Bevacizumab as adjuvant therapy in the management of pterygium: a systematic review and Meta-analysis

AIM： To evaluate the clinical effect of bevacizumab in pterygium treatment.METHODS： A systematic review and quantitative Metaanalysis was performed. Pub Med, EMBASE, Web of Science and Cochrane database were searched for eligible literatures published in English until June 2016. The endpoint was recurrence rate and pooled risk ratio（RR） was calculated.RESULTS： Nine eligible studies were included and Metaanalysis results showed no significantly difference in patients treated with bevacizumab in short term followup [3mo： RR=0.70（0.34, 1.45）; 6mo： RR=0.55（0.23, 1.32）] compared with control groups. No significant effects were observed in favor of bevacizumab in subgroup analyses： patients with subconjunctival injection of bevacizumab [3mo： RR=0.95（0.70, 1.29）; 6mo： RR=0.83（0.55, 1.28）], primary pterygium [3mo： RR=0.59（0.23, 1.54; 6mo： RR=0.59（0.23, 1.53）], simple pterygium excision [3mo： 0.32（0.05, 2.04）, P=0.23; 6mo： 0.27（0.05, 1.53）] and excision with conjunctival autograft [3mo： 1.51（0.25, 9.15）; 6mo： 1.11（0.06, 21.69）].CONCLUSION： In this Meta-analysis, we did not found the significant effect of bevacizumab in pterygium treatment, at least in short term follow-up（3mo and 6mo）.

Self-Assembly of Dimer Motors under Confined Conditions

Chemically synthetic nanomotors can consume fuel in the environment and utilize the self-generated concentration gradient to self-propel themselves in the system.We study the collective dynamics of an ensemble of sphere dimers built from linked catalytic and noncatalytic monomers.Because of the confinement from the fuel Held and the interactions among motors,the ensemble of dimer motors can self-organize into varlous nanostructures,such as a radial pattern in the spherical fuel field and a staggered radial pattern in a cylindrical fuel Held.The influence of the dimer volume fraction on the self-assembly is also investigated and the formed nanostructures are analyzed in detail.The results presented here may give insight into the application of the self-assembly of active materials.

Congenital lacrimal fistulas with secondary infection mimicking acute dacryocystitis:a case report and literature review

Dear Editor,We reported a rare case of congenital lacrimal fistula with recurrent cellulitis secondary to fistulitis,mimicking acute dacryocystitis.Congenital lacrimal fistula is an anomalous development of the lacrimal drainage system manifested by a patent communicating with skin on one side and the canaliculus,lacrimal sac,or the duct on the other[1].Most congenital lacrimal fistulas are asymptomatic.

Biological activity of the virulence factor cagA of Helicobacter pylori

Background China is one of the countries with the highest incidence of H. pylori and more than 9090 isolates possessed the cagA gene. This study was to evaluate the biological activity of the H.pylori virulence factor cagA isolated from Chinese patients. Methods cagA DNA fragments were amplified from the genomic DNA and subsequently cloned into the mammalian expression vector for cell transfection and DNA sequencing. cagA protein, phosphorylated-tyrosine cagA and the complex of cagA precipitated with SHP-2 were identified respectively by western blot in the crude cell lysate from conditionally immortalized gastric epithelial cells at 48 hours after transfection with cagA DNA. In addition, the ability of induction of scattering phenotype was examined after transient expression of cagA in AGS cells. Results The C-terminal half of cagA contained only one repeated sequence and three tandem five-amino-acid motifs glutamic acid-proline-isoleucine-tyrosine-alanine (EPIYA). Moreover, the amino acid sequence of D2 region in repeated sequence was aspartic acid-phenylanaline-aspartic acid (D-F-D) which was significantly distinguished from the three repeated sequences and aspartic acid-aspartic adid-leucine (D-D-L) in the western standard strain NCTC11637. Western blot revealed that cagA became phosphorylated in tyrosine site and bound with SHP-2 after transient expression of cagA DNA in gastric epithelial cells. Transient expression of cagA in AGS cells showed that cagA was able to induce the elongation phenotype although to a lesser extent than western strains.Conclusions cagA perturbs cell signaling pathways by binding with SHP-2. However, significant difference exists in amino acid sequence and biological function of cagA in Chinese compared with those of western countries.

