1.Theoretical framework and optimization path of rehabilitation fitness and sports services for people with disabilities from the perspective of the World Health Organization health service system
Jingyuan JIANG ; Guoxiang WANG
Chinese Journal of Rehabilitation Theory and Practice 2026;32(5):497-507
ObjectiveTo construct a theoretical framework for rehabilitation fitness and sports services for people with disabilities, analyze the practical challenges facing their development, and propose targeted optimization pathways to improve service quality. MethodsUsing literature review, policy analysis and logical reasoning, this study integrated the six building blocks of the World Health Organization health service system into a theoretical framework for rehabilitation fitness and sports services. From macro system architecture, meso-level element coordination and micro-level implementation, it elucidated the internal operational logic of each component, combined with a systematic analysis grounded in China's national context. ResultsThe theoretical framework of rehabilitation fitness and sports services for people with disabilities comprised six key elements: policy and regulation, financial support, human resources, service content, technological support and information monitoring. These elements formed a progressively deepening operational pathway from macro to micro levels, creating a continuous structure of top-level design, institutional coordination and practical implementation. The current services in China still faced structural constraints, including insufficient institutional coordination, a single-source funding structure, imbalanced resource allocation, weak professional support, lagging accessibility environments and inadequate digital governance, requiring systematic optimization through targeted interventions. ConclusionRehabilitation fitness and sports services for people with disabilities should strengthen top-level design and establish a diversified and coordinated policy system, expand funding channels to build a sustainable multi-source financing mechanism, enhance human resource development to improve long-term competency, clarify service processes to increase integration and alignment, advance the development of accessible technologies and expand the application of assistive devices, and build an intelligent regulatory system to leverage digital technologies.
2.New cultural development boosts high-quality growth of integrated traditional Chinese and western medicine hospitals:practice and research:a case study of Ruikang hospital of Guangxi university of Chinese medicine
Hongjun GAO ; Guoxiang WANG ; Ze XIA ; Huafang QIN ; Qinghong ZENG
Modern Hospital 2025;25(4):521-523
Taking Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine as an example,this paper sum-marizes the important role and practical experience of new cultural development in promoting the hospital's high-quality growth.It explores pathways for new cultural development to facilitate the high-quality advancement of integrated traditional Chinese and Western medicine hospitals,aiming to provide valuable practical guidance and theoretical support for such hospitals in the context of the new era.
3.HIC relationship of anterior-posterior and lateral-medial collisions based on the comprehensive evaluation of injury
Linna ZHU ; Guoxiang WANG ; Xun WANG ; Qinghang LUO ; Tao XIONG ; Qiuju CHEN ; Jingyu XU ; Jia YU ; Shengxiong LIU
Chinese Journal of Medical Physics 2025;42(3):406-414
Objective To explore the relationship between the head injury criterion(HIC)values in anterior-posterior(AP)collisions and lateral-medial(LM)collisions.Methods A total of 102 male SD rats were randomly divided into a control group of 0 m(6 rats),4 AP groups(12 rats/group)and 4 LM groups(12 rats/group).After adaptive training,the classical Marmarou model was used to execute the brain AP and LM collisions under a series of different height impacts,and the HIC values were calculated.The experimental group data of the walk-pole test and grip strength test were collected at 24 hours before and after injury,and the data of the proportion of hemorrhage in the corpus callosum and pyramidal tracts were collected at 24 hours after injury.Results As the collision heights increased in both AP and LM groups,there were positive correlations with changes in WP test time and peak GS,and corresponding increases in the proportion of hemorrhage in the cc and py.According to the mathematical relationships between the comprehensive injury degrees and HIC values,it was found that at the same injury degree,LM-HIC value was less than AP-HIC value.A mathematical relationship between AP-HIC and LM-HIC was fitted based on the comprehensive injury degrees.At the same HIC,LM group experienced more severe injuries,and AP group was more tolerant to head collision.Conclusion The injury severity in LM group is greater than that of AP group at the same HIC.Preliminary results show there is a linear mathematical relationship between AP-HIC and LM-HIC.These results can be expected to expand the application scope of HIC and achieve an accurate assessment of the LM collision severity.
