1.Assessment of Economic Loss Due to Health Impact of Air Pollution in City of Liaoning Province
Journal of Environment and Health 1992;0(02):-
Objective As part of the basic for cost-benefit assessment in decision for environmental protection measures, health benefit from improvement of air pollution was provided through this study. Methods According to the results from many well-done studies of local, domestic, and international authoritative institutions on relationship of air pollution and health impact, E-R functions (Exposure-Response) in terms of total mortality and morbidity of respiratory diseases from acute and chronic effects associated with increase of unit air pollutants (each 100 ?g/m3 TSP and 10 ?g/m3 SO2) were identified. As a real practice, the excess (avoidable) number of deaths and patients of respiratory diseases associated with 100 ?g/m3 TSP and 10 ?g/m3 SO2 of air pollution were estimated for Fushun City in year of 2000. The costs of medical treatment, as well as the payment for labor days were investigated. The direct and indirect economic losses from corresponding diseases were calculated. As for the estimation of economic loss from excess deaths, three methods of evaluation were applied, i.e. labor capital method; value of statistics life (VOSL), namely the method of willing to pay (WTP); and value of life year (VOLY). Results The total economic benefit combined from above aspects resulting from decreasing 100 ?g/m3 TSP ranges over 1.4 hundred millions-3.4 hundred millions yuan, accounting for 0.75%-1.95% of total product value (GDP) of Fushun City in year of 2000. Methods and indices of monetary estimation for health impact of air pollution adapted to Liaoning city was suggested. As the author's point of view, the third method of VOLY was preferable, by which, 1.48 hundred millions yuan benefit was estimated, accounting for 0.85% of GDP. Conclusions Domestic E-R functions should be worked out for assessing economic loss due to environmental pullution.
2.Assessment of the effectiveness of highly active antiretroviral therapy in 1039 adult acquired immune deficiency syndrome patients in Dehong area, Yunnan Province
Shitang YAO ; Lifen XIANG ; Yanling LI ; Jibao WANG ; Jin YANG ; Yan ZHAO ; Fujie ZHANG ; Song DUAN
Chinese Journal of Infectious Diseases 2010;28(9):551-554
Objective To evaluate the effectiveness of free highly active antiretroviral therapy (HAART) in adult infected with human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome (AIDS) patients in Dehong area. Methods Clinical data of 1039 adult HIV/AIDS patients from five counties/cities in Dehong area who initiated HAART during the period from July 1st 2004 to June 30th 2008 were retrospectively analyzed to examine their virological and immunological responses to HAART. Data were analyzed by Chi-squared test or F test. Results Among the 1039 HIV/AIDS cases, 611 were males and 428 were females. The mean age was (37.0±9.9) years and the mean treatment duration was (22. 41 ± 12. 69) months. Complete viral suppression (HIV viral load<50 copy/mL) was achieved in 781 cases (75. 17%). The percentage of patients achieving complete viral suppression rates were 76.95%, 76.49%, 70.65% and 77. 73% in patients treated for 6-12,13-24, 25-36 and more than 37 months, respectively (x2=8.646, P=0.194). The meanCD4+ T cell counts were (164.93±118.05) × 106/L at baseline, and (330.85±201.73) × 106/L, (356.24±205.49) × 106/L, (434.53±250.65) × 106/L and (396.31±202.62) × 106/L in patients treated for 6- 12, 13-24, 25-36 and more than 37 months, respectively. CD4- T cell counts were significantly different in patients treated for 6-12 and 13-24 months (F= 19. 423 , P<0. 01). Successful immune reconstitution was achieved in 927 ( 90.88 % ) cases. Seven hundred and seventeen (70.29% ) cases achieved both virological suppression and immunological reconstitution with HAART, whereas 40 cases (3. 92%) failed to achieve both virological and immunological responses. Conclusion HIV/AIDS patients in Dehong area show good virological and immunological responses to HAART.
