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Table of Content

    16 August 2017 Volume 31 Issue 4
      
    Design of treatment protocol in refractive cataract surgery is important for postoperative visual outcomes.
    BI Hongsheng
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  1-4.  doi:10.6040/j.issn.1673-3770.1.2017.026
    Abstract ( 1215 )   PDF (1070KB) ( 757 )   Save
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    Cataract surgery has developed from the traditional visual rehabilitation operation to refractive cataract surgery. Ophthalmologists should not only master knowledge related to cataract, but should also have an in-depth understanding of the optometric and refractive theory. Ophthalmologists need to plan and design the entire treatment protocol before, during, and after cataract surgery according to the visual function needs of the patients and on the basis of accurate preoperative examination, with customization of the treatment program for the individual patient. In addition, with the use of advanced surgical equipment and perfect surgical skills, excellent postoperative visual function can be attained.
    Effects of mydriasis on anterior chamber parameters measured by a Pentacam before and after cataract surgery.
    YANG Yuhuan, ZHANG Jie, ZHANG Jinpeng, YAN Hong
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  5-8.  doi:10.6040/j.issn.1673-3770.1.2017.024
    Abstract ( 1345 )   PDF (889KB) ( 602 )   Save
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    Objective To observe the effect of mydriasis on center anterior chamber depth, anterior chamber volume, corneal surface keratometry and astigmatism before and after cataract surgery. Methods This study included 25 eyes of 22 patients diagnosed with cataract and indicated for phacoemulsification with intraocular lens(IOL)implantation at Tangdu Hospital, the Fourth Military Medical University.For each patient, anterior segment parameters were measured 1-2 days before and after surgery, respectively, using a Pentacam HR system under conditions of normal pupils and dilated pupils. Results The mean preoperative central anterior chamber depths were(2.71±0.56)mm and(2.79±0.53)mm before and after mydriasis, respectively(t=-4.246; P<0.001). The mean postoperative central anterior chamber depths were(3.60±0.98)mm and(4.45±0.35)mm before and after mydriasis, respectively(t=-4.473;P<0.001). The mean postoperative anterior chamber volumes were(146.9±37.1)mm3 and(163.3±33.9)mm3 before and after mydriasis, respectively(t=-3.633;P= 0.001). Conclusions The central anterior chamber depths before and after cataract surgery and the anterior chamber volumes after cataract surgery increase after mydriasis, which may lead to errors in IOL calculation. In patients with cataracts, the central anterior chamber depths and anterior chamber volumes should be measured before mydriasis.
    Application of anterior chamber maintainer in posterior capsular rupture in cataract surgery.
    ZHENG Wanqiu, WAN Wenjuan, LI Can
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  9-12.  doi:10.6040/j.issn.1673-3770.1.2017.029
    Abstract ( 1178 )   PDF (3707KB) ( 604 )   Save
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    Objective To evaluate the effect of anterior chamber support on posterior capsular rupture in cataract surgery. Methods A total of 22 cases(22 eyes)with posterior capsular rupture during cataract surgeries that were performed between January 2014 and December 2016 were retrospectively evaluated. An anterior chamber maintainer(ACM)was used to facilitate the extraction of residual lens cortex. The following clinical parameters were recorded preoperatively and after one and seven days post-operatively: the best corrected visual acuity(BCVA), intraocular pressure(IOP), corneal edema, inflammation of the anterior chamber, and complications. Results The patients post-operative BCVA significantly improved relative to the pre-operative BCVA. Normal IOP, mild corneal edema, and mild inflammation of the anterior chamber were reported. No severe complications were found during or after surgery. Conclusion Application of ACM in cases of posterior capsular rupture during cataract surgery may stabilize the anterior chamber, alleviate vitreous disturbance, prevent expansion of posterior capsular rupture, and facilitate the extraction of residual lens cortex.
    Comparison of high order aberrations in pseudophakia with spherical intraocular lens and aspheric intraocular lens implantation.
