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Objective:To observe the abnormal clinical manifestations of retinal blood vessels and the characteristic image characteristics of optical coherence tomography (OCT) in young myopia.Methods:A case observation study. From July to December 2020, 523 young patients with different myopia refractive powers who were treated in Department of Ophthalmology of The Second Hospital of Hebei Medical University were included in the study. Among them, 277 were males and 246 were females; the median age was 19.0 (5.0) years. All the affected eyes underwent best corrected visual acuity (BCVA), frequency domain OCT (SD-OCT) examination and axial length (AL) measurement. The BCVA examination was performed using the Snellen eye chart. The median myopia refractive power of the affected eye was 5.00 (3.25) D. Among them, low myopia, moderate myopia, and high myopia were 227, 405, and 414 eyes, respectively. The average AL of the affected eye was 25.6±2.8 mm. The frequency domain OCT instrument was used to scan the temporal side of the retina, the upper and lower nasal vascular arches and the macular fovea radially. The images of retinal vascular cysts, microfolds, and lamellar hole were acquired and stored. The prevalence, composition ratio, distribution rule and OCT imaging characteristics of retinal paravascular abnormalities were observed and analyzed. The distribution of paravascular abnormalities in the retina was compared by the χ2 test; the age, refractive power, and AL of different paravascular abnormalities were compared by the K-W rank sum test. Results:Of the 1046 different diopters of myopic eyes, there were 227 eyes in mild myopia, 405 eyes in moderate myopia and 414 eyes in high myopia. Retinal paravascular abnormalities were detected by SD-OCT in 40 eyes (3.8%,40/1046). The prevalence of retinal paravascular abnormalities in moderate myopia was 0.7% (3/405) and high myopia was 8.9% (37/414). No retinal paravascular abnormalities were observed in mild myopia.Retinal paravascular cysts in 40 eyes (3.8%, 40/1046), retinal paravascular microfolds in 28 eyes (2.7%, 28/1046) and retinal paravascular lamellar holes in 13 eyes (1.2%, 13/1046). Of 40 eyes with retinal paravascular abnormalities, retinal paravascular cysts in all 40 eyes (100.0%, 40/40), retinal paravascular microfolds in 28 eyes (70.0%, 28/40) and retinal paravascular lamellar holes in 13 eyes (32.5%, 13/40). Twelve eyes with simple cyst cavity (30.0%, 12/40); 15 eyes were with cyst cavity with micro-wrinkles (37.5%, 15/40); 13 eyes were with cyst cavity, micro-wrinkles and lamellar holes (32.5%, 13/40). The temporal vascular arch retinal paravascular cysts ( χ2=25.664), microfolds ( χ2=14.973), and lamellar holes ( χ2=13.499) were significantly more than those on the nasal side, and the difference was statistically significant ( P <0.001). Conclusions:The total prevalence of retinal paravascular abnormalities in young myopia is 3.8%; it can occur in both moderate and high myopia. The paravascular cyst may be the earliest pathology of paravascular abnormalities in the retina. The three paravascular abnormalities are mostly distributed along the temporal arch of the retina.
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Objective@#To investigate the clinical value of sufentanil combined with propofol anesthesia in cerebral hemorrhage in basal ganglia.@*Methods@#From November 2015 to June 2018, 100 patients with cerebral hemorrhage in the basal ganglia of the People's Hospital of Shanxi Province were enrolled and randomly divided into two groups according to the digital table, with 50 cases in each group.The control group received fentanyl+ propofol, and the study group received sufentanil + propofol.At T0 (before induction of anesthesia), T1 (after anesthesia induction), T2 (after tracheal intubation), T3 (surgery), the hemodynamic parameters[mean arterial pressure (MAP), heart rate (HR)] level, postoperative recovery time (recovery of spontaneous breathing, recovery time and extubation time), preoperative and postoperative 6 h serum angiotensin Ⅱ (Ang Ⅱ), renin activity (PRA), neuron specific enolase (NSE) ), glial fibrillary acidic protein (GFAP) levels, the incidence of adverse reactions of the two groups were counted.@*Results@#(1)Hemodynamics: MAP and HR levels in the two groups were higher in T1, T2 and T3 than those in T0(all P<0.05), and HR and MAP in the study group were lower than those in the control group (all P<0.05). (2)Postoperative recovery: the time of extubation, recovery time and spontaneous breathing time of the study group were (12.42±3.27)min, (9.10±1.95)min, (7.32±2.23)min, respectively, which were shorter than those of the control group[(15.30±3.35)min, (12.67±2.18)min, (8.96±2.48)min] (t=4.350, 8.631, 3.477, all P<0.05). (3)Serum Ang Ⅱ and PRA: the serum Ang Ⅱ and PRA levels in the two groups at 6 h after surgery were higher than those before surgery(all P<0.05), and Ang Ⅱ, PRA levels of the study group were lower than those of the control group (t=4.350, 8.631, 3.477, all P<0.05). (4) Serum NSE and GFAP: the serum NSE and GFAP levels in the two groups at 6 h after surgery were higher than those before surgery(all P<0.05), and NSE, GFAP levels of the study group were lower than those of the control group (all P<0.05). (5) Adverse reactions: the incidence of adverse reactions in the study group [12.0%(6/50)] was lower than that in the control group [28.0%(14/50)] (χ2=4.000, P<0.05).@*Conclusion@#Sufentanil combined with propofol anesthesia in patients with cerebral hemorrhage in the basal ganglia can promote hemodynamic fluctuations, inhibit the increase of Ang Ⅱ and PRA, NSE and GFAP, and has less adverse reactions and high security.
