Objective By analyzing the current status and challenges of electronic medical record(EMR)system construction in medical institutions in Shanghai,it proposes targeted optimization strategies to provide references for advancing hospital informatization centered on EMR systems.Methods A random sampling method was employed to survey 54 secondary and tertiary medical institutions in Shanghai that have implemented EMR systems.Key informant interviews were also conducted to examine the current status and major issues in EMR system development.Results The development of EMR systems in Shanghai's medical institutions has progressed steadily,with continuous improvements in smart hospital development.However,challenges such as incomplete functionalities,limited application scope,and substandard data quality persist.Conclusion Further optimization of EMR system construction should focus on quality control standards,platform development,training and promotion efforts,and independent development capabilities to enhance its role as a robust tool for improving healthcare quality and efficiency.

A 58-year-old female patient with anti-synthetase syndrome received compound sulfamethoxazole [containing trimethoprim (TMP) 80 mg and sulfamethoxazole (SMZ) 0.4 g, SMZ-TMP] 3 tablets thrice daily orally for the treatment of Pneumocystis jirovecii pneumonia. Before medication, the patient′s blood potassium was 3.3 mmol/L and blood chlorine was 116 mmol/L. Three days after SMZ-TMP treatment, the patient′s blood potassium was 5.7 mmol/L, blood chlorine was 114 mmol/L, blood pH was 7.3, urine pH was <5.5, blood chlorine was 114 mmol/L, and bicarbonate was 15 mmol/L. Hyperkalemia type renal tubular acidosis due to SMZ-TMP was considered. The dosage of SMZ-TMP was reduced to 2 tablets once daily orally. After 1 day of diuretic and potassium excretion treatments, the patient′s blood potassium levels returned to normal; after 2 days of the treatments, her blood chlorine was 109 mmol/L and bicarbonate was 17 mmol/L; after 3 days of the treatments, her chest CT showed emphysema in the neck and mediastinum. The dose of SMZ-TMP was changed to 3 tablets thrice daily orally, and at the same time intravenous infusion of ganciclovir 0.3 g twice daily was given. And again, her blood potassium increased and blood pH decreased. Sodium bicarbonate 1 g thrice daily orally was given to correct the acidosis. After adding SMZ-TMP for 2 days, SMZ-TMP dosage was reduced to 2 tablets once daily orally again. Seven days later, the patient′s vital signs were stable, her mediastinal emphysema was significantly improved, her blood potassium was 4.7 mmol/L, and blood pH was 7.4.

OBJECTIVE To explore the clinical effect of meropenem combined with cefotaxime sodium on treatment of interstitial pneumonia(IP)patients complicated with pulmonary infection and observe the influence on vascular endothelial growth factor(VEGF),Toll-like receptor 2(TLR2)and transforming growth factor β1(TGF-β1)so as to provide guidance for treatment of the IP patients complicated with pulmonary infection and assessment of curative effect.METHODS A total of 102 IP patients complicated with pulmonary infection who were treated in Guiyang Second People's Hospital from Feb,2022 to Feb,2024 were recruited as the research subjects and were randomly divided into the CTX group and the combination group,with 51 cases in each group.The CTX group was treated with cefotaxime sodium,and the combination group was given meropenem combined with cefotaxime sodium.The curative effect,lung function indexes,blood gas indexes,T lymphocyte subsets,peripheral blood VEGF,TLR2 and TGF-β1 were observed and compared between the two groups.RESULTS There was significant difference in the effective rate of treatment between the combination group and the CTX group(Z=7.229,P=0.007).The lung function of the combination group was better than that of the CTX group after the treatment for 7 days(P＜0.05);the levels of helper T cell type 1(Th1),Th1/Th2 and CD4+Foxp3+Treg of the combination group were higher than those of the CTX group(P＜0.05),while the Th2 level of the combination group was low-er than that of the CTX group(P＜0.05).The levels of VEGF,TLR2 mRNA and TGF-β1 of the combination group were respectively(32.14±8.77)pg/ml,(1.23±0.30)mRNA and(17.25±4.56)pg/ml,lower than those of the CTX group(P＜0.05).There were no significant differences in the drug-induced adverse reactions between the two groups of patients.CONCLUSIONS Meropenem combined with cefotaxime sodium can boost the curative effect on IP patients complicated with pulmonary infection,improve the lung function and blood gas indexes,reg-ulate the immune response,intensify the immune function,reduce the expression levels of VEGF,TLR2 mRNA and TGF-β1,and promote the rehabilitation of the patients.

