Retinal neovascularization,a common pathological process of a variety of eye diseases,is a major cause of blindness.Vascular endothelial growth factor (VEGF) has been believed to be the most important therapeutic target of neovascular eye diseases.In the era of anti-VEGF for retinal diseases,several drugs aiming at the single molecular target VEGF-A have achieved considerable success in decreasing neovascularization and relieving the symptoms.In the past two years,novel anti-VEGF drugs aiming at multiple molecular targets including VEGF-A,VEGF-B and PlGF have surged into clinic service.Represented by aflibercept (VEGF Trap-Eye,Eylea) and conbercept (KH902),multiple targets anti-VEGF drugs relieve the clinical symptoms in patients resistant to single target anti-VEGF drugs.In addition,because similar curative effects are achieved with longer injection interval,risk of complications related to the intraocular injection procedure is reduced.However,it is reported that the additional inhibited targets are associated with maintaining the normal functions of blood vessels and neurons.Therefore,although there are still no severe adverse effects for these new developed drugs,further long-term observation is mandatory to evaluate their safety.In this review,we summarized the characteristics of aflibercept and conbercept,a new generation of anti-VEGF drugs,from the aspects of basic research,pharmacokinetics,efficacy,safety and the existing problems.

Objective To investigate the impact of using antithrombotic drugs (anticoagulants or antiplatelet aggregation drugs)before the onset of cerebral infarction on hemorrhagic transformation after acute cerebral infarction. Methods The consecutive patients with acute cerebral infarction from Chengdu Stroke Registry Project admitted to the Department of Neurology,West China Hospital,Sichuan University from January 1,2004 to January 1,2014 were enrolled. The baseline data on admission,previous usage of anticoagulants and anti-platelet aggregation drugs,as well as CT/ MRI and other imaging data of all patients were collected. According to the results of CT/ MRI reexamined at 72 h after admission,the patients with hemorrhagic transformation were enrolled into a hemorrhagic transformation group;the patients with non-hemorrhagic transformation were enrolled into a non-hemorrhagic transformation group according to the ratio
of 1 ∶ 1. Their gender and age were matched with the hemorrhagic transformation group. The baseline data and drug used of the patients in both groups were compared. The differences of risk factors between the two groups were analyzed with multivariate Logistic regression analysis. The relationship between hemorrhagic transformation and premorbid use of antithrombotic drugs were observed. Results A total of 6 916 patients with acute cerebral infarction were enrolled,including 433 (6. 3%)hemorrhagic transformation (hemorrhagic transformation group)and 433 non-hemorrhagic transformation. (1)There were significant differences between the patients of the two groups on admission in the National Institutes of Health Stroke Scale (NIHSS)score,atrial fibrillation,previous cerebral infarction,and blood glucose levels on admission (all P < 0. 05). (2)The proportions of using anticoagulants and antiplatelet aggregation agents in the hemorrhagic transformation group were higher than those of the non-hemorrhagic transformation group (anticoagulants:14. 1% [n = 61]vs. 3. 9% [n = 17];P < 0. 01,OR,4. 01,95% CI 2. 303 -6. 993;anti-platelet aggregation drugs:14. 3% [n =62]vs. 8. 3% [n = 36];P = 0. 005,OR,1. 84,95% CI 1. 194 -2. 846). (3)The results of multivariate Logistic regression analysis showed that the use of anticoagu-lants,anti-platelet aggregation drugs,NIHSS score on admission,and random blood glucose on admission were the independent risk factors for hemorrhagic transformation (OR [95% CI]3. 302 [1. 860 -5. 862], 2. 081 [1. 281 -3. 382],1. 047 [1. 026 -1. 069],and 1. 055 [1. 011 -1. 100],respectively (all P <0. 05). Conclusion The NIHSS score and blood glucose levels on admission are the independent risk factors of hemorrhagic transformation. Using anticoagulants or anti-platelet aggregation drugs before symptom onset is independently associated with hemorrhagic transformation,however,its relationship with the long-term prognosis of acute cerebral infarction need to be further studied.

Objective To investigate the CT manifestations in mesenteric injury.Methods CT imaging data were analyzed retrospectively in 28 patients with mesenteric injury caused by abdominal trauma,of which 26 patients were confirmed by surgery and 2 patients received conservative treatment.Results CT showed simple mesenteric injury in 5 cases,and multiple organ injury in other 23 cases.Only 18 cases were dignosed by preoperative abdominal CT,and the rate of missed diagnosis was 36%.Conclusion Multi-slice CT is an important evaluation method for the detection of acute mesenteric injury.