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Objective:To investigate the clinical value of sufentanil combined with propofol anesthesia in cerebral hemorrhage in basal ganglia.Methods:From November 2015 to June 2018, 100 patients with cerebral hemorrhage in the basal ganglia of the People's Hospital of Shanxi Province were enrolled and randomly divided into two groups according to the digital table, with 50 cases in each group.The control group received fentanyl+ propofol, and the study group received sufentanil + propofol.At T0 (before induction of anesthesia), T1 (after anesthesia induction), T2 (after tracheal intubation), T3 (surgery), the hemodynamic parameters[mean arterial pressure (MAP), heart rate (HR)] level, postoperative recovery time (recovery of spontaneous breathing, recovery time and extubation time), preoperative and postoperative 6 h serum angiotensin Ⅱ (Ang Ⅱ), renin activity (PRA), neuron specific enolase (NSE) ), glial fibrillary acidic protein (GFAP) levels, the incidence of adverse reactions of the two groups were counted.Results:(1)Hemodynamics: MAP and HR levels in the two groups were higher in T1, T2 and T3 than those in T0(all P<0.05), and HR and MAP in the study group were lower than those in the control group (all P<0.05). (2)Postoperative recovery: the time of extubation, recovery time and spontaneous breathing time of the study group were (12.42±3.27)min, (9.10±1.95)min, (7.32±2.23)min, respectively, which were shorter than those of the control group[(15.30±3.35)min, (12.67±2.18)min, (8.96±2.48)min] ( t=4.350, 8.631, 3.477, all P<0.05). (3)Serum Ang Ⅱ and PRA: the serum Ang Ⅱ and PRA levels in the two groups at 6 h after surgery were higher than those before surgery(all P<0.05), and Ang Ⅱ, PRA levels of the study group were lower than those of the control group ( t=4.350, 8.631, 3.477, all P<0.05). (4) Serum NSE and GFAP: the serum NSE and GFAP levels in the two groups at 6 h after surgery were higher than those before surgery(all P<0.05), and NSE, GFAP levels of the study group were lower than those of the control group (all P<0.05). (5) Adverse reactions: the incidence of adverse reactions in the study group [12.0%(6/50)] was lower than that in the control group [28.0%(14/50)] (χ 2=4.000, P<0.05). Conclusion:Sufentanil combined with propofol anesthesia in patients with cerebral hemorrhage in the basal ganglia can promote hemodynamic fluctuations, inhibit the increase of Ang Ⅱ and PRA, NSE and GFAP, and has less adverse reactions and high security.
