Subjective visual perceptions experienced by patients during cataract surgery under local anesthesia have been given more and more attention now.Intraoperative visual experiences,including non-light perception,light perception,one or more color sensation,flash,movement,instrument,hands or fingers of surgeon etc.,are complained in parts of patients.These sensations and experience often lead to a fear of patient.Being aware of these intraoperative sensations of fear from patient is necessary for us to take the preventing strategy in advance.In addition,counseling of these patients prior to surgery may alleviate fears and improve the satisfaction of patient with surgery outcome.This paper reviewed the current studies on this phenomenon,discussed its clinical implications and possible mechanism,and suggested novel approaches to reduce its negative impact on the surgery.

Objective To evaluate the efficacy of endovascular stent-graft placement for the treatment of Debakey Ⅲ type aortic dissection. Methods From June 2001 to July 2006, 31 patients with Debakey Ⅲ type aortic dissection were diagnosed by contrast-enhanced CT scan. Vascular access was obtained through the right or left femoral artery after arteriotomy and stent-graft was deployed into the true lumen to occlude the primary entry tear. Immediate aortography was performed after the procedure and the follow-up data of CT scan were evaluated. Results Stent-graft deployment was successfully performed in all the patients. Immediate aortography after the procedure showed no leakage in 27 patients and minor leakage in 4. After the operation, one patient showed paraplegia, and one developed left arm ischemia. No stent movement or organ ischemia was found at the early postoperative stage in the other patients. Six months after the operation, in all the 31 patients, contrast-enhanced CT scan showed the disappearance of the false lumen and thrombosis at the level of the stent; and the minor leakage of was improved in the 4 patients. Four years after the operation, one patient developed severe internal leakage at the approximal end of the stent, and was treated by thoracotomy. Conclusions Endovascular stent-graft placement is effective for the treatment of Debakey Ⅲ type aortic dissection. However, further studies are needed to evaluate its long-term outcomes.

OBJECTIVE　To assess the efficacy and safety of Lipobay (cerivastatin) and Jingbishuxin (simvastatin) on lipid profiles.METHODS　40 patients with hypercholesterolemia were randomizedly divided into Lipobay group (0.3 mg,QN) and Jingbishuxin group (domestic simvastatin tablet) (20 mg,QN)for 4 weeks.Total cholesterol (TC),low density Lipoprotein cholesterol (LDL-C),triglyceride (TG) and high density lipoprotein cholesterol (HDL-C),blood sugar,hepatic and renal function,blood and urine regular test were measured before and after the treatment.RESULTS　After 4 weeks of treatment,TC,LDL-C and TG were reduced by 29.02%,29.95%,17.21% in Lipobay the group and 22.48%,28.68%,14.74% in Jingbishuxin group,respectively.Compared the measurements after treatment with that before treatment,there were significant differences in both groups,but there was no significant difference between them.No serious adverse effect was found.CONCLUSION　Lipobay had a same efficacy and safety on lipoprotein profiles as that of Jingbishuxin in elderly.It has a good tolerance with smaller dose.

