The paper selects 4 famous foreign Evidence-based Medicine (EBM) databases-UpToDate,DynaMed,Medskills and CISMeF for analysis and comparison from 3 perspectives of the structures,retrieval methods and evidence grading standards,in order to provide reference for the construction and development of the EBM databases in China.

The semantic construction of EHR information model has experienced a developmental process from es-tablishing core data set and modeling to two-level modeling, which are usually used in combination in construction of information models at present. In general, the framework (reference model), necessary elements (core data set) and technical specifications for EHR information model were first established when its top architecture was de-signed, which was followed by the establishment of different medical concepts, subjects and special archetypes for different departments according to the framework standards.

Service quality in the outpatient department reflects the overall capacity of a hospital.It has become the focus of hospital administrators' attention how to improve service quality by following the patients-centered policy,renewing service ideas and innovating the service mode in order to satisfy patients' needs to the best extent.The authors aim to summarize the experience in and explore the effective ways of improving service quality in the outpatient department.

Objective To study the influence of different routes of keyhole limpet hemocyanin ( KLH) immuniza-tion on the T-cell-dependent antibody response in mice.Methods SPF Kunming mice were divided into four groups: the intravenous injection group, subcutaneous injection group, intraperitoneal injection group and control group.Each mouse was injected 200 μg KLH intravenously, subcutaneously or intraperitoneally daily for consecutive 10 days, respectively. Mice in the control group were given solvent injection only.Serum concentration of IgG stimulated by KLH antigen was measured 7 days after the last dosing.Spleen was isolated to calculate the organ coefficient and examined by pathology u-sing hematoxylin and eosin staining.Results Intravenously, subcutaneously and intraperitoneally administered KLH stimu-lated the generation of secondary lymphoid follicles and germinal center to varying degrees, B cell apoptosis, increased a-mount of cells in the marginal zone and other pathological changes were observed in the spleen.Intravenous and intraperito-neal administration of KLH led to more pronounced pathological changes compared with that in the subcutaneous injection group.All of the three administration routes of KLH induced generation of IgG antibody, significantly higher than that in the control group (P<0.05).Intravenous injection of KLH generated the highest concentration of IgG and organ coefficient among the three administration routes ( P<0.05) .Conclusions Different immunization routes do affect the production of IgG antibody, organ coefficient and pathological changes in the spleen, and these differences should be taken into consider-ation when analyzing the T cell dependent antibody response in mice.

Objective To compare coagulation data measured with domestic produced and imported coagulation testing solutions on SD rat and human by testing prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time(TT), fibrinogen(FIB).Methods Blood samples were obtained from SPF SD rat and human .Domestic produced and imported coagulation testing solutions were applied to test PT , APTT, TT, and FIB.Results Compared to rat data measured with imported coagulation testing solution , data measured with domestic produced coagulation testing solution of PT, APTT, FIB was significantly higher (P<0.05), while, data of TT was statistically lower(P<0.05), and there was no obvious difference in human blood coagulation .Conclusion The data measured with different coagulation testing solution varies on SD rat , so the laboratories are required to establish reference data according to different products .

Objective To study the effect of different doses of monocrotaline in combination with isopropylarterenol on the hemodynamic resonse, heart index and right heart hypertrophy index in rats.Methods Sixty-four healthy adult SD rats, male:female=1∶1, body weight 200-250 g, were randomly divided into blank control group (n=16) and three model groups (n=16 in each group).The high dose model group (n=16) received i.p.injection of monocrotaline 80 mg/kg once and epinephrine 10 mg/kg once daily for one week.The moderate dose group received i.p. injection of monocrotaline 55 mg/kg once and epinephrine 8 mg/kg once daily for one week.The low dose group received i. p.injection of monocrotaline 30 mg/kg once and epinephrine 3 mg/kg once daily for one week.The rats were fed for 6 weeks, and then pulmonary artery pressure and right ventricular pressure were tested and heart index and right ventricular hypertrophy index were determined.Results Compared with the control group, the mean pulmonary artery pressure and right ventricular systolic blood pressure in the low dose monocrotaline group were not significantly changed, but significantly changed in the moderate dose monocrotaline group ( P<0.05) .The heart index and right ventricular hypertrophy index in the low dose monocrotaline group were not significantly changed, but in the moderate dose monocrotaline group, the heart index was significantly reduced ( P<0.01 ) and the right ventricular hypertrophy index was significantly increased ( P<0.05 ) .Conclusions The use of a single injection of 55 mg/kg monocrotaline in combination with continuous injection of 8 mg/kg isopropylarterenol once daily for one week can ensure the survival rate of rats, and the successful formation of pulmonary artery hypertension, leading to heart weakness.

