Through the review of the research on electronic health records at home and abroad,the author introduced the process of the construction of electronic health records at home and abroad.By comparing the reviews,we sumed up the characteristics of the construction of the electronic health records abroad,so as to provide references to our electronic health records and improvement suggestions for insufficient health records construction in China.

BACKGROUND:Studies have shown that human leukocyte antigen (HLA)-A*0206 subtype is related to the abscess of nasopharyngeal carcinoma, but there is no corresponding transgenic animal models that could used to judge the relationship between HLA-A*0206 and nasopharyngeal carcinoma on the overal level and further research of immunotherapy and gene therapy. OBJECTIVE:To construct lentiviral vectors carrying pLVX-CMV-HLA-A*0206-HA-mCMV-ZsGreen and establish HLA-A*0206 transgenic mice. METHODS:The HLA-A*0206 sequence was synthesized. EcoRI recognition site was introduced in the 5’ end by polymerase chain reaction, and influenza virus hemagglutinin labels and BamHI recognition site were introduced in the 3’ end. Eco RI and Bam HI double enzyme digestion target fragments and the pLVX-CMV-mCMV-ZsGreen plasmids were connected to the digested productions and transfected JM109 competent cel s. The positive clones were selected and identified by double enzyme digestion and sequencing. The positive plasmid and packaging plasmids were transfected into 293T cel s, which were human renal epithelial cel line that can express SV40 large T antigen. The lentivirus containing target sequence was produced. RESULTS AND CONCLUSION:Gel electrophoresis and sequencing results showed that, HLA-A*0206 was successful y inserted into pLVX-CMV-mCMV-ZsGreen frame plasmids. Transfection efficiency was 92%after 48 hours of transfecting 293T cel s. The viral suspension titer was 5 × 108 measured by fluorescence method. Experimental findings indicate that, the lentivirus containing cytomegalovirus promoter, HLA-A*0206, influenza virus hemagglutinin label and Zsgreen report gene was successful y constructed.

Objective To accurately determine the biological characteristics , especially the disease-related indexes of SPF rabbits , and their gender differences .Methods A total of thirty 70-80 day old SPF New Zealand rabbits (male :female=1:1) were fed for a week, and then we weighed the body weight and main organs , determined the blood physiological and biochemical indexes , blood gas and arterial pressure , and measured the ventricular pressure by thoracotomy under respiratory support .Results Comparison of the male and female SPF New Zealand rabbits showed that there were significant differences in the mass of thyroid , adrenal gland, and liver (P<0.05 or P<0.01); the brain, pituitary gland, thyroid gland organ coefficients ( P<0.05 or P<0.01); the thyroid/brain, adrenal/brain, and liver/brain ratios (P<0.05 or P<0.01);the mean erythrocyte volume and mean hemoglobin content (P<0.05 or P<0.01);and in glutamyl transpetidase and amylase ( P<0.05 or P<0.01 ) , but no significant differences in blood gas analysis ,heart rate and carotid artery systolic and diastolic blood pressure , left ventricular systolic and diastolic blood pressure , and right ventricular systolic and diastolic blood pressure .Conclusions The gender has an impact on organ weight and blood physiological and biochemical indexes in New Zealand rabbits , but no significant influence on blood gas , blood pressure , heart rate and ventricular pressure in the rabbits .

OBJECTIVE:To evaluate the cost-effectiveness of3kinds of traditional Chinese medicinal injectable prepa?rations in the treatment of children's fever caused by exogenous pathogens METHODS:44cases were assigned to receive Qin_ gkailing injection(Group A),Shuanghuanglian for injection(Group B)and heartleaf houttuynia herb injection(Group C),re?spectively.The curative effects of the3groups were observed and the cost-effectiveness analysis were conducted as well.RESULTS:The costs for the3groups were28.68yuan,45.00yuan and59.40yuan,respectively;the total effective rates were80.00%,86.67%and85.71%,respectively;the cost-effectiveness ratios of the3were35.85,51.92and69.30,re?spectively;the incremental cost-effectiveness ratios of Group B and C were244.68and538.00,respectively as compared with Group A.CONCLUSION:Qingkailing injection(Group A)is the preferred option in the treatment of children's fever caused by exogenous pathogens.

