Background Studies showed that vascular endothelial growth factor (VEGF) plays an important role in the development and progress of diabetic retinopathy (DR),and the association between VEGF-2578C/A polymorphism(SNPs) and risk for DR is a hotspot.Objective This Meta analysis aimed to investigate the comprehensive and reliable conclusion in the association of VEGF-2578C/A SNPs and risk for DR in different races.Methods A systematic search of electronic databases including PubMed,Cochrane Library,EMbase,VIP,Wanfang technological,CNKI and reference lists of relevant articles was carried out until April,2014.Case-control studies on the relationship between VEGF-2578C/A SNPs and DR were selected based on inclusion and exclusion criteria,and the relevance of VEGF-2578C allele to DR,the relevance of VEGF-2578C/A SNPs to DR and the relevance of VEGF-2578A allele to Caucasian DR were quantitatively analyzed.Begger funnel plot of publication biases on the relationships of VEGF SNPs with the risk of DR under the allele and dominant models was drown.RevMan 5.0 software was used for the statistical analysis.The pooled odds ratio (OR) and corresponding 95％ confidence interval (CI) were used to assess the strength of the association.Results A total of 1 228 DR cases and 1 224 diabetes controls without retinopathy(DWR) were included from 8 independent studies (9 groups of data).A significant relationships between VEGF-2578A allelic gene and VEGF-2578AA gene type with DR were found in all samples,and the A allelic gene and AA gene type were the risk genes of DR (A versus C:OR=1.39,95％ CI=1.08-1.80,Z=2.52,P=0.01;AA versus CC+C/A:OR=1.53,95％ CI=1.05-2.24,Z=2.20,P=0.03;CC versus AA+C/A:OR=0.70,95％ CI=0.50-0.98,Z =2.10,P =0.04).When the other two studies which did not meet the HardyWeinberg Equilibrium were incorporated in a sensitivity analysis,the results were not materially altered.VEGF-2578 A allelic gene was the risk gene to Europeans with DR (OR =1.50,95％ CI=1.02-2.21,Z =2.07,P =0.04),but not among Asians in subgroup analysis (P＞0.05).No significant publication bias was found.Conclusions The Meta analysis demonstrates that VEGF-2578C/A is associated with DR in Europeans but not in Asians.Further case-control studies based on larger sample size are still needed,especially in Asians.

Objective To assess the association of vascular endothelial growth factor (VEGF) gene-460C/T and-634C/G polymorphism with diabetic retinopathy (DR) among patients in Asia and European by meta-analysis.Methods A systematic search of electronic databases (PubMed,Cochrane Library,EMBASE,VIP,Wanfang technological,CNKI,etc.) was carried out until Jun,2014.Case-control studies on the relationship between genetic polymorphism of VEGF-460C/T and VEGF-634C/G with diabetic retinopathy were included in this analysis.The data were quantitatively analyzed by RevMan 5.0 software after assessing the quality of included studies.The pooled odds ratios (OR) and their corresponding 95％ confidence intervals (CI) were used to assess the strength of the association.Results VEGF-460C/T (7 studies:899 cases and 786 controls) and VEGF-634C/G (10 studies:1615 cases and 1861 controls) were inclued in this meta-analysis.Significant association was found for-460C/T polymorphism in Aisa (C versus T:OR=1.52,95％CI was [1.22,1.90],Z=3.72,P=0.0002;CC versus CT+TT:OR=1.61,95％CI was [1.19,2.19],Z=3.05,P=0.002;TT versus CT+CC:OR=0.64,95％CI was [0.41,0.98],Z=2.07,P=0.04),and VEGF-634CC gene type was associated with DR in European (OR=1.56,95％CI [1.08,2.25],Z=2.37,P=0.02).No significant publication bias was found.Conclusions The metaanalysis demonstrated that DR was associated with VEGF-460C/T polymorphism in Asia,and C alleles and CC gene type was the risk polymorphism;VEGF-634C/G polymorphism was not associated with DR,but its CC genotype maybe the risk factor in European.Further case-control studies based on larger sample size are still needed,especially for-634C/G polymorphism.

