1.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.
2.Effect of Longmu Piyan Prescription on Oxidative Stress in Atopic Dermatitis Mice
Mengxi MA ; Siqi WU ; Qingying WANG ; Yaqin LI ; Jinhe WANG ; Na LANG ; Jianxun REN
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(5):88-95
ObjectiveThis study observes the intervention effect of Longmu Piyan prescription on oxidative stress in BALB/c mice with atopic dermatitis (AD) induced by 2,4-dinitrochlorobenzene (DNCB) and explores its mechanism. MethodThe AD model was established using the method of DNCB sensitization on the back skin of BALB/c mice. Forty male BALB/c mice were randomly divided into a blank group, a model group, a vitamin C control group (0.5×10-3 mg·kg-1), and a Longmu Piyan prescription group (26 g·kg-1). Except for the blank group, other groups were sensitized with different concentrations of DNCB on the back to induce AD, and the blank group was treated with matrix coating. The gastric administration was started on the seventh day after sensitization with 2% DNCB and on the 24th day after sensitization with 0.2% DNCB continuously for 21 days. The changes in skin lesions of each group were directly observed after the experiment. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of interleukin (IL)-4, tumor necrosis factor (TNF)-α, immunoglobulin E (IgE), and reactive oxygen species (ROS) in the serum of each group. The total antioxidant capacity determination kit-trace method (ABTS method) was used to measure the level of total antioxidant capacity (TAOC) in serum. The Hematoxylin eosin (HE) staining method was used to observe the pathological and morphological changes of the skin lesion site. The immunohistochemical method was used to detect the expression of thymic stromal lymphopoietin (TSLP) in the skin lesion site. Western blot was used to detect the expression of filaggrin (FLG) in the dorsal skin lesions. ResultThe results showed that compared with the blank group, the skin lesion score of the model group mice was significantly increased (P<0.01), and HE staining showed characteristic pathological changes of AD in the skin lesion site. At the same time, the expression of TSLP in the skin lesion was significantly increased, and that of FLG was reduced (P<0.05). The levels of TNF-α, IL-4, IgE, and ROS in serum increased, while the activity of TAOC decreased (P<0.01). Compared with the model group, the Longmu Piyan prescription group showed a significant decrease in skin lesion scores and a significant improvement in skin lesion pathology. At the same time, the expression of TSLP decreased, and the expression of FLG increased in the skin lesions (P<0.05). In addition, compared with the model group, the serum levels of TNF-α, IL-4, IgE, and ROS also decreased to varying degrees (P<0.05,P<0.01), and TAOC activity increased in the Longmu Piyan prescription group (P<0.01). ConclusionThere is a significant correlation among the degree of oxidative stress, the severity of skin lesions in AD, and the levels of inflammatory cytokines. Longmu Piyandu prescription can improve AD-like skin lesions in BALB/c mice by promoting ROS clearance, enhancing TAOC, and inhibiting oxidative stress, thus protecting the skin barrier and reducing inflammation.
3.Relationship between college students'perceived stress and their suicidal ideation:multiple mediating effect of resilience and depression
Caizhi WU ; Na MA ; Tingting HUANG ; Afang LU ; Zhihong REN ; Fenghui YUAN
Journal of Xi'an Jiaotong University(Medical Sciences) 2024;45(3):371-375
Objective To explore the relationship between perceived stress and suicidal ideation as well as the mediating effect of resilience and depression.Methods A sample of 875 college students was recruited for the study to complete a set of self-report measures of Chinese Perceived Stress Scale(CPSS),the Resiliency Scale of University Students,Suicidal Ideation Questionnaire,and Beck Depression Inventory(BDI).Results ①College students'perceived stress and depression had significantly positive correlation with their suicidal ideation,while the students'resilience had a significantly negative correlation with their perceived stress and depression.②Perceived stress did not affect suicidal ideation of the college students directly,but indirectly affected their suicidal ideation through three significant mediating pathways:the separate mediating effects of(a)resilience and(b)depression,and the serial mediating effect of(c)resilience and depression.Conclusion Resilience and depression exert a chain mediating effect between perceived stress and suicidal ideation of college students.
