Objective To present a solution of the hospital information management access control for more secure information sharing. Methods Several commonly used access control models were compared. Some problems of the RBAC model were analyzed in the hospital information circumstances. Results A solution of space-based data access control was presented on the base of the role-based access control (RBAC) module. Conclusion The space-based data access control method can reduce space consumption and maintain data consistency, which is more suitable for the use of the hospital management information system.

Feeding intolerance in preterm infants,which is an important issue that the neonatal pediatri-cians have to work out,leads to malnutrition of early preterm infants and growth restriction which have an impact on later behavioral and cognitive outcomes. Feeding intolerance is related to the immature of gastrointestinal function,perinatal asphyxia,infection and other diseases. Minimal enteral feeding,prokinetic agents and supple-mentation of the enteral probiotics,are used generally,but at present there is no guidelines for the prevention and treatment.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Fistula ; surgery ; Humans ; Hyoid Bone ; surgery ; Infection ; Male ; Middle Aged ; Thyroglossal Cyst ; surgery ; Young Adult

Objective To investigate the effect of radix paeoniae rubra (RPR) on expressions of p38MAPK, NF-κB and iNOS in ltpopolysaccharide (LPS)-induced acute lung injury (ALI) and explore its protective mechanism. Methods Forty Wistar rats with ALI were divided randomly into five groups: saline control group (Group A) , LPS group (Group B), RPR for treatment group (Group C), RPR for prevention group (Group D) and SB203580 group (Group E). The effects of RPR on protein content and the ratio of neutrophiles in bronchoalveolar lavage fluid (BALF), contents of malondidehyde (MDA) and serum NO in lung tissue were observed. Arterial blood was collected for blood gas analysis. Expressions of p38MAPK, NF-κB and iNOS in rat lung tissues were detected. Results Compared with Group A, expressions of p38MAPK, NF-κB and iNOS were significantly increased (P <0.01 orP< 0.05) , the protein content and the ratio of neutrophiles in BALF, contents of MDA and serum NO were significantly higher (P<0.01 or P<0.05) in Groups B, C, D and E. There was a significant decrease in the level of arterial bicarbonate and partial pressure of oxygen in Groups B, C, D and E (P<0.01 or P<0.05). Compared with Group B, the expressions of p38MAPK, NF-κB and iNOS were significantly lower, and the protein content and the ratio of neutrophiles in BALF, contents of MDA and serum NO were significantly decreased, while the levels of arterial bicarbonate and partial pressure of oxygen were significantly higher in Groups C, D and E (P<0.05 or P<0.01). Compared with Group B, the lunginjury of Groups C, D and E was significantly alleviated, while there was no statistical difference among Groups C, D and E in the indices of lung injury. Conclusion Protective effect of RPR on LPS-induced ALI is closely related to the inhibited expressions of p38MAPK, NF-κB and iNOS.

Objective To study arterial distribution of rectus abdominis musculocutaneous flap and to evaluate whether it can be divided into several units for reconstruction. Methods The arteries of the rectus abdominis musculocutaneous flap were studied on 60 sides of cadavers by dissection and angiography. Results The superior epigastric artery (SEA) and the inferior epigastric artery (IEA) continued in a longitudinal direction. Most of their branches took on a typical spiral configuration and communicated with each other within muscle above the level of umbilicus. Many perforating arteries penetrated through the anterior rectus sheath to get to the overlying skin, but the highest concentration of major perforators were in the paraumbilical area. The inferior epigastric artery was more significant than superior epigastric artery in supplying the skin of the musculocutaneous flap. Based on thefstudies of the vascular anatomy of muscles, we could classify arterial distribution into 3 types: type Ⅰ (SEA 26.5 %, IEA 34.6%) revealed a single main intramuscular artery: type Ⅱ (SEA 64.7 %, IEA 48.1%) had two major intramuscular branches; type Ⅲ (SEA 8.8%, IEA 17.3 %) revealed three intramuscular branches. Our anatomic studies showed that the superior and inferior epigastric artery bifurcated or divided into more than two main branches in the majority of cases (SEA 73.5%, IEA 65.4%). Conclusion The rectus abdominis musculocutaneous flap could often be divided into several regions for breast construction which is based on the distribution of each branch of the artery.

Anti-Inflammatory Agents ; pharmacology ; Child, Preschool ; Humans ; Infant ; Infant, Newborn ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications ; pathology ; Prednisone ; pharmacology