Objective To adopt the network meta analysis method to compare the incidence difference of cutaneous squamous-cell carcinoma(SCC)and rash in 5 kinds of targeted drugs regimen for treating malignant melanoma.Methods PubMed and Cochrane Library databases were retrieved by computer.The retrieval range was from their establishment to November 2015.The network meta analysis pooled the evidences of direct and indirect comparison for evaluating the pooled odds ratio(OR)and cumulative probability of cutaneous complications occurrence difference in 5 kinds of targeted drugs regimen for treating malignant melanoma.Results Six randomized controlled trials(RCTs)conforming to the inclusion criteria were included.The meta analysis results revealed that compared with Dabrafenib+Trametinib,the cutaneous SCC occurrence rate of Vemurafenib was higher(OR=9.20,95％CI=1.26-52.53),while the rash occurrence rate of Vemurafenib+Cobimetinib was higher(OR=6.81,95％CI=1.01-41.87).The surface under the cumulative ranking curves(SUCRA)value showed that adopting Trametinib had the lowest occurrence rate for SCC,and adopting Dabrafenib+Trametinib had the lowest occurrence rate of rash.Conclusion Dabrafenib+Trametinibis generate the lowest complication incidence rate of malignant melanoma.

BACKGROUND: Although bone tissue engineering has been developed rapidly, ideal scaffold materials are deficient and the ability of tissue engineered bone constructed in vitro was reported inconsistently.OBJECTIVE: To study the ectopic osteogenesis of the implantation in vitro with composite fully deproteinized bone(CFDB) compounded by autologous red marrow.DESIGN: A randomized controlled study.SETTING: Department of Orthopaedics, the 152 Hospital of Jinan Military Area Command of Chinese PLA; Ward for Retired Cadres, First People's Hospital of Pingdingshan City; Department of Orthopaedics, Chaochuan Mine Hospital of Pingdingshan Coal Industrial Group.MATERIALS: The study was completed in the Department of Orthopaedics,the 152 Hospital of Jinan Militatry Area Command of Chinese PLA. Totally 40 Japanese flap-eared white rabbits of 4 months old of either gender with a body mass from 2.0 kg to 2.5 kg were involved (provided by the Laboratory for Experimental Animals of the 152 Hospital in Pingdingshan city).INTERVENTION: Calf CFDB scaffold materials were compounded by rabbit autologous red marrow after physical and chemical managements, which were then implanted into the thigh muscles of 40 rabbits. The osteogenetic abilities of the materials compounded by autologous red marrow were analyzed at 4 weeks and 8 weeks after operations respectively.ysis of the implanted bone.RESULTS: ALP activities were(63.48 ± 0. 873) and (69. 527 ± 0. 635) IU/L respectively, and the results of osteogenetic quantitative analysis were (2.50 ±0.38) and(4.70 ±0.67) points of rabbits in the study group at week 4 and week 8 respectively. ALP activities were(2.50±0.38) and (4.70 ± 0. 67) IU/L and the results of osteogenetic quantitative analysis were( 1.90 ± 0.54 ) and(3.40 ± 0.54) points of rabbits in the control group at week 4 and week 8 respectively. The results indicated that the osteogenetic ability of the study group was significantly higher than that of the control group at the same time point, and the neogenetic bone increased along with the prolongation of the implantation time.CONCLUSION: CFDB could be applied as scaffold materials for bone tissue engineering, and its osteogenesis increases significantly after being compounded by autologous red marrow.

Objective To evaluate the value of strain rate imaging(SRl) in quantitatively detecting regional right ventricular function in hypertension(HBP) patients with different mode of left ventricle.Methods Thirty-eight patients with HBP were divided into left ventricular nermal (LVN) and left ventricular remodeling(LVR) groups according to left ventricular mass index(LVMI) and relative wall thickness(RWT).Twenty-three controls were performed echocradiography examination.Tissue velocity imagings of all the patients and controls were accepted in apical four chamber views.The indies included:peak systolic velocity(Vs),peak early diastolic velocity(Ve),peak late diastolic velocity(Va) and Ve/Va of triscular annulus,peak systolic strain rate(SRs),peak early diastolic strain rate (SRe),peak late diastolic strain rate(SRa) and SRe/SRa of right ventricular free wall.Results Compared with controls,Ve/Va of LVN group decreased significantly,but there were no difference in Vs and Ve.Compared with LVN group and controls,Ve and Ve/Va of LVR group decreased significantly,but there were no significantly difference in Vs.Compared with controls,Ss,SRe and SRe/SRa of LVN and LVR group decreased significantly,but there was no significantly difference in SRs;compared with LVN group,Ss,SRe and SRe/SRa of LVR group decreased significantly,but there was no significantly difference in SRs.Conclusions The systolic and diastolic function of RV in patients with HBP damaged with or without left ventricular remodeling.SRI can evaluated regional right ventricular funciton in these patients accurately.

