Enhancement of motor functional recovery in thoracic spinal cord injury: voluntary wheel running versus forced treadmill exercise

Spinal cord injury necessitates effective rehabilitation strategies, with exercise therapies showing promise in promoting recovery. This study investigated the impact of rehabilitation exercise on functional recovery and morphological changes following thoracic contusive spinal cord injury. After a 7-day recovery period after spinal cord injury, mice were assigned to either a trained group(10 weeks of voluntary running wheel or forced treadmill exercise) or an untrained group. Bi-weekly assessments revealed that the exercise-trained group, particularly the voluntary wheel exercise subgroup, displayed significantly improved locomotor recovery, more plasticity of dopaminergic and serotonin modulation compared with the untrained group. Additionally, exercise interventions led to gait pattern restoration and enhanced transcranial magnetic motor-evoked potentials. Despite consistent injury areas across groups, exercise training promoted terminal innervation of descending axons. In summary, voluntary wheel exercise shows promise for enhancing outcomes after thoracic contusive spinal cord injury, emphasizing the role of exercise modality in promoting recovery and morphological changes in spinal cord injuries. Our findings will influence future strategies for rehabilitation exercises, restoring functional movement after spinal cord injury.

Enhancing Learners’Performance in Grade 7 Mathematics Through 50-30-20 Exercise

Assessment exercises constitute a crucial component of the teaching and learning process,serving the purpose of gauging the degree to which learning objectives have been accomplished.This study aims to assess the mathematics performance of Grade 7 learners using the 50-30-20 exercise.Specifically,this study seeks to determine the learners’pre-test and post-test mean scores,identify significant differences between the pre-test and post-test results,evaluate learners’exercises,and propose enhanced exercises.The research employs a quasi-experimental design,with 40 Grade 7 learners in the school year 2023-2024 as participants,selected through purposive non-random sampling.Statistical data analysis involves the use of mean,standard deviation,paired t-test,and Cohen’s D effect size.Ethical considerations were paramount,as evidenced by a letter of authorization from the school head outlining the strict adherence to voluntary participation,informed parental consent,anonymity,confidentiality,risk mitigation,results-sharing protocols,and the commitment to keeping research data confidential.The data yielded a remarkable outcome:the experimental group exhibited improvement in both the pre-test and post-test.This result substantiates the initial objective of the study,showcasing a noteworthy and favorable performance among the participants.Consequently,it suggests that a majority of the participants strongly agree that the 50-30-20 exercises contribute to enhancing their understanding and problem-solving skills,as well as their ability to grasp mathematical concepts and improve their overall performance in mathematics.Therefore,the 50-30-20 exercises not only facilitated students in understanding mathematics lessons but were also aligned with the Department of Education’s development plan.

Scoping review on health-related physical fitness in patients with inflammatory bowel disease:Assessment,interventions,and future directions

BACKGROUND Reaching the Selecting Therapeutic Targets in Inflammatory Bowel Disease-II(STRIDE-II)therapeutic targets for inflammatory bowel disease(IBD)requires an interdisciplinary approach.Lifestyle interventions focusing on enhancing and preserving health-related physical fitness(HRPF)may aid in improving subjective health,decreasing disability,or even controlling inflammation.However,ambiguity remains about the status and impact of HRPF(i.e.body composition,cardiorespiratory fitness,muscular strength,muscular endurance,and flexibility)in IBD patients,hindering the development of physical activity and physical exercise training guidelines.AIM To review HRPF components in IBD patients and the impact of physical activity and physical exercise training interventions on HRPF.METHODS A systematic search in multiple databases was conducted for original studies that included patients with IBD,assessed one or more HRPF components,and/or evaluated physical activity or physical exercise training interventions.RESULTS Sixty-eight articles were included.No study examined the complete concept of HRPF,and considerable heterogeneity existed in assessment methods,with frequent use of non-validated tests.According to studies that used gold standard tests,cardiorespiratory fitness seemed to be reduced,but findings on muscular strength and endurance were inconsistent.A limited number of studies that evaluated physical activity or physical exercise training interventions reported effects on HRPF,overall showing a positive impact.CONCLUSION We performed a scoping review using a systematic and iterative approach to identify and synthesize an emerging body of literature on health-related physical fitness in patients with IBD,highlighting several research gaps and opportunities for future research.Findings of this review revealed a gap in the literature regarding the accurate assessment of HRPF in patients with IBD and highlighted important methodological limitations of studies that evaluated physical activity or physical exercise training interventions.This scoping review is a step towards performing studies and systematic reviews in the future,which was not possible at present given the heterogeneity in endpoints and designs of the available studies on this topic.Future well-designed studies are required to determine the optimal training paradigm for improving HRPF in patients with IBD before guidelines can be developed and integrated into the therapeutic strategy.

