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 systematically analyze international disability data policies and standards, as well as the application of disability data in policymaking, service optimization and inclusive social development, and to clarify the importance of international disability data policies, standard systems and disability data application for the development of disability-related services. MethodsThrough the analysis of policy content and research on the data standard system, this study explored the disability data policy framework, standard system and technical path of data interoperability and integration of international organizations including the United Nations (United Nations Statistics Division and United Nations Children's Fund), World Health Orgnization, United Nations Educational Scientific and Cultural Organization, and International Labour Organization. ResultsInternational organizations established disability data policy frameworks based on their respective mandates, involving data and service development, data standards, data governance, and data application. The international community established a disability data standard system for disability data collection, coding, exchange, interoperability, statistical analysis, data fusion and application. Building a standardized disability data standard system based on the framework of international health classification standards such as International Classification of Functioning, Disability and Health, and International Classification of Diseases, Eleventh Revision would ensure the consistency of cross-national disability data policies, and the interoperability and comparability of disability data, promoting the development of data-driven disability-related services, accurately identifying the service needs of people with disabilities, and optimizing service provision, thereby improving the quality of life and social participation of people with disabilities. ConclusionThe construction and implementation of international disability data policies and data standards have promoted the standardization and interoperability of disability data. With the application of big data, artificial intelligence and blockchain technologies in disability data, international cooperation and cross-industry data fusion in the field of disability data have been promoted, further promoting the development of data-driven disability services, ensuring equal opportunities for people with disabilities to enjoy service resources, and improving the coverage and quality of disability services.

Secondary infections are the leading cause of death in patients with bullous pemphigoid. Early identification of risk factors for secondary infections in patients with bullous pemphigoid can improve their prognosis. This review summarizes the relationships of secondary infections in bullous pemphigoid with clinical characteristics, laboratory indicators, drug treatment, and duration of hospitalization, providing a reference for clinical evaluation and treatment.

Objective:To systematically integrate the attitudes and experiences of medical staffs towards the family presence during resuscitation and provide a reference for the development of family presence during resuscitation clinical practice in China.Methods:To search PubMed, Embase, Web of Science, The Cochrane Library, CINAHL, CNKI, CBM and Wanfang database for qualitative studies on medical staff's attitudes and experiences of family presence during resuscitation since its inception to August 2022. The quality of the literature was evaluated using the Australian JBI Centre for Evidence-Based Health Care (2017) quality assessment criteria for qualitative studies, which were integrated using a pooled integration approach.Results:A total of 12 papers were included to distil the findings of 74 studies, which were summarized to form 10 new categories and 4 consolidated findings including medical staffs′ attitudes towards and reasons for family presence during resuscitation, the impact of family presence during resuscitation on the resuscitation team, the impact of family presence during resuscitation on patients and families, and the real-life dilemmas and recommendations for medical staffs to allow family presence during resuscitation.Conclusions:We should pay attention to the difficulties and needs of family presence during resuscitation by medical staff, take into account the medical context in China, and improve the humanistic care system in our hospitals by considering hospital management, clinical practice, and the demands of patients and their families, in order to improve the accessibility of family presence during resuscitation by the medical staff.

Objective:To understand the current situation of knowledge, attitude and practice about target temperature management (TTM) in patients with severe traumatic brain injury (STBI) among intensive care unit ICU nurses and analyze the influencing factors, so as to provide a reference for conducting ICU nurses′ TTM training for patients with STBI.Methods:Applying the method of cross-sectional study, from November to December 2022, a stratified whole-group sampling method was used, stratified by first-, second-, and third-level hospitals, and a self-designed questionnaire on the current status of ICU nurses′TTM for patients with STBI was used to investigate the current status of knowledge, attitude, and practice of neurosurgical ICU, emergency ICU, and comprehensive ICU nurses in 22 second- and third-level hospitals in 11 cities in Gansu Province, and multiple linear regression analysis was used to analyze the factors influencing ICU nurses′ knowledge, attitude, and practice scores.Results:A total of 543 valid questionnaires were returned, and the scores of ICU nurses on the TTM total score, knowledge, attitude and practice dimensions of STBI patients were (76.75 ± 10.42), (7.38 ± 2.74), (39.57 ± 4.87), (29.80 ± 7.18) points respectively. The results of multiple linear regression analysis showed that the factor influencing ICU nurses′ scores on the TTM knowledge dimension for STBI patients was having attended TTM-related training ( t = 2.16, P<0.05); the factors influencing ICU nurses′ scores on the TTM attitude dimension for STBI patients were college, bachelor′s degree and the position of nurse practitioner ( t = 2.65, 2.91, 2.14, all P<0.05); and the factors influencing ICU nurses′ scores on the TTM practice dimension for STBI patients were the age group of 36 to 45 years old, the department having TTM-related criteria and having knowledge of TTM-related guidelines ( t = -2.46, 2.64, 3.85, all P<0.05). Conclusions:ICU nurses have a more positive attitude toward TTM in patients with STBI, but the level of knowledge and practice needs to be improved. Managers should conduct relevant training according to the current situation and influencing factors to improve ICU nurses′ knowledge and practice of TTM in patients with STBI, ensuring the effectiveness and safety of TTM.

