Objective:To investigate the changes of respiratory function and lung volume after bariatric surgery using spiral CT three-dimensional imaging technology.Methods:Using the prospective study method, the medical records of 30 subjects undergoing sleeve gastrectomy (LSG) in the Eighth Department of General Surgery, the Second Hospital of Hebei Medical University from Jan. 2023 to Jun. 2024 were collected. Among them, 12 were males and 18 were females, aged from 20 to 45 years, with the average age of 31.1 years old. Chest CT scans were completed within 1 week before surgery and 6 months after surgery. The subject′s CT plain scan reconstructed thin-layer images of the mediastinal window were transferred to a GE workstation, and the lung volumes of both lungs and each lobe and the tracheal wall area of the five bronchial segments (RB1, RB4, RB10, LB1 + 2 and LB10) were calculated as a percentage of the airway cross-sectional area (WA%), and the posterior intercostal position corresponding to the diaphragm was recorded. Paired t-test and rank-sum test were used to compare preoperative and postoperative differences.Results:Compared with pre-operation, the subject′s body mass index decreased significantly 6 months after bariatric surgery [(42.22±7.31) kg/m 2vs (30.12±5.59) kg/m 2,t=7.31, P<0.001)]. Except for left lower lobe [(1.15±0.23) L vs (1.27±0.24) L, t=1.97, P=0.054] and right middle lobe [(0.57±0.16) L vs (0.83±0.16) L, t=1.38, P=0.172], the remaining lung parts were significantly larger after surgery than before surgery: right upper lobe [(0.80±0.17) L vs (0.94±0.19) L, t=2.79, P=0.007], right lower lobe [(1.08±0.14) L vs (1.22±0.19) L, t=3.23, P=0.002], left upper lobe [(1.12±0.20) L vs (1.24±0.23) L, t=2.26, P=0.014]. Overall, right lung volume [(2.44±0.33) L vs (2.79±0.41) L, t=3.62, P=0.001], left lung volume [(2.27±0.36) L vs (2.52±0.39) L, t=2.53, P=0.014] and total lung volume [(4.71±0.60) L vs (5.30±0.71) L, t=3.48, P=0.001] all increased significantly at 6 months after surgery compared with before surgery. All five segments of bronchus (WA%) were significantly reduced after surgery than before surgery: RB1: [(62.82±4.66) vs (66.85±3.99), t=3.60, P=0.001]; RB4: [(61.24±5.28) vs (64.31±5.51), t=2.20, P=0.031]; RB10: [(60.03±4.64) vs (62.97±5.73), t=2.18, P=0.033]; LB1+ 2: [(63.61±5.05) vs (67.90±4.30), t=3.54, P=0.001]; LB10: [(58.73±6.49) vs (62.01±5.06), t=2.17, P=0.034)]. The posterior intercostal position corresponding to the diaphragm dropped from an average of 7-8 intercostal spaces to 8-9 intercostal spaces, with a significant difference (rank mean 22.77 vs 38.23, Z=-3.67, P<0.001). Conclusion:Bariatric surgery can significantly reduce weight, reduce the pressure of chest and abdominal, improve lung compliance, reduce the internal pressure of the chest, lower the diaphragm, expand the lung volume and airway cross-sectional area, restore the original airway anatomy and respiratory physiology, so it can effectively improve the respiratory function and lung structure abnormalities caused by obesity.

In 2022, the National Cancer Center (NCC) of China reported the nationwide statistics of 2016 using population-based cancer registry data from all available cancer registries in China, which was mainly about the cancer incidence and mortality. Cancer remains a major health problem currently in our country and requires long term cooperation to deal with. This article provided a key point interpretation and analysis of cancer prevalence data in China, and provided an analysis of several main risk factors for cancer, which was conducive to the development of cancer prevention and control programs in different regions.

Humans ; Asthma/drug therapy* ; Biological Therapy

Small intestinal bacterial overgrowth (SIBO) is characterized by changes in the number or species of small intestinal flora. Patients with liver cirrhosis often have intestinal congestion, edema, and delayed peristalsis and develop SIBO, which can further aggravate intestinal abnormalities. In patients with liver cirrhosis, SIBO can lead to significant adverse clinical outcomes, and since the increase in intestinal permeability may cause bacterial translocation into systemic circulation, SIBO is considered an important risk factor in the pathogenesis of liver cirrhosis, spontaneous bacterial peritonitis, and hepatic encephalopathy. Antibiotics, especially rifaximin, are the most effective therapies for SIBO, and in addition, studies are being conducted to investigate the efficacy of potential therapies such as prokinetic agents, probiotics, non-selective β-receptor blocker, and liver transplantation.

Dalian Medical University, aiming at cultivating innovative talents, has formulated and implemented a "5+3" innovative talents training reform plan. In the whole process of medical undergraduate education, tutorial system is used as the carrier to develop a phased innovative ability training system, which covers basic scientific research ability training such as courses, lectures, experimental design, papers and so on, and strengthens the cultivation of undergraduate scientific research ability. Through statistical analysis of the results of the first "5+3" students' periodic training, it is found that the proportion of "5+3" students publishing Chinese periodicals and SCI, and hosting national innovation projects and provincial innovation projects is significantly higher than that of ordinary 5-year students ( P<0.05). Although there are some problems and deficiencies in the implementation process, the basic scientific research training with tutorial system as the core has a significant effect on improving students' scientific research thinking and innovation ability, and is feasible for training medical innovative talents.

