To evaluate the efficacy and safety of limbal relaxing incision ( LRl) for correcting corneal astigmatism during implantable collamer lens ( lCL) surgery.METHODS:A total of 185 eyes of 105 patients with high myopia and corneal keratometric astigmatism were included in the study. lCL surgery with concomitant relaxing incision was performed in 105 eyes of 60 patients in LRls group ( Group A) . Eighty eyes of 45 patients only underwent lCL surgery were in control group ( Group B) . All patients undergone ophthalmic examination that included uncorrected visual acuity ( UCVA ) , best -corrected visual acuity ( BCVA ) , Pentacam analysis system to observe the changes of corneal astigmatism before and 1wk, 1 and 3mo after surgery.RESULTS: Respectively comparing UCVA between two groups in 1 and 3mo postoperatively, the P values were considered statistically significant ( P < 0. 05 ). But, respectively comparing BCVA between two groups in 1wk, 1 and 3mo postoperatively, the P values were considered no statistically significant ( P > 0. 05 ). Preoperative corneal astigmatism was 1. 52 ± 0. 55D in group A and 1. 48 ± 0. 57D in group B, there was no statistically significant difference (P>0. 05). One week postoperatively, the astigmatism was 0. 55 ± 0. 41D in group A and 1. 20 ± 0. 48D in group B. One month postoperatively, the astigmatism was 0. 60 ± 0. 38D in group A and 0. 93 ± 0. 47D. Three months postoperatively, the astigmatism was 0. 51 ± 0. 32D in group A and 0. 96 ± 0. 40D in group B. The difference between the two groups were statistically significant ( P<0. 05 ). The difference value of corned astigmatism before surgery and 1wk, 1 and 3mo after surgery had statistical significance ( P<0. 05). ln LRls group, at preoperative and postoperative time points, the average corneal astigmatism changes were also considered statistically significant difference (P<0. 05). CONCLUSlON: LRls performed during lCL surgery appeared to be an effective and safer procedure to reduce pre-existing corneal astigmatism and improve UCVA as well as the visual quality.

[Objective]To study the antitussive and expectorant effects of aqueous extract of cudweed.[Method] The mice cough model induced by ammonia,guinea pig cough model induced by acitric acid and method of stimulating mouse’ trachea with phenol red were used in this experiment.[Results]The aqueous extract of cudweed significantly prolonged the tussive delitescence of mice,decreased the tussive times of guinea pigs and increased the secretion of mouse’ trachea induced by phenol red.[Conclusion]The antitussive and expectorant effect of cudweed was obvious.

Objective:To investigate the clinical effect of dexamethasone combined with urokinase on the tuberculous pleurisy.Methods:From August 2013 to May 2016,190 cases of tuberculous pleurisy patients in our hospital were selected.All the patients were randomly divided into the observation group and control group with of 95 patients in each group,both groups were treated with anti tuberculosis treatment,the control group was given urokinase treatment,the observation group was given dexamethasone combined with urokinase treatment,both groups were treated for 1 month.After treatment,the total effective rate,incidence of adverse reactions,total drainage time of pleural effusion,total amount of pleural effusion,thrombin time and prothrombin time of two groups were compared.Results:All patients were well tolerated with injection during the treatment and there was no severe complication after treatment;the total effective rates in the observation group and the control group were 88.4％ and 72.6％,which was significantly higher in the observation group than that of the control group (P＜0.05).The total drainage time and total amount of pleural effusion in pleural effusion in the observation group were 7.56± 2.44 d and 2867.33± 456.10 mL,the control group were 9.44± 2.89 d and 1989.92± 444.20 mL,the total drainage time in the observation group was significantly shorter than that of the control group,and the total amount of pleural effusion was significantly higher than that of the control group(P＜0.05).After treatment,the pleural effusion thrombin time and prothrombin time in both groups were significantly higher than those before treatment (P＜0.05),which were higher in the observation group than those of the control group (P＜0.05).Conclusion:Dexamethasone combined with urokinase could prolong the thrombin time and prothrombin time,shorten the time of drainage of pleural effusion,increase the pleural effusion amount,with good safety and clinical effect in the treatment of tuberculous pleurisy.

