Current research progress of diagnosis of iliac vein stenosis based on multi-modal imaging / 国际外科学杂志

Iliac vein stenosis (IVS), known as iliac vein compression syndrome, refers to a series of diseases caused by iliac vein compression or intraluminal adhesions leading to lower extremity vein or pelvic vein drainage disturbance and other clinical manifestations which is quite common in vascular surgery. The vast majority of patients with symptoms of chronic venous insufficiency (CVI) have IVS. In clinical work, IVS does not typically appear as a single symptom, while often combining with other lesions, such as varicose veins of the lower extremities, skin pigmentation, ulcer formation. Studies on its aetiology and epidemiology have found a mean age of onset of 40 years, the age of onset in females is lower than that in males, and the average of stress in females is significantly higher than that in males. Typical IVS occurs mainly in the left lower extremity in young women of reproductive age, but exceptions remain. In summary, the importance of the diagnosis of IVS in clinical practical work can be seen. CVI is a general term for all diseases that affect the morphology and function of the venous system. Compared with chronic venous disease (CVD), CVI include venous system abnormalities without symptoms or signs. Thus, it more accurately describes the diagnosis and treatment of IVS that requires clinical guidance, so its concept is quoted. With the development and advancement of medical imaging, more and more techniques provide help in the diagnosis and treatment of IVS. Therefore, professionals in various specialties have made relevant studies about the benefits and drawbacks of imaging techniques for diagnosis, treatment modalities, and prognostic management of this disease, in order to improve the diagnostic efficacy. Consequently, this review is focused on the current situation of the diagnosis and treatment of IVS under multi-modal imaging, hoping to provide choices of medical imaging technologies for the different states, and to find a better and personalized plan for patients.

Study on corneal biomechanical properties in eyes with diabetic retinopathy / 中华眼底病杂志

Objective:To observe the changes in the biomechanical properties of the cornea of diabetic retinopathy (DR), and analyze its relationship with the degree of DR.Methods:A retrospective study. From September 2020 to February 2021, 83 patients with type 2 diabetes (T2DM) combined with DR treated in the Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, 83 eyes (DR group), 30 patients with T2DM without DR recruited from the outpatient clinic 30 eyes (NDR group) and 30 eyes of non-diabetes patients (NDM group) were included in the study. All left eyes were chose as the study eye. Among the 83 eyes in the DR group, 39 eyes were non-proliferative DR (NPDR) and 44 eyes were proliferative DR (PDR). Based on this, they were divided into NPDR group and PDR group. There was no statistically significant difference in age ( t=1.10) and sex ratio ( χ2=0.46) among patients in the DR group, NDR group, and NDM group ( P>0.05); body mass index ( t=3.74), glycosylated hemoglobin ( t=35.02) and the length of the eye axis ( t=5.51), the difference was statistically significant ( P<0.05). The eye response analyzer (ORA) was used to measure the corneal hysteresis (CH), corneal resistance factor (CRF), Goldman related intraocular pressure (IOPg), and corneal compensatory intraocular pressure (IOPcc). The corneal topography was used to measure the central corneal thickness (CCT) of the examined eye. The differences of CCT, IOPcc, IOPg, CH, CRF among multiple groups were compared by one-way analysis of variance. Multiple linear regression was used to analyze the relationship between CH, CRF and related influencing factors in DR patients. Results:There were statistically significant differences in CCT, IOPcc, IOPg, CH, and CRF among the eyes of the DR group, NDR group, and NDM group ( F=3.71, 5.60, 9.72, 9.02, 21.97; P<0.05). Pairwise comparisons were between groups, CH, CRF: the difference between the DR group and the NDM group and the NDR group was statistically significant ( P<0.05); CCT: the difference between the DR group and the NDM group was statistically significant ( P<0.05), and The difference in the NDR group was not statistically significant ( P>0.05). CCT, CH, CRF: the difference between the NDR group and the NDM group was not statistically significant ( P>0.05). The results of multiple linear regression analysis showed that CCT and IOPcc in DR patients were independent influencing factors of CH [CCT: β=0.01, 95% confidence interval ( CI) 0.01-0.03, P=0.013; IOPcc: β=-0.15, 95% CI -0.25--0.05, P=0.005]; Age, CCT, IOPcc were independent influencing factors of CRF [Age: β=-0.06, 95% CI -0.09--0.03, P<0.001; CCT: β=0.01, 95% CI 0.00-0.02, P=0.049; IOPcc: β=0.16, 95% CI 0.07-0.25, P=0.001]. The comparison of CCT, CH, CRF, adjusted CH, and adjusted CRF of the eyes in the NDR group, NPDR group, and PDR group were statistically significant ( F=3.76, 5.36, 12.61, 6.59, 10.41; P<0.05). Pairwise comparison between groups, CH, CRF, adjusted CH, adjusted CRF: the difference between the NPDR group, the PDR group and the NDR group was statistically significant ( P<0.05), and the difference between the PDR group and the NPDR group was not statistically significant ( P>0.05); CCT: The difference between NPDR group and NDR group, PDR group and NPDR group was not statistically significant ( P>0.05), and the difference between PDR group and NDR group was statistically significant ( P<0.05). Conclusion:The CH and CRF of eyes with T2DM and DR are elevated; CCT and IOPcc are independent influencing factors of CH, and age, CCT and IOPcc are independent influencing factors of CRF.

