In current health care management of floating population pregnant women, health care utilization rate does not reach the ideal level.Push service has been used as a key business in development and utilization of information resources for knowledge service institution, with initiative, customized, personalized, intelligent, dynamic and integrated characteristics.On the basis of analysis of cur-rent situation about the health care management of floating population pregnant women, the paper discussed the applications of push serv-ice.New thinking of application of push service to the health care management is put forward, The right aged women can be early linked through integrated mobile phone SMS, micro message interaction, email, channel type push and other means, and broad cover and whole course service management can be achieved, leading to the enhanced care utilization rate of floating population pregnant women.

Objective·To identify the relationship between the estimated fetal weight (EFW) discordance and birth weight (BW) discordance, and evaluate the accuracy of ultrasonography in predicting birth weight discordance (△BW) of twin pregnancy. Methods·The ultrasound was used to detect the growth of twins at different gestational weeks and the data were analyzed to compare the difference between EFW discordance (△EFW) and ?BW. Results·About 15.9 percent of twins (totally 277 cases) had severe △BW (△BW ≥20%) in our study, and the percentages of dichorionic-diamniotic twin (DCDA) and monochorionic-diamniotic twin (MCDA) were 68.2% and 31.8%, respectively (P>0.01). Compared with △EFW in other gestational weeks,△EFW last time before parturition was most consistent of △BW. Furthermore, the negative predictive value of MCDA was highest (94%) at 22-24 gestational weeks. Conclusion·Twin △BW was relatively better predicted by △EFW last time before parturition. Twin pregnancy without severe △EFW (△EFW<20%), especially MCDA with △EFW<20% at 22-24 weeks, had low probability of selective intrauterine growth restriction in the future.

BACKGROUND:Lumbar spinal stenosis is clinical repaired with decompression, bone fusion and internal fixation, and different internal fixation materials can be chosen during the surgery. OBJECTIVE:To explore the influence of polyetheretherketone (PEEK) pedicle screw fixation combined with interbody fusion on the bone fusion rate of patients with lumbar spinal stenosis. METHODS:A retrospective analysis was performed in 63 cases of lumbar spinal stenosis undergoing decompression and interbody fusion. These patients were divided into control group (titanium internal fixation system,n=31) and experimental group (PEEK pedicle internal fixation system,n=32) according the internal fixation materials folowed by posterior spinal decompression with interbody fusion. The Oswestry dysfunction index scores before and 4, 12, 24 weeks postoperatively and bone fusion rates at 4, 12, 24 weeks postoperatively were compared between the two groups. RESULTS AND CONCLUSION:Oswestry dysfunction index scores showed a gradual decline in both two groups before and 4, 12 and 24 weeks after treatment, but there was no difference at different time (P > 0.05). At 4 and 24 weeks after treatment, there was no difference in the bone fusion rates between the two groups (P > 0.05), but at 12 weeks after treatment, the bone fusion rate in the experimental group was better than that in the control group (P < 0.05). During the surgery, no infection and other adverse events occurred in the two groups. These results indicate that both PEEK and titanium internal fixation systems for lumbar tube stenosis have obtained good results, but PEEK material has a better role in the bone fusion at 4-12 weeks after internal fixation.

Objective Applyingthe traditional Chinese medical knowledge service and sharing system, to explore the medication rules of ankylosing spondylitis in the medical records.Methods The ankylosing spondylitis medical records in the traditional chinese medical knowledge service and sharing system has been searched and 149 prescriptions were identified. The medication frequency, association rules, herbal combination and the cluster analyses were explored.Results Among the 149 prescriptions with 210 drugs, the use of high frequency drugs wereGouji, Baishao, Danggui, Duzhong, Weilingxian, and other medication whose frequency was more than 20 times were good at tonifying liver and kidney, activating blood circulation, clearing heat and promoting diuresis, dispelling cold and removing dampness. The high frequency of drug combinations included Sangjisheng and Gouji, Duzhong and Gouji, Baishao and Gouji, Guizhi and Baishao, Gancao and Danggui.Conclusions The treatment of ankylosing spondylitis with Chinese medicine is mainly based on tonifying liver and kidney, supplemented with drugs for warming Kidney Yang, dispelling cold and dehumidification, promoting blood circulation and removing blood stasis, clearing heat and promoting diuresis, dispelling wind and cold.

