Efficacy of 99mTc-DTPA orbital SPECT/CT on the evaluation of lacrimal gland inflammation in patients with thyroid associated ophthalmopathy / 中南大学学报(医学版)

To investigate the values of orbital single photon emission computed tomography/computerized tomography (SPECT/CT) with 99mTc-diethylene triamine pentaacetic acid (99mTc-DTPA) on the evaluation of lacrimal gland inflammation in patients with thyroid associated ophthalmopathy (TAO).
 Methods: A total of 58 TAO patients were retrospectively recruited for this study, all of whom were categorized into all active group and all inactive group based on the clinical active score (CAS). Another 12 patients with the negative images on SPECT/CT served as a normal control group (NC). All patients were undergone the 99mTc-DTPA orbit SPECT/CT. Quantitative parameters of lacrimal gland including width, length, volume, and the count ratio of region of interest (ROI) drawn on lacrimal gland to the region of occipital brain (target/non-target ratio, T/NT), were measured on axial and coronal slices, respectively. Quantitative parameters were compared among the 3 groups, and the diagnostic value on discrimination of TAO patients from inactive to active ones was evaluated.
 Results: All parameters in TAO patients (except the length on coronal slices and the mean radioactive counts of axial T/NT in the TAO inactive group) were much greater than those in the NC group (P<0.05). All parameters in the TAO active group (except the length on axial and coronal slices) were much greater than those in the TAO inactive group (P<0.05). There were significant lineal positive correlations between the parameters in all TAO patients (except the length on coronal slices ) and CAS. The best diagnostic value was detected by the max radioactive counts of axial T/NT (area under the curve=0.82, P<0.01).
 Conclusion: As an invasive imaging modality, 99mTc-DTPA orbital SPECT/CT is helpful to estimate the lacrimal gland inflammation and to assess the disease activity in TAO patients.

Evaluation of inflammatory activity in thyroid associated ophthalmopathy by SPECT/CT with 99mTc-DTPA / 中南大学学报(医学版)

Objective:To evaluate the inflammatory activity in thyroid associated ophthalmopathy (TAO) by 99mTc-diethylene triamine pentaaceticacid (99mTc-DTPA) orbital single-photon emission computed tomography (SPECT)/CT.Methods:A total of 48 patients were enrolled from Xiangya Hospital of Central South University between October 2016 and March 2017.According to clinical active score (CAS),93 eyes were divided into a TAO active group (n=72) and a TAO inactive group (n=21).All patients underwent 99mTc-DTPA orbital SPECT/CT examination,and the DTPA uptake in extraocular muscle belly was supposed to be positive.The results of 99mTc-DTPA orbital SPECT/CT examination were compared with those of CAS score evaluation.Results:The uptake rate (UR) of 99mTc-DTPA in the TAO active group was higher than that in the TAO inactive group (P＜0.01).There was a linear positive correlation between UR and its CAS scores in all patients (r=0.767,P＜0.01).Five cases (7 eyes) showed inconsistent results between 99mTc-DTPA orbital SPECT/CT examination and CAS score.Among the 7 eyes,6 eyes showed myocarditis lesions in 99mTc-DTPA orbital SPECT/CT examination while its CAS was no more than 3;meanwhile,there was 1 eye with CAS＞3,but 99mTc-DTPA orbital SPECT/CT examination showed negative myocarditis lesions.Conclusion:99mTc-DTPA orbital SPECT/CT is consistent with the CAS score in evaluation of the disease activity of TAO;99mTc-DTPA orbital SPECT/CT may be more objective and accurate to evaluate TAO than CAS.

