The diagnosis and treatment of age-related macular degeneration (AMD) is an international hotspot of eye research.Successful clinical applications of anti-VEGF drugs promoted both basic research and clinical practice of AMD.A number of countries and professional societies have established clinical guidelines for AMD management,including the epidemiology,risk factors,diagnosis,classification,and treatment process.These AMD guidelines are mostly based on recently published results of clinical trials,provided good model of evidence based medicine.It is urgent and necessary to have our own guideline which is suitable for Chinese patients.Reviewing and learning existed guidelines will help us to improve the clinical practice of AMD in China.

Cytokine-induced killer(CIK)cells are characterized by rapid proliferation, high and broad anti-tumor activities and mild toxicities. Some clinical trials demonstrate that the infusion of a large amount of CIK cells enhances the auto-immune of function in patient, which might help to clean up the remaining tumor cells and minor metastatic tumors and delay the recurrence of tumor with improved curative effects.

Macrophages are major effecter cells of nonspecific immune response,the polarization of which plays a great role in inflammation,repairing and angiogenesis.According to functional phenotypes,macrophages can be polarized to classically activated type (M1),which could promote angiogenesis,and alternatively activated type (M2),which could inhibit angiogenesis.The proportion of M1/M2 could modulate the growth of choroidal neovascularization (CNV).Under the conditions of aging and injury within the retina,macrophages may polarize to M2,which could generate several proangiogenic factors,initiating and promoting the formation of angiogenesis and fibrous scar.Therefore,regulation of macrophage polarization is expected to inhibit angiogenesis and provide new insight for treatment of CNV.

[Summary] Laparoscopic sleeve gastrectomy ( LSG) as a sole and definitive bariatric surgery has achieved well results in terms of decreasing the body mass index ( BMI ) and percentage of excess weight loss (%EWL ) , therefore reducing the obesity-related complications , but the mechanism remains unclear .As a restrictive surgical procedure , the most important mechanism of LSG might be the reduction of the volume of the stomach resulting in a limited food intake .Therefore, to achieve the best weight loss after surgery , measuring the gastric volume is an indispensable technology .Currently, gastric capacity measurement methods include imaging measurements and intraoperative direct measurement . Imaging methods include upper gastrointestinal radiography , CT three-dimensional reconstruction , MRI and radionuclide scanning , with each having its advantages and disadvantages .In this article, the measurement methods of gastric capacity before and after LSG were reviewed .

Acute lung injury (ALI) is a kind of clinical syndrome which is characterized by the rising on capillary permeability.Acute respiratory distress syndrome(ARDS) is a serious kind of manifestation of ALI and also a usual kind of critical illness in children.Alveolar macrophage is the first defense line against pathogenic microorganisms and lung injury.More and more evidences show that it plays an important role during the period of occurrence, development and prognosis in ALI.In the last few years, there is an extensive focus on the effect of alveolar macrophage in ALI.This summarization makes a general review on the recent research progress of the effect of alveolar macrophages in ALI.

Using optical imaging equipment with different wavelength and computer technology,fundus optical imaging diagnostic techniques can record fundus reflected light,auto fluorescence and emitted light after excitation by external light source in order to observe and analyze the structure and pathological process of retina and choroid.Advances in fundus optical image capture technology (including laser,confocal laser,spontaneous auto-fluorescence,multispectral imaging) and storage and analysis technology,promote this field into a high-definition digital imaging era,with features of rapid,non-invasive,wide-angle three-dimensional multi-level integration,dynamic automatic navigation location tracking and combined application of a variety of optical imaging diagnostic techniques.In order to promote clinical and scientific research of ocular fundus diseases,we need to understand the development trend of optical imaging diagnostic technique,interpret the fundus imaging features appropriately,reasonably chose different inspection techniques,establish standardized diagnosis criteria and continue to expand clinical applications.

Unregistered drug use,also called off-label drug use,has become a universal phenomenon in clinical practice worldwide.At present,there is still no definite laws and regulations in the field of off-label medication in China.The article gives an overview about the current criterion for prescription in China,the definition of off-label use,analysis of this situation and causes,how to regulate this practice to protect the patient's rights and safety,and also doctor's rights of prescription.

Age-related macular degeneration (AMD) is the mainirreversible blinding eye disease in the elderly.Its main pathogenic factors include age, genetic variation and lifestyle, but the specific pathogenesis has not been fully elucidated.As an emerging research method, proteomics technology has been gradually applied in the field of ophthalmology in recent years.A large number of studies about proteomic analysis of blood, tears, aqueous humor, vitreous humor, retina and choroid, drusen and RPE cell samples from AMD patients have been carried out to screen AMD biomarkers and explore the mechanism of AMD.These results can not only help us to make a more accurate diagnosis of AMD, but also play a guiding role in the selection of treatment targets and prognosis.

Objective To evaluate the safety,middle or short -term effect and indication of the endovascular treatment for ischemic stroke patients with extracranial carotid stenosis.Methods The clinical datas with percutaneous transluminal angioplasty and stenting for extracranial carotid artery stenosis cases were retrospectively reviewed,from which 106 cases with ischemic stroke in the past were selected for study.And theinformation including operation opportunity,operation experience,serious complications such as cerebral hemorrhage and secondary ischemic stroke were summarized.Their clinical features,methods of treatment and prognosis were analyzed specially.Results The placement of 106 cases with 120 stents was satisfaction.Cerebral hemorrhage occurred in 3 cases while thrombosis fol-lowing stent placement in 2 cases,hypotension and bradycardia in 6 cases,vasospasm in 11 cases,gastrointestinal stress bleeding in 1 case,restenosis occurred in 8 cases and no cerebral infarction occurred after operation.Apart from one case of death cerebral hemorrhage,8 cases of restenosis,the,middle or short -term results of the remaining 97 patients were satisfactory.83 cases were followed up for 3 months to 5years,there were no ischemic attack and cerebral infarction occurred.Conclusion The satisfactory effect and safety are achieved in the therapy of carotid stenosis by percutaneous transluminal angioplasty and stenting.Angioplasty and stenting may improve the cerebral hemodynamics of patients with severe /moderate internal carotid artery stenosis.It is suitable for previous ischemic stroke patients.We must be individualized to more carefully assess these patientsˊsurgical risk,strictly adhere to the indications of surgery,and general measures is the key of preventing the complications during the perioperative period.

Purpose To study the clinicopathological features and immunohistochemical characteristics of IgG4-related disease. Meth-ods The microscopic characteristics and immunohistochemical staining (EnVision) of IgG, IgG4, CD138 and CD34 have been per-formed on 12 cases of IgG4-related disease. Results IgG4-related disease were characterized by diffuse fibrosis, accompanied with in-filtrating of dense lymphocytes and plasma cells surrounding neurovascular and occlusive phlebitis. Immunohistochemical staining re-sults showed the ratio of IgG4+/IgG+ cells were over 40%. Conclusions IgG4-related disease is absent of characteristic clinical and radiographic features and is easily misdiagnosed as tumor. Preoperative serum IgG4 detection could be used as the prior examina-tion for the suspected cases.