1.Clinical Application of Harmonizing and Regulating Pivot Method in Pulmonary Fibrosis:Based on the Characteristics of Essence-Attribute-Function
Mingsheng LYU ; Hongsheng CUI ; Jia ZHU ; Weibo BI ; Ruifeng JIN ; Zhijie ZHANG ; Qiuyi CHEN ; Siyang YU
Journal of Traditional Chinese Medicine 2026;67(4):381-385
Based on the theory of "shaoyang(少阳) resembling the pivot" and collateral diseases, this article proposes that pulmonary fibrosis (PF) can be divided into three stages including wind bi (痹), constraint bi, and atrophy bi. The core pathogenesis of PF is the obstruction of the pivot and pulmonary collateral obstruction. In terms of treatment, the basic principles are to harmonize and regulate the pivot, and to promote the circulation of the lung collaterals. Depending on the different characteristics of the "essence-attribute-function", treatment methods such as harmonizing and regulating the pivot, resolving phlegm and removing stasis, supplementing deficiency and harmonizing collaterals are suggested. This approach ensures the regulation of the pivot, smooth circulation of qi and blood, unblocking of the lung collaterals and nourishing the lung body, achieving the goals of balancing the ascending and descending of qi, removing phlegm and stasis, and relieving cough and wheezing.
2.Structure, content and data standardization of rehabilitation medical records
Yaru YANG ; Zhuoying QIU ; Di CHEN ; Zhongyan WANG ; Meng ZHANG ; Shiyong WU ; Yaoguang ZHANG ; Xiaoxie LIU ; Yanyan YANG ; Bin ZENG ; Mouwang ZHOU ; Yuxiao XIE ; Guangxu XU ; Jiejiao ZHENG ; Mingsheng ZHANG ; Xiangming YE ; Jian YANG ; Na AN ; Yuanjun DONG ; Xiaojia XIN ; Xiangxia REN ; Ye LIU ; Yifan TIAN
Chinese Journal of Rehabilitation Theory and Practice 2025;31(1):21-32
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.
3.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.
4.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.
5.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.
6.Microwave imaging method based on deep convolutional autoencoder and its potential for medical application
Huangsen DENG ; Jie LIU ; Lian YAN ; Guangzheng ZHU ; Xu NING ; Mingxin QIN ; Mingsheng CHEN
Chinese Journal of Medical Physics 2025;42(2):184-189
A deep learning based microwave imaging model which can directly map the scattered electric field to the dielectric property distribution image of the target object is developed,and its potential for medical applications is explored.The two-dimensional time-domain finite difference method is used for numerical simulation to obtain a dataset of scattered electric fields;a deep convolutional autoencoder based imaging model is constructed to perform imaging studies on two types of target objects;the imaging results are quantitatively evaluated using relative error,and the model's ability to distinguish different types of strokes is also analyzed.The results show that the imaging network based on deep convolutional autoencoder exhibits excellent imaging performance when processing both numerical models.For simple objects,the model can accurately locate and preliminarily reconstruct the shape of the object,with an average relative error of 0.3012,while for the stroke models,it can effectively reconstruct the location and shape of the stroke area,and preliminarily reconstruct other brain tissues,with an average relative error of 0.077 8.The microwave imaging network based on deep convolutional autoencoder has great promise for fast and accurate image reconstruction,and the numerical example of stroke detection demonstrates its significant application potential in biomedical imaging.
