ObjectiveTo systematically analyze the global policy framework, standard systems and application technology models of digital rehabilitation within the framework of the World Health Organization (WHO) Global Digital Health Strategy and propose policy recommendations for the future development of digital rehabilitation. MethodsBased on the policies on digital health and rehabilitation development issued by the WHO, focusing on the Global Digital Health Strategy, Rehabilitation 2030 Initiative, Rehabilitation in Health Systems, Rehabilitation in Health Systems: A Guide for Action, and World Report on Disability, a systematic review was conducted, to explore the policy architecture and core content of digital rehabilitation, the standard system for digitalizing rehabilitation, and key technological models for the development of digital rehabilitation. ResultsIn the context of global health and digital transformation, the development of digital rehabilitation services was an essential component of the global digital health strategy. Building a comprehensive policy framework and content system for digital rehabilitation was critical for strengthening rehabilitation data governance, enhancing data utilization efficiency, and ensuring data privacy and security. Empowering rehabilitation with digital technology was vital for improving the standardization, effectiveness, coverage, quality and safety of rehabilitation services. International digital rehabilitation policies primarily involved the following areas: policy and governance, digital standard systems, data privacy, security and ethics, digital talent cultivation and capacity building, and monitoring, evaluation and continuous improvement of digitally empowered rehabilitation services. The standard system for rehabilitation digitization covered the three major reference classifications of the WHO Family of International Classifications, including International Classification of Diseases Eleventh Revision (ICD-11), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Interventions (ICHI), especially ICF. It also included international data interoperability standards, data security and privacy protection standards, data quality and certification standards, and health information standards, etc. The application technology models of digital rehabilitation primarily included data-driven service models, artificial intelligence -enabled models, and remote rehabilitation models combined with virtual reality, augmented reality technologies, and Internet of Things support. ConclusionThe establishment and implementation of comprehensive policies, standards and technological models for digital rehabilitation are crucial for driving the digital transformation and development of global rehabilitation services. Under the framework of the WHO Global Digital Health Strategy, it is necessary to build adaptive digital rehabilitation policy frameworks, and enhance digital governance capabilities and levels, establishing and improving digital rehabilitation standard systems, and promoting the interoperability and integration of rehabilitation data with other health big data. Meanwhile, it is essential to actively develop data-driven technological models for rehabilitation services to comprehensively improve the accessibility, availability, quality and safety of rehabilitation services.

Abstract To analyzes the characteristics, problems and enlightenment of physical activity observation tools, so as to provide reference for researchers to quickly and accurately choose appropriate observation tools to evaluate children s and adolescents physical activity. Literature search is conducted in eight databases of Chinese and English, including CNKI, Wanfang, VIP, Web of Science, PubMed, Medline, ERIC, and SPORTDiscus. Ultimately, eight observation tools for assessing physical activity in children and adolescents are included. Through summarization and comparison, it is found that the applications of those tools cover multiple age groups, the observation indicators cover multiple dimensions for each with varying emphases, and the applicable contexts vary in their specific background information, and recording methods tend to be quantitative. However, several issues remain to be addressed in practical applications. First, the observation indicators need to be supplemented and improved; second, physical activity in community environments and academic classrooms requires further attention; third, physical activity intensity needs to be scientifically evaluated; fourth, observation and recording methods need to be integrated and innovated; fifth, the number of observation subjects needs to be expanded. Future research could focus on developing observation tools tailored to the characteristics of Chinese children and adolescents, while drawing on foreign observation tools to comprehensively assess physical activity among children and adolescents.

