1.Needs for rehabilitation in China: Estimates based on the Global Burden of Disease Study 1990-2019.
Tian TIAN ; Lin ZHU ; Qingzhen FU ; Shiheng TAN ; Yukun CAO ; Ding ZHANG ; Mingxue WANG ; Ting ZHENG ; Lijing GAO ; Daria VOLONTOVICH ; Yongchen WANG ; Jinming ZHANG ; Zhimei JIANG ; Hongbin QIU ; Fan WANG ; Yashuang ZHAO
Chinese Medical Journal 2025;138(1):49-59
BACKGROUND:
As an essential part of health services, rehabilitation is of great significance to improve the health and quality of life of the whole population. Accelerating aging calls for a significant expansion of rehabilitation services in China, but rehabilitation needs remain unclear. We conducted the study to explore the rehabilitation needs in China and project the trend of rehabilitation needs from 2020 to 2034.
METHODS:
The data of health conditions that might potentially benefit from rehabilitation were obtained from Global Burden of Disease (GBD) study. Estimated annual percentage changes (EAPCs) were calculated to quantify the trends of the age-standardized rates. Projections of rehabilitation needs were made until 2034 using Bayesian age-period-cohort analysis (BAPC).
RESULTS:
Approximately 460 million persons (33.3% of the total population) need rehabilitation in China, contributing to 63 million years lived with disabilities (YLDs) in 2019. The number of prevalent cases that need rehabilitation increased from around 268 (95% uncertainty interval [UI]: 257-282) million in 1990 to almost 460 (95% UI: 443-479) million in 2019, representing an increase of 71.3%. The highest contribution to the need for rehabilitation was musculoskeletal disorders with about 322 (95% UI: 302-343) million persons in seven aggregate disease and injury categories, and hearing loss with over 95 (95% UI: 84-107) million people among 25 health conditions. Based on the projection results, there will be almost 636 million people (45% of the total population) needing rehabilitation services in China by 2034, representing an increase of 38.3%. The rehabilitation needs of neoplasms, cardiovascular diseases, and neurological disorders are expected to increase significantly from 2019 to 2034, with increases of 102.3%, 88.8% and 73.2%, respectively.
CONCLUSIONS
The need for rehabilitation in China substantially increased over the last 30 years. It is predicted that over two in five people will require rehabilitation by 2034, thus suggesting the need to develop rehabilitation services that meet individuals' rehabilitation needs.
Humans
;
China/epidemiology*
;
Global Burden of Disease
;
Female
;
Male
;
Musculoskeletal Diseases/epidemiology*
;
Rehabilitation/trends*
;
Quality of Life
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Middle Aged
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Aged
;
Bayes Theorem
2.To compare the antidepressant effects and impact on intestinal flora of different components of short-chain fatty acid
Jinrong CHEN ; Yanyan ZHANG ; Ruiyu ZHANG ; Mingxue GAO ; Penghong LIU ; Ning SUN
Chinese Journal of Nervous and Mental Diseases 2024;50(11):668-674
Objective To investigate the effects of different components of short-chain fatty acids (SCFAs) on depression-like behaviors and intestinal flora in chronic unpredictable mild stress (CUMS)-induced depressive rats. Methods Seventy-six healthy male rats were randomly divided into six groups. Rats in the acetate group (n=12),propionate group (n=15) and butyrate group (n=14) were given intraperitoneal injection (i.p.) of 50 mg/kg sodium acetate,100 mg/kg sodium propionate and 50 mg/kg sodium butyrate,respectively. Rats in the SCFAs group (n=12) were given i.p of 1∶1∶1 sodium acetate,sodium propionate and sodium butyrate mixed solution. Rats in the CUMS group (n=13) were given i.p of 1 mL/100 g saline. Rats in the control group (n=10) did not receive any treatment. Besides the control group,other groups were subjected to CUMS and intraperitoneal injection before stress for 28 days. The depression-like behaviors were assessed by sucrose preference test,forced swimming test,open field test,and then cecal fecal samples were collected to examine the composition of intestinal flora by 16S rRNA sequencing. Results Compared with the control group,the body weight of rats and the sugar preference coefficient decreased and the immobility time increased in the CUMS group (P<0.05). The butyrate group reversed the alterations in change of the sugar preference coefficient and the immobility time (P<0.05). Additionally,the sugar preference coefficient was elevated in the SCFAs group (P<0.05). The community structure of intestinal flora was changed in the CUMS group compared to the control group and was partially improved in the acetate group. The number of unique species reduced in the CUMS group but increased in the acetate group,propionate group,butyrate group and SCFAs group. LEfSe found the enrichment of Bifidobacterium in the propionate group and the enrichment of Collinsella in the SCFAs group. Conclusions Sodium butyrate significantly improves depressive-like behaviors of the CUMS-induced rats. Sodium acetate,sodium propionate,and short-chain fatty acid mixture can influence the composition of intestinal flora. However,their antidepressant effect is not significant. Sodium butyrate may be a better alternative for supplementing short-chain fatty acids in depression.
