1.Standardization of electronic medical records data in rehabilitation
Yifan TIAN ; Fang XUN ; Haiyan YE ; Ye LIU ; Yingxin ZHANG ; Yaru YANG ; Zhongyan WANG ; Meng ZHANG ; Xiaoxie LIU ; Yanyan YANG ; Bin ZENG ; Mouwang ZHOU ; Yuxiao XIE ; Guangxu XU ; Jiejiao ZHENG ; Mingsheng ZHANG ; Xiangming YE ; Fubiao HUANG ; Qiuchen HUANG ; Yiji WANG ; Di CHEN ; Zhuoying QIU
Chinese Journal of Rehabilitation Theory and Practice 2025;31(1):33-44
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.
2.Standardization of outpatient medical record in rehabilitation setting
Ye LIU ; Qing QIN ; Haiyan YE ; Yifan TIAN ; Yingxin ZHANG ; Yaru YANG ; Zhongyan WANG ; Meng ZHANG ; Xiaoxie LIU ; Yanyan YANG ; Bin ZENG ; Mouwang ZHOU ; Yuxiao XIE ; Guangxu XU ; Jiejiao ZHENG ; Mingsheng ZHANG ; Xiangming YE ; Fubiao HUANG ; Qiuchen HUANG ; Yiji WANG ; Di CHEN ; Zhuoying QIU
Chinese Journal of Rehabilitation Theory and Practice 2025;31(1):45-54
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.
3.Structure, content and data standardization of inpatient rehabilitation medical record summary sheet
Haiyan YE ; Qing QIN ; Ye LIU ; Yifan TIAN ; Yingxin ZHANG ; Yaru YANG ; Zhongyan WANG ; Meng ZHANG ; Xiaoxie LIU ; Yanyan YANG ; Bin ZENG ; Mouwang ZHOU ; Yuxiao XIE ; Guangxu XU ; Jiejiao ZHENG ; Mingsheng ZHANG ; Xiangming YE ; Fubiao HUANG ; Qiuchen HUANG ; Yiji WANG ; Di CHEN ; Zhuoying QIU
Chinese Journal of Rehabilitation Theory and Practice 2025;31(1):55-66
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.
4.Analysis of the current status and influencing factors of cognitive function and sleep quality of elderly people in Shanghai community
Yanli ZHANG ; Meng WANG ; Xuechun WANG ; Shanshan HUANG ; Jiaoqi REN ; Houguang ZHOU
Chinese Journal of Clinical Medicine 2025;32(1):58-64
Objective To analyze the cognitive function and sleep quality of the elderly in Shanghai community, and explore the related influencing factors. Methods A stratified cluster random sampling method was used to select 8 community health centers in Shanghai for a questionnaire survey, including 3 677 elderly individuals who completed the “Comprehensive Health Status Survey of Elderly Residents in Shanghai” from September 2023 to November 2023. Basic information of the elderly was collected, including age, gender, education level, smoking, drinking, mahjong playing behavior, and exercise habits. The Pittsburgh sleep quality index (PSQI) was used to assess the sleep quality of the elderly, subjective cognitive decline (SCD) self-assessment questionnaire and Mini-Mental State Examination (MMSE) were used to evaluate cognitive function, while the Hamilton Anxiety Scale (HAMA) and patient health questionnaire-9 (PHQ-9) were used to assess anxiety and depression levels, and the mini nutritional assessment (MNA) was used to evaluate nutritional status. According to the MMSE scores, the elderly were divided into three groups: no cognitive impairment (MMSE ≥ 27), mild cognitive impairment (MMSE 21-26), and moderate to severe cognitive impairment (MMSE ≤ 20). The general data, lifestyle habits, and scale scores of the three groups were compared. Ordered logistic regression was used to analyze the influencing factors of sleep quality. Results There were statistically significant differences in age, gender, waist circumference, body mass index (BMI), education level, pet ownership, smoking, drinking, mahjong playing behavior, exercise habits, and scale scores among the three groups (P<0.05). Logistic regression analysis showed that age, waist circumference, gender, drinking habits, mahjong playing behavior, and chronic comorbidities are influencing factors for the PSQI grading in the elderly (P<0.05). The MMSE score (OR=1.037, P=0.001), SCD score (OR=1.123, P<0.001), HAMA score (OR=1.183, P<0.001), PHQ-9 score (OR=1.249, P<0.001) are positive influencing factors for PSQI grading, while the MNA score is a negative influencing factor (OR=0.960, P=0.037). Conclusions Advanced age, female gender, low education level, no pet ownership, no mahjong playing behavior, no exercise habits, and poor sleep quality are risk factors for cognitive impairment in the elderly. Advanced age, female gender, no mahjong playing behavior and poor nutritional status are influencing factors for poor sleep quality in the elderly, and severe comorbidities, anxiety, depression, and subjective decline in cognitive function all affect sleep quality.
