AIM:To investigate the clinical effect of pills of six ingredients with rehmannia combined with ginkgo biloba leaf table in the prevention and treatment of early retinopathy in patients with type 2 diabetes mellitus.METHODS:A total of 82 patients (82 eyes) with type 2 diabetes mellitus who were treated with endoscopy from January 2013 to January 2015 were randomly divided into observation group and control group according to the random number table method.The control group was given conventional western medicine treatment, the observation group in the control group was given pills of six ingredients with rehmannia combined with ginkgo leaf table treatment besides the control group treatment.The diabetic retinopathy was assessed in both groups, as well as changes in blood glucose, blood pressure, and glycosylated hemoglobin.We recorded the occurrence of adverse reactions during and after treatment.RESULTS: The new diagnosed rate and the progress rate of observation group were lower than those of the control group, remission rate was higher, and the difference was statistically significant (P<0.05).There was no significant difference of the two groups on blood glucose, blood pressure and glycosylated hemoglobin before and after treatment (P>0.05).The incidence of adverse reactions between the two groups was not statistically significant (P>0.05).CONCLUSION: Type 2 diabetes mellitus patients treated with pills of six ingredients with rehmannia combined with ginkgo biloba leaf table can effectively control the rate of retinopathy, the rate of progress, improve the rate of remission with high drug safety, and have the significance of further clinical research.

Objective To build a regional cooperative healthcare system in order to make the best use of the limited medical resources,reduce the cost,and improve the quality of medical treatment.Methods Data warehouse and virtual database were used to build regional data center and realize data integration of hospital information system.Upon this foundation,a web service integration of hospital information system based on SOA was realized.Results This design scheme realized the effective management and integration of huge information resources,and managed the medical workflow effectively.Conclusion This design scheme provides the regional cooperative healthcare system with the characteristics of modularization and expansibility.Hierarchy architecture enhances the stability of the system.

Objective To monitor the hospital computer room in real time; ensure the normal running of hospital information system; overcome the disadvantages of wired monitor system. Methods Zigbee was used to build a wireless sensor network. Wireless monitor system for hospital computer room was realized. Results By exerting the advantages of zigbee, hospital computer room was monitored more effectually and the workload of the computer room keeper was reduced. Conclusion Using Hospital computer wireless monitor system based on zigbee can achieve the uniform management and monitoring effectually.

Objective To establish determination method of luteolin-7-O-glucoside in Compound Luobuma Granule. Methods Phenomenex luna C18 column (4.6 mm×150 mm, 5 μm) was used;aceto-0.5% acetic acid (14∶86) was set as the mobile phase at flow rate of 0.8 mL/min;the detection wavelength was 348 nm. Results The linear range of luteolin-7-O-glucoside was in the range of 0.031 9-0.796 3 μg (r=0.999 6), and the average recovery was 100.85% (n=6). Conclusion The method is specific, simple, and can improve quality standard and increase the controllability of Compound Luobuma Granule.

Objective To imporve the quality standard of Lianqiaobaidu Pills. Methods The TLC method was established for ephedrae herba, sophorae flavescentis radix, paeoniae radix rubra, and RP-HPLC methed was established for the determination of chlorogenic acid in Lianqiaobaidu Pills. Zorbax SB-C18 (4.6 mm×150 mm, 5 μm) column was used with methanol-acetonitrile (2∶1) - 0.04% phosphoric acid (10∶90) as the mobile phase at flow rate of 0.8 mL/min. The detection wavelength was 326 nm. Results TLC chromatographic spots were clear, and negative control had no interference. The linear range of chlorogenic acid was 0.042 2-0.464 2 μg (r=1), the average recovery (n=6) was 98.96%. Conclusion The method is simple, reliable, with strong exclusive feature, and suitable for quality control of Lianqiaobaidu Pills.

