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.

The robotic surgical system can provide a stable, clear and magnified three-dimensional view, filter the surgeon's hand tremor, and hold robotic arms with multiple degrees of freedom to ensure flexible and stable operations, which overcomes the shortcomings of traditional laparoscopy. Although the robotic surgical system has been widely used in surgical fields such as urology, obstetrics and gynecology, its role in hepatic surgery has not been fully recognized. In this article, based on the relevant literatures and their own experience, the authors briefly discuss the indications of the application of robotic surgical system in liver surgery, safety and efficacy of robotic liver resection, learning curve of robotic hepatectomy, difficult robotic hepatectomy, the cost of robotic liver resection and other issues.

Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are safe and effective minimally invasive spinal techniques for the treatment of osteoporotic and pathological vertebral fractures, which are widely used in clinical practice. Cement leakage is the most common complication, which can lead to serious consequences such as adjacent vertebral refracture, pulmonary or cerebral embolism and paraplegia. Clinically, bone cement can penetrate into different sites along different paths, form different morphologies, and present different clinical symptoms. Therefore, an impeccable classification of bone cement leakage is beneficial to study its incidence, risk factors and prevention and treatment measures. So far, domestic and foreign scholars have proposed a variety of bone cement leakage classifications and elucidated its clinical significance despite certain limitations, but no uniform standard is established. Therefore, this review summarizes various classification and risk factors of cement leakage and evaluates their clinical implications, aiming at providing a reference for further clinical studies.

Case 1, a 63-year-old female patient presented with blisters and bullae arising in erythema all over the body with itching for 2 months. Two years ago, the patient underwent peri-intestinal lymph node dissection for the treatment of malignant melanoma of the rectum and anal canal, and received intravenous injection of toripalimab for preventive treatment for 1 year, and generalized skin lesions occurred 2 weeks after drug withdrawal. Direct immunofluorescence testing of erythema on the upper extremities showed that immunoglobulin G (IgG) was deposited along the basement membrane zone; salt-split indirect immunofluorescence testing of a serum sample showed liner deposition of IgG in the epidermis. Enzyme-linked immunosorbent assay (ELISA) revealed that the serum level of anti-BP180 antibodies was over 200 U/ml. The patient was diagnosed with bullous pemphigoid, but it was doubtful whether the disease was caused by PD-1 inhibitor toripalimab or not. Then, the patient received oral minocycline at a dose of 200 mg/d and prednisolone acetate at a dose of 20 mg/d, and topically applied halometasone cream all over the body. After half-a-month treatment, the blisters crusted over and the erythema darkened in color. Case 2, a 36-year-old female patient presented with generalized blisters and itching for more than 3 months. The skin lesions manifested as tense blisters, bullae, bloody bullae and crusts on the edematous erythema. The patient had a 3-year history of vaginal malignant melanoma, which was stage Ⅳ postoperative melanoma with local recurrence and lymph node metastasis nearby the right iliac vessels. After 2-year treatment with intravenous injection of toripalimab, generalized skin lesions occurred all over the body. Direct immunofluorescence testing of the erythema showed weakly positive staining for IgG, and linear deposition of IgG along the basement membrane zone; salt-split indirect immunofluorescence testing of a serum sample showed liner deposition of IgG in the epidermis. ELISA revealed that the serum level of anti-BP180 antibodies was over 200 U/ml. The case 2 was diagnosed with bullous pemphigoid, but it was also doubtful whether the disease was caused by PD-1 inhibitor toripalimab or not. Then, the case 2 was treated with oral doxycycline at a dose of 200 mg/d and oral prednisolone acetate at a dose of 40 mg/d. After 2-week treatment, the blisters completely crusted over and erythema darkened in color.

Intravitreal injection of anti-vascular endothelial growth factor (VEGF) drugs is the main treatment for diabetic macular edema (DME), however, 30% of patients still respond poorly to its treatment. At present, imaging markers that can indicate the prognosis of anti-VEGF drug treatment include ischemic index, deep retinal capillary plexus foveal avascular zone area, number of microaneurysms, blood flow density, disorder of the inner retinal layer, outer membrane and/or the degree of damage to the ellipsoid zone, strong reflex foci, intraretinal cysts, subretinal fluid. Biomarkers include high-sensitivity C-reactive protein, neutrophil to lymphocyte ratio, anti-fumarase antibody, intraocular aqueous humor cell adhesion molecule-1, interleukin (IL)-6, IL-8, etc. Understanding these clinical markers that may predict and evaluate the prognosis of anti-VEGF drug therapy can be beneficial to adjust the treatment plan, and more effectively monitor, treat, and manage DME patients.

