The cumulative live birth rate and cost-effectiveness of the clomiphene and gonadotropin cotreatment protocol versus the mid-luteal GnRH agonist protocol in women over 35 years old.

The decrease in assisted reproductive technology success among older women, attributed to decreased oocyte quantity and quality, poses a significant challenge. Currently, no consensus on the optimal ovarian stimulation protocol for older women undergoing IVF exists. This retrospectively registered cohort study aimed to compare the cumulative live birth rate (CLBR), time to live birth (TTLB), and cost-effectiveness among women older than 35 years who were receiving either the gonadotropin-releasing hormone agonist (GnRHa) or clomiphene citrate and gonadotropin cotreatment with ovarian stimulation (CC cotreatment) protocol. To compare treatment outcomes, we performed propensity score matching (PSM) on 2871 IVF cycles in women older than 35 years who received either the GnRHa or CC cotreatment protocol, resulting in 375 cycles in each group. Additionally, a decision tree model was utilized to assess the cost-effectiveness of the two protocols. Following PSM, both groups had similar baseline characteristics. The CC cotreatment protocol resulted in a greater rate of cycle cancellation (13.07% vs. 8.00%, p = 0.032), but the groups maintained comparable fertilization rates and embryo quality. Although the TTLB was longer in the CC cotreatment group, the CLBR per initial cycle (41.07% vs. 45.33%, p = 0.269) and delivery outcomes were similar between the two groups at the 24 months follow-up. Additionally, the average cost per live birth in the CC cotreatment group was 21.27% lower than in the GnRHa group (¥32,301.42 vs. ¥39,174.22). In conclusion, for women older than 35 years undergoing IVF, the CC cotreatment protocol offered a comparable CLBR to the GnRHa protocol but with reduced costs, indicating its potential as a viable and cost-effective ovarian stimulation option.Clinical trial registration: https://www.chictr.org.cn/ , identifier [ChiCTR2300076537].

Effectiveness, cost, and safety of four regimens recommended by WHO for RR/MDR-TB treatment: a cohort study in Eastern China.

BACKGROUND: To compare the effectiveness, cost, and safety of four regimens recommended by the World Health Organization (WHO) for rifampicin resistance/multidrug-resistance tuberculosis (RR/MDR-TB) Treatment in Eastern China. METHODS: We performed a cohort study among patients with RR/MDR between 2020 and 2022 in Jiangsu Province. The treatment success rate, cost, and drug adverse reaction rate were compared. RESULTS: Between 2020 and 2022, 253 RR/MDR-TB patients were enrolled in the study. 37 (14.62%), 76 (30.04%), 74 (29.25%), and 66 (26.09%) patients had the short-term regimens, the new long-term oral regimens, the new long-term injectable regimens, and the traditional long-term regimens, respectively. The treatment success rate was the highest among patients treated with the short-term regimen (75.68%) and was the lowest among patients treated with the traditional long-term regimens (60.61%). The estimated mean cost per favorable outcome was 142.61 thousand Chinese Yuan (CNY), and the short-term regimens showed the lowest cost in the four regimes (88.51 thousand CNY vs. 174.24 thousand CNY, 144.00 thousand CNY, and 134.98 thousand CNY). Incremental cost-effectiveness ratios of the short-term regimens, the new long-term oral regimen, and the new long-term injectable regimens were -3083.04, 6040.09, and 819.68 CNY compared to the traditional long-term regimens. CONCLUSIONS: For RR/MDR-TB patients in China who meet the criteria for short-term regimens, the short-term regimens were proven to be the most cost-effective of the four regimens recommended by WHO. For RR/MDR-TB patients in China who don't meet the criteria for short-term regimens, the new long-term injectable regimens are more cost-effective than the remaining two regimens.

This is the first study to evaluate the effectiveness, cost, and safety of four regimens recommended by the WHO for RR/MDR-TB treatment in China.For RR/MDR-TB patients in China who meet the criteria for the short-term regimens, the short-term regimens were proven to be the most cost-effective of the four regimens recommended by WHO.

Comprehensive multicomponent characterization and quality assessment of Xiaoyao Wan by UPLC-Q-Orbitrap-MS, HS-SPME-GC-MS and HS-GC-IMS.

