Through the review of the research on electronic health records at home and abroad,the author introduced the process of the construction of electronic health records at home and abroad.By comparing the reviews,we sumed up the characteristics of the construction of the electronic health records abroad,so as to provide references to our electronic health records and improvement suggestions for insufficient health records construction in China.

BACKGROUND:Studies have shown that human leukocyte antigen (HLA)-A*0206 subtype is related to the abscess of nasopharyngeal carcinoma, but there is no corresponding transgenic animal models that could used to judge the relationship between HLA-A*0206 and nasopharyngeal carcinoma on the overal level and further research of immunotherapy and gene therapy. OBJECTIVE:To construct lentiviral vectors carrying pLVX-CMV-HLA-A*0206-HA-mCMV-ZsGreen and establish HLA-A*0206 transgenic mice. METHODS:The HLA-A*0206 sequence was synthesized. EcoRI recognition site was introduced in the 5’ end by polymerase chain reaction, and influenza virus hemagglutinin labels and BamHI recognition site were introduced in the 3’ end. Eco RI and Bam HI double enzyme digestion target fragments and the pLVX-CMV-mCMV-ZsGreen plasmids were connected to the digested productions and transfected JM109 competent cel s. The positive clones were selected and identified by double enzyme digestion and sequencing. The positive plasmid and packaging plasmids were transfected into 293T cel s, which were human renal epithelial cel line that can express SV40 large T antigen. The lentivirus containing target sequence was produced. RESULTS AND CONCLUSION:Gel electrophoresis and sequencing results showed that, HLA-A*0206 was successful y inserted into pLVX-CMV-mCMV-ZsGreen frame plasmids. Transfection efficiency was 92%after 48 hours of transfecting 293T cel s. The viral suspension titer was 5 × 108 measured by fluorescence method. Experimental findings indicate that, the lentivirus containing cytomegalovirus promoter, HLA-A*0206, influenza virus hemagglutinin label and Zsgreen report gene was successful y constructed.

Objective To accurately determine the biological characteristics , especially the disease-related indexes of SPF rabbits , and their gender differences .Methods A total of thirty 70-80 day old SPF New Zealand rabbits (male :female=1:1) were fed for a week, and then we weighed the body weight and main organs , determined the blood physiological and biochemical indexes , blood gas and arterial pressure , and measured the ventricular pressure by thoracotomy under respiratory support .Results Comparison of the male and female SPF New Zealand rabbits showed that there were significant differences in the mass of thyroid , adrenal gland, and liver (P<0.05 or P<0.01); the brain, pituitary gland, thyroid gland organ coefficients ( P<0.05 or P<0.01); the thyroid/brain, adrenal/brain, and liver/brain ratios (P<0.05 or P<0.01);the mean erythrocyte volume and mean hemoglobin content (P<0.05 or P<0.01);and in glutamyl transpetidase and amylase ( P<0.05 or P<0.01 ) , but no significant differences in blood gas analysis ,heart rate and carotid artery systolic and diastolic blood pressure , left ventricular systolic and diastolic blood pressure , and right ventricular systolic and diastolic blood pressure .Conclusions The gender has an impact on organ weight and blood physiological and biochemical indexes in New Zealand rabbits , but no significant influence on blood gas , blood pressure , heart rate and ventricular pressure in the rabbits .

OBJECTIVE:To evaluate the cost-effectiveness of3kinds of traditional Chinese medicinal injectable prepa?rations in the treatment of children's fever caused by exogenous pathogens METHODS:44cases were assigned to receive Qin_ gkailing injection(Group A),Shuanghuanglian for injection(Group B)and heartleaf houttuynia herb injection(Group C),re?spectively.The curative effects of the3groups were observed and the cost-effectiveness analysis were conducted as well.RESULTS:The costs for the3groups were28.68yuan,45.00yuan and59.40yuan,respectively;the total effective rates were80.00%,86.67%and85.71%,respectively;the cost-effectiveness ratios of the3were35.85,51.92and69.30,re?spectively;the incremental cost-effectiveness ratios of Group B and C were244.68and538.00,respectively as compared with Group A.CONCLUSION:Qingkailing injection(Group A)is the preferred option in the treatment of children's fever caused by exogenous pathogens.

