The efficacy of intravitreal injection of anti vascular endothelial growth factor(VEGF) drug has been recognized for the treatment of choroidal neovascularization(CNV) secondary to age-related macular degeneration(AMD), central exudative chorioretinopathy and pathological myopia, proliferative diabetic retinopathy (PDR), retinal vein occlusion, retinopathy of prematurity and neovascular glaucoma. The tendency of clinic application of anti-VEGF is increasing. Though the therapeutic effect of anti-VEGF has been confirmed, a variety of complications associated with its usage were reported. This review summared the advancement of the complication in the clinical application of anti-VEGF therapy such as its effect on normal structure and physiological function of eye, intraocular pressure elevation, rips of retinal pigment epithelium(RRPE), retinal detachment(RD), endophthalmitis and systemic side-effects.

Objective To investigate the influence of Chinese medicine ( CM) treatment on life span of middle-late primary hepatic carcinoma (PHC) patients. Results A multicenter retrospective cohort study was carried out in 489 PHC patients at the stages of Ⅱb, Ⅲa and Ⅲb collected from 15 domestic hospitals. With CM treatment as the exposure factor, the enrolled patients were divided into CM group, western medicine (WM) group and the CM-WM combination group. The main outcomes included median survival time (MST) and survival rate, and the effects of CM treatment and minimally invasive therapy on MST were observed. Results Half-a-year survival rate, one-year survival rate and two-year survival rate were 50%, 9%, 1% in CM group, 70%, 30%, 6% in CM-WM combination group, and 50%, 10%, 0% in WM group, respectively. The survival rates in CM-WM combination group differed from those in CM group and WM group (P<0.01), but the differences of survival rates between CM group and WM group were insignificant (P>0.05) . MST at the stages of Ⅱb, Ⅲa, Ⅲb in CM-WM group was obviously prolonged as compared with the other two groups (P<0.01), and MST at the stages of Ⅲa, Ⅲb in CM group was also obviously prolonged as compared with WM group (P<0.05) . The difference of MST at the stage of Ⅱb was insignificant between CM group and WM group ( P>0.05) . CM treatment and minimally invasive therapy were effective on prolonging the survival time of PHC patients ( P<0.01) . The results of COX regressionanalysis showed that Karnofsky scores, CM treatment and minimally invasive therapy were the preventive factors for the prognosis. Conclusion CM-WM combination group has the best long -term therapeutic effect. CM -WM combination treatment is effective on increasing MST and long-term survival rate, in particular for PHC patients at the stages ofⅡb, Ⅲa and Ⅲb. CM treatment and minimally invasive therapy are helpful for the prolongation of the survival time of PHC patients.

Objective To evaluate the influence of different types of needleless connector on central venous catheter-related thrombotic occlusions. Methods A detailed search was performed to identify literature about the impact of needleless connector on central venous catheter-related thrombotic occlusions , using the Cochrane Library and the databases of Pubmed,EMbase,CINAHL,CBM,CNKI and WanFang. The meta-analysis or descriptive review were performed after two authors independently searching databases,extracting data and assessing quality of included studies. Results Nine published studies were included for systematic review,which contained three randomized controlled trials,three non-randomized experimental studies and three retrospective observational studies. The results of meta-analysis for five studies showed that the split septum connector was associated with a significantly higher incidence of catheter-related thrombotic occlusions(complete occlusions and partial occlusions) than positive-displacement mechanical valve(RR=0.59,95％CI0.39-0.91,P=0.02). Standard connector and negative- displacement mechanical valve had a higher occlusions rates than positive- displacement mechanical valve ,but the difference did not reach statistical significance after merging the studies( P>0.05). Conclusion It is difficult to decide which needleless connector has the lowest rate of central venous catheter-related thrombotic occlusions because of the insufficient evidence. More large-scale and high-quality randomized controlled trials are required for further confirmation.

Objective:To summarize the experience of blood glucose management and nursing for a newborn with repeated hypoglycemia in Beckwith-Wiedemann syndrome.Method:A multidisciplinary team was formed, and formulated an individualized care plan for a large infant with Beckwith-Wiedemann syndrome. A dynamic blood glucose monitoring system was used to closely monitor blood glucose fluctuations for this children, dynamically adjusted the amount of infusion and milk according to the blood sugar situation, detected and dealed with hypoglycemia in time, strengthened the skin care of child and implemented psychological care for the family.Results:After refined treatment and care, the child′s vital signs were stable, and his blood sugar could maintain within a normal range before being discharged from the hospital.Conclusions:The use of dynamic blood glucose monitoring system under the guidance of a multidisciplinary team can effectively monitor and control the blood glucose fluctuations of children with BWS syndrome, which can provide a basis for further treatment of children.

Objective To compare clinical characteristics between acute exacerbated chronic obstructive pulmonary disease (AECOPD) patients with chronic bronchitis phenotype and emphysema phenotype.Methods A total of 73 AECOPD patients with chronic bronchitis phenotype and 82 AECOPD patients with emphysema phenotype in Tibet Chengdu Branch Hospital,West China Hospital,Sichuan University from January 2014 to November 2016 were selected.All patients had completed lung function tests,basic information collection,modified medical research council dyspnea scale (MMRC),and COPD assessment test (CAT).The serum samples were collected to detect C-reactive protein (CRP).The clinical characteristics,lung function,complications and systemic inflammation between the two groups were compared.Results There was no difference in body mass index (BMI),CAT score,serum CRP level and length of hospital stay between the AECOPD patients with chronic bronchitis phenotype and emphysema phenotype (P＞0.05).Compared with AECOPD patients with chronic bronchitis phenotype,the AECOPD patients with emphysema phenotype have longer smoking history,higher MMRC score,and more severe lung function impairment (P＜0.05).Conclusion AECOPD patients with chronic bronchitis phenotype and emphysema phenotype have different clinical characteristics,those with emphysema phenotype have more severe dyspnea and lung function impairment.