AIM: To establish the quality standard for Yanqingsong Granule (Radix P uerariae, Rhizoma Chuanxiong, Radix Paeoniae Alba, Radix Angelicae Dahuricae, et c.). METHODS: Radix Puerariae; Rhizoma Chuanxio ng; Radix Paeoniae Alba; Radix Angelicae Dahuricae. in Yanqingsong Granule were identified by TLC, and the content of puerarin was determined by HPLC. RESULTS: Radix Puerariae; Rhizoma Chuanxio ng; Radix Paeoniae Alba; Radix Angelicae Dahuricae could be identified by TLC. P uerarin showed a good linear relationship at a ran ge of 0.1716～0.8580?g,r=0.9999. The average recovery was 97.49% (RSD= 1.77% and n=6). CONCLUSION: The methods are available with a reproducibility and ca n control the quality of this granule effectively.

Abstract: Objective　To collect extensively drug-resistant tuberculosis (XDR-TB) Mycobacterium tuberculosis strains isolated from Xi'an City between 2019 and 2020, and analyze the drug resistance patterns of XDR-TB strains to second-line anti-tuberculosis drugs and the occurrence of new defined extensively drug-resistant tuberculosis in Xi'an, in order to provide evidence for guiding clinical drug use of multidrug-resistant tuberculosis (MDR-TB) patients. Methods A total of 3 088 strains of Mycobacterium tuberculosis that underwent phenotypic drug susceptibility testing at Xi'an Chest Hospital from January 2019 to December 2020 were retrospectively selected to analyze the resistance of anti-tuberculosis drug. Among the stored MDR-TB strains, 114 strains of preserved multidrug-resistant Mycobacterium tuberculosis were randomly selected for bedaquiline and linezolid susceptibility testing. Combined with the results of previous second-line drug susceptibility testing, the incidence of newly defined extensive drug resistance was analyzed. Results Among the 3 088 Mycobacterium tuberculosis strains analyzed, 411 strains (14.3%) showed resistance to isoniazid, 347 strains (11.2%) showed resistance to rifampicin, 142 strains (4.6%) showed resistance to ethambutol, 550 strains (17.8%) showed resistance to streptomycin, and 237 strains (7.6%) exhibited multidrug resistance. Of 237 MDR-TB strains, the resistance rates of ethambutol, moxifloxacin, rifampicin, sodium para-aminosalicylate, prothioconazole, capreomycin, amikacin, and clofazimine were 44.3%, 26.6%, 33.3%, 24.1%, 5.1%, 4.2%, 3.0%, and 2.5%, respectively. Among the randomly selected 114 MDR-TB strains, none showed resistance to bedaquiline, three showed resistance to linezolid, and one strain met the new definition for extensively drug-resistant tuberculosis. Conclusion In Xi'an City, high rates of resistance among MDR-TB strains are observed for ethambutol, quinolone and sodium para-aminosalicylate, and the drug susceptibility tests should be obtained as much as possible when using these drugs. The incidence of new definition extensively drug-resistant tuberculosis is low, and bedaquiline and linezolid remain effective drugs for the treatment of multidrug-resistant tuberculosis even without drug susceptibility testing results.

