Advances in application of metabolomics techniques to diagnosis and treatment of rheumatoid arthritis / 中国药理学通报

Rheumatoid arthritis (RA) is a chronic autoimmune disease with a high disability rate and unknown etiology.Early diagnosis and early treatment are essential to prevent the further development of the disease.In reeent years, metabolomics teeh- niques have been widely used in various fields of life sciences because of its wholism, dynamics, high sensitivity and high throughput.This artiele reviews the progress of metabolomics technology in various aspects of RA investigations sueh as early diagnosis, disease classification as well as drug efficacy prediction in order to provide new ideas for clinical diagnosis and treatment of RA from the metabolic perspective.

Modern Clinical Applications and Type of Disease Prevention and Treatment of Guipitang： A Review / 中国实验方剂学杂志

The Chinese herbal medicines contained in Guipitang （GPT） were retrieved in the databases， including traditional Chinese medicine systems pharmacology database and analysis platform （TCMSP）， encyclopedia of traditional Chinese medicine （ETCM）， bioinformatics analysis tool for molecular mechanism of traditional Chinese medicine （BATMAN-TCM）， and database for associated traditional Chinese medicine， gene， and disease information using text mining （TCMGeneDIT）， and the compounds and their potential targets were obtained. Disease enrichment analysis on the potential targets of GPT was carried out to obtain the diseases potentially treated by GPT using MetaCore. Disease enrichment results showed that the potential diseases treated by GPT included encephalopathy， gastrointestinal diseases， nutritional/metabolic diseases， tumors/cancers， cardiovascular system diseases， endocrine system diseases， immune system diseases， drug-related side effects/adverse reactions， and congenital/hereditary diseases. On these grounds， the diseases treated by GPT were reviewed. The results of the previous research on diseases treated by GPT were consistent with analysis results of network pharmacology. The modern applications of GPT clinically went beyond its original indications， but its applications were based on the clinical manifestation of qi and blood deficiency in the heart and spleen， presenting the characteristic of "same treatment for different diseases". This study is expected to provide a reference for the further research and development of GPT.

Platelet antibody positive rate and influencing factors in common related diseases of platelet transfusion: A retrospective study / 中国输血杂志

【Objective】 To explore platelet antibody production and its influencing factors in common platelet transfusion diseases. 【Methods】 From January 2018 to June 2020, patients who applied for platelet transfusion in the First Affiliated Hospital of Chongqing Medical University were enrolled. The solid phase agglutination method was used to detect the platelet antibodies of the patients. The platelet antibody positive rate of common platelet transfusion diseases and the types of diseases with higher platelet antibody-positive rates were analyzed. 【Results】 The overall positive rate of platelet antibodies in transfusion candidates was 15.0%. The 21~40 years old age patients(21.5%), females(18%) had a significantly higher platelet antibody positive rate than other ages and males(12.1%) (P<0.05). Besides, patients with a history of blood transfusion and pregnancy also had a higher platelet antibody positive rate. Tumors, blood and hematopoietic organ diseases, and digestive system diseases have higher platelet antibody-positive rates, which were 24.0%, 18.3%, and 16.6%, respectively. The platelet antibody positive rate varies significantly in common platelet transfusion diseases. As to transfused patients stratified by diseases, the platelet antibody positive rate of myeloid leukemia(48.7%)was higher than that of other diseases(P<0.05). In comparison, the platelet antibody positive rate of non-transfusion patients with liver failure and miscellaneous diseases(46.7%)was higher than that of others (P<0.05). 【Conclusion】 The positive rate of platelet antibody is somewhat higher in female, 21~40 years old patients. History of blood transfusion is a key risk factor for the production of platelet antibodies.

