OBJECTIVE:This study aimed to provide normative ranges of Chinese smartphone-based digits-in-noise (DIN) test results, to explore the association between speech reception threshold (SRT) and pure-tone average (PTA) threshold, and to verify the effectiveness and feasibility of the Chinese DIN. DESIGN:Chinese-speaking adult subjects with varying types, symmetry and degrees of hearing loss, were recruited. All participants completed a pure-tone audiometric hearing test and DIN test with dichotic and antiphasic stimulus presentation. STUDY SAMPLE:The overall sample consisted of 191 subjects, 24 with normal hearing and 167 with hearing loss. RESULTS:There was a positive correlation between antiphasic DIN SRTs and PTA thresholds. Receiver operating characteristic curves (ROC) were calculated based on the classification of poorer ears. When SRT was ≥ -15.8 dB, it suggested the possible presence of mild or more severe hearing loss; when SRT was ≥ -14.2 dB, it suggested the possible presence of moderate or more severe hearing loss. CONCLUSION:The Chinese DIN SRT showed a highly positive correlation with PTA and exhibited high sensitivity and specificity in detecting hearing loss. Poorer ear PTA was the primary predictor of the antiphasic DIN SRT. The present results verify the validity of the Chinese DIN in its purpose of hearing screening.

目的:比较两种家庭训练方案对腰痛患者的临床疗效.方法:门诊招募60例腰痛患者随机分为常规组(n=30)和核心组(n=30).两组患者均接受腰痛防护知识宣教及评估.常规组接受常规家庭训练方案指导;核心组接受麦吉尔(McGill)"三大训练"(Big3)家庭方案指导.之后两组患者独立完成6周家庭训练.训练前后采用汉化Oswestry功能障碍指数(Oswestry disability index,ODI)和疼痛目测类比定级法(visual analogus scale,VAS)作为主要评估指标,腰部活动度和躯干肌群的肌耐力作为次要评估指标对患者治疗效果进行评估.根据患者训练的完成度、自觉帮助度及满意度评估患者治疗依从性及家庭训练方案的可行性.结果:常规组和核心组分别有24例和25例完成了家庭训练.经过6周家庭训练后,两组患者的ODI及VAS均有明显降低(P＜0.01)、腰部ROM均有明显增加(P＜0.01);常规组部分躯干肌群和核心组全部躯干肌群的肌耐力明显增强(P＜0.01);核心组的ODI、VAS和右侧侧方肌的肌耐力与常规组比较差异具有显著性意义(P＜0.05);核心组患者的自觉帮助度及满意度得分与常规组比较差异具有显著性意义(P＜0.01).结论:两种腰痛家庭训练方案均可行并有效.与常规家庭训练方案相比,Big3家庭训练方案对于改善腰痛患者疼痛和功能障碍方面具有更好的临床疗效,并且患者的接受度更高.

Background: Cochlear implant (CI) users have difficulty appreciating music and perceiving lexical tones in Mandarin Chinese. Wearing a hearing aid (HA) in the contralateral ear for bimodal hearing may provide additional benefits. Objectives: To measure the bimodal benefits of music perception and tone recognition and to investigate the relationship between the two in Mandarin-speaking bimodal CI subjects. Materials and methods: Sixteen Mandarin-speaking bimodal CI subjects (aged between 16 and 49 years) participated in the study. Music perception (pitch discrimination, melody discrimination and instrument identification) and lexical tone recognition were tested with electric stimulation (CI alone) or bimodal stimulation (CI + HA). Results: Subjects showed a significant bimodal benefit in tone recognition in quiet and noise, and in all music perception tests. The bimodal benefit for tone recognition in noise was significantly correlated with that of pitch discrimination thresholds and instrument identification scores. Conclusion: Mandarin-speaking bimodal CI users achieved better music perception and tone recognition ability with CI + HA than with CI alone. The bimodal benefit of tone recognition was significantly correlated with that of music perception.

