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Objective:To understand the research status and research hotspots of syndrome differentiation nursing of pectoral stuffiness pain(coronary disease), analyze its existing problems, and provide reference for the development of related research in the future.Methods:The China National Knowledge Infrastructure(CNKI) database was used as a data source to search for relevant literatures. We analyzed the authors, institutions and keywords with CiteSpace 5.3.R8 software, and drew the distribution map of the number of literature published by the related authors and institutions with GraphPad Prism 6.07 software.Results:A total of 356 articles were included in the study. The research power in the field of syndrome differentiation nursing of pectoral stuffiness pain(coronary disease) was mainly concentrated in the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine. The researchers were mainly Lin Xiaoli and Yang Yuzhu. After clustering 58 keywords, 6 research hotspots of syndrome differentiation nursing for pectoral stuffiness pain(coronary disease) were discovered: importance of emotional nursing; exploration of different nursing forms; study of prognostic significance; embodiment of clinical application value; syndrome differentiation nursing of integrating Chinese and Western medicine; application of characteristic nursing technology of Traditional Chinese Medicine.Conclusions:Among the six research hotspots, the emotional nursing, syndrome differentiation nursing of integrating Chinese and Western medicine and application of characteristic nursing technology of Traditional Chinese Medicine are the research hotspots in recent years(2011-2018). In addition, in order to promote the progress and development of this field, it is necessary to strengthen cooperation and exchanges between authors and institutions, and conduct more in-depth research on the basis of existing research, constantly explore new research directions, and further improve the system of syndrome differentiation nursing.
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Objective:Through the analysis of the ancient books for pectoral stuffiness pain, to explore the relevant Chinese herbal medicine prescriptions, the main syndrome factors corresponding to the prescriptions and the content of medication nursing.Methods:We used the database of Chinese Medical Code (5th Edition) as the data source, and established a database, extracted relevant contents. In the end we carried out statistical analysis and discussion.Results:Four main syndrome factors were extracted from the 102 kinds of prescriptions, which were cold coagulation, qi stagnation, blood stasis and turbid phlegm. The corresponding medication nursing measures mainly contained five aspects, including the temperature, time, frequency, solution of taking medicine and medication taboo. Among them, the temperature of taking medicine was mainly warm and hot; the time of taking medicine was mainly before eating, after eating, empty stomach, before breakfast, at noon, Before sleep and regardless of the time; the frequency of taking medicine was mainly two times a day, three times a day, three times a day and once a night; the solution of taking medicine was mainly wine, porridge, ginger decoction, orange peel decoction, Chen-pi decoction, vinegar decoction and so on; the medication taboo was mainly onions, pork, cold, cabbage, mutton and so on.Conclusion:The study of medication nursing for pectoral stuffiness pain based on the theory of syndrome factors is beneficial to promote the theoretical and clinical research for the disease. It can promote the standardization of medication nursing, improve the nursing staff's ability of syndrome differentiation nursing, and provide a reference for clinical medication nursing of Traditional Chinese Medicine.
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Objective Based on the analysis of the ancient literatures about chest stuffiness and pains in Chrono_Medicine of traditional Chinese medicine,to study the content of timing medication in chest stuffiness and pains. Methods According to the database of Chinese Medical Code, searching the ancient literatures and establishing the database, extracting the contents of chest stuffiness and pains’s prescription which covering timing medication. And the statistical analysis and content discussion were carried out according to the choice of taking medicine. Results The 67 kinds of traditional Chinese medicine included were qi regulating agent, dispelling cold agent, expectorant agent and blood regulating agent. Besides,the time of taking medicine is used to be3:00-5:00,7:00-9:00,11:00-13:00,17:00-19:00, 19:00-21:00, 21:00-23:00.Take medicine once a day in the morning, twice a day, three times a day, three times a day and once a night. It is recommended that timing medication in clinical should be increased in time of 21:00-23:00 and 11:00-13:00 ,and paying more attention to the heart channel corresponding and the heart pericardium channel in time of 11:00- 13:00 and 19:00- 21:00. Conclusion Timing medication is beneficial to the optimization of therapeutic effect and minimization of toxicity of traditional Chinese medicine, which needs to provide the best evidence for further multi_center clinical trial research, and promote the popularization of timing medicine in clinical practice.