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Objective@#To observe the changes of choroidal capillary flow area (CBFA) and density in patients with idiopathic macular hole (IMH) before and after surgery.@*Methods@#A prospective clinical study. Thirty patients (60 eyes) with unilateral IMH diagnosed in Department of Ophthalmology of The Second Hospital of Hebei Medical University from February 2017 to March 2018 and 30 age-and sex- matched normal controls were included in this study. All eyes were divided into group A (30 affected eyes), group B (30 fellow eyes) and group C (30 normal eyes of controls). Among 30 eyes in group A, there were 5, 14, 11 eyes with hole in stage Ⅱ, Ⅲ, Ⅳ, respecitvely. The eyes in group A were divided into two subgroups according to the diameter of the holes: group D: hole diameter less than or equal to 500 μm (11 eyes), group E: hole diameter over than 500 μm (19 eyes). All eyes in group A underwent vitrectomy. Spectral-domain OCT was used to observe the diameter size of macular hole and the closure of the hole after vitrectomy in eyes of group A. The CBFA and blood flow density of superficial choroidal capillaries were measured by OCT angiography before and 3 months after vitrectomy in groups A, B and C. Univariate analysis of variance and t test were used for statistical analysis.@*Results@#Before surgery, in group A, B and C, the CBFA were 2.84±0.35, 3.19±0.23, 3.26±0.24 mm2, the blood flow density were (20.74±8.26)%, (35.18±5.20)%, (35.20±6.49)%, respectively. The CBFA and blood flow density in group A were significantly lower than those in group B and C (F=19.768, 45.583; P = 0.000, 0.000), but there was no significant difference between group B and C (F=19.768, 45.583; P=0.332, 0.994). The CBFA and blood flow density in group D were higher than those in group E (t=2.230, 2.202; P=0.034, 0.036). The diameter of macular hole was negatively correlated with CBFA and blood flow density (r=-0.377, -0.477; P=0.044, 0.009). Three months after surgery, the macular holes in group A were closed; CBFA and blood flow density in macular area were significantly higher than before surgery (t=-4.126, -4.912; P=0.000, 0.000).@*Conclusions@#CBFA and blood flow density decreased in the macular area of IMH. CBFA and blood flow density can be recovered after vitrectomy.
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Objective To observe the changes ofchoroidal capillary flow area (CBFA) and density in patients with idiopathic macular hole (IMH) before and after surgery.Methods A prospective clinical study.Thirty patients (60 eyes) with unilateral IMH diagnosed in Department of Ophthalmology of The Second Hospital of Hebei Medical University from February 2017 to March 2018 and 30 age-and sex-matched normal controls were included in this study.All eyes were divided into group A (30 affected eyes),group B (30 fellow eyes) and group C (30 normal eyes of controls).Among 30 eyes in group A,there were 5,14,11 eyes with hole in stage Ⅱ,Ⅲ,Ⅳ,respecitvely.The eyes in group A were divided into two subgroups according to the diameter of the holes:group D:hole diameter less than or equal to 500 μm (11 eyes),group E:hole diameter over than 500 μm (19 eyes).All eyes in group A underwent vitrectomy.Spectral-domain OCT was used to observe the diameter size of macular hole and the closure of the hole after vitrectomy in eyes of group A.The CBFA and blood flow density of superticial choroidal capillaries were measured by OCT angiography before and 3 months after vitrectomy in groups A,B and C.Univariate analysis of variance and t test were used for statistical analysis.Results Before surgery,in group A,B and C,the CBFA were 2.84± 0.35,3.19± 0.23,3.26±0.24 mm2,the blood flow density were (20.74 ± 8.26)％,(35.18 ± 5.20)％,(35.20± 6.49)％,respectively.The CBFA and blood flow density in group A were significantly lower than those in group B and C (F=19.768,45.583;P =0.000,0.000),but there was no significant difference between group B and C (F=19.768,45.583;P=0.332,0.994).The CBFA and blood flow density in group D were higher than those in group E (t=2.230,2.202;P=0.034,0.036).The diameter of macular hole was negatively correlated with CBFA and blood flow density (r=-0.377,-0.477;P=0.044,0.009).Three months after surgery,the macular holes in group A were closed;CBFA and blood flow density in macular area were significantly higher than before surgery (t=-4.126,-4.912;P=0.000,0.000).Conclusions CBFA and blood flow density decreased in the macular area ofIMH.CBFA and blood flow density can be recovered after vitrectomy.
