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.

Prevalence and comorbidity of chronic thromboembolic pulmonary hypertension in Shanxi province from 2018 to 2021 / 中华全科医师杂志

Objective:To survey the prevalence and comorbidity of patients with chronic thromboembolic pulmonary hypertension (CTEPH) in Shanxi province from 2018 to 2021.Methods:The data of patients with CTEPH from 2018 to 2021 were extracted from the Health Statistics Direct Reporting System of Shanxi Provincial Health Commission; the population data of Shanxi Province was obtained from the Statistical Yearbook of Shanxi Province. The prevalence rate of CTEPH in Shanxi Province in 2018, 2019, 2020 and 2021 was calculated. The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) was used to identity the specific Charlson comorbidity from other diagnosis on the medical record. The severity of the comorbidity scale was classified as mild (aCCI≤2 points), moderate (aCCI=3-5 points), moderate-severe (aCCI=6-8 points), and severe (aCCI≥9 points).Result:A total of 300 patients with CTEPH were identified in the whole province during the period with the mean age of(65.5±11.5)years, there were 31, 65, 83 and 121 cases in 2018, 2019, 2020 and 2021, and the corresponding prevalence rates were 0.9/10 6, 1.9/10 6, 2.4/10 6 and 3.5/10 6, respectively showing an increasing trend. The patients with CTEPH in this study involved 14 Charlson comorbidities, among which the chronic lung disease was in the highest proportion (198/300, 66.0%), followed by peripheral vascular disease (126/300, 42.0%) and chronic congestive heart failure (121/300, 40.3%). There were 16.3% (49/300) of patients with mild comorbidity, 56.3% (169/300) with moderate comorbidity, 22.3% (67/300) with moderate-severity comorbidity, and 5.0% (15/300) with severity comorbidity. Conclusions:The prevalence of CTEPH in Shanxi province from 2018 to 2021 was 0.9-3.5/10 6 showing an upward trend. The chronic lung disease, peripheral vascular disease and chronic congestive heart failure are the main comorbidities of patients with CTEPH, and mostly with moderate comorbidity.

Correlation between hypophosphatemia and the severity of Corona Virus Disease 2019 patients

ObjectiveRetrospectively analyze the clinical data of Corona Virus Disease 2019 (COVID-19) patients and explore the value of serum phosphorus level in evaluating the severity and prognosis of the disease. MethodsCOVID-19 patients transferred from the first emergency ward of Taiyuan fourth peoples Hospital from February 8 to March 3, 2020 were enrolled. The information of general conditions, clinical manifestations, laboratory indexes, nucleic acid detection and treatment were collected. The changes of blood phosphorus level and absolute value of lymphocytes in ordinary and severe/critical patients were recorded and compared. ResultsA total of 32 patients with COVID-19 were collected, including 12 cases of common type and 20 cases of severe/critical type. Before treatment, the serum phosphorus levels of the two groups were significantly lower than the normal level, and the serum phosphorus levels of the severe/critical patients were lower than those of the common type patients (t = 2.767, P < 0.010). After treatment, the serum phosphorus levels of the two groups reached normal, and there was no significant difference between the two groups (t = 0.231, P >0.819). The level of lymphocytes in severe/critical patients was lower than that in normal patients (t = 4.636, P < 0.001) before treatment. After treatment, the absolute value of lymphocytes in the two groups reached normal, and there was no significant difference between the two groups (t=1.208,P=0.237). There was a positive correlation between lymphocytes and serum phosphorus, and the correlation coefficient was 0.479. Conclusionhypophosphatemia is related to the severity of COVID-19, and strengthening the monitoring of serum phosphorus level of COVID-19s severe/critical patients and correcting hypophosphatemia in time are of significance to improve the prognosis.

