Comparative study of medical common data models for FAIR data sharing / 中华流行病学杂志

The common data model (CDM) is an important tool to facilitate the standardized integration of multi-source heterogeneous healthcare big data, enhance the consistency of data semantic understanding, and promote multi-party collaborative analysis. The data collections standardized by CDM can provide powerful support for observational studies, such as large-scale population cohort study. This paper provides an in-depth comparative analysis of the data storage structure, term mapping pattern, and auxiliary tools development of the three international typical CDMs, then analyzes the advantages and limitations of each CDM and summarizes the challenges and opportunities faced in the CDM application in China. It is expected that exploring the advanced technical concepts and practical patterns of foreign countries in data management and sharing will provide references for promoting FAIR (findable, accessible, interoperable, reusable) construction of healthcare big data in China and solving the current practical problems, such as the poor quality of data resources, the low degree of semantization, and the inabilities of data sharing and reuse.

Depression as the first manifestation of primary hyperparathyroidism: A case report and literature review / 中华内分泌代谢杂志

We report a case of primary hyperparathyroidism(PHPT) with depressive symptoms as initial manifestation. Literature review was conduct to further analyze the etiology, clinical manifestations, diagnosis, treatment and prognosis of the disease. The initial symptoms of the patients was the mental system depression and kidney stones was found by physical examination. She first visited a doctor in the urology department after a kidney stones was found. Blood calcium 2.86 mmol/L was found. At second visit, a doctor from endocrinology department conducted a comprehensive examination on the patient′s coexisting mental and renal system symptoms, clearly identified, her as PHPT. The clinical manifestations of PHPT are diverse. Symptoms such as depression, anxiety, mood swings, etc. are rarely evaluated. PHPT patients with onset or accompanied by psychiatric symptoms should be paid attention to by doctors, Measures should be taken to improve the quality of life and prognosis of patients through early screening of blood calcium and parathyroid hormone for timely diagnosis.

Organization moclel of the German national cohort and its enlightenments / 中华医学图书情报杂志

Objective To promote the effective management of population cohort data and to provide the beneficial reference for the cohort data management model in our country. Methods After a description of the German national cohort program with an international impact, its organizational model, data types and data management were sum-marized and analyzed, its research target and plan were outlined, its data collection and processing, integration and storage, quality protection and control were studied. Results Multisource data classification management prohibited the application for data and sharing of data use in tested subjects when they were using the data. Conclusion Data standards should be unified, multisource data classification storage should be implemented, the data analysis should be widened and deepened, the right of tested subjects should be made clear, and the data sharing procedure should be standardized in our country according to the inadequate domestic cohort research and the enlightenments of the German national cohort.

Profile and clinical significance of long non-coding RNA GAS8-AS1 in papillary thyroid microcarcinoma / 中华内分泌代谢杂志

Objective To investigate the expression level and clinical significance of long non-coding RNA(LncRNA) growth arrest specific gene-antisense 1(GAS8-AS1) in papillary thyroid microcarcinoma(PTMC) patients. Methods We investigated the expression profile of GAS8-AS1 in tissue samples of patients with PTMC as well as nodular goiter(NG) by quantitative real-time polymerase chain reaction(RT-qPCR). Results GAS8-AS1 in cancer tissue was down-regulated in PTMC patients compared with adjacent thyroid tissue and NG samples(P<0.05). Lower level of GAS8-AS1 was also correlated with central cervical lymph node metastasis(CLNM, P<0.05). The area under the ROC curve for GAS8-AS1 was up to 0.717 3 in CLNM prediction(P<0.05). Conclusion GAS8-AS1 may act as a potential biomarker for PTC diagnosis and CLNM prediction.

Problems in data security and privacy protection of healthcare wearable devices and measures for their solution / 中华医学图书情报杂志

The problems in data collection, data management and data security of healthcare wearable devices were summarized and analyzed with measures proposed for the solution of these problems and for speeding up the sustainable development of healthcare wearable devices from the aspects of technologies, management and laws, such as using multiple data coding technologies, establishing hierarchical data management and control model, adding remote control functions, investigating the responsibility for use of their data, working out law systems for protecting personal healthcare data,beefing up popularization of privacy data protection.

