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.

A method for the pretreatment and qualitative detection of 26 trace cathinone new psychoactive substances in wastewater was established and applied in actual wastewater cases. The effluent samples were eluted on the Oasis PRiME HLB solid phase extraction column by ultra-pure water drenching and methanol solution, then dried with nitrogen at 40 ℃, and finally re-dissolved with 0.1% formic acid-acetonitrile solution (95∶5), and detected by liquid chromatography-tandem mass spectrometry, The effluent sample was determined by high-performance liquid chromatography-Tandem mass spectrometry (HPLC-MS/MS) using selected reaction monitoring (SRM) mode and separated on chromatographic column UPLC BEH C18(100 mm×2.1 mm, 1.7 μm） at 35 ℃ with a mobile phase consisting of acetonitrile-0.1% formic acid in aqueous solution gradient elution. After methodological validation, the lower quantification of 26 cathinone new psychoactive substances could reach 1.50−3.00 ng/L. Among these, 21 analytes fell within the concentration range of 1.50−375.0 ng/L, while 5 were detected in the range of 3.00−750.0 ng/L, the correlation coefficient was 0.99, within-and between-batch precision was less than 7.71% and 13.91%, respectively, and the extraction recoveries were higher than 92.64% . The method is simple, accurate, and sensitive, and can be used for cathinone detection and abuse monitoring.

To explore the role of the "Clinical Practice Guidelines" column and others in the Medical Joumnal of Peking Union Medical College Hospital (Med J PUMCH) in promoting diseiplinary development.

Objective : To investigate the correlation between the expression level of YTHDF1 in oral squamous cell carcinoma ( OSCC) and clinicopathologic features and its potential prognostic value． Methods : The expression of YTHDF1 in 132 OSCC tissues and 66 paracancerous tissues was detected by immunohistochemistry (IHC) ，and the expression of YTHDF1 protein in OSCC cell lines was detected by Western blot．The correlation between YTHDF1 and clinicopathological features was analyzed by chi-square test．Kaplan-Meier and Cox factors were used to analyze the factors affecting the survival time of the patients and draw the survival curves of the YTHDF1 gene to evaluate its potential clinical significance. Results : The expression of YTHDF1 in OSCC tissues was higher than that in para- cancerous tissues (P＜0. 001) ，and the expression of YTHDF1 protein increased in OSCC cell lines compared with normal oral epithelial keratinocytes (P ＜0. 001) ．The expression of YTHDF1 was correlated with the TNM stage and T stage of patients with OSCC (P＜0. 05) ，and the patients with high expression of YTHDF1 had a shorter sur- vival time compared with those with low expression (P ＜0. 001) ． Conclusion High expression of YTHDF1 may be associated with poor patient prognosis and YTHDF1 may be able to serve as a target for OSCC treatment.

Objective To study the effects of Ginkgo biloba extract(GBE)on the proliferation and apoptosis of human cerebral adventitia fibroblasts(HBVAFs)by regulating the phosphatidylinositol 3 kinase(PI3K)/protein kinase B(AKT)signaling pathway.Methods HBVAFs cells were divided into blank group(normal culture,no treatment),experimental-L,-M,-H groups(25,50 and 100 mg·L-1 GBE treatment for 24 h)and combined group(100 mg·L-1 GBE treatment and 2 nmol·L-1 insulin-like growth factor-1 treatment for 24 h).Cell proliferation was detected by thiazole blue assay,cell apoptosis was detected by flow cytometry,and the protein expressions of phosphorylated-PI3K(p-PI3K),PI3K、phosphorylated-AKT(p-AKT)and AKT were detected by Western blot.Results The cell survival rates of experimental-L,experimental-M,experimental-H,combined and blank groups were(66.78±8.21)％,(53.51±7.40)％,(42.33±6.01)％,(75.69±5.87)％and(96.77±12.80)％;the apoptosis rates were(24.83±2.47)％,(30.07±3.06)％,(37.02±4.66)％,(16.71±2.11)％and(8.99±0.19)％;p-PI3K/PI3K ratios were 0.75±0.07,0.62±0.06,0.43±0.04,0.72±0.05 and 0.90±0.09;p-AKT/AKT ratios were 0.70±0.07,0.60±0.06,0.38±0.03,0.69±0.06 and 0.90±0.09,respectively.The above indexes of the experimental-L,-M,-H groups were compared with the blank group,and the above indexes of the combined group were compared with the experimental-H group,the differences were statistically significant(all P＜0.05).Conclusion GBE can reduce the proliferation of HBVAFs,promote apoptosis,and its mechanism is related to the inhibition of PI3K/AKT signaling pathway.

