With the constant development and perfection of hospital information systems, health information legislation has become a problem needing prompt solution. The authors explained the urgency and significance of health information legislation in the current practice of hospital information systems and pointed out specific manifestations of the involvement of legal basis. Their recommendations include: ①establishing and perfecting regulations on the management of local networks; ②establishing and perfecting a system of regulations on health information; ③expanding the development, accreditation and spread of techniques for guaranteeing network safety; ④doing a good job of the standard application and management of electronic medical records in the transition period.

Objective To explore the relationship between muscle fatigue and pain in lumbar muscle fatigue induced test. Methods From July to October, 21 healthy female volunteers were subjected to the fatigue induced test. Their root mean square (RMS) and median frequency (MF) of the surface electromyography were collected, their fatigue were assessed with Borg Fatigue Scale and Visual Analogue Scale (VAS), and their maximal voluntary contraction (MVC) and pressure pain threshold (PPT) were measured, before, during and after ex-periment. They were divided into pain or no-pain groups according to the symptom, and the differences before and after test were compared. Results There was significant difference in the scores of Borg Fatigue Scale and VAS, MVC, RMS, and MF after test (Z>6.064, P<0.001). There was significant difference between two groups in all the data before test, and there was significant difference between two groups in the difference before and after test of the VAS score (t=-4.112, P=0.001) and RMS (t>2.385, P<0.05) in some points. Receiver operating characteristic curve analysis showed that the optimal cut-off point of VAS score difference was 3.45 in predicting the pain onset, with sensi-tivity of 100％and specificity of 81.8％. Conclusion For the fatigue induced test, the fatigue VAS score difference may predict the induced pain, and RMS difference associate with the occurrence of pain. No significant is observed of the Borg Fatigue Scale and PPT.

Objective To compare the therapeutic effects between anterior internal fixator (INFIX) and external fixator (EXFIX) for anterior pelvic ring fracture.Methods A retrospective study was conducted on the 66 patients with anterior pelvic ring fracture who had been treated surgically from January 2016 to June 2017 at Department of Spinal Surgery,Hospital Affiliated to Southwest Medical University and at Department of Orthopedics,Union Hospital Affiliated to Tongji Medical College.They were divided into an observation group and a control group according to their fixation of the anterior pelvic ring.In the observation group of 33 cases fixated with INFIX,there were 20 males and 13 females,aged from 32 to 47 years (38.8 ±4.8 years).By the Tile's classification,15 of them belonged to type B and 18 to type C.In the control group of another 33 patients fixated with EXFIX,there were 19 males and 14 females,aged from 33 to 48 years (39.5 ±4.6 years).By the Tile's classification,14 of them belonged to type B and 19 to type C.The 2 groups were compared in terms of postoperative fracture reduction,pelvic function and complications.Results The 66 patients were followed up for an average of 13.7 months(from 12 to 18 months).According to the Matta criteria for fracture reduction,21 cases were excellent,9 good,2 fair and one poor in the observation group (excellent and good rate:90.9％);18 cases were excellent,8 good,5 fair and 2 poor in the control group (excellent and good rate:78.8％).The difference was statistically significant between the 2 groups (P ＜ 0.05).The pelvic function assessed by the Majeed criteria at the final follow-up was excellent in 21 cases,good in 10,fair in one and poor in one in the observation group (excellent and good rate:93.9％);it was excellent in 17 cases,good in 9,fair in 4 and poor in 3 in the control group (excellent and good rate:78.8％).The difference was also statistically significant between the 2 groups (P ＜ 0.05).The incidence of injury to the lateral femoral cutaneous nerve was 9.1％ (3/33) for the observation group and 6.1％ (2/33) for the control group,showing no significant difference between the 2 groups (P ＞ 0.05).The incidences of screw loosening and pin track infection were significantly lower in the observation group than in the control group[0 versus 24.2％ (8/33) and 0 versus 18.2％ (6/33),respectively] (both P ＜ 0.05).Conclusion Compared with EXFIX,INFIX can lead to better clinical outcomes and fewer operative complications in the treatment of anterior pelvic ring fractures.

