Objective To analyze the routine test parameter levels of patients with colorectal adenoma and colorectal cancer,and develop a prediction model.Methods A total of 580 patients diagnosed with colorectal adenoma(117 patients)and colorectal cancer(463 patients)were included in the retrospective study.The patients were randomly divided into two groups according to a 7:3 ratio:a training set with 406 cases and a validation set with 174 cases.Logistic regression analysis was used to establish a prediction model,and a nomogram was drawn.The model′s discrimination,calibration,and clinical applicability were evaluated using receiver operating characteristic curve(ROC),calibration plot,and decision curve analysis(DCA).Results Univariate logistic regression analysis identified 13 potential predictors:age,fecal occult blood test(FOBT),fibrinogen(FIB),thrombin time(TT),albumin(ALB),white blood cell value(WBC),neutrophil count(NEUT#),hematocrit value(HCT),mean corpuscular hemoglobin(MCH),red cell distribution width(RDW),platelet count(PLT),mean platelet volume(MPV),and activated partial thromboplastin time(APTT).Multivariate logistic regression analysis showed MPV,FIB,ALB,FOBT,TT,and HCT were risk factors for colorectal cancer in patients with colorectal adenoma(P<0.05).A nomogram was constructed based on these predictors to build a prediction model.The AUC of the ROC curve was 0.915 for colorectal cancer in the training set and 0.836 in the validation set.Calibration plots demonstrated high prediction accuracy and good model calibration.DCA results indicated the prediction model provided greater net benefit compared with the extreme models at threshold probabilities of approximately 55%-95%.Conclusion The developed prediction model exhibits satisfactory discrimination,calibration,and clinical applicability.The model can serve as an auxiliary tool in distinguishing between colorectal adenoma and colorectal cancer in patients.

Objective:To explore the correlation between serum protein factor level and clinical symptoms and cognitive impairment in patients with schizophrenia and to predict the degree of cognitive impairment, so as to provide an auxiliary method for clinical evaluation of cognitive impairment severity and prognosis of schizophrenia.Methods:From September 2017 to April 2019, 71 schizophrenic patients diagnosed in the First Affiliated Hospital of Kunming Medical University were selected as the patient group, and 65 healthy volunteers from the physical examination center of the same hospital were selected as the control group.The concentrations of tumor necrosis factor α(TNF-α), brain-derived neurotrophic factor(BDNF) and calcium-binding protein β(S100β) in peripheral blood were detected by ELISA method.Cognitive function was evaluated by MATRICS consensus cognitive battery(MCCB) cognitive assessment.The clinical symptoms of patients were evaluated by positive and negative syndrome scale(PANSS) scale.SPSS 20.0 software was used for statistical analysis, independent sample t-test was used for comparison between groups, and Pearson correlation analysis was used for the relationship between serum protein factor level and cognitive function and clinical symptoms.In order to objectively predict, evaluate and verify the severity of cognitive impairment in schizophrenia, Bayes discriminant function was established with serum protein factor concentration and PANSS total score as independent variables and the defect degree of cognitive factors in MCCB as dependent variables. Results:The serum TNF-α((63.2±25.2)pg/L vs (31.4±14.3)pg/L) and S100β((68.0±26.4)pg/L vs (47.3±20.2)pg/L) concentrations in the patient group were higher than those in the control group.The concentration of serum BDNF in the patient group was lower than that in the control group ((2 517.8±1 140.2)pg/L vs (5 202.2±447.2)pg/L), and the difference was statistically significant ( P=0.000). In the retrospective test of cognitive impairment severity in Bayes discriminant function model, the correct discrimination rates of four cognitive factors were speed of processing(SoP) 69.0%, Verbal learning(VeL) 63.4%, reasoning and problem solving(RPS) 76.1% and visual learning(ViL) 73.2%.The correct discrimination rates of cross-examination were SoP 66.2%, VeL 60.6%, RPS 73.2%, ViL 66.2. Conclusion:The levels of serum protein factors TNF-α, BDNF and S100β and clinical symptom scores of schizophrenia have different degrees of correlation with the severity score of cognitive impairment.Bayes discriminant function model has higher correct discrimination rate for the severity of cognitive impairment of schizophrenia.It is found that the levels of schizophrenia-related protein factors and clinical symptom scores may have predictive effect on the severity of cognitive impairment, providing a more objective basis for the clinical efficacy evaluation of schizophrenia patients.

