Objective: The objective of this study was to examine the relationship between systemic inflammation and long-term mortality in patients with hypertension. Methods: The study employed a retrospective cohort design. The study population was derived from the National Health and Nutrition Examination Survey (NHANES), and the mortality data for this population was acquired from the National Death Index (NDI) database. Systemic inflammation was quantified by the Systemic Immune Inflammation Index (SII) and the Systemic Inflammatory Response Index (SIRI), which were then categorized into four groups (Q1-Q4, with Q4 representing the highest level of SII or SIRI). Weighted Cox regression models were constructed to investigate the association between mortality and SII and SIRI, with hazard ratios (HRs) subsequently calculated. Results: A total of 7431 participants were included in the analysis. The highest quantile (Q4) of SII was associated with a higher risk of all-cause mortality (hazard ratio 1.36, 95% CI 1.1-1.69, P < 0.001). After adjustment for important covariates, the association remained significant (hazard ratio 1.70, 95% CI 1.27-2.30, P < 0.001). The highest quantile (Q4) of SIRI was also associated with the highest risk of mortality (hazard ratio 2.11, 95% CI 1.64-2.70, P < 0.001), and this association remained significant after adjustment for important covariates (hazard ratio 1.64, 95% CI 0.61-1.22, P = 0.001). Conclusion: Both SII and SIRI scores were found to be associated with mortality rates in patients with hypertension. The findings suggest that these scores may serve as complementary biomarkers to the neutrophil-to-lymphocyte ratio (NLR) for assessing mortality risk in patients with hypertension. Further investigation is warranted to elucidate the underlying mechanisms that underpin this association.

Life satisfaction (LS) exhibited gender differences and was associated with age, income, and negative emotions. There is no research on the relationship between professional values and LS, although professional values are essential for medical staff and correlate with negative emotions. This study aimed to explore the relationship between professional values and LS, the action mechanism of influencing factors of LS, and gender differences among medical staff of rehabilitation departments in China. A total of 284 participants (108 men and 176 women) completed the questionnaires. Data were analyzed using SPSS19.0 and Amos21.0. Age, length of service, and anxiety differed significantly between genders. Professional values had a direct effect on LS and an indirect effect on LS via anxiety and depression. Therefore, enhancing professional values and reducing anxiety and depression could increase the medical staff’s LS. Moreover, the LS of female medical staff improved with age.

BACKGROUND AND AIM:Burns are common in both everyday life and war. Shock, infection, and organ dysfunction are major complications, among which infection is the most common and has the highest mortality rate. The aim of this study was to evaluate the effect of photodynamic therapy(PDT) on animals suffering from burns.METHODS:Through searching Embase, PubMed, Web of Science, and the Cochrane Library, only controlled trials were collected to study the effects of PDT on animals with burns. The included studies were evaluated for methodological quality by the MINORS (Methodological Index for Non-Randomized Studies) assessment tool, and the data analysis software was used to analyze the data accordingly.RESULTS:16 articles were collected between the earliest available date and August 2022. The results of the meta-analysis showed that PDT effectively reduces TNF-α and IL-6 levels in wounds, and increases bFGF and VEGF levels, PDT can also reduce bacterial colonization at the injury site, accelerate the healing of burn wounds, and improve the survival rate.CONCLUSION:PDT has been shown to have positive effects as a treatment for animals suffering from burns. It affects the levels of cytokines, reduces bacterial counts in wounds, promotes wound healing, and improves animal survival rates.

