corrected visual acuity and good visual quality are clinic effects standard of laser in situ keratomeleusis.Visual quality descending for patients after LASIK surgery depends on many factors.This review recommends analyses the influence of visual quality for patients after LASIK surgery and it's guiding significance to LASIK from seven sides,such as visual acuity,refactive diopter,contrast sensitivity,wavefront aberration,increment of Q-value,binocular visual function,the change of dominant eye.

Objective: To evaluate ultrasound biomicroscopy(UBM) in the surgical treatment of glaucoma complicated by cataract and in the observation of the post-operation changes of the anterior chamber angle and its related structure in patients with primary angle-closure glaucoma(PACG).Methods: Combined surgery of phacoemulsification,intraocular lens(IOL) implantation and trabeculectomy was performed in 30 patients(30 eyes) with cataract and PACG.The changes of the anterior chamber angle and anterior chamber distance were determined by UBM before and 1 month after the operation.At the same time,intraocular pressure was recorded and analyzed.Results:Intraocular pressure was obviously decreased after the operation.There were significant differences between pre-and post-operation in ACD,AOD500,TIA and TCPD(P0.05).Conclusion: Combined surgery for glaucoma and cataract could deepen the anterior chamber,widen the chamber angle,and reopen the trabeculae,which contributes to the control of intraocular pressure and reduces postoperative complications such as shallow anterior chamber.Long-term effect of the surgery needs to be further investigated.

Breast cancer is called "Ruyan" in literature of traditional Chinese medicine. We synthesized the ancient and contemporary discussions and raised the theory that "Duxie" (poisonous pathogenic factor) is the etiological factor and pathologic product through the whole course of breast cancer. "Liuyin Fudu" (latent poison of six exogenous pathogenic factors) and "Qiqing Yudu" (stagnant poison of seven emotions) are the main etiological factors affecting the breast cancer occurrence. "Aidu Neisheng" (internal product of cancer poison) is the essential change in breast cancer occurrence. "Tandu Yujie" (stagnation of phlegm, poison and blood stasis) is the essential pathogenesis of the breast cancer's development. "Yudu Weiqing" (vestigial poison) is the main pathogenesis of breast cancer after operation. "Yudu Pangcuan" (vestigial poison invasion elsewhere) is the key pathogenesis of recurrence and metastasis after operation. "Sanjie Jiedu" (dispersing accumulation and detoxification) is an important therapeutic principle in breast cancer's treatment after operation. The "Tandu Yujie" pathogenesis theory and "Sanjie Jiedu" therapeutic principle developed the theory about breast cancer in traditional Chinese medicine, and have some clinical application value.

OBJECTIVE: To observe the effect of Ruyiping, a traditional Chinese compound herbal medicine composed of 5 Chinese herbs for removing toxic materials and dissipating nodules from Runing II, another traditional Chinese compound herbal medicine for treating breast cancer, in preventing recidivation and metastasis in breast cancer patients after operation. METHODS: Eighty patients with breast cancer after operation were randomly divided into Ruyiping group and Runing II group, and prescribed Ruyiping and Runing II on the basis of chemotherapy, radiotherapy and endocrine therapy respectively for two years. RESULTS: There were two patients with metastasis and three patients lost to follow-up in Ruyiping group and three and two in Runing II group. The recidivation and metastasis rates were 5.41% and 7.89% respectively. The difference between the two groups was not statistically significant (P>0.05). The difference of disease-free survival time between the two groups was also not statistically significant. CONCLUSIONS: The effect of Ruyiping in preventing recidivation and metastasis is similar to that of Runing II. Ruyiping is the essential component of Runing II for preventing recidivation and metastasis. The result provides some clinical evidences for the theory that "Yudu Pangcuan" (vestigial poison invasion elsewhere) is the essential pathogenesis of breast cancer's recidivation and metastasis and the utilization of "Sanjie Jiedu" (dispersing accumulation and detoxification) is the therapeutic principle in preventing recidivation and metastasis after operation.

