ABSTRACT
AIM: To investigate the choice of surgical approach, therapeutic effect and complications of orbital cavernous hemangioma(OCH)in different positions of orbit.METHODS: The clinical data of 128 patients of 128 eyes with OCH whose were surgically removed and pathologically diagnosed in the department of ophthalmology of the Second Affiliated Hospital of Air Force Military Medical University from January 2016 to August 2021 were retrospectively analyzed. The position of OCH in the orbit was determined by preoperative imaging examination(CT/MRI), so as to select different surgical approaches and analyze the postoperative curative effect and the incidence of complications.RESULTS: The location of OCH in the orbit: 82 eyes in the muscle cone and 46 eyes outside the muscle cone. According to the quadrant of the orbit where the tumor was located, there were 24 eyes in the upper-outer quadrant, 38 eyes in the lower-outer quadrant, 28 eyes in the upper-inner quadrant, 12 eyes in the lower-inner quadrant, and 26 eyes the intraconal central space. The selection of surgical approach: 1)OCH in the muscle cone: conjunctival approach surgery in 53 eyes, lateral orbital approach surgery in 22 eyes, lateral combined medial conjunctiva orbital approach surgery in 5 eyes, skin approach surgery in 1 eye, transnasal approach under nasal endoscope surgery in 1 eye; 2)OCH outside the muscle cone: skin approach in 29 eyes, conjunctival approach in 12 eyes and lateral orbital approach in 5 eyes. Postoperative efficacy: except for 1 eye of postoperative tumor residue, the other 127 eyes were completely removed. Postoperative complications: 1)Ocular motility disorder: 16 eyes, including conjunctival approach surgery in 11 eyes, lateral orbital approach surgery in 4 eyes, lateral combined medial conjunctiva orbital approach surgery in 1 eye; 2)Visual acuity decreased in 9 eyes: conjunctival approach surgery in 3 eyes, lateral orbital approach surgery in 6 eyes; 3)Mydriasis occurred in 9 eyes, including 4 eyes via conjunctival approach surgery and 5 eyes via lateral orbital approach surgery; 4)Intraorbital hemorrhage occurred in 3 eyes: all occurred through conjunctival approach surgery; 5)Visual acuity was lost in 2 eyes, including conjunctival approach surgery in 1 eye and lateral orbital opening approach surgery in 1 eye; 6)There were 2 eyes of ptosis, including conjunctival approach surgery in 1 case and skin approach surgery in 1 eye; 7)Tumor residue occurred in 1 eye: multiple intraorbital tumors were treated by lateral orbital approach surgery.CONCLUSION: The accurate location of OCH combined with imaging examination and the selection of appropriate surgical approaches according to different locations can successfully remove the tumor and reduce the incidence of complications.
ABSTRACT
<p><b>PURPOSE</b>To compare the clinical efficacy and complications of limited internal fixation combined with external fixation (LIFEF) and open reduction and internal fixation (ORIF) in the treatment of Pilon fracture.</p><p><b>METHODS</b>We searched databases including Pubmed, Embase, Web of science, Cochrane Library and China Biology Medicine disc for the studies comparing clinical efficacy and complications of LIFEF and ORIF in the treatment of Pilon fracture. The clinical efficacy was evaluated by the rate of nonunion, malunion/delayed union and the excellent/good rate assessed by Mazur ankle score. The complications including infections and arthritis symptoms after surgery were also investigated.</p><p><b>RESULTS</b>Nine trials including 498 pilon fractures of 494 patients were identified. The meta-analysis found no significant differences in nonunion rate (RR = 1.60, 95% CI: 0.66 to 3.86, p = 0.30), and the excellent/good rate (RR = 0.95, 95% CI: 0.86 to 1.04, p = 0.28) between LIFEF group and ORIF group. For assessment of infections, there were significant differences in the rate of deep infection (RR = 2.18, 95% CI: 1.34 to 3.55, p = 0.002), and the rate of arthritis (RR = 1.26, 95% CI: 1.03 to 1.53, p = 0.02) between LIFEF group and ORIF group.</p><p><b>CONCLUSION</b>LIFEF has similar effect as ORIF in the treatment of pilon fractures, however, LIFEF group has significantly higher risk of complications than ORIF group does. So LIFEF is not recommended in the treatment of pilon fracture.</p>
Subject(s)
Humans , Combined Modality Therapy , External Fixators , Fracture Fixation, Internal , Methods , Tibial Fractures , General SurgeryABSTRACT
