? Choroidal neovascularization is the primary pathogenesis of neovascularage - related macular degeneration ( nAMD ) , and the role of vascular endothelial growth factor ( VEGF ) in neovascularization has been widely recognized. Currently, drugs target different targets of VEGF have been widely used in the treatment of nAMD. As a subtype of VEGF, placental growth factor ( PlGF) has synergistic effects with VEGF-A on promoting angiogenesis, stimulating the migration of endothelial cell proliferation and mediating immune inflammatory response. There is no expression of PlGF in mature blood vessels so PlGF hashigh specificity. ln this paper, the role of PlGF in the pathogenesis and treatment of nAMD is reviewed.

Objective To investigate the value of high frequency ultrasound and CT in the diagnosis of laryngeal carcinoma. Methods Sixty-nine cases of laryngeal carcinoma were typed and staged by high frequency ultrasound and CT, and compared with the results of laryngoscopy and postsurgical pathology. Results The typing accuracy was ~94.2 % for ultrasonography and ~91.3 % for CT, higher than that of laryngoscopy(~73.9 %).T staging accuracy of ultrasonography was T_1 ~85.9 %,T_2 ~88.5 %,T_3 ~94.1 % and T_4 ~88.9 %, higher than that of CT (~68.8 %) and laryngoscopy (~75.0 %) in T_3 stage and superior to laryngoscopy (~66.7 %) in T_4 stage. Lymph node metastases were found in 37 cases (~53.6 %) by ultrasonography, higher than those by CT scanning (~27.5 %). Color Doppler blood flow laryngeal carcinoma was shown in 65 cases(~94.2 %),most were low resistance spectrum pattern. Conclusions High frequency ultrasonography is superior to CT and laryngoscopy in the staging of laryngeal carcinoma and is of great value in choosing the therapeutical protocol.

ObjectiveTo investigate the relationship between liver stiffness and hepatocellular carcinoma (HCC) risk in chronic heptatitis B patients with negative α-fetoprotein (AFP) tests. MethodsFrom September 2012 to August 2014, this study enrolled a total of 82 HBV-relative native HCC patients as the case group. During the same period, a total of 253 chronic hepatitis B patients were also include in this study as the control group. These 253 patients were followed up for six months. All of the two groups were AFP-negative. Liver stiffness was measured in all patients by transient elastography device Fibroscan?. Logistic regression was applied to assess the risk of HCC incidence, and stratum-specific likelihood ratios (SSLR) was calculated.ResultsThe age, liver stiffness measurements and plasma albumin of patients in case group were 53 years old (44-61), 12.00 kPa (7.50-20.75), 43.14 g/L (39.50-46.75) respectively. The age, liver stiffness measurements and plasma albumin of patients in control group were 45 years old (38-56), 8.40 kPa (5.40-13.50), 46.40 g/L (43.75-48.50) respectively. The variables were compared between two groups with unpaired studentt test, and the results were statistically significant (t=4.33, 3.56,
-4.48,P=0.00, 0.00, 0.00). The patients in case group were older, and had higher liver stiffness measurements and lower plasma albumin than that of the patients in control group. Logistic regression analysis showed that HCC incidence was associated with age,male-gender and liver stiffness, and the odds ratios (OR) was 1.053, 2.432, 6.803 respectively. When liver stiffness was<10 kPa, 10.1-15 kPa, 15.1-25 kPa,>25 kPa, SSLR for HCC presence was 0.67, 1.02,1.44, 3.98 respectively.ConclusionsLiver stiffness measured by transient elastography is useful in predicting the risk of HCC incidence in AFP-negative chronic heptatitis B patients. Clinicians needed to carry out close follow-up and appropriate intervention for these patients.

