Research on community-based rehabilitation exercise and physical activity and its benefits for people with mild and moderate disability in Shenzhen, Guangdong, China / 中国康复理论与实践

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.

Physical activity intervention and its health benefits for children and adolescents with cerebral palsy: a systematic review / 中国康复理论与实践

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.

Construction of Chinese Herbal Medicine Traceability System Based on Influencing Factors of Chinese Herbal Medicine Quality / 中国实验方剂学杂志

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.

Research progress of immune cell-derived exosomes in colorectal cancer / 中国药理学通报

Exosomes are vesicle-like bodies carrying proteins, RNA, lipids and other bioactive substances, which are secreted from intracellular to extracellular and act on target cells to play their biological functions. Colorectal cancer is one of the malig¬nant tumors with high morbidity and mortality. It has been found that immune cell-derived exosomes participate in the regulation of colorectal cancer growth, invasion, metastasis and other processes. It also plays an obvious role in tumor diagnosis,treat¬ment and post-treatment monitoring. In this review we summa¬rize the research progress of immune cell-derived exosomes in colorectal cancer.

Clinical characteristics of children with SARS-CoV-2 Omicron variant infection in Kunming / 中华儿科杂志

Objective: To investigate the clinical characteristics of hospitalized children infected with the Omicron variant in Kunming after the withdrawal of non-pharmaceutical interventions (NPI) and analyze the risk factors of severe cases. Methods: Clinical data was retrospectively collected from 1 145 children with SARS-CoV-2 Omicron infection who were hospitalized in six tertiary grade A hospitals in Kunming from December 10th, 2022 to January 9th, 2023. According to clinical severity, these patients were divided into the general and severe SARS-CoV-2 groups, and their clinical and laboratory data were compared. Between-group comparison was performed using t-test, chi-square test and Mann-Whitney U test. Spearman correlation test and multivariate Logistic regression analysis were used to determine the risk factors of severe illness. Results: A total of 1 145 hospitalized patients were included, of whom 677 were male and 468 female. The age of these patients at visit was 1.7 (0.5, 4.1) years. Specifically, there were 758 patients (66.2%) aged ≤3 years at visit and 387 patients (33.8%) aged >3 years. Of these children, 89 cases (7.8%) had underline diseases and the remaining 1 056 cases (92.2%) had no combined diseases. Additionally, of all the patients, 319 cases (27.9%) were vaccinated with one or two doses of SARS-CoV-2 vaccine, 748 cases (65.3%) had acute upper respiratory tract infection (AURTI), and six cases died (0.5%). A total of 1 051 cases (91.8%) were grouped into general SARS-CoV-2 group and 94 cases (8.2%) were grouped into severe SARS-CoV-2 group. Compared with the general cases, the severe cases showed a lower rate of SARS-CoV-2 vaccination and younger median age, lower lymphocyte count, as well as proportions of CD8+T lymphocyte (36 cases (38.3%) vs. 283 cases (26.9%), 0.5 (2.6, 8.0) vs. 1.6 (0.5, 3.9) years, 1.3 (1.0, 2.7) ×109 vs. 2.7 (1.3,4.4)×109/L, 0.17 (0.12, 0.24) vs. 0.21 (0.15, 0.16), respectively, χ2=4.88, Z=-2.21,-5.03,-2.53, all P<0.05). On the other hand, the length of hospital stay, proportion of underline diseases, ALT, AST, creatine kinase isoenzyme, and troponin T were higher in the severe group compared to those in the general group ((11.6±5.9) vs. (5.3±1.8) d, 41 cases (43.6%) vs. 48 cases (4.6%), 67 (26,120) vs. 20 (15, 32) U/L, 51 (33, 123) vs. 44 (34, 58) U/L、56.9 (23.0, 219.3) vs. 3.6 (1.9, 17.9) U/L, 12.0 (4.9, 56.5) vs. 3.0 (3.0, 7.0) ×10-3 pg/L,respectively, t=-20.43, χ2=183.52, Z=-9.14,-3.12,-6.38,-3.81, all P<0.05). Multivariate regression analysis indicated that increased leukocyte count (OR=1.88, 95%CI 1.18-2.97, P<0.01), CRP (OR=1.18, 95%CI 1.06-1.31, P<0.01), ferritin (OR=1.01, 95%CI 1.00-1.00, P<0.01), interleukin (IL)-6 (OR=1.05, 95%CI 1.01-1.08, P=0.012), D-dimer (OR=2.56, 95%CI 1.44-4.56, P<0.01) and decreased CD4+T lymphocyte (OR=0.84, 95%CI 0.73-0.98, P=0.030) were independently associated with the risk of severe SARS-CoV-2 in hospitalized children with Omicron infection. Conclusions: After the withdrawal of NPI, the pediatric inpatients with Omicron infection in Kunming were predominantly children younger than 3 years of age, and mainly manifested as AURTI with relatively low rate of severe SARS-CoV-2 infection and mortality. Elevated leukocyte counts, CRP, ferritin, IL-6, D-dimer, and decreased CD4+T lymphocytes are significant risk factors for developing severe SARS-CoV-2 infection.

