Objective To update files in local area network automatically.Methods According to the files which has to update in data-base,the order'net' in DOS was used to copy the shared files.Results Files were updated automatically.Conclusion The workload of the staff is reduced and the programs are updated rapidly and correctly Avoiding the error,ensuring the automatic update simaltaneity.[Chinese Medical Equipment Journal,2008,29(2):50]

The development and wide application of assisted reproductive techniques(ART) help many couples suffered from infertility and/or sterility to get baby.Meanwhile,the usage of ART led to much ethic problem.We,hence,investigate the strategies to deal with the ethic problem in ART correctly.

Objective To determine the clinical value of hypergammaglobulinemia as a sentinel for autoimmune pancreatitis and avoid unnecessary pancreas resection.Methods All 14 patients with autoimmune pancreatitis or related pancreatic diseases underwent routine examinations,including liver function,CA199 and imaging.Measurement of serum IgG or IgG4 was performed for patients with clinically suspected or pathologically proved autoimmune pancreatitis.Clinical features were retrospectively compared between the AIP and non-AIP patients using x2 statistics with Yates correction or Fisher exact test.Results Ten cases were finally confirmed as autoimmune pancreatitis.All patients with autoimmune pancreatitis had elevated levels of serum γ-globulins,while only one case without autoimmune pancreatitis had elevated levels of serum γ-globulins.It was proved by subsequent antibody tests that serum IgG/IgG4 and γ-globulins were simultaneously increased.Conclusions Hypergammaglobulinemia can be used as a preoperative sentinel indicator for differentiating autoimmune pancreatitis from pancreatic malignancies and avoiding unnecessary pancreas operation.

Objective To investigate the prevalence and characteristics of adverse reactions to cosmetics in China,and to provide a basis for further supervision.Methods The diagnosis of adverse reactions to cosmetics was according to 7 national standards (GB17149.1-7-1997) including the A general rule for the diagnosis and management of skin diseases induced by cosmetics.Data regarding gender,age,occupation,educational background,disease types,cosmetic types,and so on,were collected from patients with adverse reactions to cosmetics at 13 surveillance sites in China during 2005-2014.A descriptive statistical analysis was carried out.Results During 2005-2014,a total of 13 534 cases of adverse reactions to cosmetics were reported to the monitoring system.Of these cases,95.40％ (12 912/13 534) were female,and 80.85％ were young or middle-aged (20-44 years).Finally,5 446 cases were confirmed to be adverse reactions to cosmetics,among which,94.66％ (5 155/5 466) were contact dermatitis to cosmetics,and 132 were other types that were not included in the A general rule for the diagnosis and management of skin diseases induced by cosmetics.Among these confirmed cases,14 209 cosmetic products were involved,and ordinary skin care products predominated in these products.The proportion of imported cosmetic products (48.79％,6 932/14 209) was slightly higher than that of domestic products (43.21％,6 139/14 209).The number of reported eases increased by 13.16％ per year from 2005 to 2009,but decreased by 17.96％ per year from 2010 to 2014.Conclusion Adverse reactions to cosmetics are a complicated and important public health issue,and effective measures should be taken based on their characteristics.

