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.Interpretation of "Cancer statistics, 2025": A comparative study on cancer epidemiological characteristics and long-term trends between China and the United States
Ruifeng XU ; Hongrui WANG ; Yun CHE ; Na REN ; Guochao ZHANG ; Liang ZHAO
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(04):442-452
In 2025, the American Cancer Society published "Cancer statistics, 2025", which projected cancer data for the upcoming year based on incidence data collected by central cancer registries (through 2021) and mortality data obtained from the National Center for Health Statistics (through 2022). Similarly, the National Cancer Center of China released "Cancer incidence and mortality in China, 2022" in December 2024, analyzing data from 22 cancer registries across the country. This study provides a comparative analysis of cancer incidence and mortality trends in China and the United States during the same period, with a focus on sex- and age-specific distributions and long-term changes in cancer patterns. Long-term trends indicate that lung and liver cancer mortality rates in China have declined, primarily due to tobacco control measures and hepatitis B vaccination programs. However, the burden of gastric and esophageal cancers remains substantial. In the United States, mortality rates for colorectal and lung cancers have continued to decline, largely attributed to widespread screening programs and advances in immunotherapy. As economic growth and social development, China’s cancer profile is gradually shifting towards patterns observed in countries with high human development index. However, the prevention and control of upper gastrointestinal cancers remains a critical public health challenge that requires further attention.
3.Interpretation of the key points of Cancer Incidence and Mortality in China, 2016
Ruifeng XU ; Xin SUN ; Yu TIAN ; Na REN ; Qi XING ; Fanmao MENG ; Guochao ZHANG ; Liang ZHAO
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2024;31(03):343-356
In 2022, the National Cancer Center (NCC) of China reported the nationwide statistics of 2016 using population-based cancer registry data from all available cancer registries in China, which was mainly about the cancer incidence and mortality. Cancer remains a major health problem currently in our country and requires long term cooperation to deal with. This article provided a key point interpretation and analysis of cancer prevalence data in China, and provided an analysis of several main risk factors for cancer, which was conducive to the development of cancer prevention and control programs in different regions.
4.Research progress of bionic intramedullary nail of proximal femur based on "lever-fulcrum balance and reconstruction" theory in the treatment of senile intertrochanteric femoral fractures
Changjun HE ; Kun ZHANG ; Congming ZHANG ; Cheng REN ; Deyin LIU ; Yibo XU ; Na YANG ; Teng MA
International Journal of Surgery 2024;51(3):207-211
Femoral intertrochanteric fracture is one of the common types of fractures in the elderly. With the general improvement of medical and living standards, the number of elderly people is increasing, and the problem of osteoporosis has also become relatively prominent. Therefore, low violence can usually cause fractures in this area of the elderly, which has a significant negative impact on the quality of life of elderly patients. With the further development of medical technology and internal fixation materials, the emergence of proximal femoral nail antirotation(PFNA) has greatly improved the treatment effect of femoral intertrochanteric fractures in elderly patients. However, with the increasing number of patients treated, internal fixation failures have gradually been reported. In recent years, proximal femoral biomimetic intramedullary nail(PFBN) has been reported to have good clinical efficacy. Therefore, this article mainly elaborates on the theoretical basis, design characteristics, biomechanics, and clinical efficacy research of PFBN, providing more reference for the clinical treatment of femoral intertrochanteric fractures in elderly patients in the future.
5.Research progress of circulatory truncated B-type natriuretic peptides
Qiao WANG ; Peng XIAO ; Li′na FENG ; Jingyi REN
Chinese Journal of Laboratory Medicine 2024;47(3):323-331
The incidence and mortality rate of heart failure (HF) are increasing annually, resulting in a huge medical and economic burden worldwide. B-type natriuretic peptide (BNP) is the gold standard biomarker of HF recommended by national and international guidelines for the diagnosis and prognosis evaluation of HF. Recent studies suggest that BNP can be truncated in multiple forms by different enzymes rather than complete fragments in circulation, which can be contributing to the diagnosis and classification of HF. The immunoassay mostly used in clinics are unable to distinguish different truncated BNP forms due to cross-reactivity of antibody, while mass spectrometry is more accurate because it can easily distinguish through their mass-to-charge ratios. With the maturation of ambient ionization mass spectrometry and ion mobility mass spectrometry, it can help to simplify sample pre-treatment and improve the separation efficiency, in order to explore the clinical value of the heterogeneity of BNP truncated forms.
