Computer selective courses in medical colleges based on C language are facing many problems. First, C language lacks continuity with follow-up courses and well combines with professional courses, which result in loss of interest of students and few students would like choose this selective course. Second, the computer selective courses are miscellaneous and discontinuous, which occupies much time and therefore necessitate integration and optimization. The reformations and implementation schemes are proposed to optimize computer selective courses based on Java language. On the one land, different computer selective courses are optimized, credit hours are compressed, and selective interests of the students are improved. In addition, the practicability and scalability of computer selective courses are enhanced combining the characteristics of medical science specialty.

Magnesium stents have gained increasing interest as an ideal stent of future intervention. In order to study the deformation behavior of magnesium alloy stents in the interventional treatment, the finite element method was used to analysis the effects of different crimp and expansion dimensions on the mechanical properties (maximum stress, radial recoil rate, longitudinal shortening rate and radial strength). The results showed that crimping and expanding have a minimal influence on the stent radial strength. When the expansion size is same, the maximum equivalent stress and recoil rate decrease with the crimp size. When the crimp size is same, in contrast with the radial recoil rate, the maximum equivalent stress and longitudinal shortening rate increase with the expansion size. In addition the paper verified the radial strength-radial displacement curve obtained by FEM. Results are basically consistent, indicating the finite element method can efficiently provide researchers with reliable, high-quality design.
Alloys ; Finite Element Analysis ; Magnesium ; Stents

Objective To examin and analyze the structure, ultrastructure and the circulation of the spleen ellipsoid in the soft-shelled turtle, Pelodiseus sinensis. Methods Twelve turtles were used and observed by light- and electron-microscopy and injection of ink suspension in this study. Results The spleen white pulp was consisted of the periarteriolar lymphatic sheath (PALS) and periellipsoidial lymphatic sheath (PELS). There was no lymphoid nodule in the spleen. Red pulp included splenic cords and splenic sinusoids. The marginal zone was not found in the turtle spleen. When the central arteriole left out of the PALS, it divided into several ellipsoid capillaries which were surround by the PELS. The end of the ellipsoid capillary opened directly to the splenic cord and the blood cells then entered into the splenic sinusoid through the gap between the endothelial cells. The ellipsoid capillary was consisted of simple cuboidal epithelium with an uncompleted basement membrane. The ellipsoid wall was consisted of supporting cells,ellipsoid-associated cells and reticular fibres. Lymphocytes and red cells were always found on the ellipsoid wall. After 40min of the injection of ink suspesion, much carbon particles of ink were restricted on the wall. Conclusion The ellipsoid capillary in the soft-shelled turtle, just like the high endothelial venule, was the important passage of the lymphocytes and blood cells going out and into the lymph tissue. The splenic circulation in the turtle belongs to the opening model.

Objective To investigate the expression and significance of serum NSE,HCY and 8-hydroxy-2'-deoxyguanosine (8-OHdG) in the patients with acute cerebral infarction(ACI).Methods One hundred cases of ACI treated in the neurology department of this hospital from March 2013 to December 2015 were selected as the cerebral infarction group,and contemporaneous 100 persons undergoing healthy physical examination were selected as the control group.The cerebral infarction group were re-divided into three groups according to the infarction volume,the infarction area ＞ 10 cm3 as the large volume infarction group (L),5-10 cm3 as the middle volume infarction group (M) and ＜5 cm3 as the small volume infarction group (S).The levels of serum NSE,HCY and 8-OHdG were compared between the cerebral infarction group and the control group,and among the group L,M and S.The Pearson correlation test was adopted to conduct the correlation analysis between HCY,8-OHdG and NSE with the cerebral infarction volume,neural function deficit,and prognosis.Results The levels of Hcy,8-OHdG and NSE in the observation group were higher than those in the control group,the difference was statistically significant(P＜0.05);the levels of Hcy,8-OHdG and NSE in the group L were higher than those in the group M and S,the difference was statistically significant(P＜0.05);the Hcy,8-OHdG and NSE levels were positively correlated with the cerebral infarction volume and neurological deficit,and negatively correlated with the prognosis.Conclusion Serum NSE,HCY and 8-OH-dG levels are increased in the patients with ACI,moreover with the infarct volume increase,which are gradually elevated.Therefore serum NSE,HCY and 8-OHdG can be used to assess the severity and prognosis in ACI patients.

