ABSTRACT
Objective To observe the surgical outcome of the modified transconjunctival technique for minimal segmental buckling on rhegmatogenous retinal detachment (RRD).Methods This is a retrospective case series.Seventy-six patients (78 eyes) with uncomplicated RRD who underwent the modified transconjunctival technique for minimal segmental buckling were enrolled in this study.There were 41 male (42 eyes) and 35 female (36 eyes).The average age was (33.9± 15.6) years.Best corrected vision acuity (BCVA),fundus examination with three-mirrors lens,ocular B ultrasound,optical coherence tomography (OCT) were performed in all patients.BCVA was examined through Standard logarithmic visual acuity chart and transferred to logMAR vision for statistical analysis.The logMAR BCVA was 0.88± 0.88.The technique was successfully performed in all 78 eyes.After transconjunctival location of the retinal break was made,a 5 to 6 mm radial conjunctival incision was performed corresponding to the retinal break without cutting the limbal conjunctiva-Tenon's capsule.After cryopexy,a minimal explant was fixed with one to two sutures through the conjunctival opening,expanded by a pediatric speculum.BCVA,intraocular pressure,tear film stability,conjunctival recovery and retinal reattachment were collected 1 week,1 month,3 months,6 months after surgery.Results One week after surgery,retinal reattachments were achieved in 77 of 78 (98.7％) eyes and 1 eye (1.3％) received vitrectomy.Compared before surgery,the logMAR BCVA improved to 0.44± 0.41,with significant difference (t=3.092,P＜0.01).Conjunctival incision tear occurred in 1 eye.Subretinal hemorrhage occurred in 5 eyes during subretinal fluid drainage procedure.Subretinal hemorrhage occurred in 5 eyes during subretinal fluid drainage procedure.Hemorrhage was absorbed in 2 of the 5 eyes at 3 months after surgery and absorbed in all 5 eyes at 6 months after surgery.Subretinal fluid occurred in 10 eyes at 1 week after surgery and be absorbed completely at 6 months after surgery.Tear film stability improved to preoperative lever at 1 week after surgery.Less change in corneal and conjunctival sensitivity was observed in all eyes.No other surgical complications were observed within the follow-up period,such as scleral perforation,explant extrusion,diplopia or infection.Conclusions The modified transconjunctival technique for minimal segmental buckling minimizes the damage to conjunctiva without reducing the retinal reattachment rate.It can effectively treat uncomplicated RRD with preserving an intact limbal conjunctiva and rapid tear film stability recovery.
ABSTRACT
Objective To investigate the clinical manifestations and gene mutation of a pedigree with retinal lattice degeneration and granular corneal dystrophy (GCD) type 2.Methods Ten members in 3 generations of a pedigree with retinal lattice degeneration and GCD2 were included in the study, including 6 patients (3 males and 3 females) and 4 healthy family members. All members underwent visual acuity, slit lamp microscope, three-mirror lens, fundus color photography, optical coherence tomography, and corneal endothelial cells counting. Genomic DNA was extracted from peripheral venous blood (2 ml) from all the subjects and their spouses, who had no related inherited diseases. The next generation sequencing method was used to detect the mutation sites of transforming growth factor β (TGFBI), and all results underwent Sanger verification.Results Among the 12 eyes of 6 patients, the visual acuity was FC/20 cm-1.0. In the superficial central corneal stroma, snowflake-like deposits were observed in three cases (6 eyes), and a small amount of granular deposits were observed in three cases (6 eyes). Corneal endothelial cell counts were normal. Retinal lattice degeneration were observed in 3 cases, 6 eyes (including 3 cases of rhegmatogenous retinal detachment in 4 eyes); retinal thinning without obvious lattice degeneration in 4 eyes of 2 patients. Nystagmus in 1 patient and fundus examination showed no significant abnormalities. DNA sequencing results showed that the proband and 4 patients had missense mutation of TGFBI gene in exon 4 c.371G> A, the mutation site corresponding to the amino acid change encoded by TGFBI gene No. 124 Amino acids, from arginine to histidine (p.R124H). Patients with this mutation have varying degrees of clinical phenotype.Conclusions The mutation of c.701G> A (p.R124H) in TGFBI gene is the causative gene of GCD in this pedigree. The patients with this mutation have different clinical phenotypes.
