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Rhegmatogenous retinal detachment (RRD) is a retinal vitreous disease, with increasing incidence in recent years. Pars plana vitrectomy is one of the most common treatments for RRD. To prevent re-detachment after the primary surgery and guarantee the visual outcome of the patients, we highlight the techniques for RRD during the PPV, including the surgical skills to manipulate the breaks, peripheral retina and vitreous base, meanwhile, empathized on the posterior vitreous detachment and posterior vitreous cortex. The aim is to increase the rate of anatomical re-attachment and to improve visual function.

A 5-year-old girl came to the Tianjin Medical University Eye Hospital in May 2021 because of her poor eyesight after birth. The physical examination showed that she had high myopia, esotropia, horizontal tremor, and high myopia retinopathy of both eyes. After inquiring about her medical history, we found that the baby's occipital cystic mass swelled after birth, and CT examination showed that the occipital skull plate defect with meningocele, but without treatment, at present, the occipital mass had subsided by itself. Considering the eye manifestations and skull changes of the child, it may be conformed to Knobloch syndrome, after the detection of V4 by full exon gene, it was found that the child had the compound heterozygous variation of pathogenic gene COL18A1, and Knobloch syndrome was definite, Knobloch syndrome is a rare autosomal recessive hereditary disease with typical features of high myopia, retinal detachment and occipital encephalocele. At present, there is no clear treatment plan, and gene therapy may be an effective treatment for Knobloch syndrome in the future.

Diabetic retinopathy is one of the three major microvascular complications of diabetes. Proliferative diabetic retinopathy (PDR) is an important ocular complication that affects the vision and quality of life of patients. Vitrectomy is the most effective treatment option. The characteristic of fibrovascular membranes in PDR varies at different stages of the disease, which requires specific treatment strategy and techniques. In order to improve the clinical diagnosis and treatment of PDR, this article proposes that different treatment methods should be correctly adopted for different types of proliferative membranes on the basis of fully understanding the tissue morphology of these membranes, and more attention should be paid to the treatment of the vitreous body to achieve more effective therapeutic effects. (Chin J Ophthalmol, 2021, 57: 881-885) .

Objective: To report the clinical outcomes and safety profile of 27G(+) transconjunctival sutureless vitrectomy (TSV) in eyes with posterior segment disease. Methods: Prospective, interventional case series. Eyes undergoing 27G(+) TSV for a vitreoretinal surgery indication were included from Dec 2015 to Mar 2016. Change in visual acuity and occurrence of intraoperative and postoperative complications with minimum follow-up of 6 weeks were recorded. Results: Eighty-three eyes met the inclusion criteria. Surgical indications included epiretinal membrane ( n= 27), proliferative diabetic retinopathy ( n= 17), full-thickness macular hole ( n= 11), rhegmatogenous retinal detachment with or without proliferative vitreoretinopathy (PVR) ( n= 8), vitreous hemorrhage( n= 7), vitreous opacities ( n= 7), diabetic macular edema non-response to anti-VEGF agents( n= 4), intraocular lens or cataract nucleus dropped into vitreous cavity ( n= 2). Mean follow-up was 19 weeks (range 6-34 weeks). Visual acuity improved in all cases. The cutter incarcerated with trocar in a vitreous hemorrhage case. There were no other intraoperative complications and no case required sutured at the conclusion of surgery. Postoperative complications included transient ocular hypertension in 2 eyes (2.4%) and transient hypotony in 1 eye (1.2%). No cases of postoperative endophthalmitis, sclerotomy related retinal tears, or choroidal detachments were encountered in the follow-up period. Conclusion: The 27G(+) TSV was effective and safe for varied surgical indications with low rates of intraoperative and postoperative complications. (Chin J Ophthalmol, 2018, 54:918-922) .

