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【Objective】 To investigate the mechanism of C-C motif chemokine ligand 5 (CCL5) modulation by extracellular matrix stiffness in non-small cell lung cancer (NSCLC) and to determine the effect of CCL5 on the immunotherapy response of NSCLC. 【Methods】 The correlation between extracellular matrix stiffness and CCL5 expression in NSCLC was analyzed with the TCGA database. Polyacrylamide hydrogels with different stiffness were designed according to the extracellular matrix stiffness of NSCLC, and H1299 cells responding to the mechanical loading of hydrogel matrix stiffness were subjected to transcriptome sequencing. High matrix stiffness was verified to promote the expression of CCL5 by using sequence. 【Results】 High extracellular matrix stiffness upregulated CCL5 expression, and interferon-γ mediated signaling pathway might be involved in the process. NSCLC patients with high CCL5 expression had a greater abundance of cytotoxic T-cells in tumor tissue and reacted favorably to anti-programmed cell death protein 1 treatment. 【Conclusion】 Increased extracellular matrix stiffness promotes CCL5 synthesis, and CCL5 enhances immunotherapy responsiveness in NSCLC by increasing cytotoxic T cell infiltration in tumor tissue.
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ObjectiveTo investigate the effect of community-based rehabilitation exercise and physical activity on the physical activity levels, functional states, and quality of life for people with mild and moderate disabilities in community settings, to ascertain the health benefits of their engagement in such fitness sports activities, anchoring in the WHO "Global Action Plan on Physical Activity 2018-2030: More Active People for a Healthier World" and the guidelines tailored for people with disabilities, using the theoretical framework and methodology of the International Classification of Functioning, Disability and Health (ICF). MethodsAligning with the WHO guidelines for people with disabilities and the ICF, a community-based rehabilitation exercise and physical activity program was designed for individuals with mild to moderate disabilities, featuring activities like fitness training (aerobic and resistance exercises), skill exercises (such as balance and coordination), as well as sports and recreational games (ball and games, etc.). A total of 230 people with mild and moderate disabilities were recruited from 20 communities in Shenzhen, with types of disabilities including physical, speech, intellectual, and mental. Professional rehabilitation fitness instructors implemented and supervised the program. The activities were of low to moderate intensity, 30 to 50 minutes per session, five times a month for six months. The community-based rehabilitation exercise and physical activity progress of these individuals was surveyed using the International Physical Activity Questionnaire (IPAQ), and their overall functioning was evaluated with WHODAS 2.0. The health-related quality of life was measured with WHOQOL-BREF. The health benefits from participation in community-based rehabilitation exercise and physical activity were assessed in terms of functioning, activity involvement, and quality of life. ResultsAfter the fitness activities, participation levels significantly increased in IPAQ domains of work-related, transport-related, domestic and gardening activity, and leisure time (|t| > 3.391, P < 0.001). The scores significantly decreased in the domains of cognition, activity, self-care, getting along, life activities and participation; and overall scores also decreased in WHODAS 2.0 (t > 6.639, P < 0.001). The scores significantly increased in the four dimensions of WHOQOL-BREF (|t| > 7.486, P < 0.001). ConclusionAfter participating in a six-month community-based rehabilitation exercise and physical activity program of mild to moderate intensity, individuals with mild to moderate disabilities have improved in physical activity and engagement levels, and the overall functioning and quality of life.
