Objective To analyze the influence of thoracoscopy combined with laparoscopy for radical operation of esophageal carcinoma and open ones on the perioperative effects and postoperative quality of life.Methods The data in 74 esophagus cancer patients in the thoracic surgery department of our hospital from October 2012 to June 2015 were collected and divided into the endo-scopic group and open group according to different operative ways.The perioperative effects and complications in the two operation ways were analyzed.The EORTC QLQ-C30 and QLQ-OES18 were used to conduct the questionnaire investigation and comparative analysis.Results The mean intraoperative blood loss,postoperative catheter drainage,hospitalization time,occurrence rates of post-operative complications such as pneumonia,hydrothorax and gastric emptying disorder in the endoscopic group were lower than those in the open group,while the operative time was longer than that in the open group,the differences were statistically significant (P <0.05).The total healthy status and function scores at postoperative 1,12 weeks in the two groups were decreased and symp-tom scores were increased,which at postoperative 24 weeks were back to close to preoperative level.The scores in the aspects of to-tal healthy status,physical functioning,role functioning,social functioning,fatigue,pain,dyspnea and difficultly coughing at postop-erative 1,12 weeks in the endoscopic group were superior to those in the open group,in which the scores of total healthy status, physical functioning and fatigue symptom at postoperative 24 week were still superior to those in the open group,the differences were statistically significant(P <0.05).Conclusion Thoracoscopy combined with laparoscopy for radical operation of esophageal carcinoma has the advantages in the aspects of intraoperative blood loss,catheter drainage,hospitalization time,some postoperative complications and QOL scores,but the operative time is longer.

With the development of modem clinical medical engineering,especially some large medical equipment,medical engineering section needs more talents in management and maintenance profession.Aiming at problems in the section construction,some viewpoints and suggestions are put forward.It is expected that the leadership could attach importance to medical engineering section,make good use of the talents and lay solid foundation for the development of hospitals.

Objective To investigate the feasibility and effectiveness of fast track surgery (FTS) in neurosurgery. Methods One hundred fifteen patients who underwent neurosurgery surgery in Henan Province People's Hospital from June 2012 to March 2014 were enrolled in this study. All the patients were divided into FTS group (62 cases) and the tra?ditional operation group (53 cases). The clinical index, postoperative hospital stay and hospitalization cost were compared between the two groups. Results The clinical index were significantly lower in FTS group than in traditional operation group (P<0.05). Length of hospital stay (days) and hospitalization cost of FTS group were significantly shorter and lower in FTS group compared with traditonal operation group (8±1 vs. 11±2 days and RMB 4.58 ±0.75 vs. 5.78 ±0.64 ten thou?sand, respectively) (P<0.05). Conclusion FTS in neurosurgery operation is an all-new concept for surgery which can ef?fectively reduce postoperative complications, shorten length of hospital stay, decrease hospitalization cost and promote postoperative recovery.

CD38 is a multifunctional enzyme expressed in a variety of mammalian tissues, its catalytic activity was involved in a wide range of physiological processes. Based on the reported inhibitor of human CD38 NADase, 33 purine derivatives were designed and synthesized. The biological activity assay showed that compounds 20 and 38 exhibited almost the same extent of inhibitory activities on human CD38 NADase as the lead compound H2. The results also revealed that small substituents at C-6 of purine ring gave no obvious effect on inhibitory activity, but phenylpropionyl moiety at N-2 could affect the binding mode of the compound with CD38. This study provides a reliable basis for future rational design of inhibitors for CD38.

