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ObjectiveTo investigate the effect of community-based rehabilitation exercise and physical activity on the physical activity levels, functional states, and quality of life for people with mild and moderate disabilities in community settings, to ascertain the health benefits of their engagement in such fitness sports activities, anchoring in the WHO "Global Action Plan on Physical Activity 2018-2030: More Active People for a Healthier World" and the guidelines tailored for people with disabilities, using the theoretical framework and methodology of the International Classification of Functioning, Disability and Health (ICF). MethodsAligning with the WHO guidelines for people with disabilities and the ICF, a community-based rehabilitation exercise and physical activity program was designed for individuals with mild to moderate disabilities, featuring activities like fitness training (aerobic and resistance exercises), skill exercises (such as balance and coordination), as well as sports and recreational games (ball and games, etc.). A total of 230 people with mild and moderate disabilities were recruited from 20 communities in Shenzhen, with types of disabilities including physical, speech, intellectual, and mental. Professional rehabilitation fitness instructors implemented and supervised the program. The activities were of low to moderate intensity, 30 to 50 minutes per session, five times a month for six months. The community-based rehabilitation exercise and physical activity progress of these individuals was surveyed using the International Physical Activity Questionnaire (IPAQ), and their overall functioning was evaluated with WHODAS 2.0. The health-related quality of life was measured with WHOQOL-BREF. The health benefits from participation in community-based rehabilitation exercise and physical activity were assessed in terms of functioning, activity involvement, and quality of life. ResultsAfter the fitness activities, participation levels significantly increased in IPAQ domains of work-related, transport-related, domestic and gardening activity, and leisure time (|t| > 3.391, P < 0.001). The scores significantly decreased in the domains of cognition, activity, self-care, getting along, life activities and participation; and overall scores also decreased in WHODAS 2.0 (t > 6.639, P < 0.001). The scores significantly increased in the four dimensions of WHOQOL-BREF (|t| > 7.486, P < 0.001). ConclusionAfter participating in a six-month community-based rehabilitation exercise and physical activity program of mild to moderate intensity, individuals with mild to moderate disabilities have improved in physical activity and engagement levels, and the overall functioning and quality of life.
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ObjectiveTo systematically review the health benefits of different physical activities for children and adolescents with cerebral palsy. MethodsCombined with MeSH terms and free words, randomized controlled trials regarding health and functional outcomes of physical activity intervention for children and adolescents with cerebral palsy published up to December, 2023 in databases of Web of Science, PubMed, EBSCO, Cochrane and CNKI were retrieved and systematically reviewed. ResultsTen randomized controlled trials were included, involving 402 participants (aged three to 24 years), with Physiotherapy Evidence Database Scale scores of six to eight, from Australia, the United States, Brazil and Netherlands, mainly in the fields of rehabilitation medicine, neuroscience, disability research and physiotherapy, with publication dates concentrated between 2013 and 2020. The physical activities included three types: fitness-related (physical fitness, skill-related fitness), motor skill-related (gross motor skills, fine motor skills) and adaptive physical activity-related (mobility skills, recreational types); 20 to 60 minutes a time, one to five times a week, for seven to 26 weeks; the intensity was moderate to high. Intervention settings involved community and home, schools and rehabilitation institutions. The guidance and support models included sports rehabilitation, adaptive physical activity, and a combined model of sports rehabilitation and adaptive physical activity. The health benefits were reflected in physical activity-related health behaviors, physical function, activities and participation, and quality of life, such as improving the level of physical activity and reducing sedentary behavior; enhancing muscle strength, improving cardiopulmonary function, cardiovascular function, body mass and aerobic capacity, increasing gait speed, joint mobility, balance function and muscle endurance; improving motor function (mobility, movement coordination ability, balance and postural control ability, gait function); improving self-care, promoting participation in family, school and social activities, increasing social performance behaviors, and improving mental health (self-confidence, emotions, self-worth, self-esteem). ConclusionThis study reviewed the health benefits of different physical activities for children and adolescents with cerebral palsy. There are three kinds of major physical activities: fitness-related, motor skill-related and adaptive physical activity-related. Physical fitness-related activities help to improve gait function, increase walking speed, enhance muscle strength, improve cardiovascular function, optimize body mass index; skill fitness-related activities can improve balance function. Gross motor skill-related activities can improve postural control ability and muscle endurance; fine motor skill-related activities can enhance the use of fine hands. Adaptive ball-related activities help to increase physical activity levels, increase leisure activity time, improve aerobic capacity, promote family activity participation and social activity participation; adaptive leisure-related activities can improve the quality of life and well-being, improve self-care, enhance self-worth, and increase life satisfaction.
