[Human amniotic membrane plug for recurrent retinal detachment associated with pathologic myopic macular hole].

A 60-year-old woman presented with a history of "pathological myopia combined with macular hole retinal detachment, " for which she underwent vitrectomy, internal limiting membrane tamponade, and silicone oil filling surgery one year ago. Seven months ago, the silicone oil was removed. She now returned to seek medical attention as her visual acuity has declined by 10 diopters. Examination revealed a recurrence of macular hole retinal detachment. The patient was treated with combined amniotic membrane tamponade and silicone oil filling. During the surgery, the frozen amniotic membrane was cut into 2 mm × 2 mm and placed under the macular hole retina after silicone oil filling. Within 6 months after the surgery, her retina repositioned well, the macular hole closed, and her visual function improved from hand motion to 0.05. No severe complications were observed. Therefore, this surgical approach provides a new perspective for treating recurrent pathological myopia combined with macular hole retinal detachment.

[In situ semiconductor laser fenestration of type A aortic dissection during thoracic endovascular aortic repair].

Objective: To investigate the feasibility, efficacy and safety of semiconductor laser in situ fenestration of type A aortic dissection during thoracic endovascular aortic repair. Methods: The clinical data of 68 patients with type A aortic dissection treated by semiconductor laser in situ fenestration from June 2016 to January 2020 in Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University were analyzed retrospectively. Of the patients, 45 were male, 23 were female, the mean age was (52±14) years. The technical success rate and complication rates were assessed. Results: The technical success rate of 68 patients was 92.6% (63/68), only 5 patients failed due to the complex aortic arch type, 3 patients underwent chimney stent implantation, 2 patients underwent artificial vessel bypass. During the perioperative period, 1 patient died due to severe pulmonary infection, 4 patients developed neurological symptoms such as cerebral infarction after surgery, and the remaining patients had no related complications. Postoperative CTA follow-up indicated that the primary intercalation rupture was completely closed, and the main and branch stents were patency, 8 (8.8%) type Ⅰ leakage were occurred. Conclusion: It showed that in situ semiconductor laser fenestration is a feasible, effective and safe method to treat type A aortic dissection.

[The effectiveness and safety of topical 0.1% tacrolimus after high-risk penetrating keratoplasty].

Objective: To observe the effectiveness and safety of topical 0.1% tacrolimus(FK506) as immunosuppressant in high-risk penetrating corneal transplantation to prevent the immune rejection and to compare the outcomes with topical 1% Cyclosporin A (CsA). Methods: The study consists of 49 patients (50 eyes), who were fitted with the high-risk corneal transplantation standard and undergone the penetrating keratoplasty(PKP) or combined operation in Beijing Tongren hospital between March 2015 to September. With the time sequence, the patients were divided into observation group (FK506 group) and the control group (CsA group). The observation group included 9 females and 16 males with an average age of 57.8±14.8. Twenty-four patients were in the control group (25 eyes), including 10 females and 14 males, with an average age of (45.1±16.2). Observation group was treated with topical 0.1% tacrolimus, and the control group treated with topical 1%CsA. Both groups' treatment combined glucocorticoid as well. Two groups had 1 year follow-up observation. The incidence of rejection was compared by statistical methods of Cox regression. The adverse reactions were graded and compared using Mann-Whitney U test. Results: After one year, 22 cases of the observation group and 23 cases of the control group were accomplished all observations. The rejection rate was 4.54% in observation group and 27.23% in control group. The difference between the groups was statistically significant (χ(2)=4.291, P=0.038). Control group had high rejection rate. Besides, there was no severe side effects happened in both groups. After 1 month after surgery, 36.4% of the observation group showed mild corneal edema. The ratio of mild to moderate corneal edema in the control group was 26.1% and 8.7%. Three months after surgery, 4.5% of the observation group showed mild corneal edema, while 13.0% and 13.0% of the control group was found mild to moderate corneal edema. Six months after surgery, 4.5% of the observation group showed moderate corneal edema. The ratio of mild, moderate to severe corneal edema in the control group was 17.4%, 17.4% and 8.7%. The degree of corneal edema in the control group was more serious in three monthes(Z=-2.770, -2.018, -2.941, P<0.05). The differences in both monthes were statistically significant. Mild neovascularization occurred in the 13.6% of observation group. Mild to severe neovascularization occurred in the 13.0%, 4.3%, and 4.3% control groups. The degree of neovascularization in the control group was higher than that in the observation group(Z=-3.221, P=0.001). The differences in both months were statistically significant. Mild to moderate neovascularization occurred in the 18.2% and 9.1% of observation group. Mild to extremely severe neovascularization occurred in the 17.4%, 26.1%, 4.3% and 4.3% control groups. The degree of neovascularization in the control group was higher than that in the observation group(Z=-1.988, P=0.047).The differences in both monthes were statistically significant. Conclusions: Both 0.1% tacrolimus and 1% cyclosporine A are safe and effective in reducing the rejection after high-risk corneal transplantation. (Chin J Ophthalmol, 2019, 55: 419-427).

[The effect of extending proximal landing zone in thoracic endovascular aortic repair on the prognosis of Stanford type B aortic dissection].

With the continuous development of endovascular surgery, thoracic endovascular aortic repair (TEVAR) has gradually replaced traditional open surgery and has become the preferred treatment strategy for Stanford type B aortic dissection. However, the disadvantage of the short proximal landing zone greatly limited the indication of TEVAR surgery and affected the prognosis. In recent years, many strategies such as hybrid surgery, in vitro fenestrated and branched aortic endo-graft, chimney technique, in-situ fenestration technique, etc., have been developed, which greatly broadens the TEVAR indication and improved the prognosis.