This research is based on data from clinical information systems such as HIS, EMR, LIS, etc, based on the functions of the traditional paper bedside card, relying on wired network technology, using the Internet of Things technology to design and develop a multi-functional intelligent interactive electronic bedside card system for inpatients. The functional framework of the system is introduced and discussed in detail, and the design is carried out from several aspects of system architecture, network architecture, software architecture, database and software system. The results show that the system has stable performance and can ensure the real-time and accuracy of medical information. The implementation of the system can fully meet the needs of clinical first-line ward management, reduce the workload of nursing staff, improve work efficiency, and reduce the possibility of medical accidents. At the same time, it can facilitate patients to see their own health information, improve patient experience. It has important guiding significance for the development of ward management and hospital information construction.
Electronics ; Hospitals ; Humans ; Inpatients ; Internet ; Internet of Things ; Technology

This research is based on data from clinical information systems such as HIS, EMR, LIS, etc, based on the functions of the traditional paper bedside card, relying on wired network technology, using the Internet of Things technology to design and develop a multi-functional intelligent interactive electronic bedside card system for inpatients. The functional framework of the system is introduced and discussed in detail, and the design is carried out from several aspects of system architecture, network architecture, software architecture, database and software system. The results show that the system has stable performance and can ensure the real-time and accuracy of medical information. The implementation of the system can fully meet the needs of clinical first-line ward management, reduce the workload of nursing staff, improve work efficiency, and reduce the possibility of medical accidents. At the same time, it can facilitate patients to see their own health information, improve patient experience. It has important guiding significance for the development of ward management and hospital information construction.
Electronics ; Hospitals ; Humans ; Inpatients ; Internet of Things ; Technology

In this paper， the types and expression characteristics of microRNAs related to cognitive impairment in schizophrenia patients were reviewed， so as to provide a reference for further research on the characteristics of cognitive impairment in schizophrenia patients， and to open up new ideas for further research on the molecular mechanism of cognitive impairment as well as subsequent precise treatment and prognosis evaluation.

Objective In order to assess the structure damage of hip joint in ankylosing spondylitis (AS), a new radiograph-based scoring method was developed according to the radiological characteristics of hip involvement in AS, as well referring to prior existing scoring indexes. Methods A new scoring method consti-tuted of erosion, sclerosis and joint space narrowing was developed, pelvis anterior-posterior plain films acquired from patients with AS at baseline and follow-up were collected and assessed by two physicians who were trained in image reading by radiologists. All films were scored independently and blindly. Intra- and inter-reader reliability were assessed by intra-class correlation coefficient (ICC), the feasibility of this new scoring method was assessed by the mean time acquired to score a plain (two hips), its ability to detect the change of structure damage was assessed by the comparison of score differences between baseline and different follow-ups. The date were analyzed by paired-t test or nonparametric tests. Analysis of Variance (ANOVA) or nonparametric tests were utilized for the comparison of means of quantitative variables among the three groups, while Chi-square test for rates of categorical variables. Results No statistically significant differences existed in demographic data and suspected risk factors among the three groups at baseline (P>0.05). Intra-observer reliability was good (0.84 and 0.89), as well as the inter-observer reliability (0.72), the mean time needed to score was (33 ±10) seconds. Score changes were not statistically significant in the groups with follow-up duration of 1-2 and 3-4 years, but in the group of over 5 years, baseline/final scores assessed by the two observers were (6.0±2.7/7.5±3.7) and (5.6±2.1/7.1±3.6), respectively, both changes were statistically significant (t=2.86, Z=-2.99; P<0.01). Conclusion This new method is not only reproducible and easy to operate in clinic practice, but also can tell the changes of hip joint structure damage in the interval of over 5 years, further validation is requeired to demonstrate its discriminability in large populations.

Objective To investigate the serum levels of neuregulin-1 (NRG-1) and the gamma activity of the prefrontal cortex of electroencephalogram (EEG) in the resting state in first-episode schizophrenia patients and exam﹣ine their correlation with clinical symptoms and cognitive function. Methods The serum levels of NRG-1 were mea﹣sured in 53 patients and 58 controls. The gamma activity was first collected from the lead of FP1 and FP2 of the pre﹣frontal cortex of EEG and was then measured by using time-frequency analysis. The psychotic symptoms were as﹣sessed by positive and negative syndrome scale (PANSS). The MATRICS consensus cognitive battery (MCCB) was used to assess the cognitive function. Results The serum levels of NRG-1 was significantly lower in the case group than in the control [(7.36±3.96) pg/mL vs. (11.02±8.78) pg/mL, P=0.006]. The gamma activity was significantly different be﹣tween the case group and the control group [39(73.6%) vs. 14(26.4%), P<0.001]. The scores of TMT in MCCB was significantly higher while the scores of BACS SC, HVLT-R, NAB, BVMT-R and CF scores were significantly lower in the case group than the control group (P<0.01). There was a negative correlation between the serum NRG-1 level and the gamma activity in the case group (r=-0.542, P<0.001). There was a negative correlation between the serum NRG-1 level with PANSS (r=-0.360, P=0.009), while the gamma activity was positively correlated with PANSS (r=0.278, P=0.046) in the case group. The serum NRG-1 level was significantly positively correlated with the scores of HVLT-R in the case group (r=0.332, P=0.016), and the gamma activity was significantly negatively correlated with the scores of HVLT-R (r=-0.442, P=0.001) and NAB (r=-0.307, P=0.027). Conclusion The serum NRG-1 level and the gamma activity are correlated with the clinical symptoms and cognitive impairment of patients with first-episode schizophrenia to some degree, suggesting that abnormal neurobiochemical and neuroelectrophysiological reactions exist and interact with each other in the early stage of schizophrenia.

