Industrial rehabilitation is a new concept that primarily encompasses four aspects: medical industrial rehabilitation, educational industrial rehabilitation, disability industrial rehabilitation, and rehabilitation engineering industry. The development of industrial rehabilitation in China is rapid, presenting numerous opportunities while also facing significant challenges. However, to date, no scholars have summarized the definition, current status, challenges, and opportunities of industrial rehabilitation, which hinders its development in China. This paper summarizes the development status of the four aspects mentioned above, analyzes the challenges and opportunities faced, and provides suggestions for development, offering a reference for the advancement of industrial rehabilitation in China.
目的：了解ICU病房地震傷員的功能障礙的特點，為臨床康復治療提供依據。方法：運動功能評定應用MMT方法；運用關節角度尺評定關節活動度（ROM）；利用被動關節活動法評定肌張力、痙攣評定選用改良的Ashworth分級法；坐位平衡和站位平衡采用平衡反應試驗評定；日常生活活動（ADL）能力選用國際通用的Barthel指數量表評定。由我科研究生作為評定人員。結果：①ICU病房地震傷員以骨折患者為主,占70%，神經系統損傷占20%，擠壓綜合癥和肺挫傷各占5%；②女性骨折比例高于男性，為11∶3；神經系統損傷沒有多大差異；截肢和癱瘓的患者中，男性高于女性，比例分別為4∶1和3∶2；肺部感染以女性更為明顯，為7∶1；③47.6%的地震傷員關節活動受限（評定21人），93.3%的肌力下降（評定15人），15.8%肌張力下降（評定19人），36.8%肌張力增高（評定19人），30.0%的坐位平衡下降（評定10人），96.4%站立平衡下降；④ADL能力100%受限（評定20人），其中洗澡、修飾、如廁、平地行走45 m、上下樓梯受限均為100%，95%地震傷員進食能力下降，90%穿衣能力受限，35%大便失禁，60%小便控制能力下降，多數使用導尿管，95%地震傷員床椅轉移能力下降；⑤40%出現肺部感染。結論：關節活動度受限、肌力下降、肌張力異常、平衡功能障礙、ADL能力受限及肺部感染是ICU地震傷員主要功能障礙。早期康復介入、維持和改善關節活動度、肌力訓練、減張和牽伸訓練、平衡訓練、呼吸訓練、站立和行走訓練及ADL能力訓練應當作為康復治療的基本原則和方法。
Objective To systematically analyze the research landscape of China’s rehabilitation industry, identify core contradictions and evolutionary pathways, and provide evidence for policy optimization and academic innovation. Methods Literature published up to December 31, 2024 was retrieved from China National Knowledge Infrastructure, Wanfang, and Chongqing VIP databases using rehabilitation industry as the subject term. Bibliometric methods such as keyword clustering, strategic coordinate analysis, temporal evolution (CiteSpace and R language) were employed to dissect research patterns, hotspot evolution, and innovation bottlenecks of the rehabilitation industry. Results Finally, 183 articles were included for analysis. China’s rehabilitation research exhibits a policy-driven, fragmented pattern (policy-focused journals accounted for 25.68% of publications; the Ministry of Civil Affairs had the highest publication volume, accounting for 2.19%. There was a structural disconnect between demand and research: on the one hand, the outbreak of elderly rehabilitation demand was marginalized in research (located in the lower left quadrant of the strategic coordinates, but keyword clustering dissolved in the “# 0 rehabilitation industry”); on the other hand, although exercise rehabilitation was a hot topic (ranked first in frequency, centrality>0.1), its maturity was insufficient (located in the lower right quadrant of the strategic coordinates). The research hotspots continued to shift towards “integration of industry and education” and “high-quality development” (temporal evolution), with the emergence of the term “rehabilitation” (strength=4.09) marking a historical focus, while technology transformation and collaboration in the public welfare market (isolation of the language rehabilitation industry) had become key breakthrough directions. Conclusion The rehabilitation industry in China urgently needs to break the dilemma of “high yield and low cooperation”, promote research and practice collaboration through three-dimensional innovation of technology education system, and support the rehabilitation needs of an aging society.
