ObjectiveTo investigate the distribution and trend of rehabilitation personnel of China Disabled Persons' Federation (CDPF) system and the people with disabilities (PWDs) using geographical gravity model. MethodsBased on ArcGIS and statistical data, the distribution of geographical center of gravity of the rehabilitation personnel of the CDPF system from 2011 to 2021 was analyzed. According to the economic development, the areas were divided into three regions, and the eastern region included eleven provincial units, the central region includes eight provincial units, and the western region included twelve provincial units. ResultsCompared with 2011, rehabilitation staffs per thousand PWDs increased at 107.5% in 2021, 81.1%, 114.2% and 174.1% for the eastern, central, and western regions, respectively; professional staffs increased at 190.5%, 148.8%, 284.6% and 280.6% for the eastern, central, and western regions, respectively; managerial staff increased at 80.0%, 46.8%, 554.3% and 128.1% for the eastern, central, and western regions, respectively. Compared with 2011, the geographical center of gravity of the rehabilitation personnel moved about 330.9 km in 2021, while the geographical center of gravity of the PWDs moved about 169.64 km. ConclusionThe rehabilitation personnel in the CDPF system is the most in the eastern region and least in the western region. The tracks of the geographical center of gravity of the three kind of rehabilitation personnel in the CDPF system are relatively consistent. The rehabilitation personnel in the eastern region are more concentrated than those in the western region, and the density of the PWDs is more westward than that of the rehabilitation personnel, and coordination is not a perfect match yet. It is necessary to strengthen the rehabilitation personnel allocation in the western region, to balance distribution of human resources for rehabilitation of PWDs among regions.

Objective:To evaluate the role of NF-E2-related factor 2 (Nrf2)/heme oxygenase (HO-1) signaling pathway in reduction of endotoxin-induced acute lung injury (ALI) by esketamine and the relationship with NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome-mediated pyroptosis in mice.Methods:SPF male wild-type (WT) and Nrf2 knockout (KO) C57BL/6J mice, aged 6-8 weeks, weighing 20-25 g, were divided into 3 groups ( n=6 each) using a random number table method: control group (WT+ C group, KO+ C group), ALI group (WT+ ALI group, KO+ ALI group) and ALI+ esketamine group (WT+ ALI+ E group, KO+ ALI+ E group). ALI model was developed by injection of lipopolysaccharide (LPS) 15 mg/kg via the tail vein. Esketamine 10 mg/kg was intraperitoneally injected at 30 min after LPS injection, and 6 h later the medication was repeated for one time in WT+ ALI+ E and KO+ ALI+ E groups, while the equal volume of normal saline was given in the other groups. The mice were anesthetized at 12 h after LPS injection, and blood samples were obtained by cardiac puncture for determination of serum interleukin-1beta (IL-1β) and IL-18 concentrations, and bilateral lung tissues were also obtained for examination of the pathological changes of lung tissues(with the light microscope) which were scored and for determination of the content of reduced glutathione (GSH) and expression of Nrf2, HO-1 and NLRP3 inflammasome-mediated pyroptosis-related proteins (NLRP3, apoptosis-associated speck-like protein containing a CARD[ASC], pro-caspase-1, cleaved-caspase-1, gasdermin D[GSDMD]) (by Western blot). Results:Compared with the corresponding C group (WT+ C group or KO+ C group), the lung injury score and concentrations of IL-1β and IL-18 were significantly increased, the content of GSH in lung tissues was decreased, and the expression of NLRP3, ASC, pro-caspase-1, cleved-caspase-1 and GSDMD was up-regulated in WT+ ALI group and KO+ ALI group ( P<0.05), and the expression of Nrf2 and HO-1 was significantly up-regulated in WT+ ALI group( P<0.05). Compared with the corresponding ALI group (WT+ ALI group or KO+ ALI group), the lung injury score and concentrations of IL-1β and IL-18 were significantly decreased, the content of GSH in lung tissues was increased, and the expression of NLRP3, ASC, pro-caspase-1, cleved-caspase-1 and GSDMD was down-regulated in WT+ ALI+ E group and KO+ ALI+ E group ( P<0.05), and Nrf2 and HO-1 expression was significantly up-regulated in WT+ ALI+ E group( P<0.05). Compared with WT+ ALI+ E group, the lung injury score and concentrations of IL-1β and IL-18 were significantly increased, the content of GSH in lung tissues was decreased, the expression of Nrf2 and HO-1 was down-regulated, and the expression of NLRP3, ASC, pro-caspase-1, cleved-caspase-1 and GSDMD was up-regulated in KO+ ALI+ E group ( P<0.05). Conclusions:The mechanism by which esketamine reduces endotoxin-induced ALI may be related to activation of Nrf2/HO-1 signaling pathway, thus inhibiting NLRP3 inflammasome-mediated pyroptosis in mice.

