The development of Electronic Health Records (EHR) is a necessary trend of global digitization.The paper introduces the building of EHR and relevant national policies,states the construction practice of EHR in Deyang,Shanghai,Beijing,Guangzhou,Nanchang,etc.,outlooks further development,and provides helpful references for the construction of EHR of other province and city.

OBJECTIVETo analyze the echocardiographic standardized myocardial segmentation features in patients with left ventricular noncompaction (LVNC).

METHODSEchocardiographic characteristics of 9 patients with LVNC were analyzed and the localization of lesions were determined according to the standardized myocardial segmentation (SMS) recommended by American Heart Association (AHA).

RESULTSLoose trabeculation in the myocardial lesions were evidenced in all LVNC patients. Communication between deep intertrabecular recess and LV cavity was evident with color flow imaging. According to SMS of AHA, noncompaction of ventricular myocardium was localized in apical segment in all 9 patients, in apical segment of the inferior wall (IW) in 9 patients, in apical segment of the lateral wall (LW) in 7 patients, in middle segment (MS) of IW in 7 patients, in MS of LW in 6 patients. One NC segment was also evidenced in apical segment and MS of septal ventricular wall, basal segment of IW and LW and right ventricular apex, respectively. NC was not found in left ventricular anterior wall.

CONCLUSIONEchocardiographic standardized myocardial segmentation is helpful to diagnose LVNC and NC was mostly localized in the apical segments of LVNC patients.

Adolescent ; Adult ; Aged ; Cardiomyopathies ; diagnosis ; diagnostic imaging ; Child ; Child, Preschool ; Echocardiography ; methods ; Female ; Humans ; Male ; Middle Aged ; Myocardium ; pathology ; Reference Standards ; Ventricular Dysfunction, Left ; diagnosis ; diagnostic imaging ; Young Adult

Objective: To explore the feasibility and application value of intraoperative direct immunohistochemical (IHC) staining in improving the diagnosis accuracy in difficult cases of bronchiolar adenoma (BA). Methods: Nineteen cases with single or multiple pulmonary ground-glass nodules or solid nodules indicated by imaging in Cancer Hospital of Chinese Academy of Medical Sciences from January to July 2021 and with difficulty in differential diagnosis at frozen HE sections were selected. In the experimental group, direct IHC staining of cytokeratin 5/6 (CK5/6) and p63 was performed on frozen sections to assist the differentiation of BA from in situ/micro-invasive adenocarcinoma/adenocarcinoma/invasive mucinous adenocarcinoma. In the control group, two pathologists performed routine frozen HE section diagnosis on these 19 cases. The diagnostic results of paraffin sections were used as the gold standard. The sensitivity and specificity of BA diagnosis, consistency with paraffin diagnosis and time used for frozen diagnosis were compared between the experimental group and the control group. Results: The basal cells of BA were highlighted by CK5/6 and p63 staining. There were no basal cells in the in situ/microinvasive adenocarcinoma/adenocarcinoma/invasive mucinous adenocarcinoma. In the experimental group, the sensitivity and specificity with aid of direct IHC staining for BA were 100% and 86.7%, respectively, and the Kappa value of frozen and paraffin diagnosis was 0.732, and these were significantly higher than those in the control group (P<0.05). The average time consumption in the experimental group (32.4 min) was only 7 min longer than that in the control group (25.4 min). Conclusions: Direct IHC staining can improve the accuracy of BA diagnosis intraoperatively and reduce the risk of misdiagnosis, but require significantly longer time. Thus frozen direct IHC staining should be restricted to cases with difficulty in differentiating benign from malignant diseases, especially when the surgical modalities differ based on the frozen diagnosis.
Humans ; Paraffin ; Sensitivity and Specificity ; Adenocarcinoma in Situ ; Adenoma/diagnosis* ; Adenocarcinoma, Mucinous/surgery* ; Frozen Sections/methods*