Cloud computing is the third technological revolution of IT industry following personal computers and the Internet,which is bound to have a profound impact on hospital informationization.Based on an analysis of the barriers for building the information system in the hospital,we proposed the development and implementation plan of the private cloud.This plan proves the cloud can make server resources more efficient and downsize operating costs significantly.In the end,we discussed the value and perspective of hospital private cloud.

Objective To investigate the effects of exercise on learning and memory after cerebral ischemia. Methods Ninety Sprague-Dawley rats were randomly divided into a sham-operated group, a model group and a treadmill training group ( n=30 for each) , which were further subdivided into groups to receive 7 days, 14 days or 28 days of training with 10 rats in each. The training was treadmill running at 10 m/min for 30 min a day. Cerebral ische-mia was induced in the model and training groups using permanent, bilateral common carotid artery occlusion. The training began three days after the operation. Morris water maze tests were used to measure the rats′ learning and memory ability, and Nissl staining was employed to detect the survival rates of pyramidal neurons in the CA1 area of the hippocampus. Results The average escape latency in the treadmill trained group had shortened significantly by day 7, then further by days 14 and 28. It was significantly shorter than the model group′s average at each time point. The average platform crossing time increased significantly compared with the model group′s average. Few dead neu-rons were observed in the sham-operated group. On days 14 and 28 the average survival rate of pyramidal neurons in the model group was significantly lower than in the treadmill training group or the sham-operated group, though there was no significant difference on day 7. Conclusion Treadmill training can improve learning and memory after cere-bral ischemia, at least in rats. Better effects can be observed after longer training.

Objective To analyze the correlation of carotid artery stenosis(CAS)with postoperative cognitive dysfunc?tion(POCD)in patients who underwent off-pump coronary artery bypass grafting(OPCABG). Methods Between March 2014 and October 2014, a total of 157 patients who underwent OPCABG in our hospital were enrolled and divided into POCD group and non-POCD group according to their performance respondent to MMSE questionnaire survey conducted 5 days before operation. LOTCA questionnaire survey was conducted at the first day and 7th days pre-and post-operation re?spectively in order to investigate the influence of CAS on POCD in patients. Results The incidence of POCD was 30.6%(48 out of 157). Advanced age, diabetes,cultural level,carotid artery stenosis, Hb level after operation, score of LOTCA question?naire survey conducted before surgery,time of respirator and the time spend in ICU were significant predictive factors for POCD. However, multivariate logistic regression analysis showed that age, CAS and the time spend in ICU were independent risk factors for POCD, especially CAS(OR=5.078,95%CI:2.211-11.662, P<0.001). Patients with severe CAS suffer from a significant decline in cognitive function on space, time, action and ideation. Conclusion CAS is a predominant risk factor for POCD in patients undergoing OPCABG.

OBJECTIVE To investigate the patterns of catheter related infection in critically ill patients after cardiac surgery with prolonged central venous catheters. METHODS The materials of culture of catheter tip and subcutaneous segments in 166 critically ill patients after cardiac surgery with prolonged central venous catheters were reviewed. RESULTS The positive pathogenic bacteria ratio of catheter tip segments was 41.0% and the positive ratio of catheter subcutaneous segments was 47.0%.Catheterization longer than 18 days,body temperature higher than 38.5 ℃ and insertion sites of femoral veins were the variables associated with significantly increased risk of catheter related infection. CONCLUSIONS The positive pathogenic bacteria ratio of central venous catheters in critically ill patients after cardiac surgery with prolonged central venous catheters is high,more attention must be paid to catheter related infection,and efficacious interventions must be laid down.

Objective To explore the activity and its possible neural mechanism of brain default mode network by using resting state functional magnetic resonance imaging (fMRI) in patients with mild cognitive impairment (MCI). Methods The 20 amnestic MCI patients and 25 healthy controls were included in this study, and all subjects underwent mini-mental state examination (MMSE), auditory verbal learning test (AVLT) and fMRI. The data were analyzed by amplitude of low frequency fluctuation (ALFF), and the enhanced and weakened regions of ALFF were observed and compared in both MCI patients and healthy controls. Results MMSE and AVLT tests showed that the memory function was seriously impaired in MCI patients compared with healthy controls, which is based on the short and long delayed episodic memory impairment (2.4±1.7 vs. 6.6±1.4, t=3.70, P＜0.01; 2.1±1.6 vs. 6.7±1.5, t=4.16, P＜0.01). The resting state fMRI showed that MCI patients had significant decreases of ALFF in hippocampal formation, parahippocampal cortex and lateral temporal cortex as compared with health controls (t=2.58, 2.43 and 1.75, all P＜0.01), which were closely relevant to the episodic memory. And they had significant increases in temporal-parietal joint and inferior parietal lobule (t=3.14 and 2.77, both P＜0.01). Conclusions MCI patients show significant decreased active intensity of some DMN nodes that is related to episodic memory in resting state. Increased active intensity in MCI patients would be some type of compensation.

