With the increasing perfection and improvement of microsurgery technique in modern ophthalmology, especially the popularization of micro-incision cataract extraction and the rise of femtosecond-laser-assisted cataract extraction, the cataract extraction and intraocular lens implantation is gradually transformed from vision rehabilitation surgery into refractive surgery and people also pursue better postoperative visual experiences. However, the preoperative and postoperative corneal astigmatism is always the main factor affecting the postoperative visual effect. ln recent years, the development of design and materials of the intraocular lens ( lOL) provided necessary basic conditions for clinical application of the Toric lOL. The Toric lOL is primarily characterized by effective correction of cataract patients′postoperative corneal astigmatism, which results in the enhancement of patients′postoperative visual function. ln this paper, the design, classification and clinical application of Toric lOL were analyzed, and current problems and prospect were discussed.

Objective To study the relationship between extracellular signal-regulated kinases（ERK）phosphorylation and indirect activa-tion of the epidermal growth factor receptor（EGFR）in cultured cerebellar granule neurons induced by homocysteine.Methods We pri-marily cultured 7-day-old CD-1 mouse cerebellar granule neurons for 7 days and treated with different agents（saline,AG1478,Hcy and AG1478＋Hcy）.The phosphorylation of ERK was analyzed by Western blot,and apoptotic rate by flow cytometry.Results Compared with saline and AG1478 groups,the phosphorylation of ERK was increased in Hcy group（P 〈 0.05）.When we pretreated the cells with tyr-phostin AG1478,an inhibitor of EGFR,there was no difference in the activation of ERK compared with the control group.We found obvious neuronal apoptosis when 7-day-old CD-1 mouse cerebellar granule neurons were cultured for 7 days and treated with Hcy for 6 hours,and the apoptosis induced by Hcy was aggravated when the neurons were pretreated with AG1478（P 〈 0.05）.No apoptosis was found in the saline and AG1478 groups.Conclusion The role of Hcy on ERK activation suggests the involvement of an indirect activation process of EGFR,which has neural potentially protective effect.

Objective To investigate whether the vohage-gated chloride channel CLC-2 gene— CLCN2 is associated with idiopathic generalized tonie-clonic seizures(often called a grand mal seizure, GME)of Jinuo people and Han people from Yunnan province.Methods Three regions,including Intron 2, Exon 5 and Exon 19(Intron 18),of CLCN2 were selected to conduct sequence analysis.The case-control study design was used to detect association between gene polymorphism and idiopathic generalized tonic- clonic seizures of Jinuo people and Han people from Yunnan province.Results No previously reported susceptible mutations were found in Intron 2,Exon 5 and Exon 19 in Jinuo people and Han people from Yunnan province.However we found a single nucleotide polymorphism(SNP)at site 146 of Intron 18. Case-control study were carried out,using this SNP.Distribution of the 3 genotypes(TT,TC,CC)has a significant difference between the IGTCS patients of Han people and the normal controls of Han people(9, 3,29 cases and 22,9,26,respectively,x~2=16.079,P

Objective To investigate the role of Ca2+/calmodulin-dependent protein kinase Ⅱ on pain behavior in a mouse model of bone cancer pain. Methods 40 male C3H/HeN mice were divided randomly into 5 groups:sham group (S group, n=8) ,control group (C group, n=8) and KN93 treat group (T1, n=8;T2, n=8;T3, n = 8 ). Group C and T were induced mouse models of bone cancer pain by intra-left-femur inoculations of osteolytic NCTC2472 cells while group S were injected only α-MEM. On the 14 d after inoculations,group S and C received intrathecal injection of 20% DMSO 5 μl . While group T1, T2, T3 received intrathecal injection of KN93 15nmol,30nmol,60nmol which dissolved in 5 μl 20% DMSO respectively. Mice received pain behavior tests including quantification of spontaneous flinches, paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) before and at 0.5 h,2 h,4 h,8 h after administration. Results Treatment with KN93(15 nmol) have no effect on bone cancer pain,while treatment with KN93(30 nmol,60 nmol) can dose-dependently reverse quantification of spontaneous flinches, mechanical allodynia and thermal hyperalgesia which were induced by bone cancer pain, At 0. 5h after administration, the quantification of spontaneous flinches of the two groups ( (7.25 + 1.49 ), (4. 12 + 1.36 ) ) were decreased when compared with control group ( 11.62 + 1.92 ),PWMT((1.28 +0.14)g;(1.75 +0.46)g),PWTL((14.64 +2.12) s; (16.85 + 1.61)s)were increased when compared with control group ( (0.47 + 0. 16) g, ( 11.32 + 1.68 ) s) (P ＜ 0.05 ＝. The effect lasts for at least 4 h and disappears at 8 h. Conclusion CaMK Ⅱ may play an important role in the mechanism of bone cancer pain. Intrathecal KN93 injection can effectively attenuated bone cancer pain.

0.05).Conclusions There are no significant preoperative gut mucosal barrier function damages in patients with 1 d and 3 d bowel preparation for colorectal carcinoma surgery,1 d bowel preparation for colorectal carcinoma surgery can be performed in colorectal carcinoma patients,and 3 d bowel preparation can be used for certain special colorectal carcinoma patients.

