Since 1995, 8 patients with unresectable carcinoma of pancreatic body and tail has been treated by regional chemotherapy. 5-Fu and MMC were administered through a subcutaneous placed drug pump connecting to the splenic artery catheler. Twelve patients with unresectable pancreatic carcinoma being treated by peripheral venous chemotherapy were as control. The results showed that median survival time with regional chemotherapy with drug pump group as 7.0 months, and the time of peripheral venous chemotherapy group as 4.2 months. The difference between them was significant. This therapy was effective to prolong survival time of patients with unresectable pancreatic carcinoma.
Objective To explore the expressions of E-cadherin， matrix metalloproteinases-2 （MMP-2） protein，and matrix metalloproteinases-9 （MMP-9） protein in gastric cancer tissues， and to analyze the possible statistical relati-onship between the expressions of E-cadherin， MMP-2 protein， and MMP-9 protein， and clinicopathological features ofgastric cancer. Methods The ABC immunohistochemical staining was adopted to examine the expressions of E-cadherin，MMP-2 protein， and MMP-9 protein in 40 paraffin slices of gastric cancer （gastric cancer group）， with the adjacent tissue as the control group （adjacent tissue group）. The positive rates of 3 kinds of protein were compared between the2 groups， in addition， the statistical relationship between the expressions of the 3 kinds of protein and clinicopathological features of gastric cancer was examined respectively by SPSS 19.0 software. Results The expressions of E-cadherin， MMP-2 protein， and MMP-9 protein were all found in gastric cancer tissues and adjacent tissues. In gastric cancer tissue group， the expression of E-cadherin downregulated while the expressions of MMP-2 protein and MMP-9 protein upregulated in comparison to adjacent tissue group （P＜0.05）. The significant association was found between the expre-ssion of E-cadherin and the gastric cancer tissues of T3＋T4 stage， N1-N3 stage， and Ⅲ＋Ⅳ stage， which had lower positive expression rate （P＜0.05）. The expression of MMP-2 protein in gastric cancer tissues of M1 stage and Ⅲ＋Ⅳstage upregulated （P＜0.05）， and the expression of MMP-9 protein upregulated in gastric cancer tissues of T3＋T4 stage，Ⅲ＋Ⅳ stage， or lowlydifferentiated＋undifferentiated （P＜0.05）. No significant relationship was found in other clinical-pathological features and 3 kinds of protein except aforementioned significant relationship （P＞0.05）. Conclusions In the development progress of gastric cancer， the E-cadherin may get involved in the mechanism of tumor invasion and lymph node metastasis， MMP-2 protein may get involved in the mechanism of distant metastasis， and MMP-9 protein may get involved in the mechanism of differentiation and tumor invasion. The examination of those 3 kinds of markers may play an role in the judgment of tumor stage and estimation of prognosis in gastric cancer clinically.
Objective To observe the changes of optic disc structure in patients with high myopia and the correlation with the morphological markers of the fundus. MethodsA retrospective study. From July 2018 to January 2020, 90 patients (155 eyes) diagnosed as high myopia in Department of Ophthalmology of Beijing Friendship Hospital affiliated to Capital Medical University were included in the study. Among them, there were 31 males (52 eyes) and 59 females (103 eyes), with age of 57.1±14.2 years old and axial length (AL) of 28.5±2.6 mm. According to the classification of myopic macular degeneration, patients were divided into 4 groups based on forms and degree of lesions, including non-pathological myopia group, mild traction lesions group, severe traction lesions group and neovascular lesions group, 35, 58, 41, 21 eyes, respectively. The digitized fundus photographs and an Image J system were used to measure the horizontal, vertical, maximal, and minimal diameter of the optic disc, the horizontal and vertical diameter of the parapapillary δ zone and γ zone, ovality index, distance between the most superior point of the temporal superior arterial arcade and most inferior point of the temporal inferior arterial arcade (VDA), angle between the temporal arterial arcade and optic disc (angle kappa), distance between the optic disc center and the fovea (DFD), angle between the horizontal disc axis and the disc–fovea line (DFA). The correlation between the diameter of the optic disc and other parameters was analyzed. Univariate and multivariate analysis were used to compare differences between groups. ResultsThe horizontal diameter of the optic disc was positively correlated with the horizontal diameter of the δ zone (r=0.300, P＜0.001), Kappa angle (r=0.260, P=0.003), and elliptic index (r=0.650, P＜0.001); it was negatively correlated with DFD (r=－0.190, P=0.030). Optic disc vertical diameter and optic disc horizontal diameter (r=0.280), δ-zone horizontal diameter (r=0.330) and vertical diameter (r=0.460), γ-zone horizontal diameter (r=0.430) and vertical diameter (r=0.390), DFD (r=0.390) was positively correlated (P<0.001); it was negatively correlated with DFA (r=－0.210, P=0.001) and Kappa angle (r=－0.210, P=0.004). Compared with the non-pathological myopia group, there were statistically significant differences in the horizontal and vertical diameters of the optic disc in the severe traction disease group (P＜0.05). Among them, the horizontal diameter difference did not depend on the eye axis and age difference; the vertical diameter difference was caused by the eye axis difference. Compared with the non-pathological myopia group, the difference in the horizontal diameter of the optic disc in the neovascular disease group was statistically significant (P＜0.05), and did not depend on the difference in the axis and age; the difference in the vertical diameter of the optic disc was not statistically significant (P＞0.05). ConclusionThe morphology of optic disc was related to several fundus morphological markers, which was differentiated according to the age, AL and the degree of disease in patients with high myopia.
