RESUMEN
Safe and scalable dynamic autonomous data interaction between medical institutions can increase the number of clinical trial records, which is of great significance for improving the level of medical trial collaboration, especially for clinical decision-making with regard to rare diseases. Through a preset authorization access and consensus mechanism, consortium chain provides integrity and traceability management for medical clinical data. However, how to enable users have ownership of their own medical data and share their medical data safely and dynamically between different medical institutions remains an area of particular concern. To achieve dynamic communication between medical consortium chains, this paper proposes (i) a cross-chain communication mechanism by simplifying the heterogeneous node communication topology and (ii) the construction rules of the node identity credibility path-proof to carry out dynamic construction and verification of the path-proof for cross-chain transactions. In addition, the consensus of the cross-chain transaction is modeled as a threshold digital signature process with multiple privileged subgroups; thus, the intra-chain consortium consensus based on the verification node list is extended to the cross-chain consensus. A smart contract deployment and execution scheme based on rational node value transfer mechanism is proposed by analyzing the value transfer game between nodes. Experimental results showed that the proposed scheme can not only enable patients to share their records safely and autonomously in an authorized medical consortium chain within milliseconds but also realize dynamic adaptive interaction among heterogeneous consortium chains.
Asunto(s)
Cadena de Bloques , Registros Electrónicos de Salud , Telemedicina , Algoritmos , Investigación Biomédica , Confidencialidad , Humanos , Colaboración IntersectorialRESUMEN
BACKGROUND: As for the association between vitamin D receptor (VDR) gene polymorphisms and osteoporosis, the current results have yielded conflicts. Therefore, we performed a pooled analysis based on Chinese individuals to provide comprehensive data on the association between VDR BsmI, ApaI, Tru9I polymorphisms and osteoporosis risk. METHODS: Studies were identified using PubMed, Springer Link, Ovid, Chinese Wanfang Data Knowledge Service Platform, Chinese National Knowledge Infrastructure and Chinese Biology Medicine databases through to January 2017. Studies were screened according to the predefined inclusion and exclusion criteria. The association between VDR BsmI, ApaI, Tru9I polymorphisms and osteoporosis was evaluated by calculating pooled odds ratios (ORs) based on the individual ORs. The significance of the pooled OR was evaluated by a Z-test. All statistical analyses were conducted using Stata 12.0 software (StataCorp, College Station, TX, USA). RESULTS: A total of 13 studies with 1141 osteoporosis cases and 1263 controls were included in this meta-analysis. It revealed that VDR Tru9I polymorphism was associated with an increased risk of osteoporosis in a common model (OR = 2.67, CI 95% = 1.59-4.49). No significant association was observed between VDR BsmI, ApaI and osteoporosis. CONCLUSION: In conclusion, this meta-analysis suggests that VDR Tru9I polymorphism may be associated with osteoporosis risk in Chinese individuals, while BsmI, ApaI polymorphisms might not be a risk factor for osteoporosis.
Asunto(s)
Osteoporosis/genética , Polimorfismo Genético , Receptores de Calcitriol/genética , Pueblo Asiatico/genética , Estudios de Casos y Controles , China/epidemiología , Estudios de Asociación Genética , Predisposición Genética a la Enfermedad , Humanos , Oportunidad Relativa , Osteoporosis/diagnóstico , Osteoporosis/etnología , Fenotipo , Factores de RiesgoRESUMEN
OBJECTIVE: To compare the differences in the therapeutic effect on irritable bowel syndrome (IBS) between acupuncture at Tianshu (ST 25) and Dachangshu (BL 25) and western medication with Trimebutine Maleate. METHODS: Forty cases were divided randomly into an acupuncture group and a western medication group, 20 cases in each one. In acupuncture group, acupuncture was applied to Tianshu (ST 25) and Dachangshu (BL 25). Ziwu Daojiu needling technique was adopted, once daily. In western medication group, Trimebutine Maleate capsule was administered, 2 capsules in each time, 3 times per day. The assessment on the therapeutic effect was performed in 4 weeks of treatment in two groups. RESULTS: As compared with those before treatment, the time of abdominal pain, the frequency of abdominal pain, the morbidity of abnormal stool appearance, the morbidity of defecation abnormality, the morbidity of mucus stool and the score of bloating or abdominal pain on bowel movement were all reduced after treatment in two groups (all P < 0.01). The results in acupuncture group were much more significant than those in western medication group (the total score: 16.70 +/- 2.40 vs 15.70 +/- 3.01, P < 0.01). The total effective rate in acupuncture group was 95.0% (19/20), which was superior to that of 70.0% (14/20) in western medication group (P < 0.05). CONCLUSION: Acupuncture at Tianshu (ST 25) and Dachangshu (BL 25) may remarkably relieve the clinical symptoms of IBS and its efficacy is superior to that of oral medication with Trimebutine Maleate.