ABSTRACT
Objective:To observe the clinical efficacy of ultrasound cycloplasty (UCP) in the treatment of uncontrolled intraocular pressure (IOP) after glaucoma surgery.Methods:An observational case series study was carried out.Twenty-eight consecutive patients (28 eyes) with uncontrolled IOP after glaucoma surgery who received UCP treatment in The First Affiliated Hospital of Zhengzhou University from July 2018 to October 2019 were enrolled.The IOP of these patients was ≥21 mmHg (1 mmHg=0.133 kPa) under the maximum tolerated dose.According to preoperative IOP and visual acuity, the patients were divided into 8-sector group (17 eyes) and 10-sector group (11 eyes). The duration of UCP operation, preoperative and postoperative 1-day, 1-week, 2-week, 1-month and 3-month IOP and BCVA, the types of drugs for lowering IOP preoperatively and postoperatively, preoperative and postoperative 3-month ocular pain grading and corneal endothelial cell counts, and adverse reactions during the operation and after surgery were recorded.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of The First Affiliated Hospital of Zhengzhou University (No.2020-KY-154). Written informed consent was obtained from each subject prior to any medical examination.Results:The duration of UCP operation was 3 to 7 minutes, with an average of (4.30±1.26) minutes.The IOP at 1 day, 1 week, 2 weeks, 1 month and 3 months after operation was (32.96±10.49), (25.89±7.25), (24.50±6.23), (24.07±6.59), (24.32±6.52)mmHg, respectively, which were significantly lower than (45.82±8.81) mmHg before operation (all at P<0.05). There was no significant difference in IOP between the 8-sector group and 10-sector group ( Fgroup=1.271, P=0.270), but there was a significant difference in IOP between the two groups before and after operation ( Ftime=54.388, P<0.01), and the postoperative IOP at various time points in the two groups were lower than the preoperative IOP, showing statistical significances (all at P<0.05). There was no significant difference in BCVA before and after surgery ( F=2.562, P=0.075). There was a statistically significant difference in BCVA between the 8-sector group and 10-sector group ( Fgroup=12.602, P=0.001), but no statistically significant difference was found in BCVA between the two groups before and after surgery ( Ftime=1.701, P=0.139), and the BCVA in the 8-sector group was better than the 10-sector group at various time points (all at P<0.05). The types of IOP lowering drugs used in the 8-sector group and 10-sector group were 3 (2, 3) and 3 (2, 4) before operation respectively, and 0 (0, 1) and 0 (0, 0) at 3 months after operation respectively.The preoperative ocular pain grade was 2 (2, 2), and the postoperative 3-month ocular pain grade was reduced to 1 (0, 1), and the difference was statistically significant ( Z=-4.824, P<0.05). The postoperative 3-month pain grading in the 8-sector and 10-sector groups were significantly lower than the preoperative pain grading ( Z=-3.739, -3.127; both at P<0.05). The corneal endothelial cell count was significantly decreased from (1 967.15±186.06) cells/mm 2 before operation to (1 861.08±206.63) cells/mm 2 at 3 months after operation ( t=2.781, P=0.017). No serious complications occured during the operation.Postoperative adverse reactions included chemosis and bulbar hyperemia, corneal edema, headache, ocular pain, anterior chamber inflammation, etc.Serious complications such as low IOP, macular edema, vision loss or eyeball atrophy were not observed. Conclusions:UCP has no surgical incision.Treatment of both 8 sectors and 10 sectors can effectively reduce IOP, reduce the types of IOP lowering drugs, and relieve ocular pain in patients with uncontrolled IOP after glaucoma surgery with few intraoperative and postoperative adverse reactions.
