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.

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.

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.

This study aimed to evaluate the efficacy and safety of combining albumin-bound paclitaxel (abpaclitaxel) and anlotinib for ovarian cancer. In this study, 44 patients diagnosed with platinum-resistant ovarian cancer were enrolled. Patients received ab-paclitaxel along with anlotinib until disease progression or intolerable toxicity. Efficacy was assessed according to RECIST 1.1 criteria or Rustin's criteria. The primary endpoint was the investigator-evaluated objective response rate (ORR). 44 patients were enrolled between January 2021 and March 2023 with a median age of 49 years. Twenty-nine had measurable lesions and 15 had non-measurable lesions. Overall, the investigator-evaluated ORR was 56.8% (25/44; 95% CI 0.411-0.713) in intention-to-treat population and 58.1% (25/43; 95% CI 0.422-0.726) in per-protocol population. The median progression-free survival was 9.8 months, and the median duration of response was 7.4 months. For safety, grade 3/4 adverse events (AEs) included leukopenia, gum pain, hypertension, and hand-foot syndrome. The response rates were 55.0% (11/20) in patients with previous use of antiangiogenic reagents and who had previous use of PARP inhibitors. The combination of ab-paclitaxel and anlotinib showed promising anti-tumor activity and a manageable safety profile in platinum-resistant ovarian cancer. Patients with previous use of antiangiogenic drugs or PARP inhibitors still benefited from this protocol.
Humans ; Female ; Middle Aged ; Indoles/therapeutic use* ; Quinolines/therapeutic use* ; Carcinoma, Ovarian Epithelial/drug therapy* ; Adult ; Ovarian Neoplasms/drug therapy* ; Prospective Studies ; Antineoplastic Combined Chemotherapy Protocols/administration & dosage* ; Aged ; Drug Resistance, Neoplasm ; Albumin-Bound Paclitaxel/therapeutic use* ; Neoplasm Recurrence, Local/drug therapy* ; Progression-Free Survival ; Paclitaxel/administration & dosage* ; Treatment Outcome

Objective:To investigate the risk factors for lower extremity deep vein thrombosis (DVT) in patients with bone trauma and their diagnostic efficacy.Methods:A retrospective cohort study was conducted to analyze the clinical data of 108 patients with bone trauma who were admitted to Affiliated Changzhou Second People′s Hospital of Nanjing Medical University from October 2023 to February 2024, including 61 males and 47 females, aged 17-96 years [(55.2±19.5)years]. Based on the results of color Doppler ultrasonography of lower extremities within 96 hours on admission, the patients were divided into DVT group ( n=58) and non-DVT group ( n=50). In DVT group, 42 patients developed lower extremity DVT within 7 days after trauma and the other 16 patients developed lower extremity DVT after 7 days. Basic clinical data including gender, age, body mass index (BMI), underlying diseases, cause of injury, site of fracture, surgery and admission Caprini score, and admission laboratory test indicators including routine coagulation indicators [prothrombin time (PT), international normalized ratio (INR), thrombin time (TT), activated partial thromboplastin time (APTT), fibrinogen (FBG) and D-dimer (D-D)] and four thrombosis indicators [plasma thrombin-antithrombin III complex (TAT), thrombomodulin (TM), tissue-type plasminogen activator-inhibitor 1 complex (tPAIC) and plasmin-alpha2-plasmin inhibitor complex (PIC)] were collected in the two groups. Univariate analysis and multivariate binary Logistic regression analysis were conducted to investigate the correlation between these indicators and incidence of lower extremity DVT in patients with bone trauma and determine the independent risk factors. Receiver operating characteristic (ROC) curve and area under the curve (AUC) of the relevant risk factors were analyzed to evaluate and compare the diagnostic efficacy of the factors for lower extremity DVT in patients with bone trauma and further assess the diagnostic efficacy of the factors for lower extremity DVT within 7 days after bone trauma. Results:Univariate analysis revealed significant correlations of gender, age, Caprini score, D-D, TAT, TM and PIC with incidence of lower extremity DVT in patients with bone trauma ( P<0.01). The results of multivariate binary Logistic regression analysis demonstrated that Caprini score ( OR=1.36, 95% CI 1.12, 1.65, P<0.01), TAT ( OR=1.05, 95% CI 1.00, 1.10, P<0.05), and TM ( OR=1.34, 95% CI 1.02, 1.77, P<0.05) were significantly correlated to incidence of lower extremity DVT in patients with bone trauma. ROC curve analysis indicated that TAT (AUC=0.76, 95% CI 0.67, 0.86) had the highest diagnostic efficiency, followed by TM (AUC=0.72, 95% CI 0.62, 0.81) and Caprini score (AUC=0.72, 95% CI 0.62, 0.82). The combined analysis of all the factors effectively enhanced the diagnostic efficiency for DVT (AUC=0.84, 95% CI 0.77, 0.92). Additionally, TAT (AUC=0.81, 95% CI 0.71, 0.91) demonstrated better diagnostic efficacy for lower extremity DVT within 7 days after bone trauma compared with the Caprini score (AUC=0.72, 95% CI 0.61, 0.83) and TM (AUC=0.71, 95% CI 0.60, 0.83). Similarly, the combined analysis of all the factors also effectively enhanced the overall diagnostic efficacy for lower extremity DVT within 7 days after bone trauma (AUC=0.85, 95% CI 0.77, 0.93). Conclusions:Caprini score, TAT and TM are identified as independent risk factors for lower extremity DVT in patients with bone trauma, and all the three factors demonstrate good diagnostic efficacy. Their combination is found to have statistically significant higher diagnostic efficiency than each individual factor. Furthermore, TAT is proved to be the best in diagnosing lower extremity DVT within 7 days after bone trauma, while the combined analysis of all the risk factors can further improve the diagnostic efficacy.

