Primary orbital extraskeletal osteosarcoma and review of literature.

BACKGROUND: Extraskeletal osteosarcoma is a malignant tumour composed of an osteoid and/or cartilaginous matrix; it arises in soft tissues without connection to the skeleton, and to our knowledge, this type of tumour is extremely rare. CASE PRESENTATION: The present study reports a 57-year-old man with primary orbital extraskeletal osteosarcoma who presented with a history of painful swelling in the left orbit that had occurred for 11 months. Imaging of the orbit showed an atypical, well-defined heterogeneous mass attached to the posterior globe of the left orbit. The patient underwent an anterior orbitotomy and complete excision of the tumour. The mass was originated from neither the globe nor the bony orbital wall but from the soft tissue. Histopathology demonstrated an extraskeletal osteosarcoma. After 13 months of follow-up, there was apparent recurrence of the tumour. The medical history showed no complaints of previous trauma or radiotherapy. CONCLUSIONS: ESOS is a highly malignant tumour. Immunosuppression, trauma and adjuvant radiotherapy are possible predisposing factors in the development of this tumour. Prompt recognition and thorough treatment are essential for preventing orbital lesions and presence of metastasis from other organs.

What is the impact of intravitreal injection of conbercept on neovascular glaucoma patients: a prospective, interventional case series study.

BACKGROUND: The aim of the present study was to evaluate the efficacy and safety of intravitreal conbercept combined with trabeculectomy and panretinal photocoagulation for neovascular glaucoma (NVG). METHODS: Fifty patients (54 eyes) with NVG were included in this prospective study. Fifty-two eyes initially underwent intravitreal conbercept (0.5 mg/0.05 ml) treatment followed by trabeculectomy and panretinal photocoagulation. Preoperative and postoperative best-corrected visual acuity (BCVA), intraocular pressure (IOP), the number of antiglaucoma medications, and surgical complications were recorded. The levels of VEGF-A, TGF-ß1 and PLGF in aqueous humour samples collected during surgery were measured by enzyme-linked immunosorbent assay (ELISA). Light microscopy and transmission electron microscopy were used to observe the surgically excised trabecular tissue; enucleation was performed in 2 eyes, and light microscopy was used as the histopathological control. RESULTS: The follow-up period after trabeculectomy was 1 year. Of the 52 eyes, 39 completed 1 year of follow-up, and 13 were lost to follow-up. Recurrence of iris neovascularization was observed in 5 eyes, 9 had hyphema, 16 had filter-bled scarring, and no eye had complications attributable to the drug. The mean IOP was reduced from 48.1 ± 14.2 to 23.2 ± 8.7 mmHg, and the mean number of antiglaucoma medications used decreased from 3.0 (3.0, 4.0) to 1.0 (0.0, 1.0) after 1 year (both P < 0.05). The complete success rate was 76.9, 76.9, 71.0, 51.6, and 32.3% at 1 week, 1 month, 3 months, 6 months and 12 months, respectively, when the cut-off IOP was 18 mmHg. After patients underwent intravitreal injection, the concentrations of VEGF-A and TGF-ß1 in the aqueous humour in NVG patients decreased from 168.8 ± 13.4 and 159.6 ± 15.4 pg/ml to 160.2 ± 7.6 and 151.9 ± 2.3 pg/ml, respectively (both P < 0.05). Light microscopy revealed neovascularization regression in the iris in specimens treated with intravitreal conbercept. Electron microscopy revealed trabecular endothelial cell degeneration in the conbercept-treated specimens. CONCLUSIONS: Our initial findings suggest that intravitreal conbercept is an effective treatment for managing NVG that has fewer short-term postoperative complications. TRIAL REGISTRATION: Current Controlled Trials ChiCTR1800019918 , 8 December 2018, retrospectively registered.

Assessment of p16 expression and HPV infection in adenoid cystic carcinoma of the lacrimal gland.