Background Growth factor-induced proliferation and migration of retinal pigment epithelium (RPE) cells are the major pathological changes of proliferative vitreoretinopathy (PVR).Arsenic trioxide ( As2O3 ) is an active ingredient of Chinese traditional medicines,which has an inhibition on proliferation and migration of tumor cells.However,it is not clear whether As2O3 could inhibit growth factor-induced proliferation and migration of RPE cells. Objective This study was to explore the effects of As2O3 on epidermal growth factor (EGF)-induced proliferation and migration of ARPE-19 cells. Methods RPE cell line (ARPE-19 cells) were cultured.Different concentrations of As2O3(0,0.5,1.0,2.0,5.0,10.0,20.0 μmol/L) were added in the culture plate to treat ARPE-19 cells with or without 10 mg/L EGF in serum-free group for 24 and 48 hours,respectively.The MTT colorimetric assay was used to check the cell viability and evaluate the drug toxicity.The effects of As2O3 on EGF-induced proliferation of ARPE-19 cells were analyzed to get an effective and avirulent concentrations of As2O3.The effects of As2O3 on EGF-induced migration of ARPE-19 cells were observed by scratch-wound assay and the Boyden chamber assay.Results MTT assay showed that the A values were gradually declined with the increase of As2O3 concentrations after As2O3 treatment without EGF for 24 hours and 48 hours ( Fgroup =38.269,P =0.000 ; Ftime =0.874,P =0.358 ).Compared with the control group,no significant differences were seen in the A values of ARPE-19 cells in 0.5-5.0 μmol/L groups (all P＞0.05).Meantime,As2O3 reduced the A values of ARPE-19 cell with 10 mg/L EGF in dose- and time-dependent manner ( Fgroup =152.155,P =0.000 ; Ftime =51.649,P =0.000 ).There were not significant differences in 10 mg/L EGF-induced cell growth after 0.5,1.0,2.0 μmol/L As2O3 was added for 24 and 48 hours ( Fgroup =2.215,P =0.126 ;Ftime =2.230,P =0.155).However,when 5.0-20.0 μmol/L As2O3 added,the A values of 10 mg/L EGF-induced ARPE-19 cells lowed,showing a significant difference in comparison with the control groups ( all P＜0.05),with the cellular inhibiting rate 12％,32％,37％ in 24 hours and 39％,44％ and 53％ in 48 hours.Scratch-wound assay showed that EGF-induced horizontal migration of ARPE-19 cells was slow after 0.5-2.0 μmol/L As2O3 treated,and the same results also appeared in cell lognitudinal migration by Boyden chamber assay,with the inhibitory rates 22％,33％ and 46％ respectively. Conclusions As2O3 is avirulent on ARPE-19 cells within definite concentration range.At ≤ 2.0 μmol/L concentrations,As2O3 dose not affect EGF-induced proliferation of ARPE-19 cells,but it suppresses EGF-induced cell migration.At ≥ 5.0 μmol/L concentrations,As2O3 plays an inhibitory role to EGF-induced proliferation of ARPE-19 cells.
ABSTRACT
Objective: To study the influence of recombinant human erythropoietin (rhEPO) preconditioning on the liver function and expression of nuclear factor-κB (NF-κB) during early stage following liver transplantation, and to investigate the possible mechanism of rhEPO preconditioning on ischemia-reperfusion injury after liver transplantation. Methods: Twenty-six patients with advanced hepatic cirrhosis were randomly divided into two groups(n= 13) : the rhEPo pre-treatment group received subcutaneous injection of rhEPO 100 U/kg at 1, 3 and 5 d before liver transplantation, and the control group received 2 ml normal saline in the same manner. The peripheral blood samples were harvested at 1, 2, 4 and 6 h after blood supply recovery in the donator liver to examine the hepatic functions. The NF-κB p65 expression in the peripheral blood samples were examined by Western blotting analysis, the TNF-α level in the blood was detected by ABC enzyme linked immunosorbent assay. Serum ALT and AST were also determined. Results: The liver function indices and the levels of serum NF-κB p65, TNF-α in the rhEPO pretreatment group were significantly lower than those in the control group (P<0.05). Conclusion: Pre-treatment with rhEPO can inhibit hepatic inflammation early after liver transplantation, protecting hepatic function and reducing ischemia-reperfusion injury after liver transplantation.
ABSTRACT
<p><b>UNLABELLED</b>OBJECTIVE To study the effects of intra-abdominal pressure (IAP) on respiratory system, circulatory system and renal function in rats. To investigate the difference between the direct measure and indirect measure methods (via inferior vena cava and bladder) for IAP.</p><p><b>METHODS</b>Sixty Sprague-Drawly (SD) rats were randomly divided into 5 groups with different IAP (IAP value of 1-5 groups was 5, 10, 15, 20, 25 mm Hg,respectively) and healthy control group, 10 rats in each group. The parameters of respiratory system, circulatory system, renal function, and IAP value were recorded. The correlation between direct and indirect measurement methods was also analyzed.</p><p><b>RESULTS</b>There were no significant differences in above parameters between IAPI and healthy control groups. Compared with those in healthy control group, PaO2 significantly decreased (P < 0.05), SCr and BUN increased significantly in IAP2 group (P < 0.05). Other indexes in IAP3, IAP4 groups increased (P < 0.05 or P < 0.01) except for respiratory frequency(RF) and MAP (P > 0.05). PaO2 and MAP decreased (P < 0.01), and other indexes increased (P < 0.05 or P < 0.01) in IAP5 group. The values obtained from the indirect measure method were positively correlated with that from the direct measure method (r = 0.937, 0.955, P < 0.01, respectively).</p><p><b>CONCLUSIONS</b>IAP can affect respiratory system, circulatory system and renal function in different degrees in rats. The indirect measure method can replace the direct measure method for IAP measure with little injuries.</p>