Objective To investigate the current status and development of electronic health records (EHR) at home and abroad to grasp the development trends of EHR, so as to point out the direction of the development and relevant research on EHR. Methods Based on the Web of Science citation database and the principle of bibliometrics, we analyzed the retrieved literature in aspects of publication date, language, country/region, institution, author, etc. Results A total of 1 262 eligible studies were identified. The number of articles on EHR increased rapidly from only 2 in 1995 to 218 in 2012. In terms of country/region, the United States ranked the top in all countries (763 articles, accounting for 60.46%). In terms of institution, Harvard University ranked the top (135 articles, accounting for 10.70%). In terms of journal, the Journal of the American Medical Informatics Association ranked the top (106 articles, accounting for 8.40%). In terms of authors, David W. Bates ranked the top (45 articles, accounting for 3.57%). In terms of subject type, health care sciences services and medical informatics were mainly focused on. Conclusion The research on EHR has become a global hot spot and relevant bibliometrics will contribute to the timely and correctly grasp the whole picture of its development trends and main research direction.
Objective To investigate the clinicalmanifestations, electroencephalogram (EEG) characteristics, surgical treatment and prognosis of epilepsy secondary to Sturge-Weber syndrome (SWS) in children.Methods The data of 7 children with epilepsysecondaryto Sturge-Weber syndrome who were treated by surgery from May 2015 to May 2020 in our Children's Epilepsy Center were retrospectively reviewed. Their demographic characteristics, seizure forms, results of EEG and cranial imaging investigations, surgical methods, postoperative pathological reports and prognosis during follow-upwere summarized and analyzed. The prognosis were evaluated byEngel classificationat the last time point during follow-up. Results Totally 7 pediatric patients were enrolled, including 1 male (16/25, 64.0%) and 6 females.All the 7 cases presented with focal seizures at the onset among whom 2 cases developed status epilepticus during the course of the disease(epilepsiapartialiscontinuain 1 case),one case had epileptic spasmsand 1 case was characterized by cluster seizures. The interictal EEG manifestations of the cases gradually deteriorated as the course of the disease prolonged, including the slow wave on the affected side gradually increases (7/7), the amplitude gradually decreases (7/7), and the physiological wave disappears (4/7). Besides, no epileptiform discharges/incidental or a few epileptiform dischargeswere found in their interictal EEGs. Four cases underwent hemispherotomy, 1 case underwent temporo-parieto-occipital disconnection and 2 cases underwent lesion resection. The cases were followed up for 6 months to 5 years, and the average follow-up duration was 79.29 months. Six cases were rated as Engel Ⅰa during the regularfollow-up. Only 1 case was rated asEngel Ⅱ and Engel Ⅲ at 3 month and 1 year after the operation. ConclusionChildren with epilepsy secondary to SWS usually present with focal seizures and have diverse seizure forms. The EEG show characteristic changes. For the caseswith drug refractory epilepsy, detailed preoperative evaluation and reasonable surgical methods can result in a better therapeutic effect.
Objective To reveal the worldwide research status and hot topics of sleep apnea syndrome ( SAS) . Methods Articles were searched from Web of Science ( SCI) , Essential Science Indicator ( 2000 to 2010) database using sleep apnea syndrome or apnea as keywords. Retrieved documents were analyzed using the database with its own statistical functions and histcite software ( version 8.12. 16) .Results Since 1992 the international scientific papers on the SAS study showed a gradual upward trend.The United States is a world leader in this field. Recent research has focused on vascular endothelial barrier function and repair, oxidative stress, inflammation, cognitive function, special populations such as the elderlyor children patients with SAS. Conclusion Clinical researchers have paid more attention to SAS than before, but there are still many important issues unresolved.
In order to satisfy demands of massive and heterogeneous tumor clinical data processing and the multi-center collaborative diagnosis and treatment for tumor diseases, a Tumor Data Interacted System (TDIS) was established based on grid platform, so that an implementing virtualization platform of tumor diagnosis service was realized, sharing tumor information in real time and carrying on standardized management. The system adopts Globus Toolkit 4.0 tools to build the open grid service framework and encapsulats data resources based on Web Services Resource Framework (WSRF). The system uses the middleware technology to provide unified access interface for heterogeneous data interaction, which could optimize interactive process with virtualized service to query and call tumor information resources flexibly. For massive amounts of heterogeneous tumor data, the federated stored and multiple authorized mode is selected as security services mechanism, real-time monitoring and balancing load. The system can cooperatively manage multi-center heterogeneous tumor data to realize the tumor patient data query, sharing and analysis, and compare and match resources in typical clinical database or clinical information database in other service node, thus it can assist doctors in consulting similar case and making up multidisciplinary treatment plan for tumors. Consequently, the system can improve efficiency of diagnosis and treatment for tumor, and promote the development of collaborative tumor diagnosis model.
Integrating visualization toolkit and the capability of interaction, bidirectional communication and graphics rendering which provided by HTML5, we explored and experimented on the feasibility of remote medical image reconstruction and interaction in pure Web. We prompted server-centric method which did not need to download the big medical data to local connections and avoided considering network transmission pressure and the three-dimensional (3D) rendering capability of client hardware. The method integrated remote medical image reconstruction and interaction into Web seamlessly, which was applicable to lower-end computers and mobile devices. Finally, we tested this method in the Internet and achieved real-time effects. This Web-based 3D reconstruction and interaction method, which crosses over internet terminals and performance limited devices, may be useful for remote medical assistant.
