1.Content and psychometric properties of functional measurements in patients with sarcopenia based on ICF
Hui LIU ; Hang YIN ; Chenghong HU ; Shaohui JIA ; Yewenzhe FENG ; Qingkui HU
Chinese Journal of Rehabilitation Theory and Practice 2024;30(3):273-280
Objective To explore the content and psychometric properties of sarcopenia measurements for older adults. Methods Using the International Classification of Functioning,Disability and Health(ICF)linking and coding rules,a content analysis were conducted on the seven types of measurement tools for geriatric sarcopenia,including Strength,Assistance with walking,Rising from a chair,Climbing stairs,and Falls(SARC-F);Ishii Test;Mini Sar-copenia Risk Assessment-7(MSRA-7);6-minute walk test(6MWT);Barthel Index(BI);Short Physical Perfor-mance Battery(SPPB);and World Health Organization Disability Assessment Schedule 2.0(WHODAS 2.0),and psychometric property was explored. Results The seven measurement tools can be categorized into body functions and structures,activities and participation,and comprehensive categories.ICF coding for SARC-F involved muscle power functions(b730),walking(d450),changing basic body position(d410),etc.Ishii Test involved muscle power functions(b730)and weight maintenance functions(b530).MSRA-7 involved walking(d450),involuntary movement reaction functions(b755),muscle endurance functions(b740),etc.ICF coding for 6MWT involved walking(d450).SPPB involved changing basic body position(d410),control voluntary movement functions(b760),and walking(d450).BI in-volved eating(d550),drinking(d560),washing oneself(d510),caring for body parts(d520),etc.WHODAS 2.0 involved attention functions(b140),acquiring skills(d155),communication-receiving-verbal messages(d310),community life(d910),etc.SARC-F was low to medium in sensitivity,and medium to excellent in specificity.Ishii Test was medium to good in sensitivity,average to good in specificity,and good in diagnostic performance.MSRA-7 was medium to good in sensitivity,average in specificity,and average to medium in diagnostic perfor-mance,while MSRA-5 was average to good in sensitivity,average in specificity,and medium in diagnostic per-formance.6MWT was average to medium in sensitivity,and average in specificity.SPPB was average in sensitiv-ity,average to medium in specificity,and average to excellent in diagnostic performance.BI was good in reliabili-ty,and WHODAS 2.0 was excellent in reliability. Conclusion The measurement tools for sarcopenia can be categorized into body functions and structures,activities and participation,and comprehensive assessment tools combining the above.The psychometric properties of the sev-en measurement tools are low to excellent in sensitivity and average to excellent in specificity.
2.Clinical pharmaceutical practice of constructing mind map by clinical pharmacists for the consultation of pulmonary nocardiosis
Tiying DENG ; Zhimin HU ; Qing XU ; Shaohui ZHANG ; Lulu LI ; Heng GUO ; Lei HU ; Fan CHEN
China Pharmacy 2023;34(15):1899-1903
OBJECTIVE To explore the construction of mind map by clinical pharmacists for the consultation of pulmonary nocardiosis and its application in clinical practice, and to provide reference for promoting the correct selection of nocardiosis treatment drugs in clinical practice and ensuring drug safety and efficacy. METHODS A total of 7 patients with Nocardia pulmonary infection from January 2017 to April 2022 in our hospital were collected. Based on evidence-based medicine, a consultation mind map (mainly including understanding the medical history, identifying infectious bacteria, identifying risk factors, developing treatment plans, and conducting evaluations) was constructed to address the difficulties of large differences in drug sensitivity among different strains of Nocardia and numerous adverse reactions of Compound sulfamethoxazole as a first-line drug. The treatment plan was developed for 7 patients with pulmonary nocardiosis, and whole-process pharmaceutical care was provided. RESULTS Combined with the mind map, different antibiotic combination regimens were given according to the drug sensitivity results of Nocardia, the different species of Nocardia, and the patient’s allergy history. Among them, 4 cases were treated with imipenem cilastatin, the patients receiving Compound sulfamethoxazole and linezolid for a long time were given full pharmaceutical care, and the adverse drug reactions were timely treated.CONCLUSIONS Clinical pharmacists apply the consultation mind map of pulmonary nocardiosis to the treatment of inpatients, take advantage of pharmacy, participate in clinical drug therapy, and really play a role in the clinical treatment team so as to promote rational drug use.
