社区康复是机构康复的延伸，是康复的重要组成部分，让康复进入社区是工伤保险乃至工伤康复给予工伤职工的切实权益和福祉。因此，积极探索，因地制宜，多方式、多渠道建立社区康复服务模式是本文的主要目的，介绍资源中心社区服务模式是本文的重点。

BACKGROUND:The meningeal defect patients can be treated with artificial dural materials combined neurosurgical techniques which can protect the integrity of brain tissue. OBJECTIVE:To analyze the biocompatibility and application feasibility of various artificial dura mater materials. METHODS:The artificial dura materials were classified according to the different sources, and the biocompatible and application feasibility of various artificial dura mater materials were analyzed, as wel as the advantages and disadvantages of various materials. The anticoagulant and hemolytic properties of the materials were analyzed through recalcification test and hemolysis test. 100 patients receiving col agen membrane repair selected from Department of Neurosurgery, Dongfang Hospital of Beijing University of Chinese Medicine were observed. RESULTS AND CONCLUSION:The dural repair materials mainly include autologous material, al ograft materials, dissimilar materials, synthetic materials and natural materials. Each kind of material has its advantages and disadvantages. Meningeal defect complications include cerebrospinal fluid leakage, pseudo meninges, infection and arachnoiditis. There are many problems of artificial dural materials to be solved, and the novel biological dural materials and absorbable materials are the direction of dural material research.

This paper introduced the community service of industrial injury insurance in 3 years in a community in Zhuzhou, Hunan, and the problems and difficulties of the community service. 4 kinds of advice were suggested to improve the community service.

Objective To compare the cost-effectiveness of intervention protocols with or without rehabilitation approaches for burn patients.To explore the pros and cons of the two treatment programs,especially in terms of efficacy.Methods Data on 164 burn patients hospitalized in four hospitals in Hunan Province were collected and compared in terms of the therapeutic interventions employed,the direct medical costs and the effects obtained at the end of the first two months of hospitalization.The patients were divided into an early rehabilitation therapy group and a control group,based on the interventions they received.Results The average total direct medical cost of the early rehabilitation group was significantly lower than that of the control group [((￥)59 380.80 ±196.87) versus ((￥)67 471.62 ±217.23)].The average Vancouver scar scale (VSS) results in the early rehabilitation group were significantly better than those of the controls,but their Zung's Self-rating Anxiety Scale and Barthel index scores were not.The average cost-effectiveness ratio (C/E) of the early rehabilitation group as judged by these scores was lower than that of the control group.Conclusion Early rehabilitation can improve the therapy of burns patients and reduce subsequent expenditures.It is a cost-effective approach to treating burns patients.

Background Idiopathic orbital inflammatory pseudotumor (IOIP) is a commom orbital disease,with serious eye symptoms and replase tendency,and its pathogenesis is still unclear.Nuclear factor-κB (NF-κB)-related proteins participate in many important pathophysiological process,however,whether NF-κB plays a role in the IOIP process is worthy of attention.Objective This study was to explore the roles of NF-κB pathway in IOIP pathogenesis.Methods Twenty-four IOIP specimens were collected during surgery in Beijing Tongren Hospital from September 2010 to May 2016.The histopathological characteristics of IOIP were examined by hematoxylin and eosin staining.The expression and location of NF-κB/p65,p-p65,p50 and inhibitor of κB (IκB-ot) were detected by immunohistochemistry and verified by immunocytochemistry and Western blot assay.Results The histopathological features of IOIP were numerous small lymphocyte infiltraion and fibrous tissue proliferation,and a lot of epithelioid cells were seen in lacrimal gland-involved specimens.NF-κB/p65 was positively expressed in the cytoplasm of all 24 specimens and the nucleus in 15 specimens with the expressing rate of 62.5％.p50 was expressed in the cytoplasm in 22 specimens with the expressing rate of 91.7％ and in the nucleus in 17 specimens with the expressing rate of 70.8％.The positive expression of p-p65 was found in 22 specimens with the expressing rate of 91.7％,and IκB-α was expressed in the cytoplasm of 11 specimens with the expressing rate of 45.8％.These results were confirmed by immunocytochemistry and Western blot assay.Conclusions NF-κB pathway is activiated during IOIP process,and NF-κB pathway may be involved in the pathogenesis of IOIP.