ObjectiveTo evaluate the safety to perform 23G vitrectomy with scleral incisions at 5.0 mm behind the limbus.MethodsThis is a prospective uncontrolled case study. The data of 140 consecutive primary 23G vitrectomy patients (145 eyes) were enrolled in this study. There were 56 males (59 eyes) and 84 females (86 eyes), with the mean age of (56.34±9.98) years and axial length of (23.99±2.57) mm. There were 139 phakic eye and 6 aphakic eyes. All the eyes received 23G pars plana vitrectomy with scleral incisions at 5.0 mm behind the limbus. To measure the normal Chinese adult parameters of anteroposterior axis of the eyeball, lens thickness and scleral distances from the limbus to the plane passing through the lens posterior apex, the head CT scans of 105 patients without eye diseases in our hospital were studied during the same period of time for these vitrectomy surgeries. Pearson correlation analysis was used to analyze the relationship between age, anteroposterior axis of eyeball, lens thickness and scleral distances from the limbus to the plane passing through the lens posterior apex.ResultsSurgical related complications included retinal tears close to the scleral incision sites (3/145 eyes, 2.1%) and lens injury (3/121 eyes, 2.5%). No other surgical complications occurred, such as retinal hemorrhage, supra-choroidal expulsive hemorrhage and iatrogenic retinal detachment. Based on CT images, the average scleral distance from limbus to the plane passing through the lens posterior apex, anteroposterior axis of eyeball and lens thickness was (6.72±0.81), (24.39±0.97), (4.22±0.47) mm, respectively. The results of Pearson correlation analysis showed that age and lens thickness had statistically significant correlation (r=0.328 9, P=0.000 6).ConclusionPrimary 23G pars plana vitrectomy with incisions at 5.0 mm posterior to the limbus is safe.
Objective To observe the choroidal blood flow and morphological changes in patients with severe stenosis of internal carotid artery stenosis (ICAS). Methods A retrospective case-control study. Forty-six patients (46 eyes) with ICAS were enrolled in this study. There was severe stenosis in one side (the eyes in this side were set as case group) and mild or no stenosis in other side (the eyes in this side were set as control group). Color doppler ultrasound (CDI) was used to observe the changes of hemodynamic parameters of the ophthalmic artery (OA) and posterior ciliary artery (PCA), the main parameters of ultrasound Doppler imaging are peak systolic velocity (PSV), end diastolic velocity (EDV), resistance indices (RI) and the calculation of the pulsation indices (PI) through the use of a formula. Enhanced binarization of deep imaging coherence tomography (EDI-OCT) was used to measure the subfoveal choroidal thickness (SFCT). The total subfoveal choroidal area (TCA), luminal (LA), stromal (SA) and choroidal vascularity index (CVI) were obtained by modified image binarization technique. Results In the case group, the PSV in the OA and PCA was significantly lower than that of the control group (t=−2.200, −2.612; P=0.030, 0.011). There were no significant differences in EDV, RI, PI of OA (t=0.337, −1.810, −1.848; P=0.737, 0.074, 0.068) and PCA (t=−1.160, 1.400, 0.815; P=0.249, 0.165, 0.417). The SFCT (t=−3.711, P＜0.001), TCA (t=−2.736, P=0.007), LA (t=−3.188, P=0.002) and CVI (t=−2.096, P=0.039) of the case group was significantly lower than that of the control group. There were no significant differences in SA (t=−1.262, P=0.210) and LA/SA (t=−1.696, P=0.093). Conclusion In severe stenosis ICAS eyes, the PSV in the PCA and SFCT, TCA, LA, CVI are decreased.