Objective To investigate the effect of one-lung ventilation (OLV) on the occurrence of subcutanous emphysema during retroperitoneal laparoscopic urologic surgery (RPLUS).Methods Twenty-seven ASA Ⅰor Ⅱ patients,aged 29-64 yr,with body mass index 19-25 kg/m2,scheduled for elective RPLUS,were randomly divided into 2 groups:two-lung ventilation (TLV) group (group Ⅰ,n =15) and OLV group (group Ⅱ,n =12).In group Ⅰ,the patients were tracheal intubated and TLV was performed.In group Ⅱ,the left-sided double lumen endobronchial tube was inserted and TLV was performed,OLV on the non-operated side was performed starting from 10-15 min before pneumoperitoneum and TLV resumed at the end of pneumoperitoneum.The end-tidal CO2 partial pressure and minute ventilation volume were measured before pneumoperitoneum (T1),at 30 and 60 min of pneumoperitoneum (T2,3),and at 30 min after the end of pneumoperitoneum (T4).The CO2 absorption capacity was calculated.The degree of pneumoderma was assessed and the occurance of pneumoderma was recorded at the end of pneumoperitoneum.Results Compared with group Ⅰ,the CO2 absorption capacity was significantly reduced,and the degree and incidence of pneumoderma were significantly decreased in group Ⅱ (P ＜ 0.05).Conclusion OLV on the non-operated side can reduce the CO2 absorption capacity,decrease the degree of subcutaneous emphysema and reduce the occurrence of subcutanous emphysema during pneumoperitoneum in patients undergoing RPLUS.

Adult ; Female ; Hepatitis B, Chronic ; complications ; drug therapy ; Humans ; Interferon-alpha ; adverse effects ; therapeutic use ; Nephrotic Syndrome ; etiology

Objective To investigate the clinical features of bilateral native pelvic and ureteral transitional cell carcinoma (TCC) in renal transplant patients. Methods A retrospective analysis was carried out on 16 patients with bilateral native pelvic and ureteral TCC after kidney transplantation.The mean time between transplantation and diagnosis of upper urinary TCC was 56. 2 ± 33. 0 months.Two patients were suffered from bilateral upper urinary TCC at the same time. The mean interval between 2 upper urinary tract operations of the remaining 14 cases was 8. 6 ± 6. 7 months. Hematuria and hydronephrosis of native kidneys were the main symptoms and targets in checkup. Intravesical chemotherapy was postoperatively given. Results All operations were performed successfully. All specimens obtained from the operations were pathologically diagnosed as TCC. The TCC location involved pure native pelvis (n = 4), pure native ureter (n = 9), and pelvis combined with ureter (n = 19). Pelvic TCC pathological grades included grade 1 in 8 cases, grade 2 in 11 cases, and grade 3 in 4 cases; Ureteral TCC grades included grade 1 in 6 cases, grade 2 in 10 cases, and grade 3 in 12 cases.Patients were followed up for 26. 8 ± 25. 1 months. One patient died of lung metastasis. (One case of lumbar soft tissue transfer was given local excision. The remaining patients had no recurrence and metastasis. Conclusion Renal transplant patients with hematuria and native renal hydronephrosis should be highly vigilant of the occurrence of upper urinary tract TCC. TCC after renal transplantation is invasive. Prophylactic contralateral nephroureterectomy should be performed on the recipients having TCC at the bladder and one side of native upper urinary tract.

Objective To investigate the level and influencing factors of care burden in caregivers of patients with nasopharyngeal carcinoma undergoing radiotherapy. Methods Totally 117 caregivers of patients with nasopharyngeal carcinoma undergoing radiotherapy and 117 patients were investigated with general information questionnaire, Zarit caregiver Burden Interiew (ZBI), Self-Perceived Burden Scale (SPBS), Karnofsky Performance Scale (KPS). Results The caregiver burden score of nasopharyngeal carcinoma undergoing radiotherapy was 28.44±18.16,in light level.The main influencing factors included the caregiver′s occupational status, physical health level, the patients of self-perceived burden level. Conclusion Nursing staff should pay attention to the self-perceived of caregivers and patients, and to provide caregivers professional and individualized care guidance and psychological counseling, so as to reduce the burden of care and improve the quality of care for patients.

This meta-analysis aimed to comprehensively assess the efficacy and safety of hepatic resection combined with radiofrequency ablation versus hepatic resection (HR) alone for the treatment of multifocal hepatoeellular carcinomas (HCC).A literature search was conducted from the database including MEDLINE,Embase,Cochrane Central Register of Controlled Trials (CENTRAL) and China Biology Medicine (CBM) disc.The primary outcomes included the 1-,3-,5-year overall survival (OS) and disease-free survival (DFS) rate.The secondary outcomes contained the intraoperative parameters and postoperative adverse events (AEs).These parameters were all analyzed by RevMan 5.3 software.After carefully screening relevant studies,four retrospective studies of high quality involving 466 patients (197 in the combined group and 269 in the HR group) were included in this study.The pooled results showed that the 1-,3-,5-year OS rate in the combined group were comparable with those in the HR group (OR=0.77,0.96,0.88;P=0.33,0.88,0.70,respectively).Similarly,there was no significant difference in 1-,3-,5-year DFS rate between the combined group and the HR alone group (OR=0.57,0.83,0.72;P=0.17,0.37,0.32,respectively).And the intraoperative parameters and postoperative AEs were also comparable between the above two cohorts.However,two included studies reported that tumor often recurred in the ablation site in the combined group.The present meta-analysis indicated that the HR combined with RFA could reach a long-term survival outcome similar to curative HR for multifocal HCC patients.And this therapy may be a promising alternative for these patients with marginal liver function or complicated tumor distribution.Furthermore,high quality randomized controlled trials (RCTs) are imperative to verify this conclusion.