The paper analyzes the challenge of big data environment to the traditional medical information services,presents the practical significance and basis of constructing the medical information service platform,introduces the construction objectives,architecture,function feature of the platform,describes the medical information service mode based on the digital platform,including medical information resource services,intelligence study services and health decision-making support services,etc.

Objective To explore the application of ultrasonography combined with hysteroscopy for the diagnosis of dated uterine false passage. Methods From May 2012 to May 2013, a total of 3437 cases were examined in the center by ultrasonic monitoring combined with hysteroscopic examinations.Dated uterine false passage was found in 4 cases.Under the guidance of ultrasonography, the hysteroscope was introduced into the uterine cavity.The ultrasonic probe was put at the site above the pubic symphysis for comprehensive examinations, with uterine distention fluid as reference. Results There were 2 cases of uterine anteversion and 2 cases of retroversion.There were 1 case of intracervical mouth stenosis, 1 case of intracervical mouth adhesion, and no intracervical mouth stricture or adhesion in 2 cases.The uterine false passage was located in the anterior wall in 2 cases and located in the back wall in 2 cases.The distance to serosal surface was about 3 mm at the thinnest place.The uterine false passage was 3-4 cm in depth. Conclusion Ultrasound monitoring combined with hysteroscopic examination can determine the part of the uterine endometrium line, improve the accuracy of diagnosis and treatment of intrauterine lesions.

Combined Modality Therapy ; Humans ; Stomach Neoplasms ; therapy

Several reconstruction techniques are available after gastrectomy. Roux-en-Y reconstruction following distal gastrectomy is the reference in terms of long-term functional and endoscopic outcomes. It is the preferred reconstruction for benign lesions and early gastric cancer. In patients with advanced gastric cancer, BillrothII (reconstruction is an acceptable alternative. After total gastrectomy, Roux-en-Y reconstruction is the simplest solution, with satisfactory functional outcome. Addition of a jejunal reservoir seems to improve long-term outcome after total gastrectomy and could be of benefit to patients with good prognosis. After distal or total gastrectomy, hand-sewn anastomoses should be preferred because of lower costs. Mechanical sutures can facilitate transhiatal esophagojejunostomy. After proximal gastrectomy, esophago-gastric anastomosis is the basic reconstruction method. Gastric remnant is made into gastric tube in the operation. The effect of pyloroplasty remains controversial, and further study is needed to improve the quality of life after operation.
Anastomosis, Roux-en-Y ; methods ; Gastrectomy ; Gastroenterostomy ; methods ; Humans ; Reconstructive Surgical Procedures ; methods ; Stomach Neoplasms ; surgery

Humans ; Infarction, Middle Cerebral Artery/surgery* ; Thrombectomy ; Thrombosis/etiology* ; Stents/adverse effects* ; Treatment Outcome

恶性黑色素瘤的发病率和病死率在逐年增长，引发广泛关注。目前恶性黑色素瘤的治疗方式主要为手术、化疗和靶 向治疗，总体疗效极差。然而，PD-1抗体治疗恶性黑色素瘤的成功，使广大研究者把希望聚焦于生物免疫治疗。肿瘤浸润淋巴细 胞（tumor infiltrating lymphocyte，TIL）是从肿瘤组织分离出的淋巴细胞，经体外扩增后得到的能够杀伤肿瘤细胞的细胞群，具有 高杀瘤活性和高靶向性特点。临床试验研究发现，TIL对恶性黑色素瘤治疗效果显著且稳定，但其临床疗效尚未完全阐明。本文 对TIL免疫治疗的发展及其在恶性黑色素瘤治疗中的研究新进展作一综述，以期为恶性黑色素瘤的治疗提供新的策略。