Objective To investigate the efficacy and safety of low-dose and standard-dose intravenous alteplase for acute ischemic stroke. Methods The patients with acute ischemic stroke treated with intravenous alteplase from August 2012 to January 2016 were analyzed retrospectively. According to the dosage of the drug, the patients were divided into either a low-dose group (0. 6-0. 8 mg/kg) or a standard-dose group (0. 9 mg/kg). The efficacy was evaluated with the modified Rankin Scale (mRS) at 90 days, and a favorable functional outcome was defined as mRS 0-1. The safety was evaluated by the mortality at 90 days and the incidence of symptomatic intracerebral hemorrhage (SICH) within 7 d after onset. Results A total of 790 patients were enrolled, including 612 in the low-dose group and 178 in the standard-dose group. There was no significant difference in each baseline clinical data between the 2 groups. Compared with the standard-dose group, there was no significant difference in the good outcome rate of the small-dose group at day 90 (35. 6% vs. 37. 6% ; χ2 = 0. 872, P = 0. 35) and mortality (5. 1% vs. 6. 2% ;χ2 = 2. 173, P = 0. 14), but the incidence of SICH was significantly lower (1. 8% vs. 5. 1% ; χ2 = 5. 875, P =0. 015). Conclusion The efficacy of low-dose intravenous alteplase for acute ischemic stroke is equivalent to the standard-dose and the safety is better.

31 patients with cysticercosis of cerebral ventricles verified by operation or pathological investigation were reported. All patients were between 7 and 64 years of age and 14 were females. All had a single cyst. Since 29 patients (94%) were without a history of intestinal taeniasis, it was proposed that most patients of cysticercosis of cerebral ventricles were caused by hetero-infection and the entrance of Cysticercus into brain ventricle was through choroid plexus along the cerebro-spinal fluid. This is probably the reason why it occurs mostly in the 4th ventricle. The clinical manifestation of cysticercosis of cerebral ventricles were paroxysmal headache and vomiting caused by increased intracranial pressure. Ventricu-lography and CT scanning have considerable diagnostic value. Removal of Cysticercus by surgical operation is successful (Figs. 1 - 8).

Objective:To investigate nurses' knowledge, attitude and behavior status about the safety management of enteral nutrition tube in a tertiary Class A hospital in Beijing.Methods:A self-designed questionnaire based on reliability and validity was used. Besides, a convenient sampling method was used to select 309 nurses working on enteral nutrition from the hospital.Results:Nurses scored (28.58±6.09)for knowledge, (37.65±5.03)for attitude and (70.01±5.45)for behavior. The percentage of average scores in the three indicators were 57.16%, 94.13% and 93.35%. According to the single factor analysis, the score of behavior differed among nurses with different working years( F=23.61, P=0.032). The score of knowledge differed among nurses with different titles( F=4.48, P=0.012). Besides, the frequency of tube feeding operations had great effects on nurses′ knowledge and behavior ( F=9.64, P<0.001; F=34.59, P=0.018). But there was no statistical difference in the knowledge, attitude, and behavior scores among nurses trained at different frequencies( F=0.85, P=0.497; F=12.56, P=0.231; F=18.97, P=3.479). Conclusions:Nurses have a positive attitude towards the safety management of enteral nutrition tube, but their knowledge level is poor and their behavior needs to be further regulated. It is necessary to carry out relevant training to standardize clinical operations and ensure the safety management of enteral feeding tube.

With the advent of the era of accurate medical treatment,molecular targeted therapy has become a new trend of cancer treatment.The abnormal status of cancer metabolism and metabolic drug together with tumor targeted therapy are becoming the hotspot in cancer.A large number of studies have shown that metformin,a targeted metabolic drug,has synergistic anti-tumor effects when it is used in combination with various target drugs.The combination of targeted metabolic drugs and anti-tumor drugs can provide new strategies for tumor treatment.

