The paper explains factors that restricting the development of the mobile healthcare information system in small and medi -um hospitals , summarizes strategies for constructing the mobile healthcare information system in small and medium hospitals , and analy-zes advantages of the Android system as the development platform of the healthcare information system .On the basis of above , it designs a model suitable for the mobile healthcare information system in small and medium hospitals and introduces the system in details including the design principles , structure and service modes for clients , etc.

Objective To investigate the ability of auto-dermis grafts in the prevention of epidural fibrosis and adhesions, and provide reference for clinical application. Methods Five Tibet mini-pigs were used and laminectomy was performed in lumbar 2 and 4 segment. Dura was exposed and covered with auto-genous dermis grafts in lumbar 2 (the experimental group), without grafts in lumbar 4 (the autogeoous blank group). The specimens were observed grossly and histologically at 2, 4, 6, 8 and 10 weeks postoperatively. Epidural scar amount and adhere range was evaluated by modified Robertson scoring method and analyzed by SPSS 13.0. No sear and adhesion, 0 point; small amount scar and light-range adhesion, 1 point; medium sear and midrange adhesion, 2 pionts; bulk scar ang high-range adhesion, 3 pionts. Results All grafted dermis survived and thicken obviously than dermis in body surface (P< 0.05). Hair growth, sebaceous gland cyst and sweat cystogenesis were not observed. A larvaceous dissection abruption plane, little cicatricial tis-sue and adhesions rarefaction between dermis and dura were observed in the experimental group. Massive ei-catricial tissue from erector spinae filled in cavitas epiduralis was observed and dura was separated difficult-ly from cicatricial tissue in the autogeous blank group. Epidural scar amount and adhesion range in the ex-perimental group was significantly lower than the blank group (P< 0.05). Conclusion Dermis is a kind of favourable biomaterial with restraining cicatrisation and isolation barrier. Autogenous dermis grafts has the best effect on preventing peridural cicatrisation and adhesion after laminectomy.

Objective To investigate the effect of cerebrospinal lfuid replacement combined with vancomycin and dexamethasone intrathecal therapy on biochemical indicators of postoperative intracranial infection, in order to improve the clinical diagnosis and treatment. Methods 70 cases with intracranial infection collected in Third Hospital of Beijing Armed Police Corps from February 2010 to April 2013 were as subject, and randomly divided into two groups. Control group(n=35) were given cerebrospinal lfuid replacement and ceftriaxone intravenously, observation group(n=35) were given cerebrospinal lfuid replacement combined with vancomycin and dexamethasone intrathecal injection. The clinical effects and biochemical indicators were observed after treatment in two groups. Results In control group, the cure rate was 22.86%and total efifciency was 77.14%. In observation group, the cure rate was 37.14% and total efficiency was 91.43%. The differences between two groups were statistically significant (P<0.05). The differences of leukocytes, glucose, protein, intracranial pressure in two groups after treatment were also statistically signiifcant(P<0.05). Conclusion Cerebrospinal lfuid replacement combined with vancomycin and dexamethasone intrathecal injection therapy can increase intracranial infection.

Physical continuity of bone is damaged following bone defects. The use of exogenous bone morphogenetic protein (BMP) treatment depends on appropriate carrier, which releases exogenous BMP and other growth factor into the bone defect site, inducing new bone formation and achieving therapeutic purposes. There are many carrier materials for BMP, including inorganic material, synthetic polymers, biological material, and composites of these three materials. But all have some deficiencies. So many researchers have optimized them by combined, physical and chemical methods to improve the bone inductive activity. BMP, which is released from carrier or local gene, can repair bone defect effectively, affording a new way for bone defect repairing.

Objective To study decompression and internal fixation combined with interbody fusion for degenerative lumbar spinal ste-nosis. Methods One hundred cases with degenerative lumbar spinal stenosis from January 2012 to June 2012 were researched. They were randomly divided into observation group and control group. Fifty patients in the control group,they were given treatment of interbody fusion. The observation group had 50 patients,using decompression and internal fixation on the basis of the control group. The back pain VAS score, leg pain VAS score,disc height,Cobb angle,ODI score of patients 3 months and 2 years after treatment were compared with each other. Re-sults After 3 months of treatment,back pain VAS score, leg pain VAS score,ODI scores of the observation group were lower than those of the control group,the difference was significant (P<0. 05). Intervertebral height of observation group was higher than that of control group, the difference was significant(t=4. 110 0,P=0. 000 1). After 2 years of treatment,back pain VAS score,leg pain VAS score and ODI score of the observation group was still lower than those of the control group, the difference was significant(P<0. 05). Intervertebral height of the observation group still higher(P<0. 05). The change of Cobb angle was not obvious. Conclusion Decompression and internal fixation com-bined with interbody fusion for degenerative lumbar spinal stenosis has a good effect,which is worthy of promotion in clinic.

