The application of improved team-based learning based on the training goal of excellent doctors in ophthalmology internship class / 中华医学教育探索杂志

Objective:To evaluate the effect of the improved team-based learning (TBL) teaching method in the undergraduate probation course of ophthalmology based on the goal of cultivating excellent doctors.Methods:The undergraduates of clinical medicine were randomly divided into experimental group and control group. The control group ( n=50) was given conventional ophthalmology probation teaching, while the experimental group ( n=50) was given ophthalmology probation teaching of improved TBL teaching method. The theoretical examination performance and skill assessment results of students in the two groups were compared, and the subjective evaluation of the students on the teaching was also compared. SPSS 23.0 was used to conduct t-test and Wilcoxon's rank sum test. Results:The theoretical examination performance of experimental group (29.68±4.52) was better than that of control group (27.84±4.33), with significant differences ( P<0.05); the skill assessment results of experimental group (32.88±5.05) were also better than those of the control group (30.88±6.99), with significant differences ( P<0.05); the subjective evaluation of teaching effect in each item of experimental group was better than that of control group ( P<0.05). Conclusion:The improved TBL teaching method can not only improve students' theoretical knowledge and experimental skills, but also improve students' self-study and teamwork ability, which will provide a feasible educational reform plan for achieving the goal of cultivating excellent doctors.

Visual function changes of dysthyroid optic neuropathy and ROC curve analysis for early diagnostic indicators / 中南大学学报(医学版)

OBJECTIVES@#Dysthyroid optic neuropathy (DON) is a class of diseases that makes seriously endanger to the vision of patients with thyroid-associated ophthalmopathy. This study aims to observe the visual function changes in patients with DON, and to evaluate the diagnostic value of indicators diagnosing DON.@*METHODS@#A retrospective study was conducted on 98 eyes of 49 patients with dysthyroid optic neuropathy (DON) who were treated in Xiangya Hospital of Central South University from January 2017 to December 2019. All patients were received the examination of best corrected visual acuity (BCVA), Humphrey visual field, visual evoked potential (VEP), and contrast sensitivity. Ninety-eight eyes were divided into a DON group (45 eyes) and a non-DON group (53 eyes). T-test was used to compare the related indicators between the 2 groups. The sensitivity and specificity of each indicator were analyzed by receiver operating characteristic (ROC) curve.@*RESULTS@#The BCVA and visual field index (VFI) of the DON group were significantly lower than those of the non-DON group (all P<0.05). The mean deviation (MD) and pattern standard deviation (PSD) of the DON group were significantly higher than those of the non-DON group (all P<0.05). The low frequency contrast sensitivity (CSL), medium frequency contrast sensitivity (CSM), and high frequency contrast sensitivity (CSH) of the DON group were significantly lower than those of the non-DON group (all P<0.05), with CSH being particularly prominent. Compared with the non-DON group, at spatial frequencies of 15°, 30°, and 60°, the amplitude of N135 wave was significantly reduced, and the latency of N75 wave, P100 wave, and N135 wave was significantly prolonged in the DON group (all P<0.05); at spatial frequencies of 15° and 30°, the amplitude of P100 wave was significantly reduced in the DON group (P<0.05). The ROC curve analysis results showed that the area under the curve (AUC) of VFI, CSL, CSM, CSH and 15° P100 amplitude diagnosing DON were 0.812, 0.841, 0.880, 0.784, and 0.791, respectively, with CSM possessing the highest sensitivity and specificity.@*CONCLUSIONS@#The visual function of patients with DON is decreased. VFI, contrast sensitivity of low, medium, and high frequency, and 15° P100 wave amplitude might be effective indicators for early diagnosis of DON.

Advances in histone epigenetic enzyme inhibitors based on proteomics / 药学学报

As an important component of nucleosomes on the chromatin of eukaryotic cells, histones play an important role in the development and progression of tumour diseases by regulating epigenetic post-translational modifications such as acetylation and methylation. In addition, development of inhibitors targeting methyltransferase and deacetylase provides novel therapeutic strategies for cancer treatment. Mass spectrometry-based proteomics can reveal the global changes of histone modifications under the action of drugs during disease progression, which in turn provides important support for revealing drug action mechanism, drug resistance mechanism, and investigating novel drug combination strategies. This article focuses on the progress and status of proteomic research on a variety of histone modifying enzyme inhibitors, including methyltransferase inhibitors and histone deacetylase inhibitors, which will help to understand the current and further utilization of proteomics in studying histone modifications.

