Regulating the immune response to carbon tetrachloride-induced liver fibrosis in mice by blocking inducible co-stimulatory molecules and interleukin-33 / 中华肝脏病杂志

Objective: To investigate the effects of combined blockade of interleukin-33 (IL-33) and inducible co-stimulatory molecule (ICOS) on carbon tetrachloride-induced chronic liver fibrosis and imbalance of T helper lymphocyte subsets in mice. Methods: There were 40 BALB/c mice in each model and control group. Flow cytometry was used to determine the proportion of Th1/Th2/Th17 cells in the splenic lymphocyte suspension of mice, the expression levels of interferon γ, IL-4, and IL-17 in the splenic lymphocyte suspension of liver fibrosis mice after combined blockade of IL-33 and ICOS, and the pathological changes of liver histopathology in mice with liver fibrosis. Two independent sample t-test was used to compare data between groups. Results: Compared with the non-blocking group, the proportion of Th2 and Th17 cells in the IL-33/ICOS blocking group was significantly down-regulated (Th2: 65.96% ± 6.04% vs. 49.09% ± 7.03%; Th17: 19.17% ± 4.03% vs. 9.56% ± 2.03%), while the proportion of Th1 cells and Th1/Th2 ratio were up-regulated (Th1: 17.14% ± 3.02% vs. 31.93% ± 5.02%; Th1/Th2: 0.28 ± 0.06 vs. 0.62 ± 0.23), and the difference was statistically significant (t = 5.15, 6.03, 7.14, 4.28, respectively, with P < 0.05). After entering the chronic inflammation stage of liver fibrosis in mice (10 weeks), compared with the non-blocking group, the expression levels of IL-4 and IL-17 in the blockade group were significantly down-regulated [IL-4: (84.75 ± 14.35) pg/ ml vs. (77.88 ± 19.61) pg/ml; IL-17: (72.38 ± 15.13) pg/ml vs. (36.38 ± 8.65) pg/ml], while the expression of interferon γ was up-regulated [(37.25 ± 11.51) pg/ml vs. (77.88 ± 19.61) pg/ml], and the difference was statistically significant (t: IL-4: 4.71; IL-17: 5.84; interferon γ: 5.05, respectively, with P < 0.05). Liver histopathological results showed that hepatic necrosis, hepatic lobular structural disorder, and fibrous tissue hyperplasia were significantly lower in the blockade group than those in the non-blocking group at 13 weeks of liver fibrosis. Conclusion: Combined blockade of the ICOS signaling pathway and IL-33 can regulate Th2 and Th17 polarization, down-regulate the inflammatory response, and inhibit or prevent the occurrence and progression of fibrosis.

Orbital Rosai-Dorfman disease in a fifty-eight years old woman

Rosai-Dorfman disease [RDD] is rare and characterized by histiocytic proliferation and massive cervical lymphadenopathy. About 40% of patients have extra-nodal involvement. Ophthalmic involvement is seen in 10% of cases. A case of orbital Rosai Dorfman disease in a 58 years old woman is presented here, who was misdiagnosed as orbital inflammatory disease initially. The patient did not respond to a course of oral prednisolone. Then complete surgical excision of the mass was performed and the histopathological examination was consistent with a diagnosis of RDD

Effects and complications of placement of motility coupling post in porous polyethylene orbital implants / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>OBJECTIVE</b>To investigate the effects and complications of primary and secondary placements of motility coupling post (MCP) in the unwrapped porous polyethylene orbital implant (PPOI) following enucleation.</p><p><b>METHODS</b>We investigated 198 patients who received PPOI implantation following the standard enucleation procedure in the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China, from 2002 to 2004. These patients were subgrouped into PPOI-only patients (112 cases, received PPOI following enucleation), primary MCP patients (46 cases, received primary placement of MCP during PPOI operation), and secondary MCP patients (40 cases, received secondary placement of MCP 6 months after the initial surgery). Effects and complications among these three groups were compared.</p><p><b>RESULTS</b>The PPOI-only patients took shorter treatment course when compared with other two MCP groups (P<0.001), without significant difference noted between the two MCP groups. However, the two MCP groups had better prosthetic motility than PPOI-only group (P<0.001), without significant difference between the two MCP groups. In the early stage, 2 eyes in the PPOI-only group and 1 eye in the primary MCP group had PPOI infection. In PPOI-only group, 3 (2.68%) eyes had PPOI exposure, which occurred after fitting the prostheses; 4 eyes (8.70%) in primary MCP group and 1 eye (2.50%) in secondary MCP had PPOI exposure, which occurred before fitting the prostheses. After prosthesis was fit successfully, the excessive discharge and granuloma were 33.9% and 1.79% in PPOI group-only, 53.3% and 8.9% in primary MCP group, and 52.5% and 7.5% in secondary MCP group, respectively.</p><p><b>CONCLUSION</b>Both primary and secondary placements of MCP into the PPOI following enucleation can help patients to obtain desirable prosthetic motility, but may be associated with more complications. The primary placement of MCP with skilled operation in selected patients is more recommendable than secondary placement.</p>

