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Objective:To analyze the cost-effectiveness simulation of medical services for COVID-19 epidemic in Wuhan city based on the social perspective, for the sake of providing references and suggestions to deal with possible public health emergencies in the future.Methods:Through policy documents and literature review, interview survey and Delphi method, the cost and cost-effectiveness of medical services for COVID-19 in Wuhan were simulated based on the decision-tree model, from December 27, 2019 to April 26, 2020.Results:The average curing cost of per patient diagnosed with COVID-19 in Wuhan was 175 462.10 yuan, a figure calculated in the baseline that these epidemic prevention and control measures were taken on January 23, 2020. In Hypothesis 1 (with epidemic prevention and control measures taken one week before), the cost was 164 552.43 yuan, and in Hypothesis 2 (with epidemic prevention and control measures taken one week later), the cost was 187 542.37 yuan. Compared with the baseline, the incremental cost-effectiveness ratio of the medical service for COVID-19 in Wuhan under Hypothesis 1 was 183 000 yuan per patient, which was more cost effective.Conclusions:The public health prevention and control measures played an important role during the COVID-19 epidemic in Wuhan. With the cost-effectiveness simulation results taken into account, this study can provide decision-makers with better references in likewise events.
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Objective:To simulate the cost of medical services for COVID-19 epidemic in Wuhan city from the social perspective, as references and suggestions in case of possible public health emergencies in China in the future.Methods:By such means as policy documents and literature review, interview survey and Delphi method, a cost estimation model was built and confirmed to simulate the cost of medical services for COVID-19 in Wuhan, from December 27, 2019 to April 26, 2020.Results:The total cost of medical services during the COVID-19 epidemic in Wuhan was 8 152 670 867 yuan. 721 800 387 yuan(8.85%) of the medical cost was covered by medical insurance; the medical cost covered by sources other than medical insurance was 434 813 725 yuan(5.34%); the cost of additional measures related to medical service was estimated to be 6 996 056 755 yuan(85.81%).Conclusions:The total cost of medical services during the COVID-19 epidemic in Wuhan was gigantic. The cost estimation results can provide the government with basic information, decision-making basis and suggestions regarding epidemic control.
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@# Objective To explore the effect of the combination of Tuina and treadmill training on denervation skeletal muscle atrophy. Methods A total of 80 Sprague-Dawley rats (one month old) were randomly divided into control group (n=40) and manipulation group (n=40). Their sciatic nerves were transected, and the manipulative group accepted treadmill training and kneading of Tuina, while the control group accepted no intervention. Their muscle wet weight ratio, muscle satellite cells and insulin-like growth factor I (IGF-I) positive cells count were measured, and HE staining of gastrocnemius muscle were observed one, two, three and four months after intervention, ten rats in each group. Results Compared with the control group, the muscle wet weight ratio decreased three months after intervention (F=4.590, P<0.05), muscle satellite cells increased three months after intervention (F=12.466, P<0.01), and IGF-I positive cells increased two, three and four months after intervention (F>6.489, P<0.05). HE staining showed the skeletal muscle injury relieved somehow.Conclusion The combination of Tuina and treadmill training can relieve denervation skeletal muscle injury, but it is not enough for skeletal muscle atrophy, which may associate with promoting the expression of muscle satellite cells and IGF-I.
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@#Chronic obstructive pulmonary (COPD) has significant extra pulmonary effects, which could induce atrophy of peripheral skeletal muscle and respiratory muscles, and significantly influence the respiratory function and quality of life. Muscle nuclear factor (NF)-κB activation plays a key role in the skeletal muscle atrophy. This article discussed the potential mechanisms on how NF-κB signaling pathway increasing protein breakdown and reducing muscle regeneration. On this basis, we explored the role of NF-κB in skeletal muscle at-rophy in patients with COPD during exercise.
