Objective To clarify the effects of HBV co-infection on liver function of patients with different types of hepatic echinococcosis.Methods We recruited 409 patients diagnosed with hepatic echinococcosis at three hospitals in western regions in China from 2014 to 2015.Venous blood was withdrawn to detect to liver function indications.ELISA was performed to detect HBsAg.We analyzed liver function in patients stratified by different types of hepatic echinococcosis with or without HBV infection.Results The hepatic echinococcosis patients infected with HBV had more severe impairment in liver functions such as reduced albumin and increased transaminase.The patients with hepatic alveolar echinococcosis were more vulnerable to HBV infection compared with those with hepatic cystic echinococcosis (38.4％ vs.86.4％, P<0.05).In addition, liver injury was more severe in patients diagnosed with alveolar hepatic echinococcosis and HBV infection compared with those diagnosed with cystic hepatic echinococcosis and HBV infection (all P<0.05).Conclusion Hepatic alveolar echinococcosis patients co-infected with HBV have worse liver injury compared with those hepatic cystic with HBV. Therefore, they deserve special attention in clinical treatment.

Objective:To explore the application of 3D printing technology in anatomy teaching of radical resection of lung cancer in the department of thoracic surgery.Methods:Forty young doctors who took turns in the routine training of thoracic surgery department of The First Affiliated Hospital of Guangzhou Medical University from September 2018 to September 2020 were selected as the research objects. They were randomly divided into the experimental group and the control group by envelope lottery, with 20 doctors in each group. They were respectively trained with traditional teaching and 3D printing technology. After one month of training, objective teaching content test and subjective teaching effect questionnaire were used to evaluate the effect. SPSS 24.0 was used for t-test, Chi-square test or Fisher exact probability test. Results:Under plain CT scan and video-assisted thoracoscopy during operation, all the students identified five groups of anatomical structures: pulmonary artery, pulmonary bronchus, pulmonary vein, mediastinal lymph nodes in group 7, lymph nodes in groups 2 and 4 (right) or lymph nodes in groups 5 and 6 (left). The accuracy of CT and video-assisted thoracoscopy in the experimental group [(84.00±11.42) points and (74.00±13.14) points] were higher than those in the control group [(71.00±10.71) points and (56.50±9.88) points]. The subjective evaluation of the students in the experimental group was higher than those in the control group in the recognition of teaching methods, the improvement of teaching interest, the familiarity with CT images and the familiarity with intraoperative anatomy.Conclusion:Compared with the traditional teaching, 3D printing technology can improve the students' scores of objective teaching content test, and can improve the students' recognition of teaching methods, teaching interest, CT image familiarity and intraoperative anatomy familiarity.