Objective To explore the effect of head acupuncturing therapy combined with massaging key head acupoints on language and cognitive function in children with autism.Methods 60 children with autism who visited the Department of Pediatric Rehabilitation of our hospital from January 2021 to June 2022 were selected as subjects,who were then randomly divided into the conventional group treated with the conventional rehabilitation training and the combination group treated with head acupuncturing therapy combined with massaging the key acu-points,apart from conventional rehabilitation training 30 cases in each group.The cognitive function,developmental status,and parental quality of life before and after the treatment were compared between the two groups,and so were the language function and safety.Results There were no significant differences in the scores by Autism Behavior Checklist(ABC)and Childhood Autism Rating Scale(CARS),adaptability scores,language scores,and individual-social interaction scores between the conventional group and the combination group before the treatment(P>0.05).After the treatment,the scores by ABC and CARS were significantly decreased in both groups,and the scores of the combination group were significantly lower than those in the conventional group(P<0.05);The adaptability scores,language,individual-social interaction scores were significantly increased in both groups,and the scores of the combined group were significantly higher than those of the conventional group(P<0.05).The abnormal rates of symbolic expression,language comprehension,action-oriented subjects,and language development delay in the combined group were all significantly lower than those in the conventional group(P<0.05).There was no significant difference in the scores by the QL-Index between the conventional group and the combined group before the treatment(P>0.05),but after the treatment,the QL-Index scores of the conventional group and the combination group were increased,and the score of the combination group was significantly higher than that of the conventional group(P<0.05).The results of blood routine,urine routine,stool routine,liver function,and kidney function in both groups were not significantly abnormal.There was one case of mild swelling and pain at the acupunctured site in the combination group,which was improved without intervention.Conclusion Head acupuncturing therapy combined with massaging the key head acupoints can improve language function,cognitive function,and development of autis-tic children.In addition,it can enhance parental quality of life and have a high level of safety.

Objective:To explore the status of tumor inpatients' participation in medication safety behavior, and analyze its influencing factors.Methods:From October to November 2020, convenience sampling was used to select 502 patients with malignant tumor in Peking University Cancer Hospital. A survey was carried out on the patients by using the General Information Questionnaire and the Inpatients Involvement in Patient Medication Safety Scale. Multiple stepwise regression was used to analyze the influencing factors of medication safety behaviors in tumor inpatients.Results:The total score of 502 patients' participation in medication safety behavior was (88.86±16.79) . The scoring rate of the 3 dimension items from high to low were decision-making involvement, care involvement, appealing involvement. Multiple stepwise regression showed that educational level, the importance of conscious participation in medication safety, knowledge of disease treatment, medication process and participation methods were the influencing factors for tumor inpatients' participation in medication safety behavior ( P<0.05) . Conclusions:Tumor patients' participation in medication safety behavior needs to be further improved. It is necessary to improve the patient's awareness of participating in medication safety and explore feasible ways of patient participation to improve patient participation in medication safety behavior and further promote patient medication safety.

Objective To observe the protective effect of polypyrimidine bundle-binding proteinrelated splicing factor (PSF) over-expression on RPE cell injury induced by advanced glycation end products (AGEs).Methods The human RPE cells cultured in vitro were divided into three groups:normal control group (N group),blank control group (N + AGEs group),empty vector control group (Vec + AGEs group),and PSF high expression group (PSF + AGEs).group).RPE cells in N group were routinely cultured;RPE cells in N + AGEs group were only transfected but did not introduce any exogenous genes combined with AGEs induction;Vec +AGEs group and PSF + AGEs group were transfected with pcDNA The empty vector or pcDNA-PSF eukaryotic expression plasmid was introduced into RPE cells and induced by AGEs.Except the N group,the other 3 groups of cells were transfected accordingly,and were stimulated with 150 μg/ml AGEs for 72 h after 24 h.HE staining and Hoechst 33258 staining were used to observe the effect of high PSF expression on the morphological changes of RPE cells;ROS level detection was used to analyze the effect of PSF high expression on the ROS expression of RPE cells induced by AGEs;MTT colorimetric method was used to detect the high PSF expression Effects on the viability of RPE cells;Western blot was used to detect the effects of different time and dose of PSF on the expression of heme oxygenase 1 (HO-1).Results HE staining and Hoechst 33258 staining observation showed that the cells in group N were full in shape,the nucleus was round,the cytoplasm was rich,and the staining was uniform;the cells in N + AGEs group and Vec + AGEs group were reduced in size,the eosinophilic staining was enhanced,and the nucleus was densely densely stained.Pyrolysis and even fragmentation;the morphology of cells in the PSF + AGEs group was still full,the cytoplasm staining was more uniform,and the nucleus staining was uniform.The results of MTT colorimetry showed that high expression of PSF can effectively improve the viability of RPE cells,but this effect can be effectively antagonized by ZnPP,and the difference is statistically significant (F=33.26,P＜0.05).DCFH-DA test results showed that compared with the N + AGEs group and Vec + AGEs group,the ROS production in PSF + AGEs group decreased,the difference was statistically significant (F=1 1.94,P＜0.05).Western blot analysis showed that PSF protein upregulated HO-1 expression in a time-and dose-dependent manner.The relative expression level of HO-1 at 24,48,and 72 h after PSF protein was significantly higher than that at 0 h,and the difference was statistically significant (F=164.91,P＜0.05).The relative expression level of HO-1 under the action of 0.1,0.5,1.0,1.5,and 2.0 μg PSF protein was significantly higher than 0.0 μg,and the difference was statistically significant (F=104.82,P＜0.05).Conclusion PSF may inhibit the production of ROS by up-regulating the expression of HO-1,thus protecting the RPE cells induced by AGEs.

