After the development of medical informatics and the challenges it is faced were described, the charac-teristic and differential strategies for its development were put forward, including combining electronic information technology with medical informatics practical skills and medical knowledge, training more health information profes-sionals for the society, and improving the overall health information level in our country in order to achieve the sus-tainable development of medical informatics.

Delirium is an acute cerebral disorder syndrome with mean features of fluctuating course,attentional deficits,disorganization of thinking and consciousness change.The biggest difference between delirium and restless is cognitive function.Hypoactive delirium and mixed delirium are usually ignored for their inconspicuous clinic feature,while intensive care unit (ICU) delirium is paid more and more attention by clinicians.Society of Critical Care Medicine (SCCM) IPAD guidance suggests that only recommended prevention of delirium is early mobilization,which the article will further discuss.

Objective To confirm the difference in the biological characteristics between V?24 natural killer T cells(NKT) and the cytokine-induced killer cell(CIK).Methods V?24 NKT cells and CIK cells were expanded from human peripheral blood mononuclear cells.Purified TCRV?24~+ NKT cells and CD3~+CD56~+CIK cells were obtained by using Dynal beads.The phenotype and the levels of cytokine and necrosis-related factors expression on the purified NKT cells and CIK cells were determined by flow cytometry.The cytotoxicity of the purified NKT cells and CIK cells were measured by means of DIOC18 staining and flow cytometry.Results The proportions of TCRV?24~+V?11~+NKT cells and CD3~+CD56~+CIK cells were elevated up to 90% after purification.The majority of V?24 NKT cells were CD4~+ and DN NKT cells.They demonstrated high levels of expression of TCRV?24,V?11,CD3 and CD161 and a low level of expression of CD56,but most purified CD3~+CD56~+CIK cells were CD8~+ T cells,with high levels of CD3 and CD56 expression,low level CD161 expression and little TCRV?24 and V?11expression.After antigen stimulation,the purified CD3~+CD56~+CIK cells showed higher levels of expression of IFN-?,TNF-?,Perforin,FasL and TRAIL,compared to the NKT cells.CD3~+CD56~+CIK cells secreted little IL-4,whereas,V?24~+NKT cells secreted high level of IL-4.In addition,the cytotoxic effect of the CD3~+CD56~+CIK cells on tumor cell lines K562,U937 and Jurkat were more intense than that of the NKT cells.Conclusion It is evident that TCRV?24~+ NKT cells and CD3~+CD56~+CIK cells differ absolutely in many ways and might play different roles in anti-tumor immunity and immune regulation.

Oral and maxillofacial radiology (OMR) in the United States is one of the nine dental specialties recognized by the American Dental Association (ADA). It has a nearly 100-year history of development and has also established a complete set of specialist training system. Staffing, base facilities, financial status, timing of training courses, contents, plans, and goals to be achieved are all clearly defined. All training centers need to undergo regular assessments every seven years with the ADA's Commission on Dental Accreditation (CODA). After graduation, the specialist graduates can be engaged in the clinical teaching and scientific research of radiological diagnosis in universities or general hospitals. They also have the option to open their own business by setting up imaging diagnostic centers or being specialized in tele-radiology to provide imaging diagnosis or consultation report to clinicians in other disciplines, or even assisting in the development of treatment planning for dental implants and orthodontic procedures. Of course, stomatology and OMR education systems are different in China and the United States due to different national conditions. Although the experience in the United States cannot be completely copied, many concepts, standards and goals of OMR specialty training there have been practiced and improved for a long period of time and are worth learning by the Chinese OMR counterparts or relevant agencies.

Neurological outcome in critically ill neonates has become the focus of attention.Amplitude-integrated electroencephalography (aEEG),as a brain function examination of noninvasive and relatively simple operation,offers a variety of information for pediatricians while early applying to the critically ill newborus,and is helpful to predict the long-term neurological outcome.Currently,the increasing number of neonatal intensive care units are using aEEG as the neurological examination.

Stenosis or occlusion of vertebral artery origin is one of important reasons of posterior circulation ischemia. Vertebral artery stenting can reduce posterior circulation ischemia in patients with vertebral artery origin stenosis. Restenosis after stenting is an important reason influencing the long-term efficacy.This article reviews treatment approaches of vertebral artery origin stenosis, restenosis after stenting and the related factors.