Background Full femtosecond laser refractive surgery has been generally applied,but the improvement of visual quality after surgery is a vital problem.It is well-known that modulation transfer function (MTF) is a major evaluation indicator.Objective To investigate the change of the MTF of operated eyes after the full femtosecond laser refractive surgery.Methods A retrospective series of cases study was adopted.Forty eyes of 23 patients with the spherical equivalent of-2.25 to-5.75 D who received full femtosecond laser refractive surgery were enrolled in Nanjing General Hospital of Nanjing Military Command from July to October,2012.The change of visual acuities was analyzed and compared among before operation and 1 day,1 week and 1 month after operation.MTF value in total aberration,low and high order aberrations under the 3.0 mm and 6.0 mm pupil size conditions were detected with i-Trace Visual Function Analyzer at above time points.The MTF values among various time points,between different pupil diameters and different spatial frequencies (5,10,15,20,25 c/d) were compared respectively.Results Compared with the preoperation,the visual acuity improved in postoperative 1 day,1 week and 1 month,showing a significant improvement among various time points (F =10.341,P =0.000).Corrected diopter was 3.795 D at average.MTF values under the 3 mm pupil diameter gradually elevated with the lapse of time after operation,without significant differences among different time points whatever total aberration,low and high order aberrations(all at P＞0.05).The MTF values under 6 mm pupil diameter of total aberration and low order aberration were significantly higher in postoperation than those in preoperation(all at P＜0.05),but no significant difference was seen in MTF of high order aberration among various time points (F =0.260,P =0.854).Compared with the MTF under the 3 mm pupil diameter,those of low and high order aberrations under the 6 mm pupil diameter considerably declined in preoperation and postoperative 1 month (preoperation:P =0.050,0.001 ; postoperation:P =0.012,0.001).MTF values under the 3 mm pupil diameter were not different at various spatial frequencies (all at P＞ 0.05).However,MTF values under the 6 mm pupil diameter were gradually increased from preoperation through postoperative 1 month at 10,15,20 and 25 c/d (P =0.044,0.043,0.024,0.014).Conclusions Full femtosecond laser refractive surgery can eliminate low aberration,increase the MTF and acuity,and therefore improve the visual quality.MTF is one of the key indicators assessing visual quality after full femtosecond laser refractive surgery.

Objective: Epi-LASIK appeared to be effective and safe in the treatment of high myopia,but some patients complain about visual symptoms postoperation.The purpose of this study was to evaluate the high order aberrations(HOAs) of the vision-decreased eyes treated by Epi-LASIK,and to analyze the causes of postoperative glare,scieropia and monocular diplopia.Methods: We evaluated 76 eyes of 49 patients treated by Epi-LASIK with a questionnaire three months after surgery,and from them selected 34 eyes of 27 patients who scored less than 80 points and complained of postoperative visual symptoms,including glare(25 eyes in 20 patients),scieropia(7 eyes in 5 patients)and monocular diplopia(2 eyes in 2 patients).Another 42 symptom-free eyes of 22 patients treated by Epi-LASIK were included in the control group.The root mean square(RMS) of total HOAs,coma and SA were determined with the iTrace Visual Function Analyzer from the central 6.0 mm zone,and the modulation transfer function(MTF) was simulated with the iTrace 3.1 software.Results: Significant differences were found in the RMS of total HOAs,coma and SA between the eyes with visual symptoms and those without,and the values of ablation zone decentration were significantly higher in the former than in the latter(P

