AIM: To investigate the effectiveness and safety of intravitreal injection of anti-vascular endothelial growth factors (VEGF) drugs to the patients with proliferative diabetic retinopathy before vitrectomy treatment.METHODS: A Meta-analysis.A comprehensive retrieval was conducted using the database including EMbase,the Cochrane Library,Pubmed,CBM,WanFang Database,CNKI and so on.The retrieval time was limited from the building time of database to Jan.2017.The randomized controlled trial was adopted with no requirements on languages.The Jadad scale and Cochrance cooperation were used as the tool of the risk and bias evaluation to analyze the literature quality.Quality estimation of evidence-based medicine on the parameters of each evaluation index was made via GRADEpro Software.The publishing biases of enclosed documents were inspected with funnel plot.At last,the Meta analysis was conducted with Review Manager 5.3.RESULTS: Totally 16 literatures published from 2008-2016 were finally put into randomized controlled trial.A total of 923 cases were included,among which 493 cases were grouped as intravitreal injection of anti-VEGF before the combined operation of PPV group (the experimental group),and 430 cases were involved in simple PPV group (the control group).The results of Meta-analysis show: (1) The probability of intraoperative bleeding was remarkably lower than the control group [OR=0.06,95%CI (0.02,0.15),P<0.01],with statistically significant differences.(2) The duration of operation was obviously shorter than that of the control group[WMD=-29.13,95% CI (-36.95,-21.30),P<0.01],with statistically significant differences.(3) The probabilities of both early and late postoperative vitreous hemorrhage were lower than those of the control group[OR=0.34,95%CI (0.20,0.58),P<0.01],with highly statistically significant differences.(4) The best corrected visual acuity after surgery was no better than that of the control group,[WMD=-0.51(LogMAR),95%CI(-1.10,0.08),P=0.09] with no statistical significance.(5) The occurrence of iatrogenic retinal rupture was lower than that of the control group[OR=0.24,95%CI(0.14,0.40),P<0.01],with statistically significant differences.(6)Among the 493 patients included in the 16 literature,no case of ocular and general adverse effects due to anti-VEGF injections was reported.CONCLUSION: It is effective and safe for the patients with proliferative diabetic retinopathy to inject anti-VEGF drugs into vitreous cavity before vitrectomy.And it can reduce the occurrence of complications during and after surgery,improving the general treatment effects.However,the specific implementation plans,such as the injection does,the interval between the injection and the operation and so on,still need further exploration and perfection.

The corneal reconstruction is tosurgial recover the structure integrity and corneal function after suffered from various trauma, inflammation and degenerative diseases.The corneal diseases caused millions of people worldwide suffering from eyesight damages and even blindness.At present, the corneal transplant is the main therapy for corneal blindness.However, the shortage in donor corneal issue is a worldwide problem and the failure due to the immunologic rejection of host is common.Nowadays, with the development of tissue culture and bioengineering technology, the application prospect of autologous stem cell transplantation is becoming more and more popular which might replace the allogeneic transplantation, becoming an important clinical treatment of regenerative medicine.Human dental pulp stem cells (hDPSCs) is a class of adult stem cell divided from the third molar teeth.Both hDPSCs and corneal cell are from the cranial nerve in embryonic ectoderm.Extensive researches show that the hDPSCs have the potentialities in corneal cell differentiation without causing immunologic rejection of the recipient.These findings manifested the potentials of hDPSCs in the clinical applications related to ocular surface reconstruction.In this paper, the features and current investigation status of hDPSCs in ocular surface reconstruction are reviewed.

The normal growth of blood vessels is the result of dynamic balance of angiogenic factor and inhibitory factor in vascular tissue.However, when the balance is broken, the growth of new blood vessels will be induced.Endogenous angiogenesis inhibitory factor, is a group of negative feedback molecules produced by the body itself that inhibit angiogenesis.Its function of inhibiting angiogenesis is mainly realized by promoting the binding of angiogenic factor to its receptor, or its downstream angiogenesis signal, or promoting vascular endothelial apoptosis.The study of angiogenesis inhibitory factor has potential clinical significance for the prevention and treatment of retinal neovascularization.Recent studies on retinal neovascularization inhibitory factor are reviewed in this paper.