Advances in the application of damage control orthopaedics in the fractures with severe multiple injuries / 中国基层医药

With the traffic accident,sudden disaster and safety accidents occur year after year,the injured patients often complicated with multiple injuries,how to maximize the treatment of the injury to improve the survival rate,is an important problem faced by orthopedic surgeons.In recent years,damage control orthopaedics (DCO)technology has been gradually developed,DCO aims to control the patients'primary injury,to prevent further deterioration of the disease,compared with the traditional treatment,it can effectively reduce the second strike and complications,is conducive to the recovery of patients.In this paper,the development of DCO concept,the theoretical basis of DCO,the adaptation of DCO,the implementation steps of DCO and the best time,the application of DCO in the treatment of severe multiple injuries and the prospect of DCO application are reviewed.

Advances in the application of damage control orthopaedics in the fractures with severe multiple injuries / 中国基层医药

With the traffic accident, sudden disaster and safety accidents occur year after year, the injured patients often complicated with multiple injuries, how to maximize the treatment of the injury to improve the survival rate, is an important problem faced by orthopedic surgeons.In recent years, damage control orthopaedics (DCO) technology has been gradually developed, DCO aims to control the patients' primary injury, to prevent further deterioration of the disease, compared with the traditional treatment, it can effectively reduce the second strike and complications, is conducive to the recovery of patients.In this paper, the development of DCO concept, the theoretical basis of DCO, the adaptation of DCO, the implementation steps of DCO and the best time, the application of DCO in the treatment of severe multiple injuries and the prospect of DCO application are reviewed.

Thymopentin improves cardiac function in older patients with chronic heart failure.

OBJECTIVE: Recent studies have shown that activation of the immune system, inflammatory cell infiltration, and activation of inflammatory mediators play an important role in the development of heart failure. The purpose of this study was to investigate whether cardiac function can be improved by regulating the balance of lymphocyte subsets and cytokines. METHODS: Ninety-six patients with chronic heart failure (CHF) who were older than 60 years were randomly divided into two groups: CHF testing group (CHFT) received regular therapy and thymopentin (2 mg thymopentin per day, 15th as a course, three courses in total). CHF control group (CHFC) received regular therapy. Forty-five healthy individuals older than 60 years were used as normal controls. The ejection fraction of left ventricle (LVEF), inner diameter of left ventricular end-diastole (LVEDD), inner diameter of left ventricular end-systole (LVESD), plasma high sensitive C-reactive protein (hsCRP), plasma brain natriuretic peptide (BNP), 6-min walking distance (6MWT), Minnesota Living with Heart Failure Questionnaire (MLHFQ) assessment, lymphocyte subsets, and inflammatory cytokines were tested. RESULTS: The levels of LVEF, 6MWT, CD 3+, CD4+T cells, natural killer cells, CD4+/CD8+ and IL-10 in CHFT were increased (p<0.01) compared with CHFC, while BNP, hsCRP, MLHFQ, CD8+, TNF-α, IL-1ß, and TNF-α/IL-10 ratio in CHFT were decreased (p<0.01). LVEDD and LVESD were decreased, even though there was no significant difference between the two CHF groups. CONCLUSION: These data suggest that immune modulation therapy improve cardiac function and regulate cytokines and lymphocyte subsets in older patients with CHF.

Efficacy of surgical procedure for tibia-fibula fracture using a combination of internal fixation and vacuum sealing drainage / 局解手术学杂志

Objective To evaluate the efficacy of surgical procedure for tibia-fibula fracture using a combination of internal fixation and vacuum sealing drainage(VSD).Methods Totally 108 patients were enrolled in this study and these patients were from January 2012 to December 2015 divided into two groups(54 per group) according to the surgical method.Patients in the observation group were treated with locking plates or intramedullary naiis fixation combined with VSD covered the wound for the following 6 to 10 days,and then the transplantation was performed.Patients in control group received external fixation with kirschner wire and screw fixation.When granulation tissue filled the wound,flap transplantation was performed to repair tissue defect and cover the exposed bone.The average hospital stay,operation time,local infection rate,fracture healing time were recorded and analyzed.Results In the observation group,the average hospital stay was (24.8 ± 4.2) d,wound closure time was (9.4 ± 1.7) d,rate of local infection was 5.6％,rate of bone nonunion was 7.4％,rate of osteomyelitis was 1.9％,fracture healing time was (17 ±4.7)weeks;the corresponding data in the control group was (32.2 ±8.7)d,(14.1 ±3.8)d,22.2％,9.3％,0 and (16 ± 6.5) weeks.The average hospital stay,wound closure time and infection rate of the two groups were of significant difference(P ＜0.05).There was no significant difference in terms of bone nonunion rate,osteomyelitis rate and union time (P ＞ 0.05).Conclusion Tibia-fibula fracture patients can be effectively treated with a combination of internal fixation and vacuum sealing drainage (VSD).This treatment may shorten the length of hospital stay,reduce the wound-close time and lower the infection rate.