BACKGROUND:Recent development of bioengineering technology and tissue-engineered nerve brings a new hope for the treatment of peripheral nerve injuries, which has gradual y become a research spot. OBJECTIVE:To review the new progress in the repair of peripheral nerve injuries using seed cells, biomaterials and tissue-engineered nerve construction technology. METHODS:PubMed and CNKI were searched by the first authors for articles concerning nerve tissue engineering and repair of peripheral nerve injuries published prior to July 2013. The keywords were“tissue engineering, peripheral nerves, nerve injuries, stem cells, Schwann cells, scaffold, growth factor”in English and Chinese, respectively. The articles published recently or in the authorized journals were preferred in the same field. Final y, 63 articles were included in result analysis. RESULTS AND CONCLUSION:Up to now, there is a great advance in the tissue engineering technology for the repair of peripheral nerve injuries. However, most studies are stil in experimental step. For the clinical application of nerve tissue engineering, some problems to be solved include:(1) source and ethics of seed cells;(2) immunological rejection fol owing cellproliferation and transplantation;(3) stability and oncogenicity of transplanted cells;(4) degradation rate, optimal porosity, tube thickness and shape;(5) repair timing for in vitro tissue-engineered nerve construction;(6) local release and regulation of various neurobiological factors. With the development of science, many patients with nerve injuries can profit from the solve of these problems.

Objective To discuss the value of 256 spiral CT dynamic volume scanning in the diagnosis of moyamoya disease.Methods Twenty-three patients with moyamoya disease undergoing 256 spiral CT dynamic volume scanning (moyamoya group) were selected,and 18 patients having cerebrovascular disease symptoms,but the brain artery without stenosis (control group) were also selected.The volume reconstruction (VR),maximum intensity projection (MIP) and cerebral CT perfusion imaging was displayed.The cerebral CT perfusion imaging parameters of anterior,middle,posterior cerebral artery were measured and analyzed.Results VR,MIP could well reproduce lesion location,degree of stenosis and skull base abnormal vascular network change.Compared with control group,the cerebral blood volume (CBV) was increased [(8.46 ±0.91) ml/100 g vs.(2.92 ±0.72) ml/100 g],time to peak (TTP) was increased [(30.27 ±5.02) s vs.(24.83 ±4.07) s] in anterior cerebral artery,and there was significant difference (P ＜ 0.01),but there was no significant difference in the cerebral blood flow (CBF),the mean transit time (MTT)(P ＞ 0.05).Compared with control group,CBV was increased [(8.06 ± 1.05) ml/100 g vs.(6.08 ± 0.56) ml/100 g],MTT,TTP was increased [(6.34 ± 1.01) s vs.(3.83 ± 0.83) s,(32.06 ± 2.55) s vs.(25.83 ± 2.34) s] in middle cerebral artery,and there was significant difference (P＜ 0.01),but there was no significant difference in CBF (P ＞ 0.05).Compared with control group,there was no significant difference in the cerebral CT perfusion imaging parameters of posterior cerebral artery (P ＞0.05).Conclusion 256 spiral CT dynamic volume scanning can be combined with morphology and function imagings,and has important guiding significance for diagnosis of moyamoya disease.

Age-related white matter changes are considered as a manifestation of arteriolosclerotic small vessel disease and are associated with advanced age and vascular risk factors.White matter changes have been recognized as one of the manifestations of cerebral small vessel disease.They are the pathological basis of cognitive impairment and functional loss in the elderly.Studies have shown that when white matter changes develop to a certain extent,there will be many clinical symptoms,including cognitive impairment,dementia,depression,gait disturbances,and urinary incontinence,and they are associated with the increased risks of stroke and death.

Radiomics utilizes the high-throughput extraction of large amounts of quantitative features from radiographic images,giving a comprehensive quantification of tumor phenotype.Thus it can provide complementary and interchangeable information for clinical usage,such as differentiating malignant nodules from benign ones,predicting response to treatment,identifying lymph node metastasis,improving individualized treatment selection and monitoring.The advantages of radiomics give it great potential in precise treatment.But much work needs to be done before it could be used in practice.It is imperative that a standard research procedure is needed to verify its reliability and clinical value via multi-central prospective clinical trials.