Objective To investigate the cognitive difference between uni-modal (V,A) and bi-modal (VA)target stimuli from both vision and audition,and then to study the neural mechanisms of bi-modal enhancement.Methods This experiment adopted a speeded target stimuli detection task, both behavioral and electroencephalographic responses to uni-modal and bi-modal target stimuli which were combined from visual and auditory target stimuli,were recorded from 14 normal subjects using a 64-channel EEG NeuroScan system.The differences of cognitive between uni-modal and bi-modal stimulus were tested from both behavioral (reaction time (RT) and error rate (ER)) and event-related potentials (ERPs) (P2 latency and amplitude,P3 latency and amplitude)data,and the correlation between behavioral and ERPs results were analyzed.Results As a result,the RT,ER and P3 latency has significant difference between uni-modal and bi-modal target stimuli.In addition,there were significant correlation between behavioral data and P3 latency,especially from the RT and P3 latency.Conclusion By comparing the difference between uni-modal and bi-modal from both behavioral and ERPs results,we could reached the conclusion that the neural mechanism of bi-modal target detection was predominant over that of vision and audition uni-modal target detection,the enhancement take place not only involved in early ERP components (such as P1 and N1),but engaged at the late ERP components (such as P2 and P3).

Objective To explore the clinical characters,treatment and prognosis of gastrointestinal Dieulafoy lesion in China.Methods Dieulafoy was used as search term,the literatures about Chinese patients with Dieulafoy lesions from January 1998 to October 2016 were retrieved in the Chinese literature library including China National Knowledge Infrastructure,VIP network,Wanfang database and China Biology Medicine disc,and a total of 515 literatures,5 145 patients were enrolled and analyzed.The gender,age,geographical distribution,location of the lesion,treatment and prognosis of the disease were summarized.Results Among the 5 145 patients (male 3 959,female 1 186) with Dieulafoy disease,the ratio of male to female was 3.34∶1.00.The age was from 3 to 95 years,and mean age was 51 years.The lesion location was mainly in stomach (88.82％,4 570/5 145) and second was small intestine (8.28％,426/5 145).In stomach,the lesions were mainly located in gastric corpus,fundus and cardia.The small intestinal Dieulafoy lesions were mainly located in duodenum.The main manifests were sudden hematemesis,melena,and hematochezia.The treatments mainly was endoscopic treatment (72.56％,3 733/5 145),and second was surgery (25.27％,1 300/5 145).Among the5 145 patients withDieulafoy disease,5 099 patients (99.11％) were cured and 46 patients (0.89％) died.The proportions of endoscopic treatment,interventional therapy and first endoscopic treatment within 24 hours in tertiary hospitals were all higher than those of nontertiary (all P＜0.01).The cure rate of tertiary hospitals (99.22％,3 674/3 793) was significantly higher than that of nontertiary hosptials (98.54％,1 421/1 442) (x2 =0.89,P＜0.05) and the mortality was significantly lower than that of nontertiary hospitals (P＜ 0.05).Conclusions The male is more susceptible to Dieulafoy lesion which occurred at any age than the female in China.The predilection sites of Dieulafoy lesion were stomach and duodenum.The primary treatments were endoscopic treatment and surgery,and the disease usually had a good prognosis.

Majority of type 2 diabetes mellitus (T2DM) patients are highly susceptible to several forms of cognitive impairments, particularly dementia. However, the underlying neural mechanism of these cognitive impairments remains unclear. We aimed to investigate the correlation between whole brain resting state functional connections (RSFCs) and the cognitive status in 95 patients with T2DM. We constructed an elastic net model to estimate the Montreal Cognitive Assessment (MoCA) scores, which served as an index of the cognitive status of the patients, and to select the RSFCs for further prediction. Subsequently, we utilized a machine learning technique to evaluate the discriminative ability of the connectivity pattern associated with the selected RSFCs. The estimated and chronological MoCA scores were significantly correlated with R= 0.81 and the mean absolute error (MAE) =1.20. Additionally, cognitive impairments of patients with T2DM can be identified using the RSFC pattern with classification accuracy of 90.54％ and the area under the receiver operating characteristic (ROC) curve (AUC) of 0.9737. This connectivity pattern not only included the connections between regions within the default mode network (DMN), but also the functional connectivity between the task-positive networks and the DMN, as well as those within the task-positive networks. The results suggest that an RSFC pattern could be regarded as a potential biomarker to identify the cognitive status of patients with T2DM.