Xiaoyao Wan (XYW) is a prescription medicine of traditional Chinese medicine (TCM) with the effects of "soothing the liver and relieving depression," and "strengthening spleen and nourishing blood". XYW has been widely concerned in the treatment of depression and has become one of the commonly used classic formulas in clinical practice. However, the pharmacodynamic substance basis and the quality control studies of XYW are hitherto quite limited. Here, we aim to fully utilize an advanced ultra - performance liquid chromatography-quadrupole - Orbitrap mass spectrometry (UPLC-Q-Orbitrap-MS), headspace-solid phase microextraction-gas chromatography-mass spectrometry (HS-SPME-GC-MS) and headspace-gas chromatography-ion mobility spectrometry (HS-GC-IMS) technique to deep characterization of the pharmacological substance basis and quantitatively evaluate the quality of XYW. Firstly, 299 compounds were identified or tentatively characterized, including 198 non-volatile organic compounds (n-VOCs) and 101 volatile organic compounds (VOCs). Secondly, principal component analysis (PCA) and hierarchical cluster analysis (HCA) was used to analyze quality differences in XYW at different manufacturers. Thirdly, a parallel reaction monitoring (PRM) method was established and validated to quantify the fourteen major effective substances in different manufacturers of XYW, which were chosen as the benchmarked substances to evaluate the quality of XYW. In conclusion, this study shows that the strategy provides a useful method for quality control of TCM and offers a practical workflow for exploring the quality consistency of TCM.

Comprehensive multicomponent characterization and quality assessment of Shuang-Huang-Lian powder injection using ultra-high-performance liquid chromatography-quadrupole time-of-flight-mass spectrometry and ultra-high-performance liquid chromatography-quadrupole-Orbitrap-mass spectrometry.

RATIONALE: Shuang-Huang-Lian powder injection (SHLPI) is a well-known modern traditional Chinese medicine formula preparation (TCMFP) widely used to treat acute upper respiratory infections. However, SHLPI is extracted from pure Chinese medicine and administered through an injection, and many adverse reactions have been reported clinically. Therefore, it is necessary to characterize in depth the chemical composition of SHLPI and quantitatively analyze its potential allergenic components. METHODS: In this study, the samples were analyzed using ion mobility ultra-high-performance liquid chromatography-quadrupole time-of-flight-mass spectrometry (UHPLC-QTOF-MS) combined with a self-built database. Furthermore, the parallel reaction monitoring (PRM) model of ultra-high-performance liquid chromatography-quadrupole-Orbitrap-mass spectrometry (UHPLC-Q-Orbitrap-MS) was used to successfully quantify 10 representative bioactive components. RESULTS: Using this strategy 90 compounds were identified, the fragmentation pathways of five representative compounds in the five main components of SHLPI were summarized, and 10 components (neochlorogenic acid, chlorogenic acid, sweroside, forsythiaside A, luteoloside, isochlorogenic acid B, isochlorogenic acid C, baicalin, phillyrin, and baicalein) were determine as the quality markers of SHLPI based on UPLC-Q-Orbitrap-MS. CONCLUSIONS: This work comprehensively characterized the material basis of SHLPI, summarized the cracking laws of representative substances, and quantitatively analyzed 10 potential allergenic components. Therefore, this study could provide a basis for the quality control of SHLPI and the clinical rational use of drugs to reduce its adverse reactions.

Prediction of Retail Price of Sporting Goods Based on LSTM Network.

Commodity prices play a unique role as a lever to regulate the economy. Price forecasting is an important part of macrodecision-making and micromanagement. Because there are many factors affecting the price of goods, price prediction has become a difficulty in research. According to the characteristics that price data are also affected by other factors except for time series, a multifactor LSTM price prediction method is proposed based on the long-term and short-term memory network (LSTM) deep learning algorithm. This method not only makes use of the memory of LSTM to historical data but also introduces the influence of external factors on price through the full connection layer, which provides a new idea for solving the problem of price prediction. Compared with BP neural network, the experimental results show that this method has higher accuracy and better stability. Analyze the commodity description and commodity price characteristics, find out the commodities similar to the target commodity, complete the commodity price data by using the historical price data of similar commodities, and establish the training set to verify the validity of the proposed method.

A deep learning-based hybrid artificial intelligence model for the detection and severity assessment of vitiligo lesions.

