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 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 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 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 observe the therapeutic efficacy of Ai Luo Kang acupoint application in treating simple obesity. Methods Eighty simple obesity patients were randomized into a treatment group and a control group, 40 in each group. The treatment group was intervened by Ai Luo Kang acupoint application, while the control group was taken as a blank control. Thirty days later, the two groups were compared in the change of body weight and waist circumference. Results After intervention, the body weight and waist circumference were significantly changed in the treatment group (P＜0.01). There were significant differences between the two groups in comparing the body weight and waist circumference after intervention (P＜0.05). Conclusion According to the relevant criteria of the Evaluation Procedures and Methods of the Function of Health Care Products (DB22-T397-2006), Ai Luo Kang acupoint application is effective in losing weight in simple obesity.

Objective To discuss MRI manifestations of overlap syndrome of autoimmune liver diseases and the diagnostic value of the MRI .Methods Seven patients of overlap syndrome of autoimmune liver diseases were recruited .The MRI examination (inclu‐ding T1WI ,T2WI ,DWI and MRCP )were underwent on these patients .MR features of overlap syndrome were reviewed by two ra‐diologists by consensus .Two radiologists independently reviewed the studies in a blinded fashion .Results AIH/PBC 4 cases ,AIH/PSC 1 case ,PBC/PSC 1 case ,AIH/PBC/PSC 1 case was collected .MRI of AIH/PBC has the MRI feature of AIH and PBC .MRI of AIH/PSC has the MRI feature of AIH and PSC .MRI of PBC/PSC has the MRI feature of PBC and PSC .MRI feature of AIH/PBC/PSC has the MRI feature of AIH ,PBC and PSC .Conclusion If the patients who sufferd autoimmune liver diseases displayed the MIR images of other autoimmune liver diseases ,the patients were considered that had developed into overlap syndrome of autoim‐mune liver diseases .

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.

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 evaluate the relationship between the blood flow values generated from MR arterial spin labeling (ASL) perfusion imaging and pathologic indicators of angiogenesis including microvascular density (MVD) counts and vascular endothelial growth factor (VEGF) expression levels of VX2 carcinoma in rabbit soft tissue. Methods VX2 tumor was inoculated in the muscular tissue of right posterior limbs of 18 healthy New Zealand white rabbits ,on which arterial spin labeling perfusion imaging was performed by using flow sensitive alternating inversion recovery pulse sequence 3 to 4 weeks later. Arterial spin labeling images were transferred to an independent computer for post-processing and blood flow (BF) maps were generated from them. BF values were measured in 2-4 regions of interest (ROIs) for each tumor. The rabbits were sacrificed after MR imaging. The gross specimens of tumors were obtained and tumor tissues were taken from the non-necrotic regions corresponding to ROIs on BF maps. Immunohistochemical staining of the specimens was performed by using CD31 monoclonal antibody to calculate MVD counts, using VEGF antibody to calculate VEGF expression levels. Correlation between BF values and MVD counts as well as between BF values and VEGF expression levels was evaluated using Spearman correlative analysis.Results On BF maps, viable tumor tissues showed high BF values compared with muscle, but there were areas without blood perfusion in some tumors. Under microscope, the microvessels positively stained by CD31 appeared as light brown areas, and the cells positively staied by VEGF showed reddish brown areas within their cytoplasm. Totally 39 pieces of VX2 tumor tissue were analyzeed There was a significant positive correlation between the BF values(M =6. 4 ml · 100 g-1 · min-1 ) and MVD counts(M =6. 8) (r = 0. 906,P ＜ 0. 01 ), and no significant correlation between BF values and VEGF expression levels ( M = 8％ ) ( r =0. 116, P=0.483). Conclusion BF value can be used in evaluating angiogenesis of soft tissue tumor through its reflection of MVD counts, and thus may be helpful in evaluating the prognosis of soft tissue tumor and making plan for their treatment.