Objective To investigate the situation of sports participation and the unmet needs of services for 6-12 years old children with intellectual disabilities. Methods 420 children with intellectual disabilities in areas of minority nationalities in Hubei province aged 6-12 years were surveyed with a questionnaire. Statistics had been conducted for situation and unmet needs of services. Results 72.6%respon-dents wanted to participate in sport, 70%respondents participated in sport at least once a week, maining for rehabilitation;the unmet needs of services mainly focused on the special education, medical rehabilitation, functional training and the non-barrier transformation for kitchen and toilets. Conclusion Comprehensive rehabilitation and services are needed in 6-12 years old children with intellectual disabilities in areas of minority nationalities in Hubei Province. The diversity of unmet needs needed to be attend.

OBJECTIVE:To review the curative efficacy and safety of itopride vs. domperidone in the treatment of functional dyspepsia(FD). METHODS:Randomized controlled trails(RCTs)of itopride vs. domperidone in the treatment of FD were enrolled and retrieved from Cochrane Library,PubMed,EMBASE,SCI,CBM,CNKI,VIP and Wanfang Database. Other retrieval was carried out by hand. Methodological quality evaluation and meta-analysis of RCTs were carried out. RESULTS:Of total 18 RCTs enrolled,11 RCTs were graded B and 7 RCTs graded C. Itopride group were superior to domperidone group in respect of total response rate,the relief rate of nausea,abdominal distention,belching,vomiting,epigastric pain and sour regurgitation. There was no statistical significance. The incidence of ADR in itopride group was lower than in domperidone group. There was no statistical significance in difference between two groups. The relief rate of anorexia and early satiety in itopride group were superior to domperidone group. Statistical significance was noted in difference between two groups. CONCLUSION:Recent study shows itopride has better effect than domperidone on FD,which should be confirmed by high quality study.

Objective To explore the clinical characteristics and treatment in elderly patients with gastric bezoars. Methods Totally 49 patients with gastric bezoars were retrospectively analyzed,and among them,36 patients were aged 65-77 years, 48 cases underwent sequential therapy,1 elderly patient underwent surgical operation. Results There were differences in etiology, medical histories, clinical manifestations and therapeutic efficacy between elderly and non elderly patients with gastric bezoars.There were 42％ (15/36) of elderly patients eating glutinous rice cakes,4 cases with gastric surgery histories,6 cases with diabetes in elderly patients,but in non eldcrly patients only 8％ (1/13) of patients eating glutinous rice cake,and there were no cases with surgery histories and diabetes. Gastric bezoars in 48 cases were cleared away by sequential therapy. 1 elderly patient developed intestinal obstruction after surgical operation and died of infectious shock. Conclusions There are some different characteristics between elderly and nonelderly patients with gastric bezoars.Sequential therapy is safe and effective for elderly patients with gastric bezoars.

Objective To explore the association between circulating endothelial cells (CECs)and atherosclerosis in maintenance hemodialysis(MHD)patients. Methods A crosssectional study was performed to investigate the association between CECs and carotid atherosclerotic change in 65 MHD patients,25 non-hemodialysis patients with chronic kidney disease(CKD)of stage 4 or 5(CKD-non-HD)and 24 age-and Sex-matched healthy controls. CECs in peripheral blood were determined by multiparametrie flow cytometry(FCM).CECs were labeled with CD3-PerCP and CD146-PE before FCM and identified as CD3dim,CD146bright.Atherosclerosis in both groups Was assessed by the measurement of common carotid arery intimamedia thickness (CCA-IMT)and plaque of the common carotid arteries with ultrasound scanner. Results CECs were significantly higher in pre-dialysis patients[(151.52±98.24) cell/ml]and CKD-non-HD patients[(183.00±81.38)cell/ml ] compared with control group[(106.50± 24.14)cell/ml](P<0.05 and P<0.01,respectively).But the number of CECs was not significantly different between MHD and CKD-non-HD patients.CCA-IMT was also significantly higher in MHD patients[(0.94±0.36)mm]and CKD-non-HD patients [(1.02±0.37)mml compared with control group[(0.75±0.15)mm](P<0.05 and P<0.01,respectively).The number of pre-dialysis CECs was positively correlated with CCA-IMT in MHD patients(r=0.328,P<0.01).Multivariate analysis showed that CEC level was a strong independent risk factor of CCA-IMT. Conclusion InMHD patients, CEC level is associated with carotid atherosclerosis and may be used as a marker to evaluate the endothelial damage.

