Objective To dump and recover the expired data in No.1 Military Medical Project, avoiding the waste of large amount of storage space and improving the operation performance of hospital information system. Methods After clearing the backup table, the data from the original table backup was put into the backup table. The data was unloaded from the backup table to a file, and then the file was saved. The data in the original table was deleted, but it could be restored to the table when needed, and the corresponding data could be obtained through the application program. Results The storage space was enlarged after data dump. Conclusion The dump of the expired data can make data management more scientific and hospital information system run more smoothly.

The concept of EMR is described and the problems of EMR application are analyzed including restrictions on change permissions and writing time of EMR, and sounds in medical record management mechanism to ensure legality and effectiveness of record. Based on improvement of national policy, third-party management services institutions are estab- lished and related suggestions on technical and environmental support of EMR development are provided, and the future of its development in our country are expected.

Objective To probe the cause of the infant nutritional iron deficiency anemia,so to decrease effectively the percentage of afflicting such ill.Methods Investigate,count and analyze 418infants'data on brease-feeding and subsidiary food-feeding.These infants aging 6 months,1 year and 1.5years,visited Zhengzhou Maternal and Child Health Hospital periodically.Results The affliction percentage of infants aging 6 months,1 year and 1.5 years,is 26.11%,19.17%and 11.02%respectively,a significant difference may be found between the value(X2=10.28,P＜0.05);The affliction percentage of the breast-fed and non-breast-fed infants aging 6 months iS 22.46%and 38.10%,a significant difierence may also be found between the value(x2=4.08,P＜0.05);The affliction percentage of the mother's milk is rich and unitary infants aging 6 months is 16.50%and 40.00%.a significant difierence may also be found between the value(x2=8.28,P＜0.05).Conclusions Mother's milk is the ideal food for infants;subsidiary food shall be added timely and properly when the infant ages 6 months;infant systematic caring plays a very important role in the infant development,all intensive project on this issue must be carried out seriously.

Objective To investigate intraoperative changes of internal environment in infants undergoing living related liver transplantation (LRLT), and to explore appropriate treatment measures. Methods Twenty-five infants undergoing LRLT were retrospectively studied, including 12 males, 13 females, with age of (3. 4 ± 4. 6) months (ranging from 2-11 months), weight of (6. 8 ±1. 3) kg (ranging from 3. 1-8. 8 kg). Arterial blood samples were collected before the operation, at preanhepatic phase (5 min before cross-clamping), at anhepatic phase (5 min before opening inferior vena cava), 5 and 30 min after the opening inferior yena cava respectively, and at the completion of the surgery the pH value, bases excess (BE), the levels of sodium, potassium, calcium, glucose and lactate were determined. Results There were large fluctuations to the internal environment during operation. Compared with the preoperative values, the intraoperative concentrations of Na+ had no significant change; The pH value and blood level of K+ had no significant change at pre-anhepatic phase and anhepatic phase (P＞0. 05), the pH value was decreased at anhepatic phase Ⅰ (P＜0. 01 )and returned to the preoperative level at the end of the operation, and the blood level of K+ decreased at anhepatic phase and lasted till the completion of the surgery (P＜0. 01 ). The blood level of Ca2+ was decreased at pre-anhepatic phase and neohepatic phaseⅡ (P＜0. 05), and recovered at the end of the operation. Blood glucose concentration was increased significantly at preanhepatic phase to neohepatic Ⅱ, and still kept at the higher level until the end of operation. The lactate concentrations were increased significantly at pre-an.hepatic phase to neohepatic Ⅱ (P＜0. 01 ), and recovered at the end of operation. The BE was decreased at pre-anhepatic phase to neohepatic Ⅱ (P＜0. 05), and recovered at the end of the operation. Conclusion There are significant disruptions which are unique and inter-related to the internal environment parameters in infants during the operation of LRLT.Monitoring and accurate intraoperative managements for different physiological status at different phases are critical for the success of LRLT in infants.