ObjectiveTo observe the outcomes of 23G pars plana vitrectomy (PPV) and air tamponade for non-inferior rhegmatognous retinal detachment (RRD).MethodsA prospective case series study. From August 2017 to April 2018, 39 consecutive RRD patients (39 eyes) in Department of Ophthalmology of Subei People’s Hospital Affiliated to Yangzhou University were enrolled in this study. There were 20 males (20 eyes) and 19 females (19 eyes), 23 right eyes and 16 left eyes, with the mean age of 55±11 years. There were 30 eyes with lens and 9 eyes without lens or IOL. There were 21, 14 and 4 eyes with 1, 2 and equal or greater than 3 retinal tear respectively. All patients underwent 23G PPV which performed preretinal proliferative membranes and vitreous cortex removal, photocoagulation around the breaks with 3-5 rows, and filtered air tamponade. The follow-up was more than 2 months. The retinal reattachment, visual acuity and complications were observed. Pearson correlation analysis was used to analyze the correlation between BCVA and disease course. Chi-square test was performed for comparison among retinal reattachment rate and different clinical factors before operation.ResultsAt 2 months after the PPV, 35 eyes’ retina reattached, the rate of reattachment was 89.8%. In 2-3 weeks, 4 eyes were re-detached, all of them performed silicone oil tamponade. One eye was secondary to pre-macular membrane. The logMAR BCVA before and after PPV were 1.15±0.78 and 0.41±0.31, respectively (t=6.589, P=0.0001). Correlation analysis results showed that BCVA after surgery was positively correlated with BCVA before surgery (r=0.544, P=0.001). Twelve of 30 eyes with crystalline lens suffered cataract. The rate of reattachment vary in the number of the breaks (χ2=9.181, P=0.010).ConclusionPPV with air tamponade may be an optimal treatment of non-inferior RRD with better success rate and security.
ObjectiveTo investigate the lens and ora serrata safety during 23G vitrectomy with sclera incisions at 5.0 mm or 4.0 mm posterior to the limbus.MethodsA prospective case-controlled study was adopted. From April 2016 to January 2018, 290 consecutive primary 23G vitrectomy patients (300 eyes) with vitreoretinal disease in Department of Ophthalmology of Subei People’s Hospital Affiliated to Yangzhou University were enrolled in this study. Among them, 146 patients (150 eyes) received 23G pars plana vitrectomy (PPV) with scleral incisions at 5.0 mm posterior to the limbus (5.0 mm group), and 144 patients (150 eyes) at 4.0 mm (4.0 mm group). No statistically significant difference was found in age, axial length(t=−1.324, 0.867; P=0.186, 0.387) and in gender, right/left eyes, proportion of indications (χ2=1.366, 2.615, 10.195; P=0.242, 0.106, 0.070) between the two groups. The incidence rate of complications between the two groups were comparatively observed, such as lens injury, retinal tears close to the scleral incision, retinal hemorrhage, supra-choroidal expulsive hemorrhage and iatrogenic retinal detachment. Independent sample t test and χ2 test were performed for comparison between the two groups.ResultsLens injury was observed in 4 eyes (2.67%) and 14 eyes (9.33%) respectively in the 5.0 mm and 4.0 mm group during surgery (χ2=5.910, P=0.015). Retinal tears close to the scleral incision sites were observed in 5 eyes (3.33%) and 6 eyes (4.00%) respectively in the 5.0 mm and 4.0 mm group during surgery (χ2=0.094, P=0.759). The mean time of removing the vitreous base was 6.17±2.76 min and 10.03±5.56 min respectively in the 5.0 mm and 4.0 mm group (t=7.599, P＜0.01). No other surgical complications occurred in any group, such as retinal hemorrhage, supra-choroidal expulsive hemorrhage and iatrogenic retinal detachment, etc.ConclusionIn primary 23G PPV, the safety of ora serrata with incisions at 5.0 mm posterior to limbus is similar to that at 4.0 mm, but the safety of lens and the efficiency of vitreous resection is higher with incisions at 5.0 mm.