Diabetic macular edema(DME)and age-related macular degeneration(ARMD)are the leading causes of visual impairment and blindness worldwide, and their common pathological features are increased vascular permeability and abnormal neovascularization, in which cytokines such as vascular endothelial growth factor(VEGF)and angiopoietin-2(Ang-2)play an important role. Intravitreal injection of anti-VEGF agents significantly changed the clinical management of DME and ARMD, but limitations such as the non-responsive cases, the treatment burden and risks caused by frequent injections need to be overcome. Faricimab, a novel bispecific monoclonal antibody that simultaneously targets VEGF-A and Ang-2, can effectively reduce vascular permeability, decrease the number of neovascularization and alleviate retinal edema. Registered clinical studies have shown that Faricimab is effective in improving vision and reducing retinal edema, which is non-inferior to Aflibercept and Ranibizumab, maintains a long dosing interval, and has a high safety profile. This article reviews the latest advances in the treatment of DME and ARMD with Faricimab.

〔Abstract〕 In the paper , the status quo of mobile medical service is analyzed , proving a new mode of mobile medical service for pa-tients.The suggested functions like self -service information query and medical service guiding as well as solutions to the relevant system structure and information security are elaborated in detail .In addition, the feasibility of construction of applications for mobile medical di-agnosis and treatment is also discussed .

Objective To evaluate the efficacy and safety of long-term nebulized corticosteroids and inhaled bronchodilators therapy on asthma in long term poor controlled elderly patients.Methods Prospective,randomized control study was conducted.63 elderly asthma patients,who received inhaled corticosteroids or combined with other long-term medication treatment for asthma control for more than 3 months but were still in moderate to severe persistent asthma state,were randomly divided into nebulizer treatment group (n=31) and dry powder inhalation group (n=32),and they were treated correspondingly with Budesonide inhalation suspension 1 mg and Salbutamol 2.5 mg BidorBudesonide/Formoterol powder 320/9 μg inhalation Bid.Patients in the two groups were evaluated for the differences in lung function,acute exacerbations of asthma,asthma control test (ACT) and adverse effects after 12-week treatment.Results The improvement in morning peak expiratory flow (PEF) and ACT score were better in the test group than in the control group [(29.2 ±14.4) ml vs.(15.8±13.5)ml,(4.8±2.2) vs.(3.0±2.7),t=3.715 and 2.897,P=0.000 and 0.005],but there were no statistical differences in average daily use of relievers and severe acute exacerbations between the test and control groups (t=1.512,P=0.136;x2=2.238,P=0.135).The local adverse effects caused by inhaled corticosteroids had no significant difference between the two groups.Conclusions Compared with the powder inhalation,the nebulizer inhalation administration of corticosteroids and bronchodilators could improve the asthma symptoms and lung function better in elderly patients with serious asthma condition and shows a good safety in tbe12 weeks of continuous treatment.

Objective To evaluate the hematologic effects of linezolid in advanced aged patients with hospital onset of infection.Methods The clinical characteristics and complete blood routine examination results of 45 elderly patients aged(92.9±5.2)years treated with linezolid over 600 mg of lowest dose everyday for more than 72 hours were retrospectively analyzed.Results Among the 45patients,20 patients(44.4％)had substantially lower platelet,6 patients(13.3％)lower haemoglobin,1 patient(2.2％)lower absolute neutrophil,and the linezolid treatment in 19 patients were discontinued due to hematological system adverse reactions.The significant drop in platelet occurred at(10.2±3.3)days after treatment.The significant drop in hemoglobin occurred at(9.8±3.0)d after treatment.The lowest count of platelet and hemoglobin took place at(13.1±3.9)d and (10.5±3.5)d after treatment,respectively.The drops in platelet and hemoglobin of some patients took place after cease of treatment.Stepwise logistic regression analysis revealed that treatment duration(OR =1.407,P＜0.05)and creatinine clearance rate(OR=0.732,P＜0.05)were the risk factors for thrombocytopenia.Conclusions The elderly patients using linezolid more likely suffer from adverse reactions of hematological system,particularly thrombocytopeniawhich is significantly more common in patients with renal insufficiency and prolongation of treatment time.The blood routine examination should be monitored closely when elderly patients are treated with linezolid.