3.To compare the antidepressant effects and impact on intestinal flora of different components of short-chain fatty acid
Jinrong CHEN ; Yanyan ZHANG ; Ruiyu ZHANG ; Mingxue GAO ; Penghong LIU ; Ning SUN
Chinese Journal of Nervous and Mental Diseases 2024;50(11):668-674
Objective To investigate the effects of different components of short-chain fatty acids (SCFAs) on depression-like behaviors and intestinal flora in chronic unpredictable mild stress (CUMS)-induced depressive rats. Methods Seventy-six healthy male rats were randomly divided into six groups. Rats in the acetate group (n=12),propionate group (n=15) and butyrate group (n=14) were given intraperitoneal injection (i.p.) of 50 mg/kg sodium acetate,100 mg/kg sodium propionate and 50 mg/kg sodium butyrate,respectively. Rats in the SCFAs group (n=12) were given i.p of 1∶1∶1 sodium acetate,sodium propionate and sodium butyrate mixed solution. Rats in the CUMS group (n=13) were given i.p of 1 mL/100 g saline. Rats in the control group (n=10) did not receive any treatment. Besides the control group,other groups were subjected to CUMS and intraperitoneal injection before stress for 28 days. The depression-like behaviors were assessed by sucrose preference test,forced swimming test,open field test,and then cecal fecal samples were collected to examine the composition of intestinal flora by 16S rRNA sequencing. Results Compared with the control group,the body weight of rats and the sugar preference coefficient decreased and the immobility time increased in the CUMS group (P<0.05). The butyrate group reversed the alterations in change of the sugar preference coefficient and the immobility time (P<0.05). Additionally,the sugar preference coefficient was elevated in the SCFAs group (P<0.05). The community structure of intestinal flora was changed in the CUMS group compared to the control group and was partially improved in the acetate group. The number of unique species reduced in the CUMS group but increased in the acetate group,propionate group,butyrate group and SCFAs group. LEfSe found the enrichment of Bifidobacterium in the propionate group and the enrichment of Collinsella in the SCFAs group. Conclusions Sodium butyrate significantly improves depressive-like behaviors of the CUMS-induced rats. Sodium acetate,sodium propionate,and short-chain fatty acid mixture can influence the composition of intestinal flora. However,their antidepressant effect is not significant. Sodium butyrate may be a better alternative for supplementing short-chain fatty acids in depression.
4.Construction of an evaluation index system of public health emergency preparedness capacity in county-level centers for disease control and prevention
GAO Lijuan ; JING Qi ; ZHENG Wengui ; WU Fang ; DUAN Mingxue ; MA Anning
Journal of Preventive Medicine 2023;35(8):659-664
Objective:
To construct an evaluation index system of public health emergency preparedness capacity in county-level centers for disease control and prevention (CDC), so as to provide the evidence for improving the public health emergency preparedness capacity in county-level CDC.