Expert consensus on digital guided therapy for endodontic diseases / 国际口腔科学杂志·英文版

Digital guided therapy (DGT) has been advocated as a contemporary computer-aided technique for treating endodontic diseases in recent decades. The concept of DGT for endodontic diseases is categorized into static guided endodontics (SGE), necessitating a meticulously designed template, and dynamic guided endodontics (DGE), which utilizes an optical triangulation tracking system. Based on cone-beam computed tomography (CBCT) images superimposed with or without oral scan (OS) data, a virtual template is crafted through software and subsequently translated into a 3-dimensional (3D) printing for SGE, while the system guides the drilling path with a real-time navigation in DGE. DGT was reported to resolve a series of challenging endodontic cases, including teeth with pulp obliteration, teeth with anatomical abnormalities, teeth requiring retreatment, posterior teeth needing endodontic microsurgery, and tooth autotransplantation. Case reports and basic researches all demonstrate that DGT stand as a precise, time-saving, and minimally invasive approach in contrast to conventional freehand method. This expert consensus mainly introduces the case selection, general workflow, evaluation, and impact factor of DGT, which could provide an alternative working strategy in endodontic treatment.

Analysis of 4 children with DYNC1H1 gene related spinal muscular atrophy with lower extremity predominant 1 / 中华儿科杂志

Objective: To investigate the clinical features and gene variation characteristics of children with dynein cytoplasmic 1 heavy chain 1 (DYNC1H1) gene associated spinal muscular atrophy with lower extremity predominant (SMALED) 1. Methods: The clinical data of 4 SMALED1 children admitted to Peking University First Hospital from December 2018 to May 2021, who were found to have pathogenic variation of DYNC1H1 gene through genetic testing, except for other genes known to be related to motor retardation, were retrospectively summarized to analyze the phenotype and genotype characteristics. Results: There were 3 males and 1 female. The age of onset was 1 year, 1 day, 1 day and 4 months, respectively. The age of diagnosis was 4 years and 10 months, 9 months, 5 years and 9 months, and 3 years and 1 month, respectively. The clinical manifestations were muscle weakness and muscular atrophy of lower limbs, 2 cases with foot deformity, 1 case with early non progressive joint contracture, 1 case with hip dislocation and 1 case with mental retardation. De novo heterozygous missense variations in DYNC1H1 gene were found in all 4 children. According to the rating of American College of medical genetics and genomics, they were all possible pathogenic and pathogenic variations, with p.R598C, p.P776L, p.Y1109D variations had been reported, and p.I1086R variation had not been reported. Conclusions: For those with unexplained lower limb muscle weakness, muscle atrophy, joint contracture and foot deformity, upper limb motor ability related retention, with or without mental retardation, as well as the motor ability progresses slowly, it is necessary to consider the possibility of SMALED1 and the detection of DYNC1H1 gene when necessary.

