Choroid neovascularization (CNV) is pathological proliferation of choroid vascular,accompanying with bleeding and leakage,is one of the major factors caused blindness,so CNV inhibitors have become a research hotspot.At present,researches on inhibitors of vascular endothelial growth factors and their receptors,endogenous angiogenesis factors,redox and inflammatory response related factors,etc,have achieved certain progresses.In addition,as drugs with multiple targets for treatment,many Chinese herbs also show inhibition effect on CNV.This article reviews the research advances in inhibitors for CNV.

Objective To observe the changes of plasma lipoprotein concentrations after an oral glucose tolerance test and research their relation to insulin resistance in Type 2 diabetic patients.Methods The age,duration of diabetes,sex,waist circumference,hip circumference,waist-hip ratio,height,body weight,body mass index ( BMI ),systolic blood pressure,diastolic blood pressure,fasting plasma glucose,HbAl C,fasting insulin,and fasting and 60-,120-,180-minute post-load plasma glucose,plasma insulin,triglycerides ( TG),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol(LDL-C) and total cholesterol(TC) after a 75-g oral glucose tolerance test were measured in 26 Type 2 diabetic patients.Comparison of plasma fasting lipoprotein concentrations and postload lipoprotein concentrations was made,and the relation between fasting and post-load lipoprotein concentrations and Homa-IR was researched.Stepwise multiple regression analysis was applied to investigate the areas under the lipoproteins' curves over 180 minutes.Results The declination of post-load lipoprotein concentrations after the 75-g glucose tolerance test was statistically significant( all P ＜0.01 ).Plasma TG concentration both in fasting and post-load state was positively related to Homa-IR( all P ＜ 0.05 ),and plasma HDL-C concentration in fasting and post-load state was negatively related to Homa-IR( all P ＜ 0.05 ).However,the correlation between both fasting and post-load state LDL-C and TC concentration and Homa-IR had no statistical significance.Moreover,stepwise multiple regression analysis revealed Homa-IR was the independent factor capable of modulating the area of HDL-C curve over 180 minutes after the 75-g glucose tolernce test ( P ＜ 0.05 ).Conclusion There was a significant declination of plasma lipoproteins after a 75-g glucose tolerance test,and plasma fasting and post-load TG and HDL-C concentrations were related to insulin resistance.Insulin resistance should play a significant role in the post-load HDL-C concentration after 75-goral glucose tolerance test.

Objective To investigate the associations between levels of perioperative biochemical markers of the liver,kidney,lung and heart and death within 3 months postoperatively in the senile patients with femoral intertrochanteric fracture.Methods A retrospective study was conducted on the 153 senile patients with femoral intertrochanteric fracture who had been treated at Nanfang Hospital from January 2010 to January 2012.They were 71 men and 82 women,with an average age of 83.1 years.There were 70 stable and 83 unstable fractures.At preoperation (within 24 h after admission),and 24 h,25 to 48 h and 72 h postoperation,all the patients had blood examinations of biochemical markers of the liver [alanine aminotransaminase (ALT)],kidney (creatinine and urea nitrogen),lung (PaO2) and heart [brain natriuretic peptide (BNP)].The levels of biochemical markers at all time points and clinical data were compared between the living patients and those who died within 3 months postoperatively.Univariate and multivariate logistic regression analyses were conducted to estimate the independent risk factors for mortality within 3 months postoperatively.Results Of the 153 patients,32 (20.9％) died within 3 months postoperatively,including 10 men and 22 women.In the dead and surviving patients,there were respectively 25 and 17 cases who were rated as level Ⅲ or Ⅳ by ASA (American Society of Anesthesiologists).The levels of ALT,creatinine,urea nitrogen,and BNP increased to different extents while the level of PaO2 decreased postoperatively in both the dead and surviving patients.The differences between the dead and surviving patients were statistically significant (P ＜ 0.05).Multivariate logistic regression analysis showed poor preoperative physical condition (ASA level Ⅲ or Ⅳ),increased creatinine level at 25 to 48 h postoperation,decreased PaO2 at 72 h postoperation,and increased BNP level at 24 h postoperation were independent risk factors for early mortality in senile patients with femoral intertrochanteric fracture.Conclusions Femoral intertrochanteric fracture in senile patients may lead to changes in the liver,kidney,lung and heart.Prompt and dynamic monitoring of the levels of PaO2,creatinine and BNP may provide timely prediction of the poor prognosis.