3.Prevalence, types, risk factors and intervention strategies of sport injury for Paralympic athletes: a scoping review
Qingkui HU ; Hang YIN ; Shaohui JIA ; Hui LIU
Chinese Journal of Rehabilitation Theory and Practice 2023;29(10):1154-1163
ObjectiveTo analyze the occurrence of sport injury in Paralympic athletes during the Summer or Winter Paralympic Games, as well as the risk factors for sport injuries and possible interventions. MethodsThe literatures related to sport injuries of Paralympic athletes were searched in PubMed, Web of Science, EBSCO and CNKI from January, 2013 to July, 2022, and a scoping review of the retrieved literature was performed. ResultsFinally, eight English articles from China, Sweden, South Africa, Poland and the United States were included, involving 4 769 atheletes. They included one interview study, five survey studies, one retrospective study and one prospective cohort study, which were mainly from journals in the fields of sport medicine, adaptive sport and sport science, and the publication date was mainly from 2016 to 2022. The types of disability of Paralympic athletes mainly involved physical disability (upper and lower limb amputation, cerebral palsy, spinal cord injury, poliomyelitis, dysplasia and neuromuscular dystrophy, central nervous system injury, myelomeningocele, etc.), intellectual disability and visual disability. The incidence of sport injury was high in Paralympic athletes, and most of the injury occured during competitions. Acute injury, chronic overuse injury and chronic to acute injury were the three most common types of injury. Sports injuries mainly involved head and neck, upper limbs (shoulders, upper arms/forearms, elbows, wrists and fingers), trunk (abdomen, back and waist), and lower limbs (hips/groin, thighs, knees, calves, ankles and toes). Risk factors for sport injuries in Paralympic athletes mainly included previous injury history, illness, fatigue and decreased physical strength, spasticity and muscle weakness; emotional states of inattention or distraction, excessive anxiety or excitement; improper exercise training methods, lack of knowledge related to sport training and injury prevention, and motor skill deficiencies; weather, competition venues, sport facilities, use of equipment and assistive devices, age factors, etc. Injuries of Paralympic athletes could be prevented by providing rehabilitation services for Paralympic athletes, optimizing training design, conducting collective training for coaches and athletes on various types of injuries, conducting research related to sport injuries of disabled athletes, formulating prevention programs and strategies, improving the physical fitness and sport skills of Paralympic athletes, improving emergency treatment techniques for injuries, and strengthening coordination and governance structures between sport medicine and rehabilitation therapists. ConclusionThe incidence of sport injury is high in Paralympic athletes. Chronic overuse injury is the most common injury type, and the injuries most involve head, neck and upper extremities. The risk factors for sport injuries of Paralympic athletes mainly involve physical function, psychological, activities and participation, environment and other factors. The main intervention strategies include providing emergency treatment intervention and monitoring services, sport medicine treatment and rehabilitation, guidance and specialized support, and health education on sport injury prevention.