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Objective To observe the expression ofRapl,guanosine triphosphate-Rapl (GTP-Rapl),vascular endothelial growth factor (VEGF) and β-catenin in experimental choroidal neovascularization (CNV).Methods Forty-two brown Norwegian rats were randomly divided into a blank control group (7 rats) and a model group (35 rats).Both eyes were enrolled.The CNV model was established by holmium ion laser photocoagulation in the model group.At 3,7,14,21,and 28 days after photocoagulation,fluorescein fundus angiography (FFA) and choroidal vascular smear were performed to observe the degree of fluorescein leakage and CNV area in rats;Western blot and real-time quantitative polymerase chain reaction (RT-PCR) were used to detect the expression ofRap1,GTP-Rap1,VEGF,β-catenin and mRNA in CNV.Results The results of FFA examination showed that a large disc-shaped fluorescein leaked in the photo-condensation spot 14 days after photocoagulation.Laser confocal microscopy showed that compared with 7 days after photocoagulation,CNV area increased at 14,21,28 days after photocoagulation,and the difference were statistically significant (t=3.725,5.532,3.605;P＜0.05).Western blot showed that there was no significant difference in the relative expression of Rap1 protein in CNV at different time points after photocoagulation between the two groups (P=0.156).Compared with the blank control group,the relative expression of GTP-Rap1 protein was significantlydecreased,the relative expression of VEGF and β-catenin protein were significantly increased in the model group (P=0.000).The results of RT-PCR showed that there was no significant difference in the relative expression of Rap 1 mRNA at different time points after photocoagulation between the two groups (P=0.645),but there were significant difference in the relative expression of β-catenin mRNA (P=0.000).At 7,14,21 and 28 days after photocoagulation,there were significant difference in the relative expression of GTP-Rap 1 and VEGF mRNA between the two groups (P=0.000).Conclusions The expression of GTP-Rap1 in experimental CNV is significantly lower than that in normal rats.
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Objective To analyze the clinicopathological features,immunohistochemistry and differential diagnosis of metaplastic breast carcinoma.Methods A total of 32 cases of patients with metaplastic breast cancer in our hospital from March 2013 to March 2016 was randomly selected.The specimens were fixed with 4％ neutral formaldehyde solution,then dehydrated,embedded,sliced,stained with HE,and immunohistochemically stained with immunohistochemical staining machine,and then the results of macroscopic examination,microscopic examination and immunohistochemical examination were analyzed.Results Metaplastic breast cancer was lack of clear boundaries,and had no envelope.The tumor diameter was 1-5 cm,and its average was(3.1 ±1.2) cm.Section was tough and solid.Some had nodular shape,and their color was gray.Some had cysts appearance in the section.Among the 32 patients,20 patients underwent sentinel lymph node biopsy without cancer metastasis,and 12 patients underwent axillary lymph node dissection,including 8 cases with axillary lymph node metastasis;32 patients were presented as estrogen receptor (ER) (-),progesterone receptor(PR) (-),epidermal growth factor receptor-2 (HER-2) (-),broad spectrum CK (+),28 patients presented as epidermal growth factor receptor(EGFR)(+),20 patients presented as CK5/6 (+),and 8 patients presented as p53 (+),myoepithelial carcinoma p63 (+),respectively accounting for 100.0％,87.5 ％,62.5 ％ and 25.0％ in their total number.A total of 32 cases of patients with metaplastic breast carcinoma was divided into two types according to the metaplasia:pure epithelial type,including 4 cases of squamous cell carcinoma,2 cases of glandular squamous cell carcinoma and 13 cases of adenocarcinoma differentiated by spindle cell;epithelial/mesenchymal metaplastic carcinoma,its heterologous elements including 3 cases of sarcomatoid components,3 cases of rhabdomyosarcoma-like ingredients and 7 cases of ossification of cartilage and natural ingredients.Conclusion Metaplastic breast cancer,ER(-),PR(-),and HER-2 (-) should be identified with primary breast sarcoma,malignant follicular tumor,sarcomatosis and desmoplastic breast cancer.