Efficacy of different doses of botulinum toxin A injections on bromhidrosis in adolescents / 中华医学美学美容杂志

Objective To explore the therapeutic effect of different doses of botulinum toxin A injections on bromhidrosis.Methods A total of 200 cases were divided into mild-to-moderate group (N=100) and severe group (N=100) based on the grade of bromhidrosis,and each group was further divided into two groups:low dose group (50 cases) were treated by botulinum toxin A injections (100 U) and high dose group (50 cases) were treated with 200 U for bilateral axillary.The total effective rate and recurrence rate in both groups were compared.Results In the mild to moderate group,after treatment for 3 months,the total effective rate of both groups had no statistical difference (P＞ 0.05),and the same with recurrence rate in 6 months follow-up (P＞0.05).In the severe group,after treatment for 3 months,the total effective rate of the high dose group (82％) was significantly higher than that of the low dose group (64％),with statistical significance (x2 =4.110,P＜0.05).After 6 months follow-up,recurrence rate in the high dose group (22％) was significantly lower than that of the low dose group (46％),with statistical significance (x2 =6.417,P ＜ 0.05).Conclusions A suitable dose of botulinum toxin A can be selected based on the severity of bromhidrosis,which is a individualized therapy for cost savings and might have potential benefits for patients with osmidrosis.

The application value of deep learning OCT on wet age-related macular degeneration assisted diagnosis / 中华实验眼科杂志

Objective To investigate the application value of deep learning optical coherence tomography ( OCT) on wet age-related macular degeneration ( wAMD) assisted diagnosis. Methods Weakly supervised deep learning algorithms was applied on the premise that only disease or not can be provided as a marker. The OCT image automatically assisted in the diagnosis of diseased areas of wAMD,and thermograms were applied to provide a basis for doctors to detect disease areas. Based on the deep learning of weak supervision,a new network algorithm structure was proposed for detecting disease area in ophthalmic OCT images. At the same time, thermograms were adopted to improve the accuracy of the lesion map,which is the location of the lesion area. This study followed the Declaration of Helsinki. This study protocol was approved by Ethic Committee of Ningbo Eye Hospital ( No. 2018-YJ05 ) . Written informed consent was obtained from each subject before entering study cohort. Results Resnet-based deep learning algorithm gave a diagnostic accuracy rate of 94. 9％ for the disease, which was much higher than that of AlexNet 85. 3％,VGG 88. 7％, and Google-Net 89. 2％. The thermograms with different colors provided a more convenient auxiliary diagnosis basis for doctors. Conclusions Compared with the original classification network,which needs disease area markers as empirical knowledge, deep learning algorithm model not only provides better results in the classification of retinal diseases,but also marks potential disease areas. The lesion area provides a basis for judging the area of the lesion for the diagnosis of wAMD.

Primarily Exploration of Medical Orders Evaluation Mode According to Disease Classification / 中国药房

OBJECTIVE： To investigate the effects of new mode of medical orders evaluation according to disease classification. METHODS： Totally 16 kinds of common diseases were selected from each department of our hospital. Each 10 electronic medical records of each disease were randomly selected from 160 patients in the hospital information system from Jan. 1 to Dec. 31， 2016. The rationality of 10 720 medical orders were evaluated retrospectively during hospitalization. Statistical analysis was made on the relevant indicators such as unsuitable usage and dosage， the proportion of auxiliary drugs and unsuitable indications in medical orders of irrational drug use， and a new mode of prescription comment was established according to the classification of diseases. 9 862 medical orders of same disease types were collected after the implementation （from Apr.-May， 2017） of new mode and intervene to evaluate the irrational rate of them so as to evaluate the effects of new mode. RESULTS： In the samples in 2016， a total of 751 medical orders of irrational drug use were evaluated， the most of them were unsuitable usage and dosage （414 items， 55.12％）， especially in the intracerebral hemorrhage diseases （69 items， 16.67％）； under this kind of disease， most of irrational drug use was excessive dosage of single dosing （31 items， 44.92％）. The top three disease types in the list of the ratio of adjuvant drug cost in total drug cost were surgery for renal tumors （39.43％）， acute cerebral infarction （non-surgery） （37.03％） and intervertebral disc herniation surgery （35.26％）. 70 medical orders of irrational drug use were unsuitable indications （9.32％）. After the application of evaluation mode according to classification of disease types and intervene， the irrational rate of medical orders decreased from 7.00％ （751/10 720） before evaluation to 2.95％ （291/9 862）after evaluation， decreasing by 57.86％. CONCLUSIONS： The application of evaluation mode according to classification of disease types can achieve good results in controlling the irrational rate of medical orders and contribute to rational drug use in clinic.

