Objective To discuss the application effects of trinitarian visualization teaching model in endoscopy reprocessing teaching practice. Methods Subjects in the study were divided into the trinitarian visualization teaching group (n=40) and the traditional teaching group (n=43) by random number table method; Compliance and credibility rating of endoscope reprocessing procedures were compared between 2 groups. 2 weeks after training, objectives were examined and assessed by questionnaires separately. Results Compliance of the trinitarian visualization teaching group was higher than the traditional teaching group (χ2=10.501, P=0.033). The trinitarian visualization teaching group had a higher rating in compliance, with 47.47 credibility points, theory test (93.79 ± 3.81) points and 93.02%(40/43) of operation pass. The traditional teaching group had a credibility point of 43.68 credibility points, with theory test (85.25±3.14) points and 77.50%(31/40) of operation pass. Significant difference between the two groups were statistical significant (t=4.84 and 11.097, χ2=4.038,P<0.01 or 0.05). Conclusions The trinitarian visualization teaching model can be used to improve the reprocessing training quality, to save time and human resource and to reach the training demand.

Objective To approach the related factors and emergency endoscopic hemostasis measures for duode-nal papilla hemorrhage after ERCP, then sum up the clinical experience of prevention and treatment. Methods Clin-ical data of 27 patients with duodenal papilla hemorrhage treated by emergency endoscopic hemostasis were retro-spectively analyzed. Results 26 cases treated by emergency endoscopic hemostasis were successful, the success rate was 96.30 %. Conclusions Prevention is very important for duodenal papilla hemorrhage. Once bleeding after ER-CP, emergency endoscopic hemostasis is the most direct, simple and effective measure.

Objective To investigate the growth inhibition of β-elemene in ECV-304 cells,and study it's meaning to anti-angiogenesis in tumors.Methods The IC50 value of β-elemene in ECV-304 cells were got through MTT assay.Under treatment of β-elemene in ECV-304 cell,flow cytometry(FCM)was used to investigated the changing of cell cycle,electron microscope was used to show the morphological al-terations,agarose gel electrophoresis was used to detect effection on cells'DNA.Results The proliferation of ECV-304 cells was significantly inhibited by β-elemene,the IC50 value was (58.3 ±8.1)μg/ml.By FCM,we observed Cell cycle was significantly arrested in G0 /G1 phase under 60μg/ml treatment(P <0.05),apoptotic cells increased with the increase of drug concentrations.Typical apoptotic morphological alterations were found under electron microscope.Characteristic DNA-ladder standing for apoptosis was showed in agarose gel electrophoresis.Conclusions β-elemene can significantly inhibit ECV-304 cells'pro-liferation By inducing apoptosis.

Objective The study aimed to observe the influence of Puritybile capsules combined with different doses of Compound polyethylene glycol (PEG) in bowel preparation.Methods 120 patients were set into three groups (group A,B and C) randomly (40 patients in each).Group A take the routine Compound polyethylene glycol treatment orally.On the basis of the same routine Compound polyethylene glycol treat-ment,group B added regular dose of Puritybile capsules.Group C took half dose of Compound polyethylene glycol and regular dose of Puritybile capsules.The cleaning effect and adverse reaction were compared among three groups.Results According to Ottawa Scale,the cleaning effects as well as the existing of air bubbles showed no significant difference among three groups.Among which group C was 30％lower than that of group A,10％ lower than that of group B.There was no statistical differences in adverse events.Conclusions Half dose of Compound polyethylene glycol and regular dose of Puritybile capsules can guarantee the ef-fect of bowel cleaning and lower medical expense of patients.

Objective To investigate the operation process,extent of resection,protection function,the tumor recurrence and clicical value of neuronavigation with intraoperative ultrasound for treating functional glioma;signifi-cance of intraoperative ultrasound for correcting brain shift.Methods We analyzed the cliclical materical of 24 case of functional gliomas which were resected by neuronavigation with intraoperative ultrasound.Results The accuracy of localization of functional glioma was 100%.The distance of brain shift was 2 to 10mm,with an average 4.7mm.After 24 hours MRI confirmed that total removal of function glioma was achieved in 21 cases,subtotal in 3 cases.After oper-ation function improve was 20 cases,invalid of 2 cases,hemiplegia happened in 2 cases and no death in all the patients.Conclusion Neuronavigation with intraoperative ultrasound can correct brain shift and improve the accuracy of localization of functional glioma,to improve extent of function glioma and decrease dysfunction.Neuronavigation with intraoperative ultrasound is important to functional glioma.

Aiming at the characteristics of telemedicine service,we summarized our telemedical consultation work during 2006-2008.We believed that telemedical consultation from big hospitals are very important in maintaining physical and moral health conditions and treating severe sickness of grassroots officers and soldiers,it can also play active roles in the construction of basic army unit hospitals.

Objective:To investigate the construction and application of telemedicine system in Tibet Autonomous Region.Methods:From June to July 2020, medical institutions at all levels in Tibet Autonomous Region were visited. Relevant information was collected through discussion, questionnaires and field visits, and the data of effective questionnaires were statistically analyzed.Results:A total of 125 medical institutions were visited, covering 7 regions of Tibet Autonomous Region, of which 74 medical institutions were able to realize audio-video two-way communication with the telemedicine platform of the PLA General Hospital. Seventy-three valid questionnaires were collected, and 64(88%)hospitals had software or hardware audio and video terminals. Twenty-five hospitals had never carried out remote consultation, accounting for 34%. The annual remote consultation amount of 35 hospitals was less than 10 cases, and that of 11 hospitals was 11-100 cases. Only 2 hospitals had carried out remote ECG and remote ultrasound diagnosis, with an annual consultation volume of more than 100 cases.Conclusions:The hospitals at or above the county level in Tibet Autonomous Region have established telemedicine system, but there are few remote services, the system idle rate is high, and the distance education resources are not matched.

Objective:To construct a value evaluation framework for high-value medical consumables,providing a guidance for medical insurance access and hospital access management scenarios in China.Methods:It conducted literature review,qualitative in-terviews and quantitative surveys.A total of 12 experts were invited for qualitative interviews,while 100 experts from four fields of health technology assessment,medical insurance,hospital management,and clinical practice participated in the quantitative survey.Through those process,it generated the composition of the value framework and the scoring of each item.Differences in ratings be-tween different scenarios and experts were analyzed through chi-square tests.The recommendation level for each item was graded.Re-sults:A comprehensive value evaluation framework for high-value medical consumables was established,which included 6 core dimen-sions,comprised 16 items for secondary dimensions and 50 items for tertiary dimensions.It showed significant differences between the medical insurance access and hospital access scenarios,as well as among different fields of experts in the same scenario.furthermore,grading the items in two scenarios.The medical insurance access scenario had 8 highly recommended items,and the hospital access scenario had 24 highly recommended items.Conclusion:Value evaluation should encourage multi-dimensional assessments and inter-disciplinary participation,continually improving the management of high-value medical consumables in medical insurance and hospital access.