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Objective To observe the efficacy ofvitrectomy combined with internal limiting membrane (ILM) peeling and scleral shortening for myopic foveoschisis (MF).Methods Prospective and non-randomized concurrent control study.A total of 35 MF patients (35 eyes) were enrolled in this study.The patients were divided into 2 groups according to surgery,including group A (18 eyes) and group B (17 eyes),all received vitrectomy combined with ILM peeling,but group A also received scleral shortening.The best corrective visual acuity (BCVA) examination using the Snellen vision chart was converted to the minimum resolution logarithm (logMAR).Ocular axis length (AL) was measured by Zeiss IOL-Master or A-scan ultrasound (Quantel Medical,France).The maximal value of retinal foveoschisis (MxFT) was measured by frequency-domain optical coherence tomography (Heidelberg,Germany).Multifocal electroretinogram (mfERG) responses were obtained with the RETIscan system (Roland Consult,Gemany).There was no statistically significant difference between the two groups (P＞0.05) in age (t=0.460),AL (t=1.520),diopter (t=0.020),logMAR BCVA (t=-2.280),MxFT (Z=-4.179) and b-wave ERG amplitude (Z=-0.198).The changes of BCVA,AL,MxFT and b wave amplitude were followed-up for 3-12 months.Results At the last follow-up,the height of MF was decreased in 18 eyes of group A,and MF was completely disappeared in 4 eyes.The logMAR BCVA (t=7.272,5.951),MxFT (Z=-3.724,-3.622) and b-wave ERG amplitude (Z=-3.223,-3.243) in both groups A and B were statistically improved (P=0.000,0.000,0.000,0.000,0.001,0.001) compared to pre-operational results.There was significant difference of logMAR BCVA (t=-2.280) and MxFT (Z=-4.179) between the two groups (P=0.029,0.000).But there was no significant difference in the amplitude of b-wave (Z=-0.198,P=0.843).The AL in group A was shortened after surgery,the difference was statistically significant (t=10.017,P=0.000).During the follow-up,there was no ocular hemorrhage,endophthalmitis and other complications.Conclusion PPV combined with ILM peeling and scleral shortening can shorten AL significantly for MF patients,and gain relative normal anatomical structure of the fovea,thus improve the vision.
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Objective To investigate the risk factors associated with neovascular glaucoma (NVG) after pars plana vitrectomy (PPV) in eyes with proliferative diabetic retinopathy (PDR).Methods Retrospective study.One hundred and thirty-seven patients (137 eyes) with PDR who underwent PPV were recruited.There were 85 males and 52 females.The average age was (60.1 ± 8.8) years old.The duration of diabetes was (10.2 ± 3.6) years.There were 49 patients with ipsilateral carotid artery stenosis.Fifty-three eyes underwent intravitreal ranibizumab or conbercept injection before PPV.All eyes were treated with 23G standard three-port PPV.The average follow-up time after PPV was 11.5 months.Fundus fluorescein angiography (FFA) was conducted in postoperative 4-6 weeks to observe non-perfused retinal areas.Risk factors,such as ipsilateral carotid artery stenosis,the presence of non-perfusion in retina after PPV and the application of anti-vascular endothelial growth factor (VEGF) drugs before PPV,were identified by logistic regression.Results Twenty of 137 patients (14.6％) developed postoperative NVG after PPV.Ipsilateral carotid artery stenosis [odds ratio (OR) =5.048,95％ confidence interval (CI) 2.057-12.389,P=0.000] and the presence of non-perfusion in retina after PPV (OR=4.274,95％CI 1.426-12.809,P=0.009) were significant risk factors for postoperative NVG,while the application of anti-VEGF drugs was not (OR=1.426,95％CI 0.463-4.395,P=0.536).But the time from PPV to the onset of NVG varies significantly between the two groups of injection of anti-VEGF drugs or not (t=-4.370,P=0.000).Conclusions Risk factors associated with NVG after PPV in eyes with PDR included ipsilateral carotid artery stenosis and the presence of non-perfusion in retina after PPV.The application of anti-VEGF drugs before PPV can delay the onset of NVG in PDR eyes after vitrectomy.