Objective: To investigate awareness of digestive system injury caused by corona virus disease 2019 (COVID-19) in gastroenterologists. Methods: From February 21 to 23 in 2020, the electronic questionnaire was sent out to explore the condition of the basic knowledge of COVID-19 and knowledge of digestive system injury caused by COVID-19 grasped by gastroenterologists. Chi-square test was used for statistical analysis. Results: A total of 2 216 gastroenterologists from 31 provinces, autonomous regions and municipalities nationwide completed the survey. 99.7% (2 209/2 216) of gastroenterologists stated that they had read the COVID-19 diagnosis and treatment guidelines. The percentage of physicians who well knew the diagnostic criteria of suspected and confirmed cases of COVID-19 was 34.9% (774/2 216) and 39.4% (874/2 216), respectively. The percentage of physician who gave the right answer of COVID-19 detectable methods and lung imaging was 68.4% (1 516/2 216) and 71.6% (1 586/2 216), respectively. The percentage of correct answer of digestive system injury caused by COVID-19 in residents, attending physicians, associate chief physicians and chief physicians was 30.9% (134/433), 33.9% (234/691), 32.4% (213/657) and 34.9% (152/435), respectively, however there were no statistically significant differences among physicians of different level (χ²=6.60, P> 0.05). 95.6% (2 119/2 216) of gastroenterologists believed that probiotics could effectively improve bowel function, and 94.0% (2 082/2 216) of gastroenterologists considered that enteral nutrition support could improve patients’ prognosis. Conclusions The knowledge and dynamic progress of the digestive system injury caused of COVID-19 are still insufficiently grasped by gastroenterologists in China. So it is necessary to carry out systematic and pertinent training for them.

Further healthcare system reform calls for desirable pathway design. This paper introduced the logical framework of the new healthcare system reform pathway design and typical practical experience in Hangzhou.Known for " Internet+Smart healthcare" forerunner, Hangzhou has pioneered the reform of public hospitals and the construction of smart handy service for the public.With the aim of fully protecting the health rights and interests of urban and rural residents, comprehensive policy has been taken to deepen the reform of public hospitals; with the comprehensive promotion of contracted services and the primary level sharing of resources as a carrier, we will build a hierarchical medical service system of vertical linkage.We will also innovate and practice the governing philosophy of " Medicine has its limitations but we have the courage to overcome, service is boundaryless and we must pursue excellence".Promotion of party building in the industry also ranks high.Deepening the reform of " one visit for all" in the field of medical and health services as a measure to enhance people′s sense of gain; The " public-private partnership" to encourage the development of the social governance system and legalization in healthcare proves successful at this stage. However, there are still many challenges in the information security maintenance of smart healthcare, the balance of stakeholder interests in public hospitals, the all-round advancement of hierarchical medical service, standardizing and streamlining the reform of " one visit for all".

Objective:To investigate the awareness of digestive system injury caused by coronavirus disease 2019 (COVID-19) in gastroenterologists.Methods:From February 21 to 23 in 2020, the electronic questionnaire was used to learn about the condition of the basic knowledge of COVID-19 and awareness of digestive system injury caused by COVID-19 among the gastroenterologists across the country. Chi-square test was used for statistical analysis.Results:A total of 2 216 gastroenterologists from 31 provinces, autonomous regions and municipalities nationwide completed the survey. 99.7% (2 209/2 216) of gastroenterologists stated that they had read the COVID-19 diagnosis and treatment guidelines. The percentages of physicians who knew clearly about the diagnostic criteria of suspected and confirmed cases of COVID-19 was 34.9% (774/2 216) and 39.4% (874/2 216), respectively. The percentages of physician who gave the right answers of COVID-19 detectable methods and pulmonary imaging was 68.4% (1 516/2 216) and 71.6% (1 586/2 216), respectively. The percentages of correct answers of digestive system injury caused by COVID-19 were physicians and chief physicians was 30.9% (134/433) in residents, 33.9% (234/691) attending physicians, 32.4% (213/657) associated chief physicians and 34.9% (152/435) chief physicians, respectively, however there were no statistically significant differences among physicians with different professional titles ( χ2=6.60, P> 0.05). 95.6% (2 119/2 216) of gastroenterologists believed that probiotics could effectively improve bowel function, and 94.0% (2 082/2 216) of gastroenterologists considered that enteral nutrition support could improve patients’ prognosis. Conclusions:The knowledge and dynamic progress of the digestive system injury caused by COVID-19 are still insufficiently grasped by gastroenterologists in China. So it is necessary to carry out systematic and pertinent training programmes for them.

Objective:This study sought to investigate the feasibility, anatomical indications and operating points of transcatheter aortic valve replacement (TAVR) procedure in the treatment of pure aortic regurgitation (AR).Methods:The medical records of 4 elderly patients with pure AR who were treated in the cardiology department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from March 2020 to March 2021 were retrospectively analyzed. All patients were implanted with self-expandable valve stents via peripheral artery approach for TAVR treatment. The feasibility, anatomical indications and key points of TAVR were analyzed.Results:The 4 patients with pure AR who were carefully screened had an average age of 66 years, and all achieved TAVR treatment success without serious perioperative complications and death. Postoperative examination and follow-up data showed that cardiac functions and cardiac remodeling indexes were significantly improved.Conclusions:This exploratory study shows that TAVR is technically feasible and effective treatment option for selected elderly patients with native pure AR, which is worthy of further study.