The medical metaverse is a combination of medicine and other cutting-edge technologies such as computer and information ones. In the medical metaverse, medical knowledge in the real world will be transformed into a digital form, so that activities concerning diagnosis, treatment, education and clinical practice can be carried out in a virtual environment. Based on the latest research advances at home and abroad, this review expounds on the medical metaverse from the aspects of supporting technologies, applications in clinic and medical education, current deficiencies and future development.

Maili moxibustion can alleviate cancer pain, reduce bone marrow suppression, alleviate gastrointestinal reaction of chemotherapeutic drugs, alleviate cancer-related fatigue, inhibit neurotoxic reaction, improve quality of life and prolong patients' survival. It plays therapeutic effects by regulating immunity, inhibiting tumor cell proliferation and regulating tumor microenvironment. The researches of Maili moxibustion for tumor focus on reducing the toxic or side effects of radiotherapy or chemotherapy. In the future, we should continue to study the combination of Maili moxibustion and other therapies on the treatment of tumor.

Objective:To intestigate the clinical efficacy between modified Overlap anastomosis and traditional auxiliary incision anastomosis in laparoscopic total gastrectomy.Methods:The retrospective cohort study was conducted. The clinicopathological data of 115 patients with gastric cancer who were admitted to the Second Affiliated Hospital of Fujian Medical University from January 2016 to December 2018 were collected. There were 62 males and 53 females, aged from 27 to 83 years, with a median age of 62 years. Of 115 patients, 51 patients undergoing totally laparoscopic total gastrectomy with modified Overlap anastomosis using linear stapler were divided into modified Overlap group and 64 patients undergoing laparoscopic assisted total gastrectomy with traditional auxiliary incision anastomosis using circular stapler were divided into traditional assisted group. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) anastomotic complications; (4) follow-up. Follow-up using outpatient examination or telephone interview was conducted to detected tumor recurrence and survival of patients up to December 2019. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Count data were represented as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Comparison of ranked data was analyzed using the rank sum test. Results:(1) Surgical situations: the operation time, time of esophagojejunostomy, volume of intraoperative blood loss, the number of lymph node dissected, length of proximal incisional margin and length of auxiliary incision of the modified Overlap group were (234.0±11.0)minutes, (29.4±2.1)minutes, (53±14)mL, 42±13, (2.0±0.3)cm and (5.1±0.4)cm, respectively. The above indicators of the traditional assisted group were (231.0±11.0)minutes, (29.2±2.2)minutes, (50±13)mL, 40±10, (2.2±0.4)cm and (8.2±0.4)cm, respectively. There was significant difference in the length of auxiliary incision between the two groups ( t=-43.098, P<0.05), and there was no significant difference in the operation time, time of esophagojejunostomy, volume of intraoperative blood loss, the number of lymph node dissected, length of proximal incisional margin between the two groups ( t=1.168, 0.460, 0.990, 1.127, -1.926, P>0.05). (2) Postoperative situations: cases with mild, moderate, severe pain (postoperative pain degree), time to first flatus, time to initial fluid diet intake, duration of postoperative hospital stay of the modified Overlap group were 40, 9, 2, (2.9±1.0)days, (4.8±2.2)days, (11.7±2.8)days, respectively. The above indicators of the traditional assisted group were 31, 27, 6, (3.9±1.4)days, (6.5±2.5)days, (13.0±3.1)days, respectively. There were significant differences in the above indicators between the two groups ( Z=-3.217, t= -4.344, -3.888, -2.261, P<0.05). (3) Anastomotic complications: cases with anastomotic leakage, cases with anastomotic bleeding, cases with anastomotic stenosis of the modified Overlap group were 1, 1, 0, respectively. The above indicators of the traditional assisted group were all 1. There was no significant difference in the above indicators between the two groups ( P>0.05). Cases with anastomotic leakage were cured after the treatment of enteral nutritional support through nasogastric catheterization, which were confirmed by gastroenterography. Cases with anastomotic bleeding were improved by active hemostatic therapy. Cases with anastomotic stenosis were improved after the symptomatic treatment of anti-inflammatory and anti-swelling. (4) Follow-up: 109 of the 115 patients were followed up. Forty-eight of 51 patients in the modified Overlap group were followed up for 15.0-45.0 months, with a median follow-up time of 33.5 months. Sixty-one of 64 patients in the traditional assisted group were followed up for 16.0-46.0 months, with a median follow-up time of 27.0 months. There was no tumor recurrence in the modified Overlap group. One patient in the traditional assisted group had tumor recurrence with liver metastasis and survived with tumor. There was no significant difference in tumor recurrence rate between the two groups ( P>0.05). There was no patient died during the follow-up. Conclusion:Compared with traditional auxiliary incision anastomosis, patients undergoing total laparoscopic total gastrectomy with modified Overlap anastomosis have small incision, good postoperative recovery.

