ABSTRACT
ObjectiveTo investigate the current situation of accessible facilities construction and assistive technology application of existing sports venues in Shenzhen, and analyze the existing problems. MethodsFrom November 19, 2022 to Februry 17, 2023, using the standards for the construction of accessible sports venues, the accessible construction and services of public sports venues and the application of assistive technology in eight districts of Shenzhen were investigated and evaluated on the spot. ResultsThere were curb ramps and accessible public toilets for all the stadiums; surface indicator for 87.5% (7/8) stadiums; wheelchair ramps, accessible elevators and accessible wheelchair seats for 62.5% (5/8) stadiums; accessible route for 37.5% (3/8) stadiums; handrails for 12.5% (1/8) stadiums; accessible vehicles parking lots for 75% (6/8) stadiums; and 25% (2/8) stadiums used assistive technology. ConclusionThis study evaluated the accessibility of accessible facilities and assistive technologies in sports venues in Shenzhen, including entering the stadium, entering the interior of the stadium and taking exercise. In terms of accessible facilities, the number of venues for the construction of curb ramps and accessible public toilets is the most, the number of venues for the construction of accessible handrails is the least, and the application of assistive technology is the worst.
ABSTRACT
ObjectiveTo encode and analyze the measurement items of major activity and participation function assessment tools and quality of life assessment tools using International Classification of Functioning, Disability and Health (ICF). MethodsRepresentative tools in the activity category, comprehensive activity and participation category, as well as quality of life assessment tools were selected for analysis of their measurement structures and content. Based on the ICF linking rule and content matching method, the concepts of measurement items in various tools were matched with ICF categories, analyzing the relationships between the content of measurement items and the concepts of ICF categories, and then coded in ICF and ICD-11. ResultsMeasurement tools in the activity category, such as Barthel index (BI) and Instrumental Activities of Daily Living (IADL), were primarily standardized activity assessment tools in medical, rehabilitation, and community settings. The measurement was conducted through direct observation of activity function and semi-structured interviews with individuals or their caregivers, with 25 to 60 minutes. Most measurement tools were standardized reference tools. Assessment tools related to overall functioning in the activity and participation category, such as 36-item Short-Form Health Survey (SF-36), World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), World Health Organization Quality of Life-Disability (WHOQOL-DIS) and World Health Orgnization Disability Assessment Scheme 2.0 (WHODAS 2.0) were norm-referenced assessment tools applicable in medical, rehabilitation, education, and social service contexts. The measurement was carried out by professionals through interviews and observations, or completed by the assessed individuals through self-administered questionnaires, with a measurement duration of 30 to 60 minutes. In terms of measurement content, IADL and BI mainly focus on activities of self care and functional activities, corresponding to ICF categories such as mobility (d4), self-care (d5), and domestic life (d6). SF-36 primarily covers general tasks and demands (d2), communication (d3), mobility (d4), self-care (d5), and domestic life (d6). WHOQOL-BREF and WHOQOL-DIS items related to general tasks and demands (d2), communication (d3), mobility (d4), interpersonal interactions and relationships (d7), and community, social, and civic life (d9). WHODAS 2.0 was the most comprehensive measurement tool covering all nine domains of activity and participation in the ICF. ConclusionThis study amalyzed the structures and contents of items of six assessments tools using ICF nomenclature, terminology, codes and linking rules. WHOQOL-BREF, WHOQOL-DIS and WHODAS 2.0 are comprehensive functioning evaluation tools, covering all nine ICF domains of activity and participation, as well as quality of life and well-being.
ABSTRACT
ObjectiveTo systematically analyze the application of World Health Organization rehabilitation competency framework (RCF) and its supporting guidelines in education system of rehabilitation science and curriculum development. MethodsBased on the conceptual framework of RCF and its supporting guidelines, the application of its areas and the modes were analyzed to construct the education system of rehabilitation science with reference to the framework of competency-based clinical medical education. ResultsThe education system of rehabilitation science was developed based on RCF. The competences for specific scenarios in rehabilitation were defined and investigated. A structured system of vocational qualification accreditation and occupational competency standards was constructed, as well as core education system and rehabilitation curricula in rehabilitation science, which helped to train competent rehabilitation workers. ConclusionThe construction of rehabilitation subspecialties, its education system and the development of a curriculum content system based on the RCF is an important way for the development of modern rehabilitation education. RCF theoretical framework and supporting tools provide a standardized and unified method and way for China's rehabilitation science higher education system and professional certification, career access and professional standards for rehabilitation personnel. The quality of rehabilitation science education and the professional development of rehabilitation personnel will also be improved in future.
