The author analyzed how toelaborate narrative contents using structured standard with electronical -ly structured medical record information model and the relation of the two .Astructured medical record data entry way was worked outcompatible with standard terminology based on ways of expressing narrative contents using structured standard.It provided a theoretical basis for clinical use .

Objective To investigate the effect of hyperbaric oxygen treatment on course of different intervention time,cognitive impairment in patients with traumatic brain injury.Methods Ninety cases of cognitive dysfunction in patients with traumatic brain injury after hyperbaric oxygen in different intervention time were divided into group A,group B and group C,with 30 cases in each group.In 7-14 d,15-28 d,＞ 28 d after injury starting hyperbaric oxygen therapy,treatment 1 time a day,12 times for a course.The cognitive function of patients in three groups before and after 1,2,3 courses of treatment was evaluated by U.S.RLA cognition level classification standard evaluation form.Results Three groups after 1 course of treatment there was no statistically significant difference compared with before treatment RLA grading (P ＞ 0.05).Three groups after 2,3 courses of treatment compared with after 1 course of treatment RLA grading difference was statistically significant (P ＜ 0.05),three groups after 3 courses of treatment compared with after 2 courses of treatment RLA grading difference was statistically significant (P ＜ 0.05).Three groups after 1 course of treatment total effectiveness rate was no statistically significant difference(P ＞ 0.05).Group A and group B after 2,3 courses of treatment total effective rate was significantly higher than that in group C [73.33％ (22/30) and 66.67％ (20/30) vs.46.67 ％(14/30),93.33％ (28/30) and 86.67 ％(26/30) vs.60.00 ％ (18/30),P ＜ 0.05],group A was higher than group B,but there was no statistical significance (P ＞ 0.05).Conclusions Hyperbaric oxygen comprehensive therapy can effectively improve cognitive function in patients with traumatic brain injury cognitive impairment.After the injury,the earlier to start the hyperbaric oxygen therapy,the better effect it has,and the longer the course the better curative effect it has.

Objective To explore the clinical features and risk factors associated with intrahepatic and hilar cholangiocarcinoma after liver transplantation .Methods Retrospective analysis of clinical data was performed for 20 hospitalized patients with intrahepatic and hilar cholangiocarcinoma from June 25 ,2014 to October 31 ,2018 .Treatments and follow-up outcomes were analyzed .The survival rate was calculated by the Kaplan-Meier method and the survival curve plotted .Cox regression model was employed for analyzing the prognostic factors .Results The cumulative recurrence rate of patients with AJCC stage Ⅰ /Ⅱ was significantly lower than that in AJCC stage Ⅲ/Ⅳ .And the cumulative recurrence rate of stageⅠ/Ⅱ Patients was 0 and that of stage Ⅲ/Ⅳ 76％ (P=0 .042) .Cox regression model showed that CA19-9 was the only prognostic factor .An elevated level of CA19-9 was associated with high recurrence post-transplantation (HR=1 .001;95％ CI:1 .000～1 .001;P=0 .035) .Conclusions During progressive stage ,the recurrence rate is higher with a worse prognosis .And an elevation of CA19-9 is an independent poor prognostic factor after intrahepatic and hilar cholangiocarcinoma transplantation .

Objective:To explore the relationship between CD24 expression in preoperative peripheral blood as well as cancer tissue and clinical parameters and prognosis in patients with hepatocellular carcinoma (HCC) after liver transplantation (LT).Methods:From November 2018 to November 2019, clinical data were collected for 65 HCC patients and 41 patients with benign liver disease.The preoperative peripheral blood level of CD24 was detected by enzyme-linked immunosorbent assay (ELISA) and the expression of CD24 in cancerous foci and adjacent tissues examined by immunohistochemistry.Kaplan-Meier survival curves of differential CD24 expression were plotted and survival differences compared by Log-rank method.One-way ANOVA was utilized for examining the relationship between the expression level of CD24 and various clinicopathological parameters and multivariate Cox analysis for screening independent risk factors affecting patient prognosis.Results:The concentration of CD24 in preoperative peripheral blood (p-CD24) of HCC patients (6.51±2.33 μg/L) was significantly higher than that of patients with benign liver disease (4.10±0.91) μg/L, P<0.05.The positive rate of CD24 was obviously higher in cancerous tissues than that in adjacent tissues (87.7% vs. 4.6%, P<0.05). The peripheral blood level of CD24 was positively correlated with the expression intensity of CD24 in tumor tissues (t-CD24, r=0.570, P<0.001). The expression of CD24 (both in blood and cancer foci) was significantly correlated with preoperative level of gamma-glutamyl transferase (GGT), maximal tumor diameter, microvascular invasion, portal vein tumor thrombus, vessel carcinoma embolus and satellite focus ( P<0.05). The expression of CD24 in patients exceeding the Milan/UCSF criteria was higher than those fulfilling the criteria ( P<0.005). Patients with a higher expression of CD24 had worse overall survival and recurrence-free survival rates as compared to those a lower expression of CD24 ( P<0.05). Multivariate Cox analysis indicated that t-CD24 [OS: HR=3.661(1.005-13.333)], P=0.049; recurrence-free survival (RFS): [HR=4.331(1.887-9.942), P=0.001] and preoperative level of alpha fetoprotein (AFP) [OS: HR=4.900(1.590-15.097), P=0.006]; RFS: [HR=3.414(1.614-7.221), P=0.001] were independent risk factors for overall survival and recurrence-free survival in HCC patients undergoing LT. Conclusions:The preoperative peripheral blood level of CD24 in HCC patients undergoing LT indirectly reflects the expression of CD24 in cancerous tissues to a certain extent.And the expression of CD24 in cancerous tissue is one of the independent risk factors affecting OS and RFS of LT patients.