Research on Standard Compliance Test Algorithm Based on Electronic Medical Records of Traditional Chinese Medicine Outpatients.

Objectives: To effectively evaluate the compliance degree between the electronic medical records of Traditional Chinese Medicine (TCM) hospitals, as well as the information platform, and the related information standards of electronic medical records, a standard compliance testing scheme based on electronic medical records of TCM outpatients is proposed. Methods: This research selected the data of clinical outpatients accumulated in 10 years by the Digital Medicine Institute of Chengdu University of TCM and processed the data through security check and desensitization process. And then 28348 cases of processed electronic medical records of TCM outpatients were inputted into the standard compliance testing platform for assessment. The result was then outputted. Results: There are 924 cases among the 28348 that can be rated as five-star medical records, 84 cases four-star, 132 cases three-star, 12460 cases two-star, 13488 one-star, and 1260 cases zero-star through the integrity and standardization test. Conclusion: By the way of assessing the integrity and standardization of data, the standard compliance test algorithm scheme for electronic medical records of TCM outpatients introduced in this paper can solve the problems such as data unavailability caused by ununified codes and incomplete data in the data-sharing process and provides technical support for the construction of data standardization testing in electronic medical records of TCM outpatients.

Disparate cardio-cerebral vascular modulation during standing in multiple system atrophy and Parkinson disease.

PURPOSE: The dynamic variance of cerebral blood flow velocity (CBFV), monitored by transcranial doppler (TCD), can reveal the integrated effects of cardio-cerebral vascular autoregulation. We investigated the characteristics of CBFV curve during active standing in multiple system atrophy (MSA), Parkinson's disease (PD) and healthy volunteers. METHODS: The CBFV curve of middle cerebral arteries was recorded using TCD in 22 patients with probable MSA; 20 PD patients and 20 volunteers matched for age. All individuals started in a supine posture, followed by abrupt standing for 2 min before returning to supine. The features of CBFV curve were compared among the groups. RESULTS: In the healthy volunteers, the CBFV decreased following standing up but quickly rebounded and reached the same or greater level as the supine baseline. Afterwards, the CBFV decreased abruptly to a sustained level, lower than the supine baseline, forming a spike wave that appeared in CBFV curve. This spike wave was present in 5/22 of MSA, significantly less than PD patients (18/20) and volunteers (20/20) (P<0.001). The CBFV decrease after standing showed no significant difference between MSA than PD (9+/-7 vs. 6+/-3 cm/s, P=0.163). CONCLUSIONS: The different pattern of CBFV curves during active standing suggests MSA may possess cardio-cerebral vascular modulation different from PD. The clinical value of the CBFV curve in differentiating MSA from PD needs further investigation.

[The application of Montreal cognitive assessment in urban Chinese residents of Beijing].

OBJECTIVE: To study the distribution of Montreal cognitive assessment (MoCA) scores in terms of age and educational level in Chinese residents aged 50 years and over and to offer a benchmark for a cutoff score. METHODS: A total of 281 residents aged 50 years or older was drawn randomly in the urban areas of Beijing, including 215 healthy elderly controls (NC) and 66 patients meeting the clinical criteria of mild cognitive impairment (MCI). The final scores for MoCA were given in the form of mean percentage distributions specific for age, sex and educational level so as to compare the validity of MMSE mini-mental state examination and MoCA in detecting MCI. By a fitting multiple regression model the influence of the factors on MMSE and MoCA was assessed. RESULTS: Using a cutoff score of 26, MMSE had a sensitivity of 24.2% to detect MCI, whereas MoCA detected 92.4% of the MCI subjects. We found a bivariate correlation between MoCA scores and both the factors of age and educational level (P < 0.001). CONCLUSIONS: MoCA is a brief cognitive screening tool with high sensitivity and specificity for detecting MCI as currently conceptualized in patients performing normally on MMSE. Our adjustment in the cutoff scores would improve the detection of MCI and Alzheimer's disease by reducing the number of false negatives. MoCA scores should be used to identify current cognitive difficulties but not to make formal diagnoses.