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ObjectiveTo analyze the risk factors of dementia among healthy elderly individuals in the middle of their lives. MethodsA total of 175 participants aged 55 to 75 from two communities in Beijing were included from July, 2021 to April, 2023. Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) related risk factors and other demographic data were collected. According to the CAIDE assessment, participants with scores ≥ 9 were as high-risk group, and those with scores < 9 were as low-risk group. They were evaluated with Stroop Color Word Test (SCWT), two elements 1-back task paradigm and the revised Trail Making Test (TMT); measured the grip strength, 30 s forearm flexion tests and five sit-to-stand tests; the average step speed and step length of a 10-meter walk were recorded. ResultsThe average total score of CAIDE was 9.86 in the high-risk group, and was 4.95 in the low-risk group. There was no difference in age between two groups (P = 0.188). There were differences in the proportion of participants of male, less than seven years' education, systolic blood pressure > 140 mmHg, cholesterol > 6.5 mmol/L, body mass index > 30 kg/m2, and lack of physical activity between two groups (χ2 > 3.116, P < 0.05). The grip strength (t = -4.174), walking speed (t = -2.414), SCWT accuracy (Z = -2.684) were all worse in the high-risk group than in the low-risk group (P < 0.05). Logistic regression analysis showed that walking speed (OR = 25.483), grip strength (OR = 1.133) and SCWT accuracy (OR = 37.430) were independent influencing factors of dementia (P < 0.05). ConclusionWeaker grip strength, slower gait speed and worse inhibitory control might be independent influencing factors of dementia.
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ObjectiveTo 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 disabilities. MethodsBased on the World Health Organization (WHO) Global Action Plan on Physical Activity 2018-2030: More Active 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. ResultsThe time of low-intensity leisure physical activity of IPAQ increased after intervention, while the scores of domains of cognition, mobility, self-care, getting along, life activities and participation, and total score of WHODAS 2.0 decreased, and the scores of physical health, psychological health, independence, and environment dimensions, and total score of WHOQOL-BREF increased. ConclusionThe 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.
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ObjectiveTo cultivate competent rehabilitation assistive technology workers and systematically develop the undergraduate curriculum courses of assistive technology using World Health Organization Rehabilitation Competency Framework (RCF) and International Classification of Functioning, Disability and Health (ICF). MethodsThe competence of assistive technology workers was discussed based on the ICF, RCF and the service needs of modern assistive devices and technology, and the undergraduate curriculum courses of rehabilitation assistive technology were developed referring to the national vocational competence standards. ResultsReferring to the national vocational competence standards, the entry-level competence of assistive technology workers was developed based on ICF and RCF. The objectives of undergraduate education were set. Moreover, the undergraduate curriculum courses and core course of assistive technology were developed. ConclusionThe undergraduate curriculum courses of assistive technology are developed using ICF and RCF. This will help improve the quantity and competency of rehabilitation assistive technology workers and increase the access for people with disabilities to obtain assistive technology.
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ObjectiveTo encode and analyze the measurement items of major activity and participation function assessment tools and quality of life assessment tools using International Classification of Functioning, Disability and Health (ICF). MethodsRepresentative tools in the activity category, comprehensive activity and participation category, as well as quality of life assessment tools were selected for analysis of their measurement structures and content. Based on the ICF linking rule and content matching method, the concepts of measurement items in various tools were matched with ICF categories, analyzing the relationships between the content of measurement items and the concepts of ICF categories, and then coded in ICF and ICD-11. ResultsMeasurement tools in the activity category, such as Barthel index (BI) and Instrumental Activities of Daily Living (IADL), were primarily standardized activity assessment tools in medical, rehabilitation, and community settings. The measurement was conducted through direct observation of activity function and semi-structured interviews with individuals or their caregivers, with 25 to 60 minutes. Most measurement tools were standardized reference tools. Assessment tools related to overall functioning in the activity and participation category, such as 36-item Short-Form Health Survey (SF-36), World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), World Health Organization Quality of Life-Disability (WHOQOL-DIS) and World Health Orgnization Disability Assessment Scheme 2.0 (WHODAS 2.0) were norm-referenced assessment tools applicable in medical, rehabilitation, education, and social service contexts. The measurement was carried out by professionals through interviews and observations, or completed by the assessed individuals through self-administered questionnaires, with a measurement duration of 30 to 60 minutes. In terms of measurement content, IADL and BI mainly focus on activities of self care and functional activities, corresponding to ICF categories such as mobility (d4), self-care (d5), and domestic life (d6). SF-36 primarily covers general tasks and demands (d2), communication (d3), mobility (d4), self-care (d5), and domestic life (d6). WHOQOL-BREF and WHOQOL-DIS items related to general tasks and demands (d2), communication (d3), mobility (d4), interpersonal interactions and relationships (d7), and community, social, and civic life (d9). WHODAS 2.0 was the most comprehensive measurement tool covering all nine domains of activity and participation in the ICF. ConclusionThis study amalyzed the structures and contents of items of six assessments tools using ICF nomenclature, terminology, codes and linking rules. WHOQOL-BREF, WHOQOL-DIS and WHODAS 2.0 are comprehensive functioning evaluation tools, covering all nine ICF domains of activity and participation, as well as quality of life and well-being.
