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.

Liposome-mediated nucleic acid delivery has been a focus recently, but in the course of delivering nucleic acid, some hurdles seriously limit the nucleic acid exerting treatment effect. This review refers to a series of problems such as low blood stability, reticuloendothelial system absorption, the lower targeting of liposome and the restriction of endosomal escape which are suffered in liposome-mediated nucleic acid delivery; and gives a detail introduction of strategies such as PEGylation, ligand modification, photochemical internalization, the application of degradation liposome and membrane-lytic peptide, to overcome those problems.

ObjectiveTo explore the application of enlargement of plastic surgery for dural closure with radial neuro-patch in standardize large decompressive craniectomy (SLDC).MethodsTwenty-one patients (observation group) who needed a SLDC for various reasons were treated with radial incision in dura to release the high intracranial pressure and enlargement of plastic surgery for dural closure with radial neuropatch from March 2009 to June 2010.The neuro-patch were used as the dural substitutes.Twenty-one patients were treated with SLDC only for the similar reasons (control group).General healing effects were compared betweentwo groups.ResultsIn 6 hours and 72 hours after surgery,the rate of obvious effectiveness in observation group was significantly higher than that in control group [33.33％(7/21 ) vs.14.29％(3/21 ),33.33％(7/21 ) vs.19.05％(4/21 ) 、61.90％( 13/21 ) vs.28.57％(6/21 ),61.90％( 13/21 ) vs.38.10％(8/21 )](P ＜ 0.05).The rate of intracranial infection,cerebrospinal leak and epilepsy in observation group [0,0,4.76％ ( 1/21 )]was significantly lower than that in control group [14.29％ (3/21),14.29％ (3/21),19.05％ (4/21)](P ＜0.05).The rate of subcutaneous or subdural cerebrospinal fluid accumulation,cenencephalocele,cerebral ventricular malformation,brain hernia through the skull window had no significant difference between two groups [19.05％(4/21 ),0,4.76％( 1/21 ),0 in observation group;23.81％(5/21 ),9.52％(2/21 ),9.52％(2/21 ),4.76％( 1/21 ) in control group) (P ＞ 0.05 ).After followed up of 6-12 months,the rate of the well general outcome in observation group was significantly better than that in control group [85.71％ ( 18/21 ) vs.71.43％ ( 15/21 )](P ＜ 0.05 ).The rate of moderate-critical function handicapped in control group was significantly higher than that in observation group [23.81％(5/21 ) vs.9.52％(2/21 )](P＜0.05 ).ConclusionsThe SLDC is effective for decreasing the intracranial pressure,and the enlargement of plastic surgery for dural closure with radial neuro-patch can improve the efficiency and decrease the incidence of complicating diseases.This therapy can improve the patients' general quality of survival and is worth to be popularized in clinic.

Based on TCM relative diagnostic theory and clinical experience,the author put forward that atrophic glossitis is caused by yin deficiency and should be treated from yin deficiency.During the past long-term clinical practice,the treatment from Yin deficiency has been proved a sound effect in the therapy of atrophic glossitis.

