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ObjectiveTo analyze the research status, research hotspots and trends at home and abroad in the field of rehabilitation assistive devices in the past ten years. MethodsThe relevant articles of rehabilitation assistive devices from 2012 to 2021 in CNKI and Web of Science (WoS) core collection database were retrieved. The authors, countries, institutions, research hotspots, and trends were extracted with CiteSpace and VOSviewer to draw knowledge mapping. Results and ConclusionThe annual articles published at home and abroad has shown an upward trend year by year. The team with the most articles in China is the Yu Hongliu team, and the institution with the most articles is China Assistive Devices and Technology Center for Persons with Disablities. The team with the most foreign articles is the Maysam G team, and the institution with the most articles is the University of Pittsburgh. The United States has the largest number of literatures and the highest intermediary centrality. Research hotspots related to rehabilitation assistive devices at domestic and abroad mainly focus on the design and development of rehabilitation assistive device products, the application of rehabilitation assistive devices in special/vulnerable populations, the application effect of rehabilitation assistive devices and related professional services; the development trend of intelligent assistive device product design and application research based on intelligent perception, brain-like computing, deep learning and virtual/augmented reality is predicted.
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Objective:To explore the teaching effect of case-based learning (CBL) in patient safety course.Methods:A self-made CBL teaching effect questionnaire was used to conduct an online survey on 212 clinical medical undergraduates from a medical college in Chongqing.Results:A total of 212 questionnaires were collected, with 100% of effective recovery rate. Among the students, 91.0% believed that CBL teaching quality was high; 92.4% were satisfied with CBL teaching; 62.7% were the first to experience CBL teaching; 96.7% preferred CBL teaching; 94.3% said that in the future teaching, they would like to accept CBL Teaching. Most students thought that CBL played a vital role in stimulating learning interest, improving learning enthusiasm, activating classroom atmosphere, broadening learning ideas, exercising independent thinking ability, and facilitating the ability of theory connected with practice. Suggestions for the CBL teaching of patient safety courses are summarized into the following three keywords: multiple cases, more interactions, and more similar teaching.Conclusion:The application of CBL in the patient safety course is worth promoting, which is conducive to improving the teaching quality.
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Objective To investigate the colonization of Gram-negative bacilli carrying mcr-1 gene in intestinal tracts of inpatients and people having physical examination for further elucidating the molecular and epidemiological features of mcr-1 gene. Methods A total of 1263 and 750 fecal specimens were col-lected from inpatients in the First Affiliated Hospital of Guangzhou Medical University and people having physical examination in the Kingmed Physical Examination Centre, respectively. Drug-resistant bacteria were isolated using Maconkey agar supplemented with colistin. PCR was performed to detect the bacteria carrying mcr-1 gene. Multilocus sequence typing ( MLST) and enterobacterial repetitive intergenic consensus-PCR ( ERIC-PCR) were used for homology analysis. The transferability of mcr-1 gene was verified by plasmid transfer assays. Plasmids of mcr-1-carrying strains were typed by PCR-based replicon typing techniques. Twelve virulence-related genes were also detected by PCR. Results Ninety-two colistin-resistant strains were isolated from the 1263 samples from inpatients(7. 3％, 92/1263) and two of them were positive for mcr-1 gene ( one strain also carried the blaNDM-5 gene) . Thirty-six colistin-resistant strains were isolated from the 750 samples of physical examination group (4. 8％, 36/750) and one of them carried the mcr-1 gene. MLST analysis showed that three mcr-1-carrying Escherichia coli strains ( minimum inhibitory concentration of colistin:8 μg/ml) belonged to three different sequence types. Moreover, they exhibited different banding patterns in ERIC-PCR analysis. All of the mcr-1-carrying isolates could transfer mcr-1 gene to the recipient strains successfully. Six types of incompatibility plasmids were detected in the mcr-1-carrying isolates ( IncFⅡ, IncX2, IncHI2, IncFIB, IncX4 and IncX1). Virulence-related genes fimH, iutA and fyuA were detec-ted in all mcr-1-carrying Escherichia coli strains. Conclusions Colistin-resistant strains and mcr-1 gene are prevalent in inpatients and people having physical examination, which brings potential risk for the control of clinical infections.