The new classifications of biliary tract diseases based on actual anatomy / 中华外科杂志

In order to facilitate the treatment strategies for biliary tract injury, hilar cholangiocarcinoma, bile duct tumor thrombus, cholangiocellular carcinoma and bile duct cystic dilatation, many classifications have been made, even more than 10 types for one disease. Each type is represented by numbers or English alphabet, which are not only confusing but also difficult to remember. The Academician Mengchao Wu divided the liver into five sections and four segments base on its anatomy, this classification is very direct and visual, thus had been using till now. In order to overcome those complicated problems, it is considered to develop a new classification based on actual anatomic location similar to that for liver cancer, which is easy to remember and to directly determine the treatment strategy. All kinds of classifications have their own characteristics and advantages and disadvantages. This practical classifications avoid the complexity and may be useful for clinicians.

Classification Tree Model Analysis on Risk Factors of Diabetic Kidney Disease to Progress to ESRD for CKD3-4 Stages Patients / 中山大学学报(医学科学版)

@#【Objective】To analyze the risk factors of progression to end-stage renal disease（ESRD）in patients with diabetic kidney disease（DKD），and screen the high-risk population for early prevention.【Methods】The clinical data of 231 patients with diabetic nephropathy in our hospital were collected and followed up for 3 years. According to whether ESRD occurred，they were divided into non-progressing ESRD group（133 cases）and ESRD group（98 cases）. Classification tree model was used to analyze the risk factors related to ESRD，and the high-risk population was screened by node gain analysis.【Results】Four important explanatory variables were screened out by the classification tree model from the candi⁃ date variables related to early renal damage，including apolipoprotein B（ApoB），gender，diabetic retinopathy，systemic blood pressure（SBP）. ApoB level was an important factor for DKD progression. For DKD patients with the chronic kidney disease （CKD）3~4 stageswith ApoB> 1.14 mmol/L，theprobabilityofprogression toESRDfor 3 yearswas 75.0 %，and ifat the same time with diabetic retinopathy，the probability was 79.7 %.【Conclusion】The classification tree model can analyze the risk factors of progression to ESRD in DKD patients effectively，to identify the characteristics of high-risk populations.

Characteristics and progress of International Disease Classification on ICD-11 / 中华医院管理杂志

The authors described the purpose of the creation, the structure of the basic model, and the changes in the chapters of ICD-11, and analyzed its differences with ICD-10, as well as its unique advantages and current progress. The revision of ICD-11 is closely related to the development of modern medicine. It features more elaborate expression of diseases and informatization of classification tools, making it better fitting the development of medical and health information big data and facilitating the global collection and application of medical information data.

Intra and interobserver concordance between the different classifications used in Legg-Calvé-Perthes disease / Concordância intra e interobservadores das diferentes classificações usadas na doença de Legg-Calvé-Perthes

The aim of this study was to determine the intra and interobserver concordance rates of the Waldenstrõm, Catterall and Herring classifications for Legg-Calvé-Perthes disease. METHODS: One hundred radiographs of the pelvis in anteroposterior and Lauenstein views, from patients with this disease, were selected. The radiographs were classified by four physicians with different levels of experience who had previously been given guidance regarding the classifications used, in order to minimize any bias of interpretation. The radiographs were examined by the same observers at two different times in order to evaluate the intra and interobserver concordance. Reproducibility was assessed using the kappa index. RESULTS: The concordance analysis was stratified into levels (poor, slight, fair, moderate, good and excellent). The intraobserver analysis showed, for the Waldenstrõm classification, moderate concordance for three examiners and fair for one; for Herring, excellent for one examiner and good for three; and for Catterall, good for all the examiners. The interobserver analysis showed: for the three classification systems, no situations of excellent concordance; for Waldenstrõm, four situations of fair concordance, one moderate and one slight; for Herring, four situations of moderate concordance, one good and one fair; and for Catterall, four situations of moderate concordance and two fair. CONCLUSION: The classifications studied are the ones most used for guiding the treatment for Legg-Calvé-Perthes disease, but the degree of intra and interobserver concordance is far from ideal. Complementary staging systems need to be taken into consideration, so that there can be greater certainty regarding the treatment.

