Background Studies showed that vascular endothelial growth factor (VEGF) plays an important role in the development and progress of diabetic retinopathy (DR),and the association between VEGF-2578C/A polymorphism(SNPs) and risk for DR is a hotspot.Objective This Meta analysis aimed to investigate the comprehensive and reliable conclusion in the association of VEGF-2578C/A SNPs and risk for DR in different races.Methods A systematic search of electronic databases including PubMed,Cochrane Library,EMbase,VIP,Wanfang technological,CNKI and reference lists of relevant articles was carried out until April,2014.Case-control studies on the relationship between VEGF-2578C/A SNPs and DR were selected based on inclusion and exclusion criteria,and the relevance of VEGF-2578C allele to DR,the relevance of VEGF-2578C/A SNPs to DR and the relevance of VEGF-2578A allele to Caucasian DR were quantitatively analyzed.Begger funnel plot of publication biases on the relationships of VEGF SNPs with the risk of DR under the allele and dominant models was drown.RevMan 5.0 software was used for the statistical analysis.The pooled odds ratio (OR) and corresponding 95％ confidence interval (CI) were used to assess the strength of the association.Results A total of 1 228 DR cases and 1 224 diabetes controls without retinopathy(DWR) were included from 8 independent studies (9 groups of data).A significant relationships between VEGF-2578A allelic gene and VEGF-2578AA gene type with DR were found in all samples,and the A allelic gene and AA gene type were the risk genes of DR (A versus C:OR=1.39,95％ CI=1.08-1.80,Z=2.52,P=0.01;AA versus CC+C/A:OR=1.53,95％ CI=1.05-2.24,Z=2.20,P=0.03;CC versus AA+C/A:OR=0.70,95％ CI=0.50-0.98,Z =2.10,P =0.04).When the other two studies which did not meet the HardyWeinberg Equilibrium were incorporated in a sensitivity analysis,the results were not materially altered.VEGF-2578 A allelic gene was the risk gene to Europeans with DR (OR =1.50,95％ CI=1.02-2.21,Z =2.07,P =0.04),but not among Asians in subgroup analysis (P＞0.05).No significant publication bias was found.Conclusions The Meta analysis demonstrates that VEGF-2578C/A is associated with DR in Europeans but not in Asians.Further case-control studies based on larger sample size are still needed,especially in Asians.

Objective To assess the association of vascular endothelial growth factor (VEGF) gene-460C/T and-634C/G polymorphism with diabetic retinopathy (DR) among patients in Asia and European by meta-analysis.Methods A systematic search of electronic databases (PubMed,Cochrane Library,EMBASE,VIP,Wanfang technological,CNKI,etc.) was carried out until Jun,2014.Case-control studies on the relationship between genetic polymorphism of VEGF-460C/T and VEGF-634C/G with diabetic retinopathy were included in this analysis.The data were quantitatively analyzed by RevMan 5.0 software after assessing the quality of included studies.The pooled odds ratios (OR) and their corresponding 95％ confidence intervals (CI) were used to assess the strength of the association.Results VEGF-460C/T (7 studies:899 cases and 786 controls) and VEGF-634C/G (10 studies:1615 cases and 1861 controls) were inclued in this meta-analysis.Significant association was found for-460C/T polymorphism in Aisa (C versus T:OR=1.52,95％CI was [1.22,1.90],Z=3.72,P=0.0002;CC versus CT+TT:OR=1.61,95％CI was [1.19,2.19],Z=3.05,P=0.002;TT versus CT+CC:OR=0.64,95％CI was [0.41,0.98],Z=2.07,P=0.04),and VEGF-634CC gene type was associated with DR in European (OR=1.56,95％CI [1.08,2.25],Z=2.37,P=0.02).No significant publication bias was found.Conclusions The metaanalysis demonstrated that DR was associated with VEGF-460C/T polymorphism in Asia,and C alleles and CC gene type was the risk polymorphism;VEGF-634C/G polymorphism was not associated with DR,but its CC genotype maybe the risk factor in European.Further case-control studies based on larger sample size are still needed,especially for-634C/G polymorphism.

Objective To evaluate the value of strain rate imaging(SRl) in quantitatively detecting regional right ventricular function in hypertension(HBP) patients with different mode of left ventricle.Methods Thirty-eight patients with HBP were divided into left ventricular nermal (LVN) and left ventricular remodeling(LVR) groups according to left ventricular mass index(LVMI) and relative wall thickness(RWT).Twenty-three controls were performed echocradiography examination.Tissue velocity imagings of all the patients and controls were accepted in apical four chamber views.The indies included:peak systolic velocity(Vs),peak early diastolic velocity(Ve),peak late diastolic velocity(Va) and Ve/Va of triscular annulus,peak systolic strain rate(SRs),peak early diastolic strain rate (SRe),peak late diastolic strain rate(SRa) and SRe/SRa of right ventricular free wall.Results Compared with controls,Ve/Va of LVN group decreased significantly,but there were no difference in Vs and Ve.Compared with LVN group and controls,Ve and Ve/Va of LVR group decreased significantly,but there were no significantly difference in Vs.Compared with controls,Ss,SRe and SRe/SRa of LVN and LVR group decreased significantly,but there was no significantly difference in SRs;compared with LVN group,Ss,SRe and SRe/SRa of LVR group decreased significantly,but there was no significantly difference in SRs.Conclusions The systolic and diastolic function of RV in patients with HBP damaged with or without left ventricular remodeling.SRI can evaluated regional right ventricular funciton in these patients accurately.