Objective: To evaluate the effect of high dose chemotherapy with or without total body irradiation (TBI) supported by autologous hematopoietic stem cell transplantation (AHSCT) for malignant lymphoma., Methods: From June 1991 to April 2000, 32 malignant lymphoma (ML) patients were treated with AHSCT. Their ages ranged from 19 to 52 years (median 37). There were 23 non-Hodgkin's lymphoma (NHL) and 9 Hodgkin's lymphom (HD). Twelve patients received autologous bone marrow transplantation (ABMT) and 20 patients received autologous peripheral blood stem cell transplantation (APBSCT). In the latter, the mobilization plan was carboplatin and etoposide (CE) or CHOP (CTX, ADM, VCR, PDN) plus G/GM-CSF 10 micrograms/kg/d in high dose chemotherapy. BEAM (BCNU, Vp-16, AraC, MEL) or MEL 140 mg/m2 + Vp-16 200 mg + total body irradiation (TBI) 8 Gy., Results: Up to May 2000, hematopoietic reconstitution was reestabished in 100% (32/32) patients after AHSCT, with median follow-up of 1,020 days (40-3,240). The 1- and 2-year disease-free survivals (DFS) were 78.1%(25/32) and 46.9% (15/32) with the longest survival of 8 years. Even though eight patients have developed relapse, there is no transplantation-related death., Conclusion: High dose chemotherapy and radiotherapy supported by autologous hematopoietic stem cell transplantation (AHSCT) for high risk, relapsed or sensitive ML, being highly efficient, should be the first indication. It is better than the standard conventional treatment. The hematopoietic reconstitution of autologous peripheral blood stem cell transplantation (APBSCT) is quicker than autologous bone marrow transplantation (ABMT). No significant difference between chemotherapy alone and chemotherapy plus total body irradiation is observed.

Objective: To investigate mammanglobin (hMAM) mRNA as a marker for the detection of carcinoma cells by reverse transcriptase chain reaction (RT-PCR) in the peripheral blood of breast cancer patients., Methods: Blood samples from 63 breast cancer patients obtained at various stages of their disease, blood samples from 8 breast hyperplasia, 5 breast adenofibroma, 25 other cancers (stomach, colon, esophagus, lung, ovary) and 31 healthy volunteers were screened for hMAM mRNA by a nested RT-PCR combined with fluorescence quantitative PCR (FQ-PCR) assay., Results: Among 63 breast carcinoma patients, 19(30.2%) were RT-PCR positive for hMAM mRNA which was elevated with the tumor stage. None of the other cancer patients or those suffering from benign breast diseases were positive but only 1 of the 31 healthy volunteers gave detectable hMAM mRNA findings. hMAM mRNA was not detectable in the peripheral blood after operation in 6(32%) of 19 patients whose pre-operative test had been positive even though the hMAM mRNA expression increased with tumor stage. These results did not correlate with patients' stage, estrogen or pregnant receptor status., Conclusion: hMAM transcripts are detectable in the peripheral blood of some breast cancer patients. hMAM may be a novel candidate and a clinically useful breast tumor marker, especially in detecting micrometastasis.

Objective: To observe the efficacy of chemotherapy and recombinant granulocyte colony-stimulating factor (G-CSF, Glycosylated) and granulocyte-macrophage colony-stimulating factor (GM-CSF) in autologous peripheral blood stem cells (APBSC) mobilization., Methods: The mobilization regimen: CBP 350 mg/m(2) intravenously injected at day 1, Vp16 350 mg/m(2) intravenously injected from day 1 to day 3. G-CSF and GM-CSF 5 microg x kg(-1) x d(-1) each, subcutaneously injected and DXM 5 mg/d intramuscularly injected, from the day of white blood cell (WBC) recovery to (2.4 - 6.4) x 10(9)/L from nadir to the day before the end of APBSC harvesting. APBSC harvesting started when WBC > 20.0 x 10(9)/L and ended when accumulated mononuclear cells (MNC) > 5 x 10(8)/kg. CFU-GM assay and CD(34)(+) cells counting of the APBSC were performed., Results: Twenty cases underwent APBSC mobilization. APBSC harvest began at day 22.15 +/- 3.66 for two successive days. Accumulated MNC was (5.93 +/- 1.62) x 10(8)/kg, CD(34)(+) cells (23.10 +/- 11.53) x 10(6)/kg and CFU-GM (3.44 +/- 2.85) x 10(5)/kg. No severe toxicity was observed. Hematopoiesis was well reconstituted in 8 patients received single and in 1 patient received double APBSC transplantations., Conclusion: Chemotherapy combined with G-CSF + GM-CSF was a safe and highly effective method for APBSC mobilization.