Failure to identify an acute exercise effect on executive function assessed by the Wisconsin Card Sorting Test

Purpose： Acute exercise has been linked to the facilitation of executive function, but little is known regarding executive function assessed by the Wisconsin Card Sorting Test （WCST）. The present research consisted of two experiments aimed to determine whether acute aerobic exercise influences successive WCST performance. Methods： In Study 1, 27 young adults were randomly assigned to the exercise or reading control group and then instiucted to perform the WCST before and after assigned treatment. In exercise group, participants completed a single bout aerobic exercise with moderate intensity for 20 min on a stationary bike. A similar experimental protocol was replicated in Study 2 with 24 late middle-aged adults to look for age differences during adulthood and control for a potential ceiling effect at young adult age. Results： Although a significant time effect was observed in young adults, both studies revealed that there was no main effect for treatment or an interaction between treatment and time on any of the WCST indices. Conclusion： Acute aerobic exercise failed to influence executive function as assessed by the WCST, revealing that this classical neuropsy- chological test tapping executive function may not be sensitive to acute exercise. Our findings suggest that acute exercise does not broadly affect the entire family of executive functions, or its effect on a specific aspect of executive function may be task-dependent, as proposed by Etnier and Chanj~ （2009）.

新型冠状病毒感染后潜水员适潜性评估

新型冠状病毒感染(COVID-19)对全身几乎所有器官都会产生影响,其中最主要的受累器官为肺和心脏。随着COVID-19康复患者数量不断增加,越来越多的证据表明,因COVID-19住院治疗获得康复的患者中有相当大比例的人群存在后遗症,主要表现为呼吸系统和心血管系统的症状。对于潜水员,COVID-19后的运动耐受、心肺功能的恢复对其适潜性具有重要影响。一些组织和机构发布了潜水员COVID-19后的适潜性评估指南。本文对COVID-19后的呼吸和心血管系统后遗症及相关的适潜性评估方案进行简要介绍,并基于已有的相关要求和我国实际,初步提出我国潜水员COVID-19后的适潜性评估要求。

关于应用功率负荷参数指导运动健康干预的初步探索及实用方案

目的:通过开展应用功率负荷参数指导运动健康干预的初步探索实验,探究可实施的应用功率负荷参数指导运动健康干预的实用方案。方法:基于本团队前期利用S-TAG等可穿戴实时功率监测设备所进行的功率负荷运动健康干预的初步探索工作,评估功率负荷强度方案的可行性与有效性,结合相关文献及国内外既往经验,形成最终的运动健康干预方案。结果:不同风险水平的人群基于使用S-TAG所进行功率负荷指导的运动干预,心肺耐力均获得了改善,且改善效果与传统方法相当。在此基础上,本文总结出应用功率负荷参数指导的运动健康干预方案,包括形成干预前健康筛查和风险评估、体质测试、功率负荷参数指导的运动健康干预方案和常见不良事件的处置方法。建议:在不同健康水平人群中,运动功率作为运动强度指标指导运动健康干预的方案需规范、个体化;关注运动干预过程中常见不良事件,并在发生时及时处理。

以学生为中心理念的形成性评价在临床实践教学管理中的应用思考

迷你临床演练评估(Mini-clinical Evaluation Exercise,Mini-CEX)与操作技能直接观察评估(Direct Ob⁃servation of Procedural Skill,DOPS)等形成性评价工具在岗位胜任力培养上具有显著优势,在临床实践教学中被大力推广。但由于教学管理理念和方法陈旧、师资能力不足、学生主动性缺乏等原因,效果不理想。以学生为中心是当前广为认可的主流教学理念,强调以学生发展和成效为中心。本文探讨通过改革教学管理,将以学生为中心理念深度融合在形成性评价的临床教学管理中,包括改进师资建设方式、培养学生主动学习意识、优化信息化手段、使用学习档案集实施全程管理等。

