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肿瘤临床大数据管理系统设计与应用

马麟,包晨露,李青,吴静依,潘虹安,李鹏飞,张路霞,詹启敏

《中国工程科学》 2022年 第24卷 第6期   页码 127-136 doi: 10.15302/J-SSCAE-2022.06.011

摘要：

肿瘤是人类生命健康的重要威胁，随着我国医疗行业信息化的发展，医疗机构积累了大量的肿瘤临床数据，但因数据标准不统一、治理难度大等原因制约了数据价值的充分挖掘；应用人工智能（AI）等前沿信息技术建设肿瘤临床大数据管理系统，有助于肿瘤临床数据的深入应用、临床诊疗管理质量与效率提升。本文剖析了我国肿瘤临床数据治理与应用面临的问题及挑战，研判了肿瘤临床大数据管理体系的应用价值；针对肿瘤临床数据多来源、多模态的复杂特性，探索了AI 技术应用于肿瘤临床大数据管理与科研的机制及路径；设计了包括肿瘤通用数据模型构建、临床数据采集与安全管理、标准化结构化治理、分析与建模应用、数据质量管理在内的全流程解决方案，阐述了相应系统的建设框架与技术体系；以某三甲医院肺癌临床大数据平台为案例，展示了所提方案在临床实践中的可行性及应用价值。相关研究可为丰富我国肿瘤临床大数据管理系统的建设实践、探讨领域未来重点研究方向提供参考和启示。

关键词： 临床大数据；管理系统；肿瘤；人工智能；通用数据模型；自然语言处理    

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Basic consideration of research strategies for head and neck cancer

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《医学前沿（英文）》 2012年 第6卷 第4期   页码 339-353 doi: 10.1007/s11684-012-0213-7

摘要：

Head and neck cancer (HNC) consists of a group of malignancies affecting closely related anatomical regions of the upper aerodigestive tract (UADT), including the oral cavity, salivary glands, upper and lower jaw bones and facial skin; the nasal cavity, paranasal sinuses, pharynx, larynx and thyroid gland (although the latter is often excluded and considered as part of endocrine neoplasms). Of these, 90% of HNCs are histologically squamous cell carcinomas originating from the mucosal lining. These malignancies are strongly associated with certain environmental and life-style risk factors, principally tobacco in both smoked and smokeless forms, excessive alcohol consumption, diets poor in antioxidants and essential micronutrients, UV light, chemicals used in certain workplaces, and viruses, principally certain strains of human papillomavirus (HPV) and Epstein-Barr virus (EBV). These cancers are frequently aggressive in their biological behaviour with local invasion and metastasis to lymph nodes in the neck. Since most patients are already at late stages of disease at the time of diagnosis, the desirable practice of early diagnosis (first sign of the malignant lesion at an initial stage ) and early treatment, a critical priority to save lives and retain quality of life, is difficult to implement. Thus, primary prevention has been set as a key goal. This article aims to reinforce the basic knowledge of aetiology, key risk factors related to the development of head and neck cancer, basic features of clinical appearance of this group of cancers, and strategies for prevention and early detection. We also suggest basic research strategies on the basis of current knowledge, which should ultimately lead to the improvement of clinical management.

关键词： clinical management     head and neck cancer     prevention and early detection     research strategies     risk factors    

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Ontological reconstruction of the clinical terminology of traditional Chinese medicine

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《医学前沿（英文）》 2014年 第8卷 第3期   页码 358-361 doi: 10.1007/s11684-014-0348-9

摘要：

This study proposes the ontological reconstruction of the current clinical terminology of traditional Chinese medicine (TCM). It also provides an overview of preliminary work related to the said reconstruction, including the ontology-based analysis of TCM clinical terminology. We conclude that the ontological reconstruction of TCM clinical terminology provides a proper translation from the idealized organizational model to real-world implementation and to a formalized, shared, and knowledge-based framework.

