Unmet Needs and Services of Rehabilitation for People with Physical Disabilities Using Logistic Regression Analysis / 中国康复理论与实践

Objective:To explore the characteristics of unmet needs and services of rehabilitation for people with physical disabilities (PWPs). Methods:A total of 1 512 438 PWPs administration data of unmet needs and services of rehabilitation at provincial level were sampled and analyzed the characteristics of needs and services of rehabilitation, and the related factors of needs and services. Results:The reported unmet needs of PWPs from high to low were assistive devices assistive devices (55.9%), nursing care (27.0%), medicine (26.3%), functional training (23.9%) and surgery (2.3%). Received service of rehabilitation. The services of rehabilitation for PWPs arranged as assistive devices (48.2%), nursing caring (26.4%), functional training (24.3%), medicine (19.5%) and surgery (1.4%). The logistic regression model showed that age and severity of disabilities had significant effect on the reported unmet needs of rehabilitation and received services for PWPs (P < 0.001). Conclusion:PWPs reported unmet needs mainly in the fields of assistive devices, nursing care, medicine and rehabilitation training. They received primary services included assistive devices, nursing care and rehabilitation training and therapies. The services development will emphasize the accessibility and coverage. According to ICF model, it proposed to take measures to implement individualized and precise rehabilitation services to improve the quality of services.

Unmet Needs and Service of Rehabilitation for Children with Disabilities / 中国康复理论与实践

Objective:To explore the status of disability, and characteristics of unmet needs and services of rehabilitation for children with disabilities (CWDs). Methods:A total of 130 290 CWDs administration data of unmet needs and services of rehabilitation at provincial level had been sampled and analyzed. Results:CWDs accounted for 5.33% of the total population with disabilities, in which, 60.4% were boys and 39.6% were girls; 16.3% aged 0 to nine years and 83.7% were seven to 18 years old; 88.4% with agricultural household and 11.6% with non-agricultural household. The distribution of disability severity from severe to mild were 28.3%, 39.5%, 17.7% and 14.6%. The reported unmet needs included assistive devices (40.3%), functional training (37.4%), nursing care (32.2%), medicine (24.9%) and surgery (5.7%). The received services involved in assistive devices (37.9%), functional training (33.7%), nursing care (31.0%), medicine (19.7%) and surgery (2.9%). Logistic Regression model showed that severities of disabilities had significant effects on reported unmet needs and received services (P < 0.001). Conclusion:Implement rehabilitation programs would be tailored to the unmet needs of rehabilitation as CWDs had functioning oriented unmet needs. It proposed to develop individualized and structured rehabilitation services to improve the accessibility and quality of rehabilitation for CWDs.

Correlation between Gli1 expression and clinicopathological significance in human pancreatic cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To study the clinicopathological significance and relationship of Gli1, MDM2 and p53 expression in human pancreatic cancer.</p><p><b>METHODS</b>The expression of Gli1, MDM2 and p53 proteins in 57 paired paraffin embedded pancreatic ductal adenocarcinoma (PDAC) specimens and adjacent non-cancerous pancreatic tissues was detected by immunohistochemistry. The relationship between their expression and clinicopathological characters was analyzed. Quantitative real-time PCR (qRT-PCR) was used to examine the expression of Gli1 mRNA level in 14 paired fresh PDAC specimens and adjacent non-cancerous pancreatic tissues. siRNA interference were used to further detect the close relationship among them.</p><p><b>RESULTS</b>IHC showed the expression of Gli1 (50.9%), MDM2 (57.9%) and p53 (56.1%) was increased in 57 cases of pancreatic cancer compared to that in paired normal pancreatic tissues (33.3%, 26.3% and 17.5% respectively, t = 2.413, 2.848 and 2.960, all P < 0.05). Gli1 expression was positively associated with tumor TNM stage (χ(2) = 8.211, P = 0.004), invasion depth (χ(2) = 4.247, P = 0.039) and MDM2 expression (r = 0.299, χ(2) = 5.105, P = 0.024), while expression of MDM2 and p53 was associated with tumor invasion depth (χ(2) = 5.182, P = 0.023) and TNM stage (χ(2) = 5.696, P = 0.017), respectively. Univariate and multivariate analysis revealed that Gli1 was an independent adverse prognostic indicator for patients with PDAC (RR = 2.290, 95%CI: 1.051-4.992, P = 0.037), and patients with Gli1 and MDM2 co-expression had a significantly poorer overall survival than patients with their negative expression (P = 0.034). Gli1 mRNA expression was much higher in 14 cases of PDAC than that in adjacent normal pancreatic tissues (t = 2.926, P = 0.012). In p53 mutant AsPC-1 cells, Gli1 knockdown down regulated MDM2, but had no effect on p53 expression, whereas Gli1 knockdown down regulated MDM2 and up regulated p53 protein levels in p53 wild-type Capan-2 cells.</p><p><b>CONCLUSIONS</b>Gli1, MDM2 and p53 are overexpressed in PDAC, and are benefit for predicting patients' prognosis. Gli1can regulate MDM2 and wild-type p53 expression. Their co-expression might coordinately contribute to the development and progression of PDAC.</p>