Primary percutaneous coronary intervention is a main treatment for acute myocardial infarction.Although there is vast majority of patients with coronary artery to restore blood flow after percutaneous coronary interventional therapy opened the infarction related artery,no reflow phenomenon is frequently observed and seriously affect the prognosis of patients.The occurrence of no reflow in percutaneous coronary intervention (PCI) is associated with a variety of factors and the pathogenic mechanisms that cause this phenomenon are complex and interrelated.So a better understanding of these mechanisms could judge the possibility of no-reflow and promote the development of individualized prevention and treatment strategies are of great clinical significance for the prevention of no-reflow.

The objective of this study was to prepare a biodegradable poly (DL-lactide) injectable gel of tinidazole. The formulation parameters evaluated in this study included polymer molecular weight, polymer concentration, solvent and drug loading, and orthogonal design was used to optimize the formulation. The preferable formulation was that 30% (w/w) poly(DL-lactide) (MW is 5 700) dissolved in 70% (w/w) N-methyl-2-pyrrolidone with 4%-6% (w/w) tinidazole.
Delayed-Action Preparations ; Drug Carriers ; chemistry ; Gels ; Lactic Acid ; chemistry ; Polyesters ; Polymers ; chemistry ; Technology, Pharmaceutical ; methods ; Tinidazole ; administration & dosage

The nail and nail bed are indispensibal structures with important function and esthetics role on the tip of fingers. Injury of the nail and nail bed often seriously affect the appearance and function of the fingers. The correct and timely treatment is essential for the restortation of good function according to the typing and degreement of the injuries. This paper reviewed about the function of nail and nail bed, typing of injury, evaluation of therapeutic effect and reconstruction of nail bed injury.

Objective:To retrospectively summarize the clinical experiences of managing renal artery stenosis after donor kidney transplantation in children.Methods:From January 2018 to October 2021, 114 pediatric kidney transplants(donor/recipient aged <18 years)were performed.According to the findings of color Doppler ultrasonography, they were divided into two groups of normal( n=80)and rapid flow( n=34). Rapid flow group were assigned into symptomatic( n=13)and asymptomatic( n=21)sub-groups based upon clinical features of hypertension and renal instability. Results:Among them, there were 65 males and 49 females.A significant inter-gender difference existed in the proportion of higher arterial flow rate of transplanted kidney(38.5% and 18.4%, P=0.02). No significant difference existed in age or body weight of transplant recipients among all groups( P>0.05). The mean age(10.4 months)and body weight(9 kg)of donors were significantly lower in symptomatic group than those in normal group(65.3 months, 21 kg)and asymptomatic group(64.4 months, 21.2 kg). The mean velocity of symptomatic group was significantly higher than that of asymptomatic group(363.5 vs 228.8 cm/s)( P<0.001). In symptomatic group, 6 cases received medications and their clinical manifestations were completely relieved.Among 7 patients invasively treated, one percutaneous transluminal angioplasty(PTA)was offer once( n=2), twice( n=2)and triple( n=1)with clinical relief and stable renal function.One case of bleeding at puncture site during PTA had treatment failure with a gradual loss of graft function.One ineffective case of PTA was subsequently placed with an endovascular stent.However, repeated stent dilation failed due to restenosis.After surgical exploration, vascular stent removal and transplantation of renal artery clipping, clinical symptoms were relieved. Conclusions:Male recipient, low body weight or young donor may be risk factors for transplant renal artery stenosis(TRAS)during pediatric donor renal transplantation.A higher flow rate of transplanted renal artery on ultrasonography could not confirm the diagnosis of TRAS.Greater arterial flow and associated clinical manifestations often hint at a strong possibility of TRAS, requiring drug or invasive treatment interventions.If PTA efficacy is not satisfactory, multiple treatments should be performed.Nevertheless, stenting should be avoided as far as possible to prevent in-stent restenosis.