7.The Construction Analysis on the Barriers and Optimization Strategies for Meaningful Use of Digital Technologies in Primary Care Facilities
Zhong LI ; Yong GAN ; Mingsheng CHEN ; Shan JIANG
Chinese Health Economics 2025;44(5):70-74
Objective:According to the"Technology-Organization-Environment"framework,it aims to analyze barriers of meaningful use of digital technologies in primary care facilities and propose corresponding optimization strategies.Methods:Nvivo 11.0 Software is used to conduct thematic framework analysis on interview data of primary healthcare and administrative staff in a district of Jiangsu Province.Results:The barriers are as follows:(1)technology level:infrastructure needs improvement,unified technology standards for data,low level of technology usability and usefulness,and limited economic benefits;(2)organizational level:insufficient digital literacy of medical staff,low organizational innovation ability,lack of training,inertia of healthcare staff,and limited size of primary care facilities;(3)environmental level:insufficient government support,high government requirements of performance evaluation,low digital literacy of residents,not covered by medical insurance schemes,constraints on interests among stakeholders,and mismatched digital scenarios.The main reason for insufficient effective use of digital technologies includes insufficient adaptability between digital technologies and the practical needs of grassroots health services,lack of organizational change and proactive personnel behavior,low level of external environment optimization and institutional support.Conclusion:Policy makers and implementers should be demand-oriented,continuously improve digital technologies maturity in primary healthcare system,integrate organizational resources,achieve changes in primary healthcare models,optimize the external environment,and enhance collaborative governance levels.
8.Effects of oral propranolol on heart rate and blood glucose in children with hemangiomas receiving hospital care
Huaxu HUANG ; Xuanfeng CHEN ; Beichen CAI ; Jiaqi YU ; Bogen XIE ; Jian CHEN ; Mingsheng WENG ; Zhixiong XU ; Ruilin LI ; Zheng LU ; Yongxin HUANG
Chinese Journal of Medical Aesthetics and Cosmetology 2025;31(2):120-125
Objective:To investigate the effects of oral propranolol on the heart rate and blood glucose levels in children with hemangiomas receiving hospital care.Methods:A total of 259 children [77 males and 182 females, aged (125.2±85.4) days, weighted (6.3±1.6) kg], who were treated with oral propranolol for the first time under hospital care from January 2013 to August 2021, were retrospectively analyzed. After fasting, the patients administered the same dose of propranolol once daily (0.5-2.5 mg/kg). Fasting blood glucose and heart rate were measured in all children before propranolol administration and after 2 h. Heart rate was measured at 1, 3 and 6 h after propranolol administration for three consecutive days. Adverse reactions were observed and recorded.Results:Within three days of oral propranolol administration, the heart rates at 1, 3 and 6 h after propranolol administration were lower than those before propranolol administration (all P<0.001). Within three days after taking propranolol and 2 h after taking propranolol daily, blood glucose levels reduced in all children (all P<0.001). During the hospitalization period, the incidence of adverse reactions was 5.4% (14/259), including lesion ulcers in four cases, upper respiratory tract infection with fever in four, reduced eating in two, nausea and vomiting in one, lethargy in one, sinus tachycardia in one, and hyperkalemia in one. No serious adverse reactions were life-threatening. Conclusion:After oral administration of propranolol, the heart rate and blood sugar of the children decrease to different degrees compared with those before propranolol administration.