Objective To investigate the application of high frequency ultrasound in knee joint lesions of elderly patients with rheumatoid arthritis.Methods Fifty patients with rheumatoid arthritis were collected in Yangpu Hospital Affiliated to Tongji University from March 2015 to December 2016 as test group.Fifty healthy elderly people without knee joint lesion were randomly selected as control group.High frequency ultrasound was used to examine the patients in the test group and the Results of this examination were used to compare with those of the control group and observe four indexes: patellofemoral effusion,synovial thickness,cartilage thickness and blood flow in the lesion area.Results There was only a small amount of synovial fluid in the articular cavity in the control group,the thickness was (2.11± 0.94) mm,while the thickness of the test group was (10.33±2.74) mm,the difference was statistically significant (t=17.03,P<0.05);in the control group,there was no synovial hyperplasia,the thickness was (1.11±0.24) mm,while the thickness of the test group was (5.48±2.74) mm which was significantly higher than that of the control group (t=13.18,P<0.05);in the control group,the cartilage tissue was striated without echo band,the thickness was (1.76±0.29) mm,while the cartilage tissue of the experimental group had lesion,the thickness was (1.12±0.12) mm lower than that of the control group and the difference was statistically significant (t=6.44,P<0.05);in the control group,there was no blood flow signal in the joint cavity,while low-speed blood flow signal could be seen in the joint cavity of the test group,the difference was statistically significant (0 vs.96%,χ2=6.44,P<0.05).Conclusion High frequency ultrasonography is effective in the treatment of senile rheumatoid arthritis with high specificity,high sensitivity,low cost,high efficiency and simple operation and it is not subject to external conditions.Therefore,it is suitable for early examination of senile rheumatoid arthritis and clinical promotion.

Objective To observe the effect of astragalus polysaccharides ( APS) on glucose homeostasis regulation and focus on glycogen synthase kinase 3 beta (GSK3 beta) activity and subcellular localization (nuclear translocation).Methods HepG2 human hepatoma cells were cultured in vitro and treated with high glucose of different concentrations (30, 40 mM) to induce hepatocyte endoplasmic reticulum stress model, then acquire optimum operating concentration.The HepG2 cells were treated with APS of different concentrations (50, 100, 200, 400 μg/mL) to select the most effective concentration.The HepG2 cells were divided into seven groups with different treatment: negative control group (C), positive control group (Tm), 30 mM high glucose-induced group (G30), 45 mM high glucose-induced group (G45), negative control+APS group (CA), positive control+APS group ( TA) and high glucose-induced+APS group ( GA).Effect of APS at different concentrations on proliferation activity of HepG2 cells were detected by MTT assay, transcription and shear levels of XBPlmRNA in HepG2 cells by quantitative real-time PCR, and phosphorylation levels of GSK3βin cytoplasm and nucleus by immunoblotting techniques.Results The optimum operating glucose concentration was 30 mM.The most effective APS concentration was 200μg/mL.The transcription and shear levels of XBPlmRNA in HepG2 cells of GA group were lower than those of G30 group ( P<0.05), respectively, but there were no significant differences between TA and Tm group.The phosphorylation levels of GSK3βin cytoplasm and nucleus of GA group were higher than those of G group(P<0.05), respectively, but there were no significant differences between TA and Tm group. Conclusion APS could improve hepatic steatosis, and its mechanism might be that APS inhibits the activity and nuclear localization of GSK3β, then alleviate endoplasmic reticulum stress.

ObjectiveTo investigate the correlation of brainstem auditory evoked potentials(BAEP) and somatic evoked potentials (SEP) with therapeutic outcome of brain stem hemorrhage patients.MethodsBAEP and SEP were detected in the early period of 25 caees with brain stem hemorrhage by evoked potential instrument,and were surveilled dynamically.ResultsThere was good prognosis in the patients whose BAEP and SEP were normal in the first time and repeated detection.Poor prognosis happened in ones whose BAEP and SEP were abnormal in the first time and repeated detection.The difference was significant between them(P＜0.05).ConclusionCombined detection and dynamic surveillance of BAEP and SEP could predict accurately the curative result of patients with brain stem hemorrhage.

Objective To investigate the safety of different intensity anticoagulation therapy of warfarin in preventing thromboembolism in octogenarian patients with nonvalvular atrial fibrillation (NVAF). Methods The 130 patients with persistent or permanent NVAF were randomly divided into three groups: low-intensity warfarin group (35 cases, international normalized ratio, INR (1.5-2.0), moderate-intensity warfarin group (32 cases, INR 2.1-2.5) and aspirin control group (63 cases). The rate of hemorrhagic events and the effect on renal function were observed. Results The incidence of hemorrhage was the lowest in low-intensity warfarin group compared to the other groups with slight bleeding in one case. life-threatening bleeding in one case, severe bleeding in one case and slight bleeding in four cases occurred in moderate-intensity warfarin group. Life-threatening bleeding in three cases, severe bleeding in two cases and slight bleeding in six cases occurred in aspirin control group. There were significant differences in bleeding incidence among the three groups (χ2=5.13,P＜0.05). The low-intensity warfarin group and moderate-intensity warfarin group were superior to the aspirin control group in the effect on renal function (P＜0.05). Conclusions It is safe that the dose of warfarin is maintained at low anticoagulation intensity between INR 1.5 and 2.0 in octogenarians with NVAF.