关键词： ontology     traditional Chinese medicine     clinical terminology    

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一种临床动态安全清单系统配置平台的设计与实现 None

Shan NAN, Xu-dong LU, Pieter VAN GORP, Hendrikus H. M. KORSTEN, Richard VDOVJAK, Uzay KAYMAK, Hui-long DUAN

《信息与电子工程前沿（英文）》 2018年 第19卷 第7期   页码 937-946 doi: 10.1631/FITEE.1700623

摘要： 近年来的研究日益表明，清单可显著改善病人安全。为促使清单在临床实践中有效使用，医学界和信息学界都建议把清单部署成动态清单系统，实现与临床信息系统的集成，动态适配病人上下文信息。然而，由于系统与特定内容的紧密耦合，开发这样的系统非常困难。提出一种临床安全清单系统动态配置平台，整合平台内部基础设施构建动态安全清单系统，避免用户为每个应用重复开发安全清单系统。分析现有清单系统功能和实施中的经验教训，定义了该平台的设计指标。然后整合基于规则的临床决策支持技术和工作流管理技术，设计了一套技术方案。基于该技术方案，设计开发了一套动态清单配置平台，并基于多个临床案例对其不断完善。通过应用该平台，开发了针对9个典型医疗流程的242个动态清单。结果表明，使用本文提出的方法实现临床动态安全清单系统的配置，具有可行性和通用性。

关键词： 清单；工作流；临床决策支持；过程管理；病人安全    

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The clinical impact of tricuspid regurgitation in patients with a biatrial orthotopic heart transplant

《医学前沿（英文）》 2023年 第17卷 第3期   页码 527-533 doi: 10.1007/s11684-022-0967-5

摘要： In this study, we aim to elucidate the clinical impact and long-term course of tricuspid regurgitation (TR), taking into account its dynamic nature, after biatrial orthotopic heart transplant (OHT). All consecutive adult patients undergoing biatrial OHT (1984−2017) with an available follow-up echocardiogram were included. Mixed-models were used to model the evolution of TR. The mixed-model was inserted into a Cox model in order to address the association of the dynamic TR with mortality. In total, 572 patients were included (median age: 50 years, males: 74.9%). Approximately 32% of patients had moderate-to-severe TR immediately after surgery. However, this declined to 11% on 5 years and 9% on 10 years after surgery, adjusted for survival bias. Pre-implant mechanical support was associated with less TR during follow-up, whereas concurrent LV dysfunction was significantly associated with more TR during follow-up. Survival at 1, 5, 10, 20 years was 97% ± 1%, 88% ± 1%, 66% ± 2% and 23% ± 2%, respectively. The presence of moderate-to-severe TR during follow-up was associated with higher mortality (HR: 1.07, 95% CI (1.02–1.12), p = 0.006). The course of TR was positively correlated with the course of creatinine (R = 0.45). TR during follow-up is significantly associated with higher mortality and worse renal function. Nevertheless, probability of TR is the highest immediately after OHT and decreases thereafter. Therefore, it may be reasonable to refrain from surgical intervention for TR during earlier phase after OHT.

关键词： orthotopic heart transplant     tricuspid regurgitation     clinical impact     biatrial heart transplantation    

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Obesity-related glomerulopathy: pathogenesis, pathologic, clinical characteristics and treatment

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《医学前沿（英文）》 2017年 第11卷 第3期   页码 340-348 doi: 10.1007/s11684-017-0570-3

