Construction and effectiveness evaluation of surgical complication monitoring mode based on medical record homepage data / 中华医院管理杂志

Objective:To explore the establishment of a surgical complication monitoring mode based on data on the medical record homepage, and analyze its impact on the trend of changes in surgical complication incidence.Methods:A monitoring mode of surgical complication was developed based on the " structure-process-results" framework by using surgical complication rates derived from performance appraisal for a tertiary general hospital in Guangzhou. The number of surgical complications and the number of discharged surgical patients was collected from the hospital from January 2019 to June 2022 through the home page collection system for performance appraisal of national tertiary public hospitals. Descriptive analysis was used to analyze the incidence of surgical complications, and Joinpoint regression was used to analyze the trend of changes in the incidence of surgical complications. Monthly percentage change ( MPC) and average monthly percentage change ( AMPC) were calculated. Results:Since the hospital began implementing the surgical complication monitoring mode in May 2021, the incidence of surgical complications had decreased from 2.55% in June 2021 to 0.82% in June 2022, with an MPC of -5.58% ( P=0.024), which was better than the changes from January 2019 to May 2021 ( MPC=0.18%, P=0.755). Conclusions:The surgical complication monitoring mode constructed by the hospital can effectively reduce the incidence of surgical complications, providing reference for optimizing hospital′s medical quality management process and decision-making mode.

Chinese effective control and other countries uncharted challenge against COVID-19: an epidemiological and modelling study

BackgroundOn the present trajectory, COVID is inevitably becoming a global epidemic, leading to concerns regarding the pandemic potential in China and other countries. ObjectiveIn this study, we use the time-dependent reproduction number (Rt) to comprise the COVID transmissibility across different countries. MethodsWe used data from Jan 20, 2019, to Feb 29, 2020, on the number of newly confirmed cases, obtained from the reports published by the CDC, to infer the incidence of infectious over time. A two-step procedure was used to estimate the Rt. The first step used data on known index-secondary cases pairs, from publicly available case reports, to estimate the serial interval distribution. The second step estimated the Rt jointly from the incidence data and the information data in the first step. Rt was then used to simulate the epidemics across all major cities in China and typical countries worldwide. ResultsBased on a total of 126 index-secondary cases pairs from 4 international regions, we estimated that the serial interval for SARS-2-CoV was 4.18 (IQR 1.92 - 6.65) days. Domestically, Rt of China, Hubei province, Wuhan had fallen below 1.0 on 9 Feb, 10 Feb and 13 Feb (Rt were 0.99{+/-}0.02, 0.99{+/-}0.02 and 0.96{+/-}0.02), respectively. Internationally, as of 26 Feb, statistically significant periods of COVID spread (Rt >1) were identified for most regions, except for Singapore (Rt was 0.92{+/-}0.17). ConclusionsThe epidemic in China has been well controlled, but the worldwide pandemic has not been well controlled. Worldwide preparedness and vulnerability against COVID-19 should be regarded with more care. O_LSTWhat is already known on this subject?C_LSTO_LIThe basic reproduction number (R0) and the-time-dependent reproduction number (Rt) are two important indicators of infectious disease transmission. In addition, Rt as a derivative of R0 could be used to assess the epidemiological development of the disease and effectiveness of control measures. Most current researches used data from earlier periods in Wuhan and refer to the epidemiological features of SARS, which are possibly biased. Meanwhile, there are fewer studies discussed the Rt of COVID-19. Current clinical and epidemiological data are insufficient to help us understand the full view of the potential transmission of this disease. C_LI O_LSTWhat this study adds?C_LSTO_LIWe use up-to-data observation of the serial interval and cases arising from local transmission to calculate the Rt in different outbreak level area and every province in China as well as five-top sever outbreak countries and other overseas. By comparing the Rt, we discussed the situation of outbreak around the world. C_LI

Understand Research Hotspots Surrounding COVID-19 and Other Coronavirus Infections Using Topic Modeling

BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a virus that causes severe respiratory illness in humans, which results in global outbreak of novel coronavirus disease (COVID-19) currently. This study aimed to evaluate the characteristics of publications involving coronaviruses as well as COVID-19 by using topic modeling. MethodsWe extracted all abstracts and retained the most informative words from the COVID-19 Open Research Dataset, which contains 35,092 pieces of coronavirus related literature published up to March 20, 2020. Using Latent Dirichlet Allocation modeling, we trained a topic model from the corpus, analyzed the semantic relationships between topics and compared the topic distribution between COVID-19 and other CoV infections. ResultsEight topics emerged overall: clinical characterization, pathogenesis research, therapeutics research, epidemiological study, virus transmission, vaccines research, virus diagnostics, and viral genomics. It was observed that current COVID-19 research puts more emphasis on clinical characterization, epidemiological study, and virus transmission. In contrast, topics about diagnostics, therapeutics, vaccines, genomics and pathogenesis only account for less than 10% or even 4% of all the COVID-19 publications, much lower than those of other CoV infections. ConclusionsThese results identified knowledge gaps in the area of COVID-19 and offered directions for future research.

