1.Policies, standards and technological models of digital rehabilitation aligned with the framework of WHO's global digital health strategy
Yaru YANG ; Zhuoying QIU ; Di CHEN ; Zhongyan WANG ; Meng ZHANG ; Qi JING ; Yaoguang ZHANG
Chinese Journal of Rehabilitation Theory and Practice 2025;31(2):125-135
ObjectiveTo systematically analyze the global policy framework, standard systems and application technology models of digital rehabilitation within the framework of the World Health Organization (WHO) Global Digital Health Strategy and propose policy recommendations for the future development of digital rehabilitation. MethodsBased on the policies on digital health and rehabilitation development issued by the WHO, focusing on the Global Digital Health Strategy, Rehabilitation 2030 Initiative, Rehabilitation in Health Systems, Rehabilitation in Health Systems: A Guide for Action, and World Report on Disability, a systematic review was conducted, to explore the policy architecture and core content of digital rehabilitation, the standard system for digitalizing rehabilitation, and key technological models for the development of digital rehabilitation. ResultsIn the context of global health and digital transformation, the development of digital rehabilitation services was an essential component of the global digital health strategy. Building a comprehensive policy framework and content system for digital rehabilitation was critical for strengthening rehabilitation data governance, enhancing data utilization efficiency, and ensuring data privacy and security. Empowering rehabilitation with digital technology was vital for improving the standardization, effectiveness, coverage, quality and safety of rehabilitation services. International digital rehabilitation policies primarily involved the following areas: policy and governance, digital standard systems, data privacy, security and ethics, digital talent cultivation and capacity building, and monitoring, evaluation and continuous improvement of digitally empowered rehabilitation services. The standard system for rehabilitation digitization covered the three major reference classifications of the WHO Family of International Classifications, including International Classification of Diseases Eleventh Revision (ICD-11), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Interventions (ICHI), especially ICF. It also included international data interoperability standards, data security and privacy protection standards, data quality and certification standards, and health information standards, etc. The application technology models of digital rehabilitation primarily included data-driven service models, artificial intelligence -enabled models, and remote rehabilitation models combined with virtual reality, augmented reality technologies, and Internet of Things support. ConclusionThe establishment and implementation of comprehensive policies, standards and technological models for digital rehabilitation are crucial for driving the digital transformation and development of global rehabilitation services. Under the framework of the WHO Global Digital Health Strategy, it is necessary to build adaptive digital rehabilitation policy frameworks, and enhance digital governance capabilities and levels, establishing and improving digital rehabilitation standard systems, and promoting the interoperability and integration of rehabilitation data with other health big data. Meanwhile, it is essential to actively develop data-driven technological models for rehabilitation services to comprehensively improve the accessibility, availability, quality and safety of rehabilitation services.
2.Clinicopathological Features and Long-Term Prognostic Role of Human Epidermal Growth Factor Receptor-2 Low Expression in Chinese Patients with Early Breast Cancer:A Single-Institution Study
Qing Zi KONG ; Qun Li LIU ; Qin De HUANG ; Tong Yu WANG ; Jie Jing LI ; Zheng ZHANG ; Xi Xi WANG ; Ling Chuan LIU ; Di Ya ZHANG ; Kang Jia SHAO ; Min Yi ZHU ; Meng Yi CHEN ; Mei LIU ; Hong Wei ZHAO
Biomedical and Environmental Sciences 2024;37(5):457-470
Objective This study aimed to comprehensively analyze and compare the clinicopathological features and prognosis of Chinese patients with human epidermal growth factor receptor 2(HER2)-low early breast cancer(BC)and HER2-IHC0 BC. Methods Patients diagnosed with HER2-negative BC(N=999)at our institution between January 2011 and December 2015 formed our study population.Clinicopathological characteristics,association between estrogen receptor(ER)expression and HER2-low,and evolution of HER2 immunohistochemical(IHC)score were assessed.Kaplan-Meier method and log-rank test were used to compare the long-term survival outcomes(5-year follow-up)between the HER2-IHC0 and HER2-low groups. Results HER2-low BC group tended to demonstrate high expression of ER and more progesterone receptor(PgR)positivity than HER2-IHC0 BC group(P<0.001).The rate of HER2-low status increased with increasing ER expression levels(Mantel-Haenszel χ2 test,P<0.001,Pearson's R=0.159,P<0.001).Survival analysis revealed a significantly longer overall survival(OS)in HER2-low BC group than in HER2-IHC0 group(P=0.007)in the whole cohort and the hormone receptor(HR)-negative group.There were no significant differences between the two groups in terms of disease-free survival(DFS).The discordance rate of HER2 IHC scores between primary and metastatic sites was 36.84%. Conclusion HER2-low BC may not be regarded as a unique BC group in this population-based study due to similar clinicopathological features and prognostic roles.
