The article analyzed the problems in Emergency Medicine and illuminated the character-istics of the teaching model based on micro-course , and pointed out that the introduction of the micro course into the emergency training was the inevitable trend of the development of teaching. Combined with the real case of emergency training, the article described the micro teaching structure and implementation plan in detail, namely with the WeChat public number as the platform for teaching, setting up the curricu-lum according to the differences of the training staff, setting up the interactive communication area, taking into account the basic theory and expanding the study, to achieve the repeatability, individuation, interac-tivity and convenience of the teaching.

ObjectiveTo investigate the clinical effect of laparoscopic liver resection (LLR) versus open liver resection (OLR) in the treatment of patients with hepatocellular carcinoma (HCC) complicated by liver cirrhosis. MethodsA total of 136 patients who were diagnosed with HCC complicated by liver cirrhosis in Linxia Municipal People′s Hospital from January 2006 to December 2007 were enrolled and underwent LLR (LLR group, 64 patients) or OLR (OLR group, 72 patients). The short-term outcome, pathological factors, and long-term outcome were compared between the two groups. The t-test was used for comparison of continuous data between groups, the chi-square test was used for comparison of categorical data between groups, and the log-rank test was used for comparison of survival functions. ResultsThere were significant differences between the LLR group and the OLR group in time of operation ((86.43±23.55) min vs (6231±19.61) min, t=8.539, P＜0.001) and length of postoperative hospital stay ((7.22±3.45) d vs (12.27±5.31) d, t=2764, P=0.024), while there were no significant differences in intraoperative blood loss, time of hepatic portal occlusion, and overall fatality rate(all P＞005). There were also no significant differences in number of tumors, presence or absence of liver cirrhosis, microvascular invasion, resection margin, and maximum tumor diameter between the two groups (all P＞0.05). As for long-term outcome, the 1-, 3-, and 5-year disease-free survival rates were 83.30%, 48.61%, and 38.29% in the LLR group and 78.64%, 51.26%, and 4301% in the OLR group; the 1-, 3-, and 5-year overall survival rates were 97.42%, 95.13%, and 89.23% in the LLR group and 96.41%, 94.28%, and 90.06% in the OLR group. There were no significant differences in these survival rates between the two groups (all P＞005). ConclusionIn patients with HCC complicated by liver cirrhosis, LLR helps to achieve rapid postoperative recovery and similar long-term outcome compared with OLR; therefore, it holds promise for clinical application.

【Objective】 To investigate the anemia status of infants and toddlers aged 6 - 24 months in Linxia Hui Autonomous Prefecture, Gansu Province, and to comprehensively evaluate the differences in feeding behaviors between anaemic and normal children through the infant and child feeding index (ICFI) and feeding knowledge scores, so as to provide reference for the guidance of infants and young children feeding in ethnic minority areas and the promotion of children′s growth and development. 【Methods】 Taking infants and young children aged 6 - 24 months in Linxia Prefecture as the study subjects, a multi-stage random sampling method was used to select children who met the requirements from 5 townships and 5 villages in 7 counties in 2019 and 2020.Periphral blood samples were collected to test the level of hemoglobin, so as to determine the anemia status.Meanwhile, physical examination was performed and a questionnaire survey of guardians was conducted to analyze the association betweenanaemia and feeding patterns 【Results】 A total of 3 901 infants and children were included in this study, of whom 729 (18.70%) were anaemic, with a mean ICFI score of 12.56±2.70 and a mean feeding knowledge score of 1.97±1.01.There was no statistically significant association of low feeding knowledge score and low ICFI with anaemia after adjusting for confounders (P>0.05), Unqualified meat addition in ICFI was a risk factor for anaemia (OR=1.355, P=0.042), while non-bottle feeding in the past 24 hours (OR=0.762, P=0.021), and breastfeeding in the past 24 hours of infants and toddlers aged 12 - 24 months (OR=0.228, P=0.018) were protective factor for anemia in infants and toddlers aged 12 - 24 months. 【Conclusions】 The average prevalence of anemia in infants and toddlers aged 6 - 24 months in Linxia Hui Autonomous Prefecture of Gansu Province is high, but the level of infant feeding and the level of feeding knowledge of caregivers are low.Early adherence to breastfeeding, timely addition of supplementary food, and more comsumpution of meat for children are conducive to preventing anemia.