Objective: To investigate the distribution characteristics of CD36 antigen in healthy individuals in Xinjiang, China and analyze the molecular mechanisms underlying CD36 deficiency. Methods: Flow cytometry was used to assess CD36 antigen expression on platelets from 881 healthy individuals who underwent physical examinations between June and August 2023. Differences in CD36 antigen distribution among ethnic groups were compared, and genotyping and third-generation sequencing were conducted on samples with CD36 deficiency. Results: Among the 881 samples, 4 cases (0.5%) of CD36 type Ⅱ deficiency were identified. The deficiency frequency was 0.7% (3/430) in Han individuals and 0.3% (1/363) in Uygur individuals, with no statistically significant difference between the two groups (P>0.05). No mutations were detected in the coding regions of the deficient samples. Two samples exhibited a (TG)11 in intron 3. Among the 12 linked mutation sites, g. 55589 G>A was mutated to g. 55589G Del, while g. 55593 A del did not occur; however, g. 55591A>T was observed nearby. Additionally, 52742insGAAAA was present in 100% of the (TG)11 haplotypes, potentially representing a novel linked mutation. Conclusion: This study indicates that the positive frequency of CD36 antigen in Xinjiang is relatively high, suggesting a low risk of alloimmune diseases in clinical practice. The (TG)11 in intron 3 is not universally present in all CD36 type Ⅱ deficiency cases, and the number of linked mutation sites extends beyond the previously reported 12.

Background Work-related musculoskeletal disorders (WMSDs) are considered to be one of the biggest health problems in the workplace, seriously affecting the productivity and quality of life of the working population. Long working hours may associate with WMSDs, and leisure-time physical activity (LTPA) is beneficial for WMSDs. However, the independent and combined effects of these two factors on WMSDs remain poorly understood. Objective To explore the independent and joint relationships between long working hours, leisure time physical activity (LTPA), and WMSDs, and to provide a basis for prevention and intervention of WMSDs. Methods A cross-sectional survey was conducted among 1227 frontline workers from multiple secondary industry companies in Nanchong City in 2023 using cluster random sampling. Demographic characteristics information, weekly working hours, LTPA, personal health behaviors, and occupational factors were collected through questionnaires. The Chinese version of Musculoskeletal Disorders Questionnaire was used to assess WMSDs. χ² test and logistic regression were used to analyze the relationships between long working hours and/or LTPA and WMSDs. Results A total of 1227 workers were surveyed with a mean age of (41.3±9.3) years and 855 (69.7%) were male and 372 (30.3%) were female. Among then, 855 (69.7%) workers reported working >40 h per week, and 254 (20.7%) reported working ≥ 55 h per week; 561 (45.7%) reported no LTPA and 192 (15.6%) reported high LTPA. The overall positive rate of WMSDs was 57.4%. The positive rate of WMSDs was 71.3% in those working ≥55 h per week, which was significantly higher than those in the other groups (51.3%-58.2%, P<0.05). Comparison among the positive rate of WMSDs in the weekly working 41-48 h group (54.4%), the 49-54 h group (58.2%), and the ≤40 h group (51.3%) showed no statistically significant difference (P>0.05). The positive rate of WMSDs was higher in workers with no LTPA (59.0%)/low LTPA (58.9%) than in those with high LTPA (49.0%) (P<0.05). The logistic regression models showed that after adjusting gender, age, work experience, income per month, night shift, industry, prolonged fixed posture, prolonged repetition, smoking and alcohol drinking, compared with weekly working ≤40 h, the risk of WMSDs was higher in those with extra-long working hours (≥55 h·week⁻¹ ) (OR=2.155, 95%CI: 1.504, 3.088), whereas those with high LTPA had a lower risk of WMSDs (OR=0.614, 95% CI: 0.432, 0.874 ). The combination of no LTPA and extra-long working hours (≥55 h·week⁻¹) and low LTPA and extra-long working hours (≥55 h·week⁻¹) showed associations with WMSDs, with 2.360 and 2.049 times higher risk of WMSDs than that of the combination of no LTPA and standard working hours (≤40 h ·week⁻¹) respectively (P<0.05), whereas the combination of high LTPA and long working hours was not observed statistical significance (P>0.05). Conclusion Extra-long working hours and/or LTPA show different associations with the risk of WMSDs. Extra-long working hours are significantly positively associated with the risk of WMSDs, whereas high LTPA is significantly negatively associated with the risk of WMSDs. The combination of extra-long working hours with no or low LTPA is associated with elevated risk of reporting WMSDs, whereas no statistical significance is observed for the high LTPA-long work hours combination.