4.New cultural development boosts high-quality growth of integrated traditional Chinese and western medicine hospitals:practice and research:a case study of Ruikang hospital of Guangxi university of Chinese medicine
Hongjun GAO ; Guoxiang WANG ; Ze XIA ; Huafang QIN ; Qinghong ZENG
Modern Hospital 2025;25(4):521-523
Taking Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine as an example,this paper sum-marizes the important role and practical experience of new cultural development in promoting the hospital's high-quality growth.It explores pathways for new cultural development to facilitate the high-quality advancement of integrated traditional Chinese and Western medicine hospitals,aiming to provide valuable practical guidance and theoretical support for such hospitals in the context of the new era.
5.HIC relationship of anterior-posterior and lateral-medial collisions based on the comprehensive evaluation of injury
Linna ZHU ; Guoxiang WANG ; Xun WANG ; Qinghang LUO ; Tao XIONG ; Qiuju CHEN ; Jingyu XU ; Jia YU ; Shengxiong LIU
Chinese Journal of Medical Physics 2025;42(3):406-414
Objective To explore the relationship between the head injury criterion(HIC)values in anterior-posterior(AP)collisions and lateral-medial(LM)collisions.Methods A total of 102 male SD rats were randomly divided into a control group of 0 m(6 rats),4 AP groups(12 rats/group)and 4 LM groups(12 rats/group).After adaptive training,the classical Marmarou model was used to execute the brain AP and LM collisions under a series of different height impacts,and the HIC values were calculated.The experimental group data of the walk-pole test and grip strength test were collected at 24 hours before and after injury,and the data of the proportion of hemorrhage in the corpus callosum and pyramidal tracts were collected at 24 hours after injury.Results As the collision heights increased in both AP and LM groups,there were positive correlations with changes in WP test time and peak GS,and corresponding increases in the proportion of hemorrhage in the cc and py.According to the mathematical relationships between the comprehensive injury degrees and HIC values,it was found that at the same injury degree,LM-HIC value was less than AP-HIC value.A mathematical relationship between AP-HIC and LM-HIC was fitted based on the comprehensive injury degrees.At the same HIC,LM group experienced more severe injuries,and AP group was more tolerant to head collision.Conclusion The injury severity in LM group is greater than that of AP group at the same HIC.Preliminary results show there is a linear mathematical relationship between AP-HIC and LM-HIC.These results can be expected to expand the application scope of HIC and achieve an accurate assessment of the LM collision severity.
6.Hippocampal neuroinflammation and neuronal injury in the acute phase of pentylenetetrazol induced epilepsy mouse model
Linyu ZHI ; Wanruo HAN ; WANG BENJAMIN HONGYE ; Guoxiang WANG ; Xu LIU
Chinese Journal of Clinical Medicine 2025;32(2):238-247
Objective To investigate the activation of microglia and astrocytes, the secretion of pro-inflammatory factors, and the survival of neurons in the hippocampus of mice with acute seizures induced by pentylenetetrazol (PTZ) 24 hours after the onset of seizures. Methods Adult male C57BL/6 mice were randomly assigned to the control group and the PTZ-induced acute epileptic seizure group using random numbers, with 28 mice in each group. The activation status of microglia and astrocytes in the CA1 region of the hippocampus was evaluated by immunofluorescence 24 hours after the onset of seizures. RNA was extracted from the hippocampal tissue to detect the expression level of inflammatory factor mRNA, and HE staining was used to assess the survival of neurons in the hippocampus. Results Twenty-four hours after PTZ-induced acute seizures in mice, the numbers of activated Iba1+ microglia (55.72±4.29 vs 35.71±9.66, P<0.001) and GFAP+ astrocytes (51.61±8.21 vs 37.64±5.27, P<0.01) in the CA1 region were significantly increased compared with the control group; the proportion of M1 microglia was significantly increased (0.58±0.02 vs 0.35±0.08, P<
7.Development of an evaluation indicator system for access to cancer screening services: a Delphi study
Xin WANG ; Ayan MAO ; Xinyi ZHOU ; Pei DONG ; Yanjie LI ; Senyao CAI ; Yujie WU ; Huiyao HUANG ; Guoxiang LIU ; Wanghong XU ; Jiangmei QIN ; Wanqing CHEN ; Jufang SHI
Chinese Journal of Epidemiology 2025;46(2):307-315
