ObjectiveTo evaluate the 3-year efficacy of photodynamic therapy (PDT) in patients with polypoidal choroidal vasculopathy (PCV). MethodsThis is a retrospective, uncontrolled case series study. Thirty-two eyes of 29 patients with PCV were enrolled. All patients were primarily treated with the first conventional PDT. For the eye with active polypoida, residual or exudative lesions in 6 month after PDT, PDT combined with intravitreal anti vascular endothelial growth factor (VEGF)or simple vitreous injection of anti VEGF therapy were used. All the patients were followed up for at least 3 years with the mean follow-up duration of 43.64±10.84 months. The best-corrected visual acuity (BCVA) in 1, 3, 6, 12, 24 and 36 months after the primary PDT, PCV recurrence rates and number of treatments were followed and analyzed. The BCVA was converted into a logarithm of the minimal angle of resolution (logMAR) for statistical analysis. ResultsDuring the 1, 3, 6, 12 months after the primary PDT, the mean BCVA were all improved with statistically significant difference(t=2.27, 4.57, 3.77, 2.37; P<0.05). During the 24 and 36 months after PDT, the mean BCVA was decreased without statistically significant difference(t=-1.29, -0.81; P>0.05). On the final evaluation at 36 months, the mean BCVA was improved in 6 eyes(18.75%), stable in 14 eyes(43.75%), and decreased in 12 eyes(37.50%). During the follow-up time, recurrence of PCV in 24 eyes (75.00%), no recurrence in 8 eyes (25.00%). There was 1 recurrence in 12 eyes (50.00%), 2 recurrences in 9 eyes (37.50%), 3 recurrences in 3 eyes (12.50%). Initial recurrences were noted in 4 eyes (16.67%) within 12 months of baseline PDT treatment; in 11 eyes (45.83%) between 13 and 24 months; in 9 eyes (37.50%) between 25 and 36 months. The mean number of PDT and anti-VEGF was 1.86±1.04 and 4.95±3.92 in all patients, respectively. ConclusionThe 3-year efficacy of PDT in patients with PCV was poor with low improvement of visual acuity and high recurrence rate of PCV.
ObjectiveTo observe the effect of complement receptor 1 (CR1) on barrier of cultured human retinal epithelial cells (hRPE) under complement-activated oxidative stress. MethodsThe third to fifth passage of hRPE cultured on Transwell insert were used to establish a stable hRPE monolayer barrier. The hRPE monolayer barrier was exposed to 500 μmol/L ten-butyl hydroperoxide and 10% normal human serum to establish the hRPE monolayer barrier model of complement-activated oxidative stress in vitro. hRPE monolayer barriers under complement-activated oxidative stress were divided into two groups including model group and CR1 treatment (1 μg/ml) group. Model group and CR1 treatment group were treated with 1 μl phosphate buffer solution (PBS) or CR1 for 4 hours. Normal hRPE monolayer barrier were used as control in transepithelial resistance (TER) measurement experiment. TER was measured to evaluate the barrier function of hRPE. The hRPE-secreted vascular endothelial growth factor (VEGF) and chemokine (C-C Motif) Ligand 2 (CCL2), together with complement bioactive fragments (C3a, C5a) and membrane-attack complex (MAC) in the supernatant were detected by enzyme-linked immune sorbent assay. ResultsStable hRPE monolayer barrier was established 3 weeks after hRPE seeded on Transwell insert. Complement-activated oxidative stress resulted in a sharp decrease of TER to 54.51% compared with normal hRPE barrier. CR1 treatment could significantly improve TER of barrier under complement-activated oxidative stress to 63.48% compared with normal hRPE barrier(t=21.60, P < 0.05). Compared with model group, CR1 treatment could significantly decrease the concentration of VEGF and CCL2 by 11.48% and 23.47% secreted by hRPE under complement-activated oxidative stress (t=3.26, 2.43; P < 0.05). Compared with model group, CR1 treatment could also decreased the concentration of C3a, C5a and MAC by 24.00%, 27.87%, 22.44%.The difference were statistically significant (t=9.86, 2.63, 6.94; P < 0.05). ConclusionsCR1 could protect the barrier function of hRPE cells against complement-activated oxidative stress. The underlying mechanism may involve inhibiting complement activation and down-regulating the expression of VEGF and CCL2.
