Objective To realize the interface of medical insurance system of Hefei with HIS system. Methods According to the requirements of HIS interior data structure and the networking invocation rules of the medical insurance interface functions dynamic databases provided by Hefei social insurance center, the charging program of No.1 Military Medical Project was modified greatly. Results The call of link library was carried out according to the number, type and returned value of the parameters. Conclusion Modification of the interface of the medical insurance not only makes convenience of patients, increases the serving level of the hospital, but also makes the management of patients standardized, and perfects the information system of the hospital.

Objective To explore the feasibility to diagnose ureterolithiasis by 16-multidetector spiral computed tomography (16-MDCT) at different low doses based on body mass index (BMI).Methods A total of one hundred patients from 2009 Sep to 2010 Feb suspected of ureterolithiasis were randomly divided into 2 equal groups undergoing 16-MDCT at standard-dose (120 kV, 240 mA) or lowdose (120, 80, and 50 mA, respectively) based on the body mass index (BMI).Taking the clinical diagnosis as the standard, the sensitivity level, specificity level, and positive predictive value of these groups were compared.Results The dose length product ( DLP ) of the low-dose CT group and the average CT dose index (CTDIvol ) were 18.95 and 6.65 mGy, respectively.There was significant difference between the two groups ( t = 31.78, P ＜ 0.01 ).The sensitivity level, specificity level, and positive predictive value of the low-dose group were 97.1% , 94.0% , and 94.3% , respectively, all not significantly different from those of the standard-dose groups (97.3% , 96.0% , and 97.3% , respectively,P ＞0.05).Conclusions It is feasible to diagnose ureterolithiasis by low-dose 16-MDCT based on BMI with the obtained image quality meeting the clinical diagnostic requirements.

Objective To investigate the feasibility and efficacy of single ablation catheter for complete circumferential pulmonary vein antrum(PVA) isolation.Methods After performing initial circumferential lesions in 55 consecutive patients with paroxysmal atrial fibrillation,residual gaps were mapped and closed using single ablation catheter.Results The PVA isolation rates were 61.8%(34/55) in the right side,27.3%(15/55) in the left side,and 18.2%(10/55) in both sides,respectively.Twenty five gaps along the right PVA lesions and 49 gaps along the left PVA lesions were identified.All of these residual gaps were closed with single catheter approach.Mean procedure time and fluoroscopy time were 154?29(99-204) minutes and 32?7(19-49) minutes,respectively.Duration of radiofrequency energy delivery was 53?10(31-72) minutes.Conclusion Single ablation catheter technique is feasible and effective in localizing the residual gaps for complete isolation of the PVAs for ablation of paroxysmal atrial fibrillation.

Objective To dump and recover the expired data in No.1 Military Medical Project, avoiding the waste of large amount of storage space and improving the operation performance of hospital information system. Methods After clearing the backup table, the data from the original table backup was put into the backup table. The data was unloaded from the backup table to a file, and then the file was saved. The data in the original table was deleted, but it could be restored to the table when needed, and the corresponding data could be obtained through the application program. Results The storage space was enlarged after data dump. Conclusion The dump of the expired data can make data management more scientific and hospital information system run more smoothly.

The concept of EMR is described and the problems of EMR application are analyzed including restrictions on change permissions and writing time of EMR, and sounds in medical record management mechanism to ensure legality and effectiveness of record. Based on improvement of national policy, third-party management services institutions are estab- lished and related suggestions on technical and environmental support of EMR development are provided, and the future of its development in our country are expected.

Objective To introduce a simple and reliable way for atrial septal puncture. Methods Atrial septal puncture had been carried out in 627 patients with various underlying heart diseases, and the patients aged between 4-78 years old. Three protocols for precise location of atrial septal puncture points were recommended, 1) Site of atrial septal puncture point in cranial-caudal direction was determined under posterior-anterior projection, which was confined to the cranial side of the inferior margin of left atrium silhouette at a distance of 1 cone body height along the midline of spine. If the inferior margin of left atrium silhouette was unclear, angiogram of pulmonary artery to display left atrium and placement of coronary sinus electrodes could be done to verify it. 2) Under right anterior oblique 45 degree view, the puncture point was located between one cone body height anterior to posterior margin of left atrium silhouette and the isometric line between the posterior margin of left atrium silhouette and atria-ventricular suculus. 3) The arch feature of puncture needle and distal part of sheath turned into a straight line under 45 degree of right anterior oblique view. Results The success rate of atrial septal puncture was 99.8% (626/627), and that with only one try was 71.93% (451/627), the rate of tamponade was 0.32% (2/627). No death occurred. Conclusion Simple, reliable and safe, atrial septal puncture under 45 degree of right anterior oblique view is an easily-mastered approach.

