The paper analyzes the current situation of integration in healthcare industry and the difficulties in the construction of healthcare big data platform,proposes the construction of healthcare big data platform by Cloud P2P network,and the platform framework including the five layers of resource layer,sense/access layer,transfer layer,service layer and application layer.

The paper analyzes the problems existing in the architecture of traditional telemedicine based on cloud computing,puts forward a kind of telemedicine architecture that adopts Peer to Peer (P2P) Cloud hybrid network by referring to relevant researches,states the architecture characteristics and operation process,and provides several application cases of telemedicine.

The paper introduces researches related to the discovery mechanism of things and information for the Internet of Things based on P2P, analyzes and compares three kinds of distributed P 2P topological structures , and proposes information discovery for the In-ternet of Things based on unstructured P 2P.This means to use interest -based selection of hierarchical topological construction and the self-adaptable search algorithm based on interest clusters and analyze this algorithm .

Objective To evaluate the application of intra-operative cholangiography in cholecystectomy. Methods A total of 442 patients with biliary calculi underwent cholecystotomy were reviewed. Results Of the 442 cases, 3 were false positive and 1 was false negative radiologically. The accuracy rate was 99.1％. Conclusion The results suggested that the application of intra-operative cholangiography could decrease the incidence of residual calculi and avoid unnessary exploration and trauma of the common bile duct.

Objective: To investigate the factors that affect the outcome of pregnancies complicated with critically heart disease admitted to obstetric Intensive Care Unit (ICU). Methods: A retrospective study was conducted for 188 pregnant and postpartum patientscomplicated with heart disease who were admitted to the ICU in West China Second University Hospital from July 2009 to March 2013. Results: During the 4 years, there were 619 cases of pregnancy complicated with heart disease hospitalization. Among them, 188 (30.37%) patients complicated with severe heart disease were admitted to the ICU, accounting for 39.17% of the total ICU admission (480); the mean maternal age was (28.45±6.08) years old and the mean gestational time was (36.03±4.19) weeks. 23 (12.23%) patients received regular antenatal care in our hospital. 61 (32.45%) patients never received antenatal care before hospitalization. Among them, 5 patients were dead. hTe ratio for diagnosis of heart disease before pregnancy, during pregnancy and atfer admission were 39.89%, 25.54% and 34.57%, respectively; the most common heart diseases during pregnancy were congenital cardiac disease (80, 42.55%) and rheumatic heart disease (45, 23.94%) followed by arrhythmias (20, 10.64%). The most common complication were pulmonary arterial hypertension (51, 27.13%), arrhythmias (47, 25.00%) and severe heart failure (30, 15.96%); the cardiac function of 164 (87.23%) patients was at stage I–II and 5 (2.66% ) patients died when discharged from hospital. 151 (80.32%) patients received multidisciplinary consultation and 34 (18.09%) used central venous catheterization to control central venous pressure (CVP). 21 (11.17%) patients required mechanical ventilation. 11 (5.85%) patients required emergency life support (cardiopulmonary resuscitation 9 + electric deifbrillation 3). Conclusion: Pregnancy complicated with heart disease is the leading reason for admission to ICU. hTe congenital cardiac disease, rheumatic heart disease and arrhythmias are the main heart diseases during pregnancy. Multidisciplinary cooperation and intensive care are the key measures to improve the outcomes of patients with critically illness. It is very important for reduction of the maternal mortality rate through strengthening preconception care and antenatal care.

OBJECTIVE To strengthen the cleaning and disinfection management for endoscope to fulfil the specification.METHODS The management of cleaning and disinfection of the endoscopes were to be improved by methods of education,inspection,condition improvement and perfect institution.RESULTS The endoscopes which were disinfected were all reached the standards.CONCLUSIONS It is important to strengthen the cleaning and disinfection management for endoscopes.

Objective To simulate the solution drought stress conditions with polyethylene glycol (PEG) 6000 for study on the seed germination of Cassia occidentalis.Methods The seed of C.occidentalis was treated with 5% and 10% PEG 6000,respectively,then the germination rate,the activity of superoxide dismutase (SOD),peroxidase (POD),and content of malondialdehyde (MDA) were measured.Results Compared with the same period of the control,soaking with 5% PEG 6000 for 5 h could increase the activity of SOD and POD,decrease the content of MDA.PEG Pretreatment could decrease free radical accumulation and make cell membrane system less damaged in the course of absorbing water in seed.Conclusion Soaking with 5% PEG 6000 for 5 h could increase the seed germination rate of C.occidentalis.

Scenario-based teaching method can be applied in clinical skills training of obstetrics and gynecology,which increases practice opportunities of interns by imitating the real clinical work.For professional examination teaching,teachers and simulation models as simulated patients help interns improve inspection skills and provide error feedback timely; for emergency and severe diseases teaching,real cases combined simulation models,medical equipment,and multi-professional collaboration develop the clinical problem-solving competence of interns; for doctor-patient communication teaching,the communication skills of interns can be improved by scenario database which has been constructed by teachers; and for clinical skills test,the clinical practice quality of interns can be reflected accurately by integrating various clinical skill tests.Scenario-based teaching requires a large amount of scenario materials,as well as highly qualified teachers who can control the teaching process effectively.

Based on the review of literature, the evaluation method and application of medication and functional exercise compliance of patients with stroke were summarized, to provide reference for nursing staff about the effective evaluation of medication and exercise compliance of patients with stroke, as well as the early and accurate judgment of patient′s compliance, further taking nursing intervention measures, to provide a basis for improving the medication and functional exercise compliance of patients with stroke and their rehabilitation effect.

ObjectiveTo investigate the expression of midkine(MK) and its relation with angiogenesis, biological features and prognosis of pancreatic carcinoma(PC).MethodsMK expression and microvessel density(MVD) were determined in 52 cases of human PC with immunohistochemistry and results were compared with pathology.ResultsMean MVD of PC was 64?18 and positive expression of MK was detected in 38 cases (73%). The positive rate of MK was significantly lower in cases of without metastasis and at early clinical stage (stageⅠ～Ⅱ) than that with metastasis and at stage Ⅲ～Ⅳ. MVD was significantly higher in MK-positive PC than in MK-negative PC (P