Objective:To present an evaluation indicator system for access to cancer screening services.Methods:The evaluation indicator pool was constructed through a scoping review. The theoretical framework was constructed based on the multi-source indicators, and the qualitative expert consultation method was employed to form the initial version of the three-level evaluation indicator system. Delphi expert consultation method was conducted in two rounds to evaluate the relevance, importance, and availability of the proposed evaluation indicator system. The expert positive coefficient, authority coefficient, coordination degree of expert opinions, and concentration of expert opinions were subjected to analysis. Subsequently, the three-level evaluation indicator system for access to cancer screening services was adjusted and determined based on the boundary value method and the open opinions of experts. Finally, the combination weight method was employed to determine the weight.Results:The initial version of the indicator system comprised 3 primary (first-level) indicators, 11 secondary (second-level) indicators, and 46 tertiary (third-level) indicators. Delphi expert consultation was conducted for the initial version, and 17 experts ultimately completed it, exhibiting a positive coefficient of 100% and an authority coefficient of 0.87. In comparison to the initial round of consultation, Kendall's W coefficient ranges (0.15-0.43, all P<0.05) of relevance, importance, and availability scores for each tertiary indicator in the second round exhibited an improvement. The analysis of the importance dimension indicates that expert opinions are also more concentrated, as evidenced by an increase of 8.5% and 7.0% in the proportion of the tertiary indicators with an arithmetic mean above 8 and a full mark ratio above 0.5, respectively. The final evaluation indicator system comprises three primary indicators, with the weights of structure evaluation, process evaluation, and outcome evaluation being 0.338, 0.378, and 0.285, respectively. It also comprises 11 secondary indicators and 45 tertiary indicators. Conclusions:The evaluation indicator system developed in this article can be an effective evaluation tool for quantitative comparison of access to cancer screening services across different populations, cancer types, and before and after intervention. Furthermore, it is recommended that the system undergo continuous optimization concerning its application.
8.Development of an evaluation indicator system for access to cancer screening services: a Delphi study
Xin WANG ; Ayan MAO ; Xinyi ZHOU ; Pei DONG ; Yanjie LI ; Senyao CAI ; Yujie WU ; Huiyao HUANG ; Guoxiang LIU ; Wanghong XU ; Jiangmei QIN ; Wanqing CHEN ; Jufang SHI
Chinese Journal of Epidemiology 2025;46(2):307-315
Objective:To present an evaluation indicator system for access to cancer screening services.Methods:The evaluation indicator pool was constructed through a scoping review. The theoretical framework was constructed based on the multi-source indicators, and the qualitative expert consultation method was employed to form the initial version of the three-level evaluation indicator system. Delphi expert consultation method was conducted in two rounds to evaluate the relevance, importance, and availability of the proposed evaluation indicator system. The expert positive coefficient, authority coefficient, coordination degree of expert opinions, and concentration of expert opinions were subjected to analysis. Subsequently, the three-level evaluation indicator system for access to cancer screening services was adjusted and determined based on the boundary value method and the open opinions of experts. Finally, the combination weight method was employed to determine the weight.Results:The initial version of the indicator system comprised 3 primary (first-level) indicators, 11 secondary (second-level) indicators, and 46 tertiary (third-level) indicators. Delphi expert consultation was conducted for the initial version, and 17 experts ultimately completed it, exhibiting a positive coefficient of 100% and an authority coefficient of 0.87. In comparison to the initial round of consultation, Kendall's W coefficient ranges (0.15-0.43, all P<0.05) of relevance, importance, and availability scores for each tertiary indicator in the second round exhibited an improvement. The analysis of the importance dimension indicates that expert opinions are also more concentrated, as evidenced by an increase of 8.5% and 7.0% in the proportion of the tertiary indicators with an arithmetic mean above 8 and a full mark ratio above 0.5, respectively. The final evaluation indicator system comprises three primary indicators, with the weights of structure evaluation, process evaluation, and outcome evaluation being 0.338, 0.378, and 0.285, respectively. It also comprises 11 secondary indicators and 45 tertiary indicators. Conclusions:The evaluation indicator system developed in this article can be an effective evaluation tool for quantitative comparison of access to cancer screening services across different populations, cancer types, and before and after intervention. Furthermore, it is recommended that the system undergo continuous optimization concerning its application.