Determinar o índice de concordância intra e interobservadores das classificações de Waldenstrõm, Catterall e Herring na doença de Legg-Calvé-Perthes. MÉTODOS: Foram selecionadas 100 radiografias da bacia, nas incidências anteroposterior e de Lauenstein de pacientes portadores da doença. As radiografias foram classificadas por quatro médicos com diferentes níveis de experiência, previamente orientados a respeito das classificações usadas, para minimizar qualquer viés de interpretação. As radiografias foram examinadas pelos mesmos observadores em dois momentos distintos para avaliar as concordâncias inter e intraobservadores. A análise da reprodutibilidade foi avaliada pelo índice de Kappa. RESULTADOS: A análise de concordância foi estratificada em níveis (ruim, pequena, regular, moderada, boa e excelente) e evidenciou para a concordância intraobservadores: concordância moderada para três examinadores e uma regular para a classificação de Waldenstrõm; excelente para um examinador e boa para três, na classificação de Herring; na classificação de Catterall, a concordância foi considerada boa entre todos os examinadores. Em relação à análise de concordâncias interobservadores foram obtidas: nenhuma concordância excelente para os três sistemas de classificação; quatro regulares, uma moderada e uma pequena para a classificação de Waldenstrõm; quatro moderadas, uma boa e uma regular na classificação de Herring e, pelo sistema de Catterall, quatro concordâncias moderadas e duas regulares. CONCLUSÃO: As classificações estudadas são as mais usadas para guiar o tratamento da DLCP, porém o grau de concordância intra e interobservadores não é ideal e sistemas complementares de estadiamento devem ser levados em consideração, para uma maior assertividade no tratamento.

Motivos de consulta mais comuns das pessoas atendidas por uma equipe de saúde da família em Fortaleza - CE / The most common reasons for health encounters in a community assisted by a health team in Fortaleza, Ceará / Motivos de consulta más comunes de las personas atendidas por un equipo de salud de la familia en Fortaleza - CE

Objetivo: conhecer os principais motivos de consulta da população atendida em uma equipe de saúde do município de Fortaleza - CE. Métodos: estudo de caráter quantitativo, exploratório e transversal. Os dados foram coletados a partir dos registros dos atendimentos médicos efetuados durante o primeiro semestre de 2012, extraídos de banco de dados secundário, classificados com a CIAP-2, tabulados no Excel e analisados pelo Epi-Info. Resultados: houve um total de 1044 encontros, 68% para o sexo feminino e 32%, masculino. A faixa etária predominante consistiu de pessoas entre 20-39 anos. Foram encontrados 1985 motivos de consulta. Os capítulos mais comuns foram Geral e Inespecífico, Respiratório, Digestivo, Músculo-Esquelético e Circulatório. Os 30 principais motivos de consulta corresponderam a 51,49% do total. Houve grande variedade de demandas trazidas pelas pessoas e a maioria dos motivos esteve relacionada com a demanda programada. Conclusão: a CIAP-2 possibilitou uma avaliação minuciosa da demanda. Esse estudo pode servir como instrumento para auxiliar a equipe de saúde no cuidado das pessoas, por meio de capacitação, organização da clínica e ações comunitárias e individuais para enfrentamento dos problemas.

