BACKGROUND: As an essential part of health services, rehabilitation is of great significance to improve the health and quality of life of the whole population. Accelerating aging calls for a significant expansion of rehabilitation services in China, but rehabilitation needs remain unclear. We conducted the study to explore the rehabilitation needs in China and project the trend of rehabilitation needs from 2020 to 2034. METHODS: The data of health conditions that might potentially benefit from rehabilitation were obtained from Global Burden of Disease (GBD) study. Estimated annual percentage changes (EAPCs) were calculated to quantify the trends of the age-standardized rates. Projections of rehabilitation needs were made until 2034 using Bayesian age-period-cohort analysis (BAPC). RESULTS: Approximately 460 million persons (33.3% of the total population) need rehabilitation in China, contributing to 63 million years lived with disabilities (YLDs) in 2019. The number of prevalent cases that need rehabilitation increased from around 268 (95% uncertainty interval [UI]: 257-282) million in 1990 to almost 460 (95% UI: 443-479) million in 2019, representing an increase of 71.3%. The highest contribution to the need for rehabilitation was musculoskeletal disorders with about 322 (95% UI: 302-343) million persons in seven aggregate disease and injury categories, and hearing loss with over 95 (95% UI: 84-107) million people among 25 health conditions. Based on the projection results, there will be almost 636 million people (45% of the total population) needing rehabilitation services in China by 2034, representing an increase of 38.3%. The rehabilitation needs of neoplasms, cardiovascular diseases, and neurological disorders are expected to increase significantly from 2019 to 2034, with increases of 102.3%, 88.8% and 73.2%, respectively. CONCLUSIONS The need for rehabilitation in China substantially increased over the last 30 years. It is predicted that over two in five people will require rehabilitation by 2034, thus suggesting the need to develop rehabilitation services that meet individuals' rehabilitation needs.
Humans ; China/epidemiology* ; Global Burden of Disease ; Female ; Male ; Musculoskeletal Diseases/epidemiology* ; Rehabilitation/trends* ; Quality of Life ; Middle Aged ; Aged ; Bayes Theorem

Objective:To explore the therapeutic effect of peroral endoscopic myotomy (POEM) for primary achalasia (AC) in patients aged over 60 years.Methods:Data of 146 patients aged ≥60 years (the elderly group) and 146 patients aged 18-59 years (the adult group) who received POEM from November 2010 to September 2019 at the Digestive Endoscopy Center of PLA General Hospital were retrospectively analyzed. Baseline data, surgery data, surgery-related complications and surgery-related efficacy were compared.Results:There was no significant difference in gender, Ling classification, HRM classification or previous treatment between the two groups ( P>0.05). All 292 patients successfully underwent POEM surgery. The clinical success (Eckardt score ≤3) rates in the elderly group and the adult group were 96.33% (105/109) and 96.77% (90/93), respectively with no significant difference between the two groups ( χ2=0.030， P>0.05). There was no significant difference in the length of myotomy between the two groups (7.09±2.49 cm VS 7.12±2.24 cm， t=0.472， P>0.05). Complications occurred in 26 cases (17.81%) in the elderly group and 21 cases (14.38%) in the adult group with no significant difference between the two groups ( χ2=0.634， P>0.05). There was no significant difference in the postoperative hospital stay (12.61±9.69 days VS 11.00±4.43 days, t=1.825, P>0.05) or the incidence of gastroesophageal reflux [43.33% (13/30) VS 51.52% (17/33), χ2=0.422, P>0.05] between the elderly group and the adult group. Conclusion:The efficacy of POEM for AC patients over 60 years old is equivalent to that of adult patients, and the incidence of complications is similar. POEM is safe and effective for AC patients over 60 years old.

Objective To study the thyroid volume(TV) of patients with autoimmune thyroid disease (AITD) and the iodine intake and the factors associated with the goiter of patients with AITD.Methods Questionnaires,physical examination,urinary iodine concentration and thyroid B ultrasound were performed in cases of newly diagnosed patients with AITD.Result The TV of patients with AITD did not associated with the urinary iodine concentration (P ＞ 0.05).The TV associated with patients gender and age and goiter of palpation (P ＜ 0.05).Conclusion The U-shape relation did not show between iodine and goiter in patients with AITD.The goiter of patients with AITD did not associated with the iodine intake.

BackgroundThe relationship between lipids and coronary artery disease has been well established. However, this is not the case between lipids and heart failure. Ironically, high lipid levels are associated with better outcomes in heart failure, but the mechan-isms underlying the phenomenon are not fully understood. This study was performed to test the hypothesis that reduced intestinal lipid absorption due to venous congestion may lead to low lipid levels.MethodsWe collected data of clinical characteristics, echocardio-graph, and lipid profile in 442 unselected patients with congestive heart failure. Correlations between lipid levels[including total cho-lesterol(TCL), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), and triglycerides(TG)]and right ventricle end diastolic diameter (RVEDD), left ventricle end diastolic diameter (LVEDD), right atrium diameter (RA), left atrium diameter (LA), or left ventricle ejection fraction (LVEF) were analyzed using Pearson correlation and partial correlation. RVEDD, LVEDD, RA, and LA were indexed to the body surface area.ResultsThere was a significantly inverse correlation between TCL le-vels and RVEDD (r=-0.34,P<0.001) and RA (r=-0.36,P<0.001). Other lipids such as LDL-C, HDL-C, and TG had asimilar inverse correlation with RVEDD and RA. All these correlations remained unchanged after adjusting for age, gender, smoking status, physical activity levels, comorbidities, and medication use.ConclusionsLipid levels were inversely correlated to RVEDD in patients with congestive heart failure; however, because this was an observational study, further investigation is needed to verify our results as wellas identify a causal relationship, if any.

