To change the old stereotype of using literal and data information for storage and ex- change in medico—scientific records and provide a new record version rich in word and picture,a gener- al model of multi—media control system of medical records and an information storage pattern have been developed and the feasibility of development methods explored.

Objective To observe the therapeutic efficacy of low-frequency electrical stimulation (LFES) plus acupuncture in treating deglutition disorders after cerebral stroke. Method Seventy-six patients were randomized into two groups. The treatment group (38 cases) was intervened by LFES plus acupuncture;the control group (38 cases) was by LFES. Result The water drinking test scores were significantly changed after the treatment in both groups (P<0.05); after the intervention, there were significant differences in comparing the water drinking test score, improvement score, and therapeutic efficacy grading between the two groups (P<0.05). Conclusion LFES and acupuncture are both effective in treating deglutition disorders after cerebral stroke, and the combination of the two methods can enhance the clinical efficacy.

Objective To investigate the association between brain structure abnormalities and neuropsychology impairment in CAD patients.Methods Nineteen patients with CAD and 1 7 healthy adults were examed with MRI,and T1 WI,T2 WI,FLAIR,DWI and DKI image were performed,and then comparing the acquired MRI findings between two groups.Results Significant differences were observed for MK values in splenium and body of the corpus callosum,left cerebellar hemisphere and amygdala cerebelli.MK values of CAD group were lower than those of healthy group in these regions,and differences were statistically significant(P <0.05). There were significant correlation between MK values of the left amygdala cerebelli and MoCA scores in CAD group.Conclusion DKI could detect the changes of brain tissue microstructure in CAD patients early.The correlation between MK and neuropsychologi-cal function provides an important basis for early diagnosis and treatment.

Objective To investigate the morphologic changes and hemodynamic parameters of the common carotid artery in obstructive sleep apnea hypopnea syndrome(OSAHS)in a porcine model using ultrasound and color Doppler.Methods A total of 12 pigs were randomly divided into model group and control group(n=6 for each).All pigs were fed under the same conditions with exception of th ose in the model group which were kept in a hypobaric chamber for experiments.The parameters of systolic velocity(S)and diastolic velocity(D),resistant index(RI)and S/D in Doppler as well as maximum IMT(intima-media thickness)with two-dimensional ultrasound were obtained in the carotid artery of all animals were determined,and the latter was confirmed by animal dissection when the symptoms of OSAHS appeared in the model group.Results The diameter of the lumen of the common carotid artery in model group(3.18?0.17)was smaller than that of control group(3.47?0.15,P

Objective To investigate the operative treatment of displaced intra-articular fractures of the calcaneus using a small lateral incision approach.Methods Thirty-one patients with 32 intra-articular calcaneal fractures,were treated with open reduction and internal fixation through a small lateral incision approach from October 2004 to April 2006.The skin incision was made from the distal tip of the fibula to the base of the fourth metatarsal.According to Sanders classification,there were 21 typeⅡfractures and 11 typeⅢfractures.The first change of dressing was done on the second day after operation.The residual blood clots in the wounds were cleaned as much as possible when the drainage sheet was removed.The operated foot was bandaged with pressure dressing of cotton pad.Results After an average follow-up of 10.5 months(range,3 to 18 months),no soft tissue com- plications were found,and all had acceptable reduction.The preoperative X-ray film showed that B(?)hler angle was 6.84??9.36?,Gissane angle was 106.04??12.03?.The postoperative X-ray film demonstrated that B(?)hler angle was 32.06?+6.87?,Gissane angle was 115.81??9.48?,and the difference was statistically significant(P＜0.01).According to the AOFAS evaluation system for Ankle-Hindfoot,two feet scored 60-70 points,nine feet 70-80 points,16 feet 80-90 points and five feet 90-100 points.Condusion The small lateral incision approach is a good option for management of calcaneus fractures,because it causes minimal soft tissue damage,provides excellent exposure,and leads to convenience for later removal of internal fixators and subtalar arthrodesis.

Cerebral Infarction ; drug therapy ; etiology ; Female ; Humans ; Infant, Newborn ; Intracranial Hemorrhages ; drug therapy ; etiology ; Male ; Vitamin K Deficiency ; complications ; drug therapy

Objective To explore the mechanism of blood-stage treatment in patients with psoriasis vulgaris through studying the level change of IFN-?, IL-4, IL-10 and IL-17 in patients with blood-stage treatment during activity and quiescence period separately. Methods 20 patients with psoriasis vulgaris in active stage(blood heat syndrome)and 20 patients with psoriasis vulgaris in resting stage(blood stasis syndrome) were recruitedto observe the treatment effects by the PASI score,and to observe thechange of IFN-?, IL-4, IL-10, IL-17 before and after treatment in the serum by ELISA. Results The PASI scores of two groups were both significantly decreased after treatment (blood heat syndrome group t=6.685, P<0.01;blood stasis syndrome group t=4.959, P<0.01). The levels of cytokines were significantly different between patients in the periods of activity and quiescence. Onvarying degrees, the levels of cytokines of two groups were improved after treatment. The levels of cytokines IFN-?, IL-17 in blood heat group significantly decreased(t=3.024, P<0.01;t=2.543, P<0.05). The levels of cytokines IL-17 drop but the levels of cytokines IL-4 raised in blood stasis group,that were significantly differentwith the levels before treatment(t=2.417, P<0.05; t=2.547, P<0.05). Conclusion The levels of INF-?, IL-4, IL-10 and IL-17 could be effectively modulated with blood-stage treatment in treating psoriasis vulgaris.