The widespread application of next generation sequencing (NGS) in clinical settings has enabled testing, diagnosis, treatment and prevention of genetic diseases. However, many issues have arisen in the meanwhile. One of the most pressing issues is the lack of standards for reporting genetic test results across different service providers. The First Forum on Standards and Specifications for Clinical Genetic Testing was held to address the issue in Shenzhen, China, on October 28, 2017. Participants, including geneticists, clinicians, and representatives of genetic testing service providers, discussed problems of clinical genetic testing services across in China and shared opinions on principles, challenges, and standards for reporting clinical genetic test results. Here we summarize expert opinions presented at the seminar and report the consensus, which will serve as a basis for the development of standards and guidelines for reporting of clinical genetic testing results, in order to promote the standardization and regulation of genetic testing services in China.

Objective: To investigate the relationship between physical activity (PA) and the risk of incident hypertension among population in rural areas of China. Methods: The Community Intervention of Metabolic Syndrome in China & Chinese Family Health Study (CIMIC) was conducted in 2007-2008. Data on PA, smoking, drinking, blood pressure and other variables were obtained at baseline. Then the follow-up study of incident hypertension was performed during 2012-2015. A total of 41 457 participants aged ≥18 years and free from hypertension at baseline were included in the final analyses. PA was calculated as metabolic equivalent (MET) for each participant. Cox proportional hazard models were used to explore the relationship of PA with incident hypertension according to the quartiles of PA. Results: A total of 6 780 participants developed hypertension during an average follow up of 5.8 years. The annual incidence of hypertension was 2.80%. Compared to participants in the first quartile of PA, HR (95%CI) of incident hypertension decreased with the level of PA of 0.92 (0.86, 0.99), 0.72 (0.67, 0.77) and 0.70 (0.65, 0.75) for the 2^nd, 3^rd and 4^th quartile, respectively (P_trend<0.001). In subgroup analyses, compared to the first quartile, hazards of hypertension among normotensive participants (systolic blood pressure less than 120 mmHg (1 mmHg=0.133 kPa) and diastolic blood pressure less than 80 mm Hg) in the 2^nd, 3^rd and 4^th quartile were 0.82 (0.70, 0.95), 0.73 (0.63, 0.85) and 0.78 (0.67, 0.90), respectively (P_trend=0.002). Among participants with prehypertension (systolic blood pressure from 120 to 139 mmHg and/or diastolic blood pressure from 80 to 89 mmHg), similar trend for the relationship of PA and incident hypertension was also found with HR (95%CI) of 0.94 (0.87, 1.01), 0.71 (0.65, 0.77) and 0.66 (0.61, 0.71) for the 2^nd, 3^rd and 4^th quartile, respectively (P_trend<0.001). Conclusion There was linear trend association between PA and incident hypertension. Increased PA in daily life may be a protective factor against hypertension.

Objective The aim of this study was to set up a large,longitudinal and prospective database to compare the clinical manifestations in human leucocyte antigen (HLA)-B27 positive and negative patients with ankylosing spondylitis(AS) based on real-world evidence in Chinese population.Methods A total of 897 outpatients with confirmed AS were recruited consecutively by smart management system for spondyloarthritis (SMSP) from April 13,2016 to June 6,2017 in Chinese PLA General Hospital from 30 provinces and autonomous regions.801 patients with HLA-B27 data were included in the analysis.Demographic and clinical parameters including Bath ankylosing spondylitis disease activity index (BASDAI),Bath ankylosing spondylitis functional index (BASFI),ankylosing spondylitis disease activity score (ASDAS),arthritis,enthesitis,Bath ankylosing spondylitis metrology index (BASMI),erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were compared between HLA-B27 positive and negative groups.Results A total of 801 patients were included in the analysis with an average age of (30.7± 8.8) years.There were 659 males and 142 females and HLA-B27 was present in 88.0％(705/801).Males were significantly more in HLA-B27 positive patients [83.3％ (587/705) vs.75.0％ (72/96);P=0.047].The average age at disease onset was (22.3 ±7.6)years in HLA-B27 positive patients and (24.4 + 8.7) years in HLA-B27 negative ones (P=0.028).There was significant difference in diagnose delay between two groups [14.3(2.5,43.6)months in HLA-B27 positive patients vs.20.3(5.0,67.4) months in HLA-B27 negative ones,P=0.041].Anterior uveitis was found to be significantly more common in HLA-B24 positive patients [18.9％ (133/705) vs.7.3％ (7/96),P=0.005],and knee involvement less common in HLA-B27 positive patients [4.0％ (27/682) vs.10.0％(9/90),P=0.010],conversely.CRP[6.5(3.0,16.4)mg/L vs.3.5(1.6,12.3)mg/L] and ESR[11.0(4.0,24.0)mrn/1h vs.7.0(3.0,16.0)mm/1h] were significantly higher in HLA-B27 positive patients(P=0.005,0.013,respectively).But no differences in BASDAI,ASDAS,BASFI and BASMI were obtained between two groups.Conclusions HLA-B27 positive patients had a higher proportion of males,a younger age of onset and a greater risk for occurrence of anterior uveitis,suggesting a poorer prognosis.