Objective: To design a set of digital medical record MIS. Methods: According to the problems of paper-based medical records management, the protocol of digital medical record MIS using micro-digital imaging technology was proposed. Results:It realized electronic medical record storage, the front page information of medical records, medical record circulation and statistics of medical information. Conclusion: The storage of paper based medical record was effectively compressed, the information level of medical record management was clearly promoted after using the digital medical record MIS. It realized the conservation and usage for current medical records, guaranteed information security and data sharing etc.

according to the difference of femoral eccentricity on the affected and healthy sides. In the reduction group (30 cases), the difference value was <-5 mm. In the normal group (87 cases), the difference value was -5-5 mm. In the increased group (45 cases), the difference value was > 5 mm. Femoral stem and femoral prosthesis type were compared among different groups. SF-12 scale score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Harris score were evaluated and compared before and after replacement. RESULTS AND CONCLUSION:Standard eccentricity of femoral prosthesis mainly accounted for 77%, 63% and 73% in the reduction group, normal group and increased group, respectively (P > 0.05). No significant difference in average eccentricity was detected in each group between the affected and healthy sides (P> 0.05). WOMAC score was significantly higher after replacement than that before replacement in three groups (P < 0.05). No significant difference in WOMAC score was found among three groups before replacement (P > 0.05). No significant differences in pain and stiffness were detected among three groups after replacement (P > 0.05), and significant differences in physical function were found (P < 0.05). The physical function was highest in the normal group. No significant difference in SF-12 scale score was seen in the three groups before and after replacement (P > 0.05). The physical ability score was elevated after replacement in the three groups (P < 0.05). Mental scores were significantly elevated in reduction and normal groups (P < 0.05). The excelent and good rate of Harris score was significantly higher in the increased group (96%) than in the reduction group (70%) and normal group (87%) (P < 0.05). These findings indicate that the increased eccentricity contributed to the pain easement after total hip arthroplasty and promoted functional recovery. The decreased eccentricity could worsen patient’s pain, and was not conducive to the restoration of joint function after replacement.

Purpose Intravoxel incoherent motion (IVIM) MR is a method developed in recent years which can quantitatively evaluate the diffusion and perfusion characteristics of microenvironment.The aim of this study was to investigate the application value of IVIM in assessing relapsing-remitting multiple sclerosis (RRMS).Materials and Methods A retrospective analysis of the clinical data of 27 patients with RRMS confirmed clinically at the First Affiliated Hospital of Chongqing Medical University from Jun.2015 to Jan.2016 was carried out in the study.All the patients underwent the conventional MRI and IVIM MRI based on multi-b-factor (b values of 10,20,30,40,50,100,150,200,350,500,650,800,1000 s/mm2) with 3.0T MR scanner.The apparent diffusion coefficient (ADC),ADCslow,ADCfast and f values were evaluated since they could reflect the diffusion and perfusion status of RRMS lesions and normal-appearing white matter (NAWM) regions.Results The ADC,ADCslow,ADCfast and f values of the non-enhancing (NE) lesions were significantly higher than those in the NAWM regions both near and far from NE lesions (P＜0.05).However,the ADC,ADCslow,ADCfast and f values in the NAWM regions close to the NE lesions had no significant differences with those in the NAWM regions far from the lesions (P＞0.05).Conclusion The IVIM MRI can measure the diffusion and perfusion status of the lesions and NAWM in RRMS patients,which,therefore,is helpful in speculation of the pathological changes of RRMS lesions and in its injury classification and identification.

Objective To discuss the role of therapeutic drug monitoring (TDM) in pharmaceutical care by successful intervention of severe drug-drug interaction in 3 patients with hematological disease treated with voriconazole and rifampin.Methods Three patients with hematological disease were monitored for the plasma concentration of voriconazole before,during,and after the concomitant use of rifampin.The severity of this drug interaction was revealed,risks for developing invasive fungal infection and tuberculosis dissemination after chemotherapy were evaluated based on the TDM results,and alternative regimens were recommended.Results Voriconazole plasma concentration was normal at baseline but significantly depressed after combination with rifampin in all 3 cases.Concomnitant use of rifampin leads to a rapid decline in plasma concentration of voriconazole in 2-3 days,and withdraw of this enzyme induction effect takes 8-10 days after discontinuation of rifampin.Conclusion TDM is a helpful tool for providing pharmaceutical care,it helps to objectively visualize the degree of clinically important drug-drug interactions.Clinical evidence together with TDM results suggests high risk for developing invasive fungal infection and tuberculosis dissemination in hematology patients while using this combination therapy.Discontinuation of rifampin was suggested and accepted.For these patients,combination of voriconazole and rifampin should be avoided.

