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.

ObjectiveTo explore the research status and hot spots of virtual reality in the field of stroke rehabilitation. MethodsThe literature related to the application of virtual reality technology in stroke rehabilitation was retrieved in CNKI and Web of Science core collection from establishiment to August, 2024. The knowledge map of authors, institutions and keywords was drawn by Citespace 6.2.R7. ResultsA total of 485 papers were retreived, including 201 in Chinese and 284 in English. The number of articles published in both Chinese and English was on the rise. Qu Yun was the Chinese author with the most articles, and Rocco Salvatore Calabro was the English author. The Third Affiliated Hospital of Sun Yat-Sen University and IRCCS Bonino Pulejo published the most papers respectively. The results of keyword co-occurrence and clustering were consistent in the Chinese and English keywords, mainly included hemiplegia, balance function, upper limb function and cognitive function. The keywords with high bursting intensity in Chinese included motor function, cognitive function and upper limb function, while those with high bursting intensity in English included upper limb, cognitive impairment and environment. The hot spots in this field focused on the virtual reality technology for stroke patients' motor function rehabilitation, cognitive function rehabilitation, limb function rehabilitation and virtual reality technology combined with conventional treatment. ConclusionVirtual reality technology, as a simulation information technology, has been widely applied in the fields of motor function rehabilitation, cognitive function rehabilitation and limb function rehabilitation for stroke patients. The combination of virtual reality technology with conventional rehabilitation therapy could enhance the functional level and activities of daily living. More researches may focus on conjunctions of virtual reality technology with new technologies such as digital therapeutics and brain-computer interfaces, to improve the gait and upper limb functions of stroke patients.

Objective To observe the clinical efficacy of Sanjiao Tiaoqi Acupuncture in the treatment of post-stroke respiratory dysfunction.Methods Seventy-two patients with post-stroke respiratory dysfunction were randomly divided into observation group and control group,36 cases in each group.The control group was given routine treatment,and the observation group was treated with Sanjiao Tiaoqi Acupuncture on the basis of the control group,both groups were treated for 14 consecutive days.After 2 weeks of treatment,the clinical efficacy of the two groups was evaluated,and the changes of white blood cell count(WBC),C-reactive protein(CRP)and clinical pulmonary infection score(CPIS)were observed before and after treatment.The changes of diaphragmatic activity were compared before and after treatment between the two groups.Results(1)After treatment,the WBC and CRP levels of patients in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the WBC and CRP levels,with statistically significant differences(P＜0.05).(2)After treatment,the CPIS scores of patients in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving CPIS scores,with a statistically significant difference(P＜0.05).(3)After treatment,the diaphragm mobility of patients in the two groups was significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving diaphragm mobility,and the difference was statistically significant(P＜0.05).(4)The total effective rate was 91.67％(33/36)in the observation group and 75.00％(27/36)in the control group.The efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P＜0.05).Conclusion Sanjiao Tiaoqi Acupuncture for post-stroke respiratory dysfunction can significantly promote the absorption of inflammatory factors in patients and improve diaphragm mobility,with remarkable clinical efficacy.

Objective To investigate the association between the serum creatinine/cystatin C ratio(SCr/Cys C)as a Sarcopenia index(SI)and the incidence of in-hospital adverse events in patients with acute myocardial infarction(AMI)undergoing emergency percutaneous coronary intervention(PCI).Additionally,we evaluate the predictive efficacy of the SI in predicting major adverse cardiovascular events(MACEs)during hospitalization.Methods A total of 306 patients with AMI who underwent emergency PCI in the 904th Hospital of PLA Joint Logistics Support Force from January 2020 to March 2023 were consecutively included in this retrospective analysis.Patients were divided into two groups based on the occurrence of MACEs during hospitalization:MACEs group(n=43)and non-MACEs group(n=263).Clinical characteristics and pre-PCI laboratory test results were collected.Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for MACEs.The predictive performance of SI was assessed using receiver operating characteristic(ROC)curve analysis.Results The incidence of in-hospital MACEs in AMI patients was 14.1%.The results of the independent samples t-test showed that the SI level in MACEs group was significantly lower than that in non-MACEs group,with a statistically significant difference(P<0.001).The results of the multivariate logistic regression analysis suggested that new-onset atrial fibrillation,Killip class 2-4,SI,and TG were independent risk factors for in-hospital adverse events after emergency PCI.The ROC curve results showed that the predictive value of SI(AUC=0.741,95%CI 0.666-0.816)using the SCr/Cys C ratio was superior to that of single Cys C(AUC=0.658,95%CI 0.570-0.746)for predicting post-PCI MACEs,with a statistically significant difference(P<0.05),and the optimal cutoff value for SI was 78.14.After stratifying SI based on the cutoff value,the results of the independent samples t-test showed that compared to the higher SI group,the lower SI group had a higher occurrence of specific adverse events such as heart failure(P<0.001),malignant arrhythmias(P=0.009),and strokes(P=0.003),with statistically significant differences.Conclusions The results highlight SI as an independent risk factor for MACEs during hospitalization after emergency PCI in AMI patients.Furthermore,SI has proven to be an effective prognostic index for patient outcomes.

