Objective To study the effectiveness of bronchial pulmonary artery angioplasty in elderly patients with central lung.Methods 78 elderly patients with central lung were randomly divided into two groups,the control group(n=39) and the observation group(n=39).The patients in the control group were operated through pneumonectomy,while the observation group was operated through bronchial pulmonary artery angioplasty.1,3,5-year survival rates were compared.Incidence of postoperative complications were counted.The changes in pulmonary func-tion after 3 months were determined.Results The survival rates in the control group were 66.7%(26/39),46.2%(18/39),30.8%(12/39) and 79.5%(31/39),56.4%(22/39),38.5%(15/39) in the observation group.The survival rates of the observation group were significantly higher (χ2 =6.17,7.06,4.82,all P<0.05).The control group had 11 cases of complications after surgery,the rate was 28.2%.The observation group had 4 cases of postoper-ative complication,the rate was 10.1%.The incidence of complications in the observation group was significantly less than that of the control group (χ2 =6.32,P<0.05).There was no significant difference (t=0.72,0.11,0.39,all P>0.05) between the two groups before treatment about FVC,PEF and FEV1.After treatment,FEV1,FVC,PEF were significantly improved (t=5.92,7.92,4.11,7.01,5.99,6.82,all P<0.01).The degree of improvement in the observation group was higher than that of the control group (t=2.84,2.77,3.28,all P<0.05).Conclusion Bron-chial pulmonary artery angioplasty has significantly fewer complications,can be further improved lung function in eld-erly patients with central lung cancer.

Objective To study the influence of the operation through tubular stomach plus mechanical anastomosis on the life quality of patients with esophageal cancer.Methods Seventy patients with esophageal cancer were treated by operation,tubular stomach plus mechanical anastomosis were used.They were followed up for six months.The quality of life was evaluated.Results The average time for the operation was 120 min and the average amount of bleeding was 291.3ml.Compared with before surgery,there was significant difference in emotion,activity,sleep and diet ( P ＜ 0.05 ).Conclusion The operation through tubular stomach plus mechanical anastomosis could significantly improve the quality of life of patients with esophageal cancer.

Objective To evaluated the improving effect of training method of point-line-plane on development quotient in premature infants with brain injury.Methods 174 cases of premature children with brain injury were randomly divided into study group (89 cases) and control group (85 cases).Control group given Bobath and Vojta traditional rehabilitation training,and the study group was given training method of point-line-plane.Patients in both groups were evaluated synthetically based on The Evaluation Chart on Neu-robehavioral Development of Children Aged 0-6 Years,developed by Capital Institute of Pediatrics,prior to the treatment,and after the first,the second,and the third course of the training programs,respectively.Re-sults The score of developmental quotient ( DQ) between study group and control group was no significantly different(P>0.05).Compared with before treatment, the scores of DQ was significantly increased after the first, the second and the third course of training treatment in study group and control group((82.71±12.28) vs (81.17±9.63), t=0.859, P>0.05;(89.65±10.02) vs (87.02±7.39), t=1.747, P>0.05). Compared with the control group, the scores of DQ in study group was no significant difference after the first and the second course of treatment,but there was significantiy different after the third course treatment((95.26±8.87) vs (91.31±7.63), t=2.945, P=0.004).Conclusion The training method of point-line-plane can improve the clinical efficacy of premature infants with brain injury at the early phase, which is worth widely applying in clinical practice.

Purpose To study the clinic-pathological features, differential diagnosis and prognosis of extragastrointestinal stromal tumor ( EGIST) arising in the vulva and the rectovaginal septum. Methods Clinical manifestations, pathological features, immunohisto-chemistry, gene mutations, treatment and prognosis were analyzed in 1 case of EGIST arising in the vulva and 2 cases of EGIST arising in the rectovaginal septum with review of related literature. Results Case 1 was a 59-years-old woman who was found to have a 4. 4 cm × 3 cm × 3 cm recurrent mass in the right vulva after 6 months of the first resection. Case 2 was a 58-years-old woman who presen-ted with a 7. 3 cm × 6. 1 cm × 4. 6 cm mass in the rectovaginal septum. Case 3 was a 41-year-old woman who presented with an 8. 6 cm × 7. 4 cm × 6. 7 cm mass in the rectovaginal septum. Histologically, the uniform spindle cells showed the interlacing fascicular, whirl-pool and palisade patterns with high cellular density. Mitotic figures were readily identified. Immunohistochemical evaluation revealed that the tumor cells exhibited strong and diffuse staining for CD117, CD34, NES, H-Caldesmon and DOG-1. Molecular analysis showed the gene mutation of c-Kit exon 11 in all 3 cases. Conclusion EGIST should be considered in the differential diagnosis of the mesenchymal tumors arising in the vulva and the rectovaginal septum. The immunohistochemical evaluation and molecular genetic tes-ting are crucial tools for the differential diagnosis and assessment of the prognosis and targeted therapy of EGIST.