Porous polyethylene channel implants in reconstruction of orbital blowout fractures / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To evaluate the efficacy of porous polyethylene channel implants in reconstruction of orbital blowout fractures.</p><p><b>METHODS</b>Twenty-three patients with orbital blowout fractures were admitted in our eye center from June 2003 to January 2006. Porous polyethylene channel implants were used to repair the defects of orbital wall and to correct the enophthalmos. The visual acuity, the degree of enophthalmos, diplopia and position were recorded preoperatively and postoperatively.</p><p><b>RESULT</b>No patients presented loss or apparent descent of visual acuity after surgery. Postoperative mean enophthalmos (1.7+/-0.5)mm was smaller significantly than that of preoperation [(3.9 +/-1.2)mm (P<0.05)]. Diplopia disappeared in 10 patients 1 month after surgery. Diplopia disappeared in 11 patients in primary position, but it remained in other positions. Diplopia remained in primary position in 2 patients. Ocular movement in 22 patients was normal postoperatively. While primary position upward occurred in 1 patient postoperatively and 2 weeks later it became normal.</p><p><b>CONCLUSION</b>Porous polyethylene channel implants are effective in reconstruction of orbital blowout fractures.</p>

Effect of basic fibroblast growth factor (bFGF) on the treatment of exposure of the orbital implants / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>OBJECTIVE</b>To evaluate the efficacy and the indication of basic fibroblast growth factor (bFGF) in the treatment of exposure of orbital implants.</p><p><b>DESIGN</b>Retrospective and observational case series.</p><p><b>METHODS</b>We reviewed 41 patients (41 eyes) suffering exposure of orbital implants from Jan. 2000 to June 2006. The study group patients with mild exposure received combined treatment with bFGF and antibiotic drops, and while the control group patients with mild exposure were treated with antibiotic drops only. The study group patients with moderate and severe exposure received combined treatment with bFGF and antibiotic drops, and after 2 months they were subjected to amniotic membrane transplantation, while the control group patients with moderate and severe exposure underwent amniotic membrane transplantation after using antibiotic drops. Observation of the growth of conjunctival epithelium and comparison of the healing rate of the two groups.</p><p><b>RESULTS</b>The healing rates of the mild, moderate and severe exposure study group were 100% and 92.3%. The healing rates of the mild, moderate and severe exposure control group were 55.6% and 66.7% respectively. The difference of the healing rates of the mild exposure study group and the control group was significant (P=0.033). And the difference of the healing rates of the moderate and severe exposure study group and the control group was not significant (P=0.167).</p><p><b>CONCLUSION</b>bFGF may promote obviously the healing of orbital implant exposure, particularly it can be the first choice for the treatment of mild degree exposure. For the moderate and severe cases, it can be administered before surgical repair to enhance neovascularization and will tend to increase the success rate of surgical repair.</p>

Analysis of high density porous polyethylene (Medpor) orbital implant in 266 cases / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate the postoperative complications, the appearance and motility in patients who underwent placement of Medpor orbital implant after enucleation, or secondary implantion.</p><p><b>METHODS</b>A retrospective study was carried out on the 266 cases in whom a Medpor orbital implant was implanted from 2001 to 2004.</p><p><b>RESULTS</b>All the cases were followed up from 3 to 26 months. A total of 23 in 266 (8.6%) cases had documented postoperative complications: inflammatory granuloma in 2 cases (0.8%), and moderate or severe ptosis in 4 cases (1.5%), and remained upper eyelid notch with mild ptosis in 8 cases (3.0%), and lower eyelid laxity in 2 cases (0.8%). In 5 cases (1.9%), implant exposure developed: 3 cases were resolved with conservative therapy, and 2 cases with surgical revision of the socket. 2 cases experienced persistent pyogenic discharge in conjunctival sac, and the implant was took out because the discharge couldn't control with local and systemic antibiotic therapy. The motility is excellent in 148 cases and good in 11 cases after the primary obital implant, and excellent in 36 cases and good in 68 cases and bad in 3 case after the secondary implant. The difference between the primary and the secondary obital implant is obvious.</p><p><b>CONCLUSIONS</b>It is considered that Medpor orbital implant is a good method of ocular plasty. Although there are some mild postoperative complications, but those can be resolved with conservative therapy or surgical revision. Medpor orbital implant has good histocompatibility, and the operative processes are convenient. Patients are satisfied with appearance and motility. So the Medpor orbital implant is one of the best selection in ocular socket plasty.</p>