Corticosteroids,anti-vascular endothelial growth factor,antibiotics and antiviral were the main 4 classes of drugs for intravitreal injection.Depending on the class and volume of medication,age and gender of patients,ocular axial lengths or vitreous humour reflux,intraocular pressure (IOP) can be elevated transiently or persistently after intravitreal injection.Transient IOP elevation occurred in 2 weeks after intravitreal injection,and can be reduced to normal level for most patients.Only a small portion of such patients have very high IOP and need intervention measures such as anterior chamber puncture or lowering intraocular pressure by drugs.Long term IOP elevation is refers to persistent IOP increase after 2 weeks after intravitreal injection,and cause optic nerve irreversible damage and decline in the visual function of patients.Thus drug or surgical intervention need to be considered for those patients with high and long period of elevated IOP.Large-scale multicenter clinical trials need to be performed to evaluate the roles of the drug and patients factors for IOP of post-intravitreal injection,and to determine if it is necessary and how to use methods reducing IOP before intravitreal injection.

Objective To investigate the efficacy and safety of intravitreal ranibizumab and (or) triamcinolone combined with laser photocoagulation for macular edema secondary to branch retinal vein occlusion (BRVO) during one year period.Methods The data of 31 eyes from 31 consecutive patients with macular edema secondary to BRVO during one year follow-up visit were retrospectively analyzed.Mean best corrected visual acuity (BCVA) logMAR was (0.74±0.36) and mean central retinal thickness (CRT) was (484.48± 164.81) μm at baseline.All patients received standardized clinical comprehensive examinations including vision,intraocular pressure and optical coherence tomography for diagnosis before treatment.All patients received intravitreal injections of 0.5 mg ranibizumab (0.05 ml) at first visit.The continue PRN treatment were based on the visual acuity changes and the optical coherence tomography findings.Eyes received combined triamcinolone acetonide 0.05 ml (40 mg/ml) and ranibizumab for macular edema recurrence after two injections of ranibizumab and received laser photocoagulation during 10-14 days after third injections of ranibizumab.Mean injection of ranibizumab was 3.52± 2.01,15 eyes with triamcinolone acetonide (0.84 ± 1.21),21 eyes with laser photocoagulation (0.97± 0.95) and 12 eyes with three treatment.Compared the visual acuities and CRTs of the first and the last visits by statistical analysis.Results Mean visual acuity improved significantly to 0.42±0.33 logMAR (t=6.611,P=0.000).Mean improvement of visual acuity was 2.90± 3.07 lines.A gain of three or more logarithmic lines was evaluated in 20/31 eyes (64.52％) at the last visit.Mean CRT was (326.19± 117.80) μm (t=4.514,P=0.000).Mean reduction of CRT was (333.58±134.17) μm.A decrease of 100 μm of CRT was evaluated in 17/31 eyes (54.84％).No severe ocular and systematic side effect was found.Conclusion The efficacy and safety of intravitreal ranibizumab and (or) triamcinolone combined with laser photocoagulation for macular edema secondary to BRVO were assured.

Objective To investigate the clinical features,etiology and risk factors of the inpatients with ischemic stroke in the Department of Cardiology.Methods The medical records of the inpatients with ischemic stroke and the inpatients in a control group were collected retrospectively.The demographics,vascular risk factors,clinical features,and other related factors were compared in both groups.Multivariate logistic regression analysis was used to analyze the independent risk factors for in-hospital ischemic stroke in the Department of Cardiology.Results A total of 2 789 inpatients in departments of cardiology were enrolled,and 26 of them (0.93％) had in-hospital stroke.One hundred thirty inpatients from 2 763 patients without in-hospital stroke were used randomly as control cases.The proportions of the inpatients of hypertension (73.08％ vs.50.77％ ; x2=4.348,P=0.037),atrial fibrillation (50.00％ vs.15.38％; x2=15.56,P=0.000),infection (30.77％ vs.7.69％ ; x2 =11.304,P =0.003),smoking (46.15％ vs.21.54％ ; x2 =6.886,P =0.009),alcohol (26.92％ vs.11.54％ ;x2 ＝ 4.233,P =0.040),previous stroke history (19.23％ vs.4.61％ ;x2 =7.062,P =0.008),and taking anti-hypertensive drugs (42.31％ vs.21.54％ ;x2 =4.985,P =0.026),as well as systolic blood pressure (143.43 ± 18.59 mm Hgvs.129.52 ± 23.52 mm Hg; t =3.209,P=0.003; 1 mmHg =0.133 kPa),diastolic blood pressure (88.77± 11.35 mm Hg vs.77.55± 14.60 mmHg; t=2.421,P =0.020),and homocysteine levels (19.27 ± 11.08 μnol/L vs.15.30 ±5.25 μmol/L; t =2.814,P =0.006) in the stroke group were significantly higher than those in the control group in the Department of Cardiology.Multivariate logistic regression analysis showed that atrial fibrillation (odds ratio [OR] 3.310,95％ confidence interval [CI] 1.207-9.076; P =0.020),infection (OR 3.270,95％ CI 1.024-10.438; P =0.045),systolic blood pressure (OR 1.023,95％ Cl 1.002-1.045; P =0.031),and homocysteine level (OR 1.089,95％ CI 1.009-1.175; P =0.029) were the independent risk factors for in-hospital ischemic stroke in the Department of Cardiology.Conclusions Atrial fibrillation,infection,systolic blood pressure,and high homocysteine levels are the independent risk factor for in-hospital ischemic stroke in the Department of Cardiology.Active intervention and control these risk factors may have great significance for reducing its risk.

