Objective To investigate the temporal and spatial expression pattern of Caspase3、Bax and Bclxl in NmethylNnitrosourea (MNU) damaged rat retina. Methods Twenty-four 50 dayold female Sprague-Dawley rats (n=24) received single intraperitoneal injection of MNU 40 mg/kg and were examined at 1, 3, 7 and 10 days after MNU treatment (6 rats sacrificed at each timepoint). As control, six rats were injected with saline (5 ml/kg) and sacrificed 3d after injection. Expressions of Caspase-3 and bax and bcl-xl were detected by RTPCR and immunofluorescence assays, photoreceptor cell apoptosis was measured by terminal deoxynucleotidyl transferasemediated deoxyuridine triphosphatedigoxigenin nick-end labeling (TUNEL). Results Animal models were successful established and confirmed by pathological studies. RTPCR results indicated that caspase3 and bax upregulated at 1 d (caspase-3 RA =83.23plusmn;8.11，P= 0.009; bax-RA=72.73plusmn;9.46，P=0.004) and peaked at 3 d （caspase-3 RA=140.48plusmn;18.40，P=0.000；bax-RA=102.36plusmn;13.97，P=0.001）compared with control (caspase-3 RA=62.45plusmn;7.65; bax-RA =46.53plusmn;4.41). Bcl-xl expression increased and peaked at 3d (3d RA=79.83plusmn;5.58, P=0.000 vs control 45.98plusmn;3.06). It was noted that the ratios of bax / bclxl expression at 1 d, 3 d and 7 d after MNU injection were enhanced (1 d 1.15plusmn;0.14, P= 0.143; 3 d 1.28plusmn;0.16, P=0.001; 7 d 1.17plusmn;0.08, P= 0.079, vs control 1.01plusmn;0.09), and at 3 d the ratio reached the peak, whereas at10 d bax / bcl-xl ratio (0.73plusmn;0.07, P= 0.001) was decreased compared with the control. Immunofluorescence assays demonstrated that the changes of bax, bclxl and caspases3 protein expressions coincided with their RTPCR results respectively. The Bax positive cells were detected in the outer nuclear layer; while caspase3 and bclxl positive cells emerged in several layers of retina included the pigment epithelium layer, the photoreceptor cell inner segments, the outer nuclear layer, the outer plexiform layer, the inner plexiform layer and the ganglion cell layer. Photoreceptor cell apoptosis was only detected in the outer nuclear layer and peaked at 3 d in MNU treated rats (AI= 76.97plusmn;5.83, P= 0.000 vs control 0.00 plusmn; 0.00). Conclusions These data suggest that bax and bcl-xl and caspases3 may involve in the MNUinduced rat photoreceptor cell apoptosis.
Objective To investigate the clinical significance of serum cystatin C ( Cys C) in patients with non-small cell lung cancer ( NSCLC) .Methods The serumlevel of cystatin C was determined by enzyme linked immunosorbent assay ( ELISA) in patients with NSCLC, patients with benign lung diseases, and normal controls. Results The serum level of Cys C in the NSCLC patients was much higher than those in the patients with benign lung diseases and the normal control subjects [ ( 1.47 ±0.78) mg/L vs. ( 1.04 ±0.51) mg/L and ( 1.06 ±0.36) mg/L, Plt;0.01] . The level of Cys C in the NSCLC patients was significantly related to clinical stage [ TNM stage -Ⅱ vs. Ⅲ-Ⅳ: ( 1.38 ±0.88) mg/L vs. ( 1.57 ± 0.79) mg/L] , lymph node metastasis [ metastatic vs. non-metastatic: ( 1.83 ±0.97) mg/L vs. ( 1.06 ± 0.39) mg/L] , and differentiation degree [ medium-high differentiation vs. low differentiation: ( 1.63 ± 0.73) mg/L vs. ( 1.26 ±0.48) mg/L] ( all Plt;0.05) . However no correlation of Cys C with gender, age, and histological type was revealed ( Pgt;0.05) . Conclusion Cys C may contribute to the occurrence and development of NSCLC.
