Described in this paper are the characteristics of medical big data such as multi-dimensionalities, non-integrities, time sequencing, redundancies, their sources such as health service,medical insurance,health adminis-trations, producers of drugs and medical equipments, Internet, life science, their applications in R & D of drugs, diagnosis and treatment of diseases,medical insurance,intelligent decision-making,individual health management, and challenges they are faced such as data integration,data storage,data sharing, shortage of trained professionals, and privacy protection.

Objective To analyze the risk factors of congenital heart disease(CHD) in China by using the meta‐analysis method to provide reference for etiology study and prevention of CHD .Methods The Chinese literature database such as CBM , VIP ,CNKI ,Wan Fang were retrieved from 2005 to 2015 for collecting the related literatures ,then the collected literatures were screened ,performed the information extraction ,quality evaluation and merged analysis by using the Stata12 .0 software .Results In this study ,37 articles were included ,including 20 provinces (municipalities and autonomous regions) ,8 588 cases in the case group and 12 479 cases in the control group;a total of 21 risk factors(5 pre‐pregnant factors and 16 gestational factors) were included . Conclusion All 21 risk factors include 4 pre‐pregnancy factors ,15 gestational factors and 2 factors which not be verified .The top 3 risk factors and their OR values with 95% CI were gestational diabetes 5 .80(2 .72-12 .37) ,contacting the occupational risk factors 5 .14(3 .30-8 .00) ,advanced age before pregnancy 4 .96(1 .45-16 .97) .Not considering to be as the risk factors and their OR value with 95% CI are high body mass index before pregnancy 1 .32(0 .99 -1 .75) ,living near street during pregnancy 1 .36(0 .50-3 .71 ) .

Objective To study the prevalence and associated factors of secondary hyperparathyroidism (SHPT) in continuous ambulatory peritoneal dialysis (CAPD) patients.Methods A cross-section study was performed.A total of 639 eligible participants undergoing CAPD treatment more than three months in our peritoneal dialysis center from July 2011 to January 2012 were recruited in the study.All the patients were divided into SHPT group and non-SHPT group according to the intact parathyroid hormone (iPTH) level,and the associated factors of SHPT were investigated through Logistic regression analysis.Results The prevalence of SHPT was 46.95％ (300/639).Logistic regression analysis demonstrated that lower hemoglobin,hypocalcemia,hyperphosphatemia,higher alkaline phosphatase,higher Scr,higher nPCR and low calcium dialysate were independent influencing factors of SHPT.Conclusions The prevalence of SHPT is quite high in CAPD patients.Abnormal calcium-phosphorus metabolism,renal anemia,high protein diet and low calium dialysate may affect the SHPT.

Objective To investigate the effect of losartan on tubulointerstitial fibrosis of rat unilateral ureteral obstruction(UUO) model, and to study whether the use of large dose could be better exert a superior renoprotective effect than conventional dose. Methods Three days after UUO, rats were randomly assigned to conventional dose and large dose of losartan group, shamoperated group and operation group. Two treatment groups were administered orally with a daily dose of losartan 50 mg/kg or 500 mg/kg by gastric gavage. Sham-operated group and operation group received the same volume of physiological saline. Rats were sacrificed 7, 14, 21 days after obstruction. Daily urinary albumin excretion(UalbV), tail-cuff pressure(TCP), the percentage of renal tubular lesions, fractional interstitial area (INT), macrophage infiltration and the expression of transforming growth factor (TGF)-β1 mRNA were assessed and compared. Results The TCP, UalbV, percentage of tubular lesions and interstitial fibrosis, the number of interstitial macrophages and the expression of TGF-β1 mRNA were significantly increased in operation group as compared with other groups (P<0.05). Furthermore, in comparison with conventional dose, the large dose treatment significantly reduced TCP and UalbV, attenuated interstitial fibrosis and tubular lesions, suppressed macrophages infiltration and the expression of TGF-β1 mRNA. Conclusion The large dose of losartan provides superior renoprotection compared to the treatment with conventional dose in UUO model, which interrupts the positive feedback involved in the vicious cycle between inflammatory cell and Ang Ⅱ.

