ObjectiveTo systematically review anti-vascular endothelial growth factor (VEGF) drugs on visual acuity in patients with central vetinal vein occlnsion-macular edema (CRVO-ME). MethodsDatabases including PubMed, The Cochrane Library (Issue 11, 2012), EMbase, CBM, CNKI, VIP and WanFang Data were electronically searched for the randomized controlled trials (RCTs) about anti-VEGF drugs on visual acuity in patients with CRVO-ME from the date of establishment of the databases to December 2012. Two reviewers independently screened literature according to the inclusion and exclusion criteria, and evaluated the included studies. Then, meta-analysis was performed using RevMan 5.1 software. The quality of evidence was analyzed using GRADEpro 3.6 software. ResultsA total 9 trials involving 1 072 patients (1 072 eyes) were included. The results of meta-analysis showed that, anti-VEGF injection, compared with sham injection, increased BCVA score measured by ETDRS (MD=16.27, 95%CI 9.98 to 22.55, P < 0.000 01); decreased CFT score measured by OCT (MD=245.25, 95%CI 136.02 to 354.48, P < 0.000 1); gained more than 15 letters in BCVA (OR=4.43, 95% CI 2.23 to 8.83, P < 0.000 1); and the long term anti-VEGF effect index, gained no less than 15 letters in BCVA (OR=2.25, 95% CI 1.56 to 3.23, P < 0.000 1). The score of short term BCVA changes was of intermediate quality, while another three outcomes were of low quality in the GRADE system. ConclusionCurrent evidence shows that, anti-VEGF drugs could improve the visual acuity of patients with CRVO-ME. The clinicians could recommend this kind of drugs to the patients. Due to the limitations of the included studies, more large-sample multicentre high-quality RCTs are required to verify its effectiveness.
ObjectiveTo establish a model of chronic rotator cuff injury by inducing subacromial impingement syndrome in rats, so as to lay a foundation for further study on the mechanism and treatment of chronic rotator cuff injury. MethodsThe polyether-ether-ketone implants were designed and made with three-dimensional printing technique. In 48 male Sprague Dawley rats[weighing, (277.25±22.03) g], one shoulder joint was selected randomly as the experimental group; in the experimental group, the implant was pierced into shoulder joint close tothe acromion medial side and was pierced out under acromion close to the deltoid trailing edge; the penetratingpartof implant was cut off after the implanting part was fixed with 4# braided silk suture. No any treatment was performed on the contralateral shoulder of 24 rats as control group; and the implants were immediately removed after they were pierced into the contralateral shoulder joint of the other 24 rats as sham-operation group. All the rats were exposed to 30 minutes of downhill running at 17 m/minute (-13.5°) every day at 4 days after operation and the general condition of rats was observed. At 2, 4, 6, and 8 weeks after operation, 12 rats were sacrificed to collect shoulder joint samples. The hardtissueslices was used for VanGieson staining and histological observation of the supraspinatus tendon. ResultsAll ratssurvived to the end of experiment, without infection.The rats suffered limp at 2-3 daysafter operation, and the gait of most rats returned to normal at 4 days after operation.The histological results showed that the supraspinatus tendon had smooth edge, without split layers or breakage in the control group and sham-operation group. In the experimental group, the implants were positioned accurately without dislocation; 4 kinds of typical pathological changes were observed. Partial-thickness tear on bursal side appeared at 2 weeks (5 rats) and 4 weeks (2 rats), showing no significant difference between at 2 and 4 weeks (P > 0.05); intratendinous gap formed mainly at 4 weeks (10 rats) and 6 weeks (11 rats), showing significant differences when compared with that at 2 weeks (2 rats) (P < 0.05) and 8 weeks (2 rats) (P < 0.05); partial-thickness tear on articular side mainly appeared at 6 weeks (8 rats), showing significant difference when compared with that at other time points (P < 0.05); full-thickness tear was found mainly at 8 weeks (10 rats), showing significant differences when compared with that at other time points (P < 0.05). ConclusionA model of chronic rotator cuff injury is successfully established in rats through microinvasive implantation of subacromial impingement syndrome inducing implants and the pathological changes in this model are highly similar to the clinical pathological progress.