ObjectiveTo investigate the CT and MRI imaging characteristics of autoimmune pancreatitis and its clinical value.MethodsFourteen patients(13males, 1female, mean age 58.3 years) with autoimmune pancreatitis proved histopathologically or clinically were enrolled in the study.Clinical data was studied retrospectively.Among those patients,CT was performed on 12 cases and MR imaging was performed on 8 patients,6 patients underwent both CT and MR imaging.ResultsAll 14 patients had enlargement of the pancreas,which could be divided into three types including diffuse type ( n =7 ),focal type ( n =5 ) and mixed type ( n =2 ).On plain CT the pancreas was of isodensity ( n =5 ) or mild hypodensity ( n =7).In one case there was several small hypodensity cystic lesions within and around the pancreas that was rarely seen in other autoimmune pancreatitis cases.Pancreatic lesions as shown by MRI were all mildly hypointense on T1WI and mildly hyperintense on T2WI,all displayed lesions were detected as high-signal intensity areas on DWI. By medium contrast,autoimmune pancreatitis lesions demonstrated “ snow-like” heterogeneously decreased enhancement on artery phase of dynamic contrast enhanced imaging and then showed gradually delayed enhancement on portal venous phase and later phases.“Capsule-like” rim was present around the autoimmune pancreatitis lesions in 9 cases.Main pancreatic duct was irregular in shape in 4 cases and slightly dilated in 5 patients.Strictures of lower common bile duct and upper bile duct dilatation as well as thickening and enhancement of the bile duct wall were found in 9 cases.Peripheral vascular involvement was seen in 4 cases. Abdominal lymphadenopathy at hepatic portal was observed in 1 patient.Two cases showed tiny decreased enhancement lesions in the kidneys.Steroid therapy was given in 10 cases,all pancreatitis lesions ameliorated as showed by follow-up imaging examinations.ConclusionsAIP specific CT and MRI imaging findings are common in most patients which help establish the diagnosis and differential diagnosis of AIP.

Objective:To explore the technique and clinical effects of free medial plantar flap on reconstruction of the severe defect of thumb caused by electric burn.Methods:Surgical techniques and clinical effects were explored in reconstruction with free medial plantar flap for treatment of severe electric burns of thumbs. From July 2016 to July 2021, 18 patients suffered from severe electric burns of thumbs were admitted in the Department of Burn, Zhengzhou First People's Hospital. All the wounds were the entrance of electric burns. After thorough debridement, the arteries, nerves, tendons, phalanges and interphalangeal joints were exposed to various degrees. Damaged digital proper palmar arteries were ligated and defected proper palmar digital nerves were marked and further anastomosed with the nerves carried by the flap. Palmaris longus tendon grafts were employed to reconstruct the defects of flexor pollicis longus tendon. Wounds were closed by transfer of free medial plantar flaps, and the flap donor sites were closed by inguinal skin grafts. Survival of the flap was observed 1 week after surgery, and the survival of the skin graft in the foot donor site 12 days after surgery. Outpatient follow-up including observation of the appearance and texture of the flap, evaluation of sensory function, thumb alignment and finger flexion according to the Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association. Evaluate the scar hyperplasia in the foot donor site and the standing and walking functions of the donor foot.Results:All flaps survived,at 1 week after surgery. On the 12th day after surgery, all 16 foot flap survived, and 2 patients had local necrosis, and the necrosis healed completely after dressing change for 10 days, the wound healed completely. Among them, 3 patients without tendon transfer experienced a rupture of the flexor pollicis longus tendon at 2 months after surgery, and underwent another palmaris longus tendon transfer. After the surgery, functional exercise was performed with the palm and flexor fingers. After 6-12 months of follow-up, the blood supply, appearance, and texture of the flap were good and similar to that of the palmar skin of the thumb, with varying degrees of recovery in sensation. The TPD was 6-11 mm, and the thumb was restored to varying degrees. According to the Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, 13 cases in excellent and 5 cases in good. Mild scar hyperplasia remains in the flap site of donor feet, which does not affect the standing and walking functions of the donor foot.Conclusion:The texture of medial plantar skin is similar to that of palmar skin, with good wear resistance and good sensation. Furthermore, it causes a little damage to the donor site and without obvious complication. The medial plantar flap is ideal for reconstruction of a severe wound caused by electric burn in thumb.

Objective By using the computational fluid mechanic(CFD)method the tandem carotid artery stenosis(TCAS)was simulated on the model,and to compare the postoperative hemodynamic changes of different surgical procedures.Methods One patient with tandem stenosis of internal carotid artery(ICA)and common carotid artery(CCA)was selected.CFD technique was used to establish four three-dimensional(3-D)models of the carotid bifurcations,including one model of a real patient and three models of presumptive surgery.The hemodynamic analysis was performed with these models so as to explore the development mechanism of TCAS and to discuss the selection of suitable surgical plan.Results In tandem stenosis,the stenosis was preferentially formed in CCA and subsequently led to ICA stenosis.The local hemodynamic situation in TCAS was more complex and more risky than in single carotid artery stenosis.In tandem stenosis,the treatment of one stenosis site would affect the blood flow at the next stenosis site and cause restenosis or plaque rupture.Conclusion In treating patients with TCAS,CFD simulation examination should be performed when the surgical plan is formulated,which can help clinicians to predict the postoperative changes in blood flow and to choose the appropriate surgical plan.

