Objective:To observe the influence of post-operative early enteral nutrition(EEN) for oral tumour patients.Methods:Sixty patients with oral tumour were randomly divided into EEN group (30 cases) and tradition enteral nutrition(TEN) group (30 cases). The nutritional support with Nutrision fiber started within the first 12~16 h post-operatively in EEN group, The enteral feeding started within the recovery time of the gut function in TEN group. Nutritional parameters were measured before and after the operation. Results:The mean hospitalization days in EEN group and TEN group were 10.14?1.58 and 15.29?3.26 respectively(P

Objective To evaluate the methods of standard patient (SP)combined with case-based learning (CBL ) in humanistic quality cultivation for interns in the department of thoracic surgery. Methods Medical interns in the department of thoracic surgery were divided randomly into experimental(n=30)and control group(n=30)respectively. In experimental group,SP combined with CBL was used while in control group traditional teaching was used. At the end of the study,teaching effect was assessed by the final examination and questionnaires and the data were processed by t test andX2 test. P<0.05 signifies statistical differences. Results There was no significant difference in test scores between the two groups (P>0.05). Scores of history-taking,medical check-up,paper writing quality in the final examination in experimental group were significantly higher than those in control group(P<0.01). Satisfaction degrees of doctor-patient communication,responsibility and service attitude in experimental group were better than those of control group(X2=16.484,10.335,20.376,32.851,P<0.01). Conclusions SP combined with CBL teaching method can stimulate the students' interests in thoracic surgery practice,improve the doctor-patient relationship and strengthen the ability of human-istic concern. It is a better clinical thoracic practice teaching method and it is beneficial to cultivating medical students with humanistic concern.

Objective To summarize the experiences in clinical diagnosis and surgical treatment of chest cancers invading the superior vena cava (SVC). Method Retrospective study of 12 cases with chest cancers invading the SVC, SVC and innominate vein were reconstructed with prosthesis in 3 cases, the side wall of the SVC was excised and repaired in 9 cases. Results Complete resection was performed in 10cases,2 cases had incomplete resection. There was no death associated with operation in these patients. All patients were followed up for 1 - 7 years after operation,and 3 cases were lost to follow up,5 of remaining 9cases were dead because of relapse and metastasis, their median survival time was 8 months,other 4 cases lived, their median survival time was 42 months. Conclusions Patients with chest cancers invading the SVC should have surgical treatment of not only tumor resection but also the vessel reconstruction,the prognosis would be better than without surgical treatment. These patients have a high quality of life and live with long-term survival.

OBJECTIVE: To explore the mechanism of the inhibiting effects of recipe for dispersing stagnated liver qi to promote bile flow (Danshijing Tablets) on cholesterol gallstone formation and provide experimental evidence for its clinical application. METHODS: Eighty guinea pigs were randomly divided into 4 groups, which were normal control group, untreated group, ursodeoxycholic acid (UDCA)-treated group and Danshijing Tablets-treated group. The gallstones in guinea pigs were induced by high-cholesterol diet. UDCA and Danshijing Tablets were given orally to guinea pigs in the corresponding group respectively for seven weeks. Then the physical signs of the guinea pigs, the rates of gallstone formation and the histomorphological changes of the gallbladder were examined. RESULTS: The behavior of guinea pigs in the Danshijing Tablets-treated group was obviously improved and the rate of gallstone formation was significantly decreased as compared with those in both untreated and UDCA-treated groups (P<0.05). The inflammation reaction of mucous membrane in gallbladder was evidently reduced in the Danshijing Tablets-treated group and its morphological appearance turned to be approximately normal. CONCLUSION: Recipe for dispersing stagnated liver qi to promote bile flow may decrease gallstone formation. Its mechanism may be related to reducing pathologic changes in gallbladder tissues, which will reduce the damages of cholesterol to the smooth muscle in gallbladder and enhance the contractility of gallbladder.

