This study aims to investigate the isolate and identify of infectious bronchitis virus(IBV)in chickens,and study its genetic variation and pathogenicity.In 2023,two strains named CK/CH/HN/SQ202301 and CK/CH/HN/SQ202302 were obtained from suspected infectious bronchitis(IB)infected materials collected in a region of Henan Province,China.Further analysis showed that the two isolates belong to the G Ⅰ-13 and GⅥ genotypes,respectively.The cleavage sites of S protein were all RRSRR.The prediction of glycosylation sites showed that the two isolates had 18 and 12 N-glycosylation sites respectively,but no O-glycosylation site.Recombinant analysis shows that C2023-1 was a recombinant strain.Pathogenicity was assessed by infecting 1-day-old SPF chicks with the two isolates,and the results showed that C2023-1 strain infection could cause clini-cal symptoms such as depression and head shaking,as well as death in chicks,with a mortality rate of 37.5％.There were no clinical symptoms or deaths after infection with C2023-2 strain.Viral load test results showed that both isolates continued to detoxify until the 10th day,and had strong rep-lication capacity in the kidney,trachea and bursa of Fabricius.The results indicate significant differences in the genetic characteristics and pathogenicity of the two isolates due to their different genotypes.This study not only provides new epidemiological data on IB,which contributes to a bet-ter understanding of IBV's epidemiological features and control challenges,but also adds valuable bioinformatics resources for IBV by analyzing its variation mechanisms and biological information.

Objective:To explore the mediating effect of depression between self-efficacy and fear of progression in elderly patients with post-stroke epilepsy.Methods:From January 2023 to June 2024, 200 elderly patients with post-stroke epilepsy at Zhumadian Central Hospital were selected as study subjects using convenience sampling. The survey was conducted using the General Information Questionnaire, General Self-Efficacy Scale (SSEQ), Patient Health Questionnaire-9 (PHQ-9), and Fear of Progression Questionnaire-Short Form (FOP-Q-SF) .Results:A total of 200 questionnaires were distributed, and 198 valid questionnaires were collected, with a valid response rate of 99.00%. Among 198 elderly patients with post-stroke epilepsy, the SSEQ, PHQ-9, and FOP-Q-SF scores were (52.35±4.20), (13.46±1.57), and (35.70±2.10), respectively. Pearson correlation analysis revealed that SSEQ scores were negatively correlated with both PHQ-9 and FOP-Q-SF scores, while PHQ-9 scores were positively correlated with FOP-Q-SF scores ( P<0.01). Mediating analysis showed that depression partially mediated the relationship between self-efficacy and fear of progression in elderly patients with post-stroke epilepsy. The mediating effect was -0.046, with a total effect of -0.346, and the mediating effect accounted for 13.30% of the total effect. Conclusions:Depression partially mediates the relationship between self-efficacy and fear of progression in elderly patients with post-stroke epilepsy. Controlling depression not only helps enhance patients' self-efficacy but may also reduce their fear of progression.

Objective:To investigate the differential impact of ultra-high-resolution photon-counting detector CT (UHR PCD-CT) and energy-integrating detector CT (EID-CT) on image quality and calcified plaque-induced luminal stenosis in coronary CT angiography (CCTA).Methods:This retrospective analysis was conducted on patients who underwent both EID-CT and UHR PCD-CT CCTA at the Geriatric Hospital of Nanjing Medical University between January 2021 and November 2024. A total of 141 patients were included in the study, within 46 patients having scans within a 12-month interval. Image quality of all coronary artery segments was subjectively evaluated. Patients with paired scans (interval≤12 months) were included for calcified plaque analysis. Subjective visualization of calcified plaques evaluated. The blooming artifact was calculated as an objective evaluation index for assessing the calcified plaques. Additionally, the degree of coronary artery lumen stenosis resulting from calcified plaques was assessed, along with the measurement of plaque volume and the Agatston score. Changes in lumen stenosis between the two scans were also evaluated. The Wilcoxon signed-rank test was used to compare the subjective scores of coronary artery image quality and calcified plaques between the two groups, and paired-sample t-tests were used to compare the blooming artifact and lumen stenosis degree. Results:The PCD-CT image quality score was significantly higher than that of EID-CT [PCD-CT : 5 (4,5), EID-CT: 4 (4,5); Z=-21.38, P<0.001]. Compared to EID-CT, PCD-CT reduced the blooming artifact (PCD-CT: 38.88%±9.09%, EID-CT: 50.11%±11.52%; t=-12.97, P<0.001), significantly improving the subjective score for visualization of calcified plaques [PCD-CT: 5 (4,5), EID-CT: 3 (2,3); Z=-9.68, P<0.001], and the measured lumen stenosis was notably lower in PCD-CT(PCD-CT:34.88%±18.20%, EID-CT:45.31%±23.42%; t=-9.93, P<0.001). Among 129 analyzed calcified plaques, luminal stenosis was reduced on PCD-CT in 110 plaques (85.3%) and increased in 19 (14.7%), including 4 plaques that had unclear boundaries with the adjacent lumen in EID-CT CCTA images, making the stenosis difficult to assess. Conclusion:Compared to EID-CT, UHR PCD-CT for CCTA significantly improves coronary artery image quality, provides clearer visualization of calcified plaques and adjacent lumen details, and it can reduce the overestimation of coronary artery caleified plaque stenosis.

