A New Social and Technological Paradigm to Assess Chronic Patient Management Process： Preliminary Results

The present research intends to address in a comprehensive, transversal, and interdisciplinary manner the chronic patient management process in the research project named ＂PRO DOMO SUD＂ in order to identify operational inefficiencies, thus demonstrating that these are largely attributable to incurred costs and, thus, evaluate possible solutions for providing effective and appropriate responses by healthcare and social services. Can patients/older people be treated, monitored, and managed successfully with mobile and wearable technologies？ The project involved three different groups of patients/participants： Patients with heart failure shock in ＂Home Monitoring Scenario＂; Patients with different pathologies in ＂Virtual Ward Scenario＂; Patients with limited mobility due to Neurological and Orthopaedic disease in ＂Rehabilitation Scenario＂. Due to the complexity of the issue, the methodological approach adopted must be multidimensional and interdisciplinary, addressing the complexity of the chronic patient from all viewpoints, not reducing it, yet analysing, understanding, rearranging, and managing it in an organic manner. The three different scenarios were allowed to identify several impacts on organizational and clinic management of chronic diseases, the tests showed significant improvements in quality of life of patients enrolled in the project. The data deriving from the three scenario demonstrate that wearable divide and ICT, in general, can empower both patients and physician personnel allowing them to be active part in the chronic disease management process. The PRO DOMO SUD experience derived from the Living Lab, this is a new paradigm for industrial research and development activities which allows the final users to actively collaborate with the designers and technicians in the development and test of new products and services aimed to them. The Living Labs stimulate social innovation by transferring research results from the closed industrial laboratory towards real life contexts where citizens and users become co-developers.

Random Forest Analysis the Influencing Factors on Adverse Drug Reactions of Qingkailing Injection

Objective:To investigate the influencing factors of adverse drug reaction(ADR)in Qingkailing injection.Methods:Based on the hospitals centralized monitoring data of multicenter and prospective,the patients who used Qingkailing injection from January 2013 to March 2016 were monitored in 48 medical institutions in China.The nesting case-control study was used and the random forest was used for analysis.The main contents of the analysis are as follows:past history,past allergy history and ADR history,clinical diagnosis,dosage,interval drug,solvent type,combined drug use,etc.Results:A total of 30842 cases with Qingkailing injection were included,with 92 cases of adverse reactions and the incidence of adverse reactions was 3‰.According to the nested case-control study design,the influencing factors of 92 patients with ADR and 276 non-drug-related adverse reactions were displayed on the basis of statistical description(significance level P≤0.2 and clinical information)using Random forest analysis shows that the factors affecting the ADR of the Qingkailing injection according to the MeandecaseGini are from high to low in the first 15 positions:Vitamin supplements,tumors,gastrointestinal diseases,traditional Chinese medicine,previous allergic history,cerebral insufficiency,rash,urinary tract infection,vascular and lymphovascular diseases,pioglitazone,metabolic and endocrine system drugs,past ADR history,respiratory and mediastinal diseases,dioxpromazide,pneumonia.Conclusion:The incidence of adverse reactions in Qingkailing injection hospital is 3%.The factors closely related to the occurrence of ADR are previous tumors,gastrointestinal diseases,history of adverse reactions of rash,urinary tract infection,insufficient cerebral blood supply,respiratory system and other diseases,pioglitazone and other combined drugs.

Clinical Application Analysis of Andrographolide Total Ester Sulfonate Injection,a Traditional Chinese Medicine Licensed in China

Andrographolide total ester sulfonate（ATES） injection is one of the products of traditional Chinese medicine（TCM） currently used against viral infection in China.ATES injection was approved for manufacturing and marketing in January 2002.It is indicated for acute respiratory infections,tonsillitis,chronic obstructive pulmonary disease,influenza,foot and mouth disease,bronchiolitis,herpangina,mumps,infectious mononucleosis and psychosis.However,its usage also carries risk.We investigated the use of ATES at the Wuhan Union Hospital from January 2014 to December 2014 and evaluated its real-world clinical application using the hospital centralized monitoring method.A total of 848 cases were enrolled in this study.In these cases,it was mainly used for postoperative anti-inflammation and treating upper respiratory infection,pneumonia and bronchitis.Among them,39.86% were contraindicated.Irregular medication of adults and children accounted for 1.91% and 23.38%,respectively.Improper choice of solvent accounted for 3.18%.The choice of intravenous drip versus aerosol inhalation was reasonable.A case of adverse events（AEs） was observed in the monitoring period,and the incidence of adverse drug reaction（ADR） of ATES injection was 0.12%.ATES injection in our hospital is relatively safe with a low incidence of adverse reactions.The study assesses the clinical usage and adverse reactions of ATES injection,and provides suggestions for rational use in clinical practice.

Comorbidities of scars in China:a national study based on hospitalized cases

Background:Scar comorbidities seriously affect the physical and mental health of patients,but few studies have reported the exact epidemiological characteristics of scar comorbidities in China.This study aimed to investigate the prevalence of scar comorbidities in China.Methods:The data of 177,586 scar cases between 2013 and 2018 were obtained from the Hospital Quality Monitoring System based on the 10th edition of the International Classification of Diseases coding system.The total distribution of scar comorbidities and their relationship with age,aetiology and body regions were analysed.Results:Six comorbidities(contracture,malformation,ocular complications,adhesion,infection and others)were the main focus.In general,male patients outnumbered females and urban areas outnumbered rural areas.The proportion of contractures was the highest at 59,028(33.24%).Students,workers and farmers made up the majority of the occupation.Han Chinese accounted for the majority of the ethnic.The highest proportion of scar contracture occurred at 1–1.9 years of age(58.97%),after which a significant downward trend was observed.However,starting from 50 years of age,ocular complications increased gradually and significantly,eventually reaching a peak of 34.49%in those aged>80 years.Scar contracture was the most common comorbidity according to aetiology,and the highest proportion was observed in patients who were scalded(29.33%).Contractures were also the most frequent comorbidity in hands(10.30%),lower limbs(6.97%),feet(6.80%)and upper limbs(6.02%).The mean and median hospitalization durations were 12.85 and 8 days,respectively.Conclusions:Contractures were the most common comorbidities,and different comorbidities tended to occur at different ages and with different causative factors.