Prognostic factors of differentiated thyroid carcinomas ( DTC ) were analyzed and the related literatures were systematically reviewed in order to justify the diagnostic and therapeutic modalities for improving the patient′s survival.150 patients ( female,n =113 ; male,n =37 ) with histopathologically diagnosed DTC,including papillary thyroid carcinoma ( n =131,87.3％ ) and follicular thyroid carcinoma ( n =19,12.7％ ),were postoperatively followed up and their clinical data were retrospectively reviewed.Patients were followed up for 4.15-31 years wherein 140 patients( 93.3％ ) survived but with relapse in 30 patients( 20.0％ ),and 10 patients( 6.7％ ) died.Surgical procedures consisted of near-total or subtotal thyroidectomy ( n =83,55.3％ ),partial thyroidectomy ( n =64,42.7％ ),and total thyroidectomy ( n =3,2.0％ ).Out of the patients receiving lymph node dissection ( n =63 ),45 patients( 71.4％ ) had detectable lymph node metastasis.Age of onset,tumor size at initial visit,and early metastasis showed the statistically significant difference between mortality group and survival group (P＜ 0.05 ),as well as between relapse group and relapse-free group( P＜0.05 ).Age of onset,tumor size at initial visit,and early metastasis are prognostic factors for DTC.

Objective To investigate the suppressive effect of carbon monoxide-releasing molecule Ⅱ (CORM-2) on LPS induced platelet α-granule exocytosis in sepsis via soluble N-ethylmaleimide-sensitive factor attached protein receptor/mammalian uncoordinated 18b (SNARE/Munc18b) complex formation.Methods Blood was collected from healthy volunteers' cubital vein, then platelets were isolated by differential centrifugation. Platelets were randomly divided into 5 groups. The control group did not undergo any treatment, the LPS group received 10 mg/L LPS simulation, the CORM-2 group and iCORM-2 group underwent LPS simulation and immediate administration of CORM-2 (10μmol/L and 50μmol/L) or iCORM-2 (50μmol/L), respectively. Samples were incubated in a CO2-incubator at 37 ℃, 95% humidity, and 5% CO2. Platelet α-granule contents were detected by using standard enzyme linked immunosorbent assay (ELISA), including platelet factor 4 (PF4), platelet derived growth factor-BB (PDGF-BB), and matrix metalloproteinase-2 (MMP-2). The expression of P-selectin was detected by flow cytometer. Transmission electron microscope and immunofluorescence microscope was used to assess platelet α-granules distribution. Expressions of Munc18b and SNARE proteins including vesicle-associated membrane protein-8 (VAMP-8), synaptosomal-associated protein-23 (SNAP-23) and syntaxin-11 (STX-11) were detected by Western Bolt. The SNARE/Munc18b complex formation was detected by immunoprecipitation.Results Compared with the control group, levels of PF4, PDGF-BB, MMP-2 and P-selectinin LPS-induced platelets were found to markedly elevated, while CORM-2 (10μmol/L and 50μmol/L) could decrease platelet α-granule contents exocytosis: [PF4 (μg/L): 7.69±0.58, 6.03±0.71 vs. 10.13±0.82; PDGF-BB (μg/L): 112.71±1.79, 102.91±5.86 vs. 128.78±1.39; MMP-2 (ng/L): 32.94±2.73, 27.58±3.36 vs. 53.26±1.21; P-selectin: (17.14±0.57)%, (15.35±0.68)% vs. (23.78±0.62)%; allP < 0.01]. Transmission electron microscope and immunofluorescence microscope showed that the extent of platelet α-granules assembled to platelet plasma membrane was significantly decreased following CORM-2 treatment. Compared with the control group, the expressions of Munc18b and SNARE proteins and SNARE/Munc18b complex formation in LPS-stimulated platelets were significantly increased, while CORM-2 (10μmol/L and 50μmol/L) inhibited these elevations (Munc18b/GAPDH: 0.80±0.08, 0.69±0.01 vs. 0.99±0.09; VAMP-8/GAPDH: 0.72±0.09, 0.50±0.12 vs. 1.18±0.14; SNAP-23/GAPDH: 1.18±0.22, 0.63±0.10 vs. 1.90±0.08; STX-11/GAPDH: 0.76±0.02, 0.57±0.08 vs. 1.16±0.23; VAMP-8/ Munc18b: 0.65±0.09, 0.53±0.07 vs. 1.21±0.20; SNAP-23/Munc18b: 0.85±0.07, 0.55±0.09 vs. 1.26±0.08; STX-11/ Munc18b: 0.78±0.05, 0.61±0.10 vs. 1.39±0.16; allP < 0.01). Above all, the data showed a dose dependent change.Conclusion We could suggest that CORM-2 suppressed α-granule exocytosis in LPS-stimulated platelets and the potential mechanisms might involve SNARE/Munc18b complex formation.

