Objective To establish a regional medical information sharing platform used to promote the sharing of regional medical data such as electronic medical records( EMR) and medical images in order to improve medical services. Methods With reference to results and experience of the domestic and foreign research and by virtualizing re-establish-ment of the existing medical information resources,a regional medical information sharing platform was established based on cloud computing, SOA,and Web services, and then the heterogeneous information systems in different medical institutions were integrated.Results A novel cloud platform solution was proposed for clinical information exchange between medical institutions based on Web services that exchanged data and ensured the data security and privacy using XML encryption and compression.The prototype developed in a cloud environment was put into use in dozens of military hospitals to enable the sharing of clinical information.Conclusion This cloud computing platform has the advantages of dynamic scalability, distributed and ubiquitous access.It is highly feasible and practical for regional medical informatization.

Traditional Chinese medicine (TCM) is the treasure of the Chinese nation civilization. Along with China acceding to WTO, the grandness of international natural drug market and its accepting of Chinese materia medica (CMM), CMM industrialization in China gets the opportunity growing quickly. But it is faced with many challenges from all over the world.This article introduces the theory of industria-lization competitiveness, which was put forward by Pro. Michael E. Porter, Harvard University, and applied “diamond model” theory to evaluating the international competitiveness of the CMM industrialization of China. The analysis will provide the base for establishing the strategy for the development of the CMM industrialization in China and upgrading its international competitiveness.

OBJECTIVE: To study the stability of dexamethasone sodium phosphate(DSP) eye drops and predict its validity duration.METHODS: The content of DSP in eye drops was determined by HPLC and its validity duration was predi-cated using initial average rate method.RESULTS: The linear concentration range of DSP was 18～70 ?g?mL-1(r=0.999 9) with an average recovery rate of 99.74%(RSD=0.37%).The content of DSP in the eye drops decreased as its storing temperature increased and the storing time prolonged,but its pH was stable. The validity duration of the eye drops was computed to be 70 days at 25 ℃ and 438 days at 4 ℃.CONCLUSION: This eye drops were stable at 4 ℃.

Objective To evaluate and compare open and retroperitoneal laparoscopic adrenalectomy.Methods Clinical data of 30 cases undergoing open adrenalectomy and 119 cases undergoing retroperitoneal laparoscopic surgery were retrospectively analyzed. The 2 groups were compared in terms of these aspects: operation duration, intraoperative blood loss, postoperative analgesic use, time to remove drainage tube, time to resume eat, postoperative hospitalization time, complications, and tumor recurrence. In open surgery group, tumor diameter was between 0.5 cm -10.8 cm, 4.57 cm in average. 18 tumors were located on the left side and 12 tumors on the right side. In laparoscopic group, tumor diameter was between 0.8 cm -14.5 cm, 2.78 cm in average. 59tumors were located on the left side and 60 tumors on the right side. Patients in open surgery group were followed up for 6-72 months and retroperitoneal laparoscopic group 4-20 months. Results Open adrenalectomy were successful in all the 30 cases. 12 cases in laparoscopic surgery group converted to open surgery among whom 8 cases were due to poor visibility, 1 case due to renal artery injury, 1 case due to large tumor size, 1 case because of diaphragmatic injury and 1 case because of pleural injury. Laparoscopic surgery was superior to open surgery in terms of operation duration, intraoperative blood loss, postoperative analgesic use, time to start food taking, time to remove drainage tube, and postoperative hospitalization time. The difference had statistical significance (P ＜0.05 ). Conclusion Retroperitoneal laparoscopic adrenalectomy has advantages such as less trauma, less blood loss, and shorter recovery time, which make this procedure the modern golden standard for treatment of benign adrenal neoplasm.