Objective To explore the predicative value of transvaginal ultrasonography and 48 hours blood HCG ratio for ectopic pregnancy(EP).Methods A total of 90 patients in our hospital from June 2014 to May 2016 were selected as the object according to the pregnancy result and postoperative pathology (40 cases in EP group and 50 cases in control group).The endometrial thickness was measured through transvaginal ultrasonography while blood HCG was detected by chemiluminescence technique and 48 hours blood HCG ratio was calculated.To evaluate the individual and combined predicative value of endometrial thickness and 48 hours blood HCG ratio for EP,receiver operating characteristic curves(ROC) were generated and logistic regression analysis was conducted.Results The endometriam thickness and 48 h blood HCG ratio of EP group were (11.75 ± 3.42) mm and (1.06 ± 0.38) ％,respectively,which were lower than (15.52 ± 3.98) mm and (1.46 ± 0.20)％ of control group,the differences were statistically significant (P =0.000).The AUCs and their corresponding 95％ confidential intervals(CI) were 0.77[95％ CI(0.67,0.87)] and 0.82[95％ CI(0.73,0.91)],respectively.Combined ROC analysis based on the 2 indexes revealed an elevated AUC of 0.89 [95％ CI(0.83,0.95)],the differences were statistically significant(P =0.04).Conclusion The endometrial thickness and 48 hours blood HCG ratio can be acted as useful predicative biomarkers for detection of EP.A combination of the two indexes could be a useful predicative biomarker for future clinical trials with EP and may act as a suitable add-on biomarker to the panel of methods already existing for EP.

Objective To observe the perfusion pattern of hepatic angiomyolipomas using contrastenhanced ultrasound(CEUS) and compare diagnostic efficacy of contrast-enhanced ultrasound with contrastenhanced helical CT(CECT).Methods Nineteen patients with 21 resected and pathologically proven hepatic angiomyolipomas were included in this study.Low mechanical index (mechanical index less than 0.2) realtime CEUS was performed in nineteen patients (5 patients with pulse inversion harmonic, 14 patients with contrast pulse sequencing, CPS) after 2.4ml bolus injection of contrast agent SonoVue.CECT was performed using 16-slice helical CT and contrast agent Ultravist.The diagnostic performance was calculated by considering histologic results as the reference standards.Results Fifteen tumors were correctly diagnosed as hepatic angiomyolipomas,4 tumors were misdiagnosed (including 1 hepatocellular carcinoma,2hepatic adenomas, 1 hemangioma) and 2 tumors were characterized as benign lesions by CEUS.Eight tumors were correctly diagnosed as hepatic angiomyolipomas, 13 tumors were misdiagnosed (including 7hepatocellular carcinoma, 1 liposarcoma, 2 lipomas, 1 hepatic adenomas, 2 hemangiomas) by CECT.The preoperative diagnostic accuracy was 71.4% for CEUS and 38.1 % for CECT(P＜0.05 ).Conclusions CEUS can demonstrate typical imaging characteristics of most hepatic angiomyolipomas, and has higher diagnostic performance than CECT in characterization of hepatic angiomyotipomas.

Objective To observe the effect of low arsenic sub-chronic exposure on blood routine test index in rabbits to pave a way for screening early injury of the low arsenic exposure. Methods Twelve healthy male rabbits were randomly divided into four groups. They were administrated with As at the concentration of 0(control), 10, 50 and 250 μg/L in the drinking water. Blood samples were collected from the vein of the ear edge in 8 weeks, and blood test routine including leukocyte (WBC), lymphocyte (LYM), lymphocyte percentage (LYM%), neutrophil (GRA), neutrophil percentage (GRA%), monocyte (MON), monocyte percentage (MON%), red blood cell (RBC), hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin content (MCH), mean corpuscular hemoglobin concentration(MCHC), RDW, platelets(PLT), mean platelet volume(MPV), platelet hematocrit(PCT) and platelet distribution width (PDW), were detected by the ABX-60 hemocyte analyzer. Results Compared with the control group, the WBC, GRA and GRA% increased in 0, 50 and 250 μg/L groups, but there was no significance(P > 0.05). PLT and MPV had a statistical significance in 4 groups(F = 4.07,4.20, all P < 0.05). Compared with the control group[(292.00±16.97)×109/L, (7.10±0.99)fL], PLT decreased in the 250 μg/L group [(221.33±22.50)×109/L] and MPV decreased in the 50μg/L group [(5.57±0.46)fL] significantly (P < 0.05). The other index didn't change obviously. Conclusions Sub-chronic low level arsenic exposure may lead to the change in the blood system. The blood routine test may be considered for early injury of the arsenic poisoning.