Objective: To study the change of composition in long-term plaque fluid after sucrose rinse and the cariogenicity of plaque., Methods: 43 subjects, who had no regular oral hygiene and no tooth brushing at least for one year, were selected. According to their caries status, 27 as caries-free group and 16 as caries-positive group. Plaque were obtained before and at 7 minutes after a 10% sucrose rinse. Additionally, plaque samples of 15 and 30 minutes after sucrose rinse from 11 subjects were collected. The pH value and the concentrations of organic acids and inorganic ions in plaque fluid were measured., Results: At 7 minutes after sucrose rinse, pH and the concentration of ammonium were significantly decreased, and the concentrations of lactic acid and formic acid were significantly increased. All these changes were similar to those of short-term plaque. No significant difference with any single component of plaque fluid was found between caries-free group and caries-positive group, neither before sucrose rinse nor after sucrose rinse., Conclusions: Changes of the composition in the plaque fluid were basically similar between long-term and short-term plaque, but single component in plaque fluid could not reflect the cariogenicity of plaque.

Objective: To study the result of surgical treatment of patients with stage IV a primary liver carcinoma (PLC)., Methods: Twenty-seven patients with stage IV a PLC treated in 1989-1998 were retrospectively studied. The patients could be divided into 2 groups: (1) The resected group(19 cases) and (2) cytoreductive group(8 cases). Intra-operative B-ultrasound was used to prevent missing of any tumor nodules. Unresectable residual nodules were treated by ethanol injection. Multidisciplinary treatment was given in the perioperative period., Results: The overall 1-, 2- and 3-year survival rate of the 27 patients was 71.4%, 55.6% and 7.7% respectively. The 1-, 2- and 3-year survival rate of the resected and cytoreductive group of patients was 73.3%, 58.3%, 10.0% and 66.7%, 50.0%, 0% (P > 0.05) respectively. Complications occurred in 22.0% of the treated patients. There was no operative and hospitalization mortality., Conclusions: Surgical resection or cytoreductive operation with adjuvant therapy is effective as the first choice of treatment for stage IV a PLC.

Objective: To better understand the clinical and pathological features, diagnosis, treatment and prognosis of Paget's disease accompanying breast cancer., Methods: From 1958 to 1997, 34 such patients were operated and pathologically confirmed., Results: Breast cancer combined with Pagat's disease accounted for 0.9% of the total number of breast cancer patients treated in the same period of time. The mean age of patients was 47.3 years, and the mean duration of symptoms was 23.9 months. The patients received combination treatment with surgery as the major treatment modality. Among patients with nipple change as the first symptom, 26.7% of them had positive axillary nodes. The rate of metastasis was 26.7% as confirmed by surgical pathology. The 5-, 10-, and 20-year survival rate was 93.1%, 78.1% and 67.0%, respectively. Among those with palpable mass as the first symptom, metastasis to the axillary lymph nodes occurred in 52.6% of the cases, and distant metastasis in 42.1% of the cases. The rate of 5-, 10- and 20-year survival rate was 60.5%, 53.8% and 53.8%, respectively., Conclusion: Paget's disease, as a special form of breast cancer, may accompany cancer inside of the breast. In patients whose disease is confined to the nipple, their prognosis is better than those accompanied by palpable mass in the breast.

Objective: To evaluate the use of peripherally inserted central catheter(PICC) in perioperative patients with abdominal malignancies for parenteral nutrition., Methods: PICC was performed in 33 patients while subclavicular vein insertion in 30 patients for comparison in order to analyse prospectively the advantages and disadvanges of PICC., Results: There was no difference in the rate of success of catheter placement and infection between PICC and the "subclavicular" insertion (P > 0.05), but PICC had significantly longer indwelling time than that of the "subclavicular" insertion (P < 0.05). There were less risks associated with PICC insertions, but the flow rate of was lower(p < 0.05)., Conclusions: PICC can be widely used on account of its longer indwelling time, easy and safe insertion.