Study on the motivation and path of the formation of breastfeeding education behavior of nurses in NICU based on grounded theory / 中国实用护理杂志

Objective:To explore the motivation of the formation of the breastfeeding mission and education behavior of nurses in NICU, analyze the deep reasons, and construct the motivation and path theoretical model of the formation of the breastfeeding mission and education behavior of nurses in NICU.Methods:Through semi-structured interviews, the qualitative research method of grounded theory was used to study 20 nurses in the Second Affiliated Hospital, University of South China from July to September 2020, to construct the motivation and path theoretical model of the formation of the breastfeeding mission and education behavior of nurses in NICU.Results:The research identified five main categories: attitude factor, ability factor, behavior factor, internalization and externalization. Under the influence of three dimensions of attitude level, ability level and behavior level and their cross-layer interaction effects, the NICU nurses were driven to form stable breastfeeding mission and education behaviors through internalization and externalization.Conclusions:Based on the evolutionary context of "multi-dimensional factors and their interaction drivers-internalization-externalization", the relationship between attitude factors, ability factors, behavioral factors, internalization, and externalization are clarified. It provides a theoretical reference basis for managers in managing the breastfeeding propaganda and education of nurses in the NICU, and enriches the theoretical framework of breastfeeding behavior in the NICU.

Key technology of 3D bio-printing and its application in orthopedics / 中华骨科杂志

Bone defect repairing and reconstruction has been a hot research topic in orthopedics for a long time. Tissue engineering and stem cell technology have made a series of important achievements in promoting bone regeneration to treat bone defect. In recent years, 3D bio-printing, which combining with 3D printing, tissue engineering and stem cell technology, has significant advantages in optimizing the geometry, mechanical properties and biological functions of repairing tissue for bone defect by accurately controlling the shape and internal structure of scaffolds, and printing biomaterials, stem cells and (or) cells into three-dimensional biological functional structures. A series of important progress has been achieved. The common printing methods for bio-printing related to orthopedic include: Inkjet 3D bioprinting; microextrusion 3D bioprinting; laser-assisted 3D bioprinting; stereolithography; microvalve based 3D bioprinting. Various printing methods and principles are not the same, and each has advantages and disadvantages, and the applicable "bio ink" is also different. The key technologies of orthopedic bio-3D printing include: the methods of image data acquisition and 3D structure design; development and application of composite bio-scaffold materials suitable for 3D printing, tissue engineering and bone-enhancing effect; stem cell selection for ensuring graft biological performance and induced pluripotent stem cell technology; in vitro bioreactor technology for improving the maturity and biocharacterization of bioprinted tissues. The literature published in the field of biological 3D printing research has continued to grow at a high rate since 2008. Using the bibliometric analysis software VOSviewer to create a co-word matrix for high-frequency keywords and to draw a keyword co-occurrence network map analysis, biological 3D printing research hotspots are the use of tissue engineering methods to 3D printed tissue scaffolds, while studying cell survival and drug effects. The instruments and methods of bio-3D printing are also one of the research hotspots.

A CTA-based classification of first plantar metatarsal arteries in thumb reconstruction / 中华显微外科杂志