Objective:To assess the recognition of lexical tones in Mandarin-speaking bimodal cochlear implant (CI) subjects. Design:Lexical tone recognition in quiet and noise (SNR= +5 dB) was measured with electric stimulation (CI alone) or bimodal stimulation (CI + hearing aid (HA)). The recognition and confusion rates of the four tones (T1, T2, T3 and T4) were analysed. Spearman correlation analysis was performed to examine the relationship between hearing levels in the contralateral ear and bimodal benefits. Study sample:Twenty native Mandarin-speaking bimodal CI users, with ages ranging from 16-49 years. Results:Relative to the CI alone, mean tone recognition with the CI + HA improved significantly from 84.1-92.1% correct in quiet (+8 points) and from 57.9-73.1% correct in noise (+15.2 points). Tone confusions between T2 and T3 were the most prominent in all test conditions, and T4 tended to be labelled as T3 in noise. There was no significant correlation between the bimodal benefits for tone recognition and the unaided or HA-aided pure-tone thresholds at 0.25 kHz. Conclusion:Listeners with CI + HA exhibited significantly better tone recognition than with CI alone. The bimodal advantage for tone recognition was greater in noise than in quiet, perhaps due to a ceiling effect in quiet.

Blood flow restriction training is a method to improve the muscle mass and muscle strength by Pressing a pneumatic cuff wrapped around the proximal region of the target limb for limiting distal limb blood flow and by combining specific forms of movement.Current studies suggest that this method is simple and safe, and has few adverse events, which can improve muscle function and physical activity and reduce the risk of training injury in the elderly.This article reviewed and discussed the possible mechanism of blood flow restriction training and its clinical effect on the improvement of the physical activity in the elderly, in order to provide areference for further clinical research and application.

目的:研究腰椎退行性疾病患者首次行单节段腰椎手术后功能恢复的影响因素.方法:以北京市9家三级甲等医院收治的因腰椎退行性疾病首次行单节段椎管减压内固定手术的患者为研究对象,搜集人口学资料及诊疗、随访评定记录,获得病例资料共1152例.于术前、术后24周±7天分别用日本骨科学会(Japanese Orthopedic Association,JOA)腰椎评分量表评定腰椎功能,按照功能情况分为优、良、可、差;将年龄、性别、体质指数(BMI)、手术节段、术前功能、术前疼痛、是否进行一体化康复、有无术后并发症共8个因素纳入分析,使用有序多分类logistic回归分析的方法对腰椎退行性疾病术后患者功能恢复的影响因素进行分析.结果:经过有序多分类Logistic回归分析,进行围手术期骨科康复一体化治疗的患者术后24周时腰椎JOA评分显著优于接受现行骨科诊疗的患者,差异有显著性意义(P＜0.05)(OR=1.589,95％ CI [0.193,0.733]);术后无并发症的患者术后24周时腰椎JOA评分显著优于术后发生并发症的患者,差异有显著性意义(P＜0.05) (OR=2.300,95％ CI[0.112,1.555]).结论:围手术期骨科康复一体化治疗和是否发生术后并发症这两个因素是首次行腰椎管减压内固定术的患者功能预后的独立影响因素.采取骨科康复一体化模式、不伴发术后并发症的患者获得更良好的腰椎功能恢复.

Background: Categorical perception (CP) of lexical tones was examined in normal hearing (NH) people, but it was unclear whether lexical tones can be perceived categorically in sensorineural hearing loss (SNHL) people. Objectives: To explore the characteristic of lexical tone perception in native Mandarin speakers with SNHL. Materials and methods: Three types of continuum (Tone1/Tone2, Tone1/Tone4 and Tone2/Tone3) were constructed and each of them includes 15 stimuli which were resynthesized by applying the pitch-synchronous overlap and add (PSOLA) method implemented in Praat to the same Mandarin syllable, /a/, with a high-level tone produced by a female speaker. Forty native Mandarin NH speakers and 23 native Mandarin speakers with mild to moderate SNHL were recruited. A two alternative-forced-choice identification task was used to acquire the tonal perceptual data. Results: All tone perception curves owns the characteristic of CP in SNHL subjects. All tone perception curves were S-shape in SNHL subjects same as those in NH subjects. No significant difference of each continuum was observed between SNHL and NH. Conclusions: CP of lexical tone perception could be observed in native Mandarin speakers with mild to moderate SNHL. The slight damage in the peripheral auditory system did not change characteristic of lexical tone perception.

