Objective To investigate the immediate effect of transcranial direct current stimulation(tDCS)combined with seated Tai-jiquan Yunshou training under different sequences on cerebral cortical activation in stroke patients with hemiple-gia.Methods From September to December,2024,14 stroke inpatients with hemiplegia were enrolled from the Fifth Hospi-tal of Xiamen.Based on the routine medication and rehabilitation,the patients were randomly assigned to a spe-cific intervention sequence,receiving three interventions in a fixed order:tDCS followed by Yunshou(S-Y group),Yunshou followed by tDCS(Y-S group),and simultaneous tDCS and Yunshou(Sim group).Functional near-infrared spectroscopy was used to detect oxyhemoglobin(HbO?)concentration in bilateral sensorimotor cor-tex,premotor and supplementary motor cortex,and prefrontal cortex before and after each intervention.Results Three patients dropped out.In all the regions of interest,inter-group effects were significant in HbO? concentra-tions(F>3.697,P<0.05),and interaction effects were significant in some brain regions(F>3.276,P<0.05).Post-hoc test showed a general trend of Sim Group≥S-Y Group>Y-S Group(P<0.05),although some varia-tions existed across different brain regions.Conclusion Both simultaneous intervention(tDCS and Yunshou)and tDCS followed by Yunshou are more effective on immediate activation of key motor-related cortices in stroke patients with hemiplegia than Yunshou followed by tDCS intervention.

Objective To investigate the immediate effect of transcranial direct current stimulation(tDCS)combined with seated Tai-jiquan Yunshou training under different sequences on cerebral cortical activation in stroke patients with hemiple-gia.Methods From September to December,2024,14 stroke inpatients with hemiplegia were enrolled from the Fifth Hospi-tal of Xiamen.Based on the routine medication and rehabilitation,the patients were randomly assigned to a spe-cific intervention sequence,receiving three interventions in a fixed order:tDCS followed by Yunshou(S-Y group),Yunshou followed by tDCS(Y-S group),and simultaneous tDCS and Yunshou(Sim group).Functional near-infrared spectroscopy was used to detect oxyhemoglobin(HbO?)concentration in bilateral sensorimotor cor-tex,premotor and supplementary motor cortex,and prefrontal cortex before and after each intervention.Results Three patients dropped out.In all the regions of interest,inter-group effects were significant in HbO? concentra-tions(F>3.697,P<0.05),and interaction effects were significant in some brain regions(F>3.276,P<0.05).Post-hoc test showed a general trend of Sim Group≥S-Y Group>Y-S Group(P<0.05),although some varia-tions existed across different brain regions.Conclusion Both simultaneous intervention(tDCS and Yunshou)and tDCS followed by Yunshou are more effective on immediate activation of key motor-related cortices in stroke patients with hemiplegia than Yunshou followed by tDCS intervention.

Objective:To investigate the application of time series models in forecasting pre-hospital emergency ambulance trips in Handan City and develop the LPro ensemble model for improved prediction accuracy to support emergency resource allocation.Methods:Pre-hospital emergency data from Handan Emergency Medical Command Center (2019-2023) were retrospectively analyzed. From 324 799 original records, 289 949 valid records were included after cleaning. The training set (2019-2022: 215 918 records) included 35 527 records in 2019, 52 015 in 2020, 61 836 in 2021, and 66 540 in 2022. The validation set (2023) contained 74 031 records. ARIMA, linear trend seasonal, exponential smoothing, and Prophet models were fitted to the training set. The LPro ensemble model was constructed using MAPE-based weighting (linear trend seasonal model: 0.38, Prophet: 0.62). Performance metrics included MAPE, RMSE, MAE, and R 2. Results:Data showed annual growth (compound annual growth rate 23.27%) and seasonal patterns (October peaks, February troughs). Ambulance dispatches increased annually with monthly cyclical patterns. For 2023 validation predictions: ARIMA (MAPE 8.76%, RMSE 619, MAE 491, R 2 0.4563), linear trend seasonal (MAPE 9.83%, RMSE 671, MAE 545, R 2 0.3608), Prophet (MAPE 8.43%, RMSE 562, MAE 503, R 2 0.5513), exponential smoothing (MAPE 8.08%, RMSE 643, MAE 410, R 2 0.4124). LPro model showed superior performance (MAPE 7.05%, RMSE 491, MAE 393, R 2 0.6570), with 16.37% lower MAPE, 12.63% lower RMSE, 21.87% lower MAE, and 19.17% higher R 2 versus Prophet. Conclusion:The LPro ensemble model substantially enhances prediction accuracy and reliability, offering scientific support for emergency resource optimization and dispatch scheduling in Handan City.