Objective To study The effect of anti-depression treatment on endothelial function of coronary artery disease (CAD)and depressive disorder.Methods 120 CAD patients with depressive disorder treated in our hospital from September 2007 to February 2009 were ran-domized to control group (n =58)and treatment group (n =62).The patients in both groups were given conventional treatment and psychological intervention,and the patients in treatment group were added 20 mg Citalopram tablets every night.Scores of Hamilton Depression Rating Scale(HAMD)of the patients were measured and endothelial function of the patients were evaluated at 8 weeks before and after the treatment.Results After 8 week treatment,the HAMD score was (7.60±3.49)in treatment group and (20.58±3.20)in control group,the difference was signifi-cant after comparison of two groups (P <0.01).The values of FMD% were respectively (4.69± 0.58)in treatment group and (4.45±0.69)in control group which revealed that the difference was significant (P <0.05).Conclusion Citalopram can significantly improve depression and en-dothelial function of CAD patients with depression.

Objective To study The effect of anti-depression treatment on endothelial function of coronary artery disease (CAD)and depressive disorder.Methods 120 CAD patients with depressive disorder treated in our hospital from September 2007 to February 2009 were ran-domized to control group (n =58)and treatment group (n =62).The patients in both groups were given conventional treatment and psychological intervention,and the patients in treatment group were added 20 mg Citalopram tablets every night.Scores of Hamilton Depression Rating Scale(HAMD)of the patients were measured and endothelial function of the patients were evaluated at 8 weeks before and after the treatment.Results After 8 week treatment,the HAMD score was (7.60±3.49)in treatment group and (20.58±3.20)in control group,the difference was signifi-cant after comparison of two groups (P <0.01).The values of FMD% were respectively (4.69± 0.58)in treatment group and (4.45±0.69)in control group which revealed that the difference was significant (P <0.05).Conclusion Citalopram can significantly improve depression and en-dothelial function of CAD patients with depression.

Background Hyperuricemia is frequently present in patients with heart failure. Many pathological conditions, such as tissue ischemia, renal function impairment, cardiac function impairment, metabolic syndrome, and inflammatory status, may impact uric acid (UA) metabolism. This study was to assess their potential relations to UA metabolism in heart failure. Methods We retrospectively assessed clinical characteristics, echocardiological, renal, metabolic and inflammatory variables selected on the basis of previous evidence of their involvement in cardiovascular diseases and UA metabolism in a large cohort of randomly selected adults with congestive heart failure (n = 553). By clustering of indices, those variables were explored using factor analysis. Results In factor analysis, serum uric acid (SUA) formed part of a principal cluster of renal functional variables which included serum creatinine (SCr) and blood urea nitrogen (BUN). Univariate correlation coefficients between variables of patients with congestive heart failure showed that the strongest correlations for SUA were with BUN (r = 0.48, P < 0.001) and SCr (r = 0.47, P < 0.001). Conclusions There was an inverse relationship between SUA levels and measures of renal function in patients with congestive heart failure. The strong correlation between SUA and SCr and BUN levels suggests that elevated SUA concentrations reflect an impairment of renal function in heart failure.

Objective To investigate a feasibility of treatment planning in thoracic esophageal carcinoma with 3-deoxy-3-fluorothymidine (FLT) PET-CT and to compare with fluorodeoxyglucose (FDG) PET-CT based on dosimetric analysis.MethodsTwenty-two patients with esophageal squamous cell carcinoma detected by FLT and FDG PET-CT were enrolled.The gross tumor volumes ( GTV ),clinical target volume(CTV) and planning target volume ( PTV ) were delineated using treatment planning system of Philips Pinnacle3 based on the optimal threshold of FLT and FDG PET-CT respectively,and to make two groups simulation treatment planning.The parameters of dose-volume histograms in two groups planning were compared in the similar direction and ensuring prescribed dose line surround 95% target volume.Results The values of GTV,CTV and PTV in FLT PET-CT planning were less than those of FDG,that dose received by spinal cord in two planning were not significantly yet ( t = - 1.60,- 1.55,all P ＞ 0.05 ).While,the values in mean lung dose,V5,V10,V30,V40 and V50 of bilateral lung,mean heart dose,and V30 of heart in FLT PET-CT planning were significant lower than those of FDG( t = -5.442 - -2.637,all P ＜0.05).Conclusions Compared with FDG,FLT PET-CT based treatment planning brings potential benefits for lungs and heart.

Objective To determine efficacy and safety of intensive lipid lowering with atorvastatin made in China in coronary artery disease(CAD)patients with high risk factors.Methods We enrolled 104 CAD patients admitted to our hospital with high risk Factors.All patients were randomized to either low dose of atorvastatin group(n=50,10 mg/daily)or large dose of atorvastatin group(n=54,40 mg/daily)for 6 months.Total cholesterol(TC),low den- sity lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),triglycerides(TG),serum glucose,hepatic function,renal function,ereatine kinase(CK)of the patients were measured before treatment and at 1 month,3 months,6 months,respectively.Results After six-month treatment,LDL-C,TC,TG levels were reduced by 38.04%,29.37%,20.74%,respectively in the low dose atorvastatin group compared with baseline; whereas reduced by 49.14%,37.69%,26.98%,respectively in the high dose atorvastatin group as compared with baseline level.As for HDL-C,it was increase of 5.98% in low dose atorvastatin group and 3.48% in high dose atorv- astatin group.Responder rates were 54.00% in low dose of atorvastatin group and 79.24% in large dose of atorvastatin group.Much more patients in the high dose atorvastatin group achieved LDL cholesterol goal compare with low dose ator- vastatin group(P