The neurological damages of adult endemic cretinism in Tianjin GI Xian were studied with SPECT, CT, EEC, MRI. The abnormalities of blocd vessels and brain tissue, associated with the insufficiency of bleed supply arid delayed brain-development were found in these patiems. However the auditory examinations demonstrated that the pathegenesis of hearing defect was mainly at the auditory center in the temperal lobe. It was suggested that the irreversible patholcgicat damages of the blood vessels and brain development were caused by the. insufficient biosynthesis and secretion of thyroid hormone which was resulted from the delayed development and dysfunction of thyroid gland at the fetal stage.

Objective To assess the curative effects of simvastatin combine with low molecular weight heparin in patient with unstable angina.Methods The papers from China Academic Journal ( CNKI),Chongqing VIP (VIP),PubMed database were retrieved by computer,15 randomized controlled trials( 1206 patients) were included for Meta-analysis.ResultsThe overall efficiency of the two groups were compared by Fixed effects model:x2 =2.62,Consolidated RR =1.30 (95％ CI:1.23 ～ 1.38 ) ; the number of attacks after treatment of the two groups were compared by random effects model:x2 =1231.87,WMD =- 2.68 ( - 5.82,0.5 ) ; the duration time of attacks after treatment in both groups were compared by random effects model:x2 =1231.87,weighted mean difference =-2.68(-5.82,0.5).Conclusion Simvastatin combine with low molecular weight heparin could improve the overall efficiency on patient with unstable angina,and could not reduce the number of attacks after treatment,but could reduce the duration time of attacks after the treatment.

ObjectiveTo observe the therapeutic effect of nicorandil in treatment of angina pectoris. Methods155 cases of angina pectoris patients were randomly divided into the therapeutic group(85 cases)and control group(70 cases),both of which took normal doses of aspirin vitamin C effervescent tablets 0.1g/day,clopidogrel 50mg/day,elantan 50mg/day and simvastatin 40mg/day,where hypertensions or diabetics were given blood pressure and sugar control and heart failure patients were given proper diuretic therapy and other methods to release heart Ioad.Patients in the therapeutic group were additionally given 5 mg nicorandil,3 times/day.The two groups were both given one period of treatment about one month. ResultsIn therapeutic group,32 cases had significant therapeutic effectiveness,34 cases had effectiveness and 14 cases had no effectiveness with a total effective rate of 82.5%.In the control group,23 cases had significant therapeutic effectiveness,28 cases had effectiveness and 24 cases had no effectiveness with a total effective rate of 67.0%.The comparative difference of the total effectiveness of the twogroups had statistical significance(x2 =4.40,P＜0.05).No other significant adverse reaction was found except several cases of light dizzy in the two groups. ConclusionNicorandil has good therapeutic effective in treatment of angina pectoris and no significant adverse reaction.

Objective To review the survival outcomes in patients with endometrial stromal sarcoma(ESS)in Cancer Hospital，Peking Union Medical College，Chinese Academy of Medical Sciences，and to discuss prognostic factors and the role of post-operative adjuvant radiotherapy and chemotherapy.Methods Hospital records and pathology reports for 97 patients with ESS were reviewed.Among 97 patients，69 had low-grade ESS(LGESS)，16 had high-grade ESS(HGESS)and 12 had unclear grade.The median age at diagnosis was 44.0 years.The median follow-up time was 62 months(5-277 months).Atypical vaginal bleeding(43％)and prolonged and increased menses(36％)were the main symptoms.Results Totally 2-year and 5-year cumulative survival rates were 93％and 84％，respectively.Cumulative survival curves were significantly different between LGESS and HGESS，and so did cumulative survival curves between stage Ⅰ-Ⅱ and stage Ⅲ-Ⅳ(P＜0.05).Totally，34 patients(37％)had local or distant recurrence.The median time-to-recurrence(TTR)was 27 months.The recurrence rates of the patients with or without preserve of ovary were 89％and 24％，respectively(P=0.000).The local-control-rates of the patients who received or did not receive post-operative radiotherapy were 81％and 43％，respectively(P=0.011).Conclusions The prognosis of HGESS is obviously worse than that of LGESS.The risk of recurrence of patients with preserve of ovary was remarkably higher than that of patients without preserve of ovary.Postoperative radiotherapy could increase the local-control-rates.

