Traditional theories on information management have made an extreme of studies and practice on medical informatics, which has hampered the development of medical informatics. Knowledge management is a brand new theory based on information and aiming at innovation of knowledge, and is in accordance with the nature of medical informatics. Medical informatics based on knowledge management promotes management of medical information, which not only benefits the integration and development of disciplines of medical informatics, also benefits hospital informatization, implementation of evidence-based medicine, and education in medical informatics. Basic studies on medical informatics, personnel training and management should be guided by knowledge management theory in the field of informatics.

Objective To observe the efficacy and safety of fluticasone propionate ointment in the treatment of psoriasis vulgaris. Methods A randomized comparative clinical observation was performed in 68 patients with pso-riasis vulgaris, they were divided into experimental group and control group. The experimental group of 34 cases was treated with fluticasone propionate ointment and the control group of 34 cases with kenacort-A ointment. The response was evaluated at 6 weeks. Results The total effective rate of the experimental group was 94.1% and 70.6% in the control group after 6 weeks. There was a significant difference between the two groups in treatment effective rate(P<0.01). Conclusion It is effective and safety for fluticasone propionate ointment in the treatment of psoriasis vulgar-is.

Animals ; Carcinoma, Non-Small-Cell Lung ; genetics ; metabolism ; Humans ; Lung Neoplasms ; genetics ; metabolism ; Molecular Imaging ; Mutation ; Positron-Emission Tomography ; RNA, Messenger ; metabolism ; Receptor, Epidermal Growth Factor ; biosynthesis ; genetics

砄bjective: To study the cause,clinical characteristics and treatment of zygomatic complex fractres(ZCF). Methods: Medical records of 79 cases with ZCF and followed up for 3 months to 2 years were reviwed and analysed. Reduction and cosmatic outcome were assessed by clinical evaluation and postoperative images. Results: Of the 79 patients, 87.3% were male, with the peak incidence in the age group from 20 to 40 years old(73.5%). 58.2% were due to traffic accidents, 15.2% to assalts. Incidence of malar asymmetry, enophthalmos, diplopia,limited mandiblar movement and malocclusion were 83.5%,24.1%,19.0%, 60.8% and 35.4% respectively. Of the nerve disturbances, 41.8% of the infraorbital and 13.9% of the facial nerve were involved. For the treatment the most freqently used approach was the coronal incision in combination with the maxillary vestibular incision(30.4%), followed by coronal incision alone(22.8%). 40.5% of the patients were treated by rigid internal fixation with titanium miniplates alone or combined with wire fixition(20.3%). All patients but five regained satisfactary facial appearance. Three patients still showed slightly post surgical enophthalmos and diplopia at a 6 month follow up. All of the patients with malocclusion regained their functional occlusion after treatment. Conclsions:A variety of techniques can be used in the treatment of ZCF. Among them the coronal incision in combination with other incisions or alone and rigid internal fixation can produce a satisfactary outcome.

OBJECTIVE: To investigate the Polygonum capitatum's influences on the related indicators in db/db mice which is the obesity model of type 2 diabetes mellitus. METHODS: Randomly dividing the mice into 5 groups: model group, rosiglitazone hydrochloride group, low-, moderate-and high-dose groups of Polygonum capitatum (5,10,20 g·kg-1), make the db/m mice as blank control. Give the medicine for four weeks. The body weight, blood sugar were determined every week. At the end of fourth week, measuring the glucose tolerance and INS, IL-6 in serum. After all the mice were killed, testing the cholesterol and triglyceride in liver and skeletal muscle and then collecting the liver tissue for HE staining. At the meantime, the expression level of AMPK and GLUT4 in liver were detected by Q-PCR. RESULTS: Polygonum capitatum can improve the body weight, blood sugar and glucose tolerance of db/db mice as well as the content of INS and IL-6 in serum, but increase the content of SOD and decrease the content of MDA in mice, furthermore, the cholesterol and triglyceride levels in the liver and skeletal muscle were also declined. HE staining showed that Polygonum capitatum could reduce the number of vacuoles in the liver of db/db mice, and make its shape more complete and ordered. What's more, raising the expression of AMPK and GLUT4 in the liver. CONCLUSION: Polygonum capitatum can improve the condition of insulin resistance state, alleviate inflammation and advance the ability of db/db mice, which can also reduce the number of vacuoles in liver, and relieve the tissue lipid metabolic disorder. Meanwhile, Polygonum capitatum can promote the uptake of glucose in liver tissues, which is resulted from upregulation of expression in hepatic AMPK and GLUT4 gene.

