ObjectiveTo conduct a content analysis of the policy framework, core contents and priority areas of rehabilitation of physical activity and exercise in health service (RPAEHS) using World Health Organization (WHO) theory of six building blocks of health service, and to explore the policy framework, action strategies and implementation methods of RPAEHS at macro, meso and micro levels.MethodsBased on WHO Rehabilitation in Health Systems and Rehabilitation in Health Systems: A Guide to Action, together with their accompanying use tools and other policy documents, a content analysis approach was applied to explore the policy framework as well as action strategies, core contents and priority development areas of RPAEHS. ResultsRPAEHS is an integral part of modern rehabilitation, based on the International Classification of Functioning, Disability and Health (ICF) theory of functioning, disability, and health, and the concept of person-centeredness, with measures to meet the needs of RPAEHS, integrated into the health service continuum, and contributing to the sustainable development goal of universal health coverage. The development of RPAEHS involves six major areas: leadership and governance, financing, human resources, service delivery, rehabilitation sports equipment/technology/facilities, and RPAEHS monitoring and evaluation, and information systems. In the area of RPAEHS regulations, policies and governance, the state formulate laws and regulations, policy documents, and action guidelines for the development of RPAEHS to enhance government leadership and governance; broaden the funding channels for RPAEHS and optimize the funding allocation programs; improve the RPAEHS personnel training system, match RPAEHS professionals to the three levels of health and health services, and ensure that people with functioning who have RPAEHS needs can access the different levels of the health system; improve the utilization and accessibility of assistive technologies and products; and establish a monitoring and evaluation mechanism for services and health information system with big data to provide a scientific research base and data support for evidence-based related research. ConclusionRPAEHS is a series of health-related measures that use physical activity and exercise as the fundamental means to address the physical function and structure, activity and participation, and environmental and personal factors of people with functioning. RPAEHS interventions involve prevention, treatment, rehabilitation and health promotion, with the ultimate goal of promoting maximum functioning, quality of life, and well-being for people with functioning. The development of RPAEHS needs to approach from six health service components: leadership and governance, financing, human resources, service delivery, equipment/technology/facilities, and health monitoring evaluation and information systems. The policy framework, priority areas, and their core components for rehabilitation sport are constructed at three levels: macro-level policy and governance framework, meso-level action strategies and implementation, and micro-level implementation practices and monitoring and evaluation. The priority areas of RPAEHS and their core contents are mainly involved in the fields: strengthening the leadership and governance, planning and coordination capacity of RPAEHS; constructing an appropriate RPAEHS funding mechanism; developing RPAEHS human resources; improving the coverage, accessibility, effectiveness and service quality of RPAEHS; developing RPAEHS assistive technologies and products; establishing RPAEHS monitoring and evaluation and information systems, and conducting related research.

Objective     To investigate the influence of prior percutaneous coronary intervention (PCI) on the outcome of coronary artery bypass grafting (CABG). Methods     Clinical data of 5 216 patients from Jiangsu Province CABG registry who underwent primary isolated CABG from 2016 to 2019 were retrospectively analyzed. Patients were divided into a PCI group (n=673) and a non-PCI group (n=4 543) according to whether they had received PCI treatment. The PCI group included 491 males and 182 females, aged 62.6±8.2 years, and the non-PCI group included 3 335 males and 1 208 females, aged 63.7±8.7 years. Multivariable logistic regression and propensity score matching (PSM) were used to compare 30-day mortality, incidence of major complications and 1-year follow-up outcomes between the two groups. Results     Both in original cohort and matched cohort, there was no statistical difference in the 30-day mortality [14 (2.1%) vs. 77 (1.7%), P=0.579; 14 (2.1%) vs. 11 (1.6%), P=0.686], or the incidence of major complications (myocardial infarction, stroke, mechanical ventilation≥24 h, dialysis for new-onset renal failure, deep sternal wound infection and atrial fibrillation) (all P>0.05). The rate of reoperation for bleeding in the PCI group was higher than that in the non-PCI group [19 (2.8%) vs. 67 (1.5%), P=0.016; 19 (2.8%) vs. 7 (1.0%), P=0.029]. Both in original cohort and matched cohort, there was no statistical difference in 1-year survival rate between the two groups [613 (93.1%) vs. 4 225 (94.6%), P=0.119; 613 (93.1%) vs. 630 (95.2%), P=0.124], while the re-admission rate in the PCI group was significantly higher than that in the non-PCI group [32 (4.9%) vs. 113 (2.5%), P=0.001; 32 (4.9%) vs. 17 (2.6%), P=0.040]. Conclusion     This study shows that a history of PCI treatment does not significantly increase the perioperative mortality and major complications of CABG, but increases the rate of cardiogenic re-admission 1 year postoperatively.

