ObjectiveTo delineate imaging findings using an imaging platform and investigate the correlation between MRI characteristics of spinal cord atrophy and clinical diagnosis in children with spinal cord injury (SCI). MethodsImaging data of 150 children with SCI admitted to Beijing Bo'ai Hospital, China Rehabilitation Research Center, from January, 2002 to March, 2024 were collected and imported into the imaging platform. The anteroposterior and transverse diameters of the middle part of the spinal cord at the cross-section with the most severe atrophy were measured, and the relevant indicators of the previous normal spinal cord segment were measured as controls; the radiomic features were extracted. Clinical data of the children including gender, age, cause of injury, sensory level, motor level, spinal cord injury level, injury severity and disease course were collected. ResultsSpinal cord atrophy was identified in 81 cases (54%), among which 78 cases (96%) were American Spinal Injury Association Impairment Scale (AIS) grade A and 3 cases (4%) were AIS grade C. The upper boundary of the spinal cord atrophy site strongly correlated with the injury level, motor level and sensory level (r > 0.8, P < 0.001). ConclusionMore than half of children with SCI may develop secondary spinal cord atrophy, the vast majority of whom suffer from complete spinal cord injury; the upper boundary of spinal cord atrophy is correlated with the injury level.

ObjectiveTo construct an actor-network for integrating physical activity into rehabilitation services based on the World Health Organization Rehabilitation in Health Service System framework and actor-network theory (ANT). MethodsContent analysis was employed using the six building blocks of health service systems as the theoretical framework. Actors related to rehabilitation services were extracted and categorized into a rehabilitation actor pool, while a physical activity actor pool was formed based on four major physical activity scenarios. Actors from both pools were integrated, deduplicated and classified to form a final list of integrated actors. Using ANT, the construction process of the actor network integrating physical activity into rehabilitation was analyzed through the four stages of translation: problematization, interessment, enrollment and mobilization. ResultsA dynamic integration network was constructed, comprising human actors (patients, rehabilitation professionals, researchers, sports coaches, government departments, medical institutions, community organizations and industry media, etc.) and non-human actors (assistive devices, sports infrastructure, smart equipment, information systems, online exercise guidance systems, laws and regulations, strategic documents, and exercise prescriptions, etc.). The study identified maximizing rehabilitation outcomes as the mandatory passage point and elaborated on the critical role of government departments as focal actors in coordinating various stakeholders. ConclusionThe integration of physical activity into rehabilitation services is a dynamic network constructed by diverse actors through a process of translation. ANT provides an operational theoretical framework for cross-departmental governance of rehabilitation policies in China, promotes the spatial expansion of the rehabilitation field, and drives its transformation toward a networked and ecological system. The government needs to play a leading role in facilitating role reconstruction and synergy among heterogeneous actors in both the sports and rehabilitation sectors through mechanism design, to create a bidirectional empowerment mechanism that fosters mutual progress and ensures the sustainable development of integrated services.

Objective:To investigate the value of a computed tomography(CT)radiomics-based model for predicting the efficacy of neoad-juvant immunotherapy combined with chemotherapy for locally advanced gastric cancer(LAGC).Methods:Data on 114 patients with LAGC who underwent radical surgery after neoadjuvant immunotherapy combined with chemotherapy at The Second Affiliated Hospital of Xingtai Medical College between June 2019 and June 2021 were retrospectively collected.These patients'data were divided into a training set(n=67)and a validation set(n=47)based on the time of admission.High-throughput features were extracted from baseline portal phase CT images of all patients,and the selected features were used to construct the radiomics prediction model.The predictive performance of the model was evaluated using receiver operating characteristic(ROC)and calibration curves.The prognostic ability of the model was assessed using Kaplan-Meier curves.Results:Based on the maximum relevancy min-redundancy(mRMR)algorithm and least absolute shrinkage and selection operator(LASSO)regression model,5 out of 584 assessed features were incorporated into the radiomics(Rad)score.The respect-ive areas under the curve for predicting pathological complete response(pCR)in the training and validation sets were 0.865 and 0.830,re-spectively,and good fits were obtained(Hosmer-Lemeshow test:P>0.05).The optimal cut-off value for the Rad score was determined based on the Youden index.Patients with high Rad scores had significantly higher 3-year recurrence-free survival rates(82.7%vs.60.4%in the training set and 78.9%vs.53.8%in the validation set)and 3-year overall survival rates(78.9%vs.60.2%in the training set and 79.3%vs.50.0%in the validation set)than those with low Rad scores(P<0.05).Conclusions:The CT radiomics prediction model effectively predicted the pathological response and prognosis of patients with LAGC after neoadjuvant immunotherapy combined with chemotherapy and is ex-pected to serve as a practical clinical tool.

