The application of 6 important schedule management steps in construction of hospital information system was described in detail with the information system transform project in Beijing Friendship Hospital as an example. Effective management could assure the progress of project according to the plan and a specific schedule management plan should be worked out by taking into full consideration the overall environment and difficulties of the project due to the various influencing factors. The experiences with schedule management in construction of hospital information system were summarized for its further improvement.

Hospital information construction is a systematic project involving many sectors and specialties,it is thus quite necessary to implement project management in hospitalinformation construction. The problems in hospital in-formation construction were analyzed,the key points and common problems in its project management were presented, and the importance of scientific project management methods used in hospital information construction was pointed out.

Objective To investigate the role of IL-11 and CTGF in bone metastasis of breast cancer.Methods A total of 180 pathologically confirmed breast cancer patients in Tianjin Medical University Cancer Institute and Hospital were enrolled,90 of which had bone metastasis.Twenty healthy people who took physical examination at the same period were adopted as controls,excluding those with endocrine or metabolic disease or other chronic diseases.Peripheral blood samples were collected and ELISA was employed to detect IL-11 and CTGF expression.Forty paraffin-embedded breast cancer tissue sections from those with bone metastasis and forty tissue sectioned from those without bone metastasis were detected for IL-11 and CTGF expression with immunohistochemisty.Results Serum IL-11 level was (242.9 ±56.3) μg/L in the group with bone metastasis and (85.9 ± 35.7) μg/L in the group without bone metastasis,with a significant difference (F =43.532,P ＜0.01).Serum level of CTGF was (15.6 ±7.4) μg/L in the group with bone metastasis and (15.0 ± 7.0) μg/L in the group without bone metastasis,with no significant difference (F =3.007,P ＞ 0.05).The rate of positive immunohistochemical staining for IL-11 in the group with bone metastasis (57.5％) was significantly higher than that in the group without bone metastasis (14.3％) (x2 ＝ 36.626,P ＜ 0.01).There was no significant difference in the positive rate of CTGF expression between the group with bone metastasis (17.5％) and the group without metastasis (14.3％) (x2 =0.370,P ＞ 0.05).Conclusions IL-11 expression is correlated with bone metastasis of breast cancer.Breast cancer patients with high IL-11 expression are more prone to develop bone metastasis.

AIM:To investigate the molecular mechanism of Xijiao Dihuang decoction combined with Yinqiao powder (XDY) in treating viral pneumonia, and the effects of XDY on TNF-α-induced permeability in pulmonary microvascular endothelial cells (PMVEC) and the role of PKC-SSeCKS pathway involved.METHODS:The electric conductivity method was used to detect transendothelial electrical resistance (TER) of primarily cultured PMVEC on Transwell chamber at different time points to determine the permeability of PMVEC.After pretreatment for 24 h, the activity of PKC, TER, and the expression of SSeCKS at mRNA and protein levels were detected.Laser scanning confocal microscopy was used to observe the location of SSeCKS and construction of F-actin in PMVEC.RESULTS:The permeability of PMVECs induced by TNF-α reached the peak at 24 h.Compared with control group, the TER in TNF-α group was decreased, and the activity of PKC was increased.Compared with TNF-α group, the activity of PKC in TNF-α with PKC inhibitor group and TNF-α with XDY group was decreased, while the TER was increased, without difference from control group.Compared with control group, the mRNA expression of SSeCKS and phospho-SSeCKS was increased in PMVEC of TNF-α group, but decreased in TNF-α with XDY group compared with TNF-α group.In control group, F-actin was mainly located around the nucleus and at cytoplasmic borders of PMVEC, forming the dense peripheral bundle, and SSeCKS was evenly scattered in the cell.In TNF-α group, the dense peripheral bundle of F-actin surrounding the cells almost disappeared, and SSeCKS was concentrated around the nucleus.Compared with TNF-α group, the distribution and the structure of F-actin and SSeCKS nearly returned to normal in TNF-α with XDY group.CONCLUSION:XDY inhibits the activation of PKC signaling pathway in PMVEC caused by TNF-α to reduce the mRNA expression of SSeCKS and the phosphorylation of SSeCKS, thus preventing the deformation of endothelial cells and reducing the permeability of PMVEC.