5.Research on Historical Evolution and Clinical Application of Shengyutang
Yuning CAO ; Wenpan LIU ; Tianyu MA ; Lanru CHEN ; Jiahao HUANG ; Yonghai MENG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(4):235-243
Shengyutang is a famous classical formula of tonic, which is made from Siwutang with Ginseng Radix et Rhizoma and Astragali Radix. It is included in the Catalogue of Ancient Famous Classical Formulas(The First Batch). Based on the Principles of Key Information Research of Ancient Famous Classical Formulas, this paper used bibliometrics to sort out and research the key information of Shengyutang in the aspects of history, composition, origin and processing, dosage, decocting method, efficacy and indications. After research, it has been found that this formula was first recorded in Lanshi Micang written by LI Dongyuan during the Jin dynasty, composed of Rehmanniae Radix, Rehmanniae Radix Praeparata, Chuanxiong Rhizoma, Ginseng Radix et Rhizoma, Astragali Radix and Angelicae Sinensis taproot. The name of the formula passed down through generations was relatively unified, with clear origins and veins. In later generations, this formula was the mainstream, and adjustments were made to the dosage and composition according to the indication. In the formula, Astragalus membranaceus var. mongholicus was selected as the origin of Astragali Radix, and the origins of other medicinal materials were consistent with the 2020 edition of Chinese Pharmacopoeia. Except for Rehmanniae Radix Praeparata, the other medicinal materials were made from raw products, and the dosage form was boiled powder. According to the measurement standard in the Jin dynasty, the recommended usage and dosage were 1.24 g of Rehmanniae Radix, Rehmanniae Radix Praeparata, Chuanxiong Rhizoma, Ginseng Radix et Rhizoma each, 2.07 g of Astragali Radix and Angelicae Sinensis taproot each, crushed into coarse particles that pass through the 4 mesh sieve but can't pass through the 10 mesh sieve, added 1 200 mL of water and boiled to 300 mL, and removed the residue. Shengyutang has the functions of tonifying Qi and blood, and blood intake, treating various sores, and restlessness and insomnia caused by excessive blood flow. In ancient times, this formula was widely used in the treatment of surgical sores, gynecological diseases, deficiency syndrome, etc. In modern clinical practice, it is mostly used to treat gynecological, neurological, musculoskeletal, hematological diseases caused by Qi and blood deficiency. In this paper, the key information of Shengyutang was researched by reviewing relevant ancient literature, in order to provide reference for the modern application and development of this formula.
