1.Standardization of electronic medical records data in rehabilitation
Yifan TIAN ; Fang XUN ; Haiyan YE ; Ye LIU ; Yingxin ZHANG ; Yaru YANG ; Zhongyan WANG ; Meng ZHANG ; Xiaoxie LIU ; Yanyan YANG ; Bin ZENG ; Mouwang ZHOU ; Yuxiao XIE ; Guangxu XU ; Jiejiao ZHENG ; Mingsheng ZHANG ; Xiangming YE ; Fubiao HUANG ; Qiuchen HUANG ; Yiji WANG ; Di CHEN ; Zhuoying QIU
Chinese Journal of Rehabilitation Theory and Practice 2025;31(1):33-44
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.
2.Standardization of outpatient medical record in rehabilitation setting
Ye LIU ; Qing QIN ; Haiyan YE ; Yifan TIAN ; Yingxin ZHANG ; Yaru YANG ; Zhongyan WANG ; Meng ZHANG ; Xiaoxie LIU ; Yanyan YANG ; Bin ZENG ; Mouwang ZHOU ; Yuxiao XIE ; Guangxu XU ; Jiejiao ZHENG ; Mingsheng ZHANG ; Xiangming YE ; Fubiao HUANG ; Qiuchen HUANG ; Yiji WANG ; Di CHEN ; Zhuoying QIU
Chinese Journal of Rehabilitation Theory and Practice 2025;31(1):45-54
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.
3.Structure, content and data standardization of inpatient rehabilitation medical record summary sheet
Haiyan YE ; Qing QIN ; Ye LIU ; Yifan TIAN ; Yingxin ZHANG ; Yaru YANG ; Zhongyan WANG ; Meng ZHANG ; Xiaoxie LIU ; Yanyan YANG ; Bin ZENG ; Mouwang ZHOU ; Yuxiao XIE ; Guangxu XU ; Jiejiao ZHENG ; Mingsheng ZHANG ; Xiangming YE ; Fubiao HUANG ; Qiuchen HUANG ; Yiji WANG ; Di CHEN ; Zhuoying QIU
Chinese Journal of Rehabilitation Theory and Practice 2025;31(1):55-66
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.
4.Construction of a Diagnostic Model for Traditional Chinese Medicine Syndromes of Chronic Cough Based on the Voting Ensemble Machine Learning Algorithm
Yichen BAI ; Suyang QIN ; Chongyun ZHOU ; Liqing SHI ; Kun JI ; Chuchu ZHANG ; Panfei LI ; Tangming CUI ; Haiyan LI
Journal of Traditional Chinese Medicine 2025;66(11):1119-1127
ObjectiveTo explore the construction of a machine learning model for the diagnosis of traditional Chinese medicine (TCM) syndromes in chronic cough and the optimization of this model using the Voting ensemble algorithm. MethodsA retrospective analysis was conducted using clinical data from 921 patients with chronic cough treated at the Respiratory Department of Dongfang Hospital, Beijing University of Chinese Medicine. After standardized processing, 84 clinical features were extracted to determine TCM syndrome types. A specialized dataset for TCM syndrome diagnosis in chronic cough was formed by selecting syndrome types with more than 50 cases. The synthetic minority over-sampling technique (SMOTE) was employed to balance the dataset. Four base models, logistic regression (LR), decision tree (dt), multilayer perceptron (MLP), and Bagging, were constructed and integrated using a hard voting strategy to form a Voting ensemble model. Model performance was evaluated using accuracy, recall, precision, F1-score, receiver operating characteristic (ROC) curve, area under the curve (AUC), and confusion matrix. ResultsAmong the 921 cases, six syndrome types had over 50 cases each, phlegm-heat obstructing the lung (294 cases), wind pathogen latent in the lung (103 cases), cold-phlegm obstructing the lung (102 cases), damp-heat stagnating in the lung (64 cases), lung yang deficiency (54 cases), and phlegm-damp obstructing the lung (53 cases), yielding a total of 670 cases in the specialized dataset. High-frequency symptoms among these patients included cough, expectoration, odor-induced cough, throat itchiness, itch-induced cough, and cough triggered by cold wind. Among the four base models, the MLP model showed the best diagnostic performance (test accuracy: 0.9104; AUC: 0.9828). Compared with the base models, the Voting ensemble model achieved superior performance with an accuracy of 0.9289 on the training set and 0.9253 on the test set, showing a minimal overfitting gap of 0.0036. It also achieved the highest AUC (0.9836) in the test set, outperforming all base models. The model exhi-bited especially strong diagnostic performance for damp-heat stagnating in the lung (AUC: 0.9984) and wind pathogen latent in the lung (AUC: 0.9970). ConclusionThe Voting ensemble algorithm effectively integrates the strengths of multiple machine learning models, resulting in an optimized diagnostic model for TCM syndromes in chronic cough with high accuracy and enhanced generalization ability.