4.Retrospective cohort study on the correlation between hypoalbuminemia and caspofungin-induced liver injury
Fan CHEN ; Jianmin LIU ; Shuli HU ; Shaohui ZHANG
Adverse Drug Reactions Journal 2023;25(7):419-423
Objective:To explore the correlation between hypoalbuminemia and caspofungin-induced liver injury.Methods:This research was designed as a retrospective cohort study. The medical records of discharged adult patients treated with caspofungin acetate for injection (caspofungin) in Wuhan No.1 Hospital from January 1, 2019 to December 31, 2021 were extracted through the electronic medical record system. According to the average serum albumin level during caspofungin treatment, patients were divided into hypoalbuminemia group and non-hypoalbuminemia group. Propensity score matching (PSM) was performed for gender, age, weight, underlying disease, and hospital stay, etc. in a 1∶1 ratio in patients between hypoalbuminemia and non-hypoalbuminemia groups. Taking the occurrence of drug-induced liver injury as the outcome index, the incidences of liver injury were compared between the 2 groups, before and after PSM. The relative risk ( RR) and its 95% confidence interval ( CI) of caspofungin-related liver injury were calculated by cluster study method. Results:A total of 357 patients were entered, including 202 (56.6%) males and 155 (43.4%) females; 72 patients (20.2%) were in the hypoalbuminemia group and 285 patients (79.8%) were in the non-hypoalbuminemia group. Twenty-eight patients (7.8%) were judged with caspofungin-related liver injury, including 21 in the hypoalbuminemia group and 7 in the non-hypoalbuminemia group. The difference in the incidence of liver injury between the 2 groups was statistically significant whether before or after PSM [29.2% (21/72) vs. 2.5% (7/285), P<0.001; 29.2% (21/72) vs. 2.8% (2/72), P<0.001]. The results of the cluster study after PSM showed that hypoalbuminemia had a strong positive correlation with caspofungin-related liver injury ( RR=10.500, 95% CI: 2.555-43.143), and the incidence of caspofungin-related liver injury in patients with hypoalbuminemia was 26.39% higher than that in patients without hypoalbuminemia. Conclusion:Hypoalbuminemia was significantly correlated to the occurrence of caspofungin-related liver injury.
5.Retrospective cohort study on the correlation between hypoalbuminemia and caspofungin-induced liver injury
Fan CHEN ; Jianmin LIU ; Shuli HU ; Shaohui ZHANG
Adverse Drug Reactions Journal 2023;25(7):419-423
Objective:To explore the correlation between hypoalbuminemia and caspofungin-induced liver injury.Methods:This research was designed as a retrospective cohort study. The medical records of discharged adult patients treated with caspofungin acetate for injection (caspofungin) in Wuhan No.1 Hospital from January 1, 2019 to December 31, 2021 were extracted through the electronic medical record system. According to the average serum albumin level during caspofungin treatment, patients were divided into hypoalbuminemia group and non-hypoalbuminemia group. Propensity score matching (PSM) was performed for gender, age, weight, underlying disease, and hospital stay, etc. in a 1∶1 ratio in patients between hypoalbuminemia and non-hypoalbuminemia groups. Taking the occurrence of drug-induced liver injury as the outcome index, the incidences of liver injury were compared between the 2 groups, before and after PSM. The relative risk ( RR) and its 95% confidence interval ( CI) of caspofungin-related liver injury were calculated by cluster study method. Results:A total of 357 patients were entered, including 202 (56.6%) males and 155 (43.4%) females; 72 patients (20.2%) were in the hypoalbuminemia group and 285 patients (79.8%) were in the non-hypoalbuminemia group. Twenty-eight patients (7.8%) were judged with caspofungin-related liver injury, including 21 in the hypoalbuminemia group and 7 in the non-hypoalbuminemia group. The difference in the incidence of liver injury between the 2 groups was statistically significant whether before or after PSM [29.2% (21/72) vs. 2.5% (7/285), P<0.001; 29.2% (21/72) vs. 2.8% (2/72), P<0.001]. The results of the cluster study after PSM showed that hypoalbuminemia had a strong positive correlation with caspofungin-related liver injury ( RR=10.500, 95% CI: 2.555-43.143), and the incidence of caspofungin-related liver injury in patients with hypoalbuminemia was 26.39% higher than that in patients without hypoalbuminemia. Conclusion:Hypoalbuminemia was significantly correlated to the occurrence of caspofungin-related liver injury.