BACKGROUND:Studies on high glucose exposure in human periodontal ligament cel s usual y focus on the biological behaviors, pathways and secretory factors, but whether the metabolic memory is involved is little known. OBJECTIVE:To investigate the metabolic memory of high glucose exposure in human periodontal ligament cel s. METHODS:Human periodontal ligament cel s were primarily cultured and identified. Cel s at 5-8 passages were selected and randomized into four groups. Group A (controls):DMEM containing 5.5 mmol/L glucose for 8 days;group B (5-day memory group):DMEM containing 35 mmol/L glucose for 3 days and DMEM containing 5.5 mmol/L glucose for 5 days;group C (3-day memory group):DMEM containing 35 mmol/L glucose for 5 days and DMEM containing 5.5 mmol/L glucose for 3 days;group D (8-day high glucose group):DMEM containing 35 mmol/L glucose for 8 days. The cel proliferation was detected by cel counting kit-8, the cel apoptosis was determined by flow cytometry, and the levels of total proteins and alkaline phosphatase were investigated using ELISA. RESULTS AND CONCLUSION:Compared with the control group, the cel proliferation in the other three groups was significantly reduced (P<0.05), the number of apoptotic cel s was significantly increased, while the levels of total proteins and alkaline phosphatase were significantly decreased (P<0.05). These results suggest that high glucose causes persistent changes in human periodontal ligament cel s by inhibiting cel viability, increasing the apoptosis and downregulating the levels of the total proteins and alkaline phosphatase

Objective To explore and set up the nurse post ability of the leveling exam plan in a third-grade class-A hospital.Methods The entry of more than one year of nurses will participate in the examination of N1-N4 is divided into four levels.According to different levels to set up the post ability of the leveling exam plan,through the review and interview,evaluate its effects and satisfaction in a third-grade class-A hospital.Results After the post ability of the leveling exam plan,nurses of different levels get more satisfied with the score on the assessment form,specialized knowledge,the core system,emergency plan,communication skills,ability of operation and emergency disposal,which significantly higher than the traditional methods,there were statistical differences between two groups.(t value was as follows:1.46,2.13,1.98,2.57,2.69,1.87,P ＜ 0.05),but the difference of foundation knowledge was not obvious (P ＞ 0.05).The new program get higher scores of nurses in critical thinking,clinical care,ethical,legal practice and professional ability,results were significant differences (t value was as follows:2.18,2.01,1.46,2.78,P＜ 0.05),but the scores in scientific research ability,leadership,interpersonal relationship,education and consulting capacity was not significantly different (P ＞ 0.05).Conclusion It is concluded that nurses of different levels on the leveling exam plan get a higher satisfaction.Through the new program,to assess the level of nurses,effectively improve the capacity on critical thinking,clinical nursing,ethical standards,law practice and professional development.

Objective To improve the organization and management of the hospital,optimize the medical processes,improve medical quality and reduce medical costs.Methods A method of using multi-agent technology to hospital complex system modeling and simulation was introduced.The theory of complex system and its modeling method were simply introduced and the complex system characteristic and the medical processes of hospital were analyzed.Results The technology and fundation of multi-agent modeling were summarized.The steps of modeling and simulation for complex system of hospital were presented.The swarm simulation platform and the detail design of agent model in hospital were also presented.Conclusion It is proposed that the simulation research of hospital should use the methodology of multi-agent-based modeling and simulation,which is the research method of complex system.

This study examined whether exposure to nitrate in drinking water is associated with increased risk for bladder cancer by conducting a comprehensive literature research. A meta-analysis was performed with and without adjustment for confounding factors. Three groups (reference, intermediate and high groups) were established in terms of different nitrate concentrations in each included study. Separate relative risk measures were calculated for intermediate and high groups. Heterogeneity was assessed by using the Q statistics. Publication bias was evaluated by Egger's and Begg's test. Quality assessment for studies was performed by using the Newcastle-Ottawa scale. Two cohorts, two case-controls, and one ecological study were included in this study. The adjusted data showed that the combined risk ratios (RRs) were 1.13 (95% CI: 0.81 to 1.57) and 1.27 (95% CI: 0.75 to 2.15) for intermediate and high groups respectively. For unadjusted data, the corresponding RRs were 1.18 (95% CI: 0.89 to 1.57) and 1.29 (95% CI: 0.81 to 2.07). Sensitivity test indicated that results were significantly underestimated when Ward's study was included. No significant publication bias was found. There was heterogeneity among studies. The results suggested that there was no sufficient evidence that nitrate in drinking water is associated with increased risks for bladder cancer.