Objective To observe the effects of Yifei Jianpi Prescription on airway mucus hypersecretion and protein expressions of EGFR/PKC/NF-κB pathway in lipopolysaccharide(LPS)-induced acute lung injury(ALI)model rats;To explore its mechanism in the treatment of ALI.Methods Ten of 60 SPF SD rats were randomly selected as blank group,and the other rats were intratracheal instilled with LPS to establish ALI model.The model rats were randomly divided into model group,dexamethasone group and Yifei Jianpi Prescription high-,medium-and low-dosage groups,with 8 rats in each group.Each treatment group was given corresponding drug solution by gavage,and the blank group and model group were given equal volume of normal saline by gavage,once a day for 14 days.The pulmonary functions of rats were measured[peak expiratory flow(PEF),tidal volume(TV),expiratory volume(EV),50%expiratory flow rate(EF50)],HE staining was used to observe the morphology of lung tissue,AB-PAS staining was used to evaluate the proliferation and mucus secretion of goblet cells,the expressions of epidermal growth factor receptor(EGFR),protein kinase C(PKC),nuclear factor-κB(NF-κB)p65 and MUC5AC in lung tissue were detected by immunofluorescence staining,the mRNA expressions of EGFR and MUC5AC in lung tissue were detected by fluorescent quantitative PCR,and the content of MUC5AC in lung tissue was detected by ELISA.Results Compared with the blank group,PEF,TV,EV and EF50 of the model group rats significantly decreased(P<0.01);the bronchial wall was significantly thickened,the lumen narrowed,pulmonary interstitial edema and hyperemia,the thickness of alveolar wall increased,accompanied by a large number of inflammatory cells infiltration,and the lung tissue injury score increased significantly(P<0.01);goblet cells proliferated significantly,mucus secretion increased significantly(P<0.01);the protein expressions of EGFR,PKC,NF-κB p65,MUC5AC and mRNA expressions of EGFR and MUC5AC in lung tissue increased significantly(P<0.01),and the content of MUC5AC in lung tissue increased significantly(P<0.01).Compared with the model group,PEF,TV,EV and EF50 in dexamethasone group and Yifei Jianpi Prescription each dosage groups increased in varying degrees;the pathological injury of lung tissue was alleviated to varying degrees,the score of lung tissue injury was reduced;the proliferation of goblet cells was reduced,and the secretion of mucus was reduced,the expressions of EGFR,PKC,NF-κB p65,MUC5AC protein and EGFR,MUC5AC mRNA in lung tissue decreased,and the content of MUC5AC in lung tissue decreased.There was statistical significance in dexamethasone group and Yifei Jianpi Prescription high-and medium-dosage groups(P<0.01).Conclusion Yifei Jianpi Prescription can inhibit the hypersecretion of airway mucus and the high expression of EGFR/PKC/NF-κB pathway protein in rats with ALI induced by LPS.

