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 clinical significance of serum interleukin (IL)-6,IL-8,tumor necrosis factor (TNF)- α, high-sensitivity C-reactive protein (hs-C RP), total immunoglobulin (Ig) and complement C levels in children with mycoplasma pneumoniae pneumonia (MPP). Methods Sixty-one cases of children with MPP (observation group) and 60 healthy children (control group) were selected. The serum IL-6 and IL-8 levels were tested by enzyme linked immunosorbent assay(ELISA) method; the serum TNF-α level was tested by γ radioimmunoassay (RIA) counter; the serum hs-CRP, total Ig and complement C levels were tested by rate nephelometry method. Results The serum IL-6 concentration was (109.31 ±54.72) ng/L, IL-8 concentration was (128.19 ±65.87) ng/L, hs-CRP concentration was (34.13 ± 19.21) mg/L, total Ig concentration was (12.62 ± 5.51) g/L and complement C concentration was (2.98 ± 0.97) g/L in the observation group, and they were higher than those in the control group [(67.23 ±32.18) ng/L, (31.78 ±8.91) ng/L, (1.62 ±1.34) g/L, (6.71 ±3.65) g/L, (1.46 ±0.45) g/L]. The differences were significant (P ＜ 0.05 or ＜ 0.01). The serum TNF- t level between two groups had no significant difference (P＞ 0.05). Conclusions The serum cytokines IL-6 and IL-8, hs-CRP, total Ig and complement C play an important role in MPP. It has important significance to detect the serum cytokines IL-6 and IL-8, hs-CRP, total Ig and complement C levels in children with MPP.

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 investigate the clinical characteristics of tuberculous pleurisy(TP) in children in order to provide a good solution to the diagnosis and treatment of this disease.Methods Retrospective analysis was performed on the clinical data of 113 cases confirmed with TP who were admitted to Children's Hospital of Chongqing Medical University from January 2009 to December 2014.Results Among the 113 pediatric inpatients with TP,85 cases (75.2％) were sick for less than 1 month;92.9％ (105/113 cases) age ≥≥5 years old by onset;and 21.2％ (24/113 cases) patients demonstrated the contact with tuberculosis ,among whom 70.8％ (17/24 cases) attributed to linear relatives.The primary clinical manifestations included fever[96.5％ (109/113 cases)], cough [76.1％ (86/113 cases)] and chest pain[38.9％ (44/113 cases)] ,with as high as 89.0％ (87/109 cases) of the patients experiencing moderate or ardent fever.The positive rates of acid-fast bacilli smear and mycobacterium tuberculosis culture were 12.2％ (17/139 cases) and 22.7％ (15/66 cases), respectively;among the 41 patients who received pleural biopsy,40 cases (97.6％) were identified with the typical pathological changes in tuberculosis;and all 11 patients who received acid fast stain test on pleural tissues were positive to the test.Pulmonary parenchymatous lesions were revealed on CT examination in 89.1％ patients(98/113 cases),82.4％ (90/109 cases) of the patients had normal body temperature within a short period,and reduced effusion was revealed in 86 out of 98 patients who received repeated chest imaging examinations.Conclusions TP in children has acute onset typically, and the diagnosis of TP in children is more difficult than in adults,requiring considering multiple factors.Contact history with tubercular patients, etiological examination, pleural biopsy and chest CT are essential for the diagnosis of this disease.

Based on the clinical informatization construction of large comprehensive hospitals , as required by information -based closed-loop management of medical advices , the paper analyzes the objectives and contents of informatization constructization in the closed-loop management of medical advices in modern hospitals , introduces the application effects of closed -loop management of medi-cal advices , and points out that such a management mode is the basis for future development of smart health care .

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.