It is an important object to manage current electronic medical history.Authors report the quantity management of electronics medical record, the history cases' legal effect and secrete management,the case's usage management and the case's safe management so as to increase the management quantity of electronics medical cases.

Objective To investigate the clinical value of observing the differences of GSK‐3βprotein expression and activity lev‐el in the peripheral blood mononuclear cells between type 2 diabetes mellitus patients and healthy people .Methods Using ELISA to detect the GSK‐3βprotein expression and activity levels of people who contained 30 patients with type 2 diabetes whose blood glu‐cose were not controlled (test group 1) ,30 cases of patients with type 2 diabetes whose blood glucose were controlled (test group 2) and 30 cases of healthy human and all the data were analyzed .Results The GSK‐3βprotein content of Type 2 diabetes mellitus group was higher than the control group(P<0 .05) ,the activity level of GSK‐3βin test group 1 was higher than the control group and test group(P<0 .05) .The GSK‐3β protein content of test group 2 was higher than the control group(P< 0 .05) .The male GSK‐3βactivity level in the test group 1 was higher than the men′s in the control group(P<0 .05) .Conclusion The GSK‐3βprotein content has a high expression in the type 2 diabetes mellitus patients .After drug treatment ,the patients ,who have controlled the blood glu‐cose effectively ,still showes high expression of the GSK‐3βprotein content ,but the activity levels showes a significant decline .In male pa‐tients with type 2 diabetes blood sugar in the control group of GSK‐3βshowes significantly higher activity level .

Objective: To learn the disease entities and medical costs of the patients admitted in the Pediatric Department of a general hospital.Methods: We collected from the Hospital Information System(HIS) the related data of the patients admitted in the Department of Pediatrics from October 2001 to October 2007 and analyzed the patients' main types of diseases and medical expenditure.Results: Among the total number of 8 062 patients,diseases of the genitourinary,respiratory and digestive systems and of blood and hematogenic organs accounted for 47.82%,36.78%,4.22% and 3.16%,ranking as the first 4 disease entities.The per patient medical costs in the first 4 places were those of the diseases of the musculoskeletal system and connective tissues($6 368),tumors($5 845),diseases of the genitourinary system($5 818) and congenial anomalies($5 469).Conclusion: The largest number of patients were those with genitourinary system diseases,and the highest medical costs per patient were those of the diseases of the musculoskeletal system and connective tissues in the Department of Pediatrics.

Objective:To investigate the utilization and its influence factors of medical records in non-hospital staffs. Methods:Though the registration of the record copy and consult for non-hospital staffs from Sept.2002.to Aug.2006,the patients' personal information,case number,discharge date,utilization date,user persons,purpose and the copy contents,etc.were investigated.And the information was statistically analyzed by EXCEL.Results:51.55% of the utilization were for the medical insurance purpose.In which 54.61% of the total users were the patients themselves and 44.17% of which were the insurance organizations.Admission record was the most frequently copied item(22.79%) and record utilization was mostly occurred within one month after the discharge(35.08%).Conclusion:It should be emphasized that ①the medical staffs' legal consciousness be further wakened;②the management of medical records be strengthened;③the copy processes of the medical records be standardized;④the service be further improved.

Objective:To investigate the diagnostic accuracy of serological indicators and evaluate the diagnostic value of a new established combined serological model on identifying the minimal hepatic encephalopathy (MHE) in patients with compensated cirrhosis.Methods:This prospective multicenter study enrolled 263 compensated cirrhotic patients from 23 hospitals in 15 provinces, autonomous regions and municipalities of China between October 2021 and August 2022. Clinical data and laboratory test results were collected, and the model for end-stage liver disease (MELD) score was calculated. Ammonia level was corrected to the upper limit of normal (AMM-ULN) by the baseline blood ammonia measurements/upper limit of the normal reference value. MHE was diagnosed by combined abnormal number connection test-A and abnormal digit symbol test as suggested by Guidelines on the management of hepatic encephalopathy in cirrhosis. The patients were randomly divided (7∶3) into training set ( n=185) and validation set ( n=78) based on caret package of R language. Logistic regression was used to establish a combined model of MHE diagnosis. The diagnostic performance was evaluated by the area under the curve (AUC) of receiver operating characteristic curve, Hosmer-Lemeshow test and calibration curve. The internal verification was carried out by the Bootstrap method ( n=200). AUC comparisons were achieved using the Delong test. Results:In the training set, prevalence of MHE was 37.8% (70/185). There were statistically significant differences in AMM-ULN, albumin, platelet, alkaline phosphatase, international normalized ratio, MELD score and education between non-MHE group and MHE group (all P<0.05). Multivariate Logistic regression analysis showed that AMM-ULN [odds ratio ( OR)=1.78, 95% confidence interval ( CI) 1.05-3.14, P=0.038] and MELD score ( OR=1.11, 95% CI 1.04-1.20, P=0.002) were independent risk factors for MHE, and the AUC for predicting MHE were 0.663, 0.625, respectively. Compared with the use of blood AMM-ULN and MELD score alone, the AUC of the combined model of AMM-ULN, MELD score and education exhibited better predictive performance in determining the presence of MHE was 0.755, the specificity and sensitivity was 85.2% and 55.7%, respectively. Hosmer-Lemeshow test and calibration curve showed that the model had good calibration ( P=0.733). The AUC for internal validation of the combined model for diagnosing MHE was 0.752. In the validation set, the AUC of the combined model for diagnosing MHE was 0.794, and Hosmer-Lemeshow test showed good calibration ( P=0.841). Conclusion:Use of the combined model including AMM-ULN, MELD score and education could improve the predictive efficiency of MHE among patients with compensated cirrhosis.