Objective:To observe the efficacy of gemcitabine and oxaliplatin combined with targeted drug apatinib in the treatment of gallbladder cancer.Methods:The data of 82 patients with gallbladder cancer who were admitted to Haiyang People's Hospital, Yantaishan Hospital and Rongjun Hospital of Yantai City in Shandong Province from May 2017 to December 2018 were retrospectively analyzed. The patients were divided into control group and observation group according to the medication, with 41 cases in each group. Patients in the control group were treated with gemcitabine combined with oxaliplatin regimen (gemcitabine 1 000 mg/m 2 was injected intravenously for 30 minutes on the 1st and 8th day, and oxaliplatin 100 mg/m 2 was injected intravenously for 3 hours on the 1st day), the observation group was combined with apatinib mesylate 500 mg/d based on the treatment method of the control group. The treatment effect, serum tumor marker levels, adverse reactions and survival were compared between the two groups. Results:The disease control rate of the control group was 70.73% (29/41), which was significantly lower than that of the observation group [92.68% (38/41)] ( χ2 = 6.609, P < 0.05). After treatment, the levels of vascular endothelial growth factor (VEGF), carcinoembryonic antigen (CEA), soluble interleukin-2 receptor (sIL-2R) and Dickkopf-1 in the observation group were significantly lower than those in the observation group, and the differences were statistically significant ( t values were 6.011, 3.048, 4.444, and 4.514, all P < 0.05). The incidence of proteinuria and hand-foot syndrome in the observation group were significantly lower than those in the control group, and the differences were statistically significant ( χ2 values were 6.116 and 4.986, both P < 0.05). During the 1-year follow-up, 2 patients in the observation group died, and the survival rate was 95.13% (39/41); 8 patients in the control group died, and the survival rate was 80.49% (33/41). There was a statistical difference in the survival rate between the two groups ( χ2 = 4.100, P < 0.05). Conclusion:Gemcitabine and oxaliplatin combined with apatinib mesylate are effective in treating gallbladder cancer, which can effectively reduce serum tumor marker levels and improve the prognosis of gallbladder cancer patients.

Objective To study the effects of carpesium abrotanoides petroleum ether fraction on phagocytic function of macrophages and antibody forming cell in mice.Methods The extract carpesium abrotanoides petroleum ether fraction,forty five mice were divided into the control group and low and high dose groups of carpesium abrotanoides petroleum ether fraction by random number table method,15 mices in each group.The low-dose and high-dose groups of carpesium abrotanoides petroleum ether fraction were given 50 mg/kg and 100 mg/kg respectively by gavage for 10 days.The spleen weight,growth index,the phagocytosis of macrophages and the number of antibody-forming cells in peritoneal macrophages of mice were detected by chicken erythrocyte phagocytosis test and hemolytic plaque test.Results Compared with the control group,the spleen weight (192.4 ± 11.49 mg,204.6 4 10.59 mg vs.117.6 ± 10.89 mg),the growth index (6.04 ± 0.54,6.06 ± 0.40 vs.3.89 ± 0.14),antibody forming (1 216.4 ± 94.1,1 548.8 ± 86.4 vs.361.0 ± 11.7),phagocytosis percentage of macrophages (58.60％ ± 2.60％,72.0％ ± 3.08％ vs.35.49％ ± 1.64％),and Phagocytosis index (2.01 ± 0.10,2.69 ± 0.15 vs.0.37 ± 0.06) of the groups of low doses and high doses of Carpesium abrotanoides Petroleum ether fraction significantly increased (P＜0.05).Conclusions The low doses and high doses of Carpesium abrotanoides Petroleum ether fraction can enhance the mice's specific and nonspecific immune function,and protect the immune system of mice.