4.Progress in epidemiological research on hepatitis E virus in wild ruminant animals
Tongbao SUN ; Chenyu WU ; Zhaowen REN ; Na LI ; Yani WANG ; Xiaohu WANG ; Qiuyue WANG
Chinese Journal of Veterinary Science 2024;44(10):2301-2308
Hepatitis E virus(HEV)is one of the most common pathogens in acute viral hepatitis.There are at least eight distinct genotypes of HEV.Only humans can contract HEV genotypes 1 and 2,but zoonotic viruses like genotypes 3 and 4 are mostly spread by eating undercooked or in-fected pork in some affluent nations.As a result,boars,both domestic and wild,are typically regar-ded as primary hosts of HEV.Nevertheless,during the past few years,a growing body of research has demonstrated that a number of other wild ruminant animals,such as wild deer and goats,are also susceptible to HEV infection.Determining their participation in the epidemiological cycle of hepatitis E thus requires an understanding of the risk variables that influence the transmission be-tween wild ruminants and humans.With an emphasis on published serological and molecular re-search,this review offers a broad summary of the body of knowledge currently available on the epi-demiology of HEV in wild ruminants.It addresses potential risk factors that could impact the spread of HEV among animals as well as their potential to serve as a source of infectious zoonotic illnesses.It presents an overview of the most recent developments in the epidemiology of HEV in wild ruminants and offers a framework for HEV prevention and management based on science.
5.Mechanism of Mongolian drug Naru-3 in initiation of neuroinflammation of neuropathic pain from MMP9/IL-1β signaling pathway.
Fang-Ting ZHOU ; Ying ZONG ; Yuan-Bin LI ; Ren-Li CAO ; Wu-Qiong HOU ; Li-Ting XU ; Fei YANG ; Yan-Li GU ; Xiao-Hui SU ; Qiu-Yan GUO ; Wei-Jie LI ; Hui XIONG ; Chao WANG ; Na LIN
China Journal of Chinese Materia Medica 2023;48(15):4173-4186
Neuropathic pain(NP) has similar phenotypes but different sequential neuroinflammatory mechanisms in the pathological process. It is of great significance to inhibit the initiation of neuroinflammation, which has become a new direction of NP treatment and drug development in recent years. Mongolian drug Naru-3 is clinically effective in the treatment of trigeminal neuralgia, sciatica, and other NPs in a short time, but its pharmacodynamic characteristics and mechanism of analgesia are still unclear. In this study, a spinal nerve ligation(SNL) model simulating clinical peripheral nerve injury was established and the efficacy and mechanism of Naru-3 in the treatment of NPs was discussed by means of behavioral detection, side effect evaluation, network analysis, and experimental verification. Pharmacodynamic results showed that Naru-3 increased the basic pain sensitivity threshold(mechanical hyperalgesia and thermal radiation hyperalgesia) in the initiation of SNL in animals and relieved spontaneous pain, however, there was no significant effect on the basic pain sensitivity threshold and motor coordination function of normal animals under physiological and pathological conditions. Meanwhile, the results of primary screening of target tissues showed that Naru-3 inhibited the second phase of injury-induced nociceptive response of formalin test in mice and reduced the expression of inflammatory factors in the spinal cord. Network analysis discovered that Naru-3 had synergy in the treatment of NP, and its mechanism was associated with core targets such as matrix metalloproteinase-9(MMP9) and interleukin-1β(IL-1β). The experiment further took the dorsal root ganglion(DRG) and the stage of patho-logical spinal cord as the research objects, focusing on the core targets of inducing microglial neuroinflammation. By means of Western blot, immunofluorescence, agonists, antagonists, behavior, etc., the mechanism of Naru-3 in exerting NP analgesia may be related to the negative regulation of the MMP9/IL-1β signaling pathway-mediated microglia p38/IL-1β inflammatory loop in the activation phase. The relevant research enriches the biological connotation of Naru-3 in the treatment of NP and provides references for clinical rational drug use.
Rats
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Mice
;
Animals
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Matrix Metalloproteinase 9/metabolism*
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Rats, Sprague-Dawley
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Neuroinflammatory Diseases
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Interleukin-1beta/metabolism*
;
Spinal Cord/metabolism*
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Signal Transduction
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Hyperalgesia/metabolism*
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Neuralgia/metabolism*
6.Research progress on role of traditional Chinese medicine in hepatic fibrosis based on miRNA-mediated activation of NLRP3 inflammasome.
