Objective To observe the clinical efficacy of interferon by aerosol inhalation as a part of treat-ment of hand,foot and mouth disease of children.Methods The clinical data of 240 children with hand foot and mouth disease were collected,and they were divided into group A (control group)and group B (interferon treatment group)according to the order of admission.The recovery time on body temperature,rashes on the hands and feet, mouth pain,the average hospitalization time and total efficacy rate were compared.Results Group B was superior to group A in the following aspects,it took shorter time to get recovery of mouth pain,rashes on hands and feet,the aver-age hospitalization time.The recovery time for mouth pain of group A was (60.5 ±22.1 )h,which of group B was (52.8 ±19.5)h.The time for rashes on hand and foot recovery of group A was (72.3 ±25.4)h,which of group B was (54.7 ±22.5)h.The average hospitalization time of group A was (124.8 ±42.4)h,which of group was B (108.2 ±36.7)h,and the differences were statistically significant (t =2.45,2.38,2.16,P =0.018,0.015,0.032). The total effective rate of group B was 93%,which was higher than 85.3% of group A,and the difference was statistically significant (χ2 =6.012,P =0.012).Conclusion Interferon by aerosol inhalation as a part treatment of hand -foot -and -mouth disease of children (ordinary type)can increase the efficacy rate,shorten course of the disease,accelerate comprehensive rehabilitation of patients.

Objective To investigate the feasibility of high fat-introduced hyperlipeidemia model in male SD rat and study the time rule of molding .Methods 30 Male adult rats of SD Strain bred in the animal house of the institute were divided into 3 groups after 1 week adaptation , group 1:control group, normal diet;group 2:model 1 group, high fat high cholesterol diet;group 3:model 2 group, high fat high cholesterol diet .The period of experiment was 8 weeks.Food and water intake were measured everyday and body weight were measured every four days .Blood were collected by orbital venous at the end of fourth ,sixth,eighth week to test their serum lipid level .At the end of experiment ,animals were killed to collect liver and aorta tissue for HE stain .Results Compared with control group ,the food intake of model 1 was higher and model 2 was significant lower , water intake of model 2 was significant lower , the ratio of liver/weight of two model groups were significant heavier ,and weight of model groups were higher .High fat diet significantly increased TC levels of model groups at the end of fourth ,sixth week.The level of LDL-c in model 1 group were higher and the HDL-c were lower compared with control group .HE stain showed the livers of control group were regular ,arrangements of the liver cells were trim, dyeing present uniformity .The two model groups showed a large range of hepatocyte fatty change ,a few liver blood sinus were in congestion and infiltrated with inflammatory cells .Aorta HE stain showed no significant change among 3 groups.Conclusions The method of high fat-introduced hyperlipeidemia model in male SD rat is feasible and the model turned out to present hypercholesterolemia with severe fatty liver .On the other hand,levers of serum lipid increased within an increase—inter-adjustment—increase state .In the process of modeling ,how to overcome the symptom of anorexia and the state of cholesterol inter-adjustment in animals is the key to successfully establish hyperlipeidemia model .