6.Integrated Detection Techniques for Forensic DNA and DNA Methylation Markers
Na YI ; Guang-Bin ZHAO ; Ke-Lai KANG ; Yi-Ren YAO ; Ke-Li GUO ; Jie ZHAO ; Chi ZHANG ; Lei MIAO ; Le WANG ; An-Quan JI
Progress in Biochemistry and Biophysics 2024;51(9):2156-2167
DNA genetic markers have always played important roles in individual identification, kinship analysis, ancestry inference and phenotype characterization in the field of forensic medicine. DNA methylation has unique advantages in biological age inference, body fluid identification and prediction of phenotypes. The majority of current studies independently examine DNA and DNA methylation markers using various workflows, and they use various analytical procedures to interpret the biological information these two markers present. Integrated methods detect DNA and DNA methylation markers simultaneously through a single experimental workflow using the same preparation of sample. Therefore, they can effectively reduce consumption of time and cost, streamline experimental procedures, and preserve valuable DNA samples taken from crime scenes. In this paper, the integrated detection approaches of DNA and DNA methylation markers on different detection platforms were reviewed. In order to convert methylation modifications to detectable forms, several options were available for pretreatment of genomic DNA, including digestion with methylation-sensitive restriction enzyme, affinity enrichment of methylated fragments, conversion of methylated or unmethylated cytosine. Multiplexed primers can be designed for DNA markers and converted DNA methylation markers for co-amplification. The schemes of using capillary electrophoresis platform for integrated detection add the pretreatment of genomic DNA on the basis of detecting DNA genetic markers. DNA and DNA methylation markers are then integrated by co-amplification. But the limited number of fluorescent options available and the length of amplicons restrict the type and quantity of markers that can be integrated into a panel. Pyrophosphate sequencing also supports integrated detection of DNA and DNA methylation markers. On this platform, due to the conversion of unmethylated cytosine to thymine after treatment with bisulfite, the methylation level of CpG site can be directly calculated using the peak height ratio of cytosine bases and thymine bases. Therefore, the methylation levels and SNP typing can be simultaneously obtained. However, due to the limited read length of sequencing, the detection of markers with longer amplicons is restricted. It is not conducive to fully interpret the complete information of the target sequence. Next-generation sequencing also supports integrated detection of DNA and DNA methylation markers. A preliminary experimental process including DNA extraction, pretreatment of genomic DNA, co-preparation of DNA and DNA methylation library and co-sequencing, has been formed based on the next-generation sequencing platform. It confirmed the feasibility of next-generation sequencing technology for integrated detection of DNA and DNA methylation markers. In field of biomedicine, various integrated detection schemes and corresponding data analysis approaches of DNA and DNA genetic markers developed based on the above detection process.Co-analysis can simultaneously obtain the genomic genetic and epigenetic information through a single analytic process. These schemes suggest that next-generation sequencing may be an effective method for achieving more accurate and highly integrated detection, helping to explore the potential for application in forensic biological samples. We finally explore the impact of interactions between sites and different pretreatment methods on the integrated detection of DNA and DNA methylation markers, and also propose the challenge of applying third-generation sequencing for integrated detection in forensic samples.
7.Correlation between surgery control preference and perceived social support of lung cancer patients
Fengyan MA ; Na REN ; Mengbai TIAN ; Yan LIU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2024;31(09):1288-1293
Objective To investigate the current status of control preference in the surgery of lung cancer patients and explore its correlation with perceived social support. Methods General information questionnaire, control preference scale, and perceived social support scale were used to investigate the lung cancer patients who underwent surgery in Beijing Cancer Hospital from February to May 2022. Results A total of 360 survey questionnaires were distributed, and 344 valid questionnaires were collected, with an effective rate of 95.6%. The expected participation style of patients was passive in 145 patients (42.2%), while the actual participation style was more inclined to be active in 154 (44.8%) patients. The compliance rate of patients’ expected and actual participation styles in the treatment control preference process was 61.9% (Kappa=0.437, P<0.001). The results of the analysis of influencing factors showed that the level of cultural education was an influencing factor in the actual participation of lung cancer patients in surgery control preference (P=0.029). The results of Spearman's correlation analysis showed that the actual participation of lung cancer patients in surgery control preference was positively associated with perceived social support (r=0.159, P<0.01), and its dimensions including family support (r=0.152, P<0.01), friend support (r=0.133, P<0.05), and other social support (r=0.142, P<0.01). Conclusion Patients’ expected control preference style is generally consistent with their actual control preference style, which is influenced by their cultural education and positively correlated with perceived social support. Medical and nursing staff should pay attention to the participation style of patients taking surgery decisions, develop decision aids according to different education levels, and develop individualized interventions from the perspective of improving social support initially, to improve patients’ treatment compliance and treatment care satisfaction.