PDCA管理模式联合随机考核在CCU年轻护士护理能力中的应用效果分析

目的探讨PDCA管理联合随机考核模式在冠状动脉粥样硬化性心脏病监护病房(Cardiac Care Unit,CCU)年轻护士护理能力中的应用效果。方法选择2022年1月—2023年12月徐州市中心医院工作的30名心内科CCU年轻护士作为研究对象,以2022年1—12月实施常规管理模式为对照组,以2023年1—12月实施PDCA管理联合随机考核模式为研究组。比较两组年轻护士的评判性思维能力、临床演练评估能力、考核成绩、护理能力和护理质量。结果研究组评判性思维能力、临床演练评估能力、考核成绩、护理能力、护理质量显著优于对照组,差异有统计学意义(P均<0.05)。结论在CCU年轻护士的管理中,PDCA管理联合随机考核模式更为理想,可显著提升年轻护士的评判性思维能力和临床演练评估能力,提高其理论水平和实践技能,提升护理能力和护理质量。

护理迷你临床演练评估结合客观结构化临床考试教学模式对本科急诊护理实习生的培训效果

目的观察护理迷你临床演练评估(Nursing-Mini-CEX)结合客观结构化临床考试(OSCE)教学模式在本科急诊护理实习生护理培训中的应用效果。方法选取2023年7—11月郑州大学第一附属医院老院区75名本科急诊护理实习生作为对照组,接受常规教学模式;选取同期东院区75名本科急诊护理实习生作为观察组,接受Nursing-Mini-CEX结合OSCE教学模式。观察两组入科、出科时理论及急救技能考核成绩、学习积极主动性(ALS)评分、评判性思维能力测量表(CTDI-CV)、岗位胜任能力。结果出科时,观察组理论知识、操作技能得分均高于对照组(P<0.05);出科时,观察组ALS量表、CTDI-CV量表及岗位胜任能力量表中各项评分均高于对照组(P<0.05)。结论在本科急诊护理带教管理中,Nursing-Mini-CEX结合OSCE教学模式有助于提升实习生出科成绩,增强其学习主动性和评判性思维能力,并可通过多站点的迷你情景模拟演练和评估强化其岗位胜任能力,在临床带教中具有一定应用价值。

分析步行运动联合正念干预对卵巢癌患者睡眠质量的影响

目的:分析步行运动联合正念干预对卵巢癌患者睡眠质量的影响,寻求能够提升化疗期卵巢癌患者生命质量的护理措施。方法:选取2022年6月至2023年6月厦门大学附属第一医院妇产科收治的确诊为卵巢癌患者68例作为研究对象,按照随机数字表法分为对照组和观察组,每组34例。对照组给予常规护理干预,观察组给予步行运动联合正念干预。采用匹兹堡睡眠质量指数(PSQI)比较2组患者干预前后睡眠质量的变化,采用中文版Piper疲乏修订量表(PFS-R)比较2组患者干预前后的疲乏状态,采用生命质量测定量表(EORTC QLQC30)比较2组患者干预前后生命质量的变化。结果:干预后,观察组PSQI评分显著低于对照组,观察组癌因性疲乏Piper量表评分显著低于对照组,患者生命质量测定量表QLQC30评分显著高于对照组,差异均有统计学意义(均P<0.05)。结论:卵巢癌患者在化疗期间展开步行运动联合正念干预,与治疗措施之间可产生良好的辅助配合效果,能够有效提高患者的睡眠质量和生命质量,增加对抗癌症、化疗的信念,值得临床推广应用。

老年人内在能力测评与结局指标范围审查的比较研究

目的:系统综述国内外老年人内在能力测评及结局指标相关研究。方法:聚焦内在能力,系统检索中英文数据库,由2名研究员使用标准化表格提取文献的出版物信息、研究地点、研究类型、样本量及年龄分布、样本信息获取方式、内在能力领域和用于评估相应领域能力的指标及方法、综合评分计算方式、生物学标记物、相关结局指标等。结果:共纳入63篇文献,共38项测评指标(运动领域10项、认知领域6项、感观领域3项、心理领域8项、活力领域11项)、7种内在能力综合得分计算方式、13项相关结局指标。结论:建议卫生保健机构和相关人员通过前瞻性的研究方法充实内在能力内涵,在综合和了解国内外内在能力测评方法的基础上,制定和发展适合我国国情、医疗和养老环境的内在能力测评工具及综合评分界值,以标准化工具促进老年人内在能力提升。

体外膜肺氧合患者功能锻炼的最佳证据总结

目的总结体外膜肺氧合患者功能锻炼的最佳证据,为制定科学的体外膜肺氧合患者功能锻炼方案提供参考。方法系统检索国内外相关指南网站、循证数据库、相关协会网站及学术文献数据库等关于体外膜肺氧合患者功能锻炼的相关证据。检索时限为建库至2023年6月。由2名经过循证医学方法学培训的研究人员对所纳入的文献进行质量评价。结果共纳入12篇文献,包括指南2篇,系统评价5篇,专家共识3篇,随机对照试验2篇。最终提取出了前期准备、评估、运动方法和安全监测4个方面共35条最佳证据。结论总结的最佳证据可为开展体外膜肺氧合患者功能锻炼提供依据,从而为患者提供个性化的康复训练方案。