ABSTRACT
ObjectiveTo develop basic training courses for family doctor teams for people with disabilities. MethodsUtilizing the methods and theories of the World Health Organization (WHO) rehabilitation competency framework (RCF), and referring to the WHO universal health coverage global competency framework, the rehabilitation competency characteristics of family doctor teams for people with disabilities in community settings were analyzed, and a basic training course system for these teams based on the RCF was developed. Results and ConclusionBased on RCF, a competency framework for family doctor teams serving people with disabilities has been constructed. The objectives, content and training course system for basic rehabilitation training has been established.
ABSTRACT
ObjectiveTo systematically review the types of health-promoting school (HPS) curriculum and physical activity-related health services based on the WHO-HPS framework, and their impact on health of children and adolescents. MethodsThe databases of EBSCO, PubMed, Web of Science, and CNKI were searched on school-based physical activity-related services and their health benefits based on the WHO-HPS framework from 2017 to June, 2023. A systematic review of systematic reviews was conducted. ResultsA total of seven English articles were included, covering 147 studies from five countries including Switzerland, the United States, Italy, the United Kingdom and Sweden. The systematic reviews were published in the journals related to child physical education and health, HPS, and school-based physical activity. Based on the WHO-HPS framework, HPS curriculum implemented in schools primarily involved physical education classes (such as incorporating specialized sports programs like yoga and dance, increasing physical activity time) and health education programs related to physical activity. Additional activities included extracurricular programs (such as implementing children's sports, recreational and leisure programs, lunchtime enjoyment activities, and game plans, increasing physical activity time within regular school hours, creating opportunities for physical activity during breaks and after school, and providing daily physical activity plans) and integration of physical activity in other subjects. Physical activity-related health services mainly included health screening and monitoring related to physical activity, adolescent health management, and health promotion activities. The health benefits of the interventions included improvement in aerobic capacity, body mass index, cardiorespiratory function, overall physical health, and significant increases in muscle endurance and strength. They also contributed to the cessation or reduction of prolonged sedentary behavior, increased levels of all-day physical activity and moderate-to-vigorous physical activity, increased physical activity participation, significant increases in physical activity during school hours, increased proportion of moderate to vigorous physical activity during school time, increased physical activity time, improved leisure and recreational time related to physical activity, enhanced vitality, school quality of life, and energy, improved academic performance, reduced television viewing time, decreased obesity risk, reduced anxiety, improved adaptability and happiness, and promoted positive mental health. Furthermore, there was a significant improvement in students' health-related knowledge on physical activity. ConclusionImplementing HPS curriculum and physical activity-related services in schools may improve various aspects of students' health, including physical fitness, physical activity and sedentary behavior, behavioral health related to physical activity, and health literacy related to physical activity.