5.Mendelian Randomization Analysis of Correlation Between Interleukin and Risk of Gynecological Tumors
Xinying ZHOU ; Hu ZHANG ; Haiyan DAI
Cancer Research on Prevention and Treatment 2025;52(6):511-519
Objective To investigate the relationship between different interleukins (ILs) and gynecological tumors, including cervical cancer, endometrial cancer, and uterine leiomyoma using two-sample Mendelian randomization (MR) analysis. Methods IL and gynecological tumor data were obtained from European populations by using the IEU OpenGWAS open database. Two-sample MR analysis was applied, different interleukins were used as exposure factors, significant SNP in GWAS data were selected as instrumental variables, and the instrumental variables were independent of each other. The risk of three kinds of gynecological tumors was analyzed separately to explore the causal relationship between ILs predicted by genes and outcome indicators. The TwoSampleMR package in R language (4.3.1) software was used for statistical analysis. MR analysis was performed using inverse variance weighted, MR Egger regression, weighted median, simple mode, and weighted mode methods. Results IL-18 receptor 1 (P=0.039) and IL-24 (P=0.025) were negatively correlated with the risk of cervical cancer. IL-4 (P=0.040), IL-21 (P=0.026), and IL-37 (P=0.027) were positively correlated with the risk of endometrial cancer. IL-15 receptor subunit alpha (P=0.005) was negatively correlated with the risk of endometrial cancer. IL-17A (P=0.005) and IL-37 (P=0.018) were negatively correlated with the risk of uterine leiomyoma. IL-21 (P=0.035) was positively correlated with the risk of uterine leiomyoma. Conclusion Genetically predicted IL-4, IL-15Rα, IL-17A, IL-18R1, IL-21, IL-24, and IL-37 are causally associated with the risk of three gynecological tumors. Further exploration of the molecular mechanism of ILs in gynecological tumors may provide potential therapeutic targets for the treatment of gynecological tumors.
6.Herbal Textual Research on Olibanum in Famous Classical Formulas
Haiyan ZHOU ; Qingqing WANG ; Qi ZHANG ; Suping XIAO ; Meng CHEN ; Jianxin ZHOU ; Yeda ZHANG ; Danyang JIA ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(4):55-66
By consulting the ancient and moderm literature, this paper makes a textual research on the name, origin, quality evaluation, harvesting and processing of Olibanum, so as to provide a basis for the development of the famous classical formulas containing this medicinal material. According to the herbal textual research, the results showed that Olibanum was first described as a medicinal material by the name of Xunluxiang in Mingyi Bielu(《名医别录》), until Ruxiang had been used as the correct name since Bencao Shiyi(《本草拾遗》) in Tang dynasty. The main origin was Boswellia carterii from Burseraceae family. The mainly producing areas in ancient description were ancient India and Arabia, while the modern producing areas are Somalia, Ethiopia and the southern Arabian Peninsula. The medicinal part of Olibanum in ancient and modern times is the resin exuded from the bark, which has been mainly harvested in spring and summer. It is concluded that the better Olibanum has light yellow, granular, translucent, no impurities such as sand and bark, sticky powder and aromatic smell. There were many processing methods in ancient times, including cleansing(water flying, removing impurities), grinding(wine grinding, rush grinding), frying(stir-frying, rush frying, wine frying), degreasing, vinegar processing, decoction. In modern times, the main processing methods are simplified to cleansing, stir-frying and vinegar processing. Nowadays, the commonly used specifications include raw, fried and vinegar-processed products. Among the three specifications, raw products is the Olibanum after cleansing, fried products is a kind of Olibanum processed by frying method, vinegar-processed products is the processed products of pure frankincense mixed with vinegar. Based on the research results, it is recommended to select the resin exuded from the bark of B. carterii for the famous classical formulas such as Juanbitang containing Olibanum, processing method should be carried out in accordance with the processing requirements of the formulas, otherwise used the raw products if the formulas without clear processing requirements.