Objective To establish a method for simultaneous determination of four high-molecular-weight thiol derivatives (TDs) in workplace air by gas chromatography. Methods The four kinds of vapor-phase macromolecular TDs (1-pentanethiol, 1-hexanethiol, 1-benzyl mercaptan, and n-octanethiol) in the workplace air were collected using the GDH-1 air sampling tubes, desorbed with anhydrous ethanol, separated on a DB-FFAP capillary column, and determined by flame ionization detector. Results The quantitation range of the four TDs was 0.30-207.37 mg/L, with the correlation coefficients greater than 0.999 00. The minimum detection mass concentrations and minimum quantitation mass concentrations were 0.18-0.32 and 0.60-1.05 mg/m³, respectively (both calculated based on the 1.5 L sample and 3.0 mL desorption solvent). The mean desorption efficiencies ranged from 87.07% to 103.59%. The within-run and between-run relative standard deviations were 1.92%-8.22% and 1.89%-8.45%, respectively. The samples can be stored at room temperature or 4 ℃ for three days and up to 7 days at -18 ℃. Conclusion This method is suitable for the simultaneous determination of four vapor-phase TDs in workplace air.

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease affecting both upper and lower motor neurons. ALS patients develop progressive muscle atrophy, muscle weak and paralysis, finally died of respiratory failure. ALS is characterized by fast aggression and high mortality. What' s more, the disease is highly heterogeneous with unclear pathogenesis and lacks effective drugs for therapy. In this review, we summarize the main pathological mechanisms and the current drugs under development for ALS, which may provide a reference for the drug discovery in the future.

Objective To evaluate the effects of transcutaneous electrical acupoint stimulation(TEAS)combined with Chinese medicine emotional intervention on immune function and psychological stress in patients undergoing laparoscopic radical rectal cancer surgery.Methods A total of 100 patients hospitalized for laparoscopic radical surgery for rectal cancer were randomly divided into 4 groups of Group A,B,C,and D,25 patients in each group.Group A was given TEAS for 30 minutes before anesthesia,Group B was given TEAS continuously until the end of the surgery,Group C was given TEAS for 30 minutes and Chinese medicine emotional intervention before anesthesia,Group D was given TEAS continuously until the end of the surgery together with Chinese medicine emotional intervention.TEAS was performed at bilateral Zusanli(ST36)points,bilateral Sanyinjiao(SP6)points,Baihui(GV20)points,bilateral Neiguan(PC6)points.The changes of perioperative outcomes and the changes of parameters associated with the immune function,molecular mechanism of Th1/Th2 cells,and psychological stress response before the surgery and 3 days after the surgery in each group were observed.Moreover,the occurrence of adverse reactions in each group was compared.Results(1)The differences of perioperative outcomes operation time,bleeding volume and infusion amount were not statistically significant among the 4 groups(P＞0.05).The Sufentanil dosage,Remifentanil dosage,postoperative awakening time,and 24-hour postoperative pain Visual Analogue Scale(VAS)scores of group D were lower than those of Groups A,B,and C(P＜0.05),and the above indexes of group B and group C were all lower than those of Group A(P＜0.05).(2)Three days after the surgery,the levels of immune function indicators of T lymphocyte subsets CD3+,CD4+ and natural killer(NK)cells in Group D were higher than those in Groups A,B,and C(P＜0.05),while the above indexes in Groups B and C were higher than those in Group A(P＜0.05).(3)Three days after the surgery,the levels of parameters associated with the molecular mechanism of Th1/Th2 cells such as interleukin 2(IL-2)and interferon gamma(IFN-γ)in Group D were higher(P＜0.05),and the serum interleukin 10(IL-10)level was lower than those in Groups A,B,and C(P＜0.05);the serum IL-2 and IFN-γ levels in Group B and C were higher(P＜0.05)and serum IL-10 level was lower than those in Group A(P＜0.05).(4)Three days after the surgery,the scores of the psychological stress response indicators of self-rating anxiety scale(SAS)and self-rating depression scale(SDS)in Group D were lower than those in Groups A,B,and C(P＜0.05),while the above scores in Groups B and C were lower than those in Group A(P＜0.05).(5)In Group A,there was one case of nausea and vomiting;in Group B,there were two cases of nausea and vomiting and one case of dizziness;no adverse reaction occurred in Group C,and there was one case of nausea and vomiting in Group D.The incidences of adverse reactions in Groups A,B,C and D were 4.0%(1/25),12.0%(3/25),0.0%(0/25),and 4.0%(1/25),respectively.The intergroup comparison showed no statistically significant difference among the 4 groups(χ2 = 0.400,P = 0.527).Conclusion In treating patients undergoing laparoscopic radical surgery for rectal cancer,TEAS combined with Chinese medicine emotional intervention can effectively regulate the perioperative immune function,reduce the stress response,and alleviate the anxiety of the patients.Moreover,the therapy exerts certain analgesic effect,which leads to the reduction of the dosage of opioids and the increase of perioperative comfort and surgical tolerance of the patients.