Objective:To explore the environmental risk factors of different categories of congenital heart defects ( CHD) and provide evidence for further risk factors and prevention research of CHD pheno-types. Methods:Data of Guangdong CHD Register Study from 2004 to 2012 were used. In the study, 3 038 CHD cases and 3 038 paired controls from 34 hospitals distributed in 17 cities were registered and related information were collected using uniform, and structured questionnaires. All the CHD phenotypes were coded according to the International Classification of Diseases 10th Revision (ICD-10) and classified into 6 categories according to their pathological features. Univariate analyses were adopted to filter poten-tial risk factors for each category of CHD. Then multivariate conditional Logistic regression was used to calculate the odds ratios of the risk factors for each category of CHD. Results:The risk factors for left-to-right shunt CHD included low ( OR=2 . 63 , 95%CI:2 . 04 -3 . 39 ) or over birth weight ( OR =2 . 21 , 95%CI:1 . 47-3 . 32 ) , premature delivery ( OR=1 . 95 , 95%CI:1 . 53-2 . 49 ) , polyembryony ( OR=1. 99, 95%CI: 1. 22 -3. 26), maternal low education, mother as factory worker (OR =1. 62, 95%CI:1 . 32-1 . 98 ) , parity≥2 ( OR =1 . 38 , 95%CI: 1 . 13 -1 . 69 ) , maternal abnormal reproduction history ( OR=2 . 29 , 95%CI:1 . 75-3 . 01 ) , fever ( OR=2 . 38 , 95%CI:1 . 26-4 . 48 ) , virus infection ( OR=1 . 80 , 95%CI:1 . 29 -2 . 51 ) , medicine usage ( OR=1 . 73 , 95%CI:1 . 11 -2 . 69 ) , passive smoking ( OR=1 . 69 , 95%CI:1 . 26-2 . 29 ) , chemical agent contact ( OR=8 . 71 , 95%CI:2 . 33 -32 . 58 ) , living in newly decorated houses ( OR=2 . 56 , 95%CI:1 . 60-4 . 09 ) or room close to the main road ( OR=1 . 40 , 95%CI:1 . 14-1 . 72 ) in the first 3 months of pregnancy and father as factory worker ( OR=1 . 46 , 95%CI:1 . 23-1 . 73 ) . The risk factors for pulmonary outflow tract obstruction CHD in-cluded low ( OR =5 . 98 , 95% CI: 2 . 88 -12 . 44 ) or over birth weight ( OR = 6 . 56 , 95% CI:1. 19-36. 26), maternal low education, parity≥2 (OR=2. 08, 95%CI:1. 03-4. 22), virus infection in the first 3 months of pregnancy ( OR =4 . 30 , 95%CI: 1 . 27 -13 . 45 ) . The risk factors for left ventricular outflow tract obstruction CHD included father as factory worker ( OR=6 . 01 , 95%CI:1 . 05-34. 59). The risk factors for transposition of the great arteries included low birth weight (OR=12. 93, 95%CI:1. 14-146. 26), maternal low education, mother as factory worker (OR=3. 69, 95%CI:1. 53-8. 91). The risk factors for conditions with intra cardiac mixing of oxygenated and deoxygenated blood in-cluded parity=2 ( OR=3 . 45 , 95%CI:1 . 42-8 . 38 ) . The risk factors for other CHD included over birth weight (OR=4. 87, 95%CI:1. 19-19. 94), maternal abnormal reproduction history (OR=2. 96, 95%CI:1. 14 - 7. 68 ), virus infection ( OR = 4. 92, 95% CI: 1. 56 - 15. 47 ), medicine usage (OR=4. 90, 95%CI:1. 22-19. 77) or passive smoking (OR=10. 31, 95%CI:1. 25-85. 05) in the first 3 months of pregnancy. Conclusion:The environmental risk factors were discrepant among different categories of CHD. Further risk factors study of CHD phenotypes should be performed specially. To prevent CHD, attention should be paid to the risk factors which are related to multi or complex categories of CHD.

