PPV combined with internal limiting membrane flap or tamping in the treatment of large basal diameter macular hole / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To investigate the efficacy and safety of pars plana vitrectomy(PPV)combined with inverted internal limiting membrane(ILM)flap and PPV combined with ILM tamping in the treatment of large basal diameter idiopathic macular hole(IMH), and to analyze the correlation between postoperative visual acuity and preoperative parameters. <p>METHODS:This study is a retrospective clinical study. Totally 56 patients(57 eyes)with macular hole bottom diameter greater than 1 000μm, who treated in Joint Shantou International Eye Center from January 2018 to December 2020, were enrolled in this study. Thirty eyes were involved in PPV combined with inverted ILM flap(Group 1)and 27 eyes were involved in PPV combined with ILM tamping(Group 2). The best corrected visual acuity(BCVA), the closure of the macular hole, thickness of foveal neurosensory layer and complications were compared between the two groups at 1wk and 1mo after the surgery. Person correlation analysis was used to explore the correlation between preoperative parameters and BCVA at 1mo after operation.<p>RESULTS: There was no significant difference in gender, age, eye type, course of disease, preoperative BCVA, postoperative macular hole healing classification, preoperative hole bottom diameter and eye axis between the two groups(P>0.05). The closure rate of macular hole in Group 1 was 97%, of which type 1 closure was 80%. The closure rate of macular hole in Group 2 was 100%, of which type 1 closure was 78%, and there was no significant difference in the closure rate(P=0.99). The postoperative follow-up BCVA of patients in both groups was better than that before operation(all P<0.01). The BCVA of Group 1 was better than Group 2 at 1mo after operation, and the difference was statistically significant(t= -2.20, P=0.03). There was no significant difference in the thickness of foveal neurosensory layer between two groups at 1mo after operation(t=0.407, P=0.69). The BCVA at 1mo after operation was positively correlated with the hole diameter and preoperative BCVA(r=0.435, P=0.004; r=0.440, P=0.001). There was no complication in both groups during and after operation. <p>CONCLUSION:PPV combined with inverted ILM flap and PPV combined with ILM tamping can improve the closure rate of the hole. The long-term visual acuity of PPV combined with inverted ILM flap is better than that of PPV combined with ILM tamping. There is a significant positive correlation between postoperative BCVA and the bottom diameter of the hole and preoperative BCVA. Preoperative bottom diameter can be used as one of the basis for clinical prognosis.

Clinical characteristics and changes in blood electrolyte and renal function of neonates with polycythemia at high altitude / 中华儿科杂志

<p><b>OBJECTIVE</b>To analyze the relationship between neonatal hypoxia and polycythemia and to study clinical characteristics of Tibetan neonates whose family lived in Tibetan plateau for generations and Han neonates whose family moved to the plateau.</p><p><b>METHOD</b>From Jan. 2005 to Oct. 2006, totally 739 patients were hospitalized in the ward of neonatology of the hospital. Of these patients, 40 (20 were Tibetan and the other 20 were Han) with neonatal polycythemia. The clinical features, transcutaneous oxygen saturation (TcSO₂), peripheral routine tests and myocardial enzyme profile were studied.</p><p><b>RESULT</b>The values of hemoglobin (Hb), hematocrit (HCT), and erythrocyte count (RBC) of the Han neonates were significantly higher than those of the Tibetan newborns. Han neonates with polycythemia had lower TcSPO₂ than Tibetan neonates (P < 0.01). Comparison of myocardial enzymes showed that Han neonates had higher CKMB than that of Tibetan groups before treatment (P < 0.01), troponin was not significantly different between the Han and Tibetan groups before treatment (P > 0.05). The major common clinical manifestations of the Han and Tibetan newborns were tachypnea, cyanosis, irritability, weak reflexes and hypoxemia. The Han neonates additionally had poor responses, apnea, lower muscle tone, confusion and asphyxia.</p><p><b>CONCLUSION</b>The clinical characteristics, TcSO₂, peripheral blood routine tests and myocardial enzyme profile are helpful in diagnosis and treatment of neonatal polycythemia. Newborn infants born to mothers who moved to the plateau area may be more susceptible to neonatal polycythemia and are prone to impairments of other organs, esp. the functions of the heart and brain.</p>