    TIAN Jing, LIAO Xuan, LAN Changjun, TAN Qingqing, LIN Jia, WEN Baiwei
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  13-17.  doi:10.6040/j.issn.1673-3770.1.2017.031
    Abstract ( 1786 )   PDF (902KB) ( 918 )   Save
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    Objective To compare the corneal, internal, and ocular high order aberrations(HOAs)in pseudophakia of spherical intraocular lens(IOL)with aspheric IOL implantation, and to provide evidence for individual selection of aspheric IOL. Methods A prospective, non-randomized, controlled clinical study was conducted on 112 age-matched cataract patients(160 eyes). Patients were divided into four groups, and implanted with AMO Sensor AR40 IOL(group AR40, 40 eyes of 26 patients), AMO Tecnis ZA9003 IOL(group ZA9003, 40 eyes of 31 patients), Bausch & Lomb SofPort AO IOL(group AO, 40 eyes of 28 patients), or Alcon SN60WF IQ IOL(group IQ, 40 eyes of 27 patients). The corneal, internal, and ocular HOAs including total HOA(tHOA), spherical aberration(SA), coma, and trefoil were measured at three months postoperatively with a pupil diameter(PD)of 4 mm or 6 mm. Result There were no statistically significant differences in postoperative uncorrected visual acuity and best corrected visual acuity, and in postoperative corneal tHOA, SA, coma, and trefoil at 4 mm or 6 mm PD among the four groups. At 4 mm PD, there were significant differences in internal SA and coma but no differences in tHOA and trefoil; at 6 mm PD, there were significant differences in internal tHOA, SA, and coma but no differences in trefoil. In addition, there were significant differences in ocular tHOA and SA but no differences in coma and trefoil at 4 mm or 6 mm PD among the four groups. Conclusion Phacoemulsification of the cataract and implantation of an aspheric IOL can reduce corneal SA, resulting in enhanced visual quality. For aspheric IOLs with other SAs, the predictability of corneal SA is exact, which provides a clinical basis for personalized implantation of aspheric IOLs.
    Analysis of the effects of implantable contact lens and femtosecond laser small incision lenticule extraction for high myopia on ocular surface.
    XU Jingjing, GUO Haike
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  18-20.  doi:10.6040/j.issn.1673-3770.1.2017.030
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    Objective To compare differences in tear rupture time and tear meniscus height between patients with high myopia who received an implantable contact lens(ICL)or who underwent femtosecond laser small incision lenticule extraction(SMILE). Methods Of 23 patients(46 eyes)with high myopia, 11(22 eyes)underwent SMILE and 12(24 eyes)underwent ICL. At 1 and 3 postoperative months, the two groups were compared for tear film rupture time and tear stream height differences, and statistical analysis of the results was performed. Results The mean tear-film rupture times in the ICL group and SMILE group were shorter than before surgery, but there was no significant difference between the two groups(P>0.05). The mean tear-film rupture time returned to preoperative levels at 3 months after surgery. The tear meniscus height in the ICL group and the SMILE group was still lower than before surgery, but the difference was not statistically significant(P>0.05). Conclusion There was no significant difference in tear-film rupture time and tear meniscus height between posterior chamber ICL and SMILE. The reduced tear meniscus height after surgery may be related to medication.
    The calculation of intraocular lens refractive power
    WANG Lei, ZHANG Han
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  21-28.  doi:10.6040/j.issn.1673-3770.1.2017.028
    Abstract ( 2017 )   PDF (916KB) ( 1243 )   Save
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    This review describes the principles and practice involved in the calculation of intraocular lens(IOL)refractive power. The theories behind formulas for calculating IOL power are described, using regression and optical methods. The review emphasizes the importance of establishing a precise estimation of corneal power as well as accurate techniques for the measurement of axial length and for predicting postoperative anterior chamber depth. The review concludes that current improvements in diagnostic and surgical technology, combined with the latest IOL refractive power formulas, make the calculation and selection of appropriate IOL power among the most effective tools in refractive surgery today.
    Multifocal intraocular lens: progress in clinical application.
    WEI Chao, ZHANG Han
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  29-35.  doi:10.6040/j.issn.1673-3770.1.2017.027
    Abstract ( 973 )   PDF (918KB) ( 715 )   Save
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    The incidence of cataract, which is a common eye disease, is increasing every year. Phacoemulsification and intraocular lens implantation is an effective method to treat cataract. A monofocal intraocular lens can provide adequate distance visual acuity, but spectacles should be used to compensate for near visual acuity deficiency. With the development of technology, the use of multifocal intraocular lens(MIOL)is increasing. The aim of this review is to summarize the principle, characteristics, and current research progress regarding use of MIOL for treating visual acuity deficiency.
    Selection of intraocular lens for patients with age-related macular degeneration.
    JI Shuaifei, ZHANG Jie, YAN Hong
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  36-39.  doi:10.6040/j.issn.1673-3770.1.2017.025
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    Age-related macular degeneration(AMD)is a major problem, and is the leading cause of visual impairment in individuals aged above 65 years. Cataract and AMD often coexist in the elderly, and selection of intraocular lens for patients with both cataract and AMD is still controversial. This review summarizes the application of intraocular lens for patients with AMD in recent years.
