Objective:To observe any impact of supplementing conventional rehabilitation training with electrothermal acupuncture on the upper limb motor functioning of hemiplegic stroke survivors.Methods:Thirty-six hemiplegic persons who had recently survived a stroke were divided at random into an electrothermal acupuncture group ( n=18) and a control group ( n=18). Both groups received conventional rehabilitation training, while the electrothermal acupuncture group was additionally provided with daily 30-minute sessions of electrothermal acupuncture, 6 days per week for 3 weeks. Before and after the treatment everyone′s upper limb motor functioning was quantified using the Fugl-Meyer assessment (FMA-UE), and their ability in the activities of daily living (ADL) was assessed using the modified Barthel index (MBI). The Hong Kong version of the functional test for the hemiplegic upper extremity (FTHUE-HK) was also administered. Surface electromyography (sEMG) was employed to compute the co-contraction ratios (CRs) of the agonist to antagonist muscles during elbow flexion and extension. Results:After the treatment, both groups exhibited significant improvements in their average FMA-UE, FTHUE-HK and MBI results, but with significantly greater improvement in the electrothermal acupuncture group. The root mean square values of the wrist flexor and extensor and elbow flexor muscles during flexion showed significant improvement in both groups, with the average values in the electrothermal acupuncture group significantly better than those of the control group. The CR values during elbow extension in the electrothermal acupuncture group demonstrated significant improvement compared to before the treatment.Conclusions:Supplementing conventional rehabilitation measures with electrothermal acupuncture can better increase the strength of the elbow and wrist extensor muscles in the early days after a stroke. It promotes the recruitment of muscle fibers in the extensor muscle group, reduces abnormal coordination patterns in the elbow joint, and improves upper limb motor function, the practicality of hand function, and ability in the activities of daily living.

Objective To evaluate the service efficiency of nursing homes in China from a medical care integration per-spective and analyze influencing factors.Methods The three-stage Data Envelopment Analysis(DEA)model was applied to e-liminate the influence of environmental factors to analyze the efficiency of nursing homes in various provinces in China.Addition-ally,a Tobit model was used to examine the determinants of efficiency.Results During the research period,the traditional DEA model overestimated the comprehensive efficiency and scale efficiency of nursing homes in 31 provinces,municipalities,and au-tonomous regions in China,and underestimated the pure technical efficiency.Environmental factors such as per capita GDP,the elderly dependency ratio,and the proportion of urban population impacted the input variables to significantly different extents,with a comprehensive efficiency score of 0.785,a pure technical efficiency score of 0.870,and a scale efficiency score of 0.901.Key influencing factors of the service efficiency of elderly care institutions included basic elderly care facilities,regional popula-tion size,residents'consumption capacity,degree of disability of the care recipients,quality of human resources,and capacity of medical services.Conclusion After eliminating the influence of environmental factors through the three-stage DEA,the efficien-cy evaluation is more accurate.The service efficiency of nursing homes varies across different regions in China:the eastern region exhibits the highest efficiency,followed by the central region and the western region.

Robotic surgical systems, with advantages such as 3D visualization, rotating instruments, and stable imaging, are increasingly utilized in transabdominal and transanal approaches for rectal cancer surgery. Compared to traditional laparoscopy, robotic systems could educe the technical difficulty of total mesorectal excision (TME) and enhance pelvic autonomic nerve preservation, while demonstrating comparable long-term outcomes. However, the high cost and limited clinical benefits have led to reflection. Controversies persist regarding prolonged operative time, lack of haptic feedback and limited cost-effectiveness. Studies suggest robotic surgery may benefit patients with complex conditions such as obesity, narrow pelvis or low rectal tumors. The rapid development of domestic surgical robots is expected to break market monopolies, reduce costs and expand applications through telemedicine. Future efforts should focus on identifying optimal patient cohorts and generating high-quality evidence to refine the clinical utility of robotic surgery.

