Development and application of electronic patient-reported outcomes / 中华医院管理杂志

The rise of internet thinking, along with the growing acceptance of the " patient-centered" concept, has played a significant role in driving the development of electronic patient-reported outcomes (ePROs) in the field of clinical evaluation. While several large-scale and well-established ePROs evaluation systems have been widely adopted and implemented worldwide, China has lagged behind in ePROs research and electronic application. Therefore, the purpose of this paper is to comprehensively analyze and summarize the concepts, types, characteristics, state of development, and application of ePROs. Specifically, it focuses on analyzing the structure and content of ePROs evaluation network systems in the United States, France, and the United Kingdom. The ultimate objective is to provide insightful analysis and useful suggestions to aid in the development and evolution of ePROs in China.

Association between serum IgG titers to periodontal pathogens and outcomes for ischemic stroke patients / 中华老年医学杂志

Objective:To explore the relationship between serum IgG titers to periodontal pathogens and the modified Rankin Score(mRS)after a 3-month follow-up of older patients with ischemic stroke.Methods:Data on 379 older patients diagnosed with ischemic stroke at the Third Affiliated Hospital of Soochow University from January 2019 to April 2020 were retrospectively analyzed.Basic patient data and laboratory test results were collected.Serum samples were collected within three days after the stroke, and serum IgG antibody titers to 9 periodontal pathogens were detected.Patients were followed up for 3 months and the m-RS was calculated.Results:Among the 379 patients, 104(27.4%)had an mRS score ≥ 3 at 3-months.Univariate analysis after adjusting for age and sex showed that atrial fibrillation, ischemic heart disease, ischemic stroke subtypes, the National Institutes of Health Stroke Scale(NIHSS)score, and C-reactive protein(CRP)levels were all risk factors for unfavorable 3-month outcomes(all P<0.05). After fully adjusting confounding factors including age, sex, atrial fibrillation, ischemic heart disease, ischemic stroke subtypes, NIHSS score and CRP level at hospital admission, only the serum IgG antibody titer to Fusobacterium nucleatum increased the risk of unfavorable 3-month outcomes out of titers to 9 periodontal pathogens, and the odds ratio( OR)per standard deviation increase in titer was 3.01(95% CI: 1.73-5.23, P<0.001). Curve fitting showed that the relationship between serum IgG antibody titers to Fusobacterium nucleatum and unfavorable 3-month outcomes was close to a positive linear correlation( χ2=15.333, P<0.001). Stratified analysis showed that there were no subgroup variables, including smoking and drinking habits, comorbidities(hypertension, diabetes, dyslipidemia, chronic kidney disease), and the history of stroke, significantly changed the association between serum IgG antibody titers to Fusobacterium nucleatum and poor prognosis( Pvalues for the interaction were: 0.985, 0.708, 0.388, 0.903, 0.613, 0.700, 0.611). Conclusions:Serum IgG antibody titers to Fusobacterium nucleatum are independently correlated with unfavorable 3-month outcomes in older ischemic stroke patients.The higher the antibody titer, the greater the risk of adverse outcomes.

Effect and Safety of Tongyan Spray () on Hyoid Motion in Patients with Dysphagia after Ischemic Stroke / 中国结合医学杂志

OBJECTIVE@#To observe the effects and safety of Tongyan Spray () on the range and time of hyoid motion in patients with ischemic post-stroke dysphagia.@*METHODS@#Seventy-two patients with ischemic post-stroke dysphagia were selected and randomly assigned to a treatment group (36 cases) and a control group (36 cases) by a random number table from January 2013 to October 2014. All patients swallowed 4 kinds of barium meals with different traits respectively, and each patient underwent video fluoroscopy (VF) examination twice. In the treatment group, Tongyan Spray was sprayed to the pharynx on both sides and the middle part once respectively. The spray was applied 30 min before the second examination. Purified water at room temperature was used as placebo in the control group. The changes in the range and time of hyoid motion in both groups were observed before and after treatment.@*RESULTS@#Six patients dropped out in each group, and 60 patients completed the study and were included in the final analysis. Significant improvement was observed in the range of superior hyoid excursion distance and the time of hyoid motion in the treatment group compared with the control group (P<0.05). There were no obvious adverse reactions observed in oral mucosa in both groups during the whole study.@*CONCLUSION@#Tongyan Spray was an effective and safe medicine for improving swallowing function in patients with ischemic post-stroke dysphagia.

