According to the recommendations of the International Medical lnformatics Association(IMIA)on education in biomedical and health informatics(first revision)published by IMIA in 2010 and combining the actuality of the basic clinical information skills and medical informatics education of Chinese medical students,the related contents of medical informatics have been integrated into the teaching course based on current medical information retrieval curriculum and medical informatics curriculum for non-medical informatics students of medical colleges and universities was constructed,so that they can meet the requirements of the basic information skills under information-based medical and healthy practice.

Objective To investigate the accuracy of serum neuron-specific enolase (NSE)predicting malignant middle cerebral artery infarction(mMCAI).Methods A total of 40 patients with acute massive cerebral infarction within 24 hours after symptom onset were recruited.Blood samples were collected at 24,36 and 48 hours after symptom onset.Serum NSE concentration was determined by automatic electrochemiluminescence analyzer.mMCAI was defined as hernia signs in clinical practice,and CT/ MRI showed mass effect.The receiver operating characteristic curve was used to analyze the accuracy of serum NSE concentration in predicting mMCAI at 3 time points.Results Sixteen patients(40%)developed mMCAI.The serum NSE concentration for predicting the accuracy of mMCAI was poor at 24 hours after symptom onset;the serum NSE concentration for predicting the specificity of mMCAI was high (96%)at 36 hours after symptom onset,but the sensitivity was lower(69%);the serum NSE concentration for predicting the specificity(92%)and sensitivity(88%)of mMCAI were high at 48 hours.Conclusions The serum NSE conoentration and its dynamic changes may predict the occurrence of mMCAI,and the predicting time points are appropriate from 36-48 hours after symptom onset.

Objective To investigate the possibility and accuracy of predicting malignant middle cerebral artery infarction (mMCAI) with bedside electroencephalography (EEG). Methods Thirty-five patients with massive hemispheric infarction (MHI) underwent bedside EEG monitoring within 48 h of onset. The EEG indicators were interpreted blindly, and the clinical, laboratory and imaging parameters were analyzed. The patients were divided into mMCAI group and non-mMCAI group according to whether they had occurred mMCAI or not within 7 days of onset. The differences of EEG indicators, clinical, laboratory and imaging parameters between the 2 groups were compared. When the parameters of significant difference and statistical significance appeared the odds ratio (OR) of occurring mMCAI were analyzed, and their accuracy of predicting mMCAI was calculated. Results Of the 35 patients with MHI, 20 were in the mMCAI group and 15 were in the non-mMCAI group. There were significant differences in the EEG indicators (infarction on the contralateral side, including disintegration of occipital α rhythm, generalized slow-wave, dominant frequency wave low amplitude, regional attenuation without delta [RAWOD]pattern, and absence of EEG reactivity), clinical parameters (nausea accompanied with vomiting), and imaging parameters (the infracted area more than the entire MCA territory, and midline shifting 3 to 5 mm at the level of septum pellucidum) between the 2 groups (P < 0. 05). Of those, the risk of mMCAI was the highest in patients with disintegration of occipital a rhythm on the contralateral side of infarction (P = 22. 67, 95% CI 3. 89-132. 10). The sensitivity of predicting mMCAI was 85. 0%, the specificity was 80.0%, the positive predictive value was 85.0%, and the negative predictive value was 80. 0%, which were superior to other EEG indicators and clinical or imaging parameters. Conclusions Bedside EEG indicators can early predict mMCAI, moreover, the predictive accuracy is superior to the clinical and imaging parameters.

Objective To compare the diagnostic value of digital breast tomosynthesis (DBT) versus digital mammography (DM) in the evaluation mass like lesions in dense breasts. Methods Eight hundred and fifty eight patients, who had DBT and DM, with breast diseases confirmed by pathology were retrospectively reviewed. The breast density and the imaging features were classified according to the standard of American College of Radiology(2013) and breast imaging reporting and data system (BI?RADS) scores. Six hundred and thirty one patients with mass lesions in dense breasts were chosen to included. All 631 patients had DM of both breasts and DBT of affected breast prior to mastectomy. Pathological results were used as the golden standard. Detection rate and diagnostic accuracy of masses, sensitivity and specificity of diagnosis, false negative and recall rates, the margins and spicules and BI?RADS category were calculated. The detection rate and diagnostic accuracy, the margins and spicules of masses were compared with Chi?square test, the BI?RADS scores were analyzed with rank test. Results With DBT, average detection rate increased from 77.3%(488/631) to 84.3% (532/631), average diagnostic accuracy rate increased from 73.4%(463/631) to 82.3%(519/631),with statistical significant difference between groups (c2=27.191,36.890,P<0.01).Sensitivity for DBT and DM were 68.1%(205/301) and 58.8%(177/301), respectively. Specificity for DBT and DM were 95.2%(314/330)and 86.7%(286/330), respectively. Recall rate for DBT and DM were 3.6%(23/631)and 9.8%(62/631), respectively. One hundred and seventy two cases and 75 cases with circumscribed masses of benign cases were detected by DBT and DM, respectively. One hundred and eighty-two cases and 115 cases with spiculated masses of malignant cases were detected by DBT and DM, respectively, with statistical significant difference between groups (c2=70.471 and 21.707, P<0.01). Of 330 malignant cases, the numbers of BI?RADS category 0, 2, 3, 4A, 4B, 4C, 5 on DM images were 19,4,8,13,52,93,141, respectively, the numbers on DBT images were 3,1,7,5,52,83,179, respectively, with statistical significant difference(Z=-2.235,P=0.025). Of 301 benign cases, the number of BI?RADS category 0, 2, 3, 4A, 4B, 4C, 5 on DM images were 43,10,60,117,58,11,2, respectively, the number on DBT images were 20,4,64,150,55,7,1, respectively, with no statistical significant difference between groups(Z=-1.846,P=0.065). Conclusion DBT significantly improves the detection of mass?like lesions in dense breasts, display of mass margin and architectural distortion of surrounding tissue.

