Clinical Decision Support System for Diabetes Based on Ontology Reasoning and TOPSIS Analysis.

Introduction: Although a number of researchers have considered the positive potential of Clinical Decision Support System (CDSS), they did not consider that patients' attitude which leads to active treatment strategies or HbA1c targets. Materials and Methods: We adopted the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) published to propose an HbA1c target and antidiabetic medication recommendation system for patients. Based on the antidiabetic medication profiles, which were presented by the American Association of Clinical Endocrinologists (AACE) and American College of Endocrinology (ACE), we use TOPSIS to calculate the ranking of antidiabetic medications. Results: The endocrinologist set up ten virtual patients' medical data to evaluate a decision support system. The system indicates that the CDSS performs well and is useful to 87%, and the recommendation system is suitable for outpatients. The evaluation results of the antidiabetic medications show that the system has 85% satisfaction degree which can assist clinicians to manage T2DM while selecting antidiabetic medications. Conclusions: In addition to aiding doctors' clinical diagnosis, the system not only can serve as a guide for specialty physicians but also can help nonspecialty doctors and young doctors with their drug prescriptions.

Revision total hip arthroplasty using a cementless prosthesis / 中华外科杂志

<p><b>OBJECTIVE</b>To assess the operative technique and results with the usage of cementless prosthesis in hip revision.</p><p><b>METHODS</b>Retrospective study was done on revision of total hip arthroplasty with cementless prosthesis in 72 patients (41 males and 31 females) with an average age of 65.7 years (28-82 years) from January 2004 to December 2009. The reason for revision was 2 infection, 54 aseptic loosening, 4 periprosthetic fractures, 5 fracture of femoral stems and 7 cases of acetabular abrasion after hemi-arthroplasty. The operation time, bleeding loss, complications of infection, dislocation, periprosthetic fractures and loosening were evaluated. The Harris score were used for hip function evaluation.</p><p><b>RESULTS</b>The average operation time was (146±47) minutes (70-280 minutes) and bleeding loss during the operation was (970±540) ml (200-2500 ml). Bacterium cultivation during operation demonstrated infection in 2 patients. Bone windows at the lateral femoral were opened in 4 patients and extend trochanteric osteotomy was done in 7 patients. Fracture of the proximal femur occurred in 8 cases. Twenty-nine patients were treated with bone graft including 18 autografts and 11 allografts. Sixty-seven patients were followed up for an average time of 66 months (20-92 months). Additional revisions were performed in 3 cases including 2 dislocations and 1 infection. There were no death, no damage of major blood vessels and nerves. The bone graft healed during 3-5 months. The survival rates of the femoral prosthesis and the acetabulum prostheses were 95.5% and 98.4%. The mean Harris score was 86±8 (55-95 points). Osteolysis were seen in 13 hips but migration was seen in only 1 patient.</p><p><b>CONCLUSIONS</b>The cementless prosthesis is useful in revision total hip arthroplasty and the perfect clinical results are related to the reliable primary fixation.</p>