Coronavirus disease 2019 (COVID-19) can cause great damage to the elderly patients and lead to high mortality. The clinical presentations and auxiliary examinations of the elderly patients with COVID-19 are atypical, due to the physiological ageing deterioration and basal pathological state. The treatment strategy for the elderly patients has its own characteristics and treatment protocol should be considered accordingly. To improve the diagnosis, treatment, and prevention of COVID-19 in the elderly, the Expert Committee of Geriatric Respiratory and Critical Care Medicine, China Society of Geriatrics established the "Expert consensus for the diagnosis, treatment, and prevention of coronavirus disease 2019 in the elderly" . We focused on the clinical characteristics and key points for better treatment and prevention of COVID-19 in the elderly. (1) For diagnosis, atypical clinical presentation of COVID-19 in the elderly should be emphasized, which may be complicated by underlying disease. (2) For treatment, strategy of multiple disciplinary team (mainly the respiratory and critical care medicine) should be adopted and multiple systemic functions should be considered. (3) For prevention, health care model about integrated management of acute and chronic diseases, in and out of hospital should be applied.

Objective To evaluate the correlation between carbapenem consumption and resistance to carbapenems among the frequent gram-negative bacteria and provide the basis for rational use of drugs. Methods Retrospective review was used to calculate the DDDs of carbapenems(impenem and meropenem) per 100 persons per day from the year of 2004 to 2016 and resistant rate of the frequent gram-negative bacteria(Acinetobacter baumannii,Pseudomonas aeruginosa,Klebsiella pneumoniae,and Escherich-ia coli).The correlation of drug usage and resistance were analyzed by SPSS 17.0 software. Results The study demonstrated that carbapenem usage was strongly correlated with imipenem and meropenem-resistant Acinetobacter baumannii,Klebsiella pneumoniae, while has no significant correlation with Pseudomonas aeruginosa,Escherichia coli. Conclusion The growing problem of gram-negative bacteria resistant to carbapenems was strongly related to the high consumption of carbapenems.It also suggested that opti-mum antibiotic use was necessary to alleviate the threat posed by resistant microorganisms at the hospital level.

Objective To explore the MRI features about the annular ligament injuries in pediatric patients. Methods The appearance of MRI about annular ligament injuries in 15 pediatric patients diagnosed clinically were retrospectively analyzed. All patients (aged 4 years 8 months to 12 years 11 months) were scanned by MRI in 2-4 days after injury. Patients were divided into three groups according to the annular ligament injuries severity, which were simple annular ligament injuries, annular ligament injuries combined dislocation, annular ligament ruptures combined dislocation. Results Simple annular ligament injuries were showed in 2 cases, which appeared high signal but continuous configuration. Annular ligament injuries combined dislocation were showed 9 cases. Bald head sign, thickening and continuous ligment were found on axial image, together with compression of the radial joint space on sagittal and coronal view. Annular ligament ruptures combined dislocation were showed in 4 cases. The ligment showed"bald head sign", tortuosity and uneven thickening on axial view and compression of the radial joint space on sagittal and coronal view. Combining with the other tissue injuries were detected in 15 cases. Conclusion The annular ligament injuries show some MRI characteristics. Bald head sign is specific in the annular ligament injuries of pediatric patients.

Objective To explore the MRI features about the annular ligament injuries in pediatric patients. Methods The appearance of MRI about annular ligament injuries in 15 pediatric patients diagnosed clinically were retrospectively analyzed. All patients (aged 4 years 8 months to 12 years 11 months) were scanned by MRI in 2-4 days after injury. Patients were divided into three groups according to the annular ligament injuries severity, which were simple annular ligament injuries, annular ligament injuries combined dislocation, annular ligament ruptures combined dislocation. Results Simple annular ligament injuries were showed in 2 cases, which appeared high signal but continuous configuration. Annular ligament injuries combined dislocation were showed 9 cases. Bald head sign, thickening and continuous ligment were found on axial image, together with compression of the radial joint space on sagittal and coronal view. Annular ligament ruptures combined dislocation were showed in 4 cases. The ligment showed"bald head sign", tortuosity and uneven thickening on axial view and compression of the radial joint space on sagittal and coronal view. Combining with the other tissue injuries were detected in 15 cases. Conclusion The annular ligament injuries show some MRI characteristics. Bald head sign is specific in the annular ligament injuries of pediatric patients.

Under the guidance of strengthening medical undergraduates' practical ability and their competence in future jobs, Dalian Medical University has established a clinical medical talents practical ability training mode. This model has implementedThree Turnsclinical skills training pattern to strengthen the three stage (before, during and after practice) clinical skills training and concentrated on humanistic quality education through overall evaluations and set up clinical skill examination system to evaluate teach-ing effectiveness comprehensively and truly , which has effectively improved the quality of education by perfecting safeguard mechanisms and guaranteeing teaching quality.