Background: We aimed to establish and validate a deep learning-based hybrid artificial intelligence (AI) model for the objective morphometric and colorimetric assessment of vitiligo lesions. Methods: Two main datasets containing curated images of vitiligo lesions from Chinese patients (Fitzpatrick skin types III or IV) were established, including one with 2,720 images for lesion localization study and the other with 1,262 images for lesion segmentation study. Besides, an additional test set containing 145 images of vitiligo lesions from other Fitzpatrick skin types (I, II, or V) was also generated. A 3-stage hybrid model was constructed. YOLO v3 (You Only Look Once, v3) architecture was trained and validated to classify and localize vitiligo lesions, with sensitivity and error rate as primary performance outcomes. Then a segmentation study comparing 3 deep convolutional neural networks (DCNNs), Pyramid Scene Parsing Network (PSPNet), UNet, and UNet++, was carried out based on the Jaccard index (JI). The architecture with the best performance was integrated into the model. Three add-on metrics, namely VAreaA, VAreaR, and VColor were finally developed to measure absolute, relative size changes and pigmentation, respectively. Agreement between the AI model and dermatologist evaluators were assessed. Results: The sensitivity of the YOLO v3 architecture to detect vitiligo lesions was 92.91% with an error rate of 14.98%. The UNet++ architecture outperformed the others in the segmentation study (JI, 0.79) and was integrated into the model. On the additional test set, however, the model achieved a lower detection sensitivity (72.41%) and a lower segmentation score (JI, 0.69). With respect to size changes, no difference was observed between the AI model, trained dermatologists (W=0.812, P<0.05), and Photoshop analysis (P=0.075, P=0.212 respectively), which all displayed good concordance. Conclusions: We developed a novel, convenient, objective, and quantitative deep learning-based hybrid model which simultaneously evaluated both morphometric and colorimetric vitiligo lesions from patients with Fitzpatrick skin types III or IV, rendering it suitable for the assessment of severity of vitiligo lesions in Asians in both clinic and research scenarios. More work is also warranted for its use in other ethnic skin groups.

A comparison and assessment of computational method for identifying recombination hotspots in Saccharomyces cerevisiae.

Meiotic recombination is one of the most important driving forces of biological evolution, which is initiated by double-strand DNA breaks. Recombination has important roles in genome diversity and evolution. This review firstly provides a comprehensive survey of the 15 computational methods developed for identifying recombination hotspots in Saccharomyces cerevisiae. These computational methods were discussed and compared in terms of underlying algorithms, extracted features, predictive capability and practical utility. Subsequently, a more objective benchmark data set was constructed to develop a new predictor iRSpot-Pse6NC2.0 (http://lin-group.cn/server/iRSpot-Pse6NC2.0). To further demonstrate the generalization ability of these methods, we compared iRSpot-Pse6NC2.0 with existing methods on the chromosome XVI of S. cerevisiae. The results of the independent data set test demonstrated that the new predictor is superior to existing tools in the identification of recombination hotspots. The iRSpot-Pse6NC2.0 will become an important tool for identifying recombination hotspot.

Influence of patient and hospital characteristics on inpatient satisfaction in China's tertiary hospitals: A cross-sectional study.

BACKGROUND: Patient satisfaction has been seen as a key criterion when evaluating hospitals and is one of the main focuses of the current health-care reform in China. This paper aimed to explore patient- and hospital-level factors associated with inpatient satisfaction, which can provide policy implications for the evaluation and development of a patient-oriented health-care system. METHODS: The paper analyses data from the 2017 China National Patient Survey which includes 20 300 inpatients from 131 tertiary hospitals across 31 provinces. Descriptive analysis and multivariable logistic regressions are conducted to identify key factors related to satisfaction. RESULTS: Patient sociodemographic characteristics, including gender, age, income and insurance type, are found to be strongly associated with their satisfaction of inpatient experience. In terms of institutional characteristics, hospital type, size, staffing and financial performance are also significantly correlated with inpatient satisfaction. Patients are more satisfied with specialist hospitals and large hospitals measured by the number of beds and surgeries. Hospitals with higher nurse-to-bed ratio also receive more satisfaction. The financial performance of hospitals, however, is negatively associated with satisfaction. CONCLUSION: Patient satisfaction contains unique information on service quality and thus should be incorporated into the matrix of hospital evaluation. Meanwhile, differences in patient composition must be adjusted to make fair comparisons across hospitals. Moreover, future reform needs to put greater efforts in the design of comprehensive public insurance scheme, efficient hospital structure and an overall well-functioning health-care delivery system in order to better serve patients in China.

A Survey for Predicting Enzyme Family Classes Using Machine Learning Methods.