OBJECTIVE: To observe the effects of Ru'ai Shuhou Recipe (RSR), a compound traditional Chinese herbal medicine, on 5-year recurrence rate after mastectomy in breast cancer. METHODS: A total of 300 patients with breast cancer were divided into two groups: treatment group and control group. The patients in the treatment group were treated with Western medicine and RSR, and the patients in the control group were treated only with Western medicine (the same as the treatment group). In the two groups, the 5-year recurrence rates after mastectomy in breast cancer were investigated. RESULTS: Thirty-four breast cancer patients were lost to five-year follow-up during the course of investigation, and 266 breast cancer patients went through the evaluation. The 5-year recurrence rate after mastectomy in the treatment group was significantly lower than that in the control group (P<0.05). The recurrence rate after mastectomy was influenced by positive lymph node, primary breast tumor size, clinical stage, and patients' health status. There was significant difference in the 5-year recurrence rates between the two groups (P<0.05) under the following conditions, such as the positive lymph nodes more than four, the primary breast tumor larger than two centimeters, and in the clinical stage II and III, estrogen receptor (ER)-positive/progesterone receptor (PR)-positive and ER-negative/PR-negative. The recurrence rate was not associated with the operation method and age distribution. CONCLUSION: RSR can reduce the 5-year recurrence rate after mastectomy in breast cancer.

Objective Acrysof IQ Restor multifocal toric intraocular lens ( IOL) is a new product , which allows a single sur-gical procedure for presbyopia correction and corneal astigmatism management .This study was to evaluate the early clinical effects of phacoemulsification cataract surgery with implantation of a diffractive multifocal toric IOL . Methods We retrospectively analyzed 7 cases (9 eyes) of corneal astigmatism ≥1.0 diopter (D) treated by phacoemulsification with implantation of an Acrysof IQ Restor toric IOL.The patients were followed up for 3 months for observation of uncorrected distance visual acuity ( UDVA) , best corrected distance visual acuity ( CDVA) , uncorrected near visual acuity ( UNVA ) , best corrected near visual acuity ( CNVA ) , spherical equivalent (SE) refraction, focal depth, residual astigmatism, rotational stability of the IOL, contrast sensitivity (CS), and spectacle independ-ence preoperatively and at 1 week, 1 month, and 3 months after operation . Results At 3 months after surgery , the UDVA ( log-MAR), CDVA, UNVA, and CNVA were 0.07 ±0.10, 0.02 ±0.11, 0.12 ±0.06, and 0.08 ±0.07, respectively, with an SE re-fraction within ±0.50 D of the attempted spherical correction in 8 eyes (88.9%) and a focal depth of (5.32 ±1.78) D.The residual astigmatism at 3 months was significantly reduced as compared with the baseline ([0.25 ±0.28] vs [1.55 ±0.39] D, P<0.05), but showed no statistically significant differences from the preoperative an-ticipated residual astigmatism (P>0.05).At 3 months, the mean IOL axis rotation was (3.11 ±1.61)°and CS was remarkably im-proved ( P<0 .05 ) , while CS with or without glare was not significantly different from that at 1 month at all spatial frequencies ( P>0.05) except at 18.0 cpd (P<0.05). Conclusion Implantation of the Acrysof IQ Restor multifocal toric IOL provides excellent overall quality of vision, spectacle independence, visual quality, and rotational stability for patients with cataract and corneal astigmatism.

Objective To investigate whether cerebral microbleeds (CMBs) can predict hematoma expansion in hypertensive cerebral hemorrhage bleeding.Methods One hundred and forty-four patients with hypertensive cerebral hemorrhage bleeding in 6 hours after the onset of symptom were included.Gradient echo pulse sequence-T2 WI (GRE-T2 WI) and computed tomography (CT) were performed to detect the size of hematoma in half an hour after hospital admission.Based on the performance of GRE-T2 WI,patients were divided into microbleeds group and no microbleeds group.CT was performed 24 and 72 hours later to check whether hematoma was enlarged,the ratio of hematoma enlargement and the increased hematoma volume were compared between 2 groups.Results A variable number of CMBs were found in 74 cases by GRE-T2WI on admission.The hematoma volume was increased in 12.5％ (18/144) of patients by CT 24 hours later,and in 13.9％ (20/144) by CT 72 hours later.The ratio of CMBs in microbleeds group was higher than no microbleeds group significantly (70.0％ (14/20) vs 48.4％ (60/124),x2 =4.221,P ＜0.01).Besides,the ratio of the patients with the increased hematoma volume in microbleeds group was significantly higher than no microbleeds group(17.6％ (13/74) vs 10.0％ (7/70),x2 =3.172,P ＜ 0.05).Logistic multiple regression showed that CMBs was the only risk factor which could enter regression equation (OR=2.213,95％CI 1.320-2.972,P＜0.01).Conclusion CMBs patients with hypertensive cerebral hemorrhage bleeding in GRE-T2WI can predict the high risk of hematoma expansion.