目的:研究不同的正中神经电刺激(MNES)治疗时间对于昏迷患者促醒的短期疗效的差异.方法:选取124例发病48 h内,格拉斯哥昏迷量表(GCS)评分≤8分的患者,随机分为治疗2 h组(n=42)、治疗4 h组(n=41)和治疗6 h组(n=41).每日常规治疗外,对三组患者分别进行2 h、4 h和6 h MNES.治疗时间为4周,每天一次.分别于治疗前、治疗2周和治疗4周后使用GCS、改良昏迷恢复量表(CRS-R)评估患者意识水平.结果:治疗2周及治疗4周后,各组GCS评分和CRS-R评分均较治疗前明显改善(P<0.05);而治疗4周后,治疗4h组和治疗6h组评分结果优于治疗2h组(P<0.05);治疗4h组和治疗6h组间差异无统计学意义(P>0.05).结论:每天4 h的MNES可有效促进早期意识障碍患者意识恢复,进一步延长刺激时间可能不会提升促醒效果.

Introduction: Postoperative gastrointestinal dysfunction (POGD) is one of the most common complications after colorectal cancer (CRC) surgery and seriously affects the prognosis of patients. Furthermore, current clinical treatment measures have controversial efficacy or strong side effects. Electro-acupuncture (EA) is a safe therapeutic modality for POGD; however, high-quality evidence is scarce at present. This study will aim to evaluate the efficacy and safety of EA for POGD in patients with CRC.Methods: A total of 270 patients with POGD after CRC surgery will be recruited from five hospitals in China and assigned to EA, sham electro-acupuncture (SA), and routine treatment (RT) groups in a 1:1:1 ratio. Patients in the RT group will receive treatment based on enhanced recovery after surgery (ERAS), health education, and routine care. Patients in the EA and SA groups will be treated with EA or SA on the basis of RT, respectively, from postoperative days one to three, once per day. Follow-up will be performed at seven and fourteen days after surgery. The primary outcome is the time to the first postoperative passing flatus. Secondary outcomes include the following: time of first postoperative bowel movement, postoperative bowel sound recovery time, gastro-intestinal symptom rating scale, I-FEED (intake, feeling nauseated, emesis, physical exam, duration of symptoms) scale, postoperative surgical site pain degree, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Version 3.0 (EORTC QLQ-C30 (V3.0)), EORTC Quality of Life Questionnaire -Colorectal Cancer 29 (EORTC QLQ-CR29), postoperative complications, adverse acupuncture events, etc.Discussion: This study design is rigorous, and a scientific placebo acupuncture method is used. The advantages are (1) multi-center, prospective, large sample randomized control with strict quality control; (2) the placebo control method can minimize the true acupuncture effect on the basis of blinding patients as much as possible; (3) the gastrointestinal function and quality of life of POGD patients after passing flatus and defecation will be analyzed. Conclusion: The findings of the 3-arm clinical trial will demonstrate whether EA is effective and safe for patients with POGD after CRC surgery.Trial registration: ChiCTR2200062275 (registered on 31-07-2022).

BackgroundOnline lending on campus is given more attention by researchers as its prominent adverse effects on students. The deficiencies of the previous studies on its psychological factors and intervention strategies were only based on qualitative research. Moreover, there is no study on gender differences. Therefore, our study aims to analyze the gender differences in psychological risk factors and give some practical suggestions for the intervention by quantitative methods.MethodThis is a cross-sectional survey among medical college students in Chengdu. A total of 984 effective questionnaires were collected. The questionnaire includes demographic data, monthly expenses, self-evaluation for three central psychology causing online lending based on empiricism (conformity, comparison, and hedonism), and three psychological assessment instruments (the Chinese version of the Satisfaction with Life Scale, Egna Minnen av Barndoms Uppfostran, and 144-item version of Temperament and Character Inventory). T-test/χ2-test and Binary logistic regression were used to analyze the gender differences in variables and the risk factors of online lending for males and females, respectively.ResultsThe utilization rate of online lending exhibited a significant gender difference (p < 0.001). In addition, there were gender differences in the scores on SWLS and some subscales of C-EMBU and TCI-144. The risk factors for males’ were family members using online lending (OR = 5.527, 95% CI = 1.784–17.125) and lower scores on HA (OR = 0.938, 95% CI = 0.888–0.990). The risk factors for females’ online lending were family members using online lending (OR = 2.288, 95% CI = 1.201–4.362), hedonism (OR = 5.913, 95% CI = 1.327–26.341), and higher scores on mother’s punishment (OR = 1.099, 95% CI = 1.007–1.199).ConclusionThe utilization rate of online lending in males was significantly higher than in females. More attention should be paid to gender differences and the impact of family members’ using online lending on students when intervening in online lending.