    Diagnosis and treatment of reverse implantable collamer lens orientation: A case report.
    LI Xi, LI Shuyi, XU Wen
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  40-42.  doi:10.6040/j.issn.1673-3770.1.2017.023
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    The implantable collamer lens(ICL)is considered to be a safe and reversible technique used in intraocular refractive surgery. The ICL has a vaulted design to fit the space between the iris and lens. Occasionally, the ICL is implanted in the reverse anteroposterior orientation, but this may lead to an unsatisfactory refractive state and even severe complications. A patient with reverse ICL orientation was admitted to our department. The diagnostic process, treatment, and follow-up are reported.
    Expressions of eosinophils and IL5 in antrochoanal polyps and nasal polyps.
    ZHI Lili, SONG Daoliang
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  43-46.  doi:10.6040/j.issn.1673-3770.0.2017.189
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    Objective To compare eosinophil infiltration as well as the IL5 mRNA levels in antrochoanal polyps(ACP), nasal polyps with allergic rhinitis(NPwAR), and nasal polyps without allergic rhinitis(NPsAR). Methods A total of 10 patients with ACP, 9 with NPwAR, and 13 with NPsAR were enrolled in this study. Eosinophil infiltration was analyzed by hematoxylin and eosin staining. The level of IL5 mRNA was determined by quantitative PCR. Results Eosinophil infiltration in ACP was significantly less than that in NPwAR(P<0.001). Although the median eosinophil infiltration in ACP was less than that in NPsAR, the difference was not statistically significant. Eosinophil infiltration in NPsAR was significantly less than that in NPwAR(P< 0.05). The IL5 mRNA level in ACP was significantly lower than those in NPsAR(P<0.05)and NPwAR(P=0.001). In addition, the IL5 mRNA level in NPsAR was significantly lower than that in NPwAR(P<0.05). Conclusion Antrochoanal polyps may differ in their pathogenesis from NP. Eosinophils and IL5 both play a role in the etiology of NP with or without AR, but may not play important roles in the pathogenesis of ACP.
    Treatment experience of different sphenoid sinus endoscopic surgical approaches under CT scan.
    CHU Shidong, CI Jun, WANG Haiying, WANG Changyang, ZHOU Huai'en, BAO Qingfu
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  47-50.  doi:10.6040/j.issn.1673-3770.0.2017.048
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    Objective To investigate the morphology of the sphenoid sinus using images from a computed tomography(CT)scan. Methods Image data acquired between July 2008 and July 2015 from 98 inpatients with sphenoid sinus diseases were retrospectively analyzed. The sphenoid sinus diseases were treated using one of three endoscopic surgical approaches. Sixty-four, 24, and 10 patients underwent the nasal cavity-olfactory cleft, Messerklinger, and Wigand approaches, respectively. Results The patients received over 6 months of follow-up and the windows of the sphenoid sinuses remained unobstructed and the symptoms were controlled. There were no serious operative or postoperative complications. Conclusion A CT scan can guide endoscopic sphenoid sinus surgery, which is minimally invasive, safe, and effective.
    Clinical analysis of 17 patients with primary non-Hodgkins lymphoma in the nose and the pharynx.
    QIN He, HU Bin, YE Jingying
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  51-53.  doi:10.6040/j.issn.1673-3770.0.2017.199
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    Objective To analyze the clinical characteristics of primary non-Hodgkins lymphoma in the nose and pharynx. Methods The clinical data of 17 patients with pathologically confirmed non-Hodgkins lymphoma of the nose and pharynx were retrospectively reviewed. Results Six patients with non-Hodgkins lymphoma in the nasal cavity and paranasal sinuses showed nasal obstruction, nasal discharge, bloody rhinorrhea, malformation of the external nose, or hearing loss. Four patients with nasopharyngeal non-Hodgkins lymphoma presented with tinnitus and hearing loss. Seven patients with non-Hodgkins lymphoma in the oropharynx reported foreign body sensation in the throat, pharyngalgia, and dysphagia. The clinical manifestations of primary non-Hodgkins lymphoma in the nose and pharynx were non-specific. There was a large amount of necrotic tissue covering the surface of the neoplasm. In three patients, a biopsy was performed more than once before non-Hodgkins lymphoma was confirmed. Conclusion Diagnosis of primary non-Hodgkins lymphoma in the nose and pharynx is often missed. An accurate diagnosis is best achieved by pathological biopsy.
    Correlation between obstructive sleep apnea hypopnea syndrome and upper airway measurements of different genders.
