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Biomedical subjects

Hui Cao

Publications and source records attributed to Hui Cao.

48 records · Page 3Linked to original sources

Assessing explicit error reporting in the narrative electronic medical record using keyword searching.

In this study, we assessed the explicit reporting of medical errors in the electronic record. We looked for cases in which the provider explicitly stated that he or she or another provider had committed an error. The advantage of the technique is that it is not limited to a specific type of error. Our goals were to 1) measure the rate at which medical errors were documented in medical records, and 2) characterize the types of errors that were reported.

Humans↗

An experimental system for comparing speed, accuracy, and completeness of physician data entry using electronic and paper methods.

Electronic medical record (EMR) systems have important potential advantages over traditional paper-based systems, but they require that physicians assume responsibility for data entry. However, little is known about the quality of physician data entry in electronic systems. This study describes a system for comparing the speed, accuracy, and completeness of examination data entry using electronic and paper methods. Data will be shown to demonstrate that this may be a simple, reproducible, and useful technique.

Humans↗

Molecular identification of six medicinal Curcuma plants produced in Sichuan: evidence from plastid trnK gene sequences.

AIM: To establish a rapid and simple molecular identification method for six medicinals: Curcuma: C. longa, C. phaeocaulis, C. sichuanensis, C. chuanyujin, C. chuanhuangjiang, and C. chuanezhu in Sichuan Province. METHODS: A molecular approach (trnK nucleotide sequencing) was used in this study. RESULTS: The sequenced entire chloroplast trnK gene region spanned 2,699-2,705 bp. The matK gene (an intron embodied in trnK gene) sequence and the intron spacer region of the trnK gene have great diversity within these six medicinal Curcuma species. There were six single bases substitutions between trnK coding region and matK region, the 9-bp deletion and 4-bp or 14-bp insertion repeat at some sites of matK region in each taxon. CONCLUSION: These relatively variable sequences were potentially informative in the identification for these six Curcuma species at the DNA level.

Base Sequence↗

Laparoscopic management of common bile duct stones: transcystic approach and choledochotomy.

The purpose of this study was to review our experience with laparoscopic common bile duct (CBD) exploration by the transcystic approach and choledochotomy. We selected the transcystic approach for patients whose CBD stones were less than five in number and smaller than 9 mm in diameter, and whose CBD was less than 15 mm in diameter on cholangiograms. Among 217 patients with CBD stones treated laparoscopically, the transcystic approach was performed successfully in 91 of 104 patients in whom it was attempted (87.5%). The other 126 patients underwent laparoscopic choledochotomy, followed by ductal closure with transcystic drainage in 59, T-tube drainage in 46, primary ductal closure in 19, and choledochoduodenostomy in 1. Choledochotomy was converted to open surgery in only 1 patient. The transcystic approach was associated with shorter hospital stay and less morbidity than choledochotomy. However, choledochotomy also had an acceptably low rate of complications. Bile leaks occurred more frequently in those with primary ductal closure than in those with transcystic drainage or T-tube drainage. Residual stones were found in 2 patients with the transcystic approach and in 10 with choledochotomy. The residual stones were removed through the T-tube tract by choledochoscopy in 7 of these 10 patients. From these results we conclude that laparoscopic management of CBD stones is feasible for almost all patients with CBD stones. It is considered to be safe and effective and has the advantage of being a single-stage procedure.

Adult↗

Sequence analysis of Chinese and Japanese Curcuma drugs on the 18S rRNA gene and trnK gene and the application of amplification-refractory mutation system analysis for their authentication.

The botanical origins of Chinese and Japanese Curcuma drugs were determined to be Curcuma longa, C. phaeocaulis, the Japanese population of C. zedoaria, C. kwangsiensis, C. wenyujin, and C. aromatica based on a comparison of their 18S rRNA gene and trnK gene sequences with those of six Curcuma species reported previously. Moreover, to develop a more convenient identification method, amplification-refractory mutation system (ARMS) analysis of both gene regions was performed on plants. The ARMS method for the 18S rRNA gene was established using two types of forward primers designed based on the nucleotide difference at position 234. When DNAs of four Curcuma species were used as templates, PCR amplification with either of the two primers only generated a fragment of 912 base pairs (bp). However, when DNAs of the purple-cloud type of C. kwangsiensis and C. wenyujin were used, PCR amplifications with both primers unexpectedly generated the fragment, suggesting that these two were heterozygotes. The ARMS method for the trnK gene was also established using a mixture of four types of specific reverse primers designed on the basis of base substitutions and indels among six species, and common reverse and forward primers. C. phaeocaulis or the Chinese population of C. zedoaria, the Japanese population of C. zedoaria or the purple-cloud type of C. kwangsiensis, the pubescent type of C. kwangsiensis or C. wenyujin, and C. aromatica were found to show specific fragments of 730, 185, 527 or 528, and 641 or 642 bp, respectively. All species including C. longa also showed a common fragment of 897-904 bp. Using both ARMS methods, together with information on producing areas, the identification of Curcuma plants was achieved. Moreover, the ARMS method for the trnK gene was also useful for authentication of Curcuma drugs.

