Objective:To establish a complete set of EMPI system and service, resolve the problems of Patient information is inconsistent and medical data difficult to share.Methods: After analysis patient basic information management module of business systems, Propose a solution of “using IHE ITI-PIX V3 to build EMPI”.Result: By establishing master patient index and provide services to each system to be called, has realized the patients basic information integration, and on this basis to realize Hospital-wide electronic medical records.Conclusion:Without change the original business system, through the pix implementation master patient index associated with patient's id in each business system, meet the needs of patient information sharing.

Aged ; Cavernous Sinus ; Humans ; Leukemia, Myeloid, Acute ; drug therapy ; Male ; Syndrome

Objective To investigate relationship between insulin sensitivity and beta-cell function with body mass index (BMI) and age in patients with newly diagnosed type 2 diabetes mellitus (T2DM).Methods Totally, 304 patients with T2DM newly-diagnosed at admission to the first hospital affiliated to Nanjing Medical University, Jiangsu province, during 2006 to 2007 were recruited in the study. The patients were divided into three groups based on WHO criteria of obesity in Asia Pacific Region in 2003, 68 cases with normal weight ( 18. 5≤ BMI ＜ 23.0), 69 in overweight (23.0 ≤ BMI ＜ 25.0), and 167 in obesity (BMI≥25.0). Fasting serum glucose, glycesylated hemoglobin Alc (HbAlc) and lipids were measured for all the subjects, as well as oral glucose tolerance test (OGTr), C-peptide releasing tests and determination of serum insulin performed. Homeostasis model assessment of insulin resistance index (HOMA-IR), insulinogenic index (AI30/AG30) and modified beta-cell function index (MBCI) werecalculated to evaluate their insulin sensitivity and beta-cell function of the islets. All these parameters werecompared between the three groups and subgroups. Results HOMA-IR and MBCI were significantly higherin T2DM patients with obesity than those in the groups with normal weight and over-weight ( P < 0. 05 ).AI30/AG30 in obesity group was significantly higher than that in the group with normal weight (P <0. 05).Multiple linear regression analysis showed that BMI independently correlated with HOMA-IR ( P < O. 05 ).Sub-group analysis showed that △I30/△G30 and MBCI were significantly higher in those aged 60 years and over with obesity than those in the groups aged less than 60 years ( P ＜ 0. 05 ). Conclusions Non-obese patients with newly diagnosed T2DM have more severe impaired insulin secretion than that in obese ones,and their insulin resistance increases with BMI. Age has no significant correlation with pancreatic beta-cell function or insulin sensitivity.

Objective To investigate the correlation between the reason of heterotopic ossification after cervical artificial disc replacement and the degeneration of cervical facet joints.Methods From May 2009 to May 2012,133 patients who had undergone cervical artificial disc replacement were included into this study.There were 74 males and 59 females with an average age of 42.63±4.15 years old (range,23-56 years old).There were 109 patients who had undergone single level implant,and 24patients double level implant.Cervical spine A-P and the flexion-extension X-rays were taken to assess the range of motion (ROM)of the surgical level.Degeneration degree of patients' cervical facet joints were evaluated by Park grading standards with the preoperative cervical CT scan images on GE-PACS system.Heterotopic ossification (HO) situation were evaluated by McAfee classification through cervical lateral X-ray film.Patients were divided into two groups (HO group and non-HO group) according to whether heterotopic ossification appeared during the follow-up period.The data were collected before surgery to the latest follow-up.Results The average follow-up time was 2.9 years (range,2.0-4.8 years).HO was detected in 25 patients (18.80％,25/133) at latest follow-up.The ROM of surgical level of patients in HO group was significantly lower than non-HO group (6.8°±3.9° vs 9.1 °±2.4°).In addition,the degeneration degree of cervical facet joints of patients in HO group was significantly higher than that in non-HO group.There was a significant correlation between preoperative cervical facet joint degeneration and the occurrence of HO after CDR (r=0.683,P=0.033).Conclusion There was a significant correlation between preoperative cervical facet joint degeneration and the occurrence of HO after CDR.Patients present HO after surgery have significantly higher degeneration degree of cervical facet joints than patients without HO.Patients with higher degree of HO may have a higher level of cervical facet joints degeneration.