    LIU Wenjun, YU Xueying, LÜ Dan, CHEN Zhenggang, ZHANG Yanqing, MEI Xubin, YANG Ke
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  54-59.  doi:10.6040/j.issn.1673-3770.0.2017.100
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    Objective To investigate the ability of upper airway measurement to predict the severity of obstructive sleep apnea hypopnea syndrome(OSAHS)in different genders. Methods This study included 163 OSAHS patients(98 men and 65 women)diagnosed by polysomnography. Computed tomography(CT)scans of the upper airway during quiet breathing were performed. Parameters including the vertical distance from the inferior margin of the hyoid to the inferior mandibular margin(submental point)(D-HM)and from the forefront points of the hyoid to the inferior mandibular margin(submental point)were measured. Results The AHI was 14.2-52.3/h(mean, 36.22±5.64/h)in men and 9.6-46.4/h(mean, 29.38 ± 3.90/h)in women. The LSaO2 was 48%-79%(mean, 63.93%±10.51%)in men and 59%-87%(mean, 70.92%±9.17%)in women. The minimal anteroposterior diameter, left and right diameters, and area of each plane were negatively correlated with the AHI and positively correlated with LSaO2. In men, the AHI and LSaO2 were strongly correlated with the minimal cross-sectional area of the retropalatal area(r=-0.441; P < 0.01); the AHI and LSaO2 of women were strongly correlated with the minimal cross-sectional area of the lingual region(r=-0.403; P<0.01). There was a significant difference in the vertical distance from the inferior margin of 山东大学耳鼻喉眼学报31卷4期 -刘文君,等.不同性别阻塞性睡眠呼吸暂停低通气综合征患者与上气道影像学相关性的研究 \=-the hyoid to the D-HM, and in the distance from the forefront points of the hyoid to the inferior mandibular margin(submental point), between men and women(P<0.01). Some OSAHS patients received modified UPPP surgery. The effective rate in men and women 3 months after surgery was 84.31% and 58.06%, respectively. Significant postoperative differences as measured by CT scan were observed in four male OSAHS patients, but only one female patient. Conclusions CT measurements of the upper airway of OSAHS patients could help predict the severity of OSAHS. This study revealed a significant difference between the upper airway measurements of men and women. Individualized treatments should consider gender as a factor.
    Expression and methylation patterns of CDH13 in human head and neck squamous carcinoma cells.
    ZHAO Jincheng, SHI Ying, ZHANG Ying, JIA Zhanhong, MA Xin, ZHANG Jingqiu, WU Zaijun, WANG Yu
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  60-63.  doi:10.6040/j.issn.1673-3770.0.2016.362
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    Objective To explore the expression levels and methylation patterns of the tumor-suppressor gene H-Cadherin 13(CDH13)in the head and neck squamous cell carcinoma(HNSCC)SCC10A and PCI-37B cell lines. Methods We selected 2 normal oral mucosa tissues as the control group, and used quantitative PCR and western blotting, respectively, to detect the relative mRNA and protein expression levels of CDH13 in SCC10A and PCI-37B cells. We then analyzed the methylation status of the promoter region of CDH13 using methylation-specific PCR(MSP)and bisulfite sequencing PCR(BSP). Results The mRNA and protein expression levels of CDH13 in SCC10A and PCI-37B were significantly reduced compared to the control group. Methylation of the CDH13 promoter was considerably higher in SCC10A and PCI-37B cells than in normal tissues; BSP confirmed this finding. Conclusion The high methylation levels of the CDH13 gene promoter may play an important role in down-regulating the expression of CDH13 in HNSCC cells, but further study is required to determine its influence on HNSCC.
    RASSF2A methylation in laryngeal squamous cell carcinoma.
    ZHANG Mingde, ZHANG Zuping, YU Xuemin, WEI Yanhong, YUAN Ying
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  64-67.  doi:10.6040/j.issn.1673-3770.0.2016.494
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    Objective To evaluate the effects of methylation on RASSF2A expression during the development of laryngeal squamous cell carcinoma(LSCC). Methods Methylation-specific PCR was used to measure RASSF2A methylation and mRNA levels in tissues from 50 LSCCs(LSCC group)and 10 normal laryngeal tissues(control group). Results Hypermethylation was detected in the promoter region of RASSF2A in 54%(27/50)of the laryngeal cancer tissue samples but was not detected in control group tissues. The difference in hypermethylation was statistically significant(χ2=9.818, P=0.002). No significant correlations were found between the methylation levels of RASSF2A and the clinicopathological features of the patients with laryngeal cancer. The levels of RASSF2A mRNA in the LSCC group were significantly lower than those in normal mucosal tissues(χ2=9.818, P=0.002), because of methylation in RASSF2A in the laryngeal cancer tissue samples. Conclusion Epigenetic inactivation of RASSF2A through aberrant promoter methylation may play an important role during oncogenesis and the progression of LSCC.