Objective To construct a conceptual framework and methodology for developing disability eligibility/standard using the bio-psycho-social model of disability,and classification theory and methods of the International Classification of Functioning,Disability and Health(ICF).Methods Based on the ICF's bio-psycho-social model,and aliged with the United Nations Convention on the Rights of Persons with Disabilities and the World Health Organization technical documents in the fields of disability statis-tics and services,this study explored the systematic implementation of ICF to construct a conceptual framework and methodology for disability eligibility/standards,including core concepts and terminology of functioning and disability,methods and system of classification and grading,coding system,standardization of disability survey questionnaires and protocols,and assessment/evaluation tools,as well as standard system of disability data.Results The establishment of disability standards should be based on specific application contexts and functions.Stan-dards for surveys and statistics emphasized data collection and analysis,applied to the design of survey question-naires and methodologies.Standards for service eligibility focused on determining service qualification through structured assessments/evaluation of functioning and disability.Comprehensive standards served both purposes.A well-rounded disability standard integrated a clear theoretical framework,scientific classification,grading and coding systems,and standardized disability reporting and evaluation/assessment methods/tools.The conceptual framework and methodological system for disability standards based on ICF comprised five core aspects:a core conceptual and terminological system for disability;disability classification and grading methods and systems;a scientifically structured classification,grading,and coding system;standardized disability reporting and assess-ment/evaluation methods and procedures;and standardized disability data systems.Applying ICF in practice in-volved systematically integrating the theoretical framework into the development of disability classification and grading systems,constructing coding systems using ICF,implementing standardized disability reporting and as-sessment/evaluation tools derived from the ICF,designing and standardizing disability survey instruments,ques-tionnaires/protocols,and assessment/evaluation tools and protocols,and establishing ICF-based disability data standards.Conclusion ICF provides a robust conceptual framework and methodology for the development of disability eligibility/standards.The bio-psycho-social model,conceptual framework and methodological approaches of classification,grading and coding of functioning and disability,and ICF-based standardized survey and assessment/evaluation tools,enable the establishment of core disability concepts and terminology,disability classification and grading systems,disability coding systems,disability survey questionnaires and protocols and assessment/evaluation tools and programs,and disability data standards.The systematic application of the ICF framework and method-ology enhances the scientific rigor,inclusivity and applicability of disability eligibility/standards.

Objective To compare six existing Chinese standards related to visual disability,including Disability Assessment and Code for Life Insurance(Insurance Standard),Specification for Ability Assessment of Older Adults(Elderly Stan-dard),Grading of Disability due to Human Body Injury(Judicial Standard),Standard for Identify Work Ability—Gradation of Disability Caused by Work-related Injuries and Occupational Diseases(Work Injury Standard),Standard for Assessment of Disability Grades of Military Personnel(Military Standard),and Classification and Grading Criteria of Disability(Disability Classification Standard).Methods Based on the theoretical framework of International Classification of Functioning,Disability and Health(ICF)and International Classification of Diseases,the 11th Revision(ICD-11),and with reference to World Report on Vision(WRV),this study analyzed and compared five key dimensions of visual disability across the six stan-dards:definition,classification,grading,assessment methods and coding systems.Results In terms of definition,the insurance,work injury,military,and disability classification standards emphasized vi-sual structure and function,focusing on visual acuity and visual field;the insurance and elderly standards incor-porated activities and participation,reflecting the concept of functional vision;the judicial standard lacked a dedi-cated definition of visual disability.In terms of grading,each standard graded visual disability into different lev-els acoording to different functional indicators.In terms of coding,only the insurance standard adopted the ICF framework,while others used non-ICF numeric codes or lacked standardized coding.In terms of assessment tools,the elderly standard employed a customized perceptual and participation scoring system,while others re-lied primarily on vision charts.Conclusion Most current Chinese standards focus on impairments in visual function,with limited attention to activity limitations and participation restrictions.It is needed for incorporating the concept of functional vision,aligned with ICF and WRV,to establish a unified conceptual framework,terminology,coding system for visual disability,and comprehensive assessments that reflect not only impairments but also the impact on daily functioning and en-vironmental interaction.