Objective To investigate the value of cytokines in bile combined with clinical indices in predicting the degree of liver injury after liver transplantation. MethodsA total of 16 patients undergoing liver transplantation who were hospitalized in Center of Organ Transplantation, The Affiliated Hospital of Qingdao University, from January to December 2018 were enrolled, and according to the level of alanine aminotransferase (ALT) on day 1 after surgery, the patients were divided into mild liver injury (ALT ＜500 U/L) group with 10 patients and severe liver injury (ALT ＞500 U/L) group with 6 patients. Bile samples were collected on days 1, 3, 5, and 7 after surgery, and MILLIPLEX assay was used to measure the levels of 17 cytokines. R software was used to perform principal component analysis (PCA) of bile cytokines and clinical indices and gene ontology (GO) enrichment analysis of bile cytokines. The two-independent-samples t-test was used for comparison of normally distributed continuous data between two groups; The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups. A Spearman correlation analysis was performed to evaluate the correlation between clinical indices and bile cytokines. ROC curve analysis was used to evaluate the predictive value of cytokines in bile and clinical indices for liver injury after liver transplantation. ResultsCompared with the mild liver injury group, the severe liver injury group had significantly higher expression levels of bile Fractalkine (Z=-2.828, P=0.003), soluble CD40 ligand (sCD40L) (Z=-2.850, P=0.008), interleukin-4 (Z=-2.398, P=0.017), CXCL10 (Z=-2.475, P=0.023), and macrophage inflammatory protein-1α (Z=-1844, P=0.043). The correlation analysis showed that on day 1 after liver transplantation, aspartate aminotransferase, ALT, and lactate dehydrogenase were positively correlated with the levels of several cytokines in bile (all P＜0.05). The area under the ROC curve of Fractalkine, sCD40L and AST were 0.933 (0.812-1.000), 0.833 (0.589-1.000) and 0.917 (0.779-1.000), respectively, suggesting that AST and Fractalkine and sCD40L in bile on the first day after liver transplantation have significant predictive value for liver injury. The results of PCA showed that bile cytokines combined with clinical indices on day 1 after liver transplantation could better distinguish the patients with mild liver injury from those with severe liver injury. GO analysis showed that bile cytokines were associated with positive feedback regulation of external stimulus, cell chemotaxis, receptor ligand activity, cytokine activity, and cytokine-cytokine receptor interaction. ConclusionFractalkine and sCD40L in bile can predict the degree of liver injury after liver transplantation.

OBJECTIVE: To compare the cost-effect of 2 therapeutic regimens and to find out a better therapeutic regimen with reasonable price and better effect, hoping to improve the quality of burn patients and reduce the waste of medical resources. METHODS: We collected 1017 burn patients from Hunan and Sichuan, and divided them into a research group (the moist exposed burn therapy group) and a control group (the escharectomy and grafting group). We analyzed the cost and effect of the 2 groups from general condition, direct medical cost during treatment and curative effect. RESULTS: The average total cost of the research group [93633.71 (82260.79, 107576.34) yuan] was significantly lower than the control group [175077.93 (131433.23, 228918.83) yuan] (P<0.05). The total effective rate of the research group was higher (97.28%) than that in the control group (92.89%) (P<0.05). The cost-effect of the research group (962.52) was better than that of the control group (1884.79). CONCLUSION Cost-effect analysis is objective and direct in the evaluation of different treatments. The moist exposed burn therapy is a better and cheaper therapeutic regimen.
Adolescent ; Adult ; Burns ; economics ; surgery ; therapy ; China ; Cost-Benefit Analysis ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Abstract The possible mechanisms of developmental dyslexia mainly include the hypothesis of language framework and the hypothesis of non-verbal framework. The language framework assumes that people with developmental dyslexia may exhibit defects in phonetic awareness, rapid naming, phonetic memory, and orthographic processing. Studies of developmental dyslexia in Chinese have found that deficiencies in orthography may be an important cause of dyslexia, but there are diverse views and opinions regarding orthography processing. This article sorts out the research progress in behavioral and neuroimaging aspects of orthography studies, and provides references for further development of processing test materials and methods in the research of processing mechanism of developmental dyslexia orthography.