Library of China Academy of Traditional Chinese Medical Sciences has retained video data of the early 1980s,which were clinical experiences of the national-level experts of traditional Chinese medicine.To meet the research needs,to rescue the valuable film resources,and to expand continuing education programs,we took use of the hospital's research and LAN infrastructure,combined with multimedia technology,designed and built a “Chinese multimedia resource management platform”,in compliance with the idea of “base on Chinese medicine,focuse on clinical practice and respect for the classics.

BACKGROUND:Insulin-like growth factor-1 (IGF-1) is an important mitogen and an indispensable regulator during normal hair cell development. Extracellular signal regulated kinase 1/2 (ERK1/2) is also expressed in mammalian vestibular organs.OBJECTIVE: To investigate the changes of the expression and the distribution of IGF-1, IGF-1 receptor (IGF-1R) and ERK1/2 in guinea pig's vestibular epithelium following gentamycin injury.DESIGN: A randomly controlled study.SETTING: Department of Otorhinolaryngology, General Hospital of Chengdu Military Area Command of Chinese PLA.MATERIALS: Twenty healthy and adult guinea pigs, weighing 300 to 350 g, provided by the Experimental Animal Center,Fourth Military Medical University of Chinese PLA, were randomly divided into four experimental groups and a control group with 4 in each group.METHODS: The experiment was performed at Department of Otorhinolaryngology Research Laboratory of Xijing Hospital,Fourth Military Medical University of Chinese PLA from January 2002 to May 2002. In the experimental groups,gentamycin was intraperitoneally administered daily (80 mg/kg) for 10 consecutive days. For the control group, 1 mL of 0.9% sterile saline was administered in the same way. The guinea pigs, in which unsteady gait or nystagmus appeared,could be involved in the further experiments. Before being sacrificed, the animals' gait, nystagmus and the amount of food-intake were observed every day. The animals were anesthetized deeply with 50 mg/kg pentobarbital 1, 7, 14 or 21days after the last gentamycin administration and then decapitated. Bilateral otic vesicles were harvested and immersed in 4% paraformaldehyde. Then the specimens were decalcified in 10% ethylenediamine tetraacetic acid (EDTA),thereafter embedded in OCT gel and serially sectioned at a thickness of 10 μm in the cryostat. The behavioral changes of guinea pigs were observed. The morphological changes of vestibular epithelium were examined by hematoxylin and eosin (HE) staining. The expression and distribution changes of IGF-1/1R and ERK1/2 were investigated immunohistochemically. MAIN OUTCOME MEASURES: The behavioral, morphological, expression and distribution changes of IGF-1/1R and ERK1/2 of guinea pigs in each group.RESULTS: Twenty involved guinea pigs entered the stage of final analysis. ① All the guinea pigs' vestibular functions were impaired after gentamycin treatment, then partially restored without any pharmaceutical treatment. ②Morphological injury was obvious after gentamycin treatment, and improved 1 week later. ③The expression of IGF-1/1R was low in the control group, and in the 1-day group it increased significantly to its maximum. After that, its expression decreased gradually, but was still higher in the 21-day group than that in the control group. There were significant differences in the expression of IGF-1/1R among different groups (F =51.8,45.7,P ＜ 0.05). The expression changes of IGF-1 and its receptor were similar. ④The expression of ERK1/2 was low in the control group, and increased gradually after gentamycin toxicity. In the 7-day group, the immunoreactivity reached its maximum. Then the levels of ERK1/2 decreased gradually, but were still higher in the 21-day group than that in the control group. There were significant differences in the expression of ERK1/2 among different groups (F =103.7,106.4, P ＜ 0.01), but no significant differences existed in the expression between ERK1 and ERK2 among different groups (P ＞ 0.05).CONCLUSION: The expression of IGF-1/1R and ERK1/2 in vestibular epithelium increased after gentamycin treatment,and IGF-1 may play an important role as an endogenous mitogen through a paracrine or autocrine manner in the early stage of hair cell self-repair of guinea pigs. ERK1/2 may play an important role in signal transduction during vestibular hair cell self-repair after gentamycin toxicity in guinea pigs.