3.Perioperative care of patients with retroperitoneal dedifferentiated liposarcoma combined with multiple organ resection
Haibin ZHANG ; Jing ZHANG ; Di MENG ; Wei WEI
Chinese Journal of Practical Nursing 2024;40(20):1582-1587
To summarize the perioperative nursing experience of 10 patients with retroperitoneal dedifferentiated liposarcoma combined with multiple organ resection admitted to the First Affiliated Hospital of Zhejiang University School of Medicine from June 2022 to June 2023. Nursing care points include preoperative personalized exercise to improve cardiopulmonary function, multi-stage nutritional intervention to improve malnutrition, multi-form psychological care to relieve patients′anxiety and depression, prevention of infection and bleeding risk during the pre-positioning of the double J-tube. Postoperative care includes dynamic monitoring of hemodynamic indicators to guard against hypovolemic shock, close observation of drainage tubes for early recognition of complications such as intestinal leakage and urinary leakage, active intervention in gastroparesis syndrome with traditional Chinese medicine care and guarding against renal reflex anuria. Ten patients were discharged from the hospital after thoughtful and meticulous care. After 3 months of follow-up, the patients recovered well and lived a normal life.
4.Consistency of chemical constituents between formula granules and standard decoction of Coptidis Rhizoma
Dai-Liang ZHANG ; Xin-Na DONG ; Lei SHI ; Xiao-Di DONG ; Yong-Qiang LIN ; Rong-Fei ZHANG ; Jing-Hua ZHANG ; Yuan-Cheng YAO ; Feng-Chao ZHANG ; Gui-Yun CAO ; Zhao-Qing MENG
Chinese Traditional Patent Medicine 2024;46(9):2851-2858
AIM To investigate the consistency of chemical constituents between formula granules and standard decoction of Coptidis Rhizoma.METHODS Eighteen batches of standard decoctions were prepared,after which the extraction rate and contents,transfer rates of magnolflorine,jatrorrhizine,columbamine,epiberberine,coptisine,palmatine,berberin were determined,HPLC characteristic chromatograms were established.RESULTS There were 11 common peaks in the characteristic chromatograms of 18 batches of standard decoctions and 24 batches of formula granules with the similarities of 0.861-1.000,which were clusterd into two categories.The formula granules and standard decoction demonstrated approximated extraction rate and contents,transfer rates of index constituents.CONCLUSION The chemical constituents between formula granules and standard decoction of Coptidis Rhizoma display good consistency,which can provide references for the quality control,process research and clinical application of the former.
5.Detection and analysis of allergens in children with allergic diseases in Yangzhou area
Di LIU ; Tingting XU ; Shunying LIU ; Xiaojuan LI ; Nannan MENG ; Jing LI ; Haikang ZHOU ; Wenping WEI
Journal of Clinical Medicine in Practice 2024;28(21):28-32
Objective To analyze the distribution characteristics and clinical significance of allergens in children with allergic diseases in Yangzhou area. Methods A total of 1, 025 children who were treated in the Affiliated Hospital of Yangzhou University from December 2022 to December 2023 and tested for allergens were selected as study objects. The detection results of allergens were collected and the distribution characteristics of allergens were analyzed. Results Among the 1, 025 children with allergy-related diseases, 83.41% (855 cases) tested positive for allergens, with a positive rate of 66.24% (679 cases) for inhalant allergens and 61.17% (627 cases) for food allergens. The most common allergens were milk (36.20%), molds (33.27%), and house dust mites (30.34%). There was no statistically significant difference in the positive rate of allergens among different age groups (
6.Banxia Xiexintang Regulates Autophagy of Interstitial Cells of Cajal in Gastric Antrum of Rats with Gastric Electric Dysrhythmia
Di ZHANG ; Yujing LI ; Jing JI ; Dongmei ZHANG ; Meng CHEN
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(6):55-62
