Role of macrophage in ocular neovascularization.

Ocular neovascularization is the leading cause of blindness in clinical settings. Pathological angiogenesis of the eye can be divided into corneal neovascularization (CoNV), retinal neovascularization (RNV, including diabetic retinopathy and retinopathy of prematurity), and choroidal neovascularization (CNV) based on the anatomical location of abnormal neovascularization. Although anti-Vascular endothelial growth factor (VEGF) agents have wide-ranging clinical applications and are an effective treatment for neovascular eye disease, many deficiencies in this treatment strategy remain. Recently, emerging evidence has demonstrated that macrophages are vital during the process of physiological and pathological angiogenesis. Monocyte-macrophage lineage is diverse and plastic, they can shift between different activation modes and have different functions. Due to the obvious regulatory effect of macrophages on inflammation and angiogenesis, macrophages have been increasingly studied in the field of ophthalmology. Here, we detail how macrophage activated and the role of different subtypes of macrophages in the pathogenesis of ocular neovascularization. The complexity of macrophages has recently taken center stage owing to their subset diversity and tightly regulated molecular and metabolic phenotypes. In this review, we reveal the functional and phenotypic characterization of macrophage subsets associated with ocular neovascularization, more in-depth research is needed to explore the specific mechanisms by which macrophages regulate angiogenesis as well as macrophage polarization. Targeted regulation of macrophage differentiation based on their phenotype and function could be an effective approach to treat and manage ocular neovascularization in the future.

HPLC-DAD Analysis, SFE-CO2 Extraction, and Antibacterial Activity on Bioactive Compounds from Mosla chinensis Maxim.

Mosla chinensis Maxim is an annual herb with many potential purposes in agricultural, industrial, and pharmaceutical fields. At present, the extract of the whole plant from M. chinensis has been proven to demonstrate antifungal, antioxidant, and anti-inflammatory activities. Previous studies focused on the enzyme pretreatment in hydrodistillation from M. chinensis. However, organic solvent or supercritical fluid carbon dioxide extraction (SFE-CO2) methods, which are commonly utilized in industry, have seldom been studied and cannot provide multiple evaluations of yield. In this work, we analysed compounds from M. chinensis by HPLC-DAD, discussed n-hexane extraction, and conducted further investigations on SFE-CO2 through the design of response surface methodology (RSM). The sample obtained from pilot-scale SFE-CO2 was also tested against nine kinds of microorganisms. Single-factor results revealed that the extraction rates from M. chinensis by steam distillation, n-hexane extraction, and SFE-CO2 were 1%, 2.09%, and 3.26%, respectively. RSM results showed a significant improvement in extraction rate through optimising pressure and time, and the interaction of both factors was more important than that of temperature-pressure and temperature-time. A pilot-scale test with an extraction rate of 3.34% indicated that the predicted RSM condition was operable. In addition, samples from the pilot-scale SFE-CO2 showed antibacterial effects against three previously unreported bacteria (Gardnerella vaginalis, methicillin-resistant Staphylococcus aureus, and Propionibacterium acnes). These results fill the gap in previous research and provide more information for the application and development of M. chinensis in the future.

Gadolinium Enhances Dual-energy Computed Tomography Scan of Pulmonary Artery.

OBJECTIVE: To evaluate the feasibility of using gadopentetate dimeglumine (Gd-DTPA) for dual-energy computed tomography pulmonary angiography (CTPA). METHODS: Sixty-six patients were randomly divided into three groups and underwent CTPA. Group A had a turbo flash scan using an iohexol injection, Group B had a turbo flash scan using Gd-DTPA, and Group C had a dual-energy scan using Gd-DTPA. The original images of Group C were linearly blended with a blending factor of 0.5 or reconstructed at 40, 50, 60, 70, 80, 90, 100, and 110 keV, respectively. The groups were compared in terms of pulmonary artery CT value, image quality, and radiation dose. RESULTS: The pulmonary artery CT values were significantly higher in Group C40keV than in Groups B and C, but lower than in Group A. There was no significant difference in the image noise of Groups C40keV, B, and C. Moreover, Group A had the largest beam hardening artifacts of the superior vena cava (SVC), followed by Groups B and C. Group C40keV showed better vascular branching than the other three groups, among which Group B was superior to Group A. The subjective score of the image quality of Groups A, B, and C showed no significant difference, but the score was significantly higher in Group C40keV than in Groups A and B. The radiation dose was significantly lower in Group B than in Groups A and C. CONCLUSION: Gd-CTPA is recommended to patients who are unsuitable for receiving an iodine-based CTPA. Furthermore, a turbo flash scan could surpass a dual-energy scan without consideration for virtual monoenergetic imaging.

