Driven by multiple factors such as policy incentives,enhanced economic capacity of residents,aging popula-tion,and medical system reform,China's rehabilitation industry has been in a rapid development stage where opportunities and challenges coexist.Various rehabilitation hospitals urgently need new development thinking on how to seize the new opportunities for the development of rehabilitation medicine,give full play to the benefits of high-quality rehabilitation medical resources,and deal with the development of rehabilitation institutions under the new situation.Taking the tertiary rehabilitation hospital where the authors work as an example,this paper deeply analyzes the practical difficulties and challenges faced by the development of reha-bilitation hospital under the new circumstance,further explores the construction of a new working mode based on people-oriented and medical-rehabilitation integration.It also briefly summarizes the beneficial experiences and practices in the reform of rehabili-tation service models,and elaborates on the periodic achievement,so as to provide a meaningful reference for the majority of re-habilitation hospitals to plan and practice high-quality development and reform.

Objective To investigate the clinical value of high-frequency ultrasound in the diagnosis of pronator teres syndrome (PTS). Methods The high-frequency ultrasound was employed to examine and measure the median nerve of the pronator teres muscle in 30 patients with PTS and 30 healthy volunteers (control group).The long-axis diameter (LA),short-axis diameter (SA) and cross-sectional area (CSA) of the median nerve were measured.The receiver operating characteristic curve of the median nerve ultrasonic measurement results was established,and the area under the curve (AUC) was calculated.The diagnostic efficiency of each index for PTS was compared with the surgical results as a reference. Results The PTS group showed larger LA[(5.02±0.50) mm vs.(3.89±0.41) mm;t=4.38,P=0.013],SA[(2.55±0.46) mm vs.(1.70±0.41) mm;t=5.19,P=0.009],and CSA[(11.13±3.72) mm² vs.(6.88±2.68) mm²;t=8.42,P=0.008] of the median nerve than the control group.The AUC of CSA,SA,and LA was 94.3% (95%CI=0.912-0.972,Z=3.586,P=0.001),77.7% (95%CI=0.734-0.815,Z=2.855, P=0.006),and 78.8% (95%CI=0.752-0.821,Z=3.091,P=0.004),respectively.With 8.63 mm² as the cutoff value,the sensitivity and specificity of CSA in diagnosing PTS were 93.3% and 90.0%,respectively. Conclusion High-frequency ultrasound is a practical method for diagnosing PTS,and the CSA of median nerve has a high diagnostic value.
Humans ; Forearm/innervation* ; Muscle, Skeletal/innervation* ; Median Nerve/diagnostic imaging* ; Ultrasonography/methods* ; Sensitivity and Specificity

Objective:To investigate the hemodynamic changes of the main arteries and veins of the extremities and the heart in patients with hypertrophic scar secondary to extensive burns after pressure treatment, and to analyze the relevant mechanisms.Methods:A retrospective before-after self-control study was conducted. From January 2017 to February 2022, 37 patients with hypertrophic scar secondary to extensive burns who met the inclusion criteria were hospitalized in the Burn Rehabilitation Department of Guangdong Industrial Injury Rehabilitation Hospital, including 25 males and 12 females, aged 23-52 years. The patients were admitted to the hospital within 12 weeks after wound healing, and within one week after admission, rehabilitation therapists, occupational therapists, and tailors custom-made pressure products such as full-body pressure garment, pressure pants, vests, split finger gloves, split finger socks, hoods, and plastic collars, with the pressure at each part maintained at 2.67-4.00 kPa when wearing. Before the first treatment with pressure products (hereinafter referred to as before pressure treatment) and at 1 h of the first treatment with pressure products (hereinafter referred to as 1 h of pressure treatment), color Doppler ultrasonography was performed to check the pulse rate of the axillary artery, the lumen diameter, peak systolic velocity (PSV), and resistance index of the axillary artery and femoral artery on the left side, the lumen diameter, cross-sectional area, and average blood flow velocity of the axillary vein and femoral vein, and the mitral valve E peak, mitral valve A peak, tricuspid valve E peak, aortic valve PSV, and pulmonary valve PSV of the heart; an optical chromatographic skin detector was used to detect the red color, red pigment, and surface brightness of the scar on the back of the hand to reflect the filling and distribution of the scar microvessels. Data were statistically analyzed with paired sample t test. Results:Compared with those before pressure treatment, the PSV of the axillary artery of patients was significantly slowed down at 1 h of pressure treatment ( t=55.42, P<0.01); the average blood flow velocity of the axillary vein was significantly accelerated ( t=-60.50, P<0.01); the pulse rate, lumen diameter, and resistance index of the axillary artery, as well as the lumen diameter and cross-sectional area of the axillary vein did not change obviously ( P>0.05); the average blood flow velocity of the femoral vein was significantly accelerated ( t=-80.52, P<0.01); the lumen diameter, PSV, and resistance index of the femoral artery, as well as the lumen diameter and cross-sectional area of the femoral vein had no significant change ( P>0.05); the mitral valve E peak and mitral valve A peak of the heart decreased significantly (with t values of 10.71 and 21.96, respectively, P<0.01); the tricuspid valve E peak of the heart increased significantly ( t=7.57, P<0.01); the PSV of the aortic valve and pulmonary valve of the heart did not change obviously ( P>0.05). At 1 h of pressure treatment, the red color and red pigment values of the scar on the back of the hand of patients were 15.3±1.1 and 16.8±1.2, respectively, which were significantly lower than 24.5±1.3 and 23.8±1.2 before pressure treatment (with t values of 8.32 and 8.04, respectively, P<0.01). The brightness value of the scar surface on the back of the hand of patients at 1 h of pressure treatment was similar to that before pressure treatment ( P>0.05). Conclusions:After pressure treatment for the hypertrophic scar in patients secondary to extensive burn, the average blood flow velocity of the axillary vein and femoral vein in patients are obviously accelerated, the PSV of the axillary artery is significantly slowed down, the peak values of mitral valve E and mitral valve A of the heart are significantly decreased, and the tricuspid valve E peak is significantly increased. These hemodynamic changes may be related to the reduction of microvascular blood flow in the local area of scar after systemic pressure treatment.

