1.Correlation of intrinsic capacity of the elderly with sarcopenia and frailty
Journal of Public Health and Preventive Medicine 2026;37(1):134-137
Objective To investigate the status of intrinsic capacity (IC) in elderly inpatients and explore its correlation with sarcopenia and frailty. Methods A total of 320 elderly inpatients hospitalized from October 2021 to October 2024 were enrolled in this study. IC, frailty status, risk of sarcopenia, and basic activities of daily living were evaluated using the IC Comprehensive Assessment Tool, the Frailty Syndrome Rapid Screening Scale, the five-item Sarcopenia Index, and the Barthel index. The correlation between IC and sarcopenia and frailty in elderly inpatients was explored by logistic regression analysis. Results The average IC score, frailty score, 5-item sarcopenia scale score, and incidence rate of positive sarcopenia screening in the elderly inpatients were (4.08±0.52) points, (1.57±0.42) points, (3.84±0.59) points, and 33.75% (108/320), respectively. Logistic regression analysis showed that Barthel index (OR=0.286, 95%CI: 0.128-0.641, P=0.002), sarcopenia (OR=3.762, 95%CI: 1.793-7.892, P<0.001) and frailty (OR=1.236, 95%CI: 1.090-1.401, P=0.001) were the independent influencing factors for IC in the elderly. Conclusion IC decline is common in elderly patients, and elderly inpatients with sarcopenia, frailty or poor self-care ability have a higher risk of IC damage.
2.Network analysis of pain, kinesiophobia, social participation and knee function in patients after total knee arthroplasty from an ethical equity perspective
Zhiwei WANG ; Lijun MENG ; Yu WU ; Jian LIU ; Zhaojin DA ; Zeping YAN ; Shicai WU
Chinese Journal of Rehabilitation Theory and Practice 2026;32(3):364-372
ObjectiveTo explore the complex network relationships among pain, kinesiophobia, social participation and knee function in patients after total knee arthroplasty (TKA), and to analyze the moderating effects of different socio-structural factors on the rehabilitation network from an ethical equity perspective. MethodsA convenience sampling method was used to select 291 patients who underwent TKA in Qilu Hospital of Shandong University from May to July, 2023. Pain was assessed using Numerical Rating Scale, kinesiophobia with Chinese short version of the Tampa Scale for Kinesiophobia, social participation with Impact on Participation and Autonomy Questionnaire, and knee function with Hospital for Special Surgery Knee Score. A partial correlation network among pain, kinesiophobia, social participation and knee function was constructed using Graphical Least Absolute Shrinkage and Selection Operator. Key variables were identified through node centrality and bridge centrality analysis. Network Comparison Tests (NCT) were used to analyze network differences among subgroups based on different socio-structural characteristics. ResultsIn the network model, the nodes with the highest strength centrality were indoor participation, activity behavior and activity pain. Bridge centrality analysis indicated that activity pain, knee function, indoor participation and activity cognition were key bridge nodes. NCT revealed no significant differences in overall network structure or global strength among subgroups based on residence, education level or payment method (P > 0.05). However, significant differences in edge weights were found for specific edges such as activity cognition-activity behavior and knee function-indoor participation (P < 0.05). ConclusionThere is a network of interactions among pain, kinesiophobia, social participation and knee function in patients after TKA, with nodes such as indoor participation and activity pain playing key roles in the rehabilitation process. Although the overall rehabilitation network is similar across different socio-structural groups, variations exist in specific relational pathways among patients from rural areas, those with lower education levels, and those with out-of-pocket payment. This suggests that clinical rehabilitation interventions should focus on these core nodes and implement targeted support strategies for socio-structurally disadvantaged groups to promote rehabilitation equity.
