The hospital information structure, which is made up of various medical business systems, is suffering from the problems of the "information isolated island". Medical business systems in the hospital are mutually isomerous and difficult to become a whole. How to realize the internal barrier-free interaction of the patients effective medical information in the hospital and further to complete the area sharing of patients longitudinal diagnosis and treatment information has become a question having to be solved urgently in the process of healthcare informatization. Based on the HL7 standard, this paper refers to the IHE technical framework, expounds the overall structure of the interaction in the hospital internal and area sharing of medical information with the medical information exchange platform. The paper also gives the details of the whole process of the complete display of the discrete patient health information using Portal technology, which is saved in the business systems in different hospitals. It interacts internally through the information exchange platform and at last stores the information in the regional clinical data repository (CDR).
Humans ; Information Dissemination ; methods ; Medical Informatics ; organization & administration ; Medical Record Linkage

Objective To investigate the effect of split-bolus spectral computed tomography(CT) on the portal venography and radiation dose.Methods The prospective study was adopted.The clinical data of 119 patients who underwent spectral CT at China-Japan Union Hopital from September 2014 to March 2015 were collected.Patients were randomly divided into the portal venography with split-bolus spectral CT single-phase enhanced scan group and portal vein multi-phase scan group by random sequence method.In the portal venography with split-bolus spectral CT single-phase enhanced scan group,the spectral CT was used with the method of split-bolus single phase imaging,and in the portal vein multi-phase scan group,standard spiral CT was used to perform three-phase scan.Two observers evaluated CT portal venography subjectively and objectively,measured CT values,contrast to noise ratio (CNR),signal noise ratio (SNR),and calculated radiation dose.Observed indices included (1) choice of optimal monochromatic images.(2) CT values of portal veins,measurement of CNR and SNR.(3) Subjective scoring of portal venography quality.(4) Comparison of radiation dose.Measurement data with normal distribution were presented as x ± s,comparison between groups was analyzed by independent sample t test.Comparison of count data was analyzed by chi-square test.Results The 113 patients were screened for eligibility,including 59 in the portal venography with split-bolus spectral CT single-phase enhanced scan group and 54 in the portal vein multi-phase scan group.(1) Choice of optimal monochromatic images:optimal monochromatic images were abstracted at 60 keV from spectral CT portal venography.(2) CT values of portal veins and measurement of CNR and SNR:the CT values of intrahepatic portal vein,extrahepatic portal vein and branches of portal vein were (319 ± 44) HU,(328 ± 53) HU,(294 ± 45) HU in the reconstructed images at the energy level of 60 keV in the portal venography with split-bolus spectral CT single-phase enhanced scan group and (213 ±41)HU,(228 ±49)HU,(210 ±41)HU in the portal vein multi-phase scan group,with significant differences between the 2 groups(t =8.04,6.34,6.82,P ＜ 0.05).The CNR of intrahepatic portal vein,extrahepatic portal vein and branches of portal vein were 15 ± 5,24 ± 8,22 ± 7 in the portal venography with split-bolus spectral CT single-phase enhanced scan group and 13 ± 4,20 ± 6,19 ± 6 in the portal vein multi-phase scan group,respectively,with no significant difference (t =-1.13,-1.89,-1.51,P ＞ 0.05).The SNR of intrahepatic portal vein,extrahepatic portal vein and branches of portal vein were 31 ± 6,29 ± 6,27 ± 6 in the portal venography with split-bolus spectral CT single-phase enhanced scan group and 29 ± 7,28 ± 9,26 ± 6 in the portal vein multi-phase scan group,respectively,with no significant differences (t =-0.688,0.615,0.600,P ＞ 0.05).(3) Subjective scoring of portal venography quality:the subjective score of image quality of portal venography was 14.3 ± 1.0 in the portal venography with split-bolus spectral CT single-phase enhanced scan group and 12.5 ± 1.8 in the portal vein multi-phase scan group,with a significant difference (t =12.43,P ＜ 0.05).(4) Comparison of radiation dose:the radiation dose was (8.1 ± 1.1)mSv of patients in the portal venography with split-bolus spectral CT single-phase enhanced scan group and (17.4 ± 7.5) mSv in the portal vein multiphase scan group,with a significant difference (t =24.14,P ＜ 0.05).Conclusion Spectral CT portal vein imaging combined with split-bolus protocol can achieve better manifestations of portal vein and its branches,and reduce radiation dose in the scanning process.