Objective To explore the clinical method and effect of ultrasonic osteotomy in mandibular angle reduction.Methods Under intronasal approach and general anesthesia,30 patients (5 male patients and 25 female patients) underwent intraoral prominent mandibular angle reductions with ultrasonic osteotomy.The jaw bone under periosteum was explored and the mental nerves protected.According to the clinical features of mandibular angle,curved mandibular angle osteotomy,mandible margin osteotomy or outer cotex splitting osteotomy were performed.Results All the osteotomy of prominent mandibular angle reductions could be completed with ultrasonic osteotomy.There were no complications of bleeding,nerve injury and malfracture happened.After 1 year following-up,the outlines of lower mandible were natural and concordant.Compared with traditional osteotomy devices,ultrasonic osteotomy was smoother and more precisely.Conclusions Ultrasonic osteotomy can improve the precise and safty of mandibular angle reduction.but compared with traditional osteotomy devices,it takes more time for osteotomy procedure.Surgeons need adapt to the different feeling and control methods.

Objective To investigate the survival rate and the influencing factors in lupus nephritis (LN) patients with neuropsychiatric systemic lupus erythematosus (NPSLE). Methods Clinical characteristics and biochemical markers of 78 patients including 59 variances were analyzed. Patients were followed up from the onset of NPSLE to death. Patient survival rate was estimated by Kaplan-Meier method. Cox regression model was used to analyze influencing factors. Results Sixteen (20.5%) of 78 patients died of SLE or its complications. Infection was the main cause of death (31.3%). One-, 3-, 5- and 10-year survival rates were 83.2%, 81.7%, 76.7% and 76.7%, respectively. Hypertension (RR =6.965,95% CI:1.578-30.746, P= 0.010), pulmonary infection (RR=8.171,95% CI:1.954-34.177, P=0.004)and acute renal failure (RR=6.978,95%CI:2.063-23.609, P=0.002) were risk factors of mortality, while cyclophosphamide (CTX) impulse therapy (RR =0.130,95 % CI:0.031-0.541, P=0.005) and resolution of NPSLE (RR= 0.169, 95%CI:0.042-0.679,P=O.012)were protective factors. Conclusions Infection is the main cause of death in patients of LN complicated with NPSLE. Survival rate of LN patients with NPSLE in this study is lower than those of LN and NPSLE alone reported by other authors. Hypertension, pulmonary infection and acute renal failure are risk factors of mortality, while CTX impulse therapy and resolution of NPSLE reduce the mortality and improve the prognosis.

AIM: To investigate the effects of epigallocatechin-3-gallate(EGCG) on 1-methyl-4-phenylpyridinium ion(MPP+)-induced apoptosis in rat pheochromocytoma(PC12) cells and to explore the relationships between its roles of anti-oxidation,intracellular calcium homeostasis and anti-apoptosis.METHODS: Rat PC12 cells were pretreated with vehicle control or EGCG(10,50,and 100 ?mol/L) for 30 min,then cultured with MPP+(900 ?mol/L) for 24 h.The cell viability and apoptosis were monitored by MTT assay and flow cytometry using Annexin V and PI.The activity of intracellular reactive oxygen species(ROS),contents of superoxide dismutase(SOD) and malondialdehyde(MDA),cytoplasmic Ca2+ density and apoptotic morphology of mitochondria were examined by fluorescent plate-based assays,confocal microscope,and transmission electron microscope,respectively.RESULTS: MPP+ impaired the PC12 cells in a concentration-dependent pattern and induced apoptosis of the cells(31% versus control).Compared with the control,the cells pretreated with EGCG showed markedly higher rate of viability and lower apoptosis.Meanwhile,EGCG pretreatment significantly increased the SOD activity and decreased the levels of MDA and ROS.Interestingly,EGCG also decreased the concentration of cytoplasmic Ca2+ and improved the morphology of mitochondria.CONCLUSION: EGCG exhibits inhibitory effects on MPP+-induced apoptosis in rat PC12 cells,which is possibly associated with increasing the cell ability of anti-oxidation and decreasing the concentration of cytoplasmic Ca2+.