Objective To investigate the effect of Buzhong Yiqi Decoction for allergic rhinitis(AR)with spleen -qi de-ficiency in guinea pigs.Methods AR guinea -pig model was established by intraperitoneal injection of ovalbumin for general sensitization and then by nasal drip of ovalbumin for local sensitization.Spleen -qi deficiency mod el was induced by gastric infusion of cold -maceration extract of Radix et Rhizoma Rhei.Fifty -four guinea pigs were randoml y allocated to four groups:AR group(Group A),AR model with spleen -qi deficiency group(Group B),AR model with spleen -qi deficiency treated by Buzhong Yiqi group(Group C)and blank control group(Group D).Nasal symptoms were observed.The number of eosinophils(EOS )in nasal secretion was detected by sm ear cytologic examination and the number of EOS and mastocyte in nasal mucosa was exa mined by pathological section.Results Before local sensitization,nasal s ymp-toms such as nose scratching,sneezing and nasal discharge in Group A,Gro up B and Group C were severer than those in Group D and were improved in Group C in the late stage.Positive rate of EOS i n nasal secretion and nasal mucosa of Group C and Group D was lower than that in Group A and Group B and the differen ce was insignificant between Group C and Group D.The number of mastocyte i n Group C was lower than that in Group A and Group B.Conclusion Buzhong Yiqi Decoction can relieve nasal symptom s in AR Guinea pigs with spleen -qi deficiency by counteracting the infiltration of EOS and the increase of nastocytes in nasal mucosa.

Objective:To investigate the clinical value ofplatelet distribution width ratio (RDW) and neutrophil lymphocyte ratio (NLR) in the prediction of coronary no reflow in patients treated with acute percutaneous coronary intervention (PCI).Methods:66 patients underwent emergency PCI treatment in our hospital from January 2016 December 2016 were selected as the research object,RDW and NLR of the patients before treatment were detected,and coronary no reflow phenomenon after emergency PCI rate were statistically calculated.RDW and NLR of patients with no reflow and normal blood flow were compared,the relationship between RDW and NLR with no reflow and the value of them predicting coronary no reflow were analyzed.Results:The incidence of coronary no reflow after emergency PCI was 30.30％ (20/66).Compared with patients with normal blood flow,the RDW and NLR of patients with coronary no reflow were elevate (P＜0.05).Spearman correlation analysis results showed that RDW and NLR were positively correlated with coronary no reflow (r=0.826,0.878,P＜0.05).Further ROC curve analysis showed that AUC of preoperative RDW combined with NLR predicting the postoperative coronary no reflow in patients treated with emergency PCI were higher than RDW and NLR alone.Conclusion:RDW and NLR in patients treated with emergency PCI were closely related to the postoperative coronary no reflow,which might be used as reference index for evaluation of coronary no reflow after emergency PCI.

Objective To explore the efficiency of prophylactic peduncle ligature combined with high-frequency electrocoagulation in treatment of patients by peduncluated polyps of gastrointestinal tract. Methods A total of 41 patients with peduncluated polyps of gastrointestinal tract by treatment of high-frequency electrocoagulation resection were selected, and all patients were treated with prophylactic peduncle ligature by nylon rope or titanium clip before resection. The resection efficiency and complications were observed. Results All the patients underwent one-time removal of peduncluate polyps with a success rate of 100. 0％. One case had small amount of bleeding in the wound and was clipped with titanium clip. No complications such as perforation and delayed hemorrhage were observed in all patients. All the patients were followed up for 3 to 6 months, and wound healed well without recurrence. Conclusion For the large peduncluated polyps of gastrointestinal tract, prophylactic peduncle ligature before resection is a safe and effective method.

Objective To explore the efficiency of prophylactic peduncle ligature combined with high-frequency electrocoagulation in treatment of patients by peduncluated polyps of gastrointestinal tract. Methods A total of 41 patients with peduncluated polyps of gastrointestinal tract by treatment of high-frequency electrocoagulation resection were selected, and all patients were treated with prophylactic peduncle ligature by nylon rope or titanium clip before resection. The resection efficiency and complications were observed. Results All the patients underwent one-time removal of peduncluate polyps with a success rate of 100. 0％. One case had small amount of bleeding in the wound and was clipped with titanium clip. No complications such as perforation and delayed hemorrhage were observed in all patients. All the patients were followed up for 3 to 6 months, and wound healed well without recurrence. Conclusion For the large peduncluated polyps of gastrointestinal tract, prophylactic peduncle ligature before resection is a safe and effective method.

