Objective To further develop SDE for structured documentation of clinical data based on medical ontology. Methods OpenSDE was customized for the broad domain of medical ontology: medical concepts and its descriptors from history taking and physical examination were modeled into a tree structure. Results An expandable EMR system with structured data entry was developed. Conclusion Structured data entry is significant to clinical decision based on EMR.

Objective To focus on the expressiveness and flexibility of OpenSDE: an application that supports recording of structured narrative data. Methods OpenSDE enabled data entry with (customizable) forms based on trees of medical concepts. The relevant scope for data entry could be tailored per medical domain by construction of a domain-specific tree. OpenSDE was intended for structuring narrative data to make these available for both care and research. Results The OpenSDE application was used at two departments in aspects of radiology, neurology, pediatrics, and child psychiatry. Conclusion OpenSDE is superior to traditional text entry method in aspects of correct and full expression and clinical decision support.

Objective:To observe the clinical efficacy of electroacupuncture in the treatment of type 2 diabetes mellitus combined with mild and moderate carpal tunnel syndrome.Methods:Eighty patients with type 2 diabetes mellitus combined with mild to moderate carpal tunnel syndrome were randomly divided into two groups with 40 patients in each group ( n=40). In the course of the treatment, 2 patients in each group dropped out, which means 38 patients in each group were included. All patients were instructed to actively control blood glucose The control group was given Mecobalamin tablets orally, while the treatment group was given electroacupuncture of Daling and Neiguan on the affected side based onthe control group for 6 weeks. The degree of pain was assessed by VAS, and the severity of clinical symptoms was assessed by the symptom scale of Boston carpal tunnel questionnaire (BCTQ). The sensory nerve conduction velocity (SCV), the amplitude of sensory nerve action potential (SNAP) and the distal motor latency (DML) were detected by EMG evoked potential instrument. The clinical efficacy was evaluated and adverse events were recorded. Results:The total effective rate was 81.6% (31/38) in the treatment group and 60.5% (23/38) in the control group, and the difference was statistically significant ( χ2=5.094, P=0.024). After the treatment, the scores of VAS and BCTQ in the treatment group were lower than those of the control group ( t=2.639, 2.790, P=0.010, 0.007); DML (3.62 ± 0.19 ms vs. 4.00 ± 0.17 ms, t=68.891) in the treatment group was lower than that of the control group ( P<0.01), while SCV (47.36 ± 0.18 m/s vs. 42.34 ± 0.14 m/s, t=97.163) and SNAP (14.74 ± 0.18 μV vs. 12.10 ± 0.16 μV, t=51.434) in the treatment group were higher than those of the control group ( P<0.01). During the treatment, no serious adverse events occurred in two groups. Conclusions:Electroacupuncture is safe and effective in the treatment of mild and moderate carpal tunnel syndrome with type 2 diabetes. It can reduce the degree of pain and improve the symptoms of wrist joint.

Objective To study risk factors with the occurrence of the mesh exposure after pelvic floor reconstruction.Methods From Mar.2007 to Mar.2011,a retrospective study was made on the clinical data of 353 patients undergoing vaginal mesh pelvic floor reconstruction.The related complications of the mesh were surveyed,and risk factors associated with the mesh's exposure were studied by single factor and multiple factors logistic regression.Results It was found that the exposure rate was 9.6％ (34/353) after 1 year postoperative follow-up.Single factor analysis showed that patients who were not less than 70 years old,patients who were on their menopause stage,the occurrence of not less than three parturition,history of pelvic surgery,diabetes and smoking had a significant correlation (all P ＜ 0.05) with the occurrence of the mesh exposure after pelvic floor reconstruction.Multiple factors logistic regression analysis showed that patients who were not less than 70 years of age (OR =2.389),the occurrence of not less than three parturition (OR =2.688),the history of diabetes (OR =3.545),the history of pelvic surgery (OR =5.385) were the independent risk factors,and the operation experience was the protection factors (OR =0.134).Conclusions Mesh exposure is a common complication after pelvic floor reconstruction.Old age,multiple delivery,history of diabetes and history of pelvic surgery are the risk factors of mesh exposure.Preoperative full assessment and the quality of training contribute to reduce the incidence.

Objective To investigate the effect of aspirin on endothelin-1 induced proliferation of cardiac fibroblasts (CFs). Methods Isolated and cultured CFs from neonatal Sprague-Dawley rats (SD) were randomly divided into 7 groups: control, ET-1, aspirin, ET-1 +aspirin 1 mmol/L, ET-1 +aspirin 2 mmol/L, ET-1 +aspirin 5 mmol/L and ET-1 + aspirinl 10 mmol/L. CFs were counted by MTr assay. Cell cycle distribution was determined with a flow cy-tometer (FCM). [~3H]-Proline incorporation was evaluated by scintillation counting. Nitric oxide (NO) was meas-ured by colorimetry. Results 10~(-7)mol/L ET-1 significantly increased the number of CFs and [~3H]-Pro incorporation and decreased NO_2~-/NO_3~--secretion compared with the control group (P <0.01).1 ～ 10 mmol/L Aspirin inhibited the effects of ET-1 on CFs in a concentration-dependent manner (P <0.05 vs ET-1). In the ET-1 group, the percent-age of cells in the S phase was higher than that of the control, which was inhibited by 10 mmol/L Aspirin (P <0.01 vs ET-1 and control). Conclusion Aspirin can restrain the proliferation and collagen synthesis of cardiac fibroblasts induced by endothelin-1, and this effect may be partially mediated by NO.