Objective In this study,we aimed at investigating the clinical,laboratory and management characteristics of adolescent-onset SLE patients compared with adult-onset SLE patients.Methods 470 fe- male patients with SLE were divided into two subgroups:adolescent-onset SLE patients and adult-onset SLE patients.The analyzed variables included clinical,laboratory parameters,damage index and outcome charac- teristics.Results In 470 female patients with SLE,there were 98(20.85%)adolescent-onset SLE patients. The following manifestations occurred more frequently in adolescent-onset SLE patients:malar rash,cutaneous vasculitis,proteinuria and abnormal liver function.Adolescent-onset SLE patients had more severe disease features and had significantly higher mean value of SLEDAI.Mortality was higher in adolescent-onset SLE pa- tients than aduh-onset SLE patients.Renal and blood system were the organs that most frequently involved. Conclusion Adolescent-onset SLE patients accounts for roughly 20.85% of all SLE cases.It is necessary to pay more attention to adolescent-onset SLE patients because the management for them is usually more difficult and the prognosis is usually poorer than aduh-onset SLE patients.

Objective To investigate the effects of the site for access to internal jugular vein (lateral versus anterior),lying position of patients (supine versus Trendelenburg),and head rotation (0°,20°,and maximum) during central venous catheterization on the location depth and cross-sectional area (CSA) of the right internal jugular vein (IJV).Methods Fifteen healthy volunteers were recruited in this prospective observational study from September 2008 to October 2008.Healthy volunteers were placed in flat supine position and 15°.Trendelenburg position separately.In each position,IJV were measured ultrasonographically from lateral site and anterior site with the head oriented at 0°,20°,and maximum rotation separately.Data of measured CSA and location depth of internal jugular vein in different positions were compared.Results The largest CSA (2.16 ±0.89) cm2 and location depth [(1.38 ± 0.43)cm] were occurred at the lateral approach in Trendelenburg position with head oriented at maximum rotation.The CSA in Trendelenburg position was larger than that in flat supine position.Only at the maximum head rotation,lateral approach got statistically larger CSA.The effects of head rotation varied with different degrees of rotation.Conclusions Site of approach,lying position and head rotation had noticeable effects on internal jugular vein cross-sectional area.Trendelenburg position increased the CSA of IJV.

Objective To evaluate and compare C5 palsy and closure of the opened lamina after expansive open-door Laminoplasty (EOLP) with miniplate or suture/anchor fixation.Methods Between January 2011 and January 2013,a total of 142 patients with cervical myelopathy who were treated by EOLP were divided into hinge-side fixation group (fixed with suture/anchor,78 cases)and open-side fixation group (fixed with miniplate,64 cases).The Japanese Orthopaedic Association (JOA) score was used for neurological assessment and recovery rate (RR) counting.Opening angles,cervical curvature index (CCI),posterior shifting of spinal cord (PSSC) and severity of cord compression were recorded and compared.Results All patients in both group were followed up for more than 12 months.All incisions healed by first intention.C5 palsy occurred in 9 patients (9/78,11.5％) of hingeside fixation group,and 1 patients (1/64,1.6％) of open-side fixation group,showing significant difference (P=0.047).Opening angles and PSSC in hinge-side fixation group were greater than that in open-side fixation group.PSSC of 10 patients with C5 palsy were 3.97±1.19 mm,and greater than that of other patients without C5 palsy 2.57± 1.01 mm.There was no significant difference in CCI before (12.23％±3.70％,11.38％±4.29％) and 1 week (12.12％±3.77％,11.31％±4.35％) after operation.No significant difference was found in JOA scores (12.35±1.09,13.55±0.91),JOA improvement rate (64.24％±9.49％,61.78％±11.48％) and cord compression (0.74±0.71,0.75±0.67) at 12 months after operation.In 6 months postoperatively,27％ of patients in hinge-side fixation group,none in open-side fixation group were identified with 10％ decrease or more in opening angles of lamina.Conclusion EOLP with miniplate fixation has the same clinical outcome as fixed with suture/anchor,but will reduce the incidence of C5 palsy and prevent further closure of the opened lamina.