CBL联合PBL教学法在眼科住院医师规范化培训中的应用

目的分析案例式教学法联合基于问题的教学模式用于眼科住院医师规培的临床价值。方法选取2022年1—12月于淮纺医学院附属医院眼科中心进行规培60名眼科住院医师为研究对象,按随机数表法分为观察组与对照组,对照组30名医师执行标准规培方案,观察组30名医师执行案例式教学法联合基于问题的教学模式规培方案,评价两组医师的培训结果。结果规培后,观察组迷你临床演练评估各维度评分均高于对照组,差异有统计学意义(P均<0.05);观察组理论成绩、手术操作、放射诊断、心电诊断、诊疗思维评分高于对照组,差异有统计学意义(P均<0.05);观察组规培医师对于教学模式教学内容、教学过程、沟通交流、教学技术、学习效率的评分高于对照组,差异有统计学意义(P均<0.05)。结论案例式教学法联合基于问题的教学模式规培可提升眼科住院医师规培效果,提升医师规培成绩与工作能力,且规培医师对该方案的评价较高。

中青年男性握力与颈动脉粥样硬化的关联研究

目的 探讨中青年男性握力水平和颈动脉粥样硬化的关联,为运动干预动脉粥样硬化的发生发展提供依据。方法 招募454名20~59岁男性,记录人体学指标,测量身体成分、握力、心肺耐力和相关血液指标并进行颈动脉超声检查。采用t检验、单因素方差分析、Logistic回归进行统计学分析。结果 相比于低握力水平组,高握力水平组的BMI低、RSMI大、心率低、TC低、HDL低、空腹血糖低、CIMT小、Crouse积分小、等级积分小,差异均有统计学意义(均P<0.05)。Logistic回归分析显示,调整BMI、RSMI、心率、TC、HDL、空腹血糖、VO_(2max)、收缩压、舒张压后,低水平和中等水平组发生颈动脉粥样硬化的风险高于高水平组(OR=2.79、1.71)。结论 较低握力的中青年男性存在动脉粥样硬化的风险较高,握力测量有助于评估动脉粥样硬化状况。

Validation of adherence prediction system for lifestyle interventions in nonalcoholic fatty liver disease

This editorial delves into the research article by Zeng et al published in the latest issue of World Journal of Gastroenterology.The manuscript contributes significantly to addressing the global health issue of nonalcoholic fatty liver disease(NAFLD)by introducing and validating the Exercise and Diet Adherence Scale(EDAS).The article effectively conveys the importance of the study,highlighting the prevalence of NAFLD,the lack of approved drugs for its treatment,and the crucial role of lifestyle correction.The use of the Delphi method for scale development and the subsequent evaluation of its reliability add scientific rigor to the methodology.The results demonstrate that the scale is correlated with key lifestyle indicators,which makes it a promising tool for assessing patient adherence to interventions.The identification of specific score thresholds for predicting adherence to daily calorie intake and exercise adds practical value to the scale.The differentiation among scores indicative of good,average,and poor adherence enhances its clinical applicability.In conclusion,the manuscript introduces EDAS,a valuable instrument that can contribute substantially to the field of NAFLD research and clinical practice.

水中运动疗法联合陆地物理疗法治疗62例腓总神经损伤的疗效分析

目的探讨水中运动疗法配合陆地物理疗法治疗腓总神经损伤的疗效。方法方便选取2021年2月-2023年2月北京和睦家康复医院收治的62例腓总神经损伤的患者为研究对象,按照随机数表法分为对照组和水疗组,每组31例。两组在神经营养药物治疗的同时,对照组给予传统的陆地物理疗法,水疗组通过水中运动疗法及陆地物理疗法相结合的方法治疗,共治疗8周。治疗前后用康复评定及神经电生理标准评定疗效。结果治疗后,水疗组踝关节背屈主动活动度为(7.28±3.06)°、10 m步行速度为(1.27±0.44)m/s,均优于对照组,差异有统计学意义(t=2.155、2.205,P均<0.05)。水疗组步长优于对照组,差异有统计学意义(P<0.05)。水疗组受损神经传导速度增加百分比与对照组比较,差异无统计学意义(P>0.05)。水疗组重用力运动单位电位募集频率百分比、受损神经复合肌肉动作电位波幅增加百分比,均优于对照组,差异有统计学意义(P均<0.05)。结论采用水中运动疗法联合陆地物理疗法治疗腓总神经的损伤的方法,比单独陆地物理疗法更有效。