Objective To explore the frequency, clinical features, and characteristics of results of fundus fluorescein angiography (FFA) of uveitis related cystoid macular edema (CME). Methods The clinical data and FFA results of 67 patients (106 eyes) with posterior uveitis examined in our hospital from July 2002 to June 2005 were collected. The clinical features and characteristics of FFA images of CME were observed and analyzed. Results Among the106 eyes of 67 patients with uveitis,the CME was observed in 28 eyes (26.4%) of 18 patients, including 7 males and 11 females with the average age of (42.5plusmn;10.8) years. The dark area due to the choroidal fluorescence blocked by the macular edema was found at the early FFA phase, and th en followed by the punctate and sheetlike leakage of fluorescein; the capillar y was dilated at the venous phase, and the typical petaloid appearance was seen at the late phase because the fluorescein cumulated in several small vesicles in the macular area. After treated by corticosteroids and topical non-steroidal anti-inflammatory medicine and carbonic anhydrase inhibitors, the extent of CME diminished, and the visual acuity improved in varying degrees. Conclusi ons Uveitis may seriously harm the visual function, in which CME induces the damage of visual acuity. Early detection and timely treatment may prevent thepermanent visual damage. (Chin J Ocul Fundus Dis, 2006, 22: 394-396)
ObjectiveTo evaluate the value of magnetic resonance cholangiopancreatography (MRCP) on prevention of the complications in laparoscopic cholecystectomy (LC). MethodsThe clinical data of 1 079 patients underwent LC from January 2006 to June 2010 in this hospital were retrospectively analyzed. According to the use of MRCP or not in the different period, the patients were divided into nonMRCP group (n=523) and MRCP group (n=556). The occurrence of bile duct injuries (BDI) and retained common duct stone (RCDS) were compared between two groups. ResultsConversion to open surgery was performed in 35 cases in nonMRCP group and in 41 cases in MRCP group. The intraoperative and postoperative BDI were found in five patients and RCDS were found in 27 patients in nonMRCP group, and those were not found in patients in MRCP group. The differences of BDI and RCDS of patients were significant between two groups (P=0.026 and P=0.000). In nonMRCP group, 23 of 55 patients were found common bile duct stones by intraoperative cholangiography. Common bile duct stones were found by intraoperative cholangiography other than preoperative MRCP in three patients in MRCP group, while another three patients did not find common bile duct stones by intraoperative cholangiography although preoperative MRCP suggested. By MRCP, double gallbladders were found in one patient, Mirizzi syndrome in eight patients, variant cystic duct in 34 patients, accessory hepatic duct in 28 patients, and complicating common bile duct stones in 27 patients in MRCP group, the diagnostic accuracy of those were 100%, 87.5%, 94.1%, 89.3% and 88.9%, respectively. ConclusionPreoperative MRCP is helpful to prevent BDI and RCDS for the patients with LC.
Objective To evaluate the effectiveness and safety of chemotherapeutics bladder irrigation (CBI) after transurethral resection (TR) in the treatment of cystitis glandularis (CG). Methods Databases including MEDLINE, The Cochrane Library, EMbase, VIP, CNKI and CBM were searched from January 2001 to November 2011 to collect randomized controlled trials (RCTs) and case-control studies (CCSs) on pirarubicin or mitomycin bladder irrigation after TR in the treatment of CG. Two reviewers independently screened articles according to the inclusion and exclusion criteria, extracted data and evaluated the quality of the included studies. Then meta-analysis was performed using RevMan 5.0. Results A total of 11 articles involving 5 RCTs and 6 CCSs were included. Among the total 1032 patients involved, 497 patients were in the control group treated by TR alone, while the other 535 patients were in the treatment group given CBI after RT. There were two subgroups, one involving 347 patients irrigated by pirarubicin in 7 studies, and the other involving 188 patients irrigated by mitomycin in 4 studies. The results of meta-analysis showed: (a) pirarubicin bladder irrigation after TR could increase both short-term and long-term cure rates and decrease both short-term and long-term relapse rates, but no significant differences were found in both short-term and long-term improvement rates, compared with the control group. As for the safety, pirarubicin was similar to the control group in the incidence of urinary irritation, but it was superior in the incidence of bloody urine; and (b) mitomycin bladder irrigation after TR could increase long-term cure rate and decrease long-term relapse rate, but no significant differences were found in short-term cure rate and short-term improvement rate, compared with the control group. Mitomycin was similar to the control group in incidence of urinary irritation and bloody urine. Sensitivity analyses indicated the outcomes regarding to some indexes in different studies were inconsistent. Conclusion Based on the current evidence, pirarubicin or mitomycin bladder irrigation after TR can increase long-term cure rate and decrease long-term relapse rate in treating CG, but pirarubicin tends to easily cause bloody urine. For the inconsistent outcomes of different studies, the results of this meta-analysis are instable and highly possible to be inconsistent to the future outcomes, hereby it is uncertain of the better effectiveness of CBI after, TR compared with TR alone, and more high-quality and large-scale RCTs are needed to be performed.