BACKGROUND:Cortical electrical stimulation has achieved good effects in treatment of stroke through animal and clinical experiments.
OBJECTIVE:To observe the effects of a ful y implanted cortical electrical stimulation device with long time, low intensity and various frequencies stimulation protocols on the neurological function recovery in a rat model of local cerebral infarction.
METHODS:The cerebral infarction model was established through middle cerebral artery occlusion in 60 Sprague-Dawley adult male rats. Forty rats with 1-3 points by Bederson scale were detected with magnetic resonance imaging, which was used to confirm cortex infarction and to identify a location for implantation of stimulating electrode over the peri-infarct cortex. Twenty-three rats with cortex infarction were randomly divided into cortical electrical stimulation group (CES group, n=13) and no stimulation group (NS group;n=10). The device was implanted on 6 days after middle cerebral artery occlusion, and the stimulation was given for 16 days. The stimulation program consists of two sessions lasting half an hour each in the morning and in the afternoon respectively. Stimulator delivered biphasic charge balanced pulses (pulse width=200μs) with various frequencies of 50 Hz, 20 Hz and 5 Hz within 10 second blocks and then repeated. The rats of NS group were implanted with the device, but received no electrical stimulation. The behavioral tests, includingforelimb use asymmetry test and foot fault test were performed at 2 and 16 days after implantation. Final y, al of the devices were taken out to test if they were normal y working and al of the rats were sacrificed for hematoxylin-eosin staining, which can reflect the structure of peri-infarct cortex and cellmorphology.
RESULTS AND CONCLUSION:There was only one stimulator in CES group cannot normal y work, and the remaining 22 ones worked wel . The skin covered the implanted stimulator was slightly ulcerated in one rat, and the incisions of the other rats were healed wel . Hematoxylin-eosin staining showed clear and intact structure in peri-infarction cortex (i.e., electrodes were implanted at the cortex), neurons arranged in neat rows, with abundant neuronal cytoplasm and clear nucleolus. The glial cells have complete structures, and there was no edema in the intercellular spaces. Foot-fault and forelimb use asymmetry tests showed the improved neurological function in rats of CES group than that of NS group. We designed a ful-implanted cortical electrical stimulator used in cerebral ischemic rats, and established an implanted method with long time, low intensity and various frequencies pulsed electrical stimulation. The results indicated the stimulation pattern in our study is safe and effective, and it can significantly promote functional recovery in local cerebral infarction rats.

Objective To investigate the rehabilitation role of family-community-hospital rehabilitation management for communityschizophrenics. Methods 110 schizophrenic patients were divided into the control group (n=60) and the training group (n=50). The controlgroup were followed up once a month, while the training group participated in the family-community-hospital rehabilitation care. They wereassessed with Social Disability Screening Schedule (SDSS), General Well-Being Schedule (GWB), Self-Esteem Scale (SES) before and afterthe treatment, as well as the compliance and management of medcine questionnaire. Results No significant difference was found betweenthese groups with SDSS, happiness, self-esteem, compliance and management of medcine before the training(P>0.05), but were significantlyhigher in the training group(P<0.01). Conclusion Family-community-hospital rehabilitation management can significantly improvethe social function, the happiness, the self-esteem, the medication compliance and self-management of schizophrenia patients.

OBJECTIVE To analyze the risk factors and the drug-resistance of nosocomial acquired lung infection by Chryseobacterium meningosepticum.METHODS A retrospective investigation of the clinical correlative data and the drug sensitivity results of 60 cases with nosocomial acquired lung infection by C.meningosepticum from Jan 2004 to Jan 2006 was conducted in local hospital.RESULTS The patients were mainly distributed at ICU,respiration and neurosurgery wards.They had severe underlying diseases(100.0%),tracheal intubation(56.7%),central venous catheter(25.0%) and urine catheter(16.7%) treatments and applications of more than three antibiotics(68.3%).The drug-resistance of C.meningosepticum was serious.The antibiotic drugs which had higher susceptibility ratio were cefoperazone/sulbactam,fluoroquinolones,et al.CONCLUSIONS The main risk factors of nosocomial acquired lung infection by C.meningosepticum are severe underlying diseases,various invasive treatments,long-term hospitalization and inappropriate use of broad spectrum antibiotics.Clinical isolates are multi-drug resistant to many kinds of antibiotics.