The modified "seagull flap" for creating a new web in treated congenital syndactyly is deseribed. The technique is easy and this method can produce a web that is wide enough to allow adequate digital separation when fingers are abducted. The contour is satisfaction.
【摘要】 目的 分析無面部血管瘤的Sturge-Weber綜合征（SWS）的臨床特點。 方法 2008年10月收治1例女性患兒，8歲，因發作性四肢強直入院，患兒無面部血管瘤及眼部異常，僅表現為癲癇。患兒接受丙戊酸鈉抗癲癇治療。 結果 患兒經頭部CT、MRI確診為無面部血管瘤的SWS。抗癲癇治療后隨訪12個月，未再發癲癇，智力發育無減退，未出現癱瘓、蛛網膜下腔出血、腦出血、腦卒中樣發作等。 結論 無面部血管瘤的SWS確診依靠頭部CT及MRI，治療方法為藥物抗癲癇治療。復習文獻得出無面部血管瘤的SWS患者臨床表現不同于有面部血管瘤者，多僅表現出癲癇發作，且藥物治療有效，無需手術切除病灶，預后較好。【Abstract】 Objective To analyze the clinical features of Sturge-Weber syndrome without facial hemangioma. Methods One eight-year-old girl was admitted to the hospital for tonic seizure in October 2008. The physical examination results were normal with neither facial hemangioma nor ocular abnormalities. The only manifestation of the patient was epilepsy. The patient was treated with sodium valproate. Results According to cranial CT and MRI results, the patient was considered to have Sturge-Weber syndrome without facial hemangioma. The patient was treated with anticonvulsant drugs and experienced no recurrence of the seizures or any manifestations of mental retardation, hemiplegia, subarachnoid hemorrhage, cerebral hemorrhage, stroke-like episodes or migraine during the following 12 months of follow-up. Conclusion In the absence of facial hemangioma, the diagnosis can be based on cranial CT and MRI. Sturge-Weber syndrome patients without facial hemangioma are helped by anticonvulsant drugs. According to this case and the reports of literature, most patients without facial hemangioma only manifest epilepsy which can be treated effectively with antiepileptic drugs and such patients have a good prognosis without operation, which is different from those with facial hemangioma.
ObjectivesTo summarize and compare the operative mechanisms of the most representative comprehensive clinical practice guideline (CPG) databases worldwide, so as to provide references for establishing and managing Chinese CPG database.MethodsCPG databases were collected worldwide by discussing with experts in the guideline and database fields. Studies on guideline databases were searched in PubMed and CNKI to further collect CPG databases mentioned in these studies. Representative comprehensive guideline databases were finally selected by consulting relevant guideline experts. The institutions’ names of establishing and managing CPG databases, funding sources, human resources, aims, quality control measures (including CPG inclusion and updating criteria) were extracted and summarized. Databases were divided into government-led, society-led, and enterprise-led models. A descriptive analysis was conducted.ResultsThere were four government-led databases, four society-led databases and merely one enterprise-led database. The institutions of establishing CPG databases were same as the institutions of managing databases in the seven databases. All CPG databases had set up offices, seven of which were located in the capital. Most databases’ funds came from the government. Four databases implemented board management. According to the division of functions, members involved in establishing and managing CPG databases mainly included leaders, expert teams, managerial personnel, secretaries, web developers, and patient representatives. Criteria for inclusion of CPG were relevant to the purpose of establishing databases. Most databases required guidelines that had be updated within three to five years.ConclusionsThis study provides comprehensive information on operative mechanism of different CPG databases which can assist guideline database builders to optimize their operative mechanism.
Objective To investigate the clinical features and long-term prognosis of children with symptomatic epilepsy complicated by encephalofacial angiomatosis. Methods A total of 38 children with Sturge-Weber syndrome (SWS) complicated by symptomatic epilepsy who were diagnosed and treated in the Children's Hospital of Soochow University from January 2011 to June 2020 were selected as the research objects. Their clinical data were collected, and long-term follow-up studies were carried out. Results The clinical manifestations of SWS complicated by symptomatic epilepsy were diverse, with focal seizures being the most common (86.84%). Abnormalities were found in the cranial CT and MRI of all 38 children, mainly involving the parietal lobe and occipital lobe. Among the 38 children undergoing electroencephalogram (EEG) examinations, 31 had abnormal results. Among the abnormal EEGs, the background waves were asymmetrical on the left and right sides in 28 cases (the amplitude on the affected side was lower), 8 cases showed unilateral discharges to varying degrees, and 1 case showed bilateral high-amplitude discharges. Among the 38 cases, 2 did not use antiepileptic drugs, and 36 were treated with antiepileptic drugs, mainly with oxcarbazepine, topiramate, and levetiracetam. Eventually, 2 children were given surgical treatment due to drug-resistant epilepsy. Among the 38 cases, 19 (50.00%) were diagnosed with refractory epilepsy. Epilepsy occurring before the age of 2 are prone to develop into refractory epilepsy (P<0.05). All 38 children had sequelae to varying degrees, including 25 cases (65.79%) with severe sequelae and 13 cases (34.21%) with milder sequelae. Moreover, the earlier the age of epilepsy onset in children, the more likely it was to leave severe sequelae in the later stage (P=0.001). Conclusion Children with Sturge-Weber syndrome complicated by symptomatic epilepsy mainly have focal seizures. About half of them suffer from refractory epilepsy. The earlier the age of epileptic seizures, the more likely it is to develop into refractory epilepsy. The long-term prognosis of such children is rather poor. Among the 38 cases followed up, all had sequelae of varying degrees.