    Expression and clinical value of MGMT and EGFR in laryngeal squamous cell carcinoma.
    ZHU Xiaocheng, QIAN Xiaoyun, GU Yajun, SHEN Xiaohui, SONG Panpan, LI Hui, GAO Xia
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  68-72.  doi:10.6040/j.issn.1673-3770.0.2017.116
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    Objective To investigate the relationship between expression of O6-methylguanine-DNA methyltransferase(MGMT)and epidermal growth factor receptor(EGFR)in laryngeal squamous cell carcinoma(LSCC), and their relationship with clinicopathological features. Methods We collected 103 tumor tissues, detected the expression of MGMT and EGFR by immunohistochemistry(IHC), and explored their relationship with the clinicopathological features. Results The expression of MGMT in tumor tissues was positively related to differentiation degree, T stage, and clinical stage(χ2 13.302, 8.394, 11.403, P=0.001, 0.039, and 0.010, respectively). The expression of EGFR in tumor tissue was positively correlated with T stage and clinical stage(χ2 = 14.933, 16.603, P=0.002, and 0.001, respectively). Further analysis found that the expression levels of MGMT and EGFR were positively correlated(MGMT vs EGFR χ2=5.369, P=0.019). Conclusion The expression of MGMT and EGFR was correlated with T stage and clinical stage. Detecting their expression can assist in assessing the malignancy of LSCC and guide treatment.
    Total laryngectomy with partial preservation of the cricoid cartilage ring.
    FU Yugui, WANG Hailan, SUN Dechong, YANG Peizhen, CHEN Yanlin, CHEN Zhipeng
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  73-75.  doi:10.6040/j.issn.1673-3770.0.2017.061
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    Objective To explore the effect of partial preservation of the cricoid cartilage ring in total laryngectomy. Method The clinical data of 32 patients with laryngeal carcinoma or hypopharyngeal carcinoma were analyzed retrospectively. All patients underwent total laryngectomy with partial preservation of the cricoid cartilage ring. The cricoid cartilage arch was opened at the midline. Tracheostomy was performed with partial preservation of the cricoid cartilage ring. The tracheostomy was monitored postoperatively for inflammatory reactions, stenosis, and tumor recurrence. Results Of 32 patients who underwent this new tracheostomy technique following total laryngectomy, none required postoperative tracheal cannulation. The inflammatory reaction was less than with traditional tracheostomy. There was no tracheostomy stenosis or tumor recurrence during 12 to 60 months of follow-up. Conclusion Some patients with advanced laryngeal or hypopharyngeal carcinoma underwent partial preservation of the cricoid cartilage ring during total laryngectomy and none required postoperative tracheal cannulation. This new tracheostomy technique not only reduced inflammatory reactions, irritating cough, and tracheostomy stenosis, but also shortened the time of postoperative recovery.
    The effect of transforming growth factor-β1 on epithelial-mesenchymal transition in human lens epithelial cells.
    WANG Hui, WEN Yan, YAN Li, YU Xiaoming, NING Hong
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  76-79.  doi:10.6040/j.issn.1673-3770.0.2016.477
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    Objective To investigate the effect of transforming growth factor(TGF)-β1 on the epithelial-mesenchymal transition(EMT)in human lens epithelial cells(HLECs). Methods HLECs were cultured separately, according their treatment group. For this purpose, cells were divided into the TGF-β1 treatment group, siRNA-TGF-β1 group, and the control group. After culturing cells for 24 h in their respective treatment groups, cell morphologies were observed. Cell migration in each treatment group was detected using the transwell migration assay. The expression levels of TGF-β1, α-SMA, E-cadherin, and vimentin genes were detected using real-time polymerase chain reaction. The expression levels of PI3K, Akt, and p-Akt proteins were detected using Western blotting. Results In the TGF-β1 treatment group, 31.2±4.7 HLECs were found to have transformed. This number was significantly higher than that in the siRNA-TGF-β1(14.6±5.3)and control groups(3.9±1.4). Specifically, the number of cells transformed in the siRNA-TGF-β1 group was higher than that in the control group. Expression levels of TGF-β1 mRNA, α-SMA mRNA, and vimentin mRNA were the highest in the TGF-β1 treatment group, followed by lower levels in the siRNA-TGF-β1 group, and the lowest levels in the control group. In contrast, the expression levels of E-cadherin mRNA were highest in the siRNA-TGF-β1 group, followed by lower levels in the control group and the lowest levels in the TGF-β1 treatment group. These differences were statistically significant(P<0.05). The expression levels of PI3K and p-Akt proteins were the highest in the cells of the TGF-β1 treatment group, followed by lower levels in the control group. These levels were lowest in the siRNA-TGF-β1 group. The relative expression levels of Akt proteins were the highest in the siRNA-TGF-β1 group, followed by lower levels in the control group and the lowest levels in the TGF-β1 treatment group; these differences were statistically significant(P<0.05). Conclusion TGF-β1 could induce HLECs towards EMT, and thus promote HLEC migration. This mechanism could be related to the activation of PI3K/Akt signaling pathway.
