Objective To analyze the concentrations of vascular endothelial growth factor (VEGF) and pigment epithelium-derived factor (PEDF) in aqueous humor of patients with proliferative diabetic retinopathy (PDR) before and after intravitreal injection of ranibizumab.Methods Twenty-five eyes of 20 PDR patients were collected as the PDR group.Twenty-five eyes of 21 senile cataract patients were collected as the control group.There were no statistical significance in gender (x2 =0.223), age (Z=-1.555) and intraocular pressure (Z=0.225) between the two groups (P＞0.05).Samples of aqueous humor (0.1 ml) were collected just before and 7 days after the injection of ranibizumab in PDR group.Samples of aqueous (0.1 ml) humor were collected just before cataract surgery in control group.The concentrations of VEGF and PEDF in the aqueous humor were measured by enzyme-linked immunosorbent assay.Results The VEGF and PEDF concentration in the aqueous humor were reduced significantly after intravitreal injection of ranibizumab in PDR group (Z=-4.072,-4.319;P＜0.05).The concentrations of VEGF and PEDF in the aqueous humor before intravitreal injection of ranibizumab in PDR group were significantly higher than the control group (Z=-5.228, 4.706;P＜0.05).The VEGF concentration in the aqueous humor after intravitreal injection of ranibizumab in PDR group were similar to control group (Z=-1.557,P＞ 0.05).However, the concentration of PEDF in the aqueous humor after intravitreal injection of ranibizumab in PDR group still higher than control group (Z=-2.475, P＜0.05).The ratio of VEGF/PEDF before and after intravitreal injection of ranibizumab was statistically different (Z=-2.058, P＜0.05), but was the same between PDR group and control group (Z=-0.456,-0.844;P＞0.05).The aqueous humor concentrations of VEGF and PEDF were not significantly correlated with each other, neither in PDR group (r=-0.195,-0.174;P＞0.05) nor in control group (r=-0.286, P＞0.05).Conclusions Aqueous humor concentrations of VEGF and PEDF are significantly elevated in eyes with PDR.Intravitreal injection of ranibizumab significantly decreased the VEGF and PEDF in the aqueous humor after 7 days.

Background Intraocular neovascularization is a primary cause of visual reduce in proliferative diabetic retinopathy (PDR) , and intravitreal injection of ranibizumab is one of treating approachs.Researching the mechanism of intravitreal injection of ranibizumab for PDR is a new target for the prevention and management of PDR.Objective This study was to determine the levels of vascular endothelial growth factor (VEGF) and pigment epithelium-derived factor (PEDF) in aqueous humor of PDR eyes before and after intravitreai injection of ranibizumab.Methods Self-controlled observational study was designed.Fifteen eyes of 15 PDR patients with type 2 diabetes mellitus were included in Fuzhou General Hospital of Nanjing Military Command from January to August 2014, and 1 eye combined with neovascular glaucoma and iris rubeosis.Aqueous samples of 0.1 ml at each time were collected before and 7 days after the injection of ranibizumab from all patients under the informed consent.The changes of aqueous VEGF and PEDF concentrations were detected and analyzed by enzyme-linked immunosorbent assay.This study complied with Declaration of Helsinki and the protocol was approved by this hospital.Results The freeVEGF concentrations before and 7 days after intravitreal injection were (179.4±136.5) pg/ml and (27.1 ±23.5) pg/ml, respectively, showing a significant reduce after intravitreal injection of ranibizumab (t =4.172, P =0.001).PEDF concentrations before and 7 days after intravitreal injection were (394.0-±237.2) pg/ml and (267.7±199.6) pg/ml, respectively, showing a significant reduce after intravitreal injection of ranibizumab (t =5.443, P =0.000).Intraocular neovascularization vanished after intravitreal injection of ranibizumab and vitrectomy was carried out at the seventh day after intravitreal injection.Conclusions Free VEGF and PEDF levels in aqueous humor appear to be significantly decreased after intravitreal injection of ranibizumab, and ocular neovascularization disappears at same time,which avoids intraoperative bleeding during vitrectomy.