Objective To evaluate the influence of amphetamine-type stimulants on serum rapid plasma reagent (RPR) tiler and negative conversion rate of RPR in patients with syphilis. Methods Thirty-six patients with syphilis who took amphetamine-type stimulants (ATS) were recruited in this study together with 44 patients with syphilis who never took ATS and 30 normal human controls. Benzathine benzylpenicillin was given intramuscularly to all patients at a dose of 2 400 000 unit per week for 3 weeks. RPR and treponema pallidum particle agglutination (TPPA) assay were performed before treatment, 3, 6, 9 and 12 months after the therapy. Radioimmune assay and ncphelometry were used to detect the serum level of IgG, lgM and IgA. The capability of peripheral blood mononuclear cells (PBMCs) to product interferon-T (IFN-γ) and interleukin-4 (IL-4) was evaluated with ELISA. Results Before treatment, RPR titcr was significantly lower in the stimulant-taking group than in the non-taking group (χ2 = 14.93, P < 0.05). The negative conversion rates were 5.56%, 16.67% and 52.78% in stimulant-taking group 6, 9 and 12 months after the treatment, respectively, significantly lower than those in the control group (all P < 0.05). As for the serum level of IgG, IgM and IgA, there was no significant difference among the stimulant-taking group, non-taking group and normal control group (all P > 0.05). The capability of PBMCs to product IFN-γ was highest in the stimulant-taking group, followed by the non-taking group and normal control group (all P < 0.05). No significant difference was observed in the capability of PBMCs to produce IL-4 between the stimulant-taking group and non-taking group, but a significant increment was noted in these patients compared with the normal human controls (all P < 0.01). Conclusion Amphetamine-type stimulants could reduce serum RPR titer and negative conversion rate of RPR in patients with syphilis, likely by impairing cellular immunity of patients.

Objective To investigate the behavioral characteristics of circadian rhythm disturbance in 3xTg-AD mice.Methods The free-running period,average activity per hour,total amount of exercise and circadian amplitude were examined with voluntary wheel-running test in 3-to 9-month-old C57BL/6 and 3xTg-AD mice under 12 h light/12 h dark cycle and constant darkness environment.Results In constant darkness environment,the free-running period in 3-month-old 3xTg-AD mice was (23.2±0.4) h,and shorter than the period((23.5±0.2) h) in C57BL/6 mice.In 6-and 9-month-old 3xTg-AD mice,activity pattern was disorganized,without clear boundary between activity and rest phase.The free-running period was unavailable.The circadian amplitude and total exercise amount were(40.6± 11.5) counts/5 min and(2.6±0.1) × 104 counts/d,(37.0±20.8) counts/5 min and(2.3±0.4) × 104 counts/d,(29.3± 11.0) counts/5 min and(1.6± 0.9) × 104 counts/d in 3-,6-and 9-month-old 3xTg-AD mice,respectively,which was significantly lower than that in age-matched C57BL/6 mice.In 12 h light/12 h dark cycle,the circadian amplitude and total exercise amount of 3-,6-and 9-month-old 3xTg-AD mice were (87.0 ± 37.8) counts/5 min and (2.2 ± 0.8) × 104 counts/d,(25.9± 6.3) counts/5 min and (1.1 ± 0.2) × 104 counts/d,(14.3 ± 5.7) counts/5 min and (0.6 ± 0.3)× 104 counts/d respectively,and with a significant decrease from the age of 6 months.Meanwhile,the locomotor activity decreased at night and increased during the day.Conclusion The endogenous circadian rhythm disturbance emerges in 3xTg-AD mice at 3-month-old,while the exogenous circadian rhythm disorder appears at 6-month-old;the degree of disorder in circadian rhythm is gradually aggravated with the increase of age in of the AD mice.

