ABSTRACT
Rheumatoid arthritis(RA), a chronic autoimmune disease, is featured by persistent joint inflammation. The development of RA is associated with the disturbance of endogenous metabolites and intestinal microbiota. Gardeniae Fructus(GF), one of the commonly used medicinal food in China, is usually prescribed for the prevention and treatment of jaundice, inflammation, ache, fever, and skin ulcers. GF exerts an effect on ameliorating RA, the mechanism of which remains to be studied. In this study, ultra-perfor-mance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS)-based serum non-target metabolomics and 16S rDNA high-throughput sequencing were employed to elucidate the mechanism of GF in ameliorating RA induced by complete Freund's adjuvant in rats. The results showed that GF alleviated the pathological conditions in adjuvant arthritis(AA) rats. The low-and high-dose GF lo-wered the serum levels of interleukin(IL)-6, tumor necrosis factor-α(TNF-α), IL-1β, and prostaglandin E2 in the rats(P<0.05, P<0.01). Pathways involved in metabolomics were mainly α-linolenic acid metabolism and glycerophospholipid metabolism. The results of 16S rDNA sequencing showed that the Streptococcus, Facklamia, Klebsiella, Enterococcus, and Kosakonia were the critical gut microorganisms for GF to treat AA in rats. Spearman correlation analysis showed that the three differential metabolites PE-NMe[18:1(9Z)/20:0], PC[20:1(11Z)/18:3(6Z,9Z,12Z)], and PC[20:0/18:4(6Z,9Z,12Z,15Z)] were correlated with the differential bacteria. In conclusion, GF may ameliorate RA by regulating the composition of intestinal microbiota, α-linolenic acid metabolism, and glycerophospholipid metabolism. The findings provide new ideas and data for elucidating the mechanism of GF in relieving RA.
Subject(s)
Rats , Animals , Chromatography, Liquid , Gardenia , Tandem Mass Spectrometry , Gastrointestinal Microbiome , alpha-Linolenic Acid , Metabolomics/methods , Arthritis, Rheumatoid/drug therapy , Inflammation , GlycerophospholipidsABSTRACT
Chikusetsusaponin IVa (CsIVa) is a natural active monomer of triterpene saponins in the Chinese herbal medicine of Panax japonicus, which has anti-inflammatory, anti-tumor and other effects. However, its function and mechanism in triple negative breast cancer (TNBC) remain unclear. This study investigated the inhibitory effect and mechanisms of CsIVa on the proliferation of triple negative breast cancer cell line MDA-MB-231. In this study, we found that CsIVa could significantly inhibit the proliferation of MDA-MB-231 cells and eliminate its potential toxic effect on normal breast cells (MCF-10A). The transcriptome sequencing results showed that the inhibition of proliferation of MDA-MB-231 cells by CsIVa was closely related to cell cycle and the pathway regulating cell cycle. Further studies confirmed that CsIVa blocked the cell cycle in G2/M phase by down-regulating the expression of cyclin dependent kinase 1 (CDK1), cyclin B1 and up-regulating the expression of cyclin dependent kinase inhibitor 1A (p21). Moreover, CsIVa can block cell cycle through inhibiting PI3K/AKT signal pathway. In conclusion, CsIVa regulates the expression of cell cycle related proteins (p21, CDK1, cyclin B1) via inhibiting the activity of PI3K/AKT signaling pathway, blocks TNBC cell cycle, and thus exerts its anti-tumor activity.
