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Objective:To analyze the effect of vitrectomy combined with internal limiting membrane (ILM) peeling on the prevention of post-vitrectomy epiretinal membrane (ERM) in macular-off rhegmatogenous retinal detachment (RRD) and its influence on visual outcomes.Methods:A cohort study was conducted.Seventy-four patients (74 eyes) with macular-off RRD, who realized retinal reattachment after vitrectomy and silicone oil tamponade from January 2015 to January 2018 in Baoding NO.1 Central Hospital, were enrolled.The patients were divided into the non-ILM peeling group (36 cases, 36 eyes) and ILM peeling group (38 cases, 38 eyes) according to whether they received ILM peeling or not.The patients underwent silicone oil removal within 3 to 5 months after the surgery.Best corrected visual acuity (BCVA), slit-lamp microscopy, indirect ophthalmoscopy, fundus photography and optical coherence tomography (OCT) were examined before and at 1, 6 and 12 months after the surgery.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Baoding NO.1 Central Hospital (No.[2019]042). Written informed consent was obtained from each patient.Results:There was no ERM found in the two groups at 1 month after the operation.There were 3 eyes (8.33%) with ERM in the non-ILM peeling group and 2 eyes (5.26%) in the ILM peeling group at 6 months after the operation, with no statistically significant difference between them ( P=0.067). There were 9 eyes (25.00%) with ERM in the non-ILM peeling group and 4 eyes (10.53%) in the ILM peeling group at 12 months postoperatively, with no statistically significant difference between them ( χ2=2.674, P=0.102). There was a significant difference in BCVA between before and after the operation in the two groups ( Ftime=31.692, P<0.001). Postoperative 1-, 6-and 12-month BCVA were all significantly better than the preoperative BCVA in the two groups (all at P<0.05). There was no significant difference in BCVA between the two groups ( Fgroup=0.117, P=0.773). OCT images showed that there were 25 eyes (77.78%) and 30 eyes (78.95%) with the intact ellipsoid zone in the non-ILM peeling group and ILM peeling group at 12 months after the operation, respectively, with no statistically significant difference between them ( χ2=0.875, P=0.350). Conclusions:Compared with vitrectomy alone, the vitrectomy combined with ILM peeling does not show better efficacy in the prevention of ERM occurrence in macula-off RRD patients and has no obvious influence on postoperative visual acuity.
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Objective:To evaluate the changes of metamorphopsia in patients with rhegmatogenous retinal detachment (RRD) who underwent primary vitrectomy and to analyze the correlation between macular microstructure changes and metamorphopsia.Methods:It was a retrospective clinical study. From January 2017 to January 2019, 57 patients (57 eyes) with RRD were examined and diagnosed in the Department of Ophthalmology of Baoding First Central Hospital were enrolled in this study. All patients underwent 23G PPV. All patients had retinal anatomical reduction after the first PPV. The best corrected visual acuity (BCVA), intraocular pressure, slit-lamp microscope, indirect ophthalmoscope, changes of metamorphopsia, and optical coherence tomography (OCT) were examined before PPV and 1, 6, 12 months after the operation. The BCVA examination was performed using the international standard visual acuity chart, which was converted into a logarithm of the minimum angle of resolution (logMAR) BCVA for the record. The macular fovea retinal thickness (CRT) was measured by Carl Zeiss Cirrus HD-OCT5000 instrument from Carl Zeiss Company, Germany, and the microstructural changes in the macular area were recorded, including the presence of the anterior macular membrane (ERM), cystic macular edema (CME), subretinal fluid (SRF), and the integrity of the ellipsoid zone (EZ) and outer membrane (ELM). The value of metamorphopsia (M value) was measured by the M-Chart table. The changes of BCVA, M value, and the microstructure of the macular area before and after operation were analyzed. The correlation between BCVA and M value was analyzed by Pearson correlation. Spearman correlation analysis was used to analyze the correlation between the changes of macular microstructure and BCVA and M values.Results:The mean logMAR BCVA before the operation was 1.15±0.43. At 1, 6, and 12 months after the operation, the mean logMAR BCVA was 0.62±0.17, 0.39±0.18, and 0.34±0.13, respectively. The visual acuity improved significantly after operation compared with before operation, and the difference was statistically significant ( F=119.731, P=0.000). The mean CRT before the operation was 476.0±104.1 μm. At 1, 6, and 12 months after the operation, the average CRT were 299.8±29.9, 272.2±17.8, and 261.0±19.3 μm, respectively. The average CRT after the operation was significantly lower than those before the operation ( F=185.518, P=0.000). At 1, 6, and 12 months after the operation, the mean M values were 0.62±0.54, 0.43±0.41, and 0.32±0.36, respectively; the difference was statistically significant ( F=6.568, P=0.020). After the operation, 48 eyes (84.2%, 48/57) had microstructural abnormalities in the macular area, including EZ and ELM integrity disruption, SRF, CME, and ERM. Correlation analysis showed that M value was significantly positively correlated with BCVA, CRT, and SRF height before operation ( r/ rs=0.672, 0.385, 0.932; P<0.05). There was no correlation between M value and BCVA ( r/ rs=0.503), EZ and ELM integrity ( r/ rs=0.497, 0.472), SRF ( r/ rs=0.416), CME ( r/ rs=0.821) and ERM ( r/ rs=0.632) after operation ( P>0.05). Conclusions:The BCVA is significantly increased and the metamorphopsia is improved after anatomically successful RRD surgery. Postoperative M value is highly correlated with preoperative BCVA, CRT, and SRF.