Objective:To analyze the correlation between arch width and different vertical facial skeletal types of the adults with individual normal occlusion.Methods:52 adults with individual normal occlusions(females 31,males 21) were included.According to the values of mandibular plane angle MP-FH,SN-MP measured on CBCT image the subjects were divided into 3 groups(13 cases with highangle,19 with average-angle and 20 with low-angle groups).12 parameters were measured for each sample,including maxillary and mandible arch width and alveolar arch width between canines,between first premolars and between first molars,the difference between the maxillary arch width and mandibular arch width were calculated.The data were statistically analyzed by one-way ANOVA and Pearson~ rank correlation test.Results:In the group of high-angle,average-angle and low-angle the alveolar arch width(mm) between maxillary canines was 38.03 ± 1.90,39.65 ± 1.80 and 39.78 ± 2.20 respectively(P ＜ 0.05).The arch width between maxillary first premolars of high-angle group(37.01 ± 1.60) was smaller than that of low-angle group(38.65 ± 1.30).The arch width difference in canine area between maxillary and mandibular alveolar in high-angle,average-angle and low-angle groups was 7.39 ± 1.82,9.04 ± 1.43 and 9.26 ± 1.67 respectively(P ＜0.05);in maxillary first premolars area in high-angle(6.8 ± 1.59) was smaller than that in averageangle(7.79 ± 1.09),maxillary and mandibular arch width showed no statistical difference.Pearson correlation test showed that among 3 groups,upper and lower alveolar arch width difference in canine and first premolars area was negatively correlated with the mandibular plane angle.while upper and lower arch width difference showed no statistical correlation with the mandibular plane angle.Conclusion:The maxillary middle arch width of the subjects with individual normal occlusion was correlated with vertical facial type.

Objective:To investigate the effect of stroke center on the treatment time and short-term prognosis in patients with ultra-early acute cerebral infarction (ACI) within 6 h treated with intravenous thrombolysis.Methods:The clinical data of 113 patients with ultra-early ACI treated with intravenous thrombolysis from July 2017 to July 2019 in Chaoyang City Central Hospital, Liaoning Province were retrospectively analyzed. Among them, 40 patients who received intravenous thrombolysis before the establishment of the stroke center (from July 2017 to July 2018) were enrolled as control group, and 73 patients who received intravenous thrombolysis after the establishment of the stroke center (from August 2018 to July 2019) were as study group. The treatment time nodes were recorded, including the time of onset, time of ACI initial diagnosis, time of completing blood collection and index reporting, time of completing CT examination and diagnosis, time of informed consent and time of onset of intravenous thrombolysis. The short-term prognosis indexes were recorded, including the mortality rate, effective rate of intravenous thrombolysis, improvement rate of neurological deficit at discharge and length of stay.Results:The time of ACI initial diagnosis, time of informed consent and time of onset of intravenous thrombolysis in study group were significantly shorter than those in control group: (5.16 ± 1.97) min vs. (10.23 ± 7.80) min, (36.26 ± 21.89) min vs. (56.23 ± 40.97) min and (85.12 ± 35.46) min vs. (126.28 ± 50.14) min, and there were statistical differences ( P<0.01); there were no statistical difference in the time of onset, time of completing blood collection and index reporting and time of completing CT examination and diagnosis between 2 groups ( P>0.05). The mortality rate in study group was significantly lower than that in control group: 1.4% (1/73) vs. 12.5% (5/40), the effective rate of intravenous thrombolysis and improvement rate of neurological deficit at discharge were significantly higher than those in control group: 84.9% (62/73) vs. 67.5% (27/40) and 76.7% (56/73) vs. 55.0% (22/40), and there were statistical differences ( P<0.05); there was no statistical difference in length of stay between 2 groups ( P>0.05). Conclusions:The establishment of standard stroke center can shorten the treatment time and improve the prognosis of patients with ultra-early ACI.

Objective To analyze the pregnancy outcomes of fetal tetralogy of Fallot and to explore its prenatal diagnosis and treatment procedures. Methods The clinical data of 63 cases of fetal tetralogy of Fallot (62 cases were singleton and 1 case was one of twin) were collected retrospectively from November, 2013 to November, 2017 in Beijing Obstetrics and Gynecology Hospital. Results (1) Totally, 63 cases out of 46 352 pregnancies were diagnosed fetal tetralogy of Fallot by fetal ultrasonic cardiogram with about 0.136%(63/46 352) occurrence rate, and the mean gestational age was (23±3) weeks. And 50 cases (79%, 50/63) terminated pregnancy by induced labour. (2) Totally, 57 cases (90%,57/63) accepted genetic diagnosis.Eight cases (13%, 8/63) existed chromosome abnormality including 21-trimosy in 6 cases, 18-trisomy in 1 case and 22q11.2 microdeletion syndrome in 1 case; and these 8 cases were determined before 28 gestational weeks. (3) And 13 cases (21%, 13/63) of no fetal genetic abnormality selected to continue pregnancy. Twelve cases underwent full term delivery (5 cases were cesarean section delivery and 7 cases were vaginal delivery). Twelve newborns underwent surgical radical operation on heart malformation and got recovery. One case underwent preterm cesarean section at 35 gestational weeks for one of twin, and the newborn with tetralogy of Fallot was dead. The other the newborns survived and were followed up for tetralogy of Fallot surgery from 1 month to 3 years old after birth and recovered.Conclusions Fetal tetralogy of Fallot mainly is diagnosed by ultrasonic cardiogram in the second trimester. The gestational age of diagnosis may be as early as 15 gestational weeks. Fetal tetralogy of Fallot with no genetic abnormality could underwent radical heart malformation operation after birth. It is necessary to undergo genetic testing on fetal tetralogy of Fallot and prenatal multidisciplinary counseling as well.

