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The therapeutic response of anti-vascular endothelial growth factor (VEGF) differs among individuals.According to the changes of central retinal thickness,intraretinal fluid,subretinal fluid,best corrected visual acuity and other morphological or functional manifestations after treatment,the performance of the treated eyes can be classified as optimal response,poor response and non-response.A variety of factors could account for poor or non-response to anti-VEGF,such as genomic polymorphism and specific genomic risk alleles,lesion characteristics,vitreous and macular structural abnormalities,resistance to anti-VEGF drug,and the role of pericytes and others.The common counter measures include increasing the dosage,shortening the injection interval and replacing with another alternative drug,inhibition of pericytes,relieving vitreomacular anatomical abnormalities.It is still worthy of further exploration that how to assess individual reasons for non-response,so that we can give proper treatment to reduce the excessive use of anti-VEGF drugs and improve the clinical management of ocular neovascularization diseases.

BACKGROUND:With the development of sports medicine and rehabilitation medicine, electromechanical delay has been looked as an important index for evaluating the neuromuscular function at abroad. But the relevant research is little reported in China. OBJECTIVE:To review the literatures related to electromechanical delay published in recent years, and to explore the mechanisms, influential factors and the application status of the electromechanical delay, thereby providing reference for clinical practice and research. METHODS:A computer-based search of CNKI, WanFang and PubMed databases was performed for articles addressing electromechanical delay published from February 1979 to February 2017. The keywords were electromechanical delay, electro-mechanical response time in English and Chinese, respectively.Repeated and old studies were excluded, and finally 44 eligible literatures were included, including 3 Chinese and 41 English articles. RESULTS AND CONCLUSION: The mechanisms of electromechanical delay have been clarified. The type of muscle fiber and the level of muscle fatigue can influence electromechanical delay, but the underlying mechanisms still remain unclear. Whether age and gender make effect on electromechanical delay is controversial. Electromechanical delay is not only used for evaluating the athletes' ability to reaction, but also wildly used to investigate the mechanism of various sports injuries and evaluate the effectiveness of rehabilitation.

Objective To investigate effect of guanosine diphosphate (GDP) on the mitochondrial respiratory oxygen consumption and the mitochondrial membrane potential (MMP) of rat brain and explore the relationship of the change of uncoupling proteins (UCPS) activity with the oxygen consumption and MMP. Methods The mitochondria of rat brain were isolated by centrifugation. Mitochondria oxidative respiratory consumption was measured by Clark electrode after the treatment of GDP at different concentrations so as to calculate mitochondrial state 3 respiration (ST3), mitochondrial state 4 respiration (ST4), respiratory control rate (RCR), and the rate of oxidative phosphorylation (OPR). MMP was detected by Rhodamine 123 method at the different concentrations of GDP. Results With the increase of GDP concentration form 0 to 1.0 mmol/L, the values of ST3, ST4 and OPR were reduced while RCR was elevated. But when the concentration increased to 1.4 mmol/L, the former 3 indexes begun to increase while the later declined. When the GDP concentration reached to 1 mmol/L, the inhibitory rate was only 35.1%, 51.3%, 14.2% to ST3, ST4 and OPR respectively, while RCR was increased to 133.2%. No matter the concentration was over 1 mmol/L or under 1 mmol/L, the ability of inhibition was attenuated. MMP reached to the highest point when GDP exerted the highest inhibitory rate on mitochondrial respiratory oxygen consumption. Conclusion GDP, an inhibitor of UCPS, can regulate the respiratory oxygen consumption and MMP of the isolated rat brain mitochondrial directly in a dose-effect fashion. The change of UCPS activity can affect the respiratory oxygen consumption and MMP.

objective To evaluate the therapeutic efficacy of surgical and nonsurgical treatment and the clinical factors affecting the efficacy in traumatic optic neuropathy. Methods To analyse retrospectively the efficacy of recovery of visual acuity in 40 cases of traumatic optic neuropathy after treatment with transnasal endoscopic sphenoethmoidal optic canal decompression (28 cases) and drug therapy (12 cases). Results No significant difference existed between the therapeutic efficacy of surgery and that of drug therapy in patients with the visual acuity of LP～0.02. In surgery group,the therapeutic efficacy of the patients with visual acuity of LP～0.02 was better than that of the patients with no LP.The therapeutic efficacy of patients with duration shorter than seven days before sutgery is better than that of patients with duration longer than seven days. Conclusions The patients with serious traumatic comperssive optic neuropathy should not be treated with decompressive surgery and should not delay to at most seven days after injury.With or without the visual acuity of light perception of the affected eye surgery is usually an important factor affecting the therapeutic efficacy.

