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.

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 assess the clinical application of transabdominal ultrasonography for the diagnosis of achalasia. Methods: The subjects were divided into 3 groups, with 8 patients suffered from achalasia as patient group, 10 normal individuals and 8 patients with cardiac carcinoma as controls. All subjects received water provocative test to study the lower esophagus and cardia. Sonographic findings were compared between the 3 groups. After treatment by administration of drugs, pneumatic balloon dilation, or intrasphincteric injection of botulinum toxin, the 8 patients were re-examined by TAUS for longitudinal comparison. Results: (1)The normal subjects had no dilation of cardia and lower esophagus before drinking water, but their cardias opened rapidly with the drinking action. (2)All the patients of achalasia were found to have dilation of lower esophagus before taking water. During 10 min continuous TAUS scanning, 5 of 8 demonstrated absence of relaxation of cardias and absence of water from the esophagus into the stomach. The other 3 showed slight and intermittent relaxation of cardias with water flow into the stomach. Thirty minutes after water provocative test, all the 8 patients had water retardation within the lower esophagus. (3)The patients of cardiac carcinoma had an ultrasound feature of cardiac ring enlargement and thickening of cardiac wall without dilation of lower esophagus before water provocative test. Water passed the cardia more slowly. Conclusion: TAUS is a readily accepted examination. It can quickly give reliable diagnostic clues to achalasia. TAUS can also be used for making assessment of therapeutic effect on achalasia.

Objective　To improve the treatment effect of primary hepatic cancer (PHC). Methods　Analysis of the influential factors on treatment effect of PHC in China, and propose the countermeasure. Results and Conclusions　The main factors influencing the treatment effect of PHC in China are the followings: (1) Most patients with PHC of subclinical type failed to be diagnosed and treatment in time. (2) As a wrong idea PHC has been considered an “uncurable disease", so the treatment strategy is nagative. (3) Unsuitable choice of treatment resulted in some PHC unable to be resected. (4) Intraoperative massive bleeding due to unskill-operative techniques, increase the postoperative morbidity and mortality. (5) The manner of treatment is not positive for PHC patients with portal cancer thrombosis, bile duct cancer hteombosis and portal hyperlension. (6) Combined therapy can not be used or unsuitably used. The following things should be done in order to improve the treatment effect of PHC: (1) Strengthening improving the health-protective consciousness of people and regular examinaton of “high risk" population. (2) Renewing the professional knowledge in time to improve the level of diagnosis, treatment and operative techniques of medical personnel. (3) strengthening the basic medical research to make a break through in PHC treatment.

ObjectiveTo investigate the expression of Twist and N-cadherin in pancreatic cancer,and to study its relationship with clinicopathological parameters and patients' prognosis.Methods The expression of the Twist and N-cadherin in 62 tissue samples from patients with pancreatic ductal adencocarcinoma and 10 normal pancreatic tissue samples was determined by using immunohistochemistry MaxVision two step method,and the relationship with clinicopathological parameters and patients' prognosis was analyzed.ResultsThe positive expression rate of Twist in pancreatic cancer was higher than that of normal pancreatic tissues (96.8％ vs.30％,P ＜0.01 ),and the positive expression rate of N-cadherin was higher than that of normal pancreatic tissues (75.8％ vs.0,P ＜0.01),but there was no correlation between them (r =0.100,P =0.441 ).The expressions of Twist and N-cadherin was significantly correlated with TNM stage,lymph node metastasis,infiltration of portal vein or nerves and tumor location ( P ＜0.05 ),but not with age,gender and degree of differentiation ( P ＞ 0.05 ).The post-operative survival of patients decreased with the increasing Twist expression,but the survival was not associated with the expression of N-cadherin.TNM stage,the expression of Twist was independent predictive factors of prognosis for pancreatic cancer patients.ConclusionsTwist and N-cadherin are highly expressed in pancreatic cancer,and the expression was associated malignant behavior of pancreatic cancer.The abnormal expression of Twist may be a potential marker for prognosis evaluation of pancreatic cancer patients.

Spinal cord injury is a common clinical disease .Cell apoptosis is one of important pathogeneses for spinal cord in-jury, and apoptotic gene plays a very important role in apoptosis on spinal cord injury .Chinese medicine for blood-activating and stasis-dissolving has a good therapeutic effect for spinal cord injury by reducing inflammation , inhibiting apoptosis and improving microcircu-lation.In this paper, we review the research of chinese medicine for activating blood and resolving stasis during the regulation of apoto -sis gene in spinal cord injury based on related documents in the recent five years .

Environmental endocrine disruptors have garnered considerable attention in recent years be-cause of their endocrine disruption on sex development disorders. Kisspeptin system might be a novel target for endocrine disruption at the hypothalamic-pituitary-gonad axis. Environmental endocrine disruptors′estrogenic properties make them capable of interacting with the kisspeptin system,and then confer lifelong consequences in-cluding altered pubertal timing, infertility, and metabolic disorders. To date, three compounds have been well studied for their capacity to interfere with kisspeptin signaling pathways:BPA,PCB mixtures,and the phytoestro-gen GEN.

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.