ObjectiveTo explore the role of neuroimaging features monitored by functional near-infrared spectroscopy （fNIRS） in postoperative delirium （POD） in elderly patients undergoing joint replacement during perioperative period， and to provide a basis for early clinical prediction. MethodsA total of 105 elderly patients who underwent joint replacement under general anesthesia were included. The Mini-Mental State Examination （MMSE） scale was used to evaluate the patient's cognition one day before the operation. Before the start of the surgery， fNIRS was used to monitor the changes of cerebral blood oxygen saturation when the patient performed the task state. The 3-minute delirium diagnostic scale （3D-CAM scale） was used to evaluate the occurrence of POD at 24， 48 and 72 h after operation. Brain network analysis was performed and Logistic regression analysis was used to explore the relationship between fNIRS monitoring data and POD in elderly patients undergoing joint replacement surgery during preoperative task state. The receiver operating characteristic curve （ROC curve） was constructed to evaluate the diagnostic efficacy， and the Hosmer-Lemeshow goodness-of-fit test was used to test the goodness of fit of the model. ResultsAmong 105 patients， 100 cases were effectively analyzed， of which 20 cases （20%） had POD. Brain network analysis showed that the r value of functional connectivity correlation coefficient in POD group （0.069±0.118） was lower than that in non-POD group （0.073±0.084）. The low channel connectivity of right primary somatosensory cortex-right primary motor cortex （RS1-RM1） and left anterior pole-right Broca's triangle （LFP-RBA44） was an important factor affecting the occurrence of POD （P < 0.05）. Based on this result， the area under the ROC curve was 0.797 and 0.784， respectively. The results of Hosmer-Lemeshow goodness-of-fit test showed that the model fitted well （all P>0.5）. ConclusionThe neuroimaging features extracted from the cerebral oxygen saturation data monitored by fNIRS are significantly correlated with the risk of POD in elderly patients undergoing joint replacement during perioperative period. Among them， the low connectivity of preoperative RS1-RM1 and LFP-RBA44 brain network channels is an important influencing factor of POD occurrence. Predicting the occurrence of POD based on fNIRS is conducive to the early intervention and risk reduction of perioperative complications， improving medical quality and promoting precision medical practice.

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.