Humans ; Cardiovascular Diseases/chemically induced* ; East Asian People ; Risk Factors ; Heart Disease Risk Factors ; Lipids ; Anticholesteremic Agents/adverse effects* ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Treatment Outcome

Audiovisual integration is a vital information process involved in cognition and is closely correlated with aging and Alzheimer's disease (AD). In this review, we evaluated the altered audiovisual integrative behavioral symptoms in AD. We further analyzed the relationships between AD pathologies and audiovisual integration alterations bidirectionally and suggested the possible mechanisms of audiovisual integration alterations underlying AD, including the imbalance between energy demand and supply, activity-dependent degeneration, disrupted brain networks, and cognitive resource overloading. Then, based on the clinical characteristics including electrophysiological and imaging data related to audiovisual integration, we emphasized the value of audiovisual integration alterations as potential biomarkers for the early diagnosis and progression of AD. We also highlighted that treatments targeted audiovisual integration contributed to widespread pathological improvements in AD animal models and cognitive improvements in AD patients. Moreover, investigation into audiovisual integration alterations in AD also provided new insights and comprehension about sensory information processes.
Animals ; Humans ; Alzheimer Disease/pathology* ; Brain/pathology* ; Aging/physiology* ; Cognition

Objective:To compare the difference of chemical compositions of single decoction and mixed decoction of Gypsum Fibrosum - Anemarrhenae Rhizoma medicinal pair with different proportion.Methods:The Ultra Performance Liquid Chromatography (UPLC) and Ion Chromatography (IC) fingerprints of each sample were collected, and the independent sample t-test on the ratio of "peak area/weight" value of common peaks which was from the single decoction and mixed decoction samples was performed through SPSS 26.0.Results:In the UPLC fingerprint, there was significant difference in the "peak area/weight" values of peak 1, peak 2, peak 3, peak 6 and peak 13 between mixed decoction and single decoction with different compatibility ratios (1:1, 3:2, 2:1, 5:2, 3:1)( P<0.05), while peak 5 and peak 11 were without significant difference ( P>0.05). When the compatibility ratio of Gypsum Fibrosum and Anemarrhenae Rhizoma was 1:1, 3:2, 5:2, 3:1, there was significant difference in the "peak area/weight" values of peak 7 (neomangiferin) ( P<0.05). In the IC fingerprint, there was significant difference in the "peak area/weight" values of peak 1 between mixed decoction and single decoction with different compatibility ratios (1:1, 3:2, 2:1, 5:2, 3:1) ( P<0.05), while there was no significant difference in peak 5 (calcium ion) ( P>0.05). Conclusion:There are differences in the chemical component content of Gypsum Fibrosum-Anemarrhenae Rhizoma medicinal pair for single decoction and mixed decoction.

