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.

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 .

China faces opportunities and challenges as well when it participates in global environment and health governance. Major opportunities are as follows:(1) The convergence between global environment and health governance’s future trend and China’s environment and health strategies is a strongest incentive to push China to par-ticipate in global environment and health governance;(2) China can benefit from this participation in term of more access to international resources; ( 3 ) Global environmental and health issues are the areas that can best illustrate China’s international image as a responsible member; ( 4 ) Since global environmental and health governance is still young, early participation will give China a louder voice in its decision-making. The challenges that China faces are as follows:(1) Huge pressure from domestic environment and health challenges forces China to be primarily inward-looking and makes it very hard for the country to keep a high profile in global environment and health governance. China also faces the increasing international pressure. ( 2 ) The lack of global environment and health governance strategy prevents China from effectively participating in global environment and health governance. (3)“The Grand Health Outlook”hasn’t been fully established yet in China, leaving much room for improvement. (4) Intellectual sup-port is inadequate. (5) Some countries have too high expectations of China in terms of its contribution to global envi-ronmental and health governance. In order to effectively participate in this field, China should undertake coordinated planning on both the international and domestic scenes, and take some specific policies both at national and interna-tional level.

Objective To investigate the quality of marriage and sexual function of cervical cancer patients following radical hysterectomy and vaginal extension.Methods Case-control and questionnairebased methods were used in this study.Forty patients of early-stage (Ⅰ b 1 ～ Ⅰ b2) cervical cancer who had undergone vaginal extension following classic radical hysterectomy were included in the observation group,while 40 patients with matching factors and radical hysterectomy only during the same period were included in the control group.The quality of marriage and sexual function were compared with OLSON marriage prolapse and incontinence sexual function questionnaire Shon Fonn (PISQ-12).Results The operation time and postoperative vaginal length in the observation group were higher than those in the control group (P ＜ 0.05 or P ＜ 0.01).The emotional,physical,and total scores during postoperation were lower than those during preoperation (P ＜ 0.01).The emotional,physical,and total scores in the control group were lower than those in the observation group (P ＜ 0.01).The marital satisfaction,husband and wife communication,conflict resolution methods,extracurricular activities and sex scores in the observation group were higher than those in the control group (P ＜ 0.05 or P ＜ 0.01).Conclusions Patients with peritoneovaginoplasty following radical hysterectomy had much longer vagina and less self-perceived short vagina.Vaginal extension following radical hysterectomy does not worsen the pelvic floor symptoms.

Objective To study the hypoglycemic effect and mechanism of n￣butyl alcohol extraction from Anoectochilus roxburghii. Methods The total of 12 normal rats were used as normal control group, and 48 diabetic model rats were divided into model control group, and high dose, middle dose and low dose treatment groups with 12 rats in each group,three treatment groups received Anoectochilus roxburghii at dose 600,400,200 mg.kg-1 , respectively, normal control group and model control group were administered with equal volume of 0.9% sodium chlorade solution once a day.After 21 days of drug administration, the weights of rats, the levels of blood glucose and insulin were examined. Results Compared with normal control group, the body weight in model control group decreased significantly(P<0.01), while blood glucose significantly increased (P<0.01).Compared with model control group, the body weight in Anoectochilus roxburghii groups exhibited no obvious difference,while blood glucose decreased significantly (P<0.01 or P<0.05).The level of insulin in high dose group increased remarkably (P<0.05). Conclusion The n￣butyl alcohol extraction from Anoectochilus roxburghii shows markedly hypoglycemic effect,specifically for which at high dose increases the level of insulin significantly,its mechanism may involve with promoting β cells regeneration.

Objective To discuss the feasibility of endoscopic thyroidectomy via breast approach for papillary thyroid carcinoma.Methods From April 2009 to December 2013,clinical data of 90 papillary thyroid carcinoma cases undergoing endoscopic thyroidectomy was analyzed retrospectively.Results There was no conversion to open surgery,the mean operation time was 97 min,the mean intraoperative blood loss was 10 ml,the mean postoperative drainage volume was 65 ml,the mean hospital stay was 4.5 d,the mean lymph node number dissection of central compartment was 5.3.No obviously chest pain and numbness occurred.No skin flap ecchymosis,necrosis,effusion,and hematoma occurred.No hypocalcemia convulsions occurred.Transient hoarseness occurred in 3 cases which recovered within 1 to 2 months.Follow-up time ranged from 1 to 5 years,the median follow-up time was 41 months,with no tumor recurrence and lymph node enlargement.All patients were satisfied with the cosmetic results.Conclusions Endoscopic thyroidectomy via breast approach is a safe and feasible procedure in treating papillary thyroid carcinoma (cN0).

Objective To evaluate the clinical efficacy of combination of Beyond cold light whitening and fluoride removing material bleaching sys-tem for treatment of dental fluorosis. Methods Ninety patients with light,medium and heavy dental fluorosis were recruited for the study and ran-domly divided into three groups. Thirty patients with 180 dental fluorosis from the A group were treated with microbrasion and etch and Beyond cold light bleaching. Thirty patients with 175 dental fluorosis from the B group were treated with microbrasion and beyond cold light bleaching. Thirty pa-tients with 180 dental fluorosis from the C group were treated with etch and Beyond cold light bleaching. The effects of whitening were evaluated by Vita shade guide matching after treatment. Results Good lightening efficacy and 100%bleaching efficacy was achieved in the light dental fluorosis subjects from all the three groups. The Shade value improvement and overall efficacy of observer group were better than the control groups for the me-dium and heavy fluorosis(P<0.05). Conclusion For moderate to severe dental fluorosis,combination of orderly methods ofmicro-polished-etch-Beyond cold light-bleachingis more effective and convenient.

Inflammatory bowel disease( IBD)is a chronic and nonspecific intestinal inflammatory disease caused by multiple factors such as environment,genetic susceptibility and immune disturbance. Autophagy plays an important role in cellular homeostasis and immune. Autophagy abnormalities may be involved in the pathogenesis of IBD. Genome-wide association studies(GWAS)have provided compelling evidence that autophagy related genes,including ATG16L1,IRGM and NOD2,are significantly associated with IBD. This article reviewed the abnormal autophagy in pathogenesis of IBD.

In this paper, the authors analyzed the current problems in domestic hospital nursing human re-source such as widespread erosion, nursing staff slack and others. From the characteristics of nursing ethics and be-havior dynamic analysis, suggest to establish a focus on the humanities concern nursing ethics culture of the people-oriented, fundamentally effectively motivate nurses, specific include: respecting nurses and ethical personality differences;to establish a trust mechanism for nursing staff;meet the needs of nursing staff learning;to establish a nursing staff self management team, thus improve hospital nursing ethics management work, for the nursing staff to provide a stable and efficient working and living environment.