ABSTRACT
ObjectiveTo systematically analyze the typical mental health conditions and psychological disorders of children with intellectual and developmental disabilities (IDD), to construct a mental health service system and psychological interventions to these mental health conditions of children with IDD . MethodsBased on the framework of the World Health Organization Family International Classifications (WHO-FICs), the mental health conditions and related functioning were analyzed, and the mental health service framework and proposed mental health interventions were constructed.There were six main categories of mental health conditions for children with IDDConclusionThis study systematically analyzed the typical mental health status and related psychological functional impairments of children with IDD. Based on the World Health Organization health service system, a mental health service framework for children with IDD was constructed. Referring to the WHO's continuum of health services, a system of psychological intervention methods for children with IDD was established. Furthermore, the WHO-FICs were used to describe and code the functions of children with IDD, and the ICHI-β3 was applied to code and analyze the related psychological interventions. Resultsmood disorders (anxiety and depression), behavioral disorders (disruptive disorders and challenging behaviors, aggressive behaviors), traumatic disorders (post-traumatic stress disorder), mental disorders (schizophrenia), suicide and self-harm, and learning disabilities (developmental learning disabilities, attention deficit hyperactivity disorder). Mental health services for children with IDD involved in six dimensions: leadership and governance, fundraising, human resources, service delivery, mental health technologies, and information and research. Mental health services went through the continuum of health services from prevention, treatment, rehabilitation to health promotion. We delivered mental health services for children with IDD in three aspects: identifying and diagnosing mental health problems or conditions, analyzing the main factors caused mental health problems, and analyzing the environmental factors. Mental health service interventions mainly covered five categories: antidepressants, psychotherapy, stress management training, physical exercise training, healthy lifestyle education, consultation and support. Children with IDD may obtain the mental health services in hospitals, rehabilitation institutions, community and school settings.
ABSTRACT
ObjectiveTo systematically review the effect of resilience intervention on rehabilitation of traumatic brain injury. MethodsThe literatures related to resilience intervention on rehabilitation outcome of patient with traumatic brain injury were retrieved from PubMed, ScienceDirect, CNKI, Wanfang data and VIP databases through subject headings retrieval. The retrieval time was from establishment to December 31th, 2021. After filtering, the research, country, research object, research design, intervention frequency, intervention effect, rehabilitation impact and influencing factors were extracted from the literature, and the methodological quality was evaluated using the PEDro scale. ResultsA total of six valid literatures were obtained, which mainly focused on the research of resilience intervention on physical function, post-traumatic stress disorder, psychological function and social adaptation of patients with traumatic brain injury. ConclusionResilience intervention could reduce the patients' physical symptoms and post-traumatic stress disorder, and promoted the recovery of psychological functions, allowing them to maintain an optimistic attitude, and adopt flexible and effective coping style to adapt to the society.
ABSTRACT
ObjectiveIn implementation of International Classification of Functioning, Disability and Health (ICF) and reference to the Ministry of Education's Physical Education and Health Curriculum Standards for Compulsory Education (2022 Edition), a functioning-oriented adapted physical education curriculum system was developed for the development of children's core qualities in physical education and sport of children with intellectual disabilities. MethodsInternational Classification of Diseases (ICD-11) and ICF were used to systematically analyze the motor function, activity and participation of children with intellectual disabilities. Based on the ICF bio-psycho-social model of functioning, disability and health and the Ministry of Education's Physical Education and Health Curriculum Standards for Compulsory Education (2022 Edition), and with reference to the American Adapted Physical Education National Standards (3rd Edition) (APENS-3), a functioning-oriented adapted physical education curriculum system was constructed, which was suitable for the development of motor functioning and motor competence of children with intellectual disabilities. ResultsChildren with intellectual disabilities might experience slow development of basic movements, poor fitness level, low motor competence, and insufficient motor motivation. The goals of adapted physical education curriculum were mainly to promote the development of children's core quality in physical education and sport, i.e., motor competence, health behaviors, and physical moral attributes, and to master motor skills and develop motor competence, including motor competence development goals, movement development goals, physical activity participation goals, health goals, adaptation and empowerment goals. The content of adapted physical education curriculum included physical fitness activities, motor skill activities and sport related activities. The implementation process of adapted physical education program covered materials development, and adapted physical education program teaching advices. The education program was evaluated in terms of the development of motor competence, motor development, participation in physical activities, the development of healthy behaviors, and the adaptation to the natural and social environment, using a holistic and multidimensional evaluation approach to comprehensively evaluate the motor development and the mastery of building of children's core qualities in physical education and sport. Accessible environments and assistive technology should also be considerated in the development of adapted physical education programs. ConclusionBased on the bio-psycho-social health model of ICF, the Ministry of Education's Physical Education and Health Curriculum Standards for Compulsory Education (2022 Edition), and APENS-3, the theoretical framework for the development of adapted physical education curriculum for children with intellectual disabilities was developed, and a functioning-oriented adapted physical education curriculum system was established, which emphasized the development of children's core qualities in physical education and sport, i.e., motor ability, healthy behavior, and physical moral values.