Objective:To investigate the risk factors, severity of symptoms, acute exacerbations, and pulmonary function in women with chronic obstructive pulmonary disease (COPD).Methods:A total of 4 204 COPD patients, including 533 female COPD patients and 3 671 male COPD patients, were investigated from January 2017 to December 2019 in Second Xiangya Hospital of Central South University, Hunan Prevention and Treatment Institute for Occupational Disease, affiliated Hospital of Guilin Medical College and Guilin Second People's hospital. The risk factors, severity of symptoms, risk of acute exacerbation and clinical characteristics of pulmonary function in patients with COPD were comprehensively analyzed.Results:There was no statistical difference in age between male and female COPD patients ( P>0.05). There were statistically significant differences in smoking history, occupational exposure history and biofuel exposure history ( P<0.001), among which smoking history and occupational exposure history were significantly higher in males than in females ( P<0.001), and exposure history of biofuels was significantly higher in females than in males ( P<0.001). The COPD assessment test (CAT) score of male and female patients was statistically different ( P<0.05), and the mean CAT score of female patients was higher than that of male patients. The modified medical research council dyspnea scale (mMRC) grading results of male and female patients were statistically different ( P<0.05), and the mMRC grading of female patients was higher than that of male patients. There was no statistical difference in the risk of acute exacerbation between male and female patients ( P>0.05). There were statistically significant differences between male and female patients in first second exertional volume as a percentage of predicted value (FEV 1%) and forced expiratory volume in one second/forced vital capacity (FEV 1/FVC) mean value ( P<0.001), and FEV 1% predicted value and FEV 1/FVC of female patients were better than that of male patients. Conclusions:The risk factors, symptom severity and pulmonary function of female patients with COPD are different from those of male patients, providing reference for the individualized treatment of female patients with COPD.

Objective To know the situation of time delay from the patients with ischemic stroke arrived the emergency to accepted the thrombolysis treatment, and analyze the related factors in order to put forward effective process optimization measures. Methods Totally 122 patients with acute ischemic stroke admitted into a Beijing grade A tertiary hospital who needed receive thrombolysis treatment from June 2014 to June 2015 were selected as the research object according to the purpose sampling method. Then we recorded the time in the whole process which were devided into 4 steps ( arrived at the emergency department- obtained consultation of stroke physicians;obtained consultation of stroke physicians- arrived in CT chamber; arrived in CT chamber- got CT scan results; got CT scan results- accepted thrombolysis therapy ) . Results The time delayed in hospital of intravenous thrombolysis group and artery thrombolysis group were (114.95±29.48)min and (171.22±50.10)min. The step of biggest delta-T between the actual time and standard time of two groups were both from getting a CT scan results to accepting thrombolysis therapy.Conclusions The delay after getting a CT scan results is the most important reason of delay in hospital. Shorten the time of blood test, optimize the hospital management and perfect the construction of the green channel, can promote the situation of the delay in hospital, and, improve the efficiency of thrombolysis treatment.

Objective To evaluate the effectiveness of tumor cell Vimentin combined with endoscopic ultrasound-guided fine-needle biopsy(EUS-FNB)in diagnosing solid pancreatic tumors.Methods Clinical data from 110 patients who underwent EUS-FNB from October 2021 to December 2023 were retrospectively analyzed.Solid pancreatic tumors including but not limited to pancreatic cancer and pancreatic neuroendocrine tumors.The sensitivity,specificity,and accuracy of EUS-FNB were assessed by comparing its results with the final pathological diagnoses.Result Clear histopathological diagnoses were obtained in 106 cases,accounting for 96.37%.Among them,87 cases were definitively diagnosed as adenocarcinoma or pancreatic ductal adenocarcinoma.Immunohistochemical staining showed that Vimentin was expressed in the tumor cells.There was no statistically significant difference in positive rates among biopsies from different anatomical sites(P>0.05),but significant differences were observed in lesions of different diameters(P<0.05).Immunohistochemical staining suggested that Vimentin expression levels might be associated with the nature of the lesions.The overall diagnostic accuracy,sensitivity,and specificity of Vimentin combined with EUS-FNB for pancreatic masses were 86.09%,84.57%,and 100.00%,respectively.Specifically,for solid masses,the diagnostic accuracy,sensitivity,and specificity were 87.67%,86.55%,and 100.00%,respectively.For pancreatic cystic tumors,the diagnostic accuracy,sensitivity,and specificity were 65.42%,69.79%,and 100.00%,respectively.Conclusion The combination of tumor cell Vimentin and EUS-FNB demonstrates high diagnostic accuracy for solid pancreatic tumors,making it a valuable tool for clinical application.