Objective To analyze the problem existing in the process of health records informatization con-struction and explore solution on the basis of situation of health record informatization in Yanta district of Xi'an city. And to provide bases for acceleration of residents'health records informatization construction in Xi'an.Methods Send 10 investigators to study and investigate the hospital information management system of 10 full-time public universities in Yanta district.Results There were a total of 25 711 faculties in 10 full-time public universities and 19 809 facul-ties had established electronic files,the filing rate was 77.04% A.On the whole,it seemed that the teaching staff in the filing rate(78.91%)was higher than that of the retired workers filing rate(73.78%),the two groups had statisti-cally significant difference(χ2 =88.164,P <0.05)B.Conclusion Xi'an Yanta district university faculty of electron-ic health records has exceeded the national average level,but there are still many problems need to be improved.We should strengthen government investment,the establishment of the region's unified information management standards, increase publicity and education efforts,and actively create the region's resource information sharing platform.

Purpose To investigate clinicopathological features,diagnosis and differential diagnosis of tubular carcinoma of the breast.Methods Morphological observation and immunohistochemistry were applied in 29 cases of tubular carcinoma of the breast, and the literatures were also reviewed.Results The tumors were composed of open tubules, infiltrating haphazardly in the cellular desmoplastic stroma. The neoplastic tubules were enclosed by a single layer of epithelial cells with insignificant atypia or rare mitoses.The tumors were often associated with lobular neoplasm, columnar cell lesion, ductal atypical hyperplasia or carcinoma in situ. Immunostaining displayed that myoepithelial cells were absent or incomplete.Conclusions Tubular carcinoma of the breast is a peculiar subtype of breast carcinoma with good prognoses, which is easily confused with microglandular adenosis, radial sclerosing lesions,or low grade invasive ductal carcinoma.Immunohistochemistry is useful for the differential diagnosis.

Objective To research the location in cerebral circulations of recurrent stroke.Methods We included patients with acute cerebral infarction from the Department of Neurology of People's Hospital of Peking University within three years.We followed up the patients by telephone and electronic medical record to determine whether they belong to recurrent group or not.We recorded the clinical and image variables of recurrent group.We classified the recurrent group by whether the loci of recurrent stroke is in the same circulation.We determined the independent risk factors of the same circulation loci by Cox regression.Results There are 106 cases of recurrent stroke.Within 5 years,46.2％ of the cases had recurrent loci in the same circulation as first stroke loci.53.8％ of the cases had recurrent loci in the different circulation from first stroke loci.According to logistic regression,whether the recurrent loci was in the same circulation was not related to age,sex,hypertension,diabetes mellitus,smoking,but related to the survival time.The shorter the survival time was the more ratio of same circulation loci happened.The longer the survival time was the more ratio of different circulation loci happened.37％ of cases with recurrent strokes happened in the first year occupied the most cases in the 5 years.Conclusions With the long time study of the location of recurrent stroke,we get the conclusion that the longer the survival time is the more ratio of different circulation stroke happen.So we emphasize the importance of medicine for the stroke in long time.At the same time we conclude the rationality of endovascular treatments within 1 year from first stroke because recurrent loci is more often in the same circulation in 1 year.

Objective To explore clinic effect and advantages of the free arm lateral neurocutaneous flap in repairing cutaneous defects of opisthenar.Methods Between July,2012 and December,2013,12 patients with skin and soft tissue defects in opisthenar caused by trauma factor,accident,machine injury,hot crush injury etc were treated with free arm lateral neurocutaneous flap at our institution.Vessels both in recipient and donor site were detect-ed by color Doppler ultrasound preoperatively.Relative cutaneous nervers were reserved in the flap during selective operation.The flap size resected range from 6 cm × 4 cm to 10 cm × 6 cm.The posterior cutaneous nerve of the forearm were included in the flap to restore sensory sesation after transection.The wound in the donor site was closed in in-tradermal suture primarily.Postoperative algesia,touch,temperature sensation,Weber test of flap were tested and reco-rded.The critia of follow-up in this study were donor site morbidity,abnormal sensations,functional outcomes and sat-isfaction.Results The success rate was 100 percent in the series cases.The average length of follow up was 35 months (range,24 to 41 months).The wound in recipient area healed primarily and flaps showed no pigmentation but fine overall appearance,texture,and elasticity.The functional recovery of protective sensation was S3+ in 4 cases,S3 in 6,S2 in 2.Patients with liner scar in donor site were higly satisfied with the flaps for the sake of no significant joint functional outcomes.In terms of sensory sesation,the excellent and good rate of flap reached to 83 percent.Conclusion The free arm lateral flap represented a constant vascular anatomy,rich blood supply.Easy dissection,pliable texture,skin colour close to dorsum of hand and the possibility to be innervated through the posterior cutaneous nerve of the arm acceptable donor side morbidity provide a good option for the reconstruction of cutaneous defects of opisthena.