[Objective]To compare the expression of calcitonin gene-related peptide(CGRP) receptor in rat bone marrow mesenchymal stem cells(rBMSCs) and the induced osteoblasts.[Method]The rBMSCs were isolated using whole bone marrow adherence method,and classified into osteoblast-induced group and non-induced group.In the different periods of culturing(1,2,and 3 weeks),identification of osteoblasts was performed by immunohistochemistry and reverse transcriptase-polymerase chain reaction(RT-PCR),and expression of the CGRP receptor was detected by Western Blot and RT-PCR.[Result]RT-PCR test demonstrated that osteoblast-induced group had a higher expression of CGRP receptor than non-induced group at the same time point,expression of CGRP receptor was increased in a time-dependent manner in the osteoblast-induced groups.Western Blot test demonstrated that osteoblast-induced group had a higher expression of CGRP receptor than non-induced group at the same time point.Expression of CGRP receptor was increased in a time-dependent manner in osteoblast-induced groups.[Conclusion]According to the mRNA test and protein test,it is suggested that CGRP receptor exists in the rBMSCs.CGRP receptor expression increased in the progress of osteogenic differentiation.

Objective　To study the biocompatibility of bioactive glass ceramic (BGC) materials with bone marrow stromal cell (BMSc) and the osteogenic capability of BMSc using tissue-engineering methods. 　Methods　The osteogenic potential in vitro of cultured BMSc in a conditional medium was examined by histochemistry stains technique. The BMSc was cultured in combination with BGC. The attaching and extending speed of the cells to the materials, the proliferation and alkaline phosphatase activity were tested. Then the composite was implanted into the skeletal muscle beds in rabbits. All implants were examined by gross observation and histological examination. 　Results 　The BMSc showed a similar property to those of osteoblasts. BMSc can attach to and extend on BGC materials. No inhibition to celluar proliferation and ALP activity were observed by the materials. New bone can be observed in the composites of the BMSc and BGC materials.　 Conclusions　 BMSc may provide a rich cellular resource in tissue-engineered bone formation. New bone tissue can be formed by tissue engineering methods.

Medical molecular imaging not only promotes the development of medical imaging, but also pushes research progress of life science and benefits the amalgamation of multi-subjects in medical imaging. This editorial overviews the history and development trends of medical molecular imaging.
Humans ; Molecular Imaging ; trends

Objective To evaluate the effects of dexmedetomidine used to supplement analgesia with sufentanil on the stress response and inflammatory response after cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Forty-four patients of both sexes,aged 18-64 yr,with body mass index of 18-30 kg/m2,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ (New York Heart Association Ⅱ or Ⅲ),scheduled for elective cardiac valve replacement with CPB,were randomly divided into sufentanil analgesia group (group S,n =20) and dexmedetomidine supplementing sufentanil analgesia group (group DS,n=24) using a random number table.After induction of general anesthesia,the patients were endotracheally intubated and mechanically ventilated.Combined intravenous-inhalational anesthesia was used to maintain anesthesia.Dexmedetomidine was infused at 0.3 μg · kg-1 · h-1 from closure of the chest to the end of surgery in group DS,while the equal volume of normal saline was given instead in group S.The patient-controlled intravenous analgesia (PCIA) was used for postoperative analgesia.PCIA solution contained sufentanil 2 μg/kg in 100 ml of normal saline in group S,or sufentanil 2 μg/kg plus dexmedetomidine 3 μg/kg in 100 ml of normal saline in group DS.The PCIA pump was set up with a 0.5 ml bolus dose,a 5 min lockout interval and background infusion at a rate of 1.5 ml/h.Visual analogue scale score was maintained ≤ 3.When visual analogue scale score ≥ 4,morphine 0.1 mg/kg was injected intravenously.The occurrence of analgesics-related respiratory depression,bradycardia and hypotension was recorded.At the end of surgery (T0),and 12,24,48 and 72 h after surgery (T1-4),blood samples were collected from the central vein for determination of serum cortisol,β-endorphin,C-reactive protein,interleukin-2 (IL-2),and IL-6 concentrations by enzyme-linked immunosorbent assay.Results No analgesics-related adverse events were detected in the two groups.Compared with group S,the requirement for morphine was significantly decreased,the serum cortisol concentration was decreased at T2-4 and the serum β-endorphin,C-reactive protein concentrations were decreased at T1-4,the serum IL-2 concentrations were increased at T1-4,and the serum IL-6 concentrations were increased at T3 in group DS (P＜0.05).Conclusion Dexmedetomidine used to supplement analgesia with sufentanil can alleviate the stress response and inflammatory response after cardiac valve replacement with CPB.

