Objective To explore the construction and application of a new follow-up visit model in the context of Internet hospital consultation, aiming to create a novel follow-up visit model that integrates precise identification of follow-up patients, messages of follow-up reminders, online free follow-up visits, and promotional activities. Methods Satisfaction surveys were conducted among outpatient patients and doctors at Jintang County First People’s Hospital from July 2023 to June 2024. Patients and doctors were divided into two groups based on whether the online free follow-up visit program had been implemented: the pre-implementation group (July to December 2023) and the post-implementation group (January to June 2024). The satisfaction levels of patients and doctors before and after the implementation were compared and analyzed. Results A total of 17 831 patient visits and 801 doctor visits were included. Since its launch, WeChat messages had been pushed to all outpatient patients, and both WeChat and SMS messages had been pushed to patients in surgical departments. The average waiting time for outpatient visits in January-June 2024 was shortened by 2 minutes compared with the same period last year (January-June 2023). The hospital’s Case Mix Index increased by 3.7%, and the surgical volume increased by 7.5%. After the launch of the Internet hospital, both patient and doctor satisfaction improved. Conclusion The new follow-up visit model of the Internet hospital represents an important initiative in the digital transformation of hospitals and holds value and significance for promotion in more county-level medical institutions.
ObjectiveTo analyze the correlation between anti-cell membrane DNA (mDNA) antibodies and other autoantibodies and estimate its diagnosing significance for systemic lupus erythematosus (SLE). MethodsFrom January to August 2015, the sera samples from 254 patients with various autoimmune diseases, including 106 SLE, 80 rheumatoid arthritis (RA), 32 mixed connective tissue disease (MCTD), 29 Sjogren's syndrome (SS), 7 polymyositis/dermatomyositis (PM/DM) and 20 healthy controls, were collected. The anti-mDNA antibody, anti-dsDNA antibody, antinuclear antibody (ANA) and anti-keratin antibody (AKA) were detected by indirect immunofluorescent assay; anti-cyclic citrylinated peptide antibody (CCP) antibody was detected by enzyme-linked immuno sorbent assay; rheumatoid factor (RF) was detected by rat scatter turbidimetry assay; and anti-Sm antibody was detected by Western blotting method. ResultsAnti-mDNA antibody was found in 77 of 106 SLE (72.6%), 4 of 80 RA (5.0%), 6 of 32 MCTD (18.7%), 4 of 29 SS (14.7%), 0 of 7 PM/DM (0.0%) and 0 of 20 healthy controls (0.0%), respectively. It's notable higher in SLE than that in the others (P < 0.001). The sensitivity, specificity and diagnosis efficiency of anti-mDNA antibody for SLE were 72.6%, 91.7% and 84.3%, respectively. Anti-mDNA antibody was significantly correlated with ANA, anti-dsDNA antibody and anti-Sm antibody (P < 0.001), while it had no significant correlation with anti-CCP antibody, AKA and RF (P > 0.05). ConclusionAnti-mDNA antibody is closely related with other SLE associated antibodies and with high sensitivity and specificity for SLE diagnosis.