ABSTRACT
Objective:To explore the application and preliminary evaluation of multidisciplinary rounds (MDRs) in the clinical teaching of urology.Methods:A total of 20 pediatrics medical students in the clinical medicine were selected as the control group, and the traditional single department teaching rounds were used. Another 20 clinical medical students in the same grade were taken as the experimental group, and MDRs were used. The teaching officer of urology served as the general ward round teacher, combined with nephrology physicians and imaging ultrasound physicians to conduct bedside teaching rounds, and the length of the rounds was about 60 to 90 minutes. Through the teaching evaluation form and the test scores, the effect of teaching ward rounds was evaluated. SPSS 21.0 was used for statistical evaluation data, and the unpaired t-test was performed to make comparison between groups. Results:In terms of theoretical test, the average score of students in the experimental group was (92.15±0.60), which was higher than that in the control group (90.05±0.71), and the difference was statistically significant ( P=0.030). In the experimental group, 95.0%(19/20) of the medical students affirmed the MDRs model, and 100% of them thought it was necessary to introduce this model in clinical teaching. Conclusion:MDRs are patient-centered, emphasize interdisciplinary cooperation, and are operable, which deepens the understanding of medical students on urological diseases, promotes the exchange of clinical teaching experience between urology and interdisciplinary research, and improves the quality of teaching.
ABSTRACT
Objective:To explore the clinical effect of a two-staged repair and reconstruction of composite soft tissue defect of dorsal wrist with transfer of free flap (in stage-one) repair and followed by transplantation of allogeneic tendon (in stage-two) reconstruction.Methods:From December 2018 to January 2021, 6 cases with dorsal wrist composite tissue injury and extensor tendon defect were treated in the Department of Hand and Microsurgery of the Fourth People's Hospital of Guiyang City. Four cases were treated with free anterolateral thigh flap (ALTF) combined with allogeneic tendon in the first stage to reconstruct finger dorsiflexion function, and 2 cases were treated with free ilioinguinal flap combined with allogeneic tendon in the second stage to reconstruct finger dorsiflexion function. The age of the patients ranged from 22 to 62 years old. The areas of defect were 5.0 cm×12.0 cm-8.0 cm×20.0 cm. Two cases had 2 extensor tendons defect, 1 had 3 extensor tendons defect, 2 had 4 extensor tendons defect, and 1 had 5 extensor tendons defect. The length of extensor tendon defects was 7.0-22.0 cm. In 5 cases, the wounds were covered by VSD for 5 to 7 days after complete emergenly debridement. Then, after the wounds had been cleared and clean, the wounds of 3 cases were covered with free ALTF, 2 with free ilioinguinal flap, and 1 with free ALTF after skin graft scar resection. At 3-4 months later, the extension function of digit was reconstructed with the transplantation of allogeneic tendons. Postoperative appearance of the flaps and functions of digits were observed at the outpatient clinics during the follow-up.Results:The postoperative follow-up lasted for 10 to 26 (15 in average) months. All 6 flaps surrived completely, and 1 case was further treated with flap thinning at 4 months after the second surgery. During the follow-up, all flaps healed well and were good in appearance and texture. Meanwhile, the donor areas were all healed well with no dysfunction nor sensory disorder. All the transplanted tendons were in good glide without adhesion. The active motion of metacarpophalangeal joints ranged from (10±10) ° to (80±10) °. According to the Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, at the final follow-up, 4 cases were excellent and 2 cases were good.Conclusion:It is safe and effective that using the two-staged procedure in repair of composite tissue defect of dorsal wrist with stage-one ALTF or ilioinguinal flap transfer combined with stage-two reconstruction with transplantation of allogeneic tendon. It can minimize the adhesion after tendon transplantation and donor site damage
ABSTRACT
Congenital ureteropelvic junction obstruction(UPJO)is a common urinary tract obstructive disease and it is one of the common causes of hydronephrosis in children and adolescents. Untreated UPJO may cause aggrava﹣tion of hydronephrosis,chronic infection,urinary calculi,or even Worsening of renal function. UPJO＇s treatment includes conservative and surgical treatment,and surgical treatment not only includes endoscopic surgery and classic open pyelo﹣plasty,it also includes minimally invasive techniques such as laparoscopy and robot－assisted laparoscopic surgery. In recent years,the application of minimally invasive techniques in pyeloplasty has been greatly improved and developed, noW the research progress of UPJO in treatment is revieWed.
