10.3969/j.issn.2095-4344.2013.24.021

This paper introduces the work on the design and implementation of a medical record management subsystem, which is a part of a telemedicine system based on Microsoft .NET. First, an analysis is given on components and structure of medical record, together with an explanation for what is needed in a teleconsultation, how they should be organized and realized in a database, and how to deal with consultation data granularity using XML in combination with database; second, the work done during the realization stage is expatiated, including system analysis and design, database design, and system implementation.
Database Management Systems ; Hospital Information Systems ; Humans ; Information Storage and Retrieval ; methods ; Internet ; Medical Records Systems, Computerized ; Remote Consultation ; methods ; Software ; Software Design ; Telemedicine ; methods

Antigens ; chemistry ; Fixatives ; chemistry ; Humans ; Hydrogen-Ion Concentration ; Immunohistochemistry ; methods ; Microwaves ; Staining and Labeling ; methods

Hepatic fibrosis models were induced by CCl4 in rats. To explore vascular endothelial growth factor (VEGF), transforming growth factor-beta1 (TGFβ1) mRNA expression and bcl-2, Bax protein expression levels of intervention and explore the mechanism of the Aralia chinesis anti-hepatic fibrosis. Sixty male Sprague-Dawlley (SD) rats were randomly divided into six groups: nomal group, model group, high-dose (10 mL x kg(-1)), medium-dose (7.5 mL x kg(-1)), low-dose (5.0 mL x kg(-1)) of A. chinesis treated group and colchicine treated group. The change of liver histopathology was observed by HE and Masson staining. The mRNA of VEGF, TGF-β1 were detected by RT-PCR. The protein of Bcl-2 and Bax were detected by Western blot. In the model group liver cell obvious degeneration, necrosis, a large number of collagen fibers of the cable hyperplasia, part visible pseudolobule formation. A. chinesis large, medium, low-dose group and colchicine group liver cell degeneration and necrosis reduced A. chinesis small, medium, and high-dose group was gradually reduced trend and A. chinesis large, middle dose group degree of reduction is particularly significant. Compared with model group, A. chinesis of large, medium and small dose group and colchicine group VEGF mRNA expression, A. chinesis of large, medium-dose group TGF-β1 mRNA expression reduce (P < 0.05); compared with colchicine group, A. chinesis of large, middle dose group of VEGF mRNA expression decreased (P < 0.05); A. chinesis of large, middle dose group of TGF-β1 mRNA expression decreased (P < 0.01), and compared with colchicine group, large dose group of of TGF-β1 mRNA expression decreased (P < 0.05). Compared with model group, A. chinesis of large, medium and small dose group and colchicine group Bcl-2 protein expression reduce (all is P < 0.05). But A. chinesis of large, medium and small dose group and colchicine group of Bax protein expression were increased (P < 0.05). A. chinesis regulation of VEGF, TGF-β1 may prevent the activation of hepatic stellate cells, liver tissue by up regulating the anti-apoptotic protein Bax and down pro-apoptotic protein Bcl-2 expression, thereby to improve the degree of liver fibrosis.
Animals ; Apoptosis ; drug effects ; Aralia ; chemistry ; Drugs, Chinese Herbal ; administration & dosage ; Hepatic Stellate Cells ; drug effects ; metabolism ; Humans ; Liver Cirrhosis ; drug therapy ; genetics ; metabolism ; Male ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley ; Transforming Growth Factor beta1 ; genetics ; metabolism ; Vascular Endothelial Growth Factor A ; genetics ; metabolism ; bcl-2-Associated X Protein ; genetics ; metabolism

Objective To explore the effects of surface modification of PLGA-[ASP-PEG] scaffold with typeⅠcollagen on the adhesion,proliferation and osteogenic differentiation of rabbit bone marrow stromal cells (BMSCs).Methods After PLGA-[ASP-PEG] materials were modified with typeⅠcollagen chemically,the collagen was coated onto the materials physically.The BMSCs obtained from rabbits were cultured on the modified PLGA-[ ASP-PEG] and on the unmodified PLGA-[ ASP-PEG] as control.The adhesion and proliferation behavior of the cells was analyzed and the expressions of osteogenie marker alkaline phosphatase,osteocalcin,osteopontin,typeⅠcollagen and core binding factor al were also detected.Results X-ray photoelectron spectrometry(XPS) confirmed that TypeⅠcollagen was grafted onto the surface of PLGA-[ASP-PEG] successfully and the collagen content on the materials modified chemically and physically was significantly increased.The abilities of adhesion and proliferation and the expressions of osteogenie makers of the BMSCs were significantly greater than those in the control group(P＜0.05).Conclusion Since Type collagen I can improve the biocompatibility of PLGA- [ASP-PEG] scaffold materials,it can be used as a new way to optimize scaffolds in tissue engineering.

