Here we reported a research project based on Black-board to integrate medical curriculum .The key points of this research is application of clinical cases as teaching data and facilitate learning of knowledge following the principle of learning by doing and , input the concept of precision medicine and informatics in learning process with an individually designed framework of learning .The learning outcome is evaluated with big data tech-nology and thus creates a student-centered pathway of medical education .

Objective To assess the efficacy of transvaginal three-dimensional power Doppler ultrasound(3D-PDU)in predicting pregnancy outcomes after mild and moderate transcervical resection of adhesion(TCRA).Methods Sixty-six patients with mild and moderate intrauterine adhesions(IUA)who had fertility issues and underwent TCRA surgery in Tongde Hospital of Zhejiang Province from January 2020 to December 2021 were chosen,31 successful pregnancy patients were included in pregnancy group,and 35 unsuccessful pregnancy patients were included in non pregnancy group.3D-PDU examination was performed before and 3 months after surgery.The measurements of endometrial thickness(ED),uterine volume(EV),endometrial vasculogenesis index(VI),blood flow index(FI),and vasculogenesis-blood flow index(VFI)were taken.The pregnancy was followed up for 1 year to observe the prognostic value of the above related indicators on postoperative pregnancy.Results The ED,EV,VI,FI and VFI levels of patients post-operation were significantly higher than those before the operation(P＜0.05),the improvement of pregnant group patients was better than that of non pregnant group patients(P＜0.05),and area under the receiver operating characteristic curve were 0.80,0.84,0.68,0.65 and 0.88 respectively.Conclusion 3D-PDU can effectively predict the postoperative pregnancy outcome of TCRA in patients with mild to moderate IUA by measuring ED,EV,VI,FI,and VFI before and after surgery,providing reference for efficacy evaluation and guiding subsequent treatment.

Objective To analyze the influencing factors of survival of patients with airway stenosis requiring clinical interventions after lung transplantation. Methods Clinical data of 66 patients with airway stenosis requiring clinical interventions after lung transplantation were retrospectively analyzed. Univariate and multivariate Cox’s regression models were adopted to analyze the influencing factors of survival of all patients with airway stenosis and those with early airway stenosis. Kaplan-Meier method was used to calculate the overall survival and delineate the survival curve. Results For 66 patients with airway stenosis, the median airway stenosis-free time was 72 (52,102) d, 27% (18/66) for central airway stenosis and 73% (48/66) for distal airway stenosis. Postoperative mechanical ventilation time [hazard ratio (HR) 1.037, 95% confidence interval (CI) 1.005-1.070, P=0.024] and type of surgery (HR 0.400, 95%CI 0.177-0.903, P=0.027) were correlated with the survival of patients with airway stenosis after lung transplantation. The longer the postoperative mechanical ventilation time, the higher the risk of mortality of the recipients. The overall survival of airway stenosis recipients undergoing bilateral lung transplantation was better than that of their counterparts after single lung transplantation. Subgroup analysis showed that grade 3 primary graft dysfunction (PGD) (HR 4.577, 95%CI 1.439-14.555, P=0.010) and immunosuppressive drugs (HR 0.079, 95%CI 0.022-0.287, P<0.001) were associated with the survival of patients with early airway stenosis after lung transplantation. The overall survival of patients with early airway stenosis after lung transplantation without grade 3 PGD was better compared with that of those with grade 3 PGD. The overall survival of patients with early airway stenosis after lung transplantation treated with tacrolimus was superior to that of their counterparts treated with cyclosporine. Conclusions Long postoperative mechanical ventilation time, single lung transplantation, grade 3 PGD and use of cyclosporine may affect the survival of patients with airway stenosis after lung transplantation.