3.Network analysis of pain, kinesiophobia, social participation and knee function in patients after total knee arthroplasty from an ethical equity perspective
Zhiwei WANG ; Lijun MENG ; Yu WU ; Jian LIU ; Zhaojin DA ; Zeping YAN ; Shicai WU
Chinese Journal of Rehabilitation Theory and Practice 2026;32(3):364-372
ObjectiveTo explore the complex network relationships among pain, kinesiophobia, social participation and knee function in patients after total knee arthroplasty (TKA), and to analyze the moderating effects of different socio-structural factors on the rehabilitation network from an ethical equity perspective. MethodsA convenience sampling method was used to select 291 patients who underwent TKA in Qilu Hospital of Shandong University from May to July, 2023. Pain was assessed using Numerical Rating Scale, kinesiophobia with Chinese short version of the Tampa Scale for Kinesiophobia, social participation with Impact on Participation and Autonomy Questionnaire, and knee function with Hospital for Special Surgery Knee Score. A partial correlation network among pain, kinesiophobia, social participation and knee function was constructed using Graphical Least Absolute Shrinkage and Selection Operator. Key variables were identified through node centrality and bridge centrality analysis. Network Comparison Tests (NCT) were used to analyze network differences among subgroups based on different socio-structural characteristics. ResultsIn the network model, the nodes with the highest strength centrality were indoor participation, activity behavior and activity pain. Bridge centrality analysis indicated that activity pain, knee function, indoor participation and activity cognition were key bridge nodes. NCT revealed no significant differences in overall network structure or global strength among subgroups based on residence, education level or payment method (P > 0.05). However, significant differences in edge weights were found for specific edges such as activity cognition-activity behavior and knee function-indoor participation (P < 0.05). ConclusionThere is a network of interactions among pain, kinesiophobia, social participation and knee function in patients after TKA, with nodes such as indoor participation and activity pain playing key roles in the rehabilitation process. Although the overall rehabilitation network is similar across different socio-structural groups, variations exist in specific relational pathways among patients from rural areas, those with lower education levels, and those with out-of-pocket payment. This suggests that clinical rehabilitation interventions should focus on these core nodes and implement targeted support strategies for socio-structurally disadvantaged groups to promote rehabilitation equity.
4.Network analysis of pain, kinesiophobia, social participation and knee function in patients after total knee arthroplasty from an ethical equity perspective
Zhiwei WANG ; Lijun MENG ; Yu WU ; Jian LIU ; Zhaojin DA ; Zeping YAN ; Shicai WU
Chinese Journal of Rehabilitation Theory and Practice 2026;32(3):364-372
ObjectiveTo explore the complex network relationships among pain, kinesiophobia, social participation and knee function in patients after total knee arthroplasty (TKA), and to analyze the moderating effects of different socio-structural factors on the rehabilitation network from an ethical equity perspective. MethodsA convenience sampling method was used to select 291 patients who underwent TKA in Qilu Hospital of Shandong University from May to July, 2023. Pain was assessed using Numerical Rating Scale, kinesiophobia with Chinese short version of the Tampa Scale for Kinesiophobia, social participation with Impact on Participation and Autonomy Questionnaire, and knee function with Hospital for Special Surgery Knee Score. A partial correlation network among pain, kinesiophobia, social participation and knee function was constructed using Graphical Least Absolute Shrinkage and Selection Operator. Key variables were identified through node centrality and bridge centrality analysis. Network Comparison Tests (NCT) were used to analyze network differences among subgroups based on different socio-structural characteristics. ResultsIn the network model, the nodes with the highest strength centrality were indoor participation, activity behavior and activity pain. Bridge centrality analysis indicated that activity pain, knee function, indoor participation and activity cognition were key bridge nodes. NCT revealed no significant differences in overall network structure or global strength among subgroups based on residence, education level or payment method (P > 0.05). However, significant differences in edge weights were found for specific edges such as activity cognition-activity behavior and knee function-indoor participation (P < 0.05). ConclusionThere is a network of interactions among pain, kinesiophobia, social participation and knee function in patients after TKA, with nodes such as indoor participation and activity pain playing key roles in the rehabilitation process. Although the overall rehabilitation network is similar across different socio-structural groups, variations exist in specific relational pathways among patients from rural areas, those with lower education levels, and those with out-of-pocket payment. This suggests that clinical rehabilitation interventions should focus on these core nodes and implement targeted support strategies for socio-structurally disadvantaged groups to promote rehabilitation equity.
5.Ethical dilemmas and decision-making in doctor-patient relationship and social support: from the perspective of amputation
Shicai WU ; Hongwei MIN ; Lijun MENG
Chinese Journal of Rehabilitation Theory and Practice 2026;32(6):739-744
ObjectiveTo explore ethical dilemmas in amputation treatment, focusing on patient autonomy, informed consent and decision-making interaction between family members and medical teams, to provide references for clinical ethical decision-making and rehabilitation practice. MethodsThe decision-making process of amputation was analyzed from three dimensions, including patient autonomy, informed consent and shared decision-making of families and medical teams, in light of ethical principles such as non-maleficence, beneficence and justice. ResultsEthical decision-making in amputation was based on adequate informed consent of patients and their families. Medical teams made decisions on the premise of respecting patients' true will. Postoperative psychological support and social security system played a vital role in patients' rehabilitation, and national policy support was indispensable. ConclusionEthical decision-making for amputation should balance the responsibilities of medical teams and family participation on the basis of respecting patient autonomy and ensuring informed consent. Sound postoperative psychological support and social security system are essential for patients' comprehensive rehabilitation, which should be fully considered in clinical ethical practice.