Purpose: Adenoid cystic carcinoma (ACC) in the lacrimal gland is a rare malignancy. P16 is encoded by the CDKN2A gene, which is recognized as a tumor suppressor due to its inactivation in many types of tumors. However, p16 overexpression is also linked to adverse tumor parameters. These contradictory observations have also been confirmed in ACCs in the salivary glands. Furthermore, evidence of human papilloma virus (HPV) infection is found in a proportion of ACCs in the salivary glands. P16 is often overexpressed in HPV-related squamous cell carcinoma in parallel. To our knowledge, the role of p16 and HPV in ACCs in the lacrimal gland is still unknown. Methods: Twenty-one ACCs in the lacrimal gland and ten matched healthy lacrimal glands were studied. P16 was detected with immunohistochemistry (IHC), and HPV was detected with in situ hybridization (ISH) and PCR in all cases. Other cell cycle proteins were also detected with IHC, including cyclin D1 and Ki67. The methylation status of the p16 promoter was detected with methylation-specific PCR (MSP) to further investigate the regulation of p16 expression. Results: The expression rates of p16 (47.6%, 10/21), cyclin D1 (100%, 21/21), and Ki67 (52.4%, 11/21) were increased in ACCs compared to healthy lacrimal glands (negative). The results showed p16 expression was limited to the inner ductal epithelial cells in the majority of the tubular and cribriform patterns. In solid ACCs, p16 was uniformly positive. HPV was negative in all 21 cases with ISH and PCR. P16 overexpression was associated with cyclin D1 overexpression (p=0.013). Only 13 cases were tested successfully with MSP. The expression rate of p16 methylation was 23.1% (3/13) of the ACCs. Compared with primary ACCs, recurrent ACCs showed higher p16, cyclin D1, and Ki67 expression (p=0.011, p=0.026, p=0.049, respectively). Conclusions: In summary, p16 overexpression was cell-type dependent in ACCs in the lacrimal gland, while HPV infection was negative. P16 overexpression was unrelated to HPV infection. The mechanism of p16 overexpression needs to be further investigated in ACCs in the lacrimal gland.

Future Trend Forecast by Empirical Wavelet Transform and Autoregressive Moving Average.

In engineering and technical fields, a large number of sensors are applied to monitor a complex system. A special class of signals are often captured by those sensors. Although they often have indirect or indistinct relationships among them, they simultaneously reflect the operating states of the whole system. Using these signals, the field engineers can evaluate the operational states, even predict future behaviors of the monitored system. A novel method of future operational trend forecast of a complex system is proposed in this paper. It is based on empirical wavelet transform (EWT) and autoregressive moving average (ARMA) techniques. Firstly, empirical wavelet transform is used to extract the significant mode from each recorded signal, which reflects one aspect of the operating system. Secondly, the system states are represented by the indicator function which are obtained from those normalized and weighted significant modes. Finally, the future trend is forecast by the parametric model of ARMA. The effectiveness and practicality of the proposed method are verified by a set of numerical experiments.

Intraocular myofibroblastoma in an infant: a case report.

BACKGROUND: Myofibroblastoma is a benign tumor composed of spindle cells and bands of hyalinized collagen. Intraocular myofibroblastoma in infancy is rarely encountered. CASE PRESENTATION: The present study reports the case of a 4-month-old female baby with intraocular myofibroblastoma. She was suspected as corneal perforation due to the rupture of a corneal neoplasm in the right eye. The anterior segment was also involved according to the Color Doppler ultrasonography. A surgical exploration was performed and the protuberant part of the mass was resected. Conventional HE staining showed numerous spindle-shaped cells with bands of collagen beneath multilayers of well-differentiated corneal epithelia. Immunohistochemical staining demonstrated the tumor cells were strong positive for vimentin and smooth muscle actin, while negative for S-100 protein. The mass was confirmed as myofibroblastoma. After 12 month follow-up, there was no apparent growth of the tumor. CONCLUSIONS: Myofibroblastoma is a very rare type of intraocular neoplasm, which may have complicated manifestation and could be misdiagnosed as dermoid or Peter's anomaly. Histopathological and immunohistochemical staining is crucial to form a precise diagnosis.

[Clinicopathologic characteristics of angioleiomyoma of the eyelids and orbit].