Objective To study the relationship between sdLDL-C level and CHD.Methods Two hundred and thirty-one CHD patients were divided into carotid stenosis group (n=119) and carotid stenosis-free group (n=112).The relationship between serum sdLDL-C level and risk factors for CHD were analyzed by logistic stepwise regression analysis.Results The serum sdLDL-C level was significantly higher in carotid stenosis group than in carotid stenosis-free group (P＜0.05).The elevated rate of serum sdLDL-C level was significantly higher in carotid stenosis group than in carotid stenosis-free group when 1.39 mmol/L was set as its upper limit reference cutoff value (36.3％ vs 17.0％,P＜0.05).The serum levels of TC,LDL-C,apoB,D-dimer and Fib were significantly higher while those of HDL-C were significantly lower in carotid stenosis group than in carotid stenosis-free grou (P＜0.05).The serum levels of sdLDL-C were positively related with those of TC,LDL-C,apoB,D-dimer,Fib and negatively related with those of HDL-C (P＜0.01).Logistic stepwise regression analysis showed that TC,LDL-C,apoB,D-dimer,Fib and sdLDL-C were the independent risk factors for CHD (P＜0.05).Conclusion Serum sdLDL-C level is significantly higher in CHD patients and is thus an important risk factor for CHD.

Objective:To investigate the factors influencing the prognosis of patients with estrogen receptor (ER)-positive de novo stage Ⅳ breast cancer.Methods:The clinical data of 339 patients with ER-positive de novo stage Ⅳ breast cancer treated in Tianjin Medical University Cancer Hospital and Cangzhou Hospital of Integrated TCM-WM from February 2010 to December 2017 were retrospectively analyzed. Related factors such as age, time of chief complaint, the clinical T/N stage, site of metastasis, expressions of molecular markers and treatment mode were included. Univariate log-rank test and multivariate Cox regression model were used to analyze the effects of prognostic factors on patients' overall survival (OS).Results:Univariate analysis showed that there were statistically significant differences in the OS of patients stratified by clinical N stage at first diagnosis, metastasis sites at first diagnosis, ER expression, progesterone receptor (PR) expression, Ki-67 positive index and p53 expression, endocrine therapy, chemotherapy at first diagnosis, surgery and radiotherapy of the primary lesions (all P < 0.01). Multivariate Cox regression analysis results showed that metastasis sites at first diagnosis, Ki-67 positive index, surgery and radiotherapy of the primary lesions were all independent influencing factors of OS for breast cancer patients (all P < 0.01). Conclusions:Patients with ER-positive de novo stage Ⅳ breast cancer have a good prognosis when they have oligometastasis, Ki-67 positive index ≤ 20%, and they receive surgery and radiotherapy of the primary lesions.

Objective: To analyze the pregnancy outcomes of fetal tetralogy of Fallot and to explore its prenatal diagnosis and treatment procedures. Methods: The clinical data of 63 cases of fetal tetralogy of Fallot (62 cases were singleton and 1 case was one of twin) were collected retrospectively from November, 2013 to November, 2017 in Beijing Obstetrics and Gynecology Hospital. Results: (1) Totally, 63 cases out of 46 352 pregnancies were diagnosed fetal tetralogy of Fallot by fetal ultrasonic cardiogram with about 0.136%(63/46 352) occurrence rate, and the mean gestational age was (23±3) weeks. And 50 cases (79%, 50/63) terminated pregnancy by induced labour. (2) Totally, 57 cases (90%,57/63) accepted genetic diagnosis.Eight cases (13%, 8/63) existed chromosome abnormality including 21-trimosy in 6 cases, 18-trisomy in 1 case and 22q11.2 microdeletion syndrome in 1 case; and these 8 cases were determined before 28 gestational weeks. (3) And 13 cases (21%, 13/63) of no fetal genetic abnormality selected to continue pregnancy. Twelve cases underwent full term delivery (5 cases were cesarean section delivery and 7 cases were vaginal delivery). Twelve newborns underwent surgical radical operation on heart malformation and got recovery. One case underwent preterm cesarean section at 35 gestational weeks for one of twin, and the newborn with tetralogy of Fallot was dead. The other the newborns survived and were followed up for tetralogy of Fallot surgery from 1 month to 3 years old after birth and recovered. Conclusions Fetal tetralogy of Fallot mainly is diagnosed by ultrasonic cardiogram in the second trimester. The gestational age of diagnosis may be as early as 15 gestational weeks. Fetal tetralogy of Fallot with no genetic abnormality could underwent radical heart malformation operation after birth. It is necessary to undergo genetic testing on fetal tetralogy of Fallot and prenatal multidisciplinary counseling as well.