6.Analysis of sarcopenia prevalence and related factors in community-dwelling older adults based on C-MSRA-7 combined with Ishii score
Lijun WANG ; Ping WU ; Haimin XU ; Kewen CHENG ; Fen RAO ; Miaomiao YAO ; Yu ZHANG
Chinese Journal of Clinical Medicine 2026;33(4):643-650
Objective To investigate the prevalence and related factors of sarcopenia among non–bedridden older adults in the community of Baoshan District using the China mini sarcopenia risk assessment 7 (C-MSRA-7) combined with Ishii scoring system. Methods The older individuals consulting at 20 community health stations in Baoshan District between April 2025 and June 2025 were enrolled. Data were collected using a general information questionnaire, a dietary and lifestyle habits survey, the C-MSRA-7, and the mini nutritional assessment-short form (MNA-SF). Handgrip strength and anthropometric measurements were also obtained. Individuals with both Ishii score and C-MSRA-7 results positive were classified into the sarcopenia risk group, while the remaining participants were assigned to the non–sarcopenia risk group. Differences in lifestyle habits, dietary patterns, and nutritional status between the two groups were compared. Results A total of 2 611 valid questionnaires were retrieved. Univariate analysis showed statistically significant differences in alcohol consumption, physical activity frequency, body mass index (BMI), nutritional status, activities of daily living, and regularity of three meals in sarcopenia risk group (n=486) and non–sarcopenia risk group (n=2 125, P<0.05). Logistic regression analysis showed that advanced age (75–84 years: OR=2.55, 95%CI 2.03–3.21; ≥85 years: OR=3.98, 95%CI 2.24–7.07), underweight status (OR=2.19, 95%CI 1.50–3.19), weight loss>2 kg (OR=4.52, 95%CI 2.68–7.64) past 3 months, lack of regular physical activity (OR=1.77, 95%CI 1.24–2.52) , and alcohol consumption (OR=1.48, 95%CI 1.07–2.05) were independent risk factors for sarcopenia (P<0.05). Behaviors related to healthy diet, including daily milk consumption (OR=0.40, 95%CI 0.30–0.52), regular three meals (OR=0.56, 95%CI 0.41–0.78), and high-quality protein intake (OR=0.70, 95%CI 0.52–0.94), were protective factors (P<0.05). Conclusions Sarcopenia among community–dwelling, non–bedridden older adults is closely associated with physical activity levels, dietary habits, and nutritional status. Early identification of individuals at risk, enhanced nutritional education, and timely implementation of nutritional interventions and exercise programs are recommended for this population.
7.Clinical and Immunological Characteristics of Elderly Onset Rheumatoid Arthritis
Zhengfang LI ; Chanyuan WU ; Mengsi MA ; Tingting LI ; Xue WU ; Xinyan MENG ; Sha ZHANG ; Lijun WU
Medical Journal of Peking Union Medical College Hospital 2025;16(1):59-64
To investigate the clinical features and peripheral blood immune cell subsets ofelderly (≥60 years old) onset rheumatoid arthritis (EORA) patients. The patients with rheumatoid arthritis (RA) who were hospitalized in the Department of Rheumatology and Immunology of the People's Hospital of Xinjiang Uygur Autonomous Region from March 2023 to December 2023 were selected as the study objects. The demographic data, clinical characteristics, extra-articular manifestations and laboratory examination results of the patients were collected. The patients were divided into EORA group and young adult (< 60 years old)onset rheumatoid arthritis (YORA) group, and the clinical features and peripheral blood immunological indexes of the two groups were compared. A total of 187 RA patients with an average age of (62.1±12.0) years were enrolled, including 89 patients in the EORA group and 98 patients in the YORA group. Compared with YORA group, EORA group had a higher proportion of male patients(39.3% Compared with YORA, EORA has higher male proportion, joint disease degree and disease activity. EORA is prone to interstitial lung disease, anemia and high inflammation, and the level of peripheral blood NK cells is higher.
8.Ethical examination of the research and application of artificial intelligence in the field of rehabilitation
Lijun MENG ; Yiting LI ; Yingwei SUN ; Yu WU ; Shicai WU
Chinese Medical Ethics 2025;38(2):166-172
With the rapid development of artificial intelligence (AI) technology, the ethical governance of AI has gained increasing attention. The Recommendation on the Ethics of Artificial Intelligence was issued by the United Nations Educational, Scientific and Cultural Organization in 2021, which clarified several principles for the ethical governance of AI. In the field of rehabilitation medicine, the research and application of AI technology have significantly improved patients’ quality of life and survival. However, due to the specificity of the service population in rehabilitation medicine, which is mostly for the sick, injured, disabled, and elderly, a series of complex ethical issues have also arisen. This paper analyzed in detail the ethical issues and challenges encountered in the research and application of AI technology in the field of rehabilitation medicine from various aspects, such as informed consent, security of privacy and data, patients’ physical and mental rehabilitation, compliance regulation, protection of specific groups, and promotion of equity. According to the principles of the Recommendation on the Ethics of Artificial Intelligence and others, response strategies were proposed, including multi-party collaboration and interdisciplinary cooperation, improving and refining relevant laws and regulations, strengthening ethical education across society, establishing accountability mechanisms, increasing investment, promoting equity, and other measures, to promote the healthy development of research and application of AI technology in the field of rehabilitation, as well as benefit humanity.