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ObjectiveTo investigate the current situation of accessible facilities construction and assistive technology application of existing sports venues in Shenzhen, and analyze the existing problems. MethodsFrom November 19, 2022 to Februry 17, 2023, using the standards for the construction of accessible sports venues, the accessible construction and services of public sports venues and the application of assistive technology in eight districts of Shenzhen were investigated and evaluated on the spot. ResultsThere were curb ramps and accessible public toilets for all the stadiums; surface indicator for 87.5% (7/8) stadiums; wheelchair ramps, accessible elevators and accessible wheelchair seats for 62.5% (5/8) stadiums; accessible route for 37.5% (3/8) stadiums; handrails for 12.5% (1/8) stadiums; accessible vehicles parking lots for 75% (6/8) stadiums; and 25% (2/8) stadiums used assistive technology. ConclusionThis study evaluated the accessibility of accessible facilities and assistive technologies in sports venues in Shenzhen, including entering the stadium, entering the interior of the stadium and taking exercise. In terms of accessible facilities, the number of venues for the construction of curb ramps and accessible public toilets is the most, the number of venues for the construction of accessible handrails is the least, and the application of assistive technology is the worst.
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ObjectiveTo systematically analyze the typical mental health conditions and psychological disorders of children with intellectual and developmental disabilities (IDD), to construct a mental health service system and psychological interventions to these mental health conditions of children with IDD . MethodsBased on the framework of the World Health Organization Family International Classifications (WHO-FICs), the mental health conditions and related functioning were analyzed, and the mental health service framework and proposed mental health interventions were constructed.There were six main categories of mental health conditions for children with IDDConclusionThis study systematically analyzed the typical mental health status and related psychological functional impairments of children with IDD. Based on the World Health Organization health service system, a mental health service framework for children with IDD was constructed. Referring to the WHO's continuum of health services, a system of psychological intervention methods for children with IDD was established. Furthermore, the WHO-FICs were used to describe and code the functions of children with IDD, and the ICHI-β3 was applied to code and analyze the related psychological interventions. Resultsmood disorders (anxiety and depression), behavioral disorders (disruptive disorders and challenging behaviors, aggressive behaviors), traumatic disorders (post-traumatic stress disorder), mental disorders (schizophrenia), suicide and self-harm, and learning disabilities (developmental learning disabilities, attention deficit hyperactivity disorder). Mental health services for children with IDD involved in six dimensions: leadership and governance, fundraising, human resources, service delivery, mental health technologies, and information and research. Mental health services went through the continuum of health services from prevention, treatment, rehabilitation to health promotion. We delivered mental health services for children with IDD in three aspects: identifying and diagnosing mental health problems or conditions, analyzing the main factors caused mental health problems, and analyzing the environmental factors. Mental health service interventions mainly covered five categories: antidepressants, psychotherapy, stress management training, physical exercise training, healthy lifestyle education, consultation and support. Children with IDD may obtain the mental health services in hospitals, rehabilitation institutions, community and school settings.