Discovery of human bocavirus 4 in children with acute gastroenteritis in Lanzhou, China / 病毒学报

We studied the epidemiological characteristics of human bocavirus 4 (HBoV4) in children with a- cute gastroenteritis in Lanzhou (China). A total of 331 stool specimens were collected from children aged < 5 years with acute diarrhea at the First Hospital of Lanzhou University between July 2012 and June 2013. Specimens of HBoV were identified by nested polymerase chain reaction assays. Compared with related sequences in GenBank, the HBoV-positive strain isolated in the present study was,quite surprisingly, a rare genotype named HBoV4. This strain was a typical HBoV4,with high levels of nucleotide and amino acid homology to the Thailand strain, JQ267789 (98.9% and 98.7%, respectively), and the USA strain, GQ506568 (97.6% and 97.4%, respectively). This is the first report of HBoV4 as the causative agent for acute gastroenteritis in pediatric patients in China. This strain is one of two genotypes of HBoV that are currently circulating.

Heat shock improves Sca-1+ cell transplantation for treatment of myocardial infarction in mice / 中国组织工程研究

BACKGROUND:Recent studies have found that stem cels can directly differentiate into mature myocardial cels or promote their regeneration, providing a new therapeutic strategy for the treatment of myocardial infarction. However, the low cel transplantation rate reduces the myocardial differentiation ability and myocardial repair. OBJECTIVE: To study the role of heat shock treatment in Sca-1+ cel transplantation for treatment of myocardial infarction in mice. METHODS:Sca-1+ cels were isolated from the bone marrow of mice using magnetic bead sorting method, and were subjected to heat shock treatment. Animal models of myocardial infarction were made in mice, and then randomized into two groups: heat shock group and non-heat shock group, which were given 1 mL heat shock-treated Sca-1+ cels and 1 mL non-heat shock-treated Sca-1+ celsvia the tail vein, respectively. After transplantation, cel survival, heart function, myocardial cel apoptosis and myocardial fibrosis were detected. Meanwhile, the expressions of heat shock factor (HSP), HSP70 and miR-34a in the left ventricle were measured. RESULTS AND CONCLUSION:(1) The expression of sry gene in the heat shock group was significantly higher than that in the non-heat shock group. (2) The left ventricular ejection fraction and fractional shortening in the heat shock group were significantly higher than those in the non-heat shock group. The left ventricular end-diastolic diameter and systolic diameter in the heat shock group were significantly lower than those in the non-heat shock group. (3) The cardiac fibrosis and myocardial cel apoptosis in the heat shock group were significantly lower than those in the non-heat shock group. (4) The HSF and HSP70 expression in the left ventricle was significantly higher in the heat shock group than the non-heat shock group, and the miR-34a expression in the left ventricle was significantly lower in the heat shock group than the non-heat shock group. These findings indicate that heat shock-treated Sca-1+ cel transplantation can reduce myocardial apoptosis and infarct size, and improve heart function of mice with myocardial infarction.