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Objective To observe the effects of tuina on muscle atrophy after denervation and on muscle satellite cell proliferation.Methods Ninety male rabbits with denervated skeletal muscles were randomly divided into a normal group,a control group,and a treatment group.Tuina was applied daily to the right gastrocnemius muscles beginning one day after the modeling.Changes in muscle wet weight ratio and the amount of skeletal muscle satellite cells (SCs) were observed 1,2 and 3 weeks and 1,2,4 and 6 months post-modeling.Results The muscle wet weight ratios of both the treatment group and the control group were lower than those of the normal group.The weight ratio in the treatment group was significantly different from that in the control group after 2 months (0.578 ±0.163 vs 0.470 ±0.062),4 months (0.575 ±0.110 vs 0.453 ±0.101) and 6 months (0.559 ±0.083 vs 0.446 ±0.048).The amount of SCs was also significantly different in the treatment and control groups after 1 week (16.83 ±5.31 vs8.67±2.58),2 weeks (51.83±7.94 vs32.00±6.93) and4 months (11.17±3.49 vs 17.67±4.18).Conclusion Tuina therapy can promote proliferation of satellite cells and delay the atrophy of denervated skeletal muscles.
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Objective To investigate the feasibility of implementing the 24 hours treatment and management model of children with cerebral palsy in Shanghai,in order to provide a set of effective and saving manpower,material and financial rehabilitation and management model for children with cerebral palsy.Methods Firstly,the 10 exports engaged in cerebral palsy rehabilitation were selected as the in depth interviewees by the sampling method of grounded theory.Secondly,applying in depth interviews,the 10 exports were interviewed by designing interview outline and subjects.Last,the interview data were collected and analyzed.Results By analyzing the interview data in three-stage coding mode,three factors affecting the feasibility of 24 hours treatment and management model of children with cerebral palsy in Shanghai were obtained,including the favorable factors,obstacles and necessary factors.Conclusions The 24-hour treatment and management model of children with cerebral palsy in Shanghai is feasible,but it will encounter some obstacles in the implementation process.Through the policy support for health care and education sectors,the feasibility of the pattern will be greatly enhanced.
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Total knee replacement surgery is commonly used in end-stage diseases of the knee. It is important for improving surgical efficacy and patient satisfaction by promoting early rehabilitation of patients and improving knee function.
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Objective: To observe the effect of acupuncture and Chinese mina manipulation therapy in treating knee osteoarthritis, and analyze the alteration of musculus quadriceps femoris strength.Methods: A total of 80 patients were randomly assigned to a treatment group receiving acupuncture combined Chinese tuina manipulation therapy (n=40) and a control group receiving Fenbid treatment (n=40), curative effective score, Lequene & Mery assessment tests, and isokinetic evaluation were recorded before and after the treatment course. Results: The total effective rate was 90.0 % in the treatment group and 87.5% in the control group, without a significant difference between the two groups. Lequene & Mery assessment tests had no significant change. Musculus quadriceps femoris isokinetic evaluation improved significantly after the treatment course in the two groups (P＜0.05), and there was a significant difference between the two groups (P＜0.05). Conclusion: Acupuncture combined with tuina manipulation therapy and Fenbid treatment both can reduce knee pain and joint disability in the short term, though no improvement was shown in the severity of the disease.Acupuncture combined with mina manipulation therapy is better than Fenbid in improving the strength, total work and explosive force of the musculus quadriceps femoris.
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Objective: To observe the clinical effect of tuina in rehabilitation following total hip replacement. Methods: 60 cases were randomly allocated into a treatment group and control group, 30 cases in each group. Cases in the treatment were treated with combined mina and rehabilitation, while cases in the control group were treated with rehabilitation alone. All treatment retained for two weeks. The results were observed 7 d, 2 weeks and 6 weeks following the total hip replacement using Harris scale and Hamilton Anxiety Rating Scale (HAMA).Results: For Harris scale, there were significant intra-group differences in different time frames (P＜0.05); there were no statistical differences between the two groups 1 d, 7 d and 6 weeks following the total hip replacement (P＞0.05); and there were statistical differences between the two groups 2 weeks following the total hip replacement. For HAMA scale, there were significant intra-group differences in different time frames (P＜0.05); there were no significant differences between the two groups 1 d following the total hip replacement; and there were substantial differences between the two groups 7 d, 2 weeks and 6 weeks following the total hip replacement. Conclusion: In a given unit time, combined mina and rehabilitation is superior to rehabilitation alone in improving the patients' post-operative pain, articular range of motion and anxiety.
