After expounding the connotation of knowledge management, the author discusses the form of medical knowledge, the significance of medical knowledge management by hospitals, and plans of implementation. In the last section the author lists some issues that should be properly handled in hospitals management of medical knowledge. The first one is that people oriented management ought to be adopted as medical workers are at the core of medical knowledge management. The second one is that it is imperative to give full play to modern information technology, which is the instrument of medical knowledge management. And the third one is that innovations in medical knowledge and technology are the goals of medical knowledge management and it is essential to do a good job of medical knowledge transformation and enhance patient care expertise.

ObjectiveTo observe and investigate the clinical effect and security of warfarin and aspirin in anticoagulant therapy of elderly patients with paroxysmal atrial fibrillation.MethodsOne hundred and ninety-seven elderly patients with paroxysmal atrial fibrillation were chosen and divided by random digits table method into two groups:control group (99 patients) with aspirin oral treatment;experimental group (98 patients) with warfarin oral treatment,the dose was adjusted according to the international normalized ratio (INR).The incidence of thrombosis embolism and adverse reactions of two groups were compared after 1-2 years following up.ResultsThe incidences of thrombosis embolism in control group [ 12.1％ ( 12/99 ) ] and experimental group [ 2.0％ ( 2/98 ) ] had significant difference ( P ＜ 0.05 ).There was no significant difference in the incidence of bleeding between control group[ 2.0％ (2/99)] andexperimental group [ 3.1％ (3/98) ] (P ＞ 0.05 ).The incidence of gastrointestinal reaction and allergic reaction of control group was 17.2％ ( 17/99 ),while the incidence of experimental group was 4.1％ ( 4/98 ),there was statistical difference (P ＜ 0.05 ).ConclusionsWith strictly control of INR in the range between 2.0 and 3.0,warfarin anticoagulant treatment for elderly patients with paroxysmal atrial fibrillation obtains definite clinical efficacy and fewer adverse reactions.It is worthy of clinical expansion and application.

ObjectiveTo analyze the efficacy and safety of erythropoietin for anemia in patients with chronic heart failure.Methods66 cases with chronic heart failure were randomly divided into the observation group and the control group.The control group was treated with conventional anti-anemia iron treatment,and the observation group was taken erythropoietin therapy treatment on the basis of the control group.Both of the two groups were treated for 8 weeks continuously.ResultsThere were statistically significant differences between the two groups of patients after 8 weeks of treatment,cardiac function had improvement after treatment than before treatment (P ＜ 0.05 ).The observation group was significantly superior than the control group.The blood data in the two groups were compared,the Hb,RBC of the observation group were significantly increased compared with before treatment,the difference was significant (P ＜ 0.05).The RBC level did not change significantly in the control group before and after treatment.The electronic patient data in the two groups were compared,the LVEF,FS in the observation group and control group improved significantly compared with before treatment,but improvement of the observation group was significantly better than control group.The degree of improvement in the two groups were compared,the difference was significant( P ＜0.05).The SV,CO in the two groups were compared,it increasedsignificantly than before treatment,the difference was significant(P ＜ 0.05).The SV,CO before and after treatment in the control group didn't improve significantly.The E/A before and after treatment didn't improve significantly.The incidence of adverse drug reactions in the two groups showed no significant difference.ConclusionThe level of anemia had a direct impact on the degree of heart function classification.Following the usual treatment of heart failure,taking erythropoietin for anemia in patients with chronic heart treatment could significantly improve the treatment of patients with curative effect,with the advantages of safe,widely used for clinical application.

Objective To investigate the clinical efficacy of minimally invasive surgery for hypertensive intracerebral hemorrhage (HIH).Methods retrospectively analyzed the clinical data of 82 patients with HIH from March 2009 to May 2012,of43 patients in the observation group with minimally invasive surgery and 39 cases were treated with traditional craniotomy in control group.Comparing the two groups of patients with angiotensin system related indexes and 3 d internal pressure.Results The renin,angiotensin Ⅱ and aldosterone of observation group were (1.1 ±0.2) μg/(L · h),(56.7 ± 12.0) ng/L and (119.2 ± 15.6) ng/L respectively,while in control group were (2.1 ± 0.6) μg/(L · h),(77.4 ± 12.5) ng/L and (150.3 ± 22.4)ng/L respectively,there was a significant difference compared with the control group (t =6.74,8.93,5.61,respectively,P ＜ 0.05).The systolic blood pressure (SBP) preoperative and postoperative 1,2,3 days of observed group were (188 ± 12) mm Hg,(166 ± 10) mm Hg,(153 ± 9) mm Hg,(145 ± 9) mm Hg,while of control group were (189±17) mm Hg,(183 ±16) mm Hg,(179±15) mm Hg,(168±15) mm Hg(P＜0.05).The difference was statistically significant (F in group =19.41,P ＜ 0.05;F between group =21.33,P ＜0.05 ;F interactive group =17.56,P ＜ 0.05),and the observation changes of SBP were stable than the control group.Conclusion Minimally invasive operation in the treatment of HIH,can effectively control the systolic blood pressure levels.Patients recovered quickly,and of which the prognosis was good.

