The research frontiers in foreign medical informatics were analyzed according to the co-occurrence net-work map, hotspots density map and cluster tree map that were plotted for the PubMed-covered scientific papers on medical informatics from 2010 to 2014 , which showed that the research frontiers in foreign medical informatics were the natural language processing and data mining of electronic health records, medical decision-making assistant system, computer-aided drug therapy, clinical decision-making support, health service attitude, health service quality, health service model, medical records system and its linkage, information system and its integration.

Objective To evaluate the effect and feasibility of balloon dilatation for treatment of anastomotic stricture after biliary-intestinal anastomosis with percutaneous transhepatic cholangial drainage( PTCD) .Methods A total of 23 pa-tients with anastomotic stricture after biliary-intestinal anastomosis who had undergone PTCD+balloon dilatation were ana-lyzed retrospectively between Mar 2009 to Dec 2011.The patency of bile duct, jaundice index and liver function were recor-ded.Results PTCD+balloon dilatation was completed successfully in all cases, and a metallic stent was implanted in one case.Anastomotic stricture, postoperative jaundice index and liver function were improved significantly after operation.No serious complications occurred.Conclusion PTCD+balloon dilatation has good curative effect on anastomotic stricture. The complication rate is low.It is a safe, feasible and effective minimally invasive treatment.

0.05);But there was significant difference in the grade of disability between internal fixation and conservative therapy in single vertebral body(P

Malignant biliary tract obstruction is a common disease.Nowadays,endoscopic biliary drainage (EBD) and percutaneous transhepatic biliary drainage (PTBD) have been used to treat such disease.EBD is a first-line intervention for lower segment of biliary duct obstruction caused by pancreatic cancer or other tumors.PTBD is a first-line treatment for gallbladder cancer or other tumors which lead to the hilar and intrahepatic bile duct obstruction and abnormal digestive anatomy.In a word,the proper selection of the drainage should be based on the patients' condition with minimal trauma and maximum therapeutic effect.

ObjectiveTo expolre the effect of speech therapy on older child with cerebral palsy following severe dysarthria.MethodsIce simulation, lips, tongue and jaw training, pronounciation training, and Chinese massage technique were used to treat the patient. China Rehabilitation Research Center Dysarthria Assessment was used as the assessment tool.ResultsThe patient improved significantly in speech function.ConclusionSpeech therapy can improve speech function for older child with cerebral palsy following severe dysarthria.

Objective To analyze the clinical and radiographic outcomes of staged reduction and fixation in a consecutive series of patients with the old Lisfranc injuries. Methods Fifty patients (16 feet) with Lisfranc injuries were treated with staged reduction. Mean duration between injury and surgery was 4. 8month ( 3 to 8 month) . In first stage an external fixator was applied across the Lisfranc joint and distraction was done at 1 milliliter per day to 2 milliliter per day. In the second staged the ORIF ( open reduction and internal fixation) was doneand we were able to reduce all the fractures and dislocations. Extra-Articular screws and staple fixation were used for fixation. We compared categorical variables using Fisher’ s exact test and continuous variables using paired t-test or Wilcoxon signed-rank test. Results All patients were followed up 1 to 3 years ( mean 2. 2 years) in the clinic. The visual analogue scale score averaged 3. 1 points at the final follow-up, the average AOFAS scores for these patients were 55. 8 points ( range, 43 to 98 points), with a significant increase than before surgery ( P=0. 001). The mean duration between two surgeries was 3. 2 weeks (range 2. 5-4. 5 weeks). Anatomic reduction was obtained in all 15 patients. At the last follow-up, 2 patients had lost reduction. Posttraumatic osteoarthritis was observed in 5 patients, and all of them were scheduled for arthrodesis because of persistent pain. Conclusions The study have displayed that staged reduction and Extra-Articular fixation should be considered for old Lisfranc injuries with a good reduction, the firm stability, low risk of intraoperative fracture. The short-term effectiveness is good, but the long-term effectiveness needs further follow-up.

The molecular delivery vectors used in gene therapy need provide the features of safety,stability, efficiency and capacity. The current studies on the structure and action mechanism of pRNA, a packaging RNA of phage?29, showed that pRNA with multiple binding sites can through cell membrane easily and escort exogenous molecules to target cell, without inducing immune reaction. As an ideal nano-scale gene therapy vehicle, pRNA presents a promising application in delivering multiple therapeutic components to detect and treat human diseases.