Objective To compare the safety and clinical efficacy of transcatheter closure for ruptured aortic sinus aneurysm (RASA) with those of surgical treatment.Methods A total of 31 successive patients with RASA,who were treated in a single center during the period from October 2003 to May 2017,were enrolled in this study.Among them,11 patients received transcatheter closure therapy,their mean age was (36.64±10.87) years old;20 patients received surgical closure,their mean age was (28.90± 10.06) years old.The technical success rate,complications,residual shunt,operation time,hospitalization days,amount of blood transfusion,medical expenses,etc.were compared between the two groups.Results No statistically significant differences in age,sex and preoperative cardiac functional grading established by the Heart Disease Association of New York (NYHA) existed between the two groups (P＞0.05).The technical success rates in transcatheter closure group and surgical closure group were 100％ (11/11) and 95％ (19/20)respectively (P＞0.05).The amounts of blood transfusion in transcatheter closure group and surgical closure group were 0 ml and (427.25±331.36) ml respectively (P＜0.01).The time spent for operation in transcatheter closure group and surgical closure group was (60.00±00.00) min and (205.50±129.35) min respectively (P＜0.05).Days staying in intensive care unit (ICU) in transcatheter closure group and surgical closure group were 0 day and (1.50±0.61) days respectively (P＜0.01).The residual shunt rates in transcatheter closure group and surgical closure group were 9.09％ (1/11) and 10.00％ (2/20) respectively.None perioperative death occurred in both groups.No statistically significant differences in hospitalization days and in medical expenses existed between the two groups (P＞0.05).Conclusion Both transcatheter closure and surgical closure are safe and effective for the treatment of ruptured RASA,although transcatheter closure therapy has more advantageous in aspect of minimally-invasive management,operative time and length of hospital stay.For patients with a RASA which position is suitable for percutaneous interventional management,transcatheter closure therapy should be employed as a preferred therapy.

Objective: To prepare a new type of phycocyanin/carboxymethyl chitosan-CD55 ligand peptide (CPC/CMC-CD55sp) nanospheres, and to study its targeted therapeutic effect on cervical cancer Caski cells. Methods: The novel CPC/CMC-CD55sp nanospheres (CPC/CMC-CD55sp) were synthesized by ionic cross-linking method, and the properties of nanospheres were observed by transmission electron microscopy (DLS) and fourier transform infrared spectroscopy (FTIR). The expression of CD55 on the surface of Caski and fibroblast (L-929) cells was detected by Western blotting and flow cytometry. The effect of nanospheres on the proliferation of Caski cells was detected by CCK-8. Flow cytometry and fluorescence microscopy were used to detect the uptake of microspheres by Caski cells; Western blotting and flow cytometry were used to detect the effect of CPC/CMC-CD55sp on expressions of apoptosis-related proteins and apoptosis rate in Caski cells; the hemolysis test was used to determine the biological safety of the drug. Results: CPC/ CMC-CD55sp was successfully prepared with good morphology and uniform diameter; and CD55 was highly expressed on the surface of Caski cells but low expressed on the surface of L-929 cells (P<0.01). CPC/CMC-CD55sp could targeted and efficiently reach Caski cells and be ingested into the cells. It exhibited weak hemolysis effect on human peripheral blood, which was in the safe range. CPC/ CMC-CD55sp displayed obvious inhibitory effect on Caski cell proliferation, and could induce cell apoptosis (P<0.05 or P<0.01). Conclusion: The new CPC/CMC-CD55sp can targeted inhibit the growth of cervical cancer Caski cells via inducing its apoptosis and has good bio-safety, which provides a new idea for the research and development of anti-tumor marine drugs.

