Femtosecond laser is mainly used in corneal refractive surgery.In recent years,the progress of the entire process of femtosecond laser makes a dramatic change and development of corneal refractive surgery.Photoinduced decomposition of femtosecond laser can ionize human tissue and accurately carry out intratissue cutting with less influence for the outside area of target site.So it is proved to have a high safety in clinical application.Femtosecond laser-assisted cataract surgery and lens refractive surgery is going to be a new stage in ophthalmology,and its application in cataract extraction includes the cutting of clear corneal incision and anterior capsula of lens as well as cutting up of lens nuclei.The advancement of femtosecond laser in lens refractive surgery mainly is the correction of presbyopia.The progress of femtosecond laser in lens surgery was summarized.

Objective:To analyze the effects of super early rehabilitation nursing on poststroke depression, to sum up the nursing experience.Methods: The control group included 78 cases of stroke patients, the observation group included 77 cases, the observation group was given super early rehabilitation nursing after stroke seventh days, thirtieth days, ninetieth days, with Hamilton Anxiety Scale(HAMA) and Depression Scale(HAMD)assessment of patients with anxiety or depression levels, and statistical correlation index.Results: Stroke after 7 days, 30 days and 90 days in PSD group, severe occurrence of PSD was higher than that in the observation group, stroke after 30 days, 90 days in the control group are more likely to commit suicide than the observation group, stroke after 90 days of control group, PSD turnover rate is higher than that of the control group, the difference was statistically significant specific(x2=6.62,x2=13.74;P<0.05).Conclusion: PSD can occur in each time period after stroke, most self outcome; super early rehabilitation nursing is helpful to reduce the incidence of PSD risk.

Objective To establish a statistical model that can quantitatively analyze the dosimetric sparing of the bladder based on individual patient’ s anatomy in the static intensity-modulated radiotherapy (IMRT) plans for rectal cancer.Methods Static IMRT plans (7 AP fields) for 100 rectal cancer patients were used to train the model from 2012 to 2013.The anatomical features were quantitatively analyzed by the sizes of overlap regions of bladder-planning target volume (PTV) and bladder-PTV+0.5(0.5 cm margin around the PTV) .The mathematic relationship between anatomical features and dosimetric sparing of the bladder was evaluated after the bladder sparing dose was analyzed using dose-volume histogram.The established model was verified in the IMRT plans for additional 20 rectal cancer patients.Results Bladder V50 was linearly correlated with the ratio of bladder-PTV overlap size to bladder volume ( denoted as x%) , with an equation of V50=0.89x-0.99.Bladder V40 showed an approximately linear correlation with the ratio of bladder-PTV+0.5 overlap size to bladder volume (denoted as y%).The mean dose depended on both x%and y%.For the additional 20 plans, the absolute deviation between predicted and actual values for V50 and V40 were (-3.13%-3.78%) and (-5.30%-5.66%) , respectively, and the relative deviation for the mean dose was (-3.94%-3.76%) .Conclusions The model obtained in this work provides an effective method for quantitatively estimating the bladder sparing dose in IMRT plans for rectal cancer.

Objective To investigate the impact of overweight and obesity on left atrial (LA) function in healthy subjects with excess body weight.Methods Conventional echocardiography and tissue Doppler imaging were performed in 30 obese subjects (BMI≥28 kg/m2),30 overweight subjects (BMI,24to 28 kg/m2) and 30 age-matched normal subjects (BMI＜24kg/m2).Strain (S),peak systolic strain rate (SSR),peak early diastolic strain rate (ESR) and peak late diastolic strain rate (ASR) values were used to evaluating LA function.Results Compared with controls,mean S,SSR and ESR were decreased in obese subjects,while mean SSR,ESR and ASR were decreased in overweight subjects.Compared with overweight subjects,mean ESR was decreased in obese subjects.Conclusions An impaired LA function is found in overweight and obese subjects who has no other clinically appreciable cause of heart disease by using strain and SR imaging.

Objective To assess isehemic myocardial regional function of different coronary atherosclerosis using velocity vector imaging(VVI).Methods Two-dimensional images of apical four-，two-chamber and long-axis view were obtained in 50 patients with coronary artery disease.All segments of the left ventricle were divided into 5 groups：group 0 with no coronary artery stenosis，group 1 with stenosis＜50%，group 2 with stenosis 50%to 74%，group 3 with stenosis 75%to 99%and group 4 with a completely occluded coronary artery.The segmental myocardial systolic peak strain(ε)，systolic strain rate(SRs)，early diastolic strain rate(SRe)，late diastolic strain rate(SRa)and their ratio(SRe/SRa)were analyzed with VVI offline software.Results①Compared with group 0，SRe and SRe/SRa of group 1，SRs，SRe，SRe/SRa of group 2～4，εof group 2 and group 4 decreased significantly(P＜0.05).②In the comparison of four ischemic groups，ε，SRe，SRa of group 3 were markedly higher than those of group 2，while ε，SRs，SRa of group 2 were lower than those of group 1(P＜0.05)；for group 4，ε，SRs，SRe were lower than those of group 1，SRe was lower than that of group 2，and ε，SRs，SRe were lower than those of group 3(P＜0.05).ConclusionsIn the process of coronary atherosclerosis，myocardial diastolic and systolic dysfunction occurred early and orderly，and has a bidirectional change：decreased firstly，then increased and decreased at last.