3.Progress on China's national free antiretroviral therapy strategy in 2002-2014
Zhihui DOU ; Fujie ZHANG ; Yan ZHAO ; Canrui JIN ; Decai ZHAO ; Xiumin GAN ; Ye MA
Chinese Journal of Epidemiology 2015;36(12):1345-1350
Objective To analyze the progress and characteristics of China' s "Free AIDS treatment strategy" since the implementation of the national "four free and one care" policy against AIDS 12 years ago.Methods Retrospective cohort study and cross-sectional analysis had been conducted in this study.368 449 cases that had received the ‘free antiviral therapy’ from 2002 to 2014 were selected from the National Treatment Database.Data from the baseline (initial time of ART,CD4 cell count,and antiretroviral regimen) and from the follow-up program (dates and status of follow-up,CD4 cell counts) were gathered and analysed by SAS 9.3.Results The number of cases that having received new treatment was increasing year by year,accounting for 75.4% of all the cases identified from 2010 to 2014.Constituent ratios of patients with baseline CD4 cell count <200 cells/μl and clinical diagnosis of AIDS were decreasing from 81.0% in 2006 to 39.7 % in 2014.Status on drug optimization showed that:3TC replaced DDI,EFV replaced NVP and TDF replaced D4T,making the utilization rates as 99.5%,75.7%,and 60.6%,respectively,by 2014.Regions that were covered by the treatment accounted for 75.4% of all the counties/districts involved.The previous CDC-led AIDS treatment program and mode of management had been transferred to the hospital-based model.Proportion on the twice-CD4-testing model had been 75.2% since 2010,with the rate of virological detection increased from 70.8% in 2010 to 87.4% in 2014 and the virological unsuccessful testing rate decreased from 17.6% in 2010 to 11.8% in 2014.Among all the patients,the 1,5 and 10 year survival rates appeared as 92.2%,80.5% and 69.6%,respectively.For patients with baseline CD4 cell counts as <50 cells/μl or >350 cells/μl,the corresponding survival rates showed as 81.6%,69.9%,60.9% and 97.9%,89.8%,81.0%,respectively.Conclusion China's HIV/AIDS free anti-retroviral therapy program appeared as a national treatment cohort which involved large number of participants,with new patients joining in,annually.Criterion on drug optimization and treatment were consistently following the recommendation and guidelines set by WHO.Management program on treatment had gradually turned to hospital-based,with follow-up and laboratory testing programs guaranteed,ended up with satisfactory treatment effects.
4.Expert consensus on antiviral therapy of COVID-19
Fujie ZHANG ; Zhuo WANG ; Quanhong WANG ; Qing MAO ; Jinsong BAI ; Hanhui YE ; Jia TIAN ; Tianxin XIANG ; Jihong AN ; Zujiang YU ; Wenjie YANG ; Xingxiang YANG ; Xiaoju ZHANG ; Jie ZHANG ; Lina ZHANG ; Xingwang LI ; Jiabin LI ; Manxiang LI ; Zhiwei LI ; Hourong ZHOU ; Yi SHI ; Xiaoling XU ; Xiaoping TANG ; Hong TANG ; Xixin YAN ; Wenxiang HUANG ; Chaolin HUANG ; Liang DONG ; Baosong XIE ; Jiandong JIANG ; Bin XIONG ; Xuemei WEI ; Jifang SHENG ; Ronghua JIN
Chinese Journal of Clinical Infectious Diseases 2023;16(1):10-20
COVID-19 is caused by a novel coronavirus-severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), which has being spreading around the world, posing a serious threat to human health and lives. Neutralizing antibodies and small molecule inhibitors for virus replication cycle are the main antiviral treatment for novel coronavirus recommended in China. To further promote the rational use of antiviral therapy in clinical practice, the National Center for Infectious Diseases (Beijing Ditan Hospital Capital Medical University and the First Affiliated Hospital, Zhejiang University School of Medicine) invited experts in fields of infectious diseases, respiratory and intensive care to develop an Expert Consensus on Antiviral Therapy of COVID-19 based on the Diagnosis and Treatment Guideline for COVID-19 ( trial version 10) and experiences in the diagnosis and treatment of COVID-19 in China. The consensus is concise, practical and highly operable, hopefully it would improve the understanding of antiviral therapy for clinicians and provide suggestions for standardized medication in treatment of COVID-19.