Objective To investigate the underlying mechanism for recurrence of atrial fibrillation (Afib) after trans- catheter ablation and the impact of repeat ablation on Afib. Methods Patients with symptomatic and ECG confirmed recurrent Afib were enrolled in this study. All patients underwent circumferential pulmonary vein linear ablation (CPVA) under the guidance of three dimension mapping system. The end-points of the procedure were electrical isolation of pulmonary vein (PVs)s and completeness of circumferential linear lesion around PVs. A systematic follow-up was conducted to evaluate the rate of atrial tachyarrhythmia free after the second ablation. Results Twenty-three cases (51.1% of the total recurrent cases of the same time) with recurrent Afib included in this study received second ablation. Among them, 13 cases underwent segmental PV ablation and the other 10 cases received CPVA. 56.5% (13/23) of the patients suffered from persistent and chronic Afib. Recovered conduction rate of PV-left atrium (LA) was 92.3% (48/52) in patients who had undergone SPVA during their first ablation and 75.0% (30/40) in patients who had received CPVA previously. Prolonged procedure time, more fluoroscopic exposure and higher radiofrequency needed were observed in patients who had undergone SPVA during their first ablation. 82.6% (19/23) of the patients were free from atrial tachy-arrhythmia during a mean follow-up of 4.2?3.5 (4.0～9.0) months after the second ablation. Conclusion Recovered conduction of PV-LA was the major factor responsible for the recurrence of Afib after the first procedure. CPVA under the guidance of three dimension mapping system may be feasiable for patient with recurrent atrial fibrilation.

Objective To evaluate the feasibility of the cerebrospinal fluid (CSF) flow measurement by cine phase contrast MRI. Methods Evaluation of intracranial and intraspinal CSF flow was accomplished by the use of periphery gated cine phase contrast MRI technique. Normal patterns of pulsatile flow within the ventricles, cisterns and cervical subarachnoid space were established by this technique. Results CSF flow within ventricle, cistern and subarachnoid space could be clearly displayed, and the relationships between the cardiac cycle and the CSF pulsations were demonstrated on both magnitude reconstruction and phase reconstruction MR images. Conclusions Cine phase contrast MRI is capable of demonstrating intracranial and intraspinal CSF flow. As a new noninvasive technique, it is really superior than other modalities in studying the flow pattern and direction of CSF.

Objective A review of cases of congenital hip dislocation in high age children by Pemberton operation and accessory measures and investgate if the hip joint stiffness rate and ischemic necrosis rate of femoral head after operation are reduced. Methods From February 1987 to February 2000, 76 hip congenital dislocation of 58 high age children (7 years old to 14 years old) were treated by Pemberton operation and accessory measures, and were followed up from 2 years to 11 years(average, 5 years and 2 months). The accessory measures included: 1)traction of the leg for enough time with enough weight before operation, 2) immobilizing the leg by skin traction in neutral position and plank shoes instead of traditional plaster cast after operation, 3)early movement of the hip joint after operation and was allowed ambulatory late, 4) periodically the hip joint was mobilized passively. Results Six cases can only bend their hip joint below 90 degrees, accounting for 7.9% of all. 29 ischemic necrosis of femoral head occurred which accounted for 38.2%. The rate of ischemic necrosis of the femoral head and hip joint stiffness of high age children after operation were reduced obviously according to the standard by Salter. Conclusion Pemberton operation was preferred in treating the congenital hip dislocation of high age children. The accessory measures reduced the rate of ischemic necrosis of femoral head and hip joint stiffness.

Objective To evaluate the clinical result of modified anterior decompression for the treatment of cervical myelopathy due to ossification of posterior longitudinal ligament(OPLL). Methods From April 1994 to October 2002, 42 cases of OPLL involving 134 cervical segments were operated using modified anterior decompression, among them there were 35 cases, 122 segments of the continuous type; 4 cases, 9 segments of the mixed type; 3 cases, 3 segments of the solitary type. The preoperative index of thickness (O-Index) ranged from 12.4%-78.8%, with an average of 43.2%. A slot was made in the vertebral body through anterior approach and bilateral border of the ossification was dissected from the posterior wall of vertebral body with burr-drill. Results The average follow-up was 3 years and 8 months ranging from 1 year and 6 months to 8 years. The recovery of neurologic function was evaluated according to JOA score: 28 cases with mild neurologic deficit (13-16 points) improved on average 74% postoperatively; 11 cases of the moderately damaged group (8-12 points) improved on 75%; 3 cases of the severely damaged group (