Severe burn patients often have anxiety, depression, and stress-related disorders. The case we reported was very nervous and exhibited a long-term high-frequency startle response, which disrupted his sleep seriously and decreased treatment compliance. However, after psychological treatment, his startle response in the daytime and nervousness gradually improved, but the startle response at night remained unchanged. Furthermore, after his wife was given three sessions of psychological treatment to manage her fear of surgery, the startle response at night was significantly reduced. Herein, we summarize the inductive stimuli of the startle response and the critical points of psychological treatment in this case to provide the clinical experience for future research.

Background: Natural disasters such as earthquakes are highly associated with post-traumatic stress disorder (PTSD). The Wenchuan earthquake in 2008 was the worst earthquake in the modern history of China, but the long-term prevalence of PTSD among earthquake victims, particularly those with disabilities, remains unknown. This study investigated the long-term effect of PTSD brought about by the Wenchuan earthquake, and its relationship with demographic factors. Methods: A total of 308 earthquake victims who suffered from physical disabilities resulting from the Wenchuan earthquake were recruited from three hospitals in Sichuan to participate in a 10-year cross-sectional survey. Outcome measures included the Impact of Event Scale-Revised, the World Health Organization Disability Assessment Schedule, and the European Quality of Life-5 Dimensions questionnaire. Results: Statistically significant relationships were found between PTSD and gender, returning to old occupations, loss and/or severe injury of relatives and/or friends, pain, cognition, depression, and anxiety. Female gender, loss of relatives and friends, and a diagnosis of amputation or fracture were significant predictive factors for PTSD. The prevalence of PTSD for earthquake victims with physical disabilities 10 years later was 42.21%. Participation and engagement in daily life and community activities was negatively correlated with PTSD. Conclusions: Earthquake victims still presented with PTSD 10 years after the disaster, particularly among victims who had suffered permanent loss of body parts or other physical disabilities. Identification of the risk factors in victims should be implemented as early as possible to provide them with the best support for their mental wellbeing.

目的:研究"降张五步操"配合以任务为导向的作业训练对脑卒中上肢痉挛患者功能恢复的影响.方法:将60例脑卒中上肢痉挛患者按随机数字表法分为对照组和试验组,每组各30例.2组患者均给予常规康复治疗,对照组在给予常规牵伸降张的同时配合以任务为导向的作业训练,试验组在给予对照组治疗的同时配合"降张五步操",均治疗6周.治疗前、后分别选用改良Ashworth痉挛量表(MAS)评定患者肌张力、简化上肢Fugl-Meyer运动功能评分表(FMA)评定患者上肢功能,改良Barthel指数(MBI)评价患者日常生活能力.结果:治疗6周后,2组患者MAS评分、上肢FMA评分、MBI评分较治疗前均有明显改善(均P<0.05);试验组改善情况较对照组明显(均P<0.05).结论:"降张五步操"配合以任务为导向的作业训练能更有效降低脑卒中上肢肌张力,提高患者上肢运动功能和日常生活能力.

Objective To investigate the effects of acupuncture at Taichong and Taixi points on the regulation of blood pressure and cognitive function in spontaneously hypertensive rats（SHRs）.Methods The randomized block design was used to intervene the blood pressure of SHR and WKY rats by acupuncture. The learning and memory ability of rats were tested by Y-maze, and pathological examination was finally carried out.Results Acupuncture at Taichong and Taixi points effectively delayed the continuous increase of blood pressure in SHR after 11 weeks of age, but not reduced their blood pressure to the level of WKY rats in control group. It effectively improved the number of learning of SHR in Y-maze, but the improvement of memory frequency was not significant. Acupuncture effectively prevented the apoptosis of hippocampal neurons in SHR and prevented the reduction of nissl.Conclusions Acupuncture at Taichong and Taixi points could effectively slow the rising trend of SHR blood pressure, and it has certain effect on the improvement of learning and memory ability and it has been confirmed by histopathology that acupuncture plays a positive role in preventing hippocampal neuronal apoptosis.