We innovated video assessment integrated teaching method on the basis of clinical case discussion,teaching rounds,problem-based learning,case method and micro teaching.According to this video feedback teaching,students became teaching subject and teacher acted as guide.In order to realize the purposes of early contact with clinical practice,more clinical practice and repeated clinical practice teaching,we implemented student-centered small class teaching,which was heuristic,inquisitive,interactive and was discussion-based.At the same time with the help of medical simulation equipment and video feedback teaching,this method developed students' life-long learning ability and work competence and combined theory with practice,demonstration with imitation as well as standards with innovation.This method was not only suitable for theoretical study but also for skills training,especially for standardization training.

Objective To discuss the psychological behavior intervention methods on reducing the violence behavior of schizophrenia patients. Methods 120 schizophrenia patients were admitted from January to December, 2007 and randomly assigned into the behavior intervention group (group A), the psy-chological support group (group B), the health education group (group C) and the control group (group D) with 30 cases in each group. Group A received routine nursing plus behavior intervention, group B was giv-en routine nursing plus psychological support, group C adopted routine nursing plus health education, group D only received routine nursing. The intervention effect was evaluated with MOAS and the relapse rate of violence behavior went through statistics. Results After intervention, the scores of MOAS decreased sig-nificantly in group A, B, C and D compared with those before intervention. The reduction of MOAS scores in group A, B and C was significantly higher than that of group D, with the highest reduction score in group A and group B and C followed subsequently. The relapse rates of the violence behavior in group A, B and C were significantly lower than those of group D. Conclusions Routine nursing, health education, psycho-logical support and behavior intervention can all reduce and decrease the violence behavior and the inci-dence of the violence behavior, among which behavior intervention proves to be the most effective, and psy-chological support and health education go subsequently.

Objective To investigate the effects of hypertension on left atrial myocardial properties by strain and strain rate(SR)imaging.Methods A total of 56 consecutive patients with hypertension were divided into 2 groups:33 with normal LVMI and 23 with left ventricular hypertrophy.These patients and 20 controls underwent transthoracic echocardiography,strain and SR imaging examination.Atrial strain and SR values of hypertensive patients were compared with those of controls.Results When compared with the controls,early diastolic SR(ESR)was significantly decreased in hypertensive patients(P＜0.01-0.001),with time to peak late diastolic SR corrected for heart rate(TASRe)significantly increased in normal LVMI subgroup(P＜0.05).Moreover,late diastolic SR(ASR)were significantly decreased(P＜0.05)in hypertensive patients with left ventricular hypertrophy as compared with normal LVMI.Conclusions Enlargement of left atrium leads to increased reservoir function in hypertensive patients,which compensates for the deterioration of conduit function.The duration of atrial systole may be prolonged to meet the need of ventricular filling in consequence of lower left atrial booster pump function.Noninvasive quantification of left atrial function by SR imaging enables evaluation of left atrial dysfunction due to hypertension.

Objective To investigate the effect of costimulatory molecules 4-1BB/4-1BBL on T cell activation with systemic lupus erythematosus(SLE)patients.Methods The expression of NF-kB mRNA and p38 MAPK mRNA of T cells with 20 SLE patients and 20 normal controls before activation,after activation and blocked bv 4-1BB/4-1BBL were detected bv RT-PCR.The protein levels of p-p38 MAPK and NF-kB were detected by Western blot.Results The expression of NF-kB mRNA and p38 MAPK mRNA and the protein expression of NF-kB and p-p38 MAPK of T cell with SLE patients were higher than that of normal controls(P＜0.01).There were more expression of NF-kB mRNA,p38 MAPK mRNA,NF-kB protein and p-p38 MAPK protein of T cell with SLE patients stimulated by anti-CD3 monoantibody(P＜0.01).In anti-4-1BB monoantibody blockage group,there were decreased expression of p38 MAPK mRNA and p-p38 MAPK protein(P＜0.01).but not the decreased NF-kB mRNA and protein expression.Conclusion Costimulatory molecule 4-1BB plays a critical role in T cell activation of SLE by p38 MAPK signal pathway.