Objective To further develop SDE for structured documentation of clinical data based on medical ontology. Methods OpenSDE was customized for the broad domain of medical ontology: medical concepts and its descriptors from history taking and physical examination were modeled into a tree structure. Results An expandable EMR system with structured data entry was developed. Conclusion Structured data entry is significant to clinical decision based on EMR.

Objective To focus on the expressiveness and flexibility of OpenSDE: an application that supports recording of structured narrative data. Methods OpenSDE enabled data entry with (customizable) forms based on trees of medical concepts. The relevant scope for data entry could be tailored per medical domain by construction of a domain-specific tree. OpenSDE was intended for structuring narrative data to make these available for both care and research. Results The OpenSDE application was used at two departments in aspects of radiology, neurology, pediatrics, and child psychiatry. Conclusion OpenSDE is superior to traditional text entry method in aspects of correct and full expression and clinical decision support.

Objective:To observe the clinical efficacy of electroacupuncture in the treatment of type 2 diabetes mellitus combined with mild and moderate carpal tunnel syndrome.Methods:Eighty patients with type 2 diabetes mellitus combined with mild to moderate carpal tunnel syndrome were randomly divided into two groups with 40 patients in each group ( n=40). In the course of the treatment, 2 patients in each group dropped out, which means 38 patients in each group were included. All patients were instructed to actively control blood glucose The control group was given Mecobalamin tablets orally, while the treatment group was given electroacupuncture of Daling and Neiguan on the affected side based onthe control group for 6 weeks. The degree of pain was assessed by VAS, and the severity of clinical symptoms was assessed by the symptom scale of Boston carpal tunnel questionnaire (BCTQ). The sensory nerve conduction velocity (SCV), the amplitude of sensory nerve action potential (SNAP) and the distal motor latency (DML) were detected by EMG evoked potential instrument. The clinical efficacy was evaluated and adverse events were recorded. Results:The total effective rate was 81.6% (31/38) in the treatment group and 60.5% (23/38) in the control group, and the difference was statistically significant ( χ2=5.094, P=0.024). After the treatment, the scores of VAS and BCTQ in the treatment group were lower than those of the control group ( t=2.639, 2.790, P=0.010, 0.007); DML (3.62 ± 0.19 ms vs. 4.00 ± 0.17 ms, t=68.891) in the treatment group was lower than that of the control group ( P<0.01), while SCV (47.36 ± 0.18 m/s vs. 42.34 ± 0.14 m/s, t=97.163) and SNAP (14.74 ± 0.18 μV vs. 12.10 ± 0.16 μV, t=51.434) in the treatment group were higher than those of the control group ( P<0.01). During the treatment, no serious adverse events occurred in two groups. Conclusions:Electroacupuncture is safe and effective in the treatment of mild and moderate carpal tunnel syndrome with type 2 diabetes. It can reduce the degree of pain and improve the symptoms of wrist joint.

Objective To study risk factors with the occurrence of the mesh exposure after pelvic floor reconstruction.Methods From Mar.2007 to Mar.2011,a retrospective study was made on the clinical data of 353 patients undergoing vaginal mesh pelvic floor reconstruction.The related complications of the mesh were surveyed,and risk factors associated with the mesh's exposure were studied by single factor and multiple factors logistic regression.Results It was found that the exposure rate was 9.6％ (34/353) after 1 year postoperative follow-up.Single factor analysis showed that patients who were not less than 70 years old,patients who were on their menopause stage,the occurrence of not less than three parturition,history of pelvic surgery,diabetes and smoking had a significant correlation (all P ＜ 0.05) with the occurrence of the mesh exposure after pelvic floor reconstruction.Multiple factors logistic regression analysis showed that patients who were not less than 70 years of age (OR =2.389),the occurrence of not less than three parturition (OR =2.688),the history of diabetes (OR =3.545),the history of pelvic surgery (OR =5.385) were the independent risk factors,and the operation experience was the protection factors (OR =0.134).Conclusions Mesh exposure is a common complication after pelvic floor reconstruction.Old age,multiple delivery,history of diabetes and history of pelvic surgery are the risk factors of mesh exposure.Preoperative full assessment and the quality of training contribute to reduce the incidence.

Objective To explore the application ways of IHE XDS technology in electronic medical record (EMR) system and develop application system of clinical EMR integration. Methods The clinical EMR integration plan was worked out based on IHE XDS technical framework. Results A EMR solution based on IHE XDS was presented. It was consisted of the components of the clinical Data Entry, XDS Registry, clinical document Repository, EMR application server and the i-node accessing server. The system was tested and the result indicated that the system was effective and scalable. Conclusion IHE XDS profile can be not only used to realize the sharing of EMR documents across multiple hospital, but also support the collection clinical data within a hospital clinical system integration.