This paper aimed to review the recent literature on the TCM treatment for stroke sequelae. The content summarized and discussed the definition of stroke sequelae, herbalmedicine, TCM patents, acupuncture and so on. Sequelae of stroke’s pathogenesis was mainly caused by deficiency generating stasis, so the treatment principles were to tonifying Qi and blood and promote circulation and remove stasis with the common prescriptions, such asBuyang-Huanwudecoction,Xuefu-Zhuyu decoction andDihuang-Yinzi. Meanwhile, Chinese medicine patents and acupuncture treatment canimprove the brain function and ADL.

ObjectiveTo evaluate the efficacy of sphenopalatine ganglion stimulation with acupuncture for moderate-to-severe perennial allergic rhinitis.MethodsA total of 50 patients were recruited into a sphenopalatine ganglion stimulation group and a routine acupuncture group according to order of presentation, with 25 in each group. The sphenopalatine ganglion stimulation group received sphenopalatine ganglion stimulation with filiform needle, 1-2 sessions/week for 4 weeks. The routine acupuncture group received traditional acupuncture, withyingxiang(LI 20),yintang(GV29),fengchi(GB20),fengfu(GB16),zusanli(ST36) as the maln points, andyingxiang(LI 20),yintang(GV29),fengchi(GB20),fengfu(GB16),zusanli(ST36) as the adjunct points, 1-2 points from both the maln and adjunct points in each session, 2 sessions/week for 4 weeks. The nasal symptom score (2004 version), the total nasal symptom score (TNSS) and the total non-nasal symptom score (TNNSS) were used to evaluate symptom improvement. The Rhinoconjunctivitis Quality of Life Questionnalre (RQLQ) was used to assess the patients’ quality of life. The time to symptom alleviation, duration of symptom alleviation in every session and the recurrence duration during 1 month after the treatment were compared between the two groups.Results After the treatment, the score of the nasal symptom score (99.74 ± 31.89vs.196.83 ± 31.22;t=-4.912,P=0.001), TNSS (33.63 ± 12.37vs.71.82 ± 19.21;t=-3.463,P=0.003), TNNSS (33.63 ± 12.37vs.71.82 ± 19.21,t=-3.463,P=0.003) in the sphenopalatine ganglion stimulation were significant lower than those in the routine acupuncture group. Compared with the routine acupuncture group, the time to symptom alleviation was significant shorter (13.85 ± 4.21 minvs.45.63 ± 7.87 min;t=-1.763,P=0.008), while the duration of symptom alleviation was significant longer (37.92 ± 9.94 hvs.3.35 ± 1.23 h;t=7.637,P<0.01) after each session in the sphenopalatine ganglion stimulation group. Four weeks after the treatment, RQLQ score in the sphenopalatine ganglion stimulation group was significant lower than that in the routine acupuncture group (8.48 ± 3.71vs.37.68 ± 12.46;F=-7.312,P<0.01). The recurrence duration during 1 month after the treatment in the sphenopalatine ganglion stimulation group was significant longer than that in the routine acupuncture group (4.12 ± 2.15 dvs.23.53 ± 4.63 d;t=-8.879,P=0.003).ConclusionSphenopalatine Ganglion stimulation is superior to routine acupuncture in treatment of patients with moderate-to-severe perennial allergic rhinitis.

Objective To evaluate the early diagnostic value of Heart-type fatty acid-binding protein(H-FABP) for myocardial infarction in patients post off-pump coronary artery bypass (OPCAB).Methods Between March 2009 and July 2009,59 patients had been undergone OPCAB for the first time.They were divided into 3 groups (normal group,myocardial injury group and myocardial infarction group) by myocardial-bound creatiue kinase (CK-MB) 、cardiac troponio Ⅰ (cTnI) 、electrocardiogram (ECG) and echocardiogram.Serial blood samples were taken during perioperation to quantify blood levels of H-FABP,CK-MB,cTnI.Results The average H-FABP value for the patients in the myocardial infarction group is higher than the others ( P ＜ 0.01 ).H-FABP reached the peak valve at 2 hours and decreased at 4 hours after the patients arrived at ICU.H-FABP got back to the baseline one day postoperation.Receiver operating characteristic curves( ROC curve) demonstrated that H-FABP had greater diagnostic ability of myocardial infarction postoperation with area under the curve at the time of arriving at ICU ( 0.900,95％ CI 0.818 -0.981 )and 2 hours later (0.832,95％ CI 0.718 -0.946).At the time of arriving at ICU,sensitivity of H-FABP for diagnosis was 90.9％ and specificity was 77.1％.At the point of 2 hours later,sensitivity was 72.7％ and specificity was 75.0％.Conclusion The H-FABP seems to be an excellent early biomarker of cardiac necrosis after OPCAB.