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Objective To compare the effects of caffeine citrate and aminophylline combined with naloxone in the treatment of premature infants with apnea.Methods From March 2015 to March 2017,140 premature infants with apnea who were treated in neonatal intensive care unit in Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou were selected in the research.The children were randomly divided into the study group and the control group according to the digital table,with 70 cases in each group.The control group was treated with aminophyl-line combined with naloxone,and the observation group was treated with caffeine citrate.The adverse reaction of children during the treatment was recorded,and the level of apnea was evaluated after treatment.The blood gas index of children before and after 48h treatment was compared,the mortality rate of the children was counted,and the incidence of brain injury during the 1 year follow -up was analyzed.Results After treatment for 48h,the level of PaO2in the two groups was significantly higher [study group: (10.54 ±0.41) kPa,control group: (9.66 ± 0.39) kPa] than those before treatment[study group: (7.18 ±0.26) kPa,control group: (7.21 ±0.24) kPa],and the level of PaCO2[study group: (5.31 ±0.24) kPa,control group: (5.82 ±0.25) kPa]was significantly lower than those before treatment[study group: (6.83 ±0.28) kPa,control group: (6.77 ±0.30) kPa](t＝19.153,13.624,11.271,7.304;P＝0.000,0.000,0.000,0.000),and the level of PaO2in the study group was significantly higher than that in the control group,and the level of PaCO 2in the study group was significantly lower than that in the control group(t＝6.029,4.327;P＝0.000,0.000).The overall effective rate of apnea therapy in the study group (92.86%) was significantly higher than 77.14%in the control group (χ2＝4.509,P＝0.034).The mortality rate(1.43%) and the incidence rate of brain injury (0.00%) of the study group were significantly lower than those of the control group (10.00%and 7.14%)(χ2＝4.773,5.185;P＝0.029,0.023).The incidence rate of adverse reactions (30.00%) of the study group was significantly lower than 50.00%of the control group (χ2＝5.833,P＝0.016).The endometri-al thickness of the study group was significantly lower than that of the control group (P＜0.05).The rate of ovulation success(87.84%) and pregnancy success rate (45.94%) of the study group were significantly higher than those of the control group(72.97%and 28.39%)(χ2＝5.189,4.890;P＝0.023,0.027).The rate of abortion(8.82%) of the study group was significantly lower than 33.33%of the control group (χ2＝5.242,P＝0.022).During the period of treatment,the incidence rate of adverse drug reactions (6.77%) of the study group was not significantly different from 8.11%of the control group (χ2＝0.098,P＝0.754).Conclusion Compared with aminophylline combined with naloxone treatment,caffeine citrate can significantly improve the blood gas status of apnea preterm infants,improve the overall curative effect of apnea,prevent the occurrence of neonatal death and brain injury,and reduce the adverse reactions of the children during the treatment.It is worthy of clinical application.
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Objective To investigate the clinical efficacy of levothyroxine replacement therapy in children with hypothyroidism.Methods 45 children with hypothyroidism admitted from Apr.2015 to Dec.2016 were selected as observation group,and 45 healthy children in the same period were selected as the control group.Children in the control group received regular diet and were paid attention to nutritional balance.Children in the observation group were given levothyroxine sodium on the basis of dietary guidance.The two groups were treated continuously for 6 months.The levels of thyroid function,insulin-like growth factor,indicators for growth and development and inflammatory factors were measured before and after treatment in both groups.Results After treatment for 3 months and 6 months,the levels of FT3,FT4,IGF-1,IGFBP-3 and IGF-1/IGFBP-3 in the observation group increased significantly compared with those before treatment,and the levels of TSH in the observation group decreased significantly(P＜0.05).The levels of FT3,lFT4,TSH,IGF-1,IGFBP-3 and IGF-1/IGFBP-3 in the observation group after treatment for 6 months were (7.17±0.06)pmol/L,(2.74±0.07)mU/L,(207.67±9.06)μg/L,(0.46±0.02) mg/L and(34.59±1.97).The difference was not statistically significant (P＞0.05).After 3 months and 6 months of treatment,the height,body weight,osteocalcin and 25-(OH)2D3 levels in the observation group were significantly higher than those in the control group (P＜0.05),and there was no significant difference between the two groups after 6 months (P＞0.05).The difference was statistically significant (P＜0.05).Conclusion Left thyroid hormone replacement therapy can significantly improve the thyroid function of children with hypothyroidism,increase the level of thyroid-associated hormone and insulin-like growth factor,promote the growth and development of children,which is worthy of clinical application.
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Objective To analyze the death status of children ≤ 5 years old in Jiaxing City from 2013 to 2017,and to provide scientific and effective measures of decreasing the children mortality and ensuring the health of children.Methods Death surveillance data of children ≤5 years old was obtained from monitoring network covering the whole city of maternal and child health information systems and the relevant maternal and child health statistics.The mortality rate,the sequence and changing trend of main death causes,prenatal health services of children ≤5 years old in Jiaxing City from 2013 to 2017were analyzed.Results From 2013 to 2017,there were 2 788 cases death of children ≤5 years old in Jiaxing City.The neonatal mortality rate (NMR),infant mortality rate (IMR),≤5 years old children mortality rate(U5MR) in Jiaxing City were 2.33‰,3.52‰ and 4.83 ‰,respectively.The mortality rates of all ages showed a declining trend year by year (x2NMR =19.641,P＜0.001;x2IMR =31.705,P ＜0.001;x2U5MR =48.294,P ＜0.001).There were significant differences in the mortality between the lower local and the migrant children (x22013 =26.16,x22014 =18.45,x22015 =27.72,x22016 =14.49,x22017=24.19;P＜0.001).The top two causes of death in children ≤ 5 years old were drowning,premature birth and low birth weight.The top two causes of death in infants and newborns were premature birth,low birth weight and other congenital anomalies.In the recent five years,49.60％ of children ≤5 years old died in the hospital.At the same time,the proportion of deaths on the way and at home was 15.64％ and 34.76％ respectively.Although there was a gap in the level of prenatal health services between local and mobile children,the gap has been declining year by year.Conclusions The key measures to decrease the mortality rate of children under 5 years old in Jiaxing City include strengthening the management of pregnancy care and high-risk pregnancy;paying attention to tertiary prevention and doing a good job in monitoring birth defects such as prenatal screening;enhancing safety education and child supervision for parents of children in 1-4 years old;reinforcing the construction of maternal and child health professional team and the technical training of newborn resuscitation techniques such as neonatal asphyxia recovery technology;intensifying the health-care and management of migrant children and improving the ability of parents to utilize child medical service.