“5·12”汶川大地震發生已過去9個月，多數地震傷員已康復出院，回歸社會，社區康復成為時下我們醫務工作者的焦點。我們應當抓住地震傷員全面康復的時機，通過政府和康復工作者的努力，使社區康復盡快正規、完善，更重要的是要讓廣大地震傷員認識康復、參與康復，實現全面康復，讓其真正回歸家庭和社會。
ObjectiveTo explore the effect of mediastinal drainage tube placed after the esophageal cancer resection with intrathoracic anastomosis on postoperative complications such as anastomotic fistula. MethodsLiterature on the application of mediastinal drainage tubes in esophageal cancer surgery published in databases such as PubMed, EMbase, CNKI, China Biomedical Literature Database, VIP, and Wanfang were searched using English or Chinese, from the establishment of the databases to December 31, 2023. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the included retrospective studies, the Cochrane Handbook bias risk tool was used to assess the bias risk of randomized controlled trials (RCT), and Review Manager 5.4 software was used for meta-analysis. ResultsA total of 19 retrospective studies and 8 RCT involving 6320 patients were included, with 3257 patients in the observation group (mediastinal drainage tube+closed thoracic drainage tube) and 3063 patients in the control group (closed thoracic drainage tube or single mediastinal drainage tube). The NOS score of the included literature was≥6 points, and one RCT had a low risk of bias and the other RCT had a moderate risk of bias . Meta-analysis results showed that compared with the control group, the observation group had fewer postoperative lung complications [OR=0.44, 95%CI (0.36, 0.53), P<0.001], fewer postoperative cardiac complications [OR=0.40, 95%CI (0.33, 0.49), P<0.001], earlier average diagnosis time of anastomotic fistula [MD=?3.33, 95%CI (?3.95, ?2.71), P<0.001], lower inflammation indicators [body temperature: MD=?1.15, 95%CI (?1.36, ?0.93), P<0.001; white cell count: MD=?5.62, 95%CI (?7.29, ?3.96), P<0.001], and shorter postoperative hospital stay [MD=?15.13, 95%CI (?18.69, ?11.56), P<0.001]. However, there was no statistically significant difference in the incidence of postoperative anastomotic fistula between the two groups [OR=0.85, 95%CI (0.70, 1.05), P=0.13]. ConclusionPlacing a mediastinal drainage tube cannot reduce the incidence of anastomotic fistula, but it can effectively reduce the incidence of postoperative respiratory and circulatory system complications in patients and improve patients’ prognosis. It can early detect teh anastomotic fistula and fully drain digestive fluid to promote rapid healing of the fistula, alleviate the infection symptoms of postoperative anastomotic fistula, and shorten the hospital stay.
Objective To understand the preventive effect of pneumatic compression therapy on deep vein thrombosis (DVT) in lower limbs of patients with spinal cord injury. Methods Patients with spinal cord injury who transferred from Orthopedics Department to Rehabilitation Department undergoing rehabilitation in the First Affiliated Hospital of University of Science and Technology of China and discharged from April 2017 to December 2020 were retrospectively included. According to the contents of the medical order of the case data, the patients were divided into treatment group and control group. The intervention method of the treatment group was pneumatic compression therapy and conventional rehabilitation treatment, and the control group was conventional rehabilitation treatment. Multivariate logistic regression was used for statistical analysis to explore the association of pneumatic compression therapy and the risk of DVT in patients with spinal cord injury. Results Finally, 153 patients were enrolled, including 71 cases in the treatment group and 82 cases in the control group. After rehabilitation therapy, DVT occurred in 10 cases (14.1%) in the treatment group and 21 cases (25.6%) in the control group. There was no significant difference in incidence of DVT between the two groups (χ2=3.129, P=0.077). After six months of follow-up, DVT occurred in 11 cases (15.5%) in the treatment group and 12 cases (14.6%) in the control group. There was no significant difference in incidence of DVT between the two groups (χ2=0.022, P=0.822). D-dimer [odds ratio (OR) =1.104, 95% confidence interval (CI) (1.036, 1.175), P=0.002] and age [OR=1.081, 95%CI (1.040, 1.124), P<0.001] were independent risk factors for the risk of DVT after treatment. Pneumatic compression therapy was a protective factor for the risk of DVT [OR=0.210, 95%CI (0.075, 0.591), P=0.003]. Age [OR=1.057, 95%CI (1.008, 1.108), P=0.023] was an independent risk factor for the risk of DVT after six months. The effect of pneumatic compression therapy was not statistically significant (P=0.393). Conclusions After spinal cord injury, it is necessary to strengthen the management of high serum D-dimer state, especially the risk of DVT in elderly patients. Pneumatic compression therapy could be used as a treatment measure to reduce risk of DVT in patients with spinal cord injury during hospitalization, however, the preventive effect after half a year needs to be further studied.