BACKGROUND: Intravascular stent implantation is one of the main methods for intra-extracranial artery stenosis. The safety and efficacy of stent implantation has been elevated, and symptoms or ischemic advert events with artery stenosis has been reduced. However, risks of thrombosis, cerebralhemorrhage, restenosis, and hyperperfusion still existed. OBJECTIVE: To investigate the influence of atorvastatin on ischemic adverse events following cerebral middle artery stent implantation.METHODS: Twenty-four patients received cerebral middle artery stent implantation were randomly divided into 2 groups. In the treatment group, patients were received atorvastatin 40 mg + plavix 75 mg + aspirin enteric-coated tablet 300 mg, once per day; in the control group, patients were received plavix 75 mg + aspirin enteric-coated tablet 300 rag, once per day. Ischemic adverse events, such as in-stent restenosis, transient ischemic attack, cerebral infarction, or re-interventional therapy were observed by transcranial Doppler, digital subtraction angiography, nuclear magnetic resonance imaging, diffusion weighted imaging, blood lipid level and C-reactive protein level examinations prior to and at months 1, 3, 6 and 12 after stent implantation.RESULTS AND CONCLUSION: Compared with the control group, the levels of blood lipid and C-reactive protein were obviously decreased at months 1, 3, 6 and 12 after treatment (P<0.05, P<0.01 ), with dramatically declined ischemic adverse events (P<0.05, P<0.01 ). Compared with before operation, the levels of blood lipid and C-reactive protein were decreased after operation in the treatment group (P<0.05, P<0.01). No server adverse events occurred in patients treated by atorvastatin, which showed 40 mg was safe for patients. The results revealed that atorvastatin combined with antiplatelet therapy can prevent ischemic adverse events following cerebral middle artery stent implantation.

Blood Gas Analysis ; Female ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases ; therapy ; Intensive Care Units, Neonatal ; Male ; Respiration, Artificial

ObjectiveTo investigate the effect of cardiopulmonary bypass (CPB) on the secretory function of islet cells in rabbits.MethodsTwenty adult New Zealand white rabbits of both sexes,weighing 2.5-3.0kg,were randomly divided into 2 groups ( n =10 each):sham operation group (group S) and CPB group.The rabbits were anesthetized with 3％ pentobarbital sodium 30 mg/kg.Blood samples were collected from the left femoral artery at 5 min after anesthesia (T1),immediately before CPB (T2 ),immediately after aortic clamping (T3 ),and at 5,35 and 75 min after aortic unclamping (T4-6) in the two groups for determination of levels of blood glucose,insulin and glucagons.Insulin resistance index was calculated.ResultsCompared with group S,the blood glucose concentration and levels of insulin and glucagons and insulin resistance index at T3-6 were significantly increased in group CPB ( P ＜ 0.05).ConclusionAlthough increase in blood glucose enhances the secretion of insulin in islet β cells,hyperglycemia cannot be compensated completely by the increased insulin during CPB in rabbits.The increase in blood glucose may be related to islet α cell resistance.

Objective To investigate the efficacy of tamsulosin in the distal ureter calculi expelling after ureteroscopic lithotripsy. Methods A total of 120 patients with distal ureteral calculi were enrolled and randomly divided into the observation group and the control group with 60 patients in each group. Patients in the observation group received tamsulosin and traditional treatment ( including liquid impact therapy,anti-inflammatory and analgesia) ,while patients in the control group received placebo and traditional treatment after operation. The number of colic episodes,lower urinary tract symptoms,analgesic dosage,and time of calculus removing were recorded and all the data were statistically analysed through software SPSS 13. 0. Results There was no singinificant difference between the two groups in the rate of calculus removing (P>0. 05), but it took less time in the observation group (P<0. 05). In addition, it was of less low urinary tract symptoms, low-er rate of analgesic usage and colic episodes in the observation group with statistically significant differences compared with the control group (P<0. 05). Conclusion The application of tamsulosin after ureteroscopic lithotripsy can reduce the rate of colic episodes and analgesic dosage and time of calculus removing.

