Vitrectomy combined with cataract surgery in the treatment of proliferative diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To observe the clinical effect of vitrectomy combined with cataract surgery in the treatment of proliferative diabetic retinopathy (PDR). ·METHODS:Totally 80 patients (83 eyes) with PDR who underwent treatment in the hospital during the period from February 2013 to February 2017 were selected and divided into the control group and the observation group according to the treatment method. The control group was treated by vitrectomy combined with lensectomy while the observation group was treated by vitrectomy combined with phacoemulsification. The clinical curative effect was compared between the two groups. ·RESULTS: After surgery, the visual acuity of the two groups was improved significantly, and the visual acuity of the observation group was better than that of the control group (P< 0. 05). The incidence rates of iris neovascularization (INV) and capsular opacities in the observation group after surgery were lower than those in the control group (P<0.05). · CONCLUSION: The clinical effect of vitrectomy combined with phacoemulsification is better than that of vitrectomy combined with lensectomy in the treatment of PDR.

Double incision trabeculectomy combined with phacoemulsification and intraocular lens implantation for acute angle closure glaucoma with cataract / 国际眼科杂志(Guoji Yanke Zazhi)

Abstract?AIM: To observe the effect of acute angle closure glaucoma with cataract patients treated with glaucoma trabeculectomy combined two incision phacoemulsification and intraocular lens ( IOL ) implantation ( two incision triple surgery) .?METHODS: Patients admitted in our hospital during Jan.2013 to Jan.2016.The acute angle closure glaucoma with cataract patients in 40 cases ( 58 eyes ) were randomly divided into two groups:the observation group of 20 cases ( 29 eyes ) with two incision triple surgery treatment, and the control group of 20 cases ( 29 eyes ) with single incision triple after treatment.Visual acuity, intraocular pressure, bleb, corneal endothelial cell density, the area at 1mo before and after surgery, and postoperative complications of two groups were analyzed.?RESULTS: Postoperative visual acuity of two groups were significantly improved, but there was no significant difference between groups ( P >0.05 ); postoperative intraocular pressure, bleb formation rate of the observation group were 14.41 ±1.38mmHg, 90%, and the control group 14.40 ±1.40mmHg, 86% without statistical significance ( P>0.05 ), corneal endothelial cell density and area of observation group after 1mo were 1696.6±300. 8/mm2 , 540.8±71.6μm2 , and control group 1410.6±288.5/mm2 and 594.3 ±72.8μm2 with significant differences ( P0.05).?CONCLUSION: For patients with acute angle closure glaucoma and cataract given two incision triple surgery and single incision triple surgery treatment can get good outcomes, but the effect of double incision on corneal endothelial cell injury is less.

The role of endogenous vascular elastase in coronary artery reconstruction in Kawasaki disease / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the role of endogenous vascular elastase (EVE) in coronary artery between reconstruction among pediatric patients with Kawasaki disease (KD).</p><p><b>METHODS</b>Sixty children who were diagnosed with KD between January 2012 and April 2013 were selected as the case group, and peripheral venous blood samples were collected on days 0-11 (pathological stage I) and days 12-25 (pathological stage II) after the onset of disease; another 60 children without KD who visited the hospital due to acute fever during the same period were selected as the control group, and fasting peripheral venous blood samples were collected in the acute stage of fever. For both groups, serum levels of EVE and interleukin-6 (IL-6) and plasma vascular endothelial growth factor (VEGF) level were measured by enzyme-linked immunosorbent assay. For the case group, ultrasonic cardiography was used to detect coronary artery lesions (CALs) at the first, second and fourth weekends. The correlations of EVE level with IL-6 and VEGF levels were evaluated by Pearson correlation analysis.</p><p><b>RESULTS</b>Serum levels of EVE and IL-6 in the case group in pathological stages I and II were significantly higher than in the control group (P<0.05), but plasma VEGF levels in stages I and II were significantly lower than in the control group (P<0.05); in the case group, EVE and IL-6 levels were significantly higher in stage II than in stage I (P<0.05). In pathological stage II, KD patients with CALs had significantly higher serum levels of EVE and IL-6 but significantly lower plasma VEGF levels compared with those without CALs (P<0.05); KD patients with coronary artery aneurysms (CAAs) had significantly higher serum levels of EVE and IL-6 but significantly lower plasma VEGF level compared with those without CAAs (P<0.05 for all). EVE level was positively correlated with IL-6 level (r=0.915, P<0.05), yet negatively correlated with VEGF level (r=-0.769, P<0.05).</p><p><b>CONCLUSIONS</b>EVE may participate in coronary artery reconstruction in children with KD. To interfere EVE activity may reduce and prevent CALs.</p>