Objective:To describe and analyze the clinical manifestations of patients with orofacial pain of temporomandibular disorders (TMD).Methods:A retrospective study on orofacial pain was conducted for 3 425 patients diagnosed as TMD based on clinical symptoms and signs in the Department of Temporomandibular Disorders and Orofacial Pain, School of Stomatology, The Fourth Military Medical University. The patients included 1 158 males and 2 267 females with a median age of 32 years. The gender, age, course of disorders, pattern and site of pain, CT imaging diagnosis of temporomandibular joint (TMJ) were analyzed. The distribution of gender, age and disorder course interval were described. The differences in frequency of the pattern and site of pain, imaging diagnosis in different gender, age and disease course interval were compared. Chi-square test and non-parametric rank sum test were performed using software SPSS 23.0.Results:Of the 3 425 patients, 29.1% (997/3 245) had signs of joint popping, and 40.1% (1 373/3 425) had restricted opening. The pain frequency was higher in males who had disorder course less than 1 month ( P<0.01) and also in males who had open-and-close and/or lateral excursion and/or protrusion pain without tenderness or other pain without tenderness ( P<0.05). However, the pain frequency was higher in females who had tenderness ( P<0.01). The pain frequencies in those over 56 years old with tenderness combined with open-and-close and/or lateral excursion and/or protrusion pain were higher than in patients of other ages ( P<0.01). In patients with unilateral TMJ pain, the frequency in males was higher than females( P<0.01), while the frequency in females was higher in patients with unilateral TMJ pain combined with unilateral or bilateral myalgia and the frequency was higher in patients under 15 years old having bilateral TMJ pain and/or unilateral or bilateral myalgia ( P<0.05). In patients with unilateral TMJ pain, the frequency in those with disorder course≤1 month was higher than in those with other disease duration intervals ( P<0.01), while in patients with bilateral myalgia or TMJ pain plus unilateral or bilateral myalgia, the frequency in those with disorder course>3 years was higher than in those with other disease duration intervals( P<0.01). In patients with unilateral TMJ pain, the frequency was higher in those having open-and-close and/or lateral excursion and/or protrusion pain ( P<0.01). In patients with unilateral myalgia and bilateral myalgia, the frequency was higher in those having tenderness ( P<0.01). The frequency of TMJ space changes in male patients was higher than females and the frequency of hyperosteogeny and resorption in females were higher than males ( P<0.05). The frequency of TMJ space changes and developmental problems were higher in patients aged 16 to 35 years, while the frequencies of hyperosteogeny, bone resorption and cystis in those over 56 years were higher than other ages ( P<0.01). The frequency of TMJ space changes in patients with disorder course≤1 month was higher than in those with other disease duration intervals ( P<0.01), while the frequency of hyperosteogeny was higher in patients with disorder course>3 years ( P<0.01). Conclusions:The male to female ratio in the present patients with orofacial pain of TMD was about 1 to 2. Most of the patients visited hospital within half a year after the disorders occurred. The pattern and site of the orofacial pain, signs on TMJ CT images showed some distribution regularities in views of gender, age and disorder course.