We took measures to construct sound learning mechanism and a set of effective learning system,which were connected tightly with various learning ways according to the idea of ‘ school-based ’ training.Goals of learning mechanism and the set of effective learning system were to improve teacher's learning ability,enhance knowledge and competence of medical college teachers and to construct learning teaching faculty.

Objective To investigate the clinicopathological characteristics and postoperative prognosis analysis of intra-thoracic localized Castleman disease (LCD).Methods The clinical data of 9 patients with intra-thoracic LCD who accepted surgical treatment were retrospectively analyzed.There were 5 males and 4 females,with age of (32.8 ± 10.9) years.Two patients complained of chest pain,1 patient suffered from paraneoplastic pemphigus,and the rest were diagnosed by physical examination.Four cases were diagnosed with LCD by preoperative CT examination.Results All patients underwent surgical resection.Four patients were performed open surgery and 5 patients had video assisted thoracic surgery.All patients accepted radical surgery.But 2 of these patients had postoperative complications.One patient was the injury of phrenic nerve and another was pericardial effusion.Patho-histological showed hyaline vascular type of Catleman disease in all patients.All patients survived without recurrence during the follow-up for 2-53 months.Conclusions Intra-thoracic is rare and liable to misdiagnosed.For increasing the preoperative diagnosis rate of LCD,the combined application of imaging tests is important,and clinicians and radiologists should also enhance the awareness of this disease.Complete surgical resection of the tumor is the best therapeutic alternative for intra-thoracic LCD.

Objective: To investigate the therapeutic outcome of expanded scalp flaps pedicled with superficial temporal vessel for the reconstruction of large facial defects. Method: From Dec 2014 to Oct 2016, 10 cases with large facial skin defects were treated with expanded scalp flaps pedicled with superficial temporal vessel and delayed laser hair removal.Extra expanded scalp flaps were collected as experimental groups. Normal skin(forehead, temporal scalp, cheek, upper eyelid, lower eyelid and nasal dorsum)of 10 cases were collected for control, to compare skin thickness.All patients were followed at least 6 months. Results: There was no significant difference of skin thickness between the expanded scalp flaps and cheek, forehead, nasal dorsum skin(P>0.05). But upper eyelid and lower eyelids skin was significantly thinner than other local skin tissuein controls, and expanded scalp flap (P<0.05). The expanded scalp flap matched well with surrounding tissues in color, texture and thickness. Conclusions It is a good option to repair large facial skin defects with expanded scalp flaps, pedicled with superficial temporal vessel, and laser hair removal, though its shortcoming in eyelid skin defect repairment.