Enzymes are proteins that act as biological catalysts to speed up cellular biochemical processes. According to their main Enzyme Commission (EC) numbers, enzymes are divided into six categories: EC-1: oxidoreductase; EC-2: transferase; EC-3: hydrolase; EC-4: lyase; EC-5: isomerase and EC-6: synthetase. Different enzymes have different biological functions and acting objects. Therefore, knowing which family an enzyme belongs to can help infer its catalytic mechanism and provide information about the relevant biological function. With the large amount of protein sequences influxing into databanks in the post-genomics age, the annotation of the family for an enzyme is very important. Since the experimental methods are cost ineffective, bioinformatics tool will be a great help for accurately classifying the family of the enzymes. In this review, we summarized the application of machine learning methods in the prediction of enzyme family from different aspects. We hope that this review will provide insights and inspirations for the researches on enzyme family classification.

Assessment of water-soluble thiourea-formaldehyde (WTF) resin for stabilization/solidification (S/S) of heavy metal contaminated soils.

Stabilization/Solidification (S/S) can be regarded as necessary for remediation of heavy metal contaminated soil. There is, however, solid agent is not very convenient to use. Water-soluble thiourea-formaldehyde (WTF) is a novel chelating agent, which has more practical applications. The process of WTF resin for S/S process of heavy metal contaminated soils was studied. Laboratory-prepared slurries, made of field soils spiked with Cd2+ and Cr6+ were treated with WTF resin. The toxicity characteristic leaching procedure (TCLP) showed that with 2 wt% WTF, in the neutral condition of soil after treatment for 7 d, the leaching concentrations of Cd2+ and Cr6+ in contaminated soil were decreased by 80.3% and 92.6% respectively. Moreover, Tessier sequence extraction procedure showed WTF resin reduced the leaching concentration by transforming heavy metal from exchange form to organic form. The structure of WTF is obtained according to elemental analysis result and reaction mechanism. Through analysis of the infrared spectrogram of WTF and WTF heavy mental chelating precipitation, WTF can form stable chelate with heavy mental through coordination. The significant groups are hydroxyl, nitrogen and sulphur function groups in WTF mainly. Toxicology test revealed that the WTF resin is nontoxic to microorganism in the soils.

Ling classification applied in the preoperative safety and effectiveness assessment of POEM.

BACKGROUND AND STUDY AIMS: At present, peroral endoscopic myotomy (POEM) has been considered as the recommended treatment for achalasia, as it causes trauma to a smaller area and has fewer short-term serious complications than other treatments. However, due to the different morphology of esophagus, not all the patients with achalasia are eligible to receive POEM surgery. And the purpose of our study was to apply Ling classification, which proser Linghu put forward in 2011, in the preoperative assessment of POEM, expecting to reduce the occurrence rate of complications during or post-POEM. PATIENTS AND METHODS: The clinical data of 341 achalasia patients were collected and classified, according to the endoscopic pictures related to the middle and the lower parts of the esophagus. The correlation between Ling classification and LESP or Eckardt score was analyzed for the efficiency estimation, and the correlation of Ling classification and incidence of complications was counted for the safety evaluation. RESULTS: Ling classification was correlated with the LESP of 95 patients and Eckardt score of 131 patients. Compared to preoperative data, post-POEM LESP and Eckardt score both decreased significantly in all types of Ling classification (p < 0.05), while no significant difference in the decrease degree of either LESP or Eckardt score was found among different types of Ling classification (p > 0.05). This means Ling classification may not directly affect the postoperative efficacy of POEM. By analyzing the correlation between Ling classification and intraoperative complications, we found that the differences of total complications, gas-related complication and mucosal injury were all significant among all types of Ling classification (p < 0.05). CONCLUSIONS: Ling classification can be applied in the preoperative assessment of the safety and efficacy of POEM, and it might provide a guideline for how to reduce the complications during POEM surgery.

NIEluter: Predicting peptides eluted from HLA class I molecules.

