Objective:To explore the current situation of rehabilitation resource and the influencing factors of rehabilitation nursing needs of patients at home in Xuzhou so as to provide a reference for home rehabilitation for patients.Methods:From October 2018 to December 2018, this study investigated all rehabilitation medical institutions (rehabilitation specialized hospitals, general hospitals with Rehabilitation Department, community health service institutions) in Xuzhou City by general investigation. Rehabilitation specialized hospitals in Xuzhou were investigated with the method of field visit and questionnaire survey, and the investigation content included the situation and professional categories of rehabilitation professionals. At the same time, totals of 411 patients with the needs for rehabilitation in Xuzhou were investigated, and the investigation content included the basic situation, rehabilitation needs of patients, contract service by family doctors. This study also analyzed the influencing factors of home rehabilitation nursing needs by Logistic regression.Results:There were 120 rehabilitation medical institutions in Xuzhou City. The bed number was 2 675 accounted for 57.98% (2 675/4 314) of the bed number shall be equipped with. There were 402 rehabilitation physicians, 432 rehabilitation nurses and 808 rehabilitation therapists respectively occupied 31.07% (402/1 294) , 16.69% (432/2 588) and 31.22% (808/2 588) of the planning. There were 30.90% (127/411) of rehabilitation patients signed a contract with community doctors, and 45.67% (58/127) of them dissatisfied with community doctors service and the satisfaction rate was 18.90% (24/127) . The influencing factors of family doctor contract included the ages of patients ( OR=0.557) , history of hemiplegia ( OR=1.520) and the number of community doctors ( OR=1.131) . The young the ages were, the better the contract degrees were. The factors promoted the contract were hemiplegia and increasing in the number community doctors. Conclusions:In Xuzhou, the rehabilitation medical resource allocation cannot meet the needs of the masses. The insufficient rehabilitation medical resource allocation reflected in the lack of rehabilitation talents, rehabilitation medical institutions and rehabilitation equipment. The rate of family doctors contract service was in the low level, and there are still great difficulties in the home rehabilitation.

BACKGROUND: In recent years, a number of clinical trials have shown that immunocheckpoint inhibitors (ICI) have brought survival benefits to patients with advanced non-small cell lung cancer (NSCLC), however, such clinical trials comprise cohorts selected based on strict and complex entry and exclusion criteria, and the results cannot fully reflect the real world situation. The purpose of this study was to investigate the clinical efficacy and safety of immunotherapy in the real world, as well as possible prognostic factors. METHODS: Patients with advanced NSCLC receiving immunotherapy in Beijing Chest Hospital from January 2017 to July 2019 were retrospectively collected, and the following information were collected: curative effect, progression-free surival (PFS) and adverse reactions. The occurrence of adverse reactions and clinical curative effect and prognosis factors that may be relevant were explored. RESULTS: 34 patients were enrolled in this study, median PFS was 5.66 months (95%CI: 4.48-6.84), grade 1-2 and 3-4 incidence of adverse events was 61.71% (22/34) and 14.71% (5/34), there were 3 patients (8.82%) experienced fatal immune related adverse events (irAE), 2 cases were immune associated pneumonia, 1 case was immune related myocarditis. Univariate analysis showed that tumor-node-metastasis (TNM) stage and metastatic site were correlated with median PFS (P<0.05), and multivariate analysis showed that patients with extrapulmonary metastasis (OR=6.42, P=0.029) and pleural metastasis (OR=14.14, P=0.006) had shorter median PFS. CONCLUSIONS In the real world, immunotherapy has good efficacy in patients with advanced NSCLC, but the incidence of severe irAE is also higher. Distant metastasis and pleural metastasis are poor prognostic factors for advanced NSCLC patients receiving immunotherapy.