ABSTRACT
Objective To firstly report 4 cases of dermatomyositis characterized by painful palmar eruptions complicated by fatal rapidly progressive interstitial lung disease (RP-ILD) in China.Methods Four patients with dermatomyositis with painful palmar eruptions complicated by fatal RP-ILD were enrolled from the Department of Dermatology,Zhongshan Hospital,Fudan University between December 2014 and April 2017,and their clinical and pathological features were analyzed.Results Among these patients,3 were female and 1 was male.Their age ranged from 47 to 59 years.Of the 4 patients,3 had no muscular involvement.All of the 4 patients had multiple solid red papules or nodules on the bilateral palms,palmar and lateral surfaces of fingers,which preceded,followed or concurred with the onset of other skin lesions of dermatomyositis.The occurrence of type Ⅰ respiratory failure was preceded by 3 weeks to 5 months of painful palmar eruptions in the 4 patients.Early-stage palmar eruptions were easily misdiagnosed as contact dermatitis,eczema or erythema multiforme.Histopathological examination of the skin lesions on the finger palmar surface showed perivascular infiltration of a few lymphocytes in the dermis,and deposition of varying amounts of mucin-like substances around blood vessels and appendages.Of the 4 patients,3 showed positive staining for anti-melanoma differentiation-associated gene 5 antibody.Although the 4 patients received anti-inflammatory and immunosuppressive therapies,they all finally died of respiratory failure.Conclusions Dermatomyositis with painful palmar eruptions may indicate the occurrence of fatal RP-ILD,and early biopsy of skin lesions is needed to help to identify the disease.Immunosuppressive treatment should be performed timely to improve the prognosis in these patients.
ABSTRACT
Objective To analyze clinical and pathological features of dermatomyositis with panniculitis as a skin manifestation.Methods Clinical data were collected from 9 cases of dermatomyositis with panniculitis as a skin manifestation in Department of Dermatology of Zhongshan Hospital affiliated to Fudan University from October 2012 to July 2016,and their clinical and pathological features were analyzed.Results Of the 9 cases,6 were female and 3 were male,and the age ranged from 28 to 73 years.Panniculitis lesions of the 9 patients all manifested as painful indurated plaques or nodules on the buttock,thigh,waist,back,abdomen,upper extremities and cheeks.These lesions occurred before,after or simultaneously with the onset of characteristic skin and muscle lesions of dermatomyositis,especially preceded the onset of characteristic lesions of dermatomyositis by 30 years in 1 case.Histopathological examination of lesions showed liquefaction degeneration of basal cells,inflammatory infiltration of lymphocytes and plasma cells around blood vessels,in the fat lobules as well as between the lobules and septa in the dermis.The necrosis and calcification of lipocytes,lipomembranous changes,fibrinoid necrosis of damaged vessel walls and microvascular occlusion were observed in some cases.Because panniculitis preceded the onset of characteristic lesions of dermatomyositis,2 patients were misdiagnosed with lupus panniculitis and morphea profunda for several times.Most patients had good response to systemic glucocorticoids combined with immunosuppressive agents,while the patients with lipomembranous fat necrosis had poor response to the combination therapy.Conclusions Panniculitis lesions of dermatomyositis are histologically characteristic,and may do not coincide with the onset of characteristic lesions of dermatomyositis.If panniculitis lesions precede characteristic lesions of dermatomyositis,patients will be easily misdiagnosed.Thus,persistent follow-up visit will be of great importance for the diagnosis.
