Data space, as an innovative data management and sharing model, is emerging in the medical and health sectors. This study expounds on the conceptual connotation of data space and delineates its key technologies, including distributed data storage, standardization and interoperability of data sharing, data security and privacy protection, data analysis and mining, and data space assessment. By analyzing the real-world cases of data spaces within medicine and health, this study compares the similarities and differences across various dimensions such as purpose, architecture, data interoperability, and privacy protection. Meanwhile, data spaces in these fields are challenged by the limited computing resources, the complexities of data integration, and the need for optimized algorithms. Additionally, legal and ethical issues such as unclear data ownership, undefined usage rights, risks associated with privacy protection need to be addressed. The study notes organizational and management difficulties, calling for enhancements in governance framework, data sharing mechanisms, and value assessment systems. In the future, technological innovation, sound regulations, and optimized management will help the development of the medical and health data space. These developments will enable the secure and efficient utilization of data, propelling the medical industry into an era characterized by precision, intelligence, and personalization.
Humans ; Computer Security ; Information Dissemination ; Data Management ; Information Storage and Retrieval ; Data Mining

BACKGROUND: The atherogenic index of plasma (AIP) has been shown to be positively correlated with cardiovascular disease in previous studies. However, it is unclear whether elderly people with long-term high AIP levels are more likely to develop coronary heart disease (CHD). Therefore, the aim of this study was to investigate the relationship between AIP trajectory and CHD incidence in elderly people. METHODS: 19,194 participants aged ≥ 60 years who had three AIP measurements between 2018 and 2020 were included in this study. AIP was defined as log₁₀ (triglyceride/high-density lipoprotein cholesterol). The group-based trajectory model was used to identify different trajectory patterns of AIP from 2018 to 2020. Cox proportional hazards models were used to estimate the hazard ratio (HR) with 95% CI of CHD events between different trajectory groups from 2020 to 2023. RESULTS: Three different trajectory patterns were identified through group-based trajectory model: the low-level group (n = 7410, mean AIP: -0.25 to -0.17), the medium-level group (n = 9981, mean AIP: 0.02-0.08), and the high-level group (n = 1803, mean AIP: 0.38-0.42). During a mean follow-up of 2.65 years, a total of 1391 participants developed CHD. After adjusting for potential confounders, compared with the participants in the low-level group, the HR with 95% CI of the medium-level group and the high-level group were estimated to be 1.24 (1.10-1.40) and 1.43 (1.19-1.73), respectively. These findings remained consistent in subgroup analyses and sensitivity analyses. CONCLUSIONS There was a significant correlation between persistent high AIP level and increased CHD risk in the elderly. This suggests that monitoring the long-term changes in AIP is helpful to identify individuals at high CHD risk in elderly people.

Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.

Background:Gastric cancer is a malignant tumor originating from the gastric mucosal epithelium.OLGA/OLGIM staging systems are scoring systems for gastric mucosal atrophy and intestinal metaplasia based on gastroscopic pathology.Serum pepsinogen(PG)and PG Ⅰ/PG Ⅱ ratio(PGR)can reflect the gastric mucosal function and status.Studying the relationship between PG and OLGA/OLGIM stages and the changing trends is of great value for early screening of gastric cancer.Aims:To explore the relationship between serum PG and OLGA/OLGIM stages,and its application value in screening of early gastric cancer.Methods:A total of 188 healthy individuals underwent gastroscopy from June 2021 to June 2023 at Shanghai Health and Medical Center were selected.The serum PG level was measured,and the status of Helicobacter pylori(Hp)infection was evaluated.OLGA/OLGIM stages were assessed according to the findings of gastroscopic pathology,and correlated with the serum PG level.After two years of follow-up,changes of PG and PGR in subjects with different baseline OLGA/OLGIM stages were analyzed.Results:There were significant differences in PG Ⅰand PGR among subjects with various baseline OLGA/OLGIM stages(P＜0.05).OLGA/OLGIM stages were correlated with Hp infection,family history of malignant gastrointestinal tumors and spicy diet(P＜0.05).The incidences of gastric mucosal atrophy in PG Ⅰ ≤70 μg/L group and PGR≤3.0 group were significantly higher than those in PG Ⅰ＞70 μg/L group and PGR＞3.0 group,respectively(P＜0.05).The follow-up results showed that for baseline OLGA/OLGIM stage 0,PG Ⅰ showed a decreasing trend over time,while no significant change of PG Ⅰ was found in other OLGA/OLGIM stages;PG Ⅱ showed a decreasing trend while PGR showed an increasing trend over time in all stages.But all these trends were not statistically significant(P＞0.05).Conclusions:The combined detection of PG and Hp infection has important value in evaluating the severity of chronic atrophic gastritis and the risk of gastric cancer.It can be applied as an early screening project for gastric cancer in individuals undergoing physical examination.