Objective: The aim was to evaluate the development of music and lexical tone perception in Mandarin-speaking adult cochlear implant (CI) users over a period of 1 year. Study Design: Prospective patient series. Setting: Tertiary hospital and research institute. Patients: Twenty five adult CI users, with ages ranging from 19 to 75 years old, participated in a year-long follow-up evaluation. There were also 40 normal hearing adult subjects who participated as a control group to provide the normal value range. Interventions: Musical sounds in cochlear implants (Mu. S. I. C.) test battery was undertaken to evaluate music perception ability. Mandarin Tone Identification in Noise Test (M-TINT) was used to assess lexical tone recognition. The tests for CI users were completed at 1, 3, 6, and 12 months after the CI switch-on. Main Outcomes Measures: Quantitative and statistical analysis of their results from music and tone perception tests. Results: The performance of music perception and tone recognition both demonstrated an overall improvement in outcomes during the entire 1-year follow-up process. The increasing trends were obvious in the early period especially in the first 6 months after switch-on. There was a significant improvement in the melody discrimination (p<0.01), timbre identification (p <0.001), tone recognition in quiet (p<0.0001), and in noise (p<0.0001). Conclusions: Adult Mandarin-speaking CI users show an increasingly improved performance on music and tone perception during the 1-year follow-up. The improvement was the most prominent in the first 6 months of CI use. It is essential to strengthen the rehabilitation training within the first 6 months.

Abstract Conclusion: Mandarin-speaking adults can use the Fine Structure Processing (FSP) coding strategy as well as the Continuous Interleaved Sampling (CIS+) coding strategy. No loss in performance was observed after switch-over. Tone identification improves over time with the FSP coding strategy, which is of benefit to tonal-language users. After some time, fine structure was preferred. Objective: This study aimed to determine speech perception, tone perception, and the subjective preferences of Mandarin-speaking adults who received the FSP coding strategy, at upgrade from the CIS + coding strategy. Methods: Thirteen Mandarin-speaking subjects were tested at switch-over from CIS + to the FSP coding strategy ∼1-month after switch-over, 2-months after switch-over, and 3-months after switch-over with the Mandarin Hearing in Noise Test (M-HINT), the Mandarin Tone Identification in Noise Test (M-TINT), and a visual analogue scale assessing Sound and Speech Assessment (SSA). Results: There were no significant differences in the M-HINT between presentation levels (62 dB SPL vs 65 dB SPL), over time, nor when compared to the CIS + coding strategy. Tone perception improved significantly over time with the FSP coding strategy. Subjects rated the FSP coding strategy with the OPUS 2 as significantly more ‘full’ and ‘rich’ than with the CIS + coding strategy after 3-months.

Background: Meniere's disease is a unique, progressive disease of the inner ear. The complex manifestation presents diagnostic challenges. The cochlear symptoms often present before vertigo and tend to be ignored. This study aimed to analyze the characteristics of cochlear symptoms and functions associated with Meniere's disease to investigate the regularity of the development of this disorder. Methods: One-hundred fifteen patients who were diagnosed with definite unilateral Meniere's disease at the Hearing and Vestibular Clinic of the Department of Otorhinolaryngology of Beijing Tongren Hospital from August 2013 to November 2015 were recruited in this retrospective study. Initial symptoms, duration from initial symptoms to the diagnosis, hearing thresholds, audiogram patterns, and caloric test results were collected and analyzed for each patient. Data were analyzed using SPSS 13.0 statistical software by Spearman's correlation, Kruskal–Wallis H test, Chi-square test, and Fisher's exact test. Results: The average hearing threshold of these patients was 45.24 ± 18.40 dB HL. A majority of the patients (55.65%) were in Stage 3. The initial presentation of the disorder in 58 cases (50.43%) comprised only cochlear symptoms without vertigo. A weak, positive correlation was found between the degree of hearing loss and duration of the disease from initial symptoms to the diagnosis (rs = 0.288, P = 0.002). Upward-sloping, inverted “V,” downward-sloping, and flat pattern were the main audiometric patterns observed with a distinctive distribution between stages (P < 0.001). Based on the configurations of audiograms, the audiometric patterns had a weak correlation to the duration (rs = 0.269, P = 0.004), and there was a tendency of duration to rising from upward-sloping, inverted V, downward-sloping to flat pattern. (H = 10.024, P = 0.018). Frequencies of tinnitus in 56 patients (64.4%) were at the lowest points of the audiograms, i.e., the frequencies of the poorest hearing threshold. The patients at an advanced stage (Stage 3 [56] and Stage 4 [73]) exhibited a significantly higher abnormality of canal paresis than those at the earlier stages (Stage 1 [23] and Stage 2 [42]) (&khgr;2 = 5.973, P = 0.015). Conclusions: Patients with definite Meniere's disease always have a moderate to severe sensorineural hearing loss before diagnosis. Cochlear symptoms are the most common initial presentation. With the progression of the duration, the hearing impairment becomes more severe and the distribution of the audiometric pattern is distinctive between stages.