The immune system has evolved to make a diverse repertoire of peptides processed from self and foreign proteomes, which are displayed in antigen-binding grooves of major histocompatibility complex (MHC) proteins at cell surface for surveillance by T cells. These antigenic peptides are termed Naturally Processed Peptides or Naturally Presented Peptides (NPPs), which play a major role in cell-mediated immunity and rational vaccine design. Therefore, it is intensely desirable to predict NPPs from a given protein antigen, or to foretell if an MHC-binding peptide can be eluted from a given MHC protein. In this paper, we describe NIEluter, an ensemble predictor based on support vector machine (SVM). It consists of a combination of five SVM models trained with position-specific amino acid composition, position-specific dipeptide composition, Hidden Markov Model, binary encoding, and BLOSUM62 feature. NIEluter can predict NPPs of length 8-11 from six HLA alleles (A0201, B0702, B3501, B4403, B5301, and B5701) at present. Evaluated with five-fold cross-validation and independent datasets if available, NIEluter shows good performance. It outperforms MHC-NP in 7 out of 24 types of situation and precedes NetMHC3.2 in most cases, indicating that it is a helpful complement to available tools. NIEluter has been implemented as a free web service, which can be accessed at http://immunet.cn/nie/cgi-bin/nieluter.pl.

The Ebola threat: China's response to the West African epidemic and national development of prevention and control policies and infrastructure.

There is growing concern in West Africa about the spread of the Ebola hemorrhagic fever virus. With the increasing global public health risk, a coordinated international response is necessary. The Chinese government is prepared to work in collaboration with West African countries to assist in the containment and control of the epidemic through the contribution of medical expertise and mobile laboratory testing teams. Nationally, China is implementing prevention programs in major cities and provinces, the distribution of Ebola test kits, and the deployment of a new national Ebola research laboratory.

Nanoplatforms for constructing new approaches to cancer treatment, imaging, and drug delivery: what should be the policy?

Nanotechnology is the design and assembly of submicroscopic devices called nanoparticles, which are 1-100 nm in diameter. Nanomedicine is the application of nanotechnology for the diagnosis and treatment of human disease. Disease-specific receptors on the surface of cells provide useful targets for nanoparticles. Because nanoparticles can be engineered from components that (1) recognize disease at the cellular level, (2) are visible on imaging studies, and (3) deliver therapeutic compounds, nanotechnology is well suited for the diagnosis and treatment of a variety of diseases. Nanotechnology will enable earlier detection and treatment of diseases that are best treated in their initial stages, such as cancer. Advances in nanotechnology will also spur the discovery of new methods for delivery of therapeutic compounds, including genes and proteins, to diseased tissue. A myriad of nanostructured drugs with effective site-targeting can be developed by combining a diverse selection of targeting, diagnostic, and therapeutic components. Incorporating immune target specificity with nanostructures introduces a new type of treatment modality, nano-immunochemotherapy, for patients with cancer. In this review, we will discuss the development and potential applications of nanoscale platforms in medical diagnosis and treatment. To impact the care of patients with neurological diseases, advances in nanotechnology will require accelerated translation to the fields of brain mapping, CNS imaging, and nanoneurosurgery. Advances in nanoplatform, nano-imaging, and nano-drug delivery will drive the future development of nanomedicine, personalized medicine, and targeted therapy. We believe that the formation of a science, technology, medicine law-healthcare policy (STML) hub/center, which encourages collaboration among universities, medical centers, US government, industry, patient advocacy groups, charitable foundations, and philanthropists, could significantly facilitate such advancements and contribute to the translation of nanotechnology across medical disciplines.

Resting energy expenditure and glucose, protein and fat oxidation in severe chronic virus hepatitis B patients.

AIM: To study and determine the resting energy expenditure (REE) and oxidation rates of glucose, fat and protein in severe chronic hepatitis B patients. METHODS: A total of 100 patients with liver diseases were categorized into three groups: 16 in the acute hepatitis group, 56 in the severe chronic hepatitis group, and 28 in the cirrhosis group. The REE and the oxidation rates of glucose, fat and protein were assessed by indirect heat measurement using the CCM-D nutritive metabolic investigation system. RESULTS: The REE of the severe chronic hepatitis group (20.7 +/- 6.1 kcal/d per kg) was significantly lower than that of the acute hepatitis group (P = 0.014). The respiratory quotient (RQ) of the severe chronic hepatitis group (0.84 +/- 0.06) was significantly lower than that of the acute hepatitis and cirrhosis groups (P = 0.001). The glucose oxidation rate of the severe hepatitis group (39.2%) was significantly lower than that of the acute hepatitis group and the cirrhosis group (P < 0.05), while the fat oxidation rate (39.8%) in the severe hepatitis group was markedly higher than that of the other two groups (P < 0.05). With improvement of liver function, the glucose oxidation rate increased from 41.7% to 60.1%, while the fat oxidation rate decreased from 26.3% to 7.6%. CONCLUSION: The glucose oxidation rate is significantly decreased, and a high proportion of energy is provided by fat in severe chronic hepatitis. These results warrant a large clinical trail to assess the optimal nutritive support therapy for patients with severe liver disease.

