Objective:To analyse the dataflow and clinical flow in Suzhou municipal hospital radiology information system and picture archiving system, presents a set of system integration messages, and describes the effect of each message for the communication. Methods: Follow the framework of IHE and HL7 protocol, the paper uses standard messages to integrate two different systems for patient and study status communication. The integration can meet clinical users’ requirements.Results: Based on many years practice, the integration reached designed target.Conclusion: With further research on standard, the seamless system integration between different systems can help customer to make full use of each system and save more cost in system purchase.

Sepsis has relatively high morbidity and mortality in patients at intensive care unit (ICU). With the study of sepsis having continued to develop in recent years, the defects existing in this research have unceasingly exposed. Because the lack of design process of international standardized clinical randomized controlled trials (RCT) for septic patients, the situation of incomplete data record exists in these clinical studies, that may further affect the interpretation of the research results, therefore it is in urgent need to have an international standardized RCT design process for septic patients.

Objective To investigate the influence of thrombus aspiration on ventricular remodeling of patients with ST?segment elevation type of myocardial infarction ( STEMI ) who underwent emergency percutaneous coronary intervention ( PCI) and its predicative value for patients′ prognosis. Methods Three hundred and eight patients who were diagnosed with STEMI line emergency PCI and hospitalized in the Cardiology Department of Jinghai Clinical College of Medical University of Tianjin from March 2011 to March 2014 were retrospective analyzed, including 152 patients received thrombus aspiration during primary PCI as thrombus aspiration group,and the remaining 156 patients without thrombus aspiration as control group. Indexes of myocardial perfusion levels such as ST?segment resolution 2 hours after PCI and TIMI myocardial perfusion grade were measured in all patients. All patients accepted echocardiography examinations to detect left ventricular end diastolic diameter(LVED) and left ventricular ejection fraction(LVEF) 10 days after PCI. The indexes differences of the two groups,secondary end points major cardiac adverse events(MACE) at 6 months were compared. Results There was no statistical difference between the ratio of two groups for ST segment fell more than 50%( 78. 9%( 120/152) vs. 71. 2%( 111/156) ,χ2=0. 428,P=0. 669) . But for ST segment fell more than 70%,the ratio of the thrombus aspiration group was significantly higher than that in the control group ( 73. 7%( 112/152 ) vs. 47. 4% ( 74/156 ) , χ2 = 4. 701, P = 0. 001 ) . Two groups of patients were treated by echocardiography 10 days after PCI,showed the LVED in the thrombus aspiration group was lower than that in the control group((50. 2±4. 7) mm vs. (51. 6±4. 6) mm,t=2. 642,P=0. 008),while the LVEF value was higher than that in the control group((56. 9±4. 9)% vs. (49. 4±4. 2)%,t=14. 434,P=0. 001). Recurrent angina pectoris decreased significantly in the thrombus aspiration group at 6 months ( 4. 61% ( 7/152 ) vs. 10. 90%(17/156),χ2=2. 056,P=0. 040). Conclusion STEMI patients adopt thrombus aspiration that undergoing emergency PCI,not only can improve myocardial reperfusion,especially microcirculation reperfusion, but also can improve the left ventricular systolic function and the prognosis of patients.