Objective:To explore a better practicing scheme of totally implantable venous access ports (TIVAP) maintenance . Methods :From Apr .to Aug .in 2015 ,25 General Surgery nurses in North District of Zhongshan Hospital ,Fudan University , were under a phased quality review of TIVAP maintenance , meanwhile “Nurses Knowledge Questionnaire”and “Patient Questionnaire Notes”were handed ,and complications of patients under maintenance were monitored .Following the standards of JBI ,at first baseline quality maintenance review was practiced ,then evidence‐based scheme was practiced to receive the quality after invitation .Results:After this scheme practiced ,in 5 of 9 standards ,for JBI TIVAP maintenance quality review completing rates were highly increased .Two questionnaires correct rates were improved to some extent .One complication was found in 25 patients in previous baseline quality review ,while after intervention ,no complication was found .Conclusions :The evidence‐based standards of JBI TIVAP maintenance can highly improve nurses , s maintenance skills and patients , self‐management abilities ,reduce the risk of complications ,but it still need to be improved .

Objective:To investigate the dosimetry advantage of 3D-printed minimally invasive guided template used in local advanced cervical cancer intracavitary combined with interstitial radiotherapy.Methods:A total of 68 cases with locally advanced cervical cancer who were admitted to Hebei Cangzhou Hospital of intergrated traditional Chinese medicine and western medicine from May 2016 to August 2019 were selected. All the patients had eccentric tumor or large tumor (tumor diameter >5 cm) after radiotherapy. Intensity modulated radiotherapy was used for external radiotherapy, and intracavitary combined with interstitial radiotherapy was used for brachytherapy. The prescription dose of high-risk clinical target volume (HR-CTV) is 6 Gy/fraction, once a week, five fractions in total. Sixty-eight patients were randomly divided into two groups, 35 cases in the template group who received minimally invasive 3D printing guided template assisted intrauterine tube implantation and insertion needle implantation, and 33 patients in the free implantation group who received free hand intrauterine tube implantation and insertion needle implantation. The position and depth of the insertion needle were adjusted by CT-guidance, and the final CT image was transmitted to the Oncentra Brachy treatment planning system, then the target volume and organs at risk were delineated for planning and treatment.Results:A total of 340 brchytherapy plans were made, including 175 in the template group and 165 in the free implantation group. The D90 values of the HR-CTV and intermediate-risk clinical target volume (IR-CTV) in the template group were increased ( t=3.63, 2.45, P<0.05), and D2 cm3 values (dose of 2 cm 3 of organ at risk) of bladder, rectum and sigmoid colon were significantly decreased ( t=-2.81, -2.54, -2.33, P<0.05). At the same time, the average CT scanning times of each treatment in the template group was (1.78±0.53) times, the average duration of each treatment was (11.35±3.98) min, and the average number of needles used in each implant treatment was (5.21±1.37). The result of free implantation group was higher than that of the template group. The differences were statistically significant ( t=-2.26, -4.53, -3.21, P<0.05). Conclusions:For localized advanced cervical cancer patients with eccentric or large tumors, the 3D printed minimally invasive guided template for intracavitary and interstitial implantation has obvious dosimetry advantages, and the operation is simpler and the duration is shorter.

Nowadays, the new healthcare industry is closely integrated with the new-generation information techniques such as mobile Internet, Internet of things, cloud computing, and big data, which proposes higher requirements for the teaching objectives and contents of the optional course of medical informatics for non-informatics students in medical colleges and universities. Based on the actual teaching demands and the training objectives of clinical medical students, the teaching contents of the optional course of medical informatics were scientifically optimized and allocated. With "small datasets and basic application of electronic medical records/electronic health records" in medical informatics education as the main contents, numeric data, text data, and image data were modularized in medical information processing, and the methods of flipped classroom and case-driven teaching were adopted. The commonly used methods in machine learning (such as regression, classification, and clustering methods) were introduced and applied in task-based case studies, and the comprehensive algorithm case report was used for course assessment and evaluation. The teaching practice has shown that the above exploration not only stimulated the interest in the optional course of medical informatics among students, but also effectively implemented the "five early" mode of early prediction, early adjustment, early identification, early diagnosis, and early treatment among medical students.

Magnesium stents have gained increasing interest as an ideal stent of future intervention. In order to study the deformation behavior of magnesium al oy stents in the interventional treatment, the finite element method was used to analysis the effects of different crimp and expansion dimensions on the mechanical properties (maximum stress, radial recoil rate, longitudinal shortening rate and radial strength). The results showed that crimping and expanding have a minimal influence on the stent radial strength. When the expansion size is same, the maximum equivalent stress and recoil rate decrease with the crimp size. When the crimp size is same, in contrast with the radial recoil rate, the maximum equivalent stress and longitudinal shortening rate increase with the expansion size. In addition the paper verified the radial strength-radial displacement curve obtained by FEM. Results are basical y consistent, indicating the finite element method can efficiently provide researchers with reliable, high-quality design.

