The application of Toric intraocular lens (IOL) provides an opportunity for patients who want to remove cataract and correct astigmatism at the same time.In order to optimize the postoperative result and minimize the residual astigmatism, the accurate preoperative measurement and calculation of Toric IOL are crucial.To improve the accuracy, different astigmatism measurement devices with various advantages have been introduced into clinical practice one after another.Knowing the principle, advantages and disadvantages of the devices contributes to personalized selection of devices according to the patient's condition.Manual keratometer is still the gold standard tool for measuring curvature, and corneal topography is used to assess whether the corneal astigmatism is regular.Most devices can provide reliable corneal data for Toric IOL calculation, and it is recommended that at least three different devices should be used to enhance the prediction accuracy preoperatively.The posterior corneal astigmatism, which has an effect on the measurement and calculation of Toric IOL, has been attracting more attention of ophthalmologists.With high accuracy and strong applicability, Barrett Toric Calculator is preferred in Toric IOL calculation.Moreover, various Toric calculators and formulas can give stable and accurate results after modification and optimization.In this article, the effects of various corneal curvature measurement devices, posterior corneal astigmatism and Toric calculator on Toric IOL measurement and calculation were reviewed.

Objective The purpose of this study was to examine the relationship between acute mountain sickness ( AMS) and AMS susceptibility indices before ascent to high altitude and to evaluate their predictive value for AMS. Methods A total of 314 healthy male a-dults were voluntarily enrolled. Their 22 physiological and mental indices of AMS susceptibility were obtained before exposure high altitude. The diagnoses of AMS were based on the Lake Louise score ( LLS) ,an international standard scoring system for AMS. According to the char-acteristics of selected AMS susceptibility indices and the strong fault tolerance of neural network theory, the learning vector quantization ( LVQ) neural network method was adopted to build the prediction model of susceptibility to AMS. Results The results showed the sensitiv-ity of the LVQ model which distinguishes subjects with no-AMS reached 95. 00%,the average correct-prediction precision ultimately reached 72. 22%. The result of prediction is believable. Conclusion The builded LVQ model provide a scientific method for screening crowd who quickly ascend to high altitude,and also can lead to an effective preliminary screening of susceptibility to AMS.

Objective To evaluate the apparent diffusion coefficient(ADC) value of mono-exponential diffusion weighted imaging(DWI) and the true diffusion coefficient(D) value, related diffusion coefficient(D*) value, perfusion fraction (f) value of bi-exponential model DWI in reflecting the expression of vascular endothelial growth factor (VEGF).Methods Using immunohistochemical staining method to detect VEGF expression in the 28 cases of gastric carcinoma tissue section and the surrounding normal gastric tissue.The differences of ADC value, D value, D* value, f value in different VEGF expression grading and gastric carcinoma classification were analyzed respectively.Results The differences of ADC value, D value, f value between different VEGF grading were statically significant,as the higher VEGF grading accompanied wth the lower ADC values, D value and the higher of f value;and the differences of the parameters between high and low differentiated gastric carcinoma were also statically significant (P<0.05).Conclusion The ADC value of mono-exponential DWI and the D value,f value of bi-exponential model DWI could evaluate the expression of VEGF and reflect the gastric carcinoma angiogenesis.

Objective To study the characteristic and management method of steroidogenic diabetes in patients with rheumatic disease. Methods The follow-up data of steroidogenic diabetes in 38 patients with rheumatic disease were analyzed retrospectively. Results The nosogenesis of steroidogenic diabetes and fast blood sugar level was related with steroid dosage, using time, age, obesity and hypertipoidemia. The blood-fasting sugar level was not so obviously increased. Blood sugar at bedtime was (24.40±5.92)mmol/L,before breakfast was (9.52±3.64)mmol/L, after breakfast was (20.38±7.19)mmol/L, before lunch was(10.69±3.23)mmol/L, after lunch was (21.81±6.92) mmol/L, before dinner was (12.17±3.63)mmol/L. There was significant difference between blood sugar at bedtime and that in others (P<0.01 or<0.05). Most patients needed insulin to control blood sugar. Decreasing the daily dosage of steroid might be beneficial to the reduction of corticosteroid induced diabetes. Most patients could stop insulin injection when the daily dosage of steroid decreased to a certain level. Conclusions The prescription of corticesteroid in rheumatic diseases can cause temporal increase of blood sugar. Intensive follow-up aad blood sugar monitor is important for the diagnosis of steroidogenic diabetes. Promptly administration of insulin is required for blood sugar control.