Objective To investigate the effect and the possible mechanism of the apoptosis of neurons and the expression of bcl-2 gene in the neonatal rat brain after different courses of Dexamethasone (DXM). Methods Thirty-four Sprague-Dawley(SD) pregnant rats were randomized into four groups and received different courses of antenatal DXM at the dose of 0.8mg/(kg?d) intramuscularly: (1) Group 1 (n=8) received DXM on the 17th day of gestation only; (2) Group 2 (n=8) received DXM consecutively on the 17th,18th and 19th day of gestation; (3) Group 3 (n=10) received DXM consecutively for 4 days(on 17th,18th,19th and 20th day of gestation); (4) The control group (n=8) received equivalent volumes of isotonic saline intramuscularly consecutively for 4 days (gestational day 17, 18, 19, 20). On the postnatal day 1(P_1), day 7 (P_7) and day 14 (P_ 14 ), sixteen newborns in each group were randomly selected and sacrificed. The weights of the body and the whole brain were measured. Tunel was used to evaluate the apoptosis of neurons, and the content of bcl-2 protein was examined by improved Western Blot. Results (1) The brains weight of the newborn mice on P_1 were (0.301?0.030)g, (0.302?0.026)g, and (0.296?0.025)g in Group 1, 2 and 3, respectively and all significantly lower than that of the control [(0.363?0.041)g, P0.05). Conclusions Repeated doses of antenatal DXM therapy could significantly increase the apoptosis of neurons by down-regulate the bcl-2 expression and handicap the development of newborn mice′ brain.

Objective To evaluate the analgesic effects of continuous infusion of morphine into epidural space(CIEA) on postoperative pain relief after prostatectomy. Methods 40 cases of benign prostate hypertrophy were selected and randomly divided into two groups,experimental group(CIEA),0 2mg/h of morphin was injected into epidural space,control group(MI),50mg of pethidine was injected whenever patient feel pain.VAS(Vision simulate score),frequency and duration of bladder spasm,discontinuance time of bladder irrigation,HR BP and RR,were observed. Results The experimental group was superior to the control group with characteristics of stable analgesic effect,short duration and low frequency of bladder spasm(P

Objective To observe the effect of preoperative intravitreal ranibizumab injection (IVR) on the operation duration of vitrectomy and postoperative vision for the treatment of proliferative diabetic retinopathy (PDR).Methods A prospective study was carried out with the 90 PDR patients (90 eyes) who underwent vitrectomy.The 90 patients(90 eyes)were assigned to the vitrectomy only group(43 eyes) and the IVR combined with vitrectomy group (47 eyes).The IVR was performed 5-13 days prior to vitrectomy in the IVR combined with vitrectomy group.There were 15 eyes with fibrous proliferation PDR (FPDR),16 eyes with advanced PDR (APDR) without involving the macular and 16 eyes with APDR involving the macular in the vitrectomy only group.There were 14 eyes with FPDR,15 eyes with APDR without involving the macular and 14 eyes with APDR involving the macular patients in the IVR combined with vitrectomy group.All the eyes in the two groups were regularly operated by the same doctor to complete the vitrectomy.The start and end time of vitrectomy were recorded.The average follow-up time was 10 months.The changes of best corrected visual acuity (BCVA) before and 1,3 and 6 months after surgery were compared between the two groups.Results The duration of operation of the FPDR type (t=-8.300) and the APDR involving the macular type (t=-2.418) in the IVR combined with vitrectomy group was shorter than vitrectomy only group (P＜0.05).The comparison of duration of operation of the APDR without involving the macular type in the two groups has no statistically significant difference (t=-1.685,P＞0.05).At 1 month after surgery,the comparison of BCVA of the IVR combined vitrectomy group and the vitrectomy only group in APDR involving the macular type has no statistically significant difference (t=0.126,P＞0.05).At 3,6 months after surgery,the BCVA of the IVR combined vitrectomy group in APDR involving the macular type was significantly better than the BCVA of the vitrectomy only group (t=8.014,7.808;P＜0.05).At 1,3,and 6 months after surgery,the BCVA of the IVR combined vitrectomy group in FPDR type (t=3.809,1.831,0.600) and APDR without involving the macular type (t=0.003,1.092,3.931) compared with pre-treatment,the difference were not statistically significant (P＞0.05);the BCVA in APDR without involving the macular type compared with pre-treatment,the difference was distinctly statistically significant (t=2.940,4.162,6.446;P＜0.05);the BCVA in APDR involving the macular type (t =0.953,1.682,1.835) compared with pre-treatment,the difference were not statistically significant (P＞0.05).Conclusion Preoperative IVR of PDR can shorten the operation duration and improve the BCVA of APDR involving the macular type.