Objective:To evaluate the influence of telomerase reverse transcriptase (TERT) promoter mutation on radioiodine uptake status of radioactive iodine refractory papillary thyroid cancer (RAIR-PTC) and radioiodine therapy response by analyzing the mutation frequency of TERT promoter in RAIR-PTC.Methods:A total of 37 patients with RAIR-PTC (15 males, 22 females, age (49.8±16.1) years) and 40 PTC patients with effective radioiodine therapy (13 males, 27 females, age (39.8±10.9) years) between January 2005 and June 2020 in JiangYuan Hospital Affiliated to Jiangsu Institute of Nuclear Medicine were retrospectively analyzed. TERT promoter mutation and B-Raf proto-oncogene, serine/threonine kinase (BRAF) V600E mutation of patients were observed. The differences across genotype patterns on radioiodine uptake status and therapy response were compared. The Fisher′s exact test and independent-sample t test were used for data analysis. Results:The incidence rate of TERT promoter mutation in the RAIR-PTC group was 40.54% (15/37, all C228T), which was significantly higher than that in the effective radioiodine therapy group (0, 0/40; P<0.001). No statistically significant difference was found for the mutation rate of BRAF V600E between the RAIR group (64.86%, 24/37) and the effective radioiodine therapy group (72.50%, 29/40; P=0.858). Patients with TERT promoter mutation were older ( t=3.76, P=0.001) and the non-intake rate of radioiodine in distant metastases of those patients was higher ( P=0.037). Furthermore, 2/3 of patients who received targeted therapies and 3/4 deaths had TERT promoter mutation. Among 35 patients with negative thyroglobulin antibody (TgAb), 11/14 of patients with TERT mutation had a rising stimulated thyroglobulin (sTg), while the percentage of the non-TERT mutation group was 57.1% (12/21; P=0.357). Conclusion:The TERT promoter mutation rate is significantly increased in RAIR-PTC patients and can serve as a prognostic predictor in RAIR.

Objective:To evaluate clinical effect of tampon tamponade combined with wedge resection of the nail folds in the treatment of ingrown toenail-induced paronychia.Methods:A total of 96 patients with ingrown toenail-induced paronychia were collected from Department of Emergency Medicine, General Hospital of Ningxia Medical University between August 2017 and April 2019, and randomly and equally divided into 2 groups by using a random number table: control group treated surgically with the Winograd method, and treatment group treated with tampon tamponade combined with wedge resection of the nail folds. All the patients were followed up for 6 - 23 months after surgery.Results:Six months after operation, 47 (97.92%) and 41 (85.42%) cases were cured in the treatment group and control group respectively, and the cure rate significantly differed between the 2 groups ( χ2 = 4.909, P < 0.05) . The visual analogue scale scores for pain were significantly lower in the treatment group than in the control group on day 3 and 1 month after operation (both P < 0.05) . The postoperative recurrence rate and infection rate were 0 and 2.08% in the treatment group respectively, which were significantly lower than those in the control group (6.25%, 12.5%, respectively, both P < 0.05) . Conclusion:Tampon tamponade combined with wedge resection of the nail folds is effective for the treatment of ingrown toenail-induced paronychia with a simple operative procedure and a low postoperative recurrence rate, and is worthy of clinical promotion.

Objective:To investigate the effects of tuina, treadmill running or both on the expression of factors related to gastrocnemius muscle proteins after acute muscle injury and to explore the mechanisms involved.Methods:Thirty adult male Sprague-Dawley rats were randomly divided into a control group, a natural recovery group, a tuina group, a treadmill running group and a combined treatment group, each of 6. An impactor was used to induce an acute skeletal muscle injury in the right hind legs of all of the rats except those of the control group. One day after the successful modelling, the tuina, treadmill running and combined groups were given interventions as their name implied, 5 times a week for 3 weeks. The gait of rats in each group was analyzed and the number of times the rats fell into and striken by the electrical grid was counted. The injured muscles′ cross-sectional areas (CSAs) and the diameters of muscle fibers were observed using hematoxylin and eosin staining. The expression of mTOR, p-mTOR, p70S6K, p-p70S6K and smad2/3 protein were tested using western blotting. The relative expression of myostatin (MSTN) mRNA was measured using real-time quantitative polymerase chain reactions.Results:Compared with the natural recovery group, all the other groups fell into the electrical grid significantly less often. The average CSA and wet weight of the affected gastrocnemius had increased significantly in the tuina, treadmill running and combined treatment groups, with the average CSA increases in the treadmill running and combined treatment groups significantly greater compared with the tuina group. The average relative expression of mTOR, p-mTOR, p70S6K, and p-p70S6K in the other four groups increased significantly compared with the control group, while that of Smad2/3 and MSTN decreased significantly. Compared with the natural recovery group, the average increases in the other groups were significantly greater. Compared with the tuina group, the treadmill running and combined treatment groups showed significantly better improvements, on average.Conclusions:Tuina, treadmill running and their combination all can improve recovery from skeletal muscle trauma, at least in rats. However, treadmill running and combined treatment are more effect than tuina alone.

