A number of studies on hospital information system (HIS) and regional information platform have been carried out in different medical institutions since HIS was defined as one ofThe 4 Beams and 8 Pillarsin 2009 , during which good results were achieved and many problems were exposed .The application of electronic medical record (EMR), a key part of HIS, is grealy concerned.The application of electronic medical record system ( EMRS) and related problems were thus described in this paper in order to provide reference for bringing it into a better play, normalizing its management, and reducing its disadvantages.

Objective:To observe clinical significance between changes of OPN,IL-18 levels and relation ship with hepatic function in patients with chronic hepatic disease infected by HBV.Methods:The levels of OPN,IL-18 in peripheral blood of 102 patients with chronic hepatitis B,34 patients with hepatitis B-related cirrhosis,95 HBV carriers and 20 healthy people as the control group were respectively detected with ELISA.Results:The levels of OPN and IL-18 in chronic hepatitis B and hepatitis B-related cirrhosis groups were significantly increased compared with that of health control group(P

Objective:The purpose of this study is to determine levels of Ghrelin,TNF-α,IL-1 and IL-6 in peripheral blood of patients with chronic hepatitis B,liver cirrhosis,and non-alcoholic fatty liver disease which diagnosed at different extent of damage,and based on it to have a further study on the relevance between Ghrelin and inflammatory cytokines in peripheral blood in above diseases.Methods:Ghrelin,TNF-α,IL-1 and IL-6 in peripheral blood were determined by ELISA method.Results:In patients with chronic hepatitis B andhepatic cirrhosis,Ghrelin level increased significantly as compared with that in normal control group (P＜0.05,P＜0.01).Ghrelin levels in decompensated liver cirrhosis (degree B and C)groups were much higher than in chronic hepatitis B group (P＜0.05). Ghrelin level in group of non-alcoholic fatty liver disease decreased significantly as compared with that in normal control group (P<0.01). Ghrelin and inflammatory cytokines,including TNF-α,IL-1 and IL-6 showed a positive relevances in groups of chronic hepatitis B and liver cirrhosis,but not in NAFLD group which showed a negative correlations.Conclusion:Ghrelin has a higher level in peripheral blood of patients with chronic hepatitis B and liver cirrhosis,but it has a lower level in patients with non-alcoholic fatty liver disease,suggesting correlation of Ghrelin level with the occurrence and the procession of chronic liver diseass.

Objective To provide guidance for clinical prevention and treatment of bleeding during percutaneous nephrolithotomy( PC-NL) . Methods The clinical data of 1 012 patients with intraoperative and postoperative bleeding during percutaneous nephrolithotomy in our urology department were collected,hemorrhoea occurred on 36 cases,the occurrence rate was 3. 56%. The incidence,correlation with cal-culi,diabetes mellitus,examination item,technical operation were analyzed and compared. Results The incidence was 5. 52% for patients with complicated calculi. The incidence of delayed massive haemorrhage has been increased postoperatively in the diabetes mellitus patients. This incidence was 1. 81% for patients with preoperative examination. Along with the extension of time in carrying out technology,PCNL asso-ciated bleeding incidence decreased year by year. Conclusion The occurrence of haemorrhage associated with PCNL could be decreased by correctly handling complicated calculi,preoperative examination,keeping blood glucose homeostasis and improving the manipulation ability of operator.

With the rapid development of social economy and the improvement of multi-level medical insurance system, the health demand of people continually grow and the content and quality of health demand are more and more diversified. By contrast, the growth of health resources was very slow. The contradiction between supply and demand of health services becomes increasingly sharp and health expenditure growth rapidly. So by systemizing the related concepts and main international practices and enlightenment of managing health demand in developed countries, this article aimed to provide references and suggestions for reasonably managing health demand, standardizing the order of medical treatment and improving the phenomenon ofdifficulty in treatment.