Multiple gastrointestinal melanoma causing small bowel intussusception

A 61-year-old gentleman presented with small bowel intussusception from small bowel melanoma intussusceptum. He complains of intermittent abdominal distension but no history of intestinal obstruction. Apart from this, he was also symptomatic anemia which required repeated transfusion for the past few months. The contrast-enhanced computed tomography of the abdomen shows an omental mass with small bowel intussusception. He then underwent an exploratory laparotomy with segmental resection of the affected segment. Histopathological examination confirmed primary gastrointestinal melanoma. Multiple small bowel malignant melanoma is a rare disease. It remains a controversial diagnosis as it may be a primary or metastasis from an unidentified or regressed primary cutaneous melanoma. Prompt surgical intervention enables us to obtain tissue diagnosis, prevent complete intestinal obstruction and strategize the goals of treatment for the patient.

The UGT74L2 of Andrographis paniculata catalyzes phloretin to produce trilobatin and its enzymatic study / 药学学报

The last essential enzyme in the biosynthetic pathway of trilobatin, phloretin-4'-O glycosyltransferase (P4'-OGT), catalyzes the conversion of trilobatin to phloretin in vitro. However, only a few P4'-OGTs have been found in plants. This study used Malus domestica phloretin-4'-O glycosyltransferase (MdPh-4'-OGT) as a query to identify and clone two UDP-glucuronosyltransferase (UGT) genes, designated UGT74L2 and UGT74L3, from the transcriptome of Andrographis paniculata. According to a phylogenetic tree analysis, UGT74L2 and UGT74L3 belonged to the UGT74 family, which has been linked to several activities in other species. The in vitro enzymatic reaction demonstrated that UGT74L2 could particularly catalyze the formation of trilobatin from phloretin, but UGT74L3 had no effects. By using Ni-NTA affinity chromatography to extract the soluble UGT74L2 recombinant protein, the enzymatic kinetics of the activity was investigated using phloretin as the substrate. The results showed that the optimal temperature and pH for UGT74L2 enzymatic reaction were 40 ℃ and 8.0 (Tris-HCl system), respectively. Three metal ions (Ca2+, Mn2+ and Co2+) showed inhibitory effect on the activity of UGT74L2, while Mg2+ could improve the activity of UGT74L2. Other tested metal ions have no significant effect on UGT74L2. The results of enzymatic kinetic parameters that the Km value was 29.84 μmol·L-1, the kcat was 0.02 s-1, and the kcat·Km-1 was 572.6 mol-1·s-1. By homology modeling, molecular docking and mutation experiments, we found that multiple amino acids residues around the substrate binding pocket play quite an important role during catalytic process, In summary, we identified a novel P4'-OGT gene from medicinal plant Andrographis paniculata and provided a new efficient catalyst to synthesize trilobatin. Meanwhile, this study provides a reference for mining new efficient glycosylation modules from plants.

Research progress of cell membrane-coated biomimetic nanoparticle delivery systems for the treatment of lung diseases / 药学学报

Lung is susceptible to external disturbance, resulting in a variety of acute and chronic lung diseases. Functionalized nanoparticles as carriers can carry drugs through multiple biological barriers of lung into lung lesions, but there are some problems such as poor targeting and low therapeutic efficiency. As a drug carrier, membrane-coated biomimetic nanoparticles have the characteristics of immune system escape, active targeting, inflammatory chemotaxis and crossing physiological barriers due to the retention of the characteristics of the source cells. Therefore, it has been widely used in the treatment of lung diseases in recent years. In this review, the application of membrane-coated biomimetic nanoparticles in the treatment of lung diseases in the recent years was summarized and classified. Cell membrane sources include erythrocyte membrane, platelet membrane, macrophage membrane, neutrophil membrane, lung epithelial membrane, lung surfactant, endothelial membrane, cancer cell membrane, bacterial membrane, hybrid membrane and so on. The purpose of this review is to provide a new idea for treating lung diseases with membrane-coated biomimetic nanoparticles.

