In order to meet the needs of the skin venerealdiseases study direct-viewing teaching and the new curriculum reforms,and fully display the multimedia technology in the dermatology departmentteaching function,on the basis of the sixth edition of the teaching material on skin venereal diseases and in combination with the union massive pictures,theanimation as well as the correlation data,the richly colorful direct-viewing teaching coursewares were designed with abundant pictures,and the teaching effect was satisfied.Besides,some deficiencies were proposed.

Objective To explore the effect of lipo-prostaglandin E1 plus dextran 40 in the prophylaxis of hepatic veno-occlusive disease(HVOD) after hematopoietic stem cell(HSC) transplantation.Methods Two hundred and thirty-four patients,162 males and 72 females,mean age 30.6(ranged from 3 to 64),were admitted during May 1999 to April 2007 and undergone HSC transplantation.Lipo-prostaglandin E1 associated with dextran 40 were administered to all patients for the prophylaxis of hepatic veno-occlusive disease.Lipo-prostaglandin E1,10?g dissolved in 100ml saline,20?g per day iv,were administered from day 7 before transplantation(-7 day) to day 30 after transplantation(+30 day).Dextran 40,500ml per day iv,were administered from-1 day to +5 day.In order to identify the risk factors inducing HVOD,patients were allocated to 2 groups according to following factors:age(

Objective To explore the method and significance for constructing three-dimensional visual model in bronchial tree of pig lung. Methods A set of pig lung specimen was infused with epoxy resin-lead oxide through the trachea,and then casted. The Mimics 15. 0 was used to construct three-dimensional visual model in bronchial tree of pig lung by utilizing CT data of the cast specimen. Results In the reconstructed three-dimensional visual model of bronchial tree,the three-dimensional effect was realistic. This model not only clearly showed each lobar direction and distribution of bronchial tree,but also allowed three-dimensional arbitrary scaling,shifting or rotating at any angle, and the diameter and distance of each lobar bronchus could be measured with the sofeware. Conclusion The three-dimensional visual model in bronchial tree of pig lung can be successfully reconstructed from the CT dataset by using related sofeware like Mimics,which can bring morphological reference to anatomical teaching and will be helpful to the development of virtual operation.

Objective To study the characteristics of lower respiratory tract infection by Streptococcus pneumonia in children aged from 0 to 5 years and drug resistance,so as to provide the rational basis for clinical treatment and epidemiology.Methods The medical data from 4 815 children aged 0 to 5 years with lower respiratory tract infection between September 2014 and September 2016 were retrospectively reviewed.Results Totally 343 strains of Streptococcus pneumonia were isolated from 4 815 sputum samples,with the isolation rate of 7.12％.Of the isolated streptococcus pneumonia strains,80.76％ were isolated from the children with pneumonia,9.33％ were isolated from the children with bronchitis,5.83％ were isolated from the children with capillary bronchitis,4.08％ were isolated from the children with bronchial asthma.There was no significant difference in the incidence of Streptococcus pneumonia infections between the genders of the children(P>0.05),but the incidence of Streptococcus pneumonia detection rates differed significantly in different seasons and children of different ages,the difference was statistically significant(P<0.05).The resistance rates of Streptococcus pneumonia to penicillin,erythromycin and clindamycin were 51.0％,97.9％ and 97.1％ respectively;The sensitivity rates to cefotaxime and vancomycin were 71.1％ and 100.0％ respectively.Conclusion The children aged less than 1 years old are at the high risk of Streptococcus pneumonia infection and highest detection rates in winter,it is necessary to perform the drug susceptibility testing in a timely manner so as to choice reasonable antimicrobial agents to control the condition.

Objective To explore the expression status of carbonic anhydrase Ⅲ (CA Ⅲ) from quadriceps femoris muscle in two kinds of muscle clinical phenotype (skeletal muscle atrophy group and skeletal muscles non-atrophy group) of chronic obstructive pulmonary disease (COPD).Methods Totally 37 inpatients from our hospital,were divided into 11 patients without COPD and 26 patients with COPD,in addition,according to body mass index,fat free mass index and quadriceps cross-section diameter,patients with COPD were divided into 14 skeletal muscles non-atrophy patients (SMNA)and 12 skeletal muscle atrophy patients (SMA).CA Ⅲ concentration of femoris quadriceps specimens was quantitatively determined using Western blot methods,CA Ⅲ mRNA expression levels of femoris quadriceps specimens were also quantitatively measured using RT-PCR,then compared among the 3 groups.Results There was significant difference in CA Ⅲ quantitative concentration and CA Ⅲ mRNA expression level in each group (P ＜ 0.05),further more,CA Ⅲ concentration expression level was significantly higher (P ＜ 0.01)in SMA group (1.260 ± 0.068) than in SMNA group (1.110 ± 0.014),the latter was significantly higher (P ＜ 0.01) than in the control group (1.000 ± O.062).CA Ⅲ mRNA expression level was significantly higher(P ＜ 0.01) in SMNA group(2.170 ±0.412) than in the control group(1.000 ±0.115),and was significantly lower than in SMA group (3.770 ± 0.788 ; P ＜ O.01).CA Ⅲ concentration and CA Ⅲ mRNA expression level increased at equal pace in SMNA group and SMA group,however,CA Ⅲ quantitative concentration and CA Ⅲ mRNA expression level were inconsistent in the two groups.Conclusion The expression status of CA Ⅲ in quadriceps femoris muscle was different in two kinds of muscle clinical phenotype of COPD.

