Mixed reality technology can achieve a 3D reconstruction of the patient's imaging data and organically combine the real scene. This allows to simulate a real medical operation in clinical teaching. Combined with large data analysis, mixed reality technology allows to build situational awareness data models, thus providing data support for teaching interaction and disease simulations. In the present work, the application of mixed reality technology and situational awareness in clinical teaching of cardiac macrovascular surgery is explored innovatively. These technologies open a new avenue for teaching, solving the issue that stymies traditional teaching approaches and improving the teaching efficiency. It is thus important to explore and promote the applications of this innovative teaching methodology particularly in clinical teaching.

AIM:To establish quality standard for Compound Shenyi Granule(Fructus Jujubae,Radix et Rhizoma Glycyrrhizae,Radix et Rhizoma Salviae miltiorrhizae,Radix Rehmanniae).METHODS:Ziziphus jujuba Mill、Glycyrrhiza uralensis Fisch、Salvia miltiorrhiza Bge、Rehmannia glutinosa Libosch.were identified by TLC.Glycy-rrhizic acid and glycyrrhetinic acid were determined by HPLC.The chromatographic separation was performed on an Agilent ZORBAX Eclipse?DB-C_ 18(4.6 mm?250 mm,5 ?m)column by a gradient elution with methanol and 2.5 % acetic acid at a flow-rate of 1.0 mL/min;the detection wavelength was set at 254 nm.RESULTS:TLC spots developed were fairly clear and the blank test showed no interference.The linear rangers were 1.135-9.08 ?g(r=0.999 3) for glycyrrhizic acid,0.71-5.68 ?g(r=0.999 7) for glycyrrhetinic acid,respectively.CONCLUSION:The methods is effective for the quality control of Compound Shenyi Granule.

Air Pollution, Indoor ; analysis ; Anesthetics ; analysis ; Environmental Monitoring ; methods ; Isoflurane ; analysis ; Methyl Ethers ; analysis ; Operating Rooms

Background and purpose:Histological grade of DCIS is an important factor in the prognosis, high nuclear grade have higher inifltration trend and recurrence rate. This study aimed to evaluate the dynamic and morphological MRI charactristics of ductal carcinoma in situ (DCIS) of the breast, then analyze its relations with nuclear grade. Methods:Of the 94 patients, 97 lesions were proved DCIS by pathology. The morphology, maximum size, time-intensity curve of lesion were recorded or measured. Statistic was performed to identify MR imaging features that optimally discriminated HNG from non-HNG DCIS. Results:There were 49 non mass-like enhancement lesions, and 48 masses enhancement lesions. Among 49 non mass-like lesions, 29 were segmental enhancement (59.18%). Dynamic enhanced performance:50 exhibited plateau curves and 27 were washout curves. BI-RADS categories:22 BI-RADS 4A, 19 BI-RADS 4B, 29 BI-RADS 4C, and 27 BI-RADS 5. HNG lesions exhibited larger mean maximum lesion size (non-mass-like enhancement: P=0.01; mass: P=0.03), time- intensity curve was variable to approach signiifcance (P=0.01), and BI-RADS can help to discriminate the nuclear grade (P=0.02). There were no differences in lesion morphology (P>0.05). Conclusion:The preliminary ifndings suggest that DCE MR imaging features may aid in identifying patients with high risk DCIS.

OBJECTIVE:To provide reference for medical costs control in China. METHODS:Based on main characteristics of the United States health service system,information asymmetry,principal-agent theory and Freedman’s consumption theory were used to analyze the advantages of restrictive relationship among doctors,hospitals and health insurance institutions in control-ling medical costs and improving the quality of diagnosis and treatment. The growth rate of medical cost,the percentage of drug ex-penditure and other aspects were compared between China and the United States;the effect of restrictive relationship on medical cost control was demonstrated. RESULTS & CONCLUSIONS:In the United States,there are hierarchical medical system and two-way referral system;for-profit hospitals and non-profit hospitals are mutually complementary;different natures of health insur-ance system,different payment methods and strict“commercial bribe”monitoring system are carried out;doctors,hospitals and health insurance restrict each other. Not only there are many advantages in theory,but also in practice the growth rate of medical cost and the percentage of drug expenditure are superior to our country. Finally it controls the rapid growth of medical cost to a cer-tain extent. Combined with our national conditions,learning from the United States experience,restrictive relationship among doc-tors,hospitals and health insurance institutions is established to control the increase of medical cost in China through reducing infor-mation asymmetry and standardizing payment audit;establishing a scientific pattern of mixed payment;strengthening the indirect impact of the health insurance institutions on doctors and hospitals,etc.

