In order to meet the needs of the skin venerealdiseases study direct-viewing teaching and the new curriculum reforms,and fully display the multimedia technology in the dermatology departmentteaching function,on the basis of the sixth edition of the teaching material on skin venereal diseases and in combination with the union massive pictures,theanimation as well as the correlation data,the richly colorful direct-viewing teaching coursewares were designed with abundant pictures,and the teaching effect was satisfied.Besides,some deficiencies were proposed.

Objective To explore the method and significance for constructing three-dimensional visual model in bronchial tree of pig lung. Methods A set of pig lung specimen was infused with epoxy resin-lead oxide through the trachea,and then casted. The Mimics 15. 0 was used to construct three-dimensional visual model in bronchial tree of pig lung by utilizing CT data of the cast specimen. Results In the reconstructed three-dimensional visual model of bronchial tree,the three-dimensional effect was realistic. This model not only clearly showed each lobar direction and distribution of bronchial tree,but also allowed three-dimensional arbitrary scaling,shifting or rotating at any angle, and the diameter and distance of each lobar bronchus could be measured with the sofeware. Conclusion The three-dimensional visual model in bronchial tree of pig lung can be successfully reconstructed from the CT dataset by using related sofeware like Mimics,which can bring morphological reference to anatomical teaching and will be helpful to the development of virtual operation.

Objective To explore the expression status of carbonic anhydrase Ⅲ (CA Ⅲ) from quadriceps femoris muscle in two kinds of muscle clinical phenotype (skeletal muscle atrophy group and skeletal muscles non-atrophy group) of chronic obstructive pulmonary disease (COPD).Methods Totally 37 inpatients from our hospital,were divided into 11 patients without COPD and 26 patients with COPD,in addition,according to body mass index,fat free mass index and quadriceps cross-section diameter,patients with COPD were divided into 14 skeletal muscles non-atrophy patients (SMNA)and 12 skeletal muscle atrophy patients (SMA).CA Ⅲ concentration of femoris quadriceps specimens was quantitatively determined using Western blot methods,CA Ⅲ mRNA expression levels of femoris quadriceps specimens were also quantitatively measured using RT-PCR,then compared among the 3 groups.Results There was significant difference in CA Ⅲ quantitative concentration and CA Ⅲ mRNA expression level in each group (P ＜ 0.05),further more,CA Ⅲ concentration expression level was significantly higher (P ＜ 0.01)in SMA group (1.260 ± 0.068) than in SMNA group (1.110 ± 0.014),the latter was significantly higher (P ＜ 0.01) than in the control group (1.000 ± O.062).CA Ⅲ mRNA expression level was significantly higher(P ＜ 0.01) in SMNA group(2.170 ±0.412) than in the control group(1.000 ±0.115),and was significantly lower than in SMA group (3.770 ± 0.788 ; P ＜ O.01).CA Ⅲ concentration and CA Ⅲ mRNA expression level increased at equal pace in SMNA group and SMA group,however,CA Ⅲ quantitative concentration and CA Ⅲ mRNA expression level were inconsistent in the two groups.Conclusion The expression status of CA Ⅲ in quadriceps femoris muscle was different in two kinds of muscle clinical phenotype of COPD.

Objective To explore the effect of lipo-prostaglandin E1 plus dextran 40 in the prophylaxis of hepatic veno-occlusive disease(HVOD) after hematopoietic stem cell(HSC) transplantation.Methods Two hundred and thirty-four patients,162 males and 72 females,mean age 30.6(ranged from 3 to 64),were admitted during May 1999 to April 2007 and undergone HSC transplantation.Lipo-prostaglandin E1 associated with dextran 40 were administered to all patients for the prophylaxis of hepatic veno-occlusive disease.Lipo-prostaglandin E1,10?g dissolved in 100ml saline,20?g per day iv,were administered from day 7 before transplantation(-7 day) to day 30 after transplantation(+30 day).Dextran 40,500ml per day iv,were administered from-1 day to +5 day.In order to identify the risk factors inducing HVOD,patients were allocated to 2 groups according to following factors:age(

Objective To study the characteristics of lower respiratory tract infection by Streptococcus pneumonia in children aged from 0 to 5 years and drug resistance,so as to provide the rational basis for clinical treatment and epidemiology.Methods The medical data from 4 815 children aged 0 to 5 years with lower respiratory tract infection between September 2014 and September 2016 were retrospectively reviewed.Results Totally 343 strains of Streptococcus pneumonia were isolated from 4 815 sputum samples,with the isolation rate of 7.12％.Of the isolated streptococcus pneumonia strains,80.76％ were isolated from the children with pneumonia,9.33％ were isolated from the children with bronchitis,5.83％ were isolated from the children with capillary bronchitis,4.08％ were isolated from the children with bronchial asthma.There was no significant difference in the incidence of Streptococcus pneumonia infections between the genders of the children(P>0.05),but the incidence of Streptococcus pneumonia detection rates differed significantly in different seasons and children of different ages,the difference was statistically significant(P<0.05).The resistance rates of Streptococcus pneumonia to penicillin,erythromycin and clindamycin were 51.0％,97.9％ and 97.1％ respectively;The sensitivity rates to cefotaxime and vancomycin were 71.1％ and 100.0％ respectively.Conclusion The children aged less than 1 years old are at the high risk of Streptococcus pneumonia infection and highest detection rates in winter,it is necessary to perform the drug susceptibility testing in a timely manner so as to choice reasonable antimicrobial agents to control the condition.