ABSTRACT
ObjectiveTo discuss the diagnosis, assessment and rehabilitation for children with cerebral palsy complicated with speech disorder based on the tools of World Health Organization Family of International Classifications (WHO-FICs). MethodsThe diagnosis of speech disorder after cerebral palsy was classified using International Classification of Diseases, 11th Revision (ICD-11). The disorders of speech function were classified using International Classification of Functioning, Disability and Health (ICF). A structured speech function rehabilitation solution was developed based on the International Classification of Health Interventions (ICHIβ-3). ResultsAccording to ICD-11, cerebral palsy was classified as 08 Neurological Disorder, which was further classified as 8D20.0 Spastic Unilateral Cerebral Palsy and 8D20.1 Spastic Bilateral Cerebral Palsy (8D20.10 Spastic Quadriplegic Cerebral Palsy and 8D20.11 Spastic Bilateral Cerebral Palsy), with the speech disorders involving 6A00 Disorders of Intellectual Development, 6A01 Developmental Speech or Language Disorders, MA80 Speech Disturbances, MA81 Speech Dysfluency and MA82 Voice Disturbances. For ICF, the speech disorders mainly involved s1 structures of the nervous system, s3 structures invoved in voice and speech, b3 voice and speech functions, d1 learning and applying knowledge, and environment and individual factors; and could be further classified as b310 voice functions, b320 articulation functions, and b330 fluency and rhythm of speech functions. Based on ICHIβ-3, a rehabilitation solution was developed, involving the areas of body structure and function, activity and participation, and environmental factors. ConclusionBased on ICD-11, ICF and ICHIβ-3, a methodological system of assessment and interventions for speech disorders after cerebral palsy has been systematically constructed, including diagnosis of disease, assessment, intervention and coding of speech disorder.
ABSTRACT
ObjectiveTo explore the diagnoses of diseases and functioning of speech fluency disorder, analyze the main assessment content, and construct framework of intervention solution based on International Classification of Diseases 11th Revision (ICD-11), International Classification of Functioning, Disability and Health (ICF) and International Classification of Health Interventions (ICHIβ-3). MethodsThe diagnoses of diseases and functioning was discussed with ICD-11 and ICF. The assessment tools were analyzed with ICF. A holistic intervention solution was constructed with ICF and ICHIβ-3. ResultsSpeech fluency disorder is classified as 6A01.1 developmental speech fluency disorder for ICD-11. The related diseases include 6A01.0 developmental speech sound disorder, 6A01.2 developmental language disorder, cerebral palsy, MA80.0 aphasia, MA80.1 dysphasia and MA80.2 dysarthria, etc. For ICF, the categories related to speech fluency disorder might be s3 structures invovled in voice and speech; b3 voice and speech functions, especially b330 fluency and rhythm of speech functions; d1 learning and applying knowledge, d3 communication, especially d330 speaking and d355 discussion, d7 interpersonal interactions and relationships, and d9 community, social and civic life. A holistic intervention solution for speech fluency disorder was developed, involving in body structure, body function, activities and participation, and environmental factors, including assessment, training and treatment, educational counseling, and psychological and social support, etc. ConclusionA framework of diagnosis, assessment and rehabilitation has been constructed for speech fluency disorder.