    Impact of scleral tunnel incision and clear corneal incision on the tear film of patients with cataract after phacoemulsification.
    WENG Biyan, LIU Can
    J Otolaryngol Ophthalmol Shandong Univ. 2017, 31(4):  80-83.  doi:10.6040/j.issn.1673-3770.0.2016.281
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    Objective To investigate the impact of scleral tunnel incision and clear corneal incision phacoemulsification on tear film of patients with cataract. Methods Totally 86 patients with cataract who received phacoemulsification during February 2014-October 2015 were set enrolled and were divided into two groups according to the different operative insicion, 43 cases in each group. For experimental group, clear corneal incision was used. For control group, scleral tunnel incision was used., The effects of two kinds of phacoemulsification incision on the functions of tear film in each patient were observed 1, 7, 15 and 30 days after operation. Results The break-up time(BUT)in experimental group were obviously shortened compared with operation before, and experimental group were obviously shorter than those in the control group 1, 7 and 15 days after operation, 30 days after the operation, BUT of both groups were obviously longer compared with operation before, the differences were statistically significant(all P<0.05). The secretion levels in both groups were significantly improved compared with operation before, and the secretion level in experimental group were obviously higher than those of control group 1, 7, 15 and 30 days after operation, the differences were statistically significant(all P<0.05). Conclusion Impact on tear film after clear corneal incision phacoemulsification is significantly lower compared with scleral tunnel incision phacoemulsification. Therefore, clear corneal incision is more worthy of clinical pervasive application.
    Lacrimal duct laser combined with drainage tube implantation for the treatment of lacrimal duct obstruction.
    ZHANG Xiaoli, YU Hong, HAN Dongmei, YANG Ruimin, QI Wei
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  84-86.  doi:10.6040/j.issn.1673-3770.0.2017.180
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    Objective To explore the impact of lacrimal duct laser combined with drainage tube implantation on the ocular surface of patients with lacrimal duct obstruction. Methods Between January 2014 and December 2015, we treated 120 cases of lacrimal duct obstruction. A digital parity method randomly divided these individuals into a control group(60 individuals)and an observation group(60 individuals). The control group received conventional surgical treatment. The trial group received laser treatment combined with lacrimal drainage tube implantation. The data from the trial group were retrospectively analyzed. The percentage of cases in which treatment was effective was analyzed. Tear film break-up time(following extubation)and tear secretions were also analyzed. Results In the control group, treatment was effective in 75.0% of cases. This percentage was significantly lower than that in the trial group, where treatment was effective in 91.7% of cases(P<0.05). The tear film break-up time did not significantly differ between groups. Tear secretions following extubation were not significantly different between groups. In the trial group, tear secretion was significantly increased at one month after treatment compared to before treatment(P<0.05). Conclusion The use of laser treatment combined with a lacrimal drainage tube implantation was found to be a better therapeutic option than the conventional treatment for lacrimal duct obstruction. Laser combination therapy had no effect on the state of the ocular surface.
    The application of 25-gauge minimally invasive vitreoretinal surgery combined with intravitreal ranibizumab injections in the treatment of proliferative diabetic retinopathy.