Methods:
An index system framework was created based on review of health emergency policies, laws and regulations released in China from 2003 to 2023. The importance, sensitivity and accessibility of indicators were scored and screened through two rounds of Delphi expert consultations, and the weights of indicators were calculated using precedence charts. The efficiency of Delphi expert consultations was evaluated using the active coefficient, authority coefficient and coordination coefficient.
Results:
Eighteen experts participated in consultations, including 9 men, 15 with educational levels of master degree and higher, 12 with preventive medicine or public health as the specialty, and 12 with deputy senior professional titles and higher. The active coefficients of two rounds of consultations were 100.00% and 94.44%, and the authority coefficients were 0.83 and 0.84, respectively. The coordination coefficients of secondary and tertiary indicators during the second round consultation were 0.341 and 0.241, which were both higher than those during the first round (both P<0.05). The final evaluation index system included 8 primary indicators, 21 secondary indicators and 58 tertiary indicators. Among primary indicators, health emergency organization and management (0.203 1), health emergency team building (0.203 1) and financial support for health emergency (0.203 1) had the highest weights, and of secondary indicators, completion degree of health emergency administration regulations (initial weight/global weight: 0.750 0/0.152 3), health emergency team building (0.750 0/0.152 3) and financial support for emergency (0.750 0/0.152 3) had the highest weights, while among tertiary indicators, defining the duty of health emergency administration sectors had the highest weight (0.750 0/0.114 2).
Conclusion
The created evaluation index system is feasible for evaluation of the public health emergency preparedness capacity in county-level CDC.
5.Discussion on the mechanism of Jiangtang Xiaoke Granules for diabetes mellitus based on network pharmacology and molecular docking
Wenhua ZHANG ; Weiyu JIA ; Mingxue ZHOU ; Shuwen ZHANG ; Churan WANG ; Yijia JIANG ; Yanbing GONG ; Sihua GAO
International Journal of Traditional Chinese Medicine 2023;45(10):1293-1299
Objective:To predict the possible targets and signaling pathways of Jiangtang Xiaoke Granules in the treatment of diabetes mellitus (DM) using computer network pharmacology and molecular docking technology.Methods:The active components and targets of Jiangtang Xiaoke Granules were collected by ETCM; the targets of DM were searched from the databases of DisGeNET and GeneCards, and the intersections of the two were taken to draw a Venny diagram; String database was used for gene transformation and network interaction analysis; the network diagram was constructed with Cytoscape3.6.0; the predicted results were supported by molecular docking technology; GO and KEGG analysis was performed through Metascape database.Results:A total of 128 active components of Jiangtang Xiaoke Granules were screened, with 607 corresponding targets, 1 240 DM related targets, and 53 core targets. Molecular docking showed that the active components had good binding energy with the core targets. GO analysis yielded 46 functional items and KEGG analysis yielded 15 pathways.Conclusion:Jiangtang Xiaoke Granules regulate glucose homeostasis by participating in a variety of biological processes through multiple components, and multiple targets, including affecting lipids and atherosclerosis, Alzheimer disease, AMPK signaling pathway, Apelin signaling pathway, and glucagon signaling pathway.
6.Conceptual framework and its application of World Health Organization rehabilitation competency framework in rehabilitation human resource management
Fang WU ; Qi JI ; Zhouying QIU ; Hong SUN ; Anqiao LI ; Mingxue DUAN ; Qianqian GAO ; Weiqin CAI ; Wengui ZHENG
Chinese Journal of Rehabilitation Theory and Practice 2022;28(3):275-284
Objective To explore the application and method of World Health Organization Rehabilitation Competency Framework (RCF) in rehabilitation human resource management, and provide theoretical and practical reference for rehabilitation human resource management.Methods Based on the International Standard Classification of Occupations issued by the International Labour Organization, the application scope of RCF was systematically analyzed. The theoretical framework of rehabilitation human resource management based on RCF was constructed in combination with competency-based human resource management framework. On this basis, taking rehabilitation nurses as an example, the corresponding management methods and paths are proposed from four aspects of human resource management, including career management, recruitment and selection, training and development, and performance appraisal and salary management.Results Based on RCF, the theoretical framework of human resource management for rehabilitation nursing positions was constructed, and the main contents and processes of human resource management based on RCF were clarified from four aspects: recruitment and selection, training and development, performance appraisal and salary management, and career management. Occupational competency of rehabilitation professionals in International Standard Classification of Occupations was analyzed by RCF.Conclusion The rehabilitation competency framework constructed by WHO can be used to supplement the responsibilities of rehabilitation-related professionals in the International Standard Classification of Occupations issued by the International Labour Organization. RCF serves as a tool for practice managers and rehabilitation professionals in identifying selection criteria, learning objectives, and professional title assessment criteria. It can also be used in recruitment and selection, training and development, performance appraisal, salary management and career management in the field of rehabilitation human resource management.