摘要：

In light of the rapid increase in the number of obesity incidences worldwide, obesity has become an independent risk factor for chronic kidney disease. Obesity-related glomerulopathy (ORG) is characterized by glomerulomegaly in the presence or absence of focal and segmental glomerulosclerosis lesions. IgM and complement 3 (C3) nonspecifically deposit in lesions without immune-complex-type deposits during ORG immunofluorescence. ORG-associated glomerulomegaly and focal and segmental glomerulosclerosis can superimpose on other renal pathologies. The mechanisms under ORG are complex, especially hemodynamic changes, inflammation, oxidative stress, apoptosis, and reduced functioning nephrons. These mechanisms synergize with obesity to induce end-stage renal disease. A slow increase of subnephrotic proteinuria (<3.5 g/d) is the most common clinical manifestation of ORG. Several treatment methods for ORG have been developed. Of these methods, renin–angiotensin–aldosterone system blockade and weight loss are proven effective. Targeting mitochondria may offer a novel strategy for ORG therapy. Nevertheless, more research is needed to further understand ORG.

关键词： obesity-related glomerulopathy     pathogenesis     pathologic     clinical characteristics    

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Coronavirus disease 2019 (COVID-19): a clinical update

Min Zhou, Xinxin Zhang, Jieming Qu

《医学前沿（英文）》 2020年 第14卷 第2期   页码 126-135 doi: 10.1007/s11684-020-0767-8

摘要： Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has posed a significant threat to global health. It caused a total of 80 868 confirmed cases and 3101 deaths in Chinese mainland until March 8, 2020. This novel virus spread mainly through respiratory droplets and close contact. As disease progressed, a series of complications tend to develop, especially in critically ill patients. Pathological findings showed representative features of acute respiratory distress syndrome and involvement of multiple organs. Apart from supportive care, no specific treatment has been established for COVID-19. The efficacy of some promising antivirals, convalescent plasma transfusion, and tocilizumab needs to be investigated by ongoing clinical trials.

关键词： coronavirus disease 2019     epidemiology     pathology     radiology     clinical characteristics     treatment    

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Hypertension in patients with CKD in China: clinical characteristics and management

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《医学前沿（英文）》 2017年 第11卷 第3期   页码 307-309 doi: 10.1007/s11684-017-0578-8

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Bone metastasis of hepatocellular carcinoma: facts and hopes from clinical and translational perspectives

《医学前沿（英文）》 2022年 第16卷 第4期   页码 551-573 doi: 10.1007/s11684-022-0928-z

摘要： Patients with hepatocellular carcinoma (HCC) and bone metastasis (BM) suffer from greatly reduced life quality and a dismal prognosis. However, BM in HCC has long been overlooked possibly due to its relatively low prevalence in previous decades. To date, no consensus or guidelines have been reached or formulated for the prevention and management of HCC BM. Our narrative review manifests the increasing incidence of HCC BM to sound the alarm for additional attention. The risk factors, diagnosis, prognosis, and therapeutic approaches of HCC BM are detailed to provide a panoramic view of this disease to clinicians and specialists. We further delineate an informative cancer bone metastatic cascade based on evidence from recent studies and point out the main factors responsible for the tumor-associated disruption of bone homeostasis and the formation of skeletal cancer lesions. We also present the advances in the pathological and molecular mechanisms of HCC BM to shed light on translational opportunities. Dilemmas and challenges in the treatment and investigation of HCC BM are outlined and discussed to encourage further endeavors in the exploration of underlying pathogenic and molecular mechanisms, as well as the development of novel effective therapies for HCC patients with BM.

关键词： HCC     bone     osteotropism     clinical     basic researches     advances    

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Heterogeneity of the tumor immune microenvironment and clinical interventions

《医学前沿（英文）》 2023年 第17卷 第4期   页码 617-648 doi: 10.1007/s11684-023-1015-9

摘要： Heterogeneity of the tumor immune microenvironment and clinical interventions

关键词： Heterogeneity tumor immune    

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Pathogen evolution, prevention/control strategy and clinical features of COVID-19: experiences from China

《医学前沿（英文）》 doi: 10.1007/s11684-023-1043-5

摘要： Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reported at the end of 2019 as a worldwide health concern causing a pandemic of unusual viral pneumonia and many other organ damages, which was defined by the World Health Organization as coronavirus disease 2019 (COVID-19). The pandemic is considered a significant threat to global public health till now. In this review, we have summarized the lessons learnt during the emergence and spread of SARS-CoV-2, including its prototype and variants. The overall clinical features of variants of concern (VOC), heterogeneity in the clinical manifestations, radiology and pathology of COVID-19 patients are also discussed, along with advances in therapeutic agents.