Retrograde caudate lobectomy is a proper technique to resect the tumor in caudate lobe when the tumor is too big or closely adherent to the inferior vena cava.A male patient aged 44 years was admitted to the Eastern Hepatobiliary Surgery Hospital in November 2007.The ligaments around the liver were firstly dissected to mobilize the whole liver,and the right hepatic pedicle was dissected and ligated,then the liver was splited anteriorly along the Cantlie's line.The tumor was opposed in the sight and then it was dissected from the liver parenchyma.The short hepatic veins were ligated and the tumor was detached from the inferior vena cava.The inflow blood was occluded for 19 minutes,and the total blood loss was 4500 ml.The technique of retrograde caudate lobectomy can improve the success rate and safety of caudate lobectomy when the tumor in the caudate lobe is too large or adherent to the inferior vena cava.

Objective To investigate the correlation between GSTP1 exon5 A/G polymorphism and clinic phenotype of COPD in the population of the Han nationality from southwest China.Methods Using PCR followed by restriction fragment length polymorphism(PCR-RFLP),genotypes of Ile105Val polymorphism in exon5 of GSTP1 were determined in 91 patients with COPD and 87 healthy control subjects.Results No significant differences were observed in the frequencies of genotypes and alleles of exon5 of GSTP1 between COPD patients and the healthy controls.The frequency of Ile105 in pink puffer patients was much more than that in the blue bloater patients.The CT scores of emphysema in patients with Ile105 was significantly higher than those with Val105.Conclusions The genetic polymorphism of exon5 of GSTP1 may not be associated with the susceptivity of COPD in the populations of the Han nationality from southwest China,but may be correlated with clinical phenotypes and lung parenchyma damage of COPD patients in the present population.

Objective To evaluate the three-dimensional reconstruction and significance of arterial cast on chronic venous insufficiency of low extremity. Methods A set of specimen on chronic venous insufficiency of left lower extremity amputation residues was infused with epoxy resin-lead oxide through the femoral artery,and then casted. The CT data of the cast specimen was used to reconstruct 3D modal of ar-tery on chronic venous insufficiency of left lower extremity,using the volume rendering(VR) and maximum intensity projection(MIP). Re-sults The cast specimen and 3D reconstruction of chronic venous insufficiency of left lower extremity amputation residues could clearly dis-play distribution and run of lower extremity arteries,blood supply of lesion and local region embolism of small artery ( arteriole) . Conclusion The 3D modal of artery on chronic venous insufficiency of left lower extremity should provide morphological basis of exact etiology and perfect pathogenesis,also has a certain guiding significance of clinical diagnosis and treatment.

Objective To investigate the prevalence of healthcare-associated infection(HAI)in medical institutions in Pudong New Area.Methods Ten medical institutions in Pudong New Area were selected as monitored hospitals, cross-sectional survey on HAI in each hospital at a given day of November 2013 and November 2014 were conduc-ted.Prevalence of HAI in different levels of hospitals were compared.Results The prevalence rates of HAI in 2013 and 2014 were 4.04% and 3.75% respectively,there was no significant difference between two years(χ2 =0.709,P=0.400).The prevalence rates of HAI in primary,secondary,and tertiary hospitals in 2013 were 0.66%,3.32%, and 4.60% respectively,in 2014 were 0,3.52%,and 4.01 % respectively,prevalence rates of HAI in different lev-els of hospitals of each year were significantly different (all P <0.05).Prevalence rates of HAI were high in depart-ments of neurosurgery,hematology,intensive care units(ICUs),and gerontology.The prevalence rate of infection in ICUs increased obviously,from 10.09% to 18.78% (χ2 =3.921 ,P =0.048),departments of gerontology de-creased obviously,from 10.07% to 5.02%(χ2 =5.698,P =0.017).The main HAI sites were lower respiratory tract (36.72%),upper respiratory tract (9.96%),and urinary tract (12.89%).172 pathogenic isolates were de-tected in 2013,and 177 were detected in 2014,gram-negative bacteria,gram-positive bacteria,and fungi accounted for 60.74%,26.37%,and 12.89% respectively.Constituent ratios of pathogens causing HAI between two surveys were not significantly different (χ2 =5.819,P =0.830).Conclusion Among different levels of hospitals in Pudong New Area,tertiary hospitals have the highest prevalence rate,HAI in ICU increases obviously,the main HAI site is lower respiratory tract,the main pathogens are gram-negative bacteria.

Total caudate lobectomy via anterior hepatic transection is still a new technique to resect the tumor in the caudate lobe,which is mastered only by few surgeons.The procedure was successfully performed on a 21-year old patient with focal nodular hyperplasia in caudate lobe.The right and left lobes were first mobilized,then the short hepatic veins were dissected to detach the caudate lobe from the retrohepatic vena cava.Then the liver was split anteriorly and the partial middle lobe was resected.With this process,the tumor was in the sight and we dissected it from the liver parenchyma.The inflow blood was occluded 3 times with a period of 29,27 and 27 minutes,respectively,with an interval of 5 minutes.The total blood loss during operation was 1000 ml.The patient recovered quickly without any complications.The technique for caudate lobectomy via anterior hepatic transection can improve the success rate and safety of caudate lobectomy and deserve clinical consideration.