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ObjectiveTo systematically review the types of health-promoting school (HPS) curriculum and physical activity-related health services based on the WHO-HPS framework, and their impact on health of children and adolescents. MethodsThe databases of EBSCO, PubMed, Web of Science, and CNKI were searched on school-based physical activity-related services and their health benefits based on the WHO-HPS framework from 2017 to June, 2023. A systematic review of systematic reviews was conducted. ResultsA total of seven English articles were included, covering 147 studies from five countries including Switzerland, the United States, Italy, the United Kingdom and Sweden. The systematic reviews were published in the journals related to child physical education and health, HPS, and school-based physical activity. Based on the WHO-HPS framework, HPS curriculum implemented in schools primarily involved physical education classes (such as incorporating specialized sports programs like yoga and dance, increasing physical activity time) and health education programs related to physical activity. Additional activities included extracurricular programs (such as implementing children's sports, recreational and leisure programs, lunchtime enjoyment activities, and game plans, increasing physical activity time within regular school hours, creating opportunities for physical activity during breaks and after school, and providing daily physical activity plans) and integration of physical activity in other subjects. Physical activity-related health services mainly included health screening and monitoring related to physical activity, adolescent health management, and health promotion activities. The health benefits of the interventions included improvement in aerobic capacity, body mass index, cardiorespiratory function, overall physical health, and significant increases in muscle endurance and strength. They also contributed to the cessation or reduction of prolonged sedentary behavior, increased levels of all-day physical activity and moderate-to-vigorous physical activity, increased physical activity participation, significant increases in physical activity during school hours, increased proportion of moderate to vigorous physical activity during school time, increased physical activity time, improved leisure and recreational time related to physical activity, enhanced vitality, school quality of life, and energy, improved academic performance, reduced television viewing time, decreased obesity risk, reduced anxiety, improved adaptability and happiness, and promoted positive mental health. Furthermore, there was a significant improvement in students' health-related knowledge on physical activity. ConclusionImplementing HPS curriculum and physical activity-related services in schools may improve various aspects of students' health, including physical fitness, physical activity and sedentary behavior, behavioral health related to physical activity, and health literacy related to physical activity.
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ObjectiveTo develop basic training courses for family doctor teams for people with disabilities. MethodsUtilizing the methods and theories of the World Health Organization (WHO) rehabilitation competency framework (RCF), and referring to the WHO universal health coverage global competency framework, the rehabilitation competency characteristics of family doctor teams for people with disabilities in community settings were analyzed, and a basic training course system for these teams based on the RCF was developed. Results and ConclusionBased on RCF, a competency framework for family doctor teams serving people with disabilities has been constructed. The objectives, content and training course system for basic rehabilitation training has been established.
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ObjectiveTo systematically analyze the application of World Health Organization rehabilitation competency framework (RCF) and its supporting guidelines in education system of rehabilitation science and curriculum development. MethodsBased on the conceptual framework of RCF and its supporting guidelines, the application of its areas and the modes were analyzed to construct the education system of rehabilitation science with reference to the framework of competency-based clinical medical education. ResultsThe education system of rehabilitation science was developed based on RCF. The competences for specific scenarios in rehabilitation were defined and investigated. A structured system of vocational qualification accreditation and occupational competency standards was constructed, as well as core education system and rehabilitation curricula in rehabilitation science, which helped to train competent rehabilitation workers. ConclusionThe construction of rehabilitation subspecialties, its education system and the development of a curriculum content system based on the RCF is an important way for the development of modern rehabilitation education. RCF theoretical framework and supporting tools provide a standardized and unified method and way for China's rehabilitation science higher education system and professional certification, career access and professional standards for rehabilitation personnel. The quality of rehabilitation science education and the professional development of rehabilitation personnel will also be improved in future.
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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.