Objective To explore the definition, structure, terminology, framework, and models of social support and services, and mea-surement of intellectual disability based ICF approach. Methods The ICF approach and definition and approach proposed by American Asso-ciation on Intellectual and Developmental Disabilities (AAIDD) were adopted. Results The characteristics of intellectual disability are sig-nificant limitations in both intellectual functioning and adaptive behavior as expressed in conceptual, social, and practical adaptive skills, and onset before 18 years old. The framework, domains and contents of services and support for intelligence disability were proposed, as well as the updated measurement of intelligence disability based on new framework and definition. Conclusion The new framework of intel-ligence disability, system of service and support, and measurement are in accordance with the bio-psycho-social model of disability of ICF. The new paradigm will provide framework and tool of measurement, rehabilitation, education, and social services for people with intelli-gence disability.

Objective:To explore the expression of R-spondin family in colorectal cancer tissues and adjacent tissues,and to evaluate its relationship with clinic-pathological stage.Methods:A total of 64 samples of colorectal cancer tissues and adjacent tissues were collected from the patients,who received radical surgery in Xiangya Hospital,Central South University between January 2014 and August 2014.The mRNA and protein expression levels of R-spondin 1-4 and β-catenin in the colorectal cancer tissues and adjacent tissues were detected by qRT-PCR and immunohistochemistry.The relationship between the expression level of R-spondin 1-4 and the clinic-pathological factors were analyzed to explore the correlation between the expression level of R-spondin 1-4 and β-catenin in colorectal cancer.Results:Compared with the adjacent tissues,the mRNA and protein expression levels of R-spondin 1 were elevated in the colorectal cancer tissues (P＜0.05).The mRNA and protein expression levels of R-spondin 2-4 were increased in the colorectal cancer tissues than those in the normal tissues (P＜0.05),but there was no significant difference between the colorectal cancer tissues and adjacent tissues (P＞0.05).The expression level of R-spondin i was positively correlated with the nuclear expression of β-catenin in the colorectal cancer tissues (r=0.6307,P＜0.05).Conclusion:Compared with the adjacent tissues,the mRNA and protein expression levels of R-spondin 1 are significantly elevated in the colorectal cancer tissues.R-spondin 1 may play a role in promoting carcinogenesis by regulating the activity of β-catenin in the downstream of Wnt signaling pathway.

Objective To research the unmet needs and services of rehabilitation for people with physical disabilities in rural areas in Henan, China. Methods The data of 2016 Basic Service Status and Unmet Needs for People with Disabilities in Henan, China were ana-lyzed. Results A total of 1,028,598 people with physical disabilities from all 19 cities had been surveyed, accounting for 61.7% male. In terms of rehabilitation needs, there were 19,348 (1.9%) responsed surgery, 202,855 (19.7%) responsed medical treatment, 197,592 (19.2%) responsed functional training, 360,754 (35.1%) responsed assistive products, and 158,012 (15.4%) responsed nursing, there were significant differences in the number of people who needed rehabilitation among different disability levels (χ2>18.080, P<0.001). For rehabilitation ser-vice, there were 6061 (0.6%) reported surgery, 93,905 (9.1%) reported medicine, 62,967 (6.1%) reported function training, 81,437 (7.9%) reported assistive products, and 34,595 (3.4%) reported nursing, there were significant differences in the number of people who got rehabili-tation among different disability levels (χ2>15.920, P<0.01). For the people without rehabilitation services, there were 165,172 (20.3%) per-son-times lack of understanding of rehabilitation policy, 151,448 (18.6%) reported lack of rehabilitation financial support, 20,369 (2.5%) re-ported not to access rehabilitation institutions, 540,971 (66.5%) reported lack of rehabilitation professionals or services, there were signifi-cant differences in the number of people who did not get rehabilitation services among different disability levels (χ2>19.182, P<0.001). Con-clusion The unmet needs and services of rehabilitation for people with physical disabilities in rural areas in Henan were explicated. It recom-mended to train rehabilitation professionals and improve the service delivery capacity, to raise awareness, increase investment in rehabilita-tion services and provide reasonable accommodation for people with disabilities.