OBJECTIVE: To analyze the clinical pathologic characteristics of angioleiomyoma of the eyelid and orbit. METHODS: Retrospective case series study. The clinical and pathological characteristics of 8 cases of eyelid and orbital angioleiomyoma which were treated in Tianjin Eye Hospital from January 2005 to April 2014 were reviewed and analyzed. RESULTS: In the 8 cases, 5 were male and 3 were female. The median age was 52.5 years (32.0 to 65.0). Six cases of angioleiomyoma occurred in the orbit. Three of them located in the muscle cone, 2 of them located in superotemporal orbit and 1 of them located in the inferior orbit. The remaining 2 cases of angioleiomyoma occurred in the medial side of the eyelid subcutanously. Five cases were male and three cases were female. Seven cases revealed a solitary eyelid or orbital mass. One case of orbital angioleiomyoma companied with a cavernous hemangioma of ipsilateral lower eyelid. The color Doppler ultrasound of the orbit showed a well-demarcated mass with homogeneous inner-echoes without obviously blood stream signal. The CT showed a circumscribing rounded or irregular shaped soft mass with isotropic density and the CT value were 45 to 50 Hu. Grossly, the tumor appeared as a rounded or irregular oval ranged from 0.7 to 2.8 cm. Six cases had complete fibrous capsule. Microscopically, the tumor was mainly consisted of well-differentiated smooth muscle cells and thick-walled vessels. Five cases were cavernous type, two cases were venous type and one case was solid type according to histological classification. The smooth muscle cells surrounding the vascular walls and the intervascular muscle bundles showed a positive reaction for smooth muscle actin (SMA) and desmin by immunohistochemical staining. Eight patients underwent complete resection of mass. During the surgery, the tumor was observed with clear boundary and capsule surrounded by mild adhesive tissue. CONCLUSIONS: Angioleiomyoma of the eyelids or orbit was a uncommon benign tumor which was usually occured in adults, with well-encapsulated and composed of numerous thick-walled vessels and smooth muscle components. It should be considered in differential diagnosis of a well-circumscribed orbital mass, and distinguished from leiomyoma or cavernous hemangioma in pathological diagnosis.

[The study of the changes of ultra- microstructure after a momentary action of femtosecond laser with human corneal tissue in vivo].

OBJECTIVE: To observe the changes of pathology and ultra- microstructure of corneal lenticules extracted by femtosecond laser small incision lenticule extraction surgery and to investigate instantaneous damage of photodisruption of femtosecond laser to human corneal tissue in vivo. METHODS: The small incision lenticule extraction surgeries in 25 myopic eyes were performed with Carl Zeiss VisuMax femtosecond laser, and the lenticules were observed by light microscopy, scanning electron microscopy and transmission electron microscopy. RESULTS: Light microscopy showed slight edema in part of the collagen fibers in the cornea lenticule tissue. A thin layer of deep tissue dyeing at the edge of the lenticule was observed on a linear array. In the center of superficial lenticule tissue existed a few bubbles. Under the scanning electron microscope, the anterior surface of the lenticule was found to be relatively smooth, with no obvious tissue bridge. The posterior surface of the lenticule was slightly irregular compared with the anterior surface. Scattered tissue bridges and residual traces of the effect of femtosecond laser photodisruption could be observed. Under the transmission electron microscope, adjacent collagen fiber layers in the corneal lenticule matrix were detected to cross each other regularly, with no breakage of the collagen fibers or separation of the layers. The incision of the collagen fibers on one side of the lenticule was on a linear alinement. It can also be observed that the central part of the lenticule was mildly damaged. However, the stroma cells near the lenticule limbus were severely damaged. Part of the corneal stroma cells were solidified with several shivers, which might be due to the photodisruption. Some of the damaged corneal stroma cells were observed with remnants, while the spaces occupied by part of the corneal cells became fractured. CONCLUSIONS: Obvious damage of the femtosecond laser to the corneal tissue at early stage was not observed. At the edge of the area where femtosecond laser focused, there were mild thermal injury and slight structure change. There were not abnormal appearances of the tissue structure at the non-focus area.

[The clinical and pathological characteristics of 14 cases of primary iris stromal cysts].