Objective:To investigate the difference of brain activity intensity between abstinent methamphetamine-dependent (AMD) patients and healthy controls using amplitude of low-frequency fluctuation (ALFF).Methods:From April 2016 to March 2017, 29 male AMD patients from Pingtang compulsory rehabilitation center in Changsha City, Hunan Province and 31 healthy male controls were prospectively recruited. The general conditions of all AMD patients, including age of first use of MA, months of MA use, monthly MA consumption, MA use frequency of the last year and the last month, current months of drug withdrawal, times of drug withdrawal, self-assessment score of drug craving when taking drugs, smoking history (whether smoking and smoking years), drinking history (whether drinking and drinking years). The rest functional MRI data were collected. DPABI software package was used to preprocess the data and calculate ALFF value of each voxel in the whole brain of the subjects of two groups. Two samples t-test and alphasim multiple comparison correction were used. Nuclei with voxel level P<0.01 and voxel number>71 were considered as regions with significant differences between two groups, corresponding to corrected P<0.05. ALFF mean value was extracted for each region with significant differences. Taking smoking and drinking as covariates, the correlations between the mean ALFF values of regions with significant differences and MA use and abstinence were analyzed. Results:Compared with the healthy control group, it was found in the AMD group that ALFF value of left middle frontal gyrus was significantly lower ( t=-4.707), and that of right inferior frontal gyrus was significantly higher ( t=4.445). The results of correlation analysis showed that the ALFF value of right inferior frontal gyrus was negatively correlated with the frequency of MA use and the MA amounts used in the last month ( r=-0.396, P=0.034; r=-0.429, P=0.020). Conclusions:Abnormal brain activity intensity is found in AMD patients compared with healthy controls, with abnormalities mainly found in the prefrontal lobe, which is involved in cognitive, executive and emotion functions. The more MA is used, the more damages or alterations may exist in these regions.

Objective To investigate the changes of brain gray matter volume (GMV) and brain activity in patients with long?term methamphetamine (MA) abstinence compared with healthy controls. Methods This study included 44 abstinent MA patients and 40 demographically equivalent healthy controls. Structural magnetic resonance imaging (MRI) and resting?state functional MRI (rs?fMRI) were obtained on Siemens 3.0 T MR. Differences in GMV between abstinent MA group and control group were assessed using voxel?based morphometry (VBM) method. Within each region showed significant differences between two groups, the value of the fractional amplitude of low frequency fluctuation (fALFF) was calculated using the rs?fMRI data. Differences of fALFF between groups were also evaluated. Furthermore, partial correlation coefficients adjusted for age, years of education, smoking and drinking were calculated in the abstinent MA group to assess associations between the mean GMV and fALFF values in significant clusters and variables of MA use and abstinence. Results Compared with controls, abstinent MA group showed increased GMV in the right cerebellum crus and decreased GMV in the right calcarine. While fALFF values within bilateral cerebellum crus in abstinent MA patients were significantly increased. Moreover, GMV of the left cerebellar crus was positively correlated with the withdrawal time among abstinent MA patients. Conclusions Both structural and functional abnormalities were found in abstinent MA patients even after long?term abstinence. The positive correlation between GMV of left cerebellum crus and abstinent duration suggested that prolonged abstinence may be beneficial to brain recovery. The fALFF of the right calcarine was increased even with decreased GVM in the abstinent MA group. It indicates that the brain activity of this area is increased, which may imply that drug cue?induced craving is significant among methamphetamine patients even after long?term abstinence.

