Objective: To investigate health equity status of the elderly with different socioeconomic status(SES)and provide basis for health promotion. Methods:The data of 2011-2012 China Health and Retirement Longitudinal Survey was used to analyze health equity of the elderly with different SES. Results: There is an inverse socioeconomic gradient in self-evaluation of ill health and the prevalence of activity of daily living (ADL). The lower economic level is, the higher self-evaluation of ill health and the damage rate of ADL are, and the higher non-outpatient rate and non-hospitalization rate are; the urban elderly have better health and use more health services and the elderly in eastern region have better health and use more health services than those in eastern region. Conclusion: There is the health inequity for the elderly with different SES. In order to implement the health care insurance and medical assistance system of the elderly, it needs to allocate health resources to rural and western areas, narrow the gap between urban and rural areas and improve the health level of the elderly.

Objective To investigate the current status of medication compliance of patients with anky-losing spondylifis and analyze its related factors. Methods Seventy-four patients with ankylosing spondylitis were investigated about their general conditions,medication compliance and its related factors.The results were analyzed. Results Thirty-nine patients(52.7%) had good medication compliance while the rest 35 cases has poor medication compliance among which 24 patients with drug withdrawal exceeded 1 month.The medication compliance for patients with disease process of lower than 0.5 year,0.5 to 1.0 year,1 to 2 years and above 2 years was 82.0%,60.0%,25.0%and 31.0%.The logistic regression analysis showed that the disease process,dis-ease knowledge and media advertisement were the main influencing factor for medication compliance,while the age,sex,marital status,education background,adverse reaction,satisfaction degree with medication effect, economic conditions and depression were not major influencing factors. Conclusions About half of patients with anky-losing spondylitis had poor medication compliance,especialy with disease process of above 1 year.The main in-fluencing factors include disease process,disease knowledge and media advertisement.

Objective To evaluate the impacts of the essential medicine system in Jiangsu Province on rational drug use in community health service centers.Methods 7667 outpatient prescriptions from 6 community health service centers in Nantong were selected by cluster sampling from January 2009 to December 2011,the part of SDUIs(Selected Drug Use Indicators)developed by WHO and the self-design indicators were employed to analyze rational use of drugs.Results After implementation of the essential medicine system,the average types of drugs per prescription decreased from 3.02 to 2.74,the rate of antibiotic drugs usage dropped from 61.43％ to 51.2％,the rate of one antibiotic usage reduced from 33.94％to 28.58％,and two types from 20.43％to 15.8％,all with significant differences(P＜0.001).The average expenses in single prescription arose from RMB 69.70 to 87.28,the rate of essential medicine usage increased from 81.22％to 85.60％,the injection utilization decreased from 31.14％ to 14.13％,while TCM utilization ascended from 16.17％to 21.8％,all with significant differences(P＜0.001).Condusion The essential medicine systems has positive impacts on rational drug use,but the expenses of per prescription are higher,and irrational antibiotic drugs are still a serious problem.

Objective To explore the case mixed method in diagnosis-related groups ( DRGs ) of patients with cervical cancer in Nantong and to provide references for standard hospitalization expense of cervical cancer. Methods 8610 patients with cervical cancer from Nantong Tumor Hospital from 2006 to 2013 were selected for the study. The influencing factors of hospitalization expenses were screened by multiple liner regression. DRGs case mix scheme was established by Chi-squared automatic interaction dtector in the decision tree model. Results The mean hospitalization expense was 11363 yuan and the median was 9325 yuan. The influencing factors included admitting pathways, complications, therapeutic methods and prognosis of diseases. The cases of 8610 formed 11 DRGs combinations, with the corresponding hospitalization expense standards. Conclusions Case-mix diagnosis related groups are reasonable. The standards and related weights of hospitalization expenses could serve references for hospitals and medical insurance institutions.

OBJECTIVETo investigate the mortality rates of hepatocellular carcinoma (HCC) in Nantong,China from 1999 to 2011, in order to uncover dynamic trends and provide reasoned advice on intervention strategies to decrease HCC incidence and mortality in Nantong in the future.

METHODSVersions 10 and 9 of the WHO International Classification of Diseases (ICD-10 and ICD-9) were used to determine the number of HCC deaths in Nantong,China for the study's range of years. Thex2 test was applied to compare the HCC mortality rates according to sex and age. The Grey system GM(1,1) model was used to predict the next-5-year HCC mortality for Nantong.