OBJECTIVETo assess the accuracy of immunological fecal occult blood test (iFOBT) for detection of colorectal cancer (CRC).

METHODSA total of 1 197 studies published before June 2014 were selected from PubMed and Embase and 17 of which were finally included in this meta-analysis. A bivariate mixed-effects models was used for overall value merging and heterogeneity testing. In addition to the overall sensitivity and specificity, the analyses were also performed among certain subgroups, including a "colonoscopy group" (all were referred for colonoscopy diagnosis regardless screening results) and a "follow-up group" (only the screening positive were referred and all were then followed up), a qualitative group and a quantitative group (classified by the way of iFOBT result reading).

RESULTSA total of 161 502 subjects aged from 48 to 63 years were included in the analysis. IFOBT had an overall integrated sensitivity of 0.85 (95% CI: 0.79-0.89) (heterogeneity test: Q = 59.67, P < 0.001) and an overall integrated specificity of 0.93 (95% CI: 0.92-0.94) (heterogeneity test: Q = 1 722.53, P < 0.001) for detection of CRC. In the subgroup analysis, it was found that in the "colonoscopy group" and in the "follow-up group", the sensitivity were 0.81 (95%CI: 0.73-0.87) and 0.88 (95% CI: 0.81-0.92), respectively; the specificity were 0.92 (95% CI: 0.89-0.93) and 0.95 (95% CI: 0.94-0.96), respectively. It was also found that in the qualitative group and the quantitative group, the sensitivity were 0.84 (95% CI: 0.76-0.90) and 0.86 (95% CI: 0.78-0.92), respectively; the specificity were 0.94 (95% CI: 0.91-0.96) and 0.93 (95% CI: 0.91-0.94), respectively.

CONCLUSIONIFOBT had high overall sensitivity and specificity for detecting colorectal cancer.

Objective To assess the accuracy of immunological fecal occult blood test (iFOBT) for detection of colorectal cancer (CRC). Methods A total of 1 197 studies published before June 2014 were selected from PubMed and Embase and 17 of which were finally included in this meta-analysis. A bivariate mixed-effects models was used for overall value merging and heterogeneity testing. In addition to the overall sensitivity and specificity, the analyses were also performed among certain subgroups, including a“colonoscopy group”(all were referred for colonoscopy diagnosis regardless screening results) and a"follow-up group" (only the screening positive were referred and all were then followed up), a qualitative group and a quantitative group (classified by the way of iFOBT result reading). Results A total of 161 502 subjects aged from 48 to 63 years were included in the analysis. IFOBT had an overall integrated sensitivity of 0.85 (95%CI:0.79-0.89)(heterogeneity test:Q=59.67,P<0.001)and an overall integrated specificity of 0.93 (95%CI:0.92-0.94)(heterogeneity test:Q=1 722.53,P<0.001)for detection of CRC. In the subgroup analysis, it was found that in the"colonoscopy group"and in the"follow-up group", the sensitivity were 0.81 (95%CI: 0.73-0.87) and 0.88 (95%CI: 0.81-0.92), respectively; the specificity were 0.92 (95%CI: 0.89-0.93) and 0.95 (95%CI: 0.94-0.96), respectively. It was also found that in the qualitative group and the quantitative group, the sensitivity were 0.84 (95%CI:0.76-0.90) and 0.86 (95%CI:0.78-0.92), respectively;the specificity were 0.94 (95%CI: 0.91-0.96) and 0.93 (95%CI: 0.91-0.94), respectively. Conclusion IFOBT had high overall sensitivity and specificity for detecting colorectal cancer.