ABSTRACT
Circular RNAs(circRNAs)are a type of covalently closed circular non-coding RNAs that are ex-pressed across varieties of life forms.CircRNAs have a variety of characteristics such as stable structures, tissue-specific expression and the function of microRNA sponges in the regulation of genes.CircRNAs are abundant,highly expressed in neural tissues,emerging evidence also indicates that circRNAs play an important role in the pathophysiologic process of Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis and other neurological diseases.As one of the most important neurological diseases,the pathogenesis of brain damage and repair after ischemia has not yet been evalua -ted,and stroke related circRNAs are of great significance.In this review,we summarize related regulations,and the poten-tial regulatory mechanisms of cicrcRNAs in cerebrovascular diseases, and the important role of circRNAs in post stroke pathophysiologic process is also discussed.CircRNAs are expected to be a new drug target,and provide new theoretical ba-sis for the diagnosis and treatment of cerebrovascular diseases.
ABSTRACT
Objective The role of BMI1 gene in the development of gastrointestinal stromal tumor (GIST) has not yet been clarified. This study aimed to explore the expression of BMI1 gene in gastrointestinal stromal tumor,and analyze its relationship with clinical pathological features of GIST. Methods The clinical data of 68 GIST patients treated in The First People's Hospital of Nan-ning from August 2012 to October 2015 were analyzed retrospectively. The expression of BMI1 in normal gastrointestinal tissues and GIST tissues were detected with immunohistochemistry method,and analyzed the relationship between various clinicopathological pa-rameters of GIST and BMI1. The expression of BMI1 protein was detected by Western blot. Results The positive rate of BMI1 was much higher in GIST group than in non-GIST (76.47% vs 36.84%,P<0.05). The difference in the expression of BMI1 protein between the different risk groups was statistically significant (P<0.05). The positive expression rate was the highest in the high-risk group (93.75%),but had no statistically significant difference among different genders,age,locations,histological types and whether me-tastasis (P>0.05). Expression of proliferation genes such as PCNA,CyclinD1 mRNA in BMI1 positive group were higher than those in BMI1 negative group,the expression of Pro-apoptotic genes such as Caspase-7,Smac mRNA were lower than those in BMI1 negative group,the expression of anti-apoptosis genes such as Livin,p53,Bcl-2 mRNA were higher than those in BMI1 negative group (P<0.05). Conclusion The expression of BMI1 protein was increased in GIST tissue. It is correlated with the risk classification,and is an important factor affecting the prognosis of patients.
ABSTRACT
Objective To analyze and discuss the clinical efficacy of clopidogrel bisulfate combined with aspirin in the treatment of unstable angina pectoris. Methods 86 cases of unstable angina pectoris treated in my hospital from July 2015 to September 2016 were taken as the research object, randomly divided into two groups, with 43cases in each group. The observation group received clopidogrel combined with aspirin therapy; The control group received aspirin treatment alone. The clinical efficacy of the two groups was compared. Results There was no significant difference in the incidence of adverse reactions between the observation group and the control group (9.30% vs 6.98%), but the total effective rate of the clinical observation group was significantly higher (93.02% vs 76.74%, P<0.05). Conclusion Clopidogrel hydrogen sulfate combined with aspirin in the treatment of unstable angina pectoris is effective, safe and reliable..
ABSTRACT
The key to the treatment of septic shock is to provide adequate oxygen supply and improve tissue perfusion. Lactate and central venous oxygen saturation (ScvO) are commonly used as the indices of oxygen metabolism, but tissue hypoxia may still exist even when lactate and ScvOare within the normal range. Arteriovenous difference in carbon dioxide partial pressure (COgap) can accurately reflect oxygen delivery when ScvOis in the normal range. This article reviews the advantages and shortages of lactate, lactate clearance rate, ScvO, and COgap in evaluating tissue hypoxia, in order to provide a reference for treatment and severity evaluation of septic shock.