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ObjectiveTo explore the diagnoses of diseases and functioning of speech fluency disorder, analyze the main assessment content, and construct framework of intervention solution based on International Classification of Diseases 11th Revision (ICD-11), International Classification of Functioning, Disability and Health (ICF) and International Classification of Health Interventions (ICHIβ-3). MethodsThe diagnoses of diseases and functioning was discussed with ICD-11 and ICF. The assessment tools were analyzed with ICF. A holistic intervention solution was constructed with ICF and ICHIβ-3. ResultsSpeech fluency disorder is classified as 6A01.1 developmental speech fluency disorder for ICD-11. The related diseases include 6A01.0 developmental speech sound disorder, 6A01.2 developmental language disorder, cerebral palsy, MA80.0 aphasia, MA80.1 dysphasia and MA80.2 dysarthria, etc. For ICF, the categories related to speech fluency disorder might be s3 structures invovled in voice and speech; b3 voice and speech functions, especially b330 fluency and rhythm of speech functions; d1 learning and applying knowledge, d3 communication, especially d330 speaking and d355 discussion, d7 interpersonal interactions and relationships, and d9 community, social and civic life. A holistic intervention solution for speech fluency disorder was developed, involving in body structure, body function, activities and participation, and environmental factors, including assessment, training and treatment, educational counseling, and psychological and social support, etc. ConclusionA framework of diagnosis, assessment and rehabilitation has been constructed for speech fluency disorder.
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ObjectiveTo discuss the diagnosis, assessment and rehabilitation for children with cerebral palsy complicated with speech disorder based on the tools of World Health Organization Family of International Classifications (WHO-FICs). MethodsThe diagnosis of speech disorder after cerebral palsy was classified using International Classification of Diseases, 11th Revision (ICD-11). The disorders of speech function were classified using International Classification of Functioning, Disability and Health (ICF). A structured speech function rehabilitation solution was developed based on the International Classification of Health Interventions (ICHIβ-3). ResultsAccording to ICD-11, cerebral palsy was classified as 08 Neurological Disorder, which was further classified as 8D20.0 Spastic Unilateral Cerebral Palsy and 8D20.1 Spastic Bilateral Cerebral Palsy (8D20.10 Spastic Quadriplegic Cerebral Palsy and 8D20.11 Spastic Bilateral Cerebral Palsy), with the speech disorders involving 6A00 Disorders of Intellectual Development, 6A01 Developmental Speech or Language Disorders, MA80 Speech Disturbances, MA81 Speech Dysfluency and MA82 Voice Disturbances. For ICF, the speech disorders mainly involved s1 structures of the nervous system, s3 structures invoved in voice and speech, b3 voice and speech functions, d1 learning and applying knowledge, and environment and individual factors; and could be further classified as b310 voice functions, b320 articulation functions, and b330 fluency and rhythm of speech functions. Based on ICHIβ-3, a rehabilitation solution was developed, involving the areas of body structure and function, activity and participation, and environmental factors. ConclusionBased on ICD-11, ICF and ICHIβ-3, a methodological system of assessment and interventions for speech disorders after cerebral palsy has been systematically constructed, including diagnosis of disease, assessment, intervention and coding of speech disorder.
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ObjectiveIn implementation of International Classification of Functioning, Disability and Health (ICF) and reference to the Ministry of Education's Physical Education and Health Curriculum Standards for Compulsory Education (2022 Edition), a functioning-oriented adapted physical education curriculum system was developed for the development of children's core qualities in physical education and sport of children with intellectual disabilities. MethodsInternational Classification of Diseases (ICD-11) and ICF were used to systematically analyze the motor function, activity and participation of children with intellectual disabilities. Based on the ICF bio-psycho-social model of functioning, disability and health and the Ministry of Education's Physical Education and Health Curriculum Standards for Compulsory Education (2022 Edition), and with reference to the American Adapted Physical Education National Standards (3rd Edition) (APENS-3), a functioning-oriented adapted physical education curriculum system was constructed, which was suitable for the development of motor functioning and motor competence of children with intellectual disabilities. ResultsChildren with intellectual disabilities might experience slow development of basic movements, poor fitness level, low motor competence, and insufficient motor motivation. The goals of adapted physical education curriculum were mainly to promote the development of children's core quality in physical education and sport, i.e., motor competence, health behaviors, and physical moral attributes, and to master motor skills and develop motor competence, including motor competence development goals, movement development goals, physical activity participation goals, health goals, adaptation and empowerment goals. The content of adapted physical education curriculum included physical fitness activities, motor skill activities and sport related activities. The implementation process of adapted physical education program covered materials development, and adapted physical education program teaching advices. The education program was evaluated in terms of the development of motor competence, motor development, participation in physical activities, the development of healthy behaviors, and the adaptation to the natural and social environment, using a holistic and multidimensional evaluation approach to comprehensively evaluate the motor development and the mastery of building of children's core qualities in physical education and sport. Accessible environments and assistive technology should also be considerated in the development of adapted physical education programs. ConclusionBased on the bio-psycho-social health model of ICF, the Ministry of Education's Physical Education and Health Curriculum Standards for Compulsory Education (2022 Edition), and APENS-3, the theoretical framework for the development of adapted physical education curriculum for children with intellectual disabilities was developed, and a functioning-oriented adapted physical education curriculum system was established, which emphasized the development of children's core qualities in physical education and sport, i.e., motor ability, healthy behavior, and physical moral values.