9.Clinical Efficacy of Immediate Radical Surgery for Locally Advanced Prostate Cancer
Wei WANG ; Sheng LIU ; Hongqing ZHOU ; Mingsheng LIU ; Pingbo XIE ; Feng GUO ; Guanyu CHEN
Journal of Kunming Medical University 2025;46(1):43-50
Objective To explore the clinical efficacy and safety of immediate laparoscopic radical prostatectomy immediately following the diagnosis of locally advanced prostate cancer.Methods A retrospective analysis was performed for 63 patients with locally advanced prostate cancer who met the inclusion criteria diagnosed in The 1st People's Hospital of Qujing City,Yunnan Province from January 2018 to January 2023.All patients were diagnosed via ultrasound-guided transperineal prostate biopsy.The experimental group consisted of 37 patients who underwent immediate laparoscopic radical prostatectomy after pathological diagnosis,followed by postoperative adjuvant hormone therapy.The control group included 26 patients who first received 3 months of neoadjuvant hormone therapy before undergoing radical surgery,followed by adjuvant hormone therapy postoperatively.The two groups were compared in terms of surgical duration,intraoperative blood loss,length of hospital stay,duration of catheterization,positive surgical margin rate,rectal injury,positive lymph node rate,incidence of urinary fistula and lymphatic leakage,changes in PSA level,postoperative urinary control,biochemical recurrence and distant metastasis.Results In the control group,serum PSA levels,prostate volume,and clinical staging significantly decreased after neoadjuvant hormon therapy.The positive surgical margin rate in the experimental group was significantly higher than that in the control group,with a statistically significant difference(P<0.05).There were no statistically significant differences between the two groups in terms of surgical duration,intraoperative blood loss,length of hospital stay,duration of catheterization,rectal injury,positive lymph node rate,incidence of urinary fistula and lymphatic leakage(P>0.05).Follow-up at 18 to 36 months revealed no statistically significant differences between the two groups in terms of serum PSA levels at one month post-surgery,complete urinary control rate at six months post-surgery,and biochemical recurrence and distant metastasis at one and two years post-surgery(P>0.05).Conclusion Immediate laparoscopic radical prostatectomy following the diagnosis of locally advanced prostate cancer is a clinically safe and feasible treatment option.Noadjuvant hormone therapy reduces tumor staging,lowers the positive surgical margin rate,significantly decreases prostate volume,and provides greater operational space without increasing surgical risks.
10.Efficacy Analysis of Complete Pelvic Floor Peritoneal Reconstruction Technique in Orthotopic Neobladder Surgery after Total Cystectomy
Sheng LIU ; Fei YUAN ; Hongqing ZHOU ; Mingsheng LIU ; Donghuan ZOU ; Yu LI ; Guanyu CHEN ; Feng GUO
Journal of Kunming Medical University 2025;46(6):71-78
Objective To evaluate the efficacy of complete pelvic floor peritoneal reconstruction in reducing postoperative ileus incidence and accelerating recovery following laparoscopic radical cystectomy with orthotopic neobladder construction.Methods A retrospective study was conducted to select 62 patients who underwent the operation in Qujing Hospital Affiliated to Kunming Medical University from January 2017 to September 2024.According to whether complete pelvic floor peritoneal reconstruction was performed during the operation,they were divided into the conventional group(n=25)and the reconstruction group(n=37).Postoperative ileus rates and recovery parameters were compared to assess the clinical value of complete pelvic floor peritoneal reconstruction.Results The reconstruction group showed better postoperative recovery compared to the routine group:gastrointestinal function recovery time[3(2,4)d vs 4(3,5)d,P=0.032],abdominal drainage time[12(10,13.5)d vs 14(12,15)d,P=0.006],pelvic drainage time[12(9,13.5)d vs 14(11,16)d,P=0.015],postoperative hospital stay[18(15.5,26)d vs 25(17,30.5)d,P=0.016],and hospital expenses[(53,695.67±10,182.43)yuan vs(60,803.73±14,449.24)yuan,P=0.027].Postoperative nutritional markers,including total protein[(64.49±6.82)g/L vs.(61.56±4.03)g/L,P=0.038]and albumin[(36.08±5.29)g/L vs.(33.40±3.57)g/L,P=0.020],were higher in the reconstruction group.No significant difference was found in ileus incidence(44.00%vs.32.43%,P=0.355).Other parameters—baseline characteristics,postoperative globulin and prealbumin levels,gastric tube retention,stent/catheter removal time,and complications(anastomotic leakage,urinary fistula,wound infection)—showed no intergroup differences(P>0.05).Conclusion The application of complete pelvic floor peritoneal reconstruction technique in laparoscopic radical cystectomy with orthotonic neobladder provides better protection for the intestine,reduces surgical area adhesions,promotes gastrointestinal function recovery,shortens abdominal and pelvic drainage times,accelerates patient rehabilitation,reduces hospital stay and expenses.However,whether it can effectively reduce postoperative intestinal obstruction rates still requires more data and experimental verification.

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