Objective: To evaluate the efficacy and safety of intravenous iron supplementation in patients with recurrent iron deficiency anemia (IDA) . Methods: This retrospective analysis of 90 patients with recurrent IDA from May 2012 to December 2021 was conducted, comparing the efficacy and safety of the intravenous iron therapy group and the oral iron therapy group. Results: Among the 90 patients with recurrent IDA, 20 were males and 70 were females, with a median age of 40 (range: 14-85) years. A total of 60 patients received intravenous iron supplementation and 30 received oral iron supplementation. The hematologic response rates in the intravenous iron group were significantly higher than those in the oral iron group at 4 and 8 weeks after treatment [80.0% (48/60) vs 3.3% (1/30) and 96.7% (58/60) vs 46.7% (14/30), all P<0.001, respectively]. The median increase in hemoglobin levels was also significantly higher in the intravenous iron group than in the oral iron group [38 (4, 66) g/L vs 7 (1, 22) g/L at week 4 and 44.5 (18, 80) g/L vs 19 (3, 53) g/L at week 8, all P<0.001]. The intravenous iron group had a significantly higher proportion of patients who achieved normal hemoglobin levels than the oral iron group (55.0% vs 0 and 90% vs 43.3%, all P<0.001, respectively). Iron metabolism indicators were tested before and after 8 weeks of treatment in 26 and 7 patients in the intravenous and oral iron groups, respectively. The median increase in serum ferritin (SF) levels in the intravenous iron group 8 weeks after treatment was 113.7 (49.7, 413.5) μg/L, and 54% (14/26) of these patients had SF levels of ≥100 μg/L, which was significantly higher than the median increase in SF levels in the oral iron group [14.0 (5.8, 84.2) μg/L, t=4.760, P<0.001] and the proportion of patients with SF levels of ≥100 μg/L (P=0.013). The incidence of adverse reactions was 3.3% (2/60) in the intravenous iron group, which was significantly lower than that in the oral iron group [20.0% (6/30), P=0.015]. Conclusion: Intravenous iron supplementation is more effective for hematologic response, faster hemoglobin increase, and higher iron storage replenishment rates compared with oral iron supplementation in patients with recurrent IDA, and it is well tolerated by patients.
Male ; Female ; Humans ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Anemia, Iron-Deficiency/epidemiology* ; Sucrose/therapeutic use* ; Ferric Compounds/therapeutic use* ; Retrospective Studies ; Iron/therapeutic use* ; Hemoglobins/therapeutic use*

OBJECTIVE: No consensus exists on the relative risk ( RR) of lung cancer (LC) attributable to active smoking in China. This study aimed to evaluate the unified RR of LC attributable to active smoking among the Chinese population. METHODS: A systematic literature search of seven databases was conducted to identify studies reporting active smoking among smokers versus nonsmokers in China. Primary articles on LC providing risk estimates with their 95% confidence intervals ( CIs) for "ever" "former" or "current" smokers from China were selected. Meta-analysis was used to estimate the pooled RR of active smoking. RESULTS: Forty-four unique studies were included. Compared with that of nonsmokers, the pooled RR (95% CI) for "ever" "former" and "current" smokers were 3.26 (2.79-3.82), 2.95 (1.71-5.08), and 5.16 (2.58-10.34) among men, 3.18 (2.78-3.63), 2.70 (2.08-3.51), and 4.27 (3.61-5.06) among women, and 2.71 (2.12-3.46), 2.66 (2.45-2.88), and 4.21 (3.25-5.45) in both sexes combined, respectively. CONCLUSION The RR of LC has remained relatively stable (range, 2-6) over the past four decades in China. Early quitting of smoking could reduce the RR to some extent; however, completely refraining from smoking is the best way to avoid its adverse effects.
Male ; Humans ; Female ; Smoking/epidemiology* ; Smoking Cessation ; Smokers ; Risk ; Lung Neoplasms/etiology* ; Risk Factors

OBJECTIVE: To analyze the association between exposure to second-hand smoke (SHS) and 23 diseases, categorized into four classifications, among the Chinese population. METHODS: We searched the literature up to June 30, 2021, and eligible studies were identified according to the PECOS format: Participants and Competitors (Chinese population), Exposure (SHS), Outcomes (Disease or Death), and Study design (Case-control or Cohort). RESULTS: In total, 53 studies were selected. The odds ratio (OR) for all types of cancer was 1.79 (1.56-2.05), and for individual cancers was 1.92 (1.42-2.59) for lung cancer, 1.57 (1.40-1.76) for breast cancer, 1.52 (1.12-2.05) for bladder cancer, and 1.37 (1.08-1.73) for liver cancer. The OR for circulatory system diseases was 1.92 (1.29-2.85), with a value of 2.29 (1.26-4.159) for stroke. The OR of respiratory system diseases was 1.76 (1.13-2.74), with a value of 1.82 (1.07-3.11) for childhood asthma. The original ORs were also shown for other diseases. Subgroup analyses were performed for lung and breast cancer. The ORs varied according to time period and were significant during exposure in the household; For lung cancer, the OR was significant in women. CONCLUSION The effect of SHS exposure in China was similar to that in Western countries, but its definition and characterization require further clarification. Studies on the association between SHS exposure and certain diseases with high incidence rates are insufficient.
Child ; Female ; Humans ; Asthma/epidemiology* ; Breast Neoplasms ; East Asian People ; Lung Neoplasms/etiology* ; Tobacco Smoke Pollution/adverse effects* ; China