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ObjectiveTo systematically review the effect of resilience intervention on rehabilitation of traumatic brain injury. MethodsThe literatures related to resilience intervention on rehabilitation outcome of patient with traumatic brain injury were retrieved from PubMed, ScienceDirect, CNKI, Wanfang data and VIP databases through subject headings retrieval. The retrieval time was from establishment to December 31th, 2021. After filtering, the research, country, research object, research design, intervention frequency, intervention effect, rehabilitation impact and influencing factors were extracted from the literature, and the methodological quality was evaluated using the PEDro scale. ResultsA total of six valid literatures were obtained, which mainly focused on the research of resilience intervention on physical function, post-traumatic stress disorder, psychological function and social adaptation of patients with traumatic brain injury. ConclusionResilience intervention could reduce the patients' physical symptoms and post-traumatic stress disorder, and promoted the recovery of psychological functions, allowing them to maintain an optimistic attitude, and adopt flexible and effective coping style to adapt to the society.
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ObjectiveTo explore the pedagogical content knowledge of adaptive physical education teachers using the World Health Organization Rehabilitation Competency Framework (RCF), to construct an adaptive physical education competency system and establish an adaptive physical education and training system and accreditation method for teachers. MethodsUsing RCF and referring to the U. S. Adapted Physical Education National Standards 3rd version (APENS-3), we examined the pedagogical content knowledge of adaptive physical education for teachers. The structure and content of the key pedagogical knowledge contents of adaptive physical education teachers were systematically studied, and the core professional competencies of adaptive physical education teachers were constructed. ResultsBased on the RCF and teaching activities, the teaching-related core competencies of the adapted physical education teachers were constructed from the knowledge and skills in the domains of practice (teaching), and learning and development (continuing education) of RCF, and the structure and content of the knowledge of adapted physical education teachers were constructed in the five domains: students, teachers, teaching, curriculum and educational evaluation. This competency framework could be applied in the fields of professional teaching competency identification, continuing education curriculum development and continuing education competency training, and performance evaluation for adaptive physical education teachers. ConclusionIn accordance with the RCF and with reference to APENS-3, the structure of pedagogical content knowledge and its core contents for adaptive physical education teachers were systematically explored. These structures and the core contents can be applied in the identification of competencie, the development of continuing education curriculum and competency training, and the assessment of performance for adaptive physical education teachers.
