Objective To analyze the needs and current situation of home-based exercise rehabilitation for people with disabilities,develop service plans for different types of disabilities,and assess its health benefits for people with severe dis-abilities. Methods Based on the World Health Organization(WHO)Global Action Plan on Physical Activity 2018-2030:More Ac-tive People for a Healthier World and WHO Guidelines on Physical Activity and Sedentary Behavior,functional and individualized home-based exercise rehabilitation plans for people with severe disabilities were developed.Begining from May,2023,a six-month intervention was conducted for 37 people with severe disabilities.They were assessed with International Physical Activity Questionnaire(IPAQ),WHO Disability Assessment Schedule 2.0(WHODAS 2.0),WHO Quality of Life(WHOQOL-BREF)before and after intervention. Results The time of low-intensity leisure physical activity of IPAQ increased after intervention,while the scores of do-mains of cognition,mobility,self-care,getting along,life activities and participation,and total score of WHO-DAS 2.0 decreased,and the scores of physical health,psychological health,independence,and environment di-mensions,and total score of WHOQOL-BREF increased. Conclusion The functioning-oriented and individualized home exercise rehabilitation program can improve the level of physical activity,enhance the level of activity and boost the quality of life for people with severe disabilities.

The incidence of osteoporotic thoracolumbar vertebral fracture (OTLVF) in the elderly is gradually increasing. The kyphotic deformity caused by various factors has become an important characteristic of OTLVF and has received increasing attention. Its clinical manifestations include pain, delayed nerve damage, sagittal imbalance, etc. Currently, the definition and diagnosis of OTLVF with kyphotic deformity in the elderly are still unclear. Although there are many treatment options, they are controversial. Existing guidelines or consensuses pay little attention to this type of fracture with kyphotic deformity. To this end, the Lumbar Education Working Group of the Spine Branch of the Chinese Medicine Education Association and Editorial Committee of Chinese Journal of Trauma organized the experts in the relevant fields to jointly develop Clinical guidelines for the diagnosis and treatment of osteoporotic thoracolumbar vertebral fractures with kyphotic deformity in the elderly ( version 2024), based on evidence-based medical advancements and the principles of scientificity, practicality, and advanced nature, which provided 18 recommendations to standardize the clinical diagnosis and treatment.

ObjectiveTo construct the physical activity intervention effect category and framework for college students with mental and behavioral health and functioning problems based on International Classification of Functioning, Disability, and Health (ICF). MethodsThe typical mental and behavioral health and functioning condition of college students were systematically analyzed using ICF. Relevant literatures about the health and functioning outcomes of college students participating in physical activity were retrieved from the databases of PubMed, Web of Science, EBSCO, and CNKI, from the establishment to August 20th, 2022, and reviewed systematically. ResultsTen English literatures were included, involving ten randomized controlled trials with 848 participants aged 15 to 34 years from seven countries, mainly from the journals of rehabilitation science, sports rehabilitation, rehabilitation psychology and health psychology, and were mainly published after 2016. The typical mental and behavioral health and functioning problems of college students mainly focused on stress, anxiety, depression, sleep disorders, learning fatigue, mobile phone addiction, alcohol drinking disorder, sedentary behavior and physical inactivity. Physical activity interventions included Biodanza, Hatha Yoga, Tai Chi, basketball, Baduanjin, cycling, swimming, roller skating, baseball, skill training, stretching exercise, resistance training, and aerobic exercise, etc. The frequency of interventions was mainly a long-term (four to 14 weeks, one to three times per week) program of high-, moderate-, or low-intensity physical activity. The health outcomes included improving cognitive function, relieving stress, anxiety, depression and learning fatigue, reducing negative automatic thinking, enhancing mindfulness, reducing loneliness and deficiency, improving sleep quality, improving upper limb muscle endurance; promoting the development of exercise habits, increasing physical activity participation, improving activity performance and academic performance, reducing sedentary behavior, drinking behavior and problematic mobile phone use; increasing social interaction, improving health perception and psychosocial function, enriching and improving recreation and campus life, and improving the quality of interpersonal relationships, quality of life and well-being. ConclusionA conceptual framework of physical activity participation of college students with mental and behavioral health and functioning problems is constructed using ICF. The typical mental and behavioral health and functioning problems of college students are mainly classified as mental health and functioning problems, behavioral health and functioning problems. The intervention types of physical activity are divided into physical fitness category, skill category, sports category and combination category. Health outcomes can be reflected in three dimensions: physical and mental health, activity and behavioral health, and overall functioning and quality of life.