ABSTRACT
Objective To compare two different methods to detect the differences of gene mutation rate, sensitivity, specificity and coincidence rate of epidermal growth factor receptor (EGFR) in non-small-cell lung cancer (NSCLC) so as to assess the clinical value of qRT-PCR method and its environmental-friendly technologyplatforms.One uses environmental fixative poly hydroxyl acrylic acid and green transparent liquid dewaxing Van-clear alone or in combination to replace the traditional fixative 4％ (volume fraction) neutral buffered formalin and the traditional transparent dewaxing liquid xylene in application of quantitative real-time polymerase chain reaction (qRT-PCR).The other uses traditional reagents in direct sequencing.Methods We selected 91 cases of primary NSCLC specimens resected between May 2013 and March 2016 in Zhongshan Bo`ai Hospital and Zhongshan Hospital of Traditional Chinese Medicine.Five samples were taken from the same tumor lesion.We used a random number table to randomly divide these samples into Groups A, B , C, D, and E.Group A received direct sequencing method in detection of EGFR gene mutations.Besides, during the experiment, 4％ neutral buffered formalin was used for fixing, and xylene transparent dewaxing was used to make slices for DNA extraction dewaxing.Group B received qRT-PCR method to detect EGFR gene mutations.Meanwhile, during the experiment, 4％ neutral buffered formalin was used for fixing, and xylene transparent dewaxing was used to make slices for DNA extraction dewaxing.Group C received qRT-PCR method in detection of EGFR gene mutations.At the same time, during the experiment, polyhydroxy acrylic acid was used for fixing, and xylene transparent dewaxing was used to make slices for DNA extraction dewaxing.Group D received qRT-PCR method to detect EGFR gene mutations.In the meantime, 4％ neutral buffered formalin was used for fixing, Van-clear transparent dewaxing was used to make slices for DNA extraction dewaxing.Group E received qRT-PCR method in detection of EGFR gene mutations.In addition, during the experiment, polyhydroxy acrylic acid was used for fixing, and Van-clear transparent dewaxing was used to make slices for DNA extraction dewaxing.In addition, during the experiment, polyhydroxy acrylic acid was used for fixing, and Van-clear transparent dewaxing was used to make slices for DNA extraction dewaxing.The mutations of Exons 18, 19, 20, and 21 in EGFR genes were respectively determined in the five groups of NSCLC.Results ① Groups B, C, D, E and A did not significantly differ in the percentage of people with mutations or target site mutation rates of EGFR genes in NSCLC (P> 0.05).② The detection results of EGFR target site mutation in Groups B, C, D, E and A had good sensitivity, strong specificity, and high compliance rate.Conclusion The green transparent liquid dewaxing Van-clear alone or in combination to replace the traditional fixative 4％ neutral buffered formalin and the traditional transparent dewaxing liquid xylene in the application of qRT-PCR so as to detect EGFR gene mutations in NSCLC has good consistent results compared with the method that uses traditional reagents in direct sequencing.It has the significance and value in clinical application.
ABSTRACT
Objective:To observe the difference of the human telomeres RNA component (hTERC) genes’amplification in the cervical tissue by applying the environment-friendly fixative poly hydroxy acrylic acid and the transparent dewaxing solution Van-clear separately or jointly to replace the traditional fixative 4% (volume fraction)neutral buffered formalin and the conventional transparent dewaxing solu-tion xylene in the use of fluorescence in situ hybridization (FISH)for detection.Methods:In the study, 255 cases of cervical tissue specimens submitted by the Department of Gynecology in Zhongshan Boai Ho-sipital were collected from Mar.2013 to Apr.2015.Four samples were taken from the same lesion site. All the cases were divided into 4 groups and named group A,B,C,and D.Group A used 4% neutral buffered formalin fixed and xylene dewaxing to make slices.Group B used poly hydroxy acrylic fixed and xylene dewaxing to make slices.Group C used 4% neutral buffered formalin fixed and Van-clear trans-parent to make slices.Group D used poly hydroxy acrylic fixed and Van-clear transparent dewaxing to make slices.The amplification of hTERC genes in the four groups of cervical specimens was also detected by FISH technique.Results:When the hTERC genes were detected by FISH method under the fluore-scence microscope,it was obvious that the tissue profile and the background of group A,B,C and D were all clear.The probe was fixed in the accurate position so that the bright red or green fluorescence signals were easily found in these four groups.Compared with the positive rate of group A,there was no statistical significance in that of group B,C and D (P>0.05).At the same time,the coincidence rate of the FISH results was high,which showed that the new environment-friendly reagent had no significant difference in the detection of cervical hTERC genes by FISH technique.Conclusion:It is possible for the environment-friendly reagent poly hydroxy acrylic acid and Van-clear to replace 4%neutral buffered for-malin and xylene separately or jointly to detect the cervical hTERC genes by adopting FISH technique.