The analysis of clinical features of 140 cases with primary hyperparathyroidism / 中国肿瘤临床

Objective:To compare the clinical characteristics in primary hyper(-) parathyroid hormone (PHPT) of the different patholog-ic types. Methods:Clinical data of 140 patients with PHPT proved by operation and pathology during January 2010 to June 2016 were retrospectively analyzed. Results:A total of 140 PHPT patients, including 13 (9.29%) cases of parathyroid carcinoma (PC), 27 (19.29%) cases of parathyroid hyperplasia (PH), and 100 (71.43%) cases of parathyroid adenoma (PA). The duration of the PC group was longer than the PH group and the duration of the parathyroid adenoma (PH) group was longer than the PA group (P0.05). The postoperative calcium level of PC group was lowest (P<0.001), and the highest was of PTH (P<0.001). The pro-portions of clinical manifestation of the urinary system, digestive system, and nervous system in the PC group were 76.92%(10/13), 76.92%(10/13), and 15.38%(2/13), respectively, and these values were the highest in the three groups (P<0.05). The proportion of the clinical manifestation of the urinary system of the PH group was higher than that of the PA group. The fracture rate (30.77%, 4/13) and constipation rate (38.46%, 5/13) of the PC group were the highest among the three groups (P<0.05). Conclusion:The duration of patients with PC was the longest among the three groups. The percentage of young patients with PC was the highest. The abnormal parathyroid glands in the PC group were the heaviest. The PC group exhibited the lowest postoperative calcium level and the highest PTH level. The biochemistry and clinical manifestations of PC were obvious.

Hepcidin and iron metabolism in non-diabetic obese and type 2 diabetic rats / 华中科技大学学报（医学）（英德文版）

The aim of this study was to investigate the changes of iron levels and hepatic regulatory molecules expression involved in iron metabolism in non-diabetic obese/type 2 diabetic rat models. Male Wistar rats were divided into 3 groups: control group, non-diabetic obese group and type 2 diabetic group (n=20 each). The rats were evaluated physiologically and biochemically. The hepatic histopathological changes were observed using haematoxylin and eosin (HE) staining. The mRNA expression patterns of hepcidin, interleukin-6 (IL-6), hypoxia-inducible factor (HIF) and ferroportin (Fpn) in the rat liver in control group, non-diabetic obese group and type 2 diabetic group were analyzed by real-time RT-PCR. The protein expression patterns of hepcidin in liver of each group were further analyzed by immunohistochemistry and Western blotting. As compared with control group, the ferritin in non-diabetic obese group and type 2 diabetic group was increased significantly (P<0.001). However, there was no significant difference in soluble transferring receptor (sTfR):ferritin ratio among the three groups (P>0.05). The real-time RT-PCR, immunohistochemistry and Western blotting results all revealed that the expression levels of hepcidin in non-diabetic obese group and type 2 diabetic group were elevated significantly as compared with those in control group (P<0.001). The expression levels of hepcidin mRNA between non-diabetic obese group and type 2 diabetic group showed no significant difference (P>0.05). However, the protein expression levels of hepcidin in type 2 diabetic group were significantly higher than those in non-diabetic obese group (P<0.05). Compared to control group, the expression levels of IL-6 mRNA in non-diabetic obese group and type 2 diabetic group were increased significantly and the expression levels of Fpn mRNA decreased (P<0.05). However, the expression levels of HIF mRNA had no significant difference among three groups. It is suggested that iron metabolism is substantially disturbed in non-diabetic obese and type 2 diabetic rats probably by the abnormal expression of hepcidin in chronic inflammatory status. The increased hepcidin may restrain the iron release from the cells by affecting the expression of Fpn, which probably associates with the development of diabetic complication.

