This paper discussed on the importance of management system of paperless electronic medical record and pointed out that we would encountered lots of problems during the construction of paperless electronic medical record management system including authenticity,legal effect,similarity,safety,mistakes and missing of medical records.This paper analyzed these problems and proposed corresponding countermeasures including developing safety management system,whole-process monitoring of medical record quality,enhancing archive management,developing backup and recovery mechanisms,improving secrecy and authorization system,promoting borrowing management,performing copy system,strengthening electronic signature management,implementing unique number management and enhancing overall quality of personnel

Through the practice of outpatient doctor station cored by the outpatient Electronic Medical Records (EMR),the paper discusses the disadvantages of outpatient paper medical records and the advantages of outpatient EMR,summarizes the key points and difficulties in promoting outpatient EMR,and meanwhile points out to pay attention to the integration with other information system,data standardization,perfection of the management system,integrated consultation system and other issues in the practice process.

Objective To explore the relationship between calcium channel ?1 subunit (Cav1.1) gene intron 26 -67 A/G polymorphism and thyrotoxic periodic paralysis(TPP). Methods Cav1.1 gene polymorphism at position -67 was determined by polymerase chain reaction-single-strand conformation polymorphism (PCR-SSCP) in 46 male patients with TPP, 68 male Graves’ disease (GD) patients without TPP and 72 healthy male controls. The difference of genotype and the variation of allele frequencies were analyzed by Chi-square test. Results (1) Frequencies distribution of AG+GG genotype in TPP, GD and control groups were 47.83%, 14.71% and 29.17% respectively, and those of allele G were 44.57%, 13.24% and 27.78% for the three groups respectively. (2) Frequencies of -67 AG+GG genotype in TPP group were significantly higher than those in GD and CON group(OR=5.32, P

Objective:To explore the diagnostic value of treadmill exercise test (TET)and its Duke score in menopa-usal female patients with coronary heart disease (CHD).Methods:A total of 102 menopausal female patients re-ceived TET and coronary angiography (CAG)examination.With CAG as control,accuracy indexes etc.of TET combined Duke score diagnosing coronary artery disease in these patients were compared and analyzed.Results:Compared with single application of TET or Duke score,there were significant rise in specificity (27.12% vs. 30.50% vs.44.44%),positive predictive value (47.56% vs.46.75% vs.54.55%),negative predictive value (80%vs.72% vs.90.91%)and accuracy (53.92% vs.52.94% vs.64.94%)diagnosing CHD by TET combined Duke score both positive and negative,P <0.05 all;but there was no significant difference in sensitivity,P >0.05 both. There was no significant difference in CHD diagnosis between single use of TET and Duke score,P >0.05 all.Con-clusion:False positive rate of treadmill exercise test is higher in menopausal women.Treadmill exercise test com-bined Duke score is helpful to improve specificity,positive predictive value,negative predictive value and accuracy of the test.

Objective Structured Clinical Examination(OSCE) is a model of clinical skills examination.We have applied OSCE in the graduate examination of medical colleges for three years.There are different requests for training teachers and Standardized Patients(SP),setting exam place,examiners and students and so on.OSCE is worth spreading as clinical ability examination in other medical education.

To intensify the medical students' clinical skills training is the main objective of medical education,and it can promote the reform of clinical teaching.In the whole process of clinical practice,we have adopted means of teaching before receiving clinical practical training,estimating indexes of examine,making use of diversified clinical skill training,supervising clinical practical quality.The operation ability of medical students has greatly increased.

Objective To describe the characteristic endoscopic ultrasonography (EUS) features of gastric ectopic pancreas.Methods Totally 23 patients were diagnosed pathologically as having gastric ectopic pancreas.The EUS images of the lesions were retrospectively reviewed regarding layer of origin,size,growth pattern,margin,and internal echo pattern.Results The coincidence of EUS and pathologic diagnosis was 91%(21/23).EUS revealed that the lesions originated from the second,third,and/or fourth layers of the gastric wall.Most lesions were heterogenous,mainly isoechoic.The borders of the lesions were indistinct in 70%(16/23) patients. Anechoic cystic or tubular structures within the lesions appeared in 10 of the 23 lesions(43%).The mean longest/shortest diameter ratio of ectopic pancreas was 1.7.Conclusions Characteristic EUS features of gastric ectopic pancreases include:mural lateral growth pattern,third layer (submucosa) origin,indistinct margin,intermediate echogenecity,anechoic areas,and fourth-layer thickening.Careful assessment of the EUS findings may be a useful aid in the diagnosis of gastric ectopic pancreas.

Objective Promote the use of medical record information, the depth of excavation,provide strong support for clinical research and hospital management.Methods Medical Record Information lower utilization reasons put forward need to build the whole structure of the paperless electronic medical records, electronic medical records for research concluded that the key to building elements to provide support.Results Pointed out that the construction of paperless electronic medical records from the storage structure of the building medical record systems, and data warehouse technology combined start, outpatient and inpatient medical records while achieving interoperability, building regional health care, improve follow-up system, and finally pointed out the key technical implementation.Conclusions It is to promote the utilization of medical records, medical records for research to improve support efforts to promote development and progress of medicine and enhance the hospital's soft power has great significance.

Objective To observe clinical efficacy of external bath of modified Huangqi Guizhi Wuwu Decoction in relieving peripheral neurotoxicity induced by oxaliplatin.Methods Sixty patients were randomly divided into control group and treatment group (30 cases in each group). Both groups received intramuscular injection of mecobalamine (0.5 mg/d, three times a week). At the same time, the treatment group received external bath of modifiedHuangqi Guizhi Wuwu Decoction. All the courses of treatment lasted for 14 days. Clinical efficacy and adverse reactions of the two groups were observed.Results The total effective rate of treatment group was 73.3% (22/30), which was superior to that of 40.0% (12/30) in the control group, with statistical significance (P<0.05), without any adverse reaction.Conclusion External bath of modifiedHuangqi Guizhi Wuwu Decoction is effective as supportive care for alleviating chronic peripheral neurotoxicity induced by oxaliplatin.

ObjectiveTo evaluate the accuracy of the modalities in revealing the results by observing the radiofrequency ablated (RFA) lesions with contrast-enhanced ultrasonography (CEUS),magnetic resonance image (MRI) in comparison with histopathologic findings in normal rabbit kidney.Methods RFA was performed in the left kidneys of 10 rabbits.The ablated lesions were observed with conventional ultrasound(US),CEUS,MRI at 1 day,1 week after RFA.Then the rabbits subjected to postmortem and the kidney specimens were excised,stained and processed for conventional histologic study.The maximum lesion size as measured on US,CEUS and MRI was then correlated with the histopathologically determined lesion size.The utility of different imaging modalities were evaluated.ResultsIn a relatively short time (at 1 day and 1 week),CEUS and MRI may reveal the location,shape and extent of ablated lesion.And the lesion sizes with CEUS,MRI and kidney specimens were well correlated (P＞0.05).ConclusionsBoth CEUS and MRI are suitable for the accurate evaluation of the ablated lesions in the short time.CEUS can reveal the variation of flow perfusion in the ablated lesion dynamicly and in real time.