Objective To assess the accuracy of immunological fecal occult blood test (iFOBT) for detection of colorectal cancer (CRC). Methods A total of 1 197 studies published before June 2014 were selected from PubMed and Embase and 17 of which were finally included in this meta-analysis. A bivariate mixed-effects models was used for overall value merging and heterogeneity testing. In addition to the overall sensitivity and specificity, the analyses were also performed among certain subgroups, including a“colonoscopy group”(all were referred for colonoscopy diagnosis regardless screening results) and a"follow-up group" (only the screening positive were referred and all were then followed up), a qualitative group and a quantitative group (classified by the way of iFOBT result reading). Results A total of 161 502 subjects aged from 48 to 63 years were included in the analysis. IFOBT had an overall integrated sensitivity of 0.85 (95%CI:0.79-0.89)(heterogeneity test:Q=59.67,P<0.001)and an overall integrated specificity of 0.93 (95%CI:0.92-0.94)(heterogeneity test:Q=1 722.53,P<0.001)for detection of CRC. In the subgroup analysis, it was found that in the"colonoscopy group"and in the"follow-up group", the sensitivity were 0.81 (95%CI: 0.73-0.87) and 0.88 (95%CI: 0.81-0.92), respectively; the specificity were 0.92 (95%CI: 0.89-0.93) and 0.95 (95%CI: 0.94-0.96), respectively. It was also found that in the qualitative group and the quantitative group, the sensitivity were 0.84 (95%CI:0.76-0.90) and 0.86 (95%CI:0.78-0.92), respectively;the specificity were 0.94 (95%CI: 0.91-0.96) and 0.93 (95%CI: 0.91-0.94), respectively. Conclusion IFOBT had high overall sensitivity and specificity for detecting colorectal cancer.

Objective To explore the method of Oncomelania hupensis snail surveillance in transmission?interrupted re?gions of schistosomiasis,so as to provide a new pattern for the surveillance of snail status in the transmission?interrupted areas. Methods In Dongtai County,north of Jiangsu Province where the transmission of schistosomiasis was interrupted,the surveil?lance of snail status was performed by means of the village?level general survey,village?level sampling survey,snail survey in key settings of township and county,and snail reporting by residents. In addition,quality?control snail sites were set up for quali?ty control. The effectiveness and cost of the four methods of snail surveillance was compared. Results A total of 163 079 set?tings and 22 785.62 hm2 were surveyed in Dongtai County from 2008 to 2013,and 89 residual snail breeding sites were found, with a snail area of 1.48 hm2. The patterns of village?level general survey,village?level sampling survey,and snail survey in key settings of township and county were employed for investigation of 94 550,45 033 and 23 496 settings,consisting of 57.98%, 27.61%and 14.41%of total settings,and 2,0 and 6 settings were found with snails,with 0.021/thousand,0,and 0.255/thou?sand detection rates of settings with snail breading sites,respectively. The pattern of snail survey in key settings of township and county was more effective than that of village?level survey to detect snail breeding sites(χ2 =19.158,P=0). The recovery rate of quality?control snail breeding sites was 52.56%,38.27%and 73.62%for the three patterns of snail survey,respectively,and the pattern of snail survey in key settings of township and county showed a higher quality for snail survey than that of village?lev?el survey(χ2 =111.597 and 85.991,both P=0). During the period from 2008 to 2013,289 person?times reported 279 sus?pected snail habitats and 1 501 living snails,and no Oncomelania snails were found. During the 6?year period,there were 1617.5,964.7 and 527.7 thousand RMB invested for village?level general survey,village?level sampling survey,and snail sur?vey in key settings of township and county,and the cost of snail survey per hm2 was 129.88,133.6 and 162.57 RMB/hm2,re?spectively. The cost of village?level general survey and snail survey in key settings of township and county to detect a snail?breed?ing site was 808 800 and 88 000 RMB,respectively(t=12.850,P=0.000),and the cost of snail survey in key settings of town?ship and county was 10.88%of that of village?level general survey. Conclusion The snail survey in key settings of township and county is a highly effective and high?quality method for snail surveillance,which may serve as a prior way for the surveil?lance of snail status in the transmission?interrupted areas of schistosomiasis.