Objective To investigate the techniques and influence factors for the respiratory navigator echo triggered whole-heart coronary MR angiography(WH-CMRA)and evaluate its application in visualizing coronary arteries and the image quality.Methods Ninety two volunteers were acquired with WH-CMRA at 3 T MR scanner using respiratory navigator-echo gated TFE sequence.Imaging quality was visually graded as 0—Ⅳ grade according to the visual inspection,average length,diameter and sharpness of coronary arteries.The correlation between the imaging quality and respiratory pattern,heart rate and navigator efficiency was analyzed.Results The imaging quality in 92 cases was that 28 were graded as Ⅳ, 53 were graded as Ⅲ,9 were graded as Ⅱ and 2 were graded as Ⅰ.The successful rate of scan was 88% (81/92).The imaging quality is mainly graded as Ⅳ when the heart rate was less than 75 beats per minute (bpm)and the sharpness of vessel was(48?11)%.When heart rate was more than 75 bpm,the image quality was mostly graded as Ⅲ and the sharpness was(33?15)%.The correlation between heart rate and imaging quality score was negative(r=-0.726,P0.05).Conclusion 3 T WH-CMRA technique could facilitated the visualization of whole coronary arteries at free breathing but having indications on heart rate.

Objective To evaluate the clinical efficacy of coaxial micro-incision phacoemulsification for intraoperative floppy iris syndrome (IFIS) during cataract surgery.Methods A prospective randomized control study was conducted in 80 patients (80 eyes) taking tamsulosin more than two weeks with age-related cataract from October 2014 to October 2016.All cases were randomly divided into microincision group (MICS group) and standard incision group (SICS group),40 cases in each group.Coaxial 1.8 mm microincision cataract surgery was performed in the MICS group,and coaxial 2.6 mm standard incision cataract surgery was performed in the SICS group.The incidence and the degree of IFIS and complications were recorded during the operation.The uncorrected visual acuity (UCVA) was compared at 1 day,1 week,1 month after surgery.Results At postoperative 1 day,1 week and 1 month,UCVA was 0.83 ± 0.12,0.86 ±0.10,0.89 ±0.11 in the MICS group,and was 0.71-±0.12,0.75 ±0.11,0.83 ±0.12 in the SICS group,there were statistical differences (all P ＜ 0.05),the UCVA of MICS group was better than that of SICS group.The incidence of IFIS was 60.0％ in the MICS group,and 82.5％ in the SICS group,there was statistical difference (P ＜ 0.05).There was statistical difference on degree of IFIS between two groups (P ＜ 0.05),the degree of IFIS in the MICS group was lower than that in the SICS group.Conclusion The coaxial microincision phacoemuisification is a safe and effective surgery for the patients with cataract and high risk of IFIS.

Objective:To investigate the application of lateral upper arm free flap in the repair of postoperative soft tissue defects after operation in the patients with tongue cancer, and to evaluate its survival rate and repair effect. Methods:Ten patients with tongue cancer, having a desire to repair soft tissue defect after tongue cancer operation, and their systemic state could tolerate the long time operation, were selected to repair tongue cancer postoperative defects with lateral upper arm flaps. Among them, 7 cases were male, 3 cases were female;aged 45-67 years old, average 52.1 years old.Radical resection of tongue cancer was primarily finished, then the flaps were designed and prepared to repair the defects of tongue according to the location and size of defects.After the operation, the survival rate of the flap was observed, and the effect of repair was evaluated according to the shape, size, volume and movement of the tongue.Results:The lateral upper arm flaps were stable and simple to prepare, the donor sites were concealed, and the upper limbs were not abnormal.All of flaps survived, and all of wounds healed primarily.The shape, size, and texture of tongues were satisfied, and the movements of tongue were not significantly restricted.After repair, the voice, mastication and swallowing function of the patients were good without obvious influence.Conclusion:The survival rate of lateral flap of upper arm is high, and the tongue shape and function were good after tongue defect repair.It is an ideal free flap for repairing the tongue tissue defect of tongue cancer after operation.

One hundred and forty-four medical students were enrolled in the study, the participants were randomly divided into experimental group and control group with 72 in each. All students attended the theoretical lecture of general medicine. Students in experimental group took part in the extracurricular teaching activities including the nutritional course and practice, the clinical case study and problem based learning ( PBL), students in control group did not have the extracurricular activities. The results showed that although there was no difference in general testing scores between two groups, the problem solving ability and assay-writing ability of experimental group were significantly higher than those of control group.