Subject(s)
Humans , Carbon Dioxide , Blood , Lactic Acid , Metabolism , Metabolic Clearance Rate , Oxygen , Blood , Shock, Septic , MetabolismABSTRACT
Objective To analyze and discuss the clinical efficacy of clopidogrel bisulfate combined with aspirin in the treatment of unstable angina pectoris. Methods 86 cases of unstable angina pectoris treated in my hospital from July 2015 to September 2016 were taken as the research object, randomly divided into two groups, with 43cases in each group. The observation group received clopidogrel combined with aspirin therapy; The control group received aspirin treatment alone. The clinical efficacy of the two groups was compared. Results There was no significant difference in the incidence of adverse reactions between the observation group and the control group (9.30% vs 6.98%), but the total effective rate of the clinical observation group was significantly higher (93.02% vs 76.74%, P<0.05). Conclusion Clopidogrel hydrogen sulfate combined with aspirin in the treatment of unstable angina pectoris is effective, safe and reliable..
ABSTRACT
AIM To explore the effects of Shexiang Wulong Pills (Moschus Artifactus,Aconiti Radix Cocta,Pheretima,etc.) drug serum on the expression levels of miR-146a,miR-130 and miR-223 in peripheral blood mononuclear cells (PBMCs) of patients with rheumatoid arthritis (RA).METHODS PBMCs were extracted from blood of 30 cases of RA patients,cells were divided into three groups,blank control group,serum-free groupand Shexiang Wulong Pills drug serum group.After 48 hours,total RNA was extracted,then the expression levels of three miRs were detected by RT-PCR.RESULTS Compared with the serum-free group,the expression levels of miR-146a,miR-130 and miR-223 in the Shexiang Wulong Pills drug serum group were significantly decreased (P ＜ 0.01).CONCLUSION Shexiang Wulong Pills can inhibit inflammation in RA patients by down-regulating the expression levels of miR-223,miR-130 and miR-146a in PBMCs.
ABSTRACT
ABSTRACT Purpose: To determine risk factors of postoperative urethral stricture (US) and vesical neck contracture (BNC) after transurethral resection of prostate (TURP) from perioperative parameters. Materials and Methods: 373 patients underwent TURP in a Chinese center for lower urinary tract symptoms suggestive of benign prostatic obstruction (LUTS/BPO), with their perioperative and follow-up clinical data being collected. Univariate analyses were used to determine variables which had correlation with the incidence of US and BNC before logistic regression being applied to find out independent risk factors. Results: The median follow-up was 29.3 months with the incidence of US and BNC being 7.8% and 5.4% respectively. Resection speed, reduction in hemoglobin (ΔHb) and hematocrit (ΔHCT) levels, incidence of urethral mucosa rupture, re-catheterization and continuous infection had significant correlation with US, while PSA level, storage score, total prostate volume (TPV), transitional zone volume (TZV), transitional zone index (TZI), resection time and resected gland weight had significant correlation with BNC. Lower resection speed (OR=0.48), urethral mucosa rupture (OR=2.44) and continuous infection (OR=1.49) as well as higher storage score (OR=2.51) and lower TPV (OR=0.15) were found to be the independent risk factors of US and BNC respectively. Conclusions: Lower resection speed, intraoperative urethral mucosa rupture and postoperative continuous infection were associated with a higher risk of US while severer storage phase symptom and smaller prostate size were associated with a higher risk of BNC after TURP.
