By means of literature review,the paper made a comparative study of key development projects of healthcare information in China over the last decade,in terms of their project characteristics,economic environment,development entity,investment and compensation practice,development strategy,coverage,experience and promotional values.Setbacks identified include the following:discrepancy in regional development stages of healthcare information; successful pilots are limited to scientific research samples; lack of regional models; systems separation; poor continuity and coordination; waste and insufficiency of resources in the investment and construction among others.The authors recommend a better exchange of experiences in building the regional healthcare information service platforms,greater investment,better compensation mechanism,better top-tier design,and maximized coverage within reach of supervision and technology.

A comparison is made on the healthcare systems,economy,informationization environment,developers,investment and compensation mechanisms in nine countries featuring early startup,rich experiences,and relatively higher ratio of success in their development projects.This lead to a discussion focusing on the construction steps and development strategies for regional health informationization,and an analysis of the present regional health informationization overseas,common measures taken,and key factors for successful regional health informationization.Based on these,recommendations were made on development of regional health informationization compliant to China's circumstances.

Objective Current study used quantitative research methods to reveal the regional medical information research in hotspots, and summarize the mainstream knowledge base to provide the reference for researchers in the field.Methods A systematic search was conducted to find publications in CNKI, Wanfang Database and PubMed.Bibliometrics method, social network analysis, coword analysis, principal component analysis and multidimensional scaling analysis were used in this study.Results ① total 11,482 articles published from 1984 to 2013 were screened out.The development of research publications showed an increasing trend, and the papers were distributed in 1233 types of journals.The number of authors who located in Beijing, Guangdong, Jiangsu, Shanghai,Shandong ranked top five.② The top 59 high frequency key words were identified that representing the hot contents in regional health information technology research field, and was used to build knowledge network map.Among them, HIS, electronic medical records, hospital information technology,information technology were at the core of this research area.③ We summarized research and development in the field of nine major mainstream knowledge base include: research on electronic medical records, medical personnel, information systems, information security, information networks, information sharing, information integration, information technology, and information management, resident' s health record related studies;qualitative analysis and problem-oriented research;HIS and telemedicine-related research;community related research, two-way referral related research, health care reform and cloud computing-related research, telemedicine related research and V43 related research.Conclusions The development of regional medical information research has good momentum and closely follow the international trend, but the research contents and methods are still distance from international standard..Research mostly focused on hospital information system construction, regional research and applied research are weak and need to be further improved.

Objective To study the prevalence of symptomatic osteoarthritis (OA) in rural areas of Shanxi,China.Methods All the residents above 16 years old from the villages chosen by multi-stage stratified cluster sampling in Yangcheng County and Pianguan County in Shanxi Province were investigated with COPCORD procedure of WHO.All the respondents signed the informed consent forms.All statistical analysis were carried out using SAS 9.2 and SPSS standard version 13.0.Chi-square test was used for statistical analysis.P value ＜0.05 was regarded as statistically significant.Results The investigation in these two counties covered 7 126 residents,including 1 734 symptomatic OA patients,with a prevalence rate of 24.3％,where knee OA had the highest prevalence rate [13.8％(983/7 126)],other figures were as follows:lumbar vertebra,neck,hand,shoulder,elbow,ankle,hip,wrist,thoracic vertebra and foot.There were statistical differences in the prevalence of knee,ankle,neck,shoulder and hand between the two genders (P＜0.05).Conclusion The prevalence of symptomatic OA in rural areas of Shanxi,China is relatively high,but the risk factors still need to be further studied and proved.

Objective To reveal the status quo and emerging issues of co-authorship in regional health informatization research community in China.Methods The terms or keywords describing and covering regional health informatization were used to search the most relevant literatures about the subject in CNKI,Wanfang database and PubMed.Software tools were used to extract bibliographic,Social network analysis (SNA);co-authorship,and co-word analysis were used in this study.Results ①11,482 articles with 16,449 authors in the period of 1984-2013 were found.Each publication has an average of 1.43 authors,and each author has 0.70 publications.The number of coauthored literature was 7741 (67.42 ％).Both production and collaboration have been growing steadily.② Coauthored knowledge network was build which composed by 150 high-yielding Authors.The largest component comprises 43 authors(28％,43/156).The intermediate centrality of 57 authors were above 0.③ 230 2-plexes were found,and 65 2-plexes scale was 4 and over;and there was overlap among them.There were extensive cooperation between the military institutions,a large number of regional health information technology research talent were found in army research institutes..Cohesive subgroups density showed an E-I index=-0.901,which indicated that factionalism was comparatively weaker in this field,and the relationship tended to occur among subgroups.④ Cooperative network was established between the provinces and municipalities.Beijing,Guangdong,Jiangsu,Hubei were the core area.⑤ The average distance between the author=3.155,and it consistent with the small-world characteristics.⑥ The largest component of the network research can be summarized into three categories:HIS-related research,electronic medical records related research,and regional health informatization related research.Conclusions Although such collaboration is growing steadily,the collaboration behavior about regional health informatization study needs to be enhanced.Policy makers and researchers can refer to the relevant information and promote cooperation,improve the capacity of regional health information research and construction.

Objective To investigate the factor that affecting the prevalence of osteoarthritis in rural areas of Shanxi, China. Methods All the residents above 16-year-old from the villages chosen by multi-stage stratified cluster sampling in Yangcheng County and Pianguan County in Shanxi Province were investigated by COPCORD procedure of WHO. All respondents signed the informed consent forms. Chi-square test and multivariable logistic regression analysis were used for the risk factor analysis. Results Seven thousand one hundred and twenty-six permanent residents in the two counties were investigated, of which 1734 cases of patients with osteoarthritis were identified. Take with or without osteoarthritis as response variables, statistically significant variables in the univariate analysis were substituted into the logistic regression model. Forward method was used for the variable selection. The inclusion criteria set as 0.10. The results showed that, age, room heating and ventilation, marital status, occupation, education, engaged in coal mine work, accompanied cardiovascular disease were the risk factors for osteoarthritis disease. Conclusion There were many factors that affect the prevalence of osteoarthritis in Shanxi rural communities, in which lifestyle may play an important role. Early intervention on risk factors may have a significant effect on reducing the prevalence.