Objective: To study the biotransformation of gracillin by Penicillium lilacinumACC 31890,to isolate and to identify the structures of metabolites and investigate the pharmacological activities.Methods: The conversion products were isolated and purified by silica gel column chromatography and semi-preparative reversed phase liquid chromatography.Their structures were identified by MS and NMR, and the anti-inflammatory activity of the conversion products was investigated as well.Results: Three metabolites were isolated and purified, and identified as 5R-spirost-5-ene-3-ol-O-β-D-Glucopyranoside-(1→3)-β-D-glucopyranosyl (1), trillin (2) and diosgenin (3) with the conversion rate of 1%, 1% and 45%, respectively.In vitro study showed that the three products showed certain degrees of activity to inhibit the production of NO, IL-6 and MCP-1 in LPS-primed RAW264.7 macrophages.Moreover, the anti-inflammatory activity of the bioconversion products increased along with the hydrolyzation of carbohydrate chain.Diosgenin, the final product, showed the strongest anti-inflammatory activity among the three products.Conclusion: The biotransformation of gracillin by Penicillium lilacinum has a high productivity of diosgenin.The amount of glycosyls has notable influence on the anti-inflammatory activity of steroid sapoinin.

Objective To establisha high altitude military medicine digital library ( HAMMDL) in order to integrate high altitude military medicine ( HAMM ) digital resources and promote transformation of HAMM technology to health service application.Methods The solution of Web 3.0-basedHAMMDL was proposed.Ontology, the metadata and Wiki paradigm were used to manage and present resources , while the Model-View-Controller pattern was used in software design .Results Based on analysis of the functional requirements and key techniques of HAMMDL , design principles were proposed the hierarchical software architecture pattern was designed , the software supporting technology was provided and the construction method of HAMM ontologies was discussed .Conclusion With the synthesized application of relative technologies , smart utilization and socialized content management pattern of HAMM digital resources can be achieved .

Objective To examine the variation in TLR7 gene copy number of patients with systemic lupus erythematosus (SLE) in Han population,and investigate the relationship between TLR7 gene copy number variations and clinical phenotypes of SLE.Methods Determination of gene copy number of TLR7 was achieved by AccuCopyTM multiple gene copy number detection method in 337 cases of Han SLE patients and 338 healthy controls.According to the clinical phenotype stratification,all cases were divided into lupus nephritis and non-lupus nephritis group,the hematological involvement and non-hematological involvement group,anti-Smith antibody positive and negative group.The data were analyzed by non-parametric rank test.Results Based on sex,there was no significant difference in the variations in TLR7 gene copy number between in female SLE patients and female healthy controls (Z=-1.175,P=0.240).There was also no difference in male group (Z=-1.085,P=0.278).Comparing gene copy numbers variation based on the presence or absence of lupus nephritis,hematological involvement,and anti-Smith antibody,there was no statistical significant difference in female SLE patients(Z=-0.888,P=0.375; Z=-1.085,P=0.278; Z=-0.529,P=0.597).There was no difference in variation in male SLE patients,neither (Z=-0.460,P=0.646; Z=-0.340,P=0.733;Z=-0.158,P=0.874).Conclusion The variations in TLR7 gene copy number are not correlated with SLE and clinical phenotypes of SLE in Han population.