Clinicopathological significance of the expression of calreticulin in human pancreatic cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To study the clinicopathological significance of the expression of calreticulin (CRT) protein and mRNA in pancreatic ductal adenocarcinoma (PDAC).</p><p><b>METHODS</b>The expression of CRT protein in 33 paired paraffin embedded PDAC specimens and adjacent non-cancerous pancreatic tissues were detected by immunohistochemistry. Western blot and RT-PCR were used to examine the expression of CRT protein and mRNA in 12 paired fresh PDAC specimens and adjuvant non-cancerous pancreatic tissues. The relationship between the protein expression and clinicopathological features was analyzed.</p><p><b>RESULTS</b>CRT expression was much higher in 33 PDAC tissues than that in paired adjacent non-cancerous pancreatic samples (t = 2.323, P = 0.027). CRT was over expressed in 16 PDAC tissues, but only in 8 adjuvant non-cancerous pancreatic tissues (48.5% vs. 24.2%). The expression of CRT protein had no correlation with tumor position (χ(2) = 1.588, P = 0.208), differentiation (χ(2) = 1.517, P = 0.218), TNM stage (χ(2) = 2.528, P = 0.112) and lymph node metastasis (χ(2) = 1.963, P = 0.161), but had statistic significancy with the prognosis of the patients (χ(2) = 4.080, P = 0.043). The median survival time in the patients with high expression of CRT protein was longer than that in the patients with low expression. The expression of CRT mRNA was higher in PDAC than that in non-cancerous tissues detected by RT-PCR (t = 2.539, P = 0.025), but no significant difference was found in protein level (t = 1.292, P = 0.223).</p><p><b>CONCLUSIONS</b>CRT is up-regulated in PDAC and may be a prognosis factor for patients with PDAC.</p>

Clinicopathological significance of the expression of carbonic anhydrase II in human pancreatic invasive ductal cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To study the clinicopathological significance of the expression of carbonic anhydrase (CA)II protein and mRNA in primary invasive ductal cancer (IDC) of human pancreas.</p><p><b>METHODS</b>The expression of CAII protein in 33 paired paraffin embedded IDC specimens of the pancreas and paired adjacent non-cancerous pancreatic tissues was detected by immunohistochemistry. Western blot and reverse transcription polymerase chain reaction (RT-PCR) were used to examine the expression of CAII protein and mRNA level in 12 paired fresh IDC specimens of the pancreas and adjuvant non-cancerous pancreatic tissues. The relationship between the protein expression and clinicopathological features was analyzed.</p><p><b>RESULTS</b>Overexpression of CAII protein was shown in 11 cases of pancreatic IDC tissues (33.3%, 11/33), which was much lower than that in paired non-cancerous pancreatic tissues (72.7%, t = 6.275, P = 0.000). The expression of CAII protein had no correlation with tumor position (χ² = 0.992, P = 0.319), differentiation (χ² = 0.866, P = 0.352), TNM stage (χ² = 1.210, P = 0.271) and Lymph node metastasis (χ² = 0.798, P = 0.372), but had bordering statistic sig with the prognosis of the patients (χ² = 3.233, P = 0.072). The median survival time in the patients with high expression of CAII protein was 540 days, while that in the patients with low expression was 320 days. The expression of CAII protein and mRNA was lower in IDC than that in paired non-cancerous pancreatic tissues detected by Western blot and RT-PCR respectively (t = 3.399, P = 0.006; t = 2.281, P = 0.043).</p><p><b>CONCLUSION</b>CAII is down regulated in pancreatic IDC and might be relative with the prognosis.</p>