Effect of navigation endoscopy combined with three-dimensional printing technology in the treatment of orbital blowout fractures.

AIM: To explore the combined application of surgical navigation nasal endoscopy (NNE) and three-dimensional printing technology (3DPT) for the adjunctive treatment of orbital blowout fractures (OBF). METHODS: Retrospective analysis was conducted on the data of patients with OBF who underwent surgical treatment at the Affiliated Eye Hospital of Nanchang University between July 2012 and November 2022. The control group consisted of patients who received traditional surgical treatment (n=43), while the new surgical group (n=52) consisted of patients who received NNE with 3DPT. The difference in therapeutic effects between the two groups was evaluated by comparing the duration of the operation, best corrected visual acuity (BCVA), enophthalmos difference, recovery rate of eye movement disorder, recovery rate of diplopia, and incidence of postoperative complications. RESULTS: The study included 95 cases (95 eyes), with 63 men and 32 women. The patients' age ranged from 5 to 67y (35.21±15.75y). The new surgical group and the control group exhibited no statistically significant differences in the duration of the operation, BCVA and enophthalmos difference. The recovery rates of diplopia in the new surgical group were significantly higher than those in the control group at 1mo [OR=0.03, 95%CI (0.01-0.15), P<0.0000] and 3mo [OR=0.11, 95%CI (0.03-0.36), P<0.0000] post-operation. Additionally, the recovery rates of eye movement disorders at 1 and 3mo after surgery were OR=0.08, 95%CI (0.03-0.24), P<0.0000; and OR=0.01, 95%CI (0.00-0.18), P<0.0000. The incidence of postoperative complications was lower in the new surgical group compared to the control group [OR=4.86, 95%CI (0.95-24.78), P<0.05]. CONCLUSION: The combination of NNE and 3DPT can shorten the recovery time of diplopia and eye movement disorder in patients with OBF.

Tumor subtypes and signature model construction based on chromatin regulators for better prediction of prognosis in uveal melanoma.

Background: Uveal Melanoma (UM) is the most prevalent primary intraocular malignancy in adults. This study assessed the importance of chromatin regulators (CRs) in UM and developed a model to predict UM prognosis. Methods: Gene expression data and clinical information for UM were obtained from public databases. Samples were typed according to the gene expression of CRs associated with UM prognosis. The prognostic key genes were further screened by the protein interaction network, and the risk model was to predict UM prognosis using the least absolute shrinkage and selection operator (LASSO) regression analysis and performed a test of the risk mode. In addition, we performed gene set variation analysis, tumor microenvironment, and tumor immune analysis between subtypes and risk groups to explore the mechanisms influencing the development of UM. Results: We constructed a signature model consisting of three CRs (RUVBL1, SIRT3, and SMARCD3), which was shown to be accurate, and valid for predicting prognostic outcomes in UM. Higher immune cell infiltration in poor prognostic subtypes and risk groups. The Tumor immune analysis and Tumor Immune Dysfunction and Exclusion (TIDE) score provided a basis for clinical immunotherapy in UM. Conclusion: The risk model has prognostic value for UM survival and provides new insights into the treatment of UM.

Artesunate inhibits proliferation and migration of RPE cells and TGF-ß2 mediated epithelial mesenchymal transition by suppressing PI3K/AKT pathway.

AIM: To study the braking effectiveness of artesunate on transforming growth factor (TGF)-ß2 mediated epithelial-mesenchymal transition (EMT) in retinal pigment epithelium (RPE) in vitro. METHODS: The fostered ARPE-19 cells were processed with artesunate alone or combined with the TGF-ß2. The CCK-8 examination was utilized to test the cell propagation. Cell migration was detected by scratch as well as the Transwell examination. The EMT characters and activation of PI3K/Akt signal channel were estimated by Western blotting and immunofluorescence. The Western blotting was utilized in order to confirm the vitreous of controls as well as patients with proliferative vitreoretinopathy (PVR) were collected and the levels of PI3K, phospho-PI3K, Akt. RESULTS: Disposal of ARPE-19 cells with artesunate (50-150 µmol/L) obviously suppressed their propagation and immigration, which dependent on the concentration and time. Artesunate suppressed the EMT which was induced by TGF-ß2 in ARPE-19 cells through sustaining the expression of vimentin and α-SMA through the suppression of PI3K, phospho-PI3K, phospho-Akt and Akt. Levels of PI3K, phospho-PI3K, AKT and phospho-Akt was increased in the vitreous in PVR (P<0.05). CONCLUSION: Such findings indicate that PI3K/Akt signal channel is highly activated in vitreous of PVR. Artesuante is an operative depressor of the propagation, immigration and TGF-ß2-mediated EMT of ARPE-19 cells by reduced the expression of PI3K/Akt channel.