Objective To investigate the effect of estrogen replacement therapy applied in different periods to ovariectomized rats and to evaluate the cognitive function of the rats.Methods Totally 40 rats were ovariectomized to be postmenopausal models.They were divided into early hormone replacement therapy group (n =10,managed by estradiol valerate at day 3 after surgery),early control group (n =10,managed by saline at day 3 after surgery),late hormone replacement therapy (n =10,managed by estradiol valerate at day 90 after surgery for 30 days) and late control group (n =10,managed by saline at day 90 after surgery for 30 days).The behavior indicators of the rats were evaluated by Morris watermaze and hippocampal metabolite was detected by proton magnetic resonance spectroscopy,including N-acetylaspartate (NAA),choline containing compounds (Cho),creatine(Cr),myoinositol (mI),NAA/Cr,Cho/Cr and mI/Cr.Results (1) Navigation test: escape latency were (43 ± 13) s at the early control group,(28 ± 9) s at the early HRT group,(82 ±26) s at the late control group and (48 ± 18) s at late HRT group.Swimming distance were (1 404 ± 238) cm at the early control group,(878 ± 354) cm at the early HRT group,(2411 ±818) cm at the late control group and (1 310 ±434) cm at the late HRT group.The escape latency and swimming distance of the early and late HRT groups were significantly shorter than those at the control groups (P ＜ 0.05).(2) Spatial probe test: the swimming time in the target quadrant of rats in the early HRT group (34.0 ± 3.0) s were longer than those in other groups (P ＜ 0.05).(3) Proton magnetic resonance spectroscopy: NAA/Cr were 1.12 ±0.17 at the early control group,1.26 ±0.12 at the early HRT group,1.57 ±0.21 at the late control group and 1.38 ±0.28 at the late HRT group.The late HRT group and the late control group were higher than their early groups (F =6.05,P =0.040).There was no significant difference between the HRT groups and the control groups (F =0.04,P =0.860).mI/Cr were 0.69 ±0.04 at the early control group,0.46 ±0.12 at the early HRT group,0.70 ±0.03 at the late control group and 0.75 ± 0.08 at the late HRT group.There were statistically significant differences of the experimental time between the early and late groups(F =16.45,P =0.004).The differences between the early HRT group and the early control group,and the late HRT group and the late control group were significant(F =6.01,P =0.040).And there was an interaction with the experimental time and HRT measures (F =13.79,P =0.006) ; early HRT can reduce the average level of mI/Cr.Cho/Cr were 0.95 ± 0.09 at the early control group,0.80 ±0.12 at the early HRT group,0.87 ±0.09 at the late control group and 0.85 ± 0.12 at the late HRT group.There was no significant difference among those groups (P ＞0.05).NAA/mI: there was an interaction with the experimental time and HRT measures (F =12.95,P =0.007).Early HRT can elevated levels of NAA/mI,while the late results were reversed.Conclusion Earlier estrogen replacement therapy may play a positive role in improving cognitive function of the ovariectomized rats.

Objective To develop a conceptual framework for the synopsis of information of health examination reports (HERs) and its style sheet so as to provide a reference for information collection and management in health examination institutions.Methods A conceptual framework for the synopsis of information of HERs and its core data elements were developed based on HERs items from 11 health examination institutions,and a style sheet for the synopsis of information of HERs was then designed.Results The conceptual framework included 4 dimensions (e.g.identification information,health-related information,health exam summary,health evaluation and guidance),16 sub-dimensions,52 core data elements and 25 value domains.The structure and content of the designed sheet were consistent with the dimensions,subdimensions and core data elements of the conceptual framework.Conclusions The developed synopsis of information of HERs could be a feasible solution for structured and standardized representation of clients' health examination information.The selection and filling of some items should be validated and refined in the future.

Objective To construct a conceptual framework of a lifestyle questionnaire and define its dimensions,sub-dimensions and core data elements.Methods After review of lifestyle questionnaires of large-scale studies,domestic and international health information standards,health risk factors defined by the World Health Organization and paper-based health records,a conceptual framework was developed by using top-down and bottom-up strategies.Core data elements were chosen according to their importance,utility and experts' advice.Results Our conceptual framework included 9 dimensions (cigarette smoking,alcohol consumption,diet,water drinking,employment,physical exercises,daily living habits,sleep and toxic exposure) and 29 sub-dimensions.For instance,cigarette smoking included status,intensity,duration of smoking and kinds of tobacco.Furthermore,24 core data elements were extracted,and coded values were defined for parts of these data elements.Conclusions Our conceptual framework may serve as a reference for the development of lifestyle questionnaire,and the standardized data elements we extracted could be used in information exchang between institutions.However,standardization of the data elements should be further refined.