Dacryocystorhinostomy under nasal endoscope combined with lacrimal duct catheterization / 中国医师杂志

Objective To evaluate the clinical effect of dacryocystorhinostomy under nasal endoscope combined with lacrimal duct catheterization.Methods The retrospective comparative study was used to analyze 120 patients with chronic dacryocystitis in our hospital from June,2012 to May,2016,of whom 60 patients were treated with traditional dacryocystorhinostomy,and 60 patients were treated with dacryocystorhinostomy under nasal endoscope combined with lacrimal duct catheterization.Half year after the operation the patients were re-examined for the patency of their lacrimal passages and postoperative complication.The disappearance of tearing and the unobstructed patency of the lacrimal passages were set as the standard of a successful operation.The statistically analyzing was performed.Results Six months after operation,the success rate of dacryocystorhinostomy under nasal endoscope combined with lacrimal duct catheterization was 93.3％,the success rate of traditional dacryocystorhinostomy was 90.0％,without statistical difference between two types of operation (P ＞ 0.05).The skin scar formation rate in dacryocystorhinostomy under nasal endoscope combined with lacrimal duct catheterization was 0,while 100％ in traditional dacryocystorhinostomy,with statistical significant difference (P =0.00).The success rate of two-stage operation was 100％ after dacryocystorhinostomy under nasal endoscope combined with lacrimal duct catheterization for recurrence,while 16.7％ after traditional dacryocystorhinostomy,the difference is of statistical significance (P =0.048).Conclusions Dacryocystorhinostomy under nasal endoscope combined with lacrimal duct catheterization is not only reliable,effective method for treating chronic dacryocystitis,but also with less iatrogenic trauma,and no scar.

Nontarget area and threshold selection in 99mTc-DTPA orbital SPECT/CT imaging inthyroid associated ophthalmopathy / 中南大学学报(医学版)

To compare diagnostic value of 4 kinds of target-to-nontarget ratio (T/NT), and to choose a better one to assess thyroid associated ophthalmopathy (TAO) activity.
 Methods: The clinical data were collected for 29 newly-diagnosed patients (58 eyes) with TAO who underwent orbital 99mTc-DTPA single photon emission computed tomography/computed tomography (SPECT/CT) fusion images according to the clinical activity score (CAS). They were divided into an active group (18 cases, 36 eyes), an inactive group (11 cases, 22 eyes), and a control group (9 cases, 18 eyes). Diagnostic value of orbital/occipital lobe radioactive uptake count ratio (T/NT1), orbital/occipital radioactive uptake count ratio (T/NT2), orbital/thalamus radioactive uptake count ratio (T/NT3), and orbital/cerebellar radioactivity uptake count ratio (T/NT4) were calculated, and the CAS of Spearman rank correlation and receiver operating characteristic (ROC) curve were analyzed.
 Results: T/NT1, T/NT2 and CAS were correlated (r1=0.873, r2=0.527; P0.05). Area under the ROC curve of T/NT1 was 0.860, area under the ROC curve of T/NT2 was 0.581, and the accuracy for T/NT1 on TAO activity was good. T/NT1=9.74 could be used as active threshold for judge of TAO in patients.
 Conclusion: There is a good correlation between T/NT1 and CAS. TAO activity assessment possesses high diagnostic value, and SPECT/CT together with imaging anatomical location is more accurate.

Effect of AG490 on JAK2/STAT3 signaling pathway in human retinoblastoma HXO-RB44 cell lines / 中南大学学报(医学版)

To investigate the role of Janus kinase (JAK) inhibitor AG490 in the anti-proliferation and cell cycle in human retinoblastoma HXO-RB44 cell lines in vitro, and to explore its effect on the expression of JAK2/signal transducer and activator of transcription 3 (STAT3).
 Methods: Cells were divided into an experiment group and a control group, and the experiment group was further divided into 6 sub-groups according to different AG490 concentrations (6.25, 12.50, 25.00, 50.00 or 100.00 μmol/L). Cell proliferation in the different groups was analyzed by cell vitality determination. Cell cycle distribution and apoptosis rate were examined by flow cytometry. The protein levels of STAT3, p-STAT3 and vascular endothelial growth factor (VEGF) were detected by Western blot.
 Results: After 48 h treatment with AG490, the viability of HXO-RB44 cells was reduced in a concentration-dependent manner. Compared with the control group, there was no significant difference in the experiment groups except the 6.25 μmol/L group (all P>0.05). The apoptosis rates in the experiment groups were significantly increased with increase in concentration of AG490 compared with that in the control group (all P0.05), but there were significant differences in the other experiment groups (all P<0.05). 
 Conclusion: JAK inhibitor AG490 can inhibit proliferation and promote apoptosis of the retinoblastoma HXO-RB44 cells through down-regulation of JAK2/STAT3 signaling pathway.