Objective:To discusses effectiveness of CTA in the classification of first plantar metatarsal artery and its application value in thumb reconstruction.Methods:Thirty-six cases who underwent thumb reconstruction with free second toe or hallucis flap between December, 2015 and December, 2018 were retrospectively analyzed. Among these cases, 22 cases were injured by machine stranding, 7 cases by heavy objects, and 7 cases were injured by rolling. Exact first plantar metatarsal arteries of all these cases were evaluated by using CTA preoperatively. And compared with intraoperative findings at the donor sites. Free first or second toe flap for thumb reconstruction were designed preoperatively based on branching pattern of first plantar metatarsal arteries.Results:The origin, course, 3-dimensional (3D) anatomical relationship with surrounding tissues and branching pattern of all these feet first plantar metatarsal arteries of 35 cases (70 feet)were well displayed in CTA images, and 1 case (2 feet) were showed poor vascular continuity and artifacts in CTA (2.78%). According to the branching pattern of first plantar metatarsal arteries, 29 cases (58 feet, 80.56%) were ramifying type, 5 cases (10 feet, 13.88%) were main trunk type, and 1 case (2 feet, 2.78%) were tiny branch type. Preoperative CTA images and intraoperative findings at the donor site of 35 cases were remarkably consistent. According to CTA images, 27 cases underwent thumb reconstruction with hallucis flap, 8 cases underwent thumb reconstruction with second toe, and 1 case of poor vascular continuity and artifacts in CTA underwent thumb reconstruction with hallucis flap eventually. All these cases were followed-up for 6-24 (average 12) months, and all reconstructed thumbs survived. The clinical outcomes of all these reconstructed thumbs were good with satisfactory appearance, sensory recovery, excellent motion. The donor feet of all cases recovered well.Conclusion:High-quality 3D images of first plantar metatarsal arteries could be obtained by CTA, allowing preoperative assessment of blood supply and planning of donor site. Therefore, success rate of reconstructed operation could be improved with low disability rate of donor site.

Key technology of 3D bio-printing and its application in orthopedics / 中华骨科杂志

Bone defect repairing and reconstruction has been a hot research topic in orthopedics for a long time.Tissue engineering and stem cell technology have made a series of important achievements in promoting bone regeneration to treat bone defect.In recent years,3D bio-printing,which combining with 3D printing,tissue engineering and stem cell technology,has significant advantages in optimizing the geometry,mechanical properties and biological functions of repairing tissue for bone defect by accurately controlling the shape and internal structure of scaffolds,and printing biomaterials,stem cells and (or) cells into three-dimensional biological functional structures.A series of important progress has been achieved.The common printing methods for bioprinting related to orthopedic include:Inkjet 3D bioprinting;microextrusion 3D bioprinting;laser-assisted 3D bioprinting;stereolithography;microvalve based 3D bioprinting.Various printing methods and principles are not the same,and each has advantages and disadvantages,and the applicable "bio ink" is also different.The key technologies of orthopedic bio-3D printing include:the methods of image data acquisition and 3D structure design;development and application of composite bio-scaffold materials suitable for 3D printing,tissue engineering and bone-enhancing effect;stem cell selection for ensuring graft biological performance and induced pluripotent stem cell technology;in vitro bioreactor technology for improving the maturity and biocharacterization of bioprinted tissues.The literature published in the field of biological 3D printing research has continued to grow at a high rate since 2008.Using the bibliometric analysis software VOSviewer to create a co-word matrix for high-frequency keywords and to draw a keyword co-occurrence network map analysis,biological 3D printing research hotspots are the use of tissue engineering methods to 3D printed tissue scaffolds,while studying cell survival and drug effects.The instruments and methods of bio-3D printing are also one of the research hotspots.

Application value of " one-stop" scanning of coronary and head and neck CTA using low tube voltage / 中华放射医学与防护杂志

Objective To investigate the value of "one-stop" scanning of coronary and head and neck CTA in patients with normal body mass index (18 kg/m2 ≤ BMI ≤ 25 kg/m2) using low tube voltage (80 kVp).Methods In a retrospective analysis 80 patients with normal body mass index who had completed "one-stop" scanning of coronary and head and neck CTA were divided into A and B groups according to different scanning method,and 40 consecutive cases were selected in each group.Scanning parameters of group A and group B were tube voltage 80 kV,coronary CTA tube current 550 mA,head and neck CTA tube current 500 mA,and tube voltage 100 kV,coronary CTA tube current 450 mA,head and neck CTA tube current 400 mA separately.Subjective evaluation and objective evaluation were performed on the image quality of the two groups.CT values of coronary artery and head and neck CTA trunk branch vessel,contrast-to-noise ratio (CNR),image noise (SD) and effective dose between the two groups were compared.Results The image quality of both groups met the diagnostic requirements,and there was no statistically significant difference in subjective scores between two groups (P＞0.05).The CT values of coronary arteries,the main branches of the head and neck (the common carotid artery,the internal carotid artery) and SD of head and neck CTA were significantly different between two groups (t=4.737,6.552,3.359,2.165,2.685,4.617,P＜0.05).There was no statistically significant difference in SD of coronary CTA,CT values and CNR between head and neck vessels (middle cerebral artery) in group A and group B (P＞0.05).The effective dose of coronary CTA in group A (1.16±0.20) mSy was reduced by 51.1％ than that in group B (2.37±0.77) mSv.The effective dose of head and neck CTA in group A (0.37±0.03) mSv was reduced by 47.9％ than that in group B (0.71 ± 0.17) mSv.Conclusions The image quality with subjective evaluation met the diagnostic requirements when using a low-tube voltage for "one-stop"scanning of coronary and head and neck CTA.The CNR values were basically consistent with the conventional scanning method,and the patient effective dose was reduced by about 50％.