Objective:To evaluate the accuracy of serum concentration of procalcitonin (PCT) in differential diagnosis of the etiology of bloodstream infections (BSI).Methods:Patients hospitalized in ICU of China-Japan Friendship Hospital from January 2015 to June 2020 with BSI and with PCT test simultaneously when blood drawing for blood culture were enrolled. Sequential Organ Failure Assessment (SOFA) were calculated based on parameters on the day of blood culture. Difference of various indicators among different pathogen infections were compared. Receiver Operating Characteristic (ROC) Curve was used to analyze the value of PCT in differential diagnosis of BSI by different pathogens.Results:Among 1 456 patients with BSI,1 261 (86.6%) patients with monobacterial infection, 80 (5.5%) patients with candidiasis and 115 (7.9%) patients with mixed infection. The 28-day mortality was 24.5% (356/1 456) and the 60-day mortality was 30.6% (446/1456). Mortality of both 28-day and 60-day in the mixed group was significantly higher than that in the bacteriacemia group and candidemia group. PCT levels was significantly higher in patients with bacteremia caused by gram-negative bacteria (GNB) than that in gram-positive bacteria (GPB) infected bacteremia and candidemia {3.4 μg/L[95% confidence interval (95% CI) 0.7-17.0 μg/L] vs 1.3 μg/L (95% CI 0.4-7.3 μg/L); 3.4μg/L (95% CI was 0.7-17.0 μg/L) vs 1.1 μg/L (95% CI was 0.4-3.4 μg/L); P<0.01} . ROC curve analysis showed that: ① the optimal cut-off value of PCT in differential diagnosis of monobacterial bacteremia and candidemia was 7.25 μg/L, with specificity of 90.0% and the area under the ROC curve (AUROC) was 0.612 (95% CI 0.533-0.691). When PCT value was greater than 0.51 μg/L, the sensitivity of diagnostic of bacteremia could reach 73.3%. ② the optimal cut-off value of PCT in differential diagnosis of bacteremia caused by GNB infection and candidemia was 7.32 μg/L, with specificity of 90.0% and AUROC was 0.695 (95% CI 0.614-0.776). When PCT value was greater than 0.51 μg/L, the sensitivity of diagnostic of bacteremia caused by GNB infection was 84.9%.③ the optimal cut-off value of PCT in differential diagnosis of bacteremia caused by GNB and GPB infection was 0.52 μg/L, with sensitivity of 84.9% and AUROC was 0.713 (95% CI 0.672-0.755). When PCT value was greater than 7.36 μg/L, the specificity of diagnostic of bacteremia caused by GNB infection could reach 80.1%. Conclusions:PCT can provide additional information about the possible etiology of patients with BSI, especially as high levels often indicate the possibility of GNB bacteremia.

Objective To evaluate the effect of calcitriol combined with losartan on diabetic nephropathy in grade Ⅲ and early Ⅳ.Methods 47 patients with diabetic nephropathy were enrolled.Patients were randomly assigned to receive losartan or both losartan and calcitriol according to randomized table for 6 months.At baseline time and after 6 months,the 24-hour urinary protein excretion,estimated glomerular filtration rate (eGFR),serum creatinine(SCr),blood pressure,fasting blood-glucose,serum calcium,serum phosphorus,pulse wave velocity(PWV) and ankle brachial index(ABI) were measured.Results The urinary protein excretion showed that there was significant decrease in the mix-treated group[(824.81 ± 307.84) g/24h vs (390.75 ± 173.51) g/24h,t =10.51,P ＜ 0.01] and the control group [(860.64 ± 313.89) g/24h vs (676.16 ± 297.71)g/24h,t =6.91,P ＜ 0.01].Furthermore,the mix-treated group had the lower proteinuria compared the group given losartan only(t =2.56,P =0.015).No significant differences were observed decrease in estimated eGFR and change in serum calcium,serum phosphorus,PWV and ABI between the two groups.Conclusion Addition of calcitriol to a renin-angiotensin system inhibitor resulted in a safe decrease in proteinuria in patients with diabetic nephropathy.