Objective:To explore the effect of applying SHOW mode of mindfulness meditation training in the psychological intervention of patients with advanced lung cancer.Methods:From June 2020 to May 2021, a total of 130 patients with advanced lung cancer who were hospitalized in Taizhou Central Hospital were selected as the research objects by the convenient sampling method. According to the random number table method, patients were divided into the study group and the control group, with 65 cases in each group. The control group was given routine mindfulness meditation intervention, while the study group was given SHOW model mindfulness meditation training on the basis of the control group. The degree of anxiety and depression, psychological resilience and self-management efficacy of patients in the two groups were observed before and after intervention.Results:After intervention, scores of Hamilton Anxiety Scale (HAMA-14) and Hamilton Depression Scale (HAMD-17) in the two groups were lower than those before intervention and scores of HAMA-14 and HAMD-17 in the study group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . The scores of Connor-Davidson Resilience Scale (CD-RISC) and Strategies Used by People to Promote Health-Chinese (C-SUPPH) in two groups were higher than those before intervention and the scores of CD-RISC and C-SUPPH in the study group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The SHOW model mindfulness meditation training has a good application effect in the psychological intervention of patients with advanced lung cancer, which can effectively improve the degree of anxiety and depression of patients and enhance their psychological resilience and self-management efficacy.

Objective:To explore the effect of applying SHOW mode of mindfulness meditation training in the psychological intervention of patients with advanced lung cancer.Methods:From June 2020 to May 2021, a total of 130 patients with advanced lung cancer who were hospitalized in Taizhou Central Hospital were selected as the research objects by the convenient sampling method. According to the random number table method, patients were divided into the study group and the control group, with 65 cases in each group. The control group was given routine mindfulness meditation intervention, while the study group was given SHOW model mindfulness meditation training on the basis of the control group. The degree of anxiety and depression, psychological resilience and self-management efficacy of patients in the two groups were observed before and after intervention.Results:After intervention, scores of Hamilton Anxiety Scale (HAMA-14) and Hamilton Depression Scale (HAMD-17) in the two groups were lower than those before intervention and scores of HAMA-14 and HAMD-17 in the study group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . The scores of Connor-Davidson Resilience Scale (CD-RISC) and Strategies Used by People to Promote Health-Chinese (C-SUPPH) in two groups were higher than those before intervention and the scores of CD-RISC and C-SUPPH in the study group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The SHOW model mindfulness meditation training has a good application effect in the psychological intervention of patients with advanced lung cancer, which can effectively improve the degree of anxiety and depression of patients and enhance their psychological resilience and self-management efficacy.

Objective: To analyze the epidemic characteristics of enterovirus infection in Yueqing city from 2010 to 2018, and to provide reference for the prevention and control of hand, foot and mouth disease (HFMD) caused by enterovirus. Methods: Clinical data of HFMD cases caused by enterovirus infection during 2010 to 2018 were derived from the disease monitoring information report management system of Yueqing city. Descriptive epidemiological study was performed to analyze the characteristics of enterovirus infection by season, age, gender and region and the features of pathogens. Results: There were 53 178 patients with HFMD in total, including 75 severe cases and six deaths. Enterovirus infection occurred in every month of the years and peaked from April to July. Most of the cases were scattered children and nursery children under five years old and the incidence was higher in males than in females. From 2010 to 2018, the characteristics of enterovirus in Yueqing city had changed significantly. Enterovirus 71 (EV71) was the predominant pathogen during 2010 to 2014, but its detection rate had gradually decreased since 2013. In recent years, the incidence of HFMD caused by non-EV71 and non-coxsackievirus A16 (non-CVA16) enteroviruses significantly increased. Conclusions Enterovirus infection in Yueqing city was featured by significant seasonality and population-specific variation. Etiological detection should be strengthened. Comprehensive prevention and control measures should be taken to prevent the outbreak of HFMD during April to July.

