Anti-vascular endothelial growth factor (VEGF) drugs have become the first-line medications for the treatment of choroidal neovascularization (CNV).Its efficacy and safety have been confirmed by evidence-based medicine and a large number of clinical studies.However there are several issues need to be discussed before reaching a consensus for the clinical application of anti-VEGF drugs.These issues include,but not limited to the individual treatment regimen for different CNV lesions,the best anti-VEGF drug regimen,the indications and schemes of combination therapy,the factors affecting the efficacy,the potential risks of systemic and local deliveries.How to establish a reasonable personalized regimen of anti-VEGF drugs is the 1st issue need to be explored.Ranibizumab will come into China market soon.We need utilize the existing evidence-based medical research findings; take our advantages of rich resources of patients to investigate those issues to further promote the anti-VEGF applications in China.

BACKGROUND: It has been testified that it is hard for strict individualized insulin treatment to block or reverse the incidence and development of diabetic complications. The best therapeutic effect is obtained by early intervention of Chinese herb for benefiting qi, nourishing yin, activating blood circulation and resolving stasis at the same time of controlling blood glucose.OBJECTIVE: To observe the effect of huaxiaoyin (HXY), the Chinese herb for reinforcing qi, nourishing yin, promoting blood circulation and re solving stasis on blood lipid, collagen content and fluorescence degree of collagen-protein advanced glycation end products(AGEs) in thoracic aorta in diabetic rats.DESIGN: Complete randomized group division and control experiment were designed.SETTING: Traditional Chinese Medicine Department of Diagnostics,Hubei College of Traditional Chinese Medicine MATERIALS: The experiment was performed in Center Experimental Room of Hubei College of Traditional Chinese Medicine from May 2001 to August 2002, in which, 90 Wistar pedigree rats of clean grade were employed.METHODS: ① 12 rats were randomized in normal control. For the rest 78 rats, after 12-hour fasting, streptozotocin (STZ) was intravenously injected from tail at 50 mg/kg for one time. 72 hours later, it was assayed that 16.65 mmoL/L ＜ fasting blood sugar ＜ 33.3 mmol/L indicated successful modeling. Totally 76 rats had been modeled successfully. Diabetic rats were randomized into 5 groups, named model group (n=16), insulin group (n=15), HXY low-dose group (n=15), HXY middle-dose group (n=15) and HXY high-dose group (n=15). ② In normal control group and model group, gastric perfusion was prescribed with normal saline 4 mL. In insulin group, protamine zinc insulin 1-2U was injected subcutaneously. In HXY low, middle and high-dose groups, besides, subcutaneous injection of protamine zinc insulin 1.0-2.0U, HXY was administered [composed of shanyao (Rhizoma Dioscoreae), shengdi (Radix Rehanniae), huafen (Radix Trichosanthis), danshen (Radix Salviae Miltiorrhizae), huangqi (Radix Astragali), zhimu (Rhizoma Anemarrhenae), totally 12 herbs, the content of raw herbs was 2 g/mL] at 0.75, 1.5, 2.0 kg/L, 4 mL for each respectively. Gastric perfusion was administered once every day in above 6 groups,and the treating course was 8 weeks. ③ Before treatment, on the 3rd, 6th and 8th weeks after treatment, fasting blood sugar was tested with One Touch Ⅱ tester. 8 weeks later, automatic biochemistry analyzer was used to assay triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDLC) and high-density lipoprotein cholesterol (HDLC). Thoracic aorta was collected swiftly and chloramine-T method was used to assay hydroxyproline content in the extract from aorta. Hydroxyproline content ×7.14=collagen content. Fluorescence spectrometer was used to assay the fluorescence degree of AGEs in collagen extract. ④ t test was applied for difference comparison of measurement data.MAIN OUTCOME MEASURES: ① Comparison of fasting blood sugar before and after treatment in each group. ② Comparison of blood lipid,collagen content and fluorescence degree of collagen-protein AGEs in thoracic aorta in 8 weeks after treatment in each group.RESULTS: At the end of experiment, 8, 4, 2, 2 and 3 rats were died in model group, insulin group, HXY low, middle and high-dose groups respectively, due to which, 12, 8, 11, 13, 13 and 12 rats entered result analysis in various groups respectively. ① Fasting blood sugar: Before treatment, it was higher remarkably in model and various treating groups compared with normal control (P ＜ 0.01) and 8 weeks after treatment, it was lower remarkably in insulin group and various HXY groups compared with model group and before treatment (P ＜ 0.01). ② Levels of TC, TG, LDLC in serum: Those in insulin and model groups were higher remarkably than normal control (P ＜ 0.05-0.01). Those in insulin group and various HXY groups were lower remarkably than normal group (P ＜ 0.05-0.01). ③ Level of HDLC: It was lower remarkably in insulin group and model group compared with normal control (P ＜ 0.05-0.01), it was higher remarkably in HXY low and middle-dose groups compared with model group (P ＜ 0.01),it was higher remarkably in HXY low-dose group than insulin group (P ＜ 0.05).④ Levels of TC and TG in serum: Those in various HXY groups were lower remarkably than insulin group (P ＜ 0.05). ⑤ Collagen content in thoracic aorta: It was lower remarkably in various HXY group than insulin group (P ＜ 0.05), it was higher remarkably in model, insulin and HXY high-dose groups than normal control group (P ＜ 0.05-0.01) and it was lower remarkably in insulin group and various HXY group than model group (P ＜ 0.05-0.01). ⑥ Fluorescence degree of AGEs: It was lower remarkably in HXY low-dose group compared with insulin group (P ＜ 0.05),it was higher in model group compared with normal control (P ＜ 0.01) and it was lower remarkably in HXY low and middle-dose groups compared with model group (P ＜ 0.01).CONCLUSION: ①HXY, herbal formula for reinforcing qi, nourishing yin, clearing away and promoting blood circulation, increases HDLC and decreases TG, TC and LDLC to different degrees so as to improve lipid metabolic disturbance in diabetic rats, which is especially advantageous at low dose (0.75 kg/L, 4 mL). ② By reducing collagen content of thoracic aorta and decreasing fluorescence degree of collagen-protein AGEs, HXY inhibits collagen nonenzymatic glycosylation in thoracic aorta in diabetic rats.

