At present, there is no specific antidote for local anesthetic toxicity, which seriously hindered therapeutic efficts of clinical treatment. It is increasingly urgent for finding find the effective antidote to local anesthetic. This article at-tempts to interpret the molecular pharmacological mechanism from fat pool, energy metabolism, NO, ion channel and solubili-zation for the role of fatty acids in reversal of myocardial toxicity of local anesthetics. And the different characteristics of the structure and function of nano liposome and fat emulsion were compared.

AIM: To study the tilt of the intraocular lens (IOL) after Nd:YAG capsulotomy (YAG) and variation of the axial length (AL) in patients with posterior capsular opacification (PCO).METHODS: The study involved 18 eyes of 14 patients with PCO after uncomplicated phacoemulsification surgery and IOL implantation.All patients had taken examinations,including testing best corrected visual acuity (BCVA) by using standard logarithmic visual acuity chart,images of ocular anterior segment and AL by OCT.After the examinations,YAG was operated upon all patients.Each eye received one drop of Diclofenac Sodium Eye Drops immediately after YAG,and patients had taken examinations listed above again.One week later,BCVA and OCT were tested as well.Data (BCVA,tilt of IOLs,and AL) were recorded and analyzed statistically by SPSS.RESULTS: Mean patient age was 73.93±6.94y,including 5 males and 9 females,8 left eyes and 10 right eyes,altogether 14 patients with 18 eyes.In this study,tilt of IOLs was defined as the angle of anterior surface of IOL and pupil plane (briefly called Tilt,unit:°).Before YAG,mean Tilt was 2.896±2.286°,mean AL was 23.56±0.55mm.1h after YAG,mean Tilt was 4.702±2.991°,mean AL was 23.40±0.59mm,and BCVA enhanced 3.72±1.74 lines.1wk after YAG,9 patients with 12 eyes were involved in the study.The mean Tilt of these 12 eyes was 3.175±1.791° 1h after YAG and 3.434±1.835° 1wk after YAG.There were significant differences between Tilt before YAG and Tilt 1h after YAG.There were no significant differences between AL before YAG and AL 1h after YAG.There were no significant differences between Tilt 1h after YAG and Tilt 1wk after YAG.The lines of enhancement of BCVA 1h after YAG was correlated to differences between Tilt before YAG and Tilt 1h after YAG,of which the correlation coefficient was-0.523.CONCLUSION: IOLs of patients with PCO tilted after YAG,while AL rarely changed.After YAG,the less IOLs tilted,the more BCVA enhanced.

Small cell lung cancer with brain metastasis is the most common type in brain metastasis tumors with the poor prognosis. Researches show that prophylactic cranial irradiation is not only effective in the prevention and treatment of limited disease brain metastases of small cell lung cancer,but also effective for extensive disease. Moreover,certain medications such as mannitol,nimustine etc also play an important sup-porting role,but there are many other uncertain parts in terms of prevention and treatment remaining controver-sial and needing further research.

Epithelial-mesenchymal transition (EMT) of cancer can enhance the abilities of invasion and metastasis of cancer cells,which is one of the reasons for treatment failure.Peroxisome proliferator-activated receptor gamma (PPARγ) is an important regulatory factor in EMT of cancer cells.Recent researches show that activation of PPARγplays a role in the occurrence and development of EMT by regulating the E-cadherin,Smad complex and body microenvironment.Therefore,in-depth research for the relationship among PPARγ,EMT and cancer is expected to provide a new direction for tumor treatment.

Hypoxia-inducible factor-1 (HIF-1) is one of the most important hypoxia signal transmission factor,and it has been observed in many human tumors.HIF-1 could play a role of promoting tumor by regulating the expression level of transforming growth factor-β in vivo and in vitro,and then affecting the development and prognosis of tumor.

At present, about 50 million people worldwide suffer from sarcopenia, and the number is expected to reach 500 million by 2050.Sarcopenia in the elderly will be one of the major global health problems in the future.In this article, current research status and progress of the pathogenesis, diagnosis, its correlation with other diseases and treatment of sarcopenia were analyzed.

