Inflammatory bowel disease is characterized by chronic intestinal inflammation, which includes Crohn′s disease and ulcerative colitis. The parenteral complications of IBD involve almost every system of the body, and the complications of blood system are not common, including multiple myeloma, lymphoma, leukemia, anemia and platelet-related diseases. Once appearing, they usually indicate poor prognosis. This article aims to elaborate the pathogenesis and research progress of hematological system damage associated with inflammatory bowel disease.

炎症性肠病(inflammatory bowel disease,IBD)是一种特发性肠道炎症性疾病,包括克罗恩病(Crohn's disease,CD)和溃疡性结肠炎(ulcerative colitis,UC).IBD可累及皮肤、骨骼、肌、肺、肝、胆、肾脏等多个器官或系统,而IBD相关内分泌疾病相对少见.本文主要对IBD相关内分泌疾病的研究作一概述.

Inflammatory bowel disease (IBD) , which includes ulcerative colitis (UC) and Crohn′s disease (CD) , is a nonspecific chronic intestinal inflammatory disease of unknown etiology. Extraintestinal manifestations are relatively common in IBD. Due to the insufficient understanding of IBD-related muscle lesions, patients are easily misdiagnosed or neglected by clinicians. In this review, we discuss the mechanism, research status and progress of IBD-related muscle lesions, in order to provide a better understanding of the diagnosis and treatment for the clinicians.

Inflammatory bowel disease (IBD) is characterized by chronic intestinal inflammation, which includes Crohn′s disease and ulcerative colitis. The parenteral complications of IBD involve almost every system of the body. The most common complications involved in urinary system are kidney stones, tubulointerstitial nephritis, glomerulonephritis and amyloidosis. This article aims to summarize the latest research progress about the inflammatory bowel disease-associated urinary system complications

目的 探讨基于虚拟现实(VR)交互技术的胸腔穿刺术自动评估系统在教学应用中的价值.方法 选取本校2014级7年制临床医学专业两个平行班级学生98名,统一编号按随机盲选分组法分为观察组和对照组,每组49名.对照组按照传统的教学方式,观察组采用基于VR交互技术的胸腔穿刺术自动评估系统进行教学.结果 观察组学生在线理论考试与技能操作考核成绩均明显优于对照组,两组比较差异均有统计学意义[(83.77±8.82)分vs.(82.82±6.98)分、(89.95±11.34)分vs.(76.10±9.59)分,t=3.641、10.625,P=0.043、0.032];观察组学生的激发学习兴趣、培养自学驱动力、养成临床思维能力、提高知识内化效率、提升实操能力及增强学生课堂参与度均明显高于对照组,两组比较差异均有统计学意义(P<0.01).结论 基于VR交互技术的胸腔穿刺术自动评估系统能够培养医学生临床思维习惯,可有效提升教学质量、增强教学效果.

腺苷作为机体内ATP代谢过程中的重要产物,通过激活腺苷受体(AR)参与机体多种生理及病理过程的调节.AR广泛分布于体内各组织器官,通过与细胞膜上的特定受体结合发挥作用.目前已成功克隆出4种腺苷受体:A1、A2A、A2B和A3腺苷受体,其中A2B腺苷受体(A2BAR)与腺苷的亲和力最低.在某些病理状态(如炎症反应、缺血、缺氧等)下,腺苷高度聚集时才可激活A2BAR.近年来研究表明,A2BAR参与了多个系统疾病的病理生理过程.该文就不同病理生理条件下A2BAR激活对机体的调节作用及机制进行综述.

Gastrointestinal bleeding is a severe,complicated and commonly seen disease in Department of Digestive Diseases,the frequent etiology is peptic ulcer,acute gastric mucosal lesion,esophageal gastric varices and digestive tract tumors. In recent years,clinicians gradually noticed a kind of disease characterized by acute,recrudescent and life-threatening bleeding,that is the non-variceal vascular originated gastrointestinal hemorrhage. The guidelines and scholars have not paid enough attention to this problem. However,non-variceal vascular originated gastrointestinal hemorrhage is not uncommon,and is difficult and tricky in its management for clinicians. Therefore,clinicians should pay sufficient attention to the characteristics and therapeutic principles of non-variceal vascular originated gastrointestinal hemorrhage.