Clinical pathway, as a standardized, proper, sequential, and continuing process, is done for a particular diagnosis or surgery by physicians, nurses and other professionals, reducing the delay of the treatment and resources waste and maximizing the treatment quality. Most comminuted fractures of the distal humerus are dififcult to treat and usually lead to serious elbow dysfunction after the operation. Especially due to the lack of early postoperative rehabilitation, many patients with distal humerus fracture get a successful operation rather than satisifed functions. Based on the situation above, the research team of Beijing Municipal Science and Technology Commission major project “common orthopedic disease postoperative rehabilitation patterns and clinical pathway” develops early postoperative rehabilitation and clinical pathway and veriifes its feasibility and effectiveness. The results conifrm the clinical pathway as an early postoperative rehabilitation standard for the distal humerus fracture.

Objective To investigate the clinical efficacy of early rehabilitation after the internal fixation of the elbow fracture. Methods From June 2013 to March 2015, 101 elbow fracture patients were admitted in our hospital. There were 55 males and 46 females with the average age of ( 41.79 ± 16.99 ) years ( range: 13 - 84 years ). According to the international society for the research of internal ifxation with Association for the study of Internal Fixation ( AO ) classiifcation: 18 cases were of type A, 21 B, 62 C. According to Tscherne closed fracture and soft tissue injury classiifcation: 15 cases were of C0, 31 CI, 34 CII, 21 CIII. A total of 101 cases of the elbow fracture underwent open reduction and internal ifxation. All were randomly divided into the observation group (n = 51 ) and control group (n = 50 ). The observation group received preoperative rehabilitation education, and postoperative early <br> rehabilitation under the help of therapists. The control group did not receive any early postoperative rehabilitation, and had routine exercises for stability. After 12, 24 weeks, assessment was made by visual analague scale ( VAS ), range of motion ( ROM ) and hospital for special surgery ( HSS ). The relevant data were collected and analyzed.Results All cases had been followed up for 24 weeks. VAS scores: after 12 weeks, the observation group ( 1.24 ± 1.46 ) points and control group ( 1.22 ± 1.23 ) points, no statistical signiifcance (P> 0.05 ); after 24 weeks, the observation group ( 0.53 ± 0.95 ) points and control group ( 0.84 ± 1.15 ) points, no statistical signiifcance (P > 0.05 ). Elbow ROM:after 12 weeks, the observation group ( 104.27 ± 21.96 ) and control group ( 88.98 ± 30.51 ), statistically signiifcant (P < 0.01 ); after 24 weeks, the observation group ( 117.84 ± 26.06 ) and control group ( 105.40 ± 31.85 ), statistically significant ( P< 0.05 ). HSS elbow score: after 12 weeks, the observation group ( 80.08 ± 16.67 ) points and control group ( 69.02 ± 18.62 ) points, statistically significant (P< 0.01 ); after 24 weeks, the observation group ( 89.71 ± 8.90 ) points and control group ( 81.56 ± 18.07 ) points, statistically signiifcant (P < 0.01 ).Conclusions Early rehabilitation after elbow fracture surgery can improve the elbow function and prognosis, while there are no correlations between the elbow pain relief and the start point of the rehabilitation.

Objective To investigate the correlation between different modes of rehabilitation and outcomes of patients with single-segment lumbar fixation and fusion surgery within 12-week postoperatively. Methods A prospective cohort study was proceeded. All the patients who met the inclusion criteria had been followed up for 12 weeks after the surgery ( preoperatively, 3 - 5 days postoperatively, 12 weeks postoperatively by phone or outpatient service ). The data of rehabilitation and postoperative functional evaluation were collected. There were 579 cases of ifnal follow-up cases, including 279 male cases and 300 female cases. The age ranged from 49 - 51 years, mean ( 50.45 ± 12.65 ) years. The patients were categorized into 3 rehabilitation groups according to different modes. Observation group 1: 165 cases, 82 male cases, 83 female cases, aged from 46 to 51 years, with the mean age of ( 48.95 ± 12.93 ) years, professional rehabilitation during the hospitalization. Observation group 2: 194 cases, 88 male cases, 106 female cases, aged from 49 to 53 years, with the mean age of ( 51.13 ± 11.45 ) years, professional rehabilitation during the hospitalization and after the discharge. Control group: 220 cases, 109 male cases, 111 female cases, aged from 49 to 53 years, with the mean age of ( 50.98 ± 13.41 ) years, no professional rehabilitation during the hospitalization or after the discharge. Baseline data were not statistically different in 3 groups (P > 0.05 ).Results Twelve weeks after the surgery in the 3 groups, postoperative lumbar VAS score, ODI scores were signiifcantly lower than preoperatively between the observation groups and control group, with statistical significance (P < 0.05 ). Twelve weeks postoperatively, VAS scores and ODI scores in both observation group 1 and observation group 2 were signiifcantly lower than the control group with statistical significance (P< 0.05 ). No statistically significant differences were observed between the observation groups and the control group on Japanese orthopedic association ( JOA ) 12-week after surgery (P > 0.05 ). The postoperative excellent rate of the observation group 1 and group 2 were higher than the control group with statistical signiifcance (P< 0.05 ). Twelve weeks after the surgery in the 3 groups, no statistical signiifcance was observed at the lumbar range of motion (P > 0.05 ).Conclusions The pain is relieved and the quality of life is improved after the professional rehabilitation. However, rehabilitation after the discharge has limited effects on functional performance 12 weeks postoperatively.