Objective To evaluate the right ventricular function in patients with chronic obstructive pulmonary disease (COPD) by strain rate imaging. Methods Echocardiography were performed in 41 patients with COPD and 20 controls. Right ventricular frontal thickness (RVFT), right atrial end diastolic diameter(RAEDd) , right ventricular end diastolic diameter (RVEDd), right ventricular end diastolic area (RVEDa) ,right ventricular end systolic area (RVESa) (fraction of right ventricular area change (RVFA) and E/A of tricuspid valve flow were measured in 4-chamber apical view. Tissue velocity imaging (TVI) were accepted in apical four chamber apical views. The indies included peak systolic strain rate (SRs) ,peak early diastolic strain rate (SRe) ,peak late diastolic strain rate (SRa) and SRe/SRa. Results According the pulmonary pressure, the patients with COPD were divided into 2 groups: group PAH (pulmonary artery hypertension) and group NPAH (non-pulmonary artery hypertension). Compared with controls, RVFT, RAEDd and RVEDd of group PAH increased significantly, RVFA and E/A decreased significantly, the upper indices of group NPAH had no significant difference, SRs, SRe and SRe/ SRa of right ventricular free wall and interventricular septal in group PAH and group NPAH decreased significantly, but there was no significant difference of SRa. Compared with group NPAH,SRs,SRe and SRe/SRa of right ventricular free wall and interventricular septal in group PAH decreased significantly,but there was no significant difference of SRa; there was significant positive correlation between SRs of right ventricular free wall and FEV1 /FVC, DLco/VA in patients with COPD,but there was no significant correlation between SRe of right ventricular free wall and RVFA, E/A,FEV1 /FVC and DLco/VA. Conclusions Function of right ventricle in patients with COPD can be damaged with or without pulmonary hypertention; SRI can detect right ventricular function in these patients easily and noninvasive.

BACKGROUND:The traditional orthopedic fixation by C-arm positioning surface is completed, but the large C-arm injury on the human body and the long fixed time increase the suffering of patients. OBJECTIVE:To investigate the X-ray fixed in position within the orthopedic implants, navigation and effect. METHODS:Twenty-six New Zealand white rabbits were randomly divided into C-arm machine group and X-ray group, with 13 in each group. Rabbits in both groups were used to simulate soft tissue foreign body localization, intramedul ary nail implantation at distal fracture end and spinal pedicle screw entry point position. In the C-arm machine group, positioning navigation was conducted with C-arm machine. In the X-ray group, X-ray positioning navigation was used. The positioning and navigation effects were compared between the two groups. RESULTS AND CONCLUSION:(1) Compared with the C-arm machine group, the time required for navigation in the X-ray group targeting soft tissue foreign body localization, fracture distal locking intramedul ary nail implantation and pedicle screw spinal needle point location was significantly shorter (P<0.05);navigation displacement and deviation produced were significantly less (P<0.05). (2) These findings suggested that the X-ray positioning for orthopedic fixation method is relatively simple, with high availability, and can obtain a high performance-price ratio. Meanwhile, the X-ray localization can improve accuracy and shorten the fixed time.

