Objective To analyze detailed records of peasants’ hospitalization and compensation due to external causes of illness and death based on a county’s new rural cooperative medical scheme (NRCMS) from 2009 to 2010. Methods We systematically acquired the relevant record data of all inpatients via the management information system of NRCMS in this county. According to ICD-10 coding, we categorized and divided diseases into groups in basis of discharge diagnosis of each inpatient. Data were analyzed using SPSS 17.0. Results Inpatients due to external causes of illness and death who participated in the NRCMS accounted for 17.4% (7 913/45 432) of the total inpatient person-time in 2009 and 20.7% (12 568/60 643) in 2010. External causes of illness and death ranked the first in the hospitalization disease spectrum, which mainly were animal bites and accidental injuries. About 20% of their hospitalization expense was compensated by the NRCMS. More than half of the inpatients could be hospitalized for the treatment in the county township health center (59.6% in 2009 and 66.8% in 2010). Conclusion The result of this study indicates that external causes of illness and death including animal bites and accidental injuries have been a major health problem that peasants in this county face.
Objective To analyze the dynamic efficiency of township hospitals. Methods Based on the DEA-Malmquist index, this research analyzed the change of the total factor productivity indices and the decomposition items of 281 township hospitals in Hunan province with panel data from 2000 to 2008. Results Among 281 township hospitals, less than half increased their scale efficiency, while more than half increased their total factor productivity, technology, whole efficiency and technical efficiency. Increasing technology and whole efficiency was the best way to improve total factor productivity. Besides, increasing technical efficiency and scale efficiency was the best way to improve whole efficiency. Conclusions The improvement of scale efficiency is key to developing the central township hospitals, while the improvement of technology is the key to developing general township hospitals.
Synchronization analysis of electroencephalogram (EEG) and electromyogram (EMG) could reveal the functional corticomuscular coupling (FCMC) during the motor task in human. A novel method combining Gabor wavelet and transfer entropy (Gabor-TE) is proposed to quantitatively analyze the nonlinearly synchronous corticomuscular function coupling and direction characteristics under different steady-state force. Firstly, the Gabor wavelet transform method was used to acquire the local frequency-band signals of the EEG and EMG signals recorded from nine healthy controls simultaneously during performing grip task with four different steady-state forces. Secondly, the TE of local frequency-band was calculated and the unit area index of the transfer (ATE) was defined to quantitatively analyze the synchronous corticomuscular function coupling and direction characteristics under steady-state force. Lastly, the effect of EEG and EMG signal power spectrum on Gabor-TE analysis was explored. The results showed that the coupling strength in the beta band was stronger in EEG→EMG direction than in EMG→EEG direction, and the ATE values in the beta band in EEG→EMG direction decreased with the force increasing. It is also shown that the difference in TE values of gamma band present a varying regularity as the increase of force in both directions. In addition, EMG power spectrum was significantly correlated with the result of Gabor-TE inspecific frequency band. The results of our study confirmed that Gabor-TE can quantitatively describe the nonlinearly synchronous corticomuscular function coupling in both local frequency band and information transmission. The analysis of FCMC provides basic information for exploring the motor control and the evaluation of clinical rehabilitation.
To better analyze the problem of abnormal neuromuscular coupling related to motor dysfunction for stroke patients, the functional coupling of the multichannel electromyography (EMG) were studied and the difference between stroke patients and healthy subjects were further analyzed to explore the pathological mechanism of motor dysfunction after stroke. Firstly, the cross-frequency coherence (CFC) analysis and non-negative matrix factorization (NMF) were combined to construct a CFC-NMF model to study the linear coupling relationship in bands and the nonlinear coupling characteristics in different frequency ratios during elbow flexion and extension movement. Furthermore, the significant coherent area and sum of cross-frequency coherence were respectively calculated to quantitatively describe the intermuscular linear and nonlinear coupling characteristics. The results showed that the linear coupling relationship between multichannel muscles was different in frequency bands and the overall coupling was stronger in low frequency band. The linear coupling strength of the stroke patients was lower than that of the healthy subjects in different frequency bands especially in beta and gamma bands. For the nonlinear coupling, the intermuscular coupling strength of stroke patients in different frequency ratios was significantly lower than that of the healthy subjects, and the coupling strength in the frequency ratio 1∶2 was higher than that in the frequency ratio 1∶3. This method can provide a theoretical basis for exploring the intermuscular coupling mechanism of patients with motor dysfunction.
ObjectiveTo explore the association of elongase of very long chain fatty acids family member 6 (ELOVL6) gene with increased risk of large-artery atherosclerosis stroke (LAA) in Han Chinese population in Chengdu.MethodsHan Chinese populations in Chengdu, Sichuan were chosen for this study using the case-control design between January 2015 and December 2017. The genotypes and haplotypes of six single nucleotides polymorphisms (SNPs) of ELOVL6 gene (rs3813825, rs17041272, rs4141123, rs9997926, rs6824447, and rs12504538) were analyzed in different genetic models in entire samples, and gene-enviromental interaction analyses were also carried out to get an insight of the risk factors for LAA. At the same time, we also analyzed the gene expression profile in peripheral blood mononuclear cells between groups.ResultsA total of 240 LAA cases and 211 healthy controls were enrolled in this study. All the enrolled subjects presented CC genotype of rs9997926, while the other five SNPs (rs3813825, rs17041272, rs4141123, rs6824447, and rs12504538) were genotyped successfully in all the enrolled subjects. rs17041272 polymorphism and TGTTG haplotype were significantly associated with LAA risk in studied population [CC/(CG+GG): odds ratio (OR)=0.640, 95% confidence interval (CI) (0.423, 0.968), P=0.034; TGTTG: OR=1.776, 95%CI (1.069, 2.951), P=0.024], and the interaction among rs17041272, rs6824447 SNPs and dyslipidemia increased susceptibility to LAA [OR=2.737, 95%CI (1.715, 4.368), P<0.001]. The ELOVL6 gene expression level was higher in LAA subjects (t=−3.167, P=0.003).ConclusionsELOVL6 gene is associated with LAA risk in Han nationality of Chinese population in Chengdu, and the interaction of gene-environmental risk factors could be of great importance in pathophysiology of LAA.
