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 explore the psychological experience and coping styles of breast cancer patients during pregnancy. Method A qualitative research was done by interviewing 10 patients hospitalized during August 2015 to August 2016 for the purpose of investigating their psychological experience and copying styles, with the required data treated and analyzed. Result Five themes were obtained:anxiety and worry about the outcomes, longing for supports from families and society, guilty and sorrow, negative coping style. Conclusions Nurses should focus on psychological experience and coping styles of patients with breast cancer during pregnancy. They should help them with informational and social support to build effective emotion, make active coping style, alleviate their pains and ultimately improve their negative mood for the purpose of their active compliance with medical treatment.

Recent studies have shown that immune cells play an important role in the development of non-immune diseases.Regulatory T cells (Treg) are a group of T cell subsets which have immunoregulatory and immunosuppressive functions.Abnormalities in the number and function of Treg cells may cause immune imbalance, which leads to the development of diseases.Immunometabolic disorders may in turn affect the generation, proliferation and function of Treg cells.Clarification of the relationship and interaction between immunometabolism and Treg cells will make it possible to treat metabolic diseases with cellular immunotherapy.

Objective:To optimize the storage placement of drug in automatic dispensing machine so as to increase the dispensing speed and work efficiency.Methods: The drugs were dispensed on the up and down side of the center of axle wire from high to low according to the dispensed frequency. The application regularity of various drugs was analyzed by using a number of prescription information and the relevant drugs were stored in nearest tank aroundthe drug outlet as the principle of minimum time algorithm. Through optimizing the storage placement of automatic dispensing machine and applying average dispensing time as evaluation index, the change of average dispensing time between before and after 3 months of the optimization of storage placement was analyzed.Results: After the storage placement was optimized, average dispensing time was shortened 2.0s. And the difference of the time between before and after optimization was statistically significant (t=11.92,P<0.05). Conclusion: Through applying minimum time algorithm, the optimized storage placement of automatic dispensing machine shortens the dispensing time of prescription and increases work efficiency.

Objective To compare the changes of serum hepcidin,hemoglobin and other indexes of pure hemodialysis and hemodialysis combined with hemodiafiltration in treatment of maintenance hemodialysis patients,and to investigate the effect of hemodialysis combined with hemodiafiltration therapy on serum hepcidin clearance,the improvement of anemia and the relationship between them of maintenance hemodialysis patients.Methods Twenty-two patients with maintenance hemodialysis patients were collected from Shengjing Hosphal Affiliated to China Medical University from January 2015 to February 2017.This study was self-controlled study,before enrollment all patients were given only regular hemodialysis,after enrollment all patients were given hemodialysis combined with hemodiafiltration therapy for 3 months,compared the changes of serum hepcidin,hemoglobin,reticulocyte percentage,ferritin,serum iron,transferrin saturation and EPO of pure hemodialysis(before treatment) and hemodialysis combined with hemodiafiltration treatment for 3 months of patients,and analyzed the correlationship between serum hepcidin and other indexes.Results After hemodialysis combined with hemodiafiltration therapy for 3 months,compared with pure hemodialysis serum hepcidin levels were significantly lower((77.61±3.31) μg/L vs.(89.49±7.87) μg/L,t=9.660,P<0.01),hemoglobin levels were increased((112.73±11.02) g/L vs.(88.32±11.83) g/L,t=-11.957,P<0.01).The correlations between serum hepcidin and other indexes show that serum hepcidin and hemoglobin and ferritin were related,serum hepcidin was negatively correlated with hemoglobin(r=-0.851,P<0.01)and positively correlated with ferritin(r=0.385,P<0.05),and found no correlations between hepcidin and reticulocyte percentage(r=-0.151,P=0.328),serum iron(r=0.123,P=0.427),transferrin saturation(r=0.211,P=0.170) and EPO(r=-0.173,P=0.261).Conclusion To compare with pure hemodialysis,hemodialysis combined with hemodiafiltration therapy can more effectively remove hepcidin and improve anemia,and they are related.