Objective To valuate different effects in hepatectomy of three inflow occlusion methods including pringle maneuver, hemihepatic occlusion and portal venous occlusion. Methods 180 patients undergoing hepatectomy were randomly assigned to pringle group (group A), hemehepatic occlusion group (group B)or PV occlusion group (group C). The amount of blood lost, measurements of liver enzymes alanine aminotransferase (ALT), aspirate aminotransferase (AST), total bilirubin (TB), Serum albumin (ALB) and postoperative complication were also recorded. Results There was no operative mortality. One patient in group B changed into pringle maneuver due to the difficulties in dissecting the hemi-hepatic portal and was excluded. The amount of hemorrhage of three groups had no statistical difference. The ALT, AST, ALB and TB level of 1,3,7 days after operation had significant differences in three groups. The pringle group had a higher level ALT,AST,TB and lower ALB level than the other two groups. Conclusions All techniques of occlusion are effective and feasible for patients undergoing hepatectomies. However, compared with pringle maneuver, PV clamping and hemihepatic occlusion can relieve the liver function damage after hepatectomy.

Objective To explore the safety and efficacy of hepatic resection with selective hepatic vascular exclusion(SHVE). Methods SHVE was used in 246 consecutive patients undergoing major or complex liver resection in our center. Preoperative demographic and clinical data,details of the surgical procedure, pathologic diagnosis, postoperative course and complications were collected and analy zed. Results From January 2000 to July 2007, liver resections were performed IJnder SHVE in 246 patients; total SHVE, right partial SHVE and left partial SHVE in 145, 54 and 47 patients, respectively. SHVE was converted to total hepatic vascular exclusion(THVE)in 3 patients to repair the wall of inferior vena cava(IVC). Hemodynamic tolerance to SHVE was excellent, only with a slight increase in systemic and pulmonary vascular resistance during clamping.There were no deaths. and the morbidity was 24.8%.The mean leyth of hospital stay was 9.6 days(range 8-18) .Conclusion Our study showed that SHVE is a safe and effective procedurei and it is applicable to liver tumors near but not invade the inferior vena cava.

Objective To study the impact on pregnant outcome of reducing the number of embryos transferred from three to two in women at age less than 35 who received frozen-thawed embryo transfer (FET). Methods The analysis was performed on 90 FET cycles (77 infertile couples,less than 35 years old) with slow-freezing/rapid-thawing method, including 48 cycles with two embryos transferred and 42 cycles with three embryos transferred. The embryo survival rate, high quality embryo rate, clinical pregnancy rate, implantation rate and multiple pregnancies rate were analyzed. Results No significant differences in embryo survival rate (88.9% versus 88.1%), high quality embryo rate (89.6% versus 81.0%), clinical pregnancy rate (37.5% versus 42.9%), implantation rate (26.0% versus 18.3%) and multiple pregnancy rate (38.9% versus 16.7%) were observed between two and three embryos transferred group (all P > 0.05). However, there were 2 triple pregnancies in three embryos transferred group while none in two embryos transferred group. Conclusion Reducing the number of high quality embryos transferred from three to two in women at age of less than 35 years old who received FET,could decrease the incidence of triple pregnancy and keep the similar clinical pregnancy rate.

Objective To investigate the prevalence of healthcare-associated infection(HAI)in medical institutions in Pudong New Area.Methods Ten medical institutions in Pudong New Area were selected as monitored hospitals, cross-sectional survey on HAI in each hospital at a given day of November 2013 and November 2014 were conduc-ted.Prevalence of HAI in different levels of hospitals were compared.Results The prevalence rates of HAI in 2013 and 2014 were 4.04% and 3.75% respectively,there was no significant difference between two years(χ2 =0.709,P=0.400).The prevalence rates of HAI in primary,secondary,and tertiary hospitals in 2013 were 0.66%,3.32%, and 4.60% respectively,in 2014 were 0,3.52%,and 4.01 % respectively,prevalence rates of HAI in different lev-els of hospitals of each year were significantly different (all P <0.05).Prevalence rates of HAI were high in depart-ments of neurosurgery,hematology,intensive care units(ICUs),and gerontology.The prevalence rate of infection in ICUs increased obviously,from 10.09% to 18.78% (χ2 =3.921 ,P =0.048),departments of gerontology de-creased obviously,from 10.07% to 5.02%(χ2 =5.698,P =0.017).The main HAI sites were lower respiratory tract (36.72%),upper respiratory tract (9.96%),and urinary tract (12.89%).172 pathogenic isolates were de-tected in 2013,and 177 were detected in 2014,gram-negative bacteria,gram-positive bacteria,and fungi accounted for 60.74%,26.37%,and 12.89% respectively.Constituent ratios of pathogens causing HAI between two surveys were not significantly different (χ2 =5.819,P =0.830).Conclusion Among different levels of hospitals in Pudong New Area,tertiary hospitals have the highest prevalence rate,HAI in ICU increases obviously,the main HAI site is lower respiratory tract,the main pathogens are gram-negative bacteria.

Total caudate lobectomy via anterior hepatic transection is still a new technique to resect the tumor in the caudate lobe,which is mastered only by few surgeons.The procedure was successfully performed on a 21-year old patient with focal nodular hyperplasia in caudate lobe.The right and left lobes were first mobilized,then the short hepatic veins were dissected to detach the caudate lobe from the retrohepatic vena cava.Then the liver was split anteriorly and the partial middle lobe was resected.With this process,the tumor was in the sight and we dissected it from the liver parenchyma.The inflow blood was occluded 3 times with a period of 29,27 and 27 minutes,respectively,with an interval of 5 minutes.The total blood loss during operation was 1000 ml.The patient recovered quickly without any complications.The technique for caudate lobectomy via anterior hepatic transection can improve the success rate and safety of caudate lobectomy and deserve clinical consideration.