A study on the establishment of co-culture system of peripheral blood mononuclear cells with orbital fibroblasts and the secretion of IL-6 and IL-17A induced by phytagglutinin in thyroid associated ophthalmopathy / 中华实验眼科杂志

Background The pathogenic mechanism of thyroid associated ophthalmopathy (TAO) is still unclear,which is considered to be an autoimmune disease.It is confirmed that interleukin-17A (IL-17A) plays an important role in the occurrence and development of many autoimmune diseases.It is unclear that whether IL-17A participates in the pathogenesis of TAO.Objective This study was to explore whether IL-17A secreted by coculture system of peripheral blood mononuclear cells (PBMCs) and orbital fibroblasts (OFs) participates in the pathogenesis of TAO and its possible mechanism.Methods Periphery blood and orbital connective tissue were obtained from 12 patients with TAO and 8 patients who received prosthesis implantation for eyeball atrophy in Xiangya Hospital during April to December 2014.PBMCs were isolated by density gradient centrifugation,and OFs were cultured by explant culture method.The purity of T leukomonocyte in PBMCs was tested by flow cytometry,and OFs were identified by Giemsa staining and immunochemistry.OFs and PMBCs were incubated into 96-well plate in a 1:20 proportion to establish co-culture system.Different concentrations of phytagglutinin (PHA) (0,1.0,2.5,5.0,10.0 μg/ml) was added for 72 hours,and IL-6,IL-17A levels in the co-culture system supernatant and IL-17A receptor (IL-17RA) of the total cell membranes in the co-culture system were assayed by ELISA.The differences of IL-6,IL-17A,IL-17RA levels in co-culture system were compared between the TAO group and control group.Results The mean purity of T leukomonocyte in PBMCs was (81.10±0.21)％ in the TAO group and (80.05 ±0.38)％ in the control group respectively,with no significant difference between them(t =0.923,P＞0.05).Cultured OFs showed the positive response for Vimentin expression and Giemsa staining.After stimulated by 1.0 μg/ml PHA,the proliferation of both PBMCs and OFs were increased in the co-culture system.Apoptosis exist in PBMCs and the number of OFs decreased when PHA was higher than 1.0 μg/ml.The growth of PBMCs and OFs was faster in the TAO group than that in the control group in the same concentration of PHA.The contents of IL-6,IL-17A and IL-17RA in co-culture system were significantly different among various concentrations of PHA subgroups (IL-6:Fgroup =12.561,P=0.000;F ion =23.356,P =0.001.IL-17A:Fgroup =12.037,P =0.000;Fconcentration =19.206,P=0.000.IL-17RA:Fgroup =16.216,P=0.000;Fconcentraction =4.627,P=0.018).The production of IL-6,IL-17A and IL-17RA reached peak in both TAO group and the control group after 1.0 μg/ml PHA stimulated.However,the concentrations of IL-6,IL-17A and IL-17RA reduced with the increase of PHA concentration.The concentrations of IL-6,IL-17A and IL-17RA in co-culture system were significantly higher in the TAO group than those in the control group under the stimulation of the same concentration of PHA (all at P＜0.05).Conclusions The co-culture system of PBMCs and OFs stimulated with PHA can be the imitation of TAO pathogenesis in vitro,and PHA can amplify its immune reaction to imitate TAO pathogenic processes intuitively.The IL-6,IL-17A and IL-17RA secreted by PBMCs and induced by PHA are increased in TAO patients,implying that IL-17A participates in the pathogenesis of TAO through magnifying cellular immune response and inflammatory reaction.

