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

With the increasing proportion of laboratory projects in the revenue of public hospitals,how to adjust the prices of labo-ratory projects and improve the income structure of public hospitals has become one of the important contents of China's medical re-form.It is based on a systematic introduction and summary of the pricing methods for inspection projects in British Columbia,Canada,the US,and WHO.Combining with China's national conditions,it proposes three policy recommendations:establishing a cost cal-culation system and cost calculation tools for inspection projects,adopting differentiated pricing strategies based on social medical secu-rity levels,and regularly reviewing and updating the prices of inspection projects.

It summarizes the practical experience of medical insurance payment methods for medical services provided by Canadian medical staff,covering payment methods for medical services and alternative payment methods.Taking into account the current situation and conditions of the medical insurance payment method for medical services provided by medical personnel in China,it proposes policy recommendations for exploring diversified payment models,introducing direct settlement of health insurance,optimizing payment methods,considering regional differences,and ensuring the long-term sustainability of healthcare personnel health insurance payment methods.

OBJECTIVE To study the therapeutic effect of saikosaponins and paeoniflorin on rats with premenstrual dysphoric disorder(PMDD) model of liver Qi depression and the effect on neurotransmitters in hippocampal brain area. METHODS The PMDD rat model of liver Qi depression was prepared by the time-chosen chronic restraint stress method, and the depressive symptoms of rats were evaluated by the intervention of saikosaponins and paeoniflorin, the open field experiment and forced swimming experiment, and the changes of neurotransmitter levels in the hippocampal brain region of rats were detected by UHPLC-MS/MS target metabolomics. RESULTS The levels of 5-HT, Glu, GABA and NE in the hippocampal brain area of PMDD rats were significantly increased, and the levels of 5-HT, Glu, GABA, NE, DA and E were not statistically significant from those of the normal group after the intervention of saikosaponins and paeoniflorin. CONCLUSION Saikosaponins and paeoniflorin alleviates depression in rats with PMDD by regulating neurotransmitter levels, and it may be the pathway for the clinical treatment of PMDD with liver qi depression in the formulations of Bupleuri Radix and Paeoniae Radix Alba.

Objective:To investigate the training status of robotic-assisted surgery nurses in hospitals with robotic-assisted surgery system in China, and to provide reference for the training and management of robotic-assisted surgery nurses.Methods:From August to December in 2021, hospitals with robotic-assisted surgery system in China were surveyed by a self-designed questionnaire distributed online.Results:The participants in the survey of 111 hospitals in 30 provinces, cities, autonomous regions and municipalities directly under the central government, nurses cooperated with robotic-assisted surgery exist the phenomenon of their own training was up to 96.40% (107/111) of hospital, 47.75% (53/111) of the hospital said the current training content also need to add other aspects of the course. Training duration of theoretical courses was 0-13 (2.86 ± 3.03) periods arranged by hospitals, and the training duration of practical courses was 1-60 (8.38 ± 9.91) d. 35.14% (39/111) of hospitals set up regular assessment after training, and the assessment cycle of them was 1-12 (4.08 ± 3.31) months. Many hospitals put forward suggestions on strengthening English training and attaching importance to team cooperation and so on.Conclusions:In our country, Robotic-assisted surgery nurses′ training has turned to that training themselves in operating rooms, the training time, form, content and other aspects have no uniform standard, strict admittance, standardization of specialist training , these are questions need to solve.

Objective The objective of this study was to investigate and understand the life quality and its influencing factors in breast cancer patients with chemotherapy. Methods Based on the European Research and Treatment Association,the EORTC-BR53 scale consisting of QLQ-C30 and QLQ-BR23 was used as the main basis to design a questionnaire to investigate the life quality of breast cancer patients with chemotherapy. The rank sum test was used to evaluate the survival of breast cancer patients with chemotherapy. The grade logistics univariate and multivariate analyses were used to analyze the factors of prognosis and life quality of breast cancer patients. Results The median fun scores of QLQ-BR23 scale in the groups of <35 months,36~59 months and more than 60 months were 0,0,and 66. 67,respectively( P<0. 05). The median scores of annoy caused by alopecia were 33. 33,33. 33, and 10. 33 in three groups mentioned above,respectively(P<0. 05). The median scores of physical function of QLQ-C30 scale for modified radical mastectomy,segment plus sentinel and breast-conserving patients were 66. 67,66. 67,and 73. 33,respectively(P<0. 05). The median scores of nausea and vomiting in the modified radical mastectomy was 16. 67,and others were 0;the median scores of shape physique of QLQ-BR23 in three groups were 91. 67,100 and 100,respectively( P<0. 05);the median scores of sexual function were 0,16. 67 and 50,respectively(P<0. 05),and the median scores of sexual fun were 0,33. 33 and 66. 67,respectively(P<0. 05). To analyze the total symptoms of life quality,causing borrow money and pathological classification were the factors affecting the total life quality of breast cancer patients with chemotherapy(P<0. 05). The total symptoms of life quality were analyzed. Univari-ate analysis showed that borrows money due to illness and ductal carcinoma in pathological classification had significant. Conclusion The life quality of breast cancer patients with chemotherapy is mainly related to the pathological stage of patients and whether they have economic pressure.

