[Meta-analysis of fibrin glue for attaching conjunctival autografts in pterygium surgery].

OBJECTIVE: To evaluate the clinical efficacy of FG for attaching conjunctival autografts in pterygium surgery. METHODS: Search was conducted in Pubmed, EMbase, Cochrane Library, CNKI, Wanfang database, CBM and VIP, and hand-search was also performed, the methodological quality were carried out according to evidence-based medicine (EBM). The qualities of the randomized controlled trials (RCT) were evaluated according to the Cochrane Handbook for Systematic Reviews of Interventions Version 5.0. The Cochrane Collaboration's software RevMan 5.0 was used for Meta-analysis. RESULTS: Only 7 trials, involving 366 eyes, were included. Meta-analysis showed that significant differences were found between the FG and suture in recurrence [RR = 0.34, 95%CI (0.15, 0.80), P = 0.01], but there is no difference in reducing the complications [RR = 2.53, 95%CI (0.47, 13.51), P = 0.28]. CONCLUSION: Fibrin glue-assisted conjunctival autograft in pterygium surgery reduces postoperative recurrence.

[Effect of Nogo-66 on retinal microglia in chronic ocular hypertension rats].

OBJECTIVE: To study the effect of protein Nogo-66 on the expression of CD11b and MHC-II in retinal microglia of chronic ocular hypertension SD rats and the effects of protein Nogo-66 on the immunogenicity of injured retinal tissues. METHODS: It was a control experimental study. Chronic ocular hypertension rat model was established by laser photocoagulation on the anterior chamber angle and superficial vein of the sclera. One ml of Nogo-66 (0.01%) in PBS was injected subcutaneously on the day of laser treatment and 0.005% Nogo-66 PBS solution was injected into the vitreous 7 days and 1 month latter. PBS without Nogo-66 was injected in the control group. The expression of cell surface antigen CD11b and MHC-II were detected by immunohistochemistry 1 month and 1 day after the establishment of hypertension model. The difference of average IOP among groups was analyzed by variance analysis. The difference of expression of CD11b and MHC-II between the experimental and control groups was analyzed by t-test. RESULTS: The intraocular pressure (IOP) of experimental groups rised from the seventh day after model-building and the highest IOP was (24.16 ± 2.70) mm Hg (1 mm Hg = 0.133 kPa) 1 month later while that in the control groups was (15.93 ± 3.28) mm Hg. The difference between them was statistically significant (F = 2.10, P < 0.05). Expression of CD11b was (1.78 ± 0.63)% and MHC-II was (3.92 ± 1.03)% in Nogo-66 with hypertension groups, these results was significantly lower than those in Nogo-66 with normal intraocular pressure groups in which the expression of CD11b was (8.15 ± 1.97)% (t = 2.35, P < 0.05) and MHC-II was (11.45 ± 1.97)% (t = 2.14, P < 0.05). CONCLUSIONS: Protein Nogo-66 activated the cell surface antigen CD11b in nerve fiber layer of retina and induced antigen presenting molecules (MHC-II). This indicates that Nogo has the center immunogenicity and this protein could activate antigen-presenting cells to present injury antigen.

A new staging system is more discriminant than conventional staging systems for unresectable hepatocellular carcinoma.

BACKGROUND: Prediction of the life expectancy of a patient with unresectable hepatocellular carcinoma (HCC) remains difficult. The aims of the study were to construct a new staging scheme for patients with unresectable HCC and to compare the discriminatory ability of the staging scheme with the Okuda and CLIP score and TNM staging system in a cohort of patients with unresectable HCC. METHODS: A retrospective analysis of unresectable HCC cases from 1999 to 2003 was performed. The Cox model was used for multivariate analyses. The final model was derived from 10 randomly chosen training samples and the prognostic validity of the new staging scheme was assessed on the corresponding testing samples. Moreover, 54 cases with unresectable HCC were enrolled and prospectively followed up. The new staging, named the China integrated score (CIS), Okuda, TNM and CLIP systems were determined for each case. Comparisons of the survival rate between each stage were performed to evaluate their discriminatory ability. RESULTS: A simple scoring system was constructed, assigning linear scores (0/1/2) to the three covariates (TNM, alpha-fetoprotein and Child-Pugh) of the final model. The CIS system was more discriminant than the Okuda or TNM staging system, as confirmed by the Kaplan-Meier comparison of survival curves and by the Cox's regression analysis, with a median survival rate of 9.0, 2.3, 2.1 and 0.6 months in patients with CIS 2, 3, 4 and 5, respectively. The CIS system was performed as well as the CLIP score. CONCLUSION: The new staging system, accounting for both liver function and tumor characteristics, can accurately identify patients with different prognoses, particularly in the advanced phases of HCC. It should be useful as the only tool that can be applied for patients with unresectable HCC.

[Expression of CD11b in the retinal microglia in chronic hypertension rat].

OBJECTIVE: To study the expression of CD11b in the retinal microglia in laser induced ocular hypertension (OHT) SD rat. METHODS: It was an experimental study. OHT was induced by the coagulation of trabecular meshwork using 532-laser in sixty SD rats. Intraocular pressure (IOP) was measured by Tonopen-XL, the expression of CD11b in retinal microglia detected by immunohistochemistry, and retinal ganglion cells (RGCs) were labeled with Dextran Tetramethyl Rhodamine (DTR) and counted by Image-Pro Plus Version 6.0 image analysis software at 2 weeks, 1, 2, 3, 4, 5, and 6 months, respectively. All the numerical data were statistically analyzed by SPSS 13.0 software. RESULTS: Although the IOP of experimental groups are still the similar level at 2w after coagulation (t = 1.124, P = 0.287), Compared to control eyes, IOP in lasered eyes was significantly (t = 2.487, P = 0.036) increased at 1 month, lasting for 3 months and returned to normal from 5 to 6 months (t = 1.103, P = 0.290). The expression of CD11b in the retinal microglia in the lasered eyes was significantly more intensive than that in control eyes at 1 month (t = 3.333, P = 0.008) and faded after 5 months, a similar pattern to IOP response, that two group data shows significant dependability (r = 0.891, P = 0.014). The number of RGC was significantly reduced from 1 month to 6 months (t = 3.316, P = 0.009), the velocity of reducing seems dependability to the advancing of IOP (r = 0.757, P = 0.021). CONCLUSIONS: The expression of CD11b in retinal microglia is fluctuated with chronic OHT pattern and RGCs injury level indicating that the injury antigens by microglia are presented in the retina with the increase of IOP and activate the immunologic process leading to glaucomatous RGCs damage. It suggests that it is important to effectively control the IOP in order to reduce the risk of immune induced retinal damage by microglia.