Factors Affecting the Response to First-Line Treatments in Patients with Anti-N-Methyl-D-Aspartate Receptor Encephalitis

BACKGROUND AND PURPOSE: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is the most common type of autoimmune encephalitis. This study aimed to explore the possible factors affecting the response to first-line treatments in patients with anti-NMDAR encephalitis. METHODS: We enrolled 29 patients who were diagnosed as anti-NMDAR encephalitis between January 1, 2015, and June 30, 2018. They were divided into the remission and nonremission groups according to their response to first-line treatments. The demographics, clinical manifestations, main ancillary examinations, follow-up treatments, and prognosis of patients were recorded. The symptoms reported on in this study occurred before treatments or during the course of first-line treatments. RESULTS: There were 18 patients (62.07%) in the remission group and 11 patients (37.93%) in the nonremission group. Compared to the remission group, a higher proportion of the patients in the nonremission group exhibited involuntary movements, decreased consciousness, central hypoventilation, lung infection, and hypoalbuminemia. The nonremission group had a high incidence of increased intracranial pressure and significant elevations of the neutrophil-to-lymphocyte ratio in peripheral blood (NLR), aspartate aminotransferase, and fibrinogen. Six patients (54.55%) in the nonremission group received second-line immunotherapy. Only one patient (3.45%) died, which was due to multiple-organ failure. CONCLUSIONS: Anti-NMDAR-encephalitis patients with more symptoms—especially involuntary movements, disturbance of consciousness, central hypoventilation, and accompanying hypoalbuminemia and pulmonary infection—may respond poorly to first-line treatments. Positive second-line immunotherapy therefore needs to be considered. Admission to an intensive-care unit, increased cerebrospinal fluid pressure, and increased NLR might be the significant factors affecting the response to first-line treatments.

The application of 3-D scanning in the diagnosis and evaluation of pectus excavatum / 中华胸心血管外科杂志

Objective To investigate the application of 3-D scanning in the diagnosis and evaluation of pectus excava-tum.Methods From July 2016 to June 2017, chest CT concomitant 3-D scanning were performed in 90 pectus excavatum pa-tients before Nuss procudure.Another 30 cases underwent chest CT scanning for non-chest deformity causes were chosen as a control group.The transverse and anterior-posterior maximum diameter through the deepest point of chest wall deformity were measured.The surface topography index and Haller index were calculated respectively .Results There was a positive correla-tion between CT and 3-D scanning diameters of the transverse and anterior-posterior maximum diameters, and consistency rates were 94% and 82%, respectively.There was significant difference between pectus excavatum group 1.82 ±0.21 and control group 1.41 ±0.07 in the STI(P<0.001).There was a positive correlation between Haller index 5.12 ±3.36 and STI 1.82 ± 0.21, and consistency rate was 89%.The Delong's test showed no significant difference between ROC of HI and STI(Z =1.18, P=0.28).Conclusion 3-D scanning and STI of pectus excavatum is a validated alternative for CT and Haller index, especially in the infant and non-surgical treatment PE cases.

Diagnostic efficacy of lung ultrasound and X-ray for neonatal respiratory distress syndrome and transient tachypnea / 中国医学影像技术

Objective To compare the efficacy of lung ultrasound and chest X-ray for diagnosis of neonatal transient respiration syndrome (TTN) and respiratory distress syndrome (RDS).Methods Totally 120 infants with respiratory distress underwent lung ultrasound and chest X-ray within 6 h after birth.Taking clinical diagnosis as the standard,the sensitivity,specificity and accuracy of lung ultrasound and X-ray for diagnosis of TTN and RDS were calculated.Results According to clinical diagnosis,there were 75 infants of TTN and 34 of RDS.The sensitivity,specificity and accuracy of lung ultrasound in diagnosis of TTN was 96.00％ (72/75),88.89％ (40/45) and 93.33％ (112/120),respectively,higher than those of chest X-ray (85.33％ [64/75],84.44％ [38/45] and 85.00％ [102/120]).Lung ultrasound showed 85.29％ (29/34) of sensitivity,95.35％ (82/86) of specificity and 92.50％ (111/120) of accuracy for diagnosis of RDS,whereas chest X-ray showed 88.23％ (30/34) of sensitivity,89.53％ (77/86) of specificity and 89.17％ (107/120) of accuracy.Conclusion Lung ultrasound is accurate for the diagnosis of TTN and RDS.

