Objective To observe the clinical effects of surgical treatment of retinal detachment(RD) caused by macular hole(MH) in high myopia. Methods The clinical materials of 149 eyes of 149 high myopia patients with RD caused by MH were reviewed. The cases were divided into complete posterior vitreous detachment (PVD) group and incomplete PVD group. The anatomic successful rate of operative treatment was evaluated according to the applications of vitrectomy surgery and non-vitrectomy surgery respectively in each group. The visual acuity changes after the operations were also observed.Results The anatomic successful rates were as follow: 77.9% in total cases with vitrectomy surgery and 25.9% with non-vitrectomy surgery (P＜0.001); 75.5% in cases of incomplete PVD with vitrectomy surgery,and 15.0% with non-vitrectomy surgery (P＜0.001); and in non-vitrectomy cases, 57.1 % in complete PVD group and 15.0% in incomplete PVD group (P=0.05). The rates of visual improvement were 68.6% in complete PVD group and 57.0% in incomplete group (P＞0.05). Conclusions The scleral buckling combined with vitrectomy, gas intraocular tamponade and postoperative photocoagulation is an effective and optimal procedure for RD caused by MH in high myopia. (Chin J Ocul Fundus Dis，2003，19：8-10)
Objective To study the ultrastructure of macular puck er (MP) from the patients with rhegmatogenous retinal detachment (RRD) and the mechanism associated with its development． Methods Twenty specimens of MP surgically removed by vitrectomy from 13 patients were dissected into two layers in each of them．The ultrastructure of two layers,i,e,near the vitreous and near the retina,was studied with electron microscopy． Results Seven sections of the near vitreous ones appeared prodominant collagen deposits and a few of epithelial like cells,and pigment particles might be present in the cytoplasm．While cells with foot processes were found in 13 membrane sections near the retina and increasing number of various types of cells rich in collagen around were observed including fibroblast like cells and glial cells． Conclusion The findings suggest that the MP after surgery of retinal detachment may possess a characteristic lamination,and posterior hyaloid cortex was involved in the developmetn of MP． The adhesion between posterior hyaloid cortex and macular area might be a key factor for forming MP． (Chin J Ocul Fundus Dis, 2001,17:52-54)
目的 比较草酸铂联合氟尿嘧啶/亚叶酸钙 （FOLFOX4）与草酸铂联合卡培他滨（XELOX）治疗晚期结直肠癌的临床疗效。 方法 将2007年1月－2011年12月收治的58例转移或复发晚期结直肠癌患者按照化学疗法（化疗）方案的不同分为两组，其中FOLFOX4组28例（男性患者占57.1%，平均年龄56.3岁），XELOX组30例（男性患者占63.3%，平均年龄57.8岁）。所有患者疗程不少于2个化疗周期，评价指标为病情缓解率和化疗药物的毒副作用。 结果 FOLFOX4组完全缓解率（CR）和部分缓解率（PR）分别为10.7%（3/28）和32.1%（9/28），总有效率为42.8%（12/28）；XELOX组CR和PR率分别为13.3%（4/30）和30.0%（9/30），总有效率为43.3%（13/30），两组总有效率差异无统计学意义（P=0.971）。XELOX组有10.0%（3/30）和16.7%（5/30）的患者分别出现中性粒细胞降低和神经毒性，但均显著低于FOLFOX4组[39.3%（11/28）、43.3%（13/30）]（P=0.009，0.014）。XELOX组手足综合症发生率明显高于FOLFOX4组[40.0%（12/30）、14.5（4/28），P=0.029），但程度较轻, 主要为Ⅰ～Ⅱ度。 结论 XELOX与FOLFOX4化疗方案治疗晚期结直肠癌患者的疗效相似，但XELOX化疗方案毒副反应相对较小。
Abstract： Objective To summarize the clinical outcomes of maze procedure using bipolar radiofrequency ablation accompanied with valve replacement for the surgical treatment of permanent atrial fibrillation（AF） and rheumatic valve diseases. Methods A total of 124 patients with permanent AF and rheumatic valves diseases undergoing surgical treatment from March 2006 to October 2010 in the First Affiliated Hospital of Sun Yat-sen University were randomly divided into ablation group and control group using coin method with 62 patients in each group. The mean atrial fibrillation duration was（56.1±47.1） months in ablation group, and patients in this group underwent maze procedure using bipolar radiofrequency ablation and valve replacement. The mean atrial fibrillation duration was（43.8±25.6） months in control group, and patients in this group underwent only valve replacement. Demographic characteristics, cardiopulmonary bypass（CPB）time, aortic cross-clamping（ACC）time, mechanical ventilation time, intensive care unit（ICU） length of stay, postoperative complications and follow-up outcomes were compared between the two groups. Results The demographic characteristics of the two groups were not statistically different （P＞0.05）. The CPB time and ACC time between the two groups were not statistically different （P＞ 0.05）. The postoperative hospital stay of ablation group was significantly longer than that of control group （15.8±6.1 d vs. 12.9±3.1d，P=0.001）. No patient needed permanent pacemaker implantation in either group. Postoperative ejection fraction of ablation group was significantly higher than that of control group（59.6%±9.2% vs. 55.5%±5.4%，P＜ 0.01）. The rate of sinus rhythm maintenance at 6 months, 12 months, 18 months, 24 months during follow-up in ablation group were 88.5%, 87.5%, 87.1% and 82.4% respectively, 3.3%, 2.2%, 0.0%, and 0.0% in control group respectively, which was statistically different between the two groups（P＜ 0.05）. Conclusion Maze procedure using bipolar radiofrequency ablation is an effective surgical procedure for the treatment of permanent atrial fibrillation.
