac surgery was performed in them without preoperative ICA. No patients in those patients had postoperative ischemic events at follow-up; 20 had significant CAD (≥50% stenosis) and underwent surgery after preoperative ICA. CCTA was non-diagnostic in 12 patients who were referred for preoperative ICA, and 4 of 12 underwent surgery after PCI or CABG. There were no differences in cardiac events between patients who had undergone preoperative ICA and those who had not (P=0.45).

CONCLUSIONSIn patients with planned non-cardiac surgery at medium or high risk of cardiovascular events, preoperative CCTA is an effective diagnostic tool for detecting CAD. Preoperative ICA can be safely avoided in patients with normal findings or with stenosis<50% in CCTA.

Adult ; Aged ; Aged, 80 and over ; Coronary Angiography ; methods ; Coronary Artery Disease ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Perioperative Care ; Prospective Studies ; Tomography, Spiral Computed ; methods

Objective To discuss the clinical value of transabdominal sonography after bowl preparation in diagnosis of ileocecal valve syndrome ( IVS) .Methods The ultrasonic features of IVS in 37 cases were summerized and correlated with the follow-up findings after conservative treatment or the pathologic results after operation .Twenty-eight cases were confirmed by follow-up and 9 cases by operative pathology.Results Among the 37 cases of IVS,28 were idiopathic IVS (75.7%,28/37) and 9 were secondary IVS (24.3%, 9/37%).For the secondary cases, the primary diseases included 5 acute appendicitis,2 Meckel diverticulum,1 terminal ileitis and 1 carcinoma of ascending colon .The diagnostic accuracy rate of ultrasound was 89.2%(33/37).Misdiagnosis rate was 10.8%(4/37),including 1 case of idiopathic and 3 cases of secondary IVS .The IVS ultrasonic images coulde be displayed clearly using 7.0-10.0 MHz probes.In fasting examination,three ultrasonic characteristic signss were found in interminal ileum region at the right lower abdomen .And these features were bagel-shaped sign [91.9%(34/37),average size (1.9 ±1.6) cm ×(0.8 ±0.3) cm],short sleevelet-shaped sign [91.9% (34/37,average size (2.1 ± 0.4)cm ×(1.3 ±0.2) cm],and rose-shaped sign [83.8% (31/37),average size (1.4 ±0.2) cm × (1.0 ±0.2) cm].The shapes of some signs were changeable when the probe compressed .In the case of idiopathic IVS ,several pathologic changes could be seen on sonography after intestinal tract filling of oral 20%mannitol,including slight thickened mucosa and submucosa of erminalileum ,enlarged ieocecal valve and the crocodile-mouth sign.Conclusions Transabdominal ultrasonic examination with high frequency probe after bowl preparation plays an important role in diagnosis of IVS .The method is simple and accurate and should be recommended and applied clinically .

BACKGROUNDLeft main coronary artery (LMCA) stenosis has been recognized as a risk factor for early death among patients undergoing coronary artery bypass grafting (CABG). This study aimed to assess if LMCA lesions pose an additional risk of early or mid-term mortality and/or a major adverse cardiac and cerebrovascular event (MACCE) after off-pump coronary artery bypass grafting (OPCABG), compared with non-left main coronary artery stenosis (non-mainstem disease).

METHODSFrom January 1, 2009 to December 31, 2010, 4869 patients had a primary isolated OPCABG procedure at Beijing Anzhen Hospital. According to the pathology of LMCA lesions, they were retrospectively classified as a non-mainstem disease group (n = 3933) or a LMCA group (n = 936). Propensity scores were used to match the two groups, patients from the non-mainstem disease group (n = 831) were also randomly selected to match patients from the LMCA group (n = 831). Freedom from MACCE in the two groups was calculated using the Kaplan-Meier method.

RESULTSThe difference in the mortality and the rate of MACCE during the first 30 days between the non-mainstem disease group and the LMCA group did not reach statistical significance (P = 0.429, P = 0.127 respectively). With a mean follow-up of (12.8 ± 7.5) months and a cumulative follow-up of 1769.6 patient-years, the difference in the freedom from MACCEs between the two groups, calculated through Kaplan-Meier method, did not reach statistical significance (P = 0.831).

CONCLUSIONAnalysis of a high volume of OPCABG procedures proved that LMCA lesions do not pose additional early and mid-term risk to OPCABG. Therefore, a LMCA lesion is as safe as non-mainstem disease lesion during the OPCABG procedure.

