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.

Objective To investigate the effect of Danhuangsan on high glucose-induced vascular endothelial cell injury based on PINK 1/Parkin signaling pathway,and to explore its specific mechanism.Methods Human um-bilical vein endothelial cells were cultured in vitro and randomly divided into control group,growth factor group,Danhuangsan group,high glucose group,high glucose+growth factor group,high glucose+Danhuangsan group,with 3 cases in each group,treated for 48 hours.Cell scratch test was used to detect cell migration rate,and Transwell test was used to detect cell invasion rate.Immunofluorescence was used to detect the expression of anti-apoptotic protein Bcl-2,Beclin-1 and pro-apoptotic protein Bax.Western blot was used to detect the protein expression levels of PINK 1,Parkin and LC 3-Ⅱ.Results Cell scratch test and Transwell test showed that under normal environment and high glucose treatment,Danhuangsan could reduce the cell migration and invasion rate(P＜0.05).Immunofluorescence assay showed that under normal environment and high glucose treatment,Danhuang-san up-regulated the expression levels of Bcl-2 and Beclin-1 protein in cells(P＜0.05).Western blot results showed that under normal environment and high glucose treatment,Danhuangsan increased the protein expression levels of PINK 1,Parkin and LC 3-Ⅱ in cells and down-regulated the expression levels of Bax protein(P＜0.05),and the effects of Danhuang powder were significantly better than those of blank serum and growth factor(P＜0.05).Conclusion Danhuangsan can alleviate high glucose-induced endothelial cell injury by activating PINK 1/Parkin pathway,and the mechanism may be related to promoting mitophagy and enhancing the repair of damage.

Antibody-drug conjugates (ADCs) are gradually revolutionizing clinical cancer therapy. The antibody-drug conjugate linker molecule determines both the efficacy and the adverse effects, and so has a major influence on the fate of ADCs. An ideal linker should be stable in the circulatory system and release the cytotoxic payload specifically in the tumor. However, existing linkers often release payloads nonspecifically and inevitably lead to off-target toxicity. This defect is becoming an increasingly important factor that restricts the development of ADCs. The pursuit of ADCs with optimal therapeutic windows has resulted in remarkable progress in the discovery and development of novel linkers. The present review summarizes the advance of the chemical trigger, linker‒antibody attachment and linker‒payload attachment over the last 5 years, and describes the ADMET properties of ADCs. This work also helps clarify future developmental directions for the linkers.

Thirty-six puerperas who underwent emergency cesarean section at Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 24, 2020 to February 9, 2020, who all wore medical surgical masks, were retrospectively included in this study.Anesthesia management was performed under tertiary medical protection measures.A dedicated anesthesia equipment was separately sterilized.Narcotic drugs were used for one patient only, and disposable medical supplies were used for anesthetic supplies.Contact transmission should be avoided when a neonate required resuscitation, and early isolation and nucleic acid testing were provided for the neonates.The rate of suspected cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was 11% , and the rate of clinically diagnosed cases was 17% before surgery.The rate of clinically diagnosed cases of SARS-CoV-2 was 22%, the rate of confirmed cases was 8%, and the total positive rate of diagnosis was 31% after surgery.The rate of neuraxial anesthesia was 86%, the rate of general anesthesia was 14%, the time of spinal puncture was (15±7) min, the time of tracheal intubation under general anesthesia was (2.1±1.3) min, the operation time was (95±36) min, and blood loss was (276±166) ml.The Apgar score of newborns was 8.8±0.5.There was 1 neonate whose mother was diagnosed as having coronavirus disease 2019 after operation, an oropharyngeal swab specimen was obtained at 36 h of birth, and the swab was tested positive for SARS-CoV-2 by nucleic acid testing.As of February 10, 2020, an anesthesiologist involved in the operation was diagnosed to have infection by SARS-CoV-2.In conclusion, diagnosis of coronavirus disease 2019 during pregnancy is more difficult, it is necessary to perform anesthesia management for cesarean section under tertiary medical protection.Although the difficulty in anesthesia operation is increased under tertiary medical protection, anesthesiologists can carry out standardized anesthesia management and guarantee the safety of maternal and infants and anesthesiologists themselves as long as they are rigorously trained and adhere to protective protocols.