Objective To assess the therapeutic effect of fecal microbiota transplantation (FMT) on dextran sodium sulfate (DSS)-induced ulcerative colitis (UC) in mice.Methods A total of 92 female C57BL/6 mice (7 weeks old) were randomized into 4 equal groups,namely the normal control group (fed with normal water),DSS treatment group (model group,fed with 2％ DSS solution for 7 d followed by sterilized distilled water for another 7 d),preventive FMT group (fed with 2％ DSS solution with intragastric FMT administration for 7 d),and therapeutic FMT group (fed with 2％ DSS solution for 7 d followed by intragastric FMT administration for another 7 d).The changes in body weight and disease activity index (DAI) of the mice were recorded,and fecal samples were collected daily for 16S rRNA analysis.Ten mice from each group were sacrificed at days 7 and 14 for detection of serum levels of tumor necrosis factor-α (TNF-α) and D-lactate and pathological examination of the colon with HE staining and transmission electron microscopy.Immunohistochemistry was employed to detect the expression of ZO-1 and Occludin in the colon.Results Compared with the mice in the model group,the mice receiving therapeutic FMT showed significant improvements in body weight,DAI score and colon length (P ＜0.01) and obviously lowered serum levels of TNF-α (P ＜0.05) and D-lactate (P ＜0.01) with alleviated colonic epithelial damage and improved tight junction (TJ) and intestinal epithelial integrity.Preventive and therapeutic FMT both resulted in markedly increased expression levels of ZO-1 and Occludin in the colon compared with those in the model group (P ＜ 0.05,0.01),ameliorated the DSS-induced alteration of intestinal flora,promoted the proliferation of Lactobacillus and inhibited the growth of Bacteroides and Oscillosporic in the colon.Corcltusior FMT for both preventive and therapeutic purposes ameliorates the alteration of intestinal flora induced by DSS,promotes the proliferation of Lactobacillus and inhibits the growth of Bacteroides and Oscillosporia in the intestines of mice.

Objective To explore the construction method and effectiveness of employing full-time scientific researchers in military research hospitals.Methods The management method of employing full-time scientific researchers was established, including system establishment, recruitment,training, incentive mechanism, compensation and performance management.The main scientific research data of the departmentsin the early stage and late stage of construction were collected.The growth rates were analyzed.Results In the departments of full-time scientific researcher employed, the growth rates of the number of scientific research projects, research fund, total number of published SCI papers and impact factor above 5 were 84.03%, 141.24%, 131.21% and 600.0%, respectively.But the growth rates in the departments without full-time scientific researchers were 36.08%,-3.02%, 82.98% and 200.0%, respectively.The indexes in the former departments were significantly higher than those of the latter.Conclusion Scientific research in the departments with full-time scientific researchers is obviously more effective than that in the departments of no full-time scientific researcheremployed.Full-time scientific researchers will paly an important role in scientific research of hospitalx and related disciplines.

炎症性肠病(inflammatory bowel disease,IBD)是一种病因不清楚的非特异性的慢性肠道炎症性疾病,主要包括克罗恩病(Crohn'sdisease,CD)和溃疡性结肠炎(ulcerativecolitis,UC),常合并肠外表现.在炎症性肠病相关的肠外表现中,肝胆并发症发病率约为5％,溃疡性结肠炎更多发[1-2].这不仅加重了炎症性肠病治疗的复杂性,且影响其长期预后.因此,重视炎症性肠病相关的肝胆疾病对炎症性肠病患者的综合诊治有重要意义.

目的：探讨精密灌肠法用于治疗炎症性肠病（IBD）的效果和护理。方法收集2015年5月至2016年3月在该院治疗的IBD患者68例，按照随机数字表法分为对照组和改良组，各34例。对照组采用普通灌肠法，改良组采用精密灌肠法进行严密观察，比较两组灌肠法的观察效果，包括患者的腹痛情况、药物渗出、保留时间、大便次数、住院时间及满意度。结果改良组患者腹痛发生率[5.8%（2/34）]低于对照组[23.5%（8/34）]，改良组药物无溢出，保留时间（20.3±0.3）min较对照组[（40.1±20.3）min]明显延长，操作过程中舒适度较对照组明显提升，治疗后总体满意度为100.0%，差异均有统计学意义（P<0.05）。结论一次性精密灌肠法应用于治疗IBD较普通灌肠法效果更加。

长期胆汁反流对胃和食管黏膜的影响尚不明确。临床上胆汁反流至胃、食管十分常见。病理学研究发现，胆汁反流可能与胃窦黏膜肠化生有关。研究资料显示，胆汁反流不但与反流性食管炎有关，而且可能是 Barrett 食管的重要病因，与食管腺癌的发生也有一定关系。因此，明确胆汁反流对食管和胃黏膜屏障的影响具有重要的临床意义。

目的 研究并分析光动力疗法与红蓝光治疗中、重度痤疮的疗效.方法 将2014年2月～2015年12月我院收治的92例中、重度痤疮患者纳入到本组研究中,按照治疗方式的不同将92例患者分为光动力组(n=46)与红蓝光组(n=46),光动力组采用光动力疗法,红蓝光组:使用红蓝光进行照射,根据患者治疗前后GAGS分值来评估疗效.结果 在治疗2周、4周与8周,光动力组治疗有效率均优于红蓝光组,在治疗结束后,光动力组治疗有效率为91.3％,高于红蓝光组的80.4％,上述数据组间比较差异显著(P＜0.05),差异有统计学意义.结论 对于中、重度痤疮效果,采用光动力疗法可以起到良好的效果,该种疗法安全无创、操作简单,应用前景好,值得在临床中进行推广.