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As a Chinese saying goes， "good Chinese medicinal material makes good medicine"， the quality of Chinese herbal medicines is related to the development prospect of Chinese medicine industry in China. With the rapid development of new technologies such as traceability methods and monitoring instruments， it is imperative to integrate and innovate traditional Chinese herbal medicines with new-generation information technology in view of the quality problems existing in the current production and circulation of Chinese herbal medicines， and it is of great significance for the construction of traceability system to ensure the quality and safety of Chinese herbal medicines and to promote the industry of Chinese herbal medicines to move towards high-quality development. This paper reviews the development history of the traceability system of Chinese herbal medicines in China， takes the influencing factors of the quality of Chinese herbal medicines as the entry point， and proposes that the construction of the traceability system should satisfy the traceability requirements of the characteristics of Chinese herbal medicines and their traditional medication experience. By analyzing the influencing factors of the quality of Chinese herbal medicines， it is pointed out that focusing on the influencing factors to build a traceability system is of great significance for targeting the problematic links at a later stage and exploring the interrelationship between environmental factors and the quality of Chinese herbal medicines. Based on the previous explorations， the author summarizes the system framework， functional modules and practical applications of the traceability system of Chinese herbal medicines， and looks forward to the development of a traceability system with risk early warning function and expert decision-making function in its functional development. Finally， based on the factors affecting the quality of Chinese herbal medicines， the author puts forward several thoughts on construction of the traceability system， and makes an in-depth analysis and puts forward a solution for the current situation that a unified， standardized and universal traceability system has not yet been built， with a view to providing ideas and references for the construction of traceability system of Chinese herbal medicines.
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ObjectiveTo synthesize the structure, content and psychometric properties of physical activity measurement/reporting tools applied in children and adolescents with disabilities. MethodsLiterature on physical activity measurement/reporting tools for children with disabilities were retrieved from PubMed, Medline, EBSCO, Web of Science and CNKI, from establishment to June, 2023. The main structure and content characteristics of the tools were analyzed using the International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY). The psychometric properties of the tools was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). ResultsSix tools were selected, and nine papers were finally included. Two tools were globalized standard tools, namely Global Matrix 4.0 Physical Activity Report Card for Children and Youth (Global Matrix 4.0) and the Global Matrix of Para Report Card on Physical Activity of Children and Adolescents with Disabilities (Para Report Card), measuring b455 functions of motor tolerance function, b7 neuromusculoskeletal and motor-related functions; d4 mobility, d450 walking, d470 using transportation, d820 school education, d910 community life, d920 recreation and leisure; e310 immediate family, e320 friends, e460 societal attitudes, and e575general social support services, systems and policies, etc. These tools showed a complete structure, high reliability, validity and feasibility, and could be performed in a self-reported manner or completed by the custodian or school teacher. The International Physical Activity Questionnaire (IPAQ) might measure d4 mobility, d450 walking, d640 doing housework, d820 school education, d920 recreation and leisure. IPAQ was good in terms of internal consistency, content and construct validity, and cross-cultural validity, with different test-retest reliability and hypothesis testing results reported in different applied studies. Children and Adolescents Physical Activity and Sedentary-Questionnaire (CAPAS-Q) might measure the d4 mobility, d450 walking, d470 using transportation, d820 school education, and d920 recreation and leisure. CAPAS-Q was good in internal consistency, retest reliability, content and construct validity, but hypothesis testing results and cross-cultural validity were unknown. Physical Activity Questionnaire for Older Children (PAQ-C) and Physical Activity Questionnaire for Adolescents (PAQ-A) might measure d4 mobility, d450 walking, d470 using transportation, d820 school education, and d920 recreation and leisure. PAQ-C and PAQ-A were strong in internal consistency, retest reliability, content and construct validity, and cross-cultural validity, without hypothesis testing results. ConclusionIn terms of content, Para Report Card is the most comprehensive and extended physical activity measurement/reporting tool for children and adolescents with disabilities. In terms of the psychometric properties of the instruments, the multidimensional, structured physical activity measures show high internal consistency, retest reliability, and content and construct validity, with varying retest reliability and correlational validity with objective measures across studies.