Curcuma↗

[Study on epidemic trend and control policy of tuberculosis in Sichuan province].

OBJECTIVE: To evaluate efficacy of tuberculosis control policy and provide scientific evidence for drawing up tuberculosis control program. METHODS: Data of the epidemiological survey for tuberculosis in Sichuan in 2000 were analyzed and part of the results were compared with that before. RESULTS: The prevalence of active pulmonary tuberculosis, the bacteriological positive prevalence and smear positive prevalence of pulmonary tuberculosis in 2000 were 544/100 000, 250/100 000 and 144/100 000, respectively, decreased by 41.8%, 30.0% and 35.0% respectively in comparison with 1990, and the annual reduction rates were 5.3%, 3.5% and 4.2% respectively during the past 10 years. The mortality of tuberculosis and pulmonary tuberculosis was 24/100 000 and 22/100 000, respectively, decreased by 20.0% and 12.0% respectively in comparison with 1990. The prevalence of tuberculosis in minority area and mountainous area were higher than that in city, countryside and hills. 71% of infectious patients were newly detected, 33.3% of which were re-treatment cases. The economic status was found the key factor affecting the implementation of tuberculosis control. CONCLUSIONS: The modern tuberculosis control strategy, which mainly targeted infectious patients and advocated DOTS policy, is the guarantee of sustainable development of tuberculosis control, though the prevalence of pulmonary tuberculosis decreased slowly in Sichuan during the past 10 years.

Adolescent↗

[DNA sequencing and molecular identification of Patchouli and its substitute wrinkled gianthyssop].

AIM: To analyze sequences of the nuclear ribosomal RNA small subunit (18S rRNA) gene and the chloroplast matK gene of crude drug Patchouli (Pogostemon cablin) in order to provide molecular evidence for identification of Patchouli drug. METHODS: To sequence the entire 18S rRNA gene and partial matK gene of Patchouli from Guangzhou and its substitute Wrinkled Gianthyssop (Agastache rugosa) from Sichuan using PCR direct sequencing and to detect the homology of two gene sequences between these two crude drugs. RESULTS: The complete 18S rRNA gene sequence is 1,805 bp in length for Patchouli from Guangzhou whereas 1,794 bp for Wrinkled Gianthyssop from Sichuan. The 3'-end sequence of matK gene is 521 bp (747-1,268 nt from upstream of matK gene) for these two crude drugs. Based on multiple sequence alignment, it is found that there are 18 variable sites and 11 aligned gap sites in 18S rRNA sequence, 49 variable sites in 3'-matK sequence between these two crude drugs. The homology is 98.4% for 18S rRNA and 90.6% for 3'-matK between two crude drugs, respectively. CONCLUSION: DNA sequencing can provide an accurate and reliable tool in the crude drug identification of Patchouli and its substitute Wrinkled Gianthyssop.

Agastache↗

[DNA profiling of Pogostemon cablin chemotypes differing in essential oil composition].

AIM: To provide molecular evidence for quality evaluation and GAP production of Pogostemon cablin (Blanco) Benth. cultivated in different regions in Guangdong and Hainan provinces, China, by comparing two sequences (1.2 kb of plastid matK gene and 1.8 kb of nuclear 18S rRNA gene) and two chemotypes (Pogostone-type and Patchouliol-type in essential oil composition). METHODS: PCR direct sequencing was applied to detemine the matK and 18S rRNA sequences for six samples of Pogostemon cablin from different localities. RESULTS: The matK sequences of six samples of Pogostemon cablin from different regions of cultivation are 1,245 bp in length, which coding 415 amino acids of protein (maturase), and 18S rRNA sequences are 1,803-1,805 bp in size. Based on multiple sequence alignment, there are 47 variable sites in the matK sequence of these six samples, 17 in the 18S rRNA sequence. The cluster tree reconstructed by UPGMA method shows that the sequence divergence both in matK and 18S rRNA genes among six samples of Pogostemon cablin was well correlative with their regions of cultivation and intraspecific chemotypes of essential oil composition. CONCLUSION: Combining with chemical and biogeographical data, DNA sequencing can become a powerful tool in the key technique-species identification of quality evaluation and GAP production of Pogostemon cablin.