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.

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.

Case analysis and control strategy of imported malaria in Qingcheng Dis-trict,Qingyuan City from 2011 to 2016 / 中国血吸虫病防治杂志

Objective To understand the characteristics of imported malaria cases in Qingcheng District,Qingyuan City and explore the strategies and priorities in prevention and control,so as to provide the evidence for improving the diagnosis, treatment and management of imported malaria. Methods The data of imported malaria as well as the case epidemiological in-vestigations were collected and retrospectively analyzed for the species composition,original countries,population distribution, regional distribution,onset situation,diagnosis,treatment,etc. in Qingcheng District from 2011 to 2016. Results The num-ber of imported malaria cases was 13 from 2011 to 2016. All the patients were confirmed by laboratory,and of which,9 patients infected with Plasmodium falciparum,1 with P. vivax,1 with P. ovale and 2 with mixed infections(P. vivax and P. falciparum). The yearly incidence of imported malaria presented an uptrend. The infection sources of all the patients were from African coun-tries,and the exported labor workers and travelers for business from malaria endemic areas were the high risk population. The re-ported time was mainly January,February,November and December(11/13,84.62％). All the patients were male,and the ma-jority of them(12/13,2.31％)were 21-60 years old. The median time from onset to seeing a doctor was 2.5 days and the median time from seeing a doctor to being diagnosed was 1.9 day. Six patients(46.15％)were diagnosed as other diseases at the first vis-it to a doctor,and one patient died of falciparum malaria because of delayed diagnosis. Conclusions The incidence of overseas imported malaria presents an uptrend in Qingcheng District. It is necessary to further strengthen the professional training in medi-cal staff to improve the diagnosis and treatment of malaria cases. It is also necessary to strengthen the multisectoral cooperation , establish the surveillance in the high risk population,etc.

Research progress on solid dispersion technique in preparative field / 药物评价研究

Solid dispersions (SD) as a preparation of intermediates have played an important role in improving the dissolution of insoluble drugs and its bioavailability.SD technique is one of the most promising techniques to improve the dissolution and solubility of insoluble drugs,and the development of SD technique will promote the gradual perfection in preparative field.This review focuses on the carrier materials of SD,various new preparation techniques and their comparisons,application of solid dispersion formulations,and stability problems of SD.The factors influencing the stability of SD are described,and the effective measures to prevent the aging of SD are put forward.Finally,the review puts forward the practical suggestions of the solid dispersion technique.

Research progress on solid dispersion technique in preparative field / 药物评价研究

Solid dispersions (SD) as a preparation of intermediates have played an important role in improving the dissolution of insoluble drugs and its bioavailability.SD technique is one of the most promising techniques to improve the dissolution and solubility of insoluble drugs,and the development of SD technique will promote the gradual perfection in preparative field.This review focuses on the carrier materials of SD,various new preparation techniques and their comparisons,application of solid dispersion formulations,and stability problems of SD.The factors influencing the stability of SD are described,and the effective measures to prevent the aging of SD are put forward.Finally,the review puts forward the practical suggestions of the solid dispersion technique.

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.