Mogroside v stimulates osteoblast proliferation and differentiation by promoting lncRNA TUG1 expression / 中国组织工程研究

BACKGROUND: Osteoporosis is a balance disorder between bone formation of osteoblasts and bone resorption of osteoclasts during bone remodeling. Strict control of bone remodeling at the cellular level is important to maintain bone homeostasis and avoid osteoporosis. Previous studies have shown that 1.25×10-2 g/L mogroside V can promote osteoblast proliferation and differentiation, and its mechanism may be related to LncRNA TUG1. OBJECTIVE: To investigate the role of LncRNA TUG1 in the promotion of osteoblast proliferation and differentiation by mogroside V. METHODS: Osteoblasts from neonatal Sprague-Dawley rats were extracted by two-step enzymatic digestion. The cells were divided into two groups and treated with 0 and 1.25×10-2 g/L Mogroside V. The LncRNA was detected after 2 days of culture. LncRNA TUG1 silencing virus was designed and synthetized. The newly extracted osteoblasts were divided into normal cell control group, mogroside V intervention group, mogroside V+negative virus group, TUG1 silent group, and mogroside V+TUG1 silent group. The proliferation of osteoblasts was observed by FDA fluorescence staining at 2, 4, and 6 days after processing according to the above grouping conditions. After 6 days of treatment on osteoblasts, the effect of TUG1 on osteoblast proliferation and differentiation was studied by alkaline phosphatase staining, alizarin red staining and qRT-PCR. RESULTS AND CONCLUSION: LncRNA detection showed that 1.25×10-2 g/L Mogroside V significantly promoted the expression of LncRNA TUG1 in osteoblasts. FDA fluorescent staining showed that silencing of TUG1 inhibited the positive effect of mogroside V on osteoblast proliferation. After 6 days of treatment, alkaline phosphatase staining and alizarin red staining showed that silencing of TUG1 inhibited the positive effect of mogroside V on mineralization of osteoblasts. The results of qRT-PCR showed that Runx2, BSP, OCN and COL1A1 genes were highly expressed in the mogroside V intervention group, but their expression was inhibited in the mogroside V+TUG1 silent group. Overall findings indicate that mogroside V stimulates the proliferation and differentiation of osteoblasts by promoting the expression of LncRNA TUG1.

Changes of postoperative velopharyngeal function in children with cleft palate under 5 years old / 华西口腔医学杂志

OBJECTIVE@#To demonstrate the regularity of velopharyngeal function recovery after primary cleft palatoplasty and its correlation with different surgical procedures, ages, cleft types, and follow-up times.@*METHODS@#Patients with cleft palate under 5 years old who had more than two follow-up records were included in this study, and consecutive evaluations of postoperative velopharyngeal function were performed. Univariate and multivariate logistic regression analysis were used to reveal the regularity of postoperative velopharyngeal function and the possible influencing factors.@*RESULTS@#A total of 165 patients were included. Inconsistent functions of the velopharyngeal closure were observed in 31 patients, of which velopharyngeal insufficiency (VPI) in the first follow-up converted to velopharyngeal competence (VPC) in the second follow-up, accounting for 18.79% of the total, and 134 patients had consistent velopharyngeal function. The patients in the group who had consistent velopharyngeal function were younger than those in the group who were inconsistent, and the differences between the two groups were statistically significant. The younger the operation age, the patient's velopharyngeal function was more likely to stabilize at the first follow-up. At the time of the first follow-up in 15, 28, and 40 months, the probability that the patients had stable postoperative velopharyngeal function was 80%, 90%, and 95%, respectively.@*CONCLUSIONS@#The recovery of velopharyn-geal function after surgery is a dynamic process. The velopharyngeal status of patients can be converted from VPI to VPC. Meanwhile, VPC cannot switch to VPI. The follow-up time is the most important factor affecting the consistency of the evaluation of velopharyngeal function. Choosing appro-priate follow-up time is the key to obtain the stable evaluation of velopharyngeal function.

