Objective To analyze the clinical features of hepatic veno-occlusive disease (HVOD) and to explore the diagnosis criteria and treatment.Methods A total of 50 cases of HVOD administrated at The First Affiliated Hospital of College of Medicine,Zhejiang University from August 2008 to August 2011 were analyzed for etiology,clinical manifestation,laboratory examination,image,pathological features and treatment.Results Among the 50 HVOD cases,38 cases (76％)had a history of taking Gynura segetum.The main clinical manifestations were ascites,hepatomegaly,right upper quadrant pain,jaundice,and weight gain.Laboratory examinations indicated liver function injury and increased serum CA125 level.Color Doppler ultrasound showed hepatomegaly,decrease in diameter of hepatic vein and slow blood flow.The computed tomography scan suggested hepatomegaly,enhanced scan showed liver inhomogeneous enhancement at portal and delayed phase,map-like changes and markedly decrease in diameter of hepatic vein.Pathological examination suggested hepatic sinusoid congestion,central vein stenosis and vessel wall thickening.The main therapy was anticoagulant treatment.One case cured,33 cases improved,13 cases uncured and three cases died.Conclusions HVOD because of taking Gynura segetum is common in Zhejiang Province,which can be diagnosed according to medical history,clinical manifestations, and typical image characteristic.However,diagnosis of the atypical cases still needs liver biopsy.Anticoagulation therapy can achieve better efficacy.

Objective To investigate the value of "one-stop" scanning of coronary and head and neck CTA in patients with normal body mass index (18 kg/m2 ≤ BMI ≤ 25 kg/m2) using low tube voltage (80 kVp).Methods In a retrospective analysis 80 patients with normal body mass index who had completed "one-stop" scanning of coronary and head and neck CTA were divided into A and B groups according to different scanning method,and 40 consecutive cases were selected in each group.Scanning parameters of group A and group B were tube voltage 80 kV,coronary CTA tube current 550 mA,head and neck CTA tube current 500 mA,and tube voltage 100 kV,coronary CTA tube current 450 mA,head and neck CTA tube current 400 mA separately.Subjective evaluation and objective evaluation were performed on the image quality of the two groups.CT values of coronary artery and head and neck CTA trunk branch vessel,contrast-to-noise ratio (CNR),image noise (SD) and effective dose between the two groups were compared.Results The image quality of both groups met the diagnostic requirements,and there was no statistically significant difference in subjective scores between two groups (P＞0.05).The CT values of coronary arteries,the main branches of the head and neck (the common carotid artery,the internal carotid artery) and SD of head and neck CTA were significantly different between two groups (t=4.737,6.552,3.359,2.165,2.685,4.617,P＜0.05).There was no statistically significant difference in SD of coronary CTA,CT values and CNR between head and neck vessels (middle cerebral artery) in group A and group B (P＞0.05).The effective dose of coronary CTA in group A (1.16±0.20) mSy was reduced by 51.1％ than that in group B (2.37±0.77) mSv.The effective dose of head and neck CTA in group A (0.37±0.03) mSv was reduced by 47.9％ than that in group B (0.71 ± 0.17) mSv.Conclusions The image quality with subjective evaluation met the diagnostic requirements when using a low-tube voltage for "one-stop"scanning of coronary and head and neck CTA.The CNR values were basically consistent with the conventional scanning method,and the patient effective dose was reduced by about 50％.

Objective:To explore the application effect of magnetic service concept in clinical nursing for patients with acute gastroenteritis.Methods:A total of 101 patients with acute gastroenteritis undergoing magnetic service concept intervention in gastroenterology department of Lishui Central Hospital were selected as study group from January 2019 to January 2020, other 97 patients with acute gastroenteritis undergoing routine nursing intervention were enrolled as control group from January to December 2018. The scores of Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), self-care ability and quality of life before and after intervention were observed and compared between the two groups. The scores of nursing satisfaction were recorded and compared between the two groups.Results:After nursing, HAMA and HAMD scores in study group were (13.39 ± 4.56) and (17.89 ± 6.63) points, which were significantly lower than those in control group (18.60 ± 6.79) and (21.51 ± 6.03) ( t values were 6.36 and 4.11, P<0.05). After nursing, scores of self-concept, self-responsibility, self-care skills and health awareness in study group were (79.12 ± 4.98), (79.85 ± 5.47), (80.22 ± 3.89) and (76.25 ± 5.98) points, which were higher than those in control group (52.08 ± 3.63), (58.88 ± 7.25), (57.65 ± 3.62), (54.12 ± 5.06) points (t values were 23.06-43.41, P<0.05). After nursing, scores of physiology, mentality, emotion and social contact in study group were (69.14 ± 4.21), (82.13 ± 6.12), (71.25 ± 5.28) and (82.95 ± 7.22) points, which were higher than those in control group (60.41 ± 3.26), (69.57 ± 4.26), (57.13 ± 3.21), (68.07 ± 5.14) points (t values were 16.27-33.63, P<0.05). The scores of satisfaction with life care, regular wards inspections, bell calling, service attitudes and health education in study group were (90.40 ± 6.80), (91.38 ± 6.82), (90.22 ± 4.96), (90.88 ± 5.56) and (92.46 ± 6.38) points, which were higher than those in control group (81.22 ± 5.83), (80.44 ± 4.25), (82.12 ± 4.65), (83.24 ± 4.56), (82.06 ± 3.55) points (t values were 10.18-14.09, P<0.05). Conclusions:The magnetic service concept can improve psychological status and quality of life in patients with acute gastroenteritis, enhance self-care ability and nursing satisfaction.

Objective To develop an effective decision tree management model for smart triage of nervous system diseases based on artificial neural networks and Bayesian decision theory. Methods Bayesian decision theory was used as the theoretical basis, and convolutional neural network was used to complete the rapid specialist / sub-specialist machine learning. For the specialist or sub-specialist triage data, circular neural network and Bayesian algorithm were performed to complete the probability distribution and convergence of disease symptoms and diagnosis. Results The decision tree management model and theoretical demonstration were established. According to the characteristics of the transfer learning, the rapid learning of nervous system diseases and accurate triage system, and the remote smart triage system were successfully constructed. Conclusions The management model could provide theoretical references for further use, and alleviate to some extent the currently high rate of outpatient appointment withdrawal and changes.