Opacification of refractive bifocal intraocular lens in one month: Three case reports.

RATIONALE: Multifocal intraocular lenses (IOLs) are used widely. However, the discovery of LS-313 MF15/30 (Oculentis B.V.) opacity during surgery has not yet been reported. This article reports 3 cases of LS-313 MF15/30 (Oculentis B.V.) IOL opacity found during cataract surgery implantation within 1 month. PATIENT CONCERNS: Three patients underwent cataract surgery, and opacification of their IOL (LS-313 MF15/30, Oculentis B.V.) was found intraoperatively. DIAGNOSIS: The patient was diagnosed with a postoperative intraocular opacity. INTERVENTIONS: In case 1, the surgeon scrubbed the IOL with intraocular perfusion fluid and a gelatin sponge swab to reduce opacity in the central optical area of the IOL and then implanted it into the capsule bag. In case 2, the surgeon used the infusion-aspiration polishing mode for cleaning. To avoid IOL wear and bag damage, washing was stopped when turbidity in the center of the optical area was reduced. In case 3, we learned from our previous experience that the surgeon cut the IOL into 2 pieces and moved it out at the main incision, which was replaced and implanted with a brand new IOL, after the implanted IOL was again found cloudy. OUTCOMES: In case 1, more than 10 months after the surgery, the IOL was restored to transparency, no obvious eye discomfort was noted, and uncorrected visual acuity was 20/25. In case 2, the patient's IOL surrounding area was still partially turbid after more than 10 months of follow-up. In case 3, the patient's uncorrected visual acuity on postoperative day 1 was 20/20, and the best-corrected visual acuity was 20/20. LESSON: There are many reasons for the opacification of the IOL. In addition to the patient's own factors, the material, production, and packaging of the IOL, as well as the influence of external environmental temperature, the influence of the IOL implant instrument should not be ignored and needs to be considered.

[Preoperative prediction for lymph node metastasis of rectal nonmucinous adenocarcinoma based on radiomics classifier].

OBJECTIVE: To determine the value of radiomics in identifying lymph node (LN) metastasis in patients with rectal nonmucinous adenocarcinoma.
 Methods: Imaging data of 91 patients were retrospectively analyzed (61 in the training set and 30 in the test set). A total of 1 301 radiomics features were extracted from high-resolution T2-weighted images of the whole primary tumor. The least absolute shrinkage and selection operator (LASSO) logistic regression was performed to choose the optimal features and construct a radiomics classifier in the training set. Its discrimination performance was compared with that of morphological criteria by receiver operating characteristic (ROC) curve analysis, which was validated in the test set.
 Results: The radiomics classifier combined with five key features was significantly associated with LN metastasis, which distinguished LN metastasis with an area under curve (AUC) at 0.874 (95% CI 0.787 to 0.960) in the training set, and the performance was similar in the test set (AUC 0.878, 95% CI 0.727 to 1.000). The AUCs according to the morphological criteria in the training set and test set were 0.619 (95% CI 0.487 to 0.752) and 0.556 (95% CI 0.355 to 0.756), respectively. Discrimination of the radiomics classifier was superior to that of morphological criteria in both the two datasets (both P <0.05).
 Conclusion: The radiomics classifier provides individualized risk estimation for LN metastasis in rectal nonmucinous adenocarcinoma patients and it has the advantage over the morphological criteria.

Use of the chop hook to stabilize the capsular bag in patients with crystalline lens dislocations and cataracts.

Objective To observe the treatment effects of chop hook-assisted phacoemulsification surgery in patients with crystalline lens dislocation. Methods Thirty-seven eyes with cataracts and crystalline lens dislocations underwent cataract surgery. An L-shaped chop hook was introduced into the anterior chamber, and the tip was pushed or pulled to the centre of the anterior capsular edge of the zonular dialysis during the cataract operation. Postoperative follow-up was conducted for ≥ 1 month. Results All patients' postoperative visual abilities improved except one patient with glaucoma. One patient who underwent -5D intraocular lens implantation exhibited vision of 1/50. Visual acuity was less than 6/20 in 6 eyes, 6/20 to 10/20 in 7 eyes, and greater than 10/20 in 22 eyes. Conclusions L-shaped chop hooks can be used to push or pull the anterior capsular edge of the zonular dialysis for protection and avoidance of further zonular damage. This strategy provides satisfactory effects and reduces use of additional instruments.