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ObjectiveTo analyze the effect of physical activity in an adaptive physical education program on the psychomotor development of children with intellectual and developmental disabilities in the school setting. MethodsLiterature related to adaptive physical education programs and psychomotor development for children with intellectual and developmental disabilities were retrieved from EBSCO, PubMed, Embase, Web of Science and CNKI, from the establishment of the library to May, 2023, and systematically reviewed. ResultsSeven English literatures of randomized controlled trials were included, from four countries, involving 236 subjects, aged six to 18 years. The main sources were journals in the fields of sport and psychomotor, developmental disorders, adapted physical education, and children's psychomotor, with publication dates centered after 2016. Physical activity components of adaptive physical education programs in school settings primarily included muscle and balance training, perceptual-motor training, walking up and down stairs, aerobic exercise using equipment (e.g., treadmills, steppers, cross-trainers, and stationary bikes), sit-ups, jumping exercises, rhythmic activities, simultaneous static and dynamic balancing activities while focusing on visual inputs, changing positions at different rhythms and moving through space, breathing and stretching exercises, adapted table tennis motor skill training, ball control exercises, and hand-eye coordination exercises, with an intervention of light-moderate intensity, 45 to 60 minutes a time, one to five times a week, for eight to 24 weeks. The health benefit maily included the enhancement of rhythmic perception as well as the improvement of integrated visual, auditory, and tactile perception; improving muscular strength and endurance, total locomotor capacity and fine-motor capacity such as fine-motor integration, running speed and agility, and balance; improving physical flexibility and coordination, such as upper limb coordination, static balance, strength and flexibility; improvement of correct response, sustained response, and theoretical level of reactivity, and motor flexibility and agility; significant improvements in self-care (eating, dressing, and self-direction), increasing in the number of sit-ups to standard, increasing success in jumping for a ball, and improving motor skill proficiency and executive functioning. ConclusionThis systematic review constructed a PICO for the psychomotor development of children with intellectual and developmental disabilities participating in physical activity in the school setting with an adaptive physical education program based on the PRISMA guidelines. The adaptive physical education program may promote psychomotor development in children with intellectual and developmental disabilities in five main areas: perception, motor control, coordination, reaction time, and movement planning and execution.
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ObjectiveTo review the studies related to school health services and their outcomes based on the World Health Organization health-promoting school framework, to synthesize and analyze the main research scopes and related evidence in this field. MethodsLiterature about the interventions and outcomes of implementing health-promoting school health services were retrieved from PubMed, Web of Science, EBSCO and CNKI, from the establishment to June, 2023, and a scoping review was conducted. ResultsSeven papers were eventually included, involving 76 researches, more than 20 interventions, from five countries, published mainly from 2014 to 2021. The interventions included asthma education training curriculum, oral health education, menstrual management interventions, cognitive anxiety prevention programs, physical activity curriculum, cooking and nutrition curriculum, exercise and fitness interventions, mental health education programs, health-promoting diets curriculum and health education curriculum, and health skills training curriculum. The school health services programs included health screening and monitoring, disease prevention and control, and safety and first aid training for teachers and students. The health benefits of health-promoting school for students included improving health education outcomes and grades in health services elective courses; improving health condition and qualities of learning and life at school, reducing prevalence of chronic diseases and frequency of visiting the emergency room, and alleviating asthma; improving self-esteem, communication skills and social cohesion of the group, alleviating the influence of anxiety and other negative emotion, and increasing awareness of autonomy; improving activities related to healthy living, and positively affecting behaviors, attitudes and action. The health benefits of health-promoting school for teachers included improving pedagogical abilities and skills in teaching physical activity-related curriculum content, and increasing professional support for staff such as knowledge of first aid and participation in the school health service. The health benefits of health-promoting school for schools included promoting the incorporation of health education courses into regular teaching activities and increasing the school's financial investment in the construction of health-related psychosocial environments; promoting the plan and implementation of the health service in the schools. ConclusionThe school-based health services in health-promoting school consisted of two main categories: school curriculum and school health services. The health-promoting school may improve the health conditions, health behaviors and health services for the students, teachers and schools.
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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.