Objective: Through a retrospective analysis of serology and nucleic acid screening data of unpaid blood donors in south Zhejiang region, the role of nucleic acid detection in the reduction of transfusion-related infectious diseases was discussed. Methods: 179 369 unpaid blood donation in south Zhejiong province from Jan, 2016 to Dec, 2016 was chosen. Enzyme linked immunosorbent (ELISA) test for blood index of infectious hepatitis B virus surface antigen (HBsAg), hepatitis C virus antibody (anti-HCV), human immunodeficiency virus antigen and antibody. At the same time the roche, haoyuan nucleic acid detection system were used for HBV-DNA, HCV-RNA, HIV-RNA in 6 or 8 doses mix samples three projects joint detection.NAT results of the serum with negative results in the serological tests were made statisticala analysis. Results: A total of 259 ELISA-/NAT+ samples were detected, HBV-DNA+ 255 cases, HCV-RNA+ 5 cases, one case of HBV-DNA and HCV-RNA + , with a positive rate of 0.14%. The analysis system of roche nucleic acid mix inspection rate of positive was 1.40%, and the split inspection rate of positive was 60.72%. The mix inspection positive rate of the haoyuan analysis system was 1.63%, and the split inspection rate of positive was 41.67%. Conclusions The detection of nucleic acid can make up the deficiency of serological test, and effectively reduce the leakage of transfusion-related infectious diseases, and ensuring the blood safety in this area.

This study aimed at investigating the dose-effect relationship of SFI between the blood viscosity and the early-and mid-stage cardiogenic shock and the mediatory effect on rats.The end or root of left anterior descending coronary arteries (LADCA) was ligatured to establish the rat model of the early-and mid-stage cardiogenic shock.The blood viscosity indexes included low shear rate (LSR,10/s),middle shear rate (MSR,60/s),high shear rate (HSR,150/s) of the whole blood viscosity and plasma viscosity (PV),being observed 60 mins after the venous administration of 0.10,0.33,1.00,3.30,10.00 and 20.00 mL·kg-1 SFI (low dosage range:0.1-1.0 mL·kg-1,middle dosage range:1.0-10 mL·kg-1,high dosage range:10-20 mL·kg-1) with a blood rheometer.Dose-response curves were fitted by GraphPad Prism 6.0 software,the dose-response relationship of SFI between the blood viscosity and the early-and mid-stage cardiogenic shock in rats was evaluated to calculate the dose threshold parameters of the indexes.It was found that the blood viscosity indexes were improved with the dosage of 10 mL·kg-1 SFI in rats with the early-stage cardiogenic shock,while the dose-response curves of LSR,MSR and HSR at the early stage all presented favorable s shapes.Most of the effective dose range [D]2o-[D]80 and the threshold dose [D]20 were between 3.3 and 6.3 mL· kg-1.The four indexes of blood viscosity were improved with the administration of 10 and 20 mL·kg-1 SFI in mid-stage model rats with favorable s shapes in the dose-response curves.Most of the effective dose range and the threshold dose were in the range of 3.3 to 10.0 mL·kg-1.In conclusion,most of the dose-response curves of blood viscosity indexes in early-and mid-stage cardiogenic shock rats presented favorable s shapes with the threshold dose between 3.3 and 10.0 mL·kg-1,indicating an effective middle dosage range,which was converted into clinical dosage about 37.1 to 112 mL each day.The research provided an experimental basis for clinical medication.