Subject(s)
Humans , Male , Postoperative Complications/etiology , Prostatic Hyperplasia/surgery , Urethral Stricture/etiology , Urinary Bladder Neck Obstruction/etiology , Contracture/etiology , Transurethral Resection of Prostate/adverse effects , Time Factors , Logistic Models , Prospective Studies , Risk Factors , ROC Curve , Treatment Outcome , Risk Assessment/methods , Lower Urinary Tract Symptoms/surgery , Middle AgedABSTRACT
Objective To evaluate the value of preoperative ultrasonographic parameters in predicting the outcome of TURP.Methods A total of 202 patients with symptomatic benign prostatic hyperplasia (sBPH) entering our department for surgical therapy were prospectively recruited,with mean age of (65.5 ± 8.1) years,international prostate symptom score (IPSS) of 16.6 ± 8.1 and quality of life (QOL) score of 5 (3,6).Preoperative combined test of ultrasonography and urodynamics has found total prostate volume (TPV),transitional zone volume (TZV),transitional zone index (TZI),intravesical prostatic protrusion (IPP),resistive index (RI),postvoiding residue (PVR),detrusor wall index (DWT),ultrasonic estimation of bladder weight (UEBW) and maximum flow rate (Qmax) to be (75.0 ±38.5) ml,(49.9 ± 32.4) ml,0.59 ±0.14,(17.2 ±5.0) mm,0.63 ±0.12,(132.7 ±97.8)ml,(16.3 ±7.9)mm,(44.8 ± 7.1)g and (6.1 ± 6.0)ml/s respectively.A 6-monthsfollow-up after standard TURP were applied including re-measurement of IPSS,QOL score and Qmax.The patients were classified into 2 groups of effective and ineffective after the recovery being stratified into 4 levels of none,fair,good and excellent.The influence of preoperative ultrasonographic parameters on surgical outcome was analyzed by logistic regression and receiver operating characteristic (ROC) curve.Results The group of effective has 149 patients,with the preoperative TZI,IPP,RI,DWT and UEBW of 0.65 ± 0.27,(18.3 ± 3.1) mm,0.77 ± 0.18,(19.0 ± 5.0) mm and (46.6 ± 7.1) g,which were significantly higher than that of the group of ineffective (P ＜ 0.05) Lower RI,DWT and UEBW were found to be risk factors of unfavorable surgical efficacy (P ＜ 0.05) from multivariable analysis.The area under curve (AUC) of RI,DWT and UEBW in outcome prediction was 0.816,0.732 and 0.723 respectively from ROC curve,indicating the good predictive value of the 3 parameters with combined positive predictive value (PPV) of 96.3％.Conclusion RI,DWT and UEBW have favorable value in predicting TURP outcome.Measuring these parameters by preoperative ultrasonography might aid in determining the need for surgical intervention in sBPH patients.
ABSTRACT
Objective To explore the feasibility and effectiveness of the revised OSCE stations.Methods 106 sstudents of grade 2008 and 2009 from Xinhua clinical medical school of Shanghai Jiaotong University School of Medicine were involved,32 of whom (experimental group) tool modified OSCE examination and 74 of whom (control group) tool traditional OSCE examination.The revised OSCE exam was the one which on the basis of original OSCE test station setup,improved the operating part of the test stand,adopted clinical cases as stem,asked the students to make possible diagnosis,and perform the corresponding operation.We evaluated the students based on the OSCE scores from the school exam and the overall performances in the national clinical skills competition.Comparison between the two groups was performed by using t test.Results All students who have received the new training methods agreed that it stood closer to the clinical setting.Revised-OSCE trained group of students test scores than traditional OSCE trained group of students,though it didn't have statistical significance.Students from the revised-OSCE group had the score of (80.50 ± 15.45),while the traditional group had the score of (78.30 ± 17.68).By taking the revised-OSCE trainings,all the students have improved their clinical skills and two years in a row to win the Shanghai Jiaotong University School of Medicine Clinical Skills Competition.Conclusions Case-based OSCE stations are well accepted.The new OSCE stations are much closer to clinical teaching and can make better objective assessment of students,so it plays a good role in improving medical students' overall performances.