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Objective:To study the tuina effect on sleep disorder and emotional problems of chronic fatigue syndrome (CFS) cases.Method:Thirty CFS cases were treated in the treatment group,by applying one-thumb pushing,rolling and pressing-kneading manipulations along the Governor Vessel,Bladder and Yangming Meridians.The intended major points include Fengfu (GV 16),Yaoyangguan (GV 3),Xinshu (BL 15),Pishu (BL 20),Ganshu (BL 18),Hegu (LI 4) and Taixi (KI 3).The treatment was done once every other day;10 times constitute a course of treatment.Another 30 healthy cases were selected in the control group,without any intervention.The sleep quality and mental state in the two groups were evaluated by PSQI,HAMA and HAMD.In addition,the pre-treatment and post-treatment score changes were observed.Results:Before treatment,the total score of PSQI,sleep quality,time of falling asleep,sleep efficiency,sleep disorder,daytime functional impairment,and scores of HAMD and HAMA in treatment group were all substantially higher than the control group (P＜0.01).After 10 tuina treatments,the total score of PSQI,time of falling asleep,sleep disorder and daytime functional impairment as well as scores of HAMD and HAMA in treatment group were significantly changed,compared with before treatment,P＜0.05.Conclusion:Those with CFS may present with sleep disorder and mental or psychological abnormality,tuina can improve their sleep quality and adjust their mental conditions.
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Objective: To study the mechanism of Tuina in the treatment of skeletal muscle injury. Methods: Rabbits were heavily beaten at gastrocnemius muscle to make acute contusion model and then treated respectively by early Tuina and routine Tuina. The number of satellite cells of skeletal muscles was observed. Results: The number of the satellite cells continued to grow in both groups, and it began to increase significantly 3-5 days after Tuina treatment. Early Tuina treatment produces larger number of satellite cells than routine Tuina treatment.Conclusion: Early Tuina treatment is helpful to the marked recovery of skeletal muscles by increasing the number of satellite cell.
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A hemodynamic model of capillary and tissue, in which tissue pressure changed with swing manipulation of Traditional Chinese Medical Massage (TCMM), is presented in this paper to explain the hemodynamic mechanism of swing manipulation. Blood flowed in capillary with low Reynolds number. Plasma exuded through capillary according to the Starling's Law. Tissue pressure changed linearly with the massage force measured. Blood apparent viscosity, plasma protein concentration and red cell's hematocrit were taken into account. Capillary flow rate, blood apparent viscosity, filtration rate and filtration fraction with dynamical change of tissue pressure were calculated numerically, and were compared with those in static tissue pressure condition. Results showed that, dynamical change of tissue pressure led to the increase of capillary flow rate and the decrease of blood apparent viscosity, which qualitatively explained the hemodynamic mechanism of "promoting blood circulation and removing blood stasis" in swing manipulation of TCMM.
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Humans , Biomechanical Phenomena , Blood Flow Velocity , Blood Viscosity , Capillaries , Physiology , Hematocrit , Hemodynamics , Massage , Models, Cardiovascular , Pressure , Regional Blood FlowABSTRACT
OBJECTIVE: To explore the effect of treating periarthritis of shoulder with manipulation through evaluating clinical reports with the theory of evidence-based medicine (EMB). METHODS: By retrieval of some main medical literature databases in the past 5 years, 242 articles on treating periarthritis of shoulder with manipulation were available. Selected by admission standard, 10 of them were evaluated with EBM theory. RESULTS: Both single-application and union-application of manipulation were effective to periarthritis of shoulder, but the evaluated articles were all low-quality articles. CONCLUSION: Because of low quality clinic test and larvaceous publication bias, the extant evidence is not enough to recommend replacing other therapeutic methods by manipulation. The low quality of evaluated articles suggests that there exist some methodology problems in the clinic test on treating periarthritis of shoulder with manipulation.