关键词： coronavirus disease 2019     SARS-CoV-2     epidemiology     clinical features    

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健康管理的现状与发展策略

李江,陶沙,李明,傅华,王克安,田传胜,王陇德

《中国工程科学》 2017年 第19卷 第2期   页码 8-15 doi: 10.15302/J-SSCAE-2017.02.002

摘要：

本文以文献研究为基础，通过选取江苏、浙江、上海三地有代表性的社区卫生服务中心、企业、健康保险公司以及健康管理服务机构共17家单位开展了调研，结果发现我国在开展健康管理过程中存在一些问题，如社区卫生服务中心无论在人员配备上还是服务内容上都与有效的健康管理服务存在差距；企业具有开展健康管理的意愿，外资企业与大型国企都已经开展了有益的尝试并取得了不错的效果，国内中小型企业、公司缺乏独立开展职工健康管理的能力；健康保险公司由于缺乏盈利模式大多不愿意开展健康险服务，健康管理多作为附加选项服务于高端客户；健康管理服务公司的业务以体检为主，大多并没有开展真正意义上的健康管理。针对这些问题课题组提出了八个相关的政策建议及相应的对策。

关键词： 健康管理     健康风险评估     生命全程     基本公共卫生服务     临床预防服务     社区卫生服务     健康保险    

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Genetic and clinical markers for predicting treatment responsiveness in rheumatoid arthritis

Xin Wu, Xiaobao Sheng, Rong Sheng, Hongjuan Lu, Huji Xu

《医学前沿（英文）》 2019年 第13卷 第4期   页码 411-419 doi: 10.1007/s11684-018-0659-3

摘要： Although many drugs and therapeutic strategies have been developed for rheumatoid arthritis (RA) treatment, numerous patients with RA fail to respond to currently available agents. In this review, we provide an overview of the complexity of this autoimmune disease by showing the rapidly increasing number of genes associated with RA. We then systematically review various factors that have a predictive value (predictors) for the response to different drugs in RA treatment, especially recent advances. These predictors include but are certainly not limited to genetic variations, clinical factors, and demographic factors. However, no clinical application is currently available. This review also describes the challenges in treating patients with RA and the need for personalized medicine. At the end of this review, we discuss possible strategies to enhance the prediction of drug responsiveness in patients with RA.

关键词： rheumatoid arthritis     gene     clinical markers     therapy    

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Biological properties and clinical applications of berberine

Danyang Song, Jianyu Hao, Daiming Fan

《医学前沿（英文）》 2020年 第14卷 第5期   页码 564-582 doi: 10.1007/s11684-019-0724-6

摘要： Berberine, an isoquinoline alkaloid isolated from the Chinese herb and other plants, has a wide range of pharmacological properties. Berberine can be used to treat many diseases, such as cancer and digestive, metabolic, cardiovascular, and neurological diseases. Berberine has protective capacities in digestive diseases. It can inhibit toxins and bacteria, including , protect the intestinal epithelial barrier from injury, and ameliorate liver injury. Berberine also inhibits the proliferation of various types of cancer cells and impedes invasion and metastasis. Recent evidence has confirmed that berberine improves the efficacy and safety of chemoradiotherapies. In addition, berberine regulates glycometabolism and lipid metabolism, improves energy expenditure, reduces body weight, and alleviates nonalcoholic fatty liver disease. Berberine also improves cardiovascular hemodynamics, suppresses ischemic arrhythmias, attenuates the development of atherosclerosis, and reduces hypertension. Berberine shows potent neuroprotective effects, including antioxidative, antiapoptotic, and anti-ischemic. Furthermore, berberine exerts protective effects against other diseases. The mechanisms of its functions have been extensively explored, but much remains to be clarified. This article summarizes the main pharmacological actions of berberine and its mechanisms in cancer and digestive, metabolic, cardiovascular, and neurological diseases.