Objective To compare the positioning accuracy between personalized polyurethane foam with wing boards and negative pressure vacuum bag in radiotherapy for lung cancer using kilovoltage cone beam computed tomography(CBCT). Methods Thirty-nine patients with lung cancer who received chest radiotherapy in our hospital from 2015 to 2016 were enrolled as subjects. In those patients, 20 were immobilized by negative pressure vacuum bags(VB group)and the others by personalized polyurethane foam with wing boards(PF group).CBCT images were acquired weekly and registered with planning CT images. Setup errors in the left-right, superior-inferior, and anterior-posterior directions, three-dimensional(3D) displacement vector,and setup time were recorded. The margin of the planning target volume(PTV)was calculated using the Van Herk formula(2.5∑+0.7σ). Between-group comparison was made by paired t test. Results The PF group had a significant smaller setup error in the y-direction than the VB group (2.54±1.79 vs.3.19±2.14 mm,P=0.03),while there were no significant differences in setup errors in the x-or z-direction between the two groups(1.80± 1.48 vs. 1.90± 1.41 mm, P=0.46;2.14± 1.75 vs. 2.25± 1.75 mm,P=0.35). There were no significant differences in rotational setup errors in the Rx-,Ry-,or Rz-direction between the two groups(1.15°±0.76°vs. 1.15°±0.85°, P=0.50;0.71°±0.60°vs. 0.72°±0.43°, P=0.45;0.62°±0.54° vs. 0.46°±0.30°,P=0.06). The PTV margins in the x?,y?,and z?directions were expanded by 5.56, 8.57, and 7.02 mm, respectively, in the PF group, and by 5.62, 9.27, and 7.23 mm,respectively,in the VB group. The proportion of patients with 3D displacement vectors larger than 5 mm was 40% in the PF group and 45% in the VB group.Conclusions For patients undergoing radiotherapy for lung cancer,personalized polyurethane foam with wing boards can,to a certain extent,reduce the setup error in the superior-inferior direction and PTV margin expansion.[Key words] Lung neoplasms/radiotherapy; Polyurethane foam; Vacuum bag; Setup errors;Margin

Objective To evaluate the efficacy of different treatment options for cholecysto-choledocholithiasis (CCL),and try to find the ideal treatment.Methods From January 2006 to January 2016,a total of 3 107 patients with CCL from the Affiliated Hospital of Inner Mongolia Medical University were enrolled.Among them,1 283 patients were in open cholecystectomy (OC) and open common bile duct exploration (OCBDE) group,964 patients were in laparoscopic cholecystectomy (LC) and laparoscopic common bile duct exploration (LCBDE) group,and 860 patients were in endoscopic retrograde cholangiopancreatography (ERCP) + LC group.The clinical data of the three groups were analysed.One-way analysis of variance and chi-square test were performed for statistical analysis.Results From 2006 to 2010,the percentage of patients treated with OC + OCBDE,LC + LCBDE,and ERCP + LC were 56.05％ (829/1 479),25.15％ (372/1 479) and 18.80％ (278/1 479),respectively;from 2011 to 2016,the percentage of patients received the above three treatments were 27.89％ (454/1 628),36.36％ (592/1 628) and 35.75％ (582/1 628),respectively.The difference in the proportion of the same treatment at different times was statistically significant (x2 =4.775,4.168 and 0.669,all P ＜ 0.05).The success rate of surgery in the OC + OCBDE group was 100.00％ (1 370/1 370);while the success rate of surgery in the LC + LCBDE group was 94.26％ (920/976),and 56 patients converted to OC + OCBDE;the success rate of surgery in the ERCP + LC group was 95.00％ (817/860),and 31 patients converted to OC + OCBDE,and 12 patients to LC + LCBDE.The intraoperative complication in OC + OCBDE,LC + LCBDE and ERCP + LC were 2.85％ (39/1 370),3.48％ (32/920) and 1.22％ (10/817),respectively.The incidence rates of postoperative complication were 4.89％ (67/1 370),5.34％ (50/920) and 5.51％ (45/817),respectively.The incidence rates of intraoperative complication of the ERCP + LC group was lower than that of OC + OCBDE group and LC + LCBDE group,and the differences were statistically significant (x2 =6.203 and 3.001;both P ＜ 0.05).However there was no significant difference in incidence rate of postoperative complications among the three groups (all P ＞ 0.05).The hospital stay of the OC + OCBDE group,the LC + LCBDE group and the ERCP + LC group were (6.7 ± 1.3) days,(5.6 ± 1.2) days and (10.9 ± 1.6) days,respectively,and the differences were statistically significant (F =90.010,P ＜ 0.01).The hospitalization expenses of OC + OCBDE group,LC + LCBDE group and ERCP+LC group were (13 720±1 910) yuan,(18 150±1 490) yuan and (25 830 ± 2 430) yuan,respectively,and the differences were statistically significant (F =302.991,P ＜ 0.01).Conclusion The first choice of patients with CCL is endoscopic minimally invasive treatment and open surgery can be used as a remedial method for endoscopic treatment.

Objective:Based on the theory of demand analysis theory, to build teaching resources of human physiology course and explore its application effect.Methods:The three-year nursing junior college students of Batch 2018 were selected as the research objects. According to the principle of randomization, the students were divided into the observation group (97 cases) and control group (99 cases). Students in the observation group used integrated teaching resources from the perspective of demand analysis, while students in the control group used traditional curriculum resources. After the end of the course, the differences between the two groups of students' theoretical and practical assessment results and teaching experience were compared SPSS 20.0 was used for t test. Results:The results of theoretical [(73.67±8.76) vs. (70.48±8.36)] and practical skills [(84.41±4.83) vs. (83.63±4.27)] in the observation group were significantly different from those in the control group ( P<0.05). The overall scores of 9 teaching effect sub-items, such as learning awareness of inquiry, independent learning ability and critical thinking ability, were significantly higher than those of the control group ( P<0.01). Conclusion:The construction of human physiology teaching resources based on demand analysis theory can improve the effectiveness and pertinence of resource construction, and the effective use of resources in teaching can significantly improve the teaching effect, stimulate students' subjective initiative, cultivate their comprehensive ability and improve classroom efficiency.