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 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 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 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.

Acupressure ; Acupuncture, Ear ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Middle Aged ; Phytotherapy ; Postmenopause ; Premenopause ; Syndrome

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.

Objective To investigate the effect of a kind of tissue engineered bone implants on healing of segmental bone defects. Methods A 15 mm bone defect experimental model at the right radius of New Zealand white rabbit was made. 24 animals of this model were divided into three groups at random. PLGA scaffords loaded with 5 mg BMP and about 1?106 BMSCs were implanted in Group 1(n=10); PLGA scaffords loaded with 2.5 mg BMP and about 1?106 BMSCs were implanted in Group 2(n=7); PLGA scaffords loaded with 1 mg BMP and about 1?106 BMSCs were implanted in Group 3(n=7). The osteogenesis at the defect area was observed by regular roentgenography and X-ray analysis, histological changes at the bone defects at 4th, 8th, 12th weeks after operation were studied and the new bone formation was measured by image analysis. Biomechanical analysis was done 12 weeks after operation. Results A large quantity of callus was found in all the 3 groups 4 weeks after repair. At the 12th week, the complete bone healing rate was 7/8, 3/5, 3/5, respectively in Group 1, 2 and 3. Group 1 had the largest quantity of new bone measured by histopathological study and X-ray analysis, and at the 12th week, the medullary cavity in this group became united. The compress stiffness, torsion stiffness and the maximal load in Group 1 were better than those in other groups. Conclusion The tissue engineered bone contructed by PLGA scaffords that are loaded with 5 mg BMP and BMSCs is capable of repairing segmental bone defects.

[Objective]To evaluate several abdominal skin flaps used for treatment of whole-finger degloving injury of multiple fingers.[Method]Since 2000, 45 patients with whole-finger degloving injury of multiple fingers except the thumb were treated with transfer of abdominal skin flaps. Among these patients,10 were treated with random abdominal tubed pattern flaps,15 with pedicle skin flaps with thoraco-umbilical perforator artery,12 with pedicle skin flaps with superficial iliaccircumflex artery,and 8 with embedding with abdominal flaps.At the second-stage operation,fingers were dissected with pedicels or with abdominal flaps before fingerweb plasty and flap plasty were carried out for many times.[Result]All the skin flaps survived. Three fingers of 3 cases had distal cutaneous necrosis after finger web plasty.Follow-up from 5 to 36 months showed the active motion of metacarpophalangeal joints averaged 60?, and interphalangeal articulations averaged 30?.Sensation recovery reached S3 in fingers with remanent palmar digital nerve, but poor in other fingers. All fingers could perform grasping. The contour of fingers was fine except for the 3 cases of necrosis.[Conclusion]Treatment of whole-finger degloving injury of multiple fingers except the thumb with suitable abdominal flaps can restore the shape and function of hand to the greatest extent and is still a practical, safe and convenient operative method.

Objective To study the osteogenic capability of bone marrow stromal cell (BMSc) using tissue engineering methods Methods The osteogenic potential in vitro of cultured BMSc in a conditional medium were examined by phase contrast microscopy,histochemistry stains technique The BMSc were cultured in combination with bioactive glass ceramic (BGC) materials Then the composite were implanted into the skeletal muscle beds in rabbits All implants were exmined by gross observation and histological examination Results The BMSc showed a similar property to those of osteoblasts and could synthesized mineralized new bone tissue in vitro New bone tissue can be observed in the composites of the BMSc and BGC materials Conclusions New bone tissue can be formed by tissue engineering methods