Objective:To analyze the influencing factors of attention deficit hyperactivity disorder (ADHD) in children and construct a Nomogram prediction model.Methods:A total of 5 409 children aged 7 to 16 from 5 schools in Xinjiang were investigated by using SNAP-Ⅳ assessment scale and influencing factors questionnaire.Least absolute shrinkage and selection operator (LASSO) regression and multivariate Logistic regression were used to analyze and investigate the influencing factors of ADHD in children, and then Nomogram prediction model was established. Results:(1)The detection rate of ADHD was 7.3%.(2) The LASSO- Logistic regression model showed that the history of febrile convulsions ( OR=5.97, 95% CI: 3.52-9.86), the history of epilepsy disease ( OR=11.86, 95% CI: 7.83-17.89), the history of head trauma disease ( OR=10.0, 95% CI: 7.27-13.71), mother′s delivery method ( OR=2.53, 95% CI: 1.99-3.23), mother′s education level ( OR=2.26, 95% CI: 1.45-3.67), mother′s smoking more than 1 year ( OR=12.65, 95% CI: 8.30-19.34), whether the family environment is quiet ( OR=1.27, 95% CI: 1.00-1.63), and the education method of beating and scolding ( OR=3.05, 95% CI: 2.13-4.31) was an indepen-dent risk factor for children with ADHD; (3)The Nomogram prediction model was built and verified by Bootstrap for 1 000 samples.The C-index was 0.81(95% CI: 0.78-0.83), suggesting that the Nomogram prediction model has good prediction ability, accuracy, and distinction.Decision curve analysis (DCA) of the clinical decision curve suggested that patients with Nomogram model with a predictive probability threshold greater than 0.2 had a higher clinical net benefit. Conclusions:The detection rate of ADHD was 7.3%, which was higher than the national average.The Nomogram prediction model drawn here can provide individualized ADHD risk predictions for children based on the history of hyperthermia, epilepsy, and head trauma, maternal mode of childbirth, maternal education level, maternal education level, maternal smoking for more than 1 year, quiet family environment, and scolding education methods.

Objective: To characterize visual attention span in children with developmental dyslexia in Xinjiang and to explore the effects of action video game training on visual attention span,and to provide a reference for improving the visual attention span of children with dyslexia. Methods: Students from grade 3 to 5 in primary schools of Xinjiang were selected by using random clustering sampling method from July to November 2020,a total of 120 developmental dyslexia group (Group-DD), chronological age matched group (Group-CA) and reading level matched group (Group-RL) were selected and compared with visual attention spans, action video games were used to conduct intervention training for DD children, variance analysis was used to study the variation of visual attention span. Results: The accuracy and discrimination index of Group-DD (0.68±0.10, 1.21±0.87) were lower than those of Group-CA (0.77±0.99, 1.80±0.83) and Group-RL (0.71±0.11, 1.50±0.75) ( F =21.26, 15.19, P <0.05);there was no significant difference in reaction time among the three groups( P >0.05). There were statistically significant differences in the accuracy of visual attention span (0.63±0.12, 0.71±0.11,0.70±0.10), response time (760.51±185.83, 782.74±149.20, 857.27± 155.44 ), and discrimination (0.84±0.81, 1.51±0.19, 1.29±0.10) among children of different grades ( F =6.37，3.81，3.16， P < 0.05 ). After 12 hours of action video game training, the accuracy and discrimination of Group-DD intervention group (0.74±0.10, 1.53±0.88) were higher than those of Group DD control group (0.68±0.14, 1.06±0.97)( P <0.05), and there was no significant difference between Group DD intervention group and Group RL (0.76±0.12, 1.73±0.71) ( P >0.05), but there was statistical difference between Group DD intervention group and Group-CA (0.81±0.94, 2.17±0.79) ( P <0.05). Conclusion Children with dyslexia have deficits in visual attention span, with grade difference. Action video game intervention can improve visual attention span ability of developmental dyslexia children to some extent.