Objective To understand the current status,type,and effect of training programs conducted by Health Bureau and CDC in China.Methods One person of each province was selected from China field epidemiology training network and designated as contact person who was responsible for collecting information of field practical training lasting for at least 6 months for staff of public health emergency and infectious disease control in each province from October 2001 to October 2010.Questionnaire including basic condition,organization and management,training design,faculty condition,trainee condition and training outputs was designed and filled in by contact person.Results There were 35 training programs covering over 9 provinces in China.The first province and city FETP started in 2004,including Guangdong FETP,Zhejiang FETP,Hangzhou FETP,Ningbo FETP and Guizhou FETP.Thirty-five training programs had 355 mentors,22(6％)were CFETP graduates and 57 (16％)were local FETP graduates.All program funds were paid by local governments.The training programs included two parts,theoretical lectures and field practice,which occupying 10％-20％ and 80％-90％ of the whole training time,respectively.Among 6 evaluative items including emergency investigation,surveillance analysis,surveillance evaluation,planned investigation,investigation report and paper publication,most programs(50％-94％) had less than average one person per time.Conclusions Field epidemiology training program after several years of development in china achieves the certain scale.Some provincial programs are successful,but the effect and quality of training programs in different areas are uneven.We suggest optimizing of field epidemiology training resources and further expanding China field epidemiology training network.

Abstract: Objective　The study aims to investigate the diagnosis quality and accuracy of syphilis cases reported by medical facilities in Inner Mongolia, understand possible problems and influencing factors in reporting and diagnosis, providing evidence for the better formulation of syphilis control and prevention. Methods　Cross-sectional survey was conducted with 2 counties sampled randomly from 12 municipals of Inner Mongolia, different medical facilities were covered. Syphilis cases reported from July 2019 to June 2020 in medical institutions of different categories were sampled and checked. The quality and accuracy of syphilis case reporting were evaluated according to the identifiers in "Syphilis Diagnosis (WS 273-2018)" and "National STD Case Reporting Quality Management Scheme (2018)". In addition, the basic information of medical institutions and the implementation of syphilis detection in laboratories were investigated, and the physicians who reported the case first were interviewed to understand their mastery of syphilis diagnosis and reporting, thus analyzing the major factors influencing the accuracy of reports. Results　The reporting rate of syphilis in medical institutions in Inner Mongolia was 99.04% (311/314), the missing-report rate was 0.96% (3/314), the timely reporting rate was 98.05% (1 659/1 692), the completeness rate was 99.64% (1 686/1 692), the correct rate was 99.35% (1 681/1 692), the accuracy rate of internet-based input was 84.63% (1 432/1 692). There were statistical differences in the quality (χ2=13.95, P<0.05; χ2=11.40, P<0.05) and accuracy （χ2=30.06, P<0.05; χ2=44.93, P<0.05) of reports among different municipals and different types of medical facilities. The accuracy rate of syphilis reporting by medical institutions was 86.17% (1 458/1 692), the correct rate for classifying diagnosis was 87.06% (1 473/1 692), and the accuracy rate of staging was 90.25% (1 527/1 692). Multivariate logistic regression results showed that whether the first-clinic physician attended training in the past three years [OR=6.26, 95%CI: (2.12-18.46)] and whether they grasped the key points of syphilis classification standard [OR=2.79, 95%CI: (1.21-6.46)] influenced report accuracy. Conclusions　The quality of reports in Inner Mongolia medical institutions is generally high, but the accuracy rate of reporting and correctness of network input have not yet reached the target requirement of 95%. There is still room for improvement in reporting and diagnostic capabilities. It is suggested to further strengthen the training frequency and coverage for physicians on syphilis diagnosis standard.