Objective To research the social economic development and service needs of families with more than one disabled in Henan, China. Methods The data of 2016 Basic Service Status and Needs of People with Disabilities in Henan was analyzed. Results A to-tal of 74,732 (4.0%) people with disabilities from all 19 cities in Henan had been surveyed, 54.9%were males and 83.2%were from rural ar-eas. In terms of social and economic development, 41.8%of people with disabilities in urban areas were below least living baseline, 14.7%met standards of low income;23.9%of people with disabilities in rural areas were recorded as national poverty household, 35.7%were not recorded as national poverty household, 39.9%were not in poverty. In terms of housing, 75.3%of people with disabilities in urban areas had their own houses, 7.1%had housing security welfare, 12.9%had no house; 70.5%of people with disabilities in rural areas had their own houses in good condition, 3.5%had their own houses which were identified as houses in risk, 15.9%had their own houses which were sus-pected to be houses in risk, 1.7%had no house, and 2.2%had their own houses reconstruction. There were significant differences in the eco-nomic and housing conditions among different types of disabilities (χ2>51.267, P<0.001), and in people under standards of low income and others among different levels of disabilities (χ2>8.400, P<0.05). For people with disabilities in rural areas, there were significant differences in the economic and housing conditions among different types of disabilities (χ2>70.149, P<0.001), and no significant difference was found among different levels of disabilities (χ2<6.446, P>0.05). In terms of employment needs, vocational skills training 5.0%, introducing a job 3.9%, practical training in rural areas 6.6%, capital credit support 7.6%, and others 10.7%. There were significant differences in the employ-ment needs among different types of disabilities (χ2>73.180, P<0.001), and in the needs of vocational skills training, introducing a job, practi-cal training in rural areas and capital credit support among different levels of disabilities (χ2>11.440, P<0.01). In terms of caring service needs, home caring 54.1%, day care 11.1%, and institutional residential care 2.9%. There were significant differences in caring service needs both among different types and levels of disabilities (χ2>38.960, P<0.001). In terms of rehabilitation needs, surgery 2.1%, medicine 22.5%, functioning training 16.1%, assistive devices 29.8%, and nursing 14.8%. There were significant differences in rehabilitation needs among different types of disabilities (χ2>99.220, P<0.001), and in needs of nursing among different levels of disabilities (χ2=12.465, P<0.01). In terms of barrier-free reconstruction, sloping and handrail 17.7%, door 14.2%, bathroom 30.3%, kitchen 20.5%, visual doorbell with flash 3.4%, gas leak alarm device 2.3%, and internet access and screen software 0.6%. There were significant differences in barrier-free recon-struction among different types of disabilities (χ2>68.000, P<0.001) except visual doorbell with flash, gas leak alarm device and internet ac-cess and screen software. There was significant difference in needs of flash and visual doorbell, gas leak alarm device and internet access screen software among different levels of disabilities (χ2>46.960, P<0.001). Conclusion The social economic development of families with more than one disabled were faced risk. Recommendation to policy development included to improve the support efforts, and ensure their ba-sic housing, pay attention to their individual differences in employment poverty alleviation needs and provide more opportunities to get jobs, and provide financial support, increase support for home care, increase inputs of funding and assistive devices for rehabilitation services, and attach importance to their needs of barrier-free reconstruction.