Objective: the aim of this study was to establish the main reasons for engaging in consultations with a health team in Fortaleza, Ceará. Methods: the data were collected from medical records covering the first semester of 2012. They were extracted from a secondary database, coded using ICPC, and then entered into an Excel spreadsheet. Results: there were 1,044 different encounters recorded, 68% with female patients and 32% with males. Most of the patients were between 20 and 39 years old. There were 1,985 reasons for encounters, the most common of which were categorized as General and Unspecified, Respiratory, Digestive, Musculoskeletal, and Cardiovascular. The main 30 reasons for encounters accounted for 51.49% of the total number. People raised a great number of demands, most of which related to the program. Conclusion: the ICPC2 program helped to precisely evaluate patients' demands. Therefore, this study showed that the program was a tool by which the health team could take care of people through capacitation, managing the clinic, and developing actions for the individuals and community to face issues that arise ive, Musculoskeletal, and Cardiovascular. The main 30 reasons for encounters accounted for 51.49% of the total number. People raised a great number of demands, most of which related to the program. Conclusion: the ICPC2 program helped to precisely evaluate patients' demands. Therefore, this study showed that the program was a tool by which the health team could take care of people through capacitation, managing the clinic, and developing actions for the individuals and community to face issues that arise.

Objetivo: conocer los principales motivos de consulta de la población atendida en un equipo de salud de la ciudad de Fortaleza - CE. Métodos: los datos fueron recogidos desde los registros de los atendimientos médicos realizados en el primer semestre del 2012. Ellos fueron extraídos desde un banco de datos secundario, clasificados con la CIAP-2 y analizados en Excel. Resultados: hubo una totalidad de 1044 encuentros distintos. 68% fueron para el sexo femenino y 32%, masculino. El grupo de edad que predomina consistió en las personas entre 20-39 años. Fueron encontrados 1985 motivos de consulta. Los capítulos más comunes fueron General e Inespecífico, Respiratorio, Digestivo, Muslo-Esquelético y Circulatorio. Los 30 principales motivos de consulta correspondieron al 51,49% de la totalidad. Existió una gran variedad de demanda traídas por las personas y la mayoría de los motivos estuvo relacionada con la demanda programada. Conclusión: la CIAP 2 posibilitó una evaluación minuciosa de la demanda. Así, ese estudio se ha tornado un instrumento para que el equipo de salud se prepare para el cuidado a esas personas, a través de capacitación, administrando mejor la clínica y desarrollando acciones comunitarias e individuales para enfrentamiento de los problemas.

Lista especial para la codificación de la morbilidad en Oftalmología / Special list for the morbidity coding in ophthalmology

Objetivo: complementar y perfeccionar la clasificación estadística internacional de enfermedades para la especialidad de Oftalmología en el Instituto Cubano de Oftalmología Ramón Pando Ferrer durante el año 2013. Métodos: se realizó una investigación de servicios de salud clasificada, descriptiva y retrospectiva en la que se identificaron por grupos de expertos los diagnósticos que están incluidos en códigos inespecíficos o que no están representados en ningún código. Resultados: se elaboró la propuesta de nuevos códigos, a los cuales se les incluyó un quinto o sexto carácter y se aplicó a la codificación de los diversos diagnósticos en pacientes egresados durante el año 2013. Se recodificaron 432 historias clínicas y se propusieron nuevos códigos para la uveítis crónica y recurrente, la necrosis retinal aguda, la clasificación de la endoftalmitis, los traumas, el glaucoma, la úlcera corneal y las cataratas congénitas, no representadas en la lista tabular vigente. Conclusión: la mayor utilidad de los códigos propuestos depende de la claridad en el diagnóstico al egreso, reflejado por los especialistas en las historias clínicas de los pacientes. Con la utilización de estos códigos se garantiza una mayor calidad en el resumen de la información referente al diagnóstico, lo que permitirá una mejor evaluación de los protocolos asistenciales y de la utilización de los recursos con que se cuenta actualmente para la especialidad(AU)