Objective To study the regulating mechanisms of cobaltous chloride (CoCl2)induced hypoxia on muscle atrophy.Methods The mouse skeletal C2C12 myotube line was used as the cell model and divided into a control group,a CoCl2 group,a 3-Methyladenine(3MA)group and a CoCl2+3MA group.The control group was not given any treatment,the CoCl2 group was treated with 200 μM CoCl2 to induce hypoxia,and the 3MA group or CoCl2+3MA group was treated with 5 mM 3MA in the absence or presence of 200 μM CoCl2.The Giemsa stain was conducted to observe the morphology of myotubes.The multifunctional microplate reader was utilized to quantify the reactive oxygen species (ROS)expression.The autophagosome was observed by using the transmission electron microscopy.The mRNA and protein expression of hypoxia-inducible factor-1α(HIF-1α),Bcl2/adenovirus E1B19kDa interacting protein 3(BNIP3),microtubule associated protein1 light chain 3(LC3)were detected using the quantitative real time polymerase chain reaction (QRT-PCR)and Western blotting (WB).Moreover,3-Methyladenine(3MA)was used to suppress autophagy and the expression of muscle atrophy F-box(MAF-bx)was detected.Results More spindly ring-shaped myotubes were formed in the control group,while CoCl2 induced myotubes atrophy and rupture.The expression of ROS increased significantly in the CoCl2 group compared with the control group(t=-4.965,P=0.008).Transmission electron microscopy results showed autophagosome formation induced by CoCl2,and significant improvement in the HIF-1α,BNIP3 and LC3 in the CoCl2 group compared with the control group(P＜0.05).The protein expression of MAFbx decreased when co-cultured with CoCl2 and 3MA(F=18.246,P=0.001).Conclusions The skeletal muscle atrophy caused by CoCl2 induced hypoxia may be associated with autophagy promoted by the HIF-1α/BNIP3 signal pathway,and inhibition of hypoxia induced autophagy can partly reduce the atrophy in skeletal C2C12 myotubes.

Objective To analyze the magnetic resonance imaging (MRI) of the spinal cord and clinical characteristics in patients with autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy.Methods A total of 1 040 samples of cerebrospinal fluid (CSF) and sera collected in the Second Affiliated Hospital of Guangzhou Medical University from March 2013 to June 2018 were tested with tissue-and cell-based assays,and 42 patients were found positive for GFAP-IgG.The clinical data and MRI characteristics of the spinal cord of 19 patients who were positive for GFAP-IgG in CSF with autoimmune GFAP astrocytopathy and lesions in the spinal cord were retrospectively reviewed.Results There were 12 females and seven males among the 19 patients,with onset age of (44±17) years.The main manifestations of these patients included limb weakness (14/19),abnormal vision (5/19),headache (4/19),seizure (4/19),dementia (3/19),etc.On MRI of the spinal cord,five patients showed involvement in the cervical cord alone,eight showed involvement in the thoracic cord alone and six had both cervical and thoracic segment involvement.Fifteen patients had longitudinally extensive myelitic abnormalities (≥3 vertebral segments long).Seven enhancement patterns were encountered.Lesions were displayed in the spinal cord and brain in eight patients.Central gray matter involvement in the spinal cord was found in all the 19 patients.Conclusions Autoimmune GFAP astrocytopathy more frequently presents in females than in males.MRI of the spinal cord has complex presentations and longitudinally extensive myelitic abnormalities usually.Patients often show central gray matter involvement in the spinal cord.Myelitic abnormalities present more often in thoracic segment than in cervical segment.Abnormalities in lumbar segment are less encountered.