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Objective:To observe the effect of intravitreal injection of anti-vascular endothelial growth factor drugs on the subfoveal choroid thickness (SFCT) of patients with retinal vein occlusion (RVO) and macular edema (ME).Methods:A prospective clinical study. From January 2017 to January 2019, 59 monocular RVO-ME patients with 59 eyes diagnosed in the eye examination of The First Central Hospital of Baoding were included in the study. Among them, there were 31 males with 31 eyes and 28 females with 28 eyes; the average age was 57.4±10.3 years old. The course of the disease was 5 days to 1 month, all of whom had the first-onset disease. Branch retinal vein occlusion (BRVO) was found in 35 eyes (BRVO-ME group); non-ischemic central retinal vein occlusion (CRVO) was found in 24 eyes (CRVO-ME group). Best corrected visual acuity (BCVA) and frequency domain optical coherence tomography (OCT) were performed. The BCVA examination was carried out using the international standard visual acuity chart, which was converted into the logarithmic minimum angle of resolution (logMAR) visual acuity during statistics. The Cirrus HD-OCT 5000 instrument from Carl Zeiss company of Germany was used to measure the central macular thickness (CMT) and SFCT. All eyes were treated with intravitreal injection of anti-vascular endothelial growth factor drugs. The follow-up time after treatment was 6 months, and the changes of BCVA, CMT and SFCT of eyes before treatment and 2 weeks after treatment were compared and observed, as well as the occurrence of treatment-related complications. The comparison of BCVA, CMT, and SFCT at different times before and after treatment were adopted repeated measures analysis of variance; pairwise comparison of differences at different time points adopts the least significant difference t test. Results:Before treatment, the average logMAR BCVA and CMT of RVO-ME eyes were 0.92±0.46 and 604.71±169.35 μm, respectively. At 2 weeks, 1, 3, and 6 months after treatment, the average logMAR BCVA of the affected eye was significantly improved compared with that before treatment, and the CMT was significantly decreased. The difference was statistically significant ( F=55.664, 59.518; P<0.05). Before treatment, the average SFCT of the affected eye and the contralateral eye of RVO-ME patients were 306.3±65.8 and 241.3±59.8 μm, respectively. The SFCT of the affected eye was significantly thicker than that of the contralateral healthy eye, and the difference was statistically significant ( t=25.772, P<0.05). At 2 weeks, 1, 3, and 6 months after treatment, the average SFCT of the eyes were 267.7±81.4, 252.3±57.3, 239.2±46.5, 240.6±48.3 μm, respectively. Compared with before treatment, treatment SFCT decreased significantly at different times afterwards, and the difference was statistically significant ( F=924.341, P<0.001). There was no significant difference in SFCT between CRVO-ME group and BRVO-ME group at 2 weeks, 1, 3, and 6 months after treatment ( P>0.05). No complications such as endophthalmitis, cataract progression and neovascular glaucoma occurred during the follow-up period of all eyes. Conclusion:The SFCT of eyes with short course of disease and first-onset RVO-ME is thickened; anti-VEGF drug treatment can effectively reduce SFCT, improve ME, and increase BCVA.
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This report is about the application of interventional therapy for bladder rectal residual fistula in a patient whose postoperative rectal stump tumor invaded the bladder and underwent radiotherapy and chemotherapy,resulting in urinary fistula,which seriously affected the quality of life.Referring to the treatment experience of visicovaginal fistula,the patient successfully adopted double percutaneous nephrostomy combined with ureter occlusion stent and achieved good palliative treatment effect.