Thirty-six puerperas who underwent emergency cesarean section at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 24, 2020 to February 9, 2020, who all wore medical surgical masks, were retrospectively included in this study. Anesthesia management was performed under tertiary medical protection measures. A dedicated anesthesia equipment was separately sterilized. Narcotic drugs were used for one patient only, and disposable medical supplies were used for anesthetic supplies. Contact transmission should be avoided when a neonate required resuscitation, and early isolation and nucleic acid testing were provided for the neonates. The rate of suspected cases of novel coronavirus (2019-nCoV) was 11% , and the rate of clinically diagnosed cases was 17% before surgery. The rate of clinically diagnosed cases of 2019-nCoV was 22%, the rate of confirmed cases was 8%, and the total positive rate of diagnosis was 31% after surgery. The rate of neuraxial anesthesia was 86%, the rate of general anesthesia was 14%, the time of spinal puncture was (15±7) min, the time of tracheal intubation under general anesthesia was (2.1±1.3) min, the operation time was (95±36) min, and blood loss was (276±166) ml. The Apgar score of newborns was 8.8 ± 0.5. There was 1 neonate whose mother was diagnosed as having 2019 novel coronavirous disease after operation, an oropharyngeal swab specimen was obtained at 36 h of birth, and the swab was tested positive for 2019-nCoV by nucleic acid testing. As of February 10, 2020, an anesthesiologist involved in the operation was diagnosed to have infection by 2019-nCoV. In conclusion, diagnosis of 2019 novel coronavirous disease during pregnancy is more difficult, it is necessary to perform anesthesia management for cesarean section under tertiary medical protection. Although the difficulty in anesthesia operation is increased under tertiary medical protection, anesthesiologists can carry out standardized anesthesia management and guarantee the safety of maternal and infants and anesthesiologists themselves as long as they are rigorously trained and adhere to protective protocols.

The standardized training for surgical residents is the systematic and normalized training for residents in the base with national authentication, whose goal is to promote the clinical experience and skill for treatment of the patients. The base construction is an important step to apply the resident training system according to the national policies and regulations . This study analyzed the experience of the Neurosurgical Unit of Xinqiao Hospital in standardized training for surgical residents according to the base construction requirements and evaluation index. Based on the analysis, the study proposed the concrete aims, measures and applying steps for neurosurgery base construction, especially the regulations for diagnosis and treatment of neurosurgical disease , which as a whole is beneficial for promoting the quality of the standardized training of residents in future.

Objective: To explore the clinical features, the serotype distribution and drug resistance of the isolates in patient with invasive pneumococcal disease (IPD). Methods: By retrieving the laboratory information system in 18 children′s hospitals from 2012 to 2017, the children with IPD were enrolled. Streptococcus pneumoniae (Spn) must be isolated from the sterile sites (blood, cerebrospinal fluid, hydrothorax and joint effusion etc.). The clinical characteristics, serotype, drug resistance, treatment and prognosis were reviewed and analyzed. According to the telephone follow up results, the patients were divided into death group and recovered group. The index as an independent risk factor of mortality was demonstrated by multivariate logistic regression analysis. Results: There were 1 138 children with IPD, including 684 male and 454 female. The proportion of male to female was 1.5∶1. The age ranged from one day to 16 years. The median age was 1 year 3 month. The majority was under 5 years of age (89.3%, n= 1 016), especially under 2 years of age (61.9%, n=704). In all cases, 88.2% (n=1 004) were community acquired infection. The infections included meningitis (n=446, 39.2%), pneumonia with bacteremia (n=339, 29.8%), and bacteremia without focus (n=232, 20.4%). Underlying diseases were found in 242 cases (21.3%). Co-infections were determined in 62 cases (5.4%) with mycoplasma, 27 cases (2.4%) with adenovirus and 34 cases with influenza virus (3.0%). The penicillin insensitivity (PNSP) rates in meningitis and non-meningitis isolates were 69.5% (276/397) and 35.9% (221/615), respectively. There were 81 strains serotyped, in which 93.8% (76/81) were covered by 13-valent protein-polysaccharide conjugate vaccine (PCV13). In the 965 patients who were followed up by phone call, 156 cases (16.2%) were confirmed dead. The independent risk factors for the death were under 2 years of age (OR=2.143, 95%CI 1.284-3.577, P=0.004), meningitis (OR=3.066, 95%CI 1.852-5.074, P<0.01), underlying disease (OR=4.801, 95%CI 2.953-7.804, P<0.01), septic shock(OR=3.542, 95%CI 1.829-6.859, P<0.01), disseminated intravascular coagulation (DIC) (OR=4.150, 95%CI 1.468-11.733, P=0.007), multiple organ failure (OR=12.693, 95%CI 6.623-24.325, P<0.01) and complications of central nervous system (OR=1.975, 95%CI 1.144-3.410, P=0.015). Conclusions Most children with IPD were under 5 years of age, having underlying diseases and acquired the infection in community. The independent risk factors for death were under two years old, meningitis, underlying diseases and multiple organ failure. The problem of drug resistance was severe. The universal immunization of PCV13 would be effective to prevent IPD in Chinese children.