Early diagnosis of hepatocellular carcinoma(HCC)is still a great challenge in clinical practice.Tumor markers such as alpha-fetoprotein(AFP),liver enzymes,cytokines,and some special glycoproteins,though helpful,are not sensitive and specific enough for early diagnosis of HCC.The establishment of several interesting predictive diagnostic models on liver fi- brosis/cirrhosis suggests that mathematic predictive model,which is developed based on large sample size and follow-up study, might be of higher sensitivity,specificity and feasibility in clinical application.Here we suggest that more attention should be paid to this kind of multi-parameter predictive diagnostic models clinically,so as to improve the early diagnosis of HCC in a more economical and feasible way.

The authors discussed the retention and revision of the Regulations on the Handling of Medical Malpractice following the enforcement of the Tort Liability Law.These discussions also covered the amendment of the concept of medical malpractice,and the reforms to make on the medical malpractice appraisal system built upon the Regulations following the enforcement.In the meantime of applying the Law to judge cases of medical malpractice,the Regulations as an administrative regulations issued by the State Council,should be revised before playing its role in preventing medical malpractice,medical dispute handling,and penalising medical institutions and medical workers of malpractice.

Objective To evaluate the effect of mechanical dilation on cardia achalasia under an endoscope.Methods A total of 62 patients with cardia achalasia were treated with mechanical dilation by using a self-designed dilator under a gastroscope.Of the cases,one had experienced a failure of heller surgery,and four had received ballon dilation before the gastroscopy.Results Among the cases,2 were convered to open thoracic surgery becaues of rupture of the esophagus,1 patient could not tolerate the operation,1 received a second dilation because of unsatisfied outcome of the first attempt.In the other 58 patients,the surgery was completed in the first attempt.The mean dilation time was 3.5 minutes(ranged from 2 to 5 minutes).Slight mucosal hemorrhage was observed during the operation,while no continuous bleeding occurred.Cold liquid diet was given to the patients 2 hours after the dilation,and then semiliquid diet was prescribed in 6 hours,after that the patients began to take normal diet gradually.The patients were followed up for 2 to 11 years with a mean of 7.5.All of them were cured without recurrence.Conclusions Endoscopic mechanical dilation is microinvasive,safe,and effective for cardia achalasia.It is worth being widely used because of a low cost and reliable long-term outcomes.

Objective To analyze the second time blood screening results of ALT deferred donors,and to evaluate the importance of alanine aminotransferase(ALT) testing on the improvement of blood safety.Methods The ALT testing results of 565 360 blood donors from Feb.2006 to Jan.2008 of Shanghai Blood Center were studied retrospectively.The screening results and donation intervals of such donors who delayed their donation just because of their former unqualified ALT level were also analyzed.Results A total of 32 042 donors(5.67%) failed in ALT testing among 565 360 donors.And 3 395 ALT deferred donors participated the second time blood donation,among which 2 205(64.95%) passed the blood screening tests,while the other 1 190(35.05%) failed.Among the 1 190 unqualified blood donors,1 151(33.90%)failed again in ALT testing,and 11(0.32%) in Syphilis,12(0.35%) in HBsAg,7(0.21%) in anti-HCV and 1 in anit-HIV(0.03%).Meanwhile,donors failed both in ALT testing combined with HBsAg,anti-HCV,and anit-HIV sero-converted were 1(0.03%),2(0.06%) and 1(0.03%),respectively.And 72.64% of ALT deferred donors participated the second time blood donation within 6 months.The average donation intervals of donors with qualified ALT level but sero-converted were 140 days(from 24 to 267 days),and those with both unqualified ALT level and sero-converted were 158 days(from 91 to 220 days).Conclusion Before the new methods such as NAT were applied to blood donation screening system,ALT test could prevent the window-period failure of ELISA screening so as to improve the blood safety.