Altered Nutrition State in the Severe Multiple Trauma Patients Undergoing Adjuvant Recombinant Human Growth Hormone Nutritional Support Therapy / 华中科技大学学报（医学）（英德文版）

In order to observe the nutrition state in the severe multiple trauma patients undergoing adjuvant recombinant human growth hormone (rhGH) nutritional support therapy, 45 patients with severe multiple traumas (ISS＞25) were randomly divided into 3 groups. All the 3 groups had been supplied with nitrogen and caloricity according to the need of patients for 16 days. The rhGH therapy started 48 h after surgery and lasted for 14 days in two rhGH-treated groups in which rhGH was 0.2 and 0.4 U/(kg·d) respectively, and the resting group served as control one. The levels of nitrogen balance, prealbumin and safety variables (blood sugar, Na+, TT3 and TT4) were observed and compared among the three groups. The levels of nitrogen balance on the postoperative day (POD) 3 and 5 in the rhGH-treated groups were - 1.28±3.19, 5.45±2.00 and -0.18±2.55, 6.11±1.60, respectively,which were significantly higher than those in the control group (-5.17±1.68 and -1.08±3.31, P＜0.01). The values of prealbumin on the POD 3 and 5 in the rhGH-treated groups were 180.19±27.15, 194.44±50.82 and 194.94±29.65, 194.11±16.17, respectively, which were significantly higher than those in the control group (117.42±19.10 and 135.63±28.31, P＜0.01). There was no significant difference between the rhGH 0.2 U/(kg·d) group and rhGH 0.4 U/(kg·d) group in both of the levels of nitrogen balance and prealbumin. It is concluded that the nutritional support therapy with adjuvant rhGH which starts 48 h after surgery improves the nutrition state of the patients with severe multiple trauma. It is safe for severe multiple trauma patients who accept rhGH at the dose of 0.2 and 0.4 U/(kg·d).

Altered nutrition state in the severe multiple trauma patients undergoing adjuvant recombinant human growth hormone nutritional support therapy / 华中科技大学学报（医学）（英德文版）

In order to observe the nutrition state in the severe multiple trauma patients undergoing adjuvant recombinant human growth hormone (rhGH) nutritional support therapy, 45 patients with severe multiple traumas (ISS>25) were randomly divided into 3 groups. All the 3 groups had been supplied with nitrogen and caloricity according to the need of patients for 16 days. The rhGH therapy started 48 h after surgery and lasted for 14 days in two rhGH-treated groups in which rhGH was 0.2 and 0.4 U/(kg . d) respectively, and the resting group served as control one. The levels of nitrogen balance, prealbumin and safety variables (blood sugar, Na+, TT3 and TT4) were observed and compared among the three groups. The levels of nitrogen balance on the postoperative day (POD) 3 and 5 in the rhGH-treated groups were -1.28+/-3.19, 5.45+/-2.00 and -0.18+/-2.55, 6.11+/-1.60, respectively, which were significantly higher than those in the control group (-5.17+/-1.68 and -1.08+/-3.31, P<0.01). The values of prealbumin on the POD 3 and 5 in the rhGH-treated groups were 180.19+/-27.15, 194.44+/-50.82 and 194.94+/-29.65, 194.11+/-16.17, respectively, which were significantly higher than those in the control group (117.42+/-19.10 and 135.63+/-28.31, P<0.01). There was no significant difference between the rhGH 0.2 U/(kg . d) group and rhGH 0.4 U/(kg . d) group in both of the levels of nitrogen balance and prealbumin. It is concluded that the nutritional support therapy with adjuvant rhGH which starts 48 h after surgery improves the nutrition state of the patients with severe multiple trauma. It is safe for severe multiple trauma patients who accept rhGH at the dose of 0.2 and 0.4 U/(kg . d).

The Retrospective Analysis of the Data of 1176 Autistic Children / 中国心理卫生杂志

Objective: To study the general characteristics of autistic children. Methods: The data of 1176 autistic children who were diagnosed in the Institute of Mental Health, Beijing Medical University was gathered, descriptive statistics were done with SPSS software. Results: As many as 35.10% of the autistic children are identified by their parents having problems in behavior until they were 3 years old. The average age of consulting was 60.61?26.8 months. Only 21.43% children were brought to child psychiatrists under the age of 3. They were brought to hospital 35.03?27.86 months after being discovered the symptoms.Conclusion:Health education for child autism should be strengthened so that it can be early identified.