BACKGROUND:Studies on the inhibitory mechanism of Avastin for proliferative diabetic retinopathy are mostly confined to the vascular endothelial growth factor, while connective tissue growth factor and angiogenesis inhibitor also play an important role in the disease.
OBJECTIVE:To evaluate the changes of cytokines in the aqueous undergoing Avastin intravitreous injection or not prior to pars plana vitrectormy in the treatment of proliferative diabetic retinopathy.
METHODS:Thirty patients with proliferative diabetic retinopathy (30 eyes) were selected and randomly divided into groups A, B and C, each group containing 10 patients. Group A was treated with single pars plana vitrectormy;and group B and group C had 0.05 mL/1.25 mg and 0.1 mL/1.25 mg Avastin via intravitreous injection at 7 days before pars plana vitrectormy, respectively. Aqueous humor samples were col ected during pars plana vitrectormy. The levels of vascular endothelial growth factor, connective tissue growth factor and pigment epithelium-derived factor were assessed by using ELISA technique.
RESULTS AND CONCLUSION:The levels of connective tissue growth factor and pigment epithelium-derived factor in the aqueous humor of two Avastin injection groups were increased significantly compared to the group with single pars plana vitrectormy. However, the level of vascular endothelial growth factor was lower in the Avastin injection groups. In addition, there was no significant difference between two Avastin injection groups. These results reveal that intravitreous injection of Avastin assisted vitrectomy for proliferative diabetic retinopathy is more effective than single pars plana vitrectormy treatment. The underlying mechanisms may be that Avastin could inhibit the intraocular angiogenesis by not only reducing the secretion of some growth factors but also increasing the levels of anti-angiogenesis related cytokines.

BACKGROUND:Studies on the inhibitory mechanism of Avastin for early diabetic retinopathy rats are mostly confined to the vascular endothelial growth factor, while connective tissue growth factor and pigment epithelium-derived factor also play an important role in the disease.
OBJECTIVE:To evaluate the changed cytokines of aqueous humor and significance of Avastin intravitreous injection in early diabetic retinopathy rats.
METHODS:Rat models of early diabetic retinopathy were established by inducing with streptozotocin for 10 weeks. Avastin (1.25 mg and 2.5 mg) and physiological saline were injected in the vitreous space.
RESULTS AND CONCLUSION:Enzyme linked immunosorbent assay results revealed that compared with the physiological saline injection group, mass concentration of vascular endothelial growth factor was reduced, mass concentrations of pigment epithelium-derived factor and connective tissue growth factor was increased in aqueous humor of the two Avastin injection groups (P<0.05), but no significant difference in concentration of above cytokines was detected between the two groups (P>0.05). Results verified that Avastin intravitreous injection decreased vascular endothelial growth factor levels, decreased pigment epithelium-derived factor mass concentration and increased connective tissue growth factor levels in rat models of early diabetic retinopathy.

In recent years, TCM integrative data analysis has become an important issue requiring urgent solution because of the trend of exponential growth of clinical and scientific TCM research data. This article analyzed the necessity and problems of TCM integrative data analysis from the aspects of background and significance of TCM integrative data, status analysis, data visualization, and application prospect, and put forward the idea of applying data visualization method to data integrative analysis, with a purpose to provide new angles for the reasonable application of TCM data resources.

ObjectiveTo assess China’s newly evolved hot spots and novelty of structural electronic medical record in TCM field.Methods Articles about electronic medical record in TCM field were retrieved from CNKI from January 2000 to December 2015, focusing on researchers, research institutes, and key words for bibliometric analysis. Then visualization software CiteSpace was used to establish co-occurrence network.ResultsThe top 3 productive authors were LIU Bao-yan (13 articles), ZHANG Run-shun (8 articles), XIE Qi (7 articles), and ZHOU Xue-zhong (7 articles). Institutes highly cooperated with others included China Academy of Chinese Medical Sciences, Information Engineering College of Hubei University of Chinese Medicine and The First Affiliated Hospital of Henan University of Chinese Medicine. The major clusters were TCM diagnosis (#0), China’s TCM information (#1), artificial intelligence (#2), medical record management (#3), and medical laboratory department (#4). The representative keywords involved electronic medical record, TCM hospital, data mining, telemedicine, and artificial intelligence. ConclusionIn the field of TCM electronic medical record, cooperation is not sufficiently facilitated among researchers and institutes. Research hot spots are not formed and novelty is not obvious, which is probably because of the overall status quo for China’s TCM information construction.