OBJECTIVE To explore the clinical effect of meropenem combined with cefotaxime sodium on treatment of interstitial pneumonia(IP)patients complicated with pulmonary infection and observe the influence on vascular endothelial growth factor(VEGF),Toll-like receptor 2(TLR2)and transforming growth factor β1(TGF-β1)so as to provide guidance for treatment of the IP patients complicated with pulmonary infection and assessment of curative effect.METHODS A total of 102 IP patients complicated with pulmonary infection who were treated in Guiyang Second People's Hospital from Feb,2022 to Feb,2024 were recruited as the research subjects and were randomly divided into the CTX group and the combination group,with 51 cases in each group.The CTX group was treated with cefotaxime sodium,and the combination group was given meropenem combined with cefotaxime sodium.The curative effect,lung function indexes,blood gas indexes,T lymphocyte subsets,peripheral blood VEGF,TLR2 and TGF-β1 were observed and compared between the two groups.RESULTS There was significant difference in the effective rate of treatment between the combination group and the CTX group(Z=7.229,P=0.007).The lung function of the combination group was better than that of the CTX group after the treatment for 7 days(P＜0.05);the levels of helper T cell type 1(Th1),Th1/Th2 and CD4+Foxp3+Treg of the combination group were higher than those of the CTX group(P＜0.05),while the Th2 level of the combination group was low-er than that of the CTX group(P＜0.05).The levels of VEGF,TLR2 mRNA and TGF-β1 of the combination group were respectively(32.14±8.77)pg/ml,(1.23±0.30)mRNA and(17.25±4.56)pg/ml,lower than those of the CTX group(P＜0.05).There were no significant differences in the drug-induced adverse reactions between the two groups of patients.CONCLUSIONS Meropenem combined with cefotaxime sodium can boost the curative effect on IP patients complicated with pulmonary infection,improve the lung function and blood gas indexes,reg-ulate the immune response,intensify the immune function,reduce the expression levels of VEGF,TLR2 mRNA and TGF-β1,and promote the rehabilitation of the patients.

A 58-year-old female patient with anti-synthetase syndrome received compound sulfamethoxazole [containing trimethoprim (TMP) 80 mg and sulfamethoxazole (SMZ) 0.4 g, SMZ-TMP] 3 tablets thrice daily orally for the treatment of Pneumocystis jirovecii pneumonia. Before medication, the patient′s blood potassium was 3.3 mmol/L and blood chlorine was 116 mmol/L. Three days after SMZ-TMP treatment, the patient′s blood potassium was 5.7 mmol/L, blood chlorine was 114 mmol/L, blood pH was 7.3, urine pH was <5.5, blood chlorine was 114 mmol/L, and bicarbonate was 15 mmol/L. Hyperkalemia type renal tubular acidosis due to SMZ-TMP was considered. The dosage of SMZ-TMP was reduced to 2 tablets once daily orally. After 1 day of diuretic and potassium excretion treatments, the patient′s blood potassium levels returned to normal; after 2 days of the treatments, her blood chlorine was 109 mmol/L and bicarbonate was 17 mmol/L; after 3 days of the treatments, her chest CT showed emphysema in the neck and mediastinum. The dose of SMZ-TMP was changed to 3 tablets thrice daily orally, and at the same time intravenous infusion of ganciclovir 0.3 g twice daily was given. And again, her blood potassium increased and blood pH decreased. Sodium bicarbonate 1 g thrice daily orally was given to correct the acidosis. After adding SMZ-TMP for 2 days, SMZ-TMP dosage was reduced to 2 tablets once daily orally again. Seven days later, the patient′s vital signs were stable, her mediastinal emphysema was significantly improved, her blood potassium was 4.7 mmol/L, and blood pH was 7.4.

Objective By analyzing the current status and challenges of electronic medical record(EMR)system construction in medical institutions in Shanghai,it proposes targeted optimization strategies to provide references for advancing hospital informatization centered on EMR systems.Methods A random sampling method was employed to survey 54 secondary and tertiary medical institutions in Shanghai that have implemented EMR systems.Key informant interviews were also conducted to examine the current status and major issues in EMR system development.Results The development of EMR systems in Shanghai's medical institutions has progressed steadily,with continuous improvements in smart hospital development.However,challenges such as incomplete functionalities,limited application scope,and substandard data quality persist.Conclusion Further optimization of EMR system construction should focus on quality control standards,platform development,training and promotion efforts,and independent development capabilities to enhance its role as a robust tool for improving healthcare quality and efficiency.

Objective:To conduct a scoping review of research on the use of cosmetic care in breast cancer patients.Methods:Using Arksey and O'Malley's scoping review framework, PubMed, Web of Science, CINAHL, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, VIP and China Biology Medicine disc were searched for studies related to the application of cosmetic care in breast cancer patients. The search time limit was from the date construction to December 5th, 2023. The included literature were summarized and analyzed.Results:A total of 14 articles were included in this study. The intervention forms of cosmetic care were mainly education and training, group meetings, hands-on training, interviews, communication and sharing, lectures, and seminars; the content of the interventions included appearance knowledge training, image advice, make-up seminars, wig counseling and care, facial care, body care, face fixation, and prosthetic wear; and the endpoint indicators were mainly quality of life indicators, physiological indicators, psychological indicators, and social indicators.Conclusions:The content elements of the cosmetic care program were diversified, and the application of the program to breast cancer patients showed effectiveness in four aspects: quality of life, physiology, psychology, and society.