Objective:To research and summarize the characteristics and medication regulars of external medicine for hydrocephalus therapy with TCM. Methods:Retrieved literatures of explicitly recorded external medicine in all ages,input its drugs into the Excel sheet specifing and specified various terms used for drug,adopted spss17.0 frequency analysis,principal factor analysis,cluster analysis, and sought its regulars.Results:Frequency analysis of external medicine from higher to lower in order as Radix Ledebouriellas,Rhizoma Bletillae,Arborvitae seed,Cinnamon bark,Ackinthepulpit tuber,Rhizoma Zingiberis ect. Withdrawed 16 main factors from 50 original targets, used cluster analysis made 16 main factors into 10 types as eliminating phlegm for resuscitation,activating blood and disinhibiting fluid etc. Conclusion: External medicine for hydrocephalus therapy mainly as drugs for activating blood and dissolving stasis, expelling wind with diaphoresis, warming yang,reinforcing kidneys to strengthening bones,regulating qi.Multivariate statistical analysis can objectively and comprehensively reflect the characteristics and regulars of external medicine and provided some exploratory thoughts.

Objective To investigate the pathological features and clinical characteristics of primary mitochondrial myopathy and encephalomyopathy. Methods 11 cases of mitochondrial myopathy and encephalomyopathy were analyzed on clinical features, histochemical changes and ultrastructure observations of muscles. Results RRFs were found in all 11 cases by muscle staining of MGT under light microscope. 7 cases were only afflicated with muscle weakness, 4 cases also having impairment of central nervous system. The proportion of RRFs was 6.4% to 10.3%. We observed these cases under electronic microscope. In 9 cases,the ultrastructural alterations included subsarcolemmal accumulation of mitochondria,increases of the number,abnormal shape,disarrangement of cristae and paracrystaline inclusion bodies. In 2 cases the increase of mitochondrial number is only the alteration. Conclusions Typical RRF is valuable for diagnoses of mitochondrial myopathy and encephalomyopathy under light microscope. The accumulation of abnormal mitochondrials beneath sarcolemal,especially the paracrystaline inclusion bodies are significant in making a definite diagnosis of this disease under electronic microscope.

Objective To study the sensitivity of the real-time polymerase chain reaction (RT-PCR) in detecting group B streptococcus (GBS) in late pregnant women and the influence of vaginal/rectal GBS colonization on maternal and neonatal outcomes. Methods Microbiological culture and RT-PCR for GBS were both performed for each sample taken from the vagina and rectus in 617 gravidas at 35-37 weeks of gestation, with an average age of 30.1, among which 80 aged over 35. Forty-one out of the 617 women were multiparous and 576 primiparous. The laboratory results were collected and the pregnant outcomes were followed. Results (1) Out of the 617 gravidas, 21 (3.4%) were GBS positive by culture (all positive in RT-PCR) and 57 (9.2%) were GBS positive by RT-PCR. Thirth-six cases with PCR positive but culture negative results were analyzed by sequencing, and 34 showed GBS positive and 2 negative. (2) The sensitivity and specificity of RT-PCR was 100% (55/55) and 99.6% (560/562) respectively. (3) The average age of GBS positive gravidas was 30 ± 4, without significant difference compared with that of GBS negative women (31±4), P>0.05. The GBS positive rates were also similar between the primiparas and the muliparous [7.3% (3/41) vs.9.4% (54/576)] , between elderly women and those under the age of 35, and between those women who had abortions over and less than 3 times (all P>0.05). (4) No significant difference was found in the cesarean section rate between the GBS postitive and negative group [54.4% (31/57) vs.44. 6% (250/560), P>0.05]. (5) Compared with the GBS negative group, the GBS positive group had higher incidence of intrauterine infection [6.6% (37/560) vs. 15.8% (9/57)], postpartum hemorrhage (2.9% vs.10.5%) and fetal distress (25.9% vs. 38.6% ) all P <0.05, but had similar incidence of premature rupture of membranes [25.0% (140/560) vs. 33.3% (19/57) ], pretcrm birth and meconium-stained amniotic fluid. (6) The neonatal infection rate in the GBS positive group was significantly higher than that of the GBS negative group [29.8% (17/57) vs. 13.2% (77/560), P < 0.05]. One neonate in the GBS positive group developed early-onset severe GBS infection and achieved better outcome under proper treatment. Conclusions Maternal GBS carrier at 35-37 weeks of gestation can lead to adverse pregnant outcomes by increasing the incidences of intrauterine infection and neonatal infections. However, RT-PCR could be a routine method to detect GBS status in late pregnant women with its higher sensitivity and specificity.