Objective To investigate the expression of IgG4 in liver tissues of patients with type Ⅰ autoimmune hepatitis (AIH) and to analyze the clinical manifestation,biochemical indexes,immunological genetic features,pathological characteristics and the effects of immunosuppressive therapy.Methods From March 2012 to July 2013,45 patients diagnosed as type Ⅰ AIH were enrolled.Immunostaining of CD38,IgG and IgG4 in liver tissue slices was performed,inflammation grade G and fibrosis stage S were determined.At the same time,serological indexes (alanine aminotransferase (ALT),aspartate transaminase (AST),alkaline phosphatase (ALP),IgG,antinuclear antibody (ANA) titer,antibodies to asialoglycoprotein receptor (ASGPRAb)) of the patients were collected,serum IgG4 was tested and the response to immunosuppressive therapy was observed.Wilcoxon rank sum test and t test were performed for quantitative data comparison.Spearman correlation coefficient was used for correlation analysis.Results Among 45 patients with type Ⅰ AIH,five patients (11.1％) were IgG4 associated AIH (IgG4-AIH group).There were no significant differences in age,gender,biochemical indexes (serum levels of ALT,AST,ALP),immunity indexes (serum levels of IgG,ANA titer,ASGPRAb) and degree of liver fibrosis between patients with IgG4-associated AIH and classical AIH (40 cases) (all P＞ 0.05).Compared with classical AIH group (18.3(6.7) mg/L).The serum level of IgG4 of IgG4 AIH group was 25.8(9.2) mg/L,which significantly increased (Z=-2.041,P＜0.05).However,there was no significant difference in serum level of IgG4 between the two groups (P＞0.05).There was no correlation between the number of infiltrated IgG4 positive plasma cells and the serum level of IgG4 (r=0.311,P=0.279).The inflammation in the liver tissues of IgG4-AIH group was more significant compared with that of classic AIH group (H=4.120,P＜0.05).The number of CD38' or IgG+ plasma cells was larger compared with that of classical AIH (CD38(39.3(13.5)/high power field (HPF) vs (21.3(8.8))/HPF,IgG(39.3 (14.0))/HPFvs (18.5(8.9))/HPF;Z ＝-3.561 and-3.584,both P＜0.01).The number of IgG4+ plasma cells in liver tissues was positively correlated with the number of CD38+ or IgG+ plasma cells (r=0.884 and 0.791,both P＜0.01).Conclusions Among patients with type Ⅰ AIH,the incidence of IgG4-associated AIH was not high.The serum level of IgG4 did not significantly increase in these patients.However,the histological inflammation activity was significant along with many CD38+ or IgG+ plasma cells infiltration.

Objective To explore the effects of electro-acupuncture combined with surface gastric pacing on gastrointestinal dysfunction for patients with spinal cord injury (SCI).Methods Seventy-five SCI patients with gastrointestinal dysfunction were divided randomly into an electro-acupuncture group (group A),a gastric pacing treatment group (group B) and a group for which electro-acupuncture was combined with gastric pacing (group C).There were 25 cases in each group.Members of group A were given 30 minutes of electro-acupuncture per day ; those of group B had 30 minutes of gastric pacing treatment twice per day ; group C was provided with both 30 minutes of electro-acupuncture and one 30-minute gastric pacing treatment per day.All of the interventions lasted ten days.Before and after the treatment,all patients were assessed using a clinical symptoms score and with electrogastrograms,and any adverse effects were observed.Results There was a significant improvement in upper abdominal pain and epigastric discomfort,bloating and early satiety,nausea,vomiting,as well as belching and loss of appetite in each group after treatment.Before treatment there was no significant difference in the average clinical symptom scores of the three groups.After treatment the values had decreased,and those of group C were significantly lower than group A or B.The average scores of groups B and A were not significantly different.The electrogastrogram results showed than after treatment there was significant improvement in N％ and T％ in groups A and B,and also significant improvement in N％,B％ and T％ in group C compared to before treatment.Group C's improvements were all significantly greater than those observed in groups A and B.Conclusion Electro-acupuncture or gastric pacing alone can give some improvement in gastrointestinal function and its electrophysiological indicators,but their combined effects are better than when either is used alone.

ObjectiveTo assess the values of 320-detector row dynamic volume CT angiography (CTA) and transthoracic echocardiography (TTE) in follow up of coronary artery aneurysm (CAA) caused by Kawasaki disease (KD).Methods320-de-tector row CTA and TTE were applied in long-term follow-up of 8 patients with CAA caused by KD.ResultsIn 8 patients, the mean age at onset was 41.63±22.70 months and the mean follow up time was 43.50±10.99 months. In acute phase, 3 cases of giant coronary artery aneurysms (GCAA) and 5 cases of mid-small CAA were diagnosed by TTE. A total of 16/32 arteries (50%) were involved. At the end of follow-up, 3 cases of GCAA and 2 cases of mid-small CAA were still diagnosed by TTE, and small CAAs were regressed in another 3 cases. A total of 6/32 arteries (18.75%) were involved. Simultaneously at the end of follow-up, a total of 7/32 arteries (21.9%) were involved by 320-detector row CTA. The distribution was consistent with that of TTE. Mean-while, there were one case of left circumlfex artery, one case of GCAA at distal of the right coronary artery, 2 cases of thrombus, 1 case of coronary stenosis and 2 cases of calciifcation.ConclusionsCAA caused by KD may be persistent for a long time. The thrombus, stenosis, and calciifcation of coronary can occurr at late phase in GCAA. TTE is sensitive and reliable to detect proxi-mal and middle segment of coronary lesions, but has limitations in detection of distal segment of coronary arteries. 320-detector row CTA has more comprehensively view of each coronary artery lesions and is especially sensitive and reliable to detect coro-nary thrombosis, calciifcation and narrowing in proximal and distal coronary arteries after acute phase.