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Objective To observe the multimodal imaging characteristics of multiple evanescent white dot syndrom (MEWDS).Methods This was a retrospective series case study.Eighteen patients (18 eyes) diagnosed with MEWDS in Eye Center of The Second People's Hospital of Foshan from September 2015 to April 2017 were enrolled in this study.There were 12 females and 6 males,with the mean age of 35.9 years.The disease course ranged from 3 to 90 days,with the mean of 14 days.All the patients underwent BCVA,slit-lamp microscope with +90D preset lens,fundus photography,spectral domain OCT (SD-OCT) and FAF examinations.FFA was simultaneously performed in 6 eyes,FFA and ICGA were simultaneously performed in 12 eyes.Ten patients received the treatment of glucocorticoids and vasodilator substance,and other 8 patients without any treatment.The follow-up duration was 4.5 months.The multimodal imaging characteristics were reviewed and analyzed.Results Fundus color photography showed a variable number of small dots and large spots lesions (14 eyes),and/or fovea granularity (7 eyes) and disk swelling (5 eyes).A variable number of little dots and larger spots lesions showed respectively in FFA,FAF and ICGA were needle-like dots distributed in a wreathlike pattern and a large plaque occasionally confluent of early highly fluorescent,highly autofluorescence and hypofluoresence.Combined hypofluorescent spots with overlying dots were observed in 10 eyes of the late stages of the ICGA.Black lesions in the gray background show in ICGA were the most obvious and the most extensive,gray-white lesions in the gray-black show in FAF were the second,light gray-black lesions in the gray show in FFA were the least.Gray-white lesions in an orange background show in fundus photography were not obvious and transient.SD-OCT showed disruption of the ellipsoid zone and/or accumulations of hyperreflective material from the ellipsoid layer toward the outer plexiform layer and vitreous cells.During the period of following-up,some patients were prescribed low-dose glucocorticoid and some not,almost all the patients except one patient experienced recovery in BCVA and the lesions in fundus imaging.Conclusions The lesions in MEWDS eyes in modern multimodal imaging modalities among fundus photography (fovea granularity),FFA (needle-like dots distributed in a wreathlike pattern and a large plaque occasionally confluent of early highly fluorescent),ICGA (flake hypofluorescent) and SD-OCT (disruption of the ellipsoid zone) showed good consistency.Almost eyes were recovery.
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This paper analyzed the exogenous and endogenous resource elements in a view of their supportive effect on the construction and development of clinical disciplines,proposed the relationship between two resources elements and development of clinical disciplines,,and provided references to the construction of clinical disciplines by elaborating the specific content and focus of these elements.
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BACKGROUND:Liver cancer pathogenesis and intervention have attracted increasing attentions. Mesenchymal stem cel s become a popular tool for cel cancer research, because of their low immunogenicity and tumor tropism. At present, mesenchymal stem cel s have been applied to the study of liver cancer. OBJECTIVE:To summarize the advances of mesenchymal stem cel s used in liver cancer in basic and clinical research. METHODS:An online retrieval of CNKI and Pubmed database was performed by the first author for the articles about mesenchymal stem cel s and effect of modified mesenchymal stem cel s on hepatoma carcinoma cel s published from January 2004 to January 2013. The key words were“mesenchymal stem cel , liver cancer, tumor”in Chinese and English. Repetitive research was excluded, and 47 studies met the inclusion criteria. RESULTS AND CONCLUSION:Stem cel s are seldom reported in liver cancer, and the limited present study show that mesenchymal stem cel s may have a certain influence on the hepatoma carcinoma cel proliferation, invasion and biological behavior. However, due to the differences of cel lines used by the various laboratories, experimental conditions, animal models, as wel as infusion means of stem cel s, experimental results are also inconsistent. Scholars have conducted a series of studies on the mechanism of the Wnt pathway and tumor necrosis factor-related apoptosis-inducing ligand pathway. Tropism of mesenchymal stem cel s to tumor cel s, including liver cancer is widely recognized, so scholars imported therapeutic genes and drugs into mesenchymal stem cel s to interfere with the development of liver cancer, and have achieved some progress. This evidence provides new avenues for cel therapy for liver cancer. Less safety studies in vivo and clinical trials of mesenchymal stem cel s are available, therefore security risks deserve further research.