BACKGROUND:Early rehabilitation after total knee arthroplasty (TKA) can help the rapid functional recovery of knee,but some patients are fear of moving and refuse to do exercising because of kinesiophobia,thereby delaying functional recovery.Foreign study has confirmed that patients with cognitive behavioral therapy (CBT) can effectively alleviate kinesiophobia,but no related studies have been reported in China.OBJECTIVE:To explore the effectiveness of CBT on patients with kinesiophobia after TKA.METHODS:108 patients with kinesiophobia after TKA were recruited from Department of Orthopedics,the First Affiliated Hospital of Zhengzhou University,China between March 2014 and January 2015,and were then equivalently randomized into experimental and control groups using random number table.Both groups were subjected to conventional treatment,while the experimental group received extra CBT.The scores of Tampa Scale of Kinesiophobia and American Knee Society were evaluated immediately,1,3,and 6 months after hospital discharge;the hospitalization time and total hospitalization expenditure were compared between two groups immediately after discharge.RESULTS AND CONCLUSION:The scores of Tampa Scale of Kinesiophobia in the experimental group were significantly lower than those in the control group at different time points postoperatively (P ＜ 0.05).The scores of American Knee Society in the experimental group were significantly higher than those in the control group at 3 and 6 months after discharge and kept on rising (P ＜ 0.01),but showed no significant difference at discharge and 1 month after discharge (P ＞ 0.05).(2) The hospitalization time and total hospitalization expenditure in the experimental group were significantly lower than those in the control group (P ＜ 0.01).(3) To conclude,CBT cannot only shorten the hospitalization time and total hospitalization expenditure,but also relieve kinesiophobia,which is conductive for functional recovery of the knee.

Objective Currently, there are few articles about kinesiophobia in patients with total knee arthroplasty (TKA) in China.This study aims to investigate the incidence of kinesiophobia and its influencing factors in TKA patient, and provide evidence for the intervention of kinesiophobia.Methods A total of 298 TKA patients from our hospital were investigated by general information questionnaire, Tampa Scale of Kinesiophobia (TSK), Knee Self-Efficacy Scales, Simplified Coping Style Questionnaire and Social Support Rating Scale.Single-factor analysis and logistic regression analysis were conducted to explore influencing factors.Results The score of TSK was 38.50±13.52, and 31.88% of TKA patients reported kinesiophobia.Logistic regression analysis showed that duration of pain (OR=5.546, 95%CI: 2.143-14.353), education level (OR=0.145, 95%CI: 0.067-0.314), self efficacy(OR=0.606, 95%CI: 0.470-0.780), positive response (OR=0.784, 95%CI: 0.683-0.900), objective support (OR=0.807, 95%CI: 0.691-0.943) and utilization of social support (OR=0.507, 95%CI: 0.461-0.705) were factors influencing kinesiophobia in TKA patients.Conclusion Attention should be paid to the kinesiophobia in TKA patients, especially those influencing factors including duration of pain, education level, and objective support.Health care providers should encourage early stage rehabilitation exercise to improve the postoperative knee function of TKA patients.

Objective To investigate the reproductive endocrine status of women with epilepsy at childbearing age and to systematically analyze the clinical features of reproductive endocrine disorders,especially polycystic ovarian syndrome (PCOS),to facilitate early detection and timely intervention.Methods In this study,scoring of anthropometry and physical signs,menstrul assessment,examination of sex hormone and pelvic ultrasound in women with epilepsy at childbearing age were performed,and the data such as overweight,central obesity,oligo/amenorrhea,luteinizing hormone (LH)/follicule-stimulating hormone (FSH),hyperandrogenism and polycystic ovary (PCO) were collected. The characteristics of their reproductive endocrine hormone disorders were analyzed statistically. Results The age of these patients was (22. 5 ± 7.0 ) years,and women younger than 30 years old and at their peak fertility accounted for 84. 89%. The prevalence rate of PCOS in women with epilepsy at childbearing age (12. 75% ) was significantly higher than that of ordinary women at childbearing age (7.2%) in China.Highly specific indicators for PCOS were hyperandrogenism (100%),LH/FSH ＞ 2 (93%) and oligo/amenorrhea (90%),whilst the highly sensitive indicators for PCOS were PCO (92%), oligo/amenorrhea (85%) and hyperandrogenism (54%). This study revealed statistically significant difference in LH,LH/FSH and testosterone (T) between PCOS group (LH: (10.24 ± 6.92) IU/L; LH/FSH;(2.20 ± 1.16);T: ( 1.07 ± 0. 35) ng/ml) and non-PCOS group ( LH: (4. 16 ± 2.62 ) IU/L; LH/FSH:( 0. 87 ± 0. 56 );T: (0. 46 ±0. 25) ng/ml,t = -3. 899,-4. 240 and -4. 918 respectively,all P ＜0. 01 ). Conclusions Hormone indices are objective indicators for the diagnosis of PCOS. In clinical practice,attention should be paid to height,weight,abodominal circumference,menstrul history and ultrasound examination of the ovary in women with epilepsy.When reproductive endocrine hormone disorders are suspected from clinical features,the sex hormones (T,LH,and FSH ) should be checked to allow timely detection and early interventions.