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ObjectiveThe psychological and behavioral health benefits participating in yoga activities for children with autism spectrum disorder (ASD) in special education schools were reviewed using the theory and methodology of the International Classification of Functioning, Disability and Health (ICF). MethodsThe literature on benefits of yoga in psychological and behavioral health for students with ASD from special education schools participating in yoga activities was searched from PubMed, Embase, Web of Science and CNKI, from January, 2010 to July, 2023, and a systematic review was conducted. ResultsSeven papers from USA, India and Australia were included, mainly from the journals related to autism, sports therapy, and health psychology, published after 2018. The study design was all randomized controlled trials, featuring a total of 207 children with ASD aged five to 15 years. Adopted yoga interventions mainly included Mandala yoga postures, traditional yoga (breathing, posture, partner posture and relaxation) activities, etc. These simple yoga activities were incorporated into the physical health curriculum of special education schools. The benefits of yoga on psychological and behavioral health of students with ASD were mainly reflected in the following aspects: in the field of cognition, it significantly improved working memory, task monitoring, planning/organization and other aspects in reactive joint attention function and executive function; in the field of emotional development and control, it enhanced the ability of emotions/expressing emotions, empathy for others, and awareness of emotional control, and reduced in anxiety states, irritability that occurred in social, emotional, behavioral aspects, and hyperactivity and aggressive behavior; in the field of social and team activities, it improved speech/communication skills, social skills, and teamwork; in the field of psychomotor, it improved overall motor and imitation skills, exercise-related health behaviors, and sedentary behaviors. Yoga activities also relieved sleep problems. The frequency of intervention ranged from twelve to 60 minutes, one to six times a week for eight to 45 weeks. ConclusionIn the context of special education schools, the health benefits of adapted yoga activities are primarily reflected in improving the psychological health, motor function, and social skills of children with ASD.
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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.
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ObjectiveTo systematically analyze the content and health benefits of structured physical activity programs for children with autism spectrum disorders (ASD). MethodsPublished literature related to structured physical activity for children with ASD and its health benefits were searched in Wanfang database, CNKI, Embase, EBSCO and PubMed from January, 2013 to July, 2023. A systematic review was conducted using the PRISMA guidelines. ResultsSeven literatures were finally included, from China, USA, Germany, Italy and Turkey. The publication dates concentrated after 2019. The study designs were all randomised controlled trials with 193 children with ASD, aged three to 14 years. Structured physical activity intervention sites included community sports halls, special education schools, rehabilitation wards of children's hospitals, and rehabilitation centers for children with disabilities. The intervention attributes were generally treatment, rehabilitation and health promotion. The content of physical activity mainly included motor skill-based activities (e.g., running, jumping, kicking, hitting, throwing), traditional yoga activities (e.g., breathing, mimicking postures and relaxation, as well as appropriate socialization activities such as encouragement of greeting/farewell songs, touch/contact games and expressive games), and a combination of multiple types of exercises integrated with school-based curricula such as aerobic exercises (walking), endurance exercises (jumping) and neuromuscular exercises (throwing paper airplanes), mindfulness for emotions and body, and judo. The frequency of the intervention ranged from 40 to 90 minutes, one to four times a week; the intensity ranged from mild to vigorous; and the duration ranged from eight to 40 weeks. The physical and behavioral health benefits were reflected in three aspects. In terms of body composition, it could reduce fat and body mass, increase muscle strength, and improve cardiorespiratory function. In terms of function, it could improve children's language and communication function, cognitive and executive function, and motor function. In terms of physical activity-related health behaviors, it could enhance children's motivation to exercise, reduce sedentary behavior, increase social and interactive behavior, improve emotional regulation, and reduce the risk of problematic behaviors. ConclusionThe physical and behavioral health benefits of structured physical activity for children with ASD can be reflected in the areas of body composition, function, and physical activity-related health behaviors.
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@#According to the needs of CT image evaluation for transapical transcatheter aortic valve replacement (TAVR), 20 clinical questions were proposed by the Delphi method, 15 questions were initially determined, and 12 clinical questions were summarized and determined by domestic experts. PubMed, Web of Science, Wanfang, and CNKI databases were searched by computer to collect the relevant literature from inception to November 2022, and finally 53 studies were included. Based on evidence-based study and evaluation experience, 3 meetings were held to give recommendations for preoperative CT data acquisition method, preoperative imaging evaluation of aortic root, imaging evaluation of transapical approach, preoperative auxiliary guidance of TAVR by CT images combined with 3D printing, and postoperative imaging evaluation of transapical TAVR, hoping to promote the standardized and successful development of transapical TAVR in China.
