ABSTRACT
OBJECTIVE@#To solve the ESB bus performance and safety problems caused by the explosive growth of the hospital's business, and to ensure the stable interaction of the hospital's business system.@*METHODS@#Taking the construction of our hospital's information system as an example, we used AlwaysOn, load balancing and other technologies to optimize the ESB bus architecture to achieve high availability and scalability of the hospital's ESB bus.@*RESULTS@#The ESB bus high-availability architecture effectively eliminates multiple points of failure. Compared with the traditional dual-machine Cluster solution, the security is significantly improved. The nodes based on load balancing can be scaled horizontally according to the growth of the hospital's business volume.@*CONCLUSIONS@#The construction of the ESB bus high-availability architecture effectively solves the performance and security issues caused by business growth, and provides practical experience for medical information colleagues. It has certain guiding significance for the development of regional medical information.
Subject(s)
Hospital Information Systems , Information SystemsABSTRACT
Objective To evaluate the clinical effect of ultrasonic location botulinum toxin A (BTX-A)injection for lower limbs spasticity in children with cerebral palsy.Methods Seventy-five children with lower limbs spasticity resulting from cerebral palsy were divided into injection group(n =37) and control group(n =38).Ultrasonography was used to located the injection of BTX-A into the spastic muscles of the legs in injection group.Then rehabilitation training was received the day after the injection.For all patients,muscle spasticity and gross motor function measure were evaluated before treatment and in the second week,the first,third and sixth month treatment using the Modified Ashworth Scale(MAS) and the Gross Motor Function Measure(GMFM) assessment.Results In the second week,the first,third and the sixth month of treatment,the improvement of muscle spasticity and GMFM in the injection group were significantly better than before(all P ＜ 0.01).And the improvement of muscle spasticity were the greatest in the second week and the first month of the injection.The average therapeutic effect in the injection group was significantly better than that in the control group(P ＜0.05).There was no statistical difference between the evaluation score of the third month and that of the sixth month for injection group.The BTX-A injection had time limit and could be reinject after 6 months.Conclusions The ultrasound located BTX-A injection to treat lower limbs spasticity in cerebral palsy has the advantages of accurate localization,safety,good child patient compliance and more effective than only rehabilitation treatment.
ABSTRACT
Objective To investigate the association between subclinical hypothyroidism and levels of systolic blood pressure (SBP), so as to provide evidence for the development of prevention strategy and understanding the etiology of hypertension. Methods The articles on the association of subclinical hypothyroidism and systolic blood pressure levels were retrieved by searching international and national databases from 1999 to 2010. The relationship between subclinical hypothyroidism and systolic blood pressure levels was assessed by meta analysis with Stata 11software. The weighted mean difference (WMD) and 95% confidence interval (CI) were calculated,and the publication bias was assessed by Begg's test and Egger's test. Results (1) There was significant difference in SBP levels between patients with subclinical hypothyroidism and normal subjects (WMD= 2.04 mm Hg, 95% CI: 0.64 to 3.45, P＜ 0.05 ). (2) Subgroup analysis indicated that there was significant difference seen in thyroid stimulating hormone (TSH) mean difference values ＜7 mU/L group(WMD=2.33 mm Hg,95%CI:0.60 to 4.06,P＜0.05) but not in the group that TSH mean difference values were ＞7 mU/L. There was significant difference seen in the Asian group (WMD=2.62 mm Hg, 95%CI: 1.69 to 3.55,P＜0.05) in the community group(WMD=2.77mm Hg, 95%CI: 1.61 to 3.93, P＜0.05) but not in the European group and or in the hospital group.There was significant difference in the cross-sectional group (WMD=2.77 mm Hg, 95%CI: 1.61 to 3.93, P＜0.05), but not in the case-control group. (3) Results from both Begg' s test and Egger's test did not show significant difference, indicating that there was no publication bias existed.Conclusion Subclinical hypothyroidism was associated with the elevated systolic blood pressure. In terms of the role of subclinical hypothyroidism that might serve as one of the potential risk factor for the elevated systolic blood pressure. Well designed and large sample-sized prospective studies were necessary to confirm the association between subclinical hypothyroidism and systolic blood pressure.Random controlled trials were also needed to study whether the treatment could lower the risk. Active treatment for subclinical hypothyroidism might be useful for prevention and treatment of hypertension.