Objective To systematically research the policies and core contents of World Health Organization (WHO) and United Nations Educational, Scientific and Cultural Organization (UNESCO) documents on policies, guidelines and standards for health-promoting schools and health services. Methods These policy documents included Making Every School a Health-promoting School: Implementation Guidelines, WHO Guidelines on School Health Services, and Making Every School a Health Promoting School Global Standards and Indicators, which construct a conceptual and policies framework for health-promoting schools. In perspective of health service system, this study systematically explored the policies, guidelines and standards of WHO and UNESCO on health-promoting schools and health services, as well as the role of health-promoting school component systems in promoting the health of children and how physical activity can be an important area of health-promoting schools. Results The Health Promoting Schools Initiative is an important area of research for the WHO health services. Making Every School a Health-promoting School: Implementation Guidelines primarily serves students aged five to 19, teachers and other staff in schools. WHO Guidelines on School Health Services cover a variety of activity types including health promotion, health education, preventive interventions, clinical assessment and health services management. Making Every School a Health Promoting School Global Standards and Indicators covers eight global criteria and thirteen specific areas in the areas of policy resources, curriculum and environment, and community engagement. Conclusion WHO and UNESCO have proposed a series of policies related to building health-promoting schools, which focus on child health and advocate the promotion of child and adolescent health, public health, education, social and economic development through schools to achieve the goal of safeguarding the health rights of children and adolescents and meeting health needs. Following the WHO Guidelines on School Health Services and Making Every School a Health Promoting School Global Standards and Indicators, it proposed to incorporate educational and physical education tools into the school health service system.

Objective To systematically analyze the World Health Organization Rehabilitation Competency Framework (RCF) theoretical framework, methodology and its application in the field of rehabilitation.Methods We systematically analyzed RCF conceptual framework and key characteristics, and discussed how to apply the RCF in the fields of human resource planning, education program and curriculum system, and vocational competency standards and certification criteria for rehabilitation human resources.Results The RCF encompasses five domains, naming practice, professionalism, learning and development, management and leadership, and research. Rehabilitation professionals' performance is the result of the interaction of their core values and beliefs, competencies, activities, knowledge, and skills. The RCF can be used to plan rehabilitation human resources, establish competency-based rehabilitation education programs and curriculum systems, and develop competency certification standards and licensure accreditation standards.Conclusion This study analyzed background, content and implementation framework of RCF, and systematically discussed the theories and methods related to how to use the RCF to construct national rehabilitation human resources development plans, develop rehabilitation education programs and curriculum systems based on the RCF, and establish certification and assessment standards for rehabilitation human resources.