Objective To evaluate the pharmacokinetics(PK)of tenofovir alafenamide Fumarate tablets(25 mg)in healthy Chinese subjects after single oral administration to provide a basis for bioequivalence evaluation.Methods Using a single-dose,randomized,open-lable,two-period,two-way crossover design under fasting condition,while three-way crossover design under fed condition,42 healthy subjects respectively for fasting and fed study were enrolled,and randomized into two groups to receive a single dose of test product(T)or reference product(R)25 mg.Plasma concentration of tenofovir alafenamide and tenofovir were determined by liquid chromatography-tandem mass spectrometry(LC-MS/MS)method.The pharmacokinetic parameters were calculated by WinNonlin software(8.1 version)using non-compartmental model,and bioequivalence evaluation was performed for the two preparations.Relevant safety evaluations were performed during the trial.Results The test product and the reference product under fasting study,the main PK parameters of tenofovir alafenamide were as follows:Cmax were(215.17±94.24)and(199.30±71.11)ng·mL-1;AUC0-t were(135.44±71.60)and(123.91±53.82)h·ng·mL-1;the main PK parameters of tenofovir were as follows:Cmax were(7.30±2.27)and(7.12±1.74)ng·mL-1,AUC0-t of tenofovir were(237.16±47.09)and(230.06±43.41)h·ng·mL-1,respectively.The test product and the reference product under fed study,the main PK parameters of tenofovir were as follows:Cmax were(197.69±82.19)and(197.10±110.54)ng·mL-1;AUC0-t were(197.69±82.19)and(197.10±110.54)h·ng·mL-1;the main PK parameters of tenofovir were as follows:CMax were(2.57±1.37)and(2.58±1.31)ng·mL-1;AUC0-t were(227.08±74.33)and(238.51±128.30)h·ng·mL-1,respectively.The 90％confidence interval for geometric mean ratio of Cmax,AUC0-tof T and R under fed condition were between 80.00％-125.00％,respectively.The incidence of adverse events in fasting and fed tests was 21.43％and 30.95％,respectively,and no serious adverse event was reported.Conclusion The test formulation and reference formulation of tenofovir alafenamide fumarate tablets were equivalent and was safe.

Cancer is one of the leading causes of morbidity and mortality worldwide. Due to population aging, lifestyle variation and other factors, the morbidity and mortality of cancer continue to rise in China, resulting in a serious public health problem threating people's health. In response to this increasingly serious problem, tremendous efforts have been made in China, including the development of a series of policies and measures for specific needs of cancer prevention and treatment. Currently, China's strategy to reduce the disease burden of cancer mainly focuses on primary and secondary prevention. This paper summarizes the current status of disease burden of cancer and the performance of three-grade cancer prevention in China.

Objective To investigate the clinical effect of apical microsurgery combined with guided bone regeneration(GBR)on refractory apical periodontitis and masticatory function.Methods A total of 82 patients with refractory apical periodontitis admitted to our hospital from June 2019 to September 2021 were selected as the study subjects,and they were divided into the control group and the com-bined group according to the random number table,with 41 cases in each group.The control group was treated with apical microsurgery,and the combined group was treated with apical microsurgery combined with GBR.The clinical efficacy,masticatory function and the levels of bone absorption markers[Wnt3a,osteoprotegerin(OPG),receptor activator of nuclear factor-κB ligand(RANKL)]of patients in the two groups were compared.Results The total effective rate of the combined group(100%)was higher than that of the control group(85.37%),the difference was statistically significant(P<0.05).The masticatory efficiency and bite force of patients in both groups increased gradually 3,6 and 12 months after operation(P<0.05),which were higher in the combined group compared with the control group(P<0.05).The tooth mobility of patients in both groups decreased gradually 3,6 and 12 months after operation,and the tooth mobility of patients 3 and 6 months after operation in the combined group were lower than those in the control group(P<0.05).The levels of Wnt3a and OPG of patients 1 week after operation in both groups increased,which were higher in the combined group compared with the control group(P<0.05).The RANKL level of gingival crevicular fluid of patients 1 week after operation in both groups decreased,and which was lower in the combined group compared with the control group(P<0.05).Conclusion The microapical surgery combined with GBR is effective for refractory apical periodontitis,which can effectively inhibit bone resorption,and improve masticatory function.