Robotic surgical systems, with advantages such as 3D visualization, rotating instruments, and stable imaging, are increasingly utilized in transabdominal and transanal approaches for rectal cancer surgery. Compared to traditional laparoscopy, robotic systems could educe the technical difficulty of total mesorectal excision (TME) and enhance pelvic autonomic nerve preservation, while demonstrating comparable long-term outcomes. However, the high cost and limited clinical benefits have led to reflection. Controversies persist regarding prolonged operative time, lack of haptic feedback and limited cost-effectiveness. Studies suggest robotic surgery may benefit patients with complex conditions such as obesity, narrow pelvis or low rectal tumors. The rapid development of domestic surgical robots is expected to break market monopolies, reduce costs and expand applications through telemedicine. Future efforts should focus on identifying optimal patient cohorts and generating high-quality evidence to refine the clinical utility of robotic surgery.

Objective To evaluate the service efficiency of nursing homes in China from a medical care integration per-spective and analyze influencing factors.Methods The three-stage Data Envelopment Analysis(DEA)model was applied to e-liminate the influence of environmental factors to analyze the efficiency of nursing homes in various provinces in China.Addition-ally,a Tobit model was used to examine the determinants of efficiency.Results During the research period,the traditional DEA model overestimated the comprehensive efficiency and scale efficiency of nursing homes in 31 provinces,municipalities,and au-tonomous regions in China,and underestimated the pure technical efficiency.Environmental factors such as per capita GDP,the elderly dependency ratio,and the proportion of urban population impacted the input variables to significantly different extents,with a comprehensive efficiency score of 0.785,a pure technical efficiency score of 0.870,and a scale efficiency score of 0.901.Key influencing factors of the service efficiency of elderly care institutions included basic elderly care facilities,regional popula-tion size,residents'consumption capacity,degree of disability of the care recipients,quality of human resources,and capacity of medical services.Conclusion After eliminating the influence of environmental factors through the three-stage DEA,the efficien-cy evaluation is more accurate.The service efficiency of nursing homes varies across different regions in China:the eastern region exhibits the highest efficiency,followed by the central region and the western region.

Objective:To observe any impact of supplementing conventional rehabilitation training with electrothermal acupuncture on the upper limb motor functioning of hemiplegic stroke survivors.Methods:Thirty-six hemiplegic persons who had recently survived a stroke were divided at random into an electrothermal acupuncture group ( n=18) and a control group ( n=18). Both groups received conventional rehabilitation training, while the electrothermal acupuncture group was additionally provided with daily 30-minute sessions of electrothermal acupuncture, 6 days per week for 3 weeks. Before and after the treatment everyone′s upper limb motor functioning was quantified using the Fugl-Meyer assessment (FMA-UE), and their ability in the activities of daily living (ADL) was assessed using the modified Barthel index (MBI). The Hong Kong version of the functional test for the hemiplegic upper extremity (FTHUE-HK) was also administered. Surface electromyography (sEMG) was employed to compute the co-contraction ratios (CRs) of the agonist to antagonist muscles during elbow flexion and extension. Results:After the treatment, both groups exhibited significant improvements in their average FMA-UE, FTHUE-HK and MBI results, but with significantly greater improvement in the electrothermal acupuncture group. The root mean square values of the wrist flexor and extensor and elbow flexor muscles during flexion showed significant improvement in both groups, with the average values in the electrothermal acupuncture group significantly better than those of the control group. The CR values during elbow extension in the electrothermal acupuncture group demonstrated significant improvement compared to before the treatment.Conclusions:Supplementing conventional rehabilitation measures with electrothermal acupuncture can better increase the strength of the elbow and wrist extensor muscles in the early days after a stroke. It promotes the recruitment of muscle fibers in the extensor muscle group, reduces abnormal coordination patterns in the elbow joint, and improves upper limb motor function, the practicality of hand function, and ability in the activities of daily living.