BACKGROUND: Navigation systems all can improve the accuracy rate in cervical pedicle screw insertion, but cannot achieve desired outcomes because of some shortcomings, such as poor imaging quality, complicated operation, poor real-time performance, and invasive navigation.OBJECTIVE: To study the accuracy of X-ray fluoroscopy and CT three-dimensional image navigation in cervical pedicle screw insertion.METHODS: Totally 90 patients undergoing cervical pedicle screw insertion from the First Affiliated Hospital of Nanyang Medical College were enrolled, and randomly divided into control and experimental groups (n=45 per group). 132 cervical pedicle screws were inserted into the patients in the control group manually under X-ray fluoroscopy, and 128 ones were inserted into the patients in the experimental group assisted with CT three-dimensional image navigation. The operation time and intraoperative blood loss in the two groups were recorded. Postoperative CT three-dimensional reconstruction was performed to compare the placement accuracy between two groups.RESULTS AND CONCLUSION: The excellent and good rate of placement in the experimental group (95.3%) was significantly higher than that in the control group (88.6%, P < 0.05). (2) The operation time and intraoperative blood loss in the experimental group were significantly higher than those in the control group, and the navigation matching time and radiant quantity in the experimental group were significantly less than those in the control group (P < 0.05). (3) The Japanese Orthopedic Association scores showed no significant difference between two groups before surgery (P > 0.05),and were significantly improved in the experimental group compared with the control group at 3 and 6 months postoperatively (P < 0.05). The incidence of complications in the experimental group was significantly lower than that in the control group (7% versus 16%, P < 0.05). (5) These results suggest that compared with X-ray fluoroscopy, CT three-dimensional image navigation can improve the accuracy of cervical pedicle screw insertion, showing higher safety and precision. However, it needs complicated operation skills, and long operation time results in massive intraoperative blood loss; thereafter, choosing which placement method depends on the patient condition.

Objective To adopt Fst statistical method to assess the heterogeneity sources of meta‐analysis by dichotomous varia‐ble .Methods The case‐control studies on the relationship between KIF1B gene rs17401966 polymorphism and hepatocellular carci‐noma(HCC) risk were collected by retrieving the databases including Google Scholar ,EMBASE ,PubMed ,ISI Web of Knowledge and CNKI .The meta analysis was performed by using the Stata12 .0 software .The genetic differentiation degree among populations was analyzed and researched by using the Arlequin 3 .5 software .Results A total of 5 case‐control studies were finally included ,in‐volving 12 research populations .The meta analysis on 12 populations showed that KIF1B gene rs17401966G allele was negatively correlated with HCC risk (OR=0 .77 ,95% CI:0 .65-0 .93 ;P=0 .005) .However ,the strong heterogeneity existed in this pooled re‐sults .The genetic differentiation test in the included 12 populations found that Zhang′s five research populations had varying de‐grees of genetic differentiation compared to other populations .Then the proper subgroup analysis was further conducted based on Fst value ,and then the I2 value of the heterogeneity test in the group 8 and 9 was descended to less than 25% .However ,the meta analysis results of the group 8 and 9 were inconsistent .Conclusion This study showed that conducting the meta‐analysis of KIF1B gene rs17401966 polymorphism and the HCC risk can find the heterogeneity sources of meta‐analysis by conducting the genetic dif‐ferentiation test in the included population .

Objective To explore the effect of inhibiting Akt phosphorylation on tumor necrosis factor related apoptosis inducing ligand (TRAIL)-induced apoptosis of human non-small cell lung cancer (NSCLC) H1299 cells with wild type EGFR and KRAS.Methods The TRAIL-induced apoptosis was examined by the Annexin V-FITC/PI.The expressions of TRAIL-activated Akt phosphorylation and p-Akt were measured by Western blot.After cells were treated with LY294002, an inhibitor of PI3K-Akt pathway, Annexin V-FITC/PI and Western blot were used to analyze the alteration of TRAIL-induced apoptosis and Akt phosphorylation, respectively.Results H1299 cells were not sensitive to TRAIL-induced apoptosis.When TRAIL concentration was 100 ng/ml, the apoptosis rate of the test group was significantly higher than that of the control group [(15.06±1.29) ％ vs (3.56±0.50) ％, t =66.953, P =0.000].When TRAIL concentration was 500 ng/ml, the difference was not statistically significant compared with apoptosis rate of 100 ng/ml TRAIL group [(18.65±2.09) ％ vs (15.06±1.29) ％, t =2.423, P =0.136].The expression level of Akt phosphorylation in H1299 cells was increased by TRAIL in a time-dependent way.When cells were pretreated with LY294002, TRAIL-induced Akt phosphorylation was suppressed to baseline level.At the same time, the apoptosis rate in LY294002-treated group was significantly higher than that in TRAIL group [(41.65±4.62) ％ vs (15.82±0.61) ％, t =39.028, P =0.001].Conclusions TRAIL-induced Akt phosphorylation can antagonize TRAIL-induced apoptosis.Inhibition of Akt phosphorylation can significantly enhance the sensitivity of NSCLC H1299 cells with wild type EGFR and KRAS to TRAIL-induced apoptosis.