Objective To observe the changes of subfoveal choroidal thickness (SFCT) in diabetic patients with non-proliferative diabetic retinopathy (NPDR) and clinically significant macular edema(CSME),and then investigate diabetic SFCT and the relationship of diabetic CT with diabetic retinopathy (DR).Methods The patients were divided into 2 groups according to clinical guidelines of DR in China in 2014,including NPDR CSME + group(21 eyes) and NPDR CSME-group(36 eyes).All patients were underwent best corrected visual acuity (BCVA),intraocular pressure,axial length,slit lamp microscope,indirect ophthalmoscope,EDI-OCT examination,and mean arterial blood pressure measurement.The differences of BCVA,central retinal thickness (CRT) and SFCT between NPDR CSME + group and NPDR CSME-group were studied as well by means of using SPSS 18.0 for data statistics.Results There was no significant difference in gender,age,eye axis and intraocular pressure between NPDR CSME + group and NPDR CSME-group (all P ＞ 0.05).There was significant difference in BCVA between the two groups (P =0.001).The mean SFCT were (328.24 ± 101.92) μm in the NPDR CSME + group and (235.31 ± 66.98) μm in the NPDR CSME-group,and the difference was statistically significant (t =4.156,P=0.000).And plotting changes in CRT against changes in SFCT in patients with CSME revealed a positive correlation(r =0.473,P =0.000).Conclusion SFCT in NPDR CSME + patient is thicker than that in NPDR CSME-patient.And plotting changes in CRT against changes in SFCT in patients with CSME reveals a positive correlation.

Objective: To investigate the relationship between blood lipid proifles and intraocular pressure (IOP) in adult subjects. Methods: A total of 1660 adult subjects received regular physical examination in our hospital from 2015-01 to 2015-09 were enrolled. The subjects were divided into 2 groups: Hyperlipidemia group,n=356 and Non-hyperlipidemia group,n=1304. Systolic, diastolic blood pressure (SBP), (DBP), IOP and serum levels of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1(ApoA1) and apolipoprotein B (ApoB) levels were measured in all subjects. SPSS19.0 software was used to study the relationship between blood lipid proifles and IOP by univariate and multivariate liner regression analysis respectively. Results: Univariate regression analysis revealed that IOP was positively related to SBP, DBP, TC, TG, LDL-C and ApoB, all P<0.05, while negatively related to HDL-C,P=0.028. Multivariate regression analysis indicated that with adjusted age, SBP and DBP, IOP was positively related to TC, TG, LDL-C, ApoA1 and ApoB, while negatively related to HDL-C, allP<0.05. ApoB level in either Hyperlipidemia group or Non-hyperlipidemia group was signiifcantly related to IOP in both male and female genders,P<0.05. Conclusion: ApoB level was most obviously related to IOP and it might be used as a predictor for IOP elevation in clinical research, while its validity should be further studied.