Objective:To investigate the application value of biological muscle flap in laparo-scopic radical proximal gastrectomy with esophagogastric anastomosis.Methods:The retrospec-tive and descriptive study was conducted. The clinicopathological data of 10 patients with adeno-carcinoma of esophagogastric junction who were admitted to The First Affiliated Hospital of Xi′an Jiaotong University from May 2023 to August 2023 were collected. All patients were males, aged (65±5)years. All patients underwent laparoscopic radical proximal gastrectomy and esophagogastric anastomosis with digestive tract reconstruction using the esophagogastric biological muscle flap. Observation indicators: (1) surgical situations and early complications; (2) follow-up and late com-plications. Measurement data with normal distribution were represented as Mean± SD, and measure-ment data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Surgical situations and early complications. All 10 patients success-fully completed the surgery without conversion to open surgery, and the operation time was (166±18)minutes. Cases with digestive tract reconstruction as end-to-side anastomosis and Overlap anas-tomosis were 1 and 9, respectively. The time of digestive tract reconstruction, the number of lymph node dissected, volume of intraoperative blood loss, time to postoperative first anal exhaust, time to postoperative first intake of liquid food, duration of postoperative hospital stay were (40±12)minutes, 24±6, (41±9)mL, (3.4±0.5)days, (4.1±1.0)days, (8.3±0.7)days in the 10 patients. Of 4 cases with postoperative early complications, 1 case developed pulmonary infection (Clavien-Dindo grade Ⅱ) on the second day after surgery, with pulmonary infection absorbed after 5 days of antibiotic treat-ment. Two cases experienced chest distress and shortness of breath on the third day after surgery, with the diagnosis of a small to moderate amount of pleural effusion after chest B-ultrasound examination. After pleural puncture and active treatment, the symptoms of them were improved and the pleural effusion disappeared. There was 1 case with choking sensation when eating solid food, which was started from the third week after surgery. Upper gastrointestinal imaging revealed mild anastomotic stenosis of Clavien-Dindo grade Ⅰ in the patient, who was improved after conservative treatment. On the 7th day after surgery, all 10 patients underwent upper gastrointestinal angiography, and no anastomotic leakage or stenosis occurred. There was no sign of contrast agent reflux in the supine position and 30° head down position. (2) Follow-up and late complications. All 10 patients were followed up for 59.5(range, 31.0-127.0)days. The esophageal reflux scale score of 10 patients was 1.4±0.3. During the follow-up, 1 case underwent gastroscopy on 40 days after surgery, which showed reflux esophagitis with Los Angeles grade as B and the Clavien-Dindo grade as Ⅰ. There was no clinical symptom such as heartburn or acid reflux. Results of 24-hour pH monitoring showed that the patient experienced 24 instances of reflux in an upright position and 15 instances of reflux in a supine position, with no prolonged reflux. The total reflux time within 24 hours was 75 minutes. The DeMeester score was 38.3. Results of esophageal pressure measurement showed that the esophageal contraction morphology was normal, but the anastomotic opening was not well relaxed. The rest of 9 cases had no complication such as reflux esophagitis.Conclusion:Biological muscle flap applied in the laparoscopic radical proximal gastrectomy with esophagogastric anastomosis is safe and feasible, with satisfied short-term efficacy.