ObjectiveTo discuss the relationship between antinuclear antibody (ANA) fluorescence pattern detected by indirect immunity fluorescence (IIF) and antinuclear antibody profiles (including anti-dsDNA, RNP, Sm, SSa, SSb, Scl-70, Jo-1 and rib-P) in human serum. MethodsA total of 7385 cases of ANA pattern and ANA profiles were retrospectively analyzed from January 2010 to December 2013. ANA was detected by IIF substrated as HEp-2 cells, anti-dsDNA by IIF substrated as crithidia, and the other 7 antibodies by enzyme immunoblot with purified antigen. ResultsGranular pattern mostly presented as anti-RNP, anti-Sm, anti-SSa and anti-SSb (P < 0.001); homogeneous pattern was anti-dsDNA and anti-SSa (P < 0.001); nucleolus, centromere, and mixed pattern was anti-SSa (P < 0.05); cytoplasm pattern was anti-rib-P and anti-SSa (P < 0.05). But few above antibodies could be detected in Golgi, dots, rim, actin, actotropomyosin, prolifevating cell nuclear antigen (PCNA) and vementin pattern. Homogeneous pattern was shown up to 77.91% in only anti-dsDNA positive serum; granular was 96.84%, 52.01%, and 82.35% respectively in only anti-RNP or anti-SSa or anti-Sm positive. Homogeneous and nucleolus mix pattern was up to 30.53% in only anti-Scl-70 positive. Cytoplasm pattern was 50.00% and 61.54% respectively in only anti-rib-P or anti-Jo-1 positive. But no fixed relationship was found between ANA pattern and anti-SSb. ConclusionsThere is a certain relationship between ANA and antinuclear antibody profiles. Granular, homogeneous and cytoplasm pattern often can be detected more than one autoantibodies. Eight kinds of specific autoantibodies often are negative when ANA patterns are centromere, Golgi, dots, rim, actin, tropomyosin, PCNA, and vimentin. Anti-dsDNA is mainly corresponding to homogeneous, anti-RNP, anti-SSa and anti-Sm to granular, anti-Scl-70 to homogeneous and nucleoli, anti-rib-P and anti-Jo-1 to cytoplasm. The study can give suggestions for further tests application and lab result checking.
ObjectiveSystemic lupus erythematosus (SLE) patients from a SLE family with homogeneity can provide experimental basis for individualized diagnosis and treatment by studying the characteristics of laboratory tests and symptoms. MethodsLaboratory tests were analyzed for three SLE patients in the family, and set up the screen model by three laboratory tests (anitnuclear antibody positive, rheumatoid factor positive and IgE positive, ANA+RF+IgE+). All SLE cases were screened from latest four years as SLE subtype patients (named "similar family SLE patients"), then the family laboratory tests and clinical characteristics were analyzed. ResultsA total of 55 patients (6.27%) were screened as similar family SLE patients from individual SLE patients according to model from 877 cases. The laboratory tests of similar family SLE patients including creatinine, WBC, CRP were significant lower than other SLE patients (P < 0.05), but significant higher for the IgG, positive rate of anti-SSA and anti-SSB (P < 0.05), and the alopecia and skin rashes were more common in similar family SLE patients than other SLE patients. ConclusionsThe ANA+RF+IgE+ SLE patients are of lower inflammatory state and kidney involvement; Clinical symptom is priority to alopecia and skin rashes.
ObjectiveTo study the diagnosis value of anti-SSa (including anti-Ro52 and anti-Ro60). MethodsAntibodies of ENA (including Sm, Ro52, Ro60, SSb, RNP, Scl-70, Jo-1 and Rib-P) from 23145 patients with positive antinuclear antibody (ANA) were retrospected from January 2009 to December 2013. The relationship between anti-Ro52, anti-Ro60 and other test results and the diagnosis or symptomatic information of patients was also analyzed. ResultsThe anti-Ro60 positive rate was 35.19% (8 145/23 145), and the anti-Ro52 was 13.16% (3 046/23 145) in 23145 ANA positive cases (P<0.05). The positive percentage of anti-Ro60 was higher in anti-SSb, anti-RNP, anti-Sm and anti-Rib-P positive cases than anti-Ro52 (P<0.05); the results of anti-Ro52 negative and anti-Ro60 positive (Ro52-Ro60+) had a higher percentage in autoimmune diseases, non-autoimmune disease and symptoms groups than anti-Ro52 positive and anti-Ro60 negative (Ro52+Ro60-) results (P<0.05). ConclusionThe anti-Ro60 has higher positive rate than anti-Ro52, and the sensitivity and prediction value of autoimmune diseases of anti-Ro60 are better than anti-Ro52. But both anti-Ro60 and anti-Ro52 have poor specificity for disease diagnosis.