关键词： berberine     Coptis chinensis     pharmacological properties     mechanism     clinical applications    

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Anatomy and embryology of umbilicus in newborns: a review and clinical correlations

null

《医学前沿（英文）》 2016年 第10卷 第3期   页码 271-277 doi: 10.1007/s11684-016-0457-8

摘要：

Umbilicus is considered a mirror of the abdomen in newborns. Despite its importance, the umbilicus has been stated in literature and textbooks as discrete subjects with many body systems, such as the urinary, digestive, and cardiovascular ones. This article aimed to address the basic knowledge of the umbilicus in relation to clinical disorders under one integrated topic to aid physicians and surgeons in assessing newborns and infants. The umbilicus appears as early as the fourth week of fetal life when the folding of the embryonic plate occurs. The umbilicus appears initially as a primitive umbilical ring on the ventral aspect of the body. The primitive umbilicus contains the connecting stalk, umbilical vessels, vitelline duct and vessels, allantois, and loop of the intestine. Changes occur to form the definitive cord, which contains three umbilical vessels, namely, “one vein and two arteries,” embedded in Wharton’s jelly. After birth, the umbilical vessels inside the body obliterate and gradually form ligaments. Congenital disorders at the umbilicus include herniation, bleeding, and discharge of mucous, urine, or feces. Some of these disorders necessitate emergent surgical interference, whereas others may be managed conservatively. The umbilicus has many embryological remnants. Thus, the umbilicus is prone to various clinical disorders. Detecting these disorders as early as possible is essential to prevent or minimize possible complications.

关键词： anatomy     embryology     newborns     umbilicus    

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标题 作者 时间 类型 操作

肿瘤临床大数据管理系统设计与应用

马麟,包晨露,李青,吴静依,潘虹安,李鹏飞,张路霞,詹启敏

期刊论文

Basic consideration of research strategies for head and neck cancer

null

期刊论文

Ontological reconstruction of the clinical terminology of traditional Chinese medicine

null

期刊论文

一种临床动态安全清单系统配置平台的设计与实现

Shan NAN, Xu-dong LU, Pieter VAN GORP, Hendrikus H. M. KORSTEN, Richard VDOVJAK, Uzay KAYMAK, Hui-long DUAN

期刊论文

The clinical impact of tricuspid regurgitation in patients with a biatrial orthotopic heart transplant

期刊论文

Obesity-related glomerulopathy: pathogenesis, pathologic, clinical characteristics and treatment

null

期刊论文

Coronavirus disease 2019 (COVID-19): a clinical update

Min Zhou, Xinxin Zhang, Jieming Qu

期刊论文

Hypertension in patients with CKD in China: clinical characteristics and management

null

期刊论文

Bone metastasis of hepatocellular carcinoma: facts and hopes from clinical and translational perspectives

期刊论文

Heterogeneity of the tumor immune microenvironment and clinical interventions

期刊论文

Pathogen evolution, prevention/control strategy and clinical features of COVID-19: experiences from China

期刊论文

健康管理的现状与发展策略

李江,陶沙,李明,傅华,王克安,田传胜,王陇德

期刊论文

Genetic and clinical markers for predicting treatment responsiveness in rheumatoid arthritis

Xin Wu, Xiaobao Sheng, Rong Sheng, Hongjuan Lu, Huji Xu

期刊论文

Biological properties and clinical applications of berberine

Danyang Song, Jianyu Hao, Daiming Fan

期刊论文

Anatomy and embryology of umbilicus in newborns: a review and clinical correlations

null

期刊论文