Objective To compare six representative Chinese standards related to hearing disability in terms of conceptual frame-works,definitions,classification,grading and assessment.Methods Using the framework of International Classification of Functioning,Disability and Health(ICF),World Health Organization Disability Assessment Schedule 2.0(WHODAS 2.0),International Classification of Diseases,Elev-enth revision(ICD-11),and World Report on Hearing(WRH),six national standards,such as Disability Assess-ment and Code for Life Insurance(Insurance Standard),Specification for Ability Assessment of Older Adults(El-derly Standard),Grading of Disability due to Human Body Injury(Judicial Standard),Standard for Identify Work Ability—Gradation of Disability Caused by Work-related Injuries and Occupational Diseases(Work Injury Stan-dard),Standard for Assessment of Disability Grades of Military Personnel(Military Standard),and Classification and Grading Criteria of Disability(Disability Classification Standard),were analyzed in dimensions of defini-tions,coding systems,classification and grading methods,and assessment approaches.Results In terms of definitions,Insurance Standard was relatively comprehensive,covering the dimensions of body func-tion,activities and participation in ICF,which was consistent with the definition of functional hearing in the WRH.Elderly Standard focused on body function.Judicial,Work Injury and Military Standards were more in-clined to physiological damage,emphasizing auditory structure and sensory functions.Although Disability Clas-sification Standard covering dimensions of activities and participation,it did not elaborate on functional out-comes.In terms of classification and grading,different from the WRH's recommendation of 20 dB HL as the stan-dard for hearing impairment,most of the six standards still used 40 dB HL or above as the threshold.For grading levels,Insurance Standard had nine grades,while Judicial,Work Injury and Military Standards had seven grades,Elderly Standard had three grades,and Disability Classification Standard had four grades.The basis for grading relied more on physiological measurements rather than functional performance.In terms of coding systems,only Insurance Standard referred to ICF codes,while the others mostly used self-defined numerical sequences or grade codes.In terms of assessment methods,the WRH advocated a comprehensive assessment integrating auditory ability,self-reports and participation restrictions.However,currently,only Elderly Standard involved subjective sensory scoring,and the others still mainly relied on objective methods,such as pure-tone audiometers,lacking assessment dimensions for social participation and environmental factors.Conclusion Hearing disability should be defined from three levels:hearing structure and function,activity and participa-tion,and environmental factors.However,China's six standards adopt different definitions,classifications,grad-ing systems and assessment methods due to their varying purposes and application scenarios.The majority of these standards are primarily based on body function,specifically hearing loss.Future standards for hearing dis-ability need to consider the introduction of the concept of functional hearing,to determine hearing loss and its im-pact on activity and participation.

Objective To systematically compare five physical disability-related standards widely used in the fields of insurance,work related injury,forensic appraisal,and disability evaluation.The comparison covers definition,coding,classi-fication,grading,and assessment methods to reveal each standard's framework and methodology,and to provide evidence for integrating and optimizing physical disability standards.Methods Based on International Classification of Functioning,Disability and Health(ICF)and International Classifica-tion of Diseases,11th Revision(ICD-11),we analyzed and compared five physical disability-related standards,including Disability Assessment and Code for Life Insurance(Insurance Standard),Grading of Disability due to Human Body Injury(Judicial Standard),Standard for Identify Work Ability—Gradation of Disability Caused by Work-related Injuries and Occupational Diseases(Work Injury Standard),Standard for Assessment of Disability Grades of Military Personnel(Military Standard),and Classification and Grading Criteria of Disability(Disabili-ty Classification Standard).We examined definition,coding systems,classification,grading scales and assess-ment.Results According to the ICF framework,at the level of body functions and structures,physical disability mainly in-volved neuromusculoskeletal and movement related functions(b7),including joint and bone functions(b710-b729),muscle functions(b730-b749),and movement functions(b750-b789).At the activities and participation level,it primarily concerned mobility(d410-d499)and self care(d510-d599).Related conditions were commonly found in Certain infectious or parasitic diseases(01),Diseases of the nervous system(08),Diseases of the muscu-loskeletal system or connective tissue(15),Developmental anomalies(20),and Injury,poisoning or certain other consequences of external causes(22),etc.Among the five standards,only Disability Classification Standard ex-plicitly defined physical disability,yet its terminology did not followed ICF categories.Regarding coding,only the Insurance Standard adopted ICF codes;and the other four used self devised coding systems.The sub catego-ries in these physical disability standards did not fully cover all ICF categories relevant to physical disability.In terms of grading,Disability Classification Standard used a four level grading,whereas the other four standards employed ten level grading.Concerning assessment,all five emphasized evaluation of body structures and func-tions and involved daily activity capacity;however,WHO Disability Assessment Schedule(WHODAS 2.0)for comprehensive functional assessment,had not been proposed for evaluation of general functioning.Conclusion China has developed different physical disability standards to meet diverse needs.There are differences in definition,structure and content.It is necessary to revise and refine the relevant components of physical disabili-ty,including definition,classification,grading,coding and assessment,based on ICF and ICD-11,and to intro-duce WHODAS 2.0 as a comprehensive functional assessment tool.

