With the spread of PACS, it has been a challenge to integrate the storage and share of medical image. In this paper, the present situation and problems of PACS in Chinese hospitals are analyzed, and the concept of medical image data center is presented, then the architecture and key technologies of the center are discussed.

Objective To understand the influencing factors of satisfaction degree with nursing in our hospital by investigation in satisfaction degree in central injection room.Methods 252 patients were selected in our hospital from January to December 2011 as the research object,questionnaires were used to investigate the patients,and the influencing factors of satisfaction degree of nursing work were analyzed.Results Among the patients who accepted the investigation,patients' satisfaction scores were correlated with the patients' age,education level,income level,inpatient department,hospital stay time and whether they accepted an operation.Conclusions Nursing staff should pay attention to and strengthen the nursing work quality and efficiency,improve the satisfaction degree with nursing of clinical patients.

Objective To investigate the hemostatic effect of the radial hemostatic compression device(TR Band hemostatic gasbag)after transradial coronary intervention and discuss the optimal hemostasis time.Methods 266 patients who received transradial coronary angiography and used TR Band hemostatic gasbag for hemostasis were divided into group A,B and C,according to the compression time,the compression time in group A (90 cases)was 8 h,10 h in group B (87cases),12 h in group C (89 cases).The condition of bleeding,changes in blood oxygen saturation,and hand swelling in each group were compared.Results The bleeding rates of group A,B and C were respectively 16.7％,3.4％ and 9.0％,the difference was statistically significant.The incidence of hand swelling after operation in group A,B and C were respectively 27.8％,12.6％ and 21.3％,the difference was statistically significant.No significant difference was seen in blood oxygen saturation between three groups.Conclusions Application of radial hemostatic compression device after transradial coronary intervention proved good hemostasis effect,compression time for 10 h has the best effect and less adverse effect.

Objective To evaluate the outcome of valvular surgery in the elderly. Methods Between 1993 and 2004, 4546 patients underwent cardiac valve operation at our hospital. 252 patients (5.5%)(147 males, 105 females) were 65 or older [mean age (67.9?2.9) years]. Rheumatic valvular disease presented in 201(79.8%) patients and non-rheumatic valvular disease in 51 (20.2%). 56.0% of patients were in New York Heart Association (NYHA) functional class Ⅲ-Ⅳ.63 (25%) patients had aortic valve replacement (AYR), 93 (36.9%) had mitral valve replacement (MVR), 42 (16.7%) had mitral valve repair (MVP), 47 (18.7%) had AVR + MVR/MVP, and 7 (2.8%) had isolated tricuspid repair or replacement.34 (13.5 % ) had concomitant coronary artery bypass grafting (CABG) . Results Results The operative mortality was 9.1%, and the tendency of decline was observed in recent 3 years. As compared with the patients aged 16 to 64 years, the duration of mechanical ventilation, stay in ICU and in hospital postoperatively was longer [(30.6?42.8)h vs. (24.1?45.0) h,P = 0.02, (60.1?101.2) h vs. (43.0?70.6) h, P = 0.00, (25.7?41.3) days vs. (19.6?14.4) days,P=0.00]. In this group, the morbidity of postoperative complications was significant higher than that of the patients aged 16 to 64 years (10.6% vs.6.4% , P = 0.01). Preoperative NYHA function class was an important factor for postoperative mortality. Multivariate logistic regression showed that concomitant coronary artery bypass grafting (CABG) , AVR+ MVR/MVP, and prolonged cardiopulmonary bypass time, prolonged aortic cross-clamping time, postoperative acute renal failure demanding dialysis were significant independent predictors of operative mortality. Conclusion The mortality of cardiac valvular surgery in the elderly is acceptable. It is characterized by higher morbidity of postoperative complications and prolonged duration of stay in hospital. Concomitant CABG, AVR + MVR/MVP, prolonged cardiopulmonary bypass time, prolonged aortic crossclamping time and postoperative acute renal failure were significant independent predictors of operative mortality.