Objective To explore the distribution and drug resistance of pathogen in hospitalized tumor patients and to provide reference for the clinical reasonable use of antibiotics and strengthening the hospital infection control. Methods 6 500 clinical speciments were tested in hospitalized tumor patients from January to December,2013.The drug susceptibilities were tested by automated microbiology system or Kirby-Bauer disk dilution method.Drug susceptibility tests were evaluated according to CLSI standard 2012.WHONET5.6 software data were used to analyze the data.The clinical distribution and the resistance results of bacterial were analyzed retrospectively. Results A total of 2 093 strains of pathogens were isolated from 6 500 clinical speciments,among these strains, the gram-negative bacteria accounted for 55.23%,the gram-positive bacteria accounted for 11.08%,and the fungi accounted for 33.68%.Klebsiella pneumoniae,Escherichia coli,Pseudomonas aeruginosa ranked the top three species of pathogens, accounting for 16.63%, 9.60%, and 7.98%, respectively. Staphylococcus aureus, Candidaalbicans ranked the first place of gram-positive bacteria and fungi,respectively.The antibiotic resistance of Escherichia coli was strong in Enterobacteriaceae, and its resistance rates to penicillins,cephalosporins, and quinolones were more than 60%.Of the Staphylococcus,the methicillin-resistant Staphylococcus aureus(MRSA) accounted for 10.00% and the coagulase-negative Staphylococcus (MRCNS)accounted for 87.10%.There was no vancomycin resistant Staphylococcus aureus and coagulase-negative Staphylococcus detected. Enterobacteriaceae strains were found most sensitive to imipenem;gram-positive bacteria were found most sensitive to vancomycin. Conclusion The hospitalized tumor patients are susceptible to pathogens, and the gram-negative bacteria are the predominant isolated pathogen.Etiology inspection and monitoring of antibiotics sensitivity provide experimental basis for clinical infection control and prevention.

AIM:To explore a method of isolation,purification,culture and identification of human microglia.METHODS:The brain tissue from abortive fetus was sterilely obtained,then chopped and triturated gently.The suspension was filtered and centrifuged to separate and isolate mixed glia cells.The cell density was adjusted to 2?1010 cells/L with DMEM/F12 complete medium and cultured in 75 cm2 flask at 37 ℃ in CO2 incubator(marked as first 0 d).After 7-10 days culture,floating cells including microglia and oligodendrocytes appeared in the flask.The first time purification was carried out to obtain highly purified microglia,for which the flasks were shaken gently.The floating cells were collected and transferred into a new flask(marked as second 0 d).4-5 days later,when microglia and oligodendrocytes grew in confluent state,the second purification was performed,for which the mixed cultured cells were digested with trypsin-EDTA and cell suspension was centrifuged,then the cell pellet was suspended by DMEM/F12 complete medium and cultured in flask(marked as 0 h).After 2 h,non-microglial cells including oligodendrocytes and cell debris were removed,and fresh medium was added into the adherent cells.In this way,the whole procedure of microglia purification was completed and the highly purified microglial cells were obtained.After purification,the expression rate of CD45,CD11b and CD68 on/in microglia were detected by laser-confocal microscopy and flow cytometry on the basis of immuno-fluorescence staining to identify the purity of microglial cells.Microglial phagocytotic function was evaluated by phagocytosis of fluorescent microspheres.The level of activation was identified by the phenomena of membrane ruffling in combination with fluorescent phalloidin staining.RESULTS:More than 98% of the microglias that we isolated and purified expressed CD45,CD11b and CD68.Almost all of the microglias could phagocytize fluorescent microbeads CONCLUSION:We succeed in isolating and purifying human microglias,which express CD45,CD11b and CD68.Almost all of the cells exhibit phagocytic function.So these cells will be useful for further functional and proteomic studies.