Objective To explore the factors associated with laryngeal cancer relapse after postoperative radiotherapy,discuss the relationship between radiotherapy dose under various surgical procedures and relapse,and analyze their effects on survival rate.Methods The clinical data of 134 patients with laryngeal cancer treated with postoperative radiotherapy in Shijiazhuang People's Hospital were retrospectively analyzed.The risk factors of postoperative relapse were analyzed with univariate analysis,followed by multivariate Logistic regression analysis.The relationships between radiotherapy doses under various surgical procedures and the relapse were discussed.Kaplan-meler method and Log rank test were used to analyze the 2-year survival rate of laryngeal cancer patients.Results Thirty out of the 134 patients relapsed after treatment,and there was no recurrence in the remaining 104 patients.Multivariate Logistic regression analysis identified clinical stage(Ⅲ-Ⅳ),T stage(T3-T4),N stage(N1-N3),radiotherapy dose(low-dose),thyroid cartilage invasion(yes)and surgical margin(positive)as independent risk factors for postoperative laryngeal cancer relapse(OR>1,P<0.05).The relapse rates of patients receiving high-dose radiotherapy after laser vocal cord mass resection/partial laryngectomy and total laryngectomy under self-retaining laryngoscope were lower than those of patients receiving low-dose radiotherapy,with a statistically significant difference in overall relapse rate(P<0.05).As of June 2023,the median follow-up time of 134 patients undergoing postoperative radiotherapy for laryngeal cancer was 14.23 months(1-24 months),and there were 8 deaths in low-dose group and 2 deaths in high-dose group.The estimated median survival times in low-and high-dose groups were 19.13 months and 22.13 months.The survival curves in two groups were different(Log rank P=0.20),with high-dose group outperforming low-dose group.Conclusion The overall therapeutic effect of surgery combined with postoperative radiotherapy for laryngeal cancer is favorable.However,clinical stage,T stage,N stage,low-dose radiotherapy,tumor invasion into thyroid cartilage,positive surgical margin,and>11 weeks from postoperation to radiotherapy completion were risk factors for disease relapse.In clinical practice,the radiotherapy dose should be appropriately increased based on the patient's condition to improve prognosis and extend survival duration.

Objective:To compare the predictive value of different cardiac ultrasound indexes in mechanical ventilation withdrawal / weaning outcome of intensive care unit (ICU) respiratory failure.Methods:Patients who received mechanical ventilation for >48 hours and were to be withdrawn due to respiratory failure in the Department of Critical Care Medicine, 921st Hospital of the People′s Liberation Army from October 2020 to March 2023 were continuously selected, and their general information, mechanical ventilation conditions, and relevant weaning inspection indicators were recorded. Left ventricular ejection fraction (LVEF), left ventricular outflow tract velocity time integral (LVOT-VTI), left heart Tei index (TI), ratio of early mitral valve diastolic peak blood flow velocity to early mitral ring diastolic peak motion velocity (E/e′) were measured by ultrasound. According to the weaning outcome, the receiver operating characteristic (ROC) curves of different cardiac ultrasound indexes were plotted to evaluate the predictive value of the withdrawal outcome.Results:A total of 83 patients were included, of which 62 were successfully withdrawn and 21 were unsuccessful. There were significant differences in mechanical ventilation time, rapid shallow breathing index (RSBI), LVEF, VTI, left cardiac TI and E/e′ between the successful group and the failed group (all P<0.05). Multivariate regression analysis suggested that mechanical ventilation time and E/e′ were independent factors affecting the outcome of patients with respiratory failure ( OR=0.603, 0.282, all P<0.05). The area under ROC curve of E/e′ predicting mechanical ventilation withdrawal/ weaning failure was 0.844(95% CI: 0.729-0.959), which was superior to the RSBI and other cardiac ultrasound indexes. Conclusions:Echocardiography has predictive value for the outcome of mechanical ventilation of respiratory failure, and E/e′, which reflects the diastolic function of the heart, is the most effective predictor, but it is not suitable for single index prediction.