Plasma concentration of growth-differentiation factor-15 in children with congenital heart disease: relation ship to heart function and diagnostic value in heart failure / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the correlation between growth differentiation factor-15(GDF-15) and cardiac function in pediatric patients with congenital heart disease, and the diagnostic value of GDF-15 in heart failure(HF).</p><p><b>METHODS</b>From March 2011 to May 2012, 97 pediatric patients with congenital heart disease(CHD) who consecutively attended Chengdu Women's & Children's Central Hospital were enrolled in the study and assigned to HF (patients with heart failure, n=71) and Non-HF(patients without heart failure, n=26) groups. HF was defined as patients presenting with modified Ross score≥3. Plasma concentrations of GDF-15 and NT-proBNP were determined using ELISA. Left ventricular ejection fraction(LVEF) was tested by echocardiography. The correlation between GDF-15 and modified Ross score, LVEF and NT-proBNP was evaluated with Spearman's analysis. The area under the receiver-operating characteristic(ROC) curve for GDF-15 was examined, and the cut-off concentration of GDF-15 for diagnosing HF was detected.</p><p><b>RESULTS</b>The HF group demonstrated higher levels of GDF-15 and NT-proBNP, and a lower LVEF level (P<0.01) than the Non-HF group. Plasma GDF-15 level was positively correlated with modified Ross score and plasma NT-proBNP concentration (r=0.705, r=0.810 respectively; P<0.01), and negatively correlated with LVEF(r=-0.391, P<0.01). According to ROC analysis, the AUC of GDF-15 for detection of HF was 0.757. Sensitivity and specificity was 68.8% and 71.2% respectively for the cut-off value of 1306 ng/mL.</p><p><b>CONCLUSIONS</b>Plasma GDF-15 levels are significantly elevated in children with HF induced by CHD. Plasma GDF-15 levels are related to cardiac function, LVEF and plasma concentration of NT-proBNP. GDF-15 may potentially indicate HF in pediatric patients with CHD.</p>

Risk factors for coronary artery lesions in children with Kawasaki disease / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study risk factors for the development of coronary artery lesions (CAL) in children with Kawasaki disease (KD).</p><p><b>METHODS</b>The clinical data of 527 children with KD between January 2006 and January 2009 were retrospectively reviewed. A total of 15 potential factors associated with occurrence of CAL were evaluated by univariate analysis and multivariate logistic regression analysis.</p><p><b>RESULTS</b>The univariate analysis showed that age, gender, KD type, starting time of intravenous immunoglobulin (IVIG) treatment, response to IVIG treatment, additional treatment with corticosteroids, duration of fever and serum C-reactive protein level were significantly different between patients with and without CAL (P<0.05). Multivariate logistic regression analysis showed that an age of less than 1 year (OR=2.076, P<0.05) or greater than 8 years (OR=1.890, P<0.05), male sex (OR=1.972, P<0.05), incomplete KD (OR=1.426, P<0.05), delayed starting time of IVIG treatment (10 days after onset) (OR=3.251, P<0.05), no response to IVIG (OR=2.301, P<0.05) and fever duration of more than 10 days (OR=1.694, P<0.05) were independent risk factors for the development of CAL, whereas early starting time of IVIG treatment (before 5 days after onset) was a protective factor (OR=0.248, P<0.05).</p><p><b>CONCLUSIONS</b>The occurrence of CAL is associated with many factors in children with KD. Age of less than 1 year or greater than 8 years, male sex, incomplete KD, delayed IVIG treatment after onset, no response to IVIG treatment and prolonged fever duration have been identified as risk factors for the development of CAL.</p>