Adult ; Aged ; Coronary Artery Bypass, Off-Pump ; adverse effects ; mortality ; statistics & numerical data ; Coronary Artery Disease ; surgery ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Retrospective Studies

Hydroxycamptothecin (HCPT) loaded PEG modified nanostructured lipid carriers (HCPT-PEG-NLC) and nanostructured lipid carriers (HCPT-NLC) were prepared by melt emulsification and homogenization method. The morphology, particle size and encapsulation efficiency of them were investigated. HCPT concentrations in plasma, heart, liver, spleen, lung, kidney and ovary were determined after iv of HCPT injection, HCPT-PEG-NLC and HCPT-NLC in mice. The targeting indexes of HCPT-PEG-NLC and HCPT-NLC were calculated. The transmission electron microscope imaging showed that HCPT-PEG-NLC and HCPT-NLC exhibited a spherical shape. The particle sizes of them were (88.6 +/- 22.5) and (127.2 +/- 43.4) nm. The encapsulation efficiency were (90.51 +/- 3.29)% and (84.37 +/- 2.81)%, respectively. After iv injection into the tail vein of mice, HCPT plasma concentrations of HCPT-PEG-NLC and HCPT-NLC were higher than that of HCPT injection at each sampling time. They also showed longer elimination time in every tissue. HCPT-NLC accumulated in endothelial system (RES), Re and Ce of it in liver and spleen were significantly higher than HCPT-PEG-NLC. HPCT-PEG-NLC prolonged circulation time and increased bioavailability of HCPT. MRT and AUC0-24 h of it were 19.80 and 17.02 times higher than those of HCPT injection. It also significantly reduced phagocytosis of RES, and showed lung targeting effect (Re and Ce were 14.51 and 41.35). To summarize, HCPT-PEG-NLC could prolong the circulation time of HCPT in vivo, and had the lung targeting effect. It was a promising carrier to increase therapeutic effect of HCPT in treating lung cancer.
Animals ; Antineoplastic Agents, Phytogenic ; administration & dosage ; blood ; chemistry ; pharmacokinetics ; Biological Availability ; Camptothecin ; administration & dosage ; analogs & derivatives ; blood ; chemistry ; pharmacokinetics ; Delayed-Action Preparations ; Drug Delivery Systems ; Drug Stability ; Female ; Lipids ; chemistry ; Lung ; metabolism ; Mice ; Mononuclear Phagocyte System ; physiology ; Nanoparticles ; Particle Size ; Phagocytosis ; drug effects ; Polyethylene Glycols ; chemistry ; Tissue Distribution

Actins ; metabolism ; Adult ; Antigens, Neoplasm ; metabolism ; Diagnosis, Differential ; Epithelioid Cells ; chemistry ; pathology ; Female ; Humans ; Hysterectomy ; Immunohistochemistry ; Melanoma-Specific Antigens ; Mesenchymoma ; metabolism ; pathology ; surgery ; Neoplasm Proteins ; metabolism ; Uterine Neoplasms ; metabolism ; pathology ; surgery

Objective To investigate the regulatory effects of fenofibrate on TNF-α-induced CD40 expression and matrix metalloproteinase (MMP) activity in human vascular endothelial cells (HUVECs). Methods Quantitative RT-PCR and flow cytometry were employed to evaluate the effect of fenofibrate on TNF-α-induced CD40 mRNA and cell surface CD40 expression in HUVECs, and gelatin zymography was used to determine the effect of fenofibrate on the gelatinolytic activities of MMP-2 and MMP-9 in TNF-α-stimulated HUVECs. Results Fenofibrate at the concentrations of5×10-5, 1×10-4 and 2×10-4mol/L significantly reduced TNF-α-induced increment of CD40 mRNA and cell surface CD40 expressions (P＜0.01), with the maximal inhibition achieved at the concentration of 1 × 10-4 mol/L. Fenofibrate at 2× 10-4 mol/L did not further decrease CD40expression induced by TNF-α. Fenofibrate significantly inhibited the stimulatory effect of TNF-α on MMP-2 and MMP-9 activities in HUVECs. Conclusion Fenofibrate reduces TNF-α-induced increment of CD40 expression and MMP-2 and MMP-9 activities in HUVECs.

OBJECTIVETo investigate the diagnosis and differential diagnosis of extranodal Rosai-Dorfman disease.

METHODSTwo cases of extranodal Rosai-Dorfman disease were studied using hematoxylin-eosin, and immunohistochemical staining, along with a literature review.

RESULTSThe lesions of RDD were characterized by the presence of large histiocytes with emperipolesis, accompanied by infiltration of lymphocytes, plasma cells and other inflammatory cells. The large histiocytes had an abundant cytoplasm, pale to eosinophilic in appearance, positive for S-100 protein staining, with a vesicular nucleus and a small basophilic nucleolus in each cell.

CONCLUSIONSExtranodal Rosai-Dorfman disease is known as an idiopathic proliferative disease of histiocytes with a distinct morphologic feature and is very rare. Differential diagnosis from other types of fibrohistiocytic proliferation lesions is recommended.

Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Brain ; pathology ; surgery ; Brain Diseases ; metabolism ; pathology ; surgery ; Dermatologic Surgical Procedures ; Diagnosis, Differential ; Histiocytosis, Sinus ; metabolism ; pathology ; surgery ; Humans ; Male ; Middle Aged ; S100 Proteins ; metabolism ; Skin ; pathology ; Skin Diseases ; metabolism ; pathology ; surgery