Objective To analyze the impact of extent of mitral valve stenosis on the short and longterm outcome of percutaneous balloon mitral valvuloplasty (PBMV) in patients with mitral valve stenosis.Methods Two hundred and eighty-four patients with mitral valve stenosis were divided into two groups according to the Wilkins scoring system,and 191 cases whose score ≤8 were classified as group A,while the rest were classified as group B.All the patients were using the modified Inoue balloon method.Patients of successful PBMV were followed up at least 48 months and the efficiency was compared between two groups.Results The success rate of PBMV was 97.9％(187/191) and 92.5％(86/93) in group A and group B,there was significant difference between two groups (P ＜ 0.05).Echocardiography parameters improved significantly in both groups at 6 months after PBMV compared with those before PBMV (P＜ 0.05).Compared with those in group A,the changes of left atrial mean pressure [(14.31 ± 4.79) mm Hg (1 mm Hg =0.133 kPa) vs.(15.42 ± 5.14) mm Hg],across the valve pressure difference [(9.18 ± 4.66) mm Hg vs.(10.21 ± 4.38)mm Hg],pulmonary arterial systolic pressure [(26.21 ± 8.76) mm Hg vs.(32.04 ± 9.58) mm Hg],mitral valve orifice area [(1.01 ±0.16) cm2 vs.(1.21 ±0.18) cm2] after PBMV in group B were less (P＜0.05).Long-term follow-up (48-92 months) was completed in 273 successful cases and echocardiography parameters after PBMV improved significantly in both groups compared with those before PBMV during follow-up (P＜ 0.05).Compared with those in group A,the changes of left atrial mean pressure [(12.91 ±5.00) mm Hg vs.(15.1 7 ± 5.14) mm Hg],across the valve pressure difference [(7.26 ± 4.58) mm Hg vs.(9.63 ± 4.22) mm Hg],pulmonary arterial systolic pressure [(20.54 ± 7.68) mm Hg vs.(29.11 ± 8.53)mm Hg],mitral valve orifice area [(0.92 ±0.15) cm2 vs.(1.09 ±0.18) cm2] after PBMV in group B were less (P＜ 0.05).The incidence of mitral restenosis was also significantly higher in group B than that in group A [19.8％(17/86) vs.8.0％(15/187)],and there was significant difference (P ＜ 0.05).Conclusions The extent of mitral valve stenosis plays a key role on the outcome of PBMV in patients with mitral valve stenosis.Patients with lower echocardiography scores benefit more from PBMV than patients with higher echocardiography scores.

AimTo observe the effect of infiltration of Methylprednisolone on injured spinal nerve root and the protective function of Methylprednisolone to non-impressed spinal nerve root lesion. Methods The spinal nerve roots were injured in 20 rabbits. Three days later local Methylprednisolone infiltration of spinal nerve root profromed in rabbits in experiment group, while rabbits in the control roup received equal amount of 0.9% natriichloridi instead. The conduct velocity of spinal nerve root was measured one week after operation. The histological change of spinal nerve root and immunohistochemical stain of posterior horn of spine were observed by microscope. Results The conduct velocity was recovered obviously in experiment group. In observation of spinal nerve we found the edema and hyperaemia of matrix were impaired obviously, the lesion focus was minimized, the amount of inflammatory cells was decreased. The area of substance P positive fiber and its terminus in posterior of spinal was smaller in experiment group remarkably than in control group. ConclusionsThe local infiltration of Methylprednisolone can relieve inflammation, inhibit the transmission of pain and accelerate recovery of spinal nerve root.

Objective To survey the faculty doctors in psychiatric specialist training basement of Sichuan Province so as to provide a foundation for improving the faculty's ability and to promote the psychiatric specialist doctors training project.Methods To survey the 90 psychiatric specialist training faculty doctors by giving out a self-made questionnaire.Factor analysis were done by adopting SPSS 13.0.Results There were 90 self-made questionnaires given and 90 received.The effeetual questionnaires were 84.The results showed as follows:the average age of faculty doctors was 38.56±8.04,the average teaching time Was 14.32±8.44,faculty doctors with bachelor degree and more were 80.95%,the ratio of full-time teachers was 5.95%,the ratio of primary titles was 27.40%,the ratio of middle tides was 22.60%,the ratio of vice-senior titles was 33.30%,the ratio of senior titles was 16.70%;the ratio of the faculty doctors who enrolled in system training program was 28.57%,the ratio of the training time less than half year was 71.43%,the ratio of wanted to take part in system training was 95.24%.Conclusion The constitute of the faculty doctors'age.degrees and title were reasonable.But the teachingtime Was short and there were short age of full-time teachers.The time of system training was rather short.The faculty doctors demanded to take part in system training program.