Objective:To investigate the adhesion,proliferation and differentiation of the stem cells from human exfoliated deciduous teeth(SHEDs)on 3 different types of hydroxyapatite(HA)composite scaffold materials.Methods:Pulp cells from human exfoliated de-ciduous teeth were harvested from impacted deciduous teeth by enzyme digestion,expanded and cultured.Cells were verified by immuno-histochemical methods and in vitro differentiation test.Then the cells were cultured on HA/beta tricalcium phosphate (HA/TCP),HA/collagen (HA/COL)and HA/poly-ethylene propylene lactide (HA/PLGA)scaffold respectively.Adhesion rate was examined at hour 4,6,8 and 10 of culture,proliferation was observed by MTT assay on day 1,4,7 and 10 of culture,respectively.The osteogenic dif-ferentiation was studied by alkaline phosphatase(ALP)test,Von Kossa staining and calcium content measur.Results:The attachment of SHEDs was significantly lower on the HA/COL than on the other 2 scaffolds(P <0.05).The ALP activity,mineralization and calci-um content were the highest on HA/PLGA,and the last on HA/COL(P <0.05).Conclusion:HA/PLGA scaffold is more effective in the promotion of the proliferation,attachment and differentiation of SHEDs than HA/TCP and HA/COL scaffolds.

Objective To evaluate the effectiveness and safety of mouse nerve growth factor in treating dysphagia in patients with nasopharyngeal carcinoma after radiotherapy.Methods Fifty-eight post-radiotherapy nasopharyngeal carcinoma patients with dysphagia were randomly divided into an observation group and a control group.Both groups received routine treatment,but the observation group was additionally injected with mouse nerve growth factor intramuscularly every day for four weeks.Before and after the 4 weeks of treatment,both groups were evaluated using Kubota's water drinking test,videofluoroscopy and the brief version of the WHO's Quality of Life scale.Results After 4 weeks,the patients in the observation group displayed significantly greater improvement in swallowing compared with the control group.There was a significant difference in the groups' average scores on the drinking water test and in the videofluoroscopy results.Moreover,the patients in the observation group had significantly higher quality of life scores than those in the control group,on average.Conclusions Mouse nerve growth factor may have a rapid and safe therapeutic effect on dysphagia induced by radiation.No obvious adverse reactions were observed.

Gallstone ileus is a rare mechanical ileus,which was caused by discharge of giant gall bladder stone to the intestine.Understanding the causes of ileus is the key factor for treatment,and surgical treatment is the treatment of choice.An old patient with gallstone ileus was admitted to the Second Affiliated Hospital of Soochow University in April 2013.Preoperative X ray detection and computed tomography showed gallbladder wall thickening,formation of a sinus tract between the gall bladder and the duodenum,and intestinal ileus in the left iliac region (the diameter of the stone was about 4 cm).The patient received medical treatment for 3 days and then exploratory laparotomy + lithotomy.Gall bladder stones were not detected during the operation,so the gall bladder was preserved.The patient was followed up till December 2013,the sinus tract was disappeared under B sonography,and the cholecystitis was cured.