Objective:To observe the effect of simvastatin at different doses on the inflammatory factors and renal function in se-nile patients with diabetic kidney disease ( DKD) . Methods:Totally 160 cases of DKD patients were randomly divided into the control group, low dose group, conventional dose group and high dose group. All the patients were given the foundation treatment, and the low dose group, conventional dose group and high dose group was respectively given simvastatin 10, 20,40 mg·d-1 . The changes of in-flammatory cytokines (CRP, ICAM-1 and IL-1β) and renal index (BUN, Cr, UAER, 24hUpro and Uβ2-MG) among the groups were observed and compared before and after the 4-week treatment. Results:CRP in the high dose group after the treatment was significantly decreased when compared with that before the treatment and that in the control group after the treatment, and the difference was statisti-cally significant (P<0. 05). ICAM-1 in the low dose group, conventional dose group and high dose group was significantly decreased when compared with that before the treatment and that in the control group after the treatment, and the difference was statistically sig-nificant (P<0. 05). IL-1β in the four groups after the treatment had no obvious change when compared with that before the treatment, and there was no significant difference among the groups (P >0.05). BUN in the four groups after the treatment had no obvious change when compared with that before the treatment, and there was no significant difference among the groups (P>0. 05). Cr and UAER in the four groups after the treatment were significantly decreased (P<0. 05), those in the low dose group, conventional dose group and high dose group after the treatment were significantly lower than those in the control group after the treatment (P<0. 05), and those in the conventional dose group and high dose group after the treatment were significantly lower than those in the low dose group after the treatment (P<0. 05). 24hUpro in the low dose group, conventional dose group and high dose group after the treatment was significantly decreased when compared with that before the treatment and that in the control group after the treatment (P<0. 05). Uβ2-MG in the low dose group, conventional dose group and high dose group after the treatment was significantly decreased when com-pared with that before the treatment and that in the control group after the treatment (P<0. 05), that in the conventional dose group and high dose group after the treatment was significantly decreased when compared with that in the low dose group after the treatment (P<0. 05), and that in the high dose group after the treatment was significantly lower than that in the conventional dose group after the treatment (P<0. 05). ③There was no statistically significant difference in the adverse reactions incidence among the four groups (P>0. 05). Conclusion:Simvastatin can improve diabetic nephropathy conditions in two aspects of inflammation factors and renal in-dex, and simvastatin at high dose shows more advantages.

Objective To investigate mRNA expression levels of cathepsin B,cathepsin L and uPA in non-Hodgkin lymphoma (NHL) samples,and analyze the relationship between three genes and clinicopathological factors.Methods Real-time fluorescence quantitative RT-PCR was used to quantify the relative expression levels of cathepsin B,cathepsin L and uPA mRNA in 39 NHL patients without chemotherapy or radiotherapy and 15 patients with lymph node reactive hyperplasia.Relationship between their expression and clinico-pathological factors was analyzed.Results mRNA expression levels of cathepsin B,cathepsin L and uPA in NHL group were significantly higher than those in the control group (0.403 vs 0.128,0.209 vs 0.057,0.459 vs 0.031,all P ＜ 0.05).The mRNA expression levels of cathepsin B,cathepsin L and uPA were correlated with each other in NHL.The mRNA expression levels of cathepsin B,cathepsin L and uPA in advanced staged NHL were markedly higher than those in early staged NHL (0.453 vs 0.341,0.204 vs 0.085,0.372 vs 0.196,all P ＜ 0.05).mRNA levels of cathepsin B,cathepsin L and uPA were higher in NHL patients sensitive to chemotherapy than in those resistant to chemotherapy(0.401 vs 0.556,0.085 vs 0.205,0.316 vs 0.499,all P ＜ 0.05).Conclusions The high expression of cathepsin B,cathepsin L and uPA could be detected in NHL,and their expression has a close relationship with the biological behavior characters of NHL.The dynamic examination of cathepsin B,cathepsin L and uPA may be used as clinical auxiliary diagnosis and prognosis of NHL.

Object To observe the effects of Astragali Injection (Hi) and extracts from Atractylodes macrocephala Koidz. (B1, B4, B9, B13) on the migration of rat small intestinal crypt like cells line (IEC 6). Methods IEC 6 cells were inoculated in 6 well microplates and injured in 72 h, and added with Hi, B1, B4, B9, B13. Then D PBS to negative control in the same amount and EGF to positived control, the cell migration was observed in 24, 48 and 72 h after treatment. Results B4?B9?B13 and EGF significantly promoted the migration of wounded IEC 6 cells (P

Objective To study the effect of continuous passive motion (CPM) on the healing of man made full thickness defects of articular cartilage in the knee of rabbit. Methods A diameter of 3.2mm full thickness defect of articular cartilage in the facies patellaris of femur were made in 60 knees of rabbits. Then the rabbits were randomly divided into groups A,B and C. The animals in groups A and B were treated with CPM for 8 hours and 2 hours daily, respectively, for 4 weeks, while those in group C kept in cage for free activity only. Half of the animals of every group were sacrificed at the end of the 4th and 12th weeks. The H.E. staining, safranin O staining and immunohistochemical analysis of collagens I and II were conducted, the gross appearance and histological change were observed and scored. Results There was significant difference with regard to the score of gross appearance and histological change among groups A, B and C. Conclusion The healing of full thickness defects of articular cartilage in rabbits treated by CPM is better than that in rabbits without CPM treatment. CPM can promote tissue repair and stimulate synthesis of collagenⅡand the glycosaminoglycan.