Objective To establish an allogenic intraocular melanoma model and observe its pathological features.Methods Thirty-six kunming mice were devided randomly into 3 groups with 12 ones in each, and allogeneic melanoma cells B16F10(C57BL16) were inoculated into the anterior chamber (AC), vitreous cavity (VC) of right eyes and under the skin (subcutaneous, SC) of the back of right feet of each grup respectively. The incidence of tumor occurance, time of breaking through the eyeball and other general pathologic features of the tumor were observed by slip-lamp biomicroscopy and operating microscopy for continuous 32 days, and the results were statistically analyzed. Pathological examination was given for tumors at last.Results The incidence of tumor occurance in both AC (12/1 2 eyes) and VC group (11/11 eyes) was higher than that in SC group (2/12 feet)（χ2=17.143, P＝0 .000；χ2=16.218, P=0.000）. The time of eyeball diabrosis was 11-13 days in AC group and 13-32 days in VC group, and there was significant difference between these two groups (Log Rank=18.22, P=0.000). The intraocular melanomas could grow progressively, but reduced and fell off when they broke through eyeball and grew in or bit for a period. The average diameter of the tumor after 32 days after inoculation was (2.27±1.97) mm in AC group，(3.82±1.85) mm in VC group and (0.94±2.27) mm in SC group. There was significant difference between VC and SC group (t=3.322，P=0.003). In pathohistological examination, tumor tissue necrosis could be observed at the center of the subcutaneous melanomas but not in intraocular melanomas.Conclusions Allogeneic intraocular melanoma model is successfully established which is convenient, repeatable, and helpful to studying the mechanism of genesis and development of this tumor. (Chin J Ocul Fundus Dis，2003，19：333-404)
Objective To determine whether the vitreous cavity and the subretinal space of different species animals support the induction of immune deviation to soluble antigen and to observe its maintenance time. Methods Bovine serum albumin(BSA)was used as a soluble antigen and inoculated into the anterior chamber(AC),the vitreous cavity(VC)and subretinal space of different animals(rat,rabbit and monkey)respectively.Recipient animals were immunized with BSA and complete Freundrsquo;sadjuvant. Delayed-type hypersensitivity(DTH)was assessed by skin challenge.The maintenance time of deviant immune response was evaluated in the fixed time interval. Results All the animals receiving intraocular antigen inoculation did not display DTH reaction.The maintenance time of immune deviation after inoculation of antigen in different sites is (1)anterior chamber:70 days in rat,90 days in rabbit,320 days in monkey;(2)vitreous cavity:100 days in rat,１50 days in rabbit,360 days in monkey;(3)subretinal space:50 days in rat,70 days in rabbit,300 days in monkey. Conclusions The maintenance time of immune deviation varied with different species of animals and different intraocular compartment.The evolution of organisms is synchronous with that of immune system. (Chin J Ocul Fundus Dis, 1999, 15: 170-173)
Objective To examine the influence of retinal pigment epithelium(RPE) cells on antigen-specific activatedlymphocytes in vitro,and to explore the role of RPE cells in the immune privilege of the eye. Methods Co-culture systems of RPE cells with antigen-specific T lymphocyte lines and resting T lymphocytes were established in vitro．Induction of apoptosis was detected by genomic DNA electrophoresis,DNA in situ end-labelling and flow cytometry. Results RPE cells induced apoptosis in antigen-specific activated T lymphocytes. 24 hours after culture,the signs of apoptosis appeared in lymphocytes co-incubated with RPE cells．As time of co-culture went on,the number of apoptosic cells increased．Quantitative analysis of apoptosic cells showed that apoptosic cells accounted for 5.95% after 24 hours, 9.38% after 48 hours,and 17.95% after 72 hours．In contrast,RPE cells induced few apoptosis in resting T lymphocytes. Conclusions These results suggest that RPE cells possess the ability to induce the apoptosis of invading lymphocytes. This phenomenon serves as a restrain mechanism of immune response and may be of vital importance in the maintenance of immune privilege in posterior segment of eye and in the protection of eye from the damage of immunogenic inflammation. (Chin J Ocul Fundus Dis, 1999, 15: 241-244)