Objective To compare the efficacy and safety of levofloxacin 750 mg for 5 days versus 500 mg for 7‐14 days intravenous (IV ) infusion in the treatment of community‐acquired pneumonia (CAP ) . Methods This study was a multi‐center , randomized , open‐label , non‐inferiority , controlled clinical trial .The CAP patients were randomized to receive levofloxacin 750 mg IV daily for 5 days or levofloxacin 500 mg IV daily for 7‐14 days .The clinical symptoms , laboratory tests , imaging results and microbiology data were collected and compared between the two treatment groups in terms of efficacy and safety .Results A total of 241 patients were enrolled in this clinical trial from 10 study centers .Among these patients ,223 were eligible for full analysis set (FAS) analysis ,including 111 in 750 mg group and 112 in 500 mg group .Of the 223 patients in FAS ,211 were eligible for per‐protocol set (PPS) analysis ,including 107 in 750 mg group and 104 in 500 mg group .Two hundred and forty‐one patients were included in safety set (SS) ,including 121 patients in 750 mg group and 120 in 500 mg group .The median treatment duration was 5 .0 days in 750 mg and 9 .0 days in 500 mg group .The median total dose was 3 750 mg in 750 mg group and 4 500 mg in 500 mg group .The overall efficacy rate was 86 .2% in 750 mg group and 84 .7% in 500 mg group in terms of FAS at visit 4 ,which suggested that the efficacy of 750 mg group was non‐inferior to 500 mg group .Of the 111 FAS patients in 750 mg group ,40 were bacteriological evaluable ,and 41 strains of pathogens were isolated .Forty‐nine of the 112 FAS patients in 500 mg group were bacteriological evaluable ,and 51 bacterial strains were obtained .The bacterial eradication rate was 100% in both groups .The clinical treatment efficacy rate for atypical pathogens was 100% in both groups .In 750 mg group ,the most common clinical adverse drug reactions (ADRs) were injection site adverse reactions including injection site pruritus ,pain and hyperemia .The other common ADRs were insomnia ,nausea ,skin rash .The most common drug‐related laboratory abnormalities were neutrophil percentage decreased , decreased white blood cell (WBC ) count , alanine aminotransferase (ALT) and aspartate aminotransferase (AST) elevation .Most of the ADRs were mild in severity and well‐tolerated .The safety profile of the two treatments was comparable in terms of the drug‐related treatment discontinuation and the incidence of ADRs .Conclusions The short‐course regimen of levofloxacin 750 mg IV for 5 days is at least as effective and well tolerated as the long‐course regimen of 500 mg IV for 7‐14 days in treatment of CAP .

Objective:To investigate the clinical effectiveness of one-stage biplanar osteotomy correction of angulation and shortening deformity of the lower extremity after epiphyseal injury of the distal femur with a monorail external fixator.Methods:The data of 5 patients (2 males and 3 females) with angulation and shortening deformity in the lower extremity after epiphyseal injury of the distal femur were retrospectively analyzed.The patients underwent monorail external fixator assisted one-stage osteotomy correction of the distal femur and distraction osteogenesis of the middle and upper femur in Zhengzhou Orthopeadics Hospital from May 2017 to December 2019.The mean age was 13.6 years old (range: 10 to 17 years old). The affected limbs were shortened by 5.1 cm on average (range: 3.9 to 6.5 cm). The average angulation deformity of the distal femur was 24.9° (range: 17.0°to 30.5°). The mechanical lateral distal femoral angle (mLDFA), the mechanical posterior distal femoral angle (mPDFA), the mechanical axis deviation (MAD), the range of motion (ROM) of the knee, and the length of the lower limbs before surgery and at the final follow-up were measured and analyzed.Results:All patients were followed up for 22 months on average (range: 15 to 32 months). For all the 5 patients, the mechanical axis was well realigned, mLDFA, mPDFA, and MAD returned to normal range, and the length of the affected limb achieved the goal as planned before the surgery.Besides, the affected limbs were lengthened by 5.6 cm on average (range: 3.9 to 8.0 cm), and the median healing index was 35.6 d/cm (range: 29.0 to 45.0 d/cm). The bone callus in the distraction area and the osteotomy end were well healed at the final follow-up, as indicated by the X-ray results.At the end of the distraction period, the flexion ROM of the knee in all patients reached basically 90°.By the final follow-up, all patients had a normal knee ROM.No vascular or nerve injury, dislocation of hips or knee joints, re-fracture after disassembly, deep infection and other complications were observed in all patients.Conclusions:One-stage biplanar osteotomy correction of angulation and shortening deformity of the lower extremity after epiphyseal injury of the distal femur with a monorail external fixator is safe and feasible.The method requires no multiple operations and improves the tolerance of patients during the treatment period.

Distant metastasis is one of the main obstacles to cancer treatment.Overexpression of S1PR1 in malignant tumors enhances cell invasion and migration activity,mediates EMT and induces lymphangiogenesis and angiogenesis via activation of its downstream signaling pathways,eventually results in the occurrence of tumor metastasis.S1PR1 is also closely related to generation of acquired radiotherapy resistance.This article discusses the roles of S1PR1 in tumor metastasis and radiotherapy resistance.