Objective To investigate the prevalence of fatigue in rheumatoid arthritis (RA) and its relationship with other clinical and functional parameters used for the evaluation of disease activity and health related quality of life. Methods The fatigue was assessed in 230 patients with RA using visual analogue scale (VAS). The correlation between fatigue and the clinical disease activity including morning stiffness, pain, PGA, physician's global assessment, TJC, TJI, SJC, SJI, DAS28, HAQ and health-related quality of life were assessed. Results The prevalence of fatigue was 85.7% and the fatigue score of 51.7% patients was higher than 50 mm. After controlled for the possible confounding factors such as age, gender and disease duration, it was found that fatigue was highly correlated with pain, disease activity, functional disability, physical health and mental health. Conclusion Fatigue is an important symptom of RA and is correlated with pain, disease activity, functional disability and health-related quality of life.

Objective To analyze the quality of life of patients with active rheumatoid arthritis (RA) and its relationship with other clinical and functional parameters used for the evaluation of disease activity. Methods The quality of life was assessed in 127 patients with active RA using SF-36 and was compared with non-active RA and the general population. The correlation between the quality of life and the clinical measures of disease, including morning stiffness, pain, fatigue, patient's global assessment (PGA) physician's global assessment , SJC/SJ1, TJC/TJI, DAS28, HAQ were measured. Results The patients with active RA reported significantly decreased scores in all dimensions of SF-36. Fatigue, PGA, physician's global assess-ment, DAS28 and HAQ significantly correlated with the scores in all dimensions of SF-36. Pain was correlated with the scores in all dimensions of SF-36 except RE. TJI was correlated with six dimensions. TJC was correlated with five dimensions. ESR was correlated with three dimensions. Conclusion The quality of life in patients with active RA is significantly declined compared with non-active RA and the general population. Disease activity and functional status of patients with active RA is closely correlated with the quality of life.

Objective To explore the influence of different dose of Helicobacter pylori on the expression of transforming growth factorβ(TGF-β1) and B7-H1 in the infected gastric mucosal epithelial cell and the bacterial factors which influence the expression of TGF-β1.To confirm that H.pylorican induce the expression of TGF-β1 and B7-H1 to inhibit the host immune function in gastric mucosal epithelial cell.Methods (1) We investigated the expression of TGF-β1 of human gastric mucosal epithelial cells infected with different concentration(1.0 × 109 CFU/ml,4.0 × 109 CFU/ml,8.0 × 109 C FU/ml) of H.pylori(NCTC 11637) in different time-point(0 h,0.5 h,1 h,1.5 h,2 h,4 h,8 h,12 h),and compared with the expression of TGF-β1 between the deactivated H.pylori group and activated H.pylori group.The blank group is the gastric mucosa epithelial cells which does not infect H.pylori.To detect expression of TGF-β1 in infected cell culture supernatant by enzyme-linked immunosorbent assay(ELISA) and the expression of B7-H1 mRNA by in situ hybridization.(2)At the same time,the middle concentration of deactivated H.pyloriand in vitro gastric mucosal cells were incubated for 2 h and 12 h,to detect expression of TGF-β1 in the cells and cell culture supernatant.(3)In vitro gastric mucosal cells were incubated with H.pylori bacterial supernatant and sedimentation by ultrasonic crushing and centrifugation and with H.pyloribacterial supernatant and sedimentation after boiling respectively,to detect expression of TGF-β1 in the cells and cell culture supernatant after 2 h,12 h.Results (1)Compared to the control group,the expression of TGF-β1 was significantly increased after stimulation with different concentration of activated H.pylori in different time-point(P ＜0.05).The expression of TGF-β1 secretion group has a similar dynamic trend,and the highest expression is the middle concentration group(P ＜0.05).(2)There was no difference between the middle concentration of deactivated H.pylori group and the same concentration of activated H.pylorigroup(P ＞ 0.05).(3) The expression of TGF-β1 in the H.pylori bacterial supernatant group was significantly increased higher than the blank group and the H.pylori bacterial sedimentation group(P ＜0.05),and the H.pylori bacterial supernatant group after boiling was significantly lower than the H.pylori bacterial supernatant group(P ＜ 0.05),but there was no difference between H.pylori sedimentation group after boiling and not boiling(P ＞ 0.05).The B7-H1 expression of different concentration groups which the H.pylori and gastric mucosal epithelial cells cocultured 12 h are higher than the blank group(P ＜ 0.05) by in situ hybridization,and the middle concentration group is the highest expression.TGF-β1 and B7-H1 mRNA are positively correlated(r,=0.628,P ＜0.01).Conclusion H.pylori can induce the gastric mucosal epithelial cells to express the TGF-β1,the factor was the soluble protein in the H.pylori thalline.At the same time,H.pylorican induce the B7-H1 expression increased.In gastric mucosal epithelial cells,TGF-β1 and B7-H1 mRNA are positively correlated.So H.pylori can inhibit the host immune response and participate the process of immune escape by increased the expressions of TGF-β1 and B7-H1.

After the status quo of medical treatment quality management and its relevant problems were analyzed, how to build the platform for medical treatment quality management was proposed by establishing perioperative clinical data center and intelligent management engine through data sharing, integration and reconstitution based on the present hospital information system in order to standardize perioperative medical behaviors and protect the safety of patients.