Based on the subject classification of biomedical engineering in military hospital,the development modes of the discipline are discussed in this paper.

Objective To investigate the protective effect of the combined application of carlbachol and compound dietary fiber on the intestinal barrier function in burn rats.Methods The 30％ total body surface area (TBSA) Ⅲ scald Wistar rats were randomly divided into four groups.Rats in group A were fed with physiological saline,in group B were fed with compound dietary fiber,in group C were fed with carlbachol and in group D were fed with carlbachol and compound dietary fiber.The rats were sacrificed at 6,12 and 24 hours after treatment,and selected normal rats for control group.Blood samples were taken for detecting plasma endotoxin,D-lactic acid,D-lactic acid content.Tissue samples were harvested from the small intestine for pathological study under light microscopy.Results (1) The damage of the structure of small intestine mucosa was different among 4 groups,and the most obvious was at 24 h after treatment.(2)The level plasma of endotoxin in Group D was (0.517±0.034) EU/L,significant lower than that in group A ((0.659±0.074) EU/L),Group B ((0.589 ±0.027) EU/L) and Group C((0.587±0.026) EU/L),and the difference was significant(P＜0.05).(3) Dlactic acid level in Group D was (102.996±10.102) μg/L,significant lower than that in group A((133.538 ±8.621) μg/L),Group B ((121.223± 10.519) μg/L) and Group C ((122.700± 11.146) μg/L),and the difference was significant(P＜0.05).Conclusion In early stage of burn shock,the therapy of combined with carlbachol and compound dietary fiber has obvious protective effect on rat intestinal barrier.Meanwhile,it is better than the treatment effect of single carlbachol or compound dietary fiber to some extent.

OBJECTIVE To compare the similarities and differences of the two methods in analyzing the use of opioids in third grade class A medical institutions and provide a reference for the management of opioids in medical institutions. METHODS Two methods， Defined Daily Dose （DDD） and Oral Morphine Equivalent （OME）， were used to count the opioid prescription data of five comprehensive medical institutions of third grade class A （named H1-H5） in Shanxi province in 2020， calculate consumption sum of opioid， annual per capita consumption sum， patient cost burden and drug consumption sum ratio， compare the index results presented by the two analysis methods， and explore the application scenarios of the advantages of each of the two evaluation methods. RESULTS The ranking of consumption sum of opioid and patient cost burden calculated by the two methods was the same in the five sample medical institutions， but the ranking of per capita consumption sum was different. Taking the 5 medical institutions as a whole， the top 4 rankings of consumption sum ratio for each species of opioid compared by both methods were the same， i. e. remifentanil＞sufentanil＞oxycodone＞morphine. The ratio of remifentanil was close to 50%. When comparing the ranking of consumption sum ratio in each medical institution， the ranking calculated by the two methods was different for those medical institutions except for H1 medical institutions. The consumption sum ratio of fentanyl calculated by DDD method was significantly higher than that of OME method； whereas consumption sum ratio of remifentanil calculated by OME method was significantly higher than that of DDD method. Perioperative patients had the highest consumption sum ratio， about 50%. The consumption sum ratio of critically ill patients in H3 jwsydey@163.com medical institutions and inpatient patients with cancer pain and other patients in H5 medical institutions calculated by DDD method was significantly higher than that by OME method. There were differences in the order of cost burden of different types of patients calculated by two methods. CONCLUSIONS DDD method can accurately reflect the dosage of opioid drugs and facilitate the monitoring and management of the dosage； OME method can more reflect the analgesic effect and compare the cost burden of patients.