Objective: To evaluate the diagnosis and treatment of male breast carcinoma., Methods: Thirty-two male breast carcinoma cases were studied. The median age was fifty-four years old. The diagnosis, treatment and prognosis for male breast carcinoma were studied., Results: Clinical stage of the patients: I, 7 patients; II, 17 patients; III, 7 patients; IV, 1 patient. Of the 32 carcinomas, 31 patients had mass in the breast. Positive lymph nodes were found in 57.1% of the patients. The 5-year survival rate was 65.6% for all patients, 68.4% for patients undergone radical mastectomy, 66.7% for those undergone modified radical mastectomy and 57.1% for the others., Conclusion: The optimal treatment for male breast carcinoma is modified radical mastectomy combined with radiotherapy, chemotherapy and endocrine therapy.

In order to study the correlation of the CD44v gene abnormal expression and splicing with the clinicopathologic features, the expression of CD44v mRNA from normal colorectal mucosa, adenomatous polypi (precancerous disease) and colorectal carcinoma was studied by RT-PCR and cDNA hybridization. The results showed that CD44v mRNA was expressed in 65 of 67 (97%) primary cancers, in 20 of 20 metastatic tumors (100%) and in 5 of 7 (71.4%) precancerous diseases, but was not expressed in all 15 normal colon mucosa specimens. Abnormally spliced, high molecular weight CD44v could be detected in 10 of 20 (50%) primary cancers and in 18 of 20 (90%) metastatic cancers. In 10 patients with high molecular weight CD44v, metastases were found in 8, while metastases were found in only 2 of 10 patients with low expression of CD44v mRNA in the primary cancers. The results suggest that the expression of CD44v is very common in colorectal carcinoma. CD44v mRNA might be an early marker of colorectal carcinoma and its high expression is suggestive of tumor metastasis.

We have finished a retrospective study of 218 premenopausal patients who underwent primary surgery for operable breast carcinoma between March 1958 and December 1984. All these patients had available records of menstrual data and had been followed-up for more than 10 years. U-nivariate analysis showed that the menstrual timing of operation, as other known prognostic factors (tumor size, node status, histological grade, TNM classification, adjuvent systemic therapy, etc), had an influence on the patients' outcome. Multivariate analysis by Cox regression model indicated that disease-free rate and overall survival rate of patients operated during the periovulatory phase (days 7-20, 123 cases) were significantly superior to those during the perimenstrual phase (days 1-6 and 21-40, 95 cases) (P < 0.01). There were no significant differences in prognosis between patients who received their operations during the follicular phase (days 4-14, 96 cases) and those during the luteal phases (days 15-40, 122 cases) (P > 0.1). We suggest that the adequate timing of operation should be further determined by prospective, randomized clinical study.

Carcinoembryonic antigen (CEA) is frequently used in the diagnosis of the colorectal carcinoma. CA242 is a novel unique tumor-associated antigen characterized by higher tumor specificity and sensitivity for colorectal cancer, as compared with other mucin antigens. In this study, preoperative levels of serum CEA and CA242 were measured in 63 cases of colorectal carcinoma. It was disclosed that the positive rate of CA242 was higher than that of CEA, particularly in patients with colon cancer. The combined determination of CEA and CA242 significantly increased the sensitivity and accuracy in the detection of colorectal cancer as compared with the use of CEA alone (P < 0.01). In patients with advanced disease the positive rate was markedly elevated, especially in patients with liver metastasis. The results indicate that the combined use of CEA and CA242 assays is an useful adjunct diagnostic measure for colorectal carcinoma, and is helpful in the assessment of the stage of the disease as well as in making treatment plan.

From Aug 1984 to Aug 1990, under one-shot normothermic interruption of Porta Hepatis, hepatectomy was performed in 115 patients with primary liver cancer (PLC). The incidence of associated cirrhosis was 82.8% with liver function in Grade A in 59.4% of patients and in Grade B in 40.6% of patients according to Pugh's ranking criteria. Hemihepatic vascular occlusion was preferred. Due precautions were taken to prevent postoperative hepatic failure, including continuous low-pressure oxygen inhalation, the use of antioxidants and dexamethasone. Post-operative complications were: Hydrothorax (7.8%), subphrenic abscess (3.5%), bite leakage and gastrointestineal bleeding (0.9%). There was no operative mortality and hospital mortality.