ABSTRACT
ObjectiveTo study the conceptual framework and methodological system of the International Classification of Functioning, Disability and Health (ICF) in occupational therapy and its systematic implementation in clinical practice. MethodsBased on the ICF theory and the policy documents of the World Federation of Occupational Therapists, the conceptual framework of occupational therapy and the systematic implementation in clinical settings based on the ICF framework were analyzed. ResultsThis study constructed a conceptual framework and approach for occupational therapy based on ICF, and clarified the goals, principles, and implementation methods of integrated occupational therapy interventions in rehabilitation services. The goal of occupational therapy interventions was to improve the individual activity and participation through multidisciplinary and cross-cutting implementation of integrated occupational therapy programs to optimize functioning. Occupational therapy was based on the bio-psycho-social model, adhered to the principles of person-centeredness and functioning orientation, and implemented individualized intervention programs in different context. In clinical practice, it was recommended to follow ICF-based standardized process and systematically use World Health Organization Family International Classifications: functioning and unmet needs analysis using ICHI; functional classification, assessment and coding using ICF; disease classification, diagnosis and coding using ICD; intervention of occupational therapies using ICHI to build a systematic occupational therapy service system. ConclusionAn ICF-based occupational therapy concept and methodological system has been built, a comprehensive clinical occupational therapy implementation model has been established, the goal of activity and participation oriented occupational therapy interventions has been clarified, and the systematic, structured, standardized and refined level of occupational therapy has been enhanced.
ABSTRACT
ObjectiveTo explore the pedagogical content knowledge of adaptive physical education teachers using the World Health Organization Rehabilitation Competency Framework (RCF), to construct an adaptive physical education competency system and establish an adaptive physical education and training system and accreditation method for teachers. MethodsUsing RCF and referring to the U. S. Adapted Physical Education National Standards 3rd version (APENS-3), we examined the pedagogical content knowledge of adaptive physical education for teachers. The structure and content of the key pedagogical knowledge contents of adaptive physical education teachers were systematically studied, and the core professional competencies of adaptive physical education teachers were constructed. ResultsBased on the RCF and teaching activities, the teaching-related core competencies of the adapted physical education teachers were constructed from the knowledge and skills in the domains of practice (teaching), and learning and development (continuing education) of RCF, and the structure and content of the knowledge of adapted physical education teachers were constructed in the five domains: students, teachers, teaching, curriculum and educational evaluation. This competency framework could be applied in the fields of professional teaching competency identification, continuing education curriculum development and continuing education competency training, and performance evaluation for adaptive physical education teachers. ConclusionIn accordance with the RCF and with reference to APENS-3, the structure of pedagogical content knowledge and its core contents for adaptive physical education teachers were systematically explored. These structures and the core contents can be applied in the identification of competencie, the development of continuing education curriculum and competency training, and the assessment of performance for adaptive physical education teachers.
ABSTRACT
Objective:To analyze the data of Chinese medicine prescriptions for the treatment of coronavirus disease 2019 (COVID-19) in Shijiazhuang City, Hebei Province, with a view to further guide the clinical use of Chinese medicine in the prevention and treatment of COVID-19.Methods:Forty-eight patients diagnosed with COVID-19 who were treated by critical care team of Hebei Traditional Chinese Medicine Hospital in the intensive care unit (ICU) of Hebei Chest Hospital (Hebei Provincial COVID-19 designated hospital) from January 7 to March 4, 2021, were enrolled in this study. The patients' gender, age, clinical classification, past history, and all Chinese medicine prescriptions for the first visit and follow-up visits during the hospitalization were collected. A database was established based on the Ancient and Modern Medical Records Cloud Platform (V2.2.1), and the methods of frequency analysis, correlation analysis, cluster analysis, and complex network analysis were used to analyze the prescriptions of traditional Chinese medicine.Results:Among the 48 patients with COVID-19, 20 were males and 28 were females; the average age was (62.4±13.7) years old. The patients' condition was generally severe, including 17 cases of common type, 25 cases of severe type, and 6 cases of critical type, most of whom were combined with hypertension, coronary heart disease, diabetes, chronic obstructive pulmonary disease and other basic illnesses. A total of 146 valid prescriptions were included, involving 59 prescriptions and 115 Chinese medicines. Frequency analysis of 146 prescriptions showed that the commonly used prescriptions for patients with COVID-19 were Qingfei Paidu decoction (30 