6.Exploration of discipline construction at university-affiliated hospitals in building " first-class universities and disciplines"
Ting DONG ; Dan YU ; Shanshan WU ; Shaohui WANG ; Peiwu HU ; Kun TANG
Chinese Journal of Hospital Administration 2022;38(7):530-534
Discipline construction is the core of hospital development. Under the initiative to build " first-class universities and disciplines" , in order to speed up the construction of first-class hospitals, a university-affiliated hospital carried out discipline construction management by optimizing top-level design, discipline differentiation development, evaluation index system construction and strengthening its application, and carrying out process management in the form of project system.In 2018, the hospital levelled its individual disciplines as leading ones, advantageous ones, backbone ones, backbone promising ones and potential ones, each granted with corresponding funding support. Medians of the disciplinary construction scoring of disciplines at various levels from 2015 to 2018 were used as the standard scoring in examinations in the next two years(2019 and 2020), guiding the disciplines to upgrade their design for discipline construction index system. The appraisal of discipline construction in 2019 and 2020 found 38 disciplines up to the standard scoring, including 16 twice higher than the scoring, while only 7 scored lower than the standard one. The hospital has made stage-based progress in discipline reputation, faculty, science research and social contribution, initially achieving effective guidance of disciplines of the hospital.
7.Anesthesia management of living small bowel transplantation
Yueying ZHENG ; Xuexue HU ; Shaohui GUO ; Shanshan XU ; Suqin HUANG ; Shengmei ZHU
Chinese Journal of Anesthesiology 2021;41(7):827-830
Objective:To summarize the anesthesia management of living small bowel transplantation.Methods:Severn patients undergoing living and allogeneic small bowel transplantation for the first time were selected.The intraoperative hemodynamics, indexes of blood gas analysis, body temperature and blood transfusion and volume of liquid infused were analyzed.Postoperative outcomes were tracked.Results:Six cases survived and were successfully discharged from hospital successfully, and one patient died.In the operation room, 71% patients were successfully extubated after surgery.Compared with the values during anatomical separation period, Hb during vascular anastomosis and intestinal reconstruction periods and concentration of Ca 2+ during intestinal reconstruction period were significantly decreased, and the blood glucose concentration during vascular anastomosis period were increased ( P<0.05 or 0.01). Compared with the values during vascular anastomosis period, the blood glucose concentration was increased significantly during intestinal reconstruction period ( P<0.05). Crystalloid solution (57±30) ml/kg and colloid solution which mainly containing 20% albumin (15±13) ml/kg were infused mainly during anatomical separation and vascular anastomosis periods in all the patients. Conclusion:The condition of successful living small bowel transplantation is fully evaluation and preparation before surgery.Intravenous-inhalational anesthesia combined with transverses abdominis plane block and rational infusion of colloid solution with vasoactive drugs to maintain hemodynamics stability and monitor blood gas, body temperature, active adjustment of electrolytes and internal environment and stable body temperature can be helpful in maintaining perioperative stable vital signs during the perioperative period, removing the tracheal tube early at the end of surgery, and reducing the development of postoperative complications in patients undergoing living small bowel transplantation.
8.Reflections on the evaluation and management of SCI papers based on the category normalized citation impact: Taking a university hospital as an example
Shaohui WANG ; Peiwu HU ; Dan YU ; Ting DONG ; Longfei LIU ; Kun TANG
Chinese Journal of Medical Science Research Management 2021;34(4):305-309
Objective:Analyze the basic information and characteristics of SCI papers published by an institution in 2015-2019 based on the Category Normalized Citation Impact (CNCI), to provide a reference basis for SCI paper management policy improvement.Methods:Retrieve SCI papers completed by the first or correspondent unit from 2015 to 2019 from the scientific research management system of the institution. Obtain index data including journal information, impact factors, and CNCI of this group of papers from Web of science and InCites databases, and use SPSS21.0 statistical software to perform descriptive and chi-square tests.Results:The university-affiliated hospital published 3201 SCI papers from 2015-2019, with a growing trend. These papers were most frequently published in the 1
9.Clinical application effect of latissimus dorsi muscle flap in reconstruction of muscle strength around shoulder after electric burns