Xin-Hua GUO ; Yang ZHENG ; Jia-Hui WANG ; Hong-Hong WANG ; Shu-Juan LUO ; Na HUANG ; Tie-Jian ZHAO ; Bo-Wen ZHENG ; Xin-Yun LIANG ; Ri-Zhou WU ; Qiu-Yi REN
China Journal of Chinese Materia Medica 2022;47(9):2409-2418
In recent years, liver fibrosis has become a hotspot in the field of liver diseases. MicroRNA(miRNA)-mediated Nod-like receptor pyrin domain containing 3(NLRP3) inflammasome activation is pivotal in the pathogenesis of liver fibrosis. The present study mainly discussed the role of miRNA-mediated NLRP3 inflammasome activation in the pathogenesis of liver fibrosis. Different miRNA molecules regulated liver fibrosis by mediating NLRP3 inflammasome activation, including miRNA-350-3 p(miR-350-3 p)/interleukin-6(IL-6)-mediated signal transducer and activator of transcription 3(STAT3)/c-myc signaling pathway, miR-148 a-induced autophagy and apoptosis of hepatic stellate cells via hedgehog signaling pathway, miR-155-mediated NLRP3 inflammasome by the negative feedback of the suppressor of cytokine signaling-1(SOCS-1), miR-181 a-mediated downstream NLRP3 inflammatory pathway activation through mitogen-activated protein kinase kinase(MEK)/extracellular signal-regulated kinase(ERK)/nuclear transcription factor κB(NF-κB) inflammatory pathway, miR-21-promoted expression of NF-κB and NLRP3 of RAW264.7 cells in mice by inhibiting tumor necrosis factor-α inducible protein 3(A20), and miR-20 b-promoted expression of IL-1β and IL-18 by activating NLRP3 signaling pathway. Additionally, the anti-liver fibrosis mechanism of different active components in Chinese medicines(such as Curcumae Rhizoma, Glycyrrhizae Radix et Rhizoma, Aurantii Fructus, Polygoni Cuspidati Rhizoma et Radix, Moutan Cortex, Paeoniae Radix Alba, Epimedii Folium, and Cinnamomi Cortex) was also explored based on the anti-liver fibrosis effect of miRNA-mediated NLRP3 inflammasome activation.
Animals
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Hedgehog Proteins
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Inflammasomes/metabolism*
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Interleukin-6
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Liver Cirrhosis/metabolism*
;
Medicine, Chinese Traditional
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Mice
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MicroRNAs/genetics*
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NF-kappa B/metabolism*
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NLR Family, Pyrin Domain-Containing 3 Protein/metabolism*
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Proto-Oncogene Proteins c-myc/metabolism*
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Signal Transduction
7.Effect of adjuvant growth hormone during luteal phase on in-vitro fertilization-embryo transfer outcome
Mixia OUYANG ; Ling YANG ; Huizhen TANG ; Xiaoli WU ; Na ZHOU ; Sha REN ; Hong YU
Journal of Chinese Physician 2022;24(5):672-675,681
Objective:To investigate the effect of growth hormone (GH) supplementation during luteal phase one cycle before ovulation induction in patients undergoing in vitro fertilization-embryo transfer (IVF-ET).Methods:IVF-ET pregnancy-assisted patients who underwent long-term Gonadotropin Releasing Hormone-agonist (GnRH-a) protocol from January 1, 2019 to June 30, 2020 were collected from the Reproductive Center of Hunan Provincial Maternal and Child Health Hospital. Among them, 106 patients (GH group) were added with GH during luteal phase one cycle before ovulation induction, and 212 patients (control group) were not added with GH. Ovulation induction and pregnancy outcome were compared between the two groups.Results:(1) There was no statistically significant difference in primary infertility/secondary infertility rate, infertility years, age, and transplant cancellation cycle rate between the two groups (all P>0.05). (2) There were no significant differences in the number of oocytes obtained, MII oocytes, two pronucleus (2PN) oocytes, high-quality embryos and average number of transplanted embryos between GH group and control group (all P>0.05). The total amount of Gn in control group and GH group was (2 109.75±555.75)IU and (1 863±610.52)IU, respectively, with statistically significant difference ( P<0.05). (3) The embryo implantation rate of the control group and GH group was 43.73%(129/295) and 60.42%(87/144), respectively, with statistically significant difference ( P<0.05). The clinical pregnancy rates of the control group and GH group were 58.79%(107/182) and 71.91%(64/89), the difference was statistically significant ( P<0.05). The spontaneous abortion rate of early pregnancy in control group (4.67%, 5/107) was slightly higher than that in GH group (3.12%, 2/64), but there was no significant statistical difference ( P>0.05). Conclusions:For patients with normal ovarian response, adding small dose of growth hormone during luteal stage one cycle before controlled hyperovulation can improve the embryo implantation rate and clinical pregnancy rate, and reduce the amount of Gn, which is beneficial to patients.
8.Effects of the improved cattle-tongue model in the training of senior midwives
Hong LIU ; Ping REN ; Yuehong LI ; Na WU
Chinese Journal of Modern Nursing 2022;28(3):408-410
Objective:To explore the effect of the improved cattle-tongue model in the training of senior midwives.Methods:From August 2018 to August 2019, convenience sampling was adopted to select 140 senior midwives from the east, west, and south hospitals of Shanghai First Maternity and Infant Hospital and other provinces and cities for training as the research object. Midwives were trained in theoretical knowledge and operation, and an improved cattle-tongue model was used for operation training. This study compared the midwife's theoretical and skill assessment results before and after the training and their satisfaction with the training.Results:After the training, the midwife's theoretical and skill assessment scores were higher than those before the training, and the differences were statistically significant ( P<0.01) . The 140 midwives were very satisfied with the training program. Conclusions:The application of the improved cattle-tongue model for training can improve the theoretical and operational skills of senior midwives, and is worthy of clinical application.
