This research is to explore the feasibility of construction of real-time network teach-ing platform in anesthesia resident standardization training. The real-time network teaching were car-ried out by platformconstruction and teaching organization. The teaching effect was evaluated. Using the real-time network teaching platform with the four functions of learning knowledge, cultivating ability, communication and supervision can achieve good teaching effect. It was a beneficial supplement of traditional teaching.

Objective To define the risk period of acute pancreafifis-associated lung injury (APALI) by aserial study including a dynamic changes in total water content of lung, ultrastructure and number of type Ⅱ alveo-lar epithelial, and reactive oxygen metabolisms (ROMs) of lung tissue in mice with severe acute pancreatits (SAP)and a clinical analysis of APALI patients. Method ICR mice were selected to establish SAP model. The animalsreceived 7 intraperitoneal injections of caerulein (50 μg/kg body weight) at hourly intervals followed by intraperi-toueal injection of lipopolysaccharide (15 mg/kg body weight). The total water content, uhrastrueture and numberof type Ⅱ alveolar epithelial cells, and ROMs of lung tissue were detected before (0 h) and 6 hours, 12 hours,lday, 4 days and 7 days after SAP model establishment, respectively. In addition, 215 patients with APALI (PaO2< 60 mmHg) collected from the First Affiliated Hospital of Zhejiaug University between January 1998 and Decem-ber 2006 were analyzed. Statistical analysis were performed by using F-test. P-values less than 0.05 were regardedas statistically significant. Results The total water content and ultrastructure mitochondria and lamellar bodies intype Ⅱ alveolar epithelial cells of lung in SAP mice were significantly altered at 12 hours after SAP model estab-lishment, and reached maximum at 1 to 4 days later. A decrease in number of type Ⅱ alveolar epithelial cells andincrease in ROMs reached a maximum at 1 day after SAP model establishment. Furthermore, the results of clinicalstudy showed that the lung injury occurred at (3.1435±1.0199) days after SAP. The data were almost consistentwith the resalts from SAP model. Conclusions The risk period of APALI occurres between the 1st day and the4th day during the course of SAP.

Objective To improve the knowledge of X-ray findings of heart and lung in chronic renal failure ( CRF ) . Methods X-ray findings of heart and lung in 120 cases with CRF were analysed retrospectively.Results The X-ray appearances of lung and heart in CRF included augment and blur of hilum, increased, tortuous and disorder lung markings, accretion of heart, and the abnormal shadows in lung were irregular, inhomogeneus and changing fast in morphology. Conclusion Radiography can supply valuable messages and is ofconsiderable value in the diagnosis of CRF.

Objective To evaluate the diagnostic superiority of endoscopic ultrasonography (EUS) in primary gastric lymphoma (PGL) and its value in follow-up.Methods From January 2012 to June 2015,38 patients with suspected PGL under regular gastroendoscopy,biopsy and surgery operation received EUS combined with targeted deep biopsy.T test and chi-square test were performed for statistical analysis.Results Among 50 patients suspected for PGL under regular gastroendoscopy,38 patients were confirmed pathologically.The sensitivity of EUS examination with targeted deep biopsy in PGL was 86.8％ (33/38),the specificity was 83.3％ (10/12) and accuracy was 86.0％ (43/50).The accuracy of EUS examination with deep biopsy was higher than that of regular gastroscopy,and the difference was statistically significant (86.0％ (43/50) vs 57.9％ (22/38),x2 =19.4,P＜0.05).The main endosonographic characteristics of PGL were partial or diffuse thickening of stomach wall presented with,even or uneven hypoechoic lesions and extramural enlarged lymph nodes.Compared with pathological stage after surgery,the accuracy of T and N stage of EUS was 8/8 and 7/8.The times to achieve complete remission of Helicobacter pylori (H.pylori) eradication group and H.pylori eradication group were (3.3±0.8) months and (4.6± 0.9) months,respectively,and the difference between the two groups was statistically significant (t =4.3,P＜0.05).Conclusions The detection rate of EUS combined with targeted deep biopsy is high,which could clearly indicate the depth and extent of lesion invasion and guide clinical stage and selection of therapy.EUS could effectively evaluate efficacy of PGL treatment.