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Objective@#Based on the analysis of the ancient literatures about chest stuffiness and pains in Chrono-Medicine of traditional Chinese medicine,to study the content of timing medication in chest stuffiness and pains.@*Methods@#According to the database of Chinese Medical Code, searching the ancient literatures and establishing the database, extracting the contents of chest stuffiness and pains’s prescription which covering timing medication. And the statistical analysis and content discussion were carried out according to the choice of taking medicine.@*Results@#The 67 kinds of traditional Chinese medicine included were qi regulating agent, dispelling cold agent, expectorant agent and blood regulating agent. Besides,the time of taking medicine is used to be3:00-5:00,7:00-9:00,11:00-13:00,17:00-19:00, 19:00-21:00, 21:00-23:00.Take medicine once a day in the morning, twice a day, three times a day, three times a day and once a night. It is recommended that timing medication in clinical should be increased in time of 21:00-23:00 and 11:00-13:00, and paying more attention to the heart channel corresponding and the heart pericardium channel in time of 11:00-13:00 and 19:00-21:00.@*Conclusion@#Timing medication is beneficial to the optimization of therapeutic effect and minimization of toxicity of traditional Chinese medicine, which needs to provide the best evidence for further multi-center clinical trial research, and promote the popularization of timing medicine in clinical practice.
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The analysis of big data in medical field cannot be isolated from the high quality clinical database, and the construction of first aid database in our country is still in the early stage of exploration. This paper introduces the idea and key technology of the construction of multi-parameter first aid database. By combining emergency business flow with information flow, an emergency data integration model was designed with reference to the architecture of the Medical Information Mart for Intensive Care III (MIMIC-III), created by Computational Physiology Laboratory of Massachusetts Institute of Technology (MIT), and a high-quality first-aid database was built. The database currently covers 22 941 medical records for 19 814 different patients from May 2015 to October 2017, including relatively complete information on physiology, biochemistry, treatment, examination, nursing, etc. And based on the database, the first First-Aid Big Data Datathon event, which 13 teams from all over the country participated in, was launched. The First-Aid database provides a reference for the construction and application of clinical database in China. And it could provide powerful data support for scientific research, clinical decision making and the improvement of medical quality, which will further promote secondary analysis of clinical data in our country.
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Humanos , Macrodatos , Cuidados Críticos , Bases de Datos Factuales , Informática MédicaRESUMEN
Objective To construct a database containing multiple kinds of diseases that can provide "real world"data for first-aid clinical research. Methods Structured or non-structured information from hospital information system, laboratory information system, emergency medical system, emergency nursing system and bedside monitoring instruments of patients who visited department of emergency in PLA General Hospital from January 2014 to January 2018 were extracted. Database was created by forms, code writing, and data process. Results Emergency Rescue Database is a single center database established by PLA General Hospital. The information was collected from the patients who had visited the emergency department in PLA General Hospital since January 2014 to January 2018. The database included 530 585 patients' information of triage and 22 941 patients' information of treatment in critical rescue room, including information related to human demography, triage, medical records, vital signs, lab tests, image and biological examinations and so on. There were 12 tables (PATIENTS, TRIAGE_PATIENTS, EMG_PATIENTS_VISIT, VITAL_SIGNS, CHARTEVENTS, MEDICAL_ORDER, MEDICAL_RECORD, NURSING_RECORD, LAB_TEST_MASTER, LAB_RESULT, MEDICAL_EXAMINATION, EMG_INOUT_RECORD) that containing different kinds of patients' information. Conclusions The setup of high quality emergency databases lay solid ground for scientific researches based on data. The model of constructing Emergency Rescue Database could be the reference for other medical institutions to build multiple-diseases databases.
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Medical practice generates and stores immense amounts of clinical process data, while integrating and utilization of these data requires interdisciplinary cooperation together with novel models and methods to further promote applications of medical big data and research of artificial intelligence. A "Datathon" model is a novel event of data analysis and is typically organized as intense, short-duration, competitions in which participants with various knowledge and skills cooperate to address clinical questions based on "real world" data. This article introduces the origin of Datathon, organization of the events and relevant practice. The Datathon approach provides innovative solutions to promote cross-disciplinary collaboration and new methods for conducting research of big data in healthcare. It also offers insight into teaming up multi-expertise experts to investigate relevant clinical questions and further accelerate the application of medical big data.
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Objective To study the distribution of diseases in Medical Information Mart for Intensive Care Ⅲ(MIMIC-Ⅲ) database in order to provide reference for clinicians and engineers who use MIMIC-Ⅲ database to solve clinical research problems. Methods The exploratory data analysis technologies were used to explore the distribution characteristics of diseases and emergencies of patients (excluding newborns) in MIMIC-Ⅲ database were explored; then, neonatal gestational age, weight, length of hospital stay in intensive care unit (ICU) were analyzed with the same method. Results In the MIMIC-Ⅲ database, 46 428 patients were admitted for the first time, and 49 214 ICU records were recorded. There were 26 076 males and 20 352 females; the median age was 60.5 (38.6, 75.6) years, and most patients were between 60 and 80 years old. The first diagnosis in the disease spectrum analysis was firstly ranked by circulatory diseases (32%), followed by injury and poisoning (14%), digestive system disease (8%), tumor (7%), respiratory disease (6%) and so on. Patients with ischemic heart disease accounted for the largest proportion of circulatory disease (42%), the proportion of these patients gradually increased with age of 60-70 years old, then decreased. However, the proportion of patients with cerebrovascular disease declined first and then increased with age, which was the main cause of death of circulatory system disease (ICU mortality was 22.5%). Injury and poisoning patients showed a significant decrease with age. Digestive system diseases were younger than the general population (most people aged between 50 to 60 years), and non-infectious enteritis and colitis were the main causes of death (ICU mortality was 18.3%). Respiratory infections were predominant in infected patients (34%), but circulatory system infections were the main cause of death (ICU mortality was 25.6%). Secondly, in the neonatal care unit, premature infants accounted for the vast majority (82%). As the gestational age increased, the duration of ICU was decreased, and the mortality was decreased. Conclusions The diseases distribution of patients can be provided by MIMIC-Ⅲ database, which helps to grasp the overview of the volume and age distribution of the target patients in advance, and carry out the next step of research. Meanwhile, it points out the important role of exploratory data analysis in electronic health records analysis.