Objective To evaluate the effect of Danshen Chuanxiongqin injection combined with Xuesaitong capsule on blood viscosity in patients with pulmonary heart disease.Methods 80 patients with pulmonary heart disease who were admitted to our hospital between January 2013 and November 2015 were studied,the patients were randomly divided into the combined group and the control group according to the order of admission,40 cases in each group.Control groups were treated with Xuesaitong capsule,and the combined group were treated with Danshen Chuanxiongqin injection on the basis of the control group.The clinical efficacy,blood viscosity(whole blood viscosity,plasma viscosity,whole blood viscosity ratio),blood indexes(blood platelet aggregation rate,erythrocyte aggregation index,erythrocyte deformation index),cardiac function and safety were observed.Results There were no significant differences in blood rheological indexes,LVEF,MAP and HR between the two groups before treatment.After treatment,the whole blood viscosity,plasma viscosity,whole blood viscosity ratio,platelet aggregation rate,erythrocyte aggregation index,erythrocyte deformation index,MAP and HR in the two groups were significantly lower than those before treatment,while LVEF was significantly higher,and the changes in the combined group were more significant than those in the control group(P<0.05).After treatment,the clinical total effective rate of treatment in the combined group(88.89％)was significantly higher than that in the control group(62.50％).Conclusion Danshen Chuanxiongqin injection combined with Xuesaitong capsule is effective in the treatment of pulmonary heart disease.It can significantly reduce blood viscosity,blood related indexes and improve cardiac function.

AIM To prepare D-α-tocopherol polyethylene glycol 1000 succinate (TPGS)-modified artesunate liposomes and to investigate the in vitro anti-tumor activity.METHODS The liposomes prepared by thin-film dispersion method were characterized by transmission electron microscopy and particle size analyzer,and the encapsulation efficiency was determined by ultrafiltration centrifugation.The liposomes' cytotoxicity to human hepatoma HepG2 cells was evaluated by MTT method.RESULTS The average particle size,PDI,Zeta potential,encapsulation efficiency,drug loading of the liposomes were 126.7 nm,0.182,-10.1 mV,78.8％ and 18.38％,respectively.The liposomes displayed a significant inhibition on HepG2 cells with the IC50 value of 0.034 μmol/mL.CONCLUSION Compared with non-TPGS-modified artesunate liposomes,the TPGS-modified artesunate liposomes prepared by this method afford smaller vesicle size,better stability and higher encapsulation efficiency with stronger in vitro anti-tumor activity.

Objective To study the level of vitamin A of children aged 7～14 in the Dongxiang and Bonan ethnic ghettos.Methods Fifty-seven children aged seven to fourteen were sampled from rural areas in the Dongxiang and Bonan ethnic ghettos from Dongxiang Autonomous County and Jishishan region,Gansu Province.The vitamin A level in serum was detected using the fluorescence method.Results The average level of vitamin A in serum was(1.41?0.42)?mol/L for children aged seven to fourteen in the Dongxiang region,and of all the fifty-seven children,there was 4 SVAD(accounted for 7.0%)and 10 suspicious SVAD(accounted for 17.6%).The average level of vitamin A in serum was(1.67?0.53)?mol/L for children aged seven to fourteen in the Bonan region,and of all the fifty-seven children,there was 1 SVAD(accounted for 1.7%)and 7 suspicious SVAD(accounted for 12.3%).There was statistically significant difference in different national and aged groups,but no difference in SVAD and suspicious SVAD.Conclusions SVAD and suspicious SVAD exist in the Dongxiang and Bonan region,and the intervention of vitamin A supplementation should focus on children suffering from SVAD and suspicious SVAD.

AIM:To establish some HPLC-digitized fingerprint spectrum(HPLC-DFPS)in Liuwei Dihuang Dripping Pill preparation and to apply it to identification of medicinal materials.METHODS:Based on loganin and paeonoside contents adopted as qualitative and quantitative factors,relative retention value as creteria,RPHPLC was carried out on inensil ODS:column,mobile phase consisted of methanol-water(0.2% formyl acid),detection wavelength was set at 240 nm.RESULTS:Using above optimum chromatograph conditions,HPLC-DFPS of relative medicinal materials andLiwei Dihuang Dripping Pillpreparation were established.By comparison a group of characteristic peaks could be used to identify medicinal materials.CONCLUSION:This result indicates that it is practical to use HPLC-DFPS for identification of Liawei Dihuang Dripping Pill.

BACKGROUND:Valgus knee deformity is rare in the clinic. The therapeutic effects of artificial knee arthroplasty are worse than varus knee deformity. There is no unified opinion for replacement approach, soft tissue release method and procedure and prosthetic choice at present.
OBJECTIVE:To summarize case data and to observe clinical effects of total knee arthroplasty for valgus knee deformity.
METHODS:Clinical data of 37 cases of valgus knee deformity (42 knees) undergoing total knee arthroplasty, who were treated by the same group of physicians in the First Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine from January 2010 to December 2012 were retrospectively analyzed. There were 11 males (13 knees) and 26 females (29 knees), at the age from 56 to 78 years, with an average age of 63.7 years. The differences in range of motion, femorotibial angle and Hospital for Special Surgery knee score were compared before and after replacement. Clinical effects of total knee arthroplasty for valgus knee deformity were evaluated.
RESULTS AND CONCLUSION:The postoperative fol ow-up lasted from 6 to 36 months. Knee joint range of motion increased from preoperative 68.5° to an average of postoperative 108.5°. Femorotibial angle reduced from preoperative 16.82° to postoperative 5.62° on average. The average Hospital for Special Surgery knee score increased from preoperative 39 points to postoperative 88 points (P<0.05). These results suggested that the curative effect of total knee arthroplasty for valgus knee deformity is proved. Total knee arthroplasty is an effective way to improve deformity.