Objective To compare the effects of nasogastric tube and spiral nasointestinal tube on patients with severe brain injury. Methods Pa?tients receiving enteral nutrition with spiral nasointestinal tube or nasogastric tube were collected and investigated to evaluate the two schemes of en?teral nutrition from aspects of coma score,nutrition improvement,and catheter complications and so on. Results Detection of levels of total protein and prealbumin were conducted for all patients at 7 and 15 days after intubation. Each index was higher in the spiral nasointestinal tube group than in the nasogastric tube group. The reflux and aspiration rate was lower in the spiral nasointestinal tube group than in the nasogastric tube group. The dif?ferences were significant(P<0.05). Conclusion Using spiral nasointestinal tube to give enteral nutrition in patients with severe brain injury can improve the nutritional status,reduce complications,which is more contributory to the recovery.

Objective To systematically compare the operative and non-operative treatments of acute injury to the lateral ankle ligaments in terms of efficacy and complications.Methods The databases of MEDLINE (From January 1966 to October 2011 ),EMBASE (From January 1988 to October 2011 ),CBMdisc (From January 1978 to October 2011) and CNKI (From January 1980 to October 2011 ) were researched for eligible randomized-controlled trials (RCTs),controlled clinical trials,quasi randomized controlled trials and cohort study which compared operative and non-operative treatments for acute injury to the lateral ankle ligaments.The methodological quality of the eligible studies collected was evaluated.The data of the studies included were extracted for a Meta analysis to compare the motional recovery,functional stability,re-injury,residual pain and post-treatment complications of the ankle between operative and non-operative treatments.RevMan 5.0 software was used for statistical analysis.Results In all the eligible 13 studies included,713 patients were treated operatively and 817 patients non-operatively.The functional stability of the ankle was significantly better in the operative treatment group than in the non-operative treatment group [ OR =0.72,95％ CI,(0.52,0.99),P ＜ 0.05].The incidence of ankle arthrocleisis in the operative treatment group was significantly higher than in the non-operative treatment group [ OR =3.41,95％ CI (1.56,7.44),P =0.002].There were no statistical differences in the motional recovery [ OR =1.14,95％ CI (0.58,2.21),P＞ 0.05],incidence ofre-injury [OR=0.68,95％ CI (0.35,1.31),P＞0.05],residual pain [ OR =0.81,95％ CI(0.56,1.16),P＞ 0.05],or ankle dyskinesia [ OR =2.38,95％ CI (0.91,6.25),P＞ 0.05]between the 2 groups.The incidences,scar tenderness [01R=7.46,95％CI(1.32,42.08),P ＜0.05]and sensory nerve loss [OR=12.16,95％ CI(2.24,66.02),P ＜0.05]were significantly higher in the operative treatment group than in the non-operative treatment group.The total rate of complications was significantly higher in the operative treatment group than in the non-operative treatment group [0R=6.20,95％ CI (2.67,14.41),P ＜0.05].Conclusions Compared with non-operative treatments,operative treatments for acute injury to the lateral ankle ligaments can significantly improve the functional stability of the ankle,but make no significant differences in the motional restoration,re-injury or the residual pain of the ankle.In addition,operative treatments may increase the risk of complications.

Objective To further compare the effect of intravitreal injection of bevacizumab (IVB) and photodynamic therapy (PDT) for the treatment of choroidal neovascularization (CNV) secondary to pathologic myopia by meta-analysis.Methods Pertinent publications were identified through systemic searches of PubMed,EMBASE and the Cochrance Controlled Trials Register.All clinical comparative studies of IVB or PDT as initial treatment for CNV secondary to pathologic myopia were included.Meta analysis of these clinical trials was performed to analyze the effect of IVB and PDT for CNV secondary to pathologic myopia.Measurements included best corrected visual acuity (BCVA) and central foveal thickness (CFT).Results A total of 6 comparative studies involving 351 eyes were included.There were 196 eyes in IVB group and 215 eyes in PDT group.Funnel plots,Egger linear regression and Begg method did not show publication bias.Compared with PDT group,at 3,6 and 12 months after IVB treatment,BCVA significantly increased [3 months:weighted mean difference (WMD) =-0.14,95 ％ confidence interval (CI)=-0.26 to-0.01,P=0.04; 6 months:WMD=-0.18,95％ CI=-0.33 to-0.03,P=0.02; 12 months:WMD=-0.26,95％ CI=-0.35 to-0.18,P＜0.001].However,change of CFT at 3,6 and 12 months did not vary significantly between IVB group and PDT group (3 months:WMD=-22.49,95％ CI=-93.49 to 48.52,P=0.53; 6 months:WMD=-17.34,95％ CI=-56.00 to 21.31,P=0.38; 12 months:WMD=-5.32,95％ CI=-56.37 to 45.74,P=0.84).Conclusion Patients with CNV secondary to pathologic myopia experienced a significant benefit of visual improvement after IVB,but reduction in CFT after the IVB or PDT did not vary significantly.