Objective To explore rehabilitation guidance effects on the perioperative anxiety by observing patients with single segment lumbar fusion and internal fixation. Methods We randomly selected 52 patients with lumbar degenerative changes from Auguest, 8th, 2014 to February, 1st, 2015 by computer, and divided them into the observation group and the control group at the proportion of 1 : 1. There were 29 females and 23 males, with the average age of ( 43.55 ± 12.21 ) years and the average disease course of ( 14.26 ± 8.31 ) months. In the observation group, patients received rehabilitation guidance by rehabilitation doctors and therapists preoperatively and postoperatively, while the control group by nurses for the routine rehabilitation guidance. Visual Analogue Scale ( VAS ) and Self-Rating Anxiety Scale ( SAS ) were evaluated in 2 groups, and re-evaluated 1-week post-operation. The correlation between pain and anxiety preoperatively and postoperatively was analyzed.Results The VAS scores of the observation group and the control group were respectively ( 6.85 ± 1.87 ) points and ( 7.38 ± 1.63 ) points before the treatment, while the SAS scores were respectively ( 46.42 ± 10.82 ) points and ( 50.35 ± 10.10 ) points. The 2 groups were comparable in the VAS scores and SAS scores (P > 0.05 ). The VAS scores decreased to ( 1.19 ± 1.36 ) points and ( 1.73 ± 1.43 ) points respectively after the treatment, while SAS scores decreased to ( 30.08 ± 6.86 ) points and ( 35.12 ± 10.08 ) points respectively. There was significant improvement compared with that before the treatment (P< 0.05 ). Statistically signiifcance existed between the two groups (P< 0.05 ), explaining the observation group was better than the control group. Moreover, VAS and SAS scores were relevant in the correlation analysis in all patients (P< 0.05 ). In the SAS analysis of the anxiety in 25 patients, females of 41 - 50 years old accounted for the vast majority ( 18 patients, 72% ), the disease course of 23 patients ( 92% ) > 1 year, and 16 patients ( 64% ) received at least 2 conservative treatment methods. After the guidance and surgical treatment, the number of patients with mild to moderate anxiety was significantly reduced.Conclusions Patients with selective surgery are in the presence of psychological anxiety, which is associated with pain, disease course, gender, expected outcomes of the disease and other factors. Proper preoperative rehabilitation guidance, especially psychological counseling, is significant in the postoperative elimination of fear and establishment of positive attitude to the surgery and recovery.

Objective To investigate the effecting factors of elbow function recovery after the fracture surgery. Methods From July 2013 to January 2015, 107 cases of elbow fracture were treated. There were 50 males and 57 females, aged 13 - 85 years old ( average: 43 years ). According to Association for the study of Internal Fixation ( AO ) fracture classiifcation, there were 17 cases of type A, 42 cases of type B and 48 cases of type C. According to soft tissue injury classiifcation, there were 15 cases of type C0, 27 cases of type CI, 38 cases of type CII, and 27 cases of type CIII. According to articular cartilage injury classiifcation, there were 49 severe cases, 40 mild cases and 18 cases without any injuries. The time from the injury to operation ranged from 8 hours to 26 days with the average of 6 days. The distal humerus fracture occurred in 66 cases, and olecranon fracture in 41 cases. All patients underwent open reduction and internal ifxation, 88 cases with plate and screw, 19 cases with tension band. After the operation, the hospital for special surgery ( HSS ) elbow function score was used to evaluate the efifcacy. Ten related factors of postoperative elbow function recovery were analyzed by statistics including age, sex, preoperative AO fracture classiifcation, soft tissue injury classiifcation, articular cartilage injury, the time from the injury to surgery, treatment, quality of the reduction of the articular surface, start point of the postoperative rehabilitation ( early: postoperative < 30 days; delayed: postoperative≥30 days ), and postoperative complications.Results Wounds healed by the ifrst intention in 107 cases. The mean follow-up was ( 6.19 ± 0.33 ) months ( range: 5.57 - 7.68 months ). Clinical union of the fracture was achieved within 3 - 6 months after the operation. Extensor device adhesions and the scope of activities <80° occurred in 4 cases, heterotopic ossiifcation in 2 cases, nerve injury in 4 cases, and ifxation loosening in 1 cases. According to HSS elbow function score, the results were excellent in 47 cases, good in 31 cases, fair in 14 cases and poor in 15 cases with an excellent and good rate 72.90%. A single factor analysis showed that 3 factors ( age, articular cartilage injury, start point of the rehabilitation ) were signiifcantly correlated with the elbow function recovery (P < 0.05 ). A logistic regression analysis showed that age, start point of the rehabilitation were major factors in the elbow joint function recovery.Conclusions Age, articular cartilage injury, and start point of the rehabilitation can affect the elbow joint function recovery signiifcantly. Adjustment of the patient’s preoperative physical condition, rehabilitation education, symptomatic psychological counseling, appropriate strong internal ifxation, early postoperative functional rehabilitation can lessen postoperative complications and maximize the restoration of the elbow joint function.

Objective To evaluate the outcomes of different rehabilitation patterns for patients who have undergone a surgery for elbow fracture, and to put forward a suitable rehabilitation pattern for post-surgery patients with the elbow fracture.Methods A total of 129 cases receiving surgery for the elbow fracture in 9 hospitals inBeijing were divided into two groups: ( 1 ) the control group: received common orthopedic rehabilitation; ( 2 ) the observation group: received post-surgery rehabilitation in team approach. Visual analogue scale ( VAS ) and range of motion ( ROM ) were assessed 5 days, 12 weeks and 24 weeks after the surgery. The hospital for special surgery score ( HSS ) was assessed 12 weeks and 24 weeks after the surgery.Results There were no statistically significant differences in VAS ( the observation group at 5 days, 12 weeks and 24 weeks after the surgery were 3.94 ± 2.12, 1.04 ± 1.46 and 0.38 ± 0.76; the control group at 5 days, 12 weeks and 24 weeks after the surgery were 3.12 ± 1.54, 1.12 ± 1.28 and 0.75 ± 1.12 ), lfexion ( the observation group at 5 days, 12 weeks and 24 weeks after the surgery were ( 72.07 ± 28.08 ) °, ( 107.55 ± 24.11 ) ° and ( 120.40 ± 22.56 ) °; the control group at 5 days, 12 weeks and 24 weeks after the surgery were ( 68.24 ± 28.29 ) °, ( 107.50 ± 20.64 ) ° and ( 117.82 ± 18.66 ) °, and extension [ the observation group at 5 days, 12 weeks and 24 weeks after the surgery were ( 18.97 ± 18.68 ) °, ( 15.59 ± 17.51 ) ° and ( 10.51 ± 14.66 ) °; the control group at 5 days, 12 weeks and 24 weeks after the surgery were ( 17.54 ± 25.34 ) °, ( 18.24 ± 22.43 ) ° and ( 14.27 ± 23.99 ) ° ] (P > 0.05 ). The forearm pronation: the observation group 5 days and 12 weeks after the surgery were ( 51.50 ± 30.95 ) ° and ( 77.76 ± 13.23 ) °; the control group 5 days and 12 weeks after the surgery were ( 42.22 ± 29.67 ) ° and ( 74.55 ± 18.52 ) °. The supination: the observation group 5 days and 12 weeks after the surgery were ( 47.00 ± 30.92 ) ° and ( 77.14 ± 15.67 ) °; the control group 5 days and 12 weeks after the surgery were ( 41.50 ± 30.31 ) ° and ( 71.98 ± 21.99 ) °. No significant differences existed (P > 0.05 ). The observation group showed signiifcantly better rotation in the rage of motion ( ROM ) 24 weeks after the surgery [ the pronation and supination of the observation group were ( 83.06 ± 7.41 ) ° and ( 82.77 ± 7.65 ) °; the pronation and supination of control group were ( 78.30 ± 14.59 ) ° and ( 73.56 ± 22.67 ) ° ] (P= 0.035,P = 0.005 ). HSS 12 weeks after the operation: the observation group ( 77.00 ± 15.06 ) points and the control group ( 68.14 ± 19.35 ) points; no statistical signiifcance (P > 0.05 ). HSS 24 weeks after the operation: the observation group ( 89.73 ± 9.17 ) points and the control group ( 78.57 ± 20.39 ) points; the observation group was superior to the control group ( P = 0.015 ).Conclusions The rehabilitation in team approach improves functions than common orthopedic rehabilitation. It is suitable for early post-surgery rehabilitation of the elbow fracture.

Objective To investigate the effects of classiifed rehabilitation after the lumbar surgery. Methods A total of 579 cases of lumbar degenerative disease, including 279 male cases and 300 female cases, were collected from May, 2013 to April, 2014 in 9 tertiary hospitals in Beijing. The mean age was ( 50.5 ± 12.7 ) years ( range: 49 - 52 years ). All patients were randomly divided into the experimental group and control group. According to the postoperative treatment, all patients were divided into experimental group 1, experimental group 2 and control group. The experimental group 1 included 165 cases, male 82 cases, female 83 cases, aged 46 to 51 years, mean ( 48.9 ± 12.9 ) years. The experimental group 2 included 194 cases, male 88 cases, female 106 cases, aged 49 to 53 years, mean ( 51.1 ± 11.4 ) years. The control group included 220 cases, male 109 cases, female 111 cases, aged 49 to 53 years, mean ( 51.0 ± 13.4 ) years. The differences of 3 groups in gender and age were not statistically signiifcant (P > 0.05 ). The experimental group was applied with family rehabilitation ( experimental group 1 ) or received rehabilitation guidance or training in the nearby unit of the research group members under the scheme of rehabilitation after the surgery ( experimental group 2 ). Control group underwent routine scheme of treatment and rehabilitation after the surgery ( routine postoperative rehabilitation in the hospital and recovery following the surgery doctor’s advice based on personal experience ). Meanwhile, rehabilitation modes in the secondary hospital, community medical service center and family following treatments in tertiary hospitals were designed and established for patients after lumbar degeneration surgery. All the cases received visits and rehabilitation assessment at certain times. All the data were assembled after the rehabilitation and compared by function assessment, incidence rate of complications and rehabilitation cost.Results The experimental group was better than the control group in VAS score, ODI score, JOA ifne rate 24 weeks after the surgery (P < 0.05 ). There were no signiifcant differences in VAS score, ODI score between the experimental group 1 and experimental group 2 (P> 0.05 ). There were no signiifcant differences in lumbar range of motion and complications among the three groups 24 weeks after the surgery (P> 0.05 ).Conclusions Classiifed rehabilitation after the lumbar surgery is proven to be practical, effective, and safe, which is suitable for popularization in clinical practice.

Objective To evaluate the outcomes of different rehabilitation intervention patterns for patients with single-level lumbar decompression surgery ( LDS ) and to put forward a suitable rehabilitation pattern for early postoperative lumbar rehabilitation. Methods A total of 385 cases of lumbar degenerative diseases, including lumbar intervertebral disc herniation ( LDH ), lumbar canal stenosis ( LCS ) and etc., received single-level ( L4-5, L5 - S1 ) LDS in the ifrst time in 9 hospitals in Beijing. All patients were assigned to 2 groups: ( 1 ) the control group: received regular postoperative treatment; ( 2 ) the observation group: received postoperative rehabilitation intervention with team approach. A total of 220 patients were assigned to the control group, while 165 patients were in the observation group. There were 191 male patients and 194 female patients. The age of the patients ranged from 18 years old to 84 years old. The mean age was 50.1 years old. Visual analogue scale ( VAS ) was assessed before the surgery, 3 -5 days postoperatively, 12 weeks ± 7 days postoperatively and 24 weeks ± 7 days postoperatively. Modiifed Oswestry Disability Index ( ODI ), and Japanese Orthopedic Association Scores ( JOA ) were assessed before the surgery, 12 weeks ± 7 days postoperatively and 24 weeks ± 7 days postoperatively.Results There was no significant differences in general demographic information, operation situation, VAS and ODI in the two groups preoperatively (P > 0.05 ). The VAS of the observation group 3 - 5 days, 12 weeks ± 7 days and 24 weeks ± 7 days after surgery were ( 3.0 ± 1.9 ) points, ( 1.5 ± 1.3 ) points and ( 0.9 ± 1.2 ) points, showing signiifcant pain relief compared to the VAS in the control group ( 3.5 ± 2.1 ) points, ( 2.0 ± 1.8 ) points and ( 1.3 ± 1.5 ) points with statistical signiifcance (P < 0.05 ). The modiifed ODI scores of the observation group 12 weeks ± 7 days and 24 weeks ± 7 days after the surgery were ( 17.7 ± 14.7 ) and ( 8.1 ± 10.5 ) points, which were signiifcantly lower than the control group ( 22.1 ± 17.5 ) and ( 13.6 ± 13.8 ) points with statistical signiifcance (P< 0.05 ). 12 weeks ± 7 days and 24 weeks ± 7 days after the surgery, JOA improvement rates in the observation group were ( 65.2 ± 26.6 ) % and ( 81.8 ± 20.9 ) %, which were signiifcantly higher than the control group ( 59.50 ± 27.52 ) % and ( 74.46 ± 23.23 ) % with statistical signiifcance (P< 0.05 ). Conclusions Rehabilitation intervention in team approach relieves the pain and improves functions after the lumbar decompression surgery, which is suitable for the early postoperative lumbar disease rehabilitation.