Objective To investigate the factors associated with vision and hole closure for idiopathic macular hole (IMH) after vitrectomy surgery.Methods Eighty-nine eyes of 89 patients with IMH were enrolled in this retrospective study.There were 15 males and 74 females.The patients aged from 42 to 82 years,with the mean age of (64.13 ± 7.20) years.All subjects underwent best corrected visual acuity (BCVA) and optical coherence tomography (OCT) examinations.The BCVA ranged from 0.01 to 0.4,with the mean BCVA of 0.12 ± 0.09.The MH stages was ranged from 2 to 4,with the mean stages of 3.56 ± 0.77.The basal diameter ranged from 182 μm to 1569 μm,with the mean basal diameter of (782.52± 339.17) μm.The treatment was conventional 25G pars plana vitrectomy combined with phacoemulsification and intraocular implantation.Fortyone eyes received internal limiting membrane peeling and 48 eyes received internal limiting membrane grafting.The follow-up ranged from 28 to 720 days,with the mean follow-up of (153.73 ± 160.95) days.The visual acuity and hole closure were evaluated on the last visit and the possible related factors were analyzed.Results On the last visit,the BCVA ranged from 0.02 to 0.8,with the mean BCVA of 0.26±0.18.Among 89 eyes,vision improved in 45 eyes (50.56％) and stabled in 44 eyes (49.44％).Eighty-six eyes (96.63％) gained MH closure but 3 eyes (3.37％) failed.By analysis,patients of early stages of MH and smaller basal diameter of MH will gain better vision outcome (t=2.092,2.569;P＜ 0.05) and patients of early stage MH will gain high hole closure rate after surgery for IMH (t=-5.413,P＜0.05).However,gender,age,duration,preoperative BCVA,surgery technique,gas types and follow-up time had no relationship with the effect after surgery for IMH (P＞0.05).Conclusions Stages of MH and basal diameter of MH may be the factors associated with the visual outcome for idiopathic macular hole after surgery.However,age,gender,duration,surgery patterns,gas types and followup time showed no effects on operational outcomes.

Objective: To study the role of activating transcription factor 2 (ATF-2) in the growth of mandibular condyle cartilage. Methods: Primary chondrocytes of condyle were cultured. Expression plasmid of ATF-2 and plasmid bcl-2 promoter were transfected into chondrocytes. Luciferase assay and Western blot were used. Results: The absence of ATF-2 in mandibular condyle chondrocytes resulted in a decline in bcl-2 promoter activity, reduction in bcl-2 protein level. Conclusion: The results strongly imply that ATF-2 is required for adequate bcl-2 expression, and play a significant role in controlling growth plate chondrocyte progression.

AIM:To examine the role and dynamic changes of mast cell(MC) and its subpopulations in simple and irradiated-wound of rats.METHODS:MC and its subpopulations were estimated using alcian blue-safranin (ABS)double staining RESULTS:(1)The total number of MC in two groups decreased coincidently on day 2 after wounding, and the total MC increased rapidly and reached maximal gradually on day 5 and 7 after wounding, the increment of MC remained consistently 28 day after wounding (2)Both mucosal MC( MMC) and Mix MC decreased obviously on day 2 after wounding, hereafter,they remained the low level all the time However, the CTMC kept in the high level after wounding (3)The Mix MC on day 5 and the total MC during day 5-15 after wounding were lower in irradiated group than in simple wound group CONCLUSION: MC and its subpopulations could delay the healing process of simple and irradiated wound