To investigate two clusters of severe fever with thrombocytopenia syndrome virus (SFTSV) in Xinyang City, Henan Province, in 2022, and analyze their causes, transmission route, risk factors, and the characteristics of virus genetic variation. Case search and case investigation were carried out according to the case definition. Blood samples from cases, family members and neighbors and samples of biological vectors were collected for RT-PCR to detect SFTSV. The whole genome sequencing and bioinformatics analysis were performed on the collected positive samples. A total of two clustered outbreaks occurred, involving two initial cases and ten secondary cases, all of which were family recurrent cases. Among them, nine secondary cases had close contact with the blood of the initial case, and it was determined that close contact with blood was the main risk factor for the two clustered outbreaks. After genome sequencing analysis, we found that the SFTSV genotype in two cases was type A, which was closely related to previous endemic strains in Xinyang. The nucleotide sequence of the SFTSV in the case was highly homologous, with a total of nine amino acid mutation sites in the coding region. It was not ruled out that its mutation sites might have an impact on the outbreak of the epidemic.
Humans ; Severe Fever with Thrombocytopenia Syndrome/epidemiology* ; Bunyaviridae Infections/epidemiology* ; Thrombocytopenia/complications* ; Phlebovirus/genetics* ; Disease Outbreaks ; China/epidemiology*

To investigate two clusters of severe fever with thrombocytopenia syndrome virus (SFTSV) in Xinyang City, Henan Province, in 2022, and analyze their causes, transmission route, risk factors, and the characteristics of virus genetic variation. Case search and case investigation were carried out according to the case definition. Blood samples from cases, family members and neighbors and samples of biological vectors were collected for RT-PCR to detect SFTSV. The whole genome sequencing and bioinformatics analysis were performed on the collected positive samples. A total of two clustered outbreaks occurred, involving two initial cases and ten secondary cases, all of which were family recurrent cases. Among them, nine secondary cases had close contact with the blood of the initial case, and it was determined that close contact with blood was the main risk factor for the two clustered outbreaks. After genome sequencing analysis, we found that the SFTSV genotype in two cases was type A, which was closely related to previous endemic strains in Xinyang. The nucleotide sequence of the SFTSV in the case was highly homologous, with a total of nine amino acid mutation sites in the coding region. It was not ruled out that its mutation sites might have an impact on the outbreak of the epidemic.
Humans ; Severe Fever with Thrombocytopenia Syndrome/epidemiology* ; Bunyaviridae Infections/epidemiology* ; Thrombocytopenia/complications* ; Phlebovirus/genetics* ; Disease Outbreaks ; China/epidemiology*

Objective To explore the short-term and medium-term efficacy of modified loop plate suspension fixation in the treatment of acromioclavicular joint dislocation.Methods A retrospective analysis was performed in 72 patients with acromioclavicular joint dislocation and treated in Yangzhou Hospital of Traditional Chinese Medicine from December 2020 to December 2022.The patients were divided into modified group(n=37)and traditional group(n=35)according to different surgical methods.The modified group was treated with modified loop plate suspension fixation,and the traditional group was treated with clavicular hook plate fixation.The perioperative indexes,Constant-Murley score,and shoulder joint mobility and pain visual analogue scale(VAS)score before operation,3 months and 6 months after operation,postoperative complications rates,excellent and good rate of shoulder joint function recovery at 6 months after operation were compared between the two groups.Results The incision length and recovery time in the modified group were significantly shorter than those in the traditional group(P＜0.001),and the intraoperative blood loss was significantly less than that in the traditional group(P＜0.001).The Constant-Murley score,shoulder flexion and abduction activity in both groups at 3 months and 6 months after operation were significantly higher than before operation(P＜0.05),and these improvements were greater in the modified group(P＜0.05).The VAS scores of the two groups at 3 months and 6 months after operation were significantly lower than before operation(P＜0.05),and these decreases were greater in the improved group(P＜0.05).There were no significant differences in the excellent and good rate of shoulder joint function recovery and the incidence of postoperative complications between the two groups.Conclusions The modified titanium loop plate suspension fixation in the treatment of acromioclavicular joint dislocation can reduce surgical trauma and postoperative pain,and promote the recovery of shoulder joint function.