Author thinks that it is necessary to improve current clinical surgery teaching work by improving teachers'quality,advocating initiative teaching and professional education,guiding students how to deal with the relationship of doctors and patients,increasing the consciousness of law and self protection and making unified teaching content and target.

Objective To compare the difference of static balance ability in different aged people, with the maximum angle of center of mass (COM) and center of pressure (COP). Methods 37 healthy people without cardiovascular and cerebrovascular diseases including 15 young people (18~40 years old), 10 middle age people (41~65 years old) and 12 old people (>65 years old) participated in this study. The maximum angle of COM-COP and the corresponding envelope areas were recorded in 4 standing posture: natural standing, close eyes standing, single leg standing and single leg standing with eyes closed. Results There was no significant difference in the maximum angle of COM-COP among 3 groups in 3 states (nature standing, close eyes standing, single leg standing with eyes closed) (P>0.05), but there was significant difference in the state of single leg standing (P<0.05) between the young and the old, and the middle-aged and the old. Conclusion The maximum angle of COM-COP in the state of single leg standing can sensitively detect the deterioration of stability of older people. It may be a new index of static balance in clinic.

OBJECTIVE:To establish a method for simultaneous determination of ethinylestradiol and norelgestromin in hor-monal patches. METHODS:RP-HPLC method was performed on column of WondaCract ODS-2 with mobile phase of metha-nol-0.5% phosphoric acid(68∶32,V/V)at a flow rate of 1.0 ml/min,the detection wavelength was 220 nm,the detection tempera-ture was 25 ℃,and sample volume was 20 μl. RESULTS:The linear relationship was 0.872-130.8 μg/ml for ethinylestradiol(r=0.999 6) and 0.880-132.0 μg/ml for norelgestromin (r=0.999 7);RSDs of precision,reproducibility and stability tests were no more than 1.03%,average recoveries were resectively 101.50%(RSD=0.99%,n=9) and 101.68%(RSD=0.95%,n=9). CON-CLUSIONS:The established method is simple and accurate,and can be used for the content determination of ethinylestradiol and norelgestromin in hormonal patches.

The association of the progress of diabetic nephropathy with the sclerosis of major artery was investigated.Carotid intima-media thickness (CIMT) was positively correlated with urinary albumin and creatinine ratio,and negatively correlated with glomerular filtration rate in diabetes group,suggesting that thickened CIMT may predict the increasing risk of clinical nephropathy in the patients with microalbuminuria.

Objective:To understand the function of diaphragm and analyze the clinical factors affecting the function of diaphragm by measuring twitch tracheal pressure (TwPtr) in patients with mechanical ventilation and in the weaning phase.Methods:Patients with more than 48 hours of invasive mechanical ventilation admitted to the department of critical care medicine of the First Affiliated Hospital of Guangzhou Medical University from December 2015 to March 2017 were enrolled. After the patient entered the weaning stage, TwPtr of patients was monitored by two-way non repetitive automatic respiratory trigger device, the effects of duration of mechanical ventilation, severe pulmonary infection, sedative application and chronic obstructive pulmonary disease (COPD) on weaning were analyzed.Results:A total of 62 patients were included, of which 45 were male and 17 were female. The average age was (66.8±11.7) years old. Twenty-three cases had severe pneumonia. The absolute value of TwPtr in severe pneumonia group was lower than that in non-severe pneumonia group [cmH 2O (1 cmH 2O = 0.098 kPa): 10.40±5.81 vs. 14.35±5.22, P = 0.021]. However, there was no significant difference in the duration of mechanical ventilation between the severe pneumonia group and non-severe pneumonia group [days: 26 (17, 43) vs. 15 (11, 36), P = 0.091]. In 62 patients with mechanical ventilation, there was a negative correlation between TwPtr and duration of mechanical ventilation ( r = 0.414, P = 0.002), there was also a negative correlation between the duration of mechanical ventilation and TwPtr after the assessment of diaphragm function ( r = 0.277, P = 0.039). There was a linear relationship between TwPtr and sedatives ( r = 0.220, P = 0.040), but there was no correlation between TwPtr and COPD ( r = -0.178, P = 0.166). Conclusions:For patients in the weaning stage of mechanical ventilation, severe pulmonary infection is one of the factors that affect the diaphragm dysfunction. There is a certain correlation between the diaphragm dysfunction and the use of sedatives.

Delirium is an acute brain dysfunction syndrome characterized by confusion and difficulty concentrating,which mainly affects intensive care unit patients and elderly inpatients.Treatment is expensive and may also lead to increased risks of serious complications and death.The complex etiology and unknown pathological mechanisms of delirium mean that clinical drug treatment is largely ineffective.Animal models therefore provide a powerful tool to help understand the mechanism of delirium,screen new drugs,and study potential intervention measures.We review experimental research related to delirium animal models worldwide,and summarize the latest progress in the construction and evaluation of these models from the aspects of animal selection,model construction method,and model evaluation,to provide a reference for further experimental research based on delirium animal models.

Objective To systematically retrieve relevant research on the application of exercise intervention dur-ing hematopoietic stem cell transplantation for hospitalized children at home and abroad,to generalize and summa-rize the content of exercise intervention,the effect of intervention,and safety monitoring,with the purpose of provid-ing reference bases for the clinical application of exercise intervention in the future.Methods In accordance with the scoping review framework,we systematically retrieved databases including Web of Science,PubMed,Scopus,Cochrane Library,Embase,CINAHL,CNKI,VIP Database,Wanfang Data and China Biomedical Literature Database,with a retrieval timeframe from database establishment to May 19,2023.Based on the criteria for inclusion and ex-clusion of literature,we screened,summarized,extracted,and analyzed the literature.Results A total of 17 pieces of literature were included,including 5 randomized controlled trials,9 quasi-experimental studies,and 3 mixed-method studies.There were 4 categories of exercise including aerobic,anti-gravity,resistance,and stretching;most of the ex-ercises were of low to moderate intensity;the exercise interventions had a positive impact on muscle strength,quali-ty of life,cardiorespiratory function,body composition,and hematological indices;the safety monitoring consisted of red blood cell,hemoglobin,and platelet counts,temperature,joint and muscle pains,as well as falls,and syringe shedding.Conclusion The application of exercise intervention is safe and feasible,with a positive effect on chil-dren with hematopoietic stem cell transplantation in muscle strength,quality of life.Medical staff should combine with the clinical situation to formulate a reasonable and unified exercise program and to carry out scientific and standardized exercise management.