ObjectiveTo investigate the significance of cerebrospinal fluid(CSF) S-100B protein and vascular endothelial growth factor (VEGF) levels in the pathogenesis of brain injury of viral encephalitis.MethodsForty-two patients with viral encephalitis (viral encephalitis group) and 40 patients with other disease at the corresponding time period(control group) were involved in this study.CSF (routine,biochemistry and cytology) was detected,and the levels of S-100B protein and VEGF in CSF were detected by ABC-ELISA method.ResultsWhite blood cell count was (0-584) × 106/L in viral encephalitis group,and (0-200) × 106/L in control group.The levels of protein and glucose in CSF had no significant difference between two groups (P＞ 0.05),and the level of chloride in CSF in viral encephalitis group was significantly lower than that in control group[ ( 110.10 ± 31.22 ) mmol/L vs.( 123.80 ± 6.32 ) mmol/L ] (P =0.006).In viral encephalitis group,cytological examination showed that mixed type cytological reaction was in 6 cases (14.3％,6/42).The level of S-100B protein in viral encephalitis group [25.04-47.97 (28.37 ± 6.09) ng/L] was significantly higher than that in control group[ 25.04-29.64(26.03 ± 0.90) ng/L ] (t =2.462,P =0.018).The level of VEGF in viral encephalitis group[88.84～143.77(96.24 ± 13.38) ng/L] was significantly higher than that in control group [89.15～96.18 (90.67 ± 1.71 ) ng/L] (t =2.673,P =0.011 ).ConclusionsThe high levels of S-100B protein and VEGF in CSF could support the viral encephalitis diagnosis.Tracking the levels of S-100B protein and VEGF in CSF dynamically have noticeable effect on checking the condition of viral encephalitis patients.

Studies have suggested that human cytomegalovirus-activated infection is closely associated with atherosclerosis. The levels of interleukin-8 increase significantly in human cyto-megalovirus infection-related atherosclerosis, inducing and aggravating inflammatory reaction through the chemokine receptors, and thus plays an important role in the process of atherosclerosis.

Objective To explore the clinical characteristics of mycoplasma pneumonia with pulmonary atelectasis and lavage interventional effect through fiberoptic bronchoscopy in children.Methods During Jun 2012 to Apr 2013,fifty-three children diagnosed of mycoplasma pneumonia with pulmonary atelectasis who received fiberoptic bronchoscopy were enrolled as the experimental group.Thirty-five children diagnosed of mycoplasma pneumonia without pulmonary atelectasis were chosen as control group.According to the lavage interventional time of fiberoptic bronchoscopy,we divided the patients in the experimental group into two groups,the early group and late group.Clinical data and laboratory finds were collected and analyzed.Results The duration of fever,hospital stay and C-reactive protein (CRP) of the experimental group were significantly higher than those of the control group (P ＜ 0.05).The location of pulmonary atelectasis in the experimental group were usually in the right middle lobe (18 cases,33.9％).Under fiberoptic bronchoscope,all patients had obviously bronchial mucosa congestive edema.Some of them had follicular hyperplasia (9 cases,17.0％),mucosal erosion (3 cases,5.7％),mucus plug formation (7 cases,13.2％) and poor ventilation of segmental bronchi (4 cases,7.5 ％).Neutrophils (43 cases,81.1％) increased and phagocytic cells (31 cases,58.5％) dereased obviously in bronchoalevolar lavage fluid.After treatment in the experimental group,52 children (98.1％) got complete recruitment of atelectasis.The average duration of fever and hospital stay of the early group were significantly shoter than those of late group (P ＜ 0.05).Conclusion Children diagnosed of mycoplasma pneumonia with pulmonary atelectasis had longer fever duration and higher CRP level.Bronchoscopic interventional therapy promoted the recovery of pulmonary atelectasis.Using bronchoscop early in shorten the duration of fever and hospitalization in children diagnosed of mycoplasm pneumonia with pulmonary atelectasis.