7.Performance evaluation of rehabilitation workers using World Health Organization rehabilitation competency framework
Mingxue DUAN ; Qi JING ; Zhouying QIU ; Hongwei SUN ; Anqiao LI ; Fang WU ; Weiqin CAI ; Qianqian GAO ; Wengui ZHENG
Chinese Journal of Rehabilitation Theory and Practice 2022;28(3):285-294
Objective To explore the theory and method of performance evaluation for rehabilitation workers based on the World Health Organization Rehabilitation Competency Framework (RCF).Methods Using the theoretical framework and methods of the RCF, we analyzed rehabilitation workers' related competencies from the five dimensions, namely practice, professionalism, learning and development, management and leadership, and research, integrating core values and beliefs, competencies and behaviors, activities and tasks, and knowledge and skills, to construct a comprehensive evaluation method and pathway for rehabilitation workers' performance.Results Based on the RCF, which confirms the job competency requirements for rehabilitation workers, a multi-dimensional, multi-level and standardized performance evaluation index framework was formed. For example, performance evaluation system of physical therapists was consisted of five primary indicators and 26 secondary indicators from the combination of RCF and job standards.Conclusion The rehabilitation worker performance evaluation based on the RCF can evaluate the performance of rehabilitation workers in a scientific, standardized and comprehensive way. It analyzes the performance of rehabilitation workers in a multi-dimensional and systematic manner with the competence of rehabilitation workers as the center, and evaluates the quality and effectiveness of the performance of rehabilitation workers at different levels of proficiency, which makes the performance evaluation of rehabilitation workers more scientific and comprehensive, and enables rehabilitation workers to understand proficiency and clarify the gap, to promote rehabilitation workers to continuously improve their own level and enhance the quality of rehabilitation services.
8.Clinical value of transabdominal ultrasonography versus transvaginal ultrasonography in the early diagnosis of ectopic pregnancy
Chinese Journal of Primary Medicine and Pharmacy 2022;29(7):1059-1062
Objective:To investigate the clinical value of transabdominal ultrasonography versus transvaginal ultrasonography in the early diagnosis of ectopic pregnancy. Methods:A total of 100 patients with suspected early ectopic pregnancy who received treatment in Luanping Shengjian Hospital between April 2019 and April 2021 were included in this study. All of them underwent transabdominal and transvaginal ultrasonography. Surgical pathological results were used as the gold standard to analyze the diagnostic efficacy of the two examination methods. The detection rate of ectopic pregnancy by ultrasonography was compared between the two examination methods.Results:Early ectopic pregnancy was detected in 59 cases by transabdominal ultrasonography, among which seven cases were misdiagnosed and 10 cases were missed. Early ectopic pregnancy was detected in 60 cases by transvaginal ultrasonography, among which one case was misdiagnosed and three cases were missed. The sensitivity, specificity and accuracy of transvaginal ultrasonography in the early detection of ectopic pregnancy were 95.2%, 97.4% and 96.0%, respectively, which were significantly higher than those of transabdominal ultrasonography (83.9%, 81.6%, 83.0%, χ2 =4.21, 5.03, 8.99, P = 0.040, 0.025, 0.003). Transvaginal ultrasonography showed that detection rates of accessory mass, yolk sac, embryo, intrauterine pseudopregnancy sac, pelvic effusion and original vascular fluctuation were 88.7%, 50.0%, 24.2%, 22.6%, 12.9%, 87.1%, respectively, which were significantly higher than those of transabdominal ultrasonography (64.5%, 19.4%, 4.8%, 4.8%, 1.6%, 56.5%, χ2 = 10.13, 12.85, 9.36, 8.25, 5.87, 14.37, P = 0.001, < 0.001, = 0.002, = 0.004, = 0.015, < 0.001). Conclusion:Transvaginal ultrasonography is superior to transabdominal ultrasonography in the early detection of ectopic pregnancy and has a higher detection rate of sonographic manifestation than transabdominal ultrasonography.