Objective:To explore the diagnostic value of ultrasound shear wave elastography and portal vein hemodynamic parameters for chronic hepatitis and liver fibrosis.Methods:The clinical data of 48 hospitalized patients with chronic hepatitis diagnosed in Fuyang Second People's Hospital from May 2019 to July 2020 were collected and analyzed retrospectively. The patients voluntarily received portal vein hemodynamics and ultrasonic shear wave elastography. According to Scheuer's method, 48 patients were classified into 5 stages of liver fibrosis, including 10 patients in S0 stage, 13 patients in S1 stage, 10 patients in S2 stage, 10 patients in S3 stage and 5 patients in S4 stage. The average velocity of portal vein, peak portal vein velocity (PVVmax), portal vein diameter (PVD), liver stiffness measurement (LSM) and Young's modulus of liver were compared. Pathological and liver biopsy was the gold standard to analyze the sensitivity and specificity of various detection methods. The normally distributed measurement data were expressed as xˉ± s, the comparison between multiple groups was performed by one-way ANOVA, and the pairwise comparison was performed by LSD-t test. Spearman method was used to analyze the correlation between liver function classification and various parameters. ROC curve was used to analyze the diagnostic value of ultrasonic shear wave elastography, portal vein hemodynamics and combined detection in predicting liver fibrosis in chronic hepatitis. Results:In the staging of liver fibrosis, the LSM of the patients in the S0 stage was (5.29±0.19) kPa, and the Young's modulus of the liver was (21.65±2.35) kPa; the LSM of the patients in the S1 stage was (6.38±1.25) kPa, and the Young's modulus of the liver ( 22.89±3.19) kPa, LSM (9.76±1.33) kPa and hepatic Young's modulus (23.77±3.52) kPa in S2 group, LSM (15.44±2.44) kPa, hepatic Young's modulus (25.14±2.29) in S3 group, LSM (18.08±1.22) kPa and hepatic Young's modulus (27.94±2.58) kPa in patients with S4 stage, the differences between groups were statistically significant (F values ??were 115.47, 4.84, P values?were <0.001, 0.003), and the difference was statistically significant (all P<0.05). The average flow velocity of patients in S0 stage was (20.56±4.21) cm/s, PVVmax (22.19±4.33) cm/s, the average flow velocity of S1 stage was (18.39±3.79) cm/s, PVVmax (20.69±3.12) cm/s, and the average of S2 stage Flow velocity (13.46±2.21) cm/s, PVVmax (16.65±2.54) cm/s, average flow velocity in S3 stage (10.56±2.85) cm/s, PVVmax (13.42±2.46) cm/s, average flow velocity in S4 stage (8.15±1.65) cm/s, PVVmax (11.89±2.89) cm/s, the difference between the groups was statistically significant (F values were 21.35, 16.96, all P<0.001), and the difference between the two groups was statistically significant (all P<0.05). Correlation analysis by Spearman method showed that liver function grades were negatively correlated with average flow velocity and PVVmax (r values ?were -0.75 and -0.88, respectively; all P<0.001), and were positively correlated with liver Young's modulus and LSM. (r values ??were 0.54 and 0.86, respectively; all P<0.001). According to the ROC curve analysis, the AUC predicted by ultrasonic shear wave elastography was 0.75, AUC predicted by portal vein hemodynamics predicts was 0.68, and AUC predicted by combined detection predicts was 0.94. Conclusion:The combination of portal vein hemodynamics and ultrasonic shear wave elastography has a certain diagnostic power for the assessment of chronic hepatitis and liver fibrosis, with high specificity and sensitivity.

Background/Aims: Roxadustat, an oral medication for treating renal anemia, is a hypoxia-inducible factor prolyl hydroxylase inhibitor used for regulating iron metabolism and promoting erythropoiesis. To investigate the efficacy and safety of roxadustat in patients undergoing peritoneal dialysis (PD) with erythropoietin hyporesponsiveness. Methods: Single-center, retrospective study, 81 PD patients (with erythropoietin hyporesponsiveness) were divided into the roxadustat group (n = 61) and erythropoiesis-stimulating agents (ESAs) group (n = 20). Hemoglobin (Hb), total cholesterol, intact parathyroid hormone (iPTH), brain natriuretic peptide (BNP), related indicators of cardiac function and high-sensitivity C-reactive protein (hs-CRP) were collected. Additionally, adverse events were also recorded. The follow-up period was 16 weeks. Results: The two groups exhibited similar baseline demographic and clinical characteristics. At baseline, the roxadustat group had a mean Hb level of 89.8 ± 18.9 g/L, while the ESAs group had a mean Hb level of 95.2 ± 16.0 g/L. By week 16, the Hb levels had increased to 118 ± 19.8 g/L (p < 0.05) in the roxadustat group and 101 ± 19.3 g/L (p > 0.05) in the ESAs group. The efficacy of roxadustat in improving anemia was not influenced by baseline levels of hs-CRP and iPTH. Cholesterol was decreased in the roxadustat group without statin use. An increase in left ventricular ejection fraction and stabilization of BNP were observed in the roxadustat group. Conclusions For PD patients with erythropoietin hyporesponsiveness, roxadustat can significantly improve renal anemia. The efficacy of roxadustat in improving renal anemia was not affected by baseline levels of hs-CRP0 and iPTH.