Objective To investigate the influencing factors of hemorrhagic transformation in non-thrombolysis patients after acute cerebral infarction. Methods According to Chengdu Stroke Registry Project,2598 consecutive patients with acute cerebral infarction admitted to the Department of Neurology,West China Hospital within 1 week of attack from January 2010 to December 2013 were enrolled prospectively. The patients were divided into a hemorrhagic transformation group and a non-hemorrhagic transformation group according to whether they had hemorrhagic transformation or not. As for patients with hemorrhagic transformation,they were divided into a symptomatic hemorrhagic transformation (SHT)group and an asymptomatic hemorrhagic transformation (ASHT)group according to whether they had aggravation of symptom and sign. The baseline data of all patients were collected and compared between the groups. The P<0. 1 variables of the univariate analysis result were enrolled in multivariate logistic regression analysis in order to identify the independent influencing factor of hemorrhagic transformation. Results In 2598 patients,249 (9. 6%)had hemorrhagic transformation,28 of them (1. 1%)were SHT and 221 (8. 5%)were ASHT. There were significant differences in male,hypertension,dyslipidemia,atrial fibrillation,drinking and smoking ratio,blood glucose,cholesterol,low density lipoprotein cholesterol, National Institutes of Health Stroke Scale (NHISS)scores,and the trial of Org 1072 in acute stroke treatment (TOAST)classification between the HT group and the non-HT group (all P<0. 05). There were no significant difference in the related influencing factors between the SHT group and the ASHT group (all P>0. 05). The results of multivariate logistic regression analysis showed that dyslipidemia (OR,0. 588, 95%CI 0. 374-0. 924,P=0. 021)was negatively correlated with hemorrhagic transformation. Atrial fibrillation (OR,3. 188,95%CI 2. 159-4. 707,P<0. 001),blood glucose (OR,1. 081,95%CI 1. 044-1. 119,P<0.001),and NHISS score (OR,1. 305,95%CI 1. 170-1. 455,P<0. 001)were positively correlated with hemorrhagic transformation. In TOAST classification,relative to the large atherosclerotic stroke,the small artery occlusive cerebral infarction was negatively correlated with hemorrhagic transformation (OR,0. 315, 95%CI 0. 167-0. 596,P<0. 001). After removing the influencing factor of atrial fibrillation,compared with the large artery atherosclerotic stroke,cardioembolism stroke was positively correlated with hemorrhagic transformation (OR,2. 823,95%CI 1. 946-4. 095,P<0. 001). Conclusion Dyslipidemia,atrial fibrillation,blood glucose,NHISS score and TOAST classification were independently associated with hemorrhagic transformation in non-thrombolysis patients after acute cerebral infarction.

OBJECTIVE:To investigate the effects of selenium(Se)and/or vitamin E(VE)on the NO and NOS in heart,liver,kidney and serum of experimental hyperlipidemic rats.METHODS:SD rats were divided into5groups,administreated by Se and/or VE.After4weeks,the NO contents and NOS activities in heart,liver,kidney and serum were assayed by NO kit and NOS kit respectively.RESULTS:NO contents and NOS activities could be reduced in heart,liver,but increased in serum and kidney by high-fat feed(HFF).Meanwhile,VE and/or Se could increase the NO contents in all the experimental samples and NOS activities in heart,liver and kidney(P

Objective To explore the ultrasonographic features of yolk sac tumors of ovary.Methods Totally 12 patients (13 lesions) of the yolk sac tumors of ovary confirmed by pathology were analyzed retrospectively.Two-dimensional ultra sonography,color Doppler and spectral Doppler features were observed and combined with clinical manifestations.Results Ultrasound showed 1 case with bilateral single lesion and 11 cases with unilateral single lesion,the median size of tumors was 11.82 cm × 11.19 cm.Thirteen lesions showed liquid-solid mixed echo,and the blood flows in solid region were ≥ grade Ⅱ according to Adlefs semi quantitative method,the resistance index of blood was 0.37 0.55;Six cases combined with abdominal cavity effusion.Pathology showed 2 cases combined with omentum or rectal pouch metastasis and 1 case was tubal,ovarian artery and vein invasion.Conclusion Ultrasound images in the yolk sac tumors of ovary have characteristics and diagnosis must closely combine with clinical manifestations,some cases still need to be confirmed by pathology and immunohistochemist r y.