Objective To observe the histopathological changes of tumor tissue after intraoperative regional chemotherapy of rectal cancer. Methods After the treatment of intraoperative regional chemotherapy with 5-FU (15 mg/kg)， the histopathological changes of tumor tissue were detected. Results Slight changes with cancer cells in all the cases accepted intraoperative regional chemotherapy were found under light microscope such as karyopyknosis, nuclear swelling, coagulation and necrosis of cytoplasm, hydropsia of intercellular substance, invasion of inflammatory cells, and 9/15 cases with slight inflammation of vessels were observed; While those changes were found in individual cells of the cases without regional chemotherapy. The more enlarged intercellular space of cancer cell was observed under electron microscope in the case with regional chemotherapy. Conclusion The intraoperative regional chemotherapy of rectal tumor can change the histopathological appearance of tumor tissue, that is significant in preventing cancer cells diffusing during operation and relapsing after operation.
Diabetic macular edema (DME) is a common ocular complication of diabetes patients. It mainly involve macular which is closely related with visual function, thus DME is one of the major reasons causing visual impairment or blindness for diabetes patients. How to reduce the visual damage of DME is always a big challenge in the ophthalmic practice. In the past three decades, there are tremendous developments in DME treatments, from laser photocoagulation, antiinflammation drugs to antivascular endothelial growth factor therapy. However, the mechanism of DME development is not yet completely clear; every existing treatment has its own advantages and weaknesses. Therefore DME treatment still challenges us to explore further to reduce the DME damages.
Objective To observe the effect of resveratrol on retinal vasculopathy in diabetic rats. Methods Forty-five Sprague-Dawley male rats were randomly divided into the resveratrol group, treatment control group and the normal control group, 15 rats in each group. Diabetic rat models were induced with streptozotocin injection in resveratrol group and treatment control group. The same volume of sterile saline solution was injected into the rats of the normal control group. The rats of resveratrol group and treatment control group were feed with highfat diet. The rats of resveratrol group received oral gavage of resveratrol (75 mg/kg) twice a day for four months. The same volume of sterile saline solution was given by gavage in rats of treatment control group twice a day for four months. 2 ml femoral vein blood and 50 mu;l aqueous fluid of anterior chamber of the eye from rats of three groups were collected to detect fasting blood glucose, aqueous fluid glucose, cholesterol and triglyceride. The retinal vascular permeability was test by labeling with evans blue. Whole retina was isolated to detect the pericyte number. Total protein was extracted from retina to test the level of vascular endothelial growth factor (VEGF). Results The fasting blood glucose, aqueous fluid glucose, cholesterol and triglyceride in treatment control group were higher than those in normal control group, also higher than those in resveratrol group except cholesterol. The differences among the three groups were statistically significant (F=152.809, 65.230, 3.861, 15.059; P＜0.05). The retinal vascular permeability in treatment control group was higher than that in normal control group, while it in resveratrol group was lower than that in treatment control group. The differences among the three groups was statistically significant (F=11.626,P＜0.05). The pericyte number in treatment control group decreased as compared to normal control group, while it in resveratrol group increased as compared to treatment control group. The differences among the three groups was statistically significant (F=43.284, P＜0.05). The VEGF expression in treatment control group increased as compared to normal control group, while it in resveratrol group decreased as compared to treatment control group. The differences among the three groups was statistically significant (F=14.017, P＜0.05). Conclusion Resveratrol can improve abnormal retinal vasculopathy structure and function, down-regulated level of fasting blood glucose, aqueous fluid glucose, triglyceride and VEGF may be the mechanism.