Objective To evaluate the right ventricular function in patients with chronic obstructive pulmonary disease (COPD) by strain rate imaging. Methods Echocardiography were performed in 41 patients with COPD and 20 controls. Right ventricular frontal thickness (RVFT), right atrial end diastolic diameter(RAEDd) , right ventricular end diastolic diameter (RVEDd), right ventricular end diastolic area (RVEDa) ,right ventricular end systolic area (RVESa) (fraction of right ventricular area change (RVFA) and E/A of tricuspid valve flow were measured in 4-chamber apical view. Tissue velocity imaging (TVI) were accepted in apical four chamber apical views. The indies included peak systolic strain rate (SRs) ,peak early diastolic strain rate (SRe) ,peak late diastolic strain rate (SRa) and SRe/SRa. Results According the pulmonary pressure, the patients with COPD were divided into 2 groups: group PAH (pulmonary artery hypertension) and group NPAH (non-pulmonary artery hypertension). Compared with controls, RVFT, RAEDd and RVEDd of group PAH increased significantly, RVFA and E/A decreased significantly, the upper indices of group NPAH had no significant difference, SRs, SRe and SRe/ SRa of right ventricular free wall and interventricular septal in group PAH and group NPAH decreased significantly, but there was no significant difference of SRa. Compared with group NPAH,SRs,SRe and SRe/SRa of right ventricular free wall and interventricular septal in group PAH decreased significantly,but there was no significant difference of SRa; there was significant positive correlation between SRs of right ventricular free wall and FEV1 /FVC, DLco/VA in patients with COPD,but there was no significant correlation between SRe of right ventricular free wall and RVFA, E/A,FEV1 /FVC and DLco/VA. Conclusions Function of right ventricle in patients with COPD can be damaged with or without pulmonary hypertention; SRI can detect right ventricular function in these patients easily and noninvasive.

BACKGROUND: Although bone tissue engineering has been developed rapidly, ideal scaffold materials are deficient and the ability of tissue engineered bone constructed in vitro was reported inconsistently.OBJECTIVE: To study the ectopic osteogenesis of the implantation in vitro with composite fully deproteinized bone(CFDB) compounded by autologous red marrow.DESIGN: A randomized controlled study.SETTING: Department of Orthopaedics, the 152 Hospital of Jinan Military Area Command of Chinese PLA; Ward for Retired Cadres, First People's Hospital of Pingdingshan City; Department of Orthopaedics, Chaochuan Mine Hospital of Pingdingshan Coal Industrial Group.MATERIALS: The study was completed in the Department of Orthopaedics,the 152 Hospital of Jinan Militatry Area Command of Chinese PLA. Totally 40 Japanese flap-eared white rabbits of 4 months old of either gender with a body mass from 2.0 kg to 2.5 kg were involved (provided by the Laboratory for Experimental Animals of the 152 Hospital in Pingdingshan city).INTERVENTION: Calf CFDB scaffold materials were compounded by rabbit autologous red marrow after physical and chemical managements, which were then implanted into the thigh muscles of 40 rabbits. The osteogenetic abilities of the materials compounded by autologous red marrow were analyzed at 4 weeks and 8 weeks after operations respectively.ysis of the implanted bone.RESULTS: ALP activities were(63.48 ± 0. 873) and (69. 527 ± 0. 635) IU/L respectively, and the results of osteogenetic quantitative analysis were (2.50 ±0.38) and(4.70 ±0.67) points of rabbits in the study group at week 4 and week 8 respectively. ALP activities were(2.50±0.38) and (4.70 ± 0. 67) IU/L and the results of osteogenetic quantitative analysis were( 1.90 ± 0.54 ) and(3.40 ± 0.54) points of rabbits in the control group at week 4 and week 8 respectively. The results indicated that the osteogenetic ability of the study group was significantly higher than that of the control group at the same time point, and the neogenetic bone increased along with the prolongation of the implantation time.CONCLUSION: CFDB could be applied as scaffold materials for bone tissue engineering, and its osteogenesis increases significantly after being compounded by autologous red marrow.