Multifocal Toric Intraocular Lens for Traumatic Cataract in a Child.

A child suffering from traumatic cataract and corneal astigmatism of 2.14 D had a phacoemulsification operation and implantation of a ReSTOR Toric intraocular lens (IOL) to correct the astigmatism. The primary outcome measurements were the uncorrected distance visual acuity (UDVA), uncorrected near vision at 40 cm, intraocular pressure, spherical equivalent refraction, residual astigmatism, corneal astigmatism, presence of unusual optical phenomena, and use of spectacles. At 7 months postoperatively, UDVA was maintained between 16/20 and 24/20, near vision was between J1 and J3, residual spherical refraction was 0-0.37 D, and residual refractive cylinder was between 0 and 0.67 D. A multifocal toric IOL can provide the possibility of satisfactory vision for both distant and near conditions without the use of spectacles to meet children's needs when studying and doing sports. Additionally, binocular vision can be reconstructed. This intervention, therefore, seems to be a satisfactory alternative.

[The clinical efficacy of treatment on the cases of severe hallux valgus by the first metatarsal basal osteotomy combined with Chevron-Gerbert operation].

OBJECTIVE: To evaluate the clinical efficacy of treatment on the cases of severe hallux valgus by the first metatarsal basal osteotomy combined with Chevron-Gerbert operation. METHODS: From June 2004 to August 2008, 37 cases of severe hallux valgus (66 feet) underwent first metatarsal basal osteotomy combined with Chevron-Gerbert operation. There were 5 males (10 feet) and 21 females (38 feet), aged 21 - 76 years (mean 58 years). For all patients with follow-up, radiographic measurements of frontal and lateral position of foot were taken to measure the hallux valgus angle (HVA), the IMA (intermetatarsal angle) and the proximal articular set angle (PASA) preoperatively, postoperatively and in follow-up respectively. The measuring results were compared among the preoperative, the 6-week postoperative and the final follow-up. At the same time the patients were evaluated with the AOFAS Maryland score. RESULTS: Of the original 37 patients, 26 patients (48 feet) were followed up. The mean durations of follow-up was 2.3 years (range from 1 to 4 years). At final follow-up, HVA corrected 25.6° ± 3.8°, IMA corrected 8.6° ± 2.4°, and PASA corrected 4.7° ± 4.2°. According to AOFAS rating system, 91.7% patients were rated as excellent or good with excellent in 15 patients (28 feet), good in 8 patients (16 feet), and fair in 3 patients (4 feet). CONCLUSIONS: First metatarsal basal osteotomy combined with Chevron-Gerbert operation has good efficacy to the patients with severe hallux valgus. However there are disadvantages such as complexity relatively for multi-stage osteotomy and internal fixation.

[The vola stress change of patients after operation of wrop-around flap for thumb reconstruction].

OBJECTIVE: To analyse the vola stress change after operation of wrop-around flap for thumb reconstruction,to know the influence of vola pressure change after operation of wrop-around flap. METHODS: From 1996 to 2004, 23 patients after the operation of wrop-around flap for thumb reconstruction were measured the entire footprint, the vola stress of single foot and double feet on static state and walking status. There were 16 males and 7 females,with a mean age of 23.7 years (17 to 42 years). The time from operation to measuring was 1.6 to 6 years (meana 3.8 years). The results of measuring were analyzed. RESULTS: Whether static footprint analysis or dynamic mechanical analysis, the plantar pressure distribution of donated foot were obviously different with those of the opposite site. The weight bearing of heel and the fourth and fifth metatarsal heads were nearly consistent with normal foot. But the former feet were obviously different. The weight bearing of the first metatarsal head was obviously lower than normal foot. And the weight bearing of the second and third metatarsal heads were obviously higher than normal foot. CONCLUSION: The operation of wrop-around flap for thumb reconstruction has advantage of the cosmesis and function of the reconstructed thumbs nearly consistent with normal thumbs. But the operation influences the postoperative foot pressure.