Objective To apply fluo-rescencc-activated cell sorting(FACS) in sorting T lymphocyte (CD_3~+) and granulocyte (CD_(15)~+), which establish the separating method of series of cells from human peripheral blood, so that the scientific research and clinical research could be carried out were specifically. Methods 10 cases of normal peripheral blood were collected and T lymphocyte (CD_3~+) and granulocyte (CD_(15)~+) were stained with florescence conjugated antibodies. The positive cells were sorted by FACS. Results Before sorting the peripheral blood, the proportion of the T lymphocyte(CD_3~+) and granulocyte (CD_(15)~+) in the leukocyte is 48.8 % and 30.8 %; after sorting by FACS, the purity of T lymphocytes (CD_3~+) is up to 98 % and the recovery is about 95 %; the purity of granulocyte (CD_(15)~+) is up to 97 % and the recovery is about 96 %. Conclusion The FACS could Mlow us to quickly sort T lymphocyte (CD_3~+) and granulocyte (CD_(15)~+) with higher recovery and higher purity from the peripheral blood.

Objective To explore the relationship between CD+4CDhigh25CDlow127 Treg level of peripheral blood and NHL.Methods The level of peripheral blood CD+4CDhigh25CDlow127 Treg of 123 newly diagnosed NHL and 41 healthy adults were test by flow cytometry.Results The average peripheral blood CD+4CDhigh25CDlow127 Treg level were 5.0 ％ (2.7 ％) and 7.2 ％(3.8 ％) in healthy adults and newly diagnosed NHL patients,respectively.The difference between the two groups was statistically significant(Z=-2.816 P=0.001 ).The peripheral blood Treg level was significantly higher in the male NHL patients than that in the female (7.4％ vs 6.1％,Z=- 2.729,P=0.006).The peripheral blood Treg level was significantly higher in elevated LDH patients than that in normal LDH patients(7.8％ vs 7.0％,Z=-2.623 P=0.008).The peripheral blood Treg level was significantly higher in stage Ⅲ-Ⅳ patients than that in stage Ⅰ -Ⅱ patients (7.3％ vs 5.9％,Z=-2.057 P=0.04). There was no significant relationship between peripheral blood Treg level and age, IPI score,extranodal involvement,performance status,bulky disease,pathologic subtype or B symptom (P ＞0.05).Conclusions NHL patients are in an immunosuppresive statue.Patients of male,with inreased LDH level or in stage Ⅲ-Ⅳ have higher peripheral blood CD+4CDhigh25CDlow127 Treg level.

Objective The effect of intermittent iron supplementation weekly and twice weekly was studied in children with iron deficiency anemia(IDA). Methods Subjects were 58 children who were randomly divided into two groups. One group received a dosage of 2mg/kg Fe every 3d for 9 weeks. The other group received the same dose Fe once a week for 12 weeks. Results Hemoglobin and serum ferritin increased significantly after treatment in both groups (P ＜0.05), and zinc protoporphyrin decreased significantly (P ＜0. 05). But serum ferritin of both groups was different after 6 weeks of treatment (P ＜0. 01). The side effect of the group supplemented once every 3d was higher than that of the group once a week, but there was no statistically significant difference. Conclusion Iron sup plementation every 3d has a similar effect to once a week for treatment of IDA. The former should be used for the se rious patients for 6 weeks. The later should be used for infants and the patients whose resistance of intestines and stomach are not good.

Objective:To investigate the clinicopathologic features of intraspinal ganglioneuroma.Meth-ods:We collected 1 2 cases of diagnosed ganlioneuroma arising from the spine and one case of ganlioneuro-ma arising from mediastinum as the control.Clinical and radiographic features were reviewed.The pathologi-cal parameters of these cases were analyzed with routine and immunohistochemical stainings of neural fiber (NF),S-100 protein(S-100),myelin based protein(MBP),peripheral myelin protein 22(PMP22),smooth mus-cle actin(SMA),glial fibrilary acidic protein(GFAP)and Ki-67.Results:The disease was likely to occur in pa-tients aged 30-40 years old and more common in female.These cases were all intral cervical spinal tumors and presented with radicular neuralgia and mass effects of cervical spinal cord compression.Ganglioneuro-mas which occasionally contained normal spindle shaped cells were composed of mature or degenarative ganglion cells and neoplastic Schwannian stroma.Ganglion cells appeared positive for NF.Schwannian stro-ma as well as satellite cells around ganglion showed immunoreactivity for S-100.more intense than neurofi-bro-stroma.Mature spindle shaped cells showed immumoreactivity for MBP.Ki-67 labeling indices were usual-ly 0-1%while in Schwannian stroma areas were 3%.No blood vessel endothelium proliferation was ob-served.Conclusion:Intraspinal ganglioneuromas are rare benign tumors(WHO grand I),causing radicular neuralgia.It is jmportant to distinguish ganglioneuroma with spinal root encircled from Schwannoma or neuro-fibroma in the same anatomic location.The optimal treatment is surgical total resection.

Aim To explore the hemodynamic change of elderly isolated hypertension(EISH). Methods Color doppler ultrasonography were applied to examine thirty EISH patients and twenty eight elderly healthy subjects. The left ventricular systolic function as well as hemodynamic parameters were measured. Results The indices of left ventricular systolic function in EISH group such as SV,CO,EF and CI were obviously higher than those of control group(P<0.05),Linear relevant analysis show that pulse pressure was remarkable related to SV,CO,EF and CI in EISH group,with r value 0.43,0.56,0.46,0.45 respectively.Conclusion EISH patients apparently had ventricular systolic dysfunction and hemodynamic abnormality. Pulse pressure may be associated with development of sysytolic dysfunction.