Objective To discuss the polymorphisms of asthma susceptibility gene ORMDL3 in infantile wheezing,in order to provide a theoretical basis for early diagnosis of asthma.Methods One hundred and fifty wheezing infants were recruited and divided into 2 groups as asthma predictive index(API) positive group(n =80) and negative group (n =70).Taqman probe was applied to detect the genotypes of 2 single nucleotide polymorphisms (SNPs)in childhood asthma susceptibility gene ORMDL3,which were rs4794820 and rs7216389.The genotype distributions were analyzed and compared between 2 groups,and the correlations among genotype distribution and tidal breath pulmonary function,fractional exhaled nitric oxide (FeNO) concentration,percentage of eosinophils (EOS％),serum immune globulin E (total IgE) levels respectively were also analyzed,respectively.Results (1) The frequencies of rs4794820 AG and rs7216389 TC heterozygotes in the API positive group were the highest,which were significantly higher than those in the negative group(58.75％ vs.31.42％,56.25％ vs.32.86％ respectively,all P ＜0.01).The frequencies of GG and TT homozygotes in the API negative group were the highest,which were significantly higher than those in the positive group (58.57％ vs.30.00％,57.14％ vs.31.25％ respectively,all P ＜0.01).(2)The time to reach the peak expiratory flow in tidal breathing over the total expiratory time (TPTEF/TE) and the volume to reach the peak expiratory flow in tidal breathing over the total expiratory volume (VPEF/VE) of the infants in the API positive group were less than those in the API negative group(16.87 ±5.31 vs.20.12 ± 5.23,20.87 ± 5.92 vs.25.56 ± 6.77,respectively),and the FeNO concentration was higher than that in the API negative group [(22.44 ± 9.77) ppb vs.(13.23 ± 7.90)ppb],and the differences were significant (t =-3.776,-4.490,6.377,respectively;all P ＜ 0.01).(3) In the API positive group,the TPTEF/TE and VPEF/VE of the infants who expressed AG/TC genotype were lower than those who expressed GG/TT genotype (14.55 ± 4.83 vs.19.91 ± 4.17,18.85 ± 4.26 vs.25.20 ± 7.06,respectively,t =-4.727,-3.976,all P ＜ 0.01);while the FeNO concentrations,EOS％ and total IgE levels were higher than those who expressed GG/TT genotype [(25.02 ± 8.77) ppb vs.(18.39 ± 6.56) ppb,7.16 ± 2.62 vs.5.50 ± 1.34,(366 727 ±275 533) IU/L vs.(166 826 ± 62 865) IU/L,respectively] (t =3.484,3.409,4.589 respectively;all P ＜ 0.01).Conclusions Childhood asthma susceptibility gene ORMDL3 SNPs rs4794820 AG and rs7216389 TC heterozygotes are the risk factors for API positive infantile wheezing.The pulmonary function damage and airway inflammation of the infants who expressed AG/TC genotype are more serious than those who expressed GG/TT genotype,and more likely to develop persistent asthma.

ObjectiveTo access the predictive value in Postoperative mortality in patients undergoing coronary artery bypass grafting(CABG) by seven different Risk scoring system.MethodsTo collect the clinical information of patients undergoing CABG in our department.SinoSCORE,Additive EuroSCORE,Logistic EuroSCORE,OPR,Cleveland model,Parsonnet score,QMMI was used to predict postoperative mortality for all patients,and calculate the mean predictive postoperative mortality.To devided the patients to six group:group Ⅰ (0 - 1.99％ ),group Ⅱ (2.00％ - 3.99％ ),group Ⅲ (4.00％ - 5.99％ ),group Ⅳ ( 6.00％ - 7.99％ ),group Ⅴ (8.00％ - 9.99％ ),group Ⅵ ( ＞ 10％ ) by predictive postoperative mortality.Access the performance of risk scoring system predict the mortality through compare the predictive mortality and the observed mortality in different Risk stratification.To use Hosmer-Lemeshow goodness-of-fit test access the calibration.Discrimination was tested by determining the area under the receiver operating characteristic(ROC) curve(AUG).ResultsThe overall mean baseline age was ( 62.8 ± 8.8 ) years.The observed mortality in all our study patients was 1.99 ％ ( 22/1103 cases).The predictive mortality calculated by SinoSCORE,Additive EuroSCORE,Logistic EuroSCORE,OPR,Cleveland model,Parsonnet score and QMMI were 3.01％,4.38％,3.83％,1.69％,4.42％,6.71％ and3.71％.And the most closest is OPR,SinoSCORE,QMMI.Group tests confirmed Logistic EuroSCORE Overestimated the mortality in all the group.Predicted mortality calculated by Additive EuroSCORE was lower than the actual mortality in group Ⅵ and higher than the observed mortality in other group.SinoSCORE、Cleveland model、Parsonnet score、QMMI Overestimated the mortality in all the group expect group Ⅰ.OPR forecast a lower mortality Compared with observed mortality in group Ⅰ and group Ⅳ and a Slightly higher mortality in group Ⅱ,group Ⅲ.To use Hosmer - Lemeshow goodness-of-fit test access the calibration.The text proved all the risk scoring system had a good calibration for postoperative mortality (P ＞ 0.05 ).Discrimination was tested by ROC,only SinoSCORE ( AUC =0.751 ＞ 0.70) showed high discriminatory ability in predicting mortality.ConclusionSinoSCOBE have a good forecast performance for the postoperative mortality in the patients undergoing CABG in our department in seven different Risk scoring system.And SinoSCORE could be used in preoperative risk assessment.