Information processing for intelligent diagnosis of traditional Chinese medicine (TCM), an important part of the modernization of Chinese medicine, attracts world wide attention from the science circle. This article presents a systematic introduction to the development of information technology, especially the processing of pulse and tongue images and systems of computer-aided Chinese medical diagnosis. Furthermore, it points out four essential areas of future research, including epistemic logic system of syndrome differentiation, system construction technology, data miming technology and information acquisition and analysis in TCM diagnosis.

Objective To realize objectification and detailed quantification of palpation.Metbods A kind of automatic palpation device was developed to meet the needs of safeand easy operation,technique simulation,and multi-parameter monitoring in real time.Results This device mainly consisted of programmable controller and its analog-to-digital converter module,mechanical positioning device,pressing device,force testing device and hand-held touch screen,and it was designed to be operated by attenders independently.The device could collect multiple data including force,time and distance in the process of palpation,and monitor the force thresholds of pressing responses at all levels to achieve desired effects.Conclusion This device can be used in the automatic palpation for suitable body areas,especially in the comprehensive observation of acupoint-pressing responses or soft tissue tenderness.

Neural stem cell (NSC) has self-renewal and differentiation potential.It can orderly differentiate into neurons,astrocytes and oligodendrocytes in the development of central nervous system.NSC differentiation was commonly regulated by a variety of factors,including cytokines,transcription factors and epigenetic factors.Epigenetic regulation is a heritable gene expression without changing the DNA sequence.Histone modification is an important regulation mode in epigenetic modifications,which is essential in the transcription process.It also plays a critical role in the development of central nervous system.This article briefly reviews the histone methylation and demethylafion in the regulation of NSC differentiation.

Objective To explore the mechanisms of quinolones resistance in Acinetobacter baumannii and homology analysis a-mong the strains .Methods 25 strains of quinolones-resistant Acinetobacter baumannii isolated clinically were collected .Kirby-Bauer(K-B) detection was utilized to detect the sensitivity of conventional drugs ,and polymerase chain reaction (PCR) was em-ployed to detect quinolone resistance-related genes gyrA and parC which were verified by restriction enzyme digestion and sequen-cing ,repetitive extragenic palindrome(REP)-PCR was adopted to analyze the strain homology .Results Multiple resistances to 12 kinds of antibacterial agents were found among the 25 strains of Acinetobacter baumannii which were sensitive only to minocycline and amikacin ,with sensitive rates were 48 .0% and 32 .0% ,respectively ,and were all sensitive to polymyxin B [minimal inhibitory concentration(MIC)≤2 μg/mL] .gyrA and parC genes were found in the all strain .Mutation TCA→TTA(Ser→Leu) at coden 83 in gyrA gene existed in 25 strains ,mutation TCG→TTG(Ser→Leu) at coden 80 in parC gene existed in 23 strains ,mutation GAA→GGA(Glu→Gly) at coden 84 in parC gene existed in 2 strains .REP-PCR showed that the strains had high degree of homology . Conclusion Quinolone-resistant Acinetobacter baumannii has high degree of homology ,existing gyrA and parC gene mutations .

Objective:To compare the clinical outcomes between pedicle screw internal fixation via the Wiltse approach and conservative treatment in young patients with thoracolumbar fracture with Thoracolumbar Injury Classification and Severity score (TLICS) ≤ 4 points.Methods:This retrospective study included 219 young patients with thoracolumbar fracture with TLICS score ≤ 4 points who had been treated from January 2014 to December 2018 at Department of Orthopaedics, The Second Hospital of Shanxi Medical University and obtained full follow-up. They were assigned into a surgery group of 126 patients subjected to pedicle screw internal fixation via the Wiltse approach and a conservative group of 93 patients subjected to conservative treatment. The surgery group included 65 males and 61 females, aged from 18 to 37 years, with a TLICS score of 1 point in 38 cases and of 2 to 4 points in 88 ones; the conservative group included 48 males and 45 females, aged from 19 to 38 years, with a TLICS score of 1 point in 29 cases and of 2 to 4 points in 64 ones. Patients in both groups underwent thoracolumbar X-ray, CT and MRI before treatment and regular thoracolumbar X-ray reexamination after treatment. Improvements in visual analog scale (VAS) for low back pain were compared between pre- and post-treatment. The 2 groups were compared in terms of VAS, anterior height of the injured vertebra and kyphosis cobb angle between pre-treatment, one month post-treatment and the last follow-up.Results:The 2 groups were comparable due to insignificant differences between them in the pre-treatment general data ( P>0.05). In the surgery group, patients were followed up for 24 to 72 months, the average VAS scores at one month post-treatment (2.5±1.2) and the last follow-up (2.3±0.8) were significantly improved compared to the pre-treatment value (6.8±2.1) ( P<0.05), and no serious surgical complications occurred. In the conservative group, patients were followed up for 30 to 65 months, the average VAS scores at one month post-treatment (3.9±1.9) and the last follow-up (3.5±0.9) were significantly improved compared to the pre-treatment value (6.2±2.0) ( P<0.05), and the rate of complications was 11.8% (11/93, including 3 cases of neural symptoms of the lower limb, 4 cases of bedsore and 4 cases of pulmonary infection). The VAS, anterior height of the injured vertebra and kyphosis cobb angle at one month post-treatment and the last follow-up in the surgery group were all significantly better than in the conservative group ( P<0.05). Conclusion:In young patients with thoracolumbar fracture with TLICS ≤ 4 points, pedicle screw internal fixation via the Wiltse approach can lead to better therapeutic outcomes than conservative treatment, especially in relief of postoperative low back pain.