Objective To investigate the inhibitory effects of arsenic trioxide on salivary duct carcinoma cell colony and to explore a new approach to treat salivary duct carcinoma .Methods Human salivary duct carci-noma cancer cells were established .The effects of different concentrations (0.5、1、2、4μmol/L)and time(48,96 H) of arsenic trioxid on salivary duct carcinoma cell colony and the changes of the cell colony were observed with MTT assay and microscopic cell analysis .Results Human salivary duct carcinoma were significantly inhibited by Different concentrations of arsenic trioxide at different times points , and the relationship between the doses and time points are dependent ,cell atypia disappearing apoptosis appears apoptotic bodies .Conclusion Arsenic tri-oxide can significantly inhibit proliferation ,induce differentiation and promote apoptosis in the salivary duct carci-noma cells .

Objective To construct anti-IL-4R murine anti-human single-chain variable fragment (scFvs) antibodies through BL21 (DE3) prokaryotic expression system. Methods The anti-IL-4R scFv sequence was optimizated on the basis of previous findings. The optimized scFv sequence was analyzed. The recombinant plasmid pET-32a-scFv was constructed. The recombinant plasmid was detected through enzyme identification, and was turned into BL21 (DE3) prokaryotic expression bacteria to express the pET-32a-scFv recombinant protein in E.coli BL21 (DE3). The purification and renaturation were researched, and SDS-PAGE analysis was studied. The molecular weight of ScFv against IL-4R was analyzed by SDS-PAGE. The expression of the fusion protein was detected by Western-blot assay. Results The length of fusion gene scFv-MLT sequence was 761 bp. The molecular weight of the recombinant expression of proteins of anti-IL-4R single antibody was approximately 45 ku. The recombinant proteins showed high specificity with anti-6 × His-tag antibody. Conclusion This experiment successfully constructs pET-32a-scFv prokaryotic expression system of recombinant protein with high immune reactivity, which provides the basis for further study of anti-IL-4R single chain antibody as drug target.

Objective To evaluate the safety and efficacy of the temporary bedside cardiac pacing in controlling torsades de points (TdP) in patients with acquired long QT syndrome (LQTS). Methods Twelve patients with acquired LQTS were enrolled from April 2003 to August 2007 consecutively and their clinical data were analyzed. Bedside cardiac pacing was adopted when other methods couldn't terminate the repeated TdP. Results Twelve patients successfully experienced the temporary bedside cardiac pacing via femoral venous. The average time spent in bedside cardiac pacing was about (10.5±2.4) min. After cardiac pacing the interval of QT and QTc were shortened [ (0.42±0.03 ) svs (0.52±0.06) s, P < 0.05; (0.43± 0.04 ) s vs (0.53±0.05 ) s, P <0.05 ]. The TdP occurred (4.6±1.2 ) times per day before cardiac pacing and it didn't reoccur any more after bedside cardiac pacing. The average time for cardiac pacing was(3.8±1.4) d. When the patients were discharged, the interval of QT and QTe were (0.41±0.02) s and (0.42±0.05) s respectively, there were significant differences compared with that before cardiac pacing(P< 0.05). During 1 year follow-up, the patients didn't experience TdP any more, and the interval of QT and QTe were (0.41± 0.06) s and (0.42±0.05) s respectively. Conclusion The immediate bedside cardiac pacing is a safe and effective way to control the repeated TdP.

