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Proliferative diabetic retinopathy (PDR) is one of the most common cause of severe sight impairment in people with diabetes. When PDR develops to a severe stage, vitreoretinal surgery is needed to prevent its aggravation. The surgery for PDR is complicated and difficult. By deeply understanding the pathological mechanism and development law of PDR, and reasonably using various surgical techniques, assisted by emerging surgical equipment and drugs, the surgical efficacy of PDR can be continuously improved, so as to help patients improve or even restore visual function to a greater extent.
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Objective To explore the value of metabolic volume of cardiac tumor (MTV1 to that of the maximum extracardiac tumor (MTV2) ratio in predicating the cardiac tumor origin.Methods A total of 35 consecutive cases (19 males,16 females,age range:18-68 years) with multiple cardiac and extracardiac tumors were enrolled in this retrospective analysis.All of them were confirmed by pathology or clinical follow-up results and examined by 18F-fluorodeoxyglucose PET/CT from January 2010 to February 2016.Maximum standardized uptake value (SUVmax) 3.63 was used as the background threshold.MTV1 and MTV2 were automatically obtained by PETVCRA software.Receiver operating characteristic (ROC) curve was drawn to obtain the diagnostic threshold of MTV1/MTV2 ratio for cardiac tumors,and the sensitivity,specificity and accuracy were calculated.Mann-Whitney u test was used to analyze the data.Results Twelve patients were confirmed to have primary cardiac malignant tumors (PCMT),and 23 cases were metastatic cardiac malignant tumors (MCMT).There was statistical difference of MTV1 between PCMT and MCMT patients:52.9(33.3,703.4) cm3vs 8.1(1.2,24.6) cm3(z=-3.70,P＜0.05).MTV2 was 11.7(1.8,38.4) cm3 in PCMT patients,which was lower than that in MCMT patients (182.0(100.1,238.0) cm3;z=-4.17,P＜ 0.05).MTV1/MTV2 ratio of PCMT was 16.20(9.40,71.80),which was significantly higher than that of MCMT (0.10(0.01,0.60),z=-4.66,P＜0.05).When MTV1/MTV2 ratio=1.2 was selected as the cut-off value,the sensitivity,specificity and accuracy were 12/12,91.30％(21/23),94.29％(33/35) respectively.Conclusion It may be an important criterion for the diagnosis of PCMT that MTV 1 is greater than MTV2.
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Objective To explore the value of high-resolution MRI(HR-MRI) on clinical application in the differential diagnosis between Moyamoya disease(MMD) and atherosclerosis-related Moyamoya syndrome (A-MMS). Methods Seventeen cases of patients with MMD and 18 cases of patients with A-MMS in our hospital from January 2014 to September 2015 were prospectively enrolled in the study. Record the clinical data and the proximal middle cerebral artery (M1 portion) performance on HR-MRI, the max-vessel area, the min-vessel area, the max-lumen area, the min-lumen area, the wall max-thickness, the styles of M1 portion thickening (eccentric or concentric), whether the wall was enhanced or not, and analysis the recorded data statistically, t test and χ2 test were used for the statistical analysis. Results The wall max-thickness of MMD group was (0.94 ± 0.17) mm, which was smaller than that in A-MMS group (1.23 ± 0.42) mm, there was statistic significance (t=-2.977, P=0.006). The cases of M1 portion non-enhancement was 15, slight enhancement 2, strong enhancement 0 in MMD group, and non-enhancement 5, slight enhancement 5, strong enhancement 8 in the A-MMS group, the difference was significant statistically (χ2=9.794, P=0.001). The cases of M1 portion concentric thickening was 16, 9 cases in the A-MMS group, there was statistic difference between them (χ2=6.317, P=0.012). Wall concentric thickening diagnose the MMD with a sensitivity of 94.1% (16/17), specificity of 50.0% (9/18), accuracy of 71.4%(25/35). Wall strong enhancement appear in the A-MMS with a sensitivity of 44.4%(8/18), specificity of 100%(17/17), accuracy of 71.4%(25/35).With a cut-off the maximum wall thickness of 1.2 mm could be used to noninvasively differential diagnose the MMD and A-MMS with a sensitivity of 55.6%(10/18), specificity of 88.2%(15/17), accuracy of 71.4%(25/35). Conclusion HR-MRI is a good tool for the differential diagnosis between MMD and A-MMS.