Objective To observe the efficiency and security of enhanced external counter pulsation (EECP) as an adjunctive therapy for nonarteritic anterior ischemic optic neuropathy (NAION). Methods This was a retrospective casecontrol study. Forty-eight patients (48 eyes) with NAION were enrolled in this study. Thirty-two patients (32 eyes) who had been treated with blood vessel dilation and nerve nutrition drugs comprised the medicated group. Sixteen of the patients (16 eyes) in the medicated group were treated with EECP combined with blood vessel dilating and nerve nutrition drugs as EECP group. The differences were not statistically significant between groups in gender(chi;2=0.000), age (t=1.096), course (t=1.613) and visual acuity (chi;2=0.000,P＞0.05). EECP was done once a day, one hour per time, five times a week. Fourteen eyes were treated 12 times EECP and two eyes were treated 36 times EECP within the EECP group. Systemic and ocular side effects were observed during EECP treatment. Corrected visual acuity was examined after treatment and the differences of visual acuity between medicated group and EECP group treated six times and or 12 times with EECP treatment were analyzed. The correlation of visual acuity level, and course, and acuity before treatment were analyzed. A significant improvement in visual acuity was defined as a sustained improvement of three or more visual acuity gradations. An effective of treatment was defined as a sustained improvement of two or less visual acuity gradations. No effective of treatment was defined as visual acuity dropped or showed no progress. Results After six treatments of EECP, within the 16 eyes of EECP group, two eyes achieved significant improvement, five eyes had effective improvement, and nine eyes did not show any improvement. Within the 32 eyes of medicated group, three eyes achieved significant improvement, eight eyes had effective improvement, and 21 eyes did not show any improvement. There was no statistically significant difference in vision between the two groups (chi;2=0.404,P＞0.05). After 12 treatments of EECP, within the 16 eyes of EECP group, six eyes achieved significant improvement, nine eyes had effective improvement, and one eye did not show any improvement. Within the 32 eyes of medicated group, four eyes achieved significant improvement, 10 eyes had effective improvement, and 28 eyes did not show any improvement. The difference was statistically significant comparing the vision level between the two groups (chi;2=11.621,P＜0.05）. The curative effect of patients negatively correlated with course of the disease (r=-0.860，P＜0.05), but positively correlated with visual acuity before treatment (r=1.380,P＜0.05). Skin bruises, hematoma, new retinal bleeding and other side effects did not occur in patients during EECP treatment. Conclusions Many time therapy of EECP can improve vision of NAION patients. There is no local and general complications after a certain number of therapy.
Objective To observe the effect of lowering intraocular pressure(IOP) treatment on ocular hemodynamics in patients with nonarteritic anterior ischemic optic neuropathy (NAION). Methods A total of 68 patients with NAION (68 eyes) were enrolled in this study. The patients were randomly divided into treatment group (38 eyes of 38 patients) and control group (30 eyes of 30 patients). All the patients were received methylprednisolone pulse therapy (200 mg, three days), vasodilator therapy with intravenous infusion of Xueshuantong solution (300 mg), optic nerve nutritional therapy with mouse nerve growth factor (30 mu;g) and acupoint injection in temporal with compound anisodine (2 ml). The total course was 10 days. The patients of treatment group received IOP lowering treatment to reduce the IOP to ge;8 mm Hg (1 mm Hg=0.133 kPa) or in a 30% reduction. The patients of control group received no IOP lowering treatment. The peak systolic velocity (PSV), pulsatility index (PI) and resistance index (RI) of ophthalmic artery (OA), central retinal artery (CRA) and short posterior ciliary arteries (PCA) before and after treatment were comparatively analyzed by color doppler flow imaging. Results The differences of PSV (t=1.023, 1.145, 0.569), PI (t=0.679, 0.956, 1.634) and RI (t=0.816, 1.657, 0.998) of OA, CRA and PCA before treatment in treatment group and control group were not statistically significant (P＞0.05). Compared with before treatment, PSV (t=3.150, 7.650, 3.520) and PI (t=2.420, 5.430, 7.650) of OA, CRA and PCA increased obviously (P＜0.05), RI of OA, CRA and PCA decreased obviously (t=5.320, 9.640, 18.360;P＜0.05) after treatment in treatment group. In control group, the differences of PSV (t=2.090, -2.550, -2.100) and PI (t=-2.310, -2.230, -4.490) of OA, CRA and PCA between before and after treatment were not statistically significant (P＞0.05); but the differences of RI of OA, CRA and PCA between before and after treatment was statistically significant (t=2.970, 2.160, 2.690;P＜0.05). Compared with control group, PSV (t=2.632, 2.135, 5.364) and PI (t=3.251, 2.432, 4.243) of OA, CRA and PCA increased obviously (P＜0.05), RI of OA, CRA and PCA decreased obviously (t=3.664, 2.938, 4.324;P＜0.05) after treatment in treatment group. Conclusion Lowering intraocular pressure treatment can improve the ocular hemodynamics in NAION patients.