Objective To observed and analyze the clinical features of patients with nonarteritic anterior ischemic optic neuropathy (NAION) causes of misdiagnosis. MethodsA retrospective case study. From November 2014 to July 2022, 49 NAION patients with 49 eyes diagnosed in Department of Ophthalmology, The First People’s Hospital of Lanzhou were included in the study. All patients were misdiagnosed with other eye diseases at first diagnosis. All eyes were examined by best corrected visual acuity (BCVA), relative afferent pupil defect (RAPD), orbital magnetic resonance imaging (MRI), visual field, optical coherence tomography (OCT), and graphic visual evoked potential (P-VEP). Fluorescein fundus angiography (FFA) was performed in 32 eyes. Clinical and MRI, visual field, P-VEP、FFA features of the patients were retrospectively analyzed. ResultsThere were 31 males and 18 females among the 49 patients. All cases were monocular. Age was (59.3±7.8) years. All of them complained of painless visual acuity loss or occlusion sensation in one eye. There were 12 (24.5%, 12/49) and 37 (75.6%, 37/49) cases with disease duration ＞2 months and ≤2 months, respectively. In 49 eyes, misdiagnosed as optic neuritis, normal tension glaucoma (NTG) or suspected glaucoma, optic disc vasculitis, cataract, diabetic retinopathy, traumatic optic neuropathy and toxic optic neuropathy were 28 (57.1%, 28/49), 11 (22.4%, 11/49), 5 (10.2%, 5/49), 2 (4.1%, 2/49), 1 (2.0%, 1/49), 1 (2.0%, 1/49), 1 (2.0%, 1/49) eyes. 24 (49.0%, 24/49), 16 (32.7%, 16/49) and 9 (18.4%, 9/49) eyes had BCVA＜0.1, 0.1-0.5 and＞0.5, respectively. RAPD was positive in 45 eyes (91.8%, 45/49). There were 37 (75.6%, 37/49) and 12 (24.5%, 12/49) eyes with and without optic disc edema, respectively. Bleeding was observed on and around the optic disc in 15 eyes (30.6%, 15/49). MRI examination showed no obvious abnormality in the optic nerve segments of all affected eyes. OCT showed an increase in retinal nerve fiber layer thickness (307.1±62.1) μm in 37 patients with optic disc edema. The visual field examination showed that 24 eyes (49.0%, 24/49) had typical lower visual field defect connected with the physiological blind spot and circumvented the central fixation point, 6 eyes (12.2%, 6/49) had limited visual field defect connected with the physiological blind spot, and 19 eyes (38.8%, 19/49) had diffuse visual field defect. By P-VEP examination, the amplitude of P100 wave decreased moderately to severely in all affected eyes. There were 24 eyes (49.0%, 24/49) with mild peak delay and 11 eyes (22.4%, 11/49) with moderate peak delay. In 32 eyes examined by FFA, the arteries had early peridisk limitation or diffuse delayed filling, and mid-course fluorescein leakage in the corresponding area. ConclusionsThe main symptoms of NAION patients are painless visual acuity loss in one eye or occlusion of vision. The main clinical features of NAION patients are visual field defect, retinal nerve fiber layer thickening and visual electrophysiological abnormalities. NAION patients with acute or subacute visual loss accompanied by optic disc edema and/or bleeding are often misdiagnosed as optic neuritis, optic neurovasculitis and other types of optic neuropathy. NAION patients with a disease course of ＞2 months are easily misdiagnosed as NTG.