ABSTRACT
Objective:To assess the effect of combined cognitive rehabilitation training on improving cogni-tive dysfunction in amphetamine-type stimulant dependent patients.Methods:Subjects who met the clinical diagno-sis of ATS dependence by DSM-IV in compulsory isolation detoxification institute were randomly assigned into in-tervention group (n =30 )and control group (n =26 ).Control group received a regular education.Intervention group also received a combined cognitive rehabilitation training besides regular education,including psychological and physical rehabilitation for 24 weeks.The Chinese version of CogState Battery (CSB)was used to assess cogni-tive function at baseline and 24 weeks after the intervention.Results:No significant difference was found on all sub-scales scores of CogState Battery between two groups at baseline.At 24 weeks after the intervention,compared to control group,the intervention group had more improvements in three sub-scale scores,i.e.,One Card LearningTask [(0.06 ±0.12)vs. (-0.03 ±0.14),P0.05 ).Conclusion:The combined cognitive rehabilitation training could improve amphetamine-type stimulant dependent patients'visual learning and memory,working memory and spatial working memory,while have no significant im-provement on other cognitive functions.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the risk factors for early disseminated intravascular coagulation (DIC) in neonates with sepsis.</p><p><b>METHODS</b>A retrospective clinical study was performed on 100 neonates with a confirmed diagnosis of sepsis between 2012 and 2013. The children were classified into normal coagulation group, non-overt DIC group (early DIC group), and overt DIC group (late DIC group) based on the ISTH overt DIC scoring system. The clinical manifestations and risk factors were analyzed statistically.</p><p><b>RESULTS</b>Early DIC occurred in 44 (44%) cases in the 100 neonates with sepsis. The incidence of sclerema showed significant differences between the three groups (P<0.05). Asphyxia, bleeding, and Gram-negative bacterial infection were independent risk factors for early DIC.</p><p><b>CONCLUSIONS</b>Coagulation function should be actively monitored and early intervention measures should be taken for neonates with asphyxia, bleeding, and Gram-negative bacterial infection to prevent early DIC from progressing to late DIC.</p>
Subject(s)
Female , Humans , Infant, Newborn , Male , Disseminated Intravascular Coagulation , Logistic Models , Risk Factors , SepsisABSTRACT
<p><b>OBJECTIVE</b>To compare clinical results of treating Neer two- and three-part of proximal humeral fractures between anterolateral acromial approach and deltopectoral approach.</p><p><b>METHODS</b>From January 2009 to December 2012, 49 patients with Neer two- and three-part of proximal humeral fractures were treated with locked plate fixation. In anterolateral acromial approach group, there were 22 patients including 9 males and 13 females with an average of (63.2±7.6) years old, while 27 patients in deltopectoral approach including 12 males and 15 females with an average of (62.9±7.0) years old. Operative time, blood loss during operation, fracture healing time and complications were observed and compared, postoperative Constant-Murley scoring and VAS scoring were applied for evaluate function of shoulder joint and pain at 3 months, 1 and 2 years respectively.</p><p><b>RESULTS</b>All patients were followed up from 24 to 41 months with an average of 34.5 months. Operative time, blood loss, fracture healing time in anterolateral acromial approach group was (68.20±7.04) min, (151.30±20.57) ml, (10.88±4.90) weeks respectively, and better than that of in deltopectoral approach group which was (75.81±13.70) min, (242.10±37.25) ml and (13.60±2.45) weeks. Three months after operation, Constant-Murley scoring and VAS score in anterolateral acromial approach group was 88.32±5.45, 0.41±0.63 and better that of in deltopectoral approach group which was 63.53±8.31, 1.65±1.02. There was no significant differences between two groups in Constant-Murley scoring and VAS score at 1 and 2 years after operation. Each group has one case occurred loss of length humerus head height, and there was 1 case with subacromial impingement, 1 case with bolt loose and 2 cases with delayed union in deltopectoral approach. No axillary nerve injury, humeral head necrosis and breakage of internal fixation occurred both of two groups.</p><p><b>CONCLUSION</b>Both of anterolateral acromial approach and deltopectoral approach are effective in treating Neer two- and three-part of proximal humeral fractures, and can obtain excellent outcomes. Moreover, anterolateral acromial approach has advantage of less trauma, less blood loss, shorter operative time, rapid recovery of shoulder joint function and fracture.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Case-Control Studies , Fracture Fixation, Internal , Methods , Fracture Healing , Recovery of Function , Shoulder Fractures , General SurgeryABSTRACT