    ZHOU Xueyi, LI Yiming, WANG Meiju, ZHANG Yuanyuan, ZHANG Lizhuo
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  87-89.  doi:10.6040/j.issn.1673-3770.0.2017.023
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    Objective To study the effect of 25-gauge minimally invasive vitreoretinal surgery(VRS)in combination with intravitreal ranibizumab(IVR)injections to treat proliferative diabetic retinopathy(PDR). Methods Eighty-eight PDR patients(88 eyes)who had undergone 25-gauge minimally invasive VRS in our hospital were selected. The patients were divided into a treatment group(n=44)and a control group(n=44)according to the different preoperative treatments they had received. In the treatment group, IVR injections were administered 3 to 5 days prior to the surgery(25-gauge minimally invasive VRS), whereas in the control group, only the 25-gauge minimally invasive VRS was performed. Intraoperative situation, best-corrected visual acuity(BCVA), intraocular pressure, and postoperative complications were compared between the 2 groups, and statistically analyzed. Results In the treatment group, the operation time, frequency of coagulation, incidence of iatrogenic fracture, and the filling rate of silicone oil were all significantly lower in comparison with the control group(P<0.05). The BCVA values of the 2 groups postoperatively were significantly higher than the preoperative values(P<0.05). The intraocular pressure values noted in the 2 groups postoperatively were significantly lower than those observed preoperatively(P<0.05). Three months following the operation, the incidence of vitreous and retinal detachment in the treatment group was significantly lower than that in the control group(P<0.05). Conclusion The treatment of PDR with 25-gauge minimally invasive VRS in combination with IVR injections can effectively shorten the operation time, reduce the incidence of iatrogenic fracture and vitreous hemorrhage, decrease the rate of silicone oil filling, and aid in the recovery of visual acuity.
    Clinical observations of Ex-PRESS glaucoma filtration device implantation in patients with glaucoma.
    XU Xiao
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  90-93.  doi:10.6040/j.issn.1673-3770.0.2016.297
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    Objective To explore the ocular hypotensive efficacy of Ex-PRESS glaucoma filtration device implantation in patients with glaucoma and its effect on corneal endothelial cell counts. Methods Sixty-two patients with glaucoma treated at our hospital were divided into the control and research groups. The control group comprised 31 patients(33 eyes)treated with compound trabeculectomy, and the research group comprised 31 patients(35 eyes)treated with Ex-PRESS glaucoma filtration device implantation. Results The total surgical success rate was significantly higher in the research group(88.57%)than in the control group(66.67%; P<0.05). Although the vision of patients in both groups improved significantly at 6 months after the operations(P<0.05), improvement was significantly better in the research group(85.71%)than in the control group(60.61%; P<0.05). The intraocular pressure in both groups was significantly lower after operation than before(P<0.05). However, at 1, 3, and 6 months after operation, the intraocular pressure was significantly lower in the research group than in the control group(P<0.05). The corneal endothelial cell counts in both groups were significantly lower at 1, 3, and 6 months after operation than before(P<0.05). No significant intergroup difference in corneal endothelial cell counts was observed at 1, 3, and 6 months after operation(P>0.05). The complication rate was significantly lower in the research group(17.14%)than in the control group(45.45%; P<0.05). Conclusion In patients with glaucoma, the long-term effects of Ex-PRESS glaucoma filtration device implantation on intraocular pressure were superior to those of trabeculectomy, and the effects of both treatments on corneal endothelial cell counts were comparable.
    Combination of intravitreal ranibizumab with photodynamic therapy in the treatment of wet age-related macular degeneration.
    WANG Cui, YAN Xin, ZHAO Bojun
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  94-97.  doi:10.6040/j.issn.1673-3770.0.2016.227
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    Objective To investigate the potential long-term benefit of combination of intravitreal ranibizumab with photodynamic therapy for the treatment for wet age-related macular degeneration(wAMD). Methods A retrospective review was conducted on 11 eyes of 11 patients that received intravitreal ranibizumab(IVR)0.5 mg combined with standard photodynamic therapy(PDT)within 7 days, and thereafter retreatment as required with intravitreal ranibizumab monotherapy for at least 18 months. Collected data included: best-corrected visual acuity(BCVA), central retinal thickness(CRT), intraocular pressure(IOP)and number of retreatment. Results The mean BCVA was apparently improved from baseline at the 2nd, 3rd and 6th month of follow-up compared to baseline(P<0.05, showing improvement of 7.31±15.00 letters from baseline at eighteen months of follow-up. )Meanwhile, CRT decreased significantly compared with pre-treatment(P<0.05). During the treatment, IOP kept steady with no statistical difference between pre- and post-treatment.The study eyes received an average of 1.55 times(range: 0 to 8)of intravitreal anti-VEGF reagent injection during the total 18 months period after initial combination therapy. Conclusion Combination therapy could reduce times of intravitreal anit-VEGF reagent injection and maintaine long-lasting effect on wAMD.
    Clinical manifestations of polypoidal choroidal vasculopathy.