9.Diagnostic performance of ADC value and texture features based on T 2WI fat suppressed image to distinguish benign and malignant soft tissue tumors
Dong CHEN ; Bin SHI ; Mingxue ZHENG ; Fei GAO ; Jiangning DONG ; Demei SONG ; Na ZHAO ; Feng CAO ; Xinyang WEI
Chinese Journal of Radiology 2021;55(3):282-287
Objective:To investigate the value of ADC derived from DWI combined with texture analysis derived from T 2WI fat suppressed images in distinguishing benign and malignant soft tissue tumors. Methods:The MRI and DWI images of 94 patients with soft tissue tumors (44 cases with malignant and 50 cases with benign) confirmed by pathology were analyzed retrospectively in the First Affiliated Hospital of USTC West District. ADC values of solid components were measured at GE ADW4.6 workstation. The texture features were extracted by manually drawing the ROI on the maximum level of the T 2WI fat suppressed images; the ADC values and texture parameters between the two groups were statistically analyzed by SPSS17.0, and the multivariate logistic regression model were conducted to analyze and calculate the diagnostic performance. Results:ADC value of benign and malignant soft tissue tumors was (1.6±0.3)×10 -3 mm 2/s, (1.2±0.5)×10 -3 mm 2/s, respectively, and the difference was statistically significant( t=-5.382, P<0.05). Taking 1.28×10 -3 mm 2/s as the critical value, the area under curve (AUC) for the diagnosis of benign and malignant soft tissue tumors was 0.783, the sensitivity was 92.00%, and the specificity was 65.91%. Among the texture features, the AUC of frequency size, skewness, Inertia All Direction_offset7, Inverse Difference Moment angle0_offset1, Inverse Difference Moment angle0_offset7 and Haralick Correlation All Direction_offset4_SD distinguishing benign and malignant soft tissue tumors were 0.825, 0.739, 0.826, 0.816, 0.820 and 0.783, respectively. The AUC, sensitivity and specificity of the best predictive model distinguishing benign and malignant soft tissue tumors were 0.930, 88.00% and 86.36% respectively using multivariate logistic regression analysis. Conclusion:ADC combined with texture analysis is of great value in preoperative differentiation of benign and malignant soft tissue tumors.
10.Progress on anti-inflammatory natural products
Xiaoli HOU ; Mingxue SUN ; Huanhuan GAO ; Kai XIAO
Journal of Pharmaceutical Practice 2015;(1):20-27
Inflammation is the defense response of the living tissues possessing vascular system to stimulations of various injury factors ,which plays a vital role in the initiation and progression of many major diseases .Drugs used to treat inflammation in the clinical mainly include non‐steroidal anti‐inflammatory drugs (NSAIDs) ,steroidal anti‐inflammatory drugs (SAIDs) and traditional Chinese medicine .As synthetic anti‐inflammatory drugs used in clinical currently have obvious adverse reactions , more and more attention were paid to seek anti‐inflammatory drugs from natural medicines .Reviews reported before mainly fo‐cus on anti‐inflammation mechanism of natural medicine ,however ,there are few reports on the summary of anti‐inflammatory natural products .Active natural products which were reported to possess anti‐inflammatory effects in recent years were summa‐rized in order to provide information for further study of anti‐inflammatory drugs research .


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