Objective To explore the clinical accuracy of urine cellular components of RBC,WBC,etc.detected by the Urit-1500 urine analyzer.Methods 1 085 urine samples in this hospital from June to October 2013 were selected and detected by the Urit-1500 urine analyzer and the microscope detection respectively.The results of urine cellular components detected by the urine analy-zer were analyzed.Results In 1 085 urine samples,the coincidence rate of two detection methods in detecting RBC and WBC was 93.8%(1 018/1 085)and 94.0%(1 020/1 085)respectively.In 295 RBC positive urine samples tested by the urine analyzer,the number of negative results tested by microscopy was 49,accounting for 16.6%.In 790 RBC negative urine samples tested by the u-rine analyzer,the number of negative results tested by microscopy was 18,accounting for 2.3%.In 197 WBC positive urine samples tested by urine analyzer,the number of negative results tested by microscopy was 28,accounting for 14.2%.In 888 WBC negative urine samples by urine analyzer,the number of negative results tested by microscopy was 37,accounting for 4.2%.Conclusion De-tecting urine RBC and WBC by using the Urit-1500 urine analyzer should combined with the microscopy and other test indexes and even clinical data to conduct the comprehensive analysis for reducing the misdiagnosis and missed diagnosis as far as possible.

Objective To investigate the clinical and pathological characteristics of IgA nephropathy (IgAN) with macrohematuria (MH).Method 1512 consecutive patients with biopsyproven IgAN diagnosed from January 2006 to December 2011 were enrolled,and divided into MH group and control group respectively,according to whether there existed episodes of MH before renal biopsy.The clinical and pathological characteristics were compared between two groups.Patients in MH group were then divided into three groups according to the interval from the last episode of MH to renal biopsy to clarify the concomitant clinicopathological changes associated with occurrence of MH.Results The rate of MH in history was 22.1％.MH group patients had significantly lower serum creatinine,slighter proteinuria,lower prevalence of hypertension and heavier microhematuria than control group (all P ＜ 0.001).The prebiopsy durations were similar in two groups (P=0.627).In MH group,chronic pathological indicators,including global/segmental sclerosis,tubule atrophy/interstitial fibrosis were all slighter (all P＜ 0.001),whereas activity indicators,including necrosis lesions,crescents and mesangial proliferation were all more severe compared with control group (all P ＜ 0.05).Those who underwent renal biopsy within 30 days of the last episode of MH had more severe proteinuria and microhematuria,higher prevalence of necrosis lesions,more severe crescents formation,and endothelial proliferation (all P ＜ 0.05).Conclusions IgAN patients with MH in history have relatively milder clinical and chronic pathological manifestations,however more active pathological changes especially in those who suffer episode of MH recently.

Objective To investigate the clinical characteristics of hemodialysis (HD) patients complicated with arteriosclerosis obliterans (ASO) of lower extremity,and to discuss the factors that influence the curative prognosis of percutaneous transluminal angioplasty (PTA).Methods The clinical data of 211 patients with ASO of lower extremity receiving HD or not receiving HD,who were admitted to authors' hospital during the period from January 2008 to October 2015,were retrospectively analyzed.PTA was successfully accomplished in all patients.Results The median follow-up time was 2.24 years.Theamputation-free survival of HD group was significantly lower than that of non-HD group (P＜0.000 1),and the postoperative artery patency rate of HD group was also obviously lower than that of non-HD group (P＜0.000 4).The factors influencing the survival rate without amputation of the two groups were different.The independent influence factor in HD group was diabetes mellitus,while in non-HD group the independent influence factors were Fontaine stage and hyperlipidemia.The infection mortality of HD group was 55.5％ (10/18),which was higher than 22.2％(6/26) of non-HD group,the difference was statistically significant (P＜0.05).Conclusion In treating ASO of lower extremity,the curative effect of PTA is poorer in HD patients than in non-HD patients,and the presence of diabetes mellitus may be an independent factor influencing prognosis.