OBJECTIVETo explore the medical cost and its related factors of clinically confirmed severe acute respiratory syndrome (SARS) cases in Beijing.

METHODSThe average medical cost per person/day was calculated on 1272 SARS cases with complete hospitalization data from the Beijing SARS clinical database. Factors associated with medical expenditure were explored by both single factor and multi-factor analyses.

RESULTSThe medical costs of SARS patients in Beijing were 18 767.50 RMB/case and 632.02 RMB/day/case. Expenses on medication accounted for the highest proportion (0.66%). The increase in expenses on medication was significantly associated to the increase in total expenditure. Analyses by single factor, factor stratification as well as multi-factor analyses showed that: the expenditure increased significantly with the following factors of the patients: prolonged days of hospitalization, severe symptoms and signs, hospitalization at the early stage of disease onset, being medical staff themselves, with baseline diseases, being applied mechanical ventilation, and with medical insurance.

CONCLUSIONSThe medical expenditure on SARS patients at the hospital was higher than that on patients with common diseases which was associated to the following factors as: days of hospitalization, severity of disease, stage of the disease break-out, patient's occupation, baseline disease status, medical insurance status etc.

Age Factors ; China ; Cost of Illness ; Female ; Hospitalization ; economics ; Humans ; Length of Stay ; economics ; Linear Models ; Male ; Severe Acute Respiratory Syndrome ; economics ; therapy ; Sex Factors

BACKGROUNDMultimodal cocktail periarticular injection (MCPI) with a large volume of low concentration local anesthetics, adrenaline, and anti-inflammatory agents such as non-steroidal anti-inflammatory drug or steroids have shown good pain control and improvement in range of motion after surgery. This study compares the efficacy of pain control after total knee arthroplasty, using multimodal cocktail periarticular injection with steroid or without steroid.

METHODSThis is a prospective, double-blinded, randomized and control study. Seventy-two patients with osteoarthritis that met clinical criteria for total knee arthroplasty were recruited into the study, and were randomized to receive either multimodal cocktail periarticular injection with steroid or without steroid. Pain was assessed by visual analogue scale (VAS) at preoperative and postoperative at rest, and during activity. The range of motion was recorded preoperatively and postoperatively. The amount of daily and cumulative morphine consumption were measured by patient-controlled analgesia in the first 72 hours postoperatively. The duration of celecoxib usage was also recorded at the last follow-up.

RESULTSThere were no differences between the non-steroid and steroid groups with regard to VAS at rest and during activity, or range of motion, at any postoperative observation time. The postoperative Knee Society Knee Score in the steroid group improved significantly as compared with that in non-steroid group at the one-month (84.1±13.1 and 65.9±12.1; P < 0.0045), three-month follow-up (90.2±16.3 and 72.5±16.6; P < 0.0027), but after postoperative six-month the Knee Society Knee Score showed no significant difference between the groups. There was no significant difference in consumption of the morphine about daily or total consumption within 72 hours between the two groups. The duration of celecoxib usage in patients in the steroid group was significantly shorter than that in the non-steroid group ((7.2±0.7) compared with (10.5±1.9) weeks; P = 0.012).

CONCLUSIONThe patients who received the steroid injection had faster rehabilitation and less non-steroidal antiinflammatory drugs consumption.

Aged ; Arthroplasty, Replacement, Knee ; methods ; Celecoxib ; Cyclooxygenase 2 Inhibitors ; administration & dosage ; therapeutic use ; Female ; Humans ; Injections, Intra-Articular ; Male ; Pain Measurement ; Pyrazoles ; administration & dosage ; therapeutic use ; Steroids ; administration & dosage ; therapeutic use ; Sulfonamides ; administration & dosage ; therapeutic use

Animals ; Asia ; epidemiology ; History, 20th Century ; Humans ; Influenza A Virus, H2N2 Subtype ; chemistry ; genetics ; isolation & purification ; Influenza, Human ; epidemiology ; history ; virology ; Mutation

OBJECTIVETo develop and evaluate the efficiency of air purification and sterilization instrument based on nano-sized TiO(2) photocatalytic technique.

METHODSThe nano-sized TiO(2) photocatalytic air purification and sterilization instrument was designed and a sample had been prepared. The sterilization efficiencies for E.coli and Klebsiella by the nano-sized TiO(2) photocatalytic instrument and ultraviolet (UV) were measured in closed labs. The on-site efficiency of the instrument was evaluated, too.

RESULTSThe nano-sized TiO(2) photocatalytic air purification and sterilization instrument was composed of five units: rough filter, nano-sized TiO(2) photocatalytic unit, activated carbon fiber filter, negative ion generator, and programmed control unit. The E.coli killing rates by the nano-sized TiO(2) photocatalytic instrument were 76.0%, 81.8%, 77.5%, and 80.7% at 30, 60, 90, and 120 minutes, respectively. There was no significant difference between the E.coli killing rates of the instrument and UV (P > 0.05), except the 120 minutes timepoint. The Klebsiella killing rates by the instrument were 78.4%, 79.5%, 67.3%, and 58.5% at 30, 60, 90, and 120 minutes, respectively. The Klebsiella killing efficiencies of the instrument at 30 and 60 minutes were better than that of UV (P < 0.01). There was no significant difference between the Klebsiella killing efficiencies of the instrument and UV (P > 0.05).