OBJECTIVE: To analysis the clinical and pathological characteristics of primary iris stromal cyst. METHODS: Retrospective cases series study. 14 cases of primary iris stromal cyst which were treated in Tianjin Eye Hospital from Jan.1979 to Dec. 2012 were collected. They were all proved by pathological results. Their clinical and pathological features were analyzed. RESULTS: The age of 14 patients were 5 months to 50 years old, the median is 10 years old.10 patients (71.4%) were attacked from children or adolescence, among which onset age of 8 patients were less than 1-year-old. 4 patients (28.6%) occurs when they were adults. 10 cases were female and 4 cases were males. 10 cases were left eyes, 4 cases were right eyes. All cases were unilateral involvement. In these cases, 11 cases appeared as a single translucent or gray-white cystic mass on the iris surface, which 6 cases located in the inferior aspect of the iris, 2 cases appeared with diffused iris cyst and another 1 case's cyst was found occasionally in the eyeball enucleating specimen. 8 cases had corneal opacity or leucoma, 7 cases had secondary glaucoma, and 3 cases had complicated cataract. Pathological features showed: cysts located on the iris surface or in the stroma layer. The cysts of 9 cases were constructed of non-cuticular stratified squamous epithelium cells. 3 cases' cysts were constructed of lens epithelium cells and lens capsular analogical tissues, and the cysts adhesion to the lenstightly. The other 2 cysts were constructed of single or stratified epithelium cells, similar to ciliary epithelium cells. 2 cases complicated with crystalline lens dysplasia, 3 cases complicated with iris tissue dysplasia, 2 cases complicated with ciliary cysts and 1 case had chamber angle dysplasia. CONCLUSIONS: Primary iris stoma cyst is rare and it usually occurs in infant, more often in the children less than 1-year-old. Pathological examination showed that most of the cysts originated from the conjunctivaepithelium, minority cysts originated from crystalline lens epithelium or ciliary epithelium. Some cases complicated with iris, ciliary or crystalline lens malformation.

[Clinical and pathological observation of seven cases of spontaneous sub-retinal hemorrhage].

OBJECTIVE: To improve pathological understanding of massive sub-retinal hemorrhage. METHODS: Retrospective case series study. The clinical and pathological data of 7 cases of massive sub-retinal hemorrhage which were examined in the Pathological Department of Tianjin Eye Hospital from May 1988 to April 2012 were collected. The serial section of eyeball specimens were made with HE and PAS staining. The pathological section were reviewed under the light microscope. Analysis were made again combining with patients' clinical history, imaging findings and the pathological features. RESULTS: In 7 patients, 6 patients were male, 1 patient was female. The age range was from 60 to 82 years old and the average age was 71.7 years old. Four cases were on the right eye and 3 cases were on the left eye. The main clinical feature was sudden loss of vision and 2 cases had acute glaucoma symptoms. Ultrasound examination showed choroidal tumor in 6 cases and retinal detachment with vitreous hemorrhage in one case. The color Doppler ultrasound examination demonstrated choroidal substantive occupying lesion in 3 cases and two of them were detected with blood flow signal. The MRI were examined in 3 cases which showed iso-high signal in T1W1 and iso-low signal in T2W1 suggesting the choroidal melanoma in 2 cases and sub-retinal hemorrhage in 1 case. Six cases were diagnosed clinically as choroidal tumor or melanoma and 1 case was diagnosed as acute angle-closure glaucoma. The enucleation were performed in 7 cases. In these cases, 6 cases were diagnosed pathologically as vitreous hemorrhage, hemorrhagic RPE detachment and massive subretinal hemorrhage. The related choroidal lesions included soft drusen of Bruch membrane in 3 cases, choriocapillaris wall degeneration in 2 cases, fibrovascular membrane formation under RPE in 2 cases, choroidal chronic non-granulomatous inflammation in 4 cases, choroidal vessels wall thickening and sclerosis in 2 cases and choroidal vessels anomaly in one case. The secondary angle-closure glaucoma or angle-open glaucoma were accompanied respectively in 2 cases. Another case of 7 cases was diagnosed pathologically as the rupture of retinal macroaneurysm with massive sub-retinal hemorrhage. CONCLUSIONS: Massive sub-retinal hemorrhage liked to occur in the elderly male patients. The main manifestations were sudden visual loss. A small number of patients had symptoms of acute glaucoma. Ophthalmic ultrasound and imaging characteristics were usually similar to the choroidal substantive neoplasm and were easily misdiagnosed as choroidal melanoma. Pathological examination revealed that the main reasons of massive hemorrhage were from the hemorrhagic RPE detachment and the rupture of retinal macroaneurysm.

