ObjectiveTo study the conceptual framework and methodological system of the International Classification of Functioning, Disability and Health (ICF) in occupational therapy and its systematic implementation in clinical practice. MethodsBased on the ICF theory and the policy documents of the World Federation of Occupational Therapists, the conceptual framework of occupational therapy and the systematic implementation in clinical settings based on the ICF framework were analyzed. ResultsThis study constructed a conceptual framework and approach for occupational therapy based on ICF, and clarified the goals, principles, and implementation methods of integrated occupational therapy interventions in rehabilitation services. The goal of occupational therapy interventions was to improve the individual activity and participation through multidisciplinary and cross-cutting implementation of integrated occupational therapy programs to optimize functioning. Occupational therapy was based on the bio-psycho-social model, adhered to the principles of person-centeredness and functioning orientation, and implemented individualized intervention programs in different context. In clinical practice, it was recommended to follow ICF-based standardized process and systematically use World Health Organization Family International Classifications: functioning and unmet needs analysis using ICHI; functional classification, assessment and coding using ICF; disease classification, diagnosis and coding using ICD; intervention of occupational therapies using ICHI to build a systematic occupational therapy service system. ConclusionAn ICF-based occupational therapy concept and methodological system has been built, a comprehensive clinical occupational therapy implementation model has been established, the goal of activity and participation oriented occupational therapy interventions has been clarified, and the systematic, structured, standardized and refined level of occupational therapy has been enhanced.

Objective To evaluate the effects of antiretroviral therapy(ART)for the prevention of mother-to-child transmission(PMTCT)of acquired immune deficiency syndrome(AIDS)on the growth and development of 18-month-old children born by human immunodeficiency virus(HIV)-positive pregnant women in Lingshan County,Guangxi Zhuang Autonomous Region,and provide scientific evidence for improving the ART medication plan for PMTCT.Methods Lingshan County,ranking the first in the HIV-epidemic counties of Guangxi,was selected as the research site.According to the design of retrospective case-control study,we assigned all the subjects into the case group and the control group:(1)The case group included the HIV-positive pregnant women who had received ART for PMTCT and their HIV-negative infants in Lingshan County from 2010 to 2017.The historical cards and PMTCT data of them were collected from the national PMTCT database.(2)The control group included the healthy pregnant women and their healthy babies born in the Lingshan Maternity and Infant Hospital in 2017,and the children's growth and development data were collected.The stunted growth in children was defined as at least one of the three main indicators of body height,body weight,and head circumference below the normal range.Results The number of HIV-positive mothers and their infants in the case group was 391 and 368,respectively,and 87.21%(341/391)and 95.38%(351/368)of mothers and infants respectively received ART medication.The HIV positive rate,mortality rate,and mother-to-child transmission rate of 18-month-old children were 1.36%(5/368),4.35%(16/368),and 2.01%(5/249),respectively.The incidence of stunted growth of 18-month-old children in the case group and the control group was 42.12%(155/368)and 23.06%(101/438),respectively,with significant difference(
Case-Control Studies ; China/epidemiology* ; Female ; Growth and Development ; HIV ; HIV Infections/prevention & control* ; Humans ; Infant ; Infectious Disease Transmission, Vertical/prevention & control* ; Mothers ; Pregnancy ; Pregnancy Complications, Infectious/drug therapy* ; Retrospective Studies

Sojae Semen Germinatum was firstly recorded in Shennong Bencaojing， and it has a long history of edible and medicinal use. Most ancient medical practitioners described that Sojae Semen Germinatum was processed with black soya bean， while some others recorded that Sojae Semen Germinatum was processed with black soya bean and soybean or with soybean only. In modern times， black soya bean and soybean are both used. Before the Northern and Southern dynasties， the germination process of Sojae Semen Germinatum was mostly soil culture， and then changed into water culture later. The medicinal part of Sojae Semen Germinatum may also change from the initial aboveground part to the whole processed products including the soybean and the bud. The bud length was used to control the processing ending of Sojae Semen Germinatum， but there were different views of the bud length in ancient and modern times. Before the Tang dynasty， Sojae Semen Germinatum was mostly used directly. Since the Tang dynasty， various subsequent processed products of Sojae Semen Germinatum appeared. Most ancient medical practitioners confirmed that Sojae Semen Germinatum was sweet flavor， neutral in nature and non-toxic， and the mainstream believed that it belonged to the spleen， lung and stomach meridians. However， there were different opinions on its efficacy of relieving exterior syndrome by diaphoresis. In this paper， the evolution of Sojae Semen Germinatum was explored after consulting all kinds of ancient books， its historical name， processing history， quality evaluation and others were systematically summarized in order to clarify its historical development and lay a good foundation for the clinical use and further development of Sojae Semen Germinatum.