AIM: To investigate the effect and the mechanism of apolipoprotein (a) [apo (a) ] on proliferation of vascular smooth muscle cells ( VSMCs). METHODS: All VSMCs used in experiments were serial subcultured from primary cells and were identified by immunohistochemistry staining of a - actin. Cell growth assay was observed as cell counting and MTT assay. Western blotting was also employed to detect the related mechanism. RESULTS: All cells used in experiments were confirmed as VSMCs. Although apo (a) enhanced VSMCs proliferation, this effect was attenuated by anti -integrin α_vβ_3, LM609.Use these reagents alone had no effect on VSMCs growth. The results of Western blotting demonstrated that focal adhesion kinase (FAK) was activated by apo (a) and the expression of total or phosphorylated transforming growth factor β_1 (TGF -β_1) was also decreased. However, these effects described above were all blocked by LM609.CONCLUSION: Apolipoprotein (a) enhances VSMCs proliferation and this effect is mediated by integrin α_vβ_3, which activates FAK and attenuates TGF - β_1 and phospho -TGF - β_1 expression.

Animals ; Biological Warfare ; Burns ; pathology ; Burns, Chemical ; pathology ; Chemical Warfare ; China ; Humans ; Military Medicine ; Radiation Injuries ; pathology ; Wounds, Gunshot ; pathology

BackgroundRetinal pigment epithelial(RPE) cells can secrete platelet-derived growth factor (PDGF) and PDGF receptor(PDGFR).Studies have shown that PDGF plays a key role in the formation of proliferative vitreous retinopathy(PVR). ObjectiveThis study was to investigate the proliferation and apoptosis changes of RPE after blockage of the PDGFR-α expression by antisense oligonucleotide ( ASODN ) in vitro. Methods Human RPE cells strain was cultured in low glucose DMEM with 10％ fetal bovine serum.Logarithmic phase cells were collected and incubated in 96-well plate at the density of 5 × 105 cells/hole.PDGFR-α ASODN was transfected into RPE cells at different concentrations for 48 hours.The cells of the blank control group were regularly cultured without any transfection.The changes of PDGFR-α expression were detected by reverse transcription-polymerase chain reaction(RT-PCR),and the proliferation of RPE was detected by MTT as the A490 value.Hoechst 33258 fluorescence staining was used to determine the apoptosis of RPE.Flow cytometry method (FCM) was applied to detect the change of cell cycle and apoptosis rate of RPE cells. ResultsThe A490 values of RPE cells were 1.45±0.12,1.07±0.06,0.65±0.05 in blank control group,1.0 μmol/L Lipo-ASODN group and 2.0 μmol/L Lipo-ASODN group with the significant difference(P=0.00 ),and that of 1.0 μmol/L Lipo-ASODN group and 2.0 μ mol/L Lipo-ASODN group were significantly lower than the blank control group ( P =0.00,0.00).Hoechst 33258 staining showed that the apoptosis cells were obviously more in Lipo-ASODN group compared with blank control group.PDGFR-α ASODN transfection induced an increase of percentage of RPE cells in G0/G1 phase( F =206.70,P =0.00),and the apoptosis rates in 1.0 μmol/L Lipo-ASODN group and 2.0 μmol/L Lipo-ASODN group were significantly enhanced in comparison with blank control group ( 37.8 ± 1.3 vs 10.5 ± 0.1,61.2 ± 1.9 vs 10.5 ± 0.1 ) ( F =1808.90,P =0.00 ).Expression intensity of PDGFR-α mRNA in RPE cells in Lipo-ASODN groups was lower. ConclusionsBlocking the PDGFR-α expression with ASODN technology can suppress proliferation and induce apoptosis of RPE cells.Intensity of PDGFR-α mRNA expression in RPE cells is ASODN dose-dependent.ASODN targeted to PDGFR-α offers an experimental basis of the gene therapy for PVR.

Objective To explore the characteristics of dipyridamole 201 Tl myocardial perfusion imaging (MPI) SPECT in patients with dilated cardiomyopathy. Methods Thirty patients with dilated cardiomyopathy underwent pharmacological stress 201Tl MPI SPECT after intravenous infusion of dipyridamole (0. 56 mg/kg) for 4 min. The early and delayed SPECT images were acquired respectively at 10 and 240 min after 201Tl injection. The images were analyzed and reported by two or three experienced nuclear medicine physicians. Results All patients were found to have abnormal perfusion patterns at delay imaging, however 90.00% (27/30) were also abnormal at early images. Six patients had reverse redistribution. Conclusion Dipyridamole 201Tl MPI SPECT imaging may be of some value for the assessment of patients with dilated cardiomyopathy.