times, 20.55%), Xuanbai Chengqi decoction (10 times, 6.85%), and Dayuan Yin (10 times, 6.85%). The common Chinese medicines were liquorice (80 times, 54.79%), tuckahoe (76 times, 52.05%), gypsum (70 times, 47.95%), bitter almond (70 times, 47.95%), ephedra (57 times, 39.04%), scutellaria (56 times, 38.36%), tangerine peel (53 times, 36.30%), patchouli (50 times, 34.25%), atractylodes macrocephala (50 times, 34.25%), and bupleurum (43 times, 29.45%). The main effects were clearing heat and detoxification (129 times), clearing heat-fire (129 times) and eliminating dampness and diuresis (110 times). The medicinal properties were mainly warm (509 times), flat (287 times), and cold (235 times). The medicinal tastes were mainly pungent (765 times), sweet (654 times), and bitter (626 times). The medicinal channel tropism were mainly lung (1 096 times), spleen (785 times), and stomach (687 times). The correlation analysis showed that there were 17 drug combinations in total, among which the top 3 drug pairs in support were bitter almond-gypsum (0.43), ephedra-bitter almond (0.38), tangerine peel-poria (0.36), and ephedra-gypsum (0.36). Cluster analysis showed that there were 3 groups of clustering formulas. The first group was ephedra, bitter almond, and gypsum. The second group was patchouli, tuckahoe, tangerine peel, and atractylodes macrocephala. The third group was scutellaria, licorice, immature orange fruit, oriental waterplantain rhizome, bupleurum, ginger, and cassia twig. The core drugs were composed of tuckahoe, bupleurum, tangerine peel, atractylodes macrocephala, patchouli, bitter almond, scutellaria, gypsum, ephedra, and licorice.Conclusions:Middle-aged and elderly patients with COVID-19 are accompanied by Qi deficiency and internal invasion of toxins, and the pathogenesis evolves rapidly. Damp and turbid toxins often block the lungs and trap the spleen, leading to disorder of Qi movement, and even invaginate Ying and Xue, drain Yin and Yang. The treatment is based on removing turbidity and detoxification, and replenishing Qi and nourishing Yin are the principle treatments, so that the evil is eliminated and the Qi is restored.
ABSTRACT
OBJECTIVE：To know about the co gnition level and self-medication behavior of antibiotics among urban and rural residents in Lu ’an city of Anhui province ，and to investigate its influential factors and to provide reference for promoting rational use of antibiotics. METHODS ：Totally 684 urban and rural residents aged 18-80 years in Lu ’an city were randomly selected as the research objects by stage sampling method. A self-designed questionnaire was used for household survey ，involving general demographic characteristics ，antibiotics related cognitive level ，antibiotics use behavior and related influential factors ，etc. RESULTS：A total of 657 questionnaires were collected ，with effective rate of 96.1％. Among them ，305 were from urban residents and 352 from rural residents. Among the 657 respondents，38.2％ were male and 61.8％ were female ；their age was （50.30±13.26）years old ；44.7％ of them were educated in primary school or below. 7.8％ of the respondents correctly recognized that antibiotics were not effective to the virus ；12.6％ knew antibiotic resistance ；55.1％ thought that frequent use of antibiotics would reduce the sensitivity of bacteria to it ；23.1％ said they knew the difference between prescription drugs and over-the-counter drugs；58.0％ could tell at least one case of not using antibiotics. For 7 knowledge items ，75.3％ of the residents in the survey area had a total score of less than 3；the cognition level of antibiotics was higher in urban areas and people with higher education level. 66.5％ of the respondents had used antibiotics in the past one year，of which 61.0％ obtained antibiotics by prescription 65161220。E-mail： from doctors ，50.7％ purchased antibiotics by themselves in pharmacies， and 13.1％ used the above two ways both. Among the people who have used antibiotics in the past year ， 81.9％ said they could buy antibiotics without prescription. Among the 657 respondents，49.0％ said that they had to obtain prescription from doctor when taking antibiotics ；68.9％ said that they would stop taking antibiotics when their symptoms improved；19.3％ would increase their dosage in order to enhance the curative effect ；28.3％ would change drugs frequently. Compared with urban residents ，rural residents were more likely to take antibiotics based on prescriptions by physicians [odds ratio （OR）＝1.693，95％ confidence interval （CI）（1.191，2.407）]. The higher the cognitive score ，the lower the behavior rate of having to prescribe antibiotics by doctors [OR ＝0.882，95％CI（0.785，0.991）]，and they were more likely to stop taking antibiotics when symptoms improved [OR ＝1.163，95％CI（1.025，1.319）]，and male were more inclined to increase the dosage of antibiotics to enhance the efficacy [OR ＝1.841，95％CI（1.214，2.792）]. The higher the cognitive score was ，the less likely they were to increase drug dosage to enhance the curative effect [OR ＝0.894，95％CI（0.773，1.034）]，nor were they inclined to change drugs frequently [OR ＝0.873，95％CI（0.767，0.992）]. CONCLUSIONS ：The cognition level to antibiotics of urban and rural residents in Lu ’an city needs to be improved urgently ，and reasonable antibiotic use behavior needs to be standardized. Pure knowledge of antibiotics is not necessarily related to the expected rational drug use behavior. Therefore ，in addition to health promotion for the rational use of drugs for residents ，it is also necessary to create a systematic environment that promotes the rational use of antibiotics and provide residents with multi-channel services for rational use of drugs.