Treatment of rectus recession-suspension on posterior sclera surgery for restrictive strabismus in thyroid associated ophthalmopathy / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the oblique angle, diplopia and stereoacuity before and after rectus recession-suspension on posterior sclera surgery in patients with restrictive strabismus caused by thyroid associated ophthalmopathy (TAO).@*METHODS@#Data from 18 patients (19 eyes) with restrictive strabismus caused by TAO, who underwent rectus recession-suspension on posterior sclera surgery from July 2010 to June 2013 in Xiangya Hospital, Central South University, were analyzed retrospectively. Eight patients (8 eyes) or 5 patients (5 eyes) with hypotropia were operated with inferior rectus recession or superior rectus recession. Two patients (2 eyes) with esohypertropia or 3 patients (4 eyes) with esotropia were operated with inferior rectus recession plus medial rectus recession or medial rectus recession. Two patients (1 hypotropia, 1 esotropia) underwent orbital decompression surgery before strabismus surgery. All patients were performed rectus recession-suspension on posterior sclera surgery, and the oblique angle, diplopia view and stereopsis test were examined before and after the operation.@*RESULTS@#All patients were followed up for more than 6 months. The preoperative prism were 20(Δ)- 80(Δ) and postoperative prism were 2(Δ)-10(Δ). There was diplopia on the primary position before surgery in 16 patients. After surgery, the diplopia in 14 patients disappeared on the primary and 15° down gaze, and 2 patients had not diplopia on the primary position but residual diplopia on inferior field. Two patients had stereopsis before surgery, and the numbers of patients raised to 14 after surgery. Compared with pre-operation, changes of the above measured indexs in post-operation were significant difference (all P<0.05).@*CONCLUSION@#The rectus recession-suspension on posterior sclera surgery is effective to improve oblique angle and diplopia in restrictive strabismus caused by TAO, which can improve patient's living quality.

Resection of orbito-cranial fibrous dysplasia lesion and reconstruction with titanium / 中南大学学报(医学版)

OBJECTIVE@#To discuss the method and opportunity of operation for orbito-cranial fibrous dysplasia, and further to summarize our experience in repairing the bony defect with titanium after excision and assess the surgical outcomes.@*METHODS@#A retrospective study was performed in 21 patients with visual function damage and/ or orbital malformation, who treated surgically. All patients were underwent CT examinations (coronal, horizontal, sagittal and three-dimensional scans) before surgery. CT image data of patients with serious orbital skull lesions were analyzed by computer to produce the three-dimensional, solid titanium mesh prostheses used to repair the lesions; for smaller lesions solid titanium mesh prostheses were shaped artificially during surgery according to the normal orbit and the cranium. All the patients were treated surgically via craniofacial approach. After removing the diseased tissue, the defective area was repaired by titanium plate and nets.@*RESULTS@#Of the 21 patients, tumor removal was complete in 18 patients, and incomplete in 3 patients due to extensive invasion into the sious cavernosus. Of the 13 patients with vision impairment before surgery, vision was improved in 11 cases (range from 3 to 5 lines) following surgery. All orbital malformations were healed in these 11 patients.@*CONCLUSION@#Patients with fibrous dysplasia should undergo surgical treatment as soon as possible. Where this results in visual dysfunction or orbital-cranial deformities, repairing the bony defect with titanium material has many advantages: it is solid, easily molded, and easily fastened.

Mevastatin inhibits the differentiation of thyroid-associated ophthalmopathy derived orbital preadipocytes / 中南大学学报(医学版)

OBJECTIVE@#To investigate the effect of mevastatin (Mev) on the expression of peroxisome-proliferator-activated receptor-gamma (PPAR-gamma) mRNA and differentiation of Thyroid-associated ophthalmopathy (TAO) derived orbital preadipocytes in vitro.@*METHODS@#Orbital adipose tissues were obtained from TAO patients undergoing orbital decompression surgery. The orbital preadipocytes cultured from the orbital adipose tissues were divided into Group A (a control group) and Group B (an intervention group). Group B was subdivided into Group B1-B5, all groups were stimulated to differentiate into mature adipocytes with cocktail differentiation medium.The entire course of differentiation was 10 d. The differentiation of orbital preadipocytes in Group A was induced with routine inducer,while at in Group B1,B2, and B3 was interfered with 5 micromol/L (B1), 10 micromol/L(B2),20 micromol/L (B3) mevastatin respectively during the whole process of differentiation. The differentiation of orbital preadipocytes in Group B4 and B5 was interfered with 10 micromol/L mevastatin day 4 (B4) or day 8 (B5) of the differentiation process until the entire course was over. Intracellular fat accumulation in differentiated adipocytes was determined by oil red O staining. The value of optical absorption was measured at 492 nm with enzyme-linked immunosorbent assay. The expression of PPAR-gamma mRNA was detected by reverse transcription polymerase chain reaction.@*RESULTS@#The light absorption value (A) and PPAR-gamma mRNA expression of differentiated cells in Group A,B1,B2,and B3 decreased successively,and there was significant difference in any of the 2 groups among Group A, B1 and B2, and B3 (P<0.05). The value A and PPAR-gamma mRNA expression of differentiated cells in Group A, B4, and B2 decreased successively, and the difference in any of the 2 groups among these 3 groups was significant. However, there were no significant difference between Group A and B5.@*CONCLUSION@#Mevastatin inhibits the differentiation of TAO derived orbital preadipocytes by blocking PPAR-gamma mRNA expression. The degree of inhibition is not only concentration-dependent but also associated with the stage of differentiation. The earlier the differentiation, the stronger the inhibition.