Identification of Arisaematis Rhizoma and Pinelliae Rhizoma by PCR-RFLP / 中国实验方剂学杂志

ObjectiveIn recent years， with the sharp decline of wild resources in Arisaematis Rhizoma and Pinelliae Rhizoma and the immaturity of medicinal cultivation technology， their adulterants have appeared frequently in the market， and the main identifying characteristics have mostly disappeared in the circulation of medicinal materials. Therefore， there is an urgent need to establish a molecular identification method that can quickly and effectively identify the specificity of Arisaematis Rhizoma and Pinelliae Rhizoma. MethodAfter comparison of the rbcL sequences of Arisaematis Rhizoma，Pinelliae Rhizoma， and their adulterants， the specific enzyme cleavage sites Hae Ⅲ and Dra Ⅰ of Arisaematis Rhizoma and Pinelliae Rhizoma， respectively， were selected and identified by polymerase chain reaction-restriction fragment length polymorphism（PCR-RFLP）. The main system conditions of PCR-RFLP reaction were established and optimized， and their durability and the ability to detect genuine， adulterants， and mixed counterfeits were investigated. ResultThe PCR-RFLP identification method of Arisaematis Rhizoma and Pinelliae Rhizoma was established. After specific primer amplification， Arisaematis Rhizoma and Pinelliae Rhizoma could be digested by Hae Ⅲ and Dra Ⅰ-restricted endonucleases respectively， at annealing temperature of 54 ℃， the number of cycles of 35， and the amount of DNA template of 3-30 ng， producing two fragments or small cut fragments with a single band between 100-250 bp， whereas the mixed counterfeits were not cleaved and both showed a band at 250 bp. The method is highly accurate in identifying adulterants and mixed counterfeits of Arisaematis Rhizoma or Pinelliae Rhizoma. ConclusionThe PCR-RFLP method developed in this study allows for the rapid identification of Arisaematis Rhizoma and Pinelliae Rhizoma.

Screening of small molecule inhibitors of IL-15Rα using molecular docking and surface plasmon resonance technology / 生理学报

The study aims to explore the active molecules of traditional Chinese medicine that specifically bind to interleukin-15 receptor α (IL-15Rα) using molecular docking and surface plasmon resonance (SPR) technology. AutoDock molecular docking software was used to perform simulated docking of more than 3 000 compounds from 48 traditional Chinese medicines at IL-15Rα and screen the specific binding compounds. Then Biocore T200 biomolecular interaction analysis system of SPR was used to confirm the binding specificity of the selected target compounds. Finally, the biological effects of the target compounds on IL-15Rα were verified by cell biological experiments. The results showed that neoprzewaquinone A (Neo) possessed the highest specific binding affinity among the active molecules from traditional Chinese medicine, and the dissociation constant (KD) value was (0.62 ± 0.20) µmol/L. The results of cell experiment showed that Neo significantly inhibited the proliferation of Mo7e cells induced by IL-15, and the IC50 was 1.075 µmol/L, approximately 1/120 of the IC50 of Cefazolin (IL-15 specific antagonist). These results suggest that Neo is a specific inhibitor of IL-15Rα and may be a potential active drug for the treatment of diseases related to the dysfunction of the IL-15Rα signaling.

Application of deep learning image reconstruction algorithm in low-dose abdominal CT / 西安交通大学学报(医学版)

【Objective】 To investigate the value of deep learning image reconstruction (DLIR) in improving image quality and reducing beam-hardening artifacts of low-dose abdominal CT. 【Methods】 For this study we prospectively enrolled 26 patients (14 males and 12 females, mean age of 60.35±10.89 years old) who underwent CT urography between October 2019 and June 2020. All the patients underwent conventional-dose unenhanced CT and contrast-enhanced CT in the portal venous phase (noise index of 10; volume computed tomographic dose index: 9.61 mGy) and low-dose CT in the excretory phase(noise index of 23; volume computed tomographic dose index: 2.95 mGy). CT images in the excretory phase were reconstructed using four algorithms: ASiR-V 50%, DLIR-L, DLIR-M, and DLIR-H. Repeated measures ANOVA and Kruskal-Wallis H test were used to compare the quantitative (skewness, noise, SNR, CNR) and qualitative (image quality, noise, beam-hardening artifacts) values among the four image groups. Post hoc comparisons were performed using Bonferroni test. 【Results】 In either quantitative or qualitative evaluation, the SNR, CNR, overall image quality score, and noise of DLIR images were similar or better than ASiR-V 50%. In addition, the SNR, CNR, and overall image quality scores increased as the DLIR weight increased, while the noise decreased. There was no statistically significant difference in the distortion artifacts (P=0.776) and contrast-induced beam-hardening artifacts (P=0.881) scores among these groups. 【Conclusion】 Compared with the ASiR-V 50% algorithm, DLIR algorithm, especially DLIR-M and DLIR-H, can significantly improve the image quality of low-dose abdominal CT, but has limitations in reducing contrast-induced beam-hardening artifacts.