Hand chest percussion is a widely utilized airway clearance technique in medicine,providing significant auxiliary role in the treatment of lung diseases. Suitable airway clearance techniques for patients' diseases can improve their subjective symptoms,enhance their confidence in care,optimize their quality of life,reduce their disease course,and improve their pulmonary function status and prognosis. However,there is no medical setting or parent who uses mechanical sputum removal equipment. Hand chest percussion,as the primary method of airway clearance,presents challenges for elderly patients and children who are bedridden for extended periods or have communication difficulties. Improper application of this technique not only increases the burden on medical staff and families but also fails to achieve optimal sputum drainage,leading to patient discomfort and diminishing their overall experience during medical care. Therefore,the team of the department of critical care medicine of Ningbo Medical Center Lihuili Hospital designed a drum-press massage cup and obtained a National Utility Model Patent of China (ZL 202020856848.5) and Appearance Design Patent (ZL 202030236631.X). This drum-press massage cup is mainly composed of 2 parts:the massage cup and the handle. It can be disassembled and assembled,and the structure is simple and practical. It is suitable for manual chest percussion care for critically ill patients,which can also improve the efficiency of manual chest percussion for sputum drainage. It is also suitable for personal sputum drainage and treatment requirements of patients who can take care of themselves,thus saving the labor of medical and nursing staff and increasing their satisfaction. It improves the effect of airway clearance and the prognosis of patients.

Hand chest percussion is a widely utilized airway clearance technique in medicine,providing significant auxiliary role in the treatment of lung diseases. Suitable airway clearance techniques for patients' diseases can improve their subjective symptoms,enhance their confidence in care,optimize their quality of life,reduce their disease course,and improve their pulmonary function status and prognosis. However,there is no medical setting or parent who uses mechanical sputum removal equipment. Hand chest percussion,as the primary method of airway clearance,presents challenges for elderly patients and children who are bedridden for extended periods or have communication difficulties. Improper application of this technique not only increases the burden on medical staff and families but also fails to achieve optimal sputum drainage,leading to patient discomfort and diminishing their overall experience during medical care. Therefore,the team of the department of critical care medicine of Ningbo Medical Center Lihuili Hospital designed a drum-press massage cup and obtained a National Utility Model Patent of China (ZL 202020856848.5) and Appearance Design Patent (ZL 202030236631.X). This drum-press massage cup is mainly composed of 2 parts:the massage cup and the handle. It can be disassembled and assembled,and the structure is simple and practical. It is suitable for manual chest percussion care for critically ill patients,which can also improve the efficiency of manual chest percussion for sputum drainage. It is also suitable for personal sputum drainage and treatment requirements of patients who can take care of themselves,thus saving the labor of medical and nursing staff and increasing their satisfaction. It improves the effect of airway clearance and the prognosis of patients.

Objective To investigate the clinic effectiveness of self-managing on stable chronic obstructive pulmonary disease (COPD).Methods 60 stable COPD patients were divided into the experiment group and control group according to their compliance to the management. The compliant patients (experiment group) received the rehabilitation education. They were assessed with the St. George's respiratory questionnaire (SGRQ) before and a year after treatment. Results After treatment, the scores of activity restriction and the total score of SGRQ in the experiment group improved more than that in the control (P<0.05). Conclusion Self-management is important for improving quality of life in stable COPD.