Rapid intracellular pH measurement based on electroporation- surface-enhanced Raman scattering.

In this study, electroporation-surface-enhanced Raman scattering (SERS) was applied to rapidly measure intracellular pH. The generation of a sensitive SERS probe for measuring pH in the range of 6.0-8.0 was accomplished through the conjugation of the pH-sensitive molecule 4-mercaptobenzoic acid (4-MBA) to the surface of gold nanoparticles (Au NPs) through its thiol functional group. This bioprobe was then rapidly introduced into nasopharyngeal carcinoma CNE-1 cells by electroporation, followed by SERS scanning and the fitting of intensity ratios of each detection point's Raman peaks at 1423 cm-1 and 1072 cm-1, to create the pH distribution map of CNE-1 cells. The electroporation-SERS assay introduces pH bioprobes into a living cell in a very short time and disperses the nanoprobe throughout the cytoplasm, ultimately enabling rapid and comprehensive pH analysis of the entire cell. Our work demonstrates the potential of electroporation-SERS for the biochemical analysis of live cells.

Epidermal growth factor potentiates EGFR(Y992/1173)-mediated therapeutic response of triple negative breast cancer cells to cold atmospheric plasma-activated medium.

Cold atmospheric plasma (CAP) holds promise as a cancer-specific treatment that selectively kills various types of malignant cells. We used CAP-activated media (PAM) to utilize a range of the generated short- and long-lived reactive species. Specific antibodies, small molecule inhibitors and CRISPR/Cas9 gene-editing approaches showed an essential role for receptor tyrosine kinases, especially epidermal growth factor (EGF) receptor, in mediating triple negative breast cancer (TNBC) cell responses to PAM. EGF also dramatically enhanced the sensitivity and specificity of PAM against TNBC cells. Site-specific phospho-EGFR analysis, signal transduction inhibitors and reconstitution of EGFR-depleted cells with EGFR-mutants confirmed the role of phospho-tyrosines 992/1173 and phospholipase C gamma signaling in up-regulating levels of reactive oxygen species above the apoptotic threshold. EGF-triggered EGFR activation enhanced the sensitivity and selectivity of PAM effects on TNBC cells. The proposed approach based on the synergy of CAP and EGFR-targeted therapy may provide new opportunities to improve the clinical management of TNBC.

[The clinicopathologic observation of 64 cases of eyelid and eyebrow pilomatrixoma].

OBJECTIVE: To study the clinicopathologic characteristics of eyelid and eyebrow pilomatrixoma. METHODS: It was a retrospective case series study. The clinical and pathological characteristics of 64 cases of eyelid pilomatrixoma who were treated in Tianjin Eye Hospital or Tianjin Gongan Hospital from May 2003 to October 2012 were reviewed and analysed. RESULTS: In 64 cases, 21 cases were male(32.8%), 43 were female( 67.2%). The age at the time of diagnosis ranged from 1 to 66 years, 27 cases(42.1%) were before age 10 years, 13 cases(20.3%) were before age 20 years, 11 cases(17.2%) were before age 30 years, 13 cases were beyond age 30 years. The tumors were more frequent in children and younger patients, mainly involved the eyebrow and upper lid, 42 cases (65.6%) were eyebrow, 18 cases (28.1%) were upper lid, 3 cases (4.7%) were lower lid, and 1 case was inner canthus, no prominently differences between right and left eyes were showed. The clinical features mainly presented with a slowly growing asymptomatic solid mass attached to the skin, which were frequently a round nodule, clearly demarcated and more hard, with skin overlying the lesion was normal or presented some reddish or bluish discoloration. The history of the most cases were several months to one year. The greatest diameter of tumors ranged from 4 mm to 16 mm besides one case was 3.2 cm. The tumors were consisted of darkly staining basaloid cells and shadow cells, which most cases associated with polynuclear giant cell reaction and chronic inflammation. There were 24 cases(37.5%) showed varying degrees of calcification and 6 cases showed ossification, one case was presented an epidermoid cyst in the tumor and one case associated with a pilomatrixoma on homolateral upper extremity skin. CONCLUSIONS: Pilomatrixoma is a benign neoplasm which is mainly consisted of basaloid cells and shadow cells, usually combined with inflammation, foreign body giant cells, calcification and ossification.If a child or young patient has a firm subcutaneous mass in the upper eyelid or eyebrow area, a pilomatrixoma should be suspected.