Objective:To explore the application of high-throughput sequencing (HTS) technology in pathogens detection for spinal infection.Methods:From January 2019 to May 2020, a total of 41 patients including 31 males and 10 females with an average age of 59.7±11.9 years (29-75 years) were suspected of spinal infections. There were 37 patients with local pain, 15 with fever (≥38 ℃) and 18 with neurological dysfunction. The infected sites were as follows, 4 cases of cervical spine, 8 cases of thoracic spine and 29 cases of lumbar spine. There were 36 patients met the surgical indications and underwent open debridement, bone grafting, fusion and internal fixation, while the other 5 patients underwent conservative treatment (three received drug therapy and two were transferred to the internal department for chemotherapy). Lesions obtained from open surgery patients were underwent pathology and HTS examination. In 5 cases with conservative treatment, two of them underwent CT guided percutaneous puncture for samples, while one case underwent ultrasound guided percutaneous puncture for pus, one case for venous blood, and one case received lumbar puncture for cerebrospinal fluid. The samples were sent for pathological and HTS examination, while liquid specimens were sent for bacterial culture and HTS. The sensitivity and specificity of HTS results were determined according to pathological examination which was regarded as the "gold standard". Based on HTS results combined with the clinical manifestations, imaging examination and pathological results of the patients, targeted antibiotics or anti-tuberculosis drugs were selected for postoperative drug therapy. Patients with bacterial infection received anti-infection treatment for 3 months after operation. For tuberculosis patients, "tetrad" (isoniazid+rifampicin+pyrazinamide+ethambutanol) anti-tuberculosis treatments were underwent for one year. Inflammation indicators from the blood samples were observed before and after treatment, including white blood cell count (WBC), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). These indicators were used to monitor disease progression and the curative effects. All patients were followed up for at least 3 months after surgery.Results:A total of 41 patients with suspected spinal infection were included in this study. The HTS pathogen detection results were obtained within 48 h. For the initial 5 patients, first-generation sequencing verification was conducted with coincidence rate 100%. Further, no further verification was conducted in the rest patients. Among the 41 cases, a total of 26 cases had positive results with a positive rate of 63.4%(26/41). Among them, thirteen cases were with mycobacterium tuberculosis (31.7%) and 6 cases with staphylococcus (14.6%). Fungi and Brucellosis were diagnosed in 2 cases respectively, accounting for 4.9% respectively. The test were negative in 15 patients (36.6%), including 2 patients with tumor or tumor-like lesions (1 hematologic tumor and 1 eosinophilic granuloma). A total of 38 patients underwent pathological examination, which confirmed 7 cases of suppurative infection, 12 cases of tuberculosis, 2 cases of tumor or tumor-like lesions and the remaining 17 cases of inflammatory lesions. The sensitivity and specificity of HTS were 80%(16/20) and 55.6% (10/18) with positive predictive value (PPV) 66.7% (16/24) and negative predictive value (NPV) 71.4% (10/14). All patients were followed up for 3 months. The inflammation indicators of blood at 3 months were all lower than that at admission. WBC decreased from (7.50±3.26)×10 9/L at admission to (6.22±2.53)×10 9/L at 3 months after treatment without statistically significant difference ( t=1.082, P=0.290). The CRP decreased from (32.2±34.1) mg/L to (4.5±10.5) mg/L, and ESR from (44.2±26.5) mm/1 h to (18.6±12.1) mm/1 h with statistically significant difference ( t=8.963, P<0.001; t=5.421, P<0.001). Conclusion:High-throughput sequencing technology can be used in detection of spinal infection pathogens, due to its relatively high positive rate, satisfied sensitivity and good diagnostic value.

Objective:To observe the effects of static 70° head-up tilted standing and of repeated body repositioning on hemodynamics in healthy young and middle-aged persons.Methods:The hemodynamics of 24 middle-aged and 23 younger persons were studied. Both groups were requested to perform static 70° head-up tilted standing and to repeatedly change their body position from 0° to 70° of tilt at a velocity of 1°/second for ten minutes in a random order. Before, between and after each test the subjects rested supine for ten minutes. Hemodynamic variables and blood pressure were recorded non-invasively.Results:The average heart rate (HR) increased significantly in both groups when rising from supine to the testing positions. In 70° tilted standing the average HR of the youth group, 84.0±9.5bpm, was significantly higher than that in the other position and that of the middle-aged group in the same position. The average HR of the middle-aged group in 70° tilted standing was also significantly higher than in the other position. Among the middle-aged group, the average stroke volume (SV) in the testing positions was significantly lower than when resting. Significant differences were observed in the average diastolic blood pressure (DBP) between the testing and rest positions for both groups, with the average DBP of the middle-aged group significantly higher than that of the youth group in all three positions. Among the youth group, the average SV, CO and systolic blood pressure (SBP) of the males were significantly higher than among the females in all of the different body positions.Conclusions:Young persons mainly rely on an increased heart rate to maintain cardiac output while middle-aged participants appear to achieve this through increased peripheral resistance. Repeated position changes have less impact on hemodynamics than 70° inclined standing, making it a safer and more stable training method. However, the long-term effects of such intervention need to be confirmed in further studies.

