At lower lumbar levels the exiting nerve root is at risks of injury. Hence, it is advised to enlarge the foramen for safe passage of endoscopic instruments and to minimize the possibility of nerve injury.

The purpose of this study was to describe radiologic anatomy of the left atrium diverticulum. There were 20 patients with 27 left atrium diverticulums in 120 consecutive patients who underwent CT of coronary angiography. The presence probability of left atrium diverticulum was 16.7%, male of it was 13.0%, female was 17.6%. There was no difference on gender (P > 0.05). There were four patients accompanying with variation of pulmonary vein at one time. The diverticulum might be single or multiple, cystiform or tubiform. It could locate anterior wall or posterior wall or superior wall of left atrium. Left atrium diverticulums which was single, cystiform, and located in anterior wall were common. The cervix width of diverticulum was 4.9 +/- 3.2 mm, the body height of them was 5.4 +/- 2.0 mm. The ratio of body height to cervix width was from 0.47 to 4.08 (median 1.16). Ten patients of them undertook cardiac ultrasound examination at same time. There were five patients who left atrial diastolic function decreased, four patients who left ventricular systolic function decreased. Three of them both existed left atrial diastolic function decreasing and left ventricular systolic function decreasing, accompanied with mitral or aortic regurgitation. No patient was found that left atrium pressure or left ventricle diastolic pressure was increasing. The left atrium diverticulums of ten patients were probably congenital because their hemodynamical status cannot lead to diverticulum formation. It can be proved by reexamination after therapy or autopsy at last. In conclusion, multi-detector row computed tomography could provide anatomy details of left atrium diverticulum to help to finish heart and chest surgery successfully.

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HIGHLIGHTS • Bi 2 Se 3 @AIPH nanoparticles (NPs) can realize photothermal and photodynamic therapies in a cascading manner when exposed to "one" single NIR laser. • Hyperthermia produced by Bi 2 Se 3 NPs under NIR laser irradiation cannot only be used for photothermal therapy, but also the "switch" for controlled release of AIPH and excitation of free radical at the tumor site. • Free radical produced by thermal-responsive decomposition of AIPH is oxygen-independent, which treats hypoxic tumor well and further enhances immune response.