Bronchogenic Cyst ; Child ; Humans ; Male ; Neck ; pathology ; Young Adult

Objective To investigate the feasibility of using ultrasound‐mediated destruction of microbubbles ( US+ MB) to enhance the transplantation of endothelial progenitor cells ( EPCs) to confer chronic allograft vasculopathy (CAV) .Methods Bone marrow derived mononuclear cells were isolated and induced in vitro . The abdominal aorta transplantation was performed . Four groups were divided:control group without treatment (group A) ,injection with saline (group B) ,injection with EPCs (group C) ,group D ( US+MB+EPCs) was injected with EPCs and US was applied to MB prior to the infusion . All rats were killed during 8 weeks after transplantation to enable histological examination;SDF‐1α expression was detected by immunohistochemistry ,the expression of SDF‐1αand TNF‐αin the grafted aortas were detected with RT‐PCR . Results When 8 weeks after EPCs transplantation ,there was a significant improvement in aortic intima of Group D compared with Group B and C ,respectively ( P <0 .05) . In addition ,treatment of Group D significantly increased the expression of SDF‐1αand reduced the expression of TNF‐αin the grafted aortas . Conclusions US‐mediated MB destruction prior to EPCs transplantation into the grafted aortas can improves the effectiveness of endothelial repair and delay the progress of CAV .

Objective:To investigate the role of clinical pharmacists in the process of chemotherapy for a patient with intracranial glioma. Methods:Usage and dosage of antitumor drugs, drug interactions, adverse drug reactions and medication education after dis-charged as the breakthrough points, clinical pharmacists and clinicians explored options for the patient treatment and adjusted the medi-cation timely according to the condition. Results:There were no serious adverse drug reactions in the adjusted therapeutic regimen and the treatment results of the patient were satisfactory. Conclusion:Clinical pharmacists provide pharmaceutical care can play an impor-tant role in improving the safety and effectiveness of drug use.

This study was designed to summarize the clinical experience of harvesting the lung of a brain-death donor by international standardized methods so as to establish a set of standards and regulations that are applicable for harvesting the lung of brain-death donors in China. The patient was strictly determined according to international standardized method by two or more advanced neurologists, neurocranial surgeon, anesthetists, and ICU specialists using brain death diagnostic standards and brain death diagnostic technological specification. The family members signed a informed consent of abandoning treatment for brain death and he was a volunteer organ donor. The operation was performed on 1 brain-death donor who had endured 50 hours of mechanical ventilation to evaluate brain death and organ function. The donor was assessed by donor lung function test and international brain death standard. Then the organ was ready for lung transplantation.

Psychiatric professional talents are specially needed in China.Attention should be paid to the cultivation of clinical thinking ability in the process of cultivating professional master degree postgraduate majoring in mental health and psychiatry.Following measures can be taken such as using problem-based leaming(PBL) interactive teaching,organizing symposium,urging students to reviewing the language knowledge and logic knowledge,implementing specialized training to promote students' rigorous logical thinking ability,the ability to get information and interpersonal communication ability,strengthening the clinical practice teaching and paying close attention to the analysis and summary after the failure.

Objective To investigate effect of continuous veno-venous hemofiltration on treatment of children with acute re-spiratory distress syndrome .Methods A total of 84 cases of children with acute respiratory distress syndrome were divided into control group (n= 42) and observation group (n = 42) .Control group was given conventional therapy including etiological treat-ment ,mechanical ventilation ,fluid management and anti-inflammatory treatment .Besides conventional therapy similar to control group ,observation group was administrated continuous veno-venous hemofiltration .Gender ,age ,admission critical illness score (PICS) ,clinical manifestations ,blood gas indexes (PaO2 ,SaO2 ) and oxygenation index (OI = PaO2 /FiO2 ) before and after treat-ment ,duration of mechanical ventilation ,pediatric intensive care unit (ICU) hospitalization days and mortality in above two groups were analyzed retrospectively .Results There were not significant difference in gender ,age and admission critical illness score (PICS) of two groups(P> 0 .05) .PaO2 ,SaO2 and OI of observation group were higher than that of control group in the third and fifth day after treatment (P < 0 .05) .The average ICU hospitalization day of observation group was shorter than that of control group (P< 0 .05) .Mortality of observation group was lowered compared with control group (P< 0 .05) .Conclusion Veno-venous hemofiltration could effectively reduce duration of mechanical ventilation and mortality in treatment of children with acute respirato -ry distress syndrome ,which is worth clinical popularization .