The clinical effect of amniotic membrane patching in the treatment of recurrent macular hole associated with retinal detachment of high myopia / 中华眼底病杂志

Objective:To evaluate the safety and efficacy of amniotic membrane patching in the treatment of recurrent macular hole associated with retinal detachment of high myopia (MHRD).Methods:A prospective study. From March 2018 to January 2020, 11 patients (11 eyes) of recurrent macular hole associated with MHRD at the First Affiliated Hospital of Zhengzhou University were enrolled. Among them, there were 3 males (3 eyes), and 8 females (8 eyes). The average age was 63.64±5.82. The axis length (AL) was 29.10± 0.59 mm, and the logarithm of the minimum angle of resolution best corrected visual acuity (logMAR BCVA) was 2.23±0.57. Patients previously received pars plana vitrectomy (PPV) combined with internal limiting membrane stripping surgery, which was more than 1 time. All eyes underwent standard pars plana three-channel 23G PPV combined with amniotic membrane covering and silicone oil filling. The silicone oil was removed 6 months after surgery. Follow-up time was up to 3 months after silicone oil removal surgery. 1, 3, and 6 months after the operation, the same equipment and methods were used to conduct relevant examinations before the operation to observe the closure of the macular hole, retinal reattachment and changes in logMAR BCVA. The logMAR BCVA before and after surgery was compared by paired t test. Results:At 1, 3, and 6 months after the operation, the retinas of all eyes were anatomically repositioned, the macular holes were well closed, and the amniotic membrane was attached to the retina. At 3 months after the silicone oil removal operation, there was no recurrence of macular hole in all eyes; logMAR BCVA was 1.35±0.32. No serious complications occurred during and after surgery in all eyes.Conclusion:Amniotic membrane patching is a safe and effective method for recurrent macular hole associated with MHRD.

Analysis of influencing parameters of intracavitary laser closure in the treatment of varicose veins of the lower extremities / 国际外科学杂志

Varicose veins of the lower extremities are a common disease in vascular surgery and are the result of multiple factors. The clinical manifestations are mainly thickening, tortuosity and dilation of the superficial veins of the lower extremities, which may be accompanied by discomforts such as lower extremity pain and swelling of the lower legs. In severe cases, skin pigmentation of lower extremities, venous ulcers, etc. The current common treatment options include high saphenous vein ligation and stripping, endogenous laser treatment, radiofrequency ablation and foam sclerotherapy, etc. This article reviews some parameter settings and equipment selection that may affect the therapeutic effect and complications of endogenous laser treatment. Hope to help clinicians better choose the device of intracavity laser closure and find the best possible treatment plan for patients.