Objective To retrospectively analyze the clinical features,diagnostic experience and therapy of pulmonary embolism for reduction of misdiagnosis and missed diagnosis,and for improving the cure rate.Methods The data of clinical features,findings by auxiliary examination and therapeutic efficacy of 67 patients with pulmonary embolism admitted to the First Affiliated Hospital of General Hospital of PLA were summarized.The usual clinical manifestations were summarized based on the clinical symptoms of and the frequency of objective signs in the patients with the correct diagnosis.Auxiliary examinations included routine and sophisticated examinations such as CT pulmonary angiography(CTPA) and emission computed tomography(ECT),which were specially emphasized for summing up and optimizing the diagnosis.Comparisons were made of the therapeutic efficacy and complications between the treatment with thrombolysis combined with anticoagulation and simple anticoagulation.Results The primary clinical manifestations of the patients with pulmonary embolism included dyspnea,cough,chest pain,fever and hemoptysis,etc.Findings of D-Dimer assay might serve as a sensitive but not specific indicator in screening the suspected patients.For the sophisticated examinations,CTPA confirmed the diagnosis in 28 out of 31(90.32%) patients,and ECT confirmed the diagnosis in 39 out of 51(76.47%).All the patients who had undergone lung angiography received the final diagnosis,but the majority of them were reluctant to accept this examination because of potential risk of the technique.The total cure rate of thrombolysis combining anticoagulation was 90.62%(29/32),in which the administration of recombinant tissue-type plasminogen activator(rt-PA)-2h was most efficacious(with 100% of cure rate).Simple anticoagulation therapy gave a lower cure rate(68.57%,24/35) but a higher incidence of hemorrhagic complication(31.25%).After the administration of thrombolysis combined with anticoagulation therapy,both PaO2 and CTPA examinations showed significant changes for the better after the treatment compared with that before the treatment(P

Objective To investigate effects of blood serum concentration of MHD in children with epilepsy of different ages. Methods Two hundred children with epile psy were divided into four groups according to age,group A:<3 years old in-fants;group B:3~6 years old preschoolers;group C:7~13 years old school-age chidren.Group D:14~18 years old adoles-cents,each group had 50 chidren.The serum concentration of active metabolite was detected by high-perform ance liquid chromatography (HPLC)method.Results The serum concentration of MHD increase with age,but there were no statistical significance (P>0.05).Conclusion The indiv idual variation in blood serum concentrations of MHD in children with epi-lepsy adminisered with oxcarbazepine is high,therefore monitoring the blood serum concentration is helpful to adj ust the dose of medication and to promote the implementation of the individualized dosing regimens.

Objective To evaluate the effect of desflurane on emergency in patients undergoing suspension microlaryngoscopy surgery.Methods Forty adult patients with ASA Ⅰ-Ⅱ who underwent elective microlaryngoscopy surgery were randomly divided into desflurane group (group D,n =20) and sevoflurane group (group S,n =20).Time from end of the surgery to resume of spontaneous breathing,extubation,and discharge from postanesthesia care unit (PACU) were recorded.The extent of cough reflex during extubation and cough episode after extubation were recorded.Perioperative mean arterial pressure (MAP) and heart rate (HR) were recorded before anesthesia induction (T0),on suspension laryngoscope instrument (Ttary),the gas concentration reached 1.3 MAC (T1.3mac),1 min after 1.3 MAC (T1.3 1),on arrival at PACU (Tpacu),on extubation (Textu),1 min after extubation (T 1),5 min after extubation (T 5),and on discharge from PACU (Tdis).Results Time from end of the surgery to resume of spontaneous breathing was not significantly different between the two groups.Time to extubation in group D was 4.6 min,which was shorter than it was in group S (P＜0.05).Time to discharge from PACU was 5.0 min in group D,which was shorter than it was in group S (P＜0.05).Incidence of cough was 100％ in group D and 55％ in group S during extubation (P＜0.05).The episode of coughing after extubation was not significantly different between the two groups.Perioperatively,changes of MAP and HR between the two groups were not significantly different (P ＞ 0.05).Conclusions Desflurane for adult patients undergoing suspension microlaryngoscopy surgery was associated with fast emergence.The incidence of cough was higher in group D than it was in group S during extubation,but it continued a short duration.

BACKGROUND:Patients with spinal metastases may appear different degrees of pain and abnormal spinal stability, and can be treated with percutaneous baloon kyphoplasty combined with bone cement implantation. OBJECTIVE:To explore the effect of percutaneous baloon kyphoplasty with bone cement implantation on spinal stability and pain in patients with spinal metastases. METHODS:Twenty-three patients with metastatic spinal tumor were treated with percutaneous baloon dilatation kyphoplasty with polymethyl methacrylate bone cement. There were 10 females and 13 males, and their age ranged from 23 to 71 years. The visual analogue scale score, anterior and posterior edge height of vertebral body, quality of life, and motor function score of patients were observed before and after treatment. RESULTS AND CONCLUSION: Compared with before treatment, the visual analogue scale score and motor function score were significantly decreased, while anterior and posterior edge height of vertebral body were significantly increased in 23 patients at 24 hours after treatment (P < 0.05). After 12 months of folow-up, no case appeared to have spinal nerve root damage, serious adverse reactions and bone cement embolism. The patient'squality of life was significantly improved, compared with before treatment (P < 0.05). Experimental findings indicate that percutaneous baloon dilatation kyphoplasty with polymethyl methacrylate bone cement can significantly improve the spinal stability, relieve the degree of pain, and exert exact effects in treatment of spinal metastases.