Objective To observe clinical effect of treating gastropareds after subtotal gastrectomy with integrated traditional Chinese and western medicine.Methods 98 cases patients with gastroparesis after subtotal gastrectomy were randomly divided into a treatment group and a control group.The control group was treated with western medicine,and the treatment group was treated with modified Liumo decoction in addition to western medicine.A six months'follow-up was performed after the treatment to observe clinical effect.Results The therapeutic effect in the treatment group was significantly better than the control group,with P＜0.05.Conclusion Integrated traditional Chinese and western medicine therapy has better effect in treating gastroparesis after subtotal gastrectomy than exclusive western medicine therapy.

Objective To investigate correlation factor of anastomotic leakage after anus-preserving operation for low rectal cancer. Methods Clinical data of 128 cases in recent 3 years of low rectal cancer after anus-preserving operation were retrospectively analyzed. Results The incidence rate of anastomotic leakage in the group were 10.9%(14/128). The patients of male,were age of ≥ 65 years old and ＜7cm of the anal margin from lower tumor,dukes the later stages,complicated by obstruction, diabetes, and hypoalbuminemia. The take place easily anastomotic leakages in the patients which were(all P ＜ 0.05). Conclusion The rate of anastomotic leakage after anus-preserving operation for low rectal cancer is related to personal factors ,tumor factors and complicating diseases ,etc.

Objective: To compare the effect of intranasal dexmedetomidine and oral chloral hydrate in deep sedation of children. Methods: The Pubmed, EMBase, CENTRAL (Issue 4, 2018), Web of science, CBM, Wanfang Data, CNKI and VIP databases from the inception to January 2019 were searched. Randomized controlled trials (RCTs) with dexmedetomidine and chloral hydrate as interventions were included and the data were analyzed by RevMam 5.3 and Stata 12.0 software. The success rate of deep sedation, the indicator of sedation onset time, the recovery time, the incidence of vomiting and bradycardia were compared. Results: A total of 7 RCTs involving 1 007 patients were included for analysis. The results showed that the success rate of deep sedation (OR=2.55, 95%CI:1.46-4.44, P<0.01) and the incidence of bradycardia (OR=4.42, 95%CI:1.82-10.74, P<0.01) in the dexmedetomidine nasal group were significantly higher than those in the chloral hydrate oral group. The recovery time was significantly shorter (MD=-16.41, 95%CI:-21.54-11.28, P<0.01) and the incidence rate of vomiting (OR=0.04, 95%CI:0.01-0.17, P<0.01) in dexmedetomidine nasal group was significantly lower than those in the chloral hydrate oral group. There was no significant difference in the indicator of sedation onset time (MD=-0.47, 95%CI:-2.71-1.22, P=0.46). Conclusion Compared with the traditional oral chloral hydrate, intranasal dexmedetomidine has a higher sedation success rate and shorter recovery time after sedation with a lower incidence of nausea and vomiting.

The lifelong teaching and learning abilities based on training the core competency of ophthalmology residents is a new hot spot in the curriculum design of ophthalmological standardized residency training. In the standardized residency training base of Xiangya Hospital of Central South University Ophthalmic Center, a graded lecturer training curriculum with residents as core has been designed to train the critical thinking, active learning, summarizing and presenting skills of residents at all levels. According to the different tasks, the residents can present themselves through online and offline platforms so that they can gradually grow into different levels of lecturers. Through the graded training of lecturers from low level to high level, step by step, the residents are trained as active learners from the thinking mode, become student-instructors or lecturers from the teaching ability, and be more competent for future study and work.

China ; Depressive Disorder, Major ; genetics ; Humans ; Polymorphism, Single Nucleotide ; Sirtuin 1 ; genetics

Objective    To study the safety of right vertical infra-axillary thoracotomy (RVIAT) in the repair of ventricular septal defect (VSD) and the optimal age for RVIAT. Methods    Between June 2014 and June 2018, 441 children underwent VSD repair via RVIAT in our hospital. According to the age, they were divided into four groups: a 4 months to 1 year old group (R1 group, n=123), a 1-2 years old group (R2 group, n=106), a 2-5 years old group (R3 group, n=166), a >5 years old group (R4 group, n=46). The clinical effects of the patients were compared. Results    All the operations were successfully performed and no serious complication was found in all groups. No statistical difference was observed in the operation time, blood loss during operation, thoracic drainage 24 h after operation among groups (P>0.05). The cardiopulmonary bypass time, aortic cross-blocking time and ICU stay time in the R1 and R2 groups were longer than those in the R3 and R4 groups (P<0.05). In the R1 group, the postoperative ventilating time and postoperative hospital stay time were longer, and the blood transfusion volume was more than those in the R3 and R4 groups (P<0.05). The incidence of postoperative complications was higher in the R4 group than that in the R1 and R3 groups (P<0.05). Conclusion    VSD repair via RVIAT may be more effective in children >2 years old, and 2-5 years old may be the optimal age.