RESULTSAnalysis of the standardized mortality in Nantong showed a slight decreasing trend from 1999 to 2011 (x2=57 545.98, P less than 0.001),with males showing a steeper decrease than females. The total mortality of HCC during these years was 53.41 per 100,000 people,with mortality among males being significantly higher than that among females (80.81 per 100,000 people vs. 26.94 per 100,000 people; x2=13 625.42, P less than 0.001). In general, HCC mortality increased with increase in age (general trend:x2=57 545.98, P less than 0.001; male trend: x2=39 878.8, P less than 0.001; female trend: x2=20 105.3, P less than 0.001). However,HCC mortality increased significantly in women after the age of 40 and in men after the age of 35. The GM(1,1) equation was: Yt=-1265.28e(-0.0375t)+1315.5, which predicted that the HCC mortality will decrease to 25.56 per 100,000 people in 2016.

CONCLUSIONAlthough HCC mortality generally decreased from 1999 to 2011, the rate remained high. Public health intervention strategies may be more effective if they focus on males over the age of 35 and females over the age of 40.

Carcinoma, Hepatocellular ; mortality ; China ; epidemiology ; Female ; Humans ; Incidence ; Liver Neoplasms ; mortality ; Male

Objective To understand the status of type 2 diabetes mellitus (T2DM) patients′ trust in their family physicians, and to explore the role of the trust on patients′ medication adherence. Methods A total of 1078 patients with T2DM were recruited by cluster and systematic sampling method, from ten rural communities in Sanlong township in Yancheng city and five rural communities of Pingchao township in Nantong city, during February to April in 2018. The survey covered their trust behavior and attitude scale (PTBAS), and an 8-item Morisky medication adherence scale ( MMAS-8). Both measurement data and enumeration data were subject to descriptive analysis by mean ± SD and proportion respectively. Multiple linear regression was employed to explore the determinants of trust in physicians. Ordered logistic regression analysis was used to explore the relationship between patient-physician trust and medication adherence. Results The mean scoring of patients′ trust and medication adherence was 20. 16 ± 2. 13, 7. 07 ± 1. 54 respectively. 55. 40 percent of the patients had high medication compliance, 28. 53 percent of them had medium compliance and 16. 07 percent had poor compliance. Multiple linear regression analysis showed that the patient′s occupation, course of disease, self-reported health status and mental health status influenced their trust behavior (P < 0. 05). Ordered logistic regression analysis showed that each 1 point increase in patient′s trust in physicians, the medication compliance increased by 11. 0％ (OR = 1. 110, P < 0. 001). Medication adherence is also affected by age, employment status, course of illness, and mental health status. Conclusions Diabetes patients′ trust in their family physicians improves their medication adherence.

OBJECTIVE: To carry out clinical and genetic analysis for an infant manifesting perianal lesions, diarrhea and multiple intestinal perforations. METHODS: Genomic DNA of the infant was extracted and subjected to targeted capture exome sequencing. Candidate variants were verified by Sanger sequencing of his family members. RESULTS: The patient was found to harbor c.301C>T and c.188+1G>A compound heterozygous variants of the IL10RA gene, which has suggested the diagnosis of IL10RA-related very early-onset inflammatory bowel disease (VEOIBD). CONCLUSION The patient was diagnosed with IL10RA-related VEOIBD. The newly discovered c.188+1G>A variant has enriched the spectrum of IL10RA gene variations.
Genetic Testing ; Humans ; Infant ; Inflammatory Bowel Diseases/pathology* ; Mutation ; Exome Sequencing

Objective: To explore the effects of grandparent involvement in parenting on health related behaviors among urban preschool children, so as to provide a basis for the development of interventions for unhealthy behaviors among preschool children with different parenting pattern. Methods: A total of 5 431 preschool children aged 3-6 years old in Xinbei District, Changzhou City, were selected by census method during January to October, 2022. General household characteristics and health related behaviors of children were investigated by questionnaires, and the differences in health related behaviors with different parenting pattern involving grandparents were explored by the χ 2 test. A multifactorial Logistic regression model was used to analyze the effects of grandparenting on preschool children s health behaviors. Results: About 51.2% of preschoolers were raised by both parents, 46.1 % were co parented by grandparents, and 2.7% were raised by grandparents. After multifactorial Logistic regression analysis controlling for age, gender, annual household income, and family structure, children co parented by grandparents had a reduced risk of screen exposure time>1 h/d ( OR =0.79, P <0.05), with increased risks of outdoor activity time<2 h/d ( OR =1.30, P < 0.05 ), sleep duration <10 h/d ( OR =1.31, P <0.05), sleep difficulties ( OR =1.39, P <0.05) and adverse eating behaviors ( OR =1.20， P < 0.05), compared with children parented by both parents. Children raised by grandparents were at increased risk for outdoor activity time<2 h/d ( OR =2.19) and unhealthy eating behaviors ( OR =1.39) ( P <0.05). Conclusions Compared with children raised by both parents, the incidence of unhealthy behaviors is increased in children raised by parents and grandparents and in children raised by full grandparents. Active intervention should be focused on unhealthy behaviors of preschool children with pareting involving grandparents to promote the physical and mental health of preschool children.