AIM:To observe the effect of GDP on uncoupling proteins(UCPs) activity and the efficiency of oxidative phosphorylation in hypoxic exposed rat brain mitochondria.METHODS: Adult SD rats were randomly divided into three groups (control, acute hypoxia and chronic hypoxia groups). The animals were placed into a hypobaric chamber simulated 5 000 m high altitude for 0, 3 and 30 d, respectively. The mitochondria from rat brain were isolated by centrifugation. The activity of UCPs was detected by the method of [H3]-GTP binding with UCPs specifically. The maximal binding content (Bmax) and the dissociation constant (Kd) were determined by Scatchard plot. The mitochondrial potential was measured by rhodamine 123 method. Oxidative respiratory consumption was measured by Clark electrode. The experiments were conducted under the conditions with or without GDP (1 mmol/L), respectively. RESULTS: For exposed to hypoxia, Bmax and the oxidative consumption of uncoupling respiration were increased. Kd, MMP and RCR were decreased. UCPs activity was inhibited by GDP in three groups. Kd was increased 61.01%, 83.13% and 71.52% and Bmax was decreased 23.18%, 35.20% and 33.38%, respectively. The values in the acute hypoxic group were changed markedly. The sensitivity of UCPs to GDP was elevated significantly by hypoxia. With the reducing of UCPs activity, oxidative consumption of uncoupling respiration was decreased whereas RCR and MMP were increased. The results elucidated increase in the efficiency of oxidative phosphorylation.CONCLUSION: GDP increases the mitochondrial membrane potential and decreases the oxygen consumption of uncoupling respiration in hypoxic exposed rat brain mitochondria by inhibiting UCPs activity. The results suggest that the change in UCPs activity is one of the factors of mitochondrial dysfunction in oxidative phosphorylation induced by hypoxia.

Objective To conduct the diagnostic treatment in the children under 5 years old with suspected asthmatic disease and to evaluate its safety .Methods The children outpatients with suspected asthmatic diseas were selected and divided into the experi‐mental group and the control group according to odd days and even days .The conventiona therapy of anti‐infection ,relieving cough , reducing sputum and supporting treatment were administered in both groups .The experimental group was added tulobuterol tape . The cough relieve on daytime and nighttime ,initial effective time ,cough disappearance time and occurrence rate of adverse events at 24 ,72 h and on 5 d after treatment were compared between the two groups .Results The total effective rate of cough sysmptom re‐lief in the experimental group at 3 time points and nighttime was higher than that in the control group with statistical difference be‐tween the two groups(P < 0 .05) .The initial effective time had no statistically significant difference in daytime between the two groups(P> 0 .05) ,but which in daytime showed the statistically significant difference (P < 0 .05) ,especially the cough disappear‐ance time at nighttime in the experimental group was significantly shortened than that in the control group( P < 0 .05) .The oc‐curence rate of adverse events had no statistical difference between the two groups(P > 0 .05) .Conclusion Tulobuterol tape by transdermal delivery as one of diagnostic treatment measures for children under 5 years old with suspected asthmatic disease is defi‐nitely effective ,safe and convenient in application with the high compliance for children patients and acceptability by the family members ,obviously shortens the course of treatment ,which is worthy of being promoted .