A Clinical Study on Acupuncture and Moxibution Combined with Cognitive Training in Treating Cognitive Impairment after Traumatic Brain Injury / 中国中医药信息杂志

Objective To observe the clinical efficacy of acupuncture and moxibustion combined with cognitive training in treating cognitive impairment after traumatic brain injury (TBI). MethodsSixty patients were recruited into the study and randomly divided into the control group and the treatment group according to the MINIMIZE software. Patients in the control group were treated with cognitive training and regular treatment. Besides the traditional treatment, patients in the treatment group were additionally treated with acupuncture and moxibution. The treatment lasted four weeks. Mini-Mental State Examination (MMSE) and Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) were applied to evaluate the patients’ cognitive function before and after the treatment.Results In the end, there were 27 patients in the control group and 28 patients in the treatment group, because 5 patients withdrew from the study. After treatment, scores of MMSE, LOTCA and their sub-items in the control group and the treatment group increased significantly (P<0.05), and the scores in the treatment group were higher than the control group (P<0.05).Conclusion Combination of acupuncture, moxibution, and cognitive training could help patients after TBI to increase the scores of MMSE and LOTCA, and improve the cognitive impairment caused by TBI. Its therapeutic effect is superior than the pure cognitive training.

Clinical observation of cognitive impairment after traumatic brain injury treated with acupuncture and cognitive training / 中国针灸

<p><b>OBJECTIVE</b>To observe the clinical efficacy on cognitive impairment after traumatic brain injury (TBD treated with acupuncture and cognitive training.</p><p><b>METHODS</b>Sixty patients were randomized into an observation group and a control group, 30 cases in each one, and 5 cases of them were dropped out due to the earlier discharge. Finally, there were 28 cases in the observation group and 27 cases in the control group. In the control group, the cognitive training and conventional treatment were applied. In the observation group, on the basis of the treatment as the control group, acupuncture was applied to Baihui (GV 20), Fengchi (GB 20), Geshu (BL 17) and Fenglong (ST 40), once a day, for 4 weeks totally. The mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) were adopted to evaluate the cognitive function in the patients of post-TBI cognitive impairment.</p><p><b>RESULTS</b>(1) After treatment, the total score in MMSE and the score of each item were increased significantly as compared with those before treatment in the two groups (all P<0. 05). Except for the score of immediate recall, the score in MMSE and the score of each of the other items were increased significantly in the observation group as compared with those in the control group after treatment (all P<0. 05). (2)After treatment, the total score in MoCA and the score of each item were increased significantly as compared with those before treatment in the two groups (all P<. 05). Except for the score of nomenclature item, the total score in MoCA and the score of each of the other items were increased significantly in the observation group as compared with those in the control group after treatment (all P<0. 05).</p><p><b>CONCLUSION</b>Both the simple cognitive training and the combined therapy of acupuncture and cognitive training improve MMSE and MoCA scores and relieve the cognitive impairment induced by TBI. But the combined therapy achieves the much better efficacy.</p>

The effects of electroacupuncture on the expression and phosphorylation of AMPAR and CaMK Ⅱ in hippocampus in rats with vascular dementia / 中华物理医学与康复杂志