Esophageal cancer is a common malignant tumor of the digestive system, with the characteristics of high incidence and poor prognosis. Traditional treatment methods cannot bring long-term prognosis to patients, and postoperative recurrence and metastasis are also the main causes of treatment failure. With the continuous development of nanomedicine, nanoparticle drug delivery, as a new treatment method, has received extensive attention. The Fe3O4 magnetic nanoparticles due to its unique superparamagnetism and biocompatibility in the treatment of esophageal cancer research in a series of exciting progress has been made. In this paper, the Fe3O4 magnetic nanodrug delivery system for the treatment of esophageal cancer is reviewed.
Objective To systematically evaluate the efficacy and safety of single-port thoracoscopic surgery (SPTS) in the treatment of spontaneous pneumothorax. Methods Computer searches were conducted in PubMed, The Cochrane Library, Web of Science, EMbase, CNKI, WanFang, and the Chinese Medical Association databases to collect randomized controlled trials (RCTs) and cohort studies on the comparison of efficacy and safety of SPTS and three-port thoracoscopic surgery (TPTS) for the treatment of spontaneous pneumothorax from their inception to March 2024. The Cochrane RCT bias risk assessment tool and the Newcastle-Ottawa Scale (NOS) were used to assess the quality of RCT and cohort study, respectively. Meta-analysis was performed using RevMan 5.4.1. ResultsA total of 68 studies were included, comprising 23 RCTs and 45 cohort studies with a total of 5403 patients. The NOS scores of the cohort studies were 7-8 points. Meta-analysis results showed that compared with TPTS, SPTS had less intraoperative blood loss [SMD=?1.58, 95%CI (?1.93, ?1.22), P<0.001], shorter postoperative hospital stay [SMD=?1.05, 95%CI (?1.29, ?0.82), P<0.001], shorter postoperative drainage tube placement time [SMD=?0.75, 95%CI (?1.00, ?0.50), P<0.001], fewer postoperative complications [OR=0.34, 95%CI (0.26, 0.45), P<0.001], fewer postoperative recurrences [OR=0.48, 95%CI (0.32, 0.72), P<0.001], and less pain at 24, 48, and 72 h postoperatively [SMD=?1.71, 95%CI (?2.13, ?1.30), P<0.001; SMD=?1.70, 95%CI (?2.35, ?1.06), P<0.001; SMD=?1.72, 95%CI (?2.16, ?1.29), P<0.001]. Conclusion SPTS is safe and effective in the treatment of spontaneous pneumothorax with high clinical value and can be further promoted in clinical practice. Considering the limitations in the number and quality of included studies, researches with larger sample sizes and higher quality are needed to validate the above conclusions.