Objectives To investigate the diagnosis and laparoscopic surgical treatment methods of calculus of cystic duct. MethodsThe clinical data of 147 patients with calculus of cystic duct underwent laparoscopic cholecystectomy (LC) in the Second Affiliated Hospital of Wenzhou Medical College from June 2008 to June 2013 were analyzed retrospectively. ResultsAmong the 147 patients with calculus of cystic duct, 19 cases were given preoperative diagnosis by B-ultrasound and CT scanning, 128 cases were found by exploration in operation; 146 cases underwent LC successfully and 1 case was converted to laparotomy.The 147 cases were followed-up for 3 months to 2 years with an average of 7 months and all cases were out of bile duct injury, hemorrhage, bile leakage, residual calculi or other complications. ConclusionsPreoperative diagnosis of calculus of cystic duct is difficult, meanwhile, routine intraoperative probe is very necessary for the diagnosis of calculus of cystic duct.Proficiency in surgical technique with laparoscopic treatment of calculus of cystic duct is the key to the success of LC.
From September 1988 to May 1985, 67 cases of thyroid cysts were treated with aspiration and ethanol injection. Patients were followed up clinically and ultrasonically 6 month to 4 years after treatment. Cure was defined as complete disappealance of the cyst or presence of a residual fibrotic mass less than 1 cm in diameter, effectiveness was defined as the residual mass less than 50% of the original one. After one to three injections, 27 out of 36 patients of thyroid adnoma with cystic change (75 %)were cured, the effective rate was 88.2%. The cure rate of nodular goiter with cystic change was 50%(14 out of 28 cases, while the effective rate was 82%.No serious complication occurred in this series. During the period of following up, no malignant change was found. The results suggest that aspiration of thyroid cyst with ethanol injection is a simple, well tolerated and low cost technique.
ObjectiveTo observe and analyze the effect of peripore cavity size on visual function of macular area before and after surgery for idiopathic macular hole (IMH). MethodsA retrospective clinical study. From July 2020 to February 2021, a total of 25 patients with 25 eyes with monocular IMH (operation group) diagnosed by ophthalmology examination in Department of ophthalmology, Fourth Hospital of Hebei Medical University were included in the study. The control group was contralateral healthy eyes. All subjects were examined by best corrected visual acuity (BCVA), microfield of vision, frequency domain optical coherence tomography (SD-OCT), and OCT angiography (OCTA). The diameter of macular hole was measured by SD-OCT. The cystic morphology of deep capillary plexus (DCP) was detected by en face OCT, and the cystic area was measured by Image J software. MP-3 microperimeter was used to measure central macular retinal light sensitivity (MS) and mean macular retinal light sensitivity (MMS). Central macular retinal light sensitivity (CMS), MMS and cystic cavity MS were measured in the operation group. MMS was measured in the control group. The microperimetry images were superimposed on the DCP layer of OCTA to identify and calculate the average MS within the lumen and compare it with the control group. Standard three incisions were performed in all affected eyes by vitrectomy of the flat part of the ciliary body + stripping of the inner boundary membrane + intraocular sterile air filling. Three months after the operation, the same equipment and methods were used to perform relevant examinations. Paired sample t test was used to compare MS between operation group and control group. Pearson correlation analysis was used to analyze the correlation between capsular area, macular hole diameter before and after operation and MS before and after operation. The correlation between BCVA and capsular area before and after surgery was analyzed by Spearman correlation analysis. ResultsIn the surgical group, the retinal MS was (4.24±3.07) dB. The MMS of control group was (19.08±6.11) dB. The MS in the surgical group was significantly lower than that in the control group, and the difference was statistically significant (t=10.832, P＜0.01). Before operation, the area of cyst was (1.04±0.55) mm2, and the diameter of macular hole was (564.80±166.59) μm. CMS and MMS were (2.27±2.29) dB and (9.08±3.65) dB, respectively. The diameter of macular hole (r=0.50, P=0.010) and BCVA before operation (r=0.57, P＜0.001) were positively correlated with peripore cavity area. Before operation, CMS and MMS were negatively correlated with peripore cavity area (r=－0.53, －0.47; P=0.010, 0.020). At 3 months after surgery, the capsular area was negatively correlated with CMS and MMS (r=－0.65,－0.76; P=0.020, 0.030). There was no correlation with BCVA (r=0.23, P=0.470). ConclusionsRetinal MS is decreased in the peri-capsular area of IMH pore. There is a positive correlation between capsule area, BCVA and macular hole diameter before operation. The capsular area is negatively correlated with CMS and MMS before operation.
