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Objective:To observe the multimodal imaging features and explore the treatment of parafoveal exudative vascular anomaly complex (PEVAC).Methods:A retrospective study. Six patients (6 eyes) with PEVAC diagnosed in Tianjin Eye Hospital were included in this study from July 2018 to December 2021. All patients were female with monocular disease. The age was (61.1±9.3) years. All patients showed a sudden painless decline in monocular vision with metamorphopsia. All patients underwent best corrected visual acuity (BCVA), color fundus photography, fundus fluorescein angiography (FFA), optical coherence tomography (OCT) and OCT angiography (OCTA). Indocyanine green angiography (ICGA) was performed in 4 eyes. In 6 eyes, 3 eyes were treated with intravitreal injection of anti-vascular endothelial growth factor drug; 5 eyes were treated with micropulse laser photocoagulation and/or local thermal laser photocoagulation; 1 eye was treated with photodynamic therapy. Five patients were followed up for (9.2±7.4) months, and 1 patient was lost. At follow-up, the same equipment and methods were used as at the initial diagnosis. The clinical manifestations, multimodal image features and treatment response were observed.Results:Baseline BCVA of affected eyes were ranged from 0.1 to 0.5. PEVAC was isolated in 6 eyes, and the fundus showed isolated hemangioma-like leision, accompanied by small bleeding and hard exudation. There were 2 isolated hemangiomatous lesions adjacent to each other in 2 eyes. In the early stage of FFA, punctate high fluorescence lesions near the macular fovea were seen, and the leakage was enhanced in the late stage. There was no leakage in the early stage of ICGA, or slight leakage with late scouring. OCT showed an oval lesion with high reflection wall and uneven low reflection. The central macular thickness (CMT) was (431±76) μm. OCTA showed blood flow signals in PEVAC, 2 eyes in the superficial capillary plexus (SCP), and it was also observed in the deep capillary plexus (DCP), but the intensity of blood flow signal was slightly weaker than that in the SCP. The blood flow signal was visible only in DCP in 2 eyes. SCP and DCP showed similar intensity of blood flow signals in 2 eyes. After treatment, the bleeding was absorbed basically in 4 eyes, the hard exudation partially subsided, the CMT decreased, the intercortical cystic cavity of the fovea nerve decreased, the hemangiomatous lesions narrowed, and BCVA increased. In 1 eye, the macular sac was reduced and partially absorbed by hard exudation, which was later relapsed due to blood pressure fluctuation.Conclusions:The majority of PEVAC patients had monocular onset. The fundus is characterized by solitary or structure with strong reflex walls, with or without retinal cysts, hard exudates, and subretinal fluid, and visible blood flow signals inside.
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Objective To evaluate the value of transvaginal color Doppler ultrasonography for pathologic grading of endometrial cancer. Methods A total of 68 patients with histopathologic diagnosis of endometrial cancer were recruited as study subjects, and all patients underwent transvaginal color Doppler ultrasonography. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value of transvaginal color Doppler ultrasonography for identification of myometrial invasion by endometrial cancer were evaluated among endometrial cancer patients with postoperative histopathological examinations as a gold standard. Results The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of transvaginal color Doppler ultrasonography were 70.0%, 67.9%, 75.7%, 61.3% and 69.1% for the detection of myometrial invasion by endometrial cancer, respectively. The resistance index values of left and right uterine arteries were both significantly higher in endometrial cancer patients with myometrial invasion ≤ 50% than those with myometrial invasion > 50% (P < 0.01), and the resistance index values of left and right uterine arteries increased with the reduced tumor grade among endometrial cancer patients (P < 0.05). Conclusion Transvaginal color Doppler ultrasonography shows a high accuracy for identification of myometrial invasion among endometrial cancer patients, which may be used as a non-invasive tool for preoperative pathologic grading of endometrial cancer.