Objective To discuss the short-term clinical effect including functional change of lipiodol- arsenic trioxide emulsion on the primary hepatic carcinoma.Methods Fifty-two patients undergone arterial chemoemblization were selected and then randomly divided into two groups:treatment group(n=27)and control group(n=25).Patients in treatment group were treated with lipiodol-arsenic trioxide,while those in control group treated with mitomycin,epirubicin,cisplatin or lipiodol.Clinical symptoms and six liver function parameters were observed and analized.Results The clinical symptoms of patients in treatment group improved much better than those in control group,and the liver function impairment of patients in treatment group also decreased more than those in control group.Conclusions Lipiodol-arsenic trioxide is an effective and safe intervention-therapeutic embolization material for primary hepatic carcinoma.

Objective To explore the effect of surgical position and pneumoperitoneum pressure on shoulder pain following laparoscopy. Methods A total of 277 patients underwent laparoscopy were randomly selected as the subjects for study. 142 patients underwent laparoscopic cholecystectomy (LC) ( heM-high and foot-low) were divided into two groups: Group A with a pneumoporitoneum pressure of 14 mm Hg CO2 pressure, and Group B with a pneumoperitoneum pressure of 10 mmHg CO2 pressure. 135 patients underwent laparoscopic gynecologic surgery (head-low and foot-high ) were randomly divided into two groups: Group C with 14 mmHg pneumoperitoneum pressure, and Group D with 10 mm Hg pressure. The incidence of shoulder pain after laparoscopy was compared and analyzed. Results The incidence of postoperative shoulder pain was significantly high in Groups C and D, compared with Groups A and B, respectively. If compared with Groups B and D respectively, Groups A and C with a higher CO2 pressure have more shoulder pain patients. Conclusions Laparoscopic CO2 pressure and surgical position have significantly effects on postoperative shoulder pain.

Objective To investigate management approach of integrated laparoscopic operating rooms based on the new surgical model. Methods Four integrated laparoscopie operating rooms were equipped and used in PLA General Hospital. The methods of management using these instruments were sunmmrized. Results During using integrated laparoscopic operating rooms, the experience including the preparation of instnunents, arrangement, managerial focus and training related approach were summarized. Conclusions Constructing of integrated laparoscopic operating rooms is the foundation of realization of the digital hospital.

OBJECTIVETo investigate results of total knee arthroplasty using the long-stem tibial component combined with metallic wedge of knee prosthesis for the treatment of proximal defects.

METHODSFrom January 2011 to May 2013, 10 patients (11 knees) were treated with total knee arthroplasties using the long-stem tibial component with metallic tibial wedge of knee prosthesis. All the patients were female and the average age was 67 years old (ranged, 60 to 77 years old). All the patients were osteoarthritis. All the patients were classified as T2A style. The patients were evaluated according to knee score system (KSS).

RESULTSAll the patients were followed up for 12 months on average (ranged 3 to 29 months). The clinical outcome was assessed using KSS score, including knee pain score, knee stability score, knee range of motion score and knee walking score, knee stairs score. There were significantly differences at 6 weeks, 3 months, 6 months and 12 months between pre-and postoperative KSS score.

CONCLUSIONThe mechanical stability of tibial fixation in primary TKA is significantly increased by using the long-stem tibial component with metallic wedge of knee prosthesis, even in the presence of poor proximal bone.

Aged ; Arthroplasty, Replacement, Knee ; Female ; Humans ; Knee Joint ; physiopathology ; surgery ; Knee Prosthesis ; Male ; Osteoarthritis, Knee ; physiopathology ; surgery ; Range of Motion, Articular ; Tibia ; abnormalities ; physiopathology ; surgery

OBJECTIVETo evaluate the prognostic factors and fertility outcomes of borderline ovarian tumors (BOT) after conservative surgery.

METHODSThe clinical data of 109 patients with BOT who were treated in Peking Union Medical College Hospital from January 1990 to December 2007 were retrospectively analyzed. According to the FIGO staging system,there were 34(31.2%) patients at Stage Ia and Ib, 66 (60.6%) at Stage Ic, 2 (1.8%) at Stage II and 7(6.4%) at stage III. No patient was at Stage 4.

RESULTSSurgical treatment included comprehensive staging surgery (n=40, 36.7%), ovarian cystectomy (n=27,24.8%), and unilateral salpingo-ovariectomy (n=42, 38.5%). The average follow-up period was (60.3±42.5) months. Relapse occurred in 25 patients (22.9%), and the mean duration from therapy to recurrence was (36.1±31.9) months. Only one patient died of BOT. Multivariate analysis showed that surgery procedure and tumor stage were the independent prognostic factors affecting recurrence. Of 66 patients with the desire of fertility, 24 (36.4%) finally got pregnant.

CONCLUSIONSConservative surgery has comparatively good prognosis and should be the first choice for younger patients with the desire of fertility. The high-risk factors should be evaluated before the initiation of treatment.

Adolescent ; Adult ; Female ; Fertility ; Follow-Up Studies ; Humans ; Middle Aged ; Neoplasms, Glandular and Epithelial ; surgery ; Ovarian Neoplasms ; surgery ; Prognosis ; Retrospective Studies ; Treatment Outcome ; Young Adult