Objective To observe the effects of high mechanical index ultrasound contrast on hepatic metastasis of colorectal cancer. Methods Hepatic metastasis models were established by injecting Lovo cells into the spleen of SD rats.This study was divided into control group, microbubble plus ultrasound radiation group simple contrast agent group and simple ultrasound radiation group.Ultrasound contrast agent SonoVue(1 ml/kg) was injected via tail vein, high mechanical index ultrasound contrast (frequency 1.5 MHz,MI 1.7) was performed intermittently for 2 min.After 10 d,the animals were killed and the size and number of hepatic metastasis were compared.Histological pathology and its ultrastructure were observed.Results There were no significant differences between contral group,simple ultrasound radiation group and simple contrast agent group in metastatic rate ( P＞0.05).There were no obvious differences between contral group, simple ultrasound radiation group and simple contrast agent group in cells'ultrastructure by transmission electron microscopy (TEM).The number and size of hepatic metastasis decreased obviously in microbabble plus ultrasound radiation group ( P＜0.01 ), the mitochondrion was swelling and the gaps of endothelial cells were loose. Conclusions High mechanical index ultrasound contrast can inhibit the hepatic metastasis of colorectal cancer.

Objective To prepare human prostatic carcinoma-targeted ultrasound contrast agent and assess its targeted ability in vitro. Methods Human prostatic carcinoma-specific polyclonal antibody PSM(C-15) was attached to the surface of self-made liposome microbubbles by electrostatic attraction to prepare targeted microbubbles. Immunofluorescent staining assay was used to identify the combination of PSM(C-15) with liposome microbubbles and the targeted microbubbles were added to prostatic-carcinoma cells and then observed under the light and fluorescence microscope to evaluate the targeting ability of the targeted liposome microbubbles with prostatic carcinoma cells in vitro, while the common liposome microbubbles were controls. Results Targeted microbubbles were positive in immunofluorescent straining assay. In vitro study of the targeting ability showed the targeted microbubbles could actively adhere to LNCaP cell. While the control was negative. Conclusion The targeted liposome contrast agent with highly specific biological activity was prepared successfully. The contrast agent could bind to human prostatic carcinoma cells specially and effectively in vitro.

Now organophosphorus pesticides (OPs) bioremediation mainly means microbial bioremediation. However, phytoremediation has an advantage over microbial bioremediation because phytoremediation is safer and costs less than microbial bioremediation. Nevertheless, phytoremediation has limitations yet such as plants need better growth conditions and the efficiency of phytoremediation is lower. All these have confined the application of phytoremediation. Progresses of microbial bioremediation and phytoremediation of OPs were reviewed and OPs degrading enzymes and their organism sources, which are known by now, were summarized. Moreover, there are five important ways to enhance the efficiency of phytoremediation of OPs. They are culling plants, studying the action between soil and OPs, studying the genes that can resist or get rid of OPs, setting up the combined system of microbial bioremediation and phytoremediation and using degrading enzymes secreted selectively by roots.