Objective To establish a method to validate the result of transcriptome sequencing using duplex PCR tech -nology combined with capillary electrophoresis .Methods According to a previous study on transcriptome sequencing , eight differentially expressed genes were chosen as target genes for examination .The mRNA expression level of these genes was detected using duplex PCR combined with agarose gel electrophoresis , duplex PCR combined with capillary electropho-resis and Q-PCR, respectively.Then, the verification efficiency of each method was evaluated carefully .Results The ver-ification efficiency of duplex PCR combined with agarose gel electrophoresis was 50%, while that of duplex PCR combined with capillary electrophoresis and Q-PCR was both 100%.Conclusion Combination of duplex PCR technology with capil-lary electrophoresis can be used as an alternative method to validate the results of transcriptome sequencing .

Clinical characteristics,including primary and secondary sexual characteristics,basal endocrine profiles,and imaging results were reviewed.Follow-up data were recorded.16 patients had normal karyotypes,manifest amastia,infantile genitalia,amenorrhea,and delayed epiphyseal fusion at the knee and wrist joints.Serum gonadotropic hormone levels were significantly below normal values.15 patients underwent a gonadotropin-releasing hormone (GnRH) stimulation test and 6 patients had a prolonged GnRH stimulation test.16 patients underwent pituitary or brain magnetic resonance imaging (MRI),which showed small pituitaries in three patients,wing tips of suspicious nodules in 2 patients,an empty sella turcica in 1 patient,and a missing right olfactory bulb and tract in 1 patient.1 patient had no detectable uterus or accessory organs,while the other patients had primordial uteri.1 patient was diagnosed as a case of severe osteoporosis.1 patient suffered from pituitary stalk interruption syndrome.An artificial menstrual cycle due to hormone replacement therapy was not sustained after discontinuation of hormone therapy.As disease severity and the date of initiating hormone replacement varied,the results of treatment were quite different.For patients of reproductive age,it was rare to see a reversal of idiopathic hypogonadotropic hypogonadism after discontinuation of hormone therapy.

ObjectiveTo study the risk factors of renal artery pseudoaneurysm (RAP) following partial nephrectomy.MethodsOpen partial nephrectomy was performed on a total of 464 cases of renal cell cancer from July 2003 to May 2010. Five patients ( 1.1％ ) had postoperative hemorrhage from RAP.The surgery technique of the open partial nephrectomy, the clinical presentation, imaging findings and treatment of RAP were reviewed. The anatomical characteristics of these five renal tumors on enhanced CT were quantified using the R.E.N.A.L. Nephrometry Score System.ResultsAll five cases were male, two had tumors on the left side and three on the right side. Median tumor size was 3.6 cm ( range from 2.5 to 5 cm; Radius score 1 - 2). Four tumors were exophytic of these, three had a major endophytic component (≥50％) deep in the parenchyma (Exophytic/endophytic score 2 ), one was entirely endophytic (score 3 ). The distance of all the tumors to the collecting system was ≤4 mm ( Nearness score 3 ). Four of the five tumors were across the polar line and/or renal axial midline ( Location score 3 ). The other tumor was located under the lower pole ( Location score 1 ) but close to the renal hilar. All patients presented with delayed gross haematuria and decreasing hemoglobin occurred on mean postoperative day 12 (3 -23 day). Four patients complained of flank pain, two of which had signs of hypovolemia requiring blood transfusion. The diagnosis was confirmed by the contrast medium-enhanced CT and selective angiography, and RAP was found most commonly arising from the segmental branch of renal artery. Superselective microcoil angioembolization was successfully performed in four cases, once in three cases and twice in the remaining case. The procedure failed in one patient and a nephrectomy was done. At a mean follow-up of 21 months (12 -30) , all patients had normal renal function without evidence of recurrence.ConclusionsRAP should be considered in all patients who had delayed hematuria after partial nephrectomy. A central, deep tumor and its relationship to the segmental branch of renal artery could be an important risk factor for this complication. Choosing the case properly for partial nephrectomy and suturing the transected vessels and the defect of parenchymal correctly could reduce occurrence of this serious complication. Early use of selective angioembolization could be a primary choice of treatment.