Objective:To analyze the changes of fasting plasma glucose(FPG)level before and after menopause.Methods:Kailuan health checkup cohort was used to extract data of women aged≥18 years who participated in the first physical examination of Kailuan physical examination cohort and had menopausal age at the end of the seventh physical examination. A total of 3 749 women with 22 057 physical examination records were included in the analysis. Natural logarithmic transformation was applied to FPG, and a segmented linear mixed-effects model was used to analyze the changes in ln-transformed FPG before and after menopause. Additionally, an interaction analysis was performed to assess the multiplicative effect of baseline age and baseline body mass index(BMI)on ln-transformed FPG concerning pre- and post-menopausal periods.Results:The average age of the first physical examination for women in this study was (45.63±4.52)years, the median menopausal age was 51(50~53)years, and the median number of physical examinations was 6(5~7)times. The results of the piecewise linear mixed effect model showed that lnFPG increased from 1 year before menopause, with an average annual increase of 0.021 mmol/L, and continued to increase from menopause to 5 years after menopause, with an average annual increase of 0.007 mmol/L. LnFPG tended to be stable after 5 years of menopause. Baseline age could affect the changes of lnFPG before and after menopause, and there was a negative multiplicative interaction between baseline age ≥45 years and the time period from 6 years to 1 year before menopause( P=0.032). Women with baseline age ≥45 years had a higher average annual increase in lnFPG from 1 year before menopause to 5 years after menopause than women with baseline age <45 years( P<0.05). On lnFPG, there was a positive multiplicative interaction between baseline BMI and time segments around menopause. Compared to women with BMI <24.0 kg/m 2, obese women displayed more annual increase in lnFPG from 6 years to 1 year before menopause as well as from menopause to 5 years after menopause( P<0.05). Conclusions:Menopause has an adverse impact on FPG, with the most significant changes occurring within the period of one year before menopause and up to five years after menopause. Age and BMI significantly influence the changes in FPG before and after menopause.

BACKGROUND: The presence of fibrosis is a criterion for subtype classification in the newly updated hypersensitivity pneumonitis (HP) guidelines. The present study aimed to summarize differences in clinical characteristics and prognosis of non-fibrotic hypersensitivity pneumonitis (NFHP) and fibrotic hypersensitivity pneumonitis (FHP) and explore factors associated with the presence of fibrosis. METHODS: In this prospective cohort study, patients diagnosed with HP through a multidisciplinary discussion were enrolled. Collected data included demographic and clinical characteristics, laboratory findings, and radiologic and histopathological features. Logistic regression analyses were performed to explore factors related to the presence of fibrosis. RESULTS: A total of 202 patients with HP were enrolled, including 87 (43.1%) NFHP patients and 115 (56.9%) FHP patients. Patients with FHP were older and more frequently presented with dyspnea, crackles, and digital clubbing than patients with NFHP. Serum levels of carcinoembryonic antigen, carbohydrate antigen 125, carbohydrate antigen 153, gastrin-releasing peptide precursor, squamous cell carcinoma antigen, and antigen cytokeratin 21-1, and count of bronchoalveolar lavage (BAL) eosinophils were higher in the FHP group than in the NFHP group. BAL lymphocytosis was present in both groups, but less pronounced in the FHP group. Multivariable regression analyses revealed that older age, <20% of lymphocyte in BAL, and ≥1.75% of eosinophil in BAL were risk factors for the development of FHP. Twelve patients developed adverse outcomes, with a median survival time of 12.5 months, all of whom had FHP. CONCLUSIONS Older age, <20% of lymphocyte in BAL, and ≥1.75% of eosinophil in BAL were risk factors associated with the development of FHP. Prognosis of patients with NFHP was better than that of patients with FHP. These results may provide insights into the mechanisms of fibrosis in HP.
Humans ; Bronchoalveolar Lavage Fluid ; Prospective Studies ; Alveolitis, Extrinsic Allergic/diagnosis* ; Fibrosis ; Carbohydrates

Objective:To analyze the relationship between early-life famine exposure and the risk of metabolic syndrome in Chinese population.Methods:Relevant literature on the relationship between early-life famine exposure and the risk of metabolic syndrome in the Chinese population was retrieved from databases such as CNKI, Wanfang, VIP, CBM, Web of Science, and PubMed. The search was conducted from the inception of the databases up to October 2022. Two researchers independently extracted and systematically evaluated the data from the literature, and meta-analysis was performed using Stata 16.0 software. Results:A total of 12 publications met the inclusion criteria, including 71 470 study subjects. Meta-analysis results showed that early-life famine exposure increased the risk of metabolic syndrome in the Chinese population( OR=1.28, 95% CI 1.16-1.40). Subgroup analysis showed that both fetal famine exposure( OR=1.25, 95% CI 1.03-1.52) and childhood famine exposure( OR=1.29, 95% CI 1.15-1.45) increased the risk of developing metabolic syndrome compared to the non-exposed group, and this significant association was only found in the female population. Conclusion:Early-life exposure to famine may increase the risk of developing metabolic syndrome in adulthood in the Chinese population, particularly among females.