Objective To investigate the effects of preconditioning with different concentrations of nerve growth factor (NGF)-β on ischemia-reperfusion (I/R) injury in isolated rat hearts.Methods Thirty-two male Sprague-Dawley rats weighing 200-300 g,aged 8-10 weeks,were anesthetized with intraperitoneal 10％ chloral hydrate 300 mg/kg and heparin 500 IU/kg.Their hearts were excised and perfused in a Langendorff apparatus with K-H solution oxygenated with 95％ O2-5％ CO2 at 37 ℃.After 10 min of stabilization,the isolated hearts were randomly divided into 4 groups (n=8 each): I/R group and different concentrations of NGF-β groups (groups N1-N3).In group I/R,the hearts were continuously perfused with K-H solution for 30 min,perfusion was suspended for 30 min followed by 120 min reperfusion.In groups N1-N3,the hearts were continuously perfused with K-H solution containing NGF-β0.1,0.2 and 0.4 ng/ml,respectively,for 20 min,followed by 10 min washout,and perfusion was suspended for 30 min followed by 120 min reperfusion.HR,Left ventricular end-diastolic pressure (LV-EDP),left ventricular developed pressure (LVDP) and + dp/dtmax were measured at the end of 10 min stabilization (baseline,T1),immediately before suspension of perfusion (T2),and at 5,30,60 and 120 min of reperfusion (T3-6).The activities of creatine kinase MB (CK-MB) and lactate dehydrogenase (LDH) in the coronary effluent were measured at T1 and T3-T6.Myocardial tissues were obtained at T6 for detection of apoptosis (by TUNEL) and for microscopic examination.Apoptotic index (AI) was calculated.Results Compared with the baseline value at T1,LVDP and + dp/dtmax were significantly decreased,and LVEDP and activities of LDH and CK-MB were significantly increased at T3-T6 in each group,HR was significantly decreased in groups I/R,N2 and N3,while HR was significantly increased in group N1 (P ＜ 0.05).Compared with group I/R,LVDP,+ dp/dtmax and HR were significantly increased,LVEDP,activities of LDH and CK-MB and AI were significantly decreased in group N1,LVDP,+ dp/dtmax and HR were significantly decreased,and activities of LDH and CK-MB were significantly increased in group N2,and LVDP,+ dp/dtmax and HR were significantly decreased,and LVEDP,activities of LDH and CK-MB and Al were significantly increased in group N3 (P ＜ 0.05).LVDP,+ dp/dtmax and HR were significantly lower,and LVEDP,activities of LDH and CK-MB and AI were significantly higher in groups N2 and N3 than in group N1,and in group N3 than in group N2 (P ＜ 0.05).The pathologic changes were reduced in group N1 compared with I/R,N2 and N3 groups.Conclusion Preconditioning with the optimum concentration of NGF-β can at-tenuate I/R injury in isolated rat hearts,however,the injury can be aggravated when the concentration is too large,and inhibition of apoptosis in myocardial cells is involved in the mechanism of myocardial protection.

Objective To evaluate the effect of pretreatment with nerve growth factor-beta (NGF-β) on ischemia-reperfusion (I/R) injury in isolated rat hearts by comparing it with NGF-β preconditioning.Methods Pathogen-free male Sprague-Dawley rats,weighing 200-300 g,aged 8-10 weeks,were anesthetized with intraperitoneal 10％ chloral hydrate 300 mg/kg.Their hearts were excised and perfused in a Langendorff apparatus with KH solution aerated with 95％ O2 and 5％ CO2 at 37℃.Twenty-four isolated rat hearts were randomly divided into 3 groups (n =8 each) using a random number table:I/R group,NGF-β pretreatment group (group NGFPt) and NGF-β preconditioning group (group NGFPc).The hearts were perfused with K-H solution for 10 min (equilibration) in each group.In group I/R,the hearts were continuously perfused with K-H solution for 30 min.The hearts were continuously perfused with K-H solution containing NGF 0.1 μg/ml for 20 min before ischemia in group NGF-Pt.The hearts were continuously perfused with K-H solution containing NGF 0.1 μg/ml for 20 min followed by 10 min washout before ischemia in group NGFPc.The perfusion was suspended for 30 min followed by 120 min of reperfusion with K-H solution in each group.HR,left ventricular end-diastolic pressure (LVEDP),left ventricular developed pressure (LVDP) and + dp/dtmax were measured at the end of 10 min equilibration (baseline,T1),immediately before suspension of perfusion (T2),and at 5,30,60 and 120 min of reperfusion (T3-6).The activities of creatine kinase isoenzyme-MB (CK-MB) and lactate dehydrogenase (LDH) in coronary effluent were measured at T1 and T3-6.Myocardial specimens were obtained at T6 for detection of myocardial apoptosis (by TUNEL) and for microscopic examination.Apoptotic index (AI) was calculated.Results Compared with the baseline value at T1,+ dp/dtmax was significantly decreased,and LVEDP and activities of CK-MB and LDH were increased at T3-6 in each group,LVDP and HR were decreased at T3-6 in group I/R,LVDP was decreased at T3,4 in group NGFPt and at T3-6 in group NGFPc,and HR was increased at T2-6 in NGFPt and NGF Pc groups (P ＜ 0.05).Compared with group I/R,LVDP,+ dp/dtmax and HR were significantly increased and LVEDP and activities of CK-MB and LDH and AI were decreased in NGFPt and NGFPc groups (P ＜ 0.05).Compared with group NGFPc,LVDP,+ dp/dtmax and HR were significantly increased,while the LDH activity and AI were decreased (P ＜ 0.05) and no significant changes were found in LVEDP and CK-MB activity in group NGFPt (P ＞ 0.05).The pathologic changes of myocardium were significantly reduced in NGFPt and NGFPc groups as compared with I/R group.Conclusion Pretreatment with 0.1 μg/ml NGF-β attenuates I/R injury in isloated rat hearts,and the efficacy is superior to that of NGF-β preconditioning.