First serologic survey of Q fever in free-range yaks in China.

The objective of the present investigation was to determine the seroprevalence of Coxiella burnetii infection in free-range yaks in China. A total of 552 serum samples were collected from yaks in Gansu province, northwest China between April 2013 and January 2014, and antibodies against C. burnetii were evaluated using enzyme-linked immunosorbent assay (ELISA). Overall, 13.59% (75/552, 95% CI: 10.73-16.45) of the examined animals were positive for C. burnetii antibodies. There was no significant difference in C. burnetii seroprevalence between female yaks (13.78%, 95% CI: 10.36-17.19) and male yaks (13.13%, 95% CI: 7.89-18.36) (P>0.05). Coxiella burnetii seroprevalence in yaks in different age groups ranged from 10.88% to 15.26%, but the difference was not statistically significant (P>0.05). Coxiella burnetii seroprevalence in yaks sampled in different seasons ranged from 12.06% (autumn) to 18.33% (summer), but the difference was not statistically significant (P>0.05). This is the first report of C. burnetii seroprevalence in free-range yaks in China, indicating the need for measures to be taken to control C. burnetii infection in free-range yaks in China.

Seroprevalence, risk factors and genetic characterization of Toxoplasma gondii in free-range white yaks (Bos grunniens) in China.

The objective of this study was to determine the seroprevalence, risk factors and genotypes of Toxoplasma gondii in white yaks (Bos grunniens) in China. A total of 974 serum samples were collected from white yaks in Tianzhu Tibetan Autonomous County (TTAC), Gansu province, northwest China for detecting T. gondii antibodies by the modified agglutination test (MAT), and 414 tissues belonging to 138 white yaks were collected for detecting T. gondii DNA by amplification of B1 gene with a semi-nested PCR. A total of 155 serum samples (15.91%) were seropositive for T. gondii antibodies at a 1:100 cut-off, and 10 DNA samples (7.25%) were positive for the T. gondii B1 gene, which were genetically characterized using multilocus PCR-RFLP. Only one genotype (ToxoDB#9) was identified from two samples with complete genotyping results. Statistically significant differences were not observed between T. gondii seroprevalence and gender, season or pregnancy in the logistic regression analysis (P>0.05). Ages of white yaks was considered as a main risk factor associated with T. gondii infection. Our results indicated a widespread exposure to T. gondii among white yaks, and revealed the genotype ToxoDB#9 of T. gondii in white yaks for the first time in China.

Proto-oncogene expression in differentiating and non-differentiating chronic myelogenous leukaemia cells.

Despite the profound differences between the chronic and blastic phases of chronic myelogenous leukaemia, no differences between chronic and blastic phase cells have been described at the molecular level. Differences have been found in the levels of expression of c-myc, c-myb and p53, which fell when chronic phase cells were cultured, while the levels of expression of the genes were stable when blastic crisis cells were cultured. In contrast c-fms expression increased and MRS expression decreased after culture of chronic or blastic phase cells. The data suggest that the regulation of expression of some genes in blastic crisis cells is unaltered while that of others is disrupted. It is not known whether the failure of c-myc, c-myb and p53 expression to fall during the culture of blastic phase cells is the cause of or a reflection of the failure of these cells to differentiate.

The effects of cytosine arabinoside and GM-CSF in leukemic cells in vitro.

An in vitro pilot study was conducted of the possible utility of combining low doses of cytosine arabinoside (araC) and GM-CSF to stimulate leukemic cell differentiation. Cytosine arabinoside induced macrophage differentiation in some cultures but only when the drug produced substantial cytostatic effects. GM-CSF, when present alone, failed to induce leukemic cell differentiation. When GM-CSF and araC were simultaneously present the level of both araC associated cytotoxicity and araC associated differentiation were reduced in 3 studies. In only a single study was there evidence suggesting that GM-CSF increased araC-associated differentiation.

Studies of the proliferation and differentiation of immature myeloid cells in vitro: 4: Preculture proto-oncogene expression and the behaviour of myeloid leukemia cells in vitro.

Studies were conducted to determine the relationship between the pretherapy characteristics of leukemia cells and their behaviour during culture in vitro. Leukemia cells which proliferated well in vitro also proliferated well in vivo. Cells which manifested myeloid or monocytic differentiation in vivo tended to manifest differentiation along these lines in vitro. Cells which manifested high levels of expression of c-fms, c-fes, or triose phosphate isomerase prior to culture were likely to differentiate in vitro, with high levels of c-fes expression being related to myeloid maturation. These observations suggest that differentiation at the molecular level prior to culture is a requisite for leukemia cell differentiation in vitro. The same may be true for differentiation in vivo under the influence of exogenously administered agents such as cytotoxic chemotherapy or recombinant growth factors.

Effects of rGM-CSF on leukemia cell proliferation and on the incorporation of cytosine arabinoside into DNA.

In vitro studies of the effects of recombinant granulocyte macrophage-colony stimulating factor (rGM-CSF) on freshly obtained human leukemia cells were conducted to determine if there is a relationship between the effects of this growth factor on the proliferative characteristics of leukemia cells and on their incorporation of cytosine arabinoside (araC) into DNA. While rGM-CSF was found to be able to stimulate both leukemia cell proliferation and araC incorporation, for individual leukemia specimens there was no consistent relationship among these effects. In some specimens proliferation was stimulated without an increase in araC incorporation. The reverse was also observed. These studies demonstrate the difficulty in identifying assays capable of predicting the clinical effects of growth factors on leukemia cells in patients since the effect in vitro vary with the assay.