Objective To investigate the inhibitory effect oflentivirus-mediated polypyrimidine bundle binding protein-associated splicing factor (PSF) on retinal neovascularization (RNV) in mice model of oxygeninduced retinopathy (OIR).Methods One hundred and twelve 5-day-old C57BL/6J mice were randomly divided into normal control group,simple OIR model group,OIR model + lentivirus empty vector treatment group (Vec group) and OIR model + PSF lentivirus treatment group (PSF group),with 16,32,32 and 32 mice,respectively.When the mice were 7 days old,the mice in the normal control group were fed in a routine environment,and the mice in the OIR model group,Vec group and PSF group were established OIR model.The mice in the Vec group and PSF group were given an intravitreal injection of 1 μl of lentiviral vector and PSF lentivirus (titer 1 × 10~ TU/ml) at the age of 12 days.No injection was performed in the normal control group and simple OIR group.RNV was evaluated by counting the number of pre-retinal neovascular cells and analysis of non-perfusion area by immunofluorescent staining of the mouse retina.Real-time quantitative PCR was applied to detect the mRNA expression of nuclear factor erythroid 2-related factor 2 (Nrf2) and hemeoxygenase1 (HO-1).Western blot analysis was applied to detect the protein expression ofNrf2,HO-1 and PSF.Results Of the normal control group,simple OIR model group,Vec group and PSF group,the number of pre-retinal neovascular cell nuclei were 0.00,14.36 ± 5.50,15.67 ± 4.96,8.13 ± 2.09,the non-perfusion area were 0.00％,(35.71 ± 2.81)％,(36.57 ± 4.53)％,(15.33 ± 4.75)％,respectively.The differences of the number of pre-retinal neovascular cell nuclei and non-perfusion area among 4 groups were significant (F=24.87,165.70;P＜0.05).Compared with the normal control group,there were more pre-retinal neovascular cell nucleis and larger nonperfusion area in the simple OIR model group and Vec group (P＜0.05).Compared with the simple OIR model group and Vec group,there were lower pre-retinal neovascular cell nucleis and smaller non-perfusion area in the PSF group (P＜0.05).Real-time quantitative PCR and Western blot showed that the mRNA expression of Nrf2,HO-1 (F=53.66,83.54) and protein expression ofNrf2,HO-1 and PSF (F=58.38,52.69,24.79) among 4 groups were significant (P＜0.05).The rnRNA expression ofNrf2,HO-1 and protein expression of Nrf2,HO-1 and PSF in the simple OIR model group and Vec group decreased significantly than those in the normal control group (P＜0.05).The mRNA expression ofNrf2,HO-1 and protein expression ofNrf2,HO-1 and PSF in the PSF group were increased significantly than those in the simple OIR model group and Vec group (P＜0.05).model group and Vec group (P＜0.05).Conclusion Intravitreal injection of lentivirus-mediated PSF inhibits RNV in mice model of OIR possibly through up-regulating the expression of Nrf2 and HO-1.

Blood-retina barrier destruction, nerve injury, formation of neovascularization and fibroblast proliferation membrane are important pathological changes of DR, which are related to the combined effects of various vitreous cytokines. VEGF is mainly involved in increasing retinal vascular permeability and inducing neovascularization. Pigment epithelium derived factor is vital reducing vascular permeability and neuroprotection; IL plays a key role in mediating inflammatory response. TNF-α is related to inflammation, which is significantly up-regulated by hypoxia. TGF-β is an important cytokine regulating cell proliferation and differentiation. Connective tissue growth factor can promote the growth, migration and adhesion of endothelial cell. In addition, many other molecular mechanisms have not been fully elucidated, and further study on the molecular mechanism of DR is urgent. With the further study of molecular mechanism, the early intervention and targeted treatment of DR will be more effective.