Goal-directed fluid optimization based on stroke volume variation and cardiac index during one-lung ventilation in patients undergoing thoracoscopy lobectomy operations: a pilot study

OBJECTIVES: This pilot study was designed to utilize stroke volume variation and cardiac index to ensure fluid optimization during one-lung ventilation in patients undergoing thoracoscopic lobectomies. METHODS: Eighty patients undergoing thoracoscopic lobectomy were randomized into either a goal-directed therapy group or a control group. In the goal-directed therapy group, the stroke volume variation was controlled at 10%±1%, and the cardiac index was controlled at a minimum of 2.5 L.min-1.m-2. In the control group, the MAP was maintained at between 65 mm Hg and 90 mm Hg, heart rate was maintained at between 60 BPM and 100 BPM, and urinary output was greater than 0.5 mL/kg-1/h-1. The hemodynamic variables, arterial blood gas analyses, total administered fluid volume and side effects were recorded. RESULTS: The PaO2/FiO2-ratio before the end of one-lung ventilation in the goal-directed therapy group was significantly higher than that of the control group, but there were no differences between the goal-directed therapy group and the control group for the PaO2/FiO2-ratio or other arterial blood gas analysis indices prior to anesthesia. The extubation time was significantly earlier in the goal-directed therapy group, but there was no difference in the length of hospital stay. Patients in the control group had greater urine volumes, and they were given greater colloid and overall fluid volumes. Nausea and vomiting were significantly reduced in the goal-directed therapy group. CONCLUSION: The results of this study demonstrated that an optimization protocol, based on stroke volume variation and cardiac index obtained with a FloTrac/Vigileo device, increased the PaO2/FiO2-ratio and reduced the overall fluid volume, intubation time and postoperative complications (nausea and vomiting) in thoracic surgery patients requiring one-lung ventilation. .

Investigation of replantation of thumb rotation avulsion injury / 中国骨伤

<p><b>OBJECTIVE</b>To investigate replantation methods and clinical outcomes of thumb rotation avulsion injury,and to evaluate the advantages and disadvantages of each procedure.</p><p><b>METHODS</b>From Feburary 2009 to March 2012, 21 thumbs suffered from rotation avulsion injuries and replanted by different methods, including 16 males and 5 females with an average age of 32 years old ranging from 16 to 45 years old. Diffierent methods were chosen according to the traumatic condition. And the survival condition and function of the thumbs after replantation were observed and evaluated.</p><p><b>RESULTS</b>Among them, 19 replanted figers were survival, 2 cases failed. The mean follow-up period was 8 months (ranged from 3 to 14 months). According to the criteria for function assement of amputated finger issued by the Branch of Hand Surgery of Chinese Medicine Association, the results were excellent in 13 cases, good in 5, and poor in 1.</p><p><b>CONCLUSION</b>According to the traumatic condition to choose various approach in replantation of thumb with rotation avulsion, leading to a higher success rate, and provide the patients with a more aesthetic appearance and satisfied function.</p>

Abdominal random single pedicled flap of three leaves for the treatment of multiple finger skin defects / 中国骨伤

<p><b>OBJECTIVE</b>To discuss the effect of abdominal random single pedicled flap of three leaves for skin defects construction of the ends of several fingers.</p><p><b>METHODS</b>From March 2005 to October 2010, 30 patients (90 fingers) with skin defects of the ends of several fingers were treated by abdominal random single pedicled flap of three leaves, including 20 males (60 fingers) and 10 females (30 fingers) with an average age of 36 years old ranging from 15 to 56 years. The degloving injury or transverse defect of distal phalanx were treated with abdominal random single pedicled flap of three leaves. Postoperative survival of skin flap, flap shape, complications were observed, and the static two-point discrimination of flap were determined.</p><p><b>RESULTS</b>All patients were followed up for 12.6 mouths in average. All the flaps survived. The color, texture and shape of the flaps were good. The static two-point discrimination was 5 to 10 mm. The function of the hands recovered satisfactory.</p><p><b>CONCLUSION</b>The method of abdominal random single pedicled flap of three leaves has the advantages of simple, safe and less trauma for the donor site. The effect is satisfatory for skin defects construction of the ends of several fingers.</p>