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.

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 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.

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 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.

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 study the effects of standardized-lifestyle intervention on the type 2 diabetic elder patients.Methods The study group enrolled 270 individuals with type 2 diabetes mellitus randomly by using the model of “Zhiji Health Care” and the software of the lifestyle and disease prevention system.Parameters were collected during a six month period for the evaluation,such as fasting plasma glucose(FPG),postprandial glucose(PPG),cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),body mass(BMI),glycosylated hemoglobin(HbAlc),blood pressure,daily intake,total physical activity and effective physical activity and other indicators.Results After six months' standardized lifestyle intervention:(1)in the type 2 diabetic patients,the parameters of weight,BMI,waist circumference,systolic and diastolic blood pressure were significantly decreased(t values were:23.82,25.91,19.56,23.37 and 19.53,respectively,all P ＜ 0.01); FPG,PPG,HbA1c,TC,TG and LDL-C were significant decreased compared with that before intervention(t values were: 12.06,11.82,9.74,6.98,5.79 and 6.10,respectively,all P ＜ 0.0l).Meanwhile,HDL-C was significantly increased(t =2.51,P ＜ 0.05).(2)the total daily intake was significantly reduced compared with that before intervention.The effective exercise burden was significantly increased,compared with that before intervention(P ＜ 0.01).Conclusion Standard lifestyle management helps to control the blood glucose,blood pressurem,body weight and other risk factors,with reduction of complications and medical costs.

AIM To investigate the effects of taurine(TAU) and propafenone(PRO) combination on experimental arrhythmias and its influence on haemodynamics of anesthesized rats' heart. METHODS Rats were pretreated respectively with intravenous administration of saline, TAU, PRO, or TAU and PRO combination. Afterwards, the rats were intravenously administrated with BaCl 2 or aconitine to induce arrhythmia. The arrhythmia lasting time and incidence were observed and recorded on the lead Ⅱ ECG. The cumulative aconitine dosage to induce premature ventricular contraction(PVC), ventricular tachycardia(VT) and ventricular fibrillation(VF) were calculated respectively. The haemodynamic parameters such as LVSP, HR, +d p /d t max were recorded continuously in anesthetized rats pretreated with iv TAU, PRO or TAU and PRO combination. RESULT In BaCl 2 arrhythmia, the arrhythmia duration was shortened significantly; and the arrhythmia incidence was decreased in the combination group, as compared with the single same dosage drug groups. In aconitine arrhythmia, the cumulative aconitine dosages to induce PVC, VT and VF were increased significantly in the combination group. Haemodynamics parameters showed that PRO(2mg?kg -1 iv) significantly decreased LVSP and +LVd p /d t max , while these parameters were not significantly changed in the combination group with same dose of PRO. CONCLUSION TAU and PRO have synergism in antiarrhythmia in both BaCl 2 and aconitine induced arrhythmia; TAU may alleviate cardiac depression exerted by PRO.

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.