This paper elaborated that wheelchairs are the most important assistive devices for people with mobility impairment to maintain their health, improve their quality of life and promote their social participation. The situation of low service level was analyzed due to the lack of knowledge, organizations, professionals and products. Based on the foreign standard of practice for wheelchair service, the strategies and steps of wheelchair service provision in China were carried out to arouse the attention of relevant professionals, who could be active participants in wheelchair service practice and research

Objective To evaluate the effect of calcipotriol on the proliferation of and cytokine secretion by melanocytes and perilesional CD8+ cytotoxic T lymphocytes (CTLs) from patients with vitiligo.Methods Melanocytes isolated from abdominal skin and CD8+ CTLs from perilesional skin of patients with vitiligo were subjected to successive culture in vitro.After several passages,the melanocytes and CD8+ CTLs were cultured alone or in combination with or without the presence of various concentrations of calcipotriol for 24 to 48 hours.MTS (3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfopheny)-2H-tetrazolium,inner salt) method was used to evaluate the proliferative activity of cells,enzyme-linked immunosorbent assay to determine the levels of interleukin (IL)-6,tumor necrosis factor (TNF)-α and interferon (IFN)-γ in the culture supematant of cells,flow cytometry to detect cell apoptosis.Some co-cultured melanocytes and CTLs were treated with calcipotriol of 10-8 mol/L and anti-IL-6 antibody of various concentrations (0,1,2,2.5,5,10 mg/L) for two days followed by enumeration of cells.The concentrations of 108 and 10-9 mol/L (calcipotriol) were chosen for relevant tests.Results There was a marked apoptosis in MCs after coculture with CD8+ CTLs.The 24-hour treatment with calcipotriol of 104 and 10-9 mol/L had no obvious effect on the proliferation of melanocytes cultured alone (both P ＞ 0.05),but accelerated the proliferation of melanocytes cocultured with CTLs (both P ＜0.05) as well as that of CD8+ CTLs cultured alone or in combination with melanocytes (all P ＜0.05).A statistical decrease was observed in IL-6,TNF-α and IFN-γlevels in the supernatant of cocultured melanocytes and CTLs compared with those in the supernatant of melanocytes and CTLs cultured alone,and calcipotriol of 10-9 mol/L intensified the decrease in supernatant IL-6 level (t =2.89,P ＜0.05),but no statistical changes were noted for the level of TNF-α or IFN-γin the supernatant of the coculture system after treatment with calcipotriol of 104 or 104 mol/L compared with that before treatment (both P ＞ 0.05).In the coculture system pretreated with calcipotriol of 10-8 mol/L,the number of CD8+ CTLs significantly decreased (t =3.15,P ＜0.05),whereas that of melanocytes significantly increased (t =3.53,P ＜0.05) after the treatment with anti-IL-6 antibody of 5 mg/L.Conclusions Perilesional CD8+ CTLs have a specific cytotoxic effect on melanocytes,and calcipotriol may inhibit the cytotoxic effect of CD8+ CTLs by suppressing the secretion of IL-6,which may partly explain the therapeutic mechanism of calcipotriol for vitiligo.

Objectvie: To observe the law of heat transfer in Zusanli during the process of moxibustion. Methods: Thetemperature change of Zusanli was detected by self-made high-precision temperature sensor while moxibustion on lowerextremities acupoints on six meridians of foot in healthy volunteers for fifteen minutes, the temperature change curve andtemperature change rate curve were drawn with Origin software. Results: Temperature change curve of Zusanli was thebiggest when moxibustion on acupoints in stomach meridian of foot yangming, especially for Shangjuxu acupoint.Whenthe acupoints near the level of Zusanli are moxibusted, the temperature change curve of Zusanli changes obviously.Temperature change rate curves of Zusanli were basically in coincidence when moxibustion on lower extremities acupoints on six meridians of foot, and it had a downward trend. Conclusion: Heat transfer between meridians andacupoints have propagated sensation along channel, regional characteristics, consistency of transmission rate, in theprosess of moxibustion.

Objective To master the basic conditions of Kaschin-Beck disease areas and patients in Shaanxi Province,and provide a theoretical basis for prevention and control of Kaschin-Beck disease.Methods In 2018,the basic situation of the villages in Kaschin-Beck disease areas of Shaanxi Province and the implementation of prevention and control measures were investigated.The data of general population information,condition and treatment were collected from all the disease affected villages.Results The Kaschin-Beck disease areas of Shaanxi Province involves 4 194 disease affected villages in 62 counties.Among them,3 886 villages had completed the whole village water reform,215 villages changed some of the water,and 93 villages had not changed water;there were 3 835 disease affected villages met the hygienic standard of drinking water,accounting for 91.44％.A total of 60 157 patients with Kaschin-Beck disease were diagnosed.The male-female ratio was 1.0:0.9 (31 531:28 626).The age of the patients was mainly between 40 and 65 years old.There were no new cases of children.Among them,38 448 were degree Ⅰ patients,18 589 were degree Ⅱ patients and 3 120 were degree Ⅲ patients.The occupational distribution of patients was mainly peasant,with 59 703 cases,accounting for 99.25％.The distribution of education was mainly primary school,with 31 108 cases,accounting for 51.71％.There were 876 patients who had completed surgery and 23 284 patients who had been treated with long-term medication.Conclusions In recent years,there is no new case of Kaschin-Beck disease in children in Shaanxi Province.However,the condition of Kaschin-Beck disease in adults is serious,and great efforts should be made in rescue.