BACKGROUND:Cytokines play an important role in the occurrence and development of graft-versus-host disease, but there is a current lack of reports on the association between cytokines and graft-versus-host disease after al ogeneic hematopoietic stem cel transplantation for treatment ofβ-thalassemia major.
OBJECTIVE:To investigate the association between cytokines and graft-versus-host disease after al ogeneic hematopoietic stem cel transplantation forβ-thalassemia major.
METHODS:We observed the dynamic variation of interleukin 6, interleukin 8, interleukin 12, tumor necrosis factor-αand macrophage migration inhibitory factor in 11 children withβ-thalassemia major before onset of graft-versus-host disease, when graft-versus-host disease occurred, at days 4 and 7 after onset of graft-versus-host disease, and when graft-versus-host disease disappeared.
RESULTS AND CONCLUSION:There was a significant difference in serum levels of interleukin-6, interleukin-12, tumor necrosis factor-α, macrophage migration inhibitory factor in different time points, and the highest levels of different cytokines appeared when graft-versus-host disease occurred, fol owed by those at 7 days after
graft-versus-host disease. There was a significant difference in serum levels of interleukin-8 in different time points, and the highest level appeared at 4 days after graft-versus-host disease. The dynamic expression of interleukin-6, interleukin-8, interleukin-12, tumor necrosis factor-α, macrophage migration inhibitory factor can estimate the immune function ofβ-thalassemia major patients who develops graft-versus-host disease after al ogeneic hematopoietic stem cel transplantation, and can be used as the immunobiology indicators for the early diagnosis of graft-versus-host disease.

The birth and development of oocyte donation technology have brought hope for women with poor ovarian reserve and repeated failure for in vitro fertilization, as well as for those with chromosomal abnormalities, premature ovarian failure, or at perimenopausal or menopausal stages. It has not only preserved their reproductive right, but also stabilized their families and increased social harmony. However, this technology does not only involve infertile couples themselves, but also social and ethical issues concerning their families and the society. This paper has reviewed and discussed the hot issues concerning oocyte donation, e.g., source of eggs, compensation for donors, prerequisites for recipients and donors, privacy of donors, and made suggestions for further improvement for the administration of oocyte donation.
Disclosure ; ethics ; Ethics, Medical ; Family Planning Services ; ethics ; methods ; Female ; Fertilization in Vitro ; ethics ; methods ; Humans ; Infertility, Female ; Oocyte Donation ; ethics ; methods ; Tissue Donors ; ethics

[Objective]This study was designed to identify the risk factors related with reproductive endocrinology disorder in Chinese women of child-bearing age with epilepsy.[Methods]The clinical data of 102 women with epilepsy were collected.The patient were grouped according to seven aspects(seizure onset age,seizure type,seizure frequency,duration of epilepsy,AED type,age of start AED therapy and duration of therapy)and the contribution of these factors in development of PCOS and its components were analyzed.[Results]The incidence of hyperandrogenemia in the patients with an early onset age(≤14 years old)was higher than the ones with an onset age＞14 years old.Onset age≤14 was the risk factor of hyperandrogenemia in logistic regression analysis.The incidence of a/oligomenorrhea,polycystic ovaries,hyperandrogenemia and PCOS in the valproate-treated women were 40.63%,50.00%,15.65%,and 34.38%,respectively,which were higher than the no-therapy group and nonvalproate treated group.Valproate therapy was the risk factor of PCOS and its components.[Conclusion]Valproate therapy was the risk factor of PCOS and its components in Chinese women of child-bearing age with epilepsy.Onset age≤14 was the risk factor of hyperandrogenemia.