Surgical method and intraorbital foreign body extraction in 27 cases / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the surgical method and intraorbital foreign body extraction.@*METHODS@#Individualized plan was made based on radiology and foreign body extraction was performed in 27 cases (27 eyes). The outcome of extraction was analyzed. Visual acuity, eye movement, and ptosis were recorded before and after the operation.@*RESULTS@#Intraorbital foreign bodies in the 27 eyes were extracted successfully, 24 eyes (88.9%) extracted once and the other 3 eyes (11.1%) twice. The follow-up was 3-24(9.39±6.25) months. Visual acuity increased in 13 eyes (48.1%), and invariable in 13 eyes (48.1%) at the last follow-up. Disturbance of eye movement was found in 18 (66.7%) and 15 (55.5%) eyes before and after the extraction, respectively. Ptosis was found in 2 eyes (7.4%) and 1 eye (3.7%) before and after the extraction, respectively.@*CONCLUSION@#Individualized plan is helpful for the intraorbital foreign body extraction and eye recovery.

Color pattern reversal visual evoked potentials in primary open angle and angle closure glaucoma / 中南大学学报(医学版)

OBJECTIVE@#To investigate the difference in color pattern reversal visual evoked potential (CPR-VEP)between primary open angle glaucoma (POAG) and primary angle closure glaucoma (PACG) patients.@*METHODS@#Vision Monitor visual electrophysiograph made by Metro Vision Inc. in France was used to record CPR-VEP in 17 eyes of 12 POAG patients, 56 eyes of 41 PACG patients, and 26 eyes of 13 age-equivalent normal persons at an ascending series of temporal frequency (1, 2, 4, 8, 16, and 32 Hz) and color stimulation (black/white, red/green, and blue/yellow). P(100) wave amplitudes and latencies of these patients were compared respectively with those of the normal group.@*RESULTS@#With black/white stimulation, the P(100) wave amplitudes were reduced with the increase of temporal frequency in the 3 groups. The P(100) wave latencies were extended with the increase of temporal frequency with different color stimulations. The P(100) amplitudes were PACG group > NC group > POAG group and black/white > blue/yellow > red/green. The P(100) wave latencies in the POAG group and the PACG group were extended compared with the NC group, but there was no significant difference between PACG group and POAG group.@*CONCLUSION@#CPR-VEP P(100) amplitudes in the PACG group and POAG group have their own characteristics. The P(100) amplitude of PACG is higher, and POAG is lower than normal. The P(100) wave latencies of PACG and POAG are extended.

Visual prognosis of laser treatment for diabetic retinopathy / 中南大学学报(医学版)