8.Impact research of 2D-speckle tracking echocardiography with myocardial contrast echocardiography in evaluating myocardial microvascular lesions in type 2 diabetes mellitus
Na WEN ; Minjuan ZHENG ; Lu LIU ; Xingxing REN ; Jie ZHOU ; Yingcong XIAO
Chinese Journal of Diabetes 2024;32(3):187-191
Objective To evaluate myocardial microvascular lesions in patients with type 2 diabetes mellitus(T2DM)by 2D-speckle tracking echocardiography(2D-STE)and myocardial contrast echocar-diography(MCE).Methods A total of 45 T2DM patients admitted to the Endocrine Department of The First Affiliated Hospital of Air Force Military Medical University from August to November 2022 were enrolled in this study.All the patients were divided into two groups:simple T2DM group(n=22)and T2DM with microvascular complication group(MIC,n=23).In addition,24 healthy subjects were included as normal control(NC)group.2D-STE obtained the global longitudinal strain(GLS)and global circumferential strain(GCS);MCE obtained the average acoustic intensity(A),perfusion slope(b)of left ventricular segment,then myocardial blood flow(Aβ)was calculated and compared between groups.Results Compared with NC group,GLS,GCS,β and Aβ were lower in T2DM and MIC group(P<0.05).Among the parameters of 2D-STE and MCE,GLS and Aβ have high diagnostic performance(P<0.05)and GCS and β have medium diagnostic performance(P<0.05).ROC curve analysis showed that the early warning values of myocardial microcirculation disorders were-17.63%(GLS),-21.55%(GCS),0.845 s-1(β),7.045 dB/s(Aβ)in patients with T2DM.Conclusion The mechanical strain and perfusion of myocar-dium in T2DM patients have already decreased even no lesion was shown in the peripheral micro-vessels.2D-STE combined with MCE can assess the changes of myocardial elasticity and microcirculation in T2DM in real time,which is helpful for early clinical diagnosis of diabetes cardiomyopathy and intervention guidance.
9.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.
10.Spiradenocarcinoma, cylindrocarcinoma and spiradenocylindrocarcinoma: a clinicopathological study of seven cases
Jiaojie LYU ; Xu CAI ; Na LYU ; Yan ZHANG ; Xuebing JIANG ; Min REN ; Yunyi KONG
Chinese Journal of Pathology 2024;53(12):1224-1230
Objective:To investigate the clinicopathological characteristics of spiradenocarcinoma, cylindrocarcinoma, and spiradenocylindrocarcinoma, and to understand the correlations between their morphological patterns and clinical behaviors.Methods:Seven cases of spiradenocarcinoma, cylindrocarcinoma, and spiradenocylindrocarcinoma diagnosed at Fudan University Shanghai Cancer Center, Shanghai, China from 2015 to 2021 were collected. The clinicopathological characteristics and follow-up data were retrospectively analyzed. Histopathologic evaluation and immunohistochemical studies were carried out.Results:There were four men and three women in the cohort, with ages ranging from 46 to 75 years (mean, 61 years). The tumors were located on the head and neck (four cases), extremities (two cases), and trunk (one case). Histologically, the residuum of a benign neoplasm was present in all cases. One case presented salivary gland-type basal cell adenocarcinoma-like pattern, low-grade (BCAC-LG). Another case showed salivary gland-type basal cell adenocarcinoma-like pattern, high-grade (BCAC-HG). The remaining five cases were invasive adenocarcinoma, not otherwise specified (IAC-NOS). One of IAC-NOS contained a mucinous adenocarcinoma component. Immunohistochemically, BCAC-LG and BCAC-HG predominantly expressed basal cell markers such as p63 and p40, whereas IAC-NOS primarily exhibited positivity for CK7, a glandular epithelial marker. Follow-up was available for six patients, ranging from 1 to 9 years (mean, 4.5 years). Among the four patients of IAC-NOS with follow-up, three showed recurrences, two had regional lymph node metastases, and one died.Conclusions:The malignant components of spiradenocarcinomas, cylindrocarcinomas, and spiradenocylindrocarcinomas in this cohort contain BCAC-LG, BCAC-HG and IAC-NOS. This study also shows the presence of mucinous adenocarcinoma components in IAC-NOS. The tumors with IAC-NOS have a relatively poorer prognosis than those without.

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