Semaphorin 7a participants in pterygium by regulating vascular endothelial growth factor

AIM: To investigate the relationship between semaphorin 7a expression and cell proliferation and migration in pterygium fibroblasts. METHODS: Twenty-six patients with surgically diagnosed pterygium were enrolled, including 15 cases of primary pterygium and 11 cases of recurrent pterygium. In addition, 12 cases of normal conjunctival tissue were collected. The expression of semaphorin 7a in normal conjunctival tissue, primary pterygium and recurrent pterygium was detected by real-time polymerase chain reaction. Recurrent pterygium fibroblasts were isolated and cultured, and the expression of semaphorin 7a was silenced by small interfering RNA(siRNA) interference technique. Furthermore, the effects of si-semaphorin 7a interference on the mRNA and protein levels of β1-integrin, vascular endothelial growth factor A(VEGFA) and vascular endothelial growth factor receptor(VEGFR), and on fibroblast proliferation were analyzed. Transwell assay was used to detect the effect of semaphorin 7a interference on fibroblast migration. RESULTS: Semaphorin 7a was highly expressed in the primary pterygium and recurrent pterygium samples than that of the normal conjunctival tissue. Compared with the primary pterygium, the expression of semaphoring 7a in the recurrent pterygium samples was significantly increased(P<0.05). The mRNA and protein expression levels of β1-integrin, VEGFA and VEGFR were decreased after si-semaphorin 7a transfection, and as well as the cell proliferation and migration. CONCLUSION: Semaphorin 7a might play important roles in the pathogenesis of pterygium by affecting the expression of β1-integrin, VEGFA and VEGFR.

Gastric foregut cystic developmental malformation: Case series and literature review

Foregut cystic developmental malformation(FCDM) is a very rare lesion of the alimentary tract, especially in the stomach. We discuss the concepts of gastric duplication cyst, bronchogenic cysts, and FCDM. Nomenclature has been inconsistent and confusing, but, by some definitions, gastric duplication cysts involve gastric mucosa and submucosal glands, bronchogenic cysts involve respiratory mucosa with underlying cartilage and glands, and FCDM lacks gastric mucosa or underlying glands or cartilage but has pseudostratified ciliated columnar epithelium(PCCE). We searched our departmental case files from the past 15 years and identified 12 cases of FCDM in the alimentary tract. We summarize the features of these 12 cases including a report in detail on a 52-year-old man with a submucosal cyst lined with simple PCCE and irregular and stratified circular muscle layers that merged with gastric smooth muscle bundles near the lesser curvature of the gastric cardia. A literature review of cases with this histology yielded 25 cases. We propose the term gastric-FCDM for such cases. Our own series of 12 cases confirms that preoperative recognition of the entity is infrequent and problematic. The rarity of this developmental disorder, as well as a lack of understanding of its embryologic origins, may contribute to missing the diagnosis. Not appreciating the diagnosis preoperatively can lead to an inappropriate surgical approach. In contrast, presurgical recognition of the entity will contribute to a good outcome and reduced risk of complications.

Primary Hodgkin disease of the spine could mimic eosinophilic granuloma initially

Primary Hodgkin disease （HD） of bone is rare. The recognition on it is relatively confined. Bothcases arising-in male adults were suspected to be Potts disease （spinal tuberculosis） on imaging, and pathologic misdiagnosed initially. The clinical situations rapidly aggravated. The pathomorphology was remarkable malignant changed. They shared similar process in clinical, radiological and diagnostic process and could be representative. We retrospectively analyzed correlative results of them and review points of distinction from other disease entities that might be confused with it.

