Bilateral sequential cataract surgery is very common in clinical,but the ophthalmologists often ignore how to choose the timing of operation and whether the first eye can be used to improve the intraocular lens (IOL) power calculation for the second one.Despite the refinements in IOL selection with the use of third-generation IOL formulas,5％ of eyes still result in a postoperative refractive surprise of ± 1.00 D or more.This paper introduced the methods of using refraction error of the first eye to improve the IOL power calculation for the second eye,and the refractive error of the second eye can be improved by modifying the IOL power to correct up to 50％ of the error from the first eye in details.Because of the variation of the postoperative refractive surprise within a month,the interval of three to four weeks between two eyes cataract surgery is highly recommended.These conclusions may provide the advantageous guidance for us in the selection of IOL in bilateral cataract surgery.

OBJECTIVE: To characterize the pharmacokinetics of a single dose of 2.5 mg fondaparinux sodium in Chinese patients after thoracic surgery. METHODS: Thirteen patients were enrolled in the study and were given a single dose of 2.5 mg fondaparinux sodium via a subcutaneous injection. Plasma concentrations of fondaparinux sodium were measured throughout a 24 h period. The pharmacokinetic analysis was performed using WinNonlin software. RESULTS: The following pharmacokinetic parameters were derived; t1/2(7.92 ± 3.13) (4.21-15.89) h, tmax(2.52 ± 0.93) (1.38-4) h, p-1 (0.73 ± 0.18) (0.45-1.02) mg · L-1, AUClast(6. 56 ± 2.19) (3.07-9. 75)mg · h · L-1, Vz/F(3.54 ± 1.00) (2.24-5.73) L, CL/F(0.34 ± 0.14) (0.16-0.63) L · h-1, and MRTlast (6.98 ± 2.1) h. The pearson correlation coefficient, r was 0.7283(P = 0.005) between the serum creatinine(Scr) and mean residence time(MRTlast) of fondaparinux. CONCLUSION: The disposition of fondaparinux is highly variable in patients. A statistical significant correlation between Scr and MRTlast of fondaparinux was observed. Fondaparinux sodium administered by intravenous injection is well tolerated in patients.

Hypersensitivity reactions ( HSRs) are the serious problems of taxanes in the clinical appli- cation. These reactions range in severity from mild flushing and itching to bronchospasm, dyspnea and signifi-cant alterations in blood pressure with loss of consciousness or not, and death in some rare cases. Nevertheless, HSRs are often reported only sporadically in clinical trials or as case reports. The vague or inconsistent termi-nology used to describe these reactions may reflect our poor understanding of their pathophysiology. This article will reviews the advancement of taxanes HSRs.

Objective To study the influence of BiPAP on lipid level in patients with chronic heart failure of coronary heart disease.Methods 20 patients with chronic heart failure of coronary heart disease were taken BiPAP:Blood samples were taken from forearm vein before and 4 weeks and 12 weeks after treatment,the lipid level was measured and compared.Results The observation group of The coronary heart disease with chronic heart failure in pre-treatment serum level of total cholesterol(TC)(7.47±0.12)mmol/L,triglycerides(TG)(3.52±0.13)mmol/L,low-density lipoprotein cholesterol(LDLc)(3.73 ±0.11)nmmol/L,apolipoprotein-B(Apo-B)(1.37±0.02)g/Lwere significantly lower than 14 weeks after treatment TC(4.5±0.03)mmol/L,TG(2.6±0.02)mmol/L,LDLc(2.8±0.06)mmol/L,Apo-B(1.02±0.02)g/L)(t=2.154,t=2.278,t=2.311,t=2.347,P all<0.05) in coronary heart disease with chronic heart failure;The observation group after treatment 14 weeks of HDL-CH(1.45±0.02)mmol/Land Apo-A(1.21±0.03)g/L lower than before treatment HDLc(1.05±0.01)mmol/L,Apo-A(0.87±0.01)g/L(t=2.234,t=2.318,P all<0.05) in coronary heart disease with chronic heart failure.Conclusion BiPAP therapy could effectively to ameliorate lipid metabolism in patients with chronic heart failure of coronary heartdisease in the long term.

A magnitude of 8.0 earthquake struck on Wenchuan on May 12, 2008. Until July 1, 1393 injured persons had been admitted to Deyang People's Hospital. Of all injured persons, 32 were diagnosed with abdominal injury, including 18 men and 14 women. All the abdominal injuries were closed injury, and multiple abdominal viscera were involved in the abdominal injuries after the earthquake. Careful examination is crucial in preventing missed diagnosis. The incidences of the liver and spleen injuries were significantly higher than that of the intestine, and the reason may be that the liver and spleen are the parenchymal viscera. Diagnostic abdominocentesis can timely diagnose the parenchymal viscera with severe blood loss. Diagnostic peritoneal lavage combined with selective CT scan can timely diagnose the abdominal injuries with comparatively low cost.