Objective: To create a model to predict nosocomial infections in emergency intensive care units (EICU), so as to provide insights into early identification and interventions among patients with nosocomial infections. Methods: All nosocomial infections were collected from patients hospitalized in the EICU of a large tertiary hospital from 2017 to 2020. The 2017-2019 data were selected as the training set to create a logistic regression model, and the fitting effectiveness of the predictive model was evaluated using Hosmer-Lemeshow test. The 2020 data were selected as the test set to evaluate the external validation of the predictive model. In addition, the value of the model for prediction of nosocomial infections was examined using the receiver operating characteristic (ROC) curve analysis. Results : Totally 1 546 inpatients in EICU were enrolled, and the prevalence of nosocomial infections was 7.18%. Multivariable logistic regression analysis identified hospital stay duration of >7 days (OR=21.845, 95%CI: 7.901-60.398), use of ventilators (OR=3.405, 95%CI: 1.335-8.682), and surgery (OR=1.854, 95%CI: 1.121-3.064) as risk factors of nosocomial infections. The predictive model was p=ey/(1+ey), y=-6.105+(3.084×duration of hospital stay)+(1.225×use of ventilators)+(0.617×surgery). The area under ROC curve was 0.806 (95%CI: 0.774-0.838) for the training set and 0.723 (95%CI: 0.623-0.823) for the test set, and if the 0.065 cut-off of the predictive model created by the training set was included in the test set, the predictive value yield a 0.739 sensitivity and 0.642 specificity for prediction of nosocomial infections among patients hospitalized in EICU. Conclusion The created predictive model for nosocomial infections among patients hospitalized in EICU presents a high accuracy, which shows a satisfactory predictive value for high-risk nosocomial infections.

OBJECTIVES: From the point of view of clinical data representation, this study attempted to identify obstacles in translating clinical narrative guidelines into computer interpretable format and integrating the guidelines with data in Electronic Health Records in China. METHODS: Based on SAGE and K4CARE formulism, a Chinese clinical practice guideline for hypertension was modeled in Protege by building an ontology that had three components: flowchart, node, and vMR. Meanwhile, data items imperative in Electronic Health Records for patients with hypertension were reviewed and compared with those from the ontology so as to identify conflicts and gaps between. RESULTS: A set of flowcharts was built. A flowchart comprises three kinds of node: State, Decision, and Act, each has a set of attributes, including data input/output that exports data items, which then were specified following ClinicalStatement of HL7 vMR. A total of 140 data items were extracted from the ontology. In modeling the guideline, some narratives were found too inexplicit to formulate, and encoding data was quite difficult. Additionally, it was found in the healthcare records that there were 8 data items left out, and 10 data items defined differently compared to the extracted data items. CONCLUSIONS: The obstacles in modeling a clinical guideline and integrating with data in Electronic Health Records include narrative ambiguity of the guideline, gaps and inconsistencies in representing some data items between the guideline and the patient' records, and unavailability of a unified medical coding system. Therefore, collaborations among various participants in developing guidelines and Electronic Health Record specifications is needed in China.
Asian Continental Ancestry Group ; China* ; Clinical Coding ; Cooperative Behavior ; Decision Support Systems, Clinical ; Delivery of Health Care ; Electronic Health Records ; Humans ; Hypertension ; Methods* ; Practice Guidelines as Topic ; Software Design ; Translating

OBJECTIVES: This study is aimed at developing a set of data groups (DGs) to be employed as reusable building blocks for the construction of the eight most common clinical documents used in China's general hospitals in order to achieve their structural and semantic standardization. METHODS: The Diagnostics knowledge framework, the related approaches taken from the Health Level Seven (HL7), the Integrating the Healthcare Enterprise (IHE), and the Healthcare Information Technology Standards Panel (HITSP) and 1,487 original clinical records were considered together to form the DG architecture and data sets. The internal structure, content, and semantics of each DG were then defined by mapping each DG data set to a corresponding Clinical Document Architecture data element and matching each DG data set to the metadata in the Chinese National Health Data Dictionary. By using the DGs as reusable building blocks, standardized structures and semantics regarding the clinical documents for semantic interoperability were able to be constructed. RESULTS: Altogether, 5 header DGs, 48 section DGs, and 17 entry DGs were developed. Several issues regarding the DGs, including their internal structure, identifiers, data set names, definitions, length and format, data types, and value sets, were further defined. Standardized structures and semantics regarding the eight clinical documents were structured by the DGs. CONCLUSIONS: This approach of constructing clinical document standards using DGs is a feasible standard-driven solution useful in preparing documents possessing semantic interoperability among the disparate information systems in China. These standards need to be validated and refined through further study.
Asian Continental Ancestry Group ; China ; Delivery of Health Care ; Electronic Health Records ; Health Level Seven ; Hospitals, General ; Humans ; Information Systems ; Semantics

