The current problems of Diagnostics the 5-year national programming textbook for undergraduates were analyzed and several compiling suggestions were proposed. Three suggestions were put forward:modifying the definition of chief complalnt, appending a list of errors and modifying the editing style of appendix I common clinical diagnostic techniques. With this revision, the noun definition in the teaching material can be made more accurate and the textbook compiling form more perfect, so that the errors have been corrected in a timely manner, which is beneficial to teachers' teaching and students learning and can improve the quality of clinical medicine professional talent tralning.

Objective To assess the concurrent management for portal hypertension (PHT) in gastric cancer patients. Methods Retrospective analysis was made on 60 cases of gastric cancer occurring on the background of cirrhotic PHT, of which 30 cases were of Child A grade, and 30 patients were Child B class. Ten cases were on gastric cancer stage Ⅰ , 38 cases on stage Ⅱ and 12 cases were on stage Ⅲ.Radical gastrectomy plus splenectomy and devascularization were performed in 26 cases, while radical gastrectomy only was done in 34 cases. Results Postoperative Child-Pugh degrading developed in 100% cases undergoing combined procedures; while in the 34 cases undergoing radical gastrectomy only,postoperative degradation from the preoperative Child-Pugh classification occurred in 7 cases ( 20% ), P ＜0. 001. In this series the peri-operative mortality was 3%, all were patients at stage Ⅲ gastric cancer combined with Child-Pugh class B. Conclusions The principle of treatment for gastric cancer with cirrhotic portal hypertension is restrictive surgery. The main purpose is to cure cancer and not to damage liver function.

Objective To study the efficacy of the orthotopie liver transplantation for hilar cholangiocarcinoma and analyse relevant factors.Methods A retrospective study was conducted in 10 cases of hilar cholangiocarcinoma treated with orthotopic liver transplantation from 2002 to 2010.Results The male:fe5 and 8 years were 70.0%and 60.4%.50.9%and 50.9%,respectively.No tumor survival rates for 1,3,5 and 8 year were 65.3%,58.7%,50.9%and 50.9%,respectively.Operative time was(306.7±38.1)min.The average blood loss was(659.4±300.6)mL.Multiple regression analysis showed that positive lymph nodes(P=0.0092)positive surgical margin(P=0.0028)and neural invasion(P=0.021)were the most important factor affecting hilar cholangiocarcinoma recurrence after liver transplantation.Conclusions Orthotopic liver transplantation for hilar cholangiocarcinoma is an effective means.Intraoperative radical resection will receive a good effect.Resection margin and lymph node-positive are the most important factors affecting long-term survival.

Objective To investigate the effects of statins on coronary artery disease in patients with coro-nary heart disease and lipid regulating effect on curative effect .Methods 126 cases of patients with coronary heart disease were randomly divided into the control group of 60 cases and 66 cases in the treatment group ,the control group was given routine treatment of coronary heart disease ,the treatment group was treated with routine treatment with simv-astatin bedtime,before treatment and after 3,12 months when the determination of lipids ,liver function and renal func-tion index,and compared between the two groups of cardiovascular events .Results 3 months after treatment , TG, TC,LDL-C of the treatment group decreased significantly ,while the control group in 3,12 months after treatment,TC, TG,LDL-C had the rise of certain level(t=5.43,5.21,4.85,all P<0.05).The two groups after treatment in 3, 12 months in TC,TG,LDL-C had significant differences(t=5.32,5.78,5.64,6.15,6.41,6.06,all P<0.05).Dur-ing follow-up,patients in the treatment group 33 cases of cardiovascular events ,the control group of 81 cases,two groups of cardiovascular event rate had a significant difference (χ2 =13.42,P<0.01).Conclusion Statins can re-duce blood lipids in patients with coronary artery disease ,thereby reducing the patients appear related to cardiovascu-lar accidents,improve the treatment effect of coronary heart disease .

Objective To analyze the causes and results of treatment of periprosthetic femoral frac-tures after total hip arthroplasty and to explore the best operative methods for fractures. Methods 11 cases treated for periprosthetic femoral fracture after total hip arthroplasty were subjected to a retrospective fol-low-up study from December 1998 to March 2003. There were 8 men and 3 women, the mean age was 56 years (range, 43 to 75 years). There were 2 Vancouver A type fractures, 7 B2 type, 1 B3 type, 1 C type. 5 fractures were treated by nonoperative methods and other 6 by operative methods, including one fracture malunion treated initially by skin traction. There were 5 revisions using long stem supplemented with cortical allograft strut, including 4 uncemented stems with distal fixation and one cemented stem; the remaining one fracture treated by open reduction and internal fixation. Results None was lost for follow-up. The mean follow-up period was 25.6 months (range, 7 to 50 months). 9 fractures united at a mean of 4 months (range, 3 to 6 months). Nonunion was found in 2 fractures, both were treated nonoperatively. All the 6 fractures treated by operative methods united. Up to now, 7 stems were well-fixed, continuous radiolucent line was seen in one revision case, 3 stems were loosened. The function of the patients with well-fixed stems was bet-ter than those with loosened stems, the mean Harris score of the former was 91. All the cortical allograft struts were incorporated with host bone within one year. No strut fracture happened. Conclusion Type A fractures with well-fixed stems can be treated by nonoperative methods, while type B1 and type C fractures should be treated by open reduction and internal fixation, on condition there is no surgical contraindication. For fractures with loosened stems, use of an uncemented long stem with distal fixation supplemented with cortical allograft strut is the best choice.