Objective To assess the efficiency and safety of mycophenolate mofetil (MMF) in patients with multiple sclerosis (MS) and neuromyelitis optica (NMO). Methods Twenty-seven patients with MS or NMO were selected, and the patients were divided into 2 groups:MMF group (MMF combined with glucocorticoid treatment group, 10 cases) and glucocorticoid group (only glucocorticoid treatment group, 17 cases). There were 5 cases with MS and 5 cases with NMO in MMF group. There were 13 cases with MS and 4 cases with NMO in glucocorticoid group. The therapeutic efficacy 6 months after treatment, expanded disability status scale (EDSS) before treatment and 6 months after treatment, and annualized relapse rate (ARR) were compared; and the safety was observed. Results There was no statistical difference in efficacy rate 6 months after treatment between MMF group and glucocorticoid group: 9/10 vs. 11/17, P>0.05. The EDSS scores 6 months after treatment in MMF group and glucocorticoid group were significantly lower than those before treatment: (2.41 ± 2.05) scores vs. (3.40 ± 2.05) scores and (1.17 ± 0.92) scores vs. (2.38 ± 1.28) scores, and there were statistical differences (P<0.05), particularly for the patients with MS. The ARR 6 months after treatment in MMF group was significantly lower than that before treatment: 0 time/year vs. 0.75 times/year, and there was statistical difference (P<0.05). The difference of ARR before and after treatment in MMF group was significantly higher than that in glucocorticoid group: 0.75 times/year vs.- 0.46 times/year, and there was statistical difference (P<0.01), particularly for the patients with MS. Only 1 female patient had myalgia when taking higher dosage of MMF, and the symptom tended to relieve after the dosage was reduced. Conclusions MMF is effective in the treatment of MS and NMO. MS can improve the neurological function and reduce the recurrence of the disease;and the safety is high.

An on-line two dimensional liquid chromatographic (2D-LC) method was established by using an ultimate dual gradient liquid chromatography, three chromatographic columns and valve-switching technology to detect 2460A in trichoderma hazianum fermentation liquor. MF C8 column (10 mm×4. 6 mm, 5. 0 μm) was used as purification column and MG C18 column (20 mm×4. 6 mm, 5. 0 μm) was used as enriching column. Methanol and water were used as mobile phase with a gradient elution at a flow rate of 2. 0 mL/min. The sample was separated on the Thermo Hypersil GOLD C18 column (250 mm×4. 6 mm, 5. 0μm) maintained at 40 ℃ using methanol and water. The flow rate was 1. 0 mL/min and 1. 0 mL sample was injected into the 2D-LC system. The detection wavelength was 424 nm. The whole analytical time was less than 60 min. The standard curve was linear over the 2460A concentration range of 0. 0025-10. 0 mg/L(r=0. 9981, n=8). The limit of detection was calculated to be 1 . 2μg/L ( S/N=3 ) and the limit of quantification was calculated to be 2 . 5 μg/L ( S/N=10 ) . The average recoveries varied from 88 . 0% to 104 . 4%.

Objective To investigate the correlation between opportunistic infections in patients with HIV /AIDS in Dali of Yunnan Province and CD +4 lymphocyte count,discover the incidence trend of opportunistic infections in patients with HIV /AIDS in Dali and instruct early diagnosis and treatment.Methods Choosing 454 cases of opportunistic infections in patients with HIV /AIDS in Infectious Disease Dali Prefectural Hospital were chosen,ana-lyze various opportunistic infections,examining CD +4 lymphocyte count and analyze the differences of opportunistic infections on CD +4 lymphocyte count.Results 454 cases opportunistic infections with HIV /AIDS,48.24% were HCV infections,38.72% of various tuberculosis consumption phthisis,28.41% of bacterial pneumonia and 25.77%of oral condida monilia infections,high rate of opportunistic infections when CD +4 lymphocyte count <200 /μL;when CD +4 <50 /μL,53.33% of the patients with more than three pathogen infections,thus higher than those CD +4 >350 /μL of 5.56%(χ2 =34.88,P <0.01);The high rate of opportunistic infections found on patients without the treatment of HAART(40.83%,U =9.05,P <0.01),comparing to 18.79% of those with the treatment.Conclusion The com-mon opportunistic infections in our area are HCV,various tuberculosis consumption phthisis,bacterial pneumonia and oral condida monilia infections;high rate of opportunistic infections happens when CD +4 lymphocyte count are low and lower rate on those with the treatment of HAART,offering an effective method on controlling opportunistic infections.