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Background Giant idiopathic macular hole (IMH) severely affects visual acuity and increases operative difficulty during the surgery,so modifying or optimizing the operation method is helpful for improving the prognosis.Objective This study aimed to evaluate the efficacy and safty of vitrectomy combined with free internal limiting membrane transplantation for large IMH.Methods A prospective serial cases-observational study was carried out under the informed consent of each patient.Forty-two eyes of consecutive 42 patients with IMH of mean diameter (814.31±112.95)μm were included in the Second Hospital of Hebei Medical University from January 2013 to November 2015.All the eyes received vitrectomy combined with free internal limiting membrane transplantation and 12％ C3F8 filling.The best corrected visual acuity (BCVA) (LogMAR),inner segment/outer segment (IS/OS) defect range,external limiting membrane defect range,retinal thickness at macular fovea were measured with slit lamp microscope,indirect ophthalmoscope and spectral-domain optical coherence tomography (SD-OCT) before surgery and 1,3,6 and 12 months after surgery.Results IMH complete closure in 97.6％ eyes (41/44) at 12 months after surgery.BCVA was improved after operation and showed a significant difference among various time points (F =28.032,P＜0.001).The IS/OS defect range was (1 112.00±45.44),(859.00±84.55),(649.00±52.47),(486.00±46.88) and (320.00±45.13) μm before surgery and 1,3,6 and 12 months after surgery,showing a significant difference among different time points (F=38.761,P＜0.001),and the IS/OS defect range was gradually shrinked after operation compared with that before operation (all at P＜0.05).The mean defect range of external limiting membrane was (1 038.00 ±39.63),(748.00±64.12),(585.00±48.88),(438.00±42.84) and (265.00±28.97)μm before surgery and 1,3,6 and 12 months after surgery,with a significant difference among various time points (F=36.459,P＜0.001),and the mean defect range of external limiting membrane was evidently reduced (all at P＜0.05).The foveal retinal thickness value was increased at 3,6 and 12 months after surgery,which was significantly higher than that 1 month after surgery (all at P＜0.05).The high reflect signal was faded away at 3 months after operation,indicating that implanted internal limiting membrane was decomposed and metabolized.Conclusions Vitrectomy combined with autologous internal limiting membrane transplantation seems to be safe and effective for large IMH.
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Objective To observe the different changes of macular microstructure in patients with large idiopathic macular hole (IMH) treated with vitrectomy combined with internal limiting membrane (ILM) transplantation or not.Methods Forty eyes in 40 consecutive patients with giant IMH (≥500 μm) were included in the study.Twenty eyes received vitrectomy with ILM transplantation (ILM transplantation group) and others with ILM peel off (ILM removal group).During the operation,a proper size of the ILM was removed and filled in the bottom of the macular hole.The age,duration of disease and the ocular laterality of the two groups of patients were not statistically significant (P＞0.05).Minimum resolution angle in logarithmic (logMAR) best corrected visual acuity (BCVA) and frequency domain optical coherence tomography (SD-OCT) scan were examined.There was no statistically significant difference in logMAR BCVA,average defect diameter of photoreceptor ellipsoid (IS/OS) and average defect diameter of external limiting membrane (ELM) between two groups (t=0.128,1.452,1.321;P＞0.05).The logMAR BCVA and SD-OCT were examined on 1,3,6,12 months postoperatively.Results On 1 month after the surgery,there was no statistically significant difference in logMAR BCVA,average defect diameter of IS/OS and average defect diameter of ELM between two groups (t=1.226,1.435,1.018;P＞0.05).On 3,6,12 months after the surgery,compared with ILM removal group,the logMAR BCVA (t=2.059,2.871,2.415) increased and the average defect diameter of IS/OS (t =2.070,2.110,2.121) and ELM (t =2.034,3.647,3.556) significantly reduced in ILM transplantation group (P＜0.05).On 1 month after the surgery,there was statistically significant difference in CRT between two groups (t=2.113,P＜0.05).On 3,6,12 months after the surgery,there was no statistically significant difference in CRT between two groups (t=0.428,0.847,0.849;P＞0.05).Conclusion Compared with vitrectomy combined with ILM peeling surgery,the diameter of IS/OS and ELM defect were significantly decreased after vitrectomy combined with ILM transplantation in the patients with large IMH.
