Objective To investigate the clinical features of polypoidal choroidal vasculopathy. Methods The clinical manifestations and the findings of fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) of 7 eyes in 6 patients with polypoidal choroidal vasculopathy were analyzed retrospec tively.Results The ophthalmoscopic examination of PCV in this series of patients revealed orange-red lesions mainly in macular region in early stage, and then hemorrhage, exudation, edema, serous and (or) hemorrhagic detachment of retinal pigment epithelium in affected portions in advanced stage, and retinal and choroidal atrophy in late stage. FFA discovered the vascular dilation at the border of the choroidal vascular network in 1 eye, dotted hyperfluorescence in 6 eyes, and patches of hyperfluorescence in late phase. ICGA disclosed a vascular branching network in choroid with polypoid pattern of the terminal path of the vessels of network in early phase in 5 eyes, and the typical dotted or clustered polypoidal hyperfluorescence in 7 eyes in late phase.Conclusion The characteristic findings of FFA and ICGA are very diagnostic for PCV. (Chin J Ocul Fundus Dis，2003，19：269-332)
Primary pulmonary lymphoepithelioma-like carcinoma (PPLELC) is a rare type of lung cancer with special characteristics of epidemiology, clinical diagnosis, treatment and prognosis. It has close relationship with Epstein-Barr virus (EBV) infection and has prominent regional feature. Most patients are young and non-smoking. There is no specificity of clinical manifestation. Most patients are asymptomatic at the time of diagnosis. As for treatment, the standard treatment for early stage disease is complete resection. Platinum-based doublet chemotherapy has been applied in locally advanced disease as the first line therapy. Due to its rarity, the treatment of advanced PPLELC is still lack of evidence of large sample randomized controlled trial. Whether target therapy or immunotherapy is effective is worth further study. This article reviews the research progress of PPLELC, to give a particular sight for clinicians and provides a better understanding of this rare tumor for researchers.
Congenital chest deformity is caused by abnormal development of spine or ribs, resulting in sternal depression or protrusion. Pectus carinatum and pectus excavatum are the most common diseases in clinic, which can either be accompanied by other syndromes or exist alone. The genetic factors of congenital thoracic deformity can be related to single gene mutation, polygene mutation and chromosome aberration. Common clinical congenital thoracic deformity with syndromes, such as Marfan syndrome and Noonan syndrome, often have relatively fixed and clear pathogenic genes. The genetic pathogenesis of non-syndromic and independent congenital thoracic malformations is usually diverse, and treatments for syndromic and non-syndromic congenital thoracic deformity are different. Therefore, it is necessary for us to differentiate syndromic and non-syndromic congenital thoracic deformities in basic research, clinical diagnosis and treatment.
Because of the characteristics such as accurate, efficient and individuation, 3D printing is being widely applied to manufacturing industry, and being gradually expanded into the medical field. Diseases of chest wall is a common type in thoracic surgery, and surgery is a proper treatment to this kind of disease. For the past few years, 3D printing is being gradually applied in surgery of chest wall diseases. The article mainly makes a statement of two parts that including the possibility to apply 3D printing including chest wall reconstruction and chest wall orthopedic, and to analyze the possibility and application prospect of applying 3D printing to the chest wall disease.
ObjectiveTo analyze pathogenic factors and etiological characteristics of suppurative endophthalmitis.MethodsA total of 531 consecutive patients (531 eyes) with suppurative endophthalmitis who were hospitalized in Qingdao Eye Hospital of Shandong Eye Institute from January 2006 to December 2015 were included in the study. Among them, 410 patients with 410 eyes were males (77.2%), 121 patients with 121 eyes were females (22.8%). The average age of the patients was 38.62±15.36 years. The relevant medical records were collected to analyze the pathogenic factors. Samples of aqueous humor, vitreous or other intraocular samples were taken under aseptic conditions for bacterial and fungal culture and in vitro drug sensitivity test.ResultsOcular trauma was the primary pathogenic factor of suppurative endophthalmitis (60.1%), other factors included postoperative endophthalmitis (19.0%), suppurative keratitis-related endophthalmitis (17.1%) and endogenous endophthalmitis (3.8%). Postoperative endophthalmitis mainly occured after cataract surgery. A total of 224 strains of organisms were isolated, among which the predominant organisms isolated were gram-positive bacteria (54.0%) and staphylococcus epidermidis was the most common (25.0%). The other pathogenic organisms were fungi (29.5%) and gram-negative bacteria (16.5%). Among the fungi, aspergillus (10.7%) was the dominant genus, followed by fusarium (9.8%). For gram-positive organisms, susceptibilities were vancomycin 97.4%, gatifloxacin 91.8%, fusidate acid 77.9% and levofloxacin 54.6%. For gram-negative organisms, susceptibilities were gatifloxacin 85.7%, levofloxacin 77.8%, tobramycin 71.4% and ceftazidime 62.5%. For fungal isolates, sensitivities were voriconazole 88.2% and amphotericin B 84.8%.ConclusionsOcular trauma is the main pathogenic factor of suppurative endophthalmitis, followed by postoperative endophthalmitis and suppurative keratitis-related endophthalmitis. Gram-positive bacteria are the major pathogenic organisms, especially staphylococcus epidermidis followed by fungal species, among which aspergillus and fusarium were the dominating pathogenic genus.
ObjectiveTo assess the specific clinicopathological characteristics as well as prognostic value of prognostic significance of spread through air spaces (STAS) in lung adenocarcinoma.MethodsWe systematically searched the databases of PubMed, EMbase and Web of Science databases from their date of inception to March 2019. The quality of the included literature was assessed by the Newcastle-Ottawa scale (NOS). The NOS of the study higher than 6 points was considered as high quality. Software of Stata 12.0 was used for meta-analysis.ResultsTwenty retrospective cohort studies involved with totally 6 225 patients were included. Quality of included studies was high with NOS score equal or higher than 6 points. STAS was associated with male sex, ever smoking history, abnormal carcino-embryonic antigen (CEA) level, air bronchogram negative, anaplasticlymphoma kinase (ALK) arrangement positive, epidermal growth factor receptor (EGFR) mutation positive, advanced pathological tumor stage and more invasive pathological adenocarcinoma subtypes. The presence of STAS indicated significantly poor recurrence free survival (RFS) (HR=1.960, 95%CI 1.718-2.237, P<0.001) as well as poor overall survival (OS) (HR=1.891, 95%CI 1.389-2.574, P<0.001). Further subgroup analyses showed that exhibiting tumor size including diameter less than 2 cm (HR=2.344, 95%CI 1.703-3.225, P<0.001) and diameter over 2 cm (HR=2.571, 95%CI 1.559-4.238, P<0.001), resection type including lobectomy (HR=1.636, 95%CI 1.258-2.127, P<0.001) and sublobar resection (HR=3.549, 95%CI 2.092-6.021, P<0.001) in stageⅠ adenocarcinoma suggested that STAS had a bad effect on RFS.ConclusionPresence of STAS is associated with more aggressive clinicopathological features and independently associated with worse RFS and OS in lung adenocarcinoma. STAS positive has a negative effect on RFS whatever the tumor size (including the diameter<2 cm or >2 cm) and resection types in stageⅠ adenocarcinoma.