Female ; Humans ; Lymphoma ; diagnosis ; Pregnancy ; Pregnancy Complications, Neoplastic ; diagnosis

Through detailed investigation of the market circulation of Ligustici Rhizoma et Radix, at the same time, this article collected relevant articles, conducted comparative study on genuine and conventionally used Ligustici Rhizoma et Radix from the aspects of textual research, functions, chemical composition and pharmacological effect, and discussed the results of the study.

Objective To investigate the effects of thymosin α1 (Tα1) on plasma TNF-α and IL-10 of rats with acute liver failure.Methods The model of acute liver failure in rats was established.The rats in intervention group were injected with Tα1;their plasma ALT, AST and TBIL contents as well as plasma TNF-α and IL-10 levels were assayed at different time points for HE staining of liver sections.Results ① ALT, AST and TBIL in model group and intervention group increased over time.Plasma ALT, AST and TBIL were significantly lower in intervention group than in model group at the same time point (P<0.05).② Manifestations of acute liver failure such as structural disorder of liver tissue, obvious necrosis of liver cells and infiltration of inflammatory cells were observed in model group and intervention group, and worsened over time.At the same time point, liver cell necrosis and infiltration of inflammatory cells were less severe than those in model group.③ TNF-α and IL-10 were significantly higher in model and intervention groups than in control group (P<0.05).Plasma TNF-α and IL-10 showed a rising trend over time in the former groups (P<0.05).At the same time point, TNF-α was significantly lower but IL-10 was significantly higher in intervention group than in model group.Conclusion Thymosin α1 has a protective effect on acute hepatic failure in rats, and it can significantly alleviate liver inflammation and necrosis.The mechanism is related to inhibition of pro-inflammatory cytokine TNF-α and upregulation of anti-inflammatory cytokine IL-10.

Objective To evaluate the changes of function of right ventricular using echocardiography after transcatheter closure of atrial septal defect(ASD)and to study the feasibility and superiority of echocardiographic evaluation of right ventricular function. Methods In 70 patients with transcatheter closure of ASD,echocardio?graphic examinations were made different time intervals after the closure to calculate right cardiac morpnology and function. Results After closure ASD in different time intervals, the size of RAEDd1, RAEDd2, RVEDd1, RVEDd2, RVEDd3, Inferior Vena Cava and RIMP, RVEF, TAPSE and FAC were obviously decreased(P<0.01)between two groups. All events were obviously decreased compared precious function(P < 0.01)and the interaction of the time (P < 0.01). Conclusion The construction of right ventricular narrows gradually and the function recovers after transcatheter closure of ASD in a year and those who did not become worse.

Objective To investigate the circulation and use of Akebiae Caulis and Clematidis Armandii Caulis;To provide references for clinical safe medication. Methods Literature review, field survey and telephone interview were used to conduct the investigation. Results ① The market currency of the Akebiae Caulis and Clematidis Armandii Caulis was very confused, and the mainly medicinal materials on the market were Clematidis Armandii Caulis. ② The majority used medicinal materials were Clematidis Armandii Caulis, and Akebiae Caulis was rarely used. ③ The Chinese Pharmacopoeia collected Akebiae Caulis and Clematidis Armandii Caulis separately, but there was phenomenon of using Clematidis Armandii Caulis replacing of Akebiae Caulis. Conclusion Market of Akebiae Caulis is shrinking; the phenomenon of using Clematidis Armandii Caulis to replace Akebiae Caulis widespread in clinic. There are differences in the efficacy of Akebiae Caulis and Clematidis Armandii Caulis, so they should be distinguished and cannot be used to mix or substitute.

OBJECTIVE:To compare the contents of loganic acid,swertiamarin,6′-O-β-D-glucosyl gentiopicroside,gentiopi-croside,sweroside,isoorientin and isovitexin in wild and cultivated Gentiana officinalis,and to provide basis for rational use of G. officinalis. METHODS:UPLC method was adopted. The separation was performed on ACQUITY UPLC? BEH C18 column (50 mm × 2.1 mm,1.7 μm) with mobile phase consisted of methanol-0.04% phosphoric acid (gradient elution) at the flow rate of 0.3 ml/min. The detection wavelength was set at 242 nm,and column temperature was 30 ℃. RESULTS:For loganic acid,swertiama-rin,6′-O-β- D-glucosyl gentiopicroside,gentiopicroside,sweroside,isoorientin and isovitexin,a good linearity was obtained in the range of 2.1-537.1 μg,1.05-270 μg,0.92-236 μg,11.1-2 830 μg,0.75-192 μg,0.167-102 μg,0.216-52.80 μg(r≥0.999 5), respectively. Their average recoveries were 97.72%-99.84%(RSD≤3.39%,n=6). The contents of loganic acid,swertiamarin, 6′-O-β-D-glucosyl gentiopicroside,gentiopicroside,sweroside and isoorientin in the wild sample were higher than in the cultivat-ed;the content of isovitexin was lower than the cultivated,but there was no statistical significance(P>0.05). The sum of gentiopi-croside and loganin acid content were all higher than 2.5% in both wild and cultivated samples,and met the requirements of 2015 edition of Chinese Pharmacopoeia(first part). CONCLUSIONS:The content difference of 7 indicative constituents in wild and cul-tivated G. officinalis is not statistically significant,and the indicative constituents of the pharmacopoeia is qualified.