Base Sequence↗

[matK and its nucleotide sequencing of crude drug chuanxiong and phylogenetic relationship between their species from China and Japan].

AIM: To provide more molecular evidences for species relationship between Chuanxiong (Ligusticum chuanxiong Hort.) from China and Japanese Chuanxiong (Senkyu in Japanese) (Cnidium officinale Makino). METHODS: To sequence such two genes as internal transcribed spacer (ITS) from nuclear rDNA and maturase for lysine (matK) in tRNA(lys) (UUU) intron from chloroplast DNA of both Ligusticum chuanxiong and Cnidium officinale using PCR direct sequencing and to analyze the sequence variation of two genes between these two species. RESULTS: The matK gene sequence of Ligusticum chuanxiong and Cnidium officinale is 1268 bp in length, coding 422 amino acids of maturase protein. ITS gene sequence 699 bp, consisting of 54 bp of 18S rRNA-3', 215 bp of ITS1, 162 bp of 5.8S rRNA, 222 bp of ITS2, 46 bp of 26S rRNA-5'. Multiple sequence alignment shows that the sequence of two genes between dried crude drug and fresh voucher material of Ligusticum chuanxiong and Cnidium officinale, there is 1 variable site (T-->C) in matK (upstream at 595 nt) and ITS (ITS1 at 54 nt) between Ligusticum chuanxiong and Cnidium officinale. CONCLUSION: Based on homology analysis of two genes plastid matK and nuclear ITS, the origin of Chuanxiong from China and Japan ought to be identical, the scientific name Cnidium officinale of Japanese Chuanxiong should be changed to Ligusticum chuanxiong.

Amino Acid Sequence↗

[A novel approach to quality evaluation of root of Scutellaria baicalensis by DPPH free radical scavenging].

OBJECTIVE: To develop a simple, reliable approach for evaluating the quality of Huangqin (Scutellaria baicalensis). METHOD: To determine the DPPH free radical scavenging activity and assay of four bioactive components: baicalin, baicalein, wogonin and wogonin-7-O-glucuronide by HPLC. RESULT: The correlative relationship between DPPH free radical scavenging activity and baicalin content was obtained. CONCLUSION: Bioassay of DPPH free radical scavenging activity could be used as one of the methods for quality evaluation of Chinese drug Huangqin.

Biphenyl Compounds↗

The impact of managed care on the substance abuse treatment patterns and outcomes of Medicaid beneficiaries: Maryland's HealthChoice program.

The introduction of Medicaid managed care raises concern that profit motives lead to the undersupply of substance abuse (SA) services. To test effects of the Maryland Medicaid HealthChoice program on SA treatment patterns and outcomes, Medicaid eligibility files were linked to treatment provider records and two study designs were used to estimate program impact: a quasi-experimental design with matched comparison groups and a natural experiment. Patient sociodemographic and clinical characteristics were adjusted using multiple regression. Under managed care, there was a shift from residential, correctional-only, and detoxification-only treatment toward outpatient-only treatment. Among beneficiaries entering treatment, those enrolled in managed care organizations (MCOs) had similar utilization and outcomes to those in Medicaid fee-for-service; those enrolling in MCOs during treatment had longer and more intensive episodes and, as a result, better outcomes. Thus, the study disclosed no empirical evidence that health plans respond to capitation by reducing SA services.

Adolescent↗

Assessing explicit error reporting in the narrative electronic medical record using keyword searching.

BACKGROUND: Many types of medical errors occur in and outside of hospitals, some of which have very serious consequences and increase cost. Identifying errors is a critical step for managing and preventing them. In this study, we assessed the explicit reporting of medical errors in the electronic record. METHOD: We used five search terms "mistake," "error," "incorrect," "inadvertent," and "iatrogenic" to survey several sets of narrative reports including discharge summaries, sign-out notes, and outpatient notes from 1991 to 2000. We manually reviewed all the positive cases and identified them based on the reporting of physicians. RESULT: We identified 222 explicitly reported medical errors. The positive predictive value varied with different keywords. In general, the positive predictive value for each keyword was low, ranging from 3.4 to 24.4%. Therapeutic-related errors were the most common reported errors and these reported therapeutic-related errors were mainly medication errors. CONCLUSION: Keyword searches combined with manual review indicated some medical errors that were reported in medical records. It had a low sensitivity and a moderate positive predictive value, which varied by search term. Physicians were most likely to record errors in the Hospital Course and History of Present Illness sections of discharge summaries. The reported errors in medical records covered a broad range and were related to several types of care providers as well as non-health care professionals.

Abstracting and Indexing↗