Combined middle meatus and expand prelacrimal recess-maxillary ainus approach for orbital fracture treatment / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study surgical techniques and clinical applications of the intranasal endoscopic combined middle meatus and expand prelacrimal recess-maxillary ainus approach for orbital fracture treatment.@*METHOD@#A retrospective clinical analysis of 3 patients whose admitted for orbital floor fractures or medial wall fractures operated by the intranasal endoscopic middle meatus with expand prelacrimal recess-maxillary ainus approach surgical treatment was studied, and the treatment effects and the postoperative complications were analyzed.@*RESULT@#All patients had been followed up for 6 to 12 months. All cases of diplopia symptom were disappeared, enophthalmos were totally corrected, no cases of complication were found.@*CONCLUSION@#Endonasal endoscopic combined middle meatus and expand prelacrimal recess-maxillary ainus approach for orbital fracture treatment have great and clear view. This approach with less tissue damage and high therapeutic effect makes the cost lower than other methods and complications will be decreased as well, it has a great advantage in the orbital fracture treatment.

Publication patterns and citation analysis of APJTM during 2008 and June 2014

OBJECTIVE@#To draw on data about publication patterns and citation indicators of Asian Pacific Journal of Tropical Medicine (APJTM) during 2008 and June 2014 in order to know about the current state of the journal.@*METHODS@#Data used in this study were collected based on publications in APJTM from 2008 to June, 2014. Information including publication issue, type of manuscript, country/region of Corresponding author, funded research paper, and international collaboration were aggregated and analyzed with Excel software. Citation indicators including total cites, average cites of each manuscript, h-index, and impact factors were primarily drawn from Web of Science™ database on June 15, 2014 and changes over the past six and half years were interpreted. The top 10 most cited papers in Web of Science™ database were also analyzed.@*RESULTS@#Number of all submissions has arisen from less than 200 in 2008 to over 1 500 in 2013, manuscript acceptance rate has decreased to be less than 14.00% indicating its improvement in quality over this period of time. Out of the 1 115 publiations, 23.77% were fruits of funded projects or produced by funded co-authors, 87.08% of all publications in APJTM were submited by authors from 10 most contributed countries. During the studied period, each published manuscript in the journal has received an average of 1.05 cites, and at least 10 publications has been cited for more 10 times.@*CONCLUSION@#Detailed analysis shows APJTM has made great progress over the past six and half years, but authors' originating countries are still disproportionate. Efforts should be made to improve its citation indicators.

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.

Effects of pressure therapy on the proliferation and apoptosis of cells in hypertrophic scar of burn patients / 中华烧伤杂志