Objective:To investigate the radiation dose and its impact for human health after the Fukushima nuclear accident in Japan.Methods: The Fukushima nuclear accident caused by the Richter 9 earthquake of the east sea of Miyagi prefecture in Japan and huge tsunami was analyzed. And the detection results of the radiation dose from the nuclear accident that was named 7th grade event was evaluated whether existed effect for human health.Results: The radiation dose rate of the environment after this nuclear accident from the first nuclear power plant of Fukushima was increased, and the radioactive ranges of134Cs and137Cs mainly came from the leak of nuclear power plant were 100~500PBq and 6~20PBq, respectively. At the same time, the radioactive contaminations were found existed in water and foods, and they had posed a threat for marine organism.Conclusion: The detection result of nuclear accident of Fukushima has higher value for the evaluation of after-effect about human health, and the effects of Fukushima nuclear accident and its impact for life, property and ecological environment are worth pondering.

Objective:To study the dose measurements methods of neutron andγ-ray for 252Cf neutron after-load radiotherapy machine. Methods:To measure the neutron-γmixed field with one ion chamber that have the similar sensitivities of neutron andγ-ray, another ion chamber that only have sensitivities for γ-ray, little sensitivity for neutron. Verification measurement results with calculated values. Results:Calculate key parameters, measure neutron andγ-ray dose rate at the position of 2.5cm, 5cm, 7.5cm and 10cm from the 252Cf, the Maximum deviation is-5.22%compared with calculated values. Conclusion:The method of twin ion chamber can measure the neutron andγ-ray mixed field dose.

In vitro proliferation of hematopoietic stem cells(HSCs) is performed on the basis ofthe simulation of in vitro blood system by adding growth factors and promoting components. Several protocols for expansion of HSCs in vitro are currently in development. In recent years, with the understanding of the molecular and cellular mechanisms regulating HSCs maintenance and expansion, tremendous progress has been made in this field. In this paper, research progress in the study of the factors determining the in vitro HSCs proliferation is reviewed.

Objective To study the quality testing of dose delivery system of the active spot scanning proton and heavy ion accelerator,in order to provide the reference for the quality control of related equipment.Methods In the four therapy rooms,both 0.6 cc chambers and Gafchromic EBT3 films were used,respectively,to test the accelerator for dose reproducibility,dose linearity,dose stability,depth dose distribution,beam scanning position deviation and radiation field uniformity in each therapy room.Results Dose reproducibility variation coefficients are all less than 1.5％,dose linearity's maximum deviations less than 2％,dose stability's deviations less than 2％,depth dose distribution stability within 2％,beam scanning position deviation less than 1 mm,consistency of irradiation field's deviation less than 2 mm,and flatness within ± 5％.Conclusions The indicators about quality testing for the active spot scanning proton and heavy ion accelerator are all in line with the requirements of IEC standards draft.

Objective To develop the method for testing the consistency of irradiation field produced by the active spot scanning proton and heavy ion accelerator.Methods Calibration of the EBT3 films were carried out with the calibrated ion beam to establish the dose calibration curve.According to the different proton and carbon ion energies (proton:94.29,150.68,212.62 McV;carbon ion:175.99,283.43,412.54 MeV/u),EBT3 films were located in the solid water phantoms in each therapy room,respectively.Finally,the irradiated EBT3 films were scanned and the radiation field size's deviation and flatness were analyzed.Results In different conditions,radiation field size's deviations were all less than 2 mm and the flatness parameters were all controlled below the 5％.Conclusions EBT3 films can be used to test the active spot scanning proton and heavy ion accelerator's radiation field uniformity.

Objective To study the features of hippocampal atrophy (HA) by MRI in mild Alzheimer's disease(AD) patients. Methods Fifteen mild AD patients and 30 healthy controls were included in this study and all subjects were examined by both MRI and MMSE. The differences in the hippocampal volume between the mild AD and the control were analysed, and relationships between the hippocampal volume and age, MMSE scores were evaluated. Results The hippocampal volume of the mild AD was decreased significantly than that of the controls 〔(2 08?0 46)cm 3 vs (3 11?0 19)cm 3, t =2 71, P 0 05). Conclusions MRI-based HA could be used to differentiate the mild AD patients effectively from the healthy subjects and could also be regarded as a status marker for the early clinical diagnosis of AD.