Objectives:To evaluate the role of pancreas multidisciplinary team(MDT) clinic in the diagnosis of pancreatic diseases,patient compliance with MDT advice,and the impact of MDT on the postoperative survival of patients with pancreatic cancer.Methods:The study included 927 patients(554 males,373 females,aged (58.1±13.3)years (range: 15 to 89 years)) that had visited the pancreas MDT clinic of Zhongshan Hospital from May 2015 to December 2021,and 677 patients(396 males, 281 females, aged (63.6±8.9)years(range: 32 to 95 years)) who underwent radical surgery and with pathologically confirmed pancreatic adenocarcinoma from January 2012 to December 2020,of whom 79 patients had attended the pancreas MDT. The clinical and pathological data were collected and analyzed retrospectively. Diseases were classified in accordance with 2010 WHO classification of tumors of the digestive system and usual clinical practices. The Kaplan-Meier method was used for drawing the survival curve and calculating the survival rate. The univariate analysis was done by Log-rank test and the multivariate analysis was done by COX proportional hazards model. Survival rates were compared using χ 2 test. Results:Among the 927 patients that had visited the MDT clinic,233 patients(25.1%) were referred due to undetermined diagnosis. A direct diagnosis was made in 109 cases (46.8%,109/233) by the MDT clinic, of which 98 were consistent with the final diagnosis,resulting in an accuracy of 89.9%(98/109). The direct diagnosis rate in the recent years(36.6%(41/112),from June 2019 to December 2021) decreased compared to that in the previous years(56.2%(68/121),from May 2015 to May 2019),yet the accuracy in the recent years(90.2%,37/41) was basically the same as before (89.7%,61/68). The rate of compliance of the entire cohort was 71.5%(663/927), with the compliance rate in the recent two and a half years(81.4%,338/415) remarkably higher than that in the previous four years(63.4%,325/512). Patients with pancreatic cancer that attended the MDT exhibited a trend toward longer median postoperative survival than patients that did not attend the MDT,but the difference was not statistically significant(35.2 months vs.30.2 months, P>0.05). The 1-year and 3-year survival rates of patients that attended the MDT were significanly higher than patients that did not attend the MDT(88.6% vs. 78.4%, P<0.05;32.9% vs. 21.9%, P<0.05,respectively),but the 5-year survival rate was not statistically different(7.6% vs. 4.8%, P>0.05). Conclusions:The pancreas MDT clinic is an accurate and convenient way to diagnose intractable pancreatic diseases,and in the recent years the patients′ compliance rate with MDT advice has increased. Pancreatic cancer patients that have attended the MDT have higher 1-year and 3-year postoperative survival rates,but the long-term survival benefits of MDT still needs to be proved by clinical studies on a larger scale.