Objective To investigate whether single cycle ischemic preconditioning （IP） improves the myocardial preservation in patients undergoing cardiac valve replacement. Methods From August 2002 to April 2006, 85 patients who had chronic heart valve disease and required cardiac valve replacement were randomly divided into two groups. IP group, 47 allocated to receive IP and arrested with 4 C St. Thomas＇ Hospital cardioplegic solution during cardiopulmonary bypass（CPB）, preconditioning was accomplished by using single cycle of 2 minutes occlusion of aorta followed by 3 minutes of reperfusion before cross-clamping. Control group, 38 allocated to receive 4 C St. Thomas＇ Hospital cardioplegic solution alone. Myocardial protective effects were assessed by determinations of creatinine kinase-MB isoenzyme （CK-MB） and cardiac troponin I（cTnI）, ST-T changes, ventricular arrhythmias and other clinical data in ICU. Results Serum CK-MB and cTnI concentrations were increased postoperatively in two groups. At 24, 48 and 72h after operation, values of CK-MB in IP group was significantly lower than that in control group （P〈0.05）, cTnI at 24 and 48h after operation also less in IP group （P〈0.05）. The duration for patients needed for antiarrhythmic drugs in IP group was lower than that in control group （P〈0.05）. Compared with control group, fewer inotropic drugs were used in IP group. As a result, ICU stay time in IP group was shorter than that in control group （P〈0.05）. Conclusion IP enhances the myocardial protective effect when it was used with hypothermic hyper kalemic cardioplegic solution in patients undergoing cardiac valve replacement, IP significantly reduces the postoperative increase of CK-MB, cTnI and plessens the severity of postoperative ventricular arrhythmias.
OBJECTIVE: To explore the possibility of improving the performance of tissue engineering valve by means of preendothelialization with cultured human umbilical vein endothelial cell(hUVEC) and to develop a new xenogenic bioprosthesis valve material. METHODS: The porcine aortic valves treated by use of glutaraldehyde(GA), epoxychloropropane(EC), L-glutamic acid(L-GA) and cellular extraction(CE) respectively were divided into four groups; group 1(GA), group 2(EC), group 3(EC + L-GA), and group 4(EC + L-GA + CE). The cultured hUVECs were seeded onto the treated porcine aortic valve, then that stuff were examined by means of EC VIII factor staining, living cells counting and microscopy. RESULTS: The cultured hUVEC could adhere to culturing bottle wall an hour later, and propagated to two passages after seven days. The cells increased with serial passage at a 7-day interval. But the hUVEC grew slowly when seeded onto the treated valve material except group 4. The cells in group 4 covered the surface of valve completely seven days later, which could also be seen in group 3 but not completely. There was no cell growing in group 1, and only fewer in group 2. The living cell in groups 3 and 4 were significantly more than in groups 1 and 2 on the 3rd, 7th and 14th days (P lt; 0.01), meanwhile, the number of cells in group 4 were also significantly more than that in group 3 (P lt; 0.05). The covering area of cultured cell on the valve material in groups 3 and 4 was significantly larger than that in groups 1 and 2. The covering area of cell in group 4 was over 95%, and higher than that in group 3(60%-70%). The hUVEC of group 4 arranged in pattern of three dimension. So it could resist rising of foreign power from the cardiac cavity of high pressure and flowing volume. There was no cell on the leaflet surface in group 1, and only a few pinch of cells could be seen in group 2. CONCLUSION: The porcine aortic valve can be used to be an ideal xenogeneic valve scaffold; the scaffold of porcine aortic valve should be treated by use of epoxy-chloropropane, L-glutamic acid and cellular extraction, so that a best growing environment to the hUVEC would be given; the cultured hUVECs used to be source of seed living cell had a boundless prospects; the growing velocity of cultured hUVEC was controllable, which facilitated clinical application; and the endothelial cells of xenogeneic valve material which grew compactly onto the scaffold can resist rising of foreign power from the cardiac cavity itself.