Objective To adopt the network meta analysis method to compare the incidence difference of cutaneous squamous-cell carcinoma(SCC)and rash in 5 kinds of targeted drugs regimen for treating malignant melanoma.Methods PubMed and Cochrane Library databases were retrieved by computer.The retrieval range was from their establishment to November 2015.The network meta analysis pooled the evidences of direct and indirect comparison for evaluating the pooled odds ratio(OR)and cumulative probability of cutaneous complications occurrence difference in 5 kinds of targeted drugs regimen for treating malignant melanoma.Results Six randomized controlled trials(RCTs)conforming to the inclusion criteria were included.The meta analysis results revealed that compared with Dabrafenib+Trametinib,the cutaneous SCC occurrence rate of Vemurafenib was higher(OR=9.20,95％CI=1.26-52.53),while the rash occurrence rate of Vemurafenib+Cobimetinib was higher(OR=6.81,95％CI=1.01-41.87).The surface under the cumulative ranking curves(SUCRA)value showed that adopting Trametinib had the lowest occurrence rate for SCC,and adopting Dabrafenib+Trametinib had the lowest occurrence rate of rash.Conclusion Dabrafenib+Trametinibis generate the lowest complication incidence rate of malignant melanoma.

BACKGROUND:The traditional orthopedic fixation by C-arm positioning surface is completed, but the large C-arm injury on the human body and the long fixed time increase the suffering of patients. OBJECTIVE:To investigate the X-ray fixed in position within the orthopedic implants, navigation and effect. METHODS:Twenty-six New Zealand white rabbits were randomly divided into C-arm machine group and X-ray group, with 13 in each group. Rabbits in both groups were used to simulate soft tissue foreign body localization, intramedul ary nail implantation at distal fracture end and spinal pedicle screw entry point position. In the C-arm machine group, positioning navigation was conducted with C-arm machine. In the X-ray group, X-ray positioning navigation was used. The positioning and navigation effects were compared between the two groups. RESULTS AND CONCLUSION:(1) Compared with the C-arm machine group, the time required for navigation in the X-ray group targeting soft tissue foreign body localization, fracture distal locking intramedul ary nail implantation and pedicle screw spinal needle point location was significantly shorter (P<0.05);navigation displacement and deviation produced were significantly less (P<0.05). (2) These findings suggested that the X-ray positioning for orthopedic fixation method is relatively simple, with high availability, and can obtain a high performance-price ratio. Meanwhile, the X-ray localization can improve accuracy and shorten the fixed time.

With the popularization of ureteroscopy, ureteral avulsion has become a common complication of urological surgery in recent years. In the study, we reviewed the clinical management of 2 patients who underwent emergency ureterostomy and selective operation of ileoureteral substitution, emergency repair and selective operation of Boari-flap ureteroneocystostomy respectively. After 22 and 17 months of follow-up, no ureter stricture were found, and hydronephrosis were relieved compared with preoperative in both.

The neonatal resuscitation program consisted of three stages:pilot promotion, provinces promotion and grass-roots promotion in China. Neonatal resuscitation was easy to learn, training forms were various, the duration was different. There were regional differences in the pass rate of examination and standard recovery rate. The neonatal resuscitation training rate, the system execution rate and the equipment rate in primary hospitals was lower than secondary hospitals and tertiary hospitals. The primary hospitals would be the key link of the neonatal resuscitation program. We suggested to build neonatal resuscitation training and treatment system.

Objective To analyze the differences of immune responses against Mycobacterium tu-berculosis antigens induced in two different nonhuman primates and to provide rationales for the selection of suitable animal models for vaccine efficacy evaluation.Methods Expression of functional surface markers including CD69 and HLA-DR, the activation markers on CD4+and CD8+T cells from in rhesus macaques and cynomolgus monkeys were measured by flow cytometry analysis.PBMCs were isolated from rhesus ma-caques and cynomolgus monkeys with Mycobacterium tuberculosis infection and stimulated with PPD and pep-tide pools ( ESAT-6/CFP-10) .Enzyme-linked imunospot ( ELISPOT) assay was performed to detect IFN-γproducing lymphocytes.Results The CD4+and CD8+T cells isolated from rhesus macaques without Myco-bacterium tuberculosis infection expressed higher levels of CD69 and HLA-DR than those from healthy cyno-molgus monkeys (P<0.01).The numbers of IFN-γspot forming cells/106 PBMCs in rhesus macaques with Mycobacterium tuberculosis infection for 10 and 11 months were respectively 3 and 3.5 times higher than that of cynomolgus monkeys upon after the stimulation of PBMCs with PPD.The levels of IFN-γproduction by the cells from rhesus macaque group were also higher than those from cynomolgus monkey group upon after the stimulation of PBMCs with ESAT-6 or CFP-10 peptide pools.Conclusion More IFN-γproducing cells were induced in rhesus macaques than that in cynimolgus monkeys after stimulation with Mycobacterium tu-berculosis antigens.Therefore, the rhesus macaques might be a better animal model for evaluating immune responses induced by Mycobacterium tuberculosis vaccines.