To fulfill the performance optimization for database of HIS, the shortest query response time and the highest throughput of database server are realized through the minimization of the network flow, disc I/O and CPU time. The performance optimization should exist throughout the development of HIS, so the requirements of HIS applications, the logical construction and physical structure of data, the balance of conflicting databases should be involved in.

Objective To understand the correlative factors of impacting schistosomiasis prevalence so as to provide the scientific evidence for drawing up the control project in Three Gorges Reservoir areas.Methods The report system of schistosomiasis was set up,and the cases were investigated.The population were screened by indirect haemagglutination test(IHA),and the serum-positive people were examined with Kato-Katz technique.The livestock and plants imported from the schistosomiasis endemic areas were investigated.Results Eighty-eight floating people returning from schistosomiasis endemic areas and 107 floating persons from endemic areas were investigated,and the serum positive rates were 1.14% and 1.87%,respectively.No schistosome eggs were found in stool examinations.There was no livestock and plant imported from schistosomiasis endemic areas.The production of local inhabitants depended on mainly cattle,and the river water contact was popular.Conclusions There are infection resources of schistosomiasis imported from endemic areas,which has a potential risk of schistosomiasis prevalence.

Objective To investigate the clinical,imaging,intestinal pathological characteristics and prognosis of gluten ataxia (GA).Methods The clinical data,treatment and prognosis in a patient with GA that was confirmed by pathology and hospitalized in the Department of Neurology,China-Japan Friendship Hospital in July 2018,were analyzed retrospectively.The related literature was reviewed and the clinical feature was summarized.Results The patient is a 41-year old man.He suffered from progressive cerebellar ataxia,and the brain magnetic resonance imaging exhibited diffused cerebellar atrophy.Serum human leukocyte antigen (HLA) tests showed that the patient carried HLA-DQ2 genotype.IgA type anti-gliadin antibody was positive (39.39 RU/ml).Duodenoscopy biopsy revealed mild villus atrophy and lymphocytic infiltration,indicating celiac disease.The diagnosis of GA was established then and the patient was administered gluten-free diet combined with intravenous immunoglobulin,which markedly improved the cerebellar symptoms and signs of cerebellar speech,walk capability and daily living activities.He could do long distance driving independently two months later.Conclusions GA is one of immune-mediated reversible acquired cerebellar ataxia caused by gluten sensitivity.The genotype,serologic features,and clinical phenotype of GA in Chinese mainland population might be similar with those in European and American countries.

Tripterygium wilfordii Hook F (TwHF) and its extracts have long been used for the treatment of rheumatoid arthritis, autoimmune diseases, and kidney disease due to their anti-inflammatory, immunoregulatory, and other pharmacological effects. However, the clinical immunoregulatory effects of TwHF and its extracts remain unclear, so we reviewed their effects for use in clinical practice. This review provides a comprehensive summary of the recent literature on the immunoregulatory effects of TwHF and its extracts in clinical studies. TwHF and its extracts affect the proliferation and activation of Tand B cells; ratio of Tcell subsets; inflammatory response of monocytes, macrophages, and immunoglobulins; and secretion of many cytokines. Together, these effects dictate immune function in a variety of diseases. TwHF and its extracts can be used alone or in combination with existing therapies against many immune disorders through immunomodulation.