ObjectiveTo observe the effect of Crocin on structure and the expression of tumor necrosis factor-alpha; (TNF-alpha;) and interleukin-1beta; (IL-1beta;) in rat retina after injury by ischemia-reperfusion. Methods A total of 80 Sprague-Dawley male rats at the age of 8 -10 weeks were divided into control group, model group, low-dose Crocin group and high-dose Crocin group, with 20 rats in each group. The rats of control group were not treated. The rats in model, low-dose Crocin and high-dose Crocin group were induced with normal saline by anterior chamber perfusion creating a retinal ischemia-reperfusion (RIR) model. The rats of the low-dose Crocin and highdose Crocin group received intraperitoneal injection with different doses of Crocin solution (5 mg/kg, or 50 mg/kg) 30 minutes prior to ischemic injury and one time per day after successful RIR. Optical microscopy was used to observe the retinal structure. Enzymelinked immunosorbent assay (ELISA) was used to measure the expression of TNF-alpha; and IL-1beta; 6, 12, 24 and 48 hours after RIR. ResultsThe retinal structure of control group was normal. Pathological changes were found in the RIR model and low-dose Crocin group, such as retinal edema, disorganized structure and loosely packed cells. The degree of pathological changes in lowdose Crocin group was less than the RIR model group. The retinal structure of high-dose Crocin group was similar to the control group. The expression of TNF-alpha; was the highest at 24 hours after modeling, while the expression of IL-1beta; was the highest at 12 and 48 hours after RIR modeling. Six, 12, 24 and 48 hours after RIR modeling, compared with the control group, the TNF-alpha; expression of model (t=5.42, 7.94, 9.32, 9.18;P＜0.05 ), low-dose Crocin (t=3.94, 4.12, 4.98, 3.84;P＜0.05) and high-dose Crocin group (t=2.13, 2.34, 2.96, 2.78;P＞0.05) were increased. Compared with the RIR model group, the TNF-alpha; expression of low-dose Crocin (t=3.95, 4.56, 4.01, 5.12) and high-dose Crocin group (t=5.23, 7.65, 7.74, 7.63) was decreased. Compared with the control group, the IL-1beta; expression of model (t=7.23, 7.87, 7.15, 15.60), low-dose Crocin (t=5.65, 5.10, 5.54, 6.87;P＜0.05) and high-dose Crocin group (t=4.38, 5.21, 4.56, 4.75) was increased (P＜0.05). Compared with the model group, the IL-1beta; expression of low.dose Crocin group was decreased significantly 48 hours after RIR modeling (t=7.56,P＜0.05); but it decreased significantly at each time point in high-dose Crocin group (t=6.94, 5.36, 6.05, 10.50;P＜0.05). Conclusion Crocin can improve the retinal pathologic changes, while down-regulating TNF-alpha; and IL-1beta; expression in RIR rats.