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Objective To build the lentiviral vectors of pigment epithelial derived factor (PEDF) gene,and investigate their expression in human umbilical cord mesenchymal stem cells (hUCMSCs).Methods The PEDF lentiviral vectors (LV-PEDF) were built by DNA recombination and confirmed by DNA sequencing.hUCMSCs were transfected by LV-PEDF with MOI 10,30,50,respectively.The transfection efficiency was observed under fluorescence microscope.Cell immunofluorescence,immunocytochemistry and real-time PCR methods were used for detecting the expression of PEDF and VEGF.Results The PEDF cDNA was sub-cloned into pCDH-CMV-MCS-EF 1-copGFP vector successfully.DNA sequencing analysis confirmed that PEDF gene sequence was exactly the same with that reported in GenBank.pCDH-PEDF infected cells could show green fluorescence under fluorescence microscope.The transfection efficiency was 72.1％ in PEDF-MSCs.Immunofluorescence and immunochemical staining confirmed that PEDF protein was overexpressed in hUCMSCs.The relative expression of PEDF mRNA in experimental group and control group was (0.170±0.028) and (0.015 ± 0.007) respectively by RT-PCR,the difference was statistically significant (P＜0.00 1).The relative expression levels of VEGF mRNA in the two groups were (0.265 ± 0.022) and (0.285 ± 0.049),respectively,with no significant difference (P＞0.05).Conclusions We successfully built a lentivius vector carrying PEDF gene and obtained hUCMSCs with overexpressed PEDF.
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Background Retina fixed flat-mount perfused by Evans blue (EB) is a common method for the evaluation of blood-retinal barrier (BRB).However,previous method is inconvenient for some laboratories because the retinal specimen can not be observed by gereral microscope rather than confocal laser scanning microscope after the fixation.Objective This study was to modify the preparing way of flat-mounted retina in order to obtain transparent specimen for the observation of rat retinal vessels and the evaluation of leakage under the ordinary fluorescence microscope.Methods Forty male SD rats were divided into the control group,diabetes mellitus (DM) 1-month group,DM 3-month group and DM 6-month group according to the random number table.Streptozotocinum (STZ) of 2％ dissolved in 0.05 mmol/L sodium citrate-hydrochloric acid buffer was intraperitoneally injected in SD rats to establish DM models,and the equal volume of solvent was injected in the same way in the control rats.One month,three months and six months after injection,EB of 30 g/L was injected via rat femoral vein in the dose of 45 mg/kg.Fifteen minutes after injection of EB,the rats were sacrificed and the retinas were isolated and cut radially to prepare the flat-mounted retinas in PBS immediately and then were dried till the specimens were transparent.The specimens were examined under the fluorescence microscope.The percentage of EB leakage was quantitatively calculated by IPP 6.0 software.All procedures were performed following approval of the institutional animal care and use committee of Tianjin Medical University.Results The retina morphology was normal in the control group,and EB filled the vessels,exhibiting the red fluorescence under the fluorescence microscope.Compared with the control group,retinal background fluorescence was enhanced slightly in the DM 1-month group,and focal leakage of the EB from capillaries and focal dilated vessels were found in the DM 3-month group,further,vascular caliber inequality,retinal hypoperfusion area and a larger number of hyperfluorescence areas were seen in the DM 6-month group.The percentage of leakage area was (0.05 ±0.02) ％,(0.27 ±0.06) ％,(1.17 ±0.18)％ and (4.77 ±0.66)％ in the control group,DM 1-month group,DM 3-month group and DM 6-month group,respectively,showing a significant difference among the four groups (F =795.800,P＜0.001),and the leakage area was obviously larger in the DM 3-month group and DM 6-month group than that in thecontrol group (q'=10.338,q'=43.475,both at P＜0.001).Conclusions Modified EB-perfused retinal wholemount method is easy and helpful for clear visualization of retinal vessel leakage induced by BRB breakdown in the diabetic rats under the common fluorescence microscope.
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Objective To assess the value of color Doppler ultrasonogarphy in the diagnosis of subacute thyroiditis (SAT). Methods Sixty-eight patients of SAT and 30 patients with thyroid papillary carcinoma were included, and their imaging features were retrospectively reviewed. Results All the patients with SAT had either focal or diffuse hypoechogenicity of the thyroid lobes with rich blood supplying in the diseased region, among them 52 patients (76.47%, 52/68) had tenderness on palpation. Diffuse and focal lesions were found in 40 (58.82%, 40/68) and 28 patients (41.18%, 28/68). The boundary and shape of focal lesions had no diagnostic characteristics compared with those of thyroid papillary carcinoma. Punctate calcification and resistance index (RI) in the nodule were significant different between the SAT and thyroid papillary carcinoma (P＜0.05). Conclusion Color Doppler ultrasonography can display the features of SAT and is an effective method for the diagnosis of SAT.