Clinical observation on fire needles at bones combined with cupping and Tuina for knee osteoarthritistis / 中国针灸

<p><b>OBJECTIVE</b>To explore a better therapy for knee osteoarthritis.</p><p><b>METHODS</b>One hundred cases were randomly divided into a comprehensive group and an acupuncture group, 50 cases in each one. The comprehensive treatment of fire needles at bones combined with cupping and Tuina on local area of affected knee was applied in the comprehensive group. The Ashi points were mainly selected in the fire needles at bones therapy, once every other day. The cupping and Tuina therapy was adopted once a day. The conventional acupuncture was applied in the acupuncture group, in which Dubi (ST 35), Neixiyan (EX-LE 4), Xuehai (SP 10), Liangqiu (ST 34) and so on were selected, once a day. Ten days of treatment were taken as a treatment course in both two groups, and totally 1 to 2 courses was required. The pain score of joint before and after the treatment was observed and efficacy was assessed in two groups.</p><p><b>RESULTS</b>Compared before the treatment, the pain score of joint after the treatment was obviously improved in two groups (both P<0.05), and the score in the comprehensive group was lower than that in the acupuncture group (P<0.05). The clinical cured rate was 38.0% (19/50), which was superior to 20.0% (10/50) in the acupuncture group.</p><p><b>CONCLUSION</b>The comprehensive treatment of fire needles at bones combined with cupping and Tuina, considered as a better therapy for knee osteoarthritis, could improve joint pain, swelling and action function, which is superior to the conventional acupuncture.</p>

Outcomes in Neonates with Pulmonary Atresia and Intact Ventricular Septum Underwent Pulmonary Valvulotomy and Valvuloplasty Using a Flexible 2-French Radiofrequency Catheter

PURPOSE: Outcomes in 6 neonates with pulmonary atresia and intact ventricular septum (PAIVS) undergoing radiofrequency pulmonary valvulotomy and valvuloplasty (RPVV) were reported to identify the factors favorable for RPVV as the treatment of choice. MATERIALS AND METHODS: From May 2000 to January 2008, 6 patients with PAIVS were included in this retrospective study. They were aged 1 day to 90 days old. Study modalities included review of recordings of presentations and profiles of chest radiography, electrocardiography, echocardiography, and cardiac catheterization with angiography. Hemodynamic profiles from the echocardiography and the cardiac catheterization were analyzed. RESULTS: Echocardiography showed severe tricuspid regurgitation, membranous atresia of the pulmonary valve, intact ventricular septum, patent ductus arteriosus, and hypoplastic right ventricle in 6 patients. The pulmonary valve annulus were 4.2 to 6.9 mm in diameters, and those of the tricuspid valve were 7.1 to 10.1 mm. Elevated serum level of cardiac enzymes were found in 1 patient with ventriculocoronary communication (VCC). At cardiac catheterization, the ratio of systolic pressure of the right ventricle to that of the left ventricle ranged from 1.43 to 2.33 before RPVV, and from 0.54 to 1.15 after RPVV (p=0.027). The pressure gradients ranged from 76 to 136 mmHg before RPVV, and from 15 to 39 mmHg after RPVV (p=0.028). The echocardiographic gradients ranged from 16 to 32 mmHg within 24 hours after RPVV, and from 15 to 50 mmHg at the follow-ups. CONCLUSION: RPVV can be a treatment of choice for neonates with PAIVS, if there is patent infundibulum, no right-ventricular dependent coronary circulation, and adequate tricuspid valve and pulmonary valve.