Objective To obtain the information on the frequency of diagnostic X-ray examinations in Guangdong province in order to provide reference data for the rational application of diagnostic radiology.Methods A typical stratified sampling method was used to select 56 medical institutions in 7 districts in Guangdong province for the survey of the frequencies of diagnostic X-ray examinations.Multiple linear regression analysis was performed using the relevant variables of the surveyed sample (total number of hospitals,number of outpatients,number of inpatients,number of radiation workers,and number of diagnostic equipment).The dependent independent variables were fitted to the linear regression equation to estimate the frequency of routine diagnostic X-ray examinations and diagnostic CT examinations and the total frequency of diagnostic medical X-ray examinations in Guangdong province in 2016.Results By the largest percentage contribution,chest radiography accounted for 60.84％ of the routine diagnostic X-ray examinations,brain scans 28.03％ of diagnostic CT examinations,and cardiovascular interventions 48.83％ of interventional radiology.For the group of above 40 years old,the largest percentage contributions were,respectively,routine diagnostic X-ray examination 47.95％,diagnostic CT examinations 65.41％,and interventional radiology 75.64％.All types of medical X-ray examinations are concentrated in the tertiary and secondary hospitals.Based on this survey,the examination frequencies for 2016 in Guangdong were estimated to be,respectively,diagnostic X-ray examination 699 examinations per 1 000 population and CT diagnostic 231 examinations per 1 000 population,with the total of 992 examinations per 1 000 population.Conclusions This survey was completed to a limited degree and less investment.The results showed that the diagnostic radiology in Guangdong province is developing with increased frequencies,with wide varieties of X-ray examination types in the tertiary and secondary hospitals.Relevant competent defpartments should pay attention to strengthening the radiation protection of examined individuals and actively providing guidance on the correct and rational applicc ation of diagnostic radiology so as to achieve profit and avoid disadvantages.

OBJECTIVETo evaluate the structural characteristics and biocompatibility of a novel nano-Ta-Ti alloy rod for its potential application in internal fixation.

METHODSTa coating of a Ti alloy rod with nano-Ta (tantalum) powder was performed using laser melting with symmetrical grooves repleted with nano-Ta powder along the whole length. The microstructure of the cross section of Ta-Ti alloy rod, pore diameter and components of the coating were analyzed using scanning electron microscopy. The influence of this nano-Ta-Ti alloy on proliferation and differentiation of MC3T3-E1 cells was evaluated by MTT cytotoxicity test and ALP activity test.

RESULTSUnder scanning electron microscope, the Ta-coating surface presented with a gross porous (200-300 µm) structure with dense fusion between Ta particles, and no new element was produced after laser melting. Biocompatibility evaluation showed that Ti alloys with and without Ta coating both promoted the proliferation of MC3T3-E1 cells, but the coated alloy showed better performance and obviously promoted the differentiation of the osteoblasts.

CONCLUSIONAlloying between Ta and Ti can be accomplished successfully by laser melting technique, and the alloy obtained has ideal surface structure and good biocompatibility.

3T3 Cells ; Alloys ; Animals ; Biocompatible Materials ; Cell Differentiation ; Cell Proliferation ; Materials Testing ; Mice ; Microscopy, Electron, Scanning ; Osteoblasts ; cytology ; Porosity ; Tantalum ; Titanium

Objective To evaluate the structural characteristics and biocompatibility of a novel nano-Ta-Ti alloy rod for its potential application in internal fixation. Methods Ta coating of a Ti alloy rod with nano-Ta (tantalum) powder was performed using laser melting with symmetrical grooves repleted with nano-Ta powder along the whole length. The microstructure of the cross section of Ta-Ti alloy rod, pore diameter and components of the coating were analyzed using scanning electron microscopy. The influence of this nano-Ta-Ti alloy on proliferation and differentiation of MC3T3-E1 cells was evaluated by MTT cytotoxicity test and ALP activity test. Results Under scanning electron microscope, the Ta-coating surface presented with a gross porous (200-300μm) structure with dense fusion between Ta particles, and no new element was produced after laser melting. Biocompatibility evaluation showed that Ti alloys with and without Ta coating both promoted the proliferation of MC3T3-E1 cells, but the coated alloy showed better performance and obviously promoted the differentiation of the osteoblasts. Conclusion Alloying between Ta and Ti can be accomplished successfully by laser melting technique, and the alloy obtained has ideal surface structure and good biocompatibility.