7.Role of NOD-like receptor protein 3 inflammasome in the development and progression of hepatocellular carcinoma
Xuehai YU ; Bendong CHEN ; Yimin LIU ; Yongxin MA ; Xusheng ZHANG ; Hongcai ZHOU ; Haiyan MA
Journal of Clinical Hepatology 2024;40(2):397-401
In recent years, NOD-like receptor protein 3 (NLRP3) inflammasome in tumors has become a research hotspot, especially in melanoma, colorectal cancer, lung cancer, and breast cancer, and more and more evidence has shown that inflammation plays a role in the development, progression, angiogenesis, and invasion of cancer. Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer, and there are still controversies over the role of NLRP3 inflammasome in the development and progression of HCC. Therefore, this article reviews the potential impact of NLRP3 inflammasome in the progression of HCC and its mechanism of action in anticancer therapy, and it is believed that NLRP3 inflammasome can be used as an effective therapeutic target for HCC patients.
8.Clinical Efficacy of Modified Yigongsan Combined with Multi-enzyme Tablets and Bifidobacterium Triple Live Powder in Treatment of Infantile Anorexia with Spleen-Stomach Qi Deficiency Syndrome
Haiyan WANG ; Xiaojing LYU ; Li ZHAO ; Yaqian ZHOU ; Jiaqi CUI ; Yao CUI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(11):150-155
ObjectiveTo observe the clinical efficacy of modified Yigongsan combined with multi-enzyme tablets and bifidobacterium triple live powder on infantile anorexia with spleen-stomach Qi deficiency syndrome. MethodA total of 112 infantile patients anorexia with spleen-stomach Qi deficiency syndrome treated at Hebei Provincial Hospital of Traditional Chinese Medicine from January 2022 to June 2023 were enrolled and divided into a control group and an observation group, with 56 cases in each group, according to a random number table. Children in the control group were treated with multi-enzyme tablets and Bifidobacterium triple live powder, while those in the observation group were treated with modified Yigongsan in addition to the treatment in the control group. During the study, one case dropped out in the control group and two cases dropped out in the observation group. The clinical efficacy of the two groups of children was compared, including changes in traditional Chinese medicine (TCM) syndrome scores (main symptoms, secondary symptoms, tongue, and pulse), time to restore normal food intake, and increase in body weight. Changes in calcium, iron, zinc levels, hemoglobin, and albumin levels before and after treatment, as well as changes in gastrointestinal hormones such as gastrin and motilin, vasoactive intestinal peptide, somatostatin, neuropeptide Y, orexin, and leptin, were observed. The occurrence of adverse reactions in the two groups of children during the study was also recorded. ResultThe total effective rate of children in the control group after treatment was 85.19% (46/54), while that in the observation group was 98.15% (53/54) (χ2 =5.939, P<0.05). Compared with the control group, the time for food intake to return to normal in the observation group was shorter, and the increase in body weight was greater (P<0.05). Compared with the results before treatment, the TCM syndrome scores (main symptoms, secondary symptoms, tongue, and pulse) in both groups of children significantly decreased, while the levels of calcium, iron, zinc, hemoglobin, albumin, gastrin, motilin, neuropeptide Y, and orexin increased, and the levels of vasoactive intestinal peptide, somatostatin, and leptin decreased (P< 0.01). Compared with the control group after treatment, the improvement in the above indicators in the observation group was more significant (P<0.01). The incidence of adverse reactions in the two groups of children during the treatment period was similar, and the difference was not statistically significant. ConclusionModified Yigongsan combined with multi-enzyme tablets and Bifidobacterium triple live powder is highly effective in treating infantile anorexia (spleen-stomach Qi deficiency syndrome). After treatment, symptoms of the children were improved,appetite and food intake increased, gastrointestinal function was improved, body weight increased, and adverse reactions were few, indicating that the treatment was safe and reliable.
