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Speaking lesson is an effective way and teaching skill to prepare lessons for the teaching of anatomy. Taking the speaking lesson design of lecture teaching of the neck as an example, this article shows the teaching of topographic anatomy for "5+3" integrated clinical medical students. Adhering to the teaching concept of "student-centered", we have launched the theoretical teaching of "problem-centered discussion" and the experimental teaching of "operator responsibility system" in groups, with the "thanksgiving" humanistic education running through the whole process of theoretical and experimental courses. The teaching is a good way to cultivate the students' gratitude consciousness and humanistic quality, self-learning ability, critical thinking ability, communication and expression ability, hands-on operation ability and teamwork spirit, which has laid a solid foundation for training medical professionals in the new era.
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Objective To evaluate the value of energy spectrum CT with multimodal quantitative parameters in diagnosis of the metastatic lymph nodes of gastric adenocarcinoma compared with the conventional CT.Methods 37 patients with gastric adenocarcinoma diagnosed by gastroscopy underwent enhanced CT scan with gemstone spectral imaging mode.We positioned and marked the stomach lymph nodes on CT images and compared with postoperative pathologic results one to one.ROC was used to identify the critical quantitative index of energy spectrum CT in distinguishing the metastasis from benign lymph node,and to evaluate the diagnostic effect compared with CT features.Results The 40-80 keV single energy spectrum curve slope (λHU )and normalized iodine concentration (NIC)in metastasis group were lower than those in the benign one in the arterial phase with statistical differences (P <0.05 ),but without statistical differences in venous phase.The combination of arterialλHU and NIC showed significant advantages compared with CT features(P <0.01), with the sensitivity,specificity and accuracy of 84.3% vs 61.4 %,88.4% vs 81.3 % and 86.8% vs 73.6 %.Conclusion The energy spectrum CT can provide quantitative analysis for differential diagnosis of gastric cancer metastasis from benign lymph nodes,and significantly improve the diagnostic accuracy of lymph node metastasis of the cancer.
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PurposeTo investigate the correlation between iodine concentration and clinical severity of acute pancreatitis (AP) through the quantitative evaluation with dual-energy spectral computed tomography (DESCT), so as to find out an effective imaging technology in the evaluation of clinical severity of AP.Materials and Methods Sixty patients with AP confirmed clinically (AP group) and 30 patients with normal pancreas (control group) were retrospectively analyzed. All the patients underwent enhanced CT scan in the spectral imaging mode. Iodine concentration and normalized iodine concentration (NIC) were respectively measured during arterial phase and portal phase in the material-decomposition images by using a spectral imaging viewer (GSI Viewer). Results Iodine concentration and NIC were significantly higher in the control group than in the AP group (P<0.05,P<0.001). In the AP group, according to Ranson grading, 24 patients were in the mild grade, 20 patients were moderate, and 16 patients were severe. Iodine concentration and NIC decreased along with the increase of their Ranson grade. There were significant difference in iodine concentration and NIC among the three subgroups (iodine concentration on arterial phase:F=8.776,P<0.01; iodine concentration on portal phase:F=4.019,P<0.05; NIC on arterial phase:F=12.700,P<0.001; NIC on portal phase:F=8.732,P<0.01). Iodine concentration and NIC on arterial and portal phases in the mild grade group were both significantly higher than those in the moderate grade group (P<0.05); however, iodine concentration on arterial and portal phases, and NIC on arterial phase in the severe grade group were significantly lower than those in the moderate grade group (P<0.05).Conclusion DESCT can analyze hemodynamic changes in AP quantitatively, which is of great value in evaluating changes in AP of each grade.