<p><b>OBJECTIVE</b>To explore the effects of pressure therapy on proliferation and apoptosis of cells in hypertrophic scar (HS) of burn patients.</p><p><b>METHODS</b>Twenty patients who were hospitalized from September 2010 to September 2012 and started to wear pressure garment tailored by rehabilitation therapists over 20 hours a day beginning from two weeks after healing of burn wounds with the depth from deep partial-thickness to full-thickness (early stage of formation of HS) were set as pressure treatment group (PT). Another group of patients who were hospitalized in the same period with HS formed 3, 6, 12, 24 months (with 5 patients at each time point) after deep partial-thickness to full-thickness burns without receiving any treatment were set as control group. HS tissue samples from limbs and face were excised at post treatment month (PTM) 3, 6, 12, 24 in group PT (with 5 patients at each time point), and 2 to 3 days after admission in control group. Five patients out of the above-mentioned 40 patients were selected according to the random number table, and normal skin tissue samples from abdomen and thigh were also obtained to serve as normal control. The expressions of proliferating cell nuclear antigen (PCNA) in HS and normal skin tissue were determined with immunohistochemical staining. The apoptosis status was detected with situ end labeling technique. The mRNA expressions of P57(kip2) and Cyclin E were determined with real-time fluorescence quantification PCR. Data were processed with t test, one-way analysis of variance, or LSD test.</p><p><b>RESULTS</b>(1) In normal skin tissue, PCNA-positive cells were observed in the epidermal basal layer and prickle cell layer. In group PT and control group, PCNA-positive cells were observed in the epidermal basal layer, prickle cell layer, lower part of the granular cell layer, and dermis of HS. The percentages of PCNA-positive cells in HS in group PT were respectively (40.4 ± 2.9)%, (28.2 ± 6.2)%, (9.9 ± 0.7)% at PTM 3, 6, 12, which were significantly lower than those of HS formed 3, 6, 12 months after wound healing in control group [(48.3 ± 4.7)%, (36.2 ± 3.2)%, (11.4 ± 0.9)%, with t values respectively 3.186, 2.559, 2.880, P values all below 0.05]. (2) In normal skin tissue, apoptotic cells were observed in the epidermal basal layer. In group PT and control group, apoptotic cells were observed in each layer of epidermis of HS. The apoptotic indexes of HS in group PT were respectively (20.4 ± 1.2)%, (26.1 ± 0.4)%, (26.6 ± 1.0)% at PTM 6, 12, 24, which were significantly higher than those of HS formed 6, 12, 24 months after wound healing in control group [(16.2 ± 1.5)%, (23.1 ± 2.0)%, (24.8 ± 1.1)%, with t values respectively -4.904, -3.366, -2.606, P < 0.05 or P < 0.01]. (3) The mRNA expressions of P57(kip2) of HS in group PT were respectively 3.87 ± 0.20, 8.60 ± 0.78, 10.00 ± 0.57 at PTM 3, 6, 12, which were significantly higher than those of HS formed 3, 6, 12 months after wound healing in control group (3.34 ± 0.15, 6.36 ± 0.29, 9.34 ± 0.12, with t values respectively -4.880, -6.014, -2.375, P < 0.05 or P < 0.01). The mRNA expression of P57(kip2) in normal skin tissue was close to those of HS in group PT at PTM 12, 24 and those of HS formed 12, 24 months after wound healing in control group (with P values all above 0.05). (4) The mRNA expressions of Cyclin E of HS in group PT were respectively 19.30 ± 0.18, 12.77 ± 0.30, 9.21 ± 0.18 at PTM 3, 6, 12, which were significantly higher than those of HS formed 3, 6, 12 months after wound healing in control group (19.79 ± 0.34, 15.41 ± 0.26, 9.47 ± 0.17, with t values respectively 3.186, 2.559, 2.880, P < 0.05 or P < 0.01). The mRNA expression of Cyclin E in normal skin tissue was close to those of HS in group PT at PTM 12, 24 and those of HS formed 12, 24 months after wound healing in control group (with P values all above 0.05).</p><p><b>CONCLUSIONS</b>Pressure therapy can accelerate the evolution process of HS through accelerating apoptosis and inhibition of cell proliferation, thereby scar proliferation is inhibited.</p>

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.

Expression and secretion of TGF-beta2 in human retinal pigment epithelium cell line D407 regulated by atropine / 中南大学学报(医学版)

OBJECTIVE@#To investigate the regulation of atropine to the expression and secretion of TGF-beta2 in retinal pigment epithelium (RPE) cells by observing the changes of those under different treatments of atropine and carbachol.@*METHODS@#D407 cells were cultured conventionally and divided into 4 groups as follows: (1) An experimental group (Group A), cells were pretreated with 10(-4)-10(-8) mol/L atropine for 30 min, and then treated with 10(-5) mol/L carbachol; (2) a negative control group (Group B), cells were treated with 10(-4)-10(-8) mol/L atropine; (3) a positive control group (Group C), cells were treated with 10(-5) mol/L carbachol; (4) a blank control group (Group D). The concentration of TGF-beta2 in the supernate, and the level of TGF-beta2 mRNA and protein were measured by ELISA, RT-PCR, and Western blot after the 24-hour treatment. The data were analyzed by analysis of variance.@*RESULTS@#The levels of TGF-beta2 mRNA and protein in the cytoplasm and the concentration of TGF-beta2 in the supernate in the experimental groups were lower than those of the positive control group. Atropine at 10-4 mol/L could completely inhibit the effect of carbachol at 10-5 mol/L. The effect of atropine was concentration-dependent (F=1,056.897,1,320.170, and 475.657; P0.05).@*CONCLUSION@#Carbachol can promote the expression and secretion of TGF-beta2 in human RPE cells and atropine could reverse it effectively, suggesting that M receptor may be involved.