BACKGROUND:Unicompartmental knee arthroplasty has become mainstream operation for treatment of unicompartmental osteoarthritis of the knee, but unicompartmental knee arthroplastystil has some problems, such as excessive bleeding-induced postoperative blood transfusion, increased blood transfusion rate, hospitalization expense and complication of blood transfusion. As tranexamic acid for total knee arthroplasty has achieved good effects. It is significant to investigate whether local application of tranexamic acid can effectively reduce blood loss in unicompartmental arthroplasty.
OBJECTIVE:To investigate the efficacy and safety of the intra-articular tranexamic acid injection in treating perioperative blood loss in patients undergoing unicompartmental knee arthroplasty.
METHODS:122 patients with knee osteoarthritis undergoing unicompartmental knee arthroplastyinthe Department of Orthopedics, the Second Affiliated Hospital ofDalian Medical University from January 2014 to August 2015wereenroled in this study. Al patients were randomly divided into two groups. Patients in the tranexamic acid group were injected with 10 mL of tranexamic acid (containing 1000 mg) + 10 mL of sodium chloride injection in the articular cavity before loosening the tourniquet. Patients in the control group received 20 mL of sodium chloride injection in the articular cavity. In both groups, the drainage tube was clipped for 3 hours after injection.At 48 hours after replacement, the drainage tube was puled out. We compared and analyzed hemoglobin levels and hematocrit at 2 days and 1 month postoperatively, total blood loss and drainage volume at 2 days postoperatively, the number of patients receiving blood transfusion, Hospital for Special Surgery scores of knee function at 1 week and 1 month postoperatively, and thrombosis at 1 week postoperatively, and evaluated effects of tranexamic acid on blood loss after unicompartmental knee arthroplasty.
RESULTS AND CONCLUSION:(1) Hemoglobin levels and hematocrit were significantly higher in the tranexamic acid group than in the control group at 2 days postoperatively (P< 0.05). No significant difference in hemoglobin levels and hematocrit was detected at 1 month postoperatively in both groups (P> 0.05). (2) Drainage volume and total blood loss were significantly less in the tranexamic acid group than in the control group at 2 days postoperatively (P< 0.05). (3) The number of patients receiving blood transfusion was significantly less in the tranexamic acid group (0 case) than in the control group (6 cases) (P< 0.05). (4) Scores of Hospital for Special Surgery were significantly higher in the tranexamic acid group than in the control group at 1 week postoperatively (P< 0.05). No significant difference in above socres was identified between the two groups at 1 month postoperatively. (5) No venous thrombosis was found at 1 week postoperatively in both groups. (6) These results confirm that during knee medial unicompartmental arthroplasty, intra-articular injection of tranexamic acid combined with 3 hours of blood occlusion can effectively reduce drainage volume, perioperative blood loss, blood transfusion, is beneficial to the early recovery of knee jointfunction after replacement, and does not increase the risk of lower extremity deep venous thrombosis.

Objective To study the growth suppressive effect of demethylation drug 5-aza-2'-deoxycytidine on bladder tumor cells. Methods The growth suppressive effect of DAC on 4 transitional cell carcinoma (TCC) cell lines was measured using the Cell Proliferation Reagent WST-1 assay.The effects of DAC on apoptosis induction and cell cycle arrest were analyzed by flow cytometric analysis. Caspase 3, 9 activities were analyzed by APOPCYTO Caspase Colorimetric Assay Kit and PCNA expression was also investigated by Western blot to clarify the mechanism of DAC against TCC. Results DAC inhibited the growth of all TCC cell lines tested in a dose-dependant manner, however,growth suppressive effect of DAC was independent of p53 status in TCC. DAC inhibited proliferation via inducing G2/M cell cycle arrest but not via inducing apoptosis. After treated with 0, 1 and 8 μmol/L DAC, cells of RTl 12 in G2/M phase was (36.3 ± 3.4) %, (46.2 ± 4.6) % and (56.5 ±6.2) %, TCCsup was (37.5 ± 3.8) %, (48.4 ±4.9) % and (60.1 ± 6.7) %, respectively. The expression of PCNA was decreased by DAC, but caspase3, 9 activities were not activated. Conclusion DAC could suppress the growth of TCC cells and might be a new strategy to treat bladder malignancy in the future.