目的:探讨以护理工作室为依托的高级实践护士(APN)模式在缺血性脑卒中病人居家康复中的应用效果.方法:采用便利抽样的方法,将2020年10月—2021年1月成都市某三级甲等医院康复科和神经内科的缺血性脑卒中病人56例随机分为干预组29例和对照组27例.干预组采用APN模式依托护理工作室的方法进行缺血性脑卒中居家康复指导,对照组采用传统出院指导及定期健康随访的方法.分别于出院时和出院后1个月、3个月、6个月以及1年使用美国国立卫生研究院卒中量表(NIHSS)、改良Rankin量表(mRS)、改良Barthel指数评定量表(MBI)以及汉密尔顿抑郁量表(HAMD)对两组病人的神经功能恢复状况、生活自理能力及心理状况进行评估.结果:干预组病人NIHSS评分在出院1个月及3个月得分低于对照组,mRS评分在出院3个月及6个月得分低于对照组,MBI得分在出院3个月、6个月以及1年得分高于对照组,HAMD评分在出院1个月、3个月、6个月以及1年得分低于对照组,差异均有统计学意义(P<0.05).重复测量方差分析显示,出院时长、分组与出院时长的交互作用对NIHSS、mRS以及HAMD评分有影响(P<0.05).结论:APN模式依托护理工作室能改善缺血性脑卒中病人神经功能恢复,提高病人生活自理能力并且有利于病人心理状况康复.

遗传性痉挛性截瘫(hereditary spastic paraplegia, HSP)由Seeligmuller于1874年首先报道,是以双下肢进行性肌张力增高、肌力下降和剪刀步态为特征的综合征.临床表现以遗传性、进展性、痉挛性截瘫为主,症状多样.由于HSP发病率较低,加上其进展缓慢,诊断需借助基因检测,基因检测是目前确诊HSP的金标准.通过检测最常见的两种HSP相关基因SPAST和ATL1,也称SPG4和SPG3A,可以诊断50％以上的常染色体显性遗传单纯HSP[1].由于HSP发病后呈进行性发展,早期功能障碍一般不严重,很多患者未引起足够重视,加上基层医疗机构对该病诊断技术和设备能力有限,导致很多患者未能及时就诊及确诊,康复介入个案较少,目前国内尚无关于HSP患者康复报告,现报告我院收治一例HSP4型患者的康复经过,对康复疗效进行分析总结,为HSP患者的临床康复提供经验.

目的:观察FES康复踏车联合太极运动想象疗法对脑卒中患者下肢运动功能、本体感觉以及日常生活能力(ADL)的影响.方法:采用随机单盲单中心的研究方法,选取成都市第二人民医院住院的88例脑卒中患者,采用随机数字表法分为观察组和对照组2组各44例.对照组患者进行常规药物治疗和基本康复治疗,观察组在对照组治疗基础上采用FES康复踏车联合太极运动想象疗法治疗,每次20 min,每天1次,每周治疗5天,共治疗6周.比较2组患者治疗前后下肢肌群(股四头肌、股二头肌、腓肠肌、胫骨前肌)的肌电积分值(iEMG)、Fugl-Meyer评定量表(FMA)下肢评分、Berg平衡量表(BBS)评分、改良的Barthel指数评定量表(MBI)评分,比较2组患者治疗后偏瘫侧本体感觉各分区PROM偏差度.结果:治疗前,2组患者股四头肌、股二头肌、腓肠肌、胫骨前肌iEMG值组间比较差异均无统计学意义(均P>0.05);治疗后,观察组股四头肌、股二头肌、腓肠肌iEMG值和对照组股四头肌iEMG值均明显大于治疗前(均P<0.05),观察组股四头肌、股二头肌以及腓肠肌iEMG值均大于对照组(均P<0.05)、胫骨前肌iEMG值与对照组比较差异无统计学意义(P>0.05).治疗后,观察组患者偏瘫侧本体感觉PROM偏差度3个区间均明显小于对照组(均P<0.05).治疗后2组患者FMA下肢评分、BBS评分、MBI指数均较治疗前明显升高(均P<0.05),且观察组各评分均明显高于对照组(均P<0.05).结论:FES康复踏车联合太极运动想象疗法,可以有效改善患者下肢运动、平衡功能,提高患者下肢肌力、本体感觉以及ADL,最终达到优化整合各种康复干预方法,可以更早、更高效的介入康复治疗,值得临床进一步研习和推广应用.