Objective To evaluate the theoretical knowledge level of Chinese nursing students based on the problem-based learning(PBL)versus traditional teaching methods. Methods Databases including CNKI (1979-2013.03),VIP (1989-2013.03)and Wanfang (1982-2013.03)were searched (up to March,2013)for controlled studies comparing PBL and traditional teaching methods. The quality of included studies was critically evaluated and the data were analyzed by Stata 10.0 software. Results A total of 659 articles were retrieved but only 22 were included. Meta-analyses showed that there were significant differences between PBL and traditional teaching methods in improving theoreti-cal knowledge of nursing students(SMD merge=0.79,95%CI(0.55,1.03),P=0.000). Conclusions PBL can improve the theoretical scores of Chinese nursing students. However,the above conclusion needs to be confirmed by more large-scale randomized controlled trials of higher quality due to the limitation of studies include in this paper.

Objective To explore the application and value of three-dimensional reconstruction technology in diagnosis and surgical therapy of ground-glass opacity.Methods We analyzed 188 cases with GGO during October 2012 and October 2014 in Shanghai First People’s Hospital affiliated to Shanghai Jiao tong University School of Medicine respectively.Several relative parameters based on three-dimensional reconstruction were selected to differentiate GGO pathology .By ROC curve anal-ysis, optimal cut-off points were determined.Volume-doubling time(VDT) was calculated among 104 cases which had been following up at least for three months and compared among AAH, MIA and IAC.Results Cases’ mean age was 56.66 ± 9.673years(ranged from 27 to 82 years) with 67 males and 121 females.The diameter(P<0.001), total volume(TV)(P<0.001), the maximum CT attenuation(MAX)(P<0.001) and standard deviation of distribution of CT attenuation within the whole GGO(STD)(P=0.015) of malignant group were significant larger than those of benign ones except for average CT at-tenuation(AVG)(P=0.094).The AUC were just 0.64-0.80 when differentiated benign group from AIS, benign group from MIA and AAH from MIA in comparison to 0.70-0.95 when it comes to differentiating benign group and AAH from IAC .Ad-ditionally, the optimal cut-off points were 13.5-15.5 mm in diameter, 400-600 mm3 in TV, -110 -20 Hu in MAX and 120-160 in STD.The mean VDT was 865.00 ±111.33, 464.67 ±44.40 and 238.36 ±76.71 for AAH, MIA and IAC re-spectively(AAH/MIA P<0.001, MIA/IAC P=0.003).Conclusion The diameter, TV, MAX and STD of GGO based on three-dimensional reconstruction could discriminate GGO availably .Combined utilization of HRCT and three-dimensional re-construction has a valuable significance in diagnosis and treatment of GGO .