Objective To establish an expert consensus on home exercise for prevention and rehabilitation of breast cancer related lymphedema.Methods Evidence-based nursing method was used to systematically retrieve and evaluate relevant studies in databases and guideline networks,with a search period from the establishment of the databases to October 2023.Evidence was synthesized to form the expert consensus draft after literature screening,quality evaluation,evidence extraction and evidence integration.Then the final draft was formed through expert discussion meeting and 2 rounds of expert letter consultation.Results The consensus includes 5 dimensions with a total of 22 items,involving evaluation of home exercise,management of home exercise,principles of home exercise,program of home exercise and significance of home exercise.Conclusion This"consensus"was constructed in a scientific and rigorous way,and can provide guidance for promoting the home exercise for prevention and rehabilitation of breast cancer related lymphedema,and ensure the safe and effective implementation of home exercise rehabilitation.

ObjectiveTo explore the data standard system of electronic medical records in the field of rehabilitation, focusing on the terminology and coding standards, data structure, and key content categories of rehabilitation electronic medical records. MethodsBased on the Administrative Norms for the Application of Electronic Medical Records issued by the National Health Commission of China, the electronic medical record standard architecture issued by the International Organization for Standardization and Health Level Seven (HL7), the framework of the World Health Organization Family of International Classifications (WHO-FICs), Basic Architecture and Data Standards of Electronic Medical Records, Basic Data Set of Electronic Medical Records, and Specifications for Sharing Documents of Electronic Medical Records, the study constructed and organized the data structure, content, and data standards of rehabilitation electronic medical records. ResultsThe data structure of rehabilitation electronic medical records should strictly follow the structure of electronic medical records, including four levels (clinical document, document section, data set and data element) and four major content areas (basic information, diagnostic information, intervention information and cost information). Rehabilitation electronic medical records further integrated information related to rehabilitation needs and characteristics, emphasizing rehabilitation treatment, into clinical information. By fully applying the WHO-FICs reference classifications, rehabilitation electronic medical records could establish a standardized framework, diagnostic criteria, functional description tools, coding tools and terminology index tools for the coding, indexing, functional description, and analysis and interpretation of diseases and health problems. The study elaborated on the data structure and content categories of rehabilitation electronic medical records in four major categories, refined the granularity of reporting rehabilitation content in electronic medical records, and provided detailed data reporting guidance for rehabilitation electronic medical records. ConclusionThe standardization of rehabilitation electronic medical records is significant for improving the quality of rehabilitation medical services and promoting the rehabilitation process of patients. The development of rehabilitation electronic medical records must be based on the national and international standards. Under the general electronic medical records data structure and standards, a rehabilitation electronic medical records data system should be constructed which incorporates core data such as disease diagnosis, functional description and assessment, and rehabilitation interventions. The standardized rehabilitation electronic medical records scheme constructed in this study can support the improvement of standardization of rehabilitation electronic medical records data information.

ObjectiveTo analyze the data structure and standards of rehabilitation outpatient medical records, to provide data support for improving the quality of rehabilitation outpatient care and developing medical insurance payment policies. MethodsBased on the normative documents issued by the National Health Commission, Basic Standards for Medical Record Writing and Standards for Electronic Medical Record Sharing Documents, in accordance with the Quality Management Regulations for Outpatient (Emergency) Diagnosis and Treatment Information Pages (Trial), reference to the framework of the World Health Organization Family of International Classifications (WHO-FICs), the data framework and content of rehabilitation outpatient medical records were determined, and the data standards were discussed. ResultsThis study constructed a data framework for rehabilitation outpatient medical records, including four main components: patient basic information, visit process information, diagnosis and treatment information, and cost information. Three major reference classifications of WHO-FICs, International Classification of Diseases, International Classification of Functioning, Disability and Health, and International Classification of Health Interventions,were used to establish diagnostic standards and standardized terminology, as well as coding disease diagnosis, functional description, functional assessment, and rehabilitation interventions, to improve the quality of data reporting, and level of quality control in rehabilitation. ConclusionThe structuring and standardization of rehabilitation outpatient medical records are the foundation for sharing of rehabilitation data. The using of the three major classifications of WHO-FICs is valuable for the terminology and coding of disease diagnosis, functional description and assessment, and intervention in rehabilitation outpatient medical records, which is significant for sharing and interconnectivity of rehabilitation outpatient data, as well as for optimizing the quality and safety of rehabilitation medical services.

