Objective To evaluate result of invaginative esophagogastroanastomosis to prevent the leakage,anastomotic stenosis and reflux esophagitis in esophagectomy.Methods A method of invaginative esophagogastroanastomosis with esophageal mucus to gastric mucus and gastric seromuscular to esophagic nuscular were done in 148 cases cardiac cancer and 120 cases esophageal cancers.Gastro-esophagus full-thickness anastomosis were done in the control group including 112 cases cardiac cancer and 98 cases.Standardized rate and standard error toanalysis the date were adopted.Results It had significant difference between the two groups.Conclusion This anastomosis could avoid the esophagogastroanastomotic leakage,anastomotic stenosis and reflux esophagitis effectively.

Objective To observe the effect of human adipose mesenchymal stem cells (hADMSCs) on pancreatic tissue repair and inflammatory reaction of acute necrotic pancreatitis (ANP) in rat, and explore the possible mechanism.Methods Isolation and purification of hADMSCs and flow cytometry to detect the the surface markers including CD90, CD29, CD34 and CD45 were performed.Eighty SD male rats with the body weight of 170~210 g were randomly divided into 4 groups.There were 8 rats in the control group, 24 rats in other group.Control group underwent no treatment;sham operation group underwent intestinal wall stirring and then abdominal closure;ANP model group was established by open abdominal retrograde injection of sodium taurocholate into bile duct;and in hADMSCs group, DAPI labeled hADMSCs were injected by tail vein into the rat at 12 h after sodium taurocholate injection.The survival of the rats, and gross morphological and pathological changes of the pancreas was observed at 12, 24, and 48 h, and the serum TNF-α, IL-6, IL-10 and amylase were detected.The distribution of hADMSCs in the pancreas, liver and lung was examined in hADMSCs group.Results Rats in control group and sham operation group were all alive.In ANP group, 5 and 11 rats were dead at 24 and 48 h, respectively, and in hADMSCs group 12 rats were dead at 48 h.Compared with ANP group, the difference was not statistically significant (P>0.05).The pathological changes of the pancreas were significantly less severe in hADMSCs group than in ANP group.In hADMSCs group, the amylase at 12, 24 and 48 h was(999±110 )、(1 831±110)、(3 991±130 )U/L;TNF-α level was (62.40±2.35), (80.51±4.51) and (93.46±6.60)ng /L;IL-6 was (60.46±7.34), (80.61±8.40) and(100.58±9.49)ng /L;and these were all significantly lower than those in ANP model group [amylase (2 402±146), (3 292±137) and (5 632±112)U/L;TNF-α(87.13±3.39), (105.41±10.06), (114.57±3.06)ng/L;IL-6 (70.67±10.90)、(107.61±10.53)、(145.34±10.48)U/L], and the differences were all statistically significant (all P<0.05).IL-10 in hADMSCs group was (56.63±6.35), (81.32±5.96), (100.26±6.51)ng/L, which were increased compared with those in ANP model group [(45.26±8.04), (68.25±8.42), (80.38±5.71)ng/L], and the difference was statistically significant (all P<0.05).hADMSCs can migrate to the pancreas, liver, lungs and other damaged tissue, with most in pancreatic tissue, less in lung tissue, and least in liver tissue.Conclusions The mechanism of hADMSCs in repairing pancreatic tissue injury was associated with inhibiting TNF-α and IL-6 secreting and increasing IL-10, thus reducing inflammatory reaction.

ObjectiveTo analyze the outcome of psychiatric prevention and therapy program in the community in Huicheng District,Huizhou city.MethodsThe variables of supervision rate,improvement rate,society participation rate,disturbance creating rate of violence,the mean recurrence frequency in one year and hospitalization rate,etc.were observed in psychiatric patients pre-and post initiation of the program as the model of socialization,complexity,accessibility.Results3 years after carrying out the program in Huicheng District of Huizhou city,the supervision rate,improvement rate,society participation rate of psychiatric patients have significantly increased,and the disturbance creating rate of violence,the mean recurrence frequency in one year and hospitalization rate have substantially decreased.ConclusionThe psychiatric prevention and therapy program in the community in Huicheng District,Huizhou city has been shown to be an effective way for psychiatric intervention.

ObjectiveTo investigate the morbidity rate, states of distribution and therapy of psychosis, and the influence of the patients with psychosis to society. MethodsClue exploration was used mainly, assisted with filling vacancy.ResultsTotal of the patients with psychosis was 4253,the time-spot rate of every psychosis was 4.59‰, the all-life rate was 6.24‰. ConclusionSome data of psychosis in Huicheng District have been obtained.

Objective:To explore the predictive value of artificial intelligence algorithm model for venous thromboembolism（VTE）in lower extremities of trauma patients.Methods:The data of 15，856 orthopedic inpatients were retrospectively collected from the information system database in Chinese PLA General Hospital from December 1992 to November 2017. The patients were divided according to whether they had thrombosis or not. Data pretreatment and feature extraction were carried out. Four artificial intelligence algorithms including Random Forest（RF），Bayes（Bayes），Decision Tree（DTC）and Gradient Boosting Tree（GBDT）were constructed to evaluate their clinical diagnostic efficacy in VTE. The original data were divided into training set and test set according to the ratio of 8∶2 by random stratified sampling method. By comparing the area under receiver operating characteristic curve（ROC）（AUC），true positive rate（TPR）and accuracy in the above methods，the efficiency of different models in clinical diagnosis of VTE was evaluated. According to the contribution degree of the features in the model，the important features were ranked to screen the independent risk factors of VTE.Results:For RF，Bayes，DTC and GBDT algorithm models，the AUC was 0.89，0.86，0.68，0.71，with the TPR for 0.29，0.44，0.38，0.66 and the accuracy for 0.97，0.94，0.95，0.76，respectively. The RF algorithm model had the highest accuracy and the largest AUC. Analysis of important features of artificial intelligence prediction models for VTE showed that the history of thrombosis was the primary predictor of adverse outcomes. The ranking of important clinical features represented by the RF model showed that the history of thrombosis，enoxaparin sodium injection dose，last glucose measurement and first glucose measurement after surgery were important predictive characteristics of VTE.Conclusions:The RF model has the highest accuracy in risk prediction of VTE in trauma patients，which can provide a reference for the formulation of VTE prevention strategies.