PDR患者二期行硅油取出联合白内障手术的临床观察

目的探讨增殖性糖尿病视网膜病变(PDR)二期患者硅油填充术后行硅油取出联合白内障手术的临床疗效。方法回顾性分析2008—2012年于我院行硅油取出联合白内障超声乳化、人工晶体植入术的PDR患者55例(61眼),术后视力恢复情况。结果术后1个月最佳矫正视力好于术前最佳矫正视力的40眼(74.07%),与术前相同的10眼(18.52%),低于术前最佳矫正视力的4眼(7.41%)。所有患者均无角膜内皮失代偿、人工晶体移位、复发性视网膜脱离等并发症发生。结论 PDR行玻璃体切除术后合并白内障的患者,取出硅油时联合白内障超声乳化、人工晶体植入术是经济、安全、有效的治疗方法。     

Anti‐Proliferative Effects of Polyphenols from Pomegranate Rind (Punica granatum L.) on EJ Bladder Cancer Cells Via Regulation of p53/miR‐34a Axis

miRNAs and their validated miRNA targets appear as novel effectors in biological activities of plant polyphenols; however, limited information is available on miR‐34a mediated cytotoxicity of pomegranate rind polyphenols in cancer cell lines. For this purpose, cell viability assay, Realtime quantitative PCR for mRNA quantification, western blot for essential protein expression, p53 silencing by shRNA and miR‐34a knockdown were performed in the present study. EJ cell treatment with 100 µg (GAE)/mL PRE for 48 h evoked poor cell viability and caspase‐dependent pro‐apoptosis appearance. PRE also elevated p53 protein and triggered miR‐34a expression. The c‐Myc and CD44 were confirmed as direct targets of miR‐34a in EJ cell apoptosis induced by PRE. Our results provide sufficient evidence that polyphenols in PRE can be potential molecular clusters to suppress bladder cancer cell EJ proliferation via p53/miR‐34a axis. Copyright © 2015 John Wiley & Sons, Ltd.     

Using proliferative markers and Oncotype DX in therapeutic decision-making for breast cancer: the B.C. experience

Background

Proliferative scoring of breast tumours can guide treatment recommendations, particularly for estrogen receptor (er)–positive, her2-negative, T1–2, N0 disease. Our objectives were to

• □ estimate the proportion of such patients for whom proliferative indices [mitotic count (mc), Ki-67 immunostain, and Oncotype dx (Genomic Health, Redwood City, CA, U.S.A.) recurrence score (rs)] were obtained.
• □ compare the indices preferred by oncologists with the indices available to them.
• □ correlate Nottingham grade (ng) and its subcomponents with Oncotype dx.
• □ assess interobserver variation.

Methods

All of the er-positive, her2-negative, T1–2, N0 breast cancers diagnosed from 2007 to 2011 (n = 5110) were linked to a dataset of all provincial breast cancers with a rs. A 5% random sample of the 5110 cancers was reviewed to estimate the proportion that had a mc, Ki-67 index, and rs. Correlation coefficients were calculated for the rs with ng subcomponent scores. Interobserver variation in histologic grading between outside and central review pathology reports was assessed using a weighted kappa test.

Results

During 2007–2011, most cancers were histologically graded and assigned a mc; few had a Ki-67 index or rs. The ng and mc were significantly positively correlated with rs. The level of agreement in histologic scoring between outside and central pathology reports was good or very good. Very few cases with a low mc had a high rs (1.8%).

Conclusions

Patients with low ng and mc scores are unlikely to have a high rs, and thus are less likely to benefit from chemotherapy. In the context of limited resources, that finding can guide clinicians about when a rs adds the most value.     

家族性渗出性玻璃体视网膜病变的临床研究

目的：了解家族性渗出性玻璃体视网膜病变(familial exudative vitreoretinopathy,FEVR)的发病状况,探讨足月产儿眼病筛查的必要性。

方法：回顾分析2014-01/2015-08我院772例1544眼足月产儿眼底检查的资料。

结果：足月产儿772例1 544眼中,发现各期FEVR共8例15眼,检出率0.97%; 包括1期2例2眼,2期3例5眼(含1期1例另1眼),3期2例4眼,4期1例2眼,5期1例2眼。

结论：家族性渗出性玻璃体视网膜病变在新生儿眼病筛查中并不少见,甚至病情严重者在婴儿期就丧失视功能。新生儿期和婴儿期是FEVR筛查的关键时间点,早期发现、早期干预是FEVR患者获得较好视功能的关键。     