Objective: to supplement and upgrade the International Statistical Classification of Diseases for ophthalmology at Ramon Pando Ferrer Cuban Institute of Ophthalmology during 2013. Methods: retrospective, descriptive and classified research on health services in which the expert groups identified the diagnoses that are included in unspecified codes or are not represented in any code. Results: new codes were suggested to which a fifth or sixth character was added and the coding of several diagnoses was used in patients discharged in 2013. Four hundred twenty two medical histories were re-coded whereas new codes were suggested for chronic and recurrent uveitis, acute retinal necrosis, endophthalmitis classification, traumas, glaucoma, corneal ulcer and congenital cataracts since they were not represented in the current listing. Conclusions: Greater usefulness of the suggested codes will depend on the classification of diagnoses on discharge from hospital, which will be written down by specialists in the medical histories of the patients. These codes will assure higher quality of summarized information related to diagnosis and this will allow better assessment of the assistance protocols and the utilization of the resources available for this specialty at present(AU)

Correlation between Bile Reflux Gastritis and Helicobacter Pylori Infection in Children / 天津医药

Objective To assess the relationships between bile reflux gastritis (BRG) and Helicobacter pylori infec-tion in children. Methods A total of 258 BRG cases were included in BRG group and 1 749 gastric mucosal inflammation cases without bile reflux were used as control group. Children with BRG were divided into three groups according to the dis-ease classification and they were also sub-divided into three groups according to the bile reflux indexing. The infection rates of Helicobacter pylori were analyzed in different groups. Results Compared to control group (34.02%), the infection rate of Helicobacter pylori was significantly higher in BRG group (46.12%). The infection rates of Helicobacter pylori infection were 40.86%(38/93), 45.53%(56/123) and 59.52%(25/42) in patients with mild, moderate and severe infections. There was no significant difference between them (χ2=4.089, P>0.05). The positive rates of Helicobacter pylori infection were 37.32%(53/142), 53.68%(51/95) and 71.43%(15/21) in children withⅠ,ⅡandⅢreflux indexing, and there was significant differ-ence between them (χ2=12.022,P<0.01). Conclusion Helicobacter pylori infection is one of the causative factors leading to BRG in children. The bile regurgitation increased with the increasing of Helicobacter pylori infection.

Concomitância de artrite reumatoide e espondilite anquilosante em um único paciente: importância dos novos critérios de classificação / Concurrent rheumatoid arthritis and ankylosing spondylitis in one patient: the importance of new classification criteria

Relatamos um caso de concomitância de espondilite anquilosante e artrite reumatoide em um paciente caucasiano de 65 anos, com achados clínicos de poliartrite simétrica com erosão de metacarpofalangeana ao raio X convencional e dor lombar infl amatória, HLA-B27+, associada à sacroiliíte. O paciente apresentou valores elevados de fator reumatoide e antipeptídeo citrulinado cíclico (anti-CCP). Realizamos uma revisão da literatura na qual as principais características de casos previamente reportados foram comparadas às deste caso. Este é o primeiro relato de caso de concomitância das duas doenças em que se utilizou teste laboratorial para dosagem do anti-CCP associado ao preenchimento das últimas versões dos critérios ASAS axial e ACR/EULAR para a classificação de espondilite anquilosante e artrite reumatoide, respectivamente.

We report the case of concomitant ankylosing spondylitis and rheumatoid arthritis in a 65-year-old Caucasian male, who had symmetric polyarthritis with erosion of the metacarpophalangeal joint on conventional X-ray, infl ammatory low back pain with HLA-B27 positivity, and sacroiliitis. Laboratory analysis showed high levels of rheumatoid factor and anti-cyclic citrullinated peptide antibody (anti-CCP). Clinical features of previously reported cases were compared with those of our case. This is the first case report on the coexistence of both diseases in the same patient, for whom anti- CCP testing and the latest versions of axial ASAS criteria and ACR/EULAR criteria for the classification of ankylosing spondylitis and rheumatoid arthritis, respectively, were used.