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BACKGROUND:Extracorporeal shock wave has been shown to influence the physiological function of endothelial cel s via the activation of mechanoreceptors and specific signal transduction system, and gene expression regulation. OBJECTIVE:To explore the impact of different energy flow densities and numbers of shots of extracorporeal shock waves on the new vessel formation ability, migration capability and apoptosis of bone microvascular endothelial cel s. METHODS:Bone microvascular endothelial cel s isolated from the femoral head of patients undergoing arthroplasty were subcultured in vitro, and then were immunofluorescently evaluated with endothelial cel marker antibodies to CD31 and von Wil ebrand factor (vWF), and grouped according to different energy flow densities (low, 0.03 mJ/mm2;high, 0.11 mJ/mm2) and numbers of shots (400 and 800). Capil ary-like tube formation, migration capability and apoptosis of bone microvascular endothelial cel s were determined by 3-D culture in vitro, scratch test, and flow cytometry, respectively. RESULTS AND CONCLUSION:vWF and CD31 were positively expressed in approximately 100%of bone microvascular endothelial cel s, which indicates the cultured cel s had characterization of microvascular endothelial cel s. Extracorporeal shock wave enhanced angiogenesis and migration capability of bone microvascular endothelial cel s derived from the femoral head, and especial y low-energy flow density of extracorporeal shock wave exerted more superior effects. Angiogenesis of bone microvascular endothelial cel s was decreased with the increased shot number in the low-energy flow density group. In addition, extracorporeal shock wave inhibited bone microvascular endothelial cel apoptosis induced by steroids. Our results suggest that energy flow density and number of shots of extracorporeal shock waves impact the physiological function of bone microvascular endothelial cel s derived from the femoral head.
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Objective To investigate the morbidity of soldiers stationed on an island ,analyze the relationship betweendiseases and the environment,and to provide an effective method for disease prevention and treatment .Method Data ofoutpatients from troops stationed on an island between September 2012 and August 2013 were statistically investigatedaccording to the classification of diseases.The cause of disease was analyzed .In addition,90 soldiers stationed on an islandwere randomly selected to investigate their response to heat and humidity and parts susceptible to skin diseases viaquestionnaires and talks.Results A total of 789 cases of disease were identified,including 226 cases of upper respiratorytract infection,118 cases of orthopedic-related diseases,90 cases of traumatic diseases,88 cases of oral diseases,74 casesof digestive system diseases,62 cases of skin diseases,53 cases of ENT diseases,41 cases of urinary tract infection,and37 cases of anorectal diseases.The top five responses to heat and humidity were sweating,thirst,body fatigue,dizzinessand profuse sweating.The most susceptible part to skin diseases was the feet ,followed by the cheek,crotch,back andneck.Conclusion The epidemiological characteristics of diseases on this island are significant,and medical supportshould be focused on improving the overall level of hospital treatment.
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Objective To investigate the physical fitness status of stationed on an island and the influence factors of military operational ability in order to take effective intervention measures to cope with the problems encountered by the garrison force.Methods The outdoor environment heat intensity of the island was monitored and evaluated by thermal environment monitors.The physical fitness of thirty-eight soldiers randomly selected was evaluated by measuring VO 2max. Ninety soldiers stationed on this island were selected by random sampling , for whom questionnaires and interviews were designed, involving the influence factors of military operational ability .Results This island was a typical humid-hot environment, with high temperature , high humidity and high radiation .The physical fitness of soldiers declined obviously because of the typical humid-hot environment.The top five working environmental factors were high temperature , humidity, solar radiation, wind and seasonal drying .The top five personal factors were physical fatigue , overtraining, injury, mental fatigue and lack of sleep .Conclusion Considering the obviously decreased physical fitness of soldiers caused by the typical humid-hot environment , how to assess military combat effectiveness and how to determine whether the level of combat effectiveness can meet the actual needs of tropical combat , requires scientific indicators and criteria of evaluation .