ABSTRACT
Background The transdifferentiation of retinal pigment epithelial (RPE) cell to myofibroblast is a central event in the development and progression of proliferative vitreoretinopathy (PVR).N-acetylcysteine (NAC) can inhibit the transdifferentiation of multiple cells to myofibroblasts via suppressing the production of reactive oxygen species (ROS) and the phosphorylation of MAPK induced by transforming growth factor-β1 (TGF-β1),but the effect of NAC on the TGF-β1-induced transdifferentiation of human RPE cell line ARPE-19 cell to myofibroblast and its underlying molecular mechanism is still unclear.Objective This study was to investigate the effect of NAC on the TGF-β1-induced transdifferentiation of ARPE-19 cell to myofibroblast and its underlying mechanisms.Methods Human ARPE-19 cells were divided into control group,TGF-β1 treatment group,NAC intervention group and simple NAC group.Cells in the control group were not disposed,10 ng/ml TGF-β1,10 ng/ml TGF-β1 +5 mmol/L NAC and 5 mmol/L NAC were used to interfere the ARPE-19 cells for 48 hours in the other 3 groups.The morphological changes of the cells were observed by phase contrast microscopy.Real-time quantitative PCR,Western blot,immunofluorescence and ELISA were used to detect the expression of transdifferentiation marker genes-α-smoot h muscle actin (α-SMA),fibronectin and type Ⅰ collagen.The expression level of intracellular ROS induced by TGF-β1 in the presence or absence of NAC was detected using the non-fluorescent probe DCFH-DA performed by flow cytometry.The phosphorylation level of p38MAPK,ERK1/2 and SAPK/JNK were detected by Western blot.The cell counting kit-8 (CCK-8) assay was used to investigate the effect of NAC on the viability of ARPE-19 cells.Results The expressions of α-SMA,fibronectin and type Ⅰ collagen mRNA in the TGF-β1 treatment group were significantly increased,and were (2.15±0.29),(9.54 ± 1.08),(25.78 ±0.66) times higher than those of the control group,with significant differences between the two groups (all at P＜0.05).The expressions of α-SMA,fibronectin and type Ⅰ collagen protein were significantly increased,and were (8.49± 0.32),(2.53 ± 0.69),(4.45 ± 1.05) times higher than those of the control group,respectively,with significant differences between the two groups (all at P＜0.05).The expressions of α-SMA,fibronectin and type Ⅰ collagen mRNA in the NAC intervention group were (66.70± 12.57)％,(66.11±8.35)％ and (33.19±6.90)％ lower than those of the TGF-β1 treatment group,and the expressions of protein were (52.30±4.83)％,(55.03 ±2.58)％ and (56.08 ±3.65)％ lower than those of the TGF-β1 treatment group,respectively,with significant differences between the two groups (all at P＜0.05).Flow cytometry results showed that the expression level of intracellular ROS in the TGF-β1 treatment group was (2.12±0.20) times higher than that of the control group,and the intracellular ROS in the NAC intervention group was (57.41 ±9.45) ％ lower than that of the TGF-β1 treatment group,with significant differences between the groups (both at P＜0.01).Western blot results showed that the phosphorylation levels of p38MAPK,SAPK/JNK and ERK1/2 in the TGF-β1 treatment group were (9.18±1.00),(4.87±0.81) and (4.20±0.69) times higher than those of the control group,respectively,showing significant differences between the two groups (all at P＜0.05).The phosphorylation level of p38MAPK,SAPK/JNK and ERK1/2 in the NAC intervention group were (48.16± 14.82) ％,(67.90±2.90) ％ and (74.52±4.00)％ lower than those of the TGF-β1 treatment group,respectively,showing significant differences between the two groups (all at P＜0.05).Conclusions NAC inhibits the TGF-β1-induced transdifferentiation of ARPE-19 cells possibly via suppressing the production of intraeellular ROS and the phosphorylation of p38MAPK,SAPK/JNK and ERK1/2.
ABSTRACT
OBJECTIVE:To prepare rifampicin(RFP)nano-structured lipid carriers(RFP-NLCs)to improve its water-solubili-ty,and evaluate its quality. METHODS:Using liquid-solid lipid materials oleate and glyceryl monostearate as lipid materials,soy lecithin as emulsifier,poloxamer 188 as nonionic surfactant,melting-ultrasonic emulsification was used to prepare RFP-NLCs. Us-ing the comprehensive scores of particle size and encapsulation efficiency as indexes,the amount of lipid materials,proportion of liquid lipid materials,dosage,and mass ratio of soy lecithin-poloxamer 188 as factors,orthogonal test was adopted to optimize the formulation. The morphology,particle size,polydispersity index(PDI),Zeta potential,encapsulation efficiency,drug loading and in vitro release degree of prepared lipid carriers with optimal formulation were evaluated. RESULTS:In the optimal formulation, the amount of lipid materials was 150 mg,proportion of liquid lipid materials was 30%,amount of RFP was 10 mg,and mass ra-tio of soy lecithin-poloxamer 188 was 1:3. Prepared RFP-NLCs had rounded appearance,particle size was (124.07 ± 3.25) nm, PDI was 0.104±0.010,Zeta potential was(-31.07±2.94)mV,encapsulation efficiency was(80.90±2.59)%,and drug loading was(4.81±0.68)%(n=3). Compared with RFP raw materials,in vitro release degree of RFP-NLCs significantly slowed down, and the cumulative release degree within 12 h was 63.2%,which was in line with Weibull equation. CONCLUSIONS:Screened formulation can successfully prepare RFP-NLCs;the prepared RFP-NLCs have small particle size and high encapsulation efficien-cy,and the in vitro drug release shows certain sustained-release characteristics.