Objective To observe the inhibition of LipofectamineTM2000 (LF2000)mediated pSUPER recombinant plasmid expressing small interference RNA targeting hypoxia-induced factor (HIF)-1alpha;(pSUPERsiHIF-1alpha;) on retinal neovascularization in mice. Methods pSUPERsiHIF-1alpha; recombinant plasmid was created. Forty-eight (seven-day-old) C57BL/6J mice were randomly divided into a normal group, the control group, empty vector group and gene therapy group with 12 mice in each group. Mice in the normal group were kept in normal room air, while the other three groups retinal neovascularization was induced by hypoxia. The mice in control group were not treated. The mice in the vector group received intravitreous injection of pSUPER and LF2000 (1 mu;l), and the gene therapy group received pSUPERsiHIF-1alpha; and LF2000 (1 mu;l)one day before being returned to normal room air．Fluorescent angiography was used to assess the vascular pattern. The proliferative neovascular response was quantified by counting the nuclei of new vessels extending from the retina into the vitreous in cross-sections．HIF-lalpha;and vascular endothelial growth factor (VEGF) levels in retinas were measured by immune histochemical staining method and reverse transeriptase-polymerase chain reaction (RT-PCR). Results Fluorescent angiography showed radial branching pattern vessels in the normal group and distorted large vessels, obstructed capillaries, many neovascular tuffs, fluorescence leakage in the peripheral retina in the control group and vector group. The gene therapy group demonstrated a significant reduction in neovascular tufts and fluorescence leakage compared with the control group and the vector group. The number of vascular cell nuclei extending breaking through the internal limiting membrane(ILM) of control group and vector group increased significantly compared with normal group (F=5850.016,P＜0.05), while obviously decreasing in the gene therapy group compared with control group (F=3012.469,P＜0.05). Immunohistochemical staining showed the expression of HIF-1alpha; protein in nucleus and VEGF protein in cytoplasm. The expression of HIF-1alpha; protein in retina was negative, while VEGF protein was weakly positive in normal group. The expression of HIF-1alpha; and VEGF protein were both positive in control group and vector group, while weakly positive in gene therapy group. The Results of RT-PCR showed that the expression of HIF-1alpha; mRNA in retina was increased significantly in control group and vector group as compared with normal group (F=3102.326,P＜0.05), while decreasing significantly in gene therapy group as compared with control group (F=3336.425,P＜0.05). Conclusion Retinal neovascularization in the mice is significantly inhibited by intravitreal injection of LF2000-mediated recombinant plasmid pSUPERsiHIF-1alpha;.
Objective To investigate the effect of photodynamic therapy (PDT) combined with intravitreal bevacizumab on wet age-related macular degeneration (AMD). Methods In this retrospective study, 34 eyes (28 cases) diagnosed with wet AMD received PDT combined intravitreal injection of bevacizumab, including 25 eyes with classic CNV and 9 eyes with minimally classic CNV by fluorescein angiography; On optical coherence tomography (OCT), 23 eyes showed intraretinal fluid (IRF) and 11 eyes presented subretinal fluid (SRF). After signing informed consent, all patients underwent initial standard PDT followed by intravitreal bevacizumab (1.25 mg) within succeeding 3 to 7 days. Best corrected visual acuity (BCVA) and OCT with routine eye examinations were evaluated monthly. Additional bevacizumab (1.25 mg) was injected intravitreally if new or increasing fluid appreciated on OCT, or BCVA lowered more than 5 letters even with stabilized fluid. Injection was discontinued if no fluid was showed on OCT (quot;dry macularquot;), or BCVA was stabilized even with fluid after two consecutive injections. BCVA and central retinal thickness (CRT) were analyzed and compared between baseline and 6 month follow-up. The correlation between parameters such as baseline BCVA, greatest linear dimension (GLD), type of CNV, SRF or IRF and posttreatment BCVA will be analyzed. The injection number of bevacizumab and complications were recorded. Results Compared to baseline, BCVA improved (9.4plusmn;10.2) letters and reach 44.9plusmn;21.3 letters (t=5.438，P＜0.01) and CRT decreased (184.6plusmn;214.6) mu;m (t=4.810，P＜0.01) at 6 month visit. The average of injection number was 1.9plusmn;0.9 (including initial injection of combination therapy). With multiple lineal regression analysis, only baseline BCVA correlated to posttreatment BCVA at 6 month visit (r=0.802.P＜0.01). The type of CNV, GLD, SRF or IRF on OCT and CRT at baseline were not associated to post-treatment BCVA (r=0.053, -0.183, 0.139 and 0.053, respectively.P＞0.05). BCVA of eyes with SRF (14.7 letters) increased more than eyes with IRF (6.9 letters) on OCT (t=-2.207，P=0.035). The change of BCVA after treatment (t=-0.076), change of CRT (t=-1.028) and number of injections (Z=-1.505) were not different between classic CNV and minimally classic CNV (P＞0.05). The change of CRT (t=-0.020) and number of injections (Z=-0.237) did not present difference between SRF and IRF (P＞0.05). The change of BCVA (t=1.159) and number of injections (Z=-1.194) were not correlated to whether residual fluid or not at 6 month visit (P＞0.05). No severe complications were noticed during follow-up.Conclusion For wet AMD patients, PDT combined intravitreal bevacizumab could improve visual acuity, reduce retinal thickness and control CNV progress in a short-term.