Objective To investigate the effect of atorvastatin on the curative effect and cardiovascular events in patients with unstable angina pectoris.Methods128 patients with UAP were enrolled in Jinhua Central Hospital from August 2014 to August 2016, and 128 patients with UAP were randomly divided into observation group and control group.All the patients were given low salt and low fat diet.Two groups of patients were anti-platelet aggregation, blood pressure, lipid-lowering and other conventional treatment, observation group on the basis of simultaneous atorvastatin calcium 40mg/d, oral, once every month.The levels of TC, TG and LDL-C, HDL-C and the incidence of cardiovascular events were compared between the two groups before and after treatment.ResultsThere was no case of cardiac death in the observation group and the control group.The incidence of cardiovascular events in the observation group was 9.38%, which was significantly different from that in the control group (P<0.05).The levels of TC, TC and LDL-C in the observation group were significantly higher than those before treatment and control group, respectively.The clinical effect of the observation group was significantly better than that of the control group, the difference was significant (P<0.05).ConclusionAtorvastatin can significantly improve the efficacy of unstable angina treatment, and reduce blood lipid levels, reducing the incidence of cardiovascular events, improve the prognosis.

Objective To assess the accuracy of bispectral index (BIS) in monitoring the sedation level with dexmedetomidine combined with small-dose of sufentanil.And, to analyze the BIS value of the best opportunity for invasive manipulation with this sedation method.MethodsEighty elective operation patients, ASA Ⅰ~Ⅱ, were randomLy selected for the study.Before the start of anesthesia, small-dose of sufentanil 0.1μg/kg and dexmedetomidine were injected in vein in sequence.The loading dose of dexmedetomidine was 1.0μg/kg for 15 min and the maintenance dose was 0.3μg/kg for 5 min.The time-pint before the start of injection was recorded as T0.And, T1, T2, T3, and T4 respectively presented the infusion time of dexmedetomidine for 5min, 10min, 15min and 20min.According to these four time-points, 80 patients were randomLy divided into four groups: group T1, group T2, group T3,and group T4.The relevant HR, MAP, SpO2, BIS value, and OAA/S score were separately recorded.Analyze the correlation of BIS and OAA/S score, and the cutoff value of BIS for OAA/S score=1 was obtained by analyzing receiver operating characteristic (ROC) curve.ResultsThe compound use of dexmedetomidine and sufentanil significantly decreased HR.With this sedation method, BIS value was positively correlated with OAA/S score (r=0.95), and the best cutoff value of BIS values for OAA/S score=1 was 44.5.ConclusionThere was a good correlation between BIS and OAA/S score in monitoring sedation with dexmedetomidine combined with small-dose of sufentanil.BIS=44.5 could be regarded as a good monitoring index of invasive manipulation with this sedation method.

Microvesicles (MVs) is small membrane vesicles released from different cell types under different conditions.Studies have shown that MVs may mediate vascular inflammation,angiogenesis,and other pathological processes.MVs may play an important role in the pathogenesis of diabetic retinopathy (DR) by mediating endothelial cell injury,thrombosis and neovascularization.The plasma MV level may be an effective parameter to monitor the development of DR.This article will summarize the research progress of the relationship between MVs and DR in recent years.

Objective To investigate the clinical efficacy of low molecular weight heparin combined with psychological intervention in the prevention of deep venous thrombosis (DVT) in patients with varicose great saphenous vein. Methods Two patients underwent surgical varicosis of great saphenous vein saphenous vein ligation and stripping surgery group, with low molecular weight heparin to prevent deep venous thrombosis, the study group with low molecular weight heparin combined with psychological intervention, prevention and control of postoperative deep venous thrombosis, the incidence of records of two groups of patients with postoperative lower extremity deep vein thrombosis. Results The incidence of deep vein thrombosis (2.04％) in the study group was significantly lower than that in the control group (14.29％) (P<0.05), suggesting that the study group had better effect on prevention of deep vein thrombosis after operation. Conclusion The combination of psychological intervention and low molecular weight heparin can achieve more ideal prevention effect of deep vein thrombosis after operation of great saphenous varicose vein, which is beneficial to protect the quality of life and life safety of patients.