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Objective To investigate the development of tidal breathing lung function in very low birth weight infants with bronchopulmonary dysplasia(BDP).Methods Two hundred and sixty-two very low birth weight infants hospitalized in Wenzhou Children′s Hospital were enrolled as objects.All infants were given the tidal breathing pulmonary function test within a week before discharge and at the corrected age of 6 to 8 months.According to clinical diagnosis,they were divided into BPD group(n=65) and non-BPD group(n=197),and BPD group were divided into mild group(n=31),moderate group(n=20) and severe group(n=14) according to the severity.The lung function indexes were compared between different groups.Results The results of the test within a week before discharge displayed that the respiratory rates in the BPD groups were higher than those in the non-BPD group(all P＜0.05).The peak expiratory flow(TPEF),tidal expiratory flow at 75%,50%,and 25% tidal volume(TEF75,TEF50,TEF25) in moderate to severe BPD group were higher than those in other groups(all P＜0.05),while in mild BPD group were higher than those in non-BPD group(all P＜0.05).The ratio of time to peak tidal expiratory flow to total expiratory time (TPEF/TE),ratio of volume to peak tidal expiratory flow to total expiratory volume (VPEF/VE) were lower in BPD group than those in non-BPD group,the decline was more obvious as the BPD was more serious(all P＜0.05).No significant differences were found between groups in tidal volume(P＞0.05).The result at the corrected age of 6 to 8 months displayed that TPEF,TEF75,TEF50,TEF25 in severe BPD group were still higher than those in any other group(all P＜0.05),while TPEF/TE,VPEF/VE were lower than those in any other group(all P＜0.05),no significant differences were found between other groups in other indicators(P＞0.05).Conclusion Preterm infants BPD have different degrees of lung injury,but as the age grows some lung function indexes can improve gradually(at the corrected age of 6 to 8 months).However,early severe small airway obstruction is still serious.Therefore,it′s important to prevent and treat BPD for the prevention and regulation of respiratory tract disease in future.
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Objective To study the risk factors for children with acute central nervous system(CNS)viral in-fection,so that pediatrician may identify children with poor prognosis at early stages of the disease,and provide them with a theoretical basis for clinical treatment. Methods The clinical data of a cohort patients of acute CNS viral infec-tion who were hospitalized at the First Affiliated Hospital of Fujian Medical University between January 2010 and June 2013 were retrospectively collected and analyzed. According to Glasgow outcome scale on discharge,children were di-vided into good prognosis group and poor prognosis group. Clinical data and outcomes were analyzed by using univariate analysis and binary Logistic regression multivariate analysis. Results Three hundred and one cases were enrolled,278 (92. 36% )patients were assigned to the good prognosis group,and 23(7. 64% )patients were assigned to the poor prognosis group. By univariate analysis,the patients in the poor prognosis group had longer duration of sickness before admission,longer time of fever,lower white blood cell count in cerebrospinal fluid,a relatively lower calcium level,con-scious disturbance at the early stage,multiple seizures,convulsive status epilepticus,meningeal irritation sign,muscle weakness,severe changes in electroencephalogram(EEG),and abnormal neuroimaging findings(computed tomography or magnetic resonance imaging,or both)had significant differences between the good prognosis group and the poor short - term outcome groups(all P < 0. 05). By binary Logistic regression multivariate analysis,factors indicating a poor prognosis during the early stage were conscious disturbance at the early stage(0R = 4. 885,95% CI:1. 523 - 15. 670, P = 0. 008),multiple seizures(0R = 6. 352,95% CI:1. 905 - 21. 178,P = 0. 003),severe changes in EEG( 0R =4. 269,95% CI:1. 708 - 10. 666,P = 0. 002),and abnormal neuroimaging findings( 0R = 9. 740,95% CI:2. 360 -40. 192,P = 0. 002). Conclusions Conscious disturbance at the early stage,multiple seizures,severe changes in EEG and abnormal neuroimaging findings are risk factors for acute viral infection of CNS in children.