Protective effects of edaravone on ischaemia-reperfusion injury in rabbits with haemorrhagic shock

目的观察兔失血性休克再灌注过程中血浆丙二醛（MDA）、一氧化氮（NO）与超氧化物岐化酶（SOD）水平的动态变化，以及肺脏、肾脏病理改变；并探讨依达拉奉的保护作用。方法29只家兔全身肝素化后随机分为三组：假手术组（C组，n=7）、失血性休克再灌注组（I／R组，n=10）和依达拉奉保护组（I／R—edaravone组，n=12）。后两组制作失血性休克再灌注模型，在10min内通过左股动脉放血，维持平均动脉压（MAP）40 mmHg达到60 min。I／R-edaravone组静脉应用依达拉奉。然后开始复苏，要求在60 min内回输全部失血和等量生理盐水，使MAP维持在失血前70％以上。休克后10 h I／R—edamvone组静脉再次应用依达拉奉。在复苏后20h处死所有家兔，同时取所有兔的右肺部分组织和右肾部分组织作病理检查。分别测休克前、休克1 h、再灌注后1 h、5 h及20 h血浆MDA、SOD、NO含量。结果休克前三组动物血浆MDA、NO及SOD含量均无显著统计学差异。休克后I／R组家兔血浆MDA（5．35±0．29）μmol／L及NO（27．75±2．88）μmol／L水平均较C组的[（4．44±0．59）μmol／L，（25．01±4．95）μmol／L]要高，而I／R组的SOD水平（194．58±14．42）U／ml较C组（210．86±24．54）U／ml要低（P均〈0．01）。复苏后20h这些变化更加明显，I／R组MDA和NO水平持续增加l（5．69±0．24）μmol／L，（28．01±3．10）μmol／L，P〈0．05]，而SOD水平继续下降[（151．83±9．36）U／ml，P〈0．05]。与I／R组比较，I／R-edaravone组的MDA水平显著降低[（3．48±0．23）μmol／L，P〈0．01]，SOD水平明显升高[（19．5．10±11．87）U／ml，P〈0．01]。病理检查提示依达拉奉可以减轻肺脏和肾脏病理损害。结论依达拉奉通过清除自由基，有效减轻失血性休克再灌注过程中重要脏器的损害。

A tarsus construct of a novel branched polyethylene with good elasticity for eyelid reconstruction in vivo

Branched polyethylene(B-PE)elastomer was investigated for its potential medical application as a tarsus construct.The in vitro results showed that the B-PE and processed B-PE films or scaffolds did not exhibit noticeable cytotoxicity to the NIH3T3 fibroblasts and human vascular endothelial cells(ECs).The B-PE scaffolds with a pore size of 280–480 mm were prepared by using a gelatin porogen-leaching method.The porous scaffolds implanted subcutaneously in rats exhibited mild inflammatory response,collagen deposition and fast fibrovascularization,suggesting their good biocompatibility.Quantitative real-time PCR analysis showed low expression of pro-inflammatory genes and up-regulated expressions of collagen deposition and vascularization-related genes,validating the results of historical evaluation in a molecular level.The B-PE scaffolds and Medpor controls were transplanted in rabbits with eyelid defects.The B-PE scaffolds exhibited a similar elastic modulus and provided desirable repair effects with mild fibrous capsulation,less eyelid deformities,and were well integrated with the fibrovascular tissue compared with the Medpor controls.

Rationale,design,and baseline characteristics of Chinese registry in early detection and risk stratification of coronary plaques(C-STRAT)study

To the Editor:Coronary computed tomographic angiography(CCTA)has been considered as one of the most important noninvasive imaging modalities in diagnosing coronary artery disease(CAD).[1]Modern scanner of CCTA can provide precise coronary atherosclerotic plaque information,showing improved diagnostic accuracy and sensitivity for identifying obstructive CAD with a preferable temporal and spatial resolution.Several studies have demonstrated the prognosis value of CCTA for the prediction of future adverse CAD events.

Guideline for diagnosis, prophylaxis and treatment of invasive fungal infection post burn injury in China 2013

Invasive fungal infection is one of the major complication of severe burns which can induce local or systemic inflammatory response and cause serious substantial damage to the patient. The incidence of fungal infection for burn victims is increasing dramatically during recent years. This guideline, organized by Chinese Society of Burn Surgeons, aims to standardize the diagnosis, prevention and treatment of burn invasive fungal infection. It can be used as one of the tools for treatment of major burn patients.