Aim To observe the expressions of KLF4 in the myocardium of diabetic mice and their changes under Tongxinluo capsule intervention. Methods For-ty KK/Upj-Ay mice were randomly divided into diabet-ic model group(n=10)and diabetic model with Tongx-inluo(TXL low,middle,high) groups(n =10,respec-tively). C57BL/6 mice were selected as control group ( n=10 ) . At the end of the 3 th month the mice were sacrificed and were weighed. The fasting blood-glucose (FBG),glycosylated hemoglobin(HbA1c),triglyceride ( TG) ,total cholesterol ( TC ) and insulin ( FINS ) were measured to calculate HOMA-IR. Radioimmunoassay was used to measure serum TNF-αand IL-6 . The path-ological changes in the myocardium of mice were ob-served by HE staining. KLF4 mRNA was examined by Real-time PCR, while KLF4 and NF-κB protein were measured by Western blot. Results Compared to the control group,FBG,HbA1c,TG,TC,FINS,HOMA-IR,
TNF-α and IL-6 in model group were markedly in-creased;the expressions of myocardial KLF4 were markedly decreased and the expression of nuclear NF-κB protein were markedly increased ( P < 0. 01 ) . Tongxinluo capsule could significantly reduce myocar-dial pathological damage, FINS, TG, TC, TNF-α, IL-6 level and the expression of nuclear NF-κB protein and up-regulate the expression of KLF4 ( P <0. 05 ) , but had no effect on FBG and HbA1c(P>0. 05). Conclu-sions KLF4 may be involved in the development of myocardial injury during diabetes. Tongxinluo capsule can ameliorate the myocardial damage and improve the function of diabetic myocardium by up-regulating the expression of KLF4 and inhibiting the activation of NF-κB inflammatory signal pathway.

[Summary] Minimally invasive hybrid coronary revascularization ( MIHCR) represents a minimally invasive revascularization strategy that combines coronary artery bypass graft ( CABG) surgery with percutaneous coronary intervention ( PCI) .Although MIHCR is better than coronary artery bypass graft surgery in theory , there is no useful randomized controlled trial to prove the advantage of MIHCR in recent medical papers .In this paper , we reviewed different aspects of MIHCR , such as basic definitions , basic rationale , indications , operation selection and current problems .

Objective:To classify the types of radiographic feature of central salivary gland type malignant tumors of the jaws(CSMTJ) with studying the clinical data,radiographic characteristics and pathological classifications,and to help the diagnose CSMTJ correctly and effectively in future. Methods:The clinical,radiological and pathological features of 62 cases of CSMTJ were studied and summarized. Among these cases,52 cases were collected from the medical records of patients of the internal databank according to the World Health Organization (WHO) Histological Classification of Salivary Gland Tumors standard and 10 cases of CSMTJ were from Guangdong Provincial Stomatological Hospital. Results:The maxilla to mandible ratio was 1∶1.7,Among CSMTJ cases,central mucoepidermoid carcinoma of the jaws (CMCJ) was the most common pathological type and the second was central adenoid cystic carcinoma of the jaws(CACCJ). 62 cases of CSMTJ could be classified into four types:Unicystic type,Multicystic type,"Flame shape" type and Osteolytic type. Conclusion:The radiographic presentation of CSMTJ was very complicated and its classification was connected with tumor malignant degree. The classification was very helpful to determine the treatment methods and the prognosis of the CSMTJ.

There is a close relationship between osteoporosis and osteoarthritis .The joints of bearing weight often suffer the osteoarthristis with osteoporosis .There are some symptoms in the disease ,such as pain and motion disorder ,and joint abnormality in late＋ stage .The principle of rehabilitation is to improve osteoporosis , release pain and increase the function if motion .The treatment includes medicament ,acupuncture ,injection ,rehabilitation ,psychology and surgery therapies .The injection can release pain effectiverly .The methods of rehabilitation include physical therapy,exercise ,massage ,and occupational therapy.These therapies can release pain ,improve motion and increase the quality of life .The article reveiws the clinical symptoms ,diagnosis and treatment ,especially the rehabilitation therrapy.