Objective To evaluate the urine cytology silver staining combined with ultrasonography（USG）in the detection of bladder transitional cell carcinoma （TCC） recurrence after transurethral resection of bladder tumor（TURBT）in terms of sensitivity and specificity. Methods Cystoscopy was used as “gold standard”. Urine cytology combined with USG or cystoscopy was measured separately and blindly. AgNORs protein stained by silver were used in cytology with Kappa of inter-observers 0.81. For the USG, the patients were scanned with trans-rectal probe with Kappa of inter-observers 0.76. The results of urine cytology combined with USG （Positive when urine cytology and/or USG positive. Negative when both urine cytology and USG negative） were compared with “gold standard”. Results The 148 consecutive superficial TCC patients with TURBT one year previously were included in this study. Fifty seven recurrenced cases were detected. Recurrence rate was 38.51%. The sensitivity and specificity of urine cytology silver stain were 89.47% （95% CI 0.82 to 0.98） and 87.91% （95% CI 0.81 to 0.95）. Area under ROC curve was 82.22%. The sensitivity and specificity of USG were 57.90% （95% CI 0.45 to 0.71 ） and 90. 11% （ 95% CI 0.84 to 0.96）. Area under ROC curve was 73.13% . The sensitivity was improved to 94. 74% （95% CI 0.89 to 1.00） when cytology combined with USG. But specificity decreased to 84. 62% （95% CI 0.77 to 0.92 ）. Area under ROC curve was improved to 98.28%. Conclusions Urine cytology silver stain combined with USG improves the high sensitivity for follow-up TCC patients after TURBT. The non-invasive protocol is suggested.
ObjectiveTo explore the CT imaging features and independent risk factors for cystic pulmonary nodules and establish a malignant probability prediction model. Methods The patients with cystic pulmonary nodules admitted to the Department of Thoracic Surgery of the First People's Hospital of Neijiang from January 2017 to February 2022 were retrospectively enrolled. They were divided into a malignant group and a benign group according to the pathological results. The clinical data and preoperative chest CT imaging features of the two groups were collected, and the independent risk factors for malignant cystic pulmonary nodules were screened out by logistic regression analysis, so as to establish a prediction model for benign and malignant cystic pulmonary nodules. ResultsA total of 107 patients were enrolled. There were 76 patients in the malignant group, including 36 males and 40 females, with an average age of 59.65±11.74 years. There were 31 patients in the benign group, including 16 males and 15 females, with an average age of 58.96±13.91 years. Multivariate logistic analysis showed that the special CT imaging features such as cystic wall nodules [OR=3.538, 95%CI (1.231, 10.164), P=0.019], short burrs [OR=4.106, 95%CI (1.454, 11.598), P=0.008], cystic wall morphology [OR=6.978, 95%CI (2.374, 20.505), P<0.001], and the number of cysts [OR=4.179, 95%CI (1.438, 12.146), P=0.009] were independent risk factors for cystic lung cancer. A prediction model was established: P=ex/(1+ex), X=–2.453+1.264×cystic wall nodules+1.412×short burrs+1.943×cystic wall morphology+1.430×the number of cysts. The area under the receiver operating charateristic curve was 0.830, the sensitivity was 82.9%, and the specificity was 74.2%. ConclusionCystic wall nodules, short burrs, cystic wall morphology, and the number of cysts are the independent risk factors for cystic lung cancer, and the established prediction model can be used as a screening method for cystic pulmonary nodules.