Objective To evaluate the detection performance of the cobas8000 c702 fully automatic biochemical analyzer for de‐tecting the second generation Roche urine trace albumin (ALBU2) .Methods (1) The precise evaluation :with the allowable error stipulated by CLIA 88 as the basis ,the requirements were the repeat precision <1/4TEa ,and intermediate precision <1/3TEa;(2) the linear range and the evaluation of the reportable range :the EP6‐A scheme was adopted ,and extend to calculate the average re‐covery rate of dilution ,the clinical reportable range was evaluated by the average dilution recovery of 90% -110% ;(3) the carry o‐ver pollution assessment :the carry over pollution of serum albumin on urine trace albumin detection was evaluated by the judgment standard of carry over pollution rate of 0 .5% ;(4)the methodological comparative analysis :with SIEMENS BN Ⅱas the reference system ,the Roche Cobas 8000 C702 and the BN2 results were performed the correlation contrastive analysis .Results The repeat precision :low concentration CV=1 .98% .high concentration CV=1 .64% ;intermediate precision :low concentration CV=4 .35% , high concentration CV=1 .20% ;the linear range verification :the measurement range 5 .6-413 .55 mg/L ;clinical reportable range :in the maximum diluted multiples of 30 times ,the clinical reportable range was 5 .6-12 406 .5 mg/L ;the carry over pollution rate :serum albumin (42 .6 g/L) on urine trace albumin(6 .9 mg/L) ,the carry over pollution rate was 0 .28% ;the indoor comparison :in the concentration within 200 mg/L ,the regression line was Y=0 .896 X+5 .049 ,the correlation coefficient r2 =0 .994 4 ,the system shift was passed at the medical decision level .When the specimen concentration within 201-413 .55 mg/L ,the regression line was Y=0 .848X-10 .44 ,the correlation coefficient r2 =0 .917 ,the system shift was not passed at the medical decision level .Conclusion The detection of the Roche ALBU2 in the Cobas 8000 C702 platform can meet the clinical needs ,the comparison among different instruments has difference in different concentration ranges ,therefore the independent reference ranges should be established ac‐cording to the each instrument system .

Objective To observe the hemolysis,allergic reactions and stimulation of Polydatin Injection(PI),thus to provide evidence for clinical medication.Methods Hemolysis was observed by in-vitro rabbit blood hemolysis.Sys- temic allergy and passive skin allergy were tested on guinea pigs and rats.Vascular stimulation and muscle stimulation were tested on rabbits.Results There was no hemolysis or reaction in erythrocyte agglutination 30,60 and 180 rain after adding PI.No systemic anaphylaxis was found in guinea pigs.There was no skin allergy passive in rats.There was no vascular stimulation or muscle stimulation after injecting PI(0.39 mg/mL)5.6 mg/kg into rabbit ears.Con- clusion Under experimental conditions,PI(0.39 mg/mL)shows no hemolysis in vitro or agglutination reaction;it has no systemic anaphylaxis or passive skin allergy;it either has no stimulating effect in rabbit auricular vessels and muscles.

Objective To explore the hospitalization status of patients with chronic obstructive pulmonary disease ( COPD ) . Method In total, 12,838 COPD patients hospitalized from January 2008 to December 2014 were involved in the study and their hospitalization status were analyzed. Results Among the 12,838 patients, 2,499 were hospitalized for critical conditions (19.47%), 5,455 for acute attack (42.49%), 4,884 for acute exacerbation (38.04%). The ratio of male/female was 5.32:1. Those in 71 to 80 years old were at the highest risk. They were hospitalized at least for 1 time, at most for over 38 times, averaged (3.52 ± 4.05) times. Conclusions The COPD patients were hospitalized due to acute attack and acute exacerbation. The patients'age ranged from 71 to 80 years. The male patients had a predominant incidence than the female ones. The times of hospitalization were related with possible complications of other chronic diseases. Therefore, nursing staff should draw up individual continuing nursing strategies based on the patients′ hospitalization reasons to reduce the hospitalization rate of acute attack and acute exacerbation. Meanwhile, we should formulate the pre-hospital rescue plan for the hospitalized patients at the peak age and implement prospective nursing.