A novel coronavirus pneumonia outbreak in the world. The epidemic of the new coronavirus pneumonia has been preliminarily controlled successfully in China. At this time, how to construct the clinical laboratory in the hospital? This artical puts some forward thoughts, such as improve the construction of biological safety protection ability, detection ability, test platform construction, scientific research ability construction, personnel training and clinical communication ability, etc. These above advices could provide reference for the development direction of the clinical laboratory in post epidemic era.

A novel coronavirus pneumonia outbreak in the world. The epidemic of the new coronavirus pneumonia has been preliminarily controlled successfully in China. At this time, how to construct the clinical laboratory in the hospital? This artical puts some forward thoughts, such as improve the construction of biological safety protection ability, detection ability, test platform construction, scientific research ability construction, personnel training and clinical communication ability, etc. These above advices could provide reference for the development direction of the clinical laboratory in post epidemic era.

Objective To investigate the curative effect of ultra early enteral nutrition (EN) supplemented with probiotics in patients with severe acute pancreatitis (SAP).Methods Seventy-five SAP cases admitted in Second People's Hospital of Nantong from December 2014 to June 2018 were enrolled and assigned into 24 h group (who received EN & probiotics at 24 h,n =25),72 h group (who received EN & probiotics at 72 h,n =25) and the control group (who received EN & probiotics on day 7,n =25).After admission,the levels of PCT,hs-CRP and endotoxin on day 1,4 and 8 were detected.APACHE Ⅱ score on day 3 after admission,complication rate,infection rate,hospitalization duration and mortality were recorded.Results On day 1 after admission,serum PCT,hs-CRP and endotoxin concentrations among three groups were of no significant differences.On day 4 after admission,the serum concentrations of PCT and edotoxin in 24 h group were significantly lower than those in 72 h group and the control group [(3.12 ± 1.45) μg/L vs (5.26±1.52),(6.07 ± l.59) μg/L;(0.24 ± 0.02) EU/ml vs (0.35 ±0.03),(0.46±0.04) EU/ml].The serum hs-CRP in 24 h group was significantly lower than that of the control group [(20.71 ±4.89) μg/L vs (28.37 ± 4.64) μg/L],and the difference was statistically significant (P ＜ O.05).The serum concentrations of hs-CRP in 24 h group and 72 h group was of no significant difference.On day 7 after admission,the serum concentrations of PCT,hs-CRP and endotoxin in 24 h group were significantly lower than those in 72 h group and the control group (P ＜0.05);the serum concentrations of PCT,hs-CRP and endotoxin in 72 h group were significantly lower than those of the control group,and all the differences were statistically significant (all P ＜ 0.05).The score of APACHE Ⅱ (day 3 after admission) [(15.1 ± 1.8)],complication rate (52％),infection rate (8％),length of stay [(19.7 ± 5.3) d] in 24 h group were all significantly lower than those of 72h group [(17.0 ± 2.0),72％,32％,(25.4 ± 6.8) d] and control group [(18.3 ±2.6),84％,44％,(38.7 ± 12.6) d],and all the differences were statistically significant (all P ＜0.05).Conclusions Ultra EN supplemented with probiotics in treating the patients with SAP could significantly reduce the level of serum PCT,hs-CRP and endotoxin,decrease complication rate and mortality,and shorten the time of hospitalization.