9.Impact of the LAmbre device on left atrial appendage adjacent structures and left atrium
Zhengdan GE ; Dehong KONG ; Zhenyi GE ; Chunqiang HU ; Xiaochun ZHANG ; Haiyan CHEN ; Daxin ZHOU ; Xianhong SHU ; Cuizhen PAN
Chinese Journal of Ultrasonography 2024;33(2):142-150
Objective:To explore the effects of the LAmbre device and mitral annulus(MA), as well as left atrium(LA) in patients with non-valvular atrial fibrillation(NVAF) after left atrial appendage closure (LAAC) using real-time-three-dimensional transesophageal echocardiography (3D TEE).Methods:Fity-six consecutive patients who underwent LAAC with the LAmbre device in Zhongshan Hospital of Fudan University from June 2019 to March 2023 were retrospectively enrolled, with no or less than moderate mitral regurgitation (MR). All patients underwent pre-operative and follow-up two-and three-dimensional transesophageal echocardiography (2D TEE, 3D TEE) at 60 days after the operation. The quantitative parameters of MA and LA were obtained by offline analysis using QLab 13.0 (Philips Healthcare, Andover, MA). Importantly, mitral annular measurements were made at seven time points throughout the cardiac cycle: early diastole, mid-diastole, late diastole, mitral valve closure, early systole, mid-systole, and late systole, which facilitates constructing the dynamic model of MA to assess the annular morphology and dynamics.Results:The values of AP diameter (APD), AL-PM diameter (ALPMD), 3D annulus circumference (3DAC), 3D annulus area (3DAA) decreased significantly compared with pre-operative values at all time points of the cardiac cycle (all P<0.05), while non-planar angle (NPA) and AH/CD were not apparently changed (all P>0.05 ). Throughout the cardiac cycle, MA showed regular changes, gradually increased in systole with the saddle shape deepened, and gradually decreased in diastole with the saddle shape shallowed.During systole, there was an increase in the rate of change of AP in MA [pre-operative (3.01±2.64)%, post-operative (3.81±3.51)%, P=0.037] after LAAC, with no significant difference in the rate of change of ALPM, 3DAC, and 3DAA.Meanwhile, we observed an evident reduction in LA minimal volume (LAVmin) [pre-operative (78.36±25.16)ml, post-operative (70.73±22.78)ml, P=0.004] and an obvious increase in LA ejection function [pre-operative (22.88±10.09)%, post-operative (31.41±12.28)%, P<0.05] during follow-up. Conclusions:3D TEE can accurately assess the impact of LAAC on the MA and LA. The LAmbre device can affect the morphology of MA, as well as the structure and function of LA, while the change of the dynamics of MA is not so prominent.
10.Determination of chloride,sulfate and bicarbonate ions in Compound polyethylene glycol electrolyte powder (Ⅲ) by ion chromatography
Xianhua ZHANG ; Yuxin ZHAO ; Haiyan ZHOU ; Xiaolu ZHU ; Dengyan LAI ; Jiao ZHU ; Tao PENG ; Shichun YE
China Pharmacy 2024;35(22):2769-2772
OBJECTIVE To establish an ion chromatography method for the simultaneous determination of chloride, sulfate and bicarbonate ions in Polyethylene glycol electrolyte powder (Ⅲ). METHODS The chromatographic column was a Dionex IonpacTM AS11-HC anion analysis column, with a Dionex IonPacTM AG11-HC guard column. The mobile phase was 10 mmol/L potassium hydroxide at an isocratic elution flow rate of 1.2 mL/min. The detector was a conductivity detector, and the suppressor was a Dionex AERS with a suppressor current of 30 mA. The column temperature was maintained at 30 ° C, and the injection volume was 10 μL. Chloride and sulfate contents were calculated by external standard method, while bicarbonate content was determined by double logarithmic fitting standard curve method. RESULTS Under these chromatographic conditions, chloride, sulfate and bicarbonate ions were effectively separated with linear ranges of 0.055 to 0.219 mg/mL (r=0.999 9), 0.155 to 0.618 mg/mL (r=1.000 0), and 0.065 to 0.121 mg/mL (r=0.999 9), respectively. The recoveries were 98.06% to 101.34%, 97.37% to 101.25%, and 97.16% to 99.81%, respectively, with RSDs of 1.1%, 1.3% and 1.0% (n=9). The RSDs for the evaluation of precision, accuracy, stability and ruggedness were all less than 2%. CONCLUSIONS The established ion chromatography is simple, rapid, accurate, precise and durable, can simultaneously determine the contents of chloride, sulfate and bicarbonate ions in Polyethylene glycol electrolyte powder (Ⅲ), which is suitable for its quality control.

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