Objective To construct an intelligent segmentation and T-stage diagnostic model for esophageal cancer based on the DAEUnet and ConvNeXt networks using transfer learning.Methods Dicom raw data from 126 patients diagnosed with esophageal cancer between January 2018 and April 2022 were collected,including 100 cases from Department of Thoracic Surgery at the First Affiliated Hospital of Army Medical University and 26 cases from the Department of Thoracic Surgery at Shanxi Cancer Hospital.After data augmentation,a total of 60 275 images were obtained.The DAEUnet esophageal cancer intelligent segmentation network was built,and on this basis,3 classification networks,ConvNeXt,Swin Transformer,and ResNet were constructed for T-stage diagnosis of esophageal cancer.Results The Dice similarity coefficient(DSC)for esophageal cancer intelligent segmentation using the DAEUnet network was 0.82,and the DSC value of the esophagus,aorta,normal esophagus,mediastinal lymph nodes,and heart was 72.4％,87.5％,79.3％,60.5％ and 96.8％,respectively.Among the 3 T-stage diagnosis models for esophageal cancer,the ConvNeXt model performed the best,with a precision value for T1～T4 stages of 0.65,0.727,0.889 and 0.92,respectively,and an AUC value of 0.892,which were superior to the ResNet and Swin Transformer networks.Conclusion The proposed DAEUnet and ConvNeXt-based intelligent segmentation and T-stage diagnosis model for esophageal cancer improves T-stage accuracy and treatment efficiency.

Objective:To evaluate the clinical efficacy of kidney-invigorating and asthma-relieving granules in treating kidney deficiency type of bronchial asthma patients in persistent.Methods:A total of 100 patients with bronchial asthma admitted to Shanghai Municipal Hospital of TCM from March 2020 to August 2020 were selected as the research subjects. The patients were divided into control group and treatment group by random and double blind method, 50 in each group. Both groups were treated by routine basic treatment. The control group was treated with Kidney-invigorating and asthma-relieving Placebo, while the observation group was treated with kidney-invigorating and asthma-relieving granules. All the treatment lasted for 6 weeks. The TCM syndromes scores, Asthma Control Test (ACT) scores, Peak expiratory flow/predicted value (PEF%) and eosinophil in peripheral blood before and after treatment were observed.Results:A total of 91 patients completed the clinical study. There were 45 patients in the control group and 46 in the treatment group. The total effective rate in the treatment group was 93.5% (43/46), while that in the control group was 77.8% (35/45), and the difference was statistically significant ( χ2=4.579, P=0.032). After the treatment, the scores of integral efficacy on syndromes in Chinese medicine, ACT and PEF% in the treatment group were significantly higher than those in the control group ( t values were 2.802, 3.420 and 8.938, respectively, all Ps<0.01). The eosinophil in peripheral blood of patients in the treatment group was significantly lower than that of the control group ( t=3.481, P=0.001). Conclusion:On the basis of conventional treatment of western medicine, kidney-invigorating and asthma-relieving granules can relieve the clinical symptoms of asthma, improve the control level of asthma, enhance the level of PEF, reduce airway inflammation.

Objective:To know the work status of clinical pharmacy in medical institutions of Guizhou province. Methods:Ques-tionnaires were used to analyze the situation of clinical pharmacy in 108 medical institutions of Guizhou province. Results: A total of 246 questionnaires were taken back, and among the 231 valid questionnaires were received including gradeⅡor above hospitals. The main contents of clinical pharmacy work carried out in medical institutions included 7 aspects: pharmacists ’ participation in ward rounds, which accounted for 47. 11%; pharmacists’ participation in case consultation, which accounted for 16. 65%; pharmacists’ participation in teaching practice, which accounted for 38. 84%; pharmacists’ participation in prescription evaluation and analysis, which accounted for 72. 73%;pharmacists’ participation in antimicrobial drug monitoring and drug use evaluation, which accounted for 62. 37%;pharmacists’ participation in drug counsultation and education, which accounted for 58. 68%;pharmacists’ participation in adverse drug reaction monitoring and supervision, which accounted for 77. 32%. Conclusion:The development of clinical pharmacy in Guizhou province still lags behind, and the number of clinical pharmacists is insufficient, which can’ t meet the growing demand for personalized medicine. In particular, the development of clinical pharmacy is restricted by the limited pharmaceutical service. The cog-nition degree of pharmacist group in Guizhou province has been improved. However, the number and the service quality of clinical pharmacists need to be improved further.

Objective To explore the related influencing factors and nursing countermeasures of venous thrombus in tumour patients with PICC .Methods We retrospectively analyzed the clinical data of 423 cancer patients with PICC of 2014 along with calculating the incidence of venous thrombus during intubation and related risk factors.Results There were 16 patients with venous thrombus (16/423) during intubation accounting for 3.87%.Besides, the risk factors of venous thrombus included the age of patients , tumour stage, position of catheter tip, previous history of thrombus , lack of activity, obesity, low hemoglobin, short time in activated partial thromboplastin ( APTT ) .Conclusions Pay more attention to the thrombosis complications after intubation in tumour patients .Besides , a variety of measures aiming at the risk factors should be taken actively to prevent and deal with the thrombosis .