A H5N2 subtype avian influenza virus isolated from goose belongs to highly pathogenic avian influenza virus, and the intravenous pathogenicity indexes (IVPI) =2.99. But ducks are not sensitive to this isolated influenza virus. The virus can infect mouse but only replicates in lung and has no pathogenicity. HA and NA gene of this isolated strain share 99.4% and 99.8% nucleotide sequence identity to the HA gene of A/chicken/Hubei/ 489/2004 (H5N1) and the NA gene of A/chicken/Jilin/53/01 (H9N2), and share 99.3% and 99.6% amino acid sequence identity to the HA protein of A/chicken/Hubei/489/2004 (H5N1), A/swan/Guangxi/307/2004 (H5N1), A/wild duck/ Guangdong/314/2004(H5N1), A/chicken/Henan/210/2004(H5N1) and the NA protein of A/chicken/ Jilin/53/01 (H9N2). There are several continuous basic amino acids (-RRRKKR-) at the cleavage site of HA protein. Phylogenetic trees analysis of HA and NA gene suggests that the isolated influenza virus probably originated from the reassortment of H5N1 and H9N2 subtype influenza virus.

OBJECTIVE To investigate antibiotic resistance in nosocomial infections with Acinetobacter baumannii from lower respiratory tract in the intensive care unit(ICU) and guide clinically rational use of drug.METHODS Antibiotics susceptibility tests in 109 clinical isolates of A.baumannii from lower respiratiory tract were performed by K-B disk diffusion method.The results were judged according to CLSI 2007.As controls,standard strain was used simultaneously.RESULTS The sensitivity rate to cefoperazone/sulbactam was the highest,arriving at 77.1% and followed by imipenem(57.8%) and meropenem(54.9%).The other antibiotics were below 50.0%,generally.The serious cross-resistance phenomenon was in present.Pan-resistant strains had been detected.CONCLUSIONS The drug-resistant status in nosocomial infections with A.baumannii from lower respiratory tract in ICU is very serious.We should continue to strengthen the monitoring of the antibiotic resistance and prevent the outbreak epidemics of drug resistant strains in ICU.

Objective To explore the value of endothelial dysfunction assessment in predicating major adverse cardiac and cerebrovascular events (MACCE) in peritoneal dialysis (PD) patients.Methods A prospective cohort study included 136 end stage renal disease (ESRD) patients from Jan 1,2009 to Dec 31,2011 was conducted.Endothelial function was assessed by flowmediated dilation (FMD) of brachial artery.Kaplan-Meier method was used to estimate survival rate.The survival difference between the two groups was compared by the log-rank test.Multivariate Cox proportional hazards regression was used to determine the independent risk factors of MACCE.Results In the follow-up period,18 patients in low FMD (FMD≤2.7％) group occurred MACCE,and 13 patients in high FMD (FMD ＞ 2.7％) group occurred MACCE.Compared with high FMD group,MACCE-free survival rate in the low FMD group had a significantly decreased (x2=4.190,P=0.041).Multivariate Cox proportional hazards regression analysis showed that higher level of total cholesterol,lower FMD,longer PD time and higher levels of hs-CRP were all independent predictors of MACCE.Conclusion Reduced brachial artery FMD is an independent risk factor of MACCE,and the application of FMD contributes to the risk stratification of cardiac and cerebrovascular disease in PD patients.

Objective To explore the relationship of insulin resistance with serum 25-hydroxyvitamin D levels and arterial stiffness in elderly patients.Methods A total of 162 elderly inpatients (aged 60 years or over) were recruited from 2012 to 2014.Levels of fasting serum insulin,fasting serum glucose,creatinine and vitamin D were determined.Insulin resistance (IR) was evaluated by the homeostasis model assessment of insulin resistance (HOMA-IR).The patients were divided into the following three groups according to HOMA-IR:the low IR group with HOMA-IR less than 2 (n=78),the median IR group with HOMA-IR between 2 and 6 (n=43),and the high IR group with HOMA-IR greater than 6 (n=41).Arterial stiffness was assessed by carotid-femoral pulse wave velocity (cfPWV).Arterial stiffness and serum vitamin D levels were compared among the three groups.Results cfPWV was increased and the serum 25-hydroxyvitamin D level was decreased in the high insulin resistance group compared with the low insulin resistance group[(13.2± 5.7) μg/L vs.(17.8±6.2) μg/L,(14.3±5.2) m/s vs.(11.9±3.0) m/s].Multiple liner regression analysis showed that IR was negatively correlated with the serum 25 hydroxyvitamin D level (r=-0.63,P＜0.05) and positively correlated with arterial stiffness (r=0.45,P＜0.05) after adjustment for age,sex and other confounders.Conclusions Elderly patients with high insulin resistance may have lower levels of serum vitamin D and higher arterial stiffness.