ObjectiveTo explore the characteristics and treatment of intertrochanteric fracture, which the proximal part displaced forwardly and angularly.MethodsBetween March 2015 and March 2016, 40 patients with intertrochanteric fracture with forwardly and angularly displaced proximal part were treated with open reduction and intramedullary nailing fixation. There were 11 males and 29 females with the age of 56-87 years (mean, 75.7 years). The causes of injury included traffic accident in 1 case and fall in 39 cases. The body mass index was 18.9-33.8 kg/m2 (mean, 24.3 kg/m2). The time from injury to admission was 2-360 hours. The type of fracture according to AO-OTA classification was A1.2 type in 7 cases, A1.3 type in 1 case, A2.1 type in 6 cases, A2.2 type in 9 cases, A2.3 type in 12 cases, A3.2 type in 2 cases, and A3.3 type in 3 cases. The haemoglobin (Hb) value at admission and the lowest values before and after operation were recorded; the amount of transfused-blood during hospital stay and visible blood loss around operation were recorded. The short-form 36 health survey scale (SF-36) before injury and at 12 weeks after operation were recorded for evaluating the quality of living; the visual analogue scale (VAS) score at admission and at 2 days after operation were recorded for evaluating the degree of pain, the fracture union was evaluated by X-ray film and clinical examination, and the Harris hip scale were used to evaluate the injuried hip function at 12 weeks.ResultsThe lowest Hb value before operation was (99.10±16.48) g/L, which was significantly lower than that at admission［(114.33±14.93) g/L］(t=9.134, P=0.000). Eleven patients were treated with blood transfusion at amount of (520.00±269.98) mL before operation. The amount of transfused-blood during operation was (569.23±207.94) mL, and intraoperative blood loss was (373.08±154.68) mL. The lowest Hb value was (105.41±13.36) g/L after operation, and 8 patients were treated with second blood transfusion at amount of (500.00±185.16) mL. The reduction of fracture was rated as excellent in 16 cases, good in 18 cases, and poor in 6 cases according to the modified Baumgaertner criteria at 3 days after operation. Forty cases were followed up 12-15 weeks (mean, 12.8 weeks). No infection occurred. The VAS score at 2 days after operation was 3.2±0.5, which was significantly improved when compared with the value at admission (8.2±0.5) (t=37.500, P=0.000). At 12 weeks after operation, all the fractures healed; the Harris score was 82.5±6.9; and the SF-36 score was 51.4±11.5, which was significantly decreased when compared with the score before injury (54.9±11.5) (t=18.901, P=0.000). There were delirium in 4 cases, pneumonia in 8 cases, urinary infection in 5 cases, and venous thrombosis in 4 cases after operation. And all patients cured after corresponding treatment.ConclusionIntertrochanteric fracture with forwardly and angularly displaced proximal part is a type of unstable fracture, and it is difficult to reduction. It is necessary to achieve a good fracture reduction by means of auxiliary instrument. The anatomical alignment is the primary condition for the good effectiveness, and the anemia before and after the operation must be corrected.
ObjectiveTo evaluate the effectiveness of locking compress plate (LCP) for the treatment of aseptic diaphyseal humeral nonunions. MethodsBetween January 2006 and January 2012, 23 patients with aseptic diaphyseal humeral nonuninons were treated with LCP and autologous iliac crest bone graft, and the clinical data were retrospectively analyzed. There were 15 males and 8 females with the average age of 42.5 years (range, 28-60 years). The fracture located at left side in 11 cases and right side in 12 cases. The mechanism of the injury was traffic accident in 15 patients, and falling from height in 8 patients. Fracture was treated by internal fixation in 20 cases and external fixation in 3 cases. And 6 patients had open fractures and other 17 had close fractures. Based on the Weber-Cech classification, 6 cases were rated as atrophic nonunions, and 17 cases as hypertrophic nonuninons. Shoulder function was evaluated by Constant-Murley score and elbow function was evaluated by Mayo score. ResultsAfter operation, 2 patients had transient radial nerve symptoms of numbness and 1 patient had superficial infection. Primary healing of incision was obtained in the other patients. All patients were followed up 22.22 months on average (range, 16-30 months). Normal range of motion of the shoulder was found in 11 cases; and limited movements of abduction, elevation, and posterior extension were observed in 12 cases. And osseous union was observed clinically and radiographically in all patients. The average union time was 16.95 weeks (range, 12-24 weeks). The average Constant-Murley score was 81.87 (range, 50-98); and shoulder function was excellent in 14 cases, good in 6, and fair in 3. And the average Mayo score was 87.78 (range, 70-96); and the result was excellent in 14 cases, good in 7, and fair in 2. ConclusionAseptic diaphyseal humeral nonunions can be successfully treated with LCP, coupled with the use of autologous iliac crest bone graft.