Occurrence and related factors analysis of submacular fluid after pars plana vitrectomy for retinal detachment / 中华实验眼科杂志

Objective:To investigate the factors related to the occurrence of submacular fluid (SMF) after pars plana vitrectomy (PPV) in the treatment of rhegmatogenous retinal detachment (RRD).Methods:A retrospective case series observational study was performed.A total of 103 patients (103 eyes) with RRD who underwent 23G vitrectomy combined with silicone oil tamponade in The First Affiliated Hospital of Zhengzhou University from May 2017 to August 2019 were included.There were 55 males and 48 females, aged from 17 to 77, with an average of (48.65±15.80) years.The macular morphology was observed by optical coherence tomography (OCT) before surgery and 1 month and 3 months after surgery.The patients were divided into SMF group and no SMF group according to OCT results at 1 month after surgery.Clinical data were compared and analyzed, including age, gender, duration of symptoms, axial length, the preoperative status of macula (on or off), retinal detachment caused by inferior retinal break or not, the way to drain subretinal fluid intraoperative, best corrected visual acuity (BCVA). FFA was performed in 3 eyes and microperimeter examination in 2 eyes with SMF according to patients' willingness.A multivariate binary Logistic regression was used to analyze the risk factors of SMF after vitrectomy in RRD patients.This study adhered to the Declaration of Helsinki and was approved by the Ethics Committee of The First Affiliated Hospital of Zhengzhou University (No.2020-KY-334). Written informed consent was obtained from each subject prior to surgery.Results:Postoperative optical fundus examination and ocular ultrasound indicated that retinas of all eyes were completely anatomically reattached.There were 10.7% (11/103) of eyes developed SMF.The microperimeter examination results of 2 patients showed that their visual functions were worse at 3 months than those at 1 month after operation.The BCVA of patients with SMF at 1 month and 3 months after operation were worse than those without SMF, and the differences were statistically significant (both at P<0.05). Logistic regression analysis showed that macula-off RD before surgery and RD caused by inferior break of retina were risk factors for the occurrence of SMF (OR=6.401, P=0.041; OR=19.819, P=0.005), while the increasing age and the drainage of subretinal fluid through draining hole were protective factors (OR=0.939, P=0.016; OR=0.123, P=0.040).Conclusions:Macula-off RD before surgery, and RD caused by inferior break of retina may be the risk factors of SMF after PPV combined with silicone oil tamponade for RRD.Nevertheless, the increasing age and the drainage of subretinal fluid through draining hole may decrease the occurrence of SMF.And SMF after PPV may delay visual recovery.

Docetaxel-loaded nanoformulation based on star-shaped M-PLGA for cervical cancer therapy / 国际生物医学工程杂志

Objective Mannitol-poly(D,L-lactide-co-glycolide) (M-PLGA),a star-shaped biodegradable polymer,was synthesized with the intent in this research,to provide novel nanoformulation for cervical cancer chemotherapy.Methods The novel star-shaped copolymer was prepared by ring-opening polymerization,and characterized by NMR.The docetaxel-loaded M-PLGA nanoparticles,prepared by modified nano-precipitation method,were observed to be near-spherical shape with narrow size distribution.Results The CLSM results showed the uptake level of M-PLGA NPs was higher than PLGA NPs in Hela cells.A significantly higher level of cytotoxicity was achieved by docetaxel-loaded M-PLGA NPs than that of commercial Taxotere and docetaxel-loaded PLGA NPs,indicating that the star-shaped biodegradable polymer M-PLGA could be superior to the linear polymer PLGA as a drug carrier.The study on drug loading and encapsulation efficiency also proved that star-shaped M-PLGA could carry higher level of drug than linear polymer,therefore could be more efficient for cancer treatment.Conclusions In conclusion,the star-shaped M-PLGA copolymer may be used as a potential and promising drug-loaded biomaterial applied in developing novel nanoformulations for cervical cancer therapy.