Primary thyroid non-Hodgkin's lymphoma of Ann Arbor stages IE and IIE: prognostic factors / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the prognostic factors of primary non-Hodgkin's thyroid lymphoma.</p><p><b>METHODS</b>From January 1981 to January 2008, 47 patients with stage IE and IIE pathologically confirmed as suffering from B cell non-Hodgkin's lymphoma and treated in hospital, were retrospectively analyzed. Pathology: diffuse large cell B-cell lymphoma (DLBCL) 28, mucosa-associated lymphoma (MALT) 19. The cancer specific survival (CSS) were calculated using the Kaplan-Meier method and compared by the Log-rank test. Age, sex, symptoms, extrathyroid extension, radiation doses, treatment modality and histological type characteristics were evaluated using the Cox regression analysis.</p><p><b>RESULTS</b>The 5-year CSS rate was 61.8%. The 5-year CSS rate for the patients with primary tumor confined to thyroid and with extrathyroid extension were 86.7% and 50.0% (P=0.012). The 5-year CSS rate for the patients treated with radiation doses below 40 Gy and treated to 40 Gy or more were 30.8% and 79.0% (P=0.002). The 5-year CSS rate for the 18 patients with stage II received single modality therapy and the multimodality therapy were 33.3% and 61.1% (P=0.037). The 5-year CSS rate for patients with DLBCL lymphoma lesions and with MALT were 50.0% and 78.9% (P=0.038). Multivariate analysis by Cox regression showed that extrathyroid extension, radiation doses and histological type were independent prognostic factors.</p><p><b>CONCLUSIONS</b>In primary non-Hodgkin's lymphoma of the thyroid, extrathyroid extension, radiation radiation doses and histological type are important prognostic factors. For patients with the stage II received multimodality therapy have a higher CSS than the ones received single-modality therapy.</p>

Expression of WT1 gene and its isomer ratio changes during phorbol ester induced differentiation of K562 cell line / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the changes in expression of WT1 gene and ration of its isomers during phorbol ester (TPA) induced differentiation of leukemia cell line K562 by fluorescence quantitative RT-PCR and analysis the relationship between different isomers and hematogenic cell differentiation.</p><p><b>METHODS</b>The degree of cellular maturation were verified by NBT reduction test and immunophenotyping. Expression of WT1 gene was determined by fluorescence quantitative RT-PCR during differentiation of K562 cell line. The relative ratio of the four splicing variants WT1 ( + / + ), WT1 ( + / - ), WT1 ( - / + ), WT1 ( - / - ) were calculated.</p><p><b>RESULTS</b>During the differentiation of K562 cell, the NBT reduction rate and the CD9 positive rate both increased significantly (P < 0. 05). The expression of WT1 gene decreased immediately to (1.67 +/- 0.45) x 10(-3) from (4.67 +/- 1.11) x 10(-3), and then increased again to (4.64 +/- 1.53) x 10(-3) at 96 hours. The ratio of WT1 ( + / + ) was decreased gradually, from 0 hour (39.65 +/- 19.46)% to 96 hour (15.25 +/- 7.27)%. While the ratio of WT1( - / - ) was increased, from 0 hour (15.38 +/- 11.34)%, to 96 hour (37.60 +/- 11.90)%. The other two isomers ratios did not change significantly.</p><p><b>CONCLUSION</b>During the TPA induced differentiation of K562 cell, there are two high expression levels of WT1 gene. Before differentiation, the majority is WT1 ( + / + ), and after differentiation, is WT1 ( - / - ). It indicates that WT1 gene may activate or inhibit cell differentiation by regulating the ratio of its four splicing variants.</p>

Fluorescence quantitative PCR detection of WT1 gene expression in peripheral blood of patients with acute leukemias and its clinical implications / 中国实验血液学杂志

To elucidate the expression of WT1 in all types of leukemias and its implications for monitoring minimal residual disease in patients with acute leukemia, the peripheral blood from 55 leukemia patients and 10 normal voluteer was detected by using FQ-RT-PCR. Follow-up monitoring of WT1 expression of peripheral blood was performed for 20 patients with acute leukemia. The results showed that the expression of WT1 gene in all types of leukemias was significantly higher than that in normal control (P < 0.001). For ANLL and ALL patients, the survival time in the group of WT1 <or= 6.8 x 10(-3) was longer than that in the group of WT1 > 6.8 x 10(-3), (P = 0.027). Follow-up detection of the expression of WT1 in peripheral blood samples from 20 acute leukemia patients, 7 cases relapsed after complete remission has been done. In 5 of 7 relapsed patients, the expression of WT1 had obviously increased about 2 - 3 months before clinical relapse became apparent. It is concluded that the established FQ-RT-PCR method is accurate and specific. The expression of WT1 gene is relatively high in all types of leukemias compared with normal peripheral blood cells, the higher WT1 expression may associate with poor prognosis in acute leukemia, and the dynamics of WT1 level correlate with the disease status. The quantitative assessment of WT1 expression in peripheral blood samples by FQ-RT-PCR may be a useful tool for monitoring minimal residual disease.