Content comparison of assessment tools of activity and participation, and quality of life: based on ICD-11 and ICF / 中国康复理论与实践

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.

Adaptive physical activity and its health benefits for patients with spinal cord injury based on ICF: a scoping review / 中国康复理论与实践

ObjectiveTo analyze adaptive physical activity interventions and their health benefits for patients with spinal cord injury (SCI) based on International Classification of Functioning, Disability and Health (ICF). MethodsA combination of subject headings and free words was employed to search for relevant literature on physical activity in patients with SCI in PubMed, Web of Science, EBSCO and CNKI, from January, 2017 to July, 2022. A scoping review was conducted. ResultsEight English articles were included, from Australia, the United States, Estonia, Canada, Netherlands and Brazil. The study involved 150 patients with SCI and included seven randomized controlled trials and one non-randomized controlled trial. These literatures were primarily from journals in the fields of SCI, neurology, neuromuscular medicine and physical activity, with publication dates concentrated between 2017 and 2021. The included studies involved participants with complete or incomplete SCI, presenting with paraplegia, tetraplegia, and various levels of injury severity (grades A to D). The main functional disorders related to ICF included b710 mobility of joint functions, b715 stability of joint functions, b720 mobility of bone functions, b730 muscle power functions, b735 muscle tone functions, b750 motor reflex functions, b760 control of voluntary movement functions and b770 gait pattern functions; the functions involved in activities and participation included d410 changing basic body position, d415 maintaining a body position, d420 transferring oneself, d445 hand and arm use, d450 walking, d455 moving around, d570 looking after one's health, d610 acquiring a place to live, d910 community life, d920 recreation and leisure; the environmental factors involved were e1151 assistive products and technology for personal use in daily living, and e1401 assistive products and technology for culture, recreation and sport. Physical activity intervention sites mainly included home, community, medical or rehabilitation institutions. The physical activity could be classified into prevention, health promotion, treatment and rehabilitation. Patients with SCI had completed acute and subacute rehabilitation in medical and rehabilitation institutions, and returned to their families and communities, and some of them received services in medical and rehabilitation institutions from time to time. The forms of physical activity included strength training combined with routine nursing, short-term resistance training, hydrotherapy and robot treadmill activities, functional electrical stimulation and therapeutic exercise, progressive exercise training based on exoskeleton of power machine, leg bicycle assisted by electrical stimulation combined with manual bicycle, and acute exercise with different intensity. The activity frequency was twelve to 60 minutes a time, two to three times a week, lasting for three to 16 weeks, and the activity intensity was mainly medium to high. The health benefits of physical activity on patients with SCI were mainly reflected in four aspects: physical and mental health, activity and behavior health, environmental factors, quality of life and well-being. In terms of physical and mental health, it helped to improve muscle function (muscle strength, strength perception), walking function (walking speed, walking distance), respiratory and circulatory system functions (peak oxygen uptake, aerobic endurance, cardiopulmonary function, reducing the risk of cardiopulmonary diseases, etc.), immune system related functions, and improving psychosocial function (fatigue degree). In terms of activity and behavioral health, it was helpful to improve activity skills and abilities. In terms of environmental factors, the availability and effectiveness of some auxiliary equipment were confirmed. In terms of quality of life and well-being, it could improve self-living ability and quality of life. ConclusionThis study established a PICO framework for adaptive physical activity and its health effects in patients with SCI based on ICF. Physical activity for patients with SCI can be conducted in various settings, including home, community, or medical and rehabilitation institutions. The physical activities of patients with SCI are characterized by wheelchair-based adaptive physical activities, which are mainly divided into two categories: various aerobic exercises and resistance exercises based on wheelchairs, and physical activities based on auxiliary exercise equipment or intervention methods (such as robot treadmill, power machine exoskeleton, functional electrical stimulation, etc.). The frequency of physical activity in patients with SCI is twelve to 60 minutes a time, two to three times a week, lasting for three to 16 weeks, and the activity intensity is maily medium to high. Therapists and rehabilitation professionals can provide guidance and support through various means, such as online or offline supervision and one-on-one coaching, to promote the health benefits of physical activity for patients with SCI, including improved physical and psychological function, enhanced activity levels, reduced sedentary behavior, and increased self-care abilities and quality of life.