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Objective:To analyze the data of Chinese medicine prescriptions for the treatment of coronavirus disease 2019 (COVID-19) in Shijiazhuang City, Hebei Province, with a view to further guide the clinical use of Chinese medicine in the prevention and treatment of COVID-19.Methods:Forty-eight patients diagnosed with COVID-19 who were treated by critical care team of Hebei Traditional Chinese Medicine Hospital in the intensive care unit (ICU) of Hebei Chest Hospital (Hebei Provincial COVID-19 designated hospital) from January 7 to March 4, 2021, were enrolled in this study. The patients' gender, age, clinical classification, past history, and all Chinese medicine prescriptions for the first visit and follow-up visits during the hospitalization were collected. A database was established based on the Ancient and Modern Medical Records Cloud Platform (V2.2.1), and the methods of frequency analysis, correlation analysis, cluster analysis, and complex network analysis were used to analyze the prescriptions of traditional Chinese medicine.Results:Among the 48 patients with COVID-19, 20 were males and 28 were females; the average age was (62.4±13.7) years old. The patients' condition was generally severe, including 17 cases of common type, 25 cases of severe type, and 6 cases of critical type, most of whom were combined with hypertension, coronary heart disease, diabetes, chronic obstructive pulmonary disease and other basic illnesses. A total of 146 valid prescriptions were included, involving 59 prescriptions and 115 Chinese medicines. Frequency analysis of 146 prescriptions showed that the commonly used prescriptions for patients with COVID-19 were Qingfei Paidu decoction (30 times, 20.55%), Xuanbai Chengqi decoction (10 times, 6.85%), and Dayuan Yin (10 times, 6.85%). The common Chinese medicines were liquorice (80 times, 54.79%), tuckahoe (76 times, 52.05%), gypsum (70 times, 47.95%), bitter almond (70 times, 47.95%), ephedra (57 times, 39.04%), scutellaria (56 times, 38.36%), tangerine peel (53 times, 36.30%), patchouli (50 times, 34.25%), atractylodes macrocephala (50 times, 34.25%), and bupleurum (43 times, 29.45%). The main effects were clearing heat and detoxification (129 times), clearing heat-fire (129 times) and eliminating dampness and diuresis (110 times). The medicinal properties were mainly warm (509 times), flat (287 times), and cold (235 times). The medicinal tastes were mainly pungent (765 times), sweet (654 times), and bitter (626 times). The medicinal channel tropism were mainly lung (1 096 times), spleen (785 times), and stomach (687 times). The correlation analysis showed that there were 17 drug combinations in total, among which the top 3 drug pairs in support were bitter almond-gypsum (0.43), ephedra-bitter almond (0.38), tangerine peel-poria (0.36), and ephedra-gypsum (0.36). Cluster analysis showed that there were 3 groups of clustering formulas. The first group was ephedra, bitter almond, and gypsum. The second group was patchouli, tuckahoe, tangerine peel, and atractylodes macrocephala. The third group was scutellaria, licorice, immature orange fruit, oriental waterplantain rhizome, bupleurum, ginger, and cassia twig. The core drugs were composed of tuckahoe, bupleurum, tangerine peel, atractylodes macrocephala, patchouli, bitter almond, scutellaria, gypsum, ephedra, and licorice.Conclusions:Middle-aged and elderly patients with COVID-19 are accompanied by Qi deficiency and internal invasion of toxins, and the pathogenesis evolves rapidly. Damp and turbid toxins often block the lungs and trap the spleen, leading to disorder of Qi movement, and even invaginate Ying and Xue, drain Yin and Yang. The treatment is based on removing turbidity and detoxification, and replenishing Qi and nourishing Yin are the principle treatments, so that the evil is eliminated and the Qi is restored.
