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 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 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 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 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 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.

Objective To explore the unmet needs and service of rehabilitation for Chinese people with disabilities. Methods The unmet needs and services of rehabilitation data from the Second National Sample Survey of Disability and 2006-2016 Statistical Bulletin on the De-velopment of People with disabilities in China issued by China Disabled Persons Federation had been analyzed. Results The unmet needs of rehabilitation for people with disabilities in China were mainly included health care and support, assistive devices, rehabilitation therapy and services, poverty alleviation, accessible facilities, accessible information, and other rehabilitation needs. The highest rate of unmet needs of rehabilitation was in the fields of health care (34.84%) and poverty alleviation (33.25%). There were significant differences in unmet needs of rehabilitation among people with different types of disabilities (χ2=40322.1, P<0.01). For all the types of disabilities, 41.46%had not re-ceived any service and support, 30.45%received health care and support, and 0.55%received accessible information. The main approaches recommended by professionals for people with disabilities were institutional rehabilitation, and community and family based services. The main services recommended by professionals to people with psychiatric (68.18%) or visual disabilities (60.28%) were health care, to people with hearing disability (51.67%) were assistive device, and to people with intellectual (57.36%) and speech disability (47.06%) were rehabil-itation therapy and training. There were significant differences both in rehabilitation approaches and contents among people with different types of disabilities preferred by professionals (χ2=12489.9,χ2=52528.93, P<0.01). Conclusion The unmet needs of rehabilitation for people with different types of disabilities were mainly included health care and assistance, assistive devices, rehabilitation training and services, and poverty alleviation. There were significant differences among people with different types of disabilities. For service delivery, the highest rate was in health care and assistance. The gap between the service and unmet needs of poverty alleviation for people with disabilities in China was the highest. There were significant differences in rehabilitation approaches and contents recommended by professionals among people with different types of disabilities. It was recommended to construct the national and local system of policy support system and rehabilita-tion service governance, to provide precision rehabilitation services based on the unmet needs of rehabilitation, to develop the comprehen-sive rehabilitation service delivery to achieve the goal of rehabilitation for all, and to conduct scientific research on rehabilitation by using International Classification of Functioning, Disability and Health to provide evidence and support for the development of rehabilitation.

Objective To study the impact of the off-pump coronary artery bypass compared to the on-pump coronary artery bypass technique on the rate of acute kidney injury.Methods A retrospective analysis of 824 patients accepted coronary artery bypass surgery in FuWai Hospital Surgical ICU from March 2011 to January 2013.Patients were divided into two groups according to the surgical approach,597 patients in on-pump group and 227 patients in off-pump group.Then compared the difference of acute kidney injury incidence in the two groups.Results 92 patients in the on-pump group occurred AKI,the incidence of AKI was 15.4％.32 patients in the off-pump group occurred AKI,the incidence of AKI was 14.1％.Two groups of patients had no statistical difference in the incidence of AKI,x2 =0.222,P =0.638.Based on the preoperative baseline creatinine clearance levels.We defined normal creatinine clearance (SCR ≥ 60 ml/min),mild renal insufficiency (45 ml/min ＜ SCR ＜60 ml/min),moderate renal dysfunction group(31 ml/min ＜ SCR ＜45 ml/min).Decline with the preoperative creatinine clearance rate,the AKI incidence was elevated significantly,P ＜0.05.Patients with moderate renal insufficiency,offpump patients had lower incidence of AKI than those in on-pump group,P ＜ 0.05.The incidence of renal replacement in the two group patients had no statistical differences.Conclusion The incidence of AKI after coronary artery bypass surgery had no statistical differences with or without pump.In the patients with preoperative moderate renal insufficiency,off-pump can reduce the incidence of AKI,but could not change the kidney the incidence of renal replacement treatment.