Exercise rehabilitation interventions for people with spinal cord injury and their health benefits: a systematic review of systematic reviews based on ICD-11 and ICF / 中国康复理论与实践

ObjectiveBased on the International Classification of Diseases, Eleventh Revision (ICD-11) and the International Classification of Functioning, Disability and Health (ICF), systematic reviews about the effects of different types of exercise rehabilitation and related interventions on body structure and function, activity and participation, and quality of life in people with spinal cord injury (SCI) were systematically reviewed. MethodsSystematic reviews of exercise rehabilitation and health benefits in patients with spinal cord injury were searched from PubMed, Embase, EBSCO, Web of Science and CNKI, from January, 2015 to January, 2023. ResultsEight English articles were included, from Canada, the United States, South Korea, Australia, Brazil and Netherlands, derived from the fields of physical medicine and rehabilitation, neuromedicine and rehabilitation, and exercise intervention, with the publication date mainly concentrated from 2015 to 2021. A total of 165 randomized controlled trials were involved, with 2 746 participants, aged 18 to 65 years. The diseases were mainly spinal cord injury (complete or incomplete), quadriplegia, paraplegia (thoracic, lumbar and sacral injuries), and motor neuron injury (upper and lower). There were three main types of interventions: passive intervention, using sports assistive devices, such as powered exoskeleton-assisted robots, electric bicycles, etc., and functional electrical stimulation; active interventions, such as stepping exercises; training on flat ground, outdoor walking, and activities of daily living; mixed intervention (active & passive), such as combination of exercise and functional electrical stimulation, combination of exercise and motor assistive devices. The frequency of intervention was ten to 240 minutes a time, two to 18 times a week, with the intensity of low to vigorous, for one to 456 weeks. The intervention sites mainly involved families, community health service centers and sports venues. The health impact mainly involved improving cardiovascular and increasing blood flow velocity in the legs; improving musculoskeletal structure, as well as muscle strength, tolerance and flexibility; relieving spasms and improving reflex excitability of the nervous system; increasing gait speed and walking distance; improving functional independence, such as bowel regularity; improving physical health, such as reducing spasticity and drug use (e.g., baclofen), increasing the immune response to infection, and reducing the risk of disease (vascular dementia and respiratory disease); and improving psychological condition. ConclusionBased on ICD-11 and ICF, this study constructed a research framework for active or passive exercise rehabilitation and related interventions in patients with spinal cord injury. Patients with spinal cord injury can improve their body structure and function, increase their activity and participation, and improve their quality of life and well-being through passive interventions (using motor assistive devices, functional electrical stimulation), active interventions (such as stepping exercises, outdoor walking, etc.), and mixed interventions (combining exercise and functional electrical stimulation, exercise and sports assistive devices).