Objective To evaluate the effectiveness of one-stage debridement for cervical tuberculosis at different segments.Methods Clinical data of 54 patients (male 20,female 34) with cervical tuberculosis treated by one-stage debridement from Jan 1998 to Dec 2011 were reviewed retrospectively.The average age of these patients was 45.4 years (range,26-75 years).Among them,12 cases were involved in single level (C2 1 case,C4 2 cases,C5 3 cases,C6 4 cases,C7 2 cases); 36 cases in the adjacent two levels (C1,2 3 cases,C2,3 2 cases,C3,4 5 cases,C4,5 6 cases,C5,6 14 cases,C6,7 5 cases,C7T1 1 case); 5 cases in three levels(C4 6 2 cases,C5-7 2 cases,C3,5,6 1 case)and 1 case in four levels (C4-7).Five cases were involved in other spinal levels (T6 1 case,T 3 cases,L3,4 1 case).Comorbidity of cervical ossification of the posterior longitudinal ligament was found in 1 case.Before surgery,the mean VAS and JOA scores were 5.9 (range,4-9) and 10.5 (range,7-12) respectively and the mean Cobb angle of lesion segment was 26.7°± 9.1°.All cases underwent regular anti-TB treatment preoperatively,and surgical treatment were performed when blood sedimentation (ESR) was lower than 50 mm/1 h.According to the segmental involvement,different surgical approaches were performed including anterior debridement with anterior or anterior-posterior internal fixation and fusion,submandibular approach debridement with posterior occipital cervical fusion or atlantoaxial fusion.Results Mean follow-up duration was 27.3 months (range,13-52 months).Symptoms were improved significantly in all cases.Mean time of union was 3.2 months (range,2-4 months).At the last follow-up,the mean VAS and JOA scores were 5.9 (range,4-9)and 10.5 (range,7-12) respectively,and the mean Cobb angle of lesion segment was 6.8°.Regular anti-TB treatment was performed postoperatively for 18 to 20 months.Intraoperative esophageal injury was found in one case of upper cervical tuberculosis which was cured uneventfully after gastrointestinal tubation for 1 week.No cervical tuberculosis recurrence,graft loosening or pseudarthrosis was found in follow-up.Conclusion With preoperative anti-TB treatment,cervical tuberculosis can be treated by one-stage foci debridement according to the segmental involvement and deformity.Postoperative regular anti-TB treatment is a crucial factor for the final recovery of cervical tuberculosis.

Objective To investigate incidence and related factors of dysphagia after fusion with an anterior cervical plate plus cage or a stand-alone cage (Zero-p cage) following anterior cervical discectomy procedure for treating multilevel cervical spondylotic myelopathy (MCSM).Methods From September 2008to September 2011,226 patients with MCSM underwent anterior cervical discectomy and fusion using an anterior cervical plate plus cage (118 patients,P&C group) or a stand-alone cage (108 patients,Zero-p group).Neurological function was evaluated by Japan orthopedic association (JOA) scores before and after operation.Cervical X-rays were taken to assess the graft fusion,internal fixation related complications and the thickness of the prevertebral soft tissue.The Bazaz dysphagia score and Swallowing Quality of Life questionnaire were used to assess the incidence and degree of dysphagia.Results The average follow-up time was 2.4years (range,1.0 to 3.5 years).The incidence of dysphagia was 41.53％ in P&C group,while 33.33％ in Zero-p group at 2 days after operation.The thickness of the prevertebral soft tissue in P&C group was significantly thicker than that in Zero-p group at 2 days and 2 months after surgery.In Zero-p group,the incidence of dysphagia was 43.1％ in patients who underwent operation from C3 to C6,while 22％ in patients who underwent operation from C4 to C7.Conclusion Dysphagia is common after multilevel anterior cervical discectomy and fusion.The choice of implants and the extent of operation are important influencing factors of postoperative dysphagia.The use of stand-alone cage can decrease the incidence of dysphagia.The operation at higher levels has a higher incidence of dysphagia.