Objective: To investigate the changes of brain gray matter volume (GMV) and brain activity in patients with long-term methamphetamine (MA) abstinence compared with healthy controls. Methods: This study included 44 abstinent MA patients and 40 demographically equivalent healthy controls. Structural magnetic resonance imaging (MRI) and resting-state functional MRI (rs-fMRI) were obtained on Siemens 3.0 T MR. Differences in GMV between abstinent MA group and control group were assessed using voxel-based morphometry (VBM) method. Within each region showed significant differences between two groups, the value of the fractional amplitude of low frequency fluctuation (fALFF) was calculated using the rs-fMRI data. Differences of fALFF between groups were also evaluated. Furthermore, partial correlation coefficients adjusted for age, years of education, smoking and drinking were calculated in the abstinent MA group to assess associations between the mean GMV and fALFF values in significant clusters and variables of MA use and abstinence. Results: Compared with controls, abstinent MA group showed increased GMV in the right cerebellum crus and decreased GMV in the right calcarine. While fALFF values within bilateral cerebellum crus in abstinent MA patients were significantly increased. Moreover, GMV of the left cerebellar crus was positively correlated with the withdrawal time among abstinent MA patients. Conclusions Both structural and functional abnormalities were found in abstinent MA patients even after long-term abstinence. The positive correlation between GMV of left cerebellum crus and abstinent duration suggested that prolonged abstinence may be beneficial to brain recovery. The fALFF of the right calcarine was increased even with decreased GVM in the abstinent MA group. It indicates that the brain activity of this area is increased, which may imply that drug cue-induced craving is significant among methamphetamine patients even after long-term abstinence.

Objective To explore the effects and mechanism of electroacupuncture (EA) on denervation-induced atrophy in rats. Methods A total of 18 male Sprague-Dawley rats were divided into sham group (n=6), model group (n=6) and EA group (n=6). The latter two groups were clamped right sciatic nerve to establish atrophy model of skeletal muscle. On the second day after modeling, EA group accepted electroacupuncture on right Zusanli (ST36) and Huantiao (GB30) for two weeks. Their gastrocnemius muscles were obtained after intervention, and the wet weight ratio of the gastrocnemius muscles was calculated. The cross-sectional area (CSA) and diameter of muscle fibers were measured after HE staining. The protein expression of mammalian target of rapamycin (mTOR), phosphorylated mTOR (p-mTOR), 70-KD ribosomal protein S6 kinase (p70S6K) and phosphorylated p70S6k (p-p70S6k) was tested with Western blotting. The gene expression of mTOR and p70S6K was detected with real-time quantitative polymerase chain reaction. Results Compared with the sham group, the wet weight ratio of the gastrocnemius muscle, CSA and diameter of the muscle fibers decreased in the model group and EA group (P<0.001), which were more in EA group than in the model group (P<0.01); the protein expression of mTOR, p-mTOR, p70S6K and p-p70S6K increased in the model group (P<0.01), and increased more in EA group (P<0.05); the gene expression of mTOR and p70S6K increased in the model group (P<0.05) , and increased more in EA group (P<0.05).Conclusion Electroacupuncture delays the atrophy of denervated skeletal muscles, which may relate to activation of mTOR/p70S6K signal pathway to impact synthesis of skeletal muscle proteins.

Objective To observe the objective response rate, survival and safety of radiotherapy combined with Iressa for patients with locally advanced non-small cell lung cancer ( NSCLC) unsuitable for surgery or concurrent chemoradiotherapy. Methods The patients with locally advanced NSCLC unsuitable for surgery or concurrent chemoradiotherapy were recruited and received thoracic intensity-modulated radiotherapy ( IMRT) combined with Iressa 250 mg daily. Results A total of 30 patients were enrolled between July 2014 and March 2017. Twenty-nine patients were analyzed. At 1 month after radiotherapy,the complete response (CR) was 0,partial response (PR) was 21(72％),stable disease (SD) was 6(21％), progressive disease (PD) was 2(7％),the disease control rate (CR+PR+SD) was 93％,and the objective response rate was 72％. The median follow-up time was 25 months. Fourteen ( 48％) patients died,and 15 (52％) survived. Twenty-three (79％) patients obtained PD including local progression in 18(62％) and distant metastasis in 14(48％). The median survival time (MST) was 26 months and the median PFS was 11 months. The 1-year OS and PFS were 79％ and 44％,and the 2-year OS and PFS were 55％ and 18％. Univariate analysis demonstrated that smoking history and disease stage were influencing factors for OS ( P=0. 035,0. 031) . Moreover, disease stage, the primary tumor diameter, the volume of GTV and PTV were influencing factors for PFS (P=0. 000,0. 016,0. 039,0. 030). Multivariable analysis revealed that disease stage and the volume of PTV were independent prognostic factors for PFS (P=0. 000,0. 012).Two patients ( 7％) developed grade 3 acute adverse events and 7 ( 24％) experienced grade 2 acute irradiation pneumonitis. Conclusions For patients with locally advanced NSCLC unsuitable for surgery or concurrent chemoradiotherapy,IMRT combined with Iressa yields high objective response rate and well tolerance. The long-term clinical efficacy remains to be validated.