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@#Objective To explore the rehabilitation needs and its influential factors of adults with physical disability in Shanghai, and to provide evidence for decision-making of the precise rehabilitation service. Methods From November to December, 2016, the rehabilitation demands, utilization rate and its influential factors of 390 registered people with physical disability were investigated with a questionnaire. Results The service of occupational rehabilitation met 62.34%and educational rehabilitation met 52.00%of the needs of adults with physi-cal disability at the age of 18 to 40 years. The service of occupational rehabilitation met 38.71%and educational rehabilitation met 35.29%of the needs of adults with physical disability of grade two. The main obstacle to the service utilization wasDo not know(67.34%). As a part ofotherreason, the cumulative frequency oftemporarily not neededaccounted for 16.41%in all reasons. Conclusion The rehabili-tation service should focus unmet needs to complete the community rehabilitation and health governance, and optimize the service system.
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OBJECTIVE: The dynamic response of the heart during chest impact and the characteristics of heart injuries were investigated to further understand the mechanisms of heart impact injuries. METHODS: Eleven dogs and thirty-four rabbits were subjected to front thoracic impact with different impact velocities and compression response. The accelerated movement of thoracic wall during the impact period was monitored. The pathological examination of the injured heart was done and the dynamic responses and mechanisms of injuries were analyzed with mathematics models. RESULTS: The analysis of mathematics model and experimental results showed that the injury severity of heart was well correlated with the viscous criterion. The thoracic wall was involved in bi-directional movement of compression and expansion. The injured heart showed spotty or stripy hemorrhages in the ventricle endocardium. Light microscopic examination showed interstitial bleeding and rupture of the myocardial fibers in the contusion area. The biomechanical analysis indicated that there was a large deformation caused by the stress concentration on the lateral ventricle wall. CONCLUSIONS: There is a high speed and excessive deformation of the heart during the impact period, which might be the key mechanism of heart injury. The strong impact and press coming from both sternum and vertebral column and the rapid elevation of pressure in the ventricle are the main cause of deformation.
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Remote effect is one of the most important characteristics of high-velocity projectiles. It is the basic way to explore its mechanism in the changes of hemodynamic. Our experiments were desingned to observe the hemodynamic changes in 10 pigs with abdomen trauma caused by 6.35ram 1.03g high-velocity steel balls. The results showed that at one hour after trauma the level of cardiac output (CO), stroke volume (SV), left ventricle stroke work (LVSW) and mean artery pressure (MAP) decreased significantly, however, the level of pulmonary capillary wedge pressure (PCWP) increased significantly. At 8 hour after trauma, CO, SV, LVSW, MAP began to increase and PCWP began to declined slowly. At 72 hour after trauma the changes were close to the pretrauma values. From the experiments we also found that the hemodynamic changes were related to the heart injuries caused by remote effect.