PurposeMultiple sclerosis (MS) is characterized by time and spatial multiple, and it is the main reason for disabled young people. This paper aims to investigate the application of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with dual-compartment Tofts model in relapsing-remitting multiple sclerosis (RRMS) and its correlation with clinical scoring.Materials and MethodsThe clinical data of 25 patients with RRMS were retrospectively studied. The patients underwent the conventional MRI and the DCE-MRI examination. The result was processed by dual-compartment Tofts model and quantitative measurement was carried out in terms of volume transfer constant (Ktrans), rate constant between EES and blood plasma (Kep) and the volume of EES per unit volume of tissue (Ve), cerebral blood flow (CBF) and cerebral blood volume (CBV) of the lesions and normal-appearing white matter (NAWM) regions. The correlation between imaging biomarkers, expanded disability states scale (EDSS) and disease duration were also analyzed.Results ① The differences of MR imaging biomarkers Ktrans and Kep were significant between the regions of nonenhancing (NE) lesions, the NAWM regions near NE lesions and the NAWM regions far from NE lesions (χ2=6.777 and 22.343,P<0.05); however, Ve in the NE lesions had no significant differences compared with that in the NAWM regions near and far from NE lesions (P>0.05).②The CBF and CBV among these three groups had no signiifcant differences (P>0.05).③The CBF of NE lesions was signiifcantly correlated with disease duration (r=0.518,P<0.05);however, the other markers like Ktrans, Kep, Ve, CBF and CBV were neither signiifcantly correlated with EDSS nor with disease duration (r=-0.371-0.052,P>0.05).Conclusion DCE-MRI with Tofts model can quantitatively measure microvascular permeability and perfusion characteristics of lesions and NAWM regions, which thus reflects hemodynamic changes in patients with multiple sclerosis.

Objective To evaluate dynamic contrast-enhanced MRI (DCE-MRI) with Patlak model for depicting the perfusion and permeability characteristics of lesions and normal-appearing white matter (NAWM) regions in patients with relapsing-remitting multiple sclerosis (RRMS). Methods Twenty-three patients with clinical confirmed RRMS were retrospectively analyzed, who had underwent conventional MRI and DCE-MRI using a 3.0 T MR scanner . The clinical characteristics and imaging data were collected. Post-processing was performed using the Patlak model. Volume transfer constant (Ktrans), fractional plasma volume (Vp) and perfusion parameters including cerebral blood flow (CBF) and cerebral blood volume (CBV) were represented as median and interquartile range(IQR). The four parameters of non-enhanced(NE) lesions, NAWM regions located close to NE lesions(NAWM close) and NAWM regions located far from NE lesions (NAWM far) were compared using the Kruskal-Wallis H rank sum test. Artificial color mappings were also proceeded. Results MR imaging biomarkers Ktrans was 0.132(0.064, 0.233) min-1 for NE lesions, 0.111 (0.060, 0.233) min-1 for NAWM close and 0.077(0.044, 0.185) min-1 for NAWM far, respectively. CBV was 10.660(5.555, 22.193) ml · 100 g-1 for NE lesions, 9.359(4.883, 16.290) ml · 100 g-1 for NAWM close, 6.814 (4.699, 13.623) ml·100 g-1 for NAWM far, respectively. Ktrans and CBV of NE lesions was significantly higher than that of NAWM far(χ2=7.582,P<0.05;χ2=6.394,P<0.05, respectively). Ktrans and CBV of NAWM close showed no significant differences compared with NE lesions and NAWM far. Vp and CBF had no significant differences between NE lesions, NAWM close and NAWM far regions(P>0.05). Conclusion DCE-MRI with Patlak model can measure perfusion and permeability characteristics and hemodynamic abnormalities of NE lesions and NAWM regions in patients with multiple sclerosis.

Background:To date,clinical studies on intravenous rabeprazole sodium for treatment of duodenobulbar ulcer bleeding are still lacking.Aims:To evaluate the efficacy and safety of intravenous rabeprazole sodium with different doses and times of administration in treating patients with duodenobulbar ulcer bleeding.Methods:A multicenter,randomized, double-blind,positive drug parallel-group controlled trial was performed.One hundred and five patients with duodenobulbar ulcer bleeding proved by gastroscopy were randomly divided into four groups.Patients in group A,B and C were treated with intravenous rabeprazole sodium 20 mg qd,40 mg qd and 20 mg bid for 5 days,respectively.Patients in control group received intravenous omeprazole sodium 40 mg bid for 5 days.Hemostatic rate was the primary endpoint,hemostatic time and amount of blood transfusion were the secondary endpoints.Results:Hemostatic rates in group A,B,C and control group were 96.2% (25 /26),92.6% (25 /27),100.0% (26 /26)and 100.0% (26 /26),respectively,no significant difference was seen between the four groups (P >0.05).Median hemostatic time in group A,B,C and control group were 24 (24,72)h,24 (24,72)h,24 (24,48)h and 24 (24,48)h,respectively,no significant difference was seen between the four groups (P >0.05).No patient need blood transfusion during the treatment course.Slight leucopenia was the exclusive adverse effect seen in one case in group C after accomplishment of treatment.Conclusions:Three intravenous rabeprazole sodium regimens with different doses and times of administration were all effective and safe for treatment of mild to moderate duodenobulbar ulcer bleeding.Administration with 20 mg bid seems more effective among the three regimens.