基于风险评估的血栓预防策略结合早期定量运动预防缺血性脑卒中患者下肢深静脉血栓形成的效果

目的探讨基于风险评估的血栓预防策略结合早期定量运动预防缺血性脑卒中患者下肢深静脉血栓形成的效果。方法选取2020年3月至2022年3月我院收治的120例缺血性脑卒中患者,将其随机分为对照组和观察组,各60例。对照组实施常规护理,观察组实施基于风险评估的血栓预防策略结合早期定量运动。比较两组的干预效果。结果观察组的下肢深静脉血栓总发生率低于对照组,差异具有统计学意义(P<0.05)。干预后,观察组的髂静脉、股静脉、腘静脉血流速度和血流量均高于对照组,差异具有统计学意义(P<0.05)。干预后,观察组的美国国立卫生院卒中量表(NIHSS)评分低于对照组,Fugl-Meyer运动功能评定量表(FMA)评分高于对照组,差异具有统计学意义(P<0.05)。结论基于风险评估的血栓预防策略结合早期定量运动可提高缺血性脑卒中患者下肢深静脉血栓的预防效果,改善下肢血流动力学,促进神经功能及下肢功能恢复。

业绩型股权激励、行权条件与企业ESG表现

企业ESG表现颇受投资者关注,提升企业ESG表现以提高竞争力也逐渐形成共识。作为一种长期激励方式,股权激励如何促使高管提升企业ESG表现?为了研究这一问题,本文选取2008—2021年沪深A股上市公司作为研究对象,探究业绩型股权激励及其行权条件对企业ESG表现的影响。实证结果表明,业绩型股权激励显著提升企业ESG表现。当高管任期较长时,这一关系更为显著。进一步研究发现,行权业绩考核越难、行权等待期越长越有助于提升企业ESG表现,但行权有效期不影响企业ESG表现。上述研究结论有助于企业完善高管股权激励的契约结构,促进企业ESG表现的提升。

情景模拟联合Mini-CEX混合教学法在妇产科实习教学中的应用

目的:探讨基于情景模拟联合迷你临床演练评估(Mini-CEX)混合教学法在妇产科实习教学中的效果。方法:选取2021年12月~2022年12月在弋矶山医院妇产科实习的本科生80名(分10批次进入本科室)为研究对象,根据学生进入科室批次随机分为研究组和对照组,每组各40名学生。研究组接受情景模拟联合Mini-CEX混合教学法,对照组接受传统教学法;本科室实习教学结束后,两组学生统一进行Mini-CEX考核、教学满意度调查、自我评价问卷。结果:研究组学生的Mini-CEX考核各项成绩(医疗面谈、体格检查人文关怀等7个层面)均高于对照组(P<0.05),且研究组学生的总体满意度和学习兴趣、自学能力、学习记忆方面比对照组高(P<0.05)。结论:混合教学法可以增强妇产科实习生的学习兴趣,提高教学成绩和满意度。

以执业能力为导向的导师制在骨科实习生培养中的效果评价

目的探索以执业能力为导向的导师负责制在骨科实习生培养中的应用效果。方法选取2021年9月—2023年6月2021和2022学年“5+3”一体化的60名本科实习生作为研究对象,将2021学年的实习生作为对照组,2022学年的实习生作为研究组,每组30名。对照组采用标准教学模式培养,研究组采用以执业能力为导向的导师负责制模式培养,培养时间为1个月。比较2组实习生的理论和临床考核成绩、迷你临床演练评估量表(mini-clinical evaluation exercise,Mini-CEX)评分、主观-客观-评价-计划(subject-objective-assessmentplan,SOAP)评分、医患沟通技能评价量表(set elicit give understand end framework,SEGUE)评分。结果2组实习生的客观题和临床技能考核成绩比较,差异无统计学意义(P>0.05);研究组实习生的病例分析题成绩、Mini-CEX评分、SOAP评分和SEGUE评分([41.3±3.5)分、(47.9±7.0)分、(74.4±7.7)分、(20.5±3.2)分]高于对照组[(36.8±6.1)分、(36.0±7.0)分、(62.0±7.1)分、(18.1±3.0)分],差异均有统计学意义(P<0.05)。结论以执业能力为导向的导师负责制能够明显提高骨科实习生的临床诊疗水平,有助于培养出更优秀的医学人才。