Integrated Whole-Exome and Transcriptome Sequencing Indicated Dysregulation of Cholesterol Metabolism in Eyelid Sebaceous Gland Carcinoma.

Purpose: To identify the molecular background of eyelid sebaceous gland carcinomas (SCs), we conducted the integrated whole-exome sequencing and transcriptome sequencing for eyelid SCs in this study. Methods: The genetic alterations were studied by whole-exome sequencing, and the messenger RNA expression was studied using Oxford Nanopore Technologies (ONT) in five paired fresh eyelid SC tissues and adjacent normal tissues. Integrated analysis of exome and transcriptomic information was conducted for filtering candidate driver genes. Protein-protein interaction (PPI) network of filtered candidate genes was analyzed by STRING. The protein expression was verified by immunohistochemistry in 29 eyelid SCs and 17 compared normal sebaceous gland tissues. Results: The average numbers of pathogenic somatic single-nucleotide variants (SNVs) and indels in eyelid SCs were 75 and 28, respectively. Tumor protein p53 (TP53), zinc finger protein 750 (ZNF750), filaggrin 2 (FLG2), valosin-containing protein (VCP), and zinc finger protein 717 (ZNF717) were recurrent mutated genes. A mean of 844 differentially expressed genes (DEGs) were upregulated, and 1401 DEGs were downregulated in SC samples. The intersection of DEG-based pathways and mutation-based pathways was mainly involved in microbial infection and inflammation, immunodeficiency, cancer, lipid metabolism, and the other pathways. The intersection of DEGs and mutated genes consisted of 55 genes, of which 15 genes formed a PPI network with 4 clusters. The PPI cluster composed of scavenger receptor class B member 1 (SCARB1), peroxisome proliferator-activated receptor γ (PPARG), peroxisome proliferator-activated receptor γ coactivator 1α (PPARGC1A) was involved in cholesterol metabolism. The expression of SCARB1 protein was found to be increased, whereas that of PPARG protein was decreased in eyelid SCs compared to that in the normal sebaceous glands. Conclusions: Increased SCARB1 and decreased PPARG indicated that dysregulation of cholesterol metabolism might be involved in carcinogenesis of eyelid SCs. Translational Relevance: The malfunction in cholesterol metabolism might advance our knowledge of the carcinogenesis of eyelid SCs.

Shifted-excitation Raman difference spectroscopy for improving in vivo detection of nasopharyngeal carcinoma.

A strong fluorescence background is one of the common interference factors of Raman spectroscopic analysis in biological tissue. This study developed an endoscopic shifted-excitation Raman difference spectroscopy (SERDS) system for real-time in vivo detection of nasopharyngeal carcinoma (NPC) for the first time. Owing to the use of the SERDS method, the high-quality Raman signals of nasopharyngeal tissue could be well extracted and characterized from the complex raw spectra by removing the fluorescence interference signals. Significant spectral differences relating to proteins, phospholipids, glucose, and DNA were found between 42 NPC and 42 normal tissue sites. Using linear discriminant analysis, the diagnostic accuracy of SERDS for NPC detection was 100%, which was much higher than that of raw Raman spectroscopy (75.0%), showing the great potential of SERDS for improving the accurate in vivo detection of NPC.

A review on reactive oxygen species (ROS)-inducing nanoparticles activated by uni- or multi-modal dynamic treatment for oncotherapy.

Cancer seriously threatens human health. As compared to normal tissue cells, tumor cells are generally more susceptible to oxidative stress and accumulate higher concentrations of reactive oxygen species (ROS). Accordingly, nanomaterials-based therapies that boost intracellular ROS generation have recently been effective in targeting and eliminating cancer cells by causing programmed death. This review presents a comprehensive analysis of ROS-generation induced by nanoparticles and critically examines the associated therapies which can be categorized as uni-modal (chemodynamic therapy, photodynamic therapy, sonodynamic therapy) and multi-modal (uni-modal therapy + chemotherapy, uni-modal therapy + uni-modal therapy) therapies. Comparison of the relative tumor volume ratio between the experimental and initial tumor volumes shows that multi-modal therapy significantly outperformed other treatments. However, the limitations of multi-modal therapy are in the difficulties of materials preparation and sophisticated operation protocols, thus limiting its applications in clinical practice. As an emerging treatment modality, cold atmospheric plasma (CAP) is a reliable source of ROS, light, and electromagnetic fields that can be used to implement multi-modal treatments in a simple setting. Therefore, the field of tumor precision medicine is expected to increasingly benefit from these promising and rapidly emerging multi-modal therapies based on ROS-generating nanomaterials and reactive media such as CAPs.