Objective To determine the characteristics of retinal vascularization in premature infants. Methods A prospective study was carried out which included all premature infants with birth weight<2 000 g, who were hospitalized in Guangdong Women and Children's Hospital from September 1, 2009 to August 31, 2010. Close retinal screening and follow-up were carried out in order to record retinal vascularization at different post-conceptional ages. Spearman correlation analysis was performed for statistical analysis. Results A total of 231 infants were enrolled, and follow-up was completed in 212 infants giving a follow-up rate of 91.8%. Twenty-eight infants developed retinopathy of prematurity (ROP) resulting in a ROP morbidity of 13.2%, and 184 cases had full retinal vascularization. The median birth weight was 1 600 g (1 000-1 900 g) and the median gestational age was 32.4 weeks (27.0-35.5 weeks). In the 32-week post-conceptional age group, the proportion with full vascularization in ZoneⅠ,ⅡandⅢwas 87.1%(81/93), 7.5%(7/93) and 0.0%(0/93), respectively. In the 36-week post-conceptional age group, full vascularization was observed in ZoneⅠ, and the proportion with full vascularization in ZoneⅡandⅢrose sharply at 38-week and 40-week post-conceptional age, respectively. The proportion with full vascularization in ZoneⅢwas 100.0%(24/24) at 43-week post-conceptional age. According to Spearman correlation analysis, there was a positive correlation between ZoneⅡand Zone Ⅲ retinal vascularization progression and post-conceptional age (r=0.690 and 0.720;P=0.000). In premature infants, full retinal vascularization in ZoneⅠoccurred at 36-week post-conceptional age. The median gestational age for ZoneⅡand ZoneⅢretinal vascularization was 38 weeks (32.2-40.4 weeks) and 41 weeks (36.0-42.6 weeks), respectively. Therefore, a further 2-3 weeks were required for full retinal vascularization in ZoneⅡand ZoneⅢ. The time differences for under-vascularization in ZoneⅡandⅢwere 8 to 10 weeks, and the time differences for full vascularization in ZoneⅡandⅢwere 8 weeks and 6 weeks, respectively. Conclusion Retinal vascularization varies in premature infants. Almost all premature infants complete vascularization by term gestational age and the majority of infants need to be followed up to 41 weeks. It is essential to focus on the different retinal regions during maturation.

Objective To evaluate high resolution manometry in the diagnosis of hiatal hernia.Methods Clinical data were reviewed on 20 patients suffering from gastroesophageal reflux who had laparoscopic Toupet fundoplication for preoperative tentative diagnosis of hiatal hernia.Preoperative diagnosis of hiatal hernia was made collectively by endoscopy,X-ray examination,24 hour esophageal pH monitoring and high resolution manometry before surgery.Results Preoperative diagnosis of hiatal hernia was made in 3 patients by X-ray examination,in 9 patients by high resolution manometry.11 patients were finally diagnosed with hiatat hernia intraoperatively.X ray was consistent with intraoperative diagnosis in 27％ cases.Intraoperative and endoscopic diagnoses were 55％.High resolution manometry and intraoperative diagnoses were consistent in 82％.Lower esophageal sphincter length was (1.92 ± 0.38) cm in hiatal hernia group and (2.10 ± 0.92) cm in non-hiatal hernia group (t =0.60,P ＞ 0.05),lower esophageal sphincter pressure (respiratory min) was (0.64 ±0.55) kPa in hiatal hernia group and (1.31 ± 1.07) kPa in nonhiatal hernia group(t =1.80,P ＞ 0.05),and lower esophageal sphincter pressure (respiratory mean) was (1.43 ±0.92) kPa in hiatal hernia group and (2.57 ± 1.33) kPa in non-hiatal hernia group(t =2.26,P ＜0.05).The reflux parameters,including the percent total time pH ＜ 4,and DeMeester score,were significantly greater in hiatal hernia group than in non-hiatal hernia group (all P ＜ 0.05).Conclusions Hiatal hernia patients are with poor esophageal antireflux competency and severe reflux.High resolution manometry is more valuable in the diagnosis of hiatal hernia than endoscopy or X-ray examination.

Objective To investigate the clinical therapeutic effect of integrative treatment model and damage control theory in treatment of severe multiple injury. Methods A retrospective study was done on 116 patients with severe multiple injuries who were divided into integrative treatment plus damage control group, integrative treatment group and conventional treatment group. The relationship of correlative factors with mortality rate among three groups was compared before operation, during operation and after operation. Results All the indices in integrative treatment plus damage control group were better than other two groups before operation, during operation and after operation, with lower mortality rate (P<0.05). Conclusions Early use of integrative treatment model and damage control theory can obviously decrease complications, improve prognosis and decrease mortality rate for patients with severe multiple injury.