Objective To investigate the visionrelated quality of life (VRQoL) of patients with monocular rhegmatogenous retinal detachment (RRD) before and after relative surgery, and analyze its influencing factors. Methods A total of 92 patients with monocular RRD were asked to complete the Chinese-version low vision quality of life questionnaire (CLVQOL) preoperatively and at the end of the follow-up time. Results The Cronbach alpha; coefficient of the questionnaire was more than 0.7. The lowest scores were at the item of quot;adjustive abilityquot; before the surgery, and the scores of the questionnaires were significantly higher at the end of the follow-up time. The item whose score changed most caused by the surgery was quot;adjustive abilityquot;. The visual acuity in RRD eyes before the operation and the changes of the visual acuity was the chief independent risk factor of the questionnaire score before surgery and the changes of scores due to surgery, respectively. Conclusions CLVQOL can be used to assess the VRQoL of patients with monocular RRD after surgery. The qualities of life of patients with monocular RRD decrease sharply. VRQoL, especially the adjustive ability, improves obviously after operation, but the patient would be inconvenient for doing some precision work or daily house work. Improving the visual acuity of the RRD eye, giving early surgery and avoiding complications help to improve the VRQoL of the patients with monocular RRD. (Chin J Ocul Fundus Dis, 2006, 22: 106-109)
Caveolin-1 (Cav-1) protein plays a very important role in the central nervous system, and is closely related to Alzheimer’s disease (AD). Through literature review, this article summarizes the present research status of Cav-1 protein in the field of AD from three aspects: the relationship between Cav-1 gene and AD; the relationship of Cav-1 protein with learning and memory; the relationship of Cav-1 protein with amyloid β-protein and Tau protein. And the aim of this paper is to provide a new thought and evidence for exploring the mechanism of AD via Cav-1 protein.
Objective To investigate the molecular signal mechanism of transform growth factor (TGF)-β induced arterial endothelial-mesenchymal transition. Methods Rat arterial endothelial cells were primarily cultured by ex-transplant method. The endothelial cells were incubated by combinant TGF-β (10 ng/mL) for 48 hours and then were detected by immunofluorescence staining and western blotting to observe the cell surface marker expression profile and Akt/mTOR signal activation. On the other hand, the endothelial cells were preincubated by Ly294002 (20 μmol/L) and rapamycin (10 nmol/L) to inhibit the Akt/mTOR signal, and then the cells were further treated with TGF-β (10 ng/mL) for 48 hours to observe the cell surface marker expression profile without Akt/mTOR signal activation. Results Rat artery endothelial cells by TGF-β after incubation, the expressions of smooth muscle cell markers α-smooth muscle actin (α-SMA) and smooth muscle-22α (SM-22α) were up-regulated, and the endothelial cell markers CD31 and vW factor were significantly down-regulated, at the same time, the expressions of phosphorylated Akt and mTOR were also up-regulated. However, after preincubation of Ly294002 (20 μmol/L) and rapamycin (10 nmol/L) to inhibit the phosphorylation of Akt and mTOR signal, above TGF-β-induced expressions of α-SMA and SM-22α in arterial endothelial cells were significantly suppressed and the expressions of CD31 and vWF were preserved. Conclusion TGF-β-induced arterial endothelial-mesenchymal transition is dependent on activation of Akt/mTOR signal, suggesting that Akt/mTOR-dependent arterial endothelial-mesenchymal transition would be one of the mechanisms for intima hyperplasia in transplant arteriosclerosis.