Objective:To evaluate the effects of different intervention measures on duration of mechanical ventilation and the length of intensive care unit (ICU) stay in critically ill patients using network Meta-analysis.Methods:Randomized controlled trial (RCT) on the effects of different intervention measures on duration of mechanical ventilation and the length of ICU stay in critically ill patients were systematically searched in PubMed, Embase, China Biomedical Literature Database, CNKI, and other databases. The search time limit was from the establishment of the database to November 2023. Literature screening, quality assessment, and data extraction were independently conducted by two researchers. Network Meta-analysis was employed to assess the effects of each intervention on duration of mechanical ventilation and the length of ICU stay, and funnel plots were generated.Results:A total of 37 RCTs were included, involving 3?977 severe patients, 2?041 in the intervention group and 1?936 in the control group. Thirteen types of interventions were analyzed, including usual care (UC), early activity (EA), early comprehensive rehabilitation (ECR), early pulmonary rehabilitation (EPR), cluster intervention strategy (CS), sedation, analgesia and cluster nursing (SACN), music therapy (MT), neuromuscular electrical stimulation (NMES), modified education and visitation (MV), virtual reality (VR), auricular point sticking (APS), acupoint acupuncture (AA), and concerted intervention (COR). Network Meta-analysis showed that MV significantly better than COR [standardized mean difference ( SMD) = -2.35, 95% confidence interval (95% CI) was -4.30 to -0.39], EPR ( SMD = -2.59, 95% CI was -4.81 to -0.37), and UC ( SMD = -4.10, 95% CI was -5.71 to -2.49) in improving duration of mechanical ventilation in critically ill patients. COR was significantly better than UC in shortened length of ICU stay ( SMD = -5.72, 95% CI was -10.07 to -1.37). The efficacy ranking results showed that for duration of mechanical ventilation, the surface under the cumulative ranking curve (SUCRA) was highest for MV (85.4%) and EA (85.4%), followed by AA (74.9%), NMES (63.1%), ECR (51.7%), CS (48.8%), SACN (34.3%), COR (29.4%), EPR (26.1%), and UC (0.7%). For the length of ICU stay, COR had the highest SUCRA (82.3%), followed by APS (79.7%), MV (77.7%), EPR (68.0%), NMES (57.6%), CS (54.4%), ECR (51.1%), SACN (41.9%), MT (39.8%), EA (39.3%), AA (33.0%), VR (15.4%), and UC (9.8%). The funnel plot results of ICU stay showed that the publication bias between studies were relatively small. Conclusions:MV and COR appear to be effective interventions for reducing mechanical ventilation time and ICU stay in critically ill patients. However, due to the number and quality of included studies, these findings require confirmation through additional high-quality research.

Objective:To evaluate the efficacy of preoperative neoadjuvant chemoradiotherapy for low and locally advanced rectal cancer.Methods:Clinical data of 46 patients with low rectal tumors located within 6 cm from the edge of anal admitted to our hospital between February 2014 and December 2018 were retrospectively analyzed. SIB-IMRT technique was adopted for preoperative radiotherapy. Rectal tumors and positive lymph nodes were irradiated with a dose of 58.75 Gy in 25 fractions (2.35 Gy/fraction), and pelvic lymphatic drainage area was given with 50 Gy in 25 fractions (2.0 Gy/fraction). Oral administration of capecitabine was delivered for concurrent chemotherapy. Radical surgery for rectal cancer was performed at 6 to 12 weeks after the end of chemoradiotherapy. The overall survival (OS), disease-free survival (DFS), progression-free survival (PFS), local recurrence-free survival (LRFS) and metastasis-free survival (MFS) were calculated by using Kaplan- Meier method. Univariate analysis was conducted by log-rank test, and multivariate analysis was performed by Cox’s regression model. Results:After a median follow-up of 47 months, local recurrence occurred in 3 patients and distant metastasis in 6 patients. The ypCR rate was 26%(12/46), the sphincter-preservation rate was 74%(34/46), the R 0 resection rate was 100%(44/44), the overall tumor response TN down staging rate was 87%(40/46), and the postoperative complication rate was 13%(6/46). The 3-year OS, DFS, and PFS were 93%, 91% and 87%, respectively. In univariate analysis, ypN staging was an important factor affecting OS, DFS, PFS, LRFS and MFS (all P<0.05). In multivariate analysis, ypN staging was significantly correlated with DFS, PFS, LRFS and MFS (all P<0.05). Conclusions:Preoperative SIB-IMRT 58.75 Gy in 25 fractions combined with capecitabine chemotherapy is a safe and efficacious treatment for patients with low and locally advanced rectal cancer, which improves the ypCR rate and quality of life, and yields tolerable adverse reactions. Nevertheless, the long-term survival benefits remain to be validated.