PDR术后继发新生血管性青光眼围手术期血压和血糖波动性的研究

目的:研究增殖性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)行玻璃体切除硅油取出术后继发新生血管性青光眼(neovascular glaucoma,NVG)围手术期血压、血糖的波动性.方法:回顾性分析增殖性糖尿病视网膜病变行23G玻璃体切除、联合白内障超声乳化、人工晶状体植入、硅油充填术的271例271眼,行硅油取出术后继发新生血管性青光眼的14例14眼,对照组(none neovascular glaucoma,NNVG)为随机抽取同期手术后未继发NVG的同年龄、同手术方式、排除对侧眼做对比,分析发生NVG的时间、围手术期血压、血糖变异性,随访时间为手术后1 ～ 12mo,用SPSS 11.0统计学软件分析本组新生血管性青光眼的发病率、发病时间、围手术期血糖、血压、糖化血红蛋白(Hbc％)的变异性.结果:患者271例14眼继发NVG,占5.2％;男10眼(71.4％),女4眼(28.6％);年龄49 ～ 68(平均57.07)岁;继发NVG的时间为玻璃体切除术后107 ～ 135d,硅油取出术后7 ～ 45(平均31.78)d;糖尿病史10 ～ 15(平均13.2)a.NVG组:围手术期空腹血糖波动4.0 ～10.2(平均8.52±3.24)mmol/L,变异系数0.48.NNVG组:围手术期空腹血糖波动5.0 ～8.2(平均7.22±0.24)mmol/L,变异系数0.43,两组变异系数差异有显著差异(P＜0.05).Hbc％ NVG组:(10.52±0.27)％,NNVG组:(7.60±1.34)％,两组比较差异有统计学意义(P＜0.05).NVG组:围手术期收缩压140 ～180(平均152.3±15.1)mmHg,变异系数0.099,舒张压50 ～ 110(平均92.3±11.1)mmHg,变异系数0.11;NNVG组:围手术期收缩压120 ～150(平均131.4±0.1)mmHg,变异系数0.061,舒张压80～100(平均87.3±8.1)mmHg,变异系数0.08;两组相比,变异系数有差异(P＜0.05),NVG组围手术期空腹血糖的变异性明显大于NNVG组.而两组之间昼夜血压的变异性相比,NVG组白天的收缩压(systolic blood pressure,SBP)以及夜晚的舒张压(diastolic blood pressure,DBP)的变异性均大于NNVG组,均有统计学意义(P＜0.05).14例患者取油术与玻璃体切除硅油注入手术围手术期血糖的变异性、血压的变异性相比无统计学意义.结论:PDR继发NVG患者围手术期空腹血糖的变异性、白天收缩压、夜间舒张压的变异性大,最早可发生在硅油取出术后1wk.     

Proliferative Vitreoretinopathy: Pathobiology and Therapeutic Targets

The cell biology and molecular mediators of proliferative vitreoretinopathy continue to be elucidated. The purpose of this review is to summarize contemporary findings in the visual and neurosciences relevant to the pathophysiology of proliferative vitreoretinopathy, with an emphasis on the biologic mediators that represent potential therapeutic targets.     

血管细胞黏附分子与增生性玻璃体视网膜病变的相关性及其临床价值探讨

目的 探讨血管细胞黏附分子与增生性玻璃体视网膜病变的相关性及其临床价值。方法 选取2016年11月～2018年11月在我院治疗的80例增生性玻璃体视网膜病变患者,按照视网膜病变程度分为两组,视网膜病变A级、B级的患者为研究组,视网膜病变C级、D级的患者为对照组,每组40例。两组患者分别检测血管细胞黏附分子,并进行对比;经过治疗后再次检测血管细胞黏附分子含量,对比分析血管细胞黏附分子与增生性玻璃体视网膜病变的相关性。结果 研究组患者视网膜病变程度明显轻于对照组患者(P0.05),研究组患者血管黏附分子患者低、中等的患者例数明显多于对照组患者,研究组血管黏附分子患者高的患者例数明显少于对照组患者(P0.05),在治疗前,研究组患者血管黏附分子明显低于对照组患者,治疗后两组患者的血管黏附分子含量均明显降低(P0.05)。结论 血管细胞黏附分子与增生性玻璃体视网膜病变具有正相关的关系,血管黏附分子越高视网膜病变越严重,检测血管黏附分子的含量对增生性玻璃体视网膜病变的诊断及治疗具有一定的意义,值得在临床中进一步推广和应用。