Objective:To evaluate the accuracy of serum concentration of procalcitonin (PCT) in differential diagnosis of the etiology of bloodstream infections (BSI).Methods:Patients hospitalized in ICU of China-Japan Friendship Hospital from January 2015 to June 2020 with BSI and with PCT test simultaneously when blood drawing for blood culture were enrolled. Sequential Organ Failure Assessment (SOFA) were calculated based on parameters on the day of blood culture. Difference of various indicators among different pathogen infections were compared. Receiver Operating Characteristic (ROC) Curve was used to analyze the value of PCT in differential diagnosis of BSI by different pathogens.Results:Among 1 456 patients with BSI,1 261 (86.6%) patients with monobacterial infection, 80 (5.5%) patients with candidiasis and 115 (7.9%) patients with mixed infection. The 28-day mortality was 24.5% (356/1 456) and the 60-day mortality was 30.6% (446/1456). Mortality of both 28-day and 60-day in the mixed group was significantly higher than that in the bacteriacemia group and candidemia group. PCT levels was significantly higher in patients with bacteremia caused by gram-negative bacteria (GNB) than that in gram-positive bacteria (GPB) infected bacteremia and candidemia {3.4 μg/L[95% confidence interval (95% CI) 0.7-17.0 μg/L] vs 1.3 μg/L (95% CI 0.4-7.3 μg/L); 3.4μg/L (95% CI was 0.7-17.0 μg/L) vs 1.1 μg/L (95% CI was 0.4-3.4 μg/L); P<0.01} . ROC curve analysis showed that: ① the optimal cut-off value of PCT in differential diagnosis of monobacterial bacteremia and candidemia was 7.25 μg/L, with specificity of 90.0% and the area under the ROC curve (AUROC) was 0.612 (95% CI 0.533-0.691). When PCT value was greater than 0.51 μg/L, the sensitivity of diagnostic of bacteremia could reach 73.3%. ② the optimal cut-off value of PCT in differential diagnosis of bacteremia caused by GNB infection and candidemia was 7.32 μg/L, with specificity of 90.0% and AUROC was 0.695 (95% CI 0.614-0.776). When PCT value was greater than 0.51 μg/L, the sensitivity of diagnostic of bacteremia caused by GNB infection was 84.9%.③ the optimal cut-off value of PCT in differential diagnosis of bacteremia caused by GNB and GPB infection was 0.52 μg/L, with sensitivity of 84.9% and AUROC was 0.713 (95% CI 0.672-0.755). When PCT value was greater than 7.36 μg/L, the specificity of diagnostic of bacteremia caused by GNB infection could reach 80.1%. Conclusions:PCT can provide additional information about the possible etiology of patients with BSI, especially as high levels often indicate the possibility of GNB bacteremia.

OBJECTIVE: To study the role of nuclear factor-kappa B (NF-kappaB) and cycloxygenase-2 (COX-2) in the onset of phlegm obstruction due to lung-deficiency in rats and the therapeutic mechanism of Huatan Recipe. METHODS: Twenty-four SD rats were randomly divided into normal group, model group and treatment group, with 8 rats in each group. The rats in the model group and treatment group were exposed to sulfur dioxide and cold wind to establish the rat model of phlegm obstruction due to lung-deficiency, and the rats in the treatment group were also treated with Huatan Recipe, a compound traditional Chinese medicine. The expression of NF-kappaB in the bronchial epithelial cells of the rats was tested with the method of immunohistochemistry, and the COX-2 mRNA in the lung tissues of the rats was measured by using reverse transcription-polymerase chain reaction. RESULTS: The expressions of NF-kappaB and COX-2 mRNA in rats of the model group were higher than those of the normal group (P<0.01), and the expressions of NF-kappaB and COX-2 mRNA in rats of the treatment group were obviously lower than those of the model group (P<0.01). CONCLUSION: The NF-kappaB and COX-2 play an important role in the onset of phlegm obstruction in rats. Huatan Recipe may prevent the development of phlegm obstruction by down-regulating the expressions of NF-kappaB and COX-2 mRNA.

AIM:To explore a method of isolation,purification,culture and identification of human microglia.METHODS:The brain tissue from abortive fetus was sterilely obtained,then chopped and triturated gently.The suspension was filtered and centrifuged to separate and isolate mixed glia cells.The cell density was adjusted to 2?1010 cells/L with DMEM/F12 complete medium and cultured in 75 cm2 flask at 37 ℃ in CO2 incubator(marked as first 0 d).After 7-10 days culture,floating cells including microglia and oligodendrocytes appeared in the flask.The first time purification was carried out to obtain highly purified microglia,for which the flasks were shaken gently.The floating cells were collected and transferred into a new flask(marked as second 0 d).4-5 days later,when microglia and oligodendrocytes grew in confluent state,the second purification was performed,for which the mixed cultured cells were digested with trypsin-EDTA and cell suspension was centrifuged,then the cell pellet was suspended by DMEM/F12 complete medium and cultured in flask(marked as 0 h).After 2 h,non-microglial cells including oligodendrocytes and cell debris were removed,and fresh medium was added into the adherent cells.In this way,the whole procedure of microglia purification was completed and the highly purified microglial cells were obtained.After purification,the expression rate of CD45,CD11b and CD68 on/in microglia were detected by laser-confocal microscopy and flow cytometry on the basis of immuno-fluorescence staining to identify the purity of microglial cells.Microglial phagocytotic function was evaluated by phagocytosis of fluorescent microspheres.The level of activation was identified by the phenomena of membrane ruffling in combination with fluorescent phalloidin staining.RESULTS:More than 98% of the microglias that we isolated and purified expressed CD45,CD11b and CD68.Almost all of the microglias could phagocytize fluorescent microbeads CONCLUSION:We succeed in isolating and purifying human microglias,which express CD45,CD11b and CD68.Almost all of the cells exhibit phagocytic function.So these cells will be useful for further functional and proteomic studies.