ObjectiveTo explore the standardization of inpatient rehabilitation medical record summary sheet, encompassing its structure, content and data standards, to enhance the standardization level of inpatient rehabilitation medical record summary sheet, improve data reporting quality, and provide accurate data support for medical insurance payment, hospital performance evaluation, and rehabilitation discipline evaluation. MethodsBased on the relevant specifications of the National Health Commission's Basic Norms for Medical Record Writing, Specifications for Sharing Documents of Electronic Medical Records, and Quality Management and Control Indicators for Inpatient Medical Record Summary Sheet (2016 Edition), this study analyzed the structure and content of the inpatient rehabilitation medical record summary sheet. The study systematically applied the three major reference classifications of the World Health Organization Family of International Classifications, International Classification of Diseases (ICD-10/ICD-11, ICD-9-CM-3), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Interventions (ICHI Beta-3), for disease diagnosis, functional description and assessment, and rehabilitation intervention, forming a standardized terminology system and coding methods. ResultsThe inpatient rehabilitation medical record summary sheet covered four major sections: inpatient information, hospitalization information, diagnosis and treatment information, and cost information. ICD-10/ICD-11 were the standards and coding tools for admission and discharge diagnoses in the inpatient rehabilitation medical record summary sheet. The three functional assessment tools recommended by ICD-11, the 36-item version of World Health Organization Disability Assessment Schedule 2.0, Brief Model Disability Survey and Generic Functioning domains, as well as ICF, were used for rehabilitation functioning assessment and the coding of outcomes. ICHI Beta-3 and ICD-9-CM-3 were used for coding surgical procedures and operations in the medical record summary sheet, and also for coding rehabilitation intervention items. ConclusionThe inpatient rehabilitation medical record summary sheet is a summary of the relevant content of the rehabilitation medical record and a tool for reporting inpatient rehabilitation data. It needs to be refined and optimized according to the characteristics of rehabilitation, with necessary data supplemented. The application of ICD-11/ICD-10, ICF and ICHI Beta-3/ICD-9-CM-3 classification standards would comprehensively promote the accuracy of inpatient diagnosis of diseases and functions. Based on ICD-11 and ICF, relevant functional assessment result data would be added, and ICHI Beta-3/ICD-9-CM-3 should be used to code rehabilitation interventions. Improving the quality of rehabilitation medical records and inpatient rehabilitation medical record summary sheet is an important part of rehabilitation quality control, and also lays an evidence-based data foundation for the analysis and application of inpatient rehabilitation medical record summary sheet.

Objective To explore the potential therapeutic targets and mechanisms of Shujinxi External Granules in the treatment of osteoarthritis(OA).Methods The chemical constituents and targets of Shujinxi External Granules were collected from TCMSP,TCMIP,TCMID and HERB databases,and the target genes related to OA were obtained from GEO database.Screening the overlapping targets,Cytoscape software was used to construct the"Shujinxi External Granules-compounds-OA-targets"and protein-protein interaction(PPI)networks.Gene Ontology(GO)analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis were performed on the overlapping targets through DAVID database,and the compounds and proteins with the highest degree values were selected for molecular docking by using AutoDock Vina.Results There were 85 components and 915 targets were found in Shujinxi External Granules.The 4 383 targets of OA were obtained,and 248 overlapping targets were screened out between Shujinxi External Granules and OA.The key target proteins were epidermal growth factor receptor(EGFR),cyclin-dependent kinase 1(CDK1),matrix metalloproteinase 9(MMP9),and the key compounds were N-trans-feruloyltyramine,palmatine,balanophonin,aurantiamide acetate,Saroaspidin A,luteolin,schizandrin,rhynchophylline,rhynchophylline A,kaempferol,1-piperoylpiperidine.A total of 489 biological processes,162 cellular components and 87 molecular functions were obtained by using GO functional enrichment analysis,and 100 signaling pathways related to the therapeutic of Shujinxi External Granules were obtained by using KEGG pathway enrichment analysis.The molecular docking results showed that N-trans-feruloyltyramine,1-piperonoylpiperidine and rhynchophylline A had good binding ability to the key targets EGFR,CDK1 and MMP9,respectively.Conclusion The Shujinxi External Granules may bind to the key targets EGFR,CDK1,and MMP9 in the pathways in cancer,hypoxia-inducible factor 1(HIF-1)and calcium signaling pathway through the key active components,such as N-trans-feruloyltyramine,rhynchophylline A,and 1-piperoylpiperidine,to exert the therapeutic effects on OA.