Consensus on the application of negative pressure wound therapy of diabetic foot wounds

Because China is becoming an aging society,the incidence of diabetes and diabetic foot have been increasing.Diabetic foot has become one of the main health-related killers due to its high disability and mortality rates.Negative pressure wound therapy(NPWT)is one of the most effective techniques for the treatment of diabetic foot wounds and great progress,both in terms of research and its clinical application,has been made in the last 20 years of its development.However,due to the complex pathogenesis and management of diabetic foot,irregular application of NPWT often leads to complications,such as infection,bleeding and necrosis,that seriously affect its treatment outcomes.In 2020,under the leadership of Burns,Trauma and Tissue Repair Committee of the Cross-Straits Medicine Exchange Association,the writing group for‘Consensus on the application of negative pressure wound therapy of diabetic foot wounds’was established with the participation of scholars from the specialized areas of burns,endocrinology,vascular surgery,orthopedics and wound repair.Drawing on evidence-based practice suggested by the latest clinical research,this consensus proposes the best clinical practice guidelines for the application and prognostic evaluation of NPWT for diabetic foot.The consensus aims to support the formation of standardized treatment schemes that clinicians can refer to when treating cases of diabetic foot.

Curcumin-incorporated 3D bioprinting gelatin methacryloyl hydrogel reduces reactive oxygen species-induced adipose-derived stem cell apoptosis and improves implanting survival in diabetic wounds

Background:Gelatin methacryloyl(GelMA)hydrogels loaded with stem cells have proved to be an effective clinical treatment for wound healing.Advanced glycation end product(AGE),interacting with its particular receptor(AGER),gives rise to reactive oxygen species(ROS)and apoptosis.Curcumin(Cur)has excellent antioxidant activity and regulates intracellular ROS production and apoptosis.In this study,we developed a Cur-incorporated 3D-printed GelMA to insert into adiposederived stem cells(ADSCs)and applied it to diabetic wounds.Methods:GelMA hydrogels with Cur were fabricated and their in vitro effects on ADSCs were investigated.We used structural characterization,western blot,ROS and apoptosis assay to evaluate the antioxidant and anti-apoptotic activity,and assessed the wound healing effects to investigate the mechanism underlying regulation of apoptosis by Cur via the AGE/AGER/nuclear factor-κB(NF-κB)p65 pathway.Results:A 10%GelMA scaffold exhibited appropriate mechanical properties and biocompatibility for ADSCs.The circular mesh structure demonstrated printability of 10%GelMA and Cur-GelMA bioinks.The incorporation of Cur into the 10%GelMA hydrogel showed an inhibitory effect on AGEs/AGER/NF-κB p65-induced ROS generation and ADSC apoptosis.Furthermore,Cur-GelMA scaffold promoted cell survival and expedited in vivo diabetic wound healing.Conclusions:The incorporation of Cur improved the antioxidant activity of 3D-printed GelMA hydrogel and mitigated AGE/AGER/p65 axis-induced ROS and apoptosis in ADSCs.The effects of scaffolds on wound healing suggested that Cur/GelMA-ADSC hydrogel could be an effective biological material for accelerating wound healing.

A bidirectional brain-computer interface for effective epilepsy control

Brain-computer interfaces(BCIs) can provide direct bidirectional communication between the brain and a machine. Recently, the BCI technique has been used in seizure control. Usually, a closed-loop system based on BCI is set up which delivers a therapic electrical stimulus only in response to seizure onsets. In this way, the side effects of neurostimulation can be greatly reduced. In this paper, a new BCI-based responsive stimulation system is proposed. With an efficient morphology-based seizure detector, seizure events can be identified in the early stages which trigger electrical stimulations to be sent to the cortex of the brain. The proposed system was tested on rats with penicillin-induced epileptic seizures. Online experiments show that 83% of the seizures could be detected successfully with a short average time delay of 3.11 s. With the therapy of the BCI-based seizure control system, most seizures were suppressed within 10 s. Compared with the control group, the average seizure duration was reduced by 30.7%. Therefore, the proposed system can control epileptic seizures effectively and has potential in clinical applications.