Objective:To evaluate the prognostic value of sepsis-induced coagulopathy (SIC) in patients with sepsis.Methods:From January 2019 to December 2021, patients with sepsis admitted to the Intensive Care Unit of our hospital were retrospectively classified into the SIC group and non-SIC group according to SIC diagnostic criteria. The baseline clinical data, severity score, total length of hospital stay, length of ICU stay and 28-day survival were compared between the two groups. Kaplan-Meier was used to compare the 28-day survival of patients with sepsis between the two groups. Cox proportional hazard regression model was employed to analyze the risk factors of prognosis in patients with sepsis.Results:Totally 274 patients with sepsis were included in the analysis, including 139 patients in the SIC group and 135 patients in the non-SIC group. The two groups were compared in the perspectives of the Platelet count (PLT), prothrombin time (PT) , procalcitonin (PCT), D dimer, hematocrit, red blood cell distribution width, hemoglobin, acute kidney injury (AKI), the use of continuous renal replacement treatment (CRRT), the use of vasoactive drugs, sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation (APACHEⅡ) score were compared between the two groups and the difference were statistically different (all P<0.05). Kaplan-Meier analysis showed that the 28-day mortality rate in the SIC group was significantly higher than that in the non-SIC group (32.4% vs. 14.1%, P<0.05). COX proportional hazard model showed that SIC score ( HR= 2.17, 95% CI: 1.15-3.91, P<0.05), APACHEⅡ score ( HR= 1.13, 95% CI: 1.09-1.17, P<0.05) and the use of vasoactive drugs ( HR=3.66, 95% CI: 1.53-8.75, P<0.05) were independent influencing factors for 28-day death in patients with sepsis. Conclusions:Patients with sepsis and SIC have more severe disease and increased mortality risk. SIC score exhibits good clinical value in predicting the prognosis of patients with sepsis.

Objective: To evaluate the long-term clinical efficacy and follow-up of dendritic cell (DC) vaccines in combination with cytokine-induced killer cell (CIK) treatment in metastatic renal cell carcinoma. Methods: From January 2011 to December 2013, 29 patients with metastatic renal cell carcinoma (pathologically confirmed as renal clear cell carcinoma) were treated by DC vaccines-CIK at the Department of Hematopoietic Stem Cell Transplantation, the Fifth Medical Center of Chinese PLA General Hospital. The 29 patients included 24 male and 5 female, with a median age of 57(32-81) years old. Mature DC vaccine was obtained by gene transfection technology and CIK cells were obtained by i n v i t r o culture; and DC vaccine-CIK was infused back to patients through lymphatic drainage area and vein by each course. Twelve patients received first line treatment, 6 patients received second line treatment after the disease progression by targeted drug therapy or cytokine therapy, and 11 patients received third-linetreatment or above. The long-term clinical efficacy and overall survival rate were evaluated. Results: The median follow-up time was 5 (1-7) years. Treatment cycle was over 2 (2-23) cycles. One case (3.4%) achieved complete remission, 9 cases (31%) achieved partial responses, 13 cases (44.8%) demonstrated stable disease over 3 months and 6 patients (20.7%) developed progressive disease. The objective response rate was 34.4%,and the disease control rate was 79.2%. Stable disease for more than one year realized in 19 cases (65.5%). The 1-, 3- and 5-year survival rates were 93.1% (27/29), 65.5% (20/29) and 51.7% (15 / 29), respectively. Neither the median progression-free survival (PFS) nor the median survival time was achieved. No adverse reactions above grade 3 were observed during treatment. Conclusion: DC vaccines-CIK therapy for the treatment of metastatic renal cell carcinoma is affirmative; it achieved good disease control and long-term survival with controllable safety, and prolonged the survival time for advanced renal cell carcinoma patients.