Objective:To understand the current status of epidemiological investigation task force construction and the performance of infectious disease epidemic response in county (district) Centers for Disease Control and Prevention (CDCs) in China, analyze the influencing factors and provide scientific evidence to improve the construction of grassroot epidemiological investigation task force.Methods:A survey was conducted in epidemiological investigation staff in county (district) CDCs in 31 provinces (autonomous regions/municipalities) and Xinjiang Production and Construction Corps in China. A self-designed questionnaire was used to collect information based on the epidemiological dynamic data collection platform of China CDC. A descriptive epidemiological analysis was conducted, and multiple linear regression models were used to identify the factors associated with the performance of infectious disease epidemic response.Results:A total of 24 934 epidemiological investigation task force members from 2 897 county (district) CDCs were surveyed in the study. In the epidemiological investigation task force, women, those with bachelor's degree and public health workers accounted for 62.46%, 71.36%, and 49.05% respectively. Up to 91.72% of the task force members had participated in field epidemic response. The average score of awareness of epidemic investigation procedures was 60.00, while the average score of key skill proficiency in the investigation was 42.22. The epidemic response performance showed correlations with area, gender, age, education level, major, and field epidemiology training programs, those who had received longer training showed higher competency scores (all P<0.001). Conclusions:Progress has been made in the construction of epidemiological investigation task force in grass-root CDCs in China, but further improvements are needed, especially in the knowledge awareness and investigation skills of the task force. Field epidemiology training demonstrated substantial impact on the improvement of epidemic response performance, indicating that it is necessary to further strengthen the training in grassroot public health workers for the better response to infectious disease epidemics.

Objective:To investigate the value of a computed tomography(CT)radiomics-based model for predicting the efficacy of neoad-juvant immunotherapy combined with chemotherapy for locally advanced gastric cancer(LAGC).Methods:Data on 114 patients with LAGC who underwent radical surgery after neoadjuvant immunotherapy combined with chemotherapy at The Second Affiliated Hospital of Xingtai Medical College between June 2019 and June 2021 were retrospectively collected.These patients'data were divided into a training set(n=67)and a validation set(n=47)based on the time of admission.High-throughput features were extracted from baseline portal phase CT images of all patients,and the selected features were used to construct the radiomics prediction model.The predictive performance of the model was evaluated using receiver operating characteristic(ROC)and calibration curves.The prognostic ability of the model was assessed using Kaplan-Meier curves.Results:Based on the maximum relevancy min-redundancy(mRMR)algorithm and least absolute shrinkage and selection operator(LASSO)regression model,5 out of 584 assessed features were incorporated into the radiomics(Rad)score.The respect-ive areas under the curve for predicting pathological complete response(pCR)in the training and validation sets were 0.865 and 0.830,re-spectively,and good fits were obtained(Hosmer-Lemeshow test:P>0.05).The optimal cut-off value for the Rad score was determined based on the Youden index.Patients with high Rad scores had significantly higher 3-year recurrence-free survival rates(82.7%vs.60.4%in the training set and 78.9%vs.53.8%in the validation set)and 3-year overall survival rates(78.9%vs.60.2%in the training set and 79.3%vs.50.0%in the validation set)than those with low Rad scores(P<0.05).Conclusions:The CT radiomics prediction model effectively predicted the pathological response and prognosis of patients with LAGC after neoadjuvant immunotherapy combined with chemotherapy and is ex-pected to serve as a practical clinical tool.