[Clinical and histopathological features of conjunctival myxoma and angiomyxoma].

OBJECTIVE: To explore the clinical and pathological features of conjunctival myxoma and angiomyxoma. METHODS: It was a retrospective case series study. The clinical and pathological features of 3 cases of conjunctival myxoma and 2 cases of conjunctival angiomyxoma were analyzed. These cases were treated from January 2005 to December 2010 at Tianjin Eye Hospital. Routine pathological examinations and immunohistochemical staining were performed, including staining for Vimentin, S-100, SMA and CD34. RESULTS: In the 5 patients, 2 cases were male and 3 cases were female. The mean age was (55.8 ± 14.8) years, ranging from 40 to 74 years. The tumors presented as yellow-pink, translucent, cystic and(or) with solid masses. Regarding the tumor location, 2 cases involved the temporal side, 1 case involved the nasal side, 1 case involved the nasal limbus and invaded the cornea, and 1 case involved the nasal, temporal and inferior parts. The lesions of the 5 cases were excised under local anaesthesia. Histopathological examination revealed that the conjunctival myxomas were composed of abundant mucoid material and relatively small numbers of small, ovoid, spindle and stellate shaped cells with sparse vessels. The histologic features of the conjunctival angiomyxoma were similar to those of myxomas with the exception of the former being characterized by a prominent vascular structure. The immunohistochemical staining showed that tumor cells were positive for Vimentin, but negative for S-100 protein; some tumor cells were positive for CD34 and SMA. The follow-up was performed in 4 cases post-operation. One case experienced recurrence 1 month after surgical excision. CONCLUSIONS: Most of the conjunctival myxoma and angiomyxoma appear as a local yellow-pink, translucent, cystic and(or) with solid mass, and some of which had multiple tumors. The preferred management route is complete surgical excision.

[Study on the structure and function of inferior oblique connective tissue in different mammals].

OBJECTIVE: The purpose of this research lied in studying the structure and function of connective tissue of inferior oblique (IO) in rhesus, rabbit and rat. METHODS: It was an experimental study. Two adult monkeys (rhesus), five adult rabbits and five adult Wistar rats were involved in this study. The gross anatomy of an orbit in each animal was observed. Meanwhile, the fellow orbit was processed with paraffin imbedding and coronal serial section. Masson trichrome stain was used to distinguish muscle and collagen, and Weigert stain was performed for identification of elastin. RESULTS: The connective tissue around IO muscle in rhesus, rabbits and rats all connected with inferior rectus (IR) and lateral rectus (LR), but the arrangements among them were not entirely similar. Only the connective tissue around IO in rhesus consisted of dense collagen, scattered elastic fiber, and connected closely with IR, LR Pulley. The connective tissue circling IO in rabbit and rat were crumbly, and was not connected closely with the connective tissue around IR. CONCLUSION: IR and LR Pulley has some mechanics link with IO in rhesus, and can play roles in covergence in rhesus.

[Study on the structure and function of superior oblique connective tissue in different mammals].

OBJECTIVE: The purpose of this research lied in studying the structure and function of connective tissue of superior oblique (SO) in rhesus and rabbit. METHODS: It was an experimental study. Two adult monkeys (rhesus) and five adult rabbits were involved in this study. The gross anatomy of an orbit in each animal was observed. Meanwhile, the fellow orbit was processed with paraffin imbedding and coronal serial section. Masson trichrome stain was used to distinguish muscle and collagen, and Weigert stain was performed for identification of elastin. RESULTS: Connective tissue around SO in both mammals thickened anteriorly, reflected in the trochlea along with the SO tendon, and became contiguous with the nasal aspect of the SR connective tissue ring, while the tendon passed inferior to the SR pulley to insert on the sclera. CONCLUSION: The contraction of SO OL can cause SR shift nasally. This may explain the mechanism of vestibulo-ocular reflex (VOR) partly.