Objective To explore the clinical effect and safety of high frequency oscillatory ventilation (HFOV) combined thoracic close drainage for the treatment of mechanical ventilated neonates with pneumothorax.Methods Twenty-two neonates were enrolled in this study,who needed mechanical ventilation diagnosed with neonatal pneumothorax and received treatment of HFOV combined thoracic close drainage from Jan.2012 and Jun.2014 in the People's Hospital of Dongguan.We recorded blood gas analysis and parameters of breathing machine before using HFOV and 2,12,24,48 hours after using HFOV respectively.Results There were significant differences between HFOV before use (0) and 2,12,24,48 hours after using HFOV in terms of blood pH value,arterial partial pressure of oxygen(PaO2),partial pressure of arterial carbon dioxide (PaCO2),oxygenation index (OI),the inspired oxygen concentration (FiO2),mean airway pressure (MAP) (F =6.606,17.760,8.387,17.242,25.185; P ＜ 0.05).Compared with before using HFOV combined thoracic close drainage,PaO2 was significantly increased from (51.25 ± 13.16) mmHg to (62.60 ± 15.95) mmHg.PaCO2 was significantly dropped from (63.57 ± 13.81) mmHg to (54.02 ± 11.58) mmHg and OI was dropped sharply from (16.57 ± 9.09) to (11.28 ± 4.67) at 2 hours after using HFOV combined thoracic close drainage (P ＜ 0.05).FiO2 significantly decreased from (0.76 ± 0.15) to (0.60 ± 0.13),as well as MAP from (9.91 ± 1.44) cm H2 Oto (8.50 ± 1.68) cm H2O.Furthermore,pH was significantly improved from (7.24 ± 0.15) to (7.34 ±0.10) at 12 hours later(P ＜0.05).PH,PaO2,PaCO2 were roughly back to normal at 48 hours after treatment.The main complications were intraventricular hemorrhage (2 cases),subarachnoid hemorrhage (2 cases),ventilator associated pneumonia (1 case) and pulmonary hemorrhage (1 case) (not during the time of HFOV treatment).Conclusion HFOV combined thoracic close drainage for the treatment of neonates with pneumothorax is safety and effective methods.

3.0 cm in diameters.Contrast-enhancement CT showed tumors with abundant blood vessel,1 case appeared as uniform enhancement and was difficult to distinguish between tumor body and internal carotid and external carotid because of the iso-density of them.On MRI,the flow void blood vessels inside the tumors could be identified and internal carotid and external carotid separated.MRA displayed all the relation between the tumors and carotid and its branches.DSA could demonstrate the supply arteries of the tumors.Conclusion Ultrasonics,CT,MRI and DSA have own definitely characteristic value in diagnosing carotid body tumor.

Objective To evaluate the value of diffusion-weighted MRI in the functional study of kidney.Methods Fifteen volunteers as control group and 32 patients with chronic kidney disease(CKD) were underwent DW MR imaging in a dehydrated state.In CKD group,12 cases were with normal serum creatinine(Scr) level(CKD group 1) and 20 cases with Scr increased in different level(CKD group 2).Apparent Diffusion Coefficient(ADC) value of each kidney of all groups was measured and compared of their relationships with clinical data.Results The ADC values of 15 volunteers in different b values(50,100,400) were(405.366?35.9639)?10~(-5)mm~2/s,(339.646?23.0594)?10~(-5)mm~2/s,and(254.532?13.6763)?10~(-5)mm~2/s,respectively.The ADC values of CKD group 1 were(336.622?12.879)?10~(5)mm~2/s,(308.142?20.998)?10~(-5)mm~2/s,and(211.398?14.604)?10~(-5)mm~2/s,respectively.And of CKD group 2 were(307.717?84.930)?10~(-5)mm~2/s,(265.415?57.754)?10~(-5)mm~2/s,and(201.672?26.411)?10~(-5)mm~2/s,respectively.The ADC values in CKD group were lower than those of the normal kidneys(t values compared between the control group and CKD group 1 were 9.720,5.190,11.093 separately,between the control group and CKD goup 2 were 6.533,7.382,10.864 separately in different b values,with all P values less than 0.05).In CKD group 2,it had been showed negtive correlation between the level of Scr and ADC values of kidney,with mean level of Scr of(828.490?699.350) ?mol/L,but this was confirmed of no statistical meanings(the coefficient correlation were(-0.272、)-0.283、-0.023 separately in different b values,with p values more than 0.05).For the creatinine clearance rate(Ccr),it showed a weak positive correlation with ADC values of CKD group 2(the coefficient correlation were 0.511、0.430、0.335 separately,with P values less than 0.05).Conclusion(Diffusion-weighted) MRI imaging and in vivo measurement of ADC values have the potential for use as a noninvasive means to explore the functional status of the kidney.