Health benefits of integrating physical activity with chronic disease management in community-dwelling older adults: a scoping review / 中国康复理论与实践

ObjectiveTo construct a health intervention model for community-dwelling older adults with chronic diseases based on the International Classification of Diseases, Eleventh Revision (ICD-11) and the International Classification of Functioning, Disability and Health (ICF), and to analyze the health outcomes of three types of intervention models that integrate physical activity and chronic disease management. MethodsA scoping review was conducted by searching CNKI, Web of Science, PubMed and EBSCO databases for literature on community-based management of chronic diseases, physical activity, exercise rehabilitation, physical activity prescription intervention and related health outcomes up to May, 2023. ResultsEight studies from four countries were included, involving 568 randomized controlled trials and 4 359 participants aged 50 to 72. The studies were published mainly between 2017 and 2022. Community-based health intervention models for older adults with chronic diseases were categorized into three types: community health service models (chronic disease management and exercise rehabilitation), community physical activity models (prevention and health promotion) and mixed models (a combination of these two models). The community health service model focused on chronic disease management in the community, integrating community sports, and involving physical activity intervention, health education, dietary intervention, monitoring and motivation intervention, and care coordination, for six to 24 months, with the intervention attribute of rehabilitation and health promotion. The personnel involved doctors, nurses, dietitians, pharmacists, social workers and primary healthcare clinicians. The community physical activity model focused on design and implementation physical activity intervention for chronic disease in the community environment, providing relevant physical activity advice and guidance, and personalized reinforcement and support. The physical activities included walking, cycling, warm-up exercises, cardiopulmonary fitness, muscle strength and balance training, coordination and stretching exercises, Taijiquan, Yoga, Qigong, and water sports; ten to 150 minutes a time, low to vigorous, for eight to twelve months, with the intervention attribute of prevention and health promotion. The personnel involved clinical staff, primary healthcare staff, exercise intervention experts and consultants, doctors, nurses, social workers and certified exercise coaches. The mixed model involved a chronic disease prevention and management plan, including physical activity counseling, lifestyle intervention related to physical activity, personalized health guidance and exercise program design, for six to twelve months, with the intervention attribute of prevention, rehabilitation and health promotion. The personnel involved sports coaches and retired professional athletes, dietitians, nurses, personal trainers, general practitioners, occupational therapists and physiotherapists. The main health outcomes involved body function-related indicators, such as control of weight, blood pressure, waist circumference, systolic blood pressure, triglyceride and high-density lipoprotein cholesterol levels, to reduce cardiovascular risk; relief of arthritis and herpes zoster pain, improvement in cognitive function and depressive symptoms. In terms of activity-related outcomes, the physical fitness improved, involving agility and dynamic balance, flexibility, muscle strength, and aerobic endurance; while the amount of physical activity increased, as well as the time spent on mild, moderate and vigorous exercise or leisure activities; the risk of fall reduced, the level of daily physical activity improved, and the self-efficacy and level of social participation increased. ConclusionThe community-based physical activity and health services models for older adults with chronic diseases may be classified as community health service model, community physical activity model and mixed model. A comprehensive intervention integrating physical activity and community health services can improve the health status, control the symptoms of chronic diseases, improve physical and mental functions, and increase the level of physical activity and quality of life for older adults with chronic diseases. The mixed model is a hybrid model that incorporates physical activity into community health services, which can provide comprehensive health interventions to make better health and health-related benefits.

Health and functioning benefits of aerobic exercise rehabilitation for substance abuse-induced mental and behavioral disorders: a systematic review / 中国康复理论与实践