Stroke is an acute cerebrovascular disease in which sudden interruption of blood supply to the brain or rupture of cerebral blood vessels cause damage to brain cells and consequently impair the patient's motor and cognitive abilities. A novel rehabilitation training model integrating brain-computer interface (BCI) and virtual reality (VR) not only promotes the functional activation of brain networks, but also provides immersive and interesting contextual feedback for patients. In this paper, we designed a hand rehabilitation training system integrating multi-sensory stimulation feedback, BCI and VR, which guides patients' motor imaginations through the tasks of the virtual scene, acquires patients' motor intentions, and then carries out human-computer interactions under the virtual scene. At the same time, haptic feedback is incorporated to further increase the patients' proprioceptive sensations, so as to realize the hand function rehabilitation training based on the multi-sensory stimulation feedback of vision, hearing, and haptic senses. In this study, we compared and analyzed the differences in power spectral density of different frequency bands within the EEG signal data before and after the incorporation of haptic feedback, and found that the motor brain area was significantly activated after the incorporation of haptic feedback, and the power spectral density of the motor brain area was significantly increased in the high gamma frequency band. The results of this study indicate that the rehabilitation training of patients with the VR-BCI hand function enhancement rehabilitation system incorporating multi-sensory stimulation can accelerate the two-way facilitation of sensory and motor conduction pathways, thus accelerating the rehabilitation process.
Brain-computer interface (BCI) based on steady-state visual evoked potential (SSVEP) have attracted much attention in the field of intelligent robotics. Traditional SSVEP-based BCI systems mostly use synchronized triggers without identifying whether the user is in the control or non-control state, resulting in a system that lacks autonomous control capability. Therefore, this paper proposed a SSVEP asynchronous state recognition method, which constructs an asynchronous state recognition model by fusing multiple time-frequency domain features of electroencephalographic (EEG) signals and combining with a linear discriminant analysis (LDA) to improve the accuracy of SSVEP asynchronous state recognition. Furthermore, addressing the control needs of disabled individuals in multitasking scenarios, a brain-machine fusion system based on SSVEP-BCI asynchronous cooperative control was developed. This system enabled the collaborative control of wearable manipulator and robotic arm, where the robotic arm acts as a “third hand”, offering significant advantages in complex environments. The experimental results showed that using the SSVEP asynchronous control algorithm and brain-computer fusion system proposed in this paper could assist users to complete multitasking cooperative operations. The average accuracy of user intent recognition in online control experiments was 93.0%, which provides a theoretical and practical basis for the practical application of the asynchronous SSVEP-BCI system.
The full-cycle rehabilitation management for orthopedic patients can solve the problems of standardization, systematization, and whole process of orthopaedic rehabilitation management, and prevent short-term and long-term complications. The First Affiliated Hospital of Sun Yat-sen University has constructed a full-cycle rehabilitation management platform for orthopedic patients based on multi-source data since 2023, including six modules: multi-source data collection and integration module, intelligent individualized rehabilitation program setting module, and visual rehabilitation training module, and has explored a digitally-driven full-cycle rehabilitation management mode for orthopedic patients. This article elaborates on the platform’s functional design and implementation, full-cycle rehabilitation management mode, and application effectiveness, in order to provide a reference for promoting the integration of mobile health and orthopedic patient rehabilitation practice.
Objective To investigate the inpatient disease constitution of Jili Community Health Service Center (JCHSC) in Liuyang City of Hunan Province from 2008 to 2010, so as to learn about the local burden of diseases and to provide baseline data for further study. Methods Both questionnaire and focus interviews were applied to collect inpatients’ records in JCHSC between 2008 and 2010. Based on the primary diagnosis on hospital discharge record, the diseases were standardized and classified according to the International Classification of Disease, 10th Edition (ICD-10). Data including general information of the inpatients and discharge diagnosis were rearranged and analyzed by using Microsoft Excel 2003 and SPSS 13.0 software. Results a) The total numbers of inpatients were 4 804, 6 011 and 6 552 in 2008, 2009 and 2010, respectively, and males were less than famales (37.89% vs. 62.11%, 37.68% vs. 62.32%, 41.09% vs. 58.91%); b)The disease spectrum included 19 to 21 categories, accounting for 90.5% to 100% of ICD-10; c) The top 5 systematic diseases accounted for 78.91%-83.61%, including circulate, digestive, pregnancy, parturition and puerperium, genitourinary, and respiratory system diseases; d) The top 15 single diseases were coronary heart disease, urinary calculi, cholecyslithiasis or accompanied with cholecystitis, chronic gastritis, hypertension, diabetes, chronic bronchitis, pulmonary infection and inguinal hernia; and e) In these 3 years, most of the inpatients suffered from chronic diseases rather than acute diseases, mostly over 35 years old; while the acute diseases were commonly seen in patients younger than 15 years old. Conclusion a) In recent 3 years, the major inpatient systematic diseases are circulate, digestive, pregnancy, parturition and puerperium, genitourinary, and respiratory system diseases. The chronic diseases are more than the acute, and mainly focus on coronary heart disease, urinary calculi and chronic bronchitis; b) Nine common inpatient disease spectrum of the top 15 single diseases keep same in recent 3 years; and c) Further attention should be paid to the chronic patients over 35 years old and the acute patients less than 15 years old.