9.Change of forced vital capacity to weight index and future trend forecasting among Chinese Han students aged 7-18 during 2000-2019
ZHOU Yun, ZHANG Siying, ZHONG Yumei, TANG Lijun, LI Wenge, WU Xiulong
Chinese Journal of School Health 2025;46(9):1312-1317
Objective:
To explore the long term trend of forced vital capacity to weight index (FWI) among Chinese Han students aged 7-18 from 2000 to 2019, and to predict its changes over the next decade, so as to provide scientific evidences for targeted health interventions and school health policies.
Methods:
Based on the data of the five Chinese National Surveys on Students Constitution and Health conducted from 2000 to 2019, a total of 216 500, 233 565, 215 267, 214 256 and 212 632 Han students aged 7-18 were included, respectively. The long term trend of FWI among students was analyzed, and the GM (1,1) grey model was used to predict FWI changes over the next decade. Subgroup analyses were conducted by sex, age, and urban-rural residence.
Results:
The FWI levels of Chinese Han students aged 7-18 were (55.30±11.47)(47.43±11.92)(48.11±12.46)(48.75±12.81)(50.93±13.11)mL/kg in 2000, 2005, 2010, 2014, and 2019, respectively. The FWI of Chinese Han students showed a decreasing then increasing trend from 2000 to 2019, reaching the lowest point of approximately 47.03 mL/kg around 2006, and was projected to recover to 52.88 mL/kg by 2029. Boys had higher FWI for each year and the total level than girls from 2000 to 2019( t =72.58-304.66), and the decline between 2000 and 2005 was smaller in boys (13.1%) than in girls (15.4%). However, the gender gap gradually narrowed and was projected to reduce to 5.36 mL/kg by 2029. FWI increased with age, with the largest difference observed in 2014 between the 7-9 and 16-18 age groups (8.62 mL/kg). Before 2014, urban boys had slightly lower FWI than rural boys; the gap narrowed thereafter, and their FWI levels were expected to become similar by 2029. Urban girls generally had higher FWI than rural girls, and the urban-rural gap showed an increasing trend. By 2029, the largest difference was projected to occur in the 13-15 age group, reaching 7.74 mL/kg.
Conclusions
The FWI of Chinese Han students showed a trend of initial decline followed by a gradual increase from 2000 to 2019, with notable differences across sex, age, and urban-rural residence. Greater attention should be paid to the respiratory health of rural girls, and effective measures should be taken to reduce urban-rural disparities.
10.Analyzing the influencing factors of occupational burnout among disease control and prevention staffs in Sichuan Province
Chaoxue WU ; Shuang DONG ; Liang WANG ; Xunbo DU ; Lin ZHAO ; Dan SHAO ; Quanquan XIAO ; Lijun ZHOU ; Chongkun XIAO ; Heng YUAN
China Occupational Medicine 2025;52(3):288-292
Objective To assess the situation and influencing factors of occupational burnout among the staff at the Center for Disease Control and Prevention (CDC) in Sichuan Province. Methods A total of 1 038 CDC staff members in Sichuan Province were selected as the study subjects using the stratified random sampling method. Occupational burnout of the staff was assessed using the Maslach Burnout Inventory General Survey via an online questionnaire. Results The detection rate of occupational burnout was 42.3% (439/1 038). Binary logistic regression analysis result showed that, after controlling for confounding factors such as education level and alcohol consumption, CDC staffs aged at 20-<31, 31-<41, and 41-<51 years were at higher risk of occupational burnout compared with those ≥51 years (all P<0.05). CDC staffs with 5-<10 or ≥10 years of service had higher occupational burnout risk compared with those with <5 years (both P<0.05). CDC staffs with poor or fair health status, irregular diet, and poor sleep quality had higher risk of occupational burnout compared with those healthy, have regular diet, and good sleep quality (all P<0.05). The risk of occupational burnout increased with higher overtime frequency (all P<0.05). Conclusion Occupational burnout among CDC staffs in Sichuan Province is relatively high. Age, years of service, health status, diet, sleep quality, and overtime frequency are key influencing factors.


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