ObjectiveTo examine the interventions and health benefits of aerobic exercise for substance abusers using International Classification of Diseases, Eleventh Revision (ICD-11) and International Classification of Functioning, Disability and Health (ICF) framework. MethodsThe PICO framework was developed and randomized controlled trials were searched in PubMed, Web of Science, Embase, and CNKI dated from the inception of the databases to April, 2023. Then a systematic review was conducted. ResultsSeven randomized controlled trials involving 498 participants from three countries were included. The studies were mainly published in international journals such as International Journal of Mental Health and Addiction, Psychiatry Research, Mental Health and Physical Activity, BMC Sports Science, and Medicine and Rehabilitation, and covered the period from 2010 to 2022. The substance abusers in the included studies were classified into seven categories of mental and behavioral disorders, including methamphetamine dependence, cocaine dependence, cannabis dependence, opioid dependence, sedative dependence, heroin dependence, and ketamine dependence. Aerobic exercise activities included running, cycling, Tai Chi, Qigong, yoga, jumping rope, climbing, etc., with a frequency of 20 to 60 minutes per session, one to ten times per week. The activity intensity was mainly concentrated in moderate to high intensity, and the duration ranged from 12 to 48 weeks. The health outcomes were evaluated in six aspects: physical motor function, cognitive function, emotional functioning, medication cravings, physical fitness, and overall function and quality of life. ConclusionBased on ICD-11 and ICF, a theoretical framework was constructed to evaluate the health effects of aerobic exercise for substance abusers. Aerobic exercise could improve flexibility and balance, grip strength, vertical jump height, and sit and reach distance, as well as enhance physical fitness, strength, flexibility, speed and agility in substance abusers' physical function. In terms of cognitive function, aerobic exercise could help to improve working memory, attention and executive function, as well as cognitive and neurological functions. Aerobic exercise rehabilitation could also improve psychological health, such as anxiety, depression and fatigue, and increase the ability to resist substance dependence in substance abusers. In addition, aerobic exercise rehabilitation could improve physical fitness, such as body mass, blood pressure and blood lipid levels, and reduce the risk of cardiovascular disease, diabetes and other diseases. It could also improve overall social function, increase social adaptability and quality of life, and reduce the risk of substance abuse relapse in substance abusers.

Visual perception and its related factors of distance for Paralympic athletes with physical disabilities / 中国康复理论与实践

ObjectiveTo investigate the impact of posture and sports experience on distance perception in Paralympic athletes with lower limbs disabilities. MethodsFrom May to August, 2019, athletes were selected from the wheelchair racing team (n = 19) and the wheelchair fencing team (n = 16) in Shanghai, China. The athletes were tested the relative distance perception and absolute distance perception using the successive equal-appearing distance and blind walking tasks. ResultsThe interaction effects between sport and posture (F = 4.118, P < 0.05), sports events and distance judgment (F = 8.913, P < 0.01), and posture and distance judgment (F = 11.894, P < 0.01) were significant; while the main effects of sport (F = 7.467, P < 0.01) and posture (F = 11.918, P < 0.01) were significant; the relative distance judgment accuracy was better in the athletes of wheelchair fencing than in those of wheelchair racing, and in standing posture than those in sitting posture. ConclusionThe relative distance judgment accuracy is better for the Paralympic athletes standing and playing wheelchair fencers. There was no significant difference in the accuracy of absolute distance judgment between the different postures and the different sports.

Diagnosis and management of orbital and cranial complications of pediatric acute rhinosinusitis / 中华耳鼻咽喉头颈外科杂志

Objective: To review the clinical characteristics, to illustrate diagnosis and management experience of orbital and cranial complications of pediatric acute rhinosinusitis. Methods: The clinical data of 24 children with orbital and cranial complications of acute rhinosinusitis who received endoscopic sinus surgery combined with drug treatment in Beijing Children's Hospital from January 2017 to December 2021 were retrospectively reviewed. There were 19 boys and 5 girls. The age varied from 13 to 159 months, with a median 47.5 months. The following diagnoses were obtained: 12 isolated subperiosteal orbital abscess, 2 associated with preseptal abscess, 2 associated with intraorbital abscess, 7 associated with optic neuritis, and 1 associated with septic cavernous sinus thrombosis. Clinical characteristics, organism isolated and outcomes were analyzed through descriptive methods. Results: All 24 patients presented with fever; 9 presented with nasal congestion and purulent discharge. The clinical manifestations of orbital infection included orbital edema, pain, proptosis and displacement of globe in all patients, while visual impairment was recognized in 7 children. Purulent drainage was cultured in 17 patients, among which 12 were positive. All patients underwent nasal endoscopic surgical interventions uneventfully, excluding one patient who required a second surgical procedure. Follow-up period ranged from 5 to 64 months. All patients resolved fully, with the exception of 2 children who got permanent blindness with visual loss preoperative. There was no recurrence or death. Conclusions: Orbital and cranial complications of pediatric acute rhinosinusitis could be severe with an occult onset. For patients with vison impairment, any signs of intracranial complications and a lack of response to conservative management, an urgent endoscopic intervention is needed.