Objective:In this study, a gait acquisition and analysis system is developed to provide a cheap, easy-to-use solution for quantitative recording and analysis of patients' gaits.Methods:From April 2017 to October 2018, we collected the gait data of 19 patients with knee osteoarthritis and 19 healthy volunteers in the orthopaedic outpatient department. Among 19 patients, there were 9 males and 10 females, aged 50.1±9.4 years old. Among 19 healthy volunteers, there were 8 males and 11 females, aged 50.7±10.3 years old. Then, from the collected gait data, the static gait features such as gait speed, step length, stride, and dynamic gait features were automatically calculated, and the statistical difference analysis was finished to determine the correlation between these quantitative gait features and knee osteoarthritis.Results:Firstly, the gait data collected by the depth camera was compared with the data from the multi infrared camera-based motion analysis system (gold standard). The average angle error of the collected knee joint angle was 0.98 degrees, which proved the correctness of the gait data recorded by the depth camera. The statistical difference analysis of gait characteristics between the patient group and the healthy group showed that the gait characteristics with P<0.05 included: gait speed ( r=-0.922, P<0.001), step length ( r=-0.897, P=0.004), stride ( r=-0.914 , P<0.001), dynamic characteristics of angle of knee joint ( r=0.775, P=0.001). Conclusion:The gait acquisition and analysis system based on the depth camera can accurately record and store the gait data of the patients with knee osteoarthritis. Moreover, the extracted quantitative gait features have statistical differences between the patients and the healthy group, which is helpful for the gait analysis of bone joint.

Objective:To investigate the clinical features, diagnostic methods, treatment modalities, and prognosis of parathyroid multiglandular disease (PTMGD) in primary hyperparathyroidism (PHPT) .Methods:The clinical data of 29 patients with PTMGD who underwent surgery at the General Surgery Department of the Tianjin Medical University General Hospital from Dec. 2015 to Jul. 2023 were retrospectively analyzed, including the patients' preoperative and postoperative blood calcium and parathyroid hormone, the main clinical manifestations, the involvement of other systems, the main types of pathology, the accuracy of the various examinations, and the postoperative prognosis, etc., and were compared with the 291 patients who had undergone surgery for single-glandular lesion patients were compared. SPSS25 was used to analyze the data.Results:The age of onset of PTMGD was 52.7±1.9 years compared to 56.6±0.7 years in patients with monoglandular disease, P=0.047. Tumor diameter of PTMGD was (2.05±0.1) cm and (2.34±0.6) cm of monoglandular disease, P=0.006. The preoperative blood calcium was (2.56±0.59) mmol/L in PTMGD and (2.70±0.58) mmol/L in monoglandular disease, P=0.045. Preoperative parathyroid hormone (PTH), blood calcium, and Win values were positively correlated with maximum tumor diameter in patients with PTMGD (R-values of 0.362, 0.223, and 0.352, respectively) .Neck ultrasound, neck-enhanced CT and parathyroid nuclear imaging were used to localize and diagnose the diseased parathyroid glands in this group of cases.The accuracy rates were (14/25) 56%, (10/19) 53% and (11/24) 46% in patients with PTMGD, while in patients with monoglandular disease, the accuracy rates were (233/250) 89%, (131/152) 96% and (223/232) 86%. PTMGD accuracy rate was less than that of monoglandular disease,and was statistically significant ( P-value was less than 0.001 in all cases) .The accuracy of the combined localization diagnosis of the three tests in patients with PTMGD was then improved to (13/18) 72%. The pathology of PTMGD was predominantly parathyroid hyperplasia, 45/72 (63%), compared to that of monoadenopathy 18/291 (6%), P<0.001. Parathyroid adenomas predominated in patients with monoadenopathy compared to that of PTMGD, 237/291 (82%) vs. 24/72 (33%), and the proportion of parathyroid adenomas in patients with monoadenopathy was higher than that in patients with PTMGD, P<0.001. 23 patients with PTMGD were followed up, of whom 9 showed mild elevation of parathyroid hormone postoperatively, and 1 patient showed signs of hypoparathyroidism. Conclusion:The low age of onset of multiglandular lesions in primary hyperparathyroidism, mild biochemical tests, and the difficulty of accurately locating all lesions preoperatively warrant adequate preoperative evaluation to promptly identify patients with familial multiple endocrine adenomas, as well as intraoperative bilateral parathyroid exploration in patients with suspected multiglandular lesions.