BACKGROUND: Bone marrow inhibition is a predominant side effect caused by the drugs for anti-tumor.OBJECTIVE: To observe the intervention effect of traditional Chinese medicine qiongyugao on bone marrow inhibition induced by chemotherapy in experimental mice with pulmonary adenocarcinoma.DESIGN: Randomized controlled trial.SETTING: Medical College of Jinan University.MATERIALS: The experiment was completed in the Central Laboratory of Medical College of Jinan University from March to October in 2001. Fortyeight healthy, aged 6 to 8 weeks C57/BL mice were involved.METHODS: The mouse model with pulmonary adenocareinoma was made with the method of inoculability of cancer cell, and then the models were group: On the following day of inoculation, 0.2 mL normal saline was used by gavage, and normal saline was injected intraperitoneally at the dosage of amine 20 mg was diluted into 0.2 g/L with normal saline, and performed intraperitoneal injection at the dosage of 5 μL/g, once per day, and 0.2 mL platinum diamine was used as in chemotherapy group and 0.2 mL qiongyugao was administered by gavage at the same time once per day. Peripheral erythrocyte, leukocyte and blood platelet, and karyota in bone marrow counting were detected on the 21 days after administration.MAIN OUTCOME MEASURES: Peripheral erythrocyte, leukocyte and blood platelet, and karyota in bone marrow counting of the mice in each group.RESULTS: Eleven mice failing to have tumor in tumor assessment were excluded from the sample, including 3 in the control group, 4 in the chemotherapy and 4 in the combination group. During the experiment,there were 2 mice dying in each group of the control group and chemotherapy group. Totally 11 mice in the control group, 10 in the chemotherapy group and 11 in the combination group entered the result analysis. Erythrocyte, leukocyte and blood platelets in the combination group and control group were all significantly higher than those in the chemotherapy group [erythrocyte: (8.54 ±0.81 ), (8.65 ±0.77), (4.56 ±1.00) ×1012 L -1;leukocyte:(9.04 ±0.60), (9.14 ±0.71), (3.31 ±0.96) ×109 L -1;blood platelets:(949.09±111.31 ), (955.54±87.13), (399.30±131.36)× 109 L-1 ,P ＜ 0.01]. The number of karyota in bone marrow in the chemotherapy group was significantly lower than those in the combination group and control group [(5.30±1.12),(10.51±1.15),(14.36±1.02)]×106,P ＜ 0.01); while the number of karyota in the control group was higher than that in the combination group (P ＜ 0.05).CONCLUSION: Qiongyugao can enhance the counting of erythrocyte,leucocyte, blood platelets of peripheral blood and karyota in bone marrow after chemotherapy in mice with pulmonary carcinoma, improve the inhibition of bone marrow induced by chemotherapy, but can not reverse it completely.

Objective To objectively evaluate the effectiveness of reminder system in reducing catheter-associated urinary tract infections.Methods Databases were electronically searched to collect the trials.According to the inclusion and exclusion criteria,the literatures were screened,the data were extracted and the methodological quality of the included studies was assessed.Then Meta-analysis was performed by using RevMan 5.0 software.Results A total of 10 literatures involving 5 662 participants were included.The results of Meta-analysis showed that the reminder system group was superior to the control group in decreasing the incidence rate of catheter-associated urinary tract infections,shortening the days of indwelling catheter,and there were statistical differences.Conclusions Reminder system can shorten the days of indwelling catheter,decrease catheter-associated urinary tract infections,

Objective To quantify the concentration of peripheral blood plasma neutrophil gelatinase-associated lipocalin (NGAL) in patients with acute pancreatitis (AP) and to explore its value in assessment of the severity of AP.Methods From June 2011 to March 2012,83 patients with AP were selected,among those 43 cases were mild acute pancreatitis (MAP) and 40 were severe acute pancreatitis (SAP).The control group included 30 healthy individuals.The peripheral blood of patients with AP and healthy controls was collected,and plasma was isolated after centrifuged.The concentration of NGAL in plasma was detected by enzyme-linked immunosorbent assay (ELISA).The t-test was performed for comparison between groups.The correlation between the concentration of NGAL in plasma and clinical parameters of AP was analyzed by Spearman rank order correlation analysis.The diagnosis value of the concentration of NGAL in SAP was evaluated by receiver operating characteristic (ROC) curve and area under the curve (AUC).Results The concentration of plasma NGAL in AP group ((10.30± 5.97)nmol/L) was higher than that in healthy control group ((1.94±1.35) nmol/L) and the difference was statistically significant (t=11.924,P＜0.01).The concentration of plasma NGAL in SAP group ((14.61 ±5.28) nmol/L) was higher than that in MAP group ((6.27±-3.09) nmol/L) and healthy control group,the differences was statistically significant (t=8.677 and 14.539,both P＜0.01).The concentration of plasma NGAL of AP patients was positively correlated with acute physiology and chronic health evaluation-Ⅱ score,Ranson score,bedside index for severity in acute pancreatitis score,computed tomography (CT) severity index,C-reactive protein,white blood cells and the days of hospitalization (r=0.651,0.556,0.514,0.620,0.320,0.458 and 0.346,all P＜0.05).The area under the ROC curve of plasma NGAL concentration in diagnosis of SAP was 0.926 (95％CI:0,870-0.983).The cutoff value of plasma NGAL level in diagnosis of SAP was 8.44 nmol/L.The sensitivity and specificity was 87.5 ％ and 88.9％,respectively.Conclusions Plasma NGAL level is correlated with the severity of patients with AP.NGAL may be one of the markers for the early diagnosis of SAP.