ObjectiveTo observe the effect of Banxia Xiexintang on the autophagy of interstitial cells of Cajal (ICCs) in the gastric antrum of rats with gastric electric dysrhythmia, and explore the protective effect and regulatory mechanism. MethodThirty-two SD rats were randomly assigned into a normal group, a model group, a Banxia Xiexintang (24.68 g·kg-1) group, and a positive drug (2.7 mg·kg-1) group. The rat model of gastric electric dysrhythmia was established by the method of dieting every other day and drinking dilute hydrochloric acid, and Banxia Xiexintang and the positive drug were administrated for intervention. The body weight of each rat was recorded weekly. The gastric electric activity was recorded by the biological function experimental system. The ultrastructural changes of the gastric antrum tissue were observed by a transmission electron microscope. The co-expression of receptor tyrosine kinase (c-kit)/mammalian homolog of yeast Atg6 (Beclin1) in the gastric antrum tissue was detected by double immunofluorescence labeling method. The expression of microtubule-associated protein 1 light chain 3B (LC3B) and p62 protein in the gastric antrum tissue was determined by Western blot, and the LC3BⅡ/Ⅰ ratio was calculated. ResultCompared with the normal group, the modeling reduced the body weight (P<0.01) and decreased the dominant frequency and dominant power of gastric electricity (P<0.01). In addition, the modeling caused ultrastructural damage of ICCs in gastric antrum, degeneration and necrosis of organelles, and appearance of a small number of autophagic vesicles. The results of double immunofluorescence labeling showed that the modeling inhibited the positive expression of c-kit and promoted the positive expression of Beclin1 in gastric antrum tissue. Western blot results showed that the modeling increased the ratio of LC3BⅡ/Ⅰ (P<0.01) and down-regulated the expression of p62 protein (P<0.01) in the gastric antrum tissue. Compared with the model group, Banxia Xiexintang and the positive drug increased the body weight (P<0.01) and the dominant frequency and dominant power of gastric electricity (P<0.01), repaired the ultrastructural damage of ICCs in gastric antrum tissue, promoted the positive expression of c-kit and inhibited the positive expression of Beclin1 in the gastric antrum tissue. Furthermore, Banxia Xiexintang up-regulated the expression of p62 (P<0.05) and inhibited the transformation of LC3BⅠ into LC3BⅡ in gastric antrum tissue (P<0.05). ConclusionBy regulating the expression of autophagy-related proteins, Banxia Xiexintang can reduce the autophagy and regulate the number and structure of ICCs and thus improve the gastric electric rhythm of rats, which preliminarily explains the mechanism of Banxia Xiexintang in the treatment of epigastric stuffiness.
7.T cell immunotherapy mediated by dual-affinity aptamer targeted liposome
Huan-huan REN ; Guo-ping JIA ; Jing HUANG ; Meng-di WANG ; Ding-ya SUN ; Chao-nan ZHU ; Shan WANG
Acta Pharmaceutica Sinica 2023;58(5):1338-1346
Redirecting immune cells to the tumor cells and enhancing its anti-tumor immune response is a very promising cancer treatment strategy. AS1411 aptamers have high affinity for malignant tumors with high nucleolin expression, and cytotoxic T lymphocyte associated protein 4 (CTLA-4) aptamers can specifically bind to CTLA-4, which is expressed by T cells. In this study, a dual-affinity aptamer targeted liposome (Dat. Lipo) was constructed based on AS1411 aptamer and CTLA-4 aptamer, and its immunotherapeutic effect on T cells was studied. After the aptamer was modified with cholesterol, Dat. Lipo was prepared by instillation method; its effect of redirecting T cells was determined by confocal micrographs; its T cell immunotherapy effect was evaluated by cell counting kit-8 (CCK8) and T cell penetration was evaluated by tumor spheroids. The results showed that compared with liposomes loaded with one type aptamer, Dat. Lipo could effectively promote the redirection of T cells to tumor cells; Dat. Lipo had good biosafety and immunotherapeutic effect on MCF-7 and HepG2 cells in a concentration-dependent manner; Dat. Lipo could also promote T cells to infiltrate into the tumor spheroids and enhance the immunotherapy effect of T cells in different dimensions. In summary, Dat. Lipo can use the high affinity of aptamers to redirect T cells to tumor cells, enhance the effect of immunotherapy, and has a promising application prospect in tumor therapy. This study was approved by the Examination Committee of Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Cancer Hospital.