ABSTRACT
Background and purpose: Adequate tissue ifxation, transparent dewaxing is an important step of hematoxylin eosin (HE) staining and lfuorescence in situ hybridization (FISH) in detection of breast cancerHER-2 gene. The purpose of this study was to make a comparison between poly hydroxyl acrylic acid which is an environmen-tally friendly ifxation liquid and 4% neutral buffered formaldehyde in tissue ifxation for HE staining and FISH to detect theHER-2 gene in the breast cancer tissue sections. The study aimed to evaluate the feasibility of replacing 4% buffered formaldehyde, a traditional ifxation liquid, with the poly hydroxyl acrylic acid, an environmentally friendly ifxation lfuid.Methods:This project was performed on tissue samples collected from 69 cases of breast cancer, 41 cases of breast ifbroadenoma, 40 cases of uterine leiomyoma, 25 cases of cervical tissue, 25 cases of placenta obtained from the outpatient and inpatient departments of Zhongshan Boai Hospital from Mar. 2011 to Jan. 2015, from each of which two samples were drawn and two blocks of each specimen were divided into two groups randomly. Then one group was ifxed with 4% neutral buffered formaldehyde and made into 200 sections by HE while the other group was ifxed with poly hydroxyl acrylic acid and made into another 200 sections. The slice level of the two groups was determined by the staining condition of the sections, and SPSS 19.0 was employed to compare the excellent and good rate of HE staining. Additional 69 sections were produced with two groups of breast invasive ductal carcinoma tissues, and SPSS 19.0 was used to detect the ampliifcation ofHER-2 gene by FISH.Results:First, the number of best-quality slices stained with HE ifxed separately by poly hydroxyl acrylic acid and 4% neutral buffered formaldehyde was 155 and 166, respectively. The number of excellent pieces was 41 and 33, respectively, while the number of mediocre pieces was 3 and 1 with bad pieces being 1 and 0, respectively. The excellent and good rates of HE staining were 98% and 99.5%, respectively. There was no significant difference between the two groups (χ2=1.33,P>0.05).Second, the positive rates of the tis-sue slices by FISH ifxed separately by poly hydroxyl acrylic acid and 4% neutral buffered were 26.09% and 23.19%, respectively. There was no signiifcant difference between the two groups (χ2=0.50,P>0.05).Conclusion:The results obtained with HE staining and FISH using poly hydroxyl acrylic acid as a ifxation liquid are not signiifcantly different from those using 10% neutral buffered formaldehyde. Therefore, poly hydroxyl acrylic acid meets the requirements of environmental protection, and thus has the potential to be promoted and widely used.
ABSTRACT
Objective To analyze the characteristics of the dynamic changes of the radiological X-ray images in chest after applying a pulmonary surfactant(PS) named curosurf to hyaline membrane disease in grade Ⅲ～Ⅳ of the premature lungs,and to study the clinical values of the follow-ups with chest films after applying PS to evaluate its effects and to detect the complications in chest. Methods To review the definite cases of HMD in grade Ⅲ～Ⅳ with final clinical and radiological diagnosis so as to analyze the radiological image manifestations in ehest after applying PS to the premature lungs for half an hour, for 6 hours,for 24 hours, for 48 hours and for 5 days. Results Shortly after the application of PS,according to the chest films,just half an hour later, 15 cases improved their degrees of the transmittance of the two lungs; 16 cases progressively ameliorated their manifestations in chest, taking the turn for the better than the previous images; 5 cases had no improvement, among which 1 developed a complication of pulmonary hemorrhage,and 3 developed pulmonary air leakage; 3 eases accompanied with pulmonary inflammation-like lesions; 11 cases presented patent arterial duets(PDA). Generally speaking, the X-ray image manifestation was the same as the clinical symptoms. Conclusion A dynamic observation of the X-ray films in chest after the application of PS is able to make a correct iudgement of the lesions of HMD in grade Ⅲ～Ⅳ,and can promptly detect its complications if taking a short-term review.