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Objective To investigate the correlation between middle cerebral artery (MCA) atherosclerotic plaques and single subcortical infarction (SSI) using high-resolution magnetic resonance imaging (HR-MRI).Methods The patients with SSI received HR-MRI examinations at the ipsilateral MCA horizontal segment stenosis from January 2012 to November 2014 were analyzed prospectively.They were divided into proximal SSI (pSSI) and distal SSI (dSSI).The longitudinal and transverse diameters and volume of different types of infarction pattern as well as the degree of luminal stenosis of MCA deep perforating parent artery,plaque distribution,plaque enhancement or not,white matter lesions,and general information of both groups were documented respectively.Results A total of 78 patients with SSI were enrolled,including 40 (51％) in the pSSI group and 38 (49％) in the dSSI group.The proportions of Fazekas scale grade 3 white matter lesions (63.5％vs.40.0％;x2 =4.183,P=0.041) and deep white matter lesions (50.0％ vs.15.0％;x2 =10.961,P =0.001) in the dSSI group were significantly higher than those in the pSSI group.The proportions of MCA plaque in the opening (35.0％ vs.13.2％;x2=3.930,P=0.047),plaque enhancement (87.5％ vs.30.0％;x2 =25.447,P ＜ 0.001) and posterosuperior wall plaques (42.5％ vs.21.4％;x2 =9.491,P ＜ 0.001) and the degree of luminal stenosis (60.38％ ± 10.20％ vs.45.00％ ±6.44％;t =3.625,P =0.031) in the pSSI group were all significantly higher than those in the dSSI group.In addition,the longitudinal and transverse diameters and volume of the infarcts in the pSSI group were significantly larger than those in the dSSI group (all P ＜ 0.001).Multivariate logistic regression analysis showed that MCA enhanced plaques on the lesionipsilateral sides (odds ratio[OR] 11.764,95％ confidence interval[CI] 2.081-66.511;P =0.005) and posterosuperior wall plaques (OR 6.131,95％ CI 1.012-23.339;P =0.037) were independently associated with pSSI,while deep white matter lesions (OR 0.280,95％ CI 0.203-0.648;P=0.012) was independently associated with dSSI.Conclusions The atherosclerotic plaques of MCA deep perforating parent artery are common in both the pSSI group and the dSSI group.pSSI is mainly associated with the location of atherosclerotic plaques of deep perforating parent artery and enhanced plaques,while dSSI is mainly associated with deep perforating artery vasculopathy.
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Objective To observe the proportion changes of CD4+CD25+FOXP3+ T cells in peripheral blood of patients with Vogt-Koyanagi-Harada disease(VKH)before and after one month of treatment. Methods The peripheral blood samples from 15 patients with VKH disease before and after one month of treatment by glucocorticoid,and from 15 healthy volunteers were collected,and lymphoeytes were separated from them.CD4+CD25+regulatory T cells were Iabeled by antibodies of cell surface marker CD4、CD25 and transcription factor FOXP3.The proportion of CD4+CD25+FOXP3+ T cells were detected by flow cytometry. Results Before the treatment,the percentage of CD4+ CD25+FOXP3+ T cells in periphery blood was(0.30±0.19)%of CD4+ cell in VKH patients,and(1.41±0.52)%in control group,the difference was statistically significant(t=7.665,P＜0.01);after one month of treatment,the VKH patients group was(1.28±0.54)%which close to the control group.However there were two patients whose CD4+ CD25+ T cells inereased extraordinarily after one month of treatment. Conclusions The proportion of CD4+ CD25+ FOCP3+ T cells in periphery blood in VKH patients were lower than control group obviously before treatment,but were close to eontrol group after treatment.Those results indicated that VKH diseases may be associated with the decreased proportion of CD4+ CD25+ regulatory T cells.