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In early stage after liver transplantation(LT), coagulation function of recipients stays in a fragile balance. Affected by a variety of complex mechanisms, blood is usually hypercoagulable. An imbalance between coagulation factors and physiological anticoagulants, elevated level of vWF, an occurrence of fibrinolysis inhibition and dosing of immunosuppressive agents cause a hypercoagulable state in an early stage after LT. Blood hypercoagulability may lead to such thrombotic complications as hepatic artery, portal vein and deep vein thromboses. Some studies have demonstrated that postoperative prophylactic anticoagulation has some effect in reducing the risks of early postoperative thrombosis. However, there is still a great lack of high-quality evidence. This review summarized the latest researches on early coagulation dysfunction, thrombosis and preventive anticoagulation after LT.
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Prostate cancer is the most common malignancy of the male genitourinary system. In 2022, the European Association of Urology (EAU) published an update of the guidelines for prostate cancer, following the updating of evidence. The clinical application of nuclear medicine diagnostic and therapeutic techniques in the staging and grading, screening and assessment of prostate cancer, especially metastatic castration-resistant prostate cancer, is becoming more and more valuable. This article aims to introduce the application of nuclear medicine recommended in the 2022 edition of EAU guidelines for prostate cancer based on the latest clinical evidence.
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Objective:To explore the asymmetry of neonatal brain white matter using fractional anisotropy (FA) parameter generated from diffusion tensor imaging (DTI).Methods:From January 2011 to June 2013, 88 neonates with normal cranial MRI performance, aged 1-14 (7.7±0.3) days and gestational age 31-42 (37.5±0.3) weeks, were retrospectively collected from the First Affiliated Hospital of Xi′an Jiaotong University. According to the gestational age at birth, the neonates were divided into preterm group (37 cases) and term group (51 cases). DTI was processed to generate FA parametric maps. Tract-based spatial statistics (TBSS) was used to analyze the asymmetry in neonatal white matter. Regions of interest were placed in bilaterally symmetrical white matter tracts. The white matter tracts included the bilateral anterior thalamic radiation, corticospinal tract-posterior limb of the inner capsule (CST-IC), corticospinal tract-corona radiata, cingulum hippocampus part (CGH), inferior frontal occipital fasciculus (IFOF), inferior longitudinal fasciculus (ILF), superior longitudinal fasciculus (SLF), uncinate fasciculus, superior longitudinal fasciculus temporal part (SLF-temp). The FA value was measured and asymmetry index (AI) was calculated. The independent-sample t test or Mann-Whitney U test was used to compare the AI of each tract between the preterm and term groups. Partial correlation was used to analyze the effects of neonatal gestational age and birth anthropometric measures on the asymmetry of neonate at birth. Results:The results of TBSS showed that the left lateralized areas of brain white matter in the neonatal period were mainly located in the corticospinal tract, external capsule and genu of corpus callosum. The right lateralized areas of brain white matter in the neonatal period were mainly located in the optic radiation and splenium of corpus callosum. In both the preterm and term groups, the tracts related to motor (CST-IC) and language function (ILF, SLF, SLF-temp) were left asymmetry. The CGH of the preterm and the term neonates were right asymmetry, and AI was -0.086±0.114 and -0.140±0.108 respectively, with a statistically significant difference ( t=2.27, P=0.026), while the differences of AI in the remaining tracts were not statistically significant ( P>0.05). Only gestational age was correlated with the AI of ILF ( r=0.234, P=0.033), SLF ( r=0.259, P=0.018), SLF-temp ( r=0.252, P=0.022), CST-IC ( r=0.235, P=0.033). No significant correlation was found between birthweight, head circumference, body length and AI. Conclusions:The asymmetries of brain white matter already exist in neonates aged less than two weeks. The tracts associated with motor and language function are predominantly left asymmetry.
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Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.