Objective:To observe the clinical efficacy of skin needling plus heat-sensitive moxibustion in treating chronic facial paralysis. Methods:Sixty patients with chronic facial paralysis were divided into an observation group and an acupuncture group by using the random number table, 30 in each group. Patients in the observation group were given skin needling plus heat-sensitive moxibustion; while patients in the acupuncture group were given conventional acupuncture. Results:Three treatment courses later, the total effective rate was 93.3% in the observation group versus 86.7% in the control group, and the difference was statistically significant (P<0.05). Conclusion:Skin needling plus heat-sensitive moxibustion can produce a more significant efficacy than conventional acupuncture in treating chronic facial paralysis.

This study aimed to induce the differentiation of isolated and purified adipose-derived stromal cells (ADSCs) into myoblasts, which may provide a new strategy for tissue engineering in patients with stress urinary incontinence (SUI). ADSCs, isolated and cultured ex vivo, were identified by flow cytometry and induced to differentiate into myoblasts in the presence of an induction solution consisting of DMEM supplemented with 5-azacytidine (5-aza), 5% FBS, and 5% horse serum. Cellular morphology was observed under an inverted microscope. Ultrastructural changes occurring during the differentiation were observed by transmission electron microscopy and confocal laser scanning microscopy. Cellular immunohistochemical staining was applied to determine the expression of desmin protein in cells with and without induced differentiation. Reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting were used to detect mRNA and protein expression, respectively, of sarcomeric and desmin smooth muscle proteins. The results showed that ADSCs were mainly of a spindle or polygon shape. Flow cytometry analysis revealed that ADSCs did not express CD34, CD45, and CD106 but high levels of CD44 and CD90, which confirmed that the cultured cells were indeed ADSCs. After induction with a 5-aza-containing solution, morphological changes in ADSCs, including irregular cell size, were observed. Cells gradually changed from long spindles to polygons and star-shaped cells with microvilli on the cell surface. Many organelles were observed and the cytoplasm was found to contain many mitochondria, rough endoplasmic reticulum (rER), and myofilament-like structures. Cell immunohistochemical staining revealed different levels of desmin expression in each phase of the induction process, with the highest expression level found on day 28 of induction. RT-PCR and Western blot results confirmed significantly higher desmin gene expression in induced cells compared with control cells, but no significant difference between the two groups of cells in sarcomeric protein expression. It was concluded that under specific induction setting, ADSCs can be induced to differentiate into myoblasts, providing a potential new option in stem cell transplantation therapy for SUI.

Objective The effect of intermittent iron supplementation weekly and twice weekly was studied in children with iron deficiency anemia(IDA). Methods Subjects were 58 children who were randomly divided into two groups. One group received a dosage of 2mg/kg Fe every 3d for 9 weeks. The other group received the same dose Fe once a week for 12 weeks. Results Hemoglobin and serum ferritin increased significantly after treatment in both groups (P ＜0.05), and zinc protoporphyrin decreased significantly (P ＜0. 05). But serum ferritin of both groups was different after 6 weeks of treatment (P ＜0. 01). The side effect of the group supplemented once every 3d was higher than that of the group once a week, but there was no statistically significant difference. Conclusion Iron sup plementation every 3d has a similar effect to once a week for treatment of IDA. The former should be used for the se rious patients for 6 weeks. The later should be used for infants and the patients whose resistance of intestines and stomach are not good.

Objective:To investigate the clinicopathologic features of intraspinal ganglioneuroma.Meth-ods:We collected 1 2 cases of diagnosed ganlioneuroma arising from the spine and one case of ganlioneuro-ma arising from mediastinum as the control.Clinical and radiographic features were reviewed.The pathologi-cal parameters of these cases were analyzed with routine and immunohistochemical stainings of neural fiber (NF),S-100 protein(S-100),myelin based protein(MBP),peripheral myelin protein 22(PMP22),smooth mus-cle actin(SMA),glial fibrilary acidic protein(GFAP)and Ki-67.Results:The disease was likely to occur in pa-tients aged 30-40 years old and more common in female.These cases were all intral cervical spinal tumors and presented with radicular neuralgia and mass effects of cervical spinal cord compression.Ganglioneuro-mas which occasionally contained normal spindle shaped cells were composed of mature or degenarative ganglion cells and neoplastic Schwannian stroma.Ganglion cells appeared positive for NF.Schwannian stro-ma as well as satellite cells around ganglion showed immunoreactivity for S-100.more intense than neurofi-bro-stroma.Mature spindle shaped cells showed immumoreactivity for MBP.Ki-67 labeling indices were usual-ly 0-1%while in Schwannian stroma areas were 3%.No blood vessel endothelium proliferation was ob-served.Conclusion:Intraspinal ganglioneuromas are rare benign tumors(WHO grand I),causing radicular neuralgia.It is jmportant to distinguish ganglioneuroma with spinal root encircled from Schwannoma or neuro-fibroma in the same anatomic location.The optimal treatment is surgical total resection.

Aim To explore the hemodynamic change of elderly isolated hypertension(EISH). Methods Color doppler ultrasonography were applied to examine thirty EISH patients and twenty eight elderly healthy subjects. The left ventricular systolic function as well as hemodynamic parameters were measured. Results The indices of left ventricular systolic function in EISH group such as SV,CO,EF and CI were obviously higher than those of control group(P<0.05),Linear relevant analysis show that pulse pressure was remarkable related to SV,CO,EF and CI in EISH group,with r value 0.43,0.56,0.46,0.45 respectively.Conclusion EISH patients apparently had ventricular systolic dysfunction and hemodynamic abnormality. Pulse pressure may be associated with development of sysytolic dysfunction.