Artesunate inhibits the development of PVR by suppressing the TGF-ß/Smad signaling pathway.

Proliferative vitreoretinopathy (PVR) is the main cause of retinal detachment surgery failure. The epithelial-mesenchymal transition (EMT) induced by transforming growth factor (TGF-ß2) plays an important role in the development of PVR. Artesunate has been widely studied as a treatment for ophthalmic diseases because of its antioxidant, anti-inflammatory, antiapoptotic and antiproliferative properties. The purpose of this study was to investigate the effects of artesunate on the TGF-ß2-induced EMT in ARPE-19 cells and PVR development. We found that artesunate inhibited the proliferation and contraction of ARPE-19 cells after the EMT and the autocrine effects of TGF-ß2 on ARPE-19 cells. Additionally, the levels of Smad3 and p-Smad3 were increased in clinical samples, and artesunate decreased the levels of Smad3 and p-Smad3 in ARPE-19 cells treated with TGF-ß2. Artesunate also inhibited the occurrence and development of PVR in vivo. In summary, artesunate inhibits the occurrence and development of PVR by inhibiting the EMT in ARPE-19 cells.

Biological role of postoperative low level laser therapy in preventing hydroxyapatite orbital implantation exposure: A case report.

Conjunctival sac stenosis is the contraction of the conjunctival sac as a result of trauma or disease. The aim of the present study was to observe the clinical effects of low-level laser therapy (LLLT) combined with hydroxyapatite (HA) orbital implantation as a treatment strategy for conjunctival sac stenosis. A total of 10 patients with conjunctival sac stenosis were treated with scleral graft transplantation in conjunction with HA implantation and postoperative LLLT. In addition, a rabbit model was used to investigate the biological mechanism underlying the effects of LLLT with the aim of preventing and treating orbital implantation exposure. The right eyeball was removed, orbital implantation performed and LLLT applied to experimental groups. 99mTc-Methyl diphosphonate scanning methods were performed at different timepoints to compare the average radioactivity count of the region of interest between surgical (right) and control (left) eyes (R/L). Histopathological examination was performed 8 weeks post-surgery, followed by analysis of fiber vascularization. Following LLLT, moderate conjunctival wounds were completely healed within 2 weeks and severe stenosis wounds healed within 3 weeks. Following prosthesis implantation in the rabbit model, a significantly elevated R/L ratio was observed after 4 weeks, whereas no significant difference was observed compared with the control group at 6 and 8 weeks postoperatively. Histopathological examination revealed that all implants were fibrotic. Overall, the present study demonstrated that LLLT promoted the survival of conjunctival grafts, stimulated conjunctival incision healing and promoted early vascularization of HA implants. Clinical trial registration no: ChiCTR-DDT-12002660 (www.chictr.org/cn/).

Analysis of the effect of repair materials for orbital blowout fracture on complications.

AIM: To investigate the effect of repair materials for orbital blowout fractures on the occurrence of postoperative complications. METHODS: The clinical data and follow-up data of 54 subjects with orbital blowout fractures were retrospectively analyzed. The study was divided into three groups according to the used repair materials: titanium mesh (16 cases), Medpor (12 cases), and Medpor titanium mesh (26 cases). All test data were analyzed using the SPSS version 23.0 statistical software. The mean age and duration of disease between the groups were compared through one-way analysis of variance. The Chi-square (χ 2) test was used to compare the number of males and females, different fracture types, and different surgical approaches among groups. The χ 2 test was used to compare the frequencies for complications in each group. RESULTS: The baseline characteristics of age and gender in each group were matched (F=1.763, P=0.172; χ 2=0.026, P=0.987). In addition, there was no difference in the type of fracture and surgical approach (χ 2=0.460, P=0.977; χ 2=0.691, P=0.952), or the incidence of complications (χ 2=0.081, P=0.960) between the three groups. CONCLUSION: Although there is no difference in effect of various repair materials on the incidence of complications, the effect of repair materials on postoperative complications of orbital blowout fractures should not be ignored.

[Study on main pharmacodynamics and underlying mechanisms of 999 Ganmaoling].