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Background Choroidal neovascularization (CNV) is a common pathological basis of many ocular fundus diseases.Some treating methods are proved to be effective on CNV but there exist their own shortages.Celecoxib can inhibit experimental neovescularization.Sustained release drug of celecoxib and application approach can offer a basis for the therapy of CNV.Objective This study was to evaluate the sustained release ability of celecoxib-poly lactide-co-glycolide microsphere (CEL-PLGA-MS) in vitro and its inhibitory ability on experimental CNV in vivo.Methods CEL-PLGA-MS was prepared by Hebei Medical University and examined under the scanning electron microscope.The size of CEL-PLGA-MS was measured by Laser Particle Size Analyzer.The drugloading in vitro releasing was monitored by high performance liquid chromatograph (HPLC).Experimental CNV was induced by laser photocoagulation of retina in the right eyes of 72 male brown Norway (BN) rats and then were randomized into the CEL-PLGA-MS group,celecoxib group,blank PLGA group and PBS group.CEL-PLGA-MS with 320 μmol/L celecoxib,80 μmol/L celecoxib,blank PLGA microspheres solution and 0.01 mol/L PBS was intravitreally injected separately according to the grouping.CNV was assessed by fundus fluorescein angiography (FFA) on the 14th day after injection.The fibrovascular proliferation (FVP) thickness at photocoagulation spots was measured by OCT.The retinal pigment epithelium (RPE)-choroid-sclera sections were prepared for the histopathologieal examination of FVP.On the 7th and 28th day after intravitreal injection,the relative expression levels of VEGF mRNA and COX-2 mRNA in the photocoagulation area were detected by reverse transcription PCR (RTPCR).The use and feeding of the experimental animals were followed by the ARVO statement.Results CELPLGA-MS showed the spherical shape with the mean size of 2 467.9 nm and the drug-loading of 7.77％ and the drugrelease rate of 80.91％ in vitro for 45 days.It presented the controllable release characteristics.CEL-PLGA-MS agglomerated in vitreous body after injection.On the 14th day after intravitreal injection,the mean FVP thicknesses were (94.67±4.64),(98.56±4.72),(71.00±4.77),(50.44±3.01) μm in the blank PLGA microspheres group,PBS group,celecoxib group and CEL-PLGA-MS group,respectively,showing significant increases in mean FVP thickness in the blank PLGA microspheres group and PBS group compared with the celecoxib group and CEL-PLGAMS group (all at P＜0.01),and the CEL-PLGA-MS group appeared a lower mean FVP thickness value than the celecoxib group (P＜0.01).FFA revealed a large number of strong hyperfluorescences at the photocoagulation area in the rat eyes of the blank PLGA microspheres group and PBS group;while only weak hyperfluorescences were seen in the eelecoxib group and CEL-PLGA-MS group.Histopathological examinations verified the same results in the FVP thickness to OCT image.The relative expression levels of COX-2 mRNA and VEGF mRNA in the RPE-choroid-sclera were all significantly elevated in the blank PLGA microspheres group compared with the celecoxib group and CELPLGA-MS group both on the 7th and 28th day after intravitreal injection (all at P＜0.01).On the 7th day after injection,the relative expression levels of COX-2 mRNA were lower on the 7th day and the relative expression levels of COX-2 mRNA and VEGF mRNA were higher on the 28th day in the celecoxib group in comparison with the CEL-PLGA-MS group (all at P＜0.01).Conclusions CEL-PLGA-MSs are even in size with the spherical shape and controllable release characteristics in vitro.CEL-PLGA-MS can inhibit experimental CNV and was more durable effective than celecoxib after intravitrea] injection.
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Objective To observe the inhibition effect of selective cyclooxygenase-2 inhibitor (celecoxib) on the experimental choroidal neovascularization (CNV).Methods Thirty 8-10 weeks old healthy male Brown-Norway(BN) rats were randomly divided into the control,laser and celecoxib group,with 10 rats in each group.At the dosage of 50 mg/kg,celecoxib was garaged twice per day.After 7 days,experimental CNV was induced by Krypon laser on laser group and celecoxib group.Fundus fluorescein angiography (FFA) was performed on days 3,7,14,21,30 after laser photocoagulation.On days 21 after photocoagulation,5 rats in each group were sacrificed and the relative thickness of CNV membranes,the expression of COX-2,vascular endothelial growth factor(VEGF) and matrix metalloproteinase-2 (MMP-2) Were studied by histopathologic or immunohistochemistry examination.Results On days 21 after photocoagulation,the incidence of CNV in the celecoxib group is significantly lower than that in the laser group (X~2=7.1068,P=0v0077);the relative thickness of the CNV membranes in the celecoxib group is reduced 41.38% compared to the laser group,the difference is statistically significant (t=16.7600,P=0.0000).COX-2,VEGF and MMP-2 expression in the CNV membrane of celecoxib group were significantly lower than in control group (t=5.7100,5.8400,8.0200;P=0.0000);the COX-2,VEGF and MMP-2 expressions in choroid and retina of control group were weak.Conclusion Prophylactic celecoxib can reduce the expression of VEGF and MMP-2 by inhibiting COX-2,and prevent the CNV induced by laser photocoagulation.
