Objective To investigate and improve clinical treatment and care methods of convulsions in postoperative children with congenital heart disease.Methods One postoperative child suffered from convulsions with congenital heart disease in our hospital PICU in August 2013 was reviewed,and then related clinical monitoring treatment methods were summarized.Results The patient suffered three times of convulsions and after drug treatment and careful nursing,the symptoms were under control without critical condition.Then the patient was safely and stably transited into the general ward and discharged.Conclusions There are three essential points for nursing convulsions in postoperative child with congenital heart disease:strengthen monitoring after heart surgery,handle symptom of seizures in time; rapidly make sure the reasons of convulsions and make effective preventions.

Objective To explore whether apply selective perineal skin preparation or not is feasible for patients with coronary heart disease (CHD) before percutaneous coronary intervention (PCI).Methods Divided patients with CHD before PCI into the experimental group (801 cases) and the control group(798 cases) according to the hospital number.Selective perineal skin preparation was used in the experimental group,while the right forearm skin preparation was used in all the patients in the control group.The rate of skin preparation and the care hours in the two groups were compared.Results The care hours of skin preparation in the experimental group was (5.58±0.30) h,which was significant shorter than that in the control group,(66.50±1.50) h,t=-1127.03,P＜0.05.Conclusions Before PCI,for patients with CHD,applying selective perineal skin preparation is feasible.It can not only reduce care labor,decrease nursing costs,but also relieve nurse-patient psychological pressure,cut back patients' expenses;and without percutaneous entrance infection.

Objective To explore the feasibility of the functional protection exercise of radial artery after transradial coronary intervention (TRI).Methods The participants were randomly divided into intervention group and control group based on groups comparison.The age and gender were matched between the two groups.The patients of control group received normal nursing care after percutaneous coronary intervention (PCI);the patients of intervention group received both normal care and functional protection intervention.The intervention conducted for three days and two cycles per day,which included a completely block of ulnar artery blood flow for 15-20 minutes and a repeat of this step after 30 minutes interval.Results There were four cases of acute occlusion,three cases of stenosis and seven cases of decreased blood flow in the intervention group.After the functional protection exercise of radial artery,the four acute occlusion cases were all recovered;the diameter of the radial artery increased more than 20％ for the stenosis and decreased blood flow cases;and the recovery of the radial artery diameter were significantly improved for the intervention group compared with that of the control group (P ＜ 0.05).Conclusions The functional protection exercise of radial artery after TRI has significant effects on preventing the stenosis and decreased blood flow,as well as protecting the function of the radial artery.

OBJECTIVE To investigate the normal range of fraction exhaled nitric oxide(FeNO) in healthy schoolchildren in Beijing, Tianjin and Hebei Province. METHODS A total of 337 schoolchildren(161 males and 176 females) in Beijing, Tianjin and Hebei Province were selected randomly in our outpatient clinic and met the health standards. FeNO values were measured using NIOX. Age, height, weight and body mass index(BMI) were investigated. At the same time, skin prick tests were performed on children with suspected atopy. RESULTS Geometric mean of FeNO value in healthy schoolchildren in Beijing, Tianjin and Hebei Province was 13 ppb(part per billion, ppb), and the 95％ Confidence Interval(CI, bias distribution) was 5-23 ppb, which was related to the gender of schoolchildren(P ＜0.001). There was no signif icant cor relation between age, height, weight, body mass index(BMI) and regional differences(P all＞0.05). FeNO values were no significant difference among the three regions(P ＞0.05); the geometric mean of FeNO values were 13 ppb in Beijing, 13 ppb in Tianjin, and 14 ppb in Hebei; 95％CI was 5 to 21 ppb, 5 to 21 ppb, 5 to 23 ppb, respectively. CONCLUSION FeNO values of healthy schoolchildren in Beijing, Tianjin and Hebei provinces are only significantly correlated with gender. However, FeNO values are highest among schoolaged girls in Hebei, and 23 ppb is the 95％ normal range of FeNO in healthy schoolchildren in Beijing, Tianjin and Hebei province. Gender and regional factors must be considered when FeNO values are evaluated.