Objective:To establish a 180-day mortality predictive score based on frailty syndrome in elderly sepsis patients [elderly sepsis score (ESS)].Methods:A prospective study for sepsis patients aged 60 years and above who were admitted to a medical intensive care unit of the General Hospital of Southern Theatre Command from January 1st, 2018 to December 31st, 2018 was conducted. Univariate analysis was performed on 19 independent variables including gender, age, body mass index (BMI), tumor, charlson comorbidity index (CCI), activity of daily living (ADL), instrumental activity of daily living (IADL), mini-mental state examination (MMSE), geriatric depression scale (GDS), clinical frail scale (CFS), sequential organ failure assessment (SOFA), Glasgow coma scale (GCS), acute physiology and chronic health evaluation (APACHEⅡ, APACHEⅣ), modified NUTRIC score (MNS), multiple drug resistance (MDR), mechanical ventilation (MV), continuous renal replacement therapy (CRRT) and palliative care. Continuous independent variables were converted into classified variables. Multivariate binary regression analysis of risk factors was conducted to screen independent risk factors which affecting 180-day mortality in elderly sepsis patients. Then a 180-day mortality predictive score was established, and the discrimination of the mortality of patients using CFS, SOFA, GCS, APACHEⅡ, APACHEⅣ, MNS scores were compared.Results:A total of 257 patients were enrolled, with a 180-day mortality of 60.7%. Univariate analysis showed that age, tumor, CCI, ADL, IADL, MMSE, CFS, SOFA, GCS, APACHEⅡ, APACHEⅣ, MNS, MDR, MV, CRRT, palliative care were risk factors of 180-day mortality in elderly sepsis patients [age: odds ratio ( OR) = 1.027, 95% confidence interval (95% CI) was 1.005-1.050, P = 0.018; tumor: OR =2.001, 95% CI was 1.022-3.920, P = 0.043; CCI: OR = 1.193, 95% CI was 1.064-1.339, P = 0.003; ADL: OR = 0.851, 95% CI was 0.772-0.940, P = 0.001; IADL: OR = 0.894, 95% CI was 0.826-0.967, P = 0.005; MMSE: OR = 0.962, 95% CI was 0.937-0.988, P = 0.004; CFS: OR = 1.303, 95% CI was 1.089-1.558, P = 0.004; SOFA: OR = 1.112, 95% CI was 1.038-1.191, P = 0.003; GCS: OR = 0.918, 95% CI was 0.863-0.977, P = 0.007; APACHEⅡ: OR = 1.098, 95% CI was 1.053-1.145, P < 0.001; APACHEⅣ: OR = 1.032, 95% CI was 1.020-1.044, P < 0.001; MNS: OR = 1.315, 95% CI was 1.159-1.493, P < 0.001; MDR: OR = 2.029, 95% CI was 1.197-3.437, P = 0.009; MV: OR = 6.408, 95% CI was 3.480-11.798, P < 0.001, CRRT: OR = 2.744, 95% CI was 1.529-4.923, P = 0.001, palliative care: OR = 5.760, 95% CI was 2.177-15.245, P < 0.001]. By binary regression analysis, CFS stratification ( OR = 1.934, 95% CI was 1.267-2.953, P = 0.002), MV ( OR = 4.531, 95% CI was 2.376-8.644, P < 0.001), CRRT ( OR = 2.471, 95% CI was 1.285-4.752, P = 0.007), palliative care ( OR = 6.169, 95% CI was 2.173-17.515, P = 0.001) were independent risk factors of 180-day mortality in elderly patients with sepsis. The model of "ESS = 0.660×CFS stratification+1.511×MV+0.905×CRRT+1.820×palliative care" was established. Receiver operating characteristic curve (ROC curve) analysis showed that the area under the ROC curve (AUC) for predicting 180-day mortality by ESS was 0.785 (95% CI was 0.730-0.834, P < 0.001). When the best cut-off value was 2.2 points, its sensitivity was 78.9%, specificity was 70.3%, the positive predictive value was 80.4%, and the negative predictive value was 68.3%. Simplified ESS was defined as "0.5×CFS stratification+1.5×MV+1×CRRT+2×palliative care". ROC curve analysis showed that AUC for predicting 180-day mortality by simplified ESS was 0.784 (95% CI was 0.729-0.833, P < 0.001). When the best cut-off value was 2.0 points, sensitivity was 76.9%, specificity was 70.3%, the positive predictive value was 80.0%, and the negative predictive value was 66.4%. Compared with CFS, SOFA, GCS, APACHEⅡ, APACHEⅣ and MNS, ESS had a significant difference in discriminating 180-day mortality in elderly patients with sepsis (AUC was 0.785 vs. 0.607, 0.607, 0.600, 0.664, 0.702, 0.657, 95% CI: 0.730-0.734 vs. 0.537-0.678, 0.537-0.677, 0.529-0.671, 0.598-0.730, 0.638-0.766, 0.590-0.725, all P < 0.05). Conclusions:CFS, MV, CRRT, and palliative care are independent risk factors of 180-day mortality in elderly patients with sepsis. We established ESS based on these risk factors. The ESS model has good discrimination and can be used as a reference and assessment tool for prediction and treatment guidance in elderly patients with sepsis.