6.Meta-analysis of association between atmospheric ozone exposure and atherosclerotic cardiovascular disease
Bingqian WANG ; Teng YANG ; Shuting XIE ; Meng TAN ; Guoxing LI ; Jing HUANG
Journal of Environmental and Occupational Medicine 2025;42(6):740-747
Background Atherosclerotic cardiovascular disease (ASCVD) is a major contributor to the global burden of cardiovascular diseases. However, evidence from meta-analyses on the association between ambient ozone exposure and ASCVD risk remains relatively insufficient. Objective To explore the epidemiological association between ambient ozone exposure and ASCVD, providing scientific evidence for ASCVD prevention and control from the perspective of environmental risk factor management. Methods We systematically searched PubMed, Web of Science, Embase, the Cochrane Library, CNKI, Wanfang Database, CBM, and VIP for published epidemiological studies on the relationship between ambient ozone exposure and ASCVD from January 2007 to December 2023. We performed quality assessment and data extraction of the included studies, and utilized meta-analysis to evaluate the effects of short-term and long-term ozone exposure on different ASCVD outcomes, including mortality and incidence of ischemic heart disease (IHD) and ischemic stroke (IS). Results A total of 24 studies were included based on a set of predetermined eligibility criteria. The meta-analysis results indicated that short-term ozone exposure was associated with an increased risk of ASCVD mortality and incidence. Specifically, short-term ozone exposure was significantly associated with an elevated risk of IHD mortality (combined RR=1.011, 95%CI: 1.008, 1.015; P < 0.05). Additionally, short-term ozone exposure was significantly linked to increased IS mortality (combined RR=1.005, 95%CI: 1.003, 1.008; P < 0.05) and incidence (combined RR=1.015, 95%CI: 1.003, 1.027; P < 0.05). Conclusion Short-term exposure to ambient ozone significantly elevates acute cardiovascular disease risk. However, the epidemiological association between long-term ozone exposure and ASCVD remains inconclusive. Future high-quality cohort studies with refined exposure assessment methods are warranted to elucidate the chronic cardiovascular effects of ozone exposure.
7.New advances in perioperative fluid management in lung transplantation
Meng SUI ; Murong HUANG ; Ranming MA ; Mochi WANG ; Chunxiao HU
Organ Transplantation 2025;16(4):648-652
Lung transplantation is an effective treatment for various end-stage lung diseases. Optimizing perioperative fluid management can reduce the incidence of postoperative pulmonary edema and improve the prognosis of lung transplant recipients. Excessive fluid administration may lead to pulmonary edema, ischemia-reperfusion injury of the transplant lung, and increased cardiac burden, which can induce heart failure. On the other hand, overly strict fluid restriction may lead to hypovolemia, affecting tissue perfusion and causing organ dysfunction. Therefore, precise regulation of fluid balance is crucial for the postoperative recovery of lung transplant recipients. This article reviews the physiological characteristics of lung transplant recipients, types of infused fluids, fluid therapy regimens, and hemodynamic monitoring, aiming to elucidate the particularities of perioperative fluid management in lung transplantation and provide new ideas and directions for individualized fluid management.
8.Guidelines on the Technical Plan for Emergency Health Response to Acute Gelsemium Poisoning
Jiaxin JIANG ; Ruibo MENG ; Zhongxiang GAO ; Rongzong LI ; Weifeng RONG ; Weihui LIANG ; Shibiao SU ; Jian HUANG ; Cheng JIN ; LlU XIAOYONG
China Occupational Medicine 2025;52(2):203-206
Acute Gelsemium poisoning is a systemic disease primarily affecting the central nervous system and respiratory symptoms caused by the ingestion of a substantial amount of Gelsemium within a short period. It manifests as sudden onset and rapid progression, primarily caused by accidental ingestion due to misidentification, and posing significant health risks. The compilation of the Technical Plan for Emergency Health Response to Acute Gelsemium Poisoning describes in detail the specialized practice and technical requirements in the process of handling acute Gelsemium poisoning, including accident investigation and management, laboratory testing and identification, in-hospital treatment, and health monitoring. The guidelines clarify key procedures and requirements such as personal protection, investigation elements, etiology determination, medical rescue, and health education. The key to acute Gelsemium poisoning investigation lies in promptly identifying the toxin through exposure history, clinical manifestations, and sample testing. Because there is no specific antidote for Gelsemium poisoning, immediate removal from exposure, rapid elimination of the toxin, and respiratory monitoring are critical on-site rescue measures. Visual identification of food or herbal materials, followed by laboratory testing to determine Gelsemium alkaloids in samples is a rapid effective screening method. These guidelines offer a scientific, objective, and practical framework to support effective emergency responses to acute Gelsemium poisoning incidences.