Nueva clasificación de las causas de mortalidad de origen nutricional por el método Delphi / New classification of causes of mortality of nutritional origin by means of the Delphi method

Las causas de mortalidad de origen nutricional (MON) no aparecen clasificadas en las sucesivas revisiones de la clasificación internacional de enfermedades (CIE) y no existe un acuerdo para la clasificación más adecuada. El objetivo de este estudio es elaborar, a partir de la última CIE, un listado de causas de MON que sirva como referencia para estudios posteriores. Se realizó un proceso de consenso de expertos en nutrición clínica mediante el método Delphi en dos oleadas para clasificar una lista de causas de MON en cuatro grupos; 1) grupo A: errores congénitos relacionados con la nutrición, 2) grupo B: causas asociadas a otras patologías, 3) grupo C: trastornos por exceso y por defecto, y 4) excluidas. Se sometieron al consenso de los expertos 86 causas, de las cuales se consensuaron 79 (91,9%) causas de MON. Se clasificaron 14(17,7%) causas en el grupo A, 5(6,3%) causas en el grupo B, 37(46,8%) causas en el grupo C y se excluyeron 23(29,1%) causas. Se trata de una primera aportación a la clasificación de las causas de mortalidad de origen nutricional, probablemente debido a la ambigüedad y la disparidad de opiniones entre expertos que presentan estas causas. Esta nueva clasificación será muy útil ya que ayudará a homogeneizar los estudios y así se podrán obtener resultados comparables, usándose como complemento clarificador de la CIE del momento.

The causes of mortality of nutritional origin (MNO) are not classified in the consecutive reviews of the international disease classification (IDC) and there is no agreement for their most proper classification. The objective of this study is to elaborate, using the last ICD as a guide, a list of causes of mortality of nutritional origin which will be used as a reference in future studies. A two round Delphi method was organized with an expert’s consenssus in clinical nutrition. The experts were asked to classify a list of causes of MNO in 4 groups; 1) group A: congenital errors related to nutrition, 2) group B: Causes associated with other pathologies, 3) group 3: Excess and defect nutrition disorders, and 4) excluded. In total, 86 causes of MNO were taken under the consensus of experts, and 79 (91,9%) came to an agreement. 14 (17,7%) causes were classified in group A, 5 (6,3%) causes in group B, 37(46,8%) causes in group C and 23 (29,1%) were excluded. This is a first approach to the classification of mortality causes of nutritional origin, probably due to the ambiguity and disparity of opinions between experts with respect to these causes. This new classification will be very useful due to the fact that it will enable homogenization of the studies and that way we will have comparable studies, using it as a clarifier annex for the ICD of the moment.

Injury investigation of members of nation earthquake emergency relief team in Wenchuan earthquake / 中华急诊医学杂志

Objective To investigate the injury of members nation earthquake emergency relief team(NERT) in Wenchuan earthquake, and to explore right measures to protect themselves in emergency relief.Method The injury of 187 members of rescue team,who took emergency relief of"5·12" Wenchuan earthquake from 12 May to 29 May 2008, was registered according to International classification of Diseases (ICD). Results Medical staff have treated the members for 268 times, dennatogic and subcutaneous tissue disease accounted for 35.4%, masele,skeleton and connective tissue disease accounted for 26.9% ,disease of respiratory system ac-counted for 13.4% .More members responsible for search injured fixed medical aid post,the treatment times were 224,accounting for 91.0% times (91.0%). Conclusions Sufficient medical preparation,fixed medical aid post,psychological quide are very important for members of relief team.