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This report is about the application of interventional therapy for bladder rectal residual fistula in a patient whose postoperative rectal stump tumor invaded the bladder and underwent radiotherapy and chemotherapy, resulting in urinary fistula, which seriously affected the quality of life. Referring to the treatment experience of visicovaginal fistula, the patient successfully adopted double percutaneous nephrostomy combined with ureter occlusion stent and achieved good palliative treatment effect.
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Objective To study the therapeutic effect of intravitreal injection of ranibizumab combined with vitrectomy for the treatment of neovascular glaucoma (NVG). Methods The clinical data of 21 NVG patients who had underwent vitrectomy were retrospectively analyzed. The patients were treated with intravitreal injection of ranibizumab 0.5 mg, then were given the vitrectomy after 3 to 5 d after treatment. The whole retinal photocoagulation was performed during the operation. Cataract surgery was combined in 16 patients, and ciliary photocoagulation was combined in another 15 patients. All patients were followed up for 6 to 12 months, and the intraocular pressure, visual acuity and neovascularization of iris (NVI) were observed. Results The rate of NVI symptoms resolving completely 3 weeks after operation was 80.95％(17/21). The intraocular pressure 1 week, 1 month, 3 months and 6 months after operation was significantly lower than that before operation: (18.6 ± 5.1), (14.3 ± 4.8), (12.8 ± 4.4), (15.1 ± 3.7) mmHg (1 mmHg=0.133 kPa) vs. (42.8 ± 7.3) mmHg, and there was statistical difference (P<0.05). Two months after operation, 2 cases were not able to control by chemicals, and were treated with transscleral cyclophotocoagulation. Six months after operation, the intraocular pressure was completely controlled in 15 cases, and conditionally controlled in 6 cases. No ocular hypotension occurred. The visual acuity was not improved in 4 cases, but the rest were improved in different degrees. Conclusions For the patients of NVG combined with vitreous hemorrhage and obvious proliferation, intravitreal injection of ranibizumab in the first place, and then combined with vitrectomy, whole retinal photocoagulation and ciliary photocoagulation can obtain good effect.
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In our previous study, we identified a novel testis-specific expressed gene 2 (TSEG-2) from mouse testis. To further investigate its functions, 35 male Balb/c mice (8 weeks old) were divided into cryptorchidism group (n=20), sham group (n=10), and control group (n=5). In cryptorchidism group, the right testes were anchored to the inner lateral abdominal wall. In situ hybridization (ISH) was applied to measure the localization of TSEG-2 in mouse testis. Real-time quantitative PCR was performed to detect the expression of TSEG-2 gene. Meanwhile, under the mediation of polyethylenimine (PEI), the recombinant vector pEGFP-TSEG-2 (n=5) or empty vector (mock, n=5) was transfected into the testis of male mice. The transfection efficiencies were measured under a fluorescence microscope. The apoptosis of spermatogenic cells was detected by terminal deoxynuleotidyl-mediated nick end labeling (TUNEL). The results showed that TSEG-2 was expressed in convoluted seminiferous tubules, more precisely, in spermatogonia and spermatocytes. As compared with sham and control groups, the TSEG-2 transcription was significantly enhanced (P<0.05) and was correlated with apoptosis of spermatogenic cells in cryptorchid testes (P<0.05). PEI was efficient in mediating transfection of TSEG-2 into seminiferous tubules of testis. One week post-transfection, intratesticular injection of TSEG-2 resulted in increased apoptosis of spermatogenic cells in vivo (P<0.05). These results indicate that TSEG-2 may participate in the apoptosis of spermatogenic cells and the pathogenesis of cryptorchidism.
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Aim To explore the growth inhibition effects of jasmonates on human neuroblastoma SH-SY5Y cell line,and to investigate its mechanisms.Methods After administration of 0.5~2.5 mmol?L-1 jasmonates for 6~24 hrs, the growth inhibition rates of SH-SY5Y cells were studied by MTT colorimetry.Cell cycle phases were assayed by propidium iodide staining flow cytometry. Cellular apoptosis was inspected by Hoechst 33258 fluorescent staining and Annexin V-FITC and propidium iodide staining flow cytometry.Gene expressions of PCNA, cyclin D1 and N-myc were determined by reverse transcription polymerase chain reaction.Results Jasmonates inhibited the growth of SH-SY5Y cells in a dose-and time-dependent manner,while the methyl jasmonate was the most efficient. After administration of 0.5 to 2.5 mmol?L-1 of methyl jasmonate for 24 hrs,the growth inhibition rates of cells reached 5.75%~88.7%(P