Objectives:To evaluate the role of pancreas multidisciplinary team(MDT) clinic in the diagnosis of pancreatic diseases,patient compliance with MDT advice,and the impact of MDT on the postoperative survival of patients with pancreatic cancer.Methods:The study included 927 patients(554 males,373 females,aged (58.1±13.3)years (range: 15 to 89 years)) that had visited the pancreas MDT clinic of Zhongshan Hospital from May 2015 to December 2021,and 677 patients(396 males, 281 females, aged (63.6±8.9)years(range: 32 to 95 years)) who underwent radical surgery and with pathologically confirmed pancreatic adenocarcinoma from January 2012 to December 2020,of whom 79 patients had attended the pancreas MDT. The clinical and pathological data were collected and analyzed retrospectively. Diseases were classified in accordance with 2010 WHO classification of tumors of the digestive system and usual clinical practices. The Kaplan-Meier method was used for drawing the survival curve and calculating the survival rate. The univariate analysis was done by Log-rank test and the multivariate analysis was done by COX proportional hazards model. Survival rates were compared using χ 2 test. Results:Among the 927 patients that had visited the MDT clinic,233 patients(25.1%) were referred due to undetermined diagnosis. A direct diagnosis was made in 109 cases (46.8%,109/233) by the MDT clinic, of which 98 were consistent with the final diagnosis,resulting in an accuracy of 89.9%(98/109). The direct diagnosis rate in the recent years(36.6%(41/112),from June 2019 to December 2021) decreased compared to that in the previous years(56.2%(68/121),from May 2015 to May 2019),yet the accuracy in the recent years(90.2%,37/41) was basically the same as before (89.7%,61/68). The rate of compliance of the entire cohort was 71.5%(663/927), with the compliance rate in the recent two and a half years(81.4%,338/415) remarkably higher than that in the previous four years(63.4%,325/512). Patients with pancreatic cancer that attended the MDT exhibited a trend toward longer median postoperative survival than patients that did not attend the MDT,but the difference was not statistically significant(35.2 months vs.30.2 months, P>0.05). The 1-year and 3-year survival rates of patients that attended the MDT were significanly higher than patients that did not attend the MDT(88.6% vs. 78.4%, P<0.05;32.9% vs. 21.9%, P<0.05,respectively),but the 5-year survival rate was not statistically different(7.6% vs. 4.8%, P>0.05). Conclusions:The pancreas MDT clinic is an accurate and convenient way to diagnose intractable pancreatic diseases,and in the recent years the patients′ compliance rate with MDT advice has increased. Pancreatic cancer patients that have attended the MDT have higher 1-year and 3-year postoperative survival rates,but the long-term survival benefits of MDT still needs to be proved by clinical studies on a larger scale.

AIM: To assess the clinical efficacy of visual therapy in children with abnormal visual functions and asthenopia.METHODS: Retrospective case study. The data of 57 patients(114 eyes), aged 8.25±1.94 years, who underwent visual training at the optometry center of Xi'an Children's Hospital between January 2022 and April 2023, were collected. Patient assessments before and after training included refractive errors, a visual fatigue scale questionnaire, and visual function tests. These tests included the Worth 4 Dot for binocular vision, the Von Graefe method for measuring latent strabismus at distance and near, the gradient method for assessing the accommodative convergence/accommodation(AC/A)ratio, the push-up test for convergence near point, the negative lens method for amplitude of accommodation, the cross-cylinder test for accommodative response, and the flipper test for accommodative flexibility. Training programs were tailored based on the initial assessments of visual function and asthenopia. Comparisons were made between pre-training, 1 and 3 mo post-training evaluations.RESULTS: At baseline and 1 mo post-training, the visual fatigue scores were 26.00±6.77 and 19.57±8.90, respectively(P<0.05). Significant enhancements were observed in near phoria, convergence near point, and accommodative amplitude in both eyes, both negative relative accommodation(NRA)and positive relative accommodation(PRA), as well as accommodative flexibility in both eyes at 1 mo after therapy(all P<0.05), while no significant changes were found in distance phoria or accommodative response(all P>0.05). Furthermore, no significant differences were noted in the binocular amplitude of accommodation, NRA, PRA, and near phoria between 1 and 3 mo after training(all P>0.05). The visual function parameters of 30 patients with low myopia(SE: -1.99±1.22 D), 3 patients with low hyperopia(SE: +1.01±0.13 D)and 24 patients with emmetropia(SE: +0.25±0.11 D)were not statistically significant before training and at 1 mo after training(all P>0.05). Certain visual functions significantly improved at 1 mo after training, and most had returned normal by 3 mo.CONCLUSION: Vision therapy significantly enhances binocular visual function and alleviates symptoms of asthenopia in children with visual dysfunction. It is an effective, straightforward, and easily applicable method for relieving children's visual fatigue.