Evidence based medicine is not quite the same as traditional medicine, as the former stresses the combination of evidence and doctors experience, failure to achieve which will be disadvantageous to patients. In recent years, evidence based medicine has been growing silently in China. At present the ideology of evidence based medicine is being widely applied to the treatment of cardiovascular disease, including hypertension, arrhythmia, heart failure, myocardial infarction, etc. and the regulation of fat metabolism. Some medications harmful to patients have been discarded and curative effects have been improved. Of course, there are still some shortcomings. Yet evidence based medicine has also exerted an effect on people in the medical circle and the making of medical decisions.

Objective To explore the influence of long -term oral hydroxychloroquine on the blood lipids and left ventricular function in patients with systemic lupus erythematosus (SLE).Methods A total of 110 patients with SLE,who treated in our hospital from January 2012 to December 2013,were selected as the research subjects. They were divided into study group (n =55 )and control group (n =55 )according to the random number table method.The control group received conventional drug treatment,while the study group was orally given hydroxychloroquine on the basis of the control group therapy.The course of treatment was 18 months for the two groups.Then,the changes of blood lipids,left ventricular structure and function indexes before and 6,12,18 months after treatment were observed.Results The levels of TG[(1.7 ±0.3)mmol/L,(1.6 ±0.3)mmol/L,(1.2 ±0.2)mmol/L],TC[(4.5 ± 0.5)mmol/L,(4.3 ±0.4)mmol/L,(4.0 ±0.4)mmol/L],HDL -C[(1.4 ±0.4)mmol/L,(1.5 ±0.3)mmol/L, (1.6 ±0.3)mmol/L],LDL -C[(2.8 ±0.5)mmol/L,(2.3 ±0.4)mmol/L,(2.0 ±0.3)mmol/L],LVEDD[(40.3 ± 3.3)mm,(39.4 ±3.0)mm,(38.5 ±2.9)mm],LVESD[(29.4 ±2.6)mm,(28.3 ±2.3)mm,(26.7 ±3.0)mm], LVST[(9.7 ±0.4)mm,(9.5 ±0.6)mm,(9.5 ±0.5)mm],LVPWT[(10.2 ±0.4)mm,(10.0 ±0.3)mm,(9.8 ± 0.4)mm],FS[(31.4 ±6.8)%,(32.6 ±7.0)%,(32.7 ±7.7)%),LVEF[(60.4 ±5.4)%,(60.7 ±5.7)%, (61.4 ±5.6)%],E /A[(0.8 ±0.2),(0.9 ±0.3),(1.1 ±0.3)]in the study group 6,12,18 months after treat-ment were significantly better than before treatment[(2.0 ±0.4)mmol/L,(4.8 ±0.8)mmol/L,(1.1 ±0.3)mmol/L, (3.4 ±0.4)mmol/L,(42.4 ±3.8)mm,(30.7 ±3.5)mm,(9.9 ±0.6)mm,(11.2 ±0.5)mm,(30.1 ±5.7)%, (55.8 ±4.6)%,(0.7 ±0.1 )],and which were all better than those in the control group,the differences were statistically significant(tTG =2.529,2.828,2.735;tTC =3.609,3.122,3.317;tHDL -C =3.651,3.419,3.733;tLDL -C =2.008,2.144,2.338;tLVEDD =8.933,8.347,8.282;tLVESD =6.445,6.628,6.594;tLVPWT =3.015,3.331,3.905;tLVST =4.571,4.583,4.861;tLVEF =11.021,11.328,10.163;tFS =7.915,8.048,8.253;tE /A =1.886,1.769,1.537;all P <0.05).Conclusion Long -term oral hydroxychloroquine in the treatment of patients with SLE not only can improve the blood lipids situation,but also is good for the left ventricular structure and function,which may avoid the occurrence of vascular events,and it is worthy of clinical promotion.

SUMO (small ubiquitin-related modifier) is involved in the post-translational modifications of proteins,and this process is referred to as SUMOylation.SUMOylation plays an important role in the regulation of cellular activities such as strengthening the stability of the protein,nucleocytoplasmic transport,DNA repair,DNA replication,mitotic and meiotic chromosome behavior,et al.SUMOylation is a dynamic process and can be reversed by SUMO-specific proteases (SENP).Once the balance between SUMOylation and de-SUMOylation is broken,there will be an aberrant expression of SUMO or SENPs in cells to happen,which may lead to the tumor occturtrence.

