Objective To realize information management in the clinical treatment process and provide efficient services for patient. Methods From the requirement of the First Clinical College of Harbin Medical University, construction of digital clinical system was thoroughly elaborated. The functions and characters of the system were summarized. The application effect of the system was expatiated. Results The application of the system realized the whole network management for medical care, charging and pharmacy, thus optimizing the medical treatment process. Conclusion The management level and work efficiency are enhanced.

Obiective To construct the manageable, stable and reliable computer terminal environment for the hospital. Technology was successfully applied to the outpatient doctor workstation and the student electronic reading room in one hospital, and the system was running well.Conclusion The technical application can not only ensure the system security and stability, but also realize centralized management and improve efficiency.

Objective To investigate the characteristics of marital quality and social support status of the patients with breast cancer during the period of chemotherapy and the correlation of both factors.Methods Seventy-seven patients with breast cancer were divided into beginning-, middle-and final-staging groups of chemotherapy.And they were studied with Olson marital quality questionnaire and Social Support Rating Scale.Results The total scores of marital quality and other factors were the lowest in the mid-chemotherapy group.Among three groups,the mean of the objective support and availability were gradually increased with the chemotherapy going.The score of objective support was higher in the final than beginning chemotherapy groups (P =0.009).There was a positive correlation between marital satisfaction and the objective support (r =0.248, P =0.036), and between the total score of quality of marriage and subjective support (r =0.286, P = 0.015).Conclusion The marital quality of breast cancer patients receiving chemotherapy is poor,and subjective or and objective support might improve the patient's marital quality.

Objective To improve the technology of operation room video transmission for remote view and exchange.Methods The integrated controllable environment,the core technology of digital video transmission and video-on-demand were applied in the system.Results The system was easy to set up and operate.It had a strong network adaptability.Conclusion A feasible interactive platform is built for surgery teaching,research,medical management in the hospital.

Objective By simulating a high-glucose condition of peritoneal dialysis (PD)fluid,to explore the effect of high glucose on the expression of leptin and its relationship with peritoneal angiogenesis.Methods Adipocytes differentiated from 3T3-L1 were divided into high glucose group (139 mmol/l glucose) and high mannitol group.Leptin levels in supernatant collected at 0 h,12 h,24 h and 48 h were measured by ELISA.Endothelial cells (ECs) were respectively cultured with normal glouse,high glucose,high mannitol condition,supernatants of adipocyte induced by normal glouse,high glucose and high mannitol,high glucose supernatants+leptin antibody,and high mannitol supernatants + leptin antibody.Tubular structure formation and migration of ECs were detected.Results Adipocytes exposed to high glucose for 48 h produced more leptin as compared with control group,high mannitol group,12 h-high glucose group and 24 h-high glucose group (all P ＜ 0.05).Compared with ECs in normal group,ECs in high glucose had less tubular structure formation and increased migration (all P ＜ 0.01).Compared with those of ECs in high glucose,the tubular structure formation and the migration of ECs in adipocyte supernatants induced by high glucose had increased (all P ＜ 0.01),and these effects were reduced by leptin antibody (all P ＜ 0.01).Conclusion There is an up-regulation of leptin in adipocytes exposed to high glucose,which may be an alternative way to prevent peritoneal angiogenesis.

Objective To access the long-term efficacy and safety of immunosuppression on the progression of IgA nephropathy (IgAN) by Meta analysis.Methods Databases EMBASE,Pubmed,Elsevier Science Direct,Scopus,Web of Science,Google Scholar,Cochrane Library,China National Knowledge Infrastructure,WanFang and VIP Data were retrieved to collect the randomized controlled trials (RCTs) at least 3 years follow-up on immunosuppression for IgAN published before May 2014.The literatures were screened independently by two reviewers according to the inclusion and exclusion criteria,and the methodological quality was assessed.Statistic software Stata 12.0 was used to conduct analysis.Results Nine articles were included in this study with a total of 568 patients.Immurnosuppression could lowered the risk for the progression to ESRD (RR=0.32,95％CI:0.20-0.49,P ＜ 0.01).As far as the efficacy of immunosuppression,subgroup analysis indicated that three studies with more than 7 year follow-up (RR=0.28,95％CI:0.13-0.59,P ＜ 0.01) were similar with 7 studies followed by for less than 7 years (RR=0.34,95％ CI:0.19-0.59,P＜0.01); six adopted immunosuppressor monotherapy (RR=0.29,95％ CI:0.15-0.58,P＜ 0.01) were similar to two used corticosteroids plus other immunosuppression (RR=0.33,95％CI:0.18-0.59,P ＜ 0.01); There were no significant differences between four studies from Europe (RR=0.27,95％CI:0.14-0.53,P ＜ 0.01) and five from Asia (RR=0.35,95％ CI:0.19-0.65,P＜0.01).Immunosuppression was associated with an increased risk for adverse events (RR=2.33,95％ CI:1.33-4.09,P＜0.01).Conclusion Immunosuppression for IgAN may reduce long-term risk of progression to ESRD,but increase the risk of adverse events to some extent.

OBJECTIVETo observe the activity of peripheral blood monocytes (PBMs) derived macrophage scavenger receptors (MSR) and changes of serum inflammatory factor in peripheral blood in patients with coronary heart disease (CHD), and to evaluate the effect of Ginkgo biloba extract (GBE) on the MSR activity, to explore the relationship between inflammatory factor and scavenger receptors activity as well as the possible mechanism of GBE in stabilizing the atheromatous plaque.