Background Retinal photocoagulation iconsidered to be an effective therapy fodiabetiretinopathy (DR).Fundufluorescein angiography (FFA) iused to determine if panretinal photocoagulation (PRP) ineeded.SometimeFFiunsuitable fosome Dpatients,and funduphotography igenerally applied.However,whethecolofunduphotography can substitute foFFin evaluating Dgrading and advising foadministering the photocoagulation protocol iunclear.Objective Thistudy wato compare the grading outcomebetween colofunduphotography and FFin assessing DR.Methodprospective case serieself-controlled study wadesigned.Thiclinical study waapproved by the EthiCommittee of Shanghai Tenth People'Hospital,and written informed consenwaobtained from each patienprioto entering the series.Five 50° non-stereoscopiphotographwere taken in 238 eyeof 136 patientwho methe criteriof type 2 diabetes,and then the FFwaperformed.The imagewere analyzed based on the 2003 International DiabetiRetinopathy Disease Severity Scale.The comparison of the grading outcomein assessing Dbetween colofunduphotography and FFwaevaluated by the Kappagreementesusing SPS17.0.ResultFunduphotography showed mild non-proliferative D(NPDR) in 17.2％ of case(41/238),moderate NPDin 20.2％ of case(48/238),severe NPDin 27.7％ of case(66/238) and PDeyein 34.9％ of case(83/238).FFshowed mild NPDin 20.2％ of case(48/238),moderate NPDin 17.6％ of case(42/238),severe NPDin 19.3％ of case(46/238) and PDin 42.9％ of case(102/238).The concordance foDgrading between funduphotography and FFwasubstantial (κ =0.653,P＜0.01).In evaluating whetheiwanecessary to administePRP (to severe NPDand PDpatients),good concurrence waobserved between funduphotography and FF(κ=0.812,P＜0.01).ConclusionThe merge image from five 50° non-stereoscopiphotographpresentagood indicatofothe selection of PRP in Dpatientwith type 2 diabetes.However,the physicianshould be cautiouin the evaluation of retinal non-perfusion areand neovascularization by funduphotography.
ABSTRACT
Background Macular hole in high myopia has been paid tremendous attention in clinical research due to its high recurrence rate and unpredictable prognosis.Spectral domain optical coherence tomography (SD-OCT) is considered to be of a good evaluating value for macular hole,yet its application is compromised in patient with high myopia.High myopia might lead to retinal detachment which consequently prevents an accurate OCT.Therefore,it is important to assess the effectiveness of OCT on prognosis in these patients after surgical restoration of the detached retina.Objective The aim of this study was to evaluate the risk of reopening of a macular hole in highly myopic patient after removing silicone oil by SD-OCT.Methods A case-observational study was designed.Twenty-five highly myopic patients with monocular macular holes who underwent vitrectomy combined with internal limiting membrane peeling and silicone oil tamponade were included in this study.Four patients were male and 21 patients were female,with the average age (61.4±9.0) years old and diopter (-14.14 ±6.86)D.Regular ocular examination,axial length measurement,fundus photography and OCT were performed at the day before removing silicone oil and every month till the 6 months after operation.Retinal thickness,macular height index (MHI) and choroidal thickness were measured by OCT.Written informed consent was obtained from each patient.Results All 25 patients finished the follow-up of 6 months.Macular holes remained closure 6 months after operation in 19 patients (76％) and reopened in 6 patients macular holes were in 1-5 months (24％),with a mean time at (3.3± 1.4) months.The average foveal retinal thickness,MHI and the choroidal thickness at the middle of the macular hole were (216.5±95.6) μm,0.30 ± 0.09 and (122.9 ± 20.5) μm in the closed group,respectively,and those in the unclosed group were (113.5±28.7) μm,0.58±0.27 and (96.8±22.9) μm,with significant differences between the two groups (t=2.577,-4.143,2.669,P ＜ 0.05).The percentage of macular hole closure was 85.7％ in the MHI＜0.5 group and 25.0％ in the MHI ≥ 0.5 group,showing a significant difference (P =0.031).The base diameter in the unclosed hole group was significantly larger than that in the closed hole group (1070.2±393.6 μm versus 533.3±277.7 μm) (t =-3.700,P =0.001).Conclusions The measurements of the retinal thickness,MHI and the choroidal thickness at the central area of the macular hole are helpful for the evaluation of reopening risk of macular hole after removing silicone oil.