ABSTRACT
Objective To investigate the incidence and risk factors of adverse drug reactions in hematological system induced by linezolid.Methods In this retrospective study, 124 inpatients treated with linezolid (n=62) or vancomycin (n=62) for anti-infective therapy between January 2012 and December 2015 in clinical departments of the Second Affiliated Hospital of Anhui Medical University were included.The incidence hematological adverse drug reactions were observed, and the single factor and the multiple factor Logistic regression methods were used to analyze the risk factors of developing thrombocytopenia and decline of hemoglobin.Results Among the 62 inpatients treated with linezolid, thrombocytopenia occurred in 21 patients(33.87%), and decline of hemoglobin occurred in 17 patients (27.42%).No patient discontinued the use of linezolid for the reason of thrombocytopenia or decline of hemoglobin.In multiple stepwise regression analysis, linezolid use[OR=7.699,95%CI (1.408,42.090),P=0.019], treatment duration>14 d[OR=7.639,95%CI(1.162,50.226),P=0.034], baseline eGFR<80 mL·min-1[OR=6.150,95%CI(1.604,23.577),P=0.008], baseline ALB<25 g·L-1[OR=4.078,95%CI(1.017,16.351),P=0.047] and baseline platelet count<200×109·L-1[OR=6.148,95%CI(1.705,22.172),P=0.006] were independent risk factors for thrombocytopenia;linezolid use [OR=4.335,95%CI(1.308,14.365),P=0.016] and baseline ALB<25 g·L-1[OR=5.424,95%CI(1.824,16.129),P=0.002] were independent risk factors for the decline of hemoglobin.Conclusion The incidences of thrombocytopenia and anemia induced by linezolid are not rare, and most of them can be returned to normal.The risk factors of thrombocytopenia and anemia should be concerned and the routine blood test should be monitored during use.
ABSTRACT
Purpose To explore the significance of MR diffusion tensor imaging (DTI) in diagnosing and predicting the motor function of patients with acute ischemic stroke in the brainstem. Materials and Methods Twenty patients with acute ischemic stroke in the brainstem and 20 normal controls were enrolled in the study. DTI was performed on all 40 subjects. Fractional anisotropy (FA) in specific regions were measured including infarction lesions, cerebral peduncle, the posterior limb of the internal capsule in the affected side and corresponding unaffected regions. The number and the length of the corticospinal tracts (CST) of both affected and unaffected sides were also measured. The correlation of FA, the number and the length of the CST, the NIH stroke scale (NIHSS) at the admission, 3 months and 6 months was analyzed. Results The FA values of infarction, cerebral peduncle, and the posterior limb of the internal capsule, and the number of CST in the affected side were significantly less than that of the corresponding unaffected regions (P<0.05). The rFA (<7 d) in the affected cerebral peduncle was negatively correlated with NIHSS and the score of the upper and lower extremity muscle strength at the admission, after 3 months and after 6 months (P<0.05). However, the rFA of the infarction and the posterior limb of the internal capsule, the ratio of the number and the length of CST of affected/unaffected sides had no correlation with NIHSS score and the score of the muscle strength. Conclusion The rFA in the cerebral peduncle is helpful for early evaluation and predicting recovery of the motor function in the patients with acute ischemic stroke in the brainstem.