METHODSNinety-seven CHD patients with normal blood lipids were classified into the stable angina group, the unstable angina group and the acute myocardial infarction group, and 29 healthy persons were taken as control. Levels of C-reactive protein (CRP), soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in all subjects were determined. And their PBMs were isolated, cultured in vitro, and transferred into macrophage to observe the effect of GBE on the expression of scavenger receptors.

RESULTSThe levels of MSR activity, CRP, sICAM-1 and sVCAM-1 in patients with acute myocardial infarction > unstable angina > stable angina > control.

CONCLUSIONGBE could down-regulate the MSR activity in CHD patients, which was positively correlated with levels of CRP, sICAM-1 and sVCAM-1. MSR activity could be taken as a monitoring criteria for active degree of vulnerable atherosclerosis plaque. GBE has the effect of suppressing MSR activity.

Adult ; Aged ; Angina Pectoris ; blood ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Ginkgo biloba ; chemistry ; Humans ; Intercellular Adhesion Molecule-1 ; blood ; Male ; Middle Aged ; Monocytes ; metabolism ; Myocardial Infarction ; blood ; drug therapy ; Phytotherapy ; Receptors, Immunologic ; blood ; Receptors, Scavenger ; Vascular Cell Adhesion Molecule-1 ; blood

Objective To evaluate the ability of contrast-enhanced ultrasound (CEUS) as a prognostic indicator of renal function in chronic kidney disease (CKD) patients.Methods A total of 122 patients with CKD were collected,and patients with allergies to sulfur hexafluoride,pregnancy,cardiopulmonary insufficiency,urinary calculus and tumour were excluded.These patients were divided into estimated glomerular filtration rate [eGFR,ml·min1· (1.73 m2)-1] ≥60 group,eGFR 30-59 group and eGFR ＜ 30 group.CEUS was performed after an intravenous bolus injection of 1.5 ml SonoVue (BR1;Bracco Milan,Italy).Time-intensity curves (TICs) and quantitative indexes were created using QLAB quantification software.Followed up for 2 years,and patients with eGFR dropped 50％,double serum creatinine and end-stage renal disease (ESRD) were regarded as having kidney failure events.Risk factors related to kidney survival were investigated using a multivariate Cox regression model.Results One hundred patients were enrolled in the study,with 78％ patients in CKD 1-2 stages,16％ in CKD 3 stage and 6％ in CKD 4-5 stages.Patients were followed for a mean period of 14.1 months,ten (10％) patients exhibited composite kidney failure events.Among 3 groups,significant differences in the left kidney length derived peak intensity (DPI) were noted (P=0.014,P=0.010).Multivariate Cox regression analysis revealed that the DPI was an independent factor of progression of kidney disease.Multiple linear regression showed that age,basic eGFR,peak intensity were associated with eGFR decline rate.Patients with DPI ＜ 12.27 db were less to recover from kidney disease progression as compared with patients with DPI≥ 12.27 db (P=0.008).The area under the curve (AUC) for DPI was 0.778(95％ CI 0.612-0.944,P＜ 0.05),with a sensitivity of 64％ and a specificity of 88％.Conclusions The DPI might be the most valuable CEUS parameter for the evaluation of renal function.The DPI could serve as an independent predictor of the long-term prognosis of CKD patients.

Objective To investigate the effect of pyrin domain 3 (NLRP3) inflammasome in the process of contrast induced human kidney cell apoptosis.Methods Human kidney 2 (HK-2) cells were cultured in DMEM-F12 medium with 5％ FBS.Cells were divided into control group,Contrast group (O group),NLRP3-siRNA+Iohexol group (si-NLRP3+O group),ASC-siRNA+Iohexol group (si-ASC+O group),and mannitol group (M group).Different concentrations of hypotonic contrast agent were added to HK-2 cell culture plates for 24,48 and 72 h.Flow cytometry was used to detect apoptosis.NLRP3 and ASC mRNA expressions were detected by RT-PCR.The expressions of NLRP3,ASC,caspase-8/cleaved caspase-8,Bcl-2/Bax,caspase-1/cleaved caspase-1,and caspase-3/cleaved caspase-3 protein were detected by Western blot.The levels of interleukin (IL) 1β and IL-18 in supernatant were detected by ELISA.Results Compared with the control group,the rate of apoptotic cells,as well as the expressions of NLRP3,ASC and cleaved caspase-1 proteins were increased in HK-2 cells of contrast group.The expressions of NLRP3 and ASC mRNA in the contrast group also increased,so did IL-1β and IL-18 levels (all P＜0.05),suggesting that NLRP3 inflammasome in HK-2 cells was activated by contrast.Compared with the control group,the expressions of cleaved caspase-8,Bax and cleaved caspase-3 protein were increased,and the expression of anti-apoptotic protein Bcl-2 was decreased (all P ＜ 0.05).Compared with the contrast group,the rate of apoptotic cells in the si-NLRP3 + contrast group and si-ASC + contrast group was significantly decreased;the expression of cleaved caspase-1 was decreased;the expressions of Bax and cleaved caspase-3 were decreased,and Bcl-2 level was increased.The expressions of IL-1β and IL-18 in the supernatant of cells were decreased (all P ＜ 0.05).Conclusion Contrast agent can activate the NLRP3 pathway in HK-2 cells and induce apoptosis,which could be reduced by blocking the NLRP3 pathway.