Hydrogen peroxide (H₂O₂) and nitric oxide (NO) has a short half-life, low bioavailability, poor tumor targeting and systemic adverse reactions in the physiological environment. In this study, phacoemulsification and nano-precipitation were used to synthesize didecyl dimethyl ammonium bromide (DDAB)/polylactic acid nanoparticles (PLA), then L-arginine (L-Arg) and glucose oxidase (GOx)-loaded nanoparticles (GADP) were prepared, and the in vitro antitumor activity was investigated．The particle size, potential, embedding rate and the ability to produce H₂O₂/NO of the nanoparticles were investigated. Meanwhile, in vitro cell cytotoxicity against human hepatoma cells (HepG2) was evaluated．The results showed that the prepared L-Arg-DDAB/PLA (ADP) nanoparticles were spherical particles. And the particle size and zeta potential were (225.7 ± 6.33) nm and (+23.5 ± 0.12) mV, respectively. The adsorption rate of GOx was 87.23% ± 0.02%. The drug loading of L-Arg was 15.6% ± 0.22%. The pH value of glucose solution and the amount of H₂O₂ showed that GADP had good catalytic activity. In vitro cytotoxicity experiments showed that blank nanoparticles were nontoxic, while the drug-loaded nanoparticles presented enhanced antitumor effect on HepG2 cells. And can inhibit tumor cell migration. The low dose nano-scale NO delivery system GADP can effectively inhibit the migration of tumor cells and kill tumor cells, thus producing therapeutic benefits.

Objective To observe the pharmacokinetic effect of amoxicillin and clavulanate potassium tablets on amoxicillin in Chinese healthy subjects under fasting and high fat and high calorie diet.Methods 71 healthy subjects were given a single dose of amoxicillin potassium clavulanate tablets(0.375 g)on fasting or high fat diet,and venous blood samples were collected at different time points.The concentrations of amoxicillin in human plasma were determined by HPLC-MS/MS method,and the pharmacokinetic parameters were calculated by non-atrioventricular model using PhoenixWinNonlin 8.0 software.Results The main pharmacokinetic parameters of amoxicillin potassium clavulanate tablets after fasting and high fat diet were(5 105.00±1 444.00),(4 593.00±1 327.00)ng·mL-1,and postprandial-fasting ratio 89.40％,90％confidence interval(79.55％-100.19％);t1/2 were(1.52±0.16),(1.39±0.22)h;AUC0-t were(12 969.00±1 841.00),(11 577.00±1 663.00)ng·mL-1·h,and postdietary/fasting ratio 89.20％,90％confidence interval(83.92％-94.28％);AUC0-∞ were(13 024.00±1 846.00),(11 532.00±1 545.00)ng·mL-1·h,and postprandial-fasting ratio 88.60％,90％confidence interval(83.48％-93.50％).The median Tmax(range)were 1.63(0.75,3.00)and 2.50(0.75,6.00)h,respectively,and the Tmax of postprandial medication was delayed(P＜0.01).Conclusion Compared with fasting condition,amoxicillin Tmax was significantly delayed after high fat diet,while Cmax,AUC0-t and AUC0-∞ were not significantly changed,indicating that food could delay the absorption of amoxicillin,but did not affect the degree of absorption.