Objective:To explore the correlation between serum levels of interleukin-9 (IL-9), platelet activating factor (PAF), total immunoglobulin E (IgE), interferon γ (IFN-γ), and interleukin-4 (IL-4) in patients with chronic spontaneous urticaria (CSU).Methods:Sixty CSU active phase patients admitted to the First Affiliated Hospital of Hebei North University from March 2018 to March 2019 were selected and included in the CSU active phase group. Based on the 7-day Urticaria Activity Score (UAS7), they were divided into three groups: 15 mild group, 25 moderate group, and 20 severe group; And 19 patients who entered the quiescent phase of the disease after 28 days of standardized antihistamine treatment were included in the CSU quiescent phase group. Another 30 healthy subjects who participated in the physical examination at the same time at our hospital′s physical examination center were selected to be included in the healthy control group. 5 ml of fasting elbow vein blood was collected from CSU active and stationary patients, as well as healthy subjects. The serum levels of IL-9, PAF, total IgE, IFN-γ, and IL-4 were detected using enzyme-linked immunosorbent assay. Pearson correlation test was used to analyze the correlation between serum IL-9, PAF levels and total IgE, IFN-γ, and IL-4 levels in CSU active patients.Results:The serum levels of IL-9, PAF, total IgE, and IL-4 in the CSU active phase group were higher than those in the CSU stationary phase group and healthy control group (all P<0.05), and the serum IFN-γ levels were lower than those in the CSU stationary phase group and healthy control group (all P<0.05). There was no statistically significant difference in the levels of the above indicators between the healthy control group and the CSU stationary group (all P>0.05). The serum levels of IL-9, PAF, total IgE, and IL-4 in the severe group were significantly higher than those in the mild and moderate groups (all P<0.05), and the serum IFN-γ levels were significantly lower than those in the mild and moderate groups (all P<0.05); The serum levels of IL-9, PAF, total IgE, and IL-4 in the moderate group were significantly higher than those in the mild group (all P<0.05), and the serum IFN-γ levels were significantly lower than those in the mild group ( P<0.05). Pearson correlation analysis showed that serum IL-9 and PAF levels were positively correlated with serum total IgE and IL-4 levels in CSU active phase patients (IL-9: r=0.726, 0.870, PAF: r=0.788, 0.795, all P<0.01), and negatively correlated with serum IFN-γ levels (IL-9: r=-0.831, PAF: r=-0.816, all P<0.01). Conclusions:The serum levels of IL-9 and PAF in patients with active CSU are elevated and correlated with total IgE, IFN-γ, and IL-4 levels, suggesting that IL-9 and PAF may be related to the occurrence and development of CSU.

Objective To investigate the correlation between somatosensory evoked potentials(SEP)of upper limbs,and sensory and motor functions in stroke patients in different stages. Methods From June,2021 to October,2023,177 stroke patients in Shijiazhuang People's Hospital were diveded into acute stage group(within 14 days,n=25),early recovery group(14 days to one month,n=110)and middle to late recovery group(one to six months,n=42)according to the duration of the disease.General information of the patients was recorded;SEP examination was performed,and N20 lantency and amplitude were recorded.Monofilament touch and two-point discrimination sensation of the patient's hands were tested using the monofila-ment and two-point discrimination tools,respectively;and motor function was assessed with Fugl-Meyer Assess-ment-Upper Extremities(FMA-UE).The correlation between SEP,and the sensory and motor scores in each group was analyzed. Results There was no significant difference in the monofilament tactile and two-point discrimination scores among the three groups(P>0.05).SEP was not correlated with sensory and motor functions in the acute stage group(P>0.05);in the early recovery group,N20 latency was negatively correlated with monofilament tactile sensation(r=-0.267,P=0.005)and positively correlated with two-point discrimination sensation(r=0.220,P=0.021),and N20 amplitude was positively correlated with monofilament tactile sensation(r=0.328,P<0.001)and FMA-UE score(r=0.418,P<0.001),and negatively correlated with two-point discrimination(r=-0.405,P<0.001);in the middle to late recovery group,the N20 latency was negatively correlated with FMA-UE score(r=-0.313,P=0.044),and N20 amplitude was positively correlated with monofilament tactile sensation(r=0.598,P<0.001)and FMA-UE score(r=0.393,P=0.010),and negatively correlated with two-point discrimination(r=-0.591,P<0.001).Multiple linear regression analyses showed that the score of monofilament tactile sensa-tion was negatively correlated with N20 latency(β=-0.510,P=0.046),and the FMA-UE score was positively correlated with N20 amplitude(β=0.313,P=0.026)in the middle to late recovery group;in the early recovery group,the two-point discriminative sensation score was negatively correlated with N20 amplitude(β=-0.270,P=0.039). Conclusion The correlation between SEP and sensory and motor functions becomes more significant with the prolonga-tion of disease.

