Background phacoemulsification combined with limbal relaxing incision (LRI) is reported to be effective for the management of coexisting cataract astigmatism,but the influence of after phacoemulsification with LRI on corneal high-order aberration is still rarely reported.Objective This study was to evaluate the effect of cataract surgery with LRI for preoperative astigmatism or on corneal high-order aberration.Methods A selfcontrolled serial cases observational study was designed.A total of 35 cataractous eyes of 35 patients with astigmatism ≥ 1.0 D before cataract surgery were enrolled in Tianjin Medical University Eye Hospital from August 2014 to April 2015 under the informed consent of patients.LRIs were performed on the eyes during the phacoemulsification and IOL implantation.The uncorrected visual acuity (UCVA),BCVA and optometry were recorded before operation and 1 day,1 week,1 month,3 months after operation.Pentacam was employed to measure the maximal and minimal diopters,astigmatism and high-order aberrations within 3 mm of the anterior corneal surface at above-mentioned time points.All the results were compared among different time points.The optometry outcomes and the anterior corneal surface astigmatism change were analyzed using vector analysis method.Results The UCVA was 0.34 ±0.22,0.38 ± 0.25,0.43±0.27,0.42±0.28 in 1 day,1 week,1 month and 3 months after operation,which was significantly higher than 0.08 ±0.09 before operation;and the BCVA was 0.54 ± 0.27,0.64 ± 0.29,0.67 ± 0.29,0.71 ± 0.32 in 1 day,1 week,1 month and 3 months after operation,showing a significant increase in comparison with 0.22±0.51 before operation(F=54.457,P=0.000;F =62.653,P =0.000).The refractive cylindrical error and corneal astigmatism were significantly decreased after operation in comparison with before operation (F =31.061,P =0.000;F =113.043,P=0.000).High order aberrations (HOA) at postoperative 1 day,1 week,1 month,3 months were all higher than those in preoperation (F =11.189,P =0.000) under the 4 mm pupil diameter.Compared with preoperation,the vertical coma,secondary vertical coma and three leaf clover were significantly increased(all at P＜0.05),but the horizontal coma and primary spherical aberration were not significantly changed (all at P＞0.05) under the 6 mm pupil diameter.Conclusions Phacoemulsification combined with LRI can reduce the corneal astigmatism effectively and steadily,and the increase of corneal aberrations does not affect visual acuity.

Objective To compare therapeutic effect of Losartan and hydrochlorothiazed compound prepara- tion and Losartan in patients with mild to moderate hypertension and to conduct economical evaluation. Methods The trial began with 2 weeks lead-in period and followed by 8 weeks therapy. 99 cases of mild to moderate hyperten- sion were randomly divided into two groups: compound preparation group ( n = 50) and Losartan (n = 49). The pa- tients were given Losartan 50 mg/h ydrochlorothiazed 12.5 mg compound preparation and Losartan 50 mg ,once a day. If the SeDBP≥85 mm Hg at 4th week, Losartan was added to 50 rag. Results After two, four and eight weeks treatment, systolic blood pressure and diastolic decreased obviously (P < 0.01 for each) ;The overall effective rate of of antihypertension was the same in both groups, but the different ratio of availability and validity in two groups was significant ( P < 0.05 for each). Conclusion Losartan/hydrochlorothiazed compound preparation has significant advantage in improving both systolic and diastolic pressure compared with monotherapy of Losartan. In ad- dition, the patients receiving compound preparation are well tolerated, with higher compliance.

Nanotechnology has shown broad application prospects in the diagnosis and treatment of cancer. Currently, nearly 80 cancer nanomedicines are under clinical investigation, and many have been approved with enhanced anti-tumor efficacy and decreased side effects. However, the presence of various barriers in related basic research, process control and clinical trials lead to extremely low translation rate. From the perspective of clinical commercialization, we summarized the progress, clinical status, challenges and opportunities of cancer nanomedicine, and presented a cutting-edge prospect on the rational design of nanomedicine and clinical trial strategies.