ABSTRACT
Objective To establish the rapid PCR am plification program and system and to verify the technical indexes. Methods PCR m ultiplex and capillary electrophoresis detection of 24 autosom al STR loci and one Y-STR loci using the 6-color fluorescence m arking technology, as w ell as Amelogenin and Y-InDel. Meanw hile, sensitivity, specificity, identity, stability, m ixing and a batch of sam ple tests w ere investigated, and the genotype of various routine sam ples and degraded, exfoliated cell sam ples w ere observed. Results The sensitivity of the system w as 0.062 5 ng. In addition, the genotype could be detected accu-rately only around 65 m in via rapid am plification. The species-specificity w as high and the genotyping of all kinds of dry blood specim ens of filter paper and m ixed, degraded, exfoliated cell sam ples w ere accu-rate. Conclusion The rapid am plification system can significantly im prove the detection rate, and obtain accurate and stable genotyping results, w hich m ay be im portant im plications for the establishm ent of STR database and study on population genetics and forensic identification.
ABSTRACT
OBJECTIVE:To provide reference for developing the antibiotic community pharmaceutical care. METHODS:Some residents of Jiangbei district of Ningbo were randomly collected for questionnaire survey on antibiotic storage,usage,accep-tance degree and demand of pharmaceutical care,etc. And the results were analyzed statistically. RESULTS:Totally 2 000 ques-tionnaires were sent out,1 784 were effectively received with effective rate of 89.2%. 74.2% of respondents had kept antibiotics in house;61.3% lacked antibiotic knowledge and easily be confused with anti-inflammatory drugs,43.5% thought antibiotics was ef-fective for virus infections;48.4% had self-treated with antibiotics,the most common reason was cold symptoms,and it existed amount or course of antibiotics changes by themselves;only 15.1%of them had knew or heard of pharmaceutical care;majority re-spondents(88.9%)wanted to accept antibotic pharmaceutical care,hoping to learn the indications,usage and dosage,contraindica-tions,precautions and adverse reactions of antibiotics by drug consultation,lecture,etc. CONCLUSIONS:The residents lack the knowledge about rational use of antibiotics,it is urgent for pharmacists to provide antibiotic community pharmaceutical care for resi-dents with purpose,which are important guarantee for rational use of antibiotics.
ABSTRACT
Background Toric intraocular lens (Toric IOL) is a well accepted method of correct of corneal astigmatism.Axial misalignment,including the error of intraocular lens alignment during surgery and rotation of Toric IOL,is the main barrier to the precise alignment of Toric intraocular lenses.Therefore,the angle of axial misalignment is a main index to evaluate the effectiveness of Toric IOL implantation.Objective The present study is to describe a method of precisely detecting Toric IOL misalignment using postoperative digital photograph.Methods A measuring template (polar coordinates) was constructed using Adobe Photoshop software.Minimum graduate to detect the Toric axis was 1° (maximum error 0.5°).The clinical data of 24 eyes undergone Toric IOL implantation was retrospectively analyzed.Corneal astigmatism was detected by rotating Scheimpflug camera (Pentacam) or slit scan (Orbscan).Digital retro illumination picture was photographed after mydriasis.The picture was analyzed by our derived template.The steepest corneal axis and the axis of Toric IOL were then determined.The misalignment of Toric IOL was determined as the angle between the steepest corneal axis and the axis of Toric IOL.Misalignment of Toric IOL and its distribution were analyzed by statistical means.Results A method using polar coordinates and digital photo to precisely detect Toric IOL misalignment was derived.Mean Toric IOL misalignment was 10.93±6.90 degrees (0-24 degrees) in the 24 cases.The axial misalignment in all of cases were within 25 degrees,including clockwise in 14 eyes(58.33%),anticlockwise in 10 eyes (41.67%).In this study,the misalignment angle of 4 eyes were within 5 degrees;11 eyes were 5 to 10 degrees;1 eye was 10 to 15 degrees;6 eyes were 15 to 20 degrees;2 eyes were 20 to 25 degrees.Conclusion The method is feasible to the direction of Toric IOL misalignment in clinic.