Objective:To analyze the relationship of lipoprotein associated phospholipase A 2 (Lp-PLA2) and severity of coronary atherosclerosis, and evaluate the effects of rosuvastatin at different doses on the concentration of plasma Lp -PLA2.Methods: Totally 152 cases of patients with suspected coronary heart disease were treated with coronary angiography .According to the results of angiogra-phy, the patients were divided into the coronary heart disease group ( n=117 ) and the normal control group ( without coronary heart disease,n=35).Gensini integral scale was performed and referring to the number of diseased coronary arteries , the degree of coronary atherosclerosis was evaluated .The concentration of serum Lp-PLA2 was detected and the relationship of Lp-PLA2 and the severity of coronary plaque was evaluated .Meanwhile , the patients with coronary heart disease were divided into 2 groups and orally treated with rosuvastatin respectively at the routine dose (10 mg· d-1 ) and the loading dose (20 mg· d-1 ).The changes of the plasma concentra-tion of Lp-PLA2 before the treatment, in the 2nd, 4th,8th and 12th week after the medication were measured and the effect of atorvastatin at different doses on the plasma concentration of Lp-PLA2 was summarized .Results: The plasma Lp-PLA level in the control group was (22.22 ±1.75) μmol· ml-1, while that in the coronary heart disease group was (29.03 ±3.99) μmol· ml-1(P<0.05).The differences in Lp-PLA2 levels between the groups with different Gensini scores of coronary heart disease were statistically significant ( P<0.05).The higher scores were, the higher Lp-PLA2 levels were.The results of multivariate analysis showed that the severity of cor-onary atherosclerosis was significant and positive correlated with Lp-PLA2 level (OR=1.613,P<0.05).In the 2nd, 4th, 8th and 12th week after the medication , Lp-PLA2 levels in the loading dose group were significantly lower than those in the routine dose group ( P<0.05).In the 2nd, 4th, 8th and 12th week after the medication, the degree scores of coronary artery stenosis in the loading dose group were reduced.The decreasing range was significantly greater than that in the routine dose group (P<0.05).The incidence of adverse cardiovascular events in the routine dose group (27.12%) was significantly higher than that in the loading dose group (6.90%) ( P<0.05).The incidence of adverse drug reactions in the routine dose group was 11.86%, while that in the loading dose group was 18.97%(P>0.05).Conclusion:Lp-PLA2 is correlated with the severity of coronary plaque .High dose of rosuvastatin can reduce plasma Lp-PLA2 concentration in the patients .

Objective To investigate the repair and protective effect of extracorporeal membrane oxygenation (ECMO) on liver and bile duct after cardiac death in pig.Methods Eight pigs were purchased and cardiac arrest was induced by the administration of 1 g KCL intravenously,followed by 30 min cardiopulmonary resuscitation according to standard guideline.Cannulas were placed through inferior vena cava and abdominal aorta,and then connected to ECMO extracorporeal circulation pipes.ECMO was performed for 4 h.Circulation flow rate of hepatic artery and bile production were monitored and recorded.Lactate dehydrogenase (LDH),γ-glutamyl transferase (γ-GT) and direct bilirubin (DBIL) in bile were detected.Transaminase,tumor necrosis factor-α (TNF-α),interleukin-1β (IL-13),hyaluronic acid (HA),endothelin-1 (ET-1) and nitric oxide (NO) in serum were detected.Pathological change was observed by HE staining under optical microscope and cell apoptosis was detected by TUNEL.Results There was no bile production after cardiac death,which increased to 80％ of the baseline after 4h of ECMO.In addition,γ-GT,LDH and DBIL content in bile was (23.3 ± 11.8) IU/L,(15.9 ± 3.3) IU/L and (72.3 ± 21.4) mmol/ L,and IL-1,TNF-α and HA content in serum was (117.6 ± 39.0) ng/L,(120.4 ± 16.5) ng/L and (63.7 ± 4.4) ng/L,respectively,and no statistically significant differences were observed when compared with the baseline (all P ＞ 0.05).ET-1 content was (4.9 ± 1.3) ng/L and NO content was (135.3 ± 16.7)mmol/L in serum,which was statistically increased (both P ＜ 0.05).Pathological changes of liver and bile duct were significantly alleviated.Conclusion ECMO could exert protective effect on liver and bile duct after cardiac death.