Objective: To analyze the trends of overweight and obesity in children and adolescents aged 7-18 in Hainan Province from 2005 to 2019, in order to provide a scientific basis for prevention strategies. Methods: Data were sourced from a total of 42 811 students in Hainan Province in 2005, 2010, 2014 and 2019 for physical fitness and health investigation, according to the criteria of Screening for Overweight and Obesity among School aged Children and Adolescents. The linear trend of overweight and obesity was compared by using the χ 2 test and χ 2 trend test, and with 2005 as the base period, the dynamic analysis was conducted to compare the growth and development rates of overweight and obesity. Results: The detection rates of overweight in children and adolescents aged 7-18 in Hainan Province were 4.7%, 5.1%, 6.7% and 10.8% in 2005, 2010, 2014 and 2019, respectively, while the detection rates of obesity were 2.7%, 2.4%, 2.5% and 6.8%, which showed an overall upward trend by year ( χ 2 trend =370.57 , 313.55, P <0.01). All differences in overweight and obesity detection rates across gender, ethnicity, and age groups were statistically significant for each year ( χ 2=9.56-290.95, P <0.01). And the detection rates of overweight and obesity increased linearly over year in different characteristic groups ( χ 2 trend =29.92-280.11, P <0.01). The annual growth rate of overweight detection rate was higher for girls (6.4%) than for boys (6.1%), higher for ethnic minorities (7.1%) than for Han (5.7%), and higher for the 16- 18 age group (8.4%) than for the 7-9 (3.6%), 10-12 (6.2%), and 13-15 age groups (7.7%). And the annual growth rate of obesity detection rate was higher for boys (8.1%) than for girls ( 5.7% ), higher for ethnic minorities (7.1%) than for Han ( 6.8% ), and higher for the 16-18 age group (77.2%) than for the 7-9 (2.8%), 10-12 (8.2%), and 13-15 (18.7%) age groups. Conclusions The overall prevalence of overweight and obesity among children and adolescents aged 7-18 in Hainan Province continues to increase from 2005 to 2019, with differences in genders, ethnic and ages. Interventions should be implemented to reduce the incidence of overweight obesity in children and adolescents.

This study was aimed at summarizing the epidemiological characteristics and spatial-temporal changes of hemorrhagic fever with renal syndrome(HFRS)in Hubei Province,China from 2005 to 2021,to provide scientific evi-dence for HFRS prevention and control.Data on individual HFRS cases and population information in Hubei Province from 2005 to 2021 were collected from the China Disease Pre-vention and Control Information System.The temporal,spa-tial,and demographic distribution characteristics of HFRS cases are described,and statistical methods such as medians,rates,and composition ratios were used for analysis.Joinpoint re-gression and Spearman's rank correlation were used to analyze the temporal trends in incidence rates or composition ratios.Global autocorrelation and hotspot analysis were conducted for spatial clustering analysis.Binary logistic regression was per-formed to analyze risk factors for HFRS mortality.A total of 5 790 HFRS cases were reported from 2005 to 2021,including 117 deaths.The average annual incidence rate was 0.57 per 100 000 population,and the case fatality rate was 2.02％.The overall incidence rate of HFRS in Hubei Province showed an increasing trend(AAPC=4.05％,95％CI:1.32％-6.78％),whereas the case fatality rate showed a decreasing trend over the years(r,=-0.72,P=0.002).HFRS exhibited a bimodal pattern,with peaks in the spring/summer months(May to July)and in the autumn/winter months(November to January of the following year).The incidence rate during the autumn/winter peak was slightly higher than that in the spring/summer peak.The incidence rate in males was higher than in females(RR=2.96,95％CI:2.79-3.14).The three age groups with the highest incidence rates were 60-64 years(747 cases,1.55 per 100 000),65-69 years(515 cases,1.39 per 100 000),and 55-59 years(762 cases,1.23 per 100 000).The incidence rate(2005:0.05 per 100 000;2021:0.08 per 100 000)and proportion(2005:2.69％;2021:1.94％)of HFRS cases in individuals 14 years or younger showed no significant trend over the years(AAPC=0.14％,95％CI:-0.03％-0.31％;AAPC=-3.64％,95％CI:-8.79％-1.50％).The incidence rate(2005:0.58 per 100 000;2021:1.59 per 100 000)and proportion(2005:14.80％;2021:44.31％)in the age group of 60 years or a-bove showed an increasing trend over the years(AAPC=10.52％,95％CI:4.38％-16.66％;AAPC=175.98％,95％CI:143.20％-208.75％).HFRS cases exhibited significant spatial clustering(P＜0.05).The hotspots of HFRS in Hubei Province shifted from the northern region(Xiangyang,Suizhou,Jingmen)in 2005-2007 to the southern region(Qianjiang,Xiantao,Tianmen,Jingzhou)in 2020-2021.Older age(OR=1.02,95％CI:1.01-1.04)and the period of 2005-2008 versus 2017-2021(OR=0.98,95％CI:0.97-0.99)were associated with relatively higher risk of HFRS mortality.In recent years,the HFRS epidemic in Hubei Province has continued to escalate,and areas such as Qianjiang City and other ares in the middle and lower reaches of the Yangtze River have experienced high incidence rates.The population 60 years of age or above is gradually becoming more susceptible to the disease.Targeted measures should be implemented to curb the rising trend of HFRS.