Objective To discuss the operative strategies for cervical spine fracture combined with ankylosing spondylitis and the deformity of cervicothoracic kyphosis.Methods Retrospectively analyzed 21 cases of cervical spine fracture combined with ankylosing spondylitis and the deformity of cervicothoracic kyphosis,who underwent surgeries from January,2007 to August,2014.Twenty males and 1 female were included.Mean age was (48.6±7.5) years (range,36-65 years).The preoperative American Spine Injury Association (ASIA) classification distribution:2 cases of Grade A,6 cases of Grade B,7 cases of Grade C,5 cases of Grade D,and 1 case of of Grade E.The investigative surgical methods including posterior cervical open reduction,internal fixation and bone graft fusion;posterior cervical open reduction/decompression,internal fixation and bone graft fusion;or combined posterior and anterior cervical decompression,bone graft fusion and instrumentation.The operative time and blood loss were recorded,the clinical therapeutic effect was evaluated by visual analogue scale (VAS) score,ASIA grade improvement,cervical curvature (the angle between a line drawn parallel to the inferior endplate of C2 and a line drawn parallel to the inferior endplate of C7 in the lateral plane of an X-ray image) and radiological assessment (including bone graft fusion condition and internal fixation position).Results One case died from severe pulmonary infection and respiratory failure at the 45th day after operation.All the other 20 patients obtained complete follow-up with a mean time of (39.4±8.76) months (range,25-59 months).7 cases received posterior cervical open reduction,internal fixation and bone graft fusion,average operative time was (92.1±5.4) minutes and average blood loss was (96.1+23.7) ml.9 cases received the posterior cervical open reduction and decompression,internal fixation and bone graft fusion,mean operation time was (121.4± 14.0) minutes and blood loss was (250.0±38.9) ml.3 cases experienced combined posterior and anterior cervical decompression,bone graft fusion and fixation,average operative time was (222.4± 14.9) minutes and average blood loss was (354.3+46.7) ml.Mean of VAS scores at the 3th month postoperatively was 2.76±0.46,significantly lower than the preoperatively VAS scores (8.95±0.36).Mean of VAS scores at the 24th month postoperatively was 1.77±0.39,significantly lower than those at the 3th month postoperatively.The neurological function of spinal cord achieved significant improvement after operations and continued recovered gradually in the subsequent follow up.ASIA Classification distribution at the 24th month postoperatively was:0 case of Grade A,0 case of Grade B,3 cases of Grade C,8 cases of Grade D,9 case of Grade E.Mean of the cervical curvature after operation was-7.1°± 1.9°,significantly higher than preoperatively(-13.4°±3.3°) and did not have any loss of Cobb's angles at 24th month after operation.All the surviving cases achieved solid bone graft fusion.Mean bone graft fusion time was 5.8 months (range,4-9 months).There was no internal fixation loose,fracture and dislocation occurred during follow up.Conclusion All procedures can significantly relieve the painful symptoms,effectively restore the normal cervical alignment and stability,and remarkably improve the neural function of the patients suffering cervical spine fracture combined with ankylosing spondylitis and the deformity of cervicothoracic junction kyphosis.

[Summary] To evaluate the relationships between plasma GPC4 levels and HbA1C . Plasma GPC4 levels were measured in subjects with different glucose tolerances. The relationship between plasma GPC4 levels and HbA1C were studied. Increasing levels of GPC4 showed a significant linear trend and were independently associated with HbA1C . GPC4 levels gradually declined after gradually increased , which is similar with Fins, 2hIns, and AUCinsulin . GPC4 may be involved in the regulation of blood glucose and GPC4 may be regulated by insulin.