Objective To explore the effect of the combination of video feedback and telephone intervention on postdischarge rehabilitation in patients receiving artificial total hip replacement.Methods A total of 60 patients receiving artificial total hip replacement were divided into intervention group and control group with 30 cases each by random digits table method.The combination of video feedback and telephone intervention was conducted in intervention group,and conventional discharge guidance and telephone follow-up on a regular basis in control group.In intervention group,the patients or their family member were asked to record the video of the exercises and daily living when patients were at home according instructions and researchers assessed the condition of patient's joint and muscle function and provided individual education and instructions to the patients on the basis of the feedback video through telephone.Harris hip function rating scale and Functional Independence Measure (FIM) were investigated at discharge and 1,3,6 months after discharge.Results There were no significant differences in Harris hip function rating scale and FIM score at discharge between 2 groups,P＞0.05.Harris hip function rating scale score were (72.70± 11.65),(83.11±5.12),(94.83±3.08) scores at 1,3,6 months after discharge in intervention group,and (63.20±14.96),(77.00±11.62),(87.50±7.94) scores in control group,there were significant differences,P＜0.05 or ＜0.01.FIM score were (96.30±4.63),(108.76±3.28),(125.79±1.19) scores at 1,3,6 months after discharge in intervention group,and (78.23±5.09),(86.43±6.30),(96.54±5.35) scores in control group,there were significant differences,P＜0.01.Conclusion The combination of video feedback and telephone intervention could help to promote the postdischarge hip function for patients receiving artificial total hip replacement.

Tubulointerstitial fibrosis (TIF) is a common pathological feature of end-stage kidney disease. Previous studies showed that upregulation of TGFbeta1 notably contributed to the chronic renal injury and irbesartan halted the development of TIF in rats with 5/6 renal mass reduction. This study was to investigate the effects of irbesartan on chronic TIF and the mechanism involved TGFbeta1 in the rodent model of chronic renal failure involving 5/6 nephrectomy. The results showed that irbesartan significantly attenuated the rise in blood pressure and tubulointerstitial injury observed in this model. Masson staining of the renal tissue revealed that there appeared severe renal tubule atrophy and fibrosis in operation group, but the lesion was attenuated mostly in irbesartan-treated group. Immunohistochemistry showed that irbesartan treatment apparently decreased the protein expression of TGFbeta1 which was up-regulated in operation groups. Western blot showed that irbesartan treatment down-regulated the expression of TGFbeta1, phosphorylated smad2 (p-smad2), AT1R and phosphorylated p38 (p-p38) MAPK, but significantly up-regulated the protein expression of smad6 as compared with operation group. These findings suggest that irbesartan attenuates hypertension and reduces the development of TIF in rats with 5/6 renal mass reduction via changes in the expression of these proteins at least including smad6, TGF-beta1, p-smad2, AT1 and p-p38 MAPK.

Objective To investigate the thyroid ultrastructural pathological changes of diabetes mellitus (DM) rats as well as the intervention effects of insulin and aminoguanidine. Methods Totally 87 rats were treated with streptozotocin to establish DM animal models and divided into DM group(n=27),insulin intervention group(n=32) and aminoguanidine intervention group(n=28),25 rats were taken as normal controls. Twelve and 20 weeks after the animal model establishment, animals were sacrificed, thyroid tissue was taken and ultrastructure was observed. Results In the thyroid of DM rats, follicular epithelial cells present as applanate shape, microvilli were depleted, rough endoplasmic reticulum dilated to irregular vesicular. None pinocytotic vacuole and casual primary or secondary lysosome were seen. Follicular cavity was dilated, colloid in the cavity had higher electronic-density. Interstitial edema, capillary base lamian was thickened at different stage. Proteo-substance deposition with granulo-shape, cloud shape or homogeneity appeared. The number of thyroid parafollicular cells increased. But endocrine granule in parafollicular cells was few. When compared with DM group, the thyroid tissue injury of insulin intervention group and aminoguanidine intervention group were lessened to different degree. Conclusion The hypofunctional thyroid follicular cells, large quantity of proteo-substance deposition in the interstitium and increased parafollicular cells of DM rats may be related with hyperglycemia toxicity. Insulin and aminoguanidine treatment have some protection effects.