Objective To evaluate the reliability and validity of the Chinese Version of the Tampa Scale of Kinesiophobia (TSK-11) in patients receiving total knee arthroplasty. Methods The Chinese ver-sion of TSK-11 was translated from the original one,and adjusted for cultural adaptation. The reliability and validity of Chinese TSK-11 were tested among 254 eligible patients receiving total knee arthroplasty from a tertiary hospital in Henan province by convenience sampling. Results Three common factors which ex-plained 65. 177% of the total variance was extracted after the exploratory factor analysis,and each item had high factor loading quantity (>0. 4). The scale CVI was 0. 83~1. 00,the S-CVI/UA and S-CVI/Ave were 0. 91 and 0. 94,respectively. The Cronbach's α coefficient of the scale was 0. 883,and the test-retest reliabil-ity was 0. 798. The item-to-total correlations ranged from 0. 424~0. 757 (P<0. 05). Conclusion The Chi-nese version of TSK-11 has been proved to be reliable and valid with fewer understandable items,and short completion time. It can be used as a valuable tool for evaluating kinesiophobia in patients following total knee arthroplasty.

Life-space, as a multidimensional structure, is an important indicator for measuring individual movement. Since the first proposal of life-space in 1985, it has gradually been applied in multiple fields. At present, the development of life-space in foreign countries is becoming increasingly mature, while there is little research on this aspect in China. This article reviews the definition, evaluation tools, and application progress of life-space in cardiac rehabilitation, so as to provide reference for the research and application of life-space in home-based cardiac rehabilitation in China.

Objective:To explore the experience and feelings of undergraduate nurses in low-value care de-implementation, so as to provide reference for formulating specific strategies for low-value care de-implementation.Methods:From July to October 2023, purposive sampling was used to select 14 full-time undergraduate nurses from the First Affiliated Hospital of Zhengzhou University as research subjects. The phenomenological research method was used to conduct semi-structured in-depth interviews, and Colaizzi 7-step analysis method was used to analyze the data.Results:Three themes were extracted in total. Highly recognizing the low-value care de-implementation included reducing nurses' workload, improving patients' medical experience, and promoting harmonious nurse-patient relationships. Cognitive dissonance for low-value care de-implementation involved low efficiency cognition and maintaining a wait-and-see attitude. Low-value care de-implementation was hindered by multiple factors, including a lack of critical thinking, concerns about medical nursing risks, a lack of evidence-based nursing skills, a lack of organizational support, and a lack of medical knowledge among patients.Conclusions:Undergraduate nurses highly recognize the significance of low-value care de-implementation, but still face many challenges in their clinical practice. Multiple measures should be taken to promote the low-value care de-implementation in clinical practice.

Objective:To develop a virtual reality (VR) exercise rehabilitation system for home-based patients with spinal cord injury, and test patients' acceptance and experience.Methods:The VR exercise rehabilitation system for home-based patients with spinal cord injury was developed by a multidisciplinary team based on the home rehabilitation needs, evidence, and clinical experience of spinal cord injury patients, and further improved after recommendations from experts and patients. From February to July 2024, convenience sampling was used to select 148 patients with spinal cord injuries admitted to the Department of Spinal Cord and Neurological Function Reconstruction at the China Rehabilitation Research Center. Acceptance Questionnaire was used to investigate patients' acceptance of the system. Thirteen patients with spinal cord injuries were selected for semi-structured interviews to explore the themes of their experiences using VR exercise rehabilitation system for home-based patients with spinal cord injury.Results:A VR exercise rehabilitation system for home-based patients with spinal cord injury was developed, which includes four aspects of personal profile, personal assessment, training selection, and care knowledge. The total acceptance score of this system among 148 patients was (87.69±1.59). Through semi-structured interviews, three themes were identified involving excellent experience, expectation of rehabilitation effects, satisfaction with functionality and hope for continuous system updates.Conclusions:The design of VR exercise rehabilitation system for home-based patients with spinal cord injury is scientifically reasonable, which can further verify the rehabilitation effect of the system.