8.Metrological analysis of SCI papers in Shanghai tertiary obstetrics and gynecology specialized hospitals from 2017 to 2021
Yu YANG ; Xing CHENG ; Jing MENG ; Chunlin LI ; Di SONG ; Jiajun LU ; Qian WANG
Chinese Journal of Medical Science Research Management 2023;36(2):122-127
Objective:Bibliometric analysis of SCI papers in Shanghai tertiary obstetrics and gynecology specialized hospitals from 2017 to 2021 was conducted to provide reference for further improving management measures and optimizing the quality of SCI papers in specialized hospitals.Methods:The Web of Science database was used to retrieve SCI papers published by tertiary obstetrics and gynecology specialized hospitals in Shanghai from 2017 to 2021. Based on bibliometric methods VOSviwer 1.6.17 and Scimago Graphica 1.0.23 was adopted to analyze the number, journals, domestic and international cooperation, and hot research areas.Results:2 721 papers were published by Shanghai Tertiary A obstetrics and Gynecology hospitals from 2017 to 2021. These papers published in 765 journals. The number of papers published and publication journals increased year by year. The number of papers and journals with an impact factor of 3~5 is the largest, accounting for 37.96% and 35.95% of the total number of papers and journals respectively. However, papers and journals with more than 10 points accounted for only 7.98% and 10.20% respectively. Scientific Reports, a comprehensive journal, published the largest number of papers. International cooperation is concentrated in the United States. Domestic cooperation is concentrated in universities and research institutions in Jiangsu, Zhejiang and Shanghai. The hot research areas focused on Oncology, Obstetrics & Gynecology, Genetics, Reproductive Biology and other basic medical fields.Conclusions:The number of papers published by Shanghai's tertiary obstetrics and gynecology specialized hospitals has increased year by year, but there are fewer highly influential journals. Domestic and international scientific research cooperation is limited to several institutions. The achievements in the field of basic research are far more than those in clinical research.
9.Research progress of multi-source information fusion technology in quality evaluation of traditional Chinese medicine
Han LI ; Meng-di XIE ; Xin-jing GUI ; Fu-guo HOU ; Xue-hua FAN ; Hai-yang LI ; Yan-li WANG ; Xue-lin LI ; Rui-xin LIU
Acta Pharmaceutica Sinica 2023;58(10):2835-2852
The quality evaluation of traditional Chinese medicine is one of the key issues related to the modernization of traditional Chinese medicine. The quality evaluation technology system of traditional Chinese medicine mainly includes traditional evaluation (traits, microscopic and physicochemical identification), chemical evaluation and biological evaluation. Due to the complex composition of traditional Chinese medicine, the single detection method in the above evaluation technology system usually cannot obtain sufficient quality information. The multi-source information fusion strategy can organically integrate data from multiple analysis and detection technologies to obtain more comprehensive information of samples and improve the quality evaluation effect. At present, multi-source information fusion strategy has been widely used in the fields of military, industrial and food, and it is still in its infancy in the field of quality evaluation of traditional Chinese medicine. This research introduces the definition, structure, method (algorithm) and fusion level of multi-source information fusion, summarizes its research progress in the origin traceability, variety identification and pharmaceutical analysis of traditional Chinese medicine, and sorts out the specific methods of data fusion in each literature. Finally, we summarized, prospected and discussed the application, development and existing problems of information fusion technology and its application in the quality evaluation of traditional Chinese medicine, in order to provide reference for broadening the application of this technology in the field of traditional Chinese medicine.
10.Correlation analysis of the genetic variants of MTHFR,TCN2 and RFC genes and risk of congenital heart disease with ventricular septal defect
Rui-Qi YANG ; Jing HU ; Di MENG ; Yang LIU ; Li-Mei FAN
The Chinese Journal of Clinical Pharmacology 2023;39(23):3401-3403
Objective To explore the correlation between the genetic variations of methylenetetrahydrofolate reductase(MTHFR),transcobalamin Ⅱ(TCN2),and reduced folate carrier(RFC)genes and the incidence of ventricular septal defect(VSD)congenital heart disease(CHD)in children.Methods Children with VSD CHD were selected as the treatment group,and healthy children who underwent physical examination in our hospital during the same period were selected as the control group.Detection of the MTHFR C677T,MTHFR A1298C,TCN2 rs1801198,RFC rs1051266 polymorphisms were performed by the polymerase chain reaction.Binary logistic regression was used to analyze the relationship between CHD and the above gene polymorphisms.Results A total of 108 cases were included in both the treatment and control groups.The proportions of TT at MTHFR C677T locus in the treatment and control groups were 44.44%and 19.44%,CC at MTHFR A1298C locus were 51.85%and 37.04%,GG at TCN2 rs1801198 locus were 55.56%and 33.33%,with statistically significant differences(all P<0.05).Binary regression analysis showed that the polymorphisms at MTHFR C677T and TCN2 rs1801198 were risk factors for VSD CHD(both P<0.05).Conclusion The occurrence of VSD CHD is closely related to the polymorphisms at MTHFR C677T and TCN2 rs 1801198 loci.


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