Objective To improve the in vivo analgesic activity of acacetin and find leads for the development of new drugs, novel acacetin derivatives containing alkyl amide groups with different length of carbon chain were designed and synthesized according to the molecular structure of the active hit compound found in our previous work. Methods Using apigenin as the initial chemical ma-terial,the acacetin was synthesized through 3 steps,then the target compounds were prepared by conjugating hydroxy group of acace-tin at position 7 with bromoalkyl amides. The analgesic activity of the target compounds was evaluated by acetic acid writhing model of mice. Results and Conclusion Novel acacetin alkyl amide derivatives showed more potent analgesic activities than that of clinical medicine diclofenac,which could be used as leads for further development of new drugs.

Objective:To evaluate the clinical efficacy of paclitaxel combined with epirubicin neoadjuvant chemotherapy in the treatment of triple negative breast cancer and the effect on the Ki-67,p53,P-glycoprotein (P-gp) and glutathione transferase (GST-π).Methods:84 patients with triple-negative breast cancer admitted in our hospital from June 2010 to June 2012 were selected and divided into the observation group and the control group according to the order of admission.The control group was treated with epirubicin,and cyclophosphamide.The observation group was given paclitaxel neoadjuvant chemotherapy combined with epirubicin.The clinical efficacy,expressions of Ki-67,p53,P-gp and GST-π were compared between the two groups.Results:After treatment,the total remission rate of observation group was significantly higher than that of the control group [76.19％(32/42) vs 45.24％(19/42)] (P ＜0.05).Before chemotherapy,the positive expression rates of Ki-67,p53,P-gp and GST-π in the two groups showed no statistical difference(P＞0.05).After chemotherapy,the positive expression rates of Ki-67,p53,P-gp and GST-π in the observation group were significantly lower than those of the control group (P＜0.05),but the positive expression rates of Ki-67,p53,P-gp and GST-π in the control group had no significant difference compared with those before chemotherapy (P＞0.05).The positive expression rates of Ki-67,p53,P-gp and GST-π in the observation group were significantly lower than those of the control group (P ＜0.05).There was no significant difference in the incidence of adverse reaction rate between the observation group and the control group (P＞ 0.05).Conclusion:Paclitaxel combined with Epirubicin neoadjuvant chemotherapy could effectively reduce the expression of Ki-67,p53,P-gp and GST-π in triple-negative breast cancer with exact clinical efficacy.

Objective: To observe the intestinal viral shedding time in patients with hand, food and mouth disease (HFMD) induced by coxsackievirus A6 (CA6). Method: Throat swab specimens and stool specimens of HFMD children were collected from those admitted to Hangzhou Children′s Hospital between May and October 2015, while fluorescence quantitative PCR was used to detect the viral load.Eeighteen cases of HFMD children were followed up, who were confirmed as CA6 infection via laboratory tests.Stool specimen was collected every 4-7 days, and fluorescence PCR was used for virus nucleic acid detection until the stool viral nucleic acids of infected children turned to be negative.The intestinal virus shedding time of CA6-infected HFMD was compared with the intestinal virus shedding time of 65 children with enterovirus 71 (EV71) infection and 44 children with coxsackievirus A16 (CA16) infection of the previous studies (from May to September 2012). Result: The median stool viral load was 25×10⁵ copies/ml (55×10⁴ copies/mL, 9×10⁶ copies/ml) in CA6-infected children.The numbers of stool virus nucleic acid turning negative were 0 case, 4 cases, 9 cases, 3 cases and 2 cases in 18 children at 1st, 2nd, 3rd, 4th, 5th weeks. At 5th week, the stool virus nucleic acid of children in CA6 group all turned to be negative.The positive rates of stool virus nucleic acid in EV71 group and CA16 group at the 5th week, however, were 31% and 27% respectively.There were statistically significant differences in distribution of positive rate of stool virus nucleic acid between CA6 infected children with EV71 and CA16 infected children (χ²=13.894, 10.698, P<0.05). Conclusion The longest intestinal virus shedding time for CA6-infected HFMD children was 5 weeks, which is obviously shorter than that of EV71- infected children and CA16-infected children.