Traumatic supraorbital fissure syndrome (TSOFS) is a symptom complex caused by nerve entrapment in the supraorbital fissure after skull base trauma. If the compressed cranial nerve in the supraorbital fissure is not decompressed surgically, ptosis, diplopia and eye movement disorder may exist for a long time and seriously affect the patients′ quality of life. Since its overall incidence is not high, it is not familiarized with the majority of neurosurgeons and some TSOFS may be complicated with skull base vascular injury. If the supraorbital fissure surgery is performed without treatment of vascular injury, it may cause massive hemorrhage, and disability and even life-threatening in severe cases. At present, there is no consensus or guideline on the diagnosis and treatment of TSOFS that can be referred to both domestically and internationally. To improve the understanding of TSOFS among clinical physicians and establish standardized diagnosis and treatment plans, the Skull Base Trauma Group of the Neurorepair Professional Committee of the Chinese Medical Doctor Association, Neurotrauma Group of the Neurosurgery Branch of the Chinese Medical Association, Neurotrauma Group of the Traumatology Branch of the Chinese Medical Association, and Editorial Committee of Chinese Journal of Trauma organized relevant experts to formulate Chinese expert consensus on the diagnosis and treatment of traumatic supraorbital fissure syndrome ( version 2024) based on evidence of evidence-based medicine and clinical experience of diagnosis and treatment. This consensus puts forward 12 recommendations on the diagnosis, classification, treatment, efficacy evaluation and follow-up of TSOFS, aiming to provide references for neurosurgeons from hospitals of all levels to standardize the diagnosis and treatment of TSOFS.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To analyze the interventional effect of high-flow nasal cannula oxygen (HFNC) therapy in patients with stable chronic obstructive pulmonary disease (COPD) combined with hypercapnia. Methods A total of 45 patients with stable COPD complicating with hypercapnia who require long-term oxygen therapy were selected as study subjects. They were divided into three groups based on different respiratory support modes: long-term home oxygen therapy (LTOT) group, non-invasive ventilation (NIV) group, and HFNC group, with 15 patients in each group. The general condition, blood gas index, lung function index, respiratory status, quality of life, and walking test results of the three groups were compared after discharge. Results During the follow-up period, the number of admission and acute exacerbation in the HFNC group and NIV group was lower than that in the LTOT group (P < 0.05). At 6 and 12 months after discharge, the arterial partial pressure of carbon dioxide [p_a(CO₂)] in the three groups was lower than before discharge, while the arterial partial pressure of oxygen[p_a(O₂)], pulse oxygen saturation (SpO₂), forced vital capacity (FVC), and forced expiratory volume in one second (FEV₁) were higher than before discharge. Moreover, the changes in the above indicators in the HFNC group were greater than those in the NIV group and LTOT group (P < 0.05). At 1-, 3-, 6-, and 12-month after discharge, the scores of dyspnea scale of the modified Medical Research Council (mMRC) and the St. George′s Respiratory Questionnaire (SGRQ) in the three groups gradually decreased, and the 6-minute walking distance (6MWD) gradually increased. Additionally, the changesin the above indicators in the HFNC group were greater than those in the NIV group and LTOT group (P < 0.05). Conclusion HFNC can effectively alleviate dyspnea symptoms, improve lung function, promote the recovery of blood gas indicators, enhance quality of life and exercise tolerance, and reduce re-hospitalization rates in patients with stable COPD combined with hypercapnia.