Objective: To explore the association between soil selenium levels and the risk of diabetes in Chinese adults aged 35-74 years. Methods: Data for this study were derived from the China Chronic Diseases and Behavioral Risk Factors Surveillance 2010 survey. Selenium concentrations in soil were obtained from the Atlas of Soil Environmental Background Values in China. A two-level binary logistic regression model was used to determine the association between soil selenium concentrations and the risk of diabetes, with participants nested within districts/counties. Results: A total of 69,332 participants aged 35-74 years, from 158 districts/counties were included in the analysis. Concentrations of selenium in soil varied greatly across the 158 districts/counties, with a median concentration of 0.219 mg/kg ( : 0.185-0.248). The results showed that both Quartile 1 (0.119-0.185 mg/kg) and Quartile 4 (0.249-0.344 mg/kg) groups were positively associated with diabetes compared to a soil selenium concentration of 0.186-0.219 mg/kg (Quartile 2), crude odds ratios ( s) (95% ) were 1.227 (1.003-1.502) and 1.280 (1.048-1.563). The values were 0.045 and 0.013, for Quartile 1 and Quartile 4 groups, respectively. After adjusting for all confounding factors of interest, the Quartile 1 group became non-significant, and the Quartile 4 group had an adjusted (95% ) of 1.203 (1.018-1.421) relative to the reference group (Quartile 2), the values was 0.030. No significant results were seen for the Quartile 3 group (0.220-0.248 mg/kg) compared to the reference group. Conclusion Excessive selenium concentrations in soil could increase the risk of diabetes among Chinese adults aged 35-74 years.
Adult ; Aged ; China ; epidemiology ; Diabetes Mellitus ; chemically induced ; epidemiology ; Diet ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Risk Factors ; Selenium ; deficiency ; metabolism ; Soil ; chemistry

Sojae Semen Germinatum （SSG） was firstly recorded in Shennong Bencaojing. It is a dry processed product which is germinated using mature seeds of Glycine max. It is neutral in nature and sweet flavor， and its functions are to relieve heat， clear away heat and remove dampness. SSG has a long history of being used both as food and medicine， but it was not enrolled in the Chinese Pharmacopoeia until 2010. Doctors of different dynasties had different views of its processing procedures， and thus the quality of its decoction pieces is inconsistent. This article systematically straightened out the records of SSG in ancient books and modern literature， and summarized and analyzed the processing procedures， chemical constituents， quality analysis and pharmacological effects of SSG. It found that SSG contains proteins， isoflavones， saponins and other components， analytical methods for detecting these components include ultraviolet spectrophotometry （UV）， thin-layer chromatography （TLC）， high performance liquid chromatography （HPLC）， etc. It has effect such as antioxidant， anti-inflammatory， anti-osteoporosis， improvement of menopausal syndrome， treatment of cardiovascular diseases， and processing will change the type and content of its chemical components. Therefore， it is necessary to dig out active constituents of SSG， explore those changes in chemical constituents and pharmacological effect during the period of its primary and subsequent processing， and explore its action mechanism. This paper can provide the theoretical basis for standardized processing procedure， modern quality control and clinical application of SSG.

Background:Transcranial alternating current stimulation (tACS) offers a new approach for adult patients with major depressive disorder (MDD).The study is to evaluate the efficacy and safety of tACS treating MDD.Methods:This is an 8-week,double-blind,randomized,placebo-controlled study.Ninety-two drug-naive patients with MDD aged 18 to 65 years will receive 20 daily 40-min,77.5-Hz,15-mA sessions of active or sham tACS targeting the forehead and both mastoid areas on weekdays for 4 consecutive weeks (week 4),following a 4-week observation period (week 8).The primary outcome is the remission rate defined as the 17-item Hamilton depression rating scale (HDRS-17) score ≤7 at week 8.Secondary outcomes are the rates of response at weeks 4 and 8 and rate of remission at week 4 based on HDRS-17,the proportion of participants having improvement in the clinical global impression-improvement,the change in HDRS-17 score (range,0-52,with higher scores indicating more depression) over the study,and variations of brain imaging and neurocognition from baseline to week 4.Safety will be assessed by vital signs at weeks 4 and 8,and adverse events will be collected during the entire study.Discussion:The tACS applied in this trial may have treatment effects on MDD with minimal side effects.