According to the hemodynamic changes,circulatory failure is divided into warm shock and cold shock,and severe circulatory failure often co-exist in both conditions in children.Circulatory failure in children is characterized by rapid change on hemodynamic status,pathologic vasodilation,relative or absolute hypovolemia,myocardial depression,altered blood flow distribution,and metabolic disorders.Therapeutic strategies include improving cardiac output and tissue perfusion,achieving SVO2＞70％ and cardiac index to 3.3～6.0 L/( min· m2 ),ensuring the intravascular blood volume and cardiac load.

Objective To evaluate the effect of interactive case teaching(ICT) method in teaching hematology.Methods Sixty students were randomly selected from 2009 grade clinical medicine majors in the Third Military Medical University and were divided into experimental group and control group,each group with 30 students.Students in experimental group used ICT； while those in control group used traditional teaching method.Closed book exam was conducted for students in experimental group and control group at the end of the semester； question types of the exam included concept questions (nouns explain,choice,short answer questions) for 70 points,cases analysis question for 30 points,a total of 100 points.Data were expressed as mean ± standard deviation ((x) ±s) and analyzed with SPSS 20.0 independent sample t test.Questionnaire was designed and feedback from students was statistically analyzed.Results There was no statistical differences between experimental group and control group in concept questions (P =0.580),however,in terms of cases analysis question,scores in experimental group were significantly higher than those in control group (P =0.000) ； total scores of experimental group were also significantly higher than those in control group (P =0.016).Feedback showed that the students highly valued the form and effect of ICT.Conclusions Using ICT in teaching hematology can arouse students' enthusiasm for study,cultivate their independent thinking and ability of problem-solving.Meanwhile,ICT can combined theoretical teaching with clinical practice well and improve the quality of teaching.

Breast cancer is a type of heterogenetic neoplasm.Metabolic dysfunction plays a pivotal role in the pathogenesis and progress of breast cancer.N-3 polyunsaturated fatty acid (PUFA) could change fatty acid metabolism of breast cancer cells and modulate expression of oncogenes and anti-oncogenes through various ways.It may provide therapeutic opportunities in the treatment of chemotherapy,radiotherapy,endocrine therapy and molecule targeted therapy of breast cancer.

Clinical trials have demonstrated that arsenic trioxide(As2O3) was effective in the treatment of acute promyelocytic leukemia(APL), based on this facts, studies have been carried out to study its role in the treatment of solid cancer at home and abroad. Primary in vitro study showed that As2O3 could treat the cancer of digestive system such as hepatoma, esophageal carcinoma, gastric cancer, and the cancer of urinary and reproductive system such as cervical cancer, ovarian cancer, bladder transitional carcinoma,as well as lung cancer, breast cancer, prostate cancer, etc. The mechanism of As2O3 actions may be the induction of apoptosis, the inhibition of growth and the promotion of differentiation of solid cancers. This article reviews on As2O3 in treatment of solid cancer.

Objective To study the significance of serum IL-17 level in patients with acute coronary syndrome (ACS ) before and after rosuvastatin treatment .Methods Forty-eight ACS patients served as group A and 30 stable angina pectoris patients served as group B in this study .T heir blood-lipid level and serum hs-CRP and myocardial enzyme levels were measured and the number of coronary artery branches with lesions was calculated .Their association with serum IL-17 level was analyzed .Patients in group A were treated with rosuvastatin .The serum IL-17 levels were compared in two groups before and 4 weeks after rosuvastatin treatment .Results The serum IL-17 level was significantly higher in group A than in group B before rosuvastatin treatment (34.41 ± 6 .37 ng/L vs 15 .18 ± 3 .11 ng/L ,P<0 .05) and significantly lower in group A 4 weeks after rosuvastatin treatment than before rosuvastatin treatment (16 .71 ± 4 .72 ng/L vs 34 .41 ± 6.37 ng/L ,P<0 .05) .No significant difference was found in serum IL-17 level between the two groups after rosuvastatin treatment (P>0 .05) .Multivariate regression analysis showed that the serum hs-CRP and troponin level and the number of coronary artery branches with lesions were positively related with the serum IL-17 level (P=0 .012 ,0 .008 ,0 .000) .Conclusion Serum IL-17 level in ACS patients can partly reflect the severity of ACS .Early treatment of ACS with rosuvas-tatin can reduce the inflammatory reactions and serum IL-17 level ,and is of great significance in stabilizing the coronary plaques and reducing the incidence of ACS .