OBJECTIVE@#To assess the visual prognosis of laser treatment for diabetic retinopathy at different stages.@*METHODS@#Based on the Diabetic Retinopathy Photocoagulation Study Group (DRPS), 138 patients (210 eyes) with nonproliferative diabetic retinopathy (NPDR), preproliferative diabetic retinopathy (PPDR), or proliferative diabetic retinopathy (PDR) were treated with laser photocoagulation. After 3 to 6 months,visual changes were inspected, fundus fluorescence angiography (FFA) was performed. Further photocoagulation was complemented according to the remaining fluorescein leakage, non-perfusion areas, microangioma and new vessels existing or disappearing. The follow-up was 6 approximately 24 months.@*RESULTS@#After the laser photocoagulation treatment, the rate of improvement and unchanging of visual acuity was 95.83% in NPDR group, 92.86% in PPDR group and 73.81% in PDR group. After 3 to 6 months, FFA showed that the effective rate was 95.83% in NPDR group, 78.33% in PPDR group and 60.31% in PDR group.@*CONCLUSION@#The visual prognosis of diabetic retinopathy at different stages is different after retinal photocoagulation. To save the visual function of patients, the appropriate time and reasonable laser parameter should be carefully chosen in the treatment of retinal photocoagulation in DR patients of different stages, especially in those with macular edema.

Comparison of two different kinds of primary hydroxyapatite orbital implant placement / 中国组织工程研究

BACKGROUND: There are two commonly used techniques of primary orbital implant placement, one is using sclera to cover hydroxyapatite prosthesis after evisceration and the other is using sclera to wrap around the hydroxyapatite prosthesisafter enucleation, which one is more efficient and safer.OB.IECTIVE: To compare the clinical safety of the two kinds of surgery for placing hydroxyapatite prosthesis in the orbit.DESIGN, TIME AND SETTING: A retrospective case analysis was performed.between June 2000 and June 2005 at Xiangya Hospital, Central South University, Changsha, Hunan Province, ChinaPARTICIPANTS: Fifty eyes of 50 cases who were admitted between June 2000 and March 2003 to accept enucleation implants, including 39 cases with atrophic eyeball, 6 cases with anterior scleral staphyloma, 1 case with absolute glaucoma, 4cases with eyeball rupture. Forty-nine eyes of 49 cases who were admitted between April 2003 and June 2005 to accept evisceration implants, including 36 cases with atrophic eyeball, 8 cases with anterior scleral staphyloma, I case with absolute glaucoma, 4 cases with eyeball rupture. All the operations performed by the same surgeon.METHODS: In enucleation implant group, autologous sclera-wrapped hydroxyapatite orbital implant was placed into the muscle cone after enucleation. In evisceration implant group, the bared hydroxyapatite orbital implant was placed into muscle cone after evisceration, and was covered by autologous sclera in anterior.MAIN OUTCOME MEASURES: Appearance improvements and complications of patients after orbital implant placement. RESULTS: There was no significant difference between the two groups in appearance improvement. In enucleation implant group, 7 patients experienced conjunctival dehiscence and 5 patients experienced orbital implant exposure. In evisceration implant group, no conjunctival dehiscence and orbital implant exposure occurred. There were significant differences between the two groups in conjunctival dehiscence ( x2 =7.380, P < 0.01) and orbital implant exposure( x2 =5.160, P < 0.01 ).CONCLUSION: Evisceration with sclera-covered orbital implant is more simple, safe, convenient and effective than enucleation with sclera-wrapped orbital implant.

Relativity Research of Synthesis Detected CEA,NSE, CA_(50) in Serum and Hydrothorax for Lung Cancer / 医学研究杂志

Objective To study relativity of tumor marker (TM) and particularity indexed sign for lung cancer through TM about CEA、NSE、CA50 in serum and hydrothorax. seeks a best method that enhances lung cancer diagnosis rate and the prognosis appraisal. Methods 91 lung cancer patients were detected CEA、NSE、CA50 in serum and hydrothorax separately the treatment before and after the 6th week, the 6th month. Results TM in serum and hydrothorax of the patients with lung cancer was higher than those of the contrast group,it was significant(P

Comparative study on caries activity between orthodontically treated and untreated children / 实用口腔医学杂志

Objective:To investigate the influence of fixed orthodo ntic appliances on caries activity in children. Methods: By the use of Dentocult SM, Dentocult LB and Cariostat (CAT), the caries activi ty in 35 children aged 12～14-year-old treated with edgewise appliances was compared with that in 35 untreated ones. Results: The val ues of Dentocult SM, Dentocult LB and Cariostat (CAT) in orthodontically treate d children were significantly higher than those in untreated ones(P