To make a systematic analysis on literatures concerning traditional Chinese medicine (TCM) advices in Treatise on Febrile Diseases, and summarize the main connotations of traditional Chinese medicine advices, relevant TCM advices in Treatise on Febrile Diseases were collected, screened, compared, summarized and analyzed according to TCM dosage form preparation methods, TCM administration methods, medication contraindications and nursing after TCM administration. The literatures concerning medications in Treatise on Febrile Diseases were consulted, summarized and compared to standardize medicine advices and facilitate rational clinical application of TCMs. The standard medicine advices were as follows. The boiling water for TCMs shall be tap water and well water. The decoctions that have effects in promoting blood and meridians can be boiled with wine. The decoctions containing toxic components can be boiled with honey. Some TCMs shall be boiled with special methods, e. g. Herba Ephedra that could be boiled before other medicine and skimmed. Japonica rice could be added in decoctions to measure the duration of decoctions. Different dosages were required for different forms (litre, pill, medicine spoon). Administration times, temperature and frequency shall be adjusted according to target positions, functions and stage of illness. As for dietary contraindications during medication, thick porridges are recommended, where foods impacting medicine efficacy are prohibited. Regarding nursing after medication is important to recover physical functions, particularly warm porridges can go with diaphoretic recipes, while thick porridges can go with purgative recipes. And drug efficacies shall be defined by observing urine and excrements, and blood form. In conclusion, Treatise on Febrile Diseases is the first book that discusses TCM advices and records them in details. In this study, new standard medicine advices were proposed to provide important basis for improving clinical advices of TCMs and supports for developing the TCM dispensing technology.
Chin ; Cooking ; Drug Administration Routes ; Drug Administration Schedule ; Drug Interactions ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; history ; Fever ; drug therapy ; history ; History, Ancient ; Humans ; Medicine in Literature

Objective To explore the change characteristics of physiological indexes between infants and children during living-donor liver transplantation and discuss methods of regulation and control.Method In this study,42 patients were selected and assigned into two groups according to age:infants group (＜1 year,n =25),and children group (1-16 years,n =17).The preoperative and peri-operative characteristics,intra-operative operation conditions,internal environment changes before and after re-perfusion,postoperative mechanical ventilation time,ICU time,hospital time,infection rate,additional surgery,complications and survival were analyzed.Result PELD (MELD) score,historical surgery rate and hematokrit were lower in children group than in infants group (P＜ 0.05).Serum creatinine and lactate concentrations increased significantly in children group as compared with infants group (P＜0.05).Intra-operative an-hepatic phase and cold ischemia time were shortened significantly (P ＜ 0.05),and incidence rate of re-perfusion syndrome was reduced in children group as compared with infants group (P＜0.05).As compared with pre-re-perfusion,blood lactate concentrations were significantly raised only in infants group and glucose concentrations significantly raised only in children group (P＜0.05).The blood levels of K + were decreased after reperfusion in both two groups,and those in infants group were lower than in children group (P＜ 0.05).Postoperative intensive care unit time was longer in children group than in infants group (P＜ 0.05),and there was no significant difference in survival rate between two groups.Conclusion There are many differences and change characteristics to physiological indexes between infants and children during the operation of living-donor liver transplantation.Timely management and regulation are critical for the success of surgery according to the differences.