ABSTRACT
Objective To evaluate the clinical feasibility of network live broadcast of digital subtraction angiography(DSA)video streaming.Methods DSA video streaming was captured by an advanced image capture board.MPEG-4 and Directshow framework were used for data compression and transmission.Data of DSA video streaming could be transmitted easily from server sender filter to client receiver filter according to TCP and UDP protocols.Images of 24 cases were captured,which were compared with images of DSA workstation by experienced doctors.The subiective evaluation criteria included the manifestition of normal and pathological blood vessels,and sharpness,contrast degree and real time efficiency of images.Results The delay time of live broadcast was less than one second in 100 M LAN.Among 24 cases,excellent imaging quality was got in 17 cases,good in 5 cases and midst in 2 cases.Conclusion Excellent images and synchronism of DSA video are achieved in this system.which can meet clinical requirements of diagnosis and synchronism.
ABSTRACT
Objective To explore the curative effect on superselective uterine artery embolization for treatment of placenta inereta.Methods Pelvic arteriography was performed to confirm bleeding vessels.Then a 5 F Cobra catheter was inserted superselectively into uterine artery ipsilateral to bleeding,through which methotrexatum(MTX)and gelatin sponge were injected for embolization.After the procedure,bleeding,blood pressure,dischargement of placenta tissue,uterine recuperation,and plasma β-HCG were monitored.Results Bleeding vessels were confirmed in all of the 5 cases of placenta increta.Uterine artery embolization was successful at sole procedure.The operation time was 25.0 to 60.0 min.with the mean time (37.4±5.8)min.Vaginal bleeding stoped in 3.0 to 12.0 minutes after embolization and the mean time was(5.7±2.4)min.Blood pressure returned to normal after operation and vital signs were stable.Placenta tissue discharged on the 5th day to the 4th week after embolization and the mean time was 17 d.The uterus recuperated and blood β-HCG recovered simutaneously.The menstruation and ovulation during follow-up returned to normal.Conclusion Superseleetive uterine artery embolization for treatment of placenta increta has advantages such as short operation time,minimal invasion,definite curative effect and reservation of uterus,which is worthy in clinical application.
ABSTRACT
Objective To analyze the CT findings of tuberculous lymphadenitis in parotid gland, so as to improve the diagnostic accuracy of tuberculosis of parotid gland. Methods Nine cases with tuberculous lymphadenitis in parotid gland confirmed by surgical pathology and acid-fast bacilli after preoperative spiral CT plain scan and two phases dynamic enhancement scan were retrospectively analyzed.Imaging findings of CT were reviewed and compared with surgical pathology. Results Seven of the 9 cases of tuberculosis of the parotid gland occurred in the left side, and 2 in the right side, and superficial lobe involvement occurred in 8 cases and deep lobe in 1 ease. The lesion was classified as tumour type (8 cases)and infiltration type (1 case). In tumour type, the number of lesion was from 1 to 4, and the size was from 2.7 to 5.3 cm in diameter. One case of infiltration type measured 3.4 cm in diameter. On CT plain scan,the lesions showed homogeneous slight high-density with regular edge in 5 cases and irregular low-density in 4 cases, and 2 of them with partly blurred edge. On CT enhanced scan, uniform moderate enhancement was seen in 3 cases, circular enhancement in 4 cases, inhomogeneous enhancement in 1 case, and lace-like enhancement in 1 case. Local infiltration occurred in 6 cases. Lymphadenovarix in the same side of lesion occurred in 2 cases. Conclusion CT findings of tuberculous lymphadenitis in parotid gland present diversification, which correlate well with pathological changes. Understanding of characteristic CT findings of tuberculous lymphadenitis in parotid gland is helpful for differential diagnosis, but final diagnosis still depends on pathology and acid-fast baeilli.
ABSTRACT
Objective To evaluate the value of embolizing uterus artery in the treatment of serious obstetrical hemorrhage. Methods Twelve cases with obstetrical hemorrhage, including postpartum, postcesarean, ectopic pregnant, and artifical abortional bleeding, were treated by embolizing uterus artery. Results All of the 12 patients with obstetrical bleeding were successfully controlled. No serious complication happened. ConclusionThe treatment of obstetrical hemorrhage by emergently embolizing uterus artery was safe and effective.