ObjectiveTo observe the changes of multifocal electroretinogram(mfERG)and central visual field before and after surgery in patients with rhegmatogenous retinal detachment (RRD) involving the macular area. MethodsThis is a retrospective study. Sixteen patients (16 eyes) with RRD involving the macular area (RRD group) and age-matched normal 20 cases (20 eyes, normal control group) were enrolled in the study. All patients in RRD group underwent scleral buckling surgery. Before surgery and 1, 3, 6 months after surgery, RRD eyes and normal eyes were checked by using mfERG and central visual field examination, and macular reaction wave amplitude density, incubation period and 4° visual field mean sensitivity (MS) were observed. The correlation between amplitude density, incubation period and MS in RRD group and the consistency between mfERG and central visual field examination in normal control group and RRD group were analyzed. ResultsCompared with the normal control group, in RRD group before surgery the macular reaction wave N1 and P1 amplitude density reduced, the incubation period prolonged, the differences were statistically significant (P < 0.05). Postoperative 1, 3, 6 months, in RRD group macular reaction wave amplitude density improved, the incubation period reduced than before surgery, the differences were statistically significant (P < 0.05). Postoperative 1, 3, 6 months, in RRD group macular reaction wave amplitude density reduced, the incubation period prolonged compared with the normal control group, the differences were statistically significant (P < 0.05). Compared with the normal control group, 4° visual field MS significantly reduced in RRD group before surgery reduced, the differences were statistically significant (t=49.752, P < 0.05). Postoperative 1, 3, 6 months, 4° visual field MS significantly increased compared with the preoperative value, the differences were statistically significant (t=-9.580, -16.533, -19.580; P < 0.05); but were lower than that of the normal control group, the differences were statistically significant (t=-6.286, -7.493, -6.366; P < 0.05). Postoperative 1, 3, 6 months, macular reaction wave amplitude density and MS in RRD group showed positive correlation (P < 0.05), and there was no correlation between incubation period and MS (P > 0.05). mfERG and vision consistency in normal control group and RRD group showed good agreement(K=0.886, P < 0.05). ConclusionsCompared with normal control eyes, in RRD eyes involving the macula area before and after surgery, macular reaction wave amplitude density reduced, the incubation period prolonged and MS values reduced; compared with the preoperative mfERG and central visual field, macular reaction wave amplitude density improved, the incubation period reduced and MS values increased.
ObjectiveTo compare the advantages and drawbacks of harmonic scalpel (HS) versus conventional electro-scalpel (ES) in the surgery for carcinoma of uterine cervix. MethodsA total of 126 patients with stage Ⅰ uterine cervix carcinoma who underwent surgery between January 2011 and November 2015 were randomly and averagely divided into HS group and ES group with 63 patients in each. The operation time, intra-operative bleeding volume, the number of lymph nodes detected and operation cost were compared between the two groups of patients. ResultsAll the patients underwent surgery successfully. There were significant differences between the HS and ES groups in terms of operation time[(202.06±11.67) minutes vs.(223.48±18.01) minutes, P<0.001], intra-operative bleeding[(373.97±27.95) mL vs.(458.16±33.18) mL, P<0.001], operation cost[(4 171.43±276.46) yuan vs.(3 101.54±258.59) yuan, P<0.001]. There was no significant difference between the two groups in terms of the number of lymph nodes detected (10.38±2.43 vs.9.76±2.61, P=0.172). ConclusionThe use of harmonic scalpel can reduce operation time and intra-operative bleeding volume effectively, but it cannot increase the number of lymph nodes detected. Moreover, it significantly increases the operation cost and economic burden for the patients.
ObjectiveTo investigate the effects of smoking on Th17/Treg T cell subsets and cytokines expression in patients with chronic obstructive pulmonary disease (COPD) in stable stage. MethodsFrom February 2012 to June 2013, sixty outpatients with stable COPD (20 cases of non-smokers, 40 cases of smokers) and 15 normal volunteers were recruited in the study in the Traditional Chinese Medicine Hospital affiliated to Xinjiang Medical University. Th17/Treg level in peripheral blood was detected by flow cytometry method. Cytometric bead array system was used to detect TGF-β, IL-10, IL-17A, IFN-γand other inflammatory factors in serum. ResultsThe patients' age, duration of disease, lung function, disease severity, and other related data were comparable between the smoking COPD group and the non-smoking COPD group (P > 0.05). Th17/Treg level was increased in the smoking COPD group compared with the normal group (P < 0.05), and showed an increasing trend from the normal group to the non-smoking COPD group and the smoking COPD group. The level of IL-2 in the smoking and non-smoking COPD groups was lower than that in the normal group. Compared with the normal group, the level of TNF-αwas significantly decreased in the smoking and non-smoking COPD groups(P < 0.05). ConclusionsSystemic inflammatory response continuously exists in patients with COPD even in the stable phase. Smoking can partly enhance the inflammatory reaction in COPD. The Th17/Treg T cell subsets associated cytokine regulation has gradually tended to a balance in the stable phase, and inflammatory factors related recovery speed is not consistent, suggesting that smoking may play a certain role in the recovery of balance.