Objective To analyze the clinical diagnosis and treatment of recurrent cancer in gastric remnant.Methods Clinical data of 48 patients who underwent surgical re-operation because of recurrent carcinoma within gastric remnant after radical resection of gastric cancer were analyzed retrospectively.Results All 48 cases were recurrent cancer in gastric stump.The time of recurrence was 6-36 months after first radical resection.After reoperation,the mean survival time of 28 patients(58.3%)who underwent radical resection was 40 months;the mean survival time of 20 patients(41.7%)who received palliative treatment was 14.8 months(P

Objective To study the causes of local recurrence,and diagnosis and treatment outcome of recurrent colorectal cancer.Methods The clinical data of 60 patients with recurrent colorectal cancer treated during 10 years in our hospital were analyzed retrospectively.Results Among the 60 cases,40 cases(66.7 %) had recurrence within 2 years after operation.Recurrence in anastomotic stoma,perineum,abdominal incision occurred and in the abdominal cavity and pelvic cavity in 15,10,7 and 20 cases respectively,and liver metastases were found in 8 cases.All patients underwent reoperation including curative surgery for 38 patients and palliative operation for 22 patients.After radical reoperation the 1-,3-,and 5-year survival rate was 93.6 %,48.8 %,and 36.3 %,respectively,and after palliative reoperation was 54.5 %,0 %,and 0 %,respectively.Conclusions Emphasizing the application of no-tumor touch technique,resection of adequate amount of bowel,performing complete lymphadenectomy and removal of micrometastatic lesions are the major measures to prevent recurrence of rectal cancer after operation.Integrative therapy regimens,of which surgical treatment is the major component,should be considered according to the location of recurrence and the clinical staging of the recurrent cases.

According to the advantages and disadvantages of the clinical medical educa-tion of the ordinary specialized subject-to-undergraduate,the traditional teaching method has been improved in two aspects:choosing case and teaching process.It can be conformed that teaching method of case-based learning is very suitable for physiological teaching.It can improve the effective interaction of teachers and students,and enchance the students' abilities of self-study and theory with practice.

Objective:To determine the best age cutoff value of Barthel Index in the assessment of children's activities of daily living based on the scores of children's activities of daily living at different ages and the expert consensus.Methods:From December 5, 2019 to March 31, 2020, 186 children with elective surgery who were admitted to the Stomatology Department of Anhui Provincial Children's Hospital were selected as the study subject by convenience sampling. The General Information Questionnaire and Barthel Index were used to evaluate the activities of daily living of children.According to children's age, children were divided into infant group 1 (12-17 months) ( n=25), infant group 2 (18-35 months) ( n=49), preschool group (36-71 months) ( n=54), and school age group (≥ 6 years) ( n=54). The differences of children's activities of daily living in different age groups were compared. A total of 186 questionnaires were distributed, and 182 valid questionnaires were recovered, with avalid recovery rate of 97.85% (182/186). From January 7 to 14, 2020, 8 nursing experts and 2 medical experts were selected by purposive sampling.After two rounds of face-to-face expert meetings, consensus was reached on the best age cutoff value for children's activities of daily living evaluation according to the children's neuropsychiatric development progress. Results:Among children in infant group 1, 96.00% (24/25) were severely dependent and 4.00% (1/25) were moderately dependent.Among children in infant group 2, 61.22% (30/49) were severely dependent, 36.73% (18/49) were moderately dependent, and 2.04% (1/49) were lightly dependent. Among children in preschool group, 20.37% (11/54) were moderately dependent, 77.78% (42/54) were lightly dependent, and 1.85% (1/54) were completely self-care. In the school age group, 27.78% (15/54) of the children were lightly dependent and 72.22% (39/54) were completely self-care. The scores of activities of daily living in different age groups were statistically significant ( P<0.01). Through face-to-face expert meeting, the best age cutoff value for children's activities of daily living assessment was determined to be ≥ 3 years old. Conclusions:Based on the scores of children of different ages and the expert consensus, it is recommended that children ≥ 3 years old use the Barthel Index to evaluate their activities of daily living as one of the bases for establishing the nursing grade.