Objective To explore the effect of the electrocision treatment for the same period of the prostatic hyperplasia and bladder cancer patients.Methods Doing the grouping therapy for 166 patients in our hospital who have agreed on the research.Group A:doing the bladder tumor part electricity cutting surgery and removing the prostate gland excision above pubis simultaneously,60 cases,Group B:doing the bladder tumor part electricity cutting surgery and the prostate gland excision transurethral resection electricity cutting simultaneously,66 cases,Group C:only doing the bladder tumor part electricity cutting surgery transurethral resection,44 cases.Results (1) Patients' recovering situation in group A was close to that of patients in group B,but operation time and average hospitalization time was (43.2 ± 16.7) min and (11.3 ± 2.4) d,which were obviously lower than those of group A (P ＜ 0.05).The amount of blood loss of group B was (119.5 ± 72.1) ml,which was obviously less than that of group A(P ＜ 0.05).While the lien urine tube time of group B was (8.6 ± 2.4)d,less than group A.(2)Patients of group A and group B's dysuresia had been improved obviously after the operation.There were only 3.2％ of the patients in group A and group B appearing dysuresia after the operation,but in the group C there was still 28.5％ having dysuresia after the operation,(3)The incidence rate of intraoperative complications was the highest in group A(33.2％),next group C (21.3％),the lowest group B(12.6％).(4) Follow-up 1 year,the recurrent rate of the bladder tumor in group A was 25.3％,group B 18.2％,group C 23.7％,all the tumor recurrences are ectopic recurrences,and after the further consultation,none of those patients taking the electricity cutting surgery relapse again.Conclusions Patients who have Prostate hyperplasia and bladder cancer can avoid the pain of second surgery by taking the electricity cutting surgery,shorten their length of time in hospital,and reduce the costs of health care.Compared with traditional methods,the method of operation is safe relatively,and can control the incidence of complication effectively.From the follow-up visiting,we can find that this surgery has many advantages such as the reliable curative effect,and the lower recurrent rate,so it can be used widely for reference.

Neovascular age-related macular degeneration is also known as wet age-related macular degeneration (wAMD) , which is now one of potentially blinding diseases in elder population worldwide.The application of anti-vascular endothelial growth factor (VEGF) drugs is becoming the first-line therapy for wAMD at present.However, during the long-term follow up, we find that the vision of some patients dose not improve even falls after treatment, or the vision is unable to keep for a long term after its improvement.Hence,to find the key factors that affect the therapeutical effect is the focus issue nowadays.There are many factors that affect wAMD curative effect,including the limitation of drug itself, the personal conditions of the patients, the features of the choriodal neovascularization (CNV) , the formulation and implementation of the treatment regimen, etc.Imaging features of CNV and treatment timing can serve as the available indexs to analyze the prognosis.In addition,reasonable and optimized managing regimens for wAMD probably is an approach to improve the treating effect.Understanding of the factors that affect curative effect of wAMD is benefit for us to setup the individualized therapy and achieve the best vision.Ophthalmologists should fully recognize the importance of wAMD individualized treatment and management.

Diabetic macular edema (DME) is the most common reason for visual impairment in diabetic eye diseases.DME is easy to relapse and the treatment outcome is beyond satisfied.Anti-vascular endothelial growth factor (anti-VEGF) therapy has been proposed to be a first-line or key treatment regimen in the management guideline for DME.However,in clinical practice,there still are many ambiguous and controversial views in the choice and implement of different managing paradigms,including the therapeutical goal,the assessment of treatment effectiveness,the explanation of the guidelines,the regimen of anti-VEGF therapy,the value evaluation of laser photocoagulation,the use of steroids and the management of recurrent DME.Recently,the researches of treating drugs for DME are developing and making a great progress,so eye doctors should track the research results,improve the therapeutical regimen,fully understand the advantages and disadvantages of different treating methods and standardize the treatment process in order to release the best treatment effects on DME.

Ambroxol ; administration & dosage ; therapeutic use ; Bronchitis, Chronic ; etiology ; therapy ; Bronchoalveolar Lavage ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; complications ; therapy ; Treatment Outcome

The therapeutic effect of anti-vascular endothelial growth factor (VEGF) for neovascular age-related macular degeneration (nAMD) was determined by a number of factors.Comprehensive thorough analysis of clinical features,imaging results and treatment response can predict the potential efficacy and possible vision recovery for the patient,and also can optimize the treatment regime to make a personalized therapy plan.Precise medicine with data from genomics,proteomics and metabolomics study will provide more objective and accurate biology basis for individual precise treatment.The future research should focus on comprehensive assessment of factors affecting the efficacy of anti-VEGF therapy,to achieve individualized precise diagnosis and treatment,to improve the therapeutic outcome of nAMD.

Objective To observe the changes of coagulase activity and the DNA expression of coagulase of S.aureus during inducing vancomycin-resistant S.aureus in vitro.Methods Coagulase activity and DNA expression of coagulase of S.aureus were detected.Results The coagulase activity in 6 strains and the expression of coagulase DNA in 1 strain reduced.Conclusion Decreased coagulase activity and DNA expression are probably linked to vancomycin resistance of S.aureus.