Objective To explore risk factors for developing neurogenic heterotopic ossification (NHO) after traumatic brain injury (TBI).Methods Thirty-three patients suffering from TBI no more than 6 months and admitted to Guangdong Work Injury Rehabilitation Hospital between December 2015 and December 2016 were selected.Those with and without NHO was assigned to an NHO group (n =12) and a control group (n =21) respectively.The two groups were compared in terms of the duration of coma and mechanical ventilation,the time to start rehabilitation and the occurrence of infection,pressure ulceration,deep vein thrombosis (DVT) or inflammation.Muscle tension,white blood cell (WBC) count,erythrocyte sedimentation rate (ESR),high sensitivity creactive protein (hsCRP) and alkaline phosphatase (ALP) were also measured.Independent sample T tests,chi-squared tests and binary logistic regression were used to compare the two groups seeking to isolate risk factors for NHO which might be predictive.Results Significantly prolonged coma and/or mechanical ventilation were observed in NHO group compared to the control group.Significant differences were also found in the average WBC,ESR,hsCRP and ALP levels,as well as in the occurrence of infection,DVT and inflammatory symptoms between the two groups.The incidences of infection,DVT and inflammatory reaction were higher in the NHO group,as were the levels of leukocyte,ESR,hsCRP and ALP.Those differences between the groups were statistically (and of course clinically) significant.The duration of coma and mechanical ventilation,infection,DVT,inflammation,and elevated levels of leukocytes,ESR or ALP can all usefully be considered risk factors for NHO,with infection,DVT and inflammation of the highest importance.Conclusion Duration of coma and utilization of mechanical ventilation,infection,DVT,inflammation,as well as an increase of leukocytes,ESR or ALP should be considered as risk factors for NHO after TBI.

OBJECTIVETo explore clinical features and mutation types in patients from Fujian area with glutaric academia type I(GA I).

METHODSSerum acylcarnitine and urine organic acid of 3 patients were determined with tandem mass spectrometry and gas chromatographic mass spectrometry. The patients also underwent magnetic resonance imaging analysis for the cranial region. Genomic DNA was extracted from peripheral blood samples, and the 12 exons and flanking regions of the GCDH gene were amplified with PCR and subjected to direct DNA sequencing. One hundred healthy newborns were used as controls.

RESULTSMutations of the GCDH gene were identified in all of the 3 patients. Two patients have carried compound heterozygous mutations including c.1244-2A>C and c.1147C>T(p.R383C), c.406G>T(p.G136C) and c.1169G>A(p.G390E), respectively. One has carried homozygous c.1244-2A>C mutation. The same mutations were not detected among the 100 healthy newborns. Only one patient received early intervention and did not develop the disease. The other two had irreversible damagesto their intelligence.

CONCLUSIONc.1169G>A(p.G390E) is likely pathogenic mutations for GA I patients from Fujianarea. Early screening of neonatal metabolic diseases is crucial for such patients.

Objective To explore the situation of return-to-work (RTW) and its related factors in female injured works. Methods The da-ta of the basic information, counseling record and follow-up record after discharge were collected from social rehabilitation department in our center. The main influencing factors were analyzed by single factor analysis and two classification Logistic regression. Results 232 ob-jects were collected, among which, 149(64.2%) subjects had returned to work, and the median of absence time was 206.5 days. Single factor analysis indicated that their age, marriage, absence time and educational level were not correlated with the outcome of women injured work-ers' employment (P>0.05). However, place of social insurance, household register and injury severity correlated with the outcome (P<0.05). Conclusion Most of the female injured workers can return to work. The severity of injury, along with some system factors influence the RTW of them.

OBJECTIVETo assess the frequencies of CYP21A2 gene mutations among patients from Fujian area with classical 21-hydroxylase deficiency.

METHODSFor 19 probands from different families affected with classical steroid 21-hydroxylase deficiency and 74 family members, mutations of the CYP21A2 gene were analyzed with combined nested polymerase chain reaction, Sanger sequencing and multiplex ligation-dependent probe amplification. Time resolved fluorescence immunoassay was performed to determine the level of 17-hydroxyprogesterone (17-OHP) in all family members. Clinical data and laboratory results of the probands and their family members were analyzed.

RESULTSEleven mutations were identified among the 38 alleles from the 19 probands. 92.1% (35/38) of the mutant CYP21A2 alleles were due to recombination between CYP21A2 and CYP21A1P. Gene conversion and deletions were identified in 84.2% (32/38) and 7.9% (3/38) of the alleles, respectively. IVS2-13A/C>G and chimeras were the most common mutations, which respectively accounted for 34.2% (13/38) and 18.4% (7/38) of all mutant alleles. Among these, IVS2+1G>A and Q318X+356W were first reported in China. 74.3% (55/74) of the family members were carriers of heterozygous mutations. However, no significant difference was found in the 17-OHP levels between carriers and non-carriers (P>0.05).

CONCLUSIONThere seems to be a specific spectrum of CYP21A2 gene mutations in Fujian area, where IVS2-13A/C>G and chimeras are the most common mutations.

Adrenal Hyperplasia, Congenital ; genetics ; Alleles ; Female ; Humans ; Male ; Mutation ; genetics ; Steroid 21-Hydroxylase ; genetics