    YAN Xin, WANG Cui, ZHAO Bojun
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  98-102.  doi:10.6040/j.issn.1673-3770.0.2016.228
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    Objective To investigate the demographic features and clinical manifestations of polypoidal choroidal vasculopathy(PCV). Methods We retrospectively reviewed 107 eyes in 87 consecutive outpatients with a diagnosis of PCV in the Department of Ophthalmology, Shandong Provincial Hospital from August 11, 2011 to January 28, 2015. All the patients underwent an epidemiological inquiry, routine eye examination, color fundus photography fluorescein angiography and indocyanine green angiography(ICGA). Results Among the 87 PCV patients, there was a male predominance with 50(57.5%)male patients. 67(77.0%)patients were affected unilaterally. The average age was 66.4±9.4 years old(range, 41-92). Based on fundus examination, the commonest clinical fundus feature was hemorrhagic pigment epithelial detachment(PED)(55 eyes, 51.4%), which was followed by sub-retinal orange-red bulging lesions(49 eyes, 45.8%). ICGA showed that polyps located in the macular area in 83(77.6%)eyes. The average number of polypoidal lesions was 2.71±1.79(ranged from 1 to 8). The mean area of the solitary polyp and the largest one of multiple polyps was 0.52±0.35 mm2, 0.49±0.37 mm2 respectively. Conclusion Among our patients with PCV, male, unilateral, macular location of polypoidal lesions with hemorrhagic PED and sub-retinal orange-red bulging lesion are the commonest clinical fundus manifestations. In ICGA, the mean area of PCV with solitary polyp was larger than the biggest one of PCV with multiple polyps.
    A meta-analysis of subcutaneous immunotherapy and sublingual immunotherapy in the treatment of dust mite-allergic rhinitis.
    WAN Wenjin, WANG Wen, CHENG Lei
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  103-108.  doi:10.6040/j.issn.1673-3770.0.2016.475
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    Objective To evaluate the effectiveness, compliance and safety of subcutaneous immunotherapy(SCIT)and sublingual immunotherapy(SLIT)in the treatment of dust mite-allergic rhinitis. Methods Randomized controlled trials or case-control studies of SCIT and SLIT in treatment of dust mite induced allergic rhinitis were searched in PubMed, EMBASE, Web of Science, the Cochrane Library, WANFANG, VIP, CNKI and CBMdisc databases. The literatures were quality evaluated, filtered and data extracted according to the standard of Oxford CASP, 2004, and the Review Manager 5.2 software was used for meta-analysis. Results 11 literatures including 712 patients were finally selected for analysis, 6 in Chinese and 5 in English. The results showed that there was no significant difference both in the improving nasal symptom scores(SMD=0.05; 95%CI: -0.27-0.38)and in the treatment compliance(RR=1.11, 95%CI: 0.98-1.26)between the SCIT and the SLIT groups. Each was safe and effective treatment although more adverse reactions were observed in SCIT than in SLIT(RR=1.89, 95% CI: 1.00-3.60). Conclusion Both SCIT and SLIT are safe and effective in the treatment of dust mite-allergic rhinitis, while adverse reactions were more frequently observed in SCIT.
    Research progress of dry eye animal model.
    HU Jindong, LIU Xinquan
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  109-113.  doi:10.6040/j.issn.1673-3770.0.2016.420
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    Dry eye is the most common ocular surface disease; however, its pathogenesis has not yet been fully elucidated. Therefore, the establishment of a dry eye model is particularly important for research into the conditions origins and its possible treatments. The current models used to establish tear deficiency either make use of an autoimmune reaction, involve the removal of the lacrimal gland(i.e., extirpation)or blockage of the lacrimal nerve, or use drugs that inhibit parasympathetic activity. Other methods of inducing dry eye involve burning the meibomian gland, decreasing the blink rate, reducing vitamin A intake, using preservatives, changing sex hormone levels, increasing tear osmolality, or carefully controlling the system environment. Meanwhile, some researchers combine the aforementioned models to produce dry eye, including combining parasympathetic inhibitory drugs with a controlled environmental system or using preservatives following removal of the lacrimal gland. In this article, we summarize the commonly used dry eye models.
    Experience in diagnosis and treatment of isolated inflammatory diseases of thesphenoid sinus.
    WU Yuanqing, XU Jinjing, DENG Yi
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  114-116.  doi:10.6040/j.issn.1673-3770.0.2017.022
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    Application of oro-nasal combination approach under electronic nasopharyngoscope in the nasopharyngeal biopsy.
    DU Zhihong
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2017, 31(4):  117-118.  doi:10.6040/j.issn.1673-3770.0.2017.020
    Abstract ( 1093 )   PDF (857KB) ( 364 )   Save
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