Objective To observe the effec t and safety of posaconzole in prophylactic antifungal treatment of high-risk patients with hematological malignancies. Methods The effect of posaconzole on prevention of invasive fungal disease (IFD) during chemotherapy in 102 patients with hematological malignancies in Shanghai Ruijin Hospital from February 2014 to April 2017 were analyzed retrospectively. The correlation analysis was carried out by Spearman analysis. Results A total of 102 patients were included, and only 2 (1.96%) patients had IFD. 2 patients died because of development of hematological malignancies. 11 (10.8%) patients had to discontinuation of posaconzole because of sever adverse events. Two patients with IFD and 1 case of undiagnosed IFD had to discontinue posaconzole. The total rate of discontinuation was 13.7 % (14/102). There was no correlation between the time of using pothiazol and the time of hospitalization (rs= -0.02, P= 0.853) and the time of neutrophilic deficiency (rs= 0.167, P= 0.113), but the time of hospitalization was positively correlated with the time of neutrophilic deficiency (rs = 0.448, P=0.000). Conclusion Posaconzole could effectively and safely prevent IFD in patients with hematological malignancies.

Objective To observe the clinical efficacy and safety of the lenalidomide-based therapy regimen in the treatment of high-intermediate-risk B-cell non-Hodgkin lymphoma (B-NHL). Methods A retrospective analysis of 23 high-intermediate-risk B-NHL patients who were admitted to Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from June 2015 to February 2018 was conducted, of which 7 relapsed or refractory (R/R) patients received lenalidomide combined with rituximab (R2) and plus different salvage chemotherapy regimens (DHAP, GDP, ICE) of each 28-day cycle; 5 elderly patients were initially treated with R2 of each 28-day cycle; 11 patients were administered by maintenance monotherapy of lenalidomide of each 28-day cycle, or R2 therapy of 3-month cycle. The primary endpoint was overall response, and the secondary endpoints were progression-free survival (PFS) and safety. Results The median follow-up time was 4.5 months (1-20 months) in the R/R and elderly initial-treated patients. The median time to response in the R/R group was 3 months (2-7 months), of which 3 patients were complete remission (CR), overall response was 3 patients, and the median PFS was 7 months. The median time to response in the elderly initial treatment group was 4 months (2-5 months), 1 of 4 eligible patients was CR and 2 were partial remission (PR), overall response was 3 patients, and the median PFS time had not reached. The median follow-up time in the maintenance treatment group was 15 months (2-32 months), the median PFS time had not reached, and the 1-year PFS rate was 64％ (95％ CI 36％-92％). The most common grade 3-4 adverse events were leukopenia and thrombocytopenia, each accounting for 35％, and most patients were tolerable. Conclusion Lenalidomide as an immunomodulator is effective and safety for elderly initial treatment, R/R and maintenance treatment patients with high-intermediate-risk B-NHL, and it can prolong their survival.

Anti-tumor necrosis factor (T N F) - α monoclonal antibody is a first-line treatment for inflammatory bowel disease, and its therapeutic response has attracted more and more attention. Although therapeutic drug monitoring and antidrug antibody monitoring have been widely used in clinic, however, there are no laboratory indicators that can predict the therapeutic response to anti-TNF-α before the drug treatment, so as to provide a guidance of selecting therapeutic drug. Studies have shown that some baseline biomarkers can predict the therapeutic response to anti-TNF-α. This article reviewed the progress of research on biomarkers in predicting efficacy of anti-TNF-α monoclonal antibody in treatment of inflammatory bowel disease.

Objective To carry out the function evaluation and clinical adaptation service of assistive devices for a bilateral wrist-palm disarticulation case in the framework of International Classification of Functioning, Disability and Health (ICF). Methods By evaluating dysfunction and actual demand of the case, assistive devices were selected and applied in daily living, home, education and employment to achieve corresponding accessibility in activities and participation. Results and Conclusion The framework of ICF is important in evaluation of limb dysfunction and adaptation of assistive devices.

Objective To investigate the clinical application of three-dimensional intracavitary/free-hand interstitial brachytherapy technique in radical radiotherapy for cervical cancer. Methods A retrospective study was conducted on the clinical data of patients with cervical cancer who underwent radical radiotherapy using CT-guided three-dimensional intracavitary/free-hand interstitial brachytherapy technique in The Affiliated Cancer Hospital of Nanjing Medical University from April 2019 to September 2021. The short-term efficacy and adverse reactions were analyzed, and the independent predictors affecting short-term efficacy were evaluated by logistic risk regression model. Results A total of 182 patients were included, and all patients successfully completed the treatment. Clinical efficacy assessment performed 3 months after treatment revealed an overall response rate of 90.65%; the incidence of grade 3 and 4 adverse reactions in the lower gastrointestinal tract was 4.4% during treatment. After reclassifying stage IIIC patients according to the International Federation of Gynecology and Obstetrics (FIGO) 2009 staging system and including factors affecting the stage, it was found that the tumor volume before brachytherapy was the main factor affecting the clinical efficacy of patients at this stage (P = 0.004). Conclusion As a key method in radical radiotherapy for cervical cancer, three-dimensional intracavitary/free-hand interstitial brachytherapy technique is safe and effective and can be quickly popularized in primary hospitals beyond regional cancer centers for cervical cancer brachytherapy.