Genetic diversity among flue-cured tobacco cultivars based on RAPD and AFLP markers

The aim of this work was to study the genetic diversity among flue-cured tobacco cultivars. RAPD and AFLP analyses were used to assess the genetic similarity among selected accessions of flue-cured tobacco. Seventy eight RAPD and 154 AFLP polymorphic bands were obtained and used to assess the genetic diversity among 28 tobacco accessions. The cultivar relationships were estimated through the cluster analysis (UPGMA) based on RAPD data and AFLP data. The accessions were grouped into three major clusters and these shared common ancestry clustered together.

A Systematic Classification of the Congenital Bronchopulmonary Vascular Malformations: Dysmorphogeneses of the Primitive Foregut System and the Primitive Aortic Arch System

PURPOSE: We reviewed the cases of 33 patients from our clinic and 142 patients from the literature with congenital bronchopulmonary vascular malformations (BPVM), systematically analyzed the bronchopulmonary airways, pulmonary arterial supplies, and pulmonary venous drainages, and classified these patients by pulmonary malinosculation (PM). MATERIALS AND METHODS: From January 1990 to January 2007, a total of 33 patients (17 men or boys and 16 women or girls), aged 1 day to 24 years (median, 2.5 months), with congenital BPVM were included in this study. Profiles of clinical manifestations, chest radiographs, echocardiographs, esophagographs, computer tomography (CT), magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), cardiac catheterizations with angiography, contrast bronchographs, bronchoscopies, chromosomal studies, surgeries, and autopsies of these patients were analyzed to confirm the diagnosis of congenital BPVM. A total of 142 cases from the literature were also reviewed and classified similarly. RESULTS: The malformations of our 33 patients can be classified as type A isolated bronchial PM in 13 patients, type B isolated arterial PM in three, type C isolated venous PM in two, type D mixed bronchoarterial PM in five, type F mixed arteriovenous PM in one, and type G mixed bronchoarteriovenous PM in nine. CONCLUSION: Dysmorphogeneses of the primitive foregut system and the primitive aortic arch system may lead to haphazard malinosculations of the airways, arteries, and veins of the lung. A systematic classification of patients with congenital BPVM is clinically feasible by assessing the three basic bronchovascular systems of the lung independently.

Clinical results of femoral head replacements for femoral intertrochanteric fractures in the elderly / 中华创伤骨科杂志

Objective To compare the clinical results of femoral head replacement for femoral in- tertrochanteric fractures and femoral neck fractures in aged patients.Methods Forty cases of femoral in- tertrochanteric fractures and 45 cases of femoral neck fractures (aged over 80 years) underwent femoral head re- placement from August 1996 to April 2002 in our department.The clinical results of the two groups were retro- spectively compared and analyzed statistically.Their follow-up periods,ranging from 3 to 7 years,averaged 4.6 years in the intertrochanteric fracture group and 5.5 years in the neck fracture group.Results The differences in time of hospitalization,perioperative blood loss,postoperative drainage,ambulation trine,early compiications be- tween the two groups were of no statistical significance (P＞0.05).The differences in operation time and inequality in leg length after operation between the two groups were of statistical significance (P＜0.05).The operation time was longer and more limb-length inequality occurred in the intertrochanteric fracture group than in the neck fracture group.There was no significant difference in Harris score at the last follow-up between the two groups.The X-ray at the final follow-up showed that there was insignificant difference in postoperative hip joint space,hip pain,or stem loosening between the two groups (P＞0.05).The stem revision incidences were of no statistical significance be- tween the two groups (P＞0.05).The two groups reported no acetabular protrusion.Conclusion With standard cemented prostheses,femoral head replacements can achieve as similar functional outcomes for patients with in- tertrochanteric fractures as for those with femoral neck fractures.