Objective:To investigate the characteristics of endoscopic ultrasonography for rectal neuroendocrine neoplasms (R-NENs) of different origin and its influence on the diagnosis and treatment.Methods:A retrospective cross-sectional study was conducted to analyze 56 cases of R-NENs diagnosed by miniprobe endoscopic ultrasonography (MEUS) and/or pathology in the Endoscopy Center of Beijing Chaoyang Hospital, Capital Medical University from January 2016 to July 2021. The endoscopic ultrasonography characteristics, pathological features, surgical selection and the follow-up of R-NENs originating from deep mucosa and submucosa were compared.Results:Among the 56 patients, 49 were diagnosed as R-NENs.The diagnostic sensitivity, positive predictive value and diagnostic accuracy of MEUS for R-NENs were 93.88% (46/49), 86.79% (46/53) and 82.14% (46/56), respectively. R-NENs were mainly manifested by medium hypoechoic with MEUS [95.92% (47/49)]. Three R-NENs originated from submucosa were missed diagnosis, with 1 case presenting hypoechoic and 2 cases presenting hyperechoic. There were no significant differences in the tumor diameter, echo intensity under endoscopic ultrasonography, echo uniformity and pathological grade composition between deep mucosal origin and submucosal origin R-NENS (all P>0.05), but there was significant differences in the distance from tumor to anus ( χ2=5.011, P=0.025). The proportion of the distance from tumor to anus ≤5 cm of submucosal origin lesions was significantly higher than that of deep mucosal origin [43.75% (14/32) VS 17.65% (3/17)]. Endoscopic submucosal dissection [67.5% (27/40)] and transanal endoscopic microsurgery [25.0% (10/40)] were the major treatment method, but there were no significant differences in endoscopic ultrasonography manifestations and pathological grading of R-NENs between these two surgical procedures. Conclusion:There is no significant difference in endoscopic ultrasonography manifestations and pathological grade of R-NENs between deep mucosal origin and submucosal origin, suggesting that the prognosis is similar between the two types. It is no significant influence of endoscopic ultrasonography manifestations of R-NENs at different levels of origin.

Condylar displacement can lead to temporomandibular joint (TMJ) symptoms and relapse after orthognathic surgery. To minimize condylar displacement, numerous condylar positioning techniques have been applied in clinical practice. To verify the effectiveness of condylar positioning techniques in preventing postoperative TMJ symptoms and relapse, we reviewed the literature related to all types of intraoperative condylar positioning techniques in the past 20 years. According to a literature review, positioning techniques aim to seat the condyles at a preoperative position during surgery and are divided into noncomputer-aided and computer-aided condyle positioning methods. At present, computer-aided design/computer-aided manufacturing condylar positioning devices (CAD/CAM CPDs) are the most superior positioning methods and are composed of teeth-supported and bone-supported guidance. The sequence of the remaining technology positioning effect from high to low is as follows: CAD/CAM titanium plate positioning > manual positioning > computer-aided navigation system > image positioning system. Different techniques reach considerable accuracy within 1-2 mm and 1°-2° in locating the preoperative condylar position and preventing TMJ symptoms or disorders and surgical relapse to provide a clinical reference for different levels of surgeons and cases. However, this study lacks randomized controlled trials with large samples and long-term follow-up. Future studies should upgrade the current methods, improve the clinical utility, and develop new positioning techniques.