Objective To analysis the human T lymphotropic virus (HTLV) infection status in Wenzhou among voluntaty blood donors.Methods Selected 72 417 voluntary blood donors of Wenzhou from from March,1,2016,to November,30,2016,to screen HTLV-Ⅰ / Ⅱ antibody by ELISA method.The positive samples were reexamined two times,two test results of samples were determined positive by ELISA.HTLV positive samples was confiemed by Western Blotting (WB).Results Screened 23 cases of anti-HTLV positive by ELISA method,then confirmed 9 cases of HTLV positive by Western Blotting (WB).HTLV infection rate of Wenzhou blood donors was 0.01％ (9/72 417).Conclusions HTLV infection was found among volunteer blood donors in Wenzhou,but the HTLV infection rate of volunteer blood donors in Wenzhou is still at a relatively low level.

Objective The nursing staff's output and journals distribution of core scientific journals papers were analyzed, providing evaluation data and a decisive basis for scientific research management. Methods A retrospective analysis was performed to the publication of core journals papers of nursing staff in 2013-2015 based on the publication from different nursing positions , the ranking of published nursing papers from different departments and different journals by using analysis method of bibliometric. Results About 1550 nursing papers were published , of which the number of authors whose paper was published in core journals was 216 , the number of papers published in core journals was 378, and 38 authors published more than 3 papers (17.6%). The core journals papers published rate in different position was statistically significant (P<0.01). The papers published journals were concentrated in nursing class. Dominated the first 3 places in the list of core journals paper number of departments were department of nursing , cancer center and operation room, respectively. Conclusion In order to improve the nursing scientific research level of nursing staff, it is necessary to establish a theoretical system of scientific knowledge training , formulate a long-term effective mechanism in paper management , focus on scientific research talent introduction and training and mobilize the nursing research enthusiasm of nursing staff.

Objective To explore the application value of diffusion tensor imaging and diffusion tensor tractography in the benign lesion of spinal cord.Methods 30 cases with the benign lesions of spinal cord and 10 healthy volunteers underwent MRI and DTI scanning by 1.5T MR.Results Compared with normal control group,ADC values [(1.29±0.24)×10 -3 mm2/s]of extramedullary group-Ⅰwere increased slightly,and FA values (0.46±0.06)were decreased slightly(P <0.05).In extramedullary group-Ⅱ,ADC values [(2.03±0.19)×10-3 mm2/s]were significantly increased and FA values (0.37±0.03)decreased in the lesion level (P <0.05).The ADC values [(1.71±0.24)×10 -3 mm2/s]of intramedullary group was significantly elevated,and the FA values (0.30±0.06)was obviously reduced (P <0.05 ).The fiber tracts showed the abnormality of the white matter,including compression,sparseness, grow downwards,interruption and other changes.Conclusion The changes of the FA and ADC values,diffusion tensor imaging of the bundle can quantitatively evaluate the severity of spinal cord damage and stereo display fiber bundle damage.

The purpose of this study is to investigate the enantioselectivity of norgestrel (NG) transdermal permeation and the potential influence of linalool and lipids on the enantioselectivity. In vitro skin permeation studies of NG across the excised rat skins were performed with Valia-Chien diffusion cells, and the permeation samples were analyzed by enantioselective HPLC. The possible enantioselective permeation of NG across intact rat back skin and lipids extracted rat back skin and the influence of linalool were evaluated. The skin permeation rate of dl-NG was two times higher than that of l-NG when donor solutions (EtOH/H2O 2 : 8, v/v) containing l-NG or dl-NG. It may be mainly attributed to the solubility discrepancy between enantiomer and racemate. The enantioselective permeation of dl-NG across intact rat skin was observed when the donor solutions containing dl-linalool. The permeation flux of l-NG was 22% higher than that of d-NG. But interestingly, the enantioselective permeation of dl-NG disappeared under the same experimental condition except that the lipid extracted rat skin was used. Attenuated total reflection-fourier transform infrared spectroscopy analysis of stratum corneum showed that the wave number for asymmetric CH2 stretching vibrations of lipids treated with dl-linalool was greater than that of the control. The results indicated that the enantioselective permeation of NG may be contributed by the interaction between dl-linalool and lipids. More than half of lipids were composed of ceramides. The stereospecific interaction maybe existed among chiral enhancer (linalool), lipids (ceramides) and/or chiral drugs (NG).

Interest teaching method aims to inspire students' initiative and inquiry in learning.In the teaching process,we used some teaching methods including class lead-in,relevant extracurricular books and websites,scene representation,lectures on special content and arrangements of the review writing.It is important to maintain students' motivate and interest in learning human parasitology,therefore,we should no longer make students passively accept but the initiatively make inquiry learning.