Investigation of therapy for retinal angiomatosis / 中华眼底病杂志

Objective To investigate the therapeutic effects of retinal angiomatosis in differentclinical stages.To discuss the indication of vitrectomy for retinal hemangioblastoma. Methods TheclinicaI data of 22 cases(33 eyes)were retrospectively analyzed.The retinal hemangiomas were dividedinto 5 stages according to their degrees of development from simple angioma without vessel dilation tofeeder vessel dilation and intra-retinal exudates.local retinal detachment,massive retinal detachment andcomplication occurrence in proper order.The methods of treatment were laser photocoagulation,trans-scleral cryotherapy and vitrectomy. 13 eyes were treated with laser photocoagulation, 5 eyes withcryotherapy combined with laser and 11 eyes with vitrectomy.Tumor resection and silicone oil tamponadewas performed in 3 eyes during vitrectomy.The patients were followed up for 46 months on average.Visual acuity(VA),the condition of the hemangioma and retina was compared pre～and post-operationrespectively. Results In a11 13 eyes treated with laser phot.coagulation the hemangiomas regressed andthe retina remained attached.VA improved in 2 eyes,and remained unchanged in 11 eyes.Cryotherapycombined with laser photocoagulation was performed on 5 eyes. In this group,4 eyes'hemangiomasregressed and no new hemangiomas occurred,proliferative vitreous retinopathy and vitreous hemorrhagewas observed in 1 eye which vitrectomy was performed later.VA improved in 2 eyes,unchanged in 2 eyesand decreased in 1 eye.In the 11 eyes treated with vitreoretinal surgery,new hemangiomas was found in 1eye,exudative retinal detachment was caused by hemangiomas in 2 eyes,proliferative vitreous retinopathywas observed in 2 eyes.and the retina remained attached in 8 eyes.VA improved in 3 eyes,unimproved in3 eyes,and decreased in 5 eyes.In the 3 eyes with surgical resection of retinal hemangioma during vitrectomy,2 eyes'retina remained attached,1 eye had exudative retinal detachment and no new hemangiomas occurred.VA improved in 2 eyes and decreased in 1 eye. Conclusions Laser photocoagulation or combined with cryotherapy is effective in treating the hemangiomas in early stage.Vitreetomy is advisable for late stage of retinal angiomatosis,especially with vitreous hemorrhage,epiretinal membrane,proliferation and large scale of retinal detachment.Surgical resection of isolated large retinal hemangioblastoma may be useful for selected patients.

A Case of Symtomatic Inflammatory Myofibroblastic Tumor (IMT) of the Liver in Adult / 한국간담췌외과학회지

An inflammatory myofibroblastic tumor (IMT) is a rare benign hepatic neoplasm that is characterized by a mass of localized proliferations of fibroblasts and infiltrations of mononuclear inflammatory cells. An IMT can occur in a variety of locations, including the lung, orbit, parotid, pleura and stomach. However, they have rarely been encountered in the liver. An IMT of the liver most often presents in young adults. The clinical presentations of a hepatic IMT vary: asymtomatic, fever, abdominal pain, palpable mass, vomiting, obstructive jaundice, anemia and hepatosplenomegaly. Their radiographic appearance and clinical presentation make them extremely difficult to distinguish from a malignant neoplasm, preoperatively. Therefore, surgical management is used when a malignancy can not be excluded preoperatively or when the IMT produces a biliary obstruction. We encountered a 31-year-old male patient who is still alive for 38 months following a resection for symtomatic IMT.

A Survey Study of Organizational Situation of Medical Record Department for Producation of Disease Statistics on National Basis / 대한의료정보학회지

The purpose of this study was to survey the organizational situation of medical record department(MRD) in hospitals to identify the factors influencing the production ol disease statistics in Korea. 134 hospitals answered for the structured questionnaires mailed to the 218 hospitals. This studs results are as follows. 1 ) There were three types in organizational situation of MRD: independent department (70.1%) a unit in other department (26.1 %) .and in the rest 3.7%. there were no MRD or unit. 2) The differences of work performed in MR ~) or on it in the second referral level hospitals and the third referral level hospitals were statistically significant in incomplete medical record management(p<0.05) DRG coding supplying research data, quality improvement activity. cancer registration(p<0.01) and transeription of medical record( p<0.0l). 3) 66.4% of the target hospitals were performing the recheeking of disease classification data after reponsible physicians completed the incomplete record 4) statistically significant variables which affect works performed in MRD are organizational situation of MRD(<0.001) and the number of medical record professionals. 41.3% of variation of works performed in MRD was explained by variation of organizational situation and the number of medical record professionals.