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The rapid and accurate authentication of traditional Chinese medicines(TCMs)has always been a key scientific and technical problem in the field of pharmaceutical analysis.Herein,a novel heating online extraction electrospray ionization mass spectrometry(H-oEESI-MS)was developed for the rapid and direct analysis of extremely complex substances without the requirement for any sample pretreatment or pre-separation steps.The overall molecular profile and fragment structure features of various herbal medicines could be completely captured within 10-15 s,with minimal sample(＜0.5 mg)and solvent consumption(＜20 μL for one sample).Furthermore,a rapid differentiation and authentication strategy for TCMs based on H-oEESI-MS was proposed,including metabolic profile characterization,characteristic marker screening and identification,and multivariate statistical analysis model validation.In an analysis of 52 batches of seven types of Aconitum medicinal materials,20 and 21 key compounds were screened out as the characteristic markers of raw and processed Aconitum herbal medicines,respectively,and the possible structures of all the characteristic markers were comprehensively identified based on Com-pound Discoverer databases.Finally,multivariate statistical analysis showed that all the different types of herbal medicines were well differentiated and identified(R2X＞0.87,R2Y＞0.91,and Q2＞0.72),which further verified the feasibility and reliability of this comprehensive strategy for the rapid authentication of different TCMs based on H-oEESI-MS.In summary,this rapid authentication strategy realized the ultra-high-throughput,low-cost,and standardized detection of various complex TCMs for the first time,thereby demonstrating wide applicability and value for the development of quality standards for TCMs.
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Objective:To retrospectively compare the clinical efficacy of percutaneous vertebroplasty and biopsy by unilateral and bilateral pedicle approaches for the treatment of vertebral metastasis.Methods:From June 2020 to July 2022, a total of 82 patients with vertebral metastasis underwent percutaneous vertebroplasty and biopsy treated in Linyi Cancer Hospital were enrolled, 39 patients with 57 vertebral bodies were performed by unilateral pedicle approach (unilateral group) and 43 patients with 52 vertebral bodies were performed by bilateral pedicle approaches (bilateral group), used bone cement filling vertebral bodies after biopsy. The clinical efficacy and the positive rate of biopsy were compared between the two groups.Results:Both groups experienced significant pain relief in the Visual Analog Scale (VAS) score and improvement in the Oswestry Disability Index (ODI) score after operation ( P<0.05), but there were no significant differences between the two groups ( P>0.05). The operative time for a single vertebra, volume of bone cement in unilateral group were less than those in the bilateral group:(44.81 ± 13.01) min vs. (31.84 ± 11.87) min, (4.87 ± 0.92) ml vs. (4.18 ± 0.90) ml, there were significant differences ( P<0.05). There were no significant differences in the incidence of bone cement leakage and the positive rate of biopsy between both groups ( P>0.05). Conclusions:Percutaneous vertebroplasty and biopsy by unilateral and bilateral pedicle approaches are significant improvement for symptoms and functions of patients with vertebral metastasis. The clinical efficacy and the positive rate of biopsy are similar. But the former has easier operation procedure, shorter operative time and less volume of bone cement.
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Objective:To investigate the value of aspartate aminotransferase/lymphocyte ratio (ALR), γ-glutamyltranspeptidase/lymphocyte ratio (GLR) and aspartate aminotransferase/alanine aminotransferase ratio (AAR) in predicting the recurrence of hepatocellular carcinoma after liver transplantation.Methods:The retrospective cohort study was conducted. The clinicopathological data of 178 patients with hepatocellular carcinoma who underwent liver transplantation in Tianjin First Central Hospital from July 2014 to June 2018 were collected. There were 156 males and 22 females, aged (54±9)years. All patients received the first time of orthotopic liver transplantation. Observation indicators: (1) follow-up; (2) the predictive value and cutoff value of each index for tumor recur-rence of patients with hepatocellular carcinoma after liver transplantation; (3) analysis of risk factors for tumor recurrence of patients with hepatocellular carcinoma after liver transplantation; (4) cons-truction and evaluation of the predictive model for tumor recurrence of patients with hepatocellular carcinoma after liver transplantation. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were expressed as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. The Kaplan-Meier method was used to draw survival curve and the Log-rank test was used for survival analysis. Factors with P<0.05 in univariate analysis were included in multivariate analysis. Univariate analysis and multivariate analysis were performed by COX proportional risk regression model with forward method. The regression coefficient was used to build the prediction model. The receiver operating characteristic curve was drawn, and the area under curve (AUC) was used to evaluate the predictive ability of prediction model. Results:(1) Follow-up. All 178 patients with hepatocellular carcinoma were followed up for 36(range, 1?74)months after liver transplantation. During the follow-up, there were 41 patients died, 61 patients with tumor recurrence and 117 cases without tumor recurrence. The 3-, 5-year overall survival rates and 3-, 5-year tumor recurrence free survival rates of patients after liver transplantation were 72.8%, 69.9% and 57.3%, 52.8%, respectively. (2) The predictive value and cutoff value of each index for tumor recurrence of patients with hepatocellular carcinoma after liver transplantation. The AUC of preoperative serum alpha fetoprotein (AFP), tumor diameter, ALR, GLR, neutrophil to lymphocyte ratio, AAR in recipients were 0.76, 0.70, 0.69, 0.65, 0.64, 0.65 (95% confidence interval as 0.68?0.83, 0.61?0.79, 0.61?0.77, 0.57?0.74, 0.56?0.73, 0.56?0.74, P<0.05), and the corresponding best cutoff value of each index were 228.00 μg/L, 5.25 cm, 92.90, 122.40, 3.00, 2.42. (3) Analysis of risk factors for tumor recurrence of patients with hepato-cellular carcinoma after liver transplantation. Results of multivariate analysis showed the preoperative serum AFP >228.88 μg/L, number of tumor as multiple, tumor diameter >5.25 cm, ALR >92.90, AAR >2.42 were indepen-dent risk factors for tumor recurrence of hepatocellular carcinoma after liver transplantation ( hazard ratio=3.13, 1.90, 2.66, 2.40, 2.75, 95% confidence interval as 1.81?5.41, 1.08?3.35, 1.49?4.74, 1.40?4.11, 1.54?4.91, P<0.05). (4) Construction and evaluation of the predictive model for tumor recurrence of patients with hepatocellular carcinoma after liver transplantation. According to the results of multivariate analysis, the preoperative serum AFP, number of tumor, tumor diameter, ALR, AAR were used to construct the predictive model for tumor recurrence of hepatocellular carcinoma after liver transplantation. The AUC, best cutoff value, specificity and sensitivity of the predictive model were 0.83 (95% confidence interval as 0.76?0.89, P<0.05), 5.5, 80.3% and 73.8%. Of the 178 patients, there were 110 patients with low risk of tumor recurrence (scoring as 0?5) and 68 patients with high risk of tumor recurrence (scoring as 6?16) after liver transplantation. The 1-, 3-, 5-year tumor recurrence free survival rates and 1-, 3-, 5-year overall survival rates of patients with high risk of tumor recurrence were 27.7%, 18.2%, 18.2% and 63.7%, 48.9%, 48.9%, respectively. The above indicators of patients with low risk of tumor recurrence were 92.3%, 82.4%, 74.6% and 90.4%, 87.7%, 83.6%, respectively. There were significant differences of the above indicators between patients with high risk of tumor recurrence and low risk of tumor recurrence ( χ2=67.83, 21.95, P<0.05). Conclusions:The preoperative serum AFP, number of tumor, tumor diameter, ALR, AAR are independent influencing factors for tumor recurrence of hepato-cellular carcinoma after liver transplantation. The predictive model constructed based on the above indexes has a good prediction efficiency.
RESUMEN
Hepatic cystic echinococcosis (HCE) is a global public health problem. At present, the research of echinococcosis mainly focuses on etiology, epidemiology, immunology, imaging and treatment programs, while ignoring the systematic study of its natural decline and death course. The popularization of modern imaging examination methods enable researchers to obtain the clinical data of HCE in different stages, with different imaging features and pathological states. Based on CT imaging features and clinical practice, the authors discuss the natural decline and death course of HCE, in order to provide new ideas for its diagnosis and treatment.
RESUMEN
Children′s neurological diseases can cause problems in structure and function of the brain, which is often accompanied by cognitive impairment.They have a great influence on children′s intellectual development and social life, so assessing cognitive function earlier is particularly significant.Event-related potential(ERP)P300 is an important electrophysiological technique in clinical practice.Compared with other evaluation methods, P300 has the advantages of objective, repeatable and non-invasive.P300 has a good effect in the assessment of children with neurological diseases and cognitive impairment, which provides a reference for clinical diagnosis, treatment and prognosis.This article reviews the research progress of P300 in children with common neurological diseases and cognitive impairment, in order to improve the understanding of clinical workers.