To observe synergistic effects of 999 Ganmaoling (GML) and its Chinese/Western materia medica (CMM and WMM) on pharmacodynamic action and to study underlying mechanisms, their anti-inflammatory, antipyretic effects were compared by assaying the increased capillary permeability induced by glacial acetic acid in mice, ear swelling induced by Xylene in mice, non-specific pleurisy induced by carrageenan in rats, and yeast induced fever in rats. Crystal violet (CV) and microbial activity (XTT) assay were used to evaluate the inhibition of GML and its CMM and WMM on KPN biofilm formation, and scanning electron microscopy (SEM) was applied for observing KPN biofilm morphology changes. The results showed that compared with control group, GML could reduce exudation amount of Evans-Blue and the degree of Ear swelling significantly, and CMM and WMM have no significant effects. The concentration of TNF-α and IL-1ß of rat pleural effusion in GML, CMM and WMM group decreased significantly. The concentration of TNF-α, IL-1ß and IL-8 in GML group, TNF-α, IL-8 in WMM group and IL-8 in CMM in rats serum decreased significantly. The body temperature in rats decreased significantly in GML and WMM group after 4-8 h of administration. CMM group showed no significant difference in rat body temperature compare with control. Compared with control group, GML (55-13.75 g•L⁻¹) could inhibit KPN biofilm formation and reduce number of viable cells in the KPN biofilm. CMM (45-22.5 g•L⁻¹) and WMM (10 g•L⁻¹) could also inhibit KPN biofilm formation and reduce number of viable cells (P<0.01). Result of SEM also showed that GML (55 g•L⁻¹) and its CMM (45 g•L⁻¹) and WMM (10 g•L⁻¹) could interfere the bacterial arrangement of KPN biofilm and extracellular matrix. GML and its CMM & WMM could inhibit the formation of KPN biofilm, CMM & WMM in GML showed synergism and complementation in inhibit KPN biofilm. Results showed that GML had obvious anti-inflammatory and antipyretic effects and could destruct KPN mature biofilm. WMM and CMM showed obvious synergistic effect against inflammation and inhibition of KPN biofilm formation and reduction of number of viable cells but no same effects against fever.

Helium-neon laser therapy in the treatment of hydroxyapatite orbital implant exposure: A superior option.

The aim of the present study was to evaluate the efficacy of helium-neon laser therapy in the treatment of hydroxyapatite orbital implant exposure and compare the results with those of a combined drugs and surgery regimen. A total of 70 patients with hydroxyapatite orbital implant exposure in 70 eyes were randomly divided into two groups: Helium-neon laser therapy (group A) and drugs plus surgery (group B). Each group contained 35 patients. The healing rates and times of the conjunctival wound were recorded and compared following helium-neon laser treatment or the drugs plus surgery regimen. Changes in the hydroxyapatite orbital implant prior to and following helium-neon laser irradiation were analyzed. A similar animal study was conducted using 24 New Zealand white rabbits, which received orbital implants and were then received drug treatment or helium-neon therapy. In the human experiment, the rates for conjunctival wound healing were 97.14% in group A and 74.29% in group B, with a significant difference between the groups (χ2=5.71, P<0.05). Patients with mild exposure were healed after 7.22±2.11 days of helium-neon laser therapy and 14.33±3.20 days of drugs plus surgery. A statistically significant difference was found between the groups (t=8.97, P<0.05). Patients with moderate to severe exposure were healed after 18.19±2.12 days of helium-neon laser therapy and 31.25±4.21 days of drugs plus surgery. The difference between the groups was statistically significant (t=7.91, P<0.05). Enhanced magnetic resonance imaging showed that the helium-neon laser therapy significantly promoted vascularization of the hydroxyapatite orbital implant. These results, combined with pathological findings in animals, which showed that a helium-neon laser promoted vascularization and had anti-inflammatory effects, suggest that helium-neon laser irradiation is an effective method for treating hydroxyapatite orbital implant exposure, thereby avoiding secondary surgery.

[Study on the stress distribution of different superstructures for tooth-implant supported denture].

PURPOSE: To compare the stress distributions of fixed bridge, cement-retained telescopic prostheses and extracoronal precision attachment (CEKA attachment) when connect the implants to the natural teeth, in order to find a more suitable design for it. METHODS: 3-D finite element models of tooth-implant partial fixed dentures were constructed by using the ANSYS software. The partial fixed denture was supported by the second premolar and an implant (substitute the second molar). A total load of 200N was distributed to the three units of the denture in vertical and lateral (45 degree) directions. RESULTS: Both of the cement-retained telescopic and the CEKA attachment made the stress of the osseous tissues surrounding the implant and the tooth declined obviously under the loads of the two directions. The stress of the cement-retained telescopic was lower under vertical load,the stress of Ceka attachment was lower under lateral load while it caused the stress of the natural tooth increasing slightly. The stress under the lateral load was higher than that under the vertical load. CONCLUSION: Both of the cement-retained telescopic and the CEKA attachment can improve the stress distribution of tooth-implant support denture. The CEKA attachment is better under lateral loads.