The latest epidemiological data suggests that the situation of adult diabetes in China is severe, and metabolic diseases have become significant chronic illnesses that have a serious impact on public health and social development. After more than six years of practice, the National Metabolic Management Center(MMC) has developed distinctive approaches to manage metabolic patients and has achieved a series of positive outcomes, continuously advancing the standardized diagnosis and treatment model. In order to further improve the efficiency, based on the first edition, the second edition guideline was composed by incorporating experience of the past six years in conjunction with the latest international and domestic guidelines.

ObjectiveTo elucidate the critical role of rehabilitation medical records (including electronic records) in rehabilitation medicine's clinical practice and management, comprehensively analyzed the structure, core content and data standards of rehabilitation medical records, to develop a standardized medical record data architecture and core dataset suitable for rehabilitation medicine and to explore the application of rehabilitation data in performance evaluation and payment. MethodsBased on the regulatory documents Basic Specifications for Medical Record Writing and Basic Specifications for Electronic Medical Records (Trial) issued by National Health Commission of China, and referencing the World Health Organization (WHO) Family of International Classifications (WHO-FICs) classifications, International Classification of Diseases (ICD-10/ICD-11), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Interventions (ICHI Beta-3), this study constructed the data architecture, core content and data standards for rehabilitation medical records. Furthermore, it explored the application of rehabilitation record summary sheets (home page) data in rehabilitation medical statistics and payment methods, including Diagnosis-related Groups (DRG), Diagnosis-Intervention Packet (DIP) and Case Mix Index. ResultsThis study proposed a systematic standard framework for rehabilitation medical records, covering key components such as patient demographics, rehabilitation diagnosis, functional assessment, rehabilitation treatment prescriptions, progress evaluations and discharge summaries. The research analyzed the systematic application methods and data standards of ICD-10/ICD-11, ICF and ICHI Beta-3 in the fields of medical record terminology, coding and assessment. Constructing a standardized data structure and data standards for rehabilitation medical records can significantly improve the quality of data reporting based on the medical record summary sheet, thereby enhancing the quality control of rehabilitation services, effectively supporting the optimization of rehabilitation medical insurance payment mechanisms, and contributing to the establishment of rehabilitation medical performance evaluation and payment based on DRG and DIP. ConclusionStructured rehabilitation records and data standardization are crucial tools for quality control in rehabilitation. Systematically applying the three reference classifications of the WHO-FICs, and aligning with national medical record and electronic health record specifications, facilitate the development of a standardized rehabilitation record architecture and core dataset. Standardizing rehabilitation care pathways based on the ICF methodology, and developing ICF- and ICD-11-based rehabilitation assessment tools, auxiliary diagnostic and therapeutic systems, and supporting terminology and coding systems, can effectively enhance the quality of rehabilitation records and enable interoperability and sharing of rehabilitation data with other medical data, ultimately improving the quality and safety of rehabilitation services.

ObjectiveTo explore the data standard system of electronic medical records in the field of rehabilitation, focusing on the terminology and coding standards, data structure, and key content categories of rehabilitation electronic medical records. MethodsBased on the Administrative Norms for the Application of Electronic Medical Records issued by the National Health Commission of China, the electronic medical record standard architecture issued by the International Organization for Standardization and Health Level Seven (HL7), the framework of the World Health Organization Family of International Classifications (WHO-FICs), Basic Architecture and Data Standards of Electronic Medical Records, Basic Data Set of Electronic Medical Records, and Specifications for Sharing Documents of Electronic Medical Records, the study constructed and organized the data structure, content, and data standards of rehabilitation electronic medical records. ResultsThe data structure of rehabilitation electronic medical records should strictly follow the structure of electronic medical records, including four levels (clinical document, document section, data set and data element) and four major content areas (basic information, diagnostic information, intervention information and cost information). Rehabilitation electronic medical records further integrated information related to rehabilitation needs and characteristics, emphasizing rehabilitation treatment, into clinical information. By fully applying the WHO-FICs reference classifications, rehabilitation electronic medical records could establish a standardized framework, diagnostic criteria, functional description tools, coding tools and terminology index tools for the coding, indexing, functional description, and analysis and interpretation of diseases and health problems. The study elaborated on the data structure and content categories of rehabilitation electronic medical records in four major categories, refined the granularity of reporting rehabilitation content in electronic medical records, and provided detailed data reporting guidance for rehabilitation electronic medical records. ConclusionThe standardization of rehabilitation electronic medical records is significant for improving the quality of rehabilitation medical services and promoting the rehabilitation process of patients. The development of rehabilitation electronic medical records must be based on the national and international standards. Under the general electronic medical records data structure and standards, a rehabilitation electronic medical records data system should be constructed which incorporates core data such as disease diagnosis, functional description and assessment, and rehabilitation interventions. The standardized rehabilitation electronic medical records scheme constructed in this study can support the improvement of standardization of rehabilitation electronic medical records data information.