ObjectiveTo systematically evaluate the efficacy of immune checkpoint inhibitors (ICIs) in treating esophageal cancer patients of different genders. MethodsComputer searches were conducted on PubMed, The Cochrane Library, and EMbase databases to collect randomized controlled trial (RCT) on ICIs treatment for esophageal cancer patients from the establishment of the databases to January 25, 2024. Two researchers independently screened the literature and extracted data according to the inclusion and exclusion criteria. The outcome indicators were overall survival (OS) and progression-free survival (PFS), and RevMan 5.4 software was used for meta-analysis. The modified Jadad scoring scale was used to evaluate the quality of the included literature. ResultsA total of 10 RCT involving 5364 esophageal cancer patients were included in this study, with 2684 patients in the experimental group and 2680 patients in the control group. The Jadad scores of the included literature were all ≥6 points, indicating high-quality RCT. Meta-analysis results showed that female esophageal cancer patients receiving ICIs treatment [HR=0.72, 95%CI (0.59, 0.87), P<0.001] had a more significant median OS prolongation than male patients [HR=0.73, 95%CI (0.68, 0.78), P<0.001]; while male patients [HR=0.57, 95%CI (0.52, 0.64), P<0.001] had a more significant PFS prolongation than female patients [HR=0.72, 95%CI (0.55, 0.94), P=0.01]. Female patients treated with ICIs alone [HR=0.66, 95%CI (0.50, 0.87), P=0.003] had a more significant median OS prolongation than male patients [HR=0.79, 95%CI (0.72, 0.87), P<0.001]; while male patients receiving ICIs combined with chemotherapy [HR=0.67, 95%CI (0.61, 0.74), P<0.001] had a more significant median OS prolongation than female patients [HR=0.77, 95%CI (0.59, 1.01), P=0.06]. ConclusionFemale patients receiving ICIs have a slight advantage in OS compared to male patients, while male patients have an advantage in PFS. Male patients receiving ICIs combined with chemotherapy have better survival benefits than female patients, while female patients using ICIs monotherapy have better survival benefits than male patients.
Objective To systematically evaluate the efficacy and safety of Single-incision thoracoscopic surgery (SITS) and two-port video-assisted thoracoscopic surgery (2P-VATS) in the treatment of spontaneous pneumothorax. Methods The databases of CNKI, PubMed, The Cochrane Libray, Web of Science, EMbase, Wanfang and Chinese Medical Association were searched by computer. Literature on SITS treatment of spontaneous pneumothorax from the establishment of the database to March 2023. The data are processed with RevMan 5.4.1. Results Finally, 107 studies were included, including 35 RCTs, 2 cohort studies, and 70 case-control studies. Meta analysis results show that compared to 2P-VATS and three port video assisted thoracoscopic surgery (3P-VATS), SITS had a shorter surgical time [SMD=–0.53, 95%CI (–0.90, –0.16), P=0.005], less intraoperative bleeding [SMD=–1.58, 95%CI (–1.93, –1.22), P<0.000 01; SMD=–1.59, 95%CI (–2.03,–1.14), P<0.000 01], shorter postoperative hospitalization time [SMD=–1.05, 95%CI (–1.29,–0.82), P<0.000 01; SMD=–1.08, 95%CI (–1.39,–0.77), P<0.000 01], and shorter postoperative drainage (catheterization) time [SMD=–0.75, 95%CI (–1.00,–0.50), P<0.000 01; SMD=–1.23, 95%CI (–1.72,–0.75), P<0.000 01], fewer postoperative complications [OR=0.34, 95%CI (0.26,0.45), P<0.000 01; OR=0.47, 95%CI (0.33,0.68), P<0.000 1], fewer postoperative recurrences [OR=0.50, 95%CI (0.33,0.75), P=0.000 8], and lighter postoperative pain [SMD=–1.71, 95%CI (–1.98,–1.45), P<0.000 01; SMD=–2.02, 95%CI (–2.46,–1.59), P<0.000 01]. Compared with 3P-VATS, 2P-VATS had less intraoperative bleeding [SMD=–1.02, 95%CI (–1.81,–0.22), P=0.01] , shorter postoperative hospitalization time [SMD=–0.59, 95%CI (–1.11,–0.06), P=0.03], shorter postoperative drainage (catheterization) time [SMD=–0.46, 95%CI (–0.85,–0.08), P=0.02], fewer postoperative complications [OR=0.36, 95%CI (0.22,0.59), P<0.000 1] , and lighter postoperative pain [SMD=–0.80, 95%CI (–1.08,–0.53), P<0.000 01]. Conclusion SITS and 2P-VATS are an effective and safe method for the treatment of spontaneous pneumothorax and worthy of further promotion and application in clinical practice. Due to limitations in the quantity and quality of included studies, the above conclusions require more large-sample, high-quality studies to be verified.