Background Cataract is the main cause of global blindness,and surgery is the main method for the treatment of cataract,so precise preoperative parameters have an important significance for improving postoperative visual quality.Objective This study was to analyze the difference of lens thickness (LT) measured by immersion A-scan ultrasound versus optical biometry and consistency of these two methods in measuring the LT for different types of cataract eyes,and to investigate whether A-scan ultrasound for the LT measurement needs to correct the ultrasound speed parameter.Methods A reliability evaluation of diagnosis test was designed.The LT was measured on 143 cataract eyes using immersion A-scan ultrasound and Lenstar optical biometry in Tianjin Eye Hospital from September 2013 to May 2014.The eyes were assigned to nuclear cataract group (60 eyes of 50 patients),posterior subcapsular cataract group (40 eyes of 40 patients) and cortical cataract group (43 eyes of 43 patients) based on the types of cataract,and the hardness of nucleus was grade II in 20 eyes of 14 patients,grade Ⅲ in 20 eyes of 17 patients and grade Ⅳ in 20 eyes of 19 patients.The outcomes measured by immersion A-scan ultrasound versus Lenstar optical biometry were compared with paired t test,and the consistency between the two devices was analyzed by Bland-Altman agreement plot.This study complied with Helsinki declaration,and written informed consent was obtained from each patient prior to any examination.Results The mean LT value was (4.85± 0.39) mm from the immersion A-scan ultrasound and (4.74 ±0.37)mm from the Lenstar optical biometry,with a significant difference between the two devices (t =3.020,P =0.004).No significant differences were found in the LT values of the posterior subcapsular cataractous eyes and cortical cataractous eyes between the two devices (t=1.015,P =0.316;t =1.275,P =0.209).The LT values by immersion A-scan ultrasound were significantly higher in grade Ⅱ,Ⅲ and Ⅳ nuclear cataractous eyes than those by Lenstar optical biometry (t=2.175,2.378,2.383,all at P＜0.05).The outcome showed a good consistency in the posterior subcapsular cataractous eyes between the two measuring methods,with the 95％ limitation of agreement (LoA) from-0.21 to 0.18 mm.However,there were poor consistencies between the two measuring methods in the nuclear and cortical cataractous eyes,with the 95％ LoA from-0.64 to 0.43 mm and from-0.50 to 0.41 mm,respectively.Poor consistencies also were seen in grade Ⅱ,Ⅲ,Ⅳ nuclear cataractous eyes between the two measuring methods,and the 95％ LoA were-0.31 to 0.22 mm,-0.32 to 0.24mm and-1.09 to 0.62 mm,respectively.Conclusions There are differences in measuring LT of different types of cataractous eyes between immersion A-scan ultrasound and Lenstar optical biometry.The measuring values are higher by immersion A-scan ultrasound than those by Lenstar optical biometry,suggesting that the measurement of immersion A-scan ultrasound for LT of different types and nuclear hardness of cataractous eyes should correct the ultrasound speed parameters.

In recent years,mechanical thrombectomy has been the most important research progress in the treatment of acute cerebral infarction,especially the positive results of five endovascular therapy studies in 2015 has rewritten its clinical guidelines.However,the focus of these studies was mainly on the small vessel infarction(SVI),and the inclusion criteria of these studies include the following aspects:ASPECTS ≥6 points,Alberta Stroke Program Early CT Score within 6 hours after stroke onset,the infarct volume＜70 mL within 6-24 hours after stroke onset,and the presence of image mismatch or the presence of mismatch between clinical condition and perfusion imaging.The above studies excluded patients with ASPECTS＜6 points or infarct volume ≥70 mL of large core infarction(LCI).With the continuous progress of the endovascular treatment of acute ischemic stroke(AIS),the mechanical thrombectomy therapy strategy has crossed from the"time window"to the"tissue window",meanwhile,the therapeutic goal of mechanical thrombectomy has also moved from treating SVI to a new era of treating LCI that has been a very hot topic recently.Whether endovascular treatment is beneficial for patients with LCI remains uncertain.This paper aims to make a comprehensive review concerning the relevant research progress in endovascular therapy for anterior circulation large core ischemic stroke,including the imaging determination and study inclusion criteria of LCI,the postoperative blood pressure management,and the factors influencing ineffective recanalization and prognosis.(J Intervent Radiol,2023,32:1256-1262)

OBJECTIVEInvestigate the best surgical resection of esophageal cancer by comparing the efficacy and safety between Ivor-Lewis esophagectomy and Sweet esophagectomy.

METHODSThe relevant literatures comparing Ivor-Lewis esophagectomy with Sweet esophagectomy were searched through PubMed, Embase, the Cochrane Library, Google scholar, CNKI, CBM, VIP, WanFang Data. RevMan 5.2 software was used for data analysis.

RESULTSA total of 4106 patients in 15 studies were reviewed and the data were pooled for analysis. Meta-analysis showed that, compared with the Sweet group, Ivor-Lewis operative time was significantly longer(pooled mean difference=57.40; 95%CI:42.43 to 72.38; P=0.000), operative bleeding was significantly higher(pooled mean difference=28.39, 95%CI:4.06 to 52.72, P=0.02); the number of lymph node dissection significantly more(pooled mean difference=4.19, 95%CI:3.06 to 5.32, P=0.000); No significant difference was present in hospital stay, vocal cord paralysis, chylous leakage, pulmonary complications, anastomotic leakage(all P>0.05). The 5-year survival between the two groups showed no significant difference(P=0.52).

CONCLUSIONSThe two kinds of operation have the same long term effect. Compared with Ivor-Lewis operation, Sweet operation is easier to perform, less time consuming and more tolerable. Ivor-Lewis operation can dissect more lymph nodes than Sweet operation, without increased complications.

Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology