This article reviews the role of high-density lipoprotein cholesterol (HDL-C) in the elderly population, questioning the established view that advocates the ubiquitous health benefits of HDL cholesterol. High levels of HDL-C have been found to be associated with an increased risk of debilitating fractures, dementia, and cardiovascular disease, predominantly affecting older men, through the use of large population-based studies such as the ASPREE trial and the UK Biobank. Possible mechanisms are closely linked to cholesterol crystallization and altered HDL particle function. These findings call for a refinement of the understanding of high-density lipoprotein cholesterol (HDL-C), which implies adjustments to clinical guidelines and risk assessment strategies in older populations.

Most rehabilitation therapists in China are graduates from the major of rehabilitation therapeutics, which focuses highly on training in skills and capacities. However, problems still exist in its overall product as well as process, such as the disconnect between the genuine and expected competency level of graduates, the dissonance between education in theory and training in practice, and discordance of medical education in schools and in hospitals. Based on this, the Rehabilitation Therapeutics program in Shanghai Sanda University cooperated with Shanghai General Hospital and developed a ″2+ 1+ 1″ system, which is a three-phase training model, based on a real integration of theory and practice as well as a set of clinically oriented course system. Meanwhile, mechanism for deepening cooperation was implemented and teacher-group in ″bi-positioning″ was set for student education. This model has effectively improved the quality of professional development and talent training, shortened the identity formation process from students to rehabilitation therapist and provided experience and reference for the cultivation of applied talents in rehabilitation therapy.

随着生活水平提高,我国人民的健康观念及康复意识不断改善,加上国家政策的大力扶持,康复医学事业得到飞速发展[1-2].同时,康复医学高等教育也快速发展.截至2017年,开设本科康复治疗学专业的高等院校达到141所,开设专科康复治疗技术专业的高等院校达到241所[3].尽管许多研究指出我国康复治疗人才缺口巨大,康复治疗人才培养严重不足[4-7],但是,面对着急剧扩大的招生规模,康复治疗相关专业的毕业生就业问题已然成为康复行业及相关学校关心和担心的焦点问题,也是康复医学事业和康复医学教育长期健康可持续发展的关键问题.

康复治疗人才培养是决定我国康复医学事业发展的关键.近二十年来,越来越多的高校开设本科康复治疗学专业,我国康复治疗专业本科教育规模在短时间内呈现出爆发式增长.与此同时,国家越来越强调"质量是高等教育的生命线",要求切实保障和提高本科教育质量[1].不少高校越来越重视康复治疗专业本科教育质量,走向内涵式发展道路.

在发达国家美国，康复科已是较成熟的医学相关学科，其教育培养体系、从业资格认证、学科分化等较为规范。随着我国人口老龄化的形势和大健康产业的进展，康复相关行业的人才培养、专业化进程有待大力推进。康复治疗学重点针对功能障碍进行干预，而功能障碍的诊断和治疗往往需回归解剖结构，本文则基于解剖学重要性、应用价值，结合相关数据比较，浅探中国与美国的康复治疗学专业(物理治疗方向)差异，旨在为我国康复治疗相关专业发展提供借鉴与思考。

目的:通过对上海市5家康复医学科专科医师规范化培训(以下简称专培)基地的学员进行调查分析,了解上海市康复专业专培现状,据此提出改进措施,提高专培工作质量,并以期为全国康复医学专业毕业后教育改革提供参考.方法:自行设计《上海市康复医学科专科医师规范化培训调查问卷》,通过微信链接向上海市5家康复医学科专培基地所有在培及已结业的康复医师发放问卷,线上回收问卷并统计分析.调查内容包括专培学员的基本情况、专培学员对培训政策的熟悉程度、专培基地的实际培训情况、学员对培训的满意程度等.结果:学员对专科医师规范化培训有较高的认同感及接受度,对专培政策及制度较为熟悉,对所在基地的教学活动、学习资源、培训总体效果满意.但在教师带教、学员科研能力提升、培训课程配置等方面没有得到学员普遍认可.此外学员对临床实践能力、临床思维能力等方面的培训仍具有较高的需求度.结论:上海市康复医学科专科医师规范化培训工作开展顺利,学员有较高的满意度,但仍需不断改进与提高.

康复治疗师作为康复医学重要的专业技术人员,其岗位能力决定了患者的临床疗效.现阶段,我国康复治疗师人才缺口与人民健康需求发展不平衡的矛盾日益突出,而作为掌握和具体实施康复治疗技术的康复治疗师,尚无规范化培训的相关要求和培养模式.如何加快康复治疗师队伍的培训,培养出具有较强专业能力的专业技术人才,提升我国康复医疗整体水平,还需要不断探索.为此,国内多家单位相继开展了1年或2年的康复治疗技术专业毕业后教育暨康复治疗师规范化培训试点工作,培养出具有较强岗位能力的康复治疗专业技术人才.本共识经过国内多位专家多年的探讨和实践,所述康复治疗师毕业后的培养模式已经过试行,此共识对推广治疗师毕业后的规范化培训和提高岗位能力具有重大的现实意义,也为康复治疗师毕业后规范化培训的正式开展建立了良好的基础.

康复治疗人才培养与学科建设及行业发展密切相关.在市场需求的拉动下,增设或转型开办康复治疗专业的高等院校逐渐增多,到2018年底,全国开设康复治疗专业的高等院校已经达434所,其中高职高专院校278所,本科院校156所[1].我国康复治疗专业教育已由数量快速增长到质量规范、由外延式扩张向内涵式提升转变的关键阶段.在内涵发展中,立足本土同时借鉴国际经验是重要路径.本文基于法国精神运动康复的学科内涵与理念,简要阐述其融入中国康复治疗人才培养的重要意义与可能路径,以他山之石攻玉,为中国康复治疗教育更快走向理性繁荣提供借鉴.

Background There were limited studies on the effect of skin temperature and local blood flow using kinesio tape (KT) adhered to the skin in different taping methods. This study aimed to determine the short-term effect of KT and athletic tape (AT) on skin temperature in the lower back and explore the possible effect of different taping methods (Y-strip and fan-strip taping) on local microcirculation. Materials and Methods Twenty-six healthy participants completed the test-retest reliability measurement of the infrared thermography (IRT), intraclass correlation coefficient (ICC), and standard error of measurement (SEM) were calculated to evaluate the reliability. Then, 21 healthy participants received different taping condition randomly for 5 times, including Y-strip of kinesio taping (KY), fan-strip of kinesio taping (Kfan), Y-strip of athletic taping (AY), fan-strip of athletic taping (Afan), and no taping (NT). Above taping methods were applied to the participants’ erector spinae muscles on the same side. Skin temperature of range of interest (ROI) was measured in the taping area through IRT at pre taping and 10 min after taping. Additionally, participants completed self-perceived temperature evaluation for different taping methods through visual analog scaling. One-way repeated-measured analysis of variance was used to compare the temperature difference among different taping methods. Bonferroni test was used for post hoc analysis. Results There was a good test-retest reliability (ICC = 0.82, 95% CI = 0.60–0.92; SEM = 0.33; and MD = 0.91) of the IRT. Significant differences were observed in the short-term effect on skin temperature among all different taping methods (p = 0.012, F = 3.435, and ηp2 = 0.147), post hoc test showed a higher significantly skin temperature difference in Kfan taping compared to no taping (p = 0.026, 95% CI = 0.051–1.206); However, no significant differences were observed among self-perceived temperature (p = 0.055, F = 2.428, and ηp2 = 0.108). Conclusion This study showed that the fan-strip of KT increased significantly the skin temperature of the waist after taping for 10 min. The application of KT may modify the skin temperature of the human body and promote local microcirculation, although it remained unclear for the real application.

To provide references for safe and effective implementing rehabilitation treatment during hospitalization,in this article,we exploratively discusses the principle and strategy of treatment for inpatients with COVID-19 based on clinical characteristics as infectious pulmonary diseases.The foundation of rehabilitation intervention in COVID-19 is'integration of prevention,treatment and rehabilitation'frame.The earlier the rehabilitation intervention starts,the better the prognosis will be,in the stable stage of the disease.Anoxia is the main clinical manifestation for inpatients with COVID-19.The best intervention point for inpatient's rehabilitation may be resolving the disease-caused anoxia via systemic management approaches safely and efficiently in rehabilitation medicine.Thus,this article proposes that we should keep on the principle,'No Excess,No Absence',and use the strategy basing on'Energy Conservation and Emission Reduction'as common goal management in the cooperation of multidisciplinary team approach on inpatient of COVID-19 rehabilitation.The series of stabilization,relaxation and energy-saving on'physical-mental level'were the major methods.And meanwhile the interaction among evaluation and intervention on individual and environment at the same time with the inclusion of COVID-19 prevention and control will rule into rehabilitation management process.The rehabilitation intervention on COVID-19 inpatients is not only the technique-oriented but also a systemic management process.The option of health efficacy promotion approaches via systemic vision is the demonstration of the most important concept in rehabilitation medicine,'People Frist of All'.The cognition on various meaning in rehabilitation medicine will provide new for rehabilitation field.

Objective: To compare the efficacy of kinesio taping on chronic non-specific low back pain with that of other general physical therapies. Methods: Relevant studies published up to 31 July 2018 were searched in electronic databases (PubMed, Web of Science, Science Direct, Physiotherapy Evidence Database (PEDro), Cochrane Library, Wan-fang Data, Vip Data and China National Knowledge Infrastructure). The quality of included studies was assessed using a risk of bias assessment tool, as recommended by the Cochrane Collaboration. Data from visual analogue scales and Oswestry Disability Index were extracted as selected outcome indicators. Tests of heterogeneity were performed. Weighted mean difference (WMD) data with its 95% confidence intervals (95% CI) were used as a measure of effect sizes, in order to pool the results from each included study using either a fixed or random effects model (where appropriate and possible). Results: Eight studies fulfilled the inclusion and exclusion criteria. The quality of included studies was moderate. Patients with chronic non-specific low back pain in the kinesio taping group achieved better pain relief (WMD= -1.22; 95% CI -1.49 to -0.96, I-2 = 91%, p< 0.00001) and activities of daily living (WMD= -7.11; 95% CI -8.70 to -5.51, I-2 =77%, p < 0.0001) than those in the control group. Conclusion: Kinesio taping may be a new, simple and convenient choice for intervention in low back pain. In the future, we can measure the efficacy about kinesio taping via clinical application in order to prove the possibility of treatment for low back pain.

BACKGROUND:Asthma is a chronic disease involving an immune response, which is characterized by non-specific inflammation and airway remodeling. Glucocorticoids are clinically beneficial in controlling asthma, but further options are needed. In our study, fastigial nucleus electrostimulation (FNS) was applied in a rat asthma model for the first time to investigate the effects of pre-intervention.OBJECTIVE:To observe the effects of FNS on airway inflammation and remodeling in asthmatic rats.METHODS:Forty rats were assigned randomly to the normal control (CON), model (MDL), FNS, or budesonide (BUD) groups. Asthma was induced with chicken egg (OVA). The animals in the CON and MDL groups were treated with normal saline. The animals in the other two groups received FNS or budesonide, respectively.RESULTS:The results indicated that IgE in the serum and airway fiber areas were higher in the MDL group than in other groups. After treatment for 3 weeks, collagen fibers in the bronchial wall in the FNS group were significantly lower compared with the MDL group.CONCLUSION:FNS significantly reduced IL-4, IL-13, TNF-α, OVA-IgE and TGF-β1 in serum and BALF, and increased IFN-γ. Our results suggest that FNS may ameliorate asthma symptoms and induce changes of cytokines in the serum and lung milieu.