[Clinicopathological observation of solitary fibrous tumor of the orbit].

OBJECTIVE: To study the clinicopathological characteristics of orbital solitary fibrous tumor. METHODS: It was a retrospective case series study. The clinical and pathological characteristics of 8 cases of orbital solitary fibrous tumor that were treated in Tianjin Eye Hospital from January 2003 to December 2011 were reviewed and analyzed. Immunohistochemical staining was performed, investigating the expression of CD34, vimentin, S-100 and SMA. RESULTS: In the 8 cases, 5 cases were male and 3 cases were female; 6 cases involved the right orbit and 2 cases involved the left orbit. Patients' ages ranged from 30 to 60 years, and the mean age was 41 years; duration of symptoms ranged from 2 months to 5 years. The locations of the tumor were in the superior or superotemporal orbit (5 cases), lacrimal sac and medial orbit (2 cases), or inferior orbit (1 case). The clinical features mainly included the swelling of the upper lid, unilateral painless orbital or lacrimal sac mass, proptosis and diplopia. CT scan usually revealed a moderately or intensely enhanced mass that was well-circumscribed. Complete tumor removal was performed in all cases. The tumor sizes ranged from 1.2 - 3.1 cm and appeared as a round or irregular oval mass with a thin fibrous capsule; incomplete capsule was found in 3 tumors. Microscopic observation revealed that the tumor was composed mainly of spindle or oval cells in a fascicular, storiform, hemangiopericytoma-like or a "patternless" pattern, with numerous thick bands of collagen that showed diffuse positive staining for CD34 and vimentin. Five cases had been followed-up from 6 to 86 months postoperatively, no evidence of local recurrence had been found in these patients. CONCLUSIONS: Orbital solitary fibrous tumor is a spindle cell tumor with diffuse positive staining for CD34 and vimentin. This tumor usually is well circumscribed and encapsulated. Complete excision is the preferred treatment. The tumor should be distinguished from other spindle cell tumors in the orbit.

Multimodal therapy in the management of primary orbital mesenchymal chondrosarcoma.

AIM: To evaluate the ophthalmic manifestations, radiographic features, and prognosis of Chinese patients with primary orbital mesenchymal chondrosarcoma (MCS). METHODS: The study included 6 cases with primary orbital MCS treated at Tianjin Eye Hospital from January 2009 to December 2019. Patitent ophthalmic manifestations, radiographic features, diagnosis, pathology, therapeutic regimens, and prognosis were retrospectively reviewed. RESULTS: Six patitents with primary orbital MCS were identified. The mean age at the first visit was 33y (range, 25-42y). All six patients displayed manifestations of exophthalmos, diplopia, limitation of eye displacement, upper eyelid oedema, decreased visual acuity and ptosis. The mean disease history and range were 5 and 2-8mo, respectively. The tumors were located in the superonasal extraconal compartment (2/6, 33.3%), intraconal compartment (2/6, 33.3%), and bitemporal extraconal compartment (2/6, 33.3%), respectively. Radiographic features were a well-defined, orbital mass with calcification and ossification on computed tomography (CT), and marked heterogenous enhancement on dynamic magnetic resonance imaging (MRI). Five patients were treated with tumor resection and one patient received orbital exenteration. Five patients in the cohort received postoperative radiation therapy, two patients received chemotherapy, and one patient did not receive postoperative adjuvant therapy because he refused. The histopathologic classification revealed a tumour composed of a mixture of mature chondroid tissue surrounded by small, round, and undifferentiated mesenchymal cells. Immunohistochemistry revealed Bcl-2, vimetin, CD99, and S-100 were expressed were expressed. After surgeries, two patients have developed a local recurrence. The median recurrence time of 58mo (52-64mo). One patient had distant recurrence included the lungs occurred 52mo after the initial surgery. CONCLUSION: The possibilty of orbital MCS need to be considered when a painless, slowly growing orbital mass with calcification and ossification. From our experience, trimodality treatment of radiation therapy, chemotherapy and surgery maybe the best option. Orbital MCS has a high tendency for late recurrence, regular long-term follow-up after complete excision is mandatory.