Objective To explore the applications of case analysis learning and traditional teaching method in clinical practice teaching effect for students majoring rehabilitation therapy in the course of musculoskeletal rehabilitation.Methods 83 program students of Rehabitation Therapeutics in grade 2011 were chosen to participate in the clinical practice teaching in the course of musculoskeletal rehabilitation of 12 credit hours.Class 1 was taught by the traditional teaching method,while Class 2 was taught by the case analysis learning,making clinical case analysis,practical operation and case discussion working as teams.After learning,we made an analysis of two classes through the form of theory examination,practical operation and the questionnaire.The evaluation scores were shown by (x ± s)and comparison was made between the two groups with t test after SPSS software for statistical analysis.Results Taught by the case analysis,the theoretical performance of Class 2 was (83.37 ± 5.59),better than Class 1 (80.85 ± 6.98),but the difference was not statistically significant (P=0.056),but in the practice operation the achievements of Class 2 were (72.65 ± 8.05) points better than Class 1 (66.49 ± 12.86),and the difference was statistically significant(P=0.024).The survey results showed that in Class 2 which adopted case analysis teaching,students' satisfaction was higher than that of Class 1 which kept traditional teaching,and the difference was statistically significant(P＜0.05).Conclusion Case analysis teaching in musculoskeletal rehabilitation application effect is better than the traditional teaching in clinical practice teaching and can be extended to other clinical teaching of rehabilitation therapy specialty.

Objective To study the mechanism of glutamine dipeptide on wound healing after operations on bums. Methods Totally, 30 burned patients were randomly divided into study group and control group (15 cases in each group). All patients received parental nutrition support after operation. Study group patients were supplemented with glutamine dipeptide at a dose of 0. 5 g · kg±1 · d±1. The plasma free hydroxyproline level was measured by a standard amino acid analyzer 1 day before operation and 7 days after operation and the wound healing time was recor± ded. Results The plasma free hydroxyproline levels of both groups were higher than the normal values before opera± tion but without significant difference [control group: (2. 24 ±0. 84) fig/ml, study group: (2. 32 ±0.92) μg/ml, normal value: (1.27 ±0.44) μg/ml]. On the post±operative 7 day, the plasma free hydroxyproline level of study group [ (4. 31 ±1. 05) μg/ml] was significantly higher than that of control group [ (3. 04± 1. 01) μ/ml] (P = 0.002). The wound healing time of study group [ (29. 7±5.3) d] was shorter than that of control group but with± out significant difference [ (33. 3 ±7.5) d, P = 0. 14 ]. Conclusion The intravenous supplementation of glutamine dipeptide may increase the plasma hydroxyproline level after operation and thus promote wound healing.

OBJECTIVE: In order provide important evidences for epidemiologic survey, clinical diagnosis, treatment and preservation of allergic diseases in this area, we investigate the distribution of the common allergens in allergic rhinitis and allergic asthma in Jingmen area and the sensitization condition of the major allergen house dust mite. METHOD: Four hundred and twenty-five patients with suspected allergic rhinitis and asthma in our area accepted skin prick tests of 10 standard allergen agents and specificity IgE detection. The different positivity ratios of allergens in different age groups were compared and the correlation between the two different technique methods testing the dust mite allergen was analyzed. RESULT: Among 425 patients with suspected allergic rhinitis and asthma in our area, 298 patients were positive and 89 patients suffered a combined allergic asthma. House dust mite (292 cases) and dermatophagoides farinae (289 cases) were the commonest allergens. The other common allergens were mugwort (45), ragweed (31), fungus I (19), fungus II (15), spring-pollen II (14), poly-animal hair (14), spring-pollen I (9), poly-feather (3). There was a correlation between skin test and sIgE test for house dust mite, dermatophagoides farinae in children group, and the positivity ratios were significantly higher than the adults group. CONCLUSION Dust mite is the most important allergen in allergic rhinitis and asthma in Jingmen.
Adolescent ; Adult ; Allergens ; analysis ; immunology ; Animals ; Asthma ; diagnosis ; epidemiology ; immunology ; Child ; China ; epidemiology ; Female ; Humans ; Immunoglobulin E ; blood ; Male ; Middle Aged ; Pyroglyphidae ; Rhinitis, Allergic, Perennial ; diagnosis ; epidemiology ; immunology ; Skin Tests ; Young Adult