Objective To investigate the radioprotective function and its mechanism of Sulforaphane (SF) in mice acute radiation-induced lung injury.Methods Totally 40 female C57BL/6J mice were equally divided into 5 groups randomly.Group A,treated by SF 3 mg/kg plus radiation;group B,treated by SF 5 mg/kg plus radiation;group C,treated by SF 10 mg/kg plus radiation;radiation group with a single dose of 12 Gy in 6 MV X-ray by a linear accelerator,and control group with sham radiation.The mice in drug group were administered intraperitoneally with different concentration of SF every other day from 7 d before irradiation to 7 d after irradiation,while the same volume of DMSO plus physiological saline solvent was given in the control and radiation groups.After being sacrificed at 14 d of SF administration,the pathomorphological changes of mice were observed in trauma lung tissue,the positioning and expression of NLRP3 was observed by immunohistochemical staining,the levels of IL-6,TNF-α and TGF-β1 in bronchoalveolar lavage fluid (BALF) were measured by ELISA,the expressions of NLRP3 and IL-1β mRNA in lung tissue were assayed by qRT-PCR,the expressions of NF-κB p65,NLRP3 and IL-1β proteins in lung tissue were assayed by Western blot,the activity of NF-κB was detected by EMSA.Results In comparison with radiation group,there was an obvious amelioration in pathological injury of lung tissue in the treatment groups:the expression of NLRP3 in lung tissue decreased;the concentration of NLRP3 in the drug intervention group (SF 10 mg / kg) markedly decreased (F =42.750,P ＜ 0.05).the IL-6,TNF-a and TGF-β1 levels in BALF decreased (tIL-6 =-62.65-21.00;tTNF-α =-32.18-16.57;tTGF-β1 =-58.22-46.11,P ＜ 0.05);the expressions of NLRP3 and IL-1β mRNA markedly decreased (tNLRP3 =-6.56-5.68;tIL-1β =-29.75--21.20,P ＜ 0.05),and the expressions of NF-κB p65,NLRP3 and IL-1β proteins decreased (tNF-κB p65 =-34.00--1.71,tNLRP3 =-25.01--16.91,tIL-1β =-73.70--55.14,P ＜ 0.05);the relative expressions of NF-κB p65 and NLRP3 were reduced in a dose-dependent manner (r =0.945,0.926);and the activity of NF-κB were obviously reduced (tNF-κB =-38.68,-614.82,-2 831.40,P ＜ 0.05).Conclusions Sulforaphane effectively alleviates the RILI in lung of mice by downregulating the expressions of inflammatory factor NLRP3.

Objective To explore whether the antagonistic effect of decorin (DCN)on progression of glomeruloselerosis is associated with the inhibition of the expression of type I and type II transforming growth factor-? receptors (TGF-?R I and TGF-?R II )in mesangial cells (MsC). Methods RT-RCR and Western blot analysis were used to detect the expression of TGF-?R I and TGF-?R II mRNA and their proteins on cultured rat MsC stimulated by exogenous TGF-?1. Lipofectin-mediated method was used to transfect DCN vector into MsC. After screening and identifying of transfected MsC, RT-PCR and Western blot analysis were adapted to detect the changes of TGF-?R I and TGF-?R II expression respectively. Results The expression of TGF-?R I and TGF-?R II mRNA and their proteins on normal MsC stimulated by exogenous TGF-?1 increased in time-dependent manner and reached the peak at 24th hour. Compared with normal and untransfected MsC (1P-1), the mRNA and protein expression of TGF-?R I and TGF-?R II on MsC (3D-5, 7D-1) transfecled by DCN gene decreased significantly, and DCN gene transfection could antagonize the increase of mRNA and protein expression of both receptors caused by exogenous TGF-?1. Conclusions The expression of both TGF-?R I and TGF-?R II decreases obviously in MsC overexpressing DCN gene, which may be one of the importan antagonistic mechanisms of decorin involved in the development of glomeruloselerosis mediated by TGF-?.