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OBJECTIVE：To know about the co gnition level and self-medication behavior of antibiotics among urban and rural residents in Lu ’an city of Anhui province ，and to investigate its influential factors and to provide reference for promoting rational use of antibiotics. METHODS ：Totally 684 urban and rural residents aged 18-80 years in Lu ’an city were randomly selected as the research objects by stage sampling method. A self-designed questionnaire was used for household survey ，involving general demographic characteristics ，antibiotics related cognitive level ，antibiotics use behavior and related influential factors ，etc. RESULTS：A total of 657 questionnaires were collected ，with effective rate of 96.1％. Among them ，305 were from urban residents and 352 from rural residents. Among the 657 respondents，38.2％ were male and 61.8％ were female ；their age was （50.30±13.26）years old ；44.7％ of them were educated in primary school or below. 7.8％ of the respondents correctly recognized that antibiotics were not effective to the virus ；12.6％ knew antibiotic resistance ；55.1％ thought that frequent use of antibiotics would reduce the sensitivity of bacteria to it ；23.1％ said they knew the difference between prescription drugs and over-the-counter drugs；58.0％ could tell at least one case of not using antibiotics. For 7 knowledge items ，75.3％ of the residents in the survey area had a total score of less than 3；the cognition level of antibiotics was higher in urban areas and people with higher education level. 66.5％ of the respondents had used antibiotics in the past one year，of which 61.0％ obtained antibiotics by prescription 65161220。E-mail： from doctors ，50.7％ purchased antibiotics by themselves in pharmacies， and 13.1％ used the above two ways both. Among the people who have used antibiotics in the past year ， 81.9％ said they could buy antibiotics without prescription. Among the 657 respondents，49.0％ said that they had to obtain prescription from doctor when taking antibiotics ；68.9％ said that they would stop taking antibiotics when their symptoms improved；19.3％ would increase their dosage in order to enhance the curative effect ；28.3％ would change drugs frequently. Compared with urban residents ，rural residents were more likely to take antibiotics based on prescriptions by physicians [odds ratio （OR）＝1.693，95％ confidence interval （CI）（1.191，2.407）]. The higher the cognitive score ，the lower the behavior rate of having to prescribe antibiotics by doctors [OR ＝0.882，95％CI（0.785，0.991）]，and they were more likely to stop taking antibiotics when symptoms improved [OR ＝1.163，95％CI（1.025，1.319）]，and male were more inclined to increase the dosage of antibiotics to enhance the efficacy [OR ＝1.841，95％CI（1.214，2.792）]. The higher the cognitive score was ，the less likely they were to increase drug dosage to enhance the curative effect [OR ＝0.894，95％CI（0.773，1.034）]，nor were they inclined to change drugs frequently [OR ＝0.873，95％CI（0.767，0.992）]. CONCLUSIONS ：The cognition level to antibiotics of urban and rural residents in Lu ’an city needs to be improved urgently ，and reasonable antibiotic use behavior needs to be standardized. Pure knowledge of antibiotics is not necessarily related to the expected rational drug use behavior. Therefore ，in addition to health promotion for the rational use of drugs for residents ，it is also necessary to create a systematic environment that promotes the rational use of antibiotics and provide residents with multi-channel services for rational use of drugs.
ABSTRACT
Objective To investigate the incidence and risk factors of adverse drug reactions in hematological system induced by linezolid.Methods In this retrospective study, 124 inpatients treated with linezolid (n=62) or vancomycin (n=62) for anti-infective therapy between January 2012 and December 2015 in clinical departments of the Second Affiliated Hospital of Anhui Medical University were included.The incidence hematological adverse drug reactions were observed, and the single factor and the multiple factor Logistic regression methods were used to analyze the risk factors of developing thrombocytopenia and decline of hemoglobin.Results Among the 62 inpatients treated with linezolid, thrombocytopenia occurred in 21 patients(33.87%), and decline of hemoglobin occurred in 17 patients (27.42%).No patient discontinued the use of linezolid for the reason of thrombocytopenia or decline of hemoglobin.In multiple stepwise regression analysis, linezolid use[OR=7.699,95%CI (1.408,42.090),P=0.019], treatment duration>14 d[OR=7.639,95%CI(1.162,50.226),P=0.034], baseline eGFR<80 mL·min-1[OR=6.150,95%CI(1.604,23.577),P=0.008], baseline ALB<25 g·L-1[OR=4.078,95%CI(1.017,16.351),P=0.047] and baseline platelet count<200×109·L-1[OR=6.148,95%CI(1.705,22.172),P=0.006] were independent risk factors for thrombocytopenia;linezolid use [OR=4.335,95%CI(1.308,14.365),P=0.016] and baseline ALB<25 g·L-1[OR=5.424,95%CI(1.824,16.129),P=0.002] were independent risk factors for the decline of hemoglobin.Conclusion The incidences of thrombocytopenia and anemia induced by linezolid are not rare, and most of them can be returned to normal.The risk factors of thrombocytopenia and anemia should be concerned and the routine blood test should be monitored during use.