Objective To determine the effect of video-assisted retroperitoneal debridement in treatment of infected necrotizing pancreatitis.Methods The clinical data of patients with infected necrotizing pancreatitis was retrospectively analyzed.Heart rate,mean arterial pressure,body temperature and indicators for inflammatory response including level of WBC,CRP and procalcitonin before and after VARD treatment were compared.Results After VARD treatment,the heart rate (preoperative vs.postoperative 8 h,108 ± 22/min vs.95 ± 17/min),mean arterial pressure (preoperative vs.postoperative 12 h,66 ± 18 mmHg vs.79 ± 19 mmHg) and body temperature(preoperative vs.postoperative 24 h,38.3 ± 1.7 ℃ vs.37.3 ± 1.3 ℃) improved significantly (all P ＜ 0.05).Level of WBC [preoperative vs.postoperative 48 h,(13.8 ±6.6) × 109/L vs.(10.1 ±5.2) × 109/L],CRP(preoperative vs.postoperative 48 h,145 ± 88 mg/L vs.95 ± 4 mg/L) and procalcitonin (preoperative vs.postoperative 48 h,1.4 ± 0.7 μg/L vs.0.9 ± 0.4 μg/L) also decreased significantly(all P ＜ 0.05).Conclusions VARD therapy can significantly reduce systemic inflammation and improve the general condition of infected necrotizing pancreatitis patients.

Objective To determine the effects of cyclooxygenase-2 (COX-2) on risk stratification and prognosis of patients with gastrointestinal stromal tumor (GIST).Methods Literatures in the Cochrane libraries of clinical comparative trials,PubMed,EMBASE,Cancer Lit and Chinese BioMedical Literature from 1966 to 2012 were retrieved using the Cochrane systematic evaluation method.The original data were extracted and crosschecked by 2 reviewers.The indicator for assessment including positive rates of COX-2 in GIST patients with different tumor diameters (＜5 cm versus ≥5 cm),mitosis of cancer cells (＜5/50 HPF versus ≥5/50 HPF) and National Institute of Health (NIH) risk stratifications (very low + low versus intermediate + high).The relationship between COX-2 expression and recurrence and metastasis of GIST was evaluated.All the data were analyzed using the RevMan 5.1 software with Meta analysis.The heterogeneity between studies was analyzed using the I2.The binary data were presented by odds ration (OR) and 95％ confidence interval (95 ％ CI).Results Seven articles with a total of 415 patients were included in the analysis.The COX-2 expression did not correlate with the tumor diameters,NIH risk stratifications and tumor metastasis and recurrence (OR =0.60,0.72,2.46,P ＞ 0.05),but with the mitosis of cancer cells (OR =0.46,P ＜ 0.05).Conclusion COX-2 expression is partly correlated with risk stratification of GIST,but has no effect on the prognosis.

Objective To investigate the change of homocysteine (Hcy),high sensitive C-reactive protein (hs-CRP)and Inter-leukin 6 (IL-6)in patients with Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS)complicated by Cerebral Infarction (CI).Methods Chose 55 patients with OSAHS and 56 patients with CI.All patients with OSAHS were divided into mild group,moderate group and severe group by polysomnography,and all patients were divided into simple OSAHS group,sim-ple CI group and OSAHS complicated by CI group.All the patients’sleep apnea hypoventilation index (AHI),the lowest oxygen saturation (LSpO2 ),average blood oxygen saturation (MSpO2 ),sleep apnea the longest (LAT)and the level of Hcy,hs-CRP,IL-6 were determined,and compared with 30 cases of control group.Results The AHI,LAT,Hcy,hs-CRP and IL-6 of simple OSAHS group and simple CI group were obviously higher than that in control group,LSpO2 ,MSpO2 were obviously lower,the differences were statistical significant (P<0.05).The AHI,LAT,Hcy,hs-CRP and IL-6 of OS-AHS complicated by CI group were obviously higher than that in simple groups,but LSpO2 and MSpO2 were obviously low-er,and the differences were statistical significant (P<0.05).With the aggravation of OSAHS,Hcy,hs-CRP and IL-6 were gradually increased.Hcy,hs-CRP and IL-6 were positively correlated with AHI in patients with OSAHS,correlation coeffi-cient were 0.751,0.678 and 0.635,respectively (P<0.001).Conclusion OSAHS was closely related to the occurrence and development of CI,the dynamic monitoring of Hcy,hs-CRP and IL-6 levels has a certain reference value for evaluation of therapeutic effect.