克罗恩病(Crohn's disease,CD)是一种病因不明的肠道炎症性疾病,在胃肠道的任何部位均可发生,主要好发于末端回肠和右半结肠,其发病机制复杂,目前认为主要与感染、遗传、肠道微生态失衡、体液免疫和细胞免疫有一定关系.最新研究表明中消化道细菌过度生长(mid-gut bacterial overgrowth,MGBO)在CD的发病及进展过程中也起重要作用.本文就MGBO在CD中的研究进展,包括可能的影响因素、诊断、治疗等作一概述.

Objective To determine the effect of recombinant adenovirus p53 (rAd-p53) therapy in combi-nation with transcatheter hepatic arterial themoembolization (TACE) for patients with primary liver cancer (PLC). Methods A total of 72 patients with advanced PLC were enrolled in this study from Jan. 2008 to Dec. 2014. Patients were divided into TACE group (mitomycin 8 mg,epirubicin 5 mg/m2,oxaliplatin 30 mg/m2,n=36) and p53 treatment group (rAd-p53,mitomycin 8 mg,epirubicin 5mg/m2,oxaliplatin 30 mg/m2,n=36). The procedure was re-peated once every 28 days for 4 times as a course. The therapeutic effects were evaluated according to the clini-cal symptoms,CT scans and liver functions. Results In TACE group,the total effective rate (CR+PR) was 50%including no complete response (CR) and partial response(PR) of 50%,stable disease (SD) was 5.6%,and pro-gressive disease(PD) was 44.4%;In p53 treatment group,the total effective rate was 69.4%,including CR of 5.6%, PR of 63.8%,SD of 5.6%,and PD of 25%;The Karnofsky performance score in p53 treatment group was improved better than in TACE group(P<0.05);The adverse effects in rAd-p53-treated patients was transient and self-limited fever. Conclusion The rAd-p53 therapy in combination with TACE is effective for patients with advanced PLC.

中消化道有独特的解剖学定位、组织学结构,是人体发挥消化、吸收、免疫、传输的最重要区域.黏膜屏障是上述生理功能正常发挥的基础,对维持机体稳态具有十分重要的意义,其也是中消化道疾病发生、发展的首要打击部位.本文将重点阐述作为中消化道黏膜屏障重要组成部分的小肠黏膜屏障对机体稳态维持的重要作用.

Based on information technology,combined with the teaching characteristics of dermatovenereology,the information resource library was established to perform traditional Figure diagnose disease.Focused on clinical practice needs,self-testing and interactive communication platform were more considered in the construction of network course.Development the quality of online courses to attract the medical students to participate,innovated personnel training methods to improve teaching effectiveness.

目的:讨论个性化护理在整形美容围术期护理中的必要性.方法:选取2012年4月以后于我院进行整形美容手术并接受个性化围术期护理的患者96例作为试验组,选取2012年4月前于我院进行整形美容手术并接受常规围术期护理的患者112例作为对照组,两组进行患者满意度和恢复时间的统计对比.结果:试验组满意率达92.71％,明显高于对照组的满意率75.89％.试验组平均恢复时间为(10.2±7.4)天,明显短于对照组平均恢复时间(18.9±8.2)天,两组数据均有显著性差异(P＜0.05).结论:个性化的围术期护理可以提高整形美容手术护理质量,减少医疗纠纷的发生.

Professional title evaluation relates to the vital interests of professional and technical staff and has been the significant w ork of personnel department. Professional title evaluation is helpful in selecting excellent professional and technical cadres,promoting effectively the overall development of medical treatment,teaching and research in medical colleges for the sake of the improvement in the overall strength and level of medical colleges. The authors make brief overview of the range,procedure,standards and supervision,and summarize the w orking experience.

Objective To explore the effect of intraoperative tension adjustment and postoperative scar formation in the treatment of circular skin defects using modified purse-string suture.Methods Twenty-eight cases of circular lesions in the face region were selected and resected along the edge.We first used purse-string suture technique to reduce the circular defect area,and then closed the wound with linear suture in random direction.After 7 days,the stitches were removed and longterm follow-up effects were observed.Results All patients had no facial organ deformation and displacement,the length of the linear scar lesions was shorter than the preoperative length.In 28 cases,one patient's surgical wound was dehisced after removal of stitches in 24 h,and the rest of the skin defects healed after operation in stage Ⅰ.All cases were followed up for 3 months to 1 year,and had a satisfactory therapeutic effect.Conclusions Modified purse-string suture can linearly close the dicision in stage Ⅰ,reduce the scar area and maintain the normal morphology and relative position of the nearby organs.