Objective The objective of this study was to investigate the relationship between the methylation of phosphodies-terase 4C(PDE4C)gene in peripheral blood leukocytes,and its interaction with environmental factors and the pathogenesis of breast cancer. Methods A case-control study was conducted to select 402 cases of breast cancer and 470 cancer-free controls from Octo-ber 2010 to December 2014. The specific DNA methylation-modified quantitative PCR method was used to detect the methylation of PDE4C gene. The use of crossover analysis and multivariate logistic regression was used to analyze the relationship between the level of gene methylation and its interaction with environmental factors and the pathogenesis of breast cancer. Results PDE4C methylation was not found to be significantly associated with the onset of breast cancer. High-frequency/high-intake of whole grains,vegetables, onion-based plants,poultry,milk,and regular exercise could reduce the risk of breast cancer;high-frequency/high-intake of pork, irregular menstrual cycle,and a high psychological stress index could increase the risk of breast cancer. PDE4C hypermethylation had a significant combining effect with edible onion-producing plants greater than 3 times/week,with an OR of 0. 373(95% CI:0. 208~0. 668,P=0. 001). Conclusion Hypermethylation of PDE4C is not an independent risk factor for breast cancer,and its combination with environmental factors affects the risk of breast cancer.

To establish a time-resolved fluorescence immunochromatographic assay for quantitative determination of carbohydrate antigen 19-9 (CA19-9) in serum, we prepared CA19-9 test strips by integrating double-antibody sandwich method and fluorescence immunochromatography technique. Carboxy fluorescent microspheres and nitrocellulose membrane were used as carriers for labeling and coating CA19-9 pairing antibodies. We optimized the process by adjusting the amount of labeling and coating antibody. According to the linear range, lowest detection limit and precision, We evaluated the time-resolved fluorescence immunochromatographic assay of CA19-9. When the amount of labeled antibody was 80 μg for 20 μL fluorescent microspheres, and the concentration of coated antibody on the test line was 1.5 mg/mL, the optimal reaction time was 15 minutes. Assay linear range was 12.5 to 800 U/mL and the minimum detection limit was 6.32 U/mL. The Within-run and between-run coefficient of variation were less than 15%. Average recovery rate was 101%. By detecting 50 clinical samples in parallel with Roche electrochemical luminescence detection kit, correlation coefficient was 0.980 6. The experiment, initially established a fluorescence immunochromatographic detection method to quantitative detection of serum CA19-9, which has a good clinical application prospect.

Objective To explore the interaction between family history of diabetes and hyperlipidemia on the risk of diabetes in population with normotension.Methods A multistage stratified probability random sampling was conducted to select a representative sample of urban residents aged 20-74 years in Harbin.A total of 376 diabetes patients with normotension and 3 692 residents with normal blood pressure,normal fasting glucose,and normal 2 hours glucose from OGTT were surveyed.The interaction was evaluated by using crossover analysis and additive model.Results Multivariate logistic regression analysis indicated that there was a possible additive interaction between family history of diabetes and hyperlipidemia on the risk of diabetes.The relative excess risk due to the interaction,the attributable proportion due to the interaction,and the synergy index were 1.97 (95％CI:-0.32-4.26),0.30 (95％CI:0.03-0.57),and 1.54 (95％CI:0.96-2.47),respectively.There were significant combination effects between family history of diabetes and high both total cholesterol and triglyceride,isolated high total cholesterol,and isolated high triglyceride levels;the ORs were 10.55 (95％CI:5.62-19.80),7.81 (95％CI:3.65-16.71) and 5.13 (95％CI:3.22-8.16),respectively.Conclusion There might be synergistic effect between family history of diabetes and hyperlipidemia on the risk of diabetes in population with normotension.

OBJECTIVE:To evaluate the association between UGT1A1 gene polymorphism and irinotecan-induced 3-4 degree neutropenia,and to provide evidenced-based reference for clinical treatment. METHODS:Retrieved from CJFD,Wanfang data-base,VIP,PubMed,EMBase,Science direct and Cochrane library,related studies about UGT1A1*28 and UGT1A1*6 gene polymorphism and irinotecan-induced 3-4 degree neutropenia were collected. After data extraction and quality evaluation of included studies,Meta-analysis was conducted by using Review Man 5.3 software. RESULTS:A total of 29 studies were included,involv-ing 2408 patients. UGT1A1*28 includ wild genotype TA 6/6(UGT1A1*1/*1)and mutations genotype TA 6/7(UGT1A1*1/*28)、TA 7/7(UGT1A1*28/*28),UGT1A1*6 includ wild genotype GG and mutations genotype GA、AA. Results of Meta-analysis showed:the incidence of 3-4 degree neutropenia in UGT1A1*28 and UGT1A1*6 mutations genotype were significantly higher than wild genotype,with statistical significance [UGT1A1*28:OR=1.92,95%CI(1.52,2.44),P<0.001;UGT1A1*6:OR=2.49, 95%CI(1.46,4.26),P<0.001]. Using medium-dose and high-dose of irinotecan,the incidence of 3-4 degree neutropenia in UGT1A1*28 and UGT1A1*6 mutations genotype were significantly higher than wild genotype,with statistical significance [UGT1A1*28:OR=2.06,95%CI(1.57,2.70),P<0.001);UGT1A1*6:OR=1.92,95%CI(1.35,2.74),P<0.001]. Using low-dose of irinotecan,there was no statistical significance in the incidence of 3-4 degree neutropenia between UGT1A1*28,UGT1A1*6 mutations genotype and wild genotype [UGT1A1*28:OR=1.20,95%CI(0.70,2.08),P=0.51;UGT1A1*6:OR=3.19,95%CI (0.85,11.89),P=0.08]. CONCLUSIONS:Using medium-dose and high-dose of irinotecan,UGT1A1*28 and UGT1A1*6 muta-tions will increase the risk of severe neutropenia in cancer patients. Using low-dose of irinotecan,there is no clear correlation be-tween gene polymorphism and the neutropenia.