ABSTRACT
BACKGROUND:Digital three-dimensional model which can reflect the fine structure of the chambers inside heart not only enhances the understanding of cardiac physiology, but also provides basic medical data for the study of cardiac electrophysiology simulation and endocardial electrophysiological mapping navigation. OBJECTIVE:To construct the digital three-dimensional model of cardiac cavity from sectional data and in conformity with the actual anatomical structure. METHODS:Image segmentation was accomplished in MATLAB environment. Firstly, registration of human cardiac cavity slice dataset was realized. Secondly, classifying each composition was achieved by clustering method according to color characteristics of the image. Then, both cardiac cavity and related connected region was distinguished by region growing method. At last, the processed image was reconstructed through dedicated medical processing software into three-dimensional model of the cardiac cavity. RESULTS AND CONCLUSION:The proposed method could reconstruct quite exquisite three-dimensional model of the cardiac cavity. In models, left and right atrial and ventricular structure was clear. Aorta and superior vena cava were visible. Three tricuspid and mitral valve were also observed. Results indicated that reconstructed model can reflect the anatomical characteristics of cardiac cavity accurately, and provide basic medical data for the study on electrophysiological simulation and endocardial electric mapping.
ABSTRACT
Objective To evaluate the clinical value of ultrasonography guided percutaneous core needle biopsy in pancreatic lesions. Methods Thirty-four patients with 36 pancreatic lesions in Shanghai First People′s Hospital Afifliated to Shanghai Jiao Tong University from February 2012 to November 2013 underwent conventional ultrasound-guided percutaneous core needle biopsy using automatic gun and 18-gauge biopsy needles. The site, size, internal and surrounding vascularity, the sampling number of the lesions, and whether the specimens′ quality was satisfied were recorded. Then specimens were sent for pathological examination, and all above observations were compared with the ifnal diagnosis. Results The number of lesions with 2, 3 and 4 samplings was 32, 2 and 2, respectively. The average number of sampling was 2.2 (mean, 2.17;standard deviation, 0.51) and the acquisition rate of satisifed specimens was 89%(32/36). The pathological results of biopsy were malignant in 31 of 36 lesions including 27 cases of ductal adenocarcinoma, 2 cases of lymphoma, 1 case of small cell neuroendocrine carcinoma and 1 case of uterine leiomyosarcoma metastasis. The other 5 lesions were non-malignant including 3 cases of benign lesion, 1 cases of atypical hyperplasia and 1 cases of granulation tissue. The 36 lesions were ifnally diagnosed as 34 cases of pancreatic malignancy, 2 cases of non-malignant neoplasm. The sensitivity, speciifcity, accuracy, positive predictive value and negative predictive value of ultrasonography guided percutaneous core needle biopsy in pancreatic lesions were 91%(31/34), 100%(2/2), 92%(33/36), 100%(31/31) and 40%(2/5), respectively. Youden index was 0.91. Two patients had mild upper abdominal pain and 1 patient had transient elevated serum amylase. No pancreatitis, pancreatic fistula, peritonitis, bleeding or dispersion of malignant cells along the penetrating channel or other serious complications occurred. Conclusion Ultrasonography guided percutaneous core needle biopsy is a simple, rapid, safe and effective diagnostic method in pancreatic lesions with high clinical value.
ABSTRACT
Mitogen activated protein kinase(MAPK)is one of the four biggest signal transduction systems which contain four subtribes named p38,ERK5/BMK1,ERK and JNK/SAPK respectively.Previous studies have shown that MAPK pathway is involved in growth,cell differentiation,perishing,the synchronization of cell function and so on.ERK/MAPK,one of the members of MAPK family,and Sma-and MAD-related(Smad)play important roles in the proliferation of fibroblast,modulating inflammation mediator production as well as transferring factors activity in the process of pulmonary fibrosis(PF).This review focuses on relationship between Smads and ERK in the pathogenesis and progression of PF.