Objective To observe the effectiveness of probucol for non-proliferative diabetic retinopathy (NPDR) with hyperlipidemia.Methods Fifty-two patients (104 eyes) of NPDR with hyperlipidemia were enrolled in this study.The patients were randomly divided into treatment group and control group,26 patients (52 eyes) in each group.Both groups received diet and exercise guidance,oral hypoglycemic agents and (or) intensive insulin therapy.After blood sugar and blood pressure were controlled,the treatment group received probucol 0.5 g,two times per day; and the control group received atorvastatin of 10 mg,one time per day.The total course was 12 months.Before and after one,three,six and 12 months,all patients underwent vision,ophthalmoscope,fundus fluorescein angiography,blood and urine tested.Variations of visual acuity,fundus condition,macular edema,triglyceride (TG),total cholesterol (TC),low-density lipoprotein cholesterol (LDLC),high-density lipoprotein cholesterol (HDLC) and 8-0HdG were observed before and after treatment.Results The total effective rate of visual prognosis were 44.23％ and 40.38％ in the treatment group and the control group,the difference had no statistical significacy (Z＝-0.335,P＞0.05).Retinal hemorrhages and microaneurysms alleviated after treatment in both groups.The total efficiency of fundus prognosis was 65.38％ in the treatment group and 36.54％ in the control group,and the difference was statistically significant (Z=-2.973,P＜0.05).Macular edema was in six and five eyes in the treatment group and the control group respectively,which were lower than before treatment,the difference was statisticaly significant (x2=4.833,4.300; P＜0.05).Between the two groups,the difference was not statistically significant (x2 =0.102,P＞ 0.05).Twelve months after treatment,TG,TC and LDLC were decreased in the treatment group (t=15.653,7.634,14.871) and control group (t=13.275,7.415,13.632),and the difference was statistically significant (P＜0.05).HDLC showed no significant difference than before in the two groups (t=0.584,0.275; P＞0.05).TG,TC,LDLC and HDLC showed no difference between the two groups (t＝1.857,0.133,1.671,0.875; P＞0.05).8-0HdG decreased gradually during the one,three,six and 12 months in the treatment group (t=7.352,15.581,27.324,28.143) and control group (t =6.877,8.672,14.671,14.855) after treatment,and the difference was statistically significant (P＜0.05).In the first month aftertreatment,8 0HdG showed no difference between the two groups (t=0.513,P＞0.05).In the 3,6,and 12 months after treatment,the 8 0HdG was lower in the treatment group than that in the control group,and the difference was statistically significant (t =3.434,5.917,5.226; P＜0.05).Conclusion In the treatment of NPDR with hyperlipidemia,probucol can reduce blood lipid,stable visual function and relieve macular edema.

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.

Atherosclerosis obliterans of lower extremity artery mainly involve the aorto-lliac artery,femoral-popliteal artery and below-knee arteries.At present the major treatment of the disease is endovascular treatment.Due to anatomical differences between the three arteries,the principles and effect of endovascular treatment are different.The endovascular treatment of iliac- femoral lesions,because of its patency rate not lower than surgery,has become the preferred way.On account of the high incidence of femoral- popliteal lesions and the dissatisfaction for patency rate,the endovascular treatment of femoral-popliteal lesions has become a hot research.Endovascular therapy in the below-knee arteries is still in the exploration,currently a small balloon-based.

ObjectiveTo investigate the clinical features,early diagnosis and therapeutic methods of primary tumor of the duodenum.MethodsThe clinical data of 130 patients of primary tumor of the duodenum who were hospitalized in Peaking University Third Hospital from 1974 to 2010 were summarized.There were 30 cases of benign tumors and 100 cases of malignancy. ResultsMore than 90％ of primary tumors of the duodenum were located at the duodenal bulb and descendent part.59％ of malignant tumors were located in the area of duodenal papilla. The mean diameter of benign tumors was less than 2 cm compared with more than 3 cm in malignancies. Upper abdominal pain,jaundice,black stool,intestinal obstruction and abdominal mass were among the most common clinical manifestations. Jaudice was most common in papilla tumors,and intestinal obstruction and palpable abdominal mass often indicate advanced stage.Duodenofiberscopy combined with air barium double contrast radiography increase the diagnosis rate.Among the 30 benign cases,11 cases underwent simple tumor resection,14 cases received endoscopic tumor resection and 3 cases underwent pancreaticoduodenectomy.Resection rate and the 5-year survival rate was 100％. Of the 100 malignant cases,56 cases underwent standard pancreaticoduodenectomy,3 cases received pylorus preserving pancreaticoduodenectomy,9 cases underwent simple tumor resection and 12 cases received segmental duodenectomy.Resection rate was 84％.The 5-year survival rate was 46％ in 59 cases receiving Whipple's procedure.ConclusionsPrimary tumor of the duodenum lacks specific clinical features. Simple tumor resection and segmental duodenectomy can be done for benign cases, while pancreaticoduodenectomy is the therapy of choice for malignant cases.

Vascular injury is a severe complication when combined with biliary injuries in laparoscopic cholecystectomy. The most frequent injury is damage to the right branch of the hepatic artery. The incidence ranges between 6. 7% and 61.1%. When bile duct transection is combined with vascular injury, the clinical course is complicated by liver ischaemia or necrosis, biliary stricture, and liver lobar atrophy which sometimes necessitating liver resection or even transplantation. Reconstruction of vascular injury is helpful when the injury is identified early.