Wanfu ZHANG ; Jing XU ; Xiaolong HU ; Fei HAN ; Lin TONG ; Shaohui LI ; Shengtao XIANG ; Hao GUAN
Chinese Journal of Burns 2021;37(7):622-628
Objective:To investigate the clinical application effect of latissimus dorsi muscle flap in reconstruction of muscle strength around shoulder after electric burns.Methods:From March 2014 to September 2020, 13 patients with electric burns and severe injury around shoulder were admitted to the First Affiliated Hospital of Air Force Medical University, including 11 males and 2 females, aged 19-55 years. A retrospective observational study was conducted. The left upper limbs were injured in 8 cases, and the right upper limbs were injured in 5 cases, all with eschar wounds of Ⅲ-Ⅳ degree. Among which, there were biceps defects in 6 cases, deltoid defects in 3 cases, triceps defects in 2 cases, and composite defects of multiple muscles around shoulder in 2 cases. The surgery was carried out in two stages. In stage Ⅰ, debridement and exploration of electric burn wounds around shoulders were conducted to preserve local tissue and save the limb as much as possible on the premise of guaranteeing the stability of the body condition. After the last debridement, the wound area was from 10 cm×6 cm to 40 cm×15 cm, the muscle defect area was from 8 cm×4 cm to 19 cm×12 cm, and the humerus was exposed in 7 patients. In stage Ⅱ, according to the residual limb defect degree, muscle reconstruction around shoulder was conducted with the latissimus dorsi muscle flap, and area of the latissimus dorsi muscle flap was 15 cm×6 cm to 20 cm×18 cm. The residual wounds were repaired with autologous split-thickness skin grafts of head, and the donor sites of muscle flaps were sutured directly. The survivals of the muscle flaps and wounds closure post operation, and the appearances of the donor sites and recipient sites during follow-up were observed. At the last follow-up, the shoulder joint function was evaluated using the trial standard for the evaluation of the functions of the upper limbs of the Hand Surgery Society of the Chinese Medical Association, and the satisfaction degrees of patients for appearance and function recoveries of shoulder were investigated by self-made questionnaire with reference to the concise test scoring system of shoulder joint.Results:All of the 13 muscle flaps around shoulder survived after surgery. Two patients had residual wounds in the skin grafting area, the wound in one of the patients was healed after dressing change, and the wound in the other 1 patient was healed with the second autologous split-thickness skin grafting on head after dressing change. During follow-up of 6 to 18 months for all the patients, the muscle flaps of patients were full in appearance and not bloated, and atrophic scar in the repaired area was soft in texture and closed with normal skin around. Linear suture scars were left in the donor sites of muscle flaps, which did not affect the overall appearance. At the last follow-up, the active abduction range of the shoulder joint was 60-90°, upward lift on 120-180°, muscle strength recovered to level Ⅳ and above in 8 cases and to level Ⅲ in 5 cases, and the shoulder joint function was evaluated as excellent in 8 cases and good in 5 cases; 10 patients were very satisfied and 3 patients were satisfied with the appearance and function recovery of the shoulders.Conclusions:The application of latissimus dorsi muscle flap provides a better choice for the muscle strength reconstruction around shoulder after electric burns, with good appearance of the operative areas and ideal prognosis of upper limb function.
10.A hierarchical management model for college affiliated hospitals based on scientific research performance appraisal
Juan LIU ; Kun TANG ; Peiwu HU ; Shaohui WANG ; Dan YU ; Ting DONG ; Xuliang CHEN
Chinese Journal of Medical Science Research Management 2020;33(3):198-202
Objective:To explore the feasibility and effect of establishing a hierarchical management model based on scientific research performance assessment.Methods:In our hospital, each department was classified as one of the four levels based on the scientific research performance: leading disciplines, dominant disciplines, backbone disciplines or developing disciplines.Continuing assessment was conducted to monitor the discipline development.Results:There were 41 departments in the hospital, including 5 leading disciplines, 9 dominant disciplines, 14 backbone disciplines and 7 developing disciplines. After two years of construction, more than 200 national-level projects have been funded, and the total funding number is nearly 200 million Yuan.30 national or provincial-level scientific and technological achievements awards have been awarded. 213 patents have been granted.More than 1 000 SCI papers were published. The number of major key projects has been continuously increased.Conclusions:Establishing a hierarchical management model based on scientific research performance assessment plays a positive role in scientific research.

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