ObjectiveTo analyze the data structure and standards of rehabilitation outpatient medical records, to provide data support for improving the quality of rehabilitation outpatient care and developing medical insurance payment policies. MethodsBased on the normative documents issued by the National Health Commission, Basic Standards for Medical Record Writing and Standards for Electronic Medical Record Sharing Documents, in accordance with the Quality Management Regulations for Outpatient (Emergency) Diagnosis and Treatment Information Pages (Trial), reference to the framework of the World Health Organization Family of International Classifications (WHO-FICs), the data framework and content of rehabilitation outpatient medical records were determined, and the data standards were discussed. ResultsThis study constructed a data framework for rehabilitation outpatient medical records, including four main components: patient basic information, visit process information, diagnosis and treatment information, and cost information. Three major reference classifications of WHO-FICs, International Classification of Diseases, International Classification of Functioning, Disability and Health, and International Classification of Health Interventions,were used to establish diagnostic standards and standardized terminology, as well as coding disease diagnosis, functional description, functional assessment, and rehabilitation interventions, to improve the quality of data reporting, and level of quality control in rehabilitation. ConclusionThe structuring and standardization of rehabilitation outpatient medical records are the foundation for sharing of rehabilitation data. The using of the three major classifications of WHO-FICs is valuable for the terminology and coding of disease diagnosis, functional description and assessment, and intervention in rehabilitation outpatient medical records, which is significant for sharing and interconnectivity of rehabilitation outpatient data, as well as for optimizing the quality and safety of rehabilitation medical services.

ObjectiveTo explore the standardization of inpatient rehabilitation medical record summary sheet, encompassing its structure, content and data standards, to enhance the standardization level of inpatient rehabilitation medical record summary sheet, improve data reporting quality, and provide accurate data support for medical insurance payment, hospital performance evaluation, and rehabilitation discipline evaluation. MethodsBased on the relevant specifications of the National Health Commission's Basic Norms for Medical Record Writing, Specifications for Sharing Documents of Electronic Medical Records, and Quality Management and Control Indicators for Inpatient Medical Record Summary Sheet (2016 Edition), this study analyzed the structure and content of the inpatient rehabilitation medical record summary sheet. The study systematically applied the three major reference classifications of the World Health Organization Family of International Classifications, International Classification of Diseases (ICD-10/ICD-11, ICD-9-CM-3), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Interventions (ICHI Beta-3), for disease diagnosis, functional description and assessment, and rehabilitation intervention, forming a standardized terminology system and coding methods. ResultsThe inpatient rehabilitation medical record summary sheet covered four major sections: inpatient information, hospitalization information, diagnosis and treatment information, and cost information. ICD-10/ICD-11 were the standards and coding tools for admission and discharge diagnoses in the inpatient rehabilitation medical record summary sheet. The three functional assessment tools recommended by ICD-11, the 36-item version of World Health Organization Disability Assessment Schedule 2.0, Brief Model Disability Survey and Generic Functioning domains, as well as ICF, were used for rehabilitation functioning assessment and the coding of outcomes. ICHI Beta-3 and ICD-9-CM-3 were used for coding surgical procedures and operations in the medical record summary sheet, and also for coding rehabilitation intervention items. ConclusionThe inpatient rehabilitation medical record summary sheet is a summary of the relevant content of the rehabilitation medical record and a tool for reporting inpatient rehabilitation data. It needs to be refined and optimized according to the characteristics of rehabilitation, with necessary data supplemented. The application of ICD-11/ICD-10, ICF and ICHI Beta-3/ICD-9-CM-3 classification standards would comprehensively promote the accuracy of inpatient diagnosis of diseases and functions. Based on ICD-11 and ICF, relevant functional assessment result data would be added, and ICHI Beta-3/ICD-9-CM-3 should be used to code rehabilitation interventions. Improving the quality of rehabilitation medical records and inpatient rehabilitation medical record summary sheet is an important part of rehabilitation quality control, and also lays an evidence-based data foundation for the analysis and application of inpatient rehabilitation medical record summary sheet.