ObjectiveTo elucidate the critical role of rehabilitation medical records (including electronic records) in rehabilitation medicine's clinical practice and management, comprehensively analyzed the structure, core content and data standards of rehabilitation medical records, to develop a standardized medical record data architecture and core dataset suitable for rehabilitation medicine and to explore the application of rehabilitation data in performance evaluation and payment. MethodsBased on the regulatory documents Basic Specifications for Medical Record Writing and Basic Specifications for Electronic Medical Records (Trial) issued by National Health Commission of China, and referencing the World Health Organization (WHO) Family of International Classifications (WHO-FICs) classifications, International Classification of Diseases (ICD-10/ICD-11), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Interventions (ICHI Beta-3), this study constructed the data architecture, core content and data standards for rehabilitation medical records. Furthermore, it explored the application of rehabilitation record summary sheets (home page) data in rehabilitation medical statistics and payment methods, including Diagnosis-related Groups (DRG), Diagnosis-Intervention Packet (DIP) and Case Mix Index. ResultsThis study proposed a systematic standard framework for rehabilitation medical records, covering key components such as patient demographics, rehabilitation diagnosis, functional assessment, rehabilitation treatment prescriptions, progress evaluations and discharge summaries. The research analyzed the systematic application methods and data standards of ICD-10/ICD-11, ICF and ICHI Beta-3 in the fields of medical record terminology, coding and assessment. Constructing a standardized data structure and data standards for rehabilitation medical records can significantly improve the quality of data reporting based on the medical record summary sheet, thereby enhancing the quality control of rehabilitation services, effectively supporting the optimization of rehabilitation medical insurance payment mechanisms, and contributing to the establishment of rehabilitation medical performance evaluation and payment based on DRG and DIP. ConclusionStructured rehabilitation records and data standardization are crucial tools for quality control in rehabilitation. Systematically applying the three reference classifications of the WHO-FICs, and aligning with national medical record and electronic health record specifications, facilitate the development of a standardized rehabilitation record architecture and core dataset. Standardizing rehabilitation care pathways based on the ICF methodology, and developing ICF- and ICD-11-based rehabilitation assessment tools, auxiliary diagnostic and therapeutic systems, and supporting terminology and coding systems, can effectively enhance the quality of rehabilitation records and enable interoperability and sharing of rehabilitation data with other medical data, ultimately improving the quality and safety of rehabilitation services.

ObjectiveTo explore the data standard system of electronic medical records in the field of rehabilitation, focusing on the terminology and coding standards, data structure, and key content categories of rehabilitation electronic medical records. MethodsBased on the Administrative Norms for the Application of Electronic Medical Records issued by the National Health Commission of China, the electronic medical record standard architecture issued by the International Organization for Standardization and Health Level Seven (HL7), the framework of the World Health Organization Family of International Classifications (WHO-FICs), Basic Architecture and Data Standards of Electronic Medical Records, Basic Data Set of Electronic Medical Records, and Specifications for Sharing Documents of Electronic Medical Records, the study constructed and organized the data structure, content, and data standards of rehabilitation electronic medical records. ResultsThe data structure of rehabilitation electronic medical records should strictly follow the structure of electronic medical records, including four levels (clinical document, document section, data set and data element) and four major content areas (basic information, diagnostic information, intervention information and cost information). Rehabilitation electronic medical records further integrated information related to rehabilitation needs and characteristics, emphasizing rehabilitation treatment, into clinical information. By fully applying the WHO-FICs reference classifications, rehabilitation electronic medical records could establish a standardized framework, diagnostic criteria, functional description tools, coding tools and terminology index tools for the coding, indexing, functional description, and analysis and interpretation of diseases and health problems. The study elaborated on the data structure and content categories of rehabilitation electronic medical records in four major categories, refined the granularity of reporting rehabilitation content in electronic medical records, and provided detailed data reporting guidance for rehabilitation electronic medical records. ConclusionThe standardization of rehabilitation electronic medical records is significant for improving the quality of rehabilitation medical services and promoting the rehabilitation process of patients. The development of rehabilitation electronic medical records must be based on the national and international standards. Under the general electronic medical records data structure and standards, a rehabilitation electronic medical records data system should be constructed which incorporates core data such as disease diagnosis, functional description and assessment, and rehabilitation interventions. The standardized rehabilitation electronic medical records scheme constructed in this study can support the improvement of standardization of rehabilitation electronic medical records data information.