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Objective To investigate the surgical selection of retinal detachment with myopic macular holes. Methods Management strategies were adopted according to the ocular symptoms of patients with high myopia involved in posterior chorioretinal atrophy, the colour showed by the bottom of macular holes and the shape of posterior staphyloma. Seventy-five eyes of 72 patients fulfilled the study criteria. The patients were followed up in an average of eight-month-observation and were divided into three groups: single 16% C2F6 gas tamponade (26 eyes of 26 patients) as group A,vitrectomy combined with 16% C2F6 gas tamponade (26 eyes of 23 patients) as group B and vitrectomy with silicon oil tamponade (23 eyes of 23 patients) as group C. Results 69.2%(18/26) of the macular holes were closed in group A, 73.1%(19/26)in group B and 87.0% (20/23) in group C after the primary surgery. Comparison of postoperative outcomes,macular hole closure rate was not significantly different among three groups (P= 0.3184). Conclusions It suggests that good anatomic retinal reattachment be achieved using any approach. However, the optimal surgical choice regarding of the personality case offered less surgical burden and more rapid visual rehabilitation to patients.
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Objective hole.Research demonstrated that amnion promotes the proliferation of and its mechanism.Methodswhite rabbit.The cells were primarily cultured and passaged in DM/F12 with 10% fetal bovine serum and identified with glial fibrillary acidic using 0.25% trypsin and 0.05%EDTA and suspended in 10% fetal bovine serum+DMEM/F12.0.5 mL of the amnion supernatant was added to the medium for 12 hours.The expression of EGFR in the cells was detected by immunohistochemistry.The difference of EGFR expression with or without the amnion was evaluated.ResultsCultured cells showed a positive response for GFAP and S-100.The intermediate filaments with a length of 8-10 nm were exhibited under the transmission electron microscope.EGFR was fainly expressed in cultured hours,the expression of EGFR was obviously increased with a significant difference in the gray scale between the two groups(571 588.80±67 862.68 vs.1 000 352.00±98 386.22)(t=4.035,P＜0.01).Conclusion
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Objective To observe the effect of amniotic homogenate on closing holes in experimental rhegmatogenous retinal detachment and investigate its mechanism.Methods Forty rabbits were randomly divided into group A,B,C and D with 10 rabbits in each group.Group A and C were the treatment groups,and group B and D were the control groups.All eyes of rabbits underwent pars plana vitrectomy,retinectomy,and fluid-air exchange.The surface of the breaks was treated with 0.1 ml amniotic homogenate in experimental groups and 0.1 ml PBS in control groups.At the end of operation,20% SF6 was tamponaded and the retina reattaced.The animals were executed 14 (group A and B) and 28 days (group C and D) after the surgery.The tissue sections were observed by light microscope,electron microscope and immunocytochemistry method.Results Fourteen days after the surgery,the retina reattached in 6 eyes in group A (60%) and 2 eyes in group B (20%) (P=0.021),Twenty-eight days after the surgery,the retina reattached in 8 eyes in group C (80%) and 3 eyes in group D (30%) (P=0.046).The difference of the rate of retinal reattachment among the 4 groups were statistical significant (P<0.05).Light postoperative inflammation of ocular anterior segment was observed,which was controlled 3-5 days after treated with topical steroids.The result of light microscopy showed that the eyes in treatment groups had multilayer of fibroblast like cells around the retinal breaks,adhering to the choroid and retinal pigment epithelial cells.The proliferative cells around the retinal breaks obvious less in control groups than that in the treatment groups,and the retina could not adhere to the choroid.The results of electron microscopy were the same as that of light microscopy.Immunohistochemistry staining of the fibroblast-like cells revealed positve glial fibrillary acidic protein,which suggested that the proliferative cells around the retinal breaks were retinal glial cells.Conclusions Amniotic homogenate helps to seal retinal breaks and promote retinal reattachment by stimulating the proliferation of retinal glial cells around the breaks.
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OBJECTIVE To investigate approaches to the prevention of sharps injuries. METHODS A retrospective questionnaire was performed for 193 nurses of a general hospital from the time of Jan 2004 to Jun 2005. RESULTS The questionnaires indicated that 46.1% nurses had suffered sharps injuries,with averaged of 1.6 times per person,of which 36.7% and 32.4% were caused respectively by syringe needles and glass wares.Opening ampules,disposal of used sharps,installing the syringe needles and transmitting sharp devices were the four major events in which sharps injuries might happen,accounted for 29.5%,22.3%,15.8% and 10.1%,respectively.It is also noted that 79.1% nurses suffering from the injury wore no gloves. CONCLUSIONS Occupational hazards of sharps injuries are threatening nurses.Certain prophylactic measures should be taken to control and prevent sharps injuries.