Objective To explore the surgical treatment of intra -articular calcaneal fractures with bone nodules joint angle in the preoperative and intraoperative evaluation of prognosis of postoperative analysis.Methods 22 cases of affected joint surface after calcaneal fractures,open reduction and internal fixation with steel plate in the operation treatment.Used Sanders classification:preoperative,intraoperative,postoperative again calcaneal tubercle joint angle measurement.According to the Maryland foot scoring system to evaluate postoperative effect.Results All patients were followed up for 8 to 20 months.The excellent and good rate of the patients was 90%,the postoperative complications:heel broadening,subtalar arthritis in 2 cases,poor healing in 2 cases (after the treatment and healing). Conclusion It has high value of the calcaneal tubercle joint angle measurement in the joint surface after calcaneal fractures.

Objective To investigate the clinical intervention effect of superficial needling at point Fenglong on gastroscopy side reaction.Methods Eighty-two gastroscopy patients were randomly allocated to treatment and control groups, 40 cases each. The treatment group received gastroscopy and superficial needling at point Fenglong, and the control group, gastroscopy and sham acupuncture at point Fenglong. The pain score and the incidence of nausea and vomiting were observed in the two groups during gastroscopy.Results There was a statistically significant difference in the pain score between the two groups (P<0.05). The incidence of nausea and vomiting was 31.7% in the treatment group and 65.9% in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion Superficial needling at point Fenglong can effectively reduce the incidence of gastroscopy side reaction.

Objective To explore the optimal formula of vascular endothelial growth factor,angiopoietin and basic fibroblast growth factor on autologous fat angiogenesis and tissue proliferation.Methods Wistar rat mesenteric fat in 9 groups trimmed into particles were added a 6μl complex solution of the three factors in the formula of 1 ∶ 0 ∶ 0,0 ∶ 1 ∶ 0,0 ∶ 0 ∶ 1,1/2 ∶ 1/2 ∶ 0,0 ∶ 1/2 ∶ 1/2,1/2 ∶ 0 ∶ 1/2,1/3 ∶ 1/3 ∶ 1/3,2/3 ∶ 1/6 ∶ 1/6,1/6 ∶ 2/3 ∶ 1/6,then injected in each rat subcutaneously.15 weeks later the transplantated fat was removed,to observe the fat cell appearance and counting the number of capillaries in the graft.Statistical genetic algorithm was used to set up a Scheffer egression model to optimize fat angiogenesis number.Results In one growth factor group fat vacuoles was uneven size;in two growth factors group,fat cell size tended to be homogeneous and in the three growth factor group,fat cell size was uniformity;the highest angiogenesis rate was 12.092,when the formula of VEGF165,Ang-1 and b-FGF was 0.380∶0.280:0.340.Conclusions Formula of VEGF165,Ang-1,bFGF at 0.380 ∶ 0.280 ∶ 0.340 could improve blood vessels density and increase implanted fat survival.

Objective To investigate compliance rate of clinic appointments among residents contracting family doctor service and its influencing factors.Methods Total 1 442 clinic appointments among residents contracting family doctor service in Yuetan community were investigated by face to face questionnaire.Results Among 1 442 clinic appointments in Yuetan community health service center in June 2015,563 were kept with a compliance rate of 37.2％.There were significant difference in compliance rate among the residents with difference degree of education (OR =1.461,95 ％ CI:1.296-1.646,P =0.000),between those with and without chronic diseases(OR =2.009,95％ CI:1.136-3.550,P =0.016),with and without receiving first contact care at community (OR =1.360,95％ CI:1.036-1.785,P =0.027),with and without satisfying with family doctor service (OR =1.315,95 ％ CI:1.060-1.630,P =0.013),with and without recognizing clinic appointment system (OR =2.765,95％ CI:2.142-3.569,P =0.000).Among the 906 failed appointments,the reasons were forgetting the appointment in 525 (57.9％),missing the date in 124 (13.7％),time conflict in 92 (10.2％),not bring reservation form in 85 (9.4％),being hospitalized or engaging in other medical service in 41 (4.5％) andneglecting appointment system in 39 (4.3％).Conclusion Compliance rate of clinic appointments among residents contracting family doctor service is lower,and necessary measures should be taken to increase the compliance rate.