0) and the correlation coefficient were low.The absence of intravesical occurrence of the cancer in solitary primary tumor cases was significantly less than that in the multiple ones ( P =0).The intravesical occurrence rate of the cancer elevated with the pathological stage of the primary cancer ( P =0.0039).92.5% of cases with initial concurrent involvement of the bladder have had the occurrence of bladder cancer within 2 years after surgical treatment. Conclusions The number and the stage of the primary tumor,with concurrent bladder involvement or not and the internal between the occurrence of the bladder cancer and the upper urinary tract cancer are the significant factors for prognosis,the coefficient correlation between the 4 factors being low.

Irritable bowel syndrome(IBS)is one of the most common functional gastrointestinal disorders,which impacts on patients’quality of life as well as physical and mental health. Studies have shown that visceral hypersensitivity (VHS)is an important pathophysiological factor in the pathogenesis of IBS,and neural regulation plays a key role in the process of VHS. This article reviewed the advances in study on effect of neural regulation pathway on pathogenesis of VHS in IBS.

Objective To investigate the effects of propofol on lung nitric oxide synthase (NOS) in rats and the mechanism of its pulmonary artery and bronchus dilating effects. Methods Forty SD rats weighing (210+40)g were randomly divided into two groups: propofol group received propofol 100mg-kg-1 ip and when its righting reflex was lost propofol was continuously infused at 10mg'kg-1 h-1 through the vein in the tail for 10min, then the animal was killed; control group received normal saline 10 ml'kg-1 ip and the animals were killed 20 min later. After sacrificing the animals the chest was opened and the lungs were removed. The NO level in the broncho-alveolar lavage fluid (BALF) was measured in 10 animals. NOS activity and NO content of the lung tissue homogenate were examined in 10 animals. Cellular distribution and expression of endothelial NOS (eNOS) and neural NOS (nNOS) in the lung were examined by immunohistochemistry in 5 animals. Results The NO level in BALF, NO content and NOS activity in the lung homogenate were significantly higher in propofol group than those in control group (P

Objective To study the change of interleakin-18 (IL-18) in patients of pregnancy induced hypertension syndrome(PIH) and its correlation with endothelint-1 (ET-1). Methods Serum levels of IL-18 and plasma levels of ET-1 in 47 PIH patients and 30 normal pregnancy women were measured with ELISA and RSA respectively. Results (1)Serum IL-18 of PIH group (M=43.76 ng/L) was significantly higher than that of normal pregnancy group (M=37.975 ng/L) , H=42.845,P

Objective To evaluate the practicability and safety of 25-gauge (25G) transconjunctival sutureless vitrectomy system (TSV25G) and describe the preliminary experience. Methods Eighteen patients underwent TSV25G. The time of procedures of setting-up the three-port cannulae and closing the cuts were recorded. The pre- and post-operative ocular tension, visual acuity and complications were observed. Results The average time of setting-up the three-port cannulae and closing the cuts was 1 minutes 24 seconds and 32 seconds, respectively. The average preoperative ocular tension was 16.3 mm Hg(1 mm Hg=0.133 kPa); the average postoperative ocular tension at the first day, first week, and first month was 13.0, 15.9, and 16.4 mm Hg, respectively. The visual acuity before and one month after operation the was HM/20 cm～0.2 and HM/50 cm～0.6, respectively. No postoperative complication was found. Conclusion TSV25G may simplify the operation, minimize the surgical induced trauma, and decrease the operating time and the postoperative inflammatory response.

BACKGROUND:Currently, what we know about exosomes is that it can be produced by a variety of cel s and transfer a variety of materials, producing subsequent function of regulation.
OBJECTIVE:To review the function of exosomes in mesenchymal stem cel differentiation, in order to provide reference for further in-depth study.
METHODS:With the key words of“exosome, mesenchymal stem cel , differentiation”in Chinese and English, respectively, a computer-based search was performed for articles published in CNKI, Medline and Embase databases from January 2001 to September 2016. After the initial screening, the reserved articles were further detailed, summarized and concluded.
RESULTS AND CONCLUSION:Exosomes are a kind of vesicles 40-100 nm in diameter, which can be secreted by a variety of cel types, containing functional products, such as functional protein, gene product, lipid and so on. As a bridge of adjacent cel s transferring functional products, exosomes are becoming an issue of concern in the microenvironment for cel interaction. In the differentiation of mesenchymal stem cel s, exosomes also play an indispensable role via pathway regulation.