Objective To study early face processing of mild cognitive impairment patients by using ERP method．Methods Sixteen healthy old man(normal group)and sixteen mild cognitive impairment patients(MCI group)served as subjects in experiment．Two runs of 300 stimuli(duration：50ms)of 3 facial and 3 non-facial pictures were randomly presented with equal probability(ISI：from 1000ms to 1500ms randomly)，and the subjects were asked to react to facial stimuli and non-facial stimuli by pressing the left button and risht button respectively as quickly as possible．Thirty-two channels electroencephalogram(EEG)Was recorded by Neuroscan Nuamps Systern．Results 1)Specific-face component N170 was found in both groups．Which was distributed at the temporal-occipital region．2)Compared with N170 in normal group，N170 amplitude Was significantly lower((-4．42±0．28)Μv vs(-7．00±0．28)Μv，F=41．52，P<0．01)at temporal-occipital region and delayed((158．91±2．17)ms vs(140．97±2．17)ms，F=34．09，P<0．01) in mild cognitive impairment group．Conclusion The early face processing mechanism of mild cognitive impairment patients may be different from normal people．

Objective To evaluate the effect of calcitriol combined with losartan on diabetic nephropathy in grade Ⅲ and early Ⅳ.Methods 47 patients with diabetic nephropathy were enrolled.Patients were randomly assigned to receive losartan or both losartan and calcitriol according to randomized table for 6 months.At baseline time and after 6 months,the 24-hour urinary protein excretion,estimated glomerular filtration rate (eGFR),serum creatinine(SCr),blood pressure,fasting blood-glucose,serum calcium,serum phosphorus,pulse wave velocity(PWV) and ankle brachial index(ABI) were measured.Results The urinary protein excretion showed that there was significant decrease in the mix-treated group[(824.81 ± 307.84) g/24h vs (390.75 ± 173.51) g/24h,t =10.51,P ＜ 0.01] and the control group [(860.64 ± 313.89) g/24h vs (676.16 ± 297.71)g/24h,t =6.91,P ＜ 0.01].Furthermore,the mix-treated group had the lower proteinuria compared the group given losartan only(t =2.56,P =0.015).No significant differences were observed decrease in estimated eGFR and change in serum calcium,serum phosphorus,PWV and ABI between the two groups.Conclusion Addition of calcitriol to a renin-angiotensin system inhibitor resulted in a safe decrease in proteinuria in patients with diabetic nephropathy.

Objective To investigate the radioprotective function and its mechanism of Sulforaphane (SF) in mice acute radiation-induced lung injury.Methods Totally 40 female C57BL/6J mice were equally divided into 5 groups randomly.Group A,treated by SF 3 mg/kg plus radiation;group B,treated by SF 5 mg/kg plus radiation;group C,treated by SF 10 mg/kg plus radiation;radiation group with a single dose of 12 Gy in 6 MV X-ray by a linear accelerator,and control group with sham radiation.The mice in drug group were administered intraperitoneally with different concentration of SF every other day from 7 d before irradiation to 7 d after irradiation,while the same volume of DMSO plus physiological saline solvent was given in the control and radiation groups.After being sacrificed at 14 d of SF administration,the pathomorphological changes of mice were observed in trauma lung tissue,the positioning and expression of NLRP3 was observed by immunohistochemical staining,the levels of IL-6,TNF-α and TGF-β1 in bronchoalveolar lavage fluid (BALF) were measured by ELISA,the expressions of NLRP3 and IL-1β mRNA in lung tissue were assayed by qRT-PCR,the expressions of NF-κB p65,NLRP3 and IL-1β proteins in lung tissue were assayed by Western blot,the activity of NF-κB was detected by EMSA.Results In comparison with radiation group,there was an obvious amelioration in pathological injury of lung tissue in the treatment groups:the expression of NLRP3 in lung tissue decreased;the concentration of NLRP3 in the drug intervention group (SF 10 mg / kg) markedly decreased (F =42.750,P ＜ 0.05).the IL-6,TNF-a and TGF-β1 levels in BALF decreased (tIL-6 =-62.65-21.00;tTNF-α =-32.18-16.57;tTGF-β1 =-58.22-46.11,P ＜ 0.05);the expressions of NLRP3 and IL-1β mRNA markedly decreased (tNLRP3 =-6.56-5.68;tIL-1β =-29.75--21.20,P ＜ 0.05),and the expressions of NF-κB p65,NLRP3 and IL-1β proteins decreased (tNF-κB p65 =-34.00--1.71,tNLRP3 =-25.01--16.91,tIL-1β =-73.70--55.14,P ＜ 0.05);the relative expressions of NF-κB p65 and NLRP3 were reduced in a dose-dependent manner (r =0.945,0.926);and the activity of NF-κB were obviously reduced (tNF-κB =-38.68,-614.82,-2 831.40,P ＜ 0.05).Conclusions Sulforaphane effectively alleviates the RILI in lung of mice by downregulating the expressions of inflammatory factor NLRP3.