Objective To investigate the therapeutic effect of transplantation of limbal epithelial cells and decellularized porcine cornea construct in rabbits with corneal alkali burn.Methods Allogeneic rabbit limbal epithelial cells were cultured and identified.Porcine cornea scaffold was fabricated by decellularization.The LECs-DPC construct was cultured and transplanted to the alkali-burned corneal surface of rabbits(4month follow-up).Results Immunocytochemistry and RT-PCR analyses revealed the presence of ABCG2 positive limbal stem cells.A general view showed the corneas were clear and vessel-free postoperatively.HE and Masson Trichrome staining results indicated the epithelial stratification,fewer cellular infiltration,DPC' integration into host corneal tissues,and more regular collagen configuration.Transmission electron microscopy exhibited formation of desmosomes and microvilli.Conclusion Allogeneic limbal epithelial cells transplantation using DPC as a carrier can restore corneal clarity after alkali burn in a rabbit model.

Aberrant promoter methylation in special genes such as tumor suppressor genes is early eventin carcinogenesis of lung cancer. Aberrant methylation, resulting in corresponding mRNA silence or overexpression , closely relates to carcinogenesis, development, treatment response and prognosis of lung cancer and it may become a potential biomarker. Methylation of special genes may provide evidences for individual treatment of lung cancers.

Objectives To investigate the changes and signiifcance of serum tumor necrosis factor-α(TNF-α) and anti-ds-DNA antibody in systemic lupus erythematosus (SLE) and lupus nephritis (LN) in children. Methods Sixty-seven children with SLE among whom 52 children had LN were selected and 30 healthy children were selected as normal controls. The level of serum TNF-αwas measured by enzyme-linked immunosorbent assay, and the anti-ds-DNA antibody level was measured by radioimmunoassay. Results The serum levels of TNF-αand anti-ds-DNA antibody were signiifcantly higher in children with SLE or LN than those in healthy controls (P all<0.01). Furthermore, the serum levels of TNF-αand anti-ds-DNA antibody were signiifcantly higher in active phase than in stationary phase of SLE and LN (P all<0.01). The serum TNF-αlevel was positively correlated with SLE disease activity index score and serum anti-ds-DNA level in 67 SLE patients (P<0.05). Conclu-sions The serum levels of TNF-αand anti-ds-DNA antibody were increased in children with SLE and LN and were positively correlated with disease activity.

Objective Depression is a mood disorder that causes a persistent feeling of sadness,with high morbidity rates and great social impairment.Increasingly studies show the abnormalities of brain networks.We summarized the results of resting state functional magnetic resonance imaging study of depression,and demonstrated the neural loops mechanism from neuroimaing perspective.Methods The key words depression, resting state and network were searched in PubMed,CNKI and Wan Fang databases from January 2000 to December 2014.The nodes of depression related network and the alterations of cortex resting-state networks were summarized.Results 24 studies focusing on resting state network of depression were identified.40 studies based on ROI (region of interest) analysis,which included amygdala,frontal lobe,pregenual anterior cingulate cortex and cerebellum.The functional connectivity of ROIs were calculated and compared between groups.8 studies based on ICA (independent component analysis),the resting state networks were extracted and compared between groups.Two based on graph theory,the functional connectivity of whole brain were analyzed and compared.Conclusion There are abnormalities of functional connectivity among limbic system-thalamus-frontal cortex,and the changes of functional connectivity were associated with clinical symptom and drug efficacy of depression.

