Objective To observe the clinical efficacy of three types of drainage in the treatment of malignant obstructive jaundice.Methods 84 patients with malignant obstructive jaundice were selected,40 cases were treated with bridge drainage,24 cases were undergone percutaneous transhepatic cholangial drainage(PTCD) and 20 cases were treated with Roux-En-Y anastomosis.The changes of total bilirubin and direct bilirubin were detected 1,3,7 and 14 days after operation.Results The total bilirubin and direct bilirubin after 1,3,7 and 14 days had significantly decreased compared with pre-treatment(P ＜0.05),the decline rates in bridge drainage group were faster than the other two groups (P ＜ 0.05).Conclusion The three types of drainage for treating malignant obstructive jaundice have exact effect,and the bridge drainage can reduce the bilirubin to lower levels more quickly than the other two methods.

Objective:To design a software to read and display CT and RT structure and draw a new contour without treatment planning system (TPS).Methods: In order to display the contour information drawn by doctors, the first step was to match CT images and RT structure then the same screen rendering of CT and RT structures could be applied. In order to add contour in RT structure obtaining the coordinates interactively, connecting coordinate points were the essential steps. Then a unique identity was given in the area of that contour to ensure its unique results. Results: The software successfully read and displayed CT and RT structures and drew a new contour without TPS.Conclusion: In this study, the software establishes a basis to improve the precision of the radiotherapy dose.

Orthostatic hypotension(OH)is a fall blood pressure after an upright position.OH commonly occurs in persons with high level spinal cord injury(SCI),limiting exercise and rehabilitation.But to date,the reasons of OH following spinal cord injury are not very clear.It is reviewed in this article which mainly included:possible reasons of OH after spinal cord injury;typical symptoms,measurements and diagnoses;treatments and prevention.

Objective To describe the survival status and to analyze the related factors of mortality among elderly patients with first-ever stroke.Methods Totally 1 96 elderly patients with first-ever stroke from January 2010 to January 2014 were enroll for the study.The survival status of all cases was attained through follow-up,and the deadline of follow-up was July 30,2014.The deceased patients because of stroke were divided into death group while the others were divided into survival group.Univariate com-parison and multivariate Logistic regression analysis were performed to screen out the related factors of death.Results The median follow-up time was 41 months,and 14 cases were lost to follow-up.The survival rate 28 d,1 year and 3 years after the onset were 73.47%,66.81% and 58.89%.Age,complication,Glasgow score,NIHSS score and blood WBC were the independent influence fac-tors of death (P <0.05).Conclusion The death among elderly patients with first-ever stroke are more concentrated in 28 d after the onset.Advanced age,complications,decrease of Glasgow score,increase of NIHSS score and blood WBC could increase the death risk.

Bariatric and metabolic surgery is an effective treatment for obesity and metabolic syndrome with definite results. In recent years, bariatric and metabolic surgery has developed rapidly, and the surgical indications and procedures have gradually matured. At the same time, the complications have also been widely discussed, including those specific to bariatric metabolic surgery and the risks common to gastrointestinal surgery, of which gastrointestinal leak is one of the most important and serious complications, which can be life-threatening in severe cases. This paper will review the mechanisms, clinical manifestations, diagnostic strategies, prevention, and treatment advances related to gastrointestinal leak after bariatric metabolic surgery based on the two major procedures that cause gastrointestinal leak, namely, staple line leak after laparoscopic sleeve gastrectomy and gastrojejunostomy leak after laparoscopic Roux-en-Y gastric bypass.

Acromegaly is a commonly functional pituitary tumor. Standardized managements are crucial for the patients. Chinese Expert Consensus on the Diagnosis and Treatment of Acromegaly(2020) has been updated in 2020 based upon latest advance. This essential introduction about genetic causes would further guide and standardize the management of acromegaly.

The standardized patient (SP) has been widely used in medical education and clinical training. The teacher-standardized patient (TSP) is played by health providers or medical educators, taking roles as patient, evaluator and teaching guider. The consultation ability of general practitioners includes two aspects: the clinical competency and doctor-patient communication skill. This article reviews the application of TSP in evaluation of consultation ability of general practitioners, focusing on the recruit, training, assessment and application of teacher-standardized patients.

Riedel thyroiditis is a benign disease, which is often self-limited. Examinations, such as CT and histologic diagnosis can distinguish it from malignant neoplasms and hashimoto's thyroiditis. Riedel thyroiditis is an uncommon form of chronic thyroiditis in which the thyroid gland is replaced by fibrous tissue. It can be cured by surgery and medicine.
Chronic Disease ; Diagnosis, Differential ; Hashimoto Disease ; diagnosis ; Humans ; Thyroiditis ; diagnosis

Objective To investigate the economic effects in patients with primary hypertension by four kinds of treatment.Methods 160 cases with primary hypertension were randomly divided into Benazepril group(n=40)、Perindopril group(n=40)、Amlodipine group(n=40) and Nitrendipine group(n=40),and data was evaluated with the pharmacoeconomic cost-effective analysis method.Results Hypertensive efficacy in 4 groups were not sig-nificantly different(x2=3.26,P>0.05);The symptom total score before treatment and after treatment was sisnifi-canfly different(a11 P<0.05);The SF-36 Scale after treatment in 4 groups were higher than before treatment(all P<0.05);The costs of pefindopril was lower than the benazepril.Conclusion Pharmacoeconomies played an important role in optimizing therapeutic scheme,guiding rational drug use and increasing economic effectiveness.

OCT angiography (OCTA) is a non-invasive imaging technique for detecting blood flow information of the retina and choroid.Dye injection is not needed with OCTA,which is different from fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA).OCTA is able to observe blood flow in different retinal and choroidal segmentation slab.This revolutionary breakthrough in OCTA algorithm provides more and more accurate blood flow informations in the diagnosis of ocular vessel diseases and the study on pathogenesis of some vessel-related eye diseases.However,like other biometric technology,OCTA has its limitations and shortcomings,for example,OCTA presents a smaller observational area than FFA and ICGA,and some factors affect the imaging quality and cause misdiagnosis during the examination and reading image.Fully understanding the principle of OCTA and its image features are helpful for eye doctors to better interpret the blood flow changes of retinal diseases,choroidal diseases,glaucoma and neuro-ophthalmic diseases.Ophthalmologists should correctly apply this imaging tool for a better monitoring and following up of these diseases.