Objective:To predict the efficacy and safety of cephalosporins antibiotics combined with metronidazole for intra-abdominal infections using Bayesian network meta analysis.Methods:Databases including PubMed, Embase, the Cochrane Library, CNKI, Wanfang database, VIP database were searched for literatures from January 1990 to May 2018 with the key words of ( "intraabdominal infections" [MeSH Terms]) AND ( "Cephalosporins*" [MeSH Terms]) AND ( "randomized controlled trial" [MeSH Terms]),腹腔感染,继发性腹膜炎,腹腔脓肿,头孢. The randomized controlled trials (RCTs) about comparison of efficacy and safety between cephalosporins antibiotics combined with metronidazole versus other antibiotics for intra-abdominal infections were received and included. Experimental group included patients who received cephalosporins antibiotics combined with metronidazole for intra-abdominal infections, and control group included patients who received other antibiotics for intra-abdominal infections. The primary outcomes were the clinical cure rates, microbial clearance rate and incidence of serious adverse drug reactions. R 3.6.2 software random Bayesian model was used for meta analysis. The Markov Chain Monte Carlo was used for direct evaluation and indirect prediction. The tracing method, density plotting and leverage figure method were used to evaluate the model convergence and stability. No closed loop formed between intervention measures, so there was no need to evaluate consistency.Results:(1) Document retrieval: a total of 18 available RCTs were enrolled. There were 6 792 patients, including 3 402 in the experimental group, 3 390 in the control group. (2) Results of Bayesian network meta analysis. ① The clinical cure rates of the third generation cephalosporins+ metronidazole, carbapenems were significantly lower than the fourth generation cephalosporins+ metronidazole [ odds ratio ( OR)=0.46, 0.61, 95% confidence interval( CI) as 0.26-0.81, 0.38-0.97, P<0.05]. There was no significant difference in the clinical cure rate between the fifth generation cephalosporins+ metronidazole and carbapenems ( OR=1.03, 95% CI as 0.59-1.80, P>0.05). ② The microbial clearance rates of the fifth generation cephalosporins+ metronidazole, carbapenems were significantly lower than the fourth generation cephalosporins+ metronidazole ( OR=0.84, 0.41, 95% CI as 0.73-0.98, 0.23-0.74, P<0.05). There was no significant difference in the microbial clearance rate between the fifth generation cephalosporins+ metronidazole and carbapenems ( OR=0.76, 95% CI as 0.27-1.80, P>0.05). ③ The incidence of serious adverse drug reactions was significantly lower for the third generation cephalosporins+ metronidazole, the fourth generation cephalosporins antibiotics+ cetronidazole, the fifth generation cephalosporins+ metronidazole, carbapenems, quinolones+ metronidazole, and tigecycline than for quinolones ( OR=0.13, 0.13, 0.14, 0.13, 0.15, 0.13, 95% CI as 0.03-0.50, 0.02-0.98, 0.02-0.75, 0.02-0.59, 0.02-0.78, 0.02-0.57, P<0.05). Compared with carbapenems, the third generation cephalosporins+ metronidazole, the fourth generation cephalosporins+ metronidazole, the fifth generation cephalosporins+ metronidazole had no significant difference in the incidence of serious adverse drug reactions ( OR=0.96, 1.00, 1.10, 95% CI as 0.52-1.60, 0.31-3.50, 0.49-2.30, P>0.05). (3) Ranking of the efficacy and safety. ① The ranking list for clinical cure rates of different therapeutic regimens showed from high to low as quinolones+ metronidazole, the fourth generation cephalosporins+ metronidazole, synthetic penicillins, the second generation cephalosporins+ metronidazole, the fifth generation cephalosporins+ metronidazole, carbapenems, the third generation cephalosporins+ metronidazole, tigecycline, quinolones. The corresponding ranking probabilities of above regimens were 51.73%, 35.72%, 22.57%, 31.37%, 24.98%, 32.82%, 34.69%, 29.05%, 72.36%, respectively. ② The ranking list for microbial clearance rates of different therapeutic regimens showed from high to low as quinolones+ metronidazole, the fourth generation cephalosporins+ metronidazole, the second generation cephalosporins+ metronidazole, synthetic penicillins, the fifth generation cephalosporins+ metronidazole, carbapenems, the third generation cephalosporins+ metronidazole, tigecycline, quinolones. The corresponding ranking probabilities of above regimens were 89.62%, 77.01%, 38.60%, 20.94%, 26.26%, 26.39%, 22.22%, 20.19%, 62.55%, respectively. ③ The ranking list for incidence of serious adverse drug reactions of different therapeutic regimens showed from high to low as quinolones, quinolones+ metronidazole, the fifth generation cephalosporins+ metronidazole, carbapenems, the third generation cephalosporins+ metronidazole, tigecycline, the fourth generation cephalosporins+ metronidazole. The corresponding ranking probabilities of above regimens were 96.21%, 30.46%, 21.09%, 25.27%, 27.26%, 19.45%, 31.69%, respectively. Conclusion:In the treatment of middle- and low-risk intra-abdominal infections, it is recommended to empirically use cephalosporins+ metronidazole instead of carbapenems.

Objective:To compare the application effects of high-definition two-dimensional (HD-2D) and glasses-free three-dimensional (GF-3D) display systems in thoracoscopy teaching.Methods:A total of 40 clinical medicine interns with no surgical experience from The First Affiliated Hospital of Guangzhou Medical University were recruited and were required to participate in a 1-week training course of endoscopy. They were then randomly allocated to the HD-2D group and GF-3D group and asked to perform three tasks: peg transfer, circular cutting, and suture knotting. Their performance was measured with a system that scored speed and precision. SPSS 25.0 was used to conduct t-test, Pearson Chi-square test and Fisher exact test for the comparison. Results:The mean time for the peg transfer test in GF-3D group was shorter than that in HD-2D group, without statistically significant difference [(63.20±21.11) s vs. (71.15± 17.26) s, P = 0.212]. The mean time for the circular cutting test in GF-3D group was shorter than that in HD-2D group, without statistically significant difference [(112.50±16.67) s vs. (118.15±24.43) s, P=0.410]. The mean time for the suture knotting test in GF-3D group was shorter than that in HD-2D group, with statistically significant difference [(301.50±32.77) s vs. (341.75±57.23) s, P=0.019]. The total score in GF-3D group was higher than that in HD-2D group, with statistically significant difference [(78.33±5.88) points vs. (72.08±6.83) points, P=0.005]. Conclusion:The GF-3D display system is clearly superior to the HD-2D system because it reduces the surgical learning curve, and is therefore suitable for basic teaching and skills training.

SARS-CoV-2 can cause multiple organ injuries in some susceptible people in a short time, which seriously threatens the health and safety of people, and intensive care and multiple extracorporeal organ support are important means of treatment. Although many experts’ consensus and clinical guidelines have been published, a series of clinical problemsstill exist during the treatment procedure, and no consensushas not been reached until now. Therefore,in this paper wemake some reflections and explorations to provide experience and help for clinicians.