ABSTRACT
Objective To investigate the interventional therapy and its value in the metal foreign matter in the stomach. Methods Eight patients with metal foreign matter in the stomach was studied. All patients were male, and their age ranged from 28 to 46 years with the mean age of 32.2 years. All patients had the medical history of swallowing metal foreign matter in compulsory detoxification or imprisonment. The catheter was inserted into the stomach lead by guide wire lubricated by paraffine. Then the guide wire was withdrawn and a 2.6 m long guide wire was folded in the middle and was inserted into the sromach through the catheter. A loop was made on the guide wire, and the loop was controlled to to hitch the forigen mater, then the guide wire was drawn out slowly . Results A total of 12 metal foreign matters in the stomach in all 8 patients were taken out safely, and no comqlications occurred. Conclusion The interventional therapy for the metal foreign matter in the stomach is simply, minimal invasive, cheap, effective, and with little complication. This therapy is a clinic treatment, the patient is glad to accept, and is the ideal therapy for foreign matter in the stomach.
ABSTRACT
Objective To evaluate the therapeutic effect of Pingyangmycin lipiodol emulsion (PLE) embolization for cavernous hemangioma of liver (CHL). Methods Seldinger technique was adopted and the catheter was super-selectively sent into the supplying artery of tumors in 18 CHL patients, 5-10 ml of Lidocaine and 5-20 ml of PLE were slowly injected. Before the embolization, 50-100 mg of pethidine was routinely injected. The embolization was conducted in several times in patients with large tumors, with multiple supplying arteries, and whose age was above 60 years. During the 3-48 months'follow-up after the operation,the change of the tumor diameter before and after the embolization was compared by using CT and ultrasound. The clinical symptomatic relief and the complications were also observed. Results The CHL of all the 18 cases were filled up by PLE. The foci were completely vanished in 9 cases, reduced by over 50% in 7 cases,and reduced by 25%-50% in 2 cases,respectively. The follow-up angiographic examination was performed in six cases, the tumor staining was completely vanished and the tumor-supplying artery was closed up. The improving rate of the clinical symtoms reached 89% . There were no serious complications. Conclusion The PLE embolization in hepatic cavernous hemangioma proves to be reliable, safe, minimally invasive, and with little side effect. This therapy, therefore, can be the first method of choice in treating the cavernous hemangioma of the liver.
ABSTRACT
Objective:To evaluate the efficacy and safety of selective arterial embolization in the treatement of obstetrical and gynecological bleeding.Methods:16 cases with obstetrical and gynecological hemorrhage,including postpartum,trophoblastic disease,uterine fibroids,ectopic pregnant and artifical abortinal bleeding were treated by selective arterial embolization.Results:The embolization successfully controlled the bleeding in all patients.No serious complication happened.Conclusion:Selective arterial embolization is safe and effective,it′s complicationis is lower and patient′s fertility can also be preserved.
ABSTRACT
Objective To compare intraindividual higher-order aberrations(HOA)after implantation of aspherical and spherical intraocular lenses(IOL).Design Prospective,case-controlled study.Participants 33 patients(66 eyes)were between 50 and 76 years of ages.The patients with bilateral senile cataracts were operated with phacoemulsification and IOL implantation.All the patients had no other ocular pathologies and no previous ophthalmic surgery.Patients with keratometric astigmatism higher than-2.0 diopters(D)were excluded from the study.Methods Wavefront aberration measurements of 33 patients(66 eyes)after implantation of a spherical IOL(Canon Staar KS-3)in one eye and an aspherical IOL(Cannon Staar KS-3Ai)in the contralateral eye were analyzed.The eyes were randomly assigned to groups of the spherical IOL or the aspherical IOL.Third-order,4th-order,5th-order,total HOA root-mean-squares(RMS),and 4th-order spherical aberrations(Z40)were compared 3 months after surgery.Main Outcome Measures Visual acuity(VA),the best corrected visual acuity(BCVA),the centrality of IOL,refraction data,diameter of pupil size,3rd-order,4th-order,5th-order and total HOA RMS,and 4th-order spherical aberration(Z40)RMS were measured.Results Fourth-order aberration RMS(0.193?0.098?m),Z40 RMS(0.037?0.099?m),total HOA RMS(0.498?0.072?m)in the aspherical IOL group were lower than those with the spherical IOL(0.403?0.155?m,0.381?0.142?m,0.737?0.164?m,respectively)at 6mm pupil diameter.For 3rd-and 5th-order RMS at 6mm pupil diameter,total HOA RMS(at 5mm pupil diameter),no significant difference was found in both IOLs.Under mesopic conditions,ten patients(30%)with an aspheric IOL had better contrast sensitivity.The average myopic shift were(-0.29?0.09)D and(-0.87?0.16)D in the aspherical and spherical IOL groups at 6mm pupil diameter(P