Influencing the use of antibiotics in a Chinese pediatric intensive care unit.

OBJECTIVES: To demonstrate the effectiveness of an intervention in antibiotics prescribing, and evaluate the use of antibiotics in the pediatric intensive care unit (PICU) at the Beijing Children's Hospital. METHODS: Our interventions included (1) educating the pediatricians on antibiotics prescribing, (2) applying an antimicrobial spectrum chart, and (3) controlling the prescription of specific antibiotics with the use of a guideline. Nine hundred clinical records, including clinical information and antibiotic usage data, were selected retrospectatively from the PICU admissions during the pre- and post-intervention periods. RESULTS: In this 5-year survey, the mean rate of antibiotic prescribing was greater than 95% in the PICU. More than 76% of the prescriptions were started empirically. The most frequently used antibiotics were third-generation cephalosporins. After the intervention, we found a reduction in the rate of antibiotic cost/patient/day (P < 0.05); a decrease in the prescription rate of third-generation cephalosporins and macrolides (P < 0.01); an increase in the prescription rate of beta-lactam/beta-lactamase inhibitors and second-generation cephalosporins (P < 0.01); a reduction in the empiric treatment (P < 0.01); and a significant reduction in the incidence rates of bacterial resistance for imipenem-, cefepime-, and ceftazidime-resistant Pseudomonas aeruginosa (P < 0.05), and cefepime-resistant Escherichia coli and Klebsiella pneumoniae (P < 0.01). CONCLUSION: Our interventions led to a significant reduction of broad-spectrum antibiotic prescribing associated with the significant reduction in bacterial resistance in the PICU. The implementation of the antibiotics guideline appeared to be effective.

Five-year surveillance of antimicrobial use in Chinese Pediatric Intensive Care Units.

In order to demonstrate antibiotic usage in Chinese Pediatric Intensive Care Units (PICUs), and provide some data to further study on relation of antimicrobial use and resistance. We reviewed the use of antibiotics in Chinese PICUs from 2002 to 2006. All data, including general data and antibiotic use data, were obtained from five PICUs of pediatric teaching hospitals in China. The results of antibiotic use were expressed as defined daily doses (DDDs) per 100 patient-days by WHO in this study. All 12 743 patients were included from the five PICUs in this study. Length of stay in PICUs was essentially unchanged, but the percentage of antimicrobial costs vs. drug costs dramatically decreased in this study period (p < 0.01). The percentage of empiric treatment decreased by year (from 82.2% to 70.2%). while the percentage of therapeutic treatment increased by year (from 11.2% to 24.2%) from 2002 to 2006. Total antibiotic usage decreased from 72.1 DDDs per 100 patient-days to 35.5 DDDs per 100 patient-days from 2002 to 2006 (p < 0.05). The significant increase was found in the DDDs per 100 patient-days of second generation cephalosporins in this study (p < 0.05). While usages of the some antibiotics decreased, for example penicillins, third-generation cephalosporins, and macrolides in this study period. The data of antimicrobial use were obtained from five PICUs of biggest pediatric teaching hospital in this 5-year period, which could serve as a basis of antibiotic treatment and a benchmark in future study of antibiotic use.

Charge couple device-based system for 3-dimensional real time positioning on the assessment of segmental range of motion of lumbar spine.

OBJECTIVE: To observe the tested results of the segmental range of motion (ROM) of lumbar spine by charge couple device (CCD)-based system for 3-dimensional real-time positioning (CCD system), and to analyze its clinical significance. METHODS: Seven patients with lumbar joint dysfunction and 8 healthy subjects were tested twice by the CCD-based system with an interval of 10 min. RESULTS: The ROM of the patients was obviously lesser than that of the healthy subjects. The measuring data of segmental ROM of lumbar spine by CCD system is correlated significantly to the same data checked later on the same subjects in every direction of the movements. The differences between two checks are usually less than 1 degree. CONCLUSION: Specially designed CCD based system for 3-dimensional real-time positioning could objectively reflect the segmental ROM of lumbar spine. The system would be of great clinical significance in the assessment of the biomechanical dysfunction of lumbar spine and the effect of the treatment applied.