9.Mechanism of Shenqi guben formula in improving cancer-related fatigue by regulating IL-17 signaling pathway
Xin LI ; Chongkai FANG ; Yue HUANG ; Yaoxuan LI ; Haifu HUANG ; Xianlin WU ; Zhesheng CHEN ; Meng LI
China Pharmacy 2025;36(14):1722-1729
OBJECTIVE To explore the mechanism of Shenqi guben formula (SQGB) in improving cancer-related fatigue (CRF) based on network pharmacology and cellular experiments. METHODS Active components of SQGB and CRF-related targets were identified on the basis of databases such as the Traditional Chinese Medicine Systems Pharmacology platform. An in vitro CRF cell model was established by inducing A549 cells with interleukin-17 (IL-17). Cells were treated with low (1.0 mg/mL) or high (1.5 mg/mL) concentrations of SQGB. The effects on cell viability, migration, apoptosis, inflammatory factors, mRNA expression, apoptosis-related proteins and key proteins 011) of IL-17 signaling pathway were evaluated using scratch assay, flow cytometry, ELISA, real-time fluorescent quantitative PCR and Western blot analysis. RESULTS SQGB contained 84 active components acting on 209 potential CRF targets. Among E-these, quercetin, kaempferol, and luteolin were identified as the core components of the compound. Core targets included tumor protein p53, AKT serine/threonine kinase 1, IL-6, and tumor necrosis factor (TNF). IL-17, TNF and phosphatidylinositol-3- kinase-serine/threonine protein kinase (PI3K/Akt) signaling pathways were identified as crucial pathways. Compared with IL-17 intervention group, the cell migration rate, B-cell lymphoma 2 (Bcl-2) protein expression, the levels of IL-6 and TNF-α in the supernatant, mRNA expression of IL-17 receptor A (IL-17RA), TNF-α, and IL-6, as well as the protein expression of IL-17RA and nuclear factor kappa-B p65 subunit (p65), and phosphorylated (p)-p65/p65 ratio in IL-17+SQGB low- and high- quality concentration groups were all significantly decreased or down-regulation (P<0.05); the apoptosis rate, expression levels of Bcl-2 associated X protein (Bax) and cleaved caspase-3 protein, the ratio of Bax/Bcl-2, the expression level of p-p38 protein, and the p- p38/p38 ratio were all significantly increased or up-regulated (P<0.05). Moreover, the improvement effects of these indicators were mostly better in the high-quality concentration groups compared to the low-quality concentration groups (P<0.05). CONCLUSIONS SQGB ameliorates CRF by regulating the IL-17 signaling pathway, inhibiting the expression of inflammatory factors, and activating p38 MAPK-dependent apoptosis pathway.
10.Research progress on radiation protection of mobile CT
Yuehui HUANG ; Hanlin LIAO ; Kun MENG ; Duoshuang XIE
Chinese Journal of Radiological Health 2025;34(3):450-455
Mobile computed tomography (CT) can be used for critically ill patients’ bedside CT scans in an operating room or intensive care unit because of its flexibility and convenience compared to conventional CT. Meanwhile, attention has been paid to the ionizing radiation hazards brought by mobile CT scans due to a lack of wall shielding protection from a fixed machinery room, especially the control of radiation dose to the surrounding medical staff and the public. This article mainly discusses the radiation protection of mobile CT from aspects such as radiation protection principles, protection management, and protection of examinees, staff, and the public by summarizing relevant standards, guidelines, and literature in China and globally to provide a reference for the standardized use of mobile CT.

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