Objective To evaluate the therapeutic effect of recombinant adeno-associated viral vector (rAAV) expressing human tissue kallikrein gene (rAAV-HK) on insulin resistance and renal complications in tyDe2 diabetic rats. Methods Male Wistar rats were injected low dose streptozotocin and fed with high fat and sucrose diets to form type 2 diabetic model. rAAV mediated HK gene (HK group) or LacZ gene (LacZ group) were introduced to the diabetic rats, and their systolic blood pressure, fasting blood glucose and insulin, serum creatinine, urine creatinine, urine osmolarity and urine microalbumin were measured. The homeostasis model assessment of insulin resistance (HOMA-IR), urinary albumin excretion rate (UAER) and creatinine clearance rate (Ccr) were calculated. The expression of PI3-kinase p11o catalytic subunit (p110) and Akt phosphorylation on Thr-308 were detected by Western blot. The morphology of kidney wag observed. Results Delivery of rAAVHK resulted in a reduction in blood pressure at 2 weeks and the hypotensive effect lasted for the duration of the study. The HOMA-IR was significantly lower in HK group than LacZ group (4.76±0.33 vs 8.36±0.48, P<0.01) at the end of the study, fasting insulin level was reduced [(8.19±2.45 vs 13.85±3.76)mIU/L. P<0.01], but there was no significant change in fasting blood glucose [(13.09±3.01 vs 13.58±2.88)mmol/L].The phosphorylation of p11o and Akt Thr-308 were significantly decreased in skeletal muscle and liver in LacZ group and were almost corrected by HK gene therapy. The UAER and Ccr were significantly lower and urinary osmolarity were higher in HK-treated rats compared with LaeZ rats. Histological assessment indicated that the renal complication was relieved by HK gene delivery. Conclusion The rAAV-mediated HK gene delivery efficiently attenuated insulin resistance partly through PI3K/Akt pathway and diabetic nephropathy in type 2diabetic rats.

This study examined the role of high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6) and cystatin C in ischemic stroke complicating atrial fibrillation (AF) and the relationship of systemic inflammation with this disease in order to identify AF patients who are at high risk of stroke and need optimal anticoagulant therapy. A total of 103 AF patients, simple (n=75) or complicated by ischemic stroke (n=28), and 112 control subjects were recruited. IL-6 level was detected by using enzyme linked immunosorbent assay. Cystatin C and hsCRP levels were measured by means of a particle-enhanced immunonephelometric assay. The results showed that the AF patients had higher levels of hsCRP (P=0.004), IL-6 (P=0.000), and cystatin C (P=0.000) than control subjects. Plasma hsCRP level was increased in the AF patients with ischemic stroke as compared to the patients with simple AF (P=0.036). The AF patients who had the level of hsCRP exceeding 3.83 mg/L were at a higher risk than those with hsCRP level lower than 3.83 mg/L (P=0.030). After adjusting for other factors, cystatin C remained positively associated with IL-6 (r=0.613) and hsCRP (r=0.488). It was concluded that hsCRP is positively correlated with ischemic stroke complicating AF and may be a risk factor independent of other risk factors for AF. Elevated cystatin C level is also indicative of the increased risk of AF.

Objective:To investigate the expression of receptor for advanced glycation end products (RAGE)in the thyroid tissue of diabetes mellitus (DM)rats.Methods:The rat model of DM was established by high-lipid diet and vena caudalis injection of streptozocin.The rats of DM models were then randomly divided into three groups:DM group(n=17),insulin intervention group(n=16)and aminoguanidine intervention group(n=16).Nine normal rats were taken as controls.Twelve weeks after the establishment of DM model,rats were sacrificed and the thyroid tissue was taken to determine RAGE mRNA and the protein expression with the method of RT-PCR and Western Blot.Results:The levels of RAGE mRNA and protein expression were higher in the thyroid tissue of DM rats than those in controls (P＜0.05).The levels of RAGE mRNA and protein expression were lower in the thyroid tissue of insulin intervention group and aminoguanidine intervention group than thor of DM group (P＜0.05).Conclusion:The levels of RAGE mRNA and protein expression were up-regulated in the thyroid tissue of DM rats,which can be restrained by controlling blood glucose and blocking the formation of advanced glycation end products.