Objective To evaluate the value of mediastinoscopy in the diagnosis of undifferentiated mediastinal diseases. Methods A total of 35 mediastinoscopies were performed for patients with undifferentiated mediastinal disease from November 1999 to February 2002 and suspicious tissues at peritracheal,retrosternal,subcarinal,or bilateral hilar areas were obtaiued for pathological examination. Results Thirty four of 35 patients with undetermined mediastinal diseases had definite pathologic diagnosis.The diagnosis accuracy was 97%(34/35).Of the 34 patients,18 were diagnosed as malignant accounting for 52.9%.Sixteen of the 34 were diagnosed as benign,accounting for 47.1%.The diagnostic consistency of preoperation and postoperation was 47.1%(16/34).The misdiagnosis of preoperation was 52.9%(18/34).In this series,the benigns were apt to lead to misdiagnosis.10 of 16 patients with benign disease were diagnoscd as initially malignancies,representing 62.5%.In the entire group one patient had complications (2.9%).Yet no perioperative death occurred. Conclusions Mediastinoscopy is a valuable procedure which helps mede a correct diagnosis of mediastinal diseases.Given its safety and usefulness It is suggested that mediastinoscopy should be used routinely in the diagnosis of undifferentiated mediastinal diseases.

1.0 cm) by radiographic examinations, video-mediastinoscopy showed positive results in 30 cases, and negative in 14 cases, in which the surgical exploration found no evidence of metastasis to mediastinal lymph nodes. No postoperative complications and mortality were observed. Conclusions Video-mediastinoscopy offers clear operation field, high resolution, convenient application, safety and reliability. We suggest that it be adopted as a routine method in the diagnosis of mediastinal tumor and the staging of lung cancer.

Objective To evaluate the efficacy and safety of video-assisted thoracoscopic surgery in the treatment of esophageal leiomyoma.Methods Clinical data of 49 patients with esophageal leiomyoma from September 1996 to February 2009 treated by video-assisted thoracoscopic enucleation were reviewed retrospectively.Three or four trocars were used during the operation.The procedure of the surgery was similar to that of open thoracoscopic enucleation.Results In the 49 patients,video-assisted thoracoscopic leiomyoma enucleation was successfully completed in 42 cases.The other 7 patients were converted to open thoracotomy because of the following reasons:dense pleural adhesion in 2,location failure of small tumor(

Objective To evaluate the role of mediastinoscopy with biopsy on right trachea-bronchial lymph node (R4) in the diagnosis and pathologic staging of lung cancer. Methods From November 1999 to May 2004, sixty-six patients with lung cancer (47 right and 19 left) received mediastinoscopic biopsy on R4 lymph node. 17 patients were preoperative diagnosed and 49 suspected have lung cancer. The approach included cervical mediastinoscopy in 62 cases, parasternal mediastinoscopy in 1 and cervical combined with parasternal mediastinoscopy in 3. Results In total 66 patients, R4 lymph node positive was found in 49 cases, including 38 patients with right lung cancer and 11 with left lung cancer. The metastasis rate in small cell lung cancer, adenocarcinoma and squamous cell carcinoma were 100%, 82.2% and 52%, respectively. For 49 preoperatively suspected lung cancer patients, malignant tumor was confirmed by mediastinoscopy with biopsy in 40 and open thoracic surgery in 9. All the operations were successful and the patients recovered smoothly without severe postoperative complications. Conclusion R4 lymph node is one of the most common and important site for the tumor metastasis in lung cancer. Mediastinoscopy with biopsy on R4 lymph node has incomparable advantages in diagnosis and staging lung cancer over other examinations and biopsy on other sites of lymph nodes.

Objective To evaluate the value of MRI in diagnosing the premature closure and other deformities of the growth plate followed physeal injury. Methods Twenty-one children with suspected or known premature closure of the growth plate followed injury were examined with X-ray and MRI. In addition to conventional T 1WI and T 2WI for all cases, 8 were also examined with spectral pre-saturation inversion recovery sequence. The value of MRI in diagnosing and imaging the premature closure of the growth plate (PCGP) was analyzed. Results PCGP was seen in all 21 cases, 6 in the distal femur, 6 in the proximal tibia, and 9 in the distal tibia. 19 patients with angular deformities and 2 cases with both angular and shorten deformities. MRI can much more clearly visualize the cartilage of the growth plate than conventional X-ray. A stripe of low signal intensity through the cartilage of the growth plate indicated premature closure of the growth plate. 8 cases with spectral pre-saturation inversion recovery sequence can visualize the PCGP more clearly than with Spin Echo and Fast Field Echo. Conclusion MRI has an important role in diagnosing and visualizing the PCGP. The configuraton of the PCGP can be accurately mapped with MR imaging and treatment planning is facilitated.