9.Survey on infection source of a cold-chain product associated COVID-19 epidemic caused by 2019-nCoV Delta variant in Beijing.
Shuang Sheng WU ; Zhen Yong REN ; Ying SUN ; Jiao Jiao ZHANG ; Hai ZHAO ; Xiang Feng DOU ; Chun Na MA ; Lei JIA ; Peng YANG ; Xinghuo PANG
Chinese Journal of Epidemiology 2022;43(8):1230-1236
Objective: To investigate the source and the transmission chain of a cold-chain product associated COVID-19 epidemic caused by 2019-nCoV Delta variant in Beijing. Methods: Epidemiological investigation were used to verify the exposure points of the cases. Close contacts were traced from the exposure points, and human and environmental samples were collected for nucleic acid tests. Positive samples were analyzed by gene sequencing. Results: A total of 112 cases of COVID-19 were reported in the epidemic from January 18 to February 6, 2022 in Beijing. Except for 1 case was uncertain, there were epidemiological links among 111 cases. The source of infection was the packages of imported cold-chain products from Southeast Asia, which were harvested and stored in a local cold-storage in January 2021, and packaged and sent to the cold-storage A in A district in June 2021, and then sold in batches in cold-storage B in B district from January 2022. The first case was infected in the handling of positive frozen products, and then 77 cases occurred due to working, eating and living together with the index case in the cold-storage B, cold-storage C and restaurant D. Besides the cold-storage B, C and the restaurant D, there were 16 sub-transmission chains, resulting in additional 35 cases. Conclusion: The epidemic indicated that the risk of 2019-nCoV infection from imported cold-chain products contaminated by package and highlighted the importance to strengthen the management of cold-chain industry in future.
Beijing/epidemiology*
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COVID-19/epidemiology*
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Epidemics
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Humans
;
SARS-CoV-2
10.Epidemiological characteristics of hepatitis B in Haidong Area of Qinghai Province in 2018 - 2020
Yan GAO ; Ting YE ; Guang-hong RONG ; Ren-na WU ; Yu-xia YANG
Journal of Public Health and Preventive Medicine 2022;33(5):87-90
Objective To study the characteristics of hepatitis B before and after hepatitis B vaccine was included in the immunization program in Haidong area, and to provide basis for the prevention and control strategy of hepatitis B. Methods The annual incidence of hepatitis B before (2000 -2002) and after (2018 -2020) hepatitis B vaccine was analyzed by descriptive epidemiological method from the hepatitis B cases reported by the notifiable infectious diseases reporting system and hepatitis B surveillance system in Haidong region. After the hepatitis B vaccine was included in the immunization program, the experimental group was used to analyze the characteristics of hepatitis B disease before and after the hepatitis B vaccine was included in the immunization program, including age, sex, region, occupation and season of onset. A certain number of people were randomly selected to compare the vaccination rate of hepatitis B vaccine before and after inclusion in the immunization program. Results The incidence of hepatitis B increased year by year before hepatitis B vaccine was included in the immunization program, but decreased year by year after hepatitis B vaccine was included in the immunization program, and the difference between the two groups was statistically significant (P<0.05). There was no significant difference between the two groups ( P>0.05). Before and after the introduction of hepatitis B vaccine into the immunization program, the incidence of hepatitis B mainly concentrated in 20 to 60 years old, 0 to 19 years old, the lowest incidence, there was no statistical significance between the two groups (P>0.05). The incidence of hepatitis B vaccine in males was higher than that in females before and after hepatitis B vaccine was included in the immunization program, and there was no statistical significance between the two groups (P>0.05). The incidence of hepatitis B in urban areas was higher than that in rural areas before hepatitis B vaccine was included in the immunization program, and the incidence of hepatitis B in rural areas was higher than that in urban areas after hepatitis B vaccine was included in the immunization program, with statistical significance (P<0.05). Before the introduction of hepatitis B vaccine into the immunization program, the incidence of hepatitis B mainly concentrated in farmers, the proportion of farmers increased from 50.99% to 53.31%, the proportion of students decreased from 5.38% to 2.56%, and the difference was statistically significant (P<0.05). After hepatitis B vaccine was included in the immunization program, the vaccination rate of hepatitis B vaccine increased from (93.61%) to (98.18%), and the difference between the two groups was statistically significant (P<0.05). Conclusion The hepatitis B vaccine in Haidong area has achieved remarkable effect and effectively controlled the incidence of hepatitis B.


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