目的:分析成都市多家医院康复医学学科的人员构成情况，探讨康复医学学科专业人员的合理配置。方法:通过调查成都22个区(市)县辖区内综合医院、中医医院康复医学科和康复医院的人员配置情况，结合国内外先进康复机构的经验，探索康复医学科的专业人员合理配置。结果:目前成都区域内康复医师、康复治疗师严重不足，缺口较大；康复医师、康复治疗师培养体系不完善、过程不规范，人员质量参差不齐。不同人员配置水平医院的康复医疗服务能力也有所差别。结论:康复医学科专业人员的合理配置应明确康复科医师的专业类别和职责，推动康复治疗师的规范化培训，建立注册制度，从而逐步形成符合学科发展规律和共识的运作模式。

调查显示,脑卒中发病后均有不同程度的功能障碍,易导致患者焦虑甚至抑郁,且康复周期长,医疗费用高,易给患者及其家庭造成压力,亟需强有力的社会支持.医务社会工作者可以运用专业的理论、方法与技能根据患者需求为其提供心理、社会、经济等支持.作者以四川省成都市医务社会工作实践为素材,选取了脑卒中患者的典型个案,从资源链接角度进行专业介入,通过完善支持网络,促使患者缓解消极情绪,积极治疗.结案后,医务社工结合实务过程从自身角色、资源整合与运用、医院特性方面进行了反思.

工伤事故的发生对职工造成了不同程度的伤害,包括生理层面、心理层面和社会层面等.医务社会工作者将工伤职工纳入服务对象范畴,了解并满足其需求,处理与其相关系统的关系,提高其在院期间的生活质量,促进其回归社会、重返工作岗位.文章以成都市第二人民医院康复医学科多专业合作模式下对工伤患者的介入为研究内容,从医务社工的角度进行服务总结,并探索医务社工在多专业角度下的服务内容.

Objective:To compare the effects of repetitive transcranial magnetic stimulation (TMS) at three different relatively high frequencies on neuropathic pain so as to find the best frequency.Methods:One hundred Sprague-Dawley rats were randomly divided into a sham operation group, a model group, a TMS group and a control stimulation group. The TMS group was further divided into a 5Hz group, a 10Hz group, and a 20Hz group. The rats in the model, control stimulation and TMS groups received constriction injury of the sciatic nerve, while the rats in the sham group were given a sham version of the operation. On the third day after the operation the rats in the TMS group and the control stimulation group began to receive TMS treatment. Neuropatic pain was evaluated on the day before the operation, and on the 3rd, 5th, 7th, 10th and 12th days after the operation. The evaluations included the paw withdrawal thermal latency (PWTL) and the paw withdrawal mechanical threshold (PWMT).Results:The average PWTLs and PWMTs in all of the TMS groups increased with the TMS treatment. Those of the 10Hz and 20Hz groups were significantly higher than the 5Hz group′s average, while there were no significant differences between the 10Hz group and 20Hz group.Conclusions:High-frequency TMS at different frequencies has different effects on neuropathic pain, at least in rats. The treatment efficacy at 10 and 20Hz is superior to that at 5Hz.