Objective To evaluate the synergistic effect of Baoxinkang on chronic heart failure ( CHF) rats by observing the effect of the combination of Baoxinkang and conventional medicine intervention on cardiac function and adenylate metabolism. Methods Sixty Sprague-Dawley rats were randomly divided into 6 groups, namely sham-operation group, model group, Baoxinkang group ( Baoxinkang 1 020 mg/kg) , conventional medicine intervention group (metoprolol 10 mg/kg, captopril 5 mg/kg, and digoxin 0.022 5 mg/kg), combination group 1 ( conventional medicine intervention + Baoxinkang 1 020 mg/kg) , and combination group 2 ( conventional medicine intervention + trimetazidine 10 mg/kg) . Abdominal aora was constricted to establish CHF rat model. The rats except for the sham-operation group and model group were given the corresponding medicine according to the experimental design for 6 weeks. Echocardiography ( ECHO) was performed to evaluate the cardiac function of rats. High performance liquid chromatography was utilized to investigate the contents of myocardiac adenylate of adenosine triphosphate ( ATP) , adenosine diphosphate ( ADP) , adenosine monophosphate (AMP) . Total adenylate nucleotide pool (TAN) was equal to ATP+ADP+AMP, energy charge (EC) was equal to ( ATP+0.5 ×ADP) /TAN. Results The results of ECHO showed that the heart size was reduced, left ejection fraction and cardiac output were increased in the combination group 1 compared with the model group and conventional medicine intervention group. The levels of ATP, TAN, and EC were significantly increased, whereas the levels of ADP and AMP were decreased in the combination group 1 (P<0.05 or P<0.01). However, there were no significant differences of heart size, left ejection fraction, cardiac output, ATP, ADP, AMP, TAN or EC between combination group 1 and combination group 2 ( P>0.05) . Conclusion Baoxinkang may have some synergistic effect on the improvement of CHF rat cardiac energy metabolism disorder treated by conventional medicine.

Aim To construct eukaryotic expressing plasmid of hi FGF2 ( high molecular weight isoform fi-broblast growth factor-2,hi FGF2) gene and to investi-gate its effect on apoptosis after its overexpression in HEK293 cells. Methods The DNA template primer was designed and synthesized. The pDsRed1-N1 plas-mids were digested by the restriction enzymes of Nhel and Hind III. The hi FGF2 was ligated with linearized pDsRed1-N1 by T4 DNA Ligase. The recombinant plasmid was identified by endonuclease digestion and sequenced. The recombinant hi FGF2 plasmid was transient transfected into HEK293 cells by Lipofectami-neTM 2000 Reagent. The transfection efficiency was de-tected by fluorescence inversion microscope. The cell apoptosis was detected by Annexin V-FITC/PI apopto-sis detection kit with flow cytometry analysis. Results The pDsRed1-N1 eukaryotic expression vector was consistent with the design. The recombinant hi FGF2 plasmid was transfected in HEK293 cells. The trans-fection rate was more than 70%. The FITC/PI dyeing rate in hi-FGF2 over-expression HEK297 cells was a-bout ( 29. 12 ± 2. 81 )%. Conclusions pDsRed1-N1 eukaryotic expression vector is successfully constructed and transfected into HEK293 cells. Over-expression of hi FGF2 induces cell apoptosis.

Objective To evaluate the diagnostic and prognostic value of BRAF V600E mutation screening of ultrasound-guided fine-needle aspiration (FNA)specimens in patients with thyroid nodule. Methods The BRAF V600E mutation status were assessed in FNA specimens of 104 patients with thyroid nodules before operations.The BRAF mutation status,clinical,and pathology records of the patients were reviewed and the associations between these characteristics and papillary thyroid cancer (PTC ) were analyzed.Results Seventy-one PTC and 14 benign thyroid nodules were included in this study.BRAF V600E mutations were found in 57/71 (80%)PTC.All benign thyroid nodules had no BRAF V600E mutation.The sensitivity,specificity,positive predictive value and negative predictive value of BRAF V600E mutations in differentiation between PTC and benign thyroid nodules were 80%,100%,100% and 50%(P < 0.001 ).In 44 patients with PTC who underwent surgery,the central compartment lymph node metastases and extrathyroidal invasion were not significantly different between BRAF-positive and BRAF-negative PTC (P = 0.283 and 0.307 ).Conclusions BRAF V600E mutation may be a potential tool to facilitate ultrasound in diagnosis of PTC.In patients with PTC,the presence of the BRAFV600E mutation was not significantly associated with prognostic factors.

In the field of military medicine,advanced military technologies are widely used.Meanwhile they demand changes and pose challenges to military medicine.In this paper,we discuss the characteristics of those technologies and their influences.Some thoughts are proposed to strengthen the military medical research.