Objective To observe the improvement of postoperative pulmonary function and oxygen partial pressure during general anesthesia for open abdominal surgery with lung protective ventilation strategies and alveolar recruitment maneuvers. Methods Seventy patients who underwent selective open abdominal surgery were selected, and they were divided into standard ventilation group (tidal volume 8 ml/kg) and protective ventilation group (tidal volume 6 ml/kg, 5 cmH2O positive end-expiratory pressure, and alveolar recruitment maneuvers, 1 cmH2O=0.098 kPa) according to the random digits table method with 35 cases each. The airway pressure, blood pressure, pulse oxygen saturation (SpO2), end-tidal partial pressure of carbon dioxide (PETCO2) and adverse reactions were observed. The SpO2, partial pressure of O2 (PaO2) and pulmonary function before surgery and 1, 3, 5 d after surgery were measured. Results The respiratory rate, airway pressure and PETCO2 levels in protective ventilation group were significantly higher than those in standard ventilation group: (12.3 ± 2.1) times/min vs. (10.2 ± 1.0) times/min, (15.1 ± 2.8) cmH2O vs. (13.5 ± 2.3) cmH2O, (34.6 ± 2.1) mmHg (1 mmHg=0.133 kPa) vs. (32.1 ± 1.4) mmHg, and there were statistical differences (P<0.05). The SpO2 in 2 groups was maintained at 0.99. There was no statistical difference in the incidence of postoperative complications between 2 groups (P>0.05). The SpO2 and PaO2 levels at 1, 3 d after surgery in protective ventilation group were significantly higher than those in standard ventilation group:0.951 ± 0.018 vs. 0.936 ± 0.016 and 0.964 ± 0.018 vs. 0.949 ± 0.018, (74.8 ± 6.8) mmHg vs. (65.0 ± 6.2) mmHg and (79.6 ± 6.0) mmHg vs. (70.6 ± 5.3) mmHg, and there were statistical differences (P<0.05). The forced expiratory volume in 1 s (FEV1), percentage of the estimated value of FEV1, forced vital capacity (FVC) and percentage of the estimated value of FVC at 1, 3 and 5 d after surgery in protective ventilation group were significantly higher than those in standard ventilation group, the FEV1/FVC at 1 d after surgery was significantly higher than that in standard ventilation group, and there were statistical differences (P<0.05). Conclusions The lung protective ventilation strategy and alveolar recruitment maneuvers can improve the postoperative pulmonary function and oxygen partial pressure during general anesthesia for abdominal surgery. Low vital volume, appropriate positive end-expiratory pressure and recruitment maneuvers can protect the lung in general anesthesia patients.

Objective To investigate the safety of vaginal delivery in gravidas with previous cesarean section and its influencing factors.Methods Four hundred and seventy-four full-term gravidas who received cesarean section at the Department of Obstetrics and Gynecology of Peking University First Hospital from January 1,2012 to August 31,2014 were enrolled in this study.Among those subjects,38 who underwent successful vaginal delivery were grouped into vaginal birth after cesarean (VBAC) group,and the other 436 accepting repeated cesarean section were grouped into cesarean group.Delivery outcomes and maternal/neonatal complications of the two groups were retrospectively analyzed with two-sample t-test and Chi-square test.Results Among the 45 patients (9.5％) who attempted VBAC,seven underwent cesarean section for suspected fetal distress and the other 38 (84.4％) succeeded in vaginal birth without uterine rupture.The amount of postpartum hemorrhage in patients of cesarean group was more than that of VBAC group [(330.8±94.8) vs (257.7± 199.7) ml,t=2.021,P＜0.01] after exclusion of three patients with dangerous placenta previa,and the postpartum hospital stay was shorter than that of cesarean group [(2.5± 1.4) vs (4.5± 1.3) d,t=7.952,P＜0.01].There were three newborns with neonatal asphyxia,twelve with neonatal infections and forty transferred to the Pediatrics Department following cesarean section.Besides,complications of headache and urinary retention occurred in 20 and 32 mothers after cesarean section,respectively.However,no complication occurred in VBAC group.Sixty-three cesarean sections were indicated as thin lower uterine segment and among them,fourteen (22.2％) had muscular rupture.Among the six patients who complained of tenderness in lower uterine segment,three were found having muscular rupture during cesarean section.Conclusion VBAC is an option for gravidas with history of cesarean section only if they meet the criteria for VBAC attempt.VBAC could lower the cesarean section rate without increase the incidence of complications.The rate of trial of labor after cesarean was low,patients education should be strengthened to increase it.

Objective To build an architecture for medical information integration based on SOA(Service-Oriented Architecture)by analyzing the characters of medical information integration and the integration technology of SOA. Methods Virtual database was built by XML Schema mapping for conform share of medical data based on XML technology. The method and principle of Web Services for medical information were researched and built. Results Medical information systems could uniformly exchange information based on standards of Web Services, and the conform medical information share mode was realized. Conclusion The integration of medical information systems based on SOA not only has the characteristics of loose-coupling and customization agility but also makes information share possible because of conform mode.