Objective To explore the effects of estradiol on the telomerase activity and apoptosis of lens epithelial cells and its mechanisms.Methods Fifty adult female Sprague-Dawley rats were randomly divided into five groups (n =10):ovariectomized group,estradiol group 1,estradiol group 2,estradiol group 3 and sham group.All rats were prepared for ovariectomized models except that of the sham group.After 2 weeks of the operation,rats in the 5 groups were given naphthalene solution through a stomach tube,and meanwhile,estradiol group 1,estradiol group 2,estradiol group 3 received estradiol valerate with the dose of 0.21 mg · kg-1 · d-1,0.42 mg · kg-1 · d-1 and 0.84 mg · kg-1 · d-1,accordingly,while rats in the ovariectomized group and sham group were given 9 g · L-1 Nacl by stomach perfusion with a dose of 0.42 mg · kg-1 ·d-1.Then,the opacity of the lens in each group was examined by a slit lamp microscope every week.After 12 weeks of naphthalene solution administration,all rats were sacririced and the serum estradiol concentration was determined by radioimmunoassay.Next,the lenses were taken out,and TERT mRNA expression of lens epithelial cells (LEC) was measured by RT-qPCR,and finally,the apoptotic rate was detected by TUNEL method.Results The opacity of lens in the ovariectomized group was different from that in the estradiol group 1,estradiol group 2,estradiol group 3 and sham group,with statistical significances (all P ＜ 0.05),and the opacity of lens in the estradiol group 1,2,3 and sham group were mild and occurred later.The serum estradiol concentration in the ovariectomized group (8.19 ± 1.45)ng · L-1 was significantly lower than that of estradiol groupl,2,3 and sham group,and there were significant differences (all P ＜ 0.05).Thc relative expression of TERT mRNA in LEC in the ovariectomized group (0.371 2-±0.056 4) was significantly lower than that in estradiol group 1,2,3,but the apoptotic rate of LEC (0.602 1 ±0.010 8) was obviously higher than that of estradiol group 1,2,3 in a dose-dependent manner,and there were significant differences (all P ＜ 0.05).Pearson correlation analysis showed the relative expression of LEC TERT mRNA in rats was negatively correlated with the apoptosis rate(r =-0.859,P ＜ 0.05).Conclusion Estradiol can up-regulate TERT mRNA expression and enhance telomerase activity of LEC in naphthalene-induced ovariectomized female rats in a dose-dependent manner.Estradiol can inhibit the LEC apoptosis in naphthalene-induced ovariectomized female rats,and the mechanism may be related to the increase of telomerase activity in the LEC.

Objective To explore the effect of multi-disciplinary team (MDT) combined with bundle management on prevention and control of multidrug-resistant organism (MDRO) infection in the intensive care unit(ICU).Methods Patients who were admitted to the ICU in a tertiary first-class hospital from January 2013 to December 2015 were studied,MDT combined with bundle management has been applied in the prevention and control of MDRO infection in ICU since January 2014,continuous quality improvement program was performed one year later,isolation of MDROs from specimens of ICU patients before implementation(in the year of 2013),after implementation(in the year of 2014),and after continuous quality improvement(in the year of 2015) was compared.Results The infection rates of MDROs in ICU patients before implementation,after implementation,and after continuous quality improvement were 26.55％ (154/580),17.13％ (117/683),and 12.01％ (77/641) respectively,showing a downward trend,with a significant difference (x2 =44.030,P＜0.001);the total isolation rates of MDROs in ICU patients were 64.44％(154/239),63.59％(117/184),and 43.26％ (77/178) respectively,showing a downward trend,with a significant difference (x2 =22.284,P＜0.001).The main MDROs in ICU were multidrug-resistant (MDR) and pandrug resistant(PDR) Acinetobacterbaumannii (44.54％).Conclusion MDT combined with bundle management can decrease MDRO infection rate and isolation rate in ICU.

[Objectives]To observe the clinical effects of the immediate implant placement of Zimmer dental implant sys-tem in the mandibular posterior region.[Methods]67 cases with a total of 89 mandible posterior teeth to deal with immediate implantion which selected to be treated with Zimmer dental implant system.76 teeth between implant and tooth socket bone wall were simultaneously filled with Bio-oss Collagen.The upper structure was repaired with PFM porcelain crown after the postoperative phase I of 3~6 months.All the patients were followed up for 6~24 months.[Results]During the clinical follow up,the implant survival rate was 100%. In 67 patients,89 implants was successfully loaded,with stable implants,good condition in synosteosis and without adverse subjective symptoms. All of the 67 patients had achieved good synosteosis and success loads clinically and radiologically.[Conclusion]A good osseointegration is obtained in the mandibular posterior re-gion with Zimmer dental implant system,Correctly dealing with Bio-oss Collagen between implant and tooth socket bone wall.At the same time,it can shorten the time of therapy,simplify the procedure,so that the clinical results are more satis-factory.