A kind of skin cell segregating unit based on 80C196 microcomputer is presented in this paper. The front-end controller is a single-chip microcomputer. The unit enables manipulation for 6 patients simultaneously which provides a great convenience for clinical manipulation of vitiligo. With use of serial port communication technology it's possible to monitor and control the front-end controller in a PC terminal. The involvement of computer image acquisition technology realizes synchronous acquisition of pathologic skin cell before/after the manipulation. Clinical test of the unit proves its conformity with national standards and fulfillment of designed technology goal.

Team training significantly affects the performance of clinicians in neonatal resuscitation, which plays an important role in improving outcomes of asphyxiated newborns. Since 2016, team training was formally described in the Textbook of Neonatal Resuscitation, including 10 key points, which were summarized into three core elements in this review: teamwork, communication, and leadership. We review the application of these three elements in current team training and the main training approaches, aiming to offer a framework for standardized team training and to improve the success rate of neonatal resuscitation.

With the rapid development of artificial intelligence (AI), especially deep learning, AI research in the field of ophthalmology has presented a trend of diversification in disease types, generalization in scenarios and deepening in researches. The AI algorithm has showed a good performance in the studies of diabetic retinopathy, age-related macular degeneration, glaucoma and other ocular diseases, yielding up the great potential of ophthalmic AI. However, most studies are still in their infancy, and the application of ophthalmic AI still faces many challenges such as lack of interpretability for results, deficiency of data standardization, and insufficiency of clinical applicability. At the same time, it should also be noted that the development of multi-modal imaging, the innovation of digital technologies (such as 5G and the Internet of Things) and telemedicine, and the new discovery that retina status can reflect systemic diseases have brought new opportunities for the development of ophthalmic AI. Learn the current status of AI research in the field of ophthalmology, grasp the new challenges and opportunities in its development process, successfully realizing the transformation of ophthalmic AI from research to practical application.

Objective: To observe the clinical efficacy of Nie-pinching the spine, puncturing Sifeng (EX-UE 10) plus Chinese herbs in treating pediatric anorexia due to dysfunction of spleen in transportation. Methods: A total of 64 kids were randomized into an observation group and a control group by the random number table method, with 32 cases in each group. Patients in both groups received Jian Pi Kai Wei (strengthening spleen and stomach) powder according to pattern differentiation of traditional Chinese medicine (TCM). In addition, patients in the observation group received Nie-pinching the spine and puncturing Sifeng (EX-UE 10). Nie-pinching the spine was applied twice a week, and puncturing Sifeng (EX-UE 10) was performed once a week, with 2 weeks counted as 1 course of treatment. After 2 courses of treatment, the body mass index (BMI), peripheral blood leptin level and the microelements Zn, Fe and Se were compared at different time points (before treatment, after the first and second courses of treatment), as well as the therapeutic efficacy and onset time. Results: After 2 courses of treatment, 31 cases in each group were evaluated. After the 1st course and the 2nd course, the BMI and serum Zn, Fe and Se levels in the observation group increased significantly (all P<0.05), the leptin level decreased substantially (both P<0.05); the BMI in the control group showed a substantial rise (P<0.05), while the Zn, Fe and Se levels slightly increased showing no statistical significance (all P>0.05), and the leptin level decreased but the difference showed no statistical significance (P>0.05). After the 1st and the 2nd courses of treatment, the BMI, serum Zn, Fe and Se levels increased more significantly (all P<0.05), and the serum leptin level decreased more significantly (both P<0.05) in the observation group than in the control group. After the 2nd course, the total effective rate and recovery rate in the observation group were both higher than those in the control group (both P<0.05), together with a quicker onset time (P<0.05). Conclusion: Nie-pinching the spine, puncturing Sifeng (EX-UE 10) plus Chinese herbs is effective for pediatric anorexia due to dysfunction of spleen in transportation. It can decrease leptin, increase Zn, Fe and Se levels, alleviate apositic symptoms and increase BMI in the kids.

Objective:The study was aimed to inverstigate the effects of different levels of pressure and dura-tion of carbon dioxide and saline in the neck of rabbits on metabolic, hemodynamic, serum sodium concentrations and hematocrit changes. Method:Twenty-one New Zealand rabbits were randomly divided into 7 groups according to the following pressure of CO_2 or saline:0 kPa, 0. 67 kPa CO_2, 1.33 kPa CO_2,2.00 kPa CO_2 , 0.67 kPa saline, 1.33 kPa saline, and 2.00 kPa saline. In order to make a space for the endoscopic thyroidectomy, we filled the neck of rabbits with carbon dioxide and saline . Arterial partial pressure of CO_2(PaCO_2), pH, heart rate (HR), mean arterial pressure (MAP) , central venous pressure (CVP), serum sodium concentration and hematocrit were measured at baseline, 45 min and 90 min after filling with gas or saline and 30 tnin post-filling. Result:Insufflation of CO_2 at 0.67 kPa did not have any significant effect on the parameters. PaCO_2 increased significantly 45 min and 90 min after insufflation of 1.33 kPa CO_2(P<0.01). Marked changes in PaCO_2, pH and CVP occurred 45 min and 90 min after insufflation of 2.00 kPa CO_2 (P<0.01), and the parameters did not return to baseline in 30min after desufflation(P<0.05). In animals receiving saline irrigation no significant changes occurred in PaCO_2, pH and serum sodium concentrations at any time point. There was a tendency of decrease in HCT, but no statistically significant changes were found (P>0.05). CVP increased significantly 90min after saline irrigation at 1.33 kPa(P <0.05). A significant increase in CVP occurred 45 min and 90 min after saline irrigation at 2.00 kPa(P<0.05). No significant changes in HR and MAP occurred in all animals. Conclusion: Filling with saline which does not cause hypercapnia, acidosis or dilutional hyponatremia can be used in endoscopic neck surgery to create and maintain a working space.