Objective To evaluate the effects of combined induction therapy of interferon(IFN) and chemotherapy on survival of the patients with small cell lung cancer(SCLC)by meta-analysis.Methods Search all of clinical trials for addition of IFN to initial chemotherapy and single chemotherapy for induction therapy in SCLC patients in MEDLINE、EMBASE and COCHRANE Library.The references of related studies and education books of ASCO and ESMO meeting were handsearched.The quality of included trials was evaluated.Data were extracted by two reviewers independently with a designed extraction form.Revman 4.2.7 software was used for data analysis.Results The addition of IFN increased 1-year survival and response rate,but both of the results had no significant statistical difference.Conclusion IFN-chemotherapy induction treatment might not influence survival and response rate of patients with NSCLC.To resolve the problem,a series of controlled,prospective,randomized,double-blind,well-designed,multi-center trials should be performed.

Serum levels of testosterone (T), free testosterone (T_f), dehydroepiandrosterone sulfate, estradiol and sex hormone binding globulin were measured in patients with pregnancy-induced hypertension syndrome (PIH). Results showed that the levels of T and T_f and mean arterial pressure were significantly higher in the PIH group than those in the control group (all P

Objective: The aim of this study is to review the experience of using bidirectional Glenn shunt without cardiopulmonary bypass(CPB). Methods: Fifty-eight patients underwent bidirectional Glenn shunt without CPB between May, 2000 and September, 2001. The age was (3.65?1.59) years and the weight was (13.6?4.0) kg. The procedure consists of establishing temporary bypass with cannulae placed in the SVC and right auricular appendage for venous drainage and transection of right SVC. The cardiac end of the SVC is overseen. The cranial end is anastomosed to a longitudinal incision in the superior margin of the right pulmonary artery with absorbable running suture. The anterior wall of the anastomosis is widened with pericardium patch. Results: There was no operative mortality. Five cases had postoperative complications including coma in 1 and chylothorax in 4. The mean SVC crossclamp time was (48?15) mins. The preoperative oxygen saturation and CVP were 0.75?0.09 and (12.8?2.3) mmHg, respectively. While the postoperative oxygen saturation and CVP were 0.93?0.05 and (16.5?2.9) mmHg, respectively. The drainage was (145?103)ml. The average mechanical ventilation time was (13?7) hrs. The mean postoperative hospital stay was (10?5) days. Conclusion: Bidirectional Glenn shunt without CPB is a safe and reliable method, for complicated congenital heart diseases children with inadequate pulmonary blood flow when anatomic and primary physiological correction are not suitable.

Objective: To evaluate the effect of perfusion of pulmonary artery using hypothermic protective solution on the inflammatory response of lung during cardiopulmonary bypass. Methods: 40 children with TOF were divided into control group (n=20) and protective group (n=20). The basic parameters (age, weight, C/T ratio, oxygen saturate) were not different between both groups. In control group, the operation was performed using routine approaches. While in protective group pulmonary artery were infused with 4℃ protective solution during CPB. Plasma TNF-?, IL-6 and IL-8 of tracheal suction was measured. Lung biopsy specimens were obtained after operations for study on histological changes. At same time, patients' pulmonary functions and clinic index were monitored. Results: TNF-? was lower in protective group when compared with control group immediately and at 24h after operations (P

Objectives:To investigate the association and the prognostic significance of the expression of telomerase activity (TA) and apoptosis (APO) in tissues of primary breast cancer.Methods:TRAP-PCR and ELISA were developed to detect the expression of TA,and make quantitative and qualitative analysis respectively.TUNEL was also used to evaluate apoptosis cells in cancer lesions and count apoptosis index (AI).The expression levels of proteins of oncogene Bcl-2 and p53 were measured by means of S-P immunohistochemistry.Results:The mean TA positive expression rate was 89.8%,and its mean optic density was (A) 0.63±0.29,which were significantly higher than those of normal tissues and benign breast lesions (P<0.05).The 5 years survival rate of patients with positive TA expression was lower (60.3%) than those of negative expression (77.4%).There were no relations between TA expression and patients ages,TNM staging,lymph nodes metastasis,size,locations and pathological types of cancer.But TA was positively correlated with APO (r=0.733 1,P<0.05) and the protein expression of oncogene Bcl-2 (r=0.781 4,P<0.05) and negatively correlated with that of p53 (r=-0.625 5,P<0.05).Moreover,in patients receiving preoperative chemotherapy,the levels of TA expression were much lower than those without chemotherapy (64.7% vs 85.1%),and the former had higher AI than the latter (7.19±3.75% vs 3.23±2.04%),intraarterial chemotherapy group were superior significantly to adjuvant group (P<0.05).Multivariate Cox Regression Analysis showed that only TA and AI influenced the survival time of primary breast cancer patients,and patients with higher positive TA expression and AI>4.0% had shorter survival time than those of negative TA expression and AI<4.0% patients.Conclusions:There was a significant correlation between TA and APO and its related oncogene Bcl-2,p53.TA and APO are of great diagnostic values,therapeutic helps and prognostic significance in the formation and the development of primary breast cancer.