Objective To study the correlation between individual gene polymorphisms of transforming growth factor (TGF)-β1 + 869 T/C,tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) + 1525 G/A genes and nodular thyroid disease.Methods From September 2007 to December 2009,a total of 544 patients with nodular thyroid disease diagnosed in the Department of Endocrinology,The First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology were selected,including 136 cases of nodular goiter patients (node group),132 cases of thyroid tumor (adenoma group),146 cases of Graves patients (GD group),and 130 cases of Hashimoto's thyroiditis (HT group).One hundred and thirty-five healthy subjects were enrolled as control group.Two milliliters of fasting venous blood of all subjects were collected.Polymorphisms of the TGF-β1 + 869 T/C and the TRAIL 1525 A/G genes were identified by the polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) and the restriction fragment length polymorphism (PCR-RFLP) methods.Results TGF-β1 + 869 T/C:The CC genotypes and C allele frequencies of nodular goiter group [47.0％(64/136),63.2％(172/ 272)] were significantly higher than those of normal control group [18.0％(22/135),45.2％ (122/270); x2 =30.76,17.79,all P ＜ 0.05].The genotypes and allele frequencies of adenoma group[42.4％ (56/132),59.1％ (156/264)] were significantly higher than those of the normal control group (x2 =24.40,10.34,all P ＜ 0.05).The risk of population carrying the C allele suffering from nodular goiter was 2.086 times of those carrying the T allele (OR =2.086; 95％ CI:1.480-2.943).The risk of population carrying the C allele suffering from adenoma was 1.752 times of those carrying the T allele (OR =1.752,95％ CI:1.244-2.469).TRAIL + 1525 G/A:the genotypes and allele frequencies of nodular goiter group [40.4％ (55/136),62.9％ (171/272)] were significantly higher than those of normal control group [12.0％ (16/135),48.5％ (131/270); x2 =9.176,11.307,all P ＜ 0.05].The genotypes and allele frequencies of adenoma group[53.3％ (70/132),73.1％ (193/264)] were significantly higher than those of the normal control group (x2 =9.806,33.82,all P ＜ 0.05).The risk of population carrying the G allele suffering from nodular goiter was 1.796 times of those carrying the A allele (OR =1.796,95％ CI:1.275-2.531).The risk of population carrying the G allele suffering from adenoma was 2.884 times of those carrying the A allele (OR =2.884,95％ CI:2.009-4.142).Conclusions TGF-β1 + 869 T/C and TRAIL + 1525 G/A gene polymorphisms may be related to the incidence of nodular thyroid diseases; G allele of TRAIL and C allele of TGF-β1 may be predisposing genes of patients with nodular goiter.

Objective To explore the diagnostic significance of Xpert MTB/RIF in cerebrospinal fluid,and evaluate the application for early diagnosis of tuberculous meningitis(TBM).Methods Sixty cases of TBM and 30 cases of non-TBM patients were selected as our subjects.Xpert MTB/RIF and modified Ziehl-Neelsen stain were performed in cerebrospinal fluid.The detection rate of the system and the resistance of the patients were analyzed.Results Eleven cases were diagnosed as the positive cases in 60 cases with TBM,and 0 case was diagnosed as TBM in control group.Sensitivity and specificity of Xpert with TBM were 18.33％ and 100％,respectively.The difference of the two groups was statistically significant (P =0.014).The positive rate of definite group was 23.68％(9 cases),18.18％(2 cases) in probable group and 0％ in possible group,and the difference of the three groups was statistically significant(x2 =3.070,P＞0.05).The resistance rate was 36.36％ (4/11).Sensitivity of the modified Ziehl-Neelsen staín was 63.33％ (38/60).Eleven cases were detected positive by Xpert MTB/RIF,9 cases were positive with modified acid fast staining,and the positive rate was 18.33％,and the difference of the two methods was statistically significant (P =0.000).Conclusion Xpert MTB/RIF test is simple and rapid diagnostic method.The combination of Xpert MTB/RIF and modified ZiehlNeelsen stain will improve the efficiency of the early diagnosis of TBM.