Humans ; Staphylococcus lugdunensis/genetics* ; Peptides, Cyclic ; Chromosomes ; Operon/genetics* ; Staphylococcal Infections/genetics* ; Bacterial Proteins/genetics* ; Anti-Bacterial Agents

Objective:To explore the relationship of serum interleukin (IL) -9 and platelet-activating factor (PAF) levels with serum total immunoglobulin E (IgE) levels, disease severity and disease course in patients with chronic spontaneous urticaria (CSU) .Methods:A total of 60 patients with active CSU were collected from Department of Dermatology, the First Affiliated Hospital of Hebei North University from March 2018 to March 2019 (active CSU group), and divided into mild group, moderate group and severe group according to 7-day urticaria activity score (UAS7). After 28-day standard antihistamine therapy, the patients whose condition became stable were included in the stable CSU group. During the same period, 30 health examinees were included in the healthy control group. Peripheral venous blood samples were collected from the subjects in each group, enzyme-linked immunosorbent assay (ELISA) was performed to detect serum levels of IL-9 and PAF, and immunoturbidimetric assay to detect the serum total IgE level. Correlations of serum IL-9 and PAF levels with serum total IgE levels, UAS7 scores and disease courses were analyzed in patients with CSU. One-way analysis of variance was used for comparisons among multiple groups, least significant difference- t test for multiple comparisons, and Pearson correlation analysis for correlation analysis. Results:Totally, 28 males and 32 females were included in the active CSU group, their age ranged from 11 to 68 years (34.68 ± 8.62 years), and the disease duration ranged from 2 months to 7 years (1.42 ± 0.41 years). In the healthy control group, 14 were males and 16 were females, and their age ranged from 10 to 70 years (35.06 ± 7.89 years). According to UAS7, 12, 26, and 22 patients were diagnosed with mild, moderate and severe CSU respectively, and 22 were included in the stable CSU group after standard treatment. The levels of serum IL-9, PAF and total IgE significantly differed among the active CSU group, stable CSU group and healthy control group (IL-9: 144.34 ± 23.19 vs. 109.25 ± 20.77 vs. 107.23 ± 19.23 pg/ml; PAF: 362.45 ± 51.45 vs. 223.18 ± 32.46 vs. 221.23 ± 28.38 pg/ml; total IgE: 168.12 ± 32.48 vs. 24.04 ± 7.04 vs. 21.76 ± 5.95 IU/ml; F = 38.80, 148.38, 499.12, respectively, all P < 0.001), and were significantly higher in the active CSU group than in the stable CSU group and healthy control group (all P < 0.05), while there was no significant difference between the stable CSU group and healthy control group (all P > 0.05). Pearson correlation analysis showed that the serum IL-9 and PAF levels were positively correlated with serum total IgE levels and UAS7 scores (all P < 0.05), but not correlated with the disease course (both P > 0.05) . Conclusion:Serum IL-9 and PAF levels in patients with active CSU were markedly elevated along with the increase in disease severity, and closely correlated with serum total IgE levels.