Objective To observe the effect of electroacupuncture(EA) on the hippocampal expression of GluA1,pGluA1,CaMK Ⅱ and pCaMK Ⅱ in rats with vascular dementia(VD),so as to find out the underlying mo lecular mechanisms of EA in treating VD.Methods Thirty-two Wistar rats were randomly divided into a shamoperation group,a model group,a sham-acupuncture group,and an EA group (8 in each group).Permanent bilateral common carotid artery occlusion was performed to model vascular dementia in the model group,the shamacupuncture group and the EA group,while exposure but no occlusion of the bilateral common carotid were performed in the sham-operating group.Novel object recognition test was adopted to prove the establishment of VD rat model.All the rats were kept in an immobilization apparatus while receiving treatments.EA was applied ontoBaihui (GV20) and Zusanli (ST36) in EA group for 30 min,once daily for 7 days.Sham-acupuncture group were treated with needles inserted 0.5 mm superficially.And the sham-operation group and the model group were only immobilized.The protein expression of GluA1,pGluA1,CaMK Ⅱ and pCaMK Ⅱ in hippocampal tissue was detected by western blotting.Results The expression of GluA1 in the model group (1.216 ± 0.102) was significantly less than in the sham-operating group (1.918 ± 0.137) (P ＜ 0.05).The expression of GluA1 in the EA group (1.653 ± 0.169) was significantly higher than in the model group (1.216 ± 0.102) and in sham-acupuncture group (1.231 ±0.188) (P＜0.05).The expression of CaMKⅡ in the model group (1.516±0.392) was less than in the sham-operating group (2.187 ± 0.231) (P ＜ 0.05).The expression of CaMK Ⅱ in the EA group (2.733 ±0.387) was significantly higher than in the model group (1.516 ±0.392) and sham-acupuncture group (1.493 ±0.205) (P＜0.05).The expression ofpGluA1 in the model group (1.502 ±0.419) was less than in the sham-operating group (2.253 ± 0.244) (P ＜ 0.05).The expression of pGluA1 in the EA group (2.382 ± 0.308) was significantly higher than in the model group (1.502 ± 0.419) and the sham-acupuncture group (1.498 ± 0.223) (P ＜ 0.05).The expression of pCaMK Ⅱ in the model group (0.394 ± 0.227) was less than in the sham-operating group (0.667 ±0.175) (P＜0.05).The expression ofpCaMKⅡ in the EA group (1.189± 0.346) was significantly higher than in the model group (0.394 ± 0.227) and the sham-acupuncture group (0.408 ± 0.231) (P ＜ 0.05).Conclusion EA can enhance the protein expression and phosporylation of GluA1 and CaMK Ⅱ,causing silent synapses transforming into functional synapses,and consequently,long term potentiation was facilitated and cognitive impairment was improved by EA.

Botulinum toxin in the treatment of sialorrhea attributable to brain damage : A preliminary study / 中华物理医学与康复杂志

Objective To evaluate the effect of ultrasound-guided botulinum toxin A injection into the salivary glands in treating patients with sialorrhea attributable to brain damage.Methods Nine subjects with sialorrhea attributable to traumatic brain injury (n =5),cerebral infarction (n =3) and hypoxic ischemic encephalopathy (n =1) were recruited into the study.With the guidance of ultrasound,15 units (U) of botulinum toxin type A was injected into the highest and lowest points of the two parotid glands,and 20 U was injected into two points of both submandibular glands.The saliva flow rate and the severity and frequency of sialorrhea were recorded before the treatment and 1 week,4 weeks and 12 weeks later using the Drooling Scoring System (DSS).Results The saliva flow rate before treatment (0.49 ± 0.12 g/min) decreased significantly to 0.24 ± 0.08 g/min after 1 week,but then increased again to 0.28 ±0.12 g/min after 4 weeks and 0.34 ±0.11 g/min after 12 weeks.The average DSS severity score showed the same pattern:4.35 ± 0.48 initially 1.92 ± 0.37 after 1 week,1.92 ± 0.37 after 2 weeks and 2.32 ± 0.64 after 12 weeks.The DSS frequency score,however,remained significantly lower:3.56 ± 0.49 initially,2.01 ± 0.42 after 1 and 4 weeks and 2.28 ± 0.63 after 12 weeks.Conclusion Botulinum toxin type A can effectively improve the salivary secretion and sialorrhea attributable to brain damage.

Epidemiological survey and analysis on an outbreak of gastroenteritis due to water contamination / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To document the investigation and control of an outbreak of gastroenteritis in City G, South China, and provide a reference for preventing future outbreaks.</p><p><b>METHODS</b>An ambispective cohort study was designed. Attack rate (AR) and relative risks (RR) were calculated to identify the causes of gastroenteritis. Investigations using questionnaires included personal interviews with patients and doctors, reviews of medical records, laboratory examinations of fecal specimens and continuous hygiene monitoring of water samples from the waterworks.</p><p><b>RESULTS</b>Overall, 427/71534 (AR=5.97%) cases were identified between October 31 and November 12 2010. Geographic distribution was highly localized, with 80% of cases occurring in the areas supplied by waterworks-A. Consumption of water provided solely by waterworks-A was found to be associated with illness (RR=8.20, 95 CI%:6.12-10.99) compared with that from waterworks-B. Microbiological analyses confirmed the presence of Norovirus in six of eight fecal samples from symptomatic patients, two water samples from waterworks-A and two sewage samples. After taking effective measures, the hygienic indices of waterworks-A met health criteria again on November 9 and no cases were reported 3 days later.</p><p><b>CONCLUSION</b>The outbreak reported here was caused by drinking tap water contaminated with sewage at the source. Early identification of possible contamination sources and awareness of changes that might negatively impact water quality are important preventive measures to protect public health.</p>