Objective:To observe the effect of interleukin-6 (IL-6) on the phenotype and function of human umbilical vein endothelial cells (HUVECs) and explore the role of IL-6 in the process of endothelial-to-mesenchymal transition (EndMT).Methods:The experimental research method was used. Fresh umbilical cord discarded after normal maternal delivery was collected. On the second day of the primary cell isolation and cultivation, the cell morphology was observed under inverted phase contrast microscope. HUVECs of the 4th passage were identified by immunofluorescence method, and 2 batches of HUVECs ofthe 3rd to 5th passages were used for the subsequent experiments. The first batch of cells were divided into 6 groups according to the random number table (the same below): blank control group, 5 ng/mL IL-6 group, 10 ng/mL IL-6 group, 25 ng/mL IL-6 group, 50 ng/mL IL-6 group, and 100 ng/mL IL-6 group. The second batch of cells were divided into 4 groups: blank control group, 10 ng/mL IL-6 group, 25 ng/mL IL-6 group,and 50 ng/mL IL-6 group; the cells in blank control group was cultured with complete culture medium only, while the cells in the other groups were added with IL-6 of the corresponding final mass concentrations.Cells from the 1st batch were cultured for 72 hours after grouping, the morphology of HUVECS in the 6 groups was observed under inverted phase contrast microscope. At 72 h after grouping culture, the positive expressions of coagulation factor Ⅷ and α vascular smooth muscle actin (α-SMA) in HUVECs in the 6 groups were detected by immunofluorescence method, and the ratio of the number of double positive cells to the number of coagulation factor Ⅷ positive cells (the ratio of double positive cells for short) was calculated, with 6 samples per group; mRNA expression levels of vascular endothelial cadherin and α-SMA of HUVECs in 6 groups were detected by reverse transcription-polymerase chain reaction, with 3 samples per group.Cells from the 2nd batch were cultured 72 hours after grouping, the protein expression levels of vascular endothelial cadherin, α-SMA, and type Ⅰ collagen in the 4 groups were detected by Western blotting, with 3 samples per group. Data were statistically analyzed with one-way analysis of variance and Bonferroni correction.Results:On the 2nd day after isolation and cultivation, the primary cells were in short spindle shape or polygon, cells of the 4th passage were identified as HUVECs by immunofluorescence method. At 72 hours of culture after grouping, the cells from the 1st batch in the 6 groups changed to long spindle shape morphologically along with the increase of IL-6 concentration, the intercellular connections decreased or disappeared with the gap between cells becoming larger. At 72 h after grouping culture, compared with that inblank control group, the ratio of double positive cells in 25 ng/mL IL-6 group, 50 ng/mL IL-6 group, and 100 ng/mL IL-6 group were significantly increased ( P<0.01); compared with that in 5 ng/mL IL-6 group, the ratio of double positive cells in 25 ng/mL IL-6 group, 50 ng/mL IL-6 group, and 100 ng/mL IL-6 group were significantly increased ( P<0.01); compared with that in 10 ng/mL IL-6 group, the ratio of double positive cells in 50 ng/mL IL-6 group and 100 ng/mL IL-6 group were significantly increased ( P<0.01); the ratio of double positive cells in 100 ng/mL IL-6 group was significantly increased compared with those in 25 ng/mL IL-6 group and 50 ng/mL IL-6 group ( P<0.01). At 72 h after grouping culture, compared with that in blank control group, the mRNA expression levels of vascular endothelial cadherin of cells in 25 ng/mL IL-6 group, 50 ng/mL IL-6 group, and 100 ng/mL IL-6 group were significantly decreased ( P<0.01 or P<0.05); compared with that in 5 ng/mL IL-6 group, the mRNA expression levels of vascular endothelial cadherin of cells in 50 ng/mL IL-6 group and 100 ng/mL IL-6 group were significantly decreased ( P<0.01); compared with that in 10 ng/mL IL-6 group, the mRNA expression levels of vascular endothelial cadherin of cells in 50 ng/mL IL-6 group and 100 ng/mL IL-6 group were significantly decreased ( P<0.01); compared with that in 25 ng/mL IL-6 group, the mRNA expression levels of vascular endothelial cadherin of cells in 50 ng/mL IL-6 group and 100 ng/mL IL-6 group were significantly decreased ( P<0.01). At 72 h after grouping culture, compared with that in blank control group, the mRNA expression levels of α-SMA of cells in 5 ng/mL IL-6 group, 10 ng/mL IL-6 group, 25 ng/mL IL-6 group, 50 ng/mL IL-6, group, and 100 ng/mL IL-6 group were significantly increased ( P<0.05 or P<0.01). Cells from the 2nd batch were cultured for 72 hours after grouping. Compared with 1.391±0.026 in blank control group, the protein expressions of vascular endothelial cadherin of cells in 10 ng/mL IL-6 group (1.185±0.063), in 25 ng/mL IL-6 group (0.717±0.078), and in 50 ng/mL IL-6 group (0.239±0.064) were significantly decreased ( P<0.05); compared with that in 10 ng/mL IL-6 group, the protein expressions of vascular endothelial cadherin of cells in 25 ng/mL IL-6 group and 50 ng/mL IL-6 group were significantly decreased ( P<0.01); compared with that in 25 ng/mL IL-6 group, the protein expression of vascular endothelial cadherin of cells in 50 ng/mL IL-6 group was significantly decreased ( P<0.01). At 72 h after grouping culture, compared with that in blank control group, the protein expression levels of α-SMA of cells in 10 ng/mL IL-6 group, 25 ng/mL IL-6 group, and 50 ng/mL IL-6 group were significantly increased ( P<0.01); compared with that in 10 ng/mL IL-6 group, the protein expression levels of α-SMA of cells in 25 ng/mL IL-6 group and 50 ng/mL IL-6 group were significantly increased ( P<0.01). At 72 h after grouping culture, compared with that in blank control group, the protein expressions of type Ⅰ collagen of cells in 25 ng/mL IL-6 group and 50 ng/mL IL-6 group were significantly increased ( P<0.05). Conclusions:After IL-6 treatment, the phenotype and function of HUVECS showed the characteristics of mesenchymal cells in a concentration-dependent manner. The inflammatory factor can promote the process of EndMT, and become one of the important factors regulating the mechanism of tissue fibrosis.

【Objective】 To construct and validate a risk prediction model for cognitive impairment after stroke based on demographic, clinical, and neuroimaging characteristics. 【Methods】 Through the medical record system, we collected all data of the patients. We finished cognitive function testing three months after the indexed stroke. The Mini-Mental State Examination Scale score≤26 was defined as cognitive dysfunction. Optimal subset regression analysis was used to screen variables, Logistic regression analysis was used to construct a predictive model for cognitive impairment, and C-index, calibration chart and clinical decision curve analyses were used to evaluate the discrimination, consistency, and clinical availability of the model. And nomograms were used to express the performance of the model. 【Results】 Seven variables were selected: cognitive function before stroke, age, years of education, National Institutes of Health Stroke Scale score at admission, history of ischemic heart disease, the number of old lacunar infarct lesions, and medial temporal lobe atrophy scale. The prediction model had a C-index of 0.845 (95% CI: 0.805-0.885). The clinical decision curve showed that the model had a positive net benefit when the threshold probability was 9.0%-90.0%. 【Conclusion】 The predictive model of cognitive impairment in stroke patients has good predictive efficiency and provides an effective assessment tool for screening high-risk cases of cognitive impairment in patients with stroke of various subtypes.