9.Diagnostic value of 3D echocardiography in mitral insufficiency
Hu ZHANG ; Yongbo HOU ; Zhu WANG ; Zhongxin ZHOU ; Guoxiang WANG
China Medical Equipment 2024;21(12):93-97
Objective:To explore application value of three-dimensional (3D) echocardiography in mitral insufficiency (MI). Methods:A total of 180 MI patients who admitted to The Affiliated Hospital of Xuzhou Medical University from January 2023 to November 2023 were selected,and they were divided into a severe group (n=130) and a mild group (n=50) based on the MI severity. Both groups received routine echocardiography and 3D echocardiography to compare the parameters of routine echocardiography,and analyze the diagnostic efficacy of echocardiography for left ventricular configuration and systolic function in MI patients. Results:The heart rate and QRS interval of patients in the severe group were respectively higher than those in the mild group (t=3.910,6.336,P<0.05),respectively. The left ventricular end diastolic diameter (LVEDD),LVEDD index,left ventricular (LV) length,LV length index,left ventricular end diastolic volume (LVEDV),LVEDV index,left ventricular end systolic volume (LVESV),LVESV index,LV mass index (LVMI),relative wall thickness (RWT),and two-dimensional echocardiogram sphericity index (2D-SI) in the severe group were all higher than those in the mild group (t=27.729,14.509,11.745,8.182,24.171,32.989,25.988,20.994,22.707,6.331,20.603,P<0.05). The three-dimensional left ventricular ejection fraction (3D-LVEF) of the severe group was lower than that of the mild group,and the three-dimensional end diastolic velocity (3D-EDV) of blood flow,3D-EDV index,and three-dimensional echocardiogram sphericity index (3D-SI) of the severe group were all higher than those of the mild group (t=2.855,24.320,10.409,36.056,P<0.05). The results of receiver operating characteristic (ROC) curve showed that the sensitivities of LVEDD index,LVEDV index,LVESV index,3D-LVEF,3D-EDV index,and 3D-SI were respectively 70.83%,68.47%,81.25%,71.58%,72.42% and 90.38% in diagnosing MI. The specificities of them were respectively 67.40%,65.06%,79.64%,68.10%,71.68% and 90.38%. The area under curve (AUC) values of the ROC curve were respectively 0.658,0.612,0.814,0.726,0.799 and 0.852. 3D-SI had the highest sensitivity and specificity in diagnosing left ventricular remodeling of MI patients. Conclusion:3D echocardiography has higher application value in MI,which can reflect the remodeling and systolic function of left ventricle. Among of them,3D-SI can better describe the remodeling of left ventricle of patients,and can serve as a reference for the research progress of clinical observation for MI.
10.Research on functional prognosis prediction model of non-cardiac ischemic stroke based on machine learn-ing,thromboelastography and white matter lesions
Min XIA ; Guoxiang HUANG ; Jianli WANG ; Nengwei YU ; Daizong WU
Chinese Journal of Nervous and Mental Diseases 2024;50(12):726-734
Objective To explore the role and value of thromboelastography(TEG)combined with white matter hyperintensity(WMH)in predicting the functional prognosis of patients with non-cardiogenic acute ischemic stroke(AIS)through machine learning.Methods This study included 130 patients with non-cardiogenic AIS from August 2022 to February 2024.General clinical data,TEG and WMH information of all patients were collected.Three months later,functional outcomes were followed up using the modified Rankin scale(mRS),with an mRS score of≥2 indicating a poor prognosis.The prediction models were divided into four feature sets according to different ranges of predictors:set A(general clinical data+TEG indicators+WMH score),set B(general clinical data+TEG indicators),set C(general clinical data+WMH score),and set D(general clinical data).For each feature set,three machine learning algorithms,traditional logistic regression(LR)model,random forests(RF),neural network(NNET),and K-nearest neighbors(KNN),were used to construct models for predicting the 3-month neurological function outcome of patients with non-cardiogenic AIS.Bootstrap resampling internal validation was used to compare the performance of prediction models.Results The training and testing of the model were performed on 130 patient samples,and the AUC value and its confidence interval of the model were corrected by the 0.632+method(optimism correction).For the LR,NNET,and KNN models,the corrected AUC values of feature set A were significantly better than those of feature set D(DeLong test,P<0.05).For all models,the corrected AUC value of feature set A was higher than that of other feature sets.For feature set A,the corrected AUC value(0.830)of the NNET model was higher than that of other models.Among the 19 features of feature set A,six features with important associations with functional prognosis were selected including National Institute of Health stroke scale(NIHSS)score,stroke history,small artery occlusion subtype,periventricular white matter hyperintensities(PWMH)score,and TEG indicators maximum amplitude(MA)and LY30.Conclusion Combining TEG indicators and WMH information on the basis of general clinical data can significantly improve the accuracy of predicting poor functional prognosis in patients with non-cardiogenic AIS.The prediction models established by machine learning-based NNET and KNN algorithms have high predictive value.

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