Objective: To analyze the risk factors for lung cancer and to provide scientific evidence for prevention of lung cancer. Methods: A total of 461 newly diagnosed patients with primary lung cancer from January 2015 to June 2017 in Shaoxing were selected as the case group. Six hundred healthy residents with the same residence,distribution of gender and age as the cases were selected as the control group by frequency matching method. A questionnaire survey was conducted to collect demographic characteristics,family history of major chronic diseases,disease history and behavioral factors. The method of case-control study and multivariate logistic regression model were used for statistical analysis of the risk factors for lung cancer. Results: The results of multivariate logistic regression analysis showed that after adjusting for age and gender,family history of cancer（OR=6.606,95%CI：3.439-12.689）,history of lung diseases（OR=2.836,95%CI：1.208-6.659）,high level of stress（OR=2.485,95%CI：1.830-3.376）,low consumption of fresh vegetables（OR=3.116,95%CI：2.470-3.930）and smoking（OR=6.029,95%CI：3.716-9.783）were risk factors for lung cancer;after adjusting for age,gender,family history of cancer,history of lung diseases,stress levels and consumption of fresh vegetables,quitting smoking for less than ten years was a risk factor for lung cancer（OR=4.751,95%CI：2.404-9.386）compared with quitting smoking for ten years or above. Conclusion Family history of cancer,history of lung diseases,high level of stress,low consumption of fresh vegetables and smoking were risk factors for lung cancer.

Objective:To investigate the effects of 3D video thoracoscopic surgery combined with 3D CTBA (three-dimensional computed tomography bronchography and angiography) method in clinical education practice of the undergraduates.Methods:The study included in 60 undergraduate clinical interns from our hospital, and they were randomly divided into the experimental group ( n=30) and control group ( n=30). The teaching content was diagnosis and surgical treatment of lung cancer. The experimental group applied 3D video thoracoscopic surgery combined with 3D CTBA teaching method. The interns studied the anatomy of lung and diagnosis of lung cancer based on the 3DCTBA and visited the operation of lung cancer under 3D thoracoscopy, which enhanced their knowledge of anatomical structure of lung. The control group applied traditional thoracoscopic surgery for lung cancer. Upon termination of clinic practice, all interns were tested with theoretical and clinical knowledge of lung cancer. A questionnaire survey was conducted among them to access the teaching effect. SPSS 18.0 was used for t test and chi-square test. Results:The scores of theory test were not significantly different between two groups. The scores of anatomic and operational knowledge of lung in the experimental group were significantly higher compared with the control group ( P<0.05). Questionnaire result showed that new teaching method could promote the interest in learning, motivated the desire for thoracic surgery, and improved the comprehension of clinical knowledge. More students approved the new teaching method. Conclusion:The new method, 3D video thoracoscopic surgery combined with 3D CTBA, has beneficial effect on clinical interns, which contributes to inspire the motivation and interest of learning and deepen clinic knowledge, and is a promising teaching method worthy of further exploration and application.

To summarize the clinical experience regarding a patient with early recurrence of atypical hemolytic uremic syndrome (aHUS) after renal transplantation. AHUS is a rare disease with high recurrence rate and poor prognosis. Although the patient was treated with plasma exchange, intravenous gamma globulin, rituximab block B lymphocyte, hormone shock and so on, he still suffered renal transplantation failure. The risk of aHUS recurrence after renal transplantation should be fully evaluated.

Objective:To explore the risk factors of paralytic ileus (PI) after simultaneous pancreas-kidney (SPK) transplantation.Methods:From January 2017 to December 2019, clinical data were reviewed retrospectively for 115 cases of SPK transplantation. The risk factors of PI after SPK were analyzed. According to the occurrence of PI, they were divided into two groups of occurrence and non-occurrence. One-way analysis of variance was utilized for analyzing such influencing factors as gender, age, body mass index (BMI), diabetic type, duration of diabetes, mode of dialysis, duration of dialysis, diabetic gastroenterology, history of open surgery, bowel preparation, operative duration, hemorrhagic volume, immunosuppressant and hypoproteinemia. Multivariate Logistic regression analysis was performed for screening the suspected risk factors.Results:Among them, 19 patients (16.5%) had PI. Univariate analysis showed that PI was associated with diabetic gastroenterology, operative duration, history of open surgery, no bowel preparation and hypoproteinemia ( P<0.05). Multivariate Logistic regression analysis revealed that the risk factors of PI after SPK included diabetic gastroenterology, operative duration time, history of open surgery and no bowel preparation ( P<0.05). Conclusions:Diabetic gastroenterology, operative duration, history of open surgery and no bowel preparation are risk factors for PI after SPK. Clinical interventions for the above factors are necessary.