Objective To evaluate the efifcacy of early lfexion exercises in lumbar range of motion in patients with lumbar internal ifxation and fusion. Methods From September 2013 to June 2014, 66 patients after posterior single segmental lumbar interbody fusion were enrolled in this study. The patients were randomly allocated into the experimental group (n= 33, 19 males, 14 females ) with the average age of ( 41.21 ± 9.95 ) years ( range: 22 - 58 years ) and a control group (n= 33, 17 males, 16 females ) with the average age of ( 42.91 ± 8.17 ) years ( range: 29 - 57 years ). Both groups received regular rehabilitation after the surgery. Besides this, patients in the experimental group received lumbar flexion exercises 4 weeks after the surgery. The outcomes were evaluated at 12, 24 and 52 weeks after the surgery by lumbar anterioposterior and lateral X-ray, and hyperextension and hyperlfexion X-ray. CT scan was performed at 18-month follow-up to evaluate the fusion rate.Results At 12-week follow-up, patients in the experimental group ( 20.91 ± 2.58 ) ° had signiifcant improvement in lumbar range of motion (P < 0.01 ) than those in the control group ( 17.33 ± 3.06 ) °. At 24-week follow-up, patients in the experimental group ( 24.73 ± 3.23 ) ° had signiifcant improvement in lumbar range of motion (P < 0.01 ) than those in the control group ( 19.09 ± 3.38 ) °. At 52-week follow-up, patients in the experimental group ( 29.85 ± 3.03 ) ° had signiifcant improvement in lumbar range of motion (P < 0.01 ) than those in the control group ( 20.67 ± 3.34 ) °. At 18-month follow-up, the fusion rate was 100% and no internal ifxator failure ( loosing, dislocation, breakage ) occurred in both groups.Conclusions Early lfexion exercises after single segmental lumbar fusion can signiifcantly promote the restoration of the lumbar range of motion with satisfactory safety.

Objective To analyze the reasons of antimicrobial drugs high prevention usage rate in Ⅰ incision surgery perioperative. Methods A general survey of type Ⅰ incision surgery perioperative preventive medications was taken in a grade 3 and first-class hospital in a quarter of 2014 and compared with the overall situation, and use of quality management tools to analyze possible cause of the prophylactic usage rate on the high side. Results In the past three years, the type Ⅰ incision operation preventive antimicrobial rate from 80.56% decreased to 48.53%, do not meet the indicators prescribed by the health planning commission. Research data show that antimicrobial drugs in principle usage rate is higher (47.55%), do not need to use 9.28% of the diseases is not rational drug use behavior. Drugs, the lack of professional knowledge, the lack of training, the index set of component ratio is high and no difference, disease prevention regulation does not reach the designated position, etc were the reasons for hospital type Ⅰ incision preventive antimicrobial agents usage. Conclusion Hospital should strengthen the knowledge training and examination for perioperative antimicrobial drugs for type Ⅰ incision; Combined with antibacterial drug monitoring and control system, strengthen the guidance of clinical pharmacists function; Recommend the health administrative department to differentiate setting parameter values of type Ⅰ incision prophylaxis.