Background Neovascular glaucoma (NVG) is a serious eye disease with a variety of causes.It results from the secretion of growth factors by hypoxic retinal tissue,such as vascular endothelial growth factor (VEGF),but anti-VEGF treatment alone dose not completely inhibit neovascularization.Our previous study found that platelet-derived growth factor-c (PDGF-C) is also an important factor in pathological angiogenesis.However,the role of PDGF-C in the development of NVG remains unknown.Objective This study was to quantitatively detect the levels of VEGF and PDGF-C in the aqueous humor of patients with NVG and provide a basis for the anti-angiogenesis therapy.Methods A prospective cohort study was carried out.Sixty-two eyes of 62 patients with advanced NVG and 11 control subjects with age related cataract were included in Xijing Hospital of the Fourth Military Medical University from January 2014 to August 2015.Ten of 62 NVG eyes received retinal photocoagulation and/or cryotherapy,and 16 eyes resulted from central retinal vein occlusion,20 eyes from diabetic retinopathy,5 eyes from postopeartion of retinal detachment,4 eyes from Eales disease and 7 eyes from unknown cause.Iris neovascularization of grade Ⅱ was found in 13 eyes,grade Ⅲ in 29 eyes and grade Ⅳ in 10 eyes.Aqueous humor specimen was collected for 0.1-0.2 ml during the surgery,and the contents of VEGF and PDGF-C in the aqueous humor were detected by ELISA assay.Written informed consent was obtained from each subject prior to any medical procedure.Results The VEGF and PDGF-C concentrations in the aqueous humor were (1 138.17±69.31) ng/L and (29.80±1.64) ng/L in the NVG group,respectively,which were significantly higher than (679.54±49.81) ng/L and (18.60±1.85)ng/L in the control subjects (t=20.95,20.49,both at P＜0.01).The VEGF and PDGF-C concentrations in aqueous humor were (1 095.99±52.71) ng/L and (28.55±0.94) ng/L in the retinal photocoagulation group,showing significantly decreases in comparison with (1 146.28±69.57) ng/L and (30.04± 1.64) ng/L in the untreatment group (t =-2.160,P =0.034;t =-2.760,P =0.008).The VEGF content in aqueous humor was positively correlated with PDGF-C content in the patients with NVG (r=0.346,P=0.006).However,the aqueous levels of VEGF and PDGF-C were not significantly different among various primary disease groups and different iris neovascularitation gradings (all at P＞0.05).Conclusions Both VEGF and PDGF-C contents in the aqueous humour are considerably elevated in NVG patients.Retinal photocoagulation and/or cryotherapy can inhibit the release of VEGF and PDGF-C in the aqueous humor.PDGF-C may be a target for the treatment of NVG.

Neovascular glaucoma ( NVG ) is a series of blinding and intractable eye diseases, which caused by various intraocular or extraocular diseases. The iris and angle neovascularization and vascular membrane fiber contraction may eventually lead to progressive elevation of intraocular pressure and angle closure. Because of complex etiology, the treatment of NVG is intractable and inefficient. Based on the articles published in recent years, we reviewed the progressions of the relevant cytokines and animal models.

Objective To evaluate the excursion of the diaphragm and analyze the value in predicting weaning from mechanical ventilation in intensive care unit patients.Methods The patients with mechanical ventilation (＞48 hours) in ICU at Hebei Forth Medical University Hospital from June 2014 to December were classified into a success group or a failure group according to the weaning outcome.T-piece spontaneous breathing (SBT),airway occlusion pressure at 0.1 sec (P0.1) and maximal inspiratory pressure (MIP),rapid shallow breathing index (RSBI) and P0.1/MIP were measured or calculated.During the period of the 1 st hour SBT,the excursion of diaphragm was measured with ultrasonography.The predictive value of each parameter to weaning was evaluated with ROC curve.Results A total of 98 patients were enrolled in this study,including 74 successfully weaning and 24 failed.There were significant differences between two groups (success group and failure group) in P0.1 [(2.00 ± 2.00) cmH2O (1 cmH2O =0.098 kPa) vs (3.00 ±2.75)cmH2O,P ＜0.05],RSBI (39.14 ± 16.81 vs 52.00 ± 19.18,P ＜0.05),left diaphragmatic excursion [(1.12 ± 0.97) cm vs (0.69 ± 1.00) cm,P ＜ 0.001],right diaphragmatic excursion(1.87 ± 0.75) cm vs (1.17 ± 0.76) cm,P ＜ 0.001] and mean value of left and right diaphragmatic excursion [(1.57 ± 0.52) cm vs (0.83 ± 0.53) cm,and P ＜ 0.001].The ventilation time [2.00 (2.00-4.00) d vs 4.00 (2.00-5.00) d],ICU hospital lengths of stay [4.50 (3.00-7.25) d vs 8.50 (6.25-15.25) d] and total hospital lengths of stay [20.00 (15.00-25.25) d vs 25.00 (20.25-37.25)d] were also statistically significant in success group and failure group respectively (all P ＜ 0.05).The cutoff value of diaphragmatic excursion for predicting successful extubation was determined to be 1.14 cm by ROC curve analysis.The sensitivity of diaphragmatic excursion to predict successful weaning was 89.2％ and the specificity was 75.0％,the AUCROC was 0.849.Conclusion As an early predictor of diaphragmatic dysfunction,diaphragmatic excursion is probably superior to the traditional parameters in predicting weaning from ventilator in ICU patients.