Objective To explore the differences in morphology and structure of collagen fiber of the hilar bile duct between human and rat. Methods The morphology and structure of vertical and horizontal cross-section of human and rat collagen fiber of the normal and dilated hilar bile duct, and their changes under stress were observed after Masson trichrome staining. Results The morphology and structure of collagen fiber of hilar bile duet in human was similar to that in rat. The collagen fiber mainly distributed in the middle and outer layer of the hilar bile duct. The wave-like collagen fiber bundles were arranged in parallel, consistent with the longitudinal axis direction of the bile duct, and connected by the small branches. Conclusions The morphology and structure of collagen fiber of the hilar bile duct in human is similar to that in rat. The anatomical structure of the collagen fiber is adapted to its function.

[Objective]To evaluate the effects of sutureless technique in comparison to conventional techniques for repair of total anomalous pulmonary venous connection(TAPVC)with the method of propensity score analysis.[Methods]From October 2007 to December 2013,179 consecutive patients were enrolled in this study. Patients were operated with sutureless technique(n = 81)or Conventional technique(n=98),and followed up at an interval of 1 month,3 months,6 months and then once a year post-operation. During analysis,three type of propensity-score matching methods,including nearest neighbor caliper matching,Mahalanobis metric matching with propensity score ,optimal full matching were used to create balanced groups of patients receiving each treatment. Surgeons’performance difference was assessed with random frailty proportional hazards models with gamma. Composite endpoints was defined by postoperative death or late death or postoperative pulmonary venous obstruction(PVO),which was evaluated with Kaplan-Meier curve and multivariable Cox proportional hazard model,adjusted by Preoperative-PVO,age,gender,weight and TAPVC type.[Results]Nearest neighbor caliper matching method was the best choice during propensity score analysis. After matching ,sutureless group included 73 patients and Conventional group73 patients. In sutureless group,cardiopulmonary bypass(CPB)time(Z=2.18, P=0.030),cross-clamp time(Z=3.63,P<0.001),rate of composite endpoints(HR 95%CI=0.20(0.06~0.61),P=0.005),late death(HR 95%CI=0.03(0.01~0.55),P=0.017)were significantly better than that in Conventional group. In subgroup analysis ,for patients with pre-PVO,decreased composite endpoints was seen in sutureless group.[Conclusion]Comparison using thepropensity score analysis demonstrated that sutureless strategy for primary repair of TAPVC may associate with decreased mortality rate of post-PVO and CPB time and cross-clamp time.

Objective To understand the anatomical features of the mine wound and provide anatomical basis for the treatment through anatomical observation of the mine wound amputation stump. Methods Three mine wound amputation stumps were dissected. The nerves, arteries and veins were separated and the length of the muscle,nerves,blood vessels and bleeding area were measured,respectively. The sec-tions of muscle tissue were observed by microscope. Results Most of the muscle tissues,nerves and blood vessels were torn and the fractures were comminuted. Observed by the microscope found that the distal muscle tissue was broken,the muscle fiber was contracted,ruptured and mortified. The muscle tissues of proximal part showed edema,most of the muscle fiber was normal and light stain,their texture was fuzzy. Conclusion The mine wound has remote effect. The shock wave of mine explosion may spread along the limbs,which leads to the tissues ruptured and hemorrhage.

Objective To study the expression of forkhead box 2(FOXC2)and delta-like liGand 4 (DLL4)in invasive ductal carcinoma(IDC)of breast and the clinical siGnificance. Methods The expression of FOXC2 and DLL4 in l22 cases of IDC(Grade Ⅰ33,Grade Ⅱ40,GradeⅢ 49)were observed by tissue chip and immunohistochemistry. The relationship of the expression with clinicopatholoGical characteristics and between FOXC2 and DLL4 were statistically analyzed. PCR experiment was performed in normal breast tissue,ductal carcinoma in situ(DCIS)IDC Grade Ⅰ,Grade Ⅱ and Grade Ⅲ(l0 cases respectively). Results The positive rate of FOXC2 and DLL4 in IDC was 77. 87% and 74. 59% respectively. A hiGher expression was observed in GradeⅢ than in GradeⅠand Ⅱ( P<0. 05 ). The expression of FOXC2 was related to the neGative expression of ER. The expression of DLL4 was related to the tumour size,clinical staGe and lymph node metastasis( P<0. 05). The RCR of FOXC2 and DLL4 were Gradually increased in normal breast tissue,DCIS,IDC GradeⅠ, Grade Ⅱ and Grade Ⅲ(P<0. 05). Moreover the expression of FOXC2 was related to the expression of DLL4(r=0. 233,P=0. 0l0). Conclusion FOXC2 and DLL4 miGht toGether have influence on the proGression and outcome of breast carcinoma,and could be important markers of proGnosis. DLL4 miGht be reGulated by variety of factors includinG FOXC2 at the same time.