CONCLUSIONThe air sterilization efficiency of the nano-sized TiO(2) photocatalytic instrument should be equivalent or better as compared with the UV. This instrument might be used for the air purification and sterilization of the public locations.

Air Pollution ; prevention & control ; Decontamination ; methods ; Disinfection ; methods ; Nanostructures ; Photochemistry ; Titanium

BACKGROUNDIt is well recognized that meteorological factors have important infuences on the onset and development of many kinds of diseases. The present study was undertaken to investigate the effects of the meteorological elements on admission rates of cerebral infarction patients with hypertensive nephropathy at Changchun city, Jilin Province, northeast China.

METHODSA total of 763 medical records of inpatients from nine hospitals at Changchun city, during a period from April 6 to April 17 in 2010, were reviewed. These patients were admitted to hospitals due to the occurrence of cerebral infarction. The hypertensive nephropathy was evidenced with certain diagnosis of essential hypertension and hypertension-related kidney injuries. The cerebral infarction was diagnosed according to the World Health Organization (Stroke) standard. All the meteorological data were from practical monitoring records in Jilin Province Meteorological Observatory. The relationships between the epidemiological prevalence of cerebral infarction and meteorological variables were analyzed using the time series models of statistics.

RESULTSCompared with admission rates before the violent change in meteorological status (April 6 to April 17, 2010), the number of admission patients suffering from cerebral infarction remarkably peaked on April 12. Such an increase was highly correlated with heavy precipitation, elevation of daily average relative humidity, and reduction of average daily air temperature. With the betterment of the meteorological conditions on April 17, the admission rates of cerebral infarction patients dropped to the same level as the dates before snowing (April 6 to April 11).

CONCLUSIONSThe meteorological changes are highly associated with the occurrence of cerebral infarction in patients with hypertensive renal injury in northeast China. This study also suggested that an intensive medical interference for those patients with hypertension-induced organ injuries is very necessary in preventing the occurrence of cerebral infarction with hypertensive nephropathy when there is a violent change in meteorological condition.

Adult ; Aged ; Aged, 80 and over ; Cerebral Infarction ; China ; Female ; Hospitalization ; statistics & numerical data ; Humans ; Hypertension, Renal ; Male ; Meteorological Concepts ; Middle Aged ; Nephritis ; Patient Admission ; statistics & numerical data

OBJECTIVETo study the relationship of timing of hospitalization and the severity, course, fatality of severe acute respiratory syndrome (SARS) patients.

METHOD1291 hospital records of clinically diagnosed SARS patients with complete data gathered from "2003 Beijing SARS Clinical Database" were analyzed.

RESULTSSARS cases were categorized into four groups, according to the time of hospitalization after onset of the disease: within 3 days, during day 4 to day 7, during day 8 to day 14 and after day 14. The numbers of cases for each group were 568, 496, 177 and 50 respectively. Data showed that from group 1 to 4, the prevalence rates of major symptoms on the first day of hospitalization were: (1) 9.7%, 16.5%, 23.1% and 24.0% for "feeling chest pain" (P < 0.001), (2) 7.4%, 13.7%, 19.2% and 22.0% for "suffering from breathing obstruction" (P < 0.001), (3) 32.8%, 44.8%, 59.9% and 48.0%, for "coughing" (P < 0.001) and (4) 14.1%, 22.4%, 27.1% and 18.0% for "coughing up phlegm" (P = 0.0002), respectively. The rates of high respiratory frequency (>or= 24 bits/min.) were 11.1%, 15.5%, 22.8% and 25.5% (P < 0.001). The rates of abnormal chest X-ray were 80.3%, 89.0%, 92.3% and 88.9%, respectively (P = 0.002). The average numbers of abnormal lung field (the lung were divided into 6 fields) were 1.7, 1.9, 2.5 and 2.6 (P < 0.001); The numbers of cases receiving continuous oxygen supply treatment were 33.6%, 50.0%, 53.7% and 74.0% (P < 0.001), and the numbers of cases receiving glucocorticosteroids treatment were 28.2%, 35.9%, 53.7% and 62.0% (P < 0.001), respectively. With cases having had chronic baseline diseases prior to SARS infection, the age-standardized fatality rates were 14.9%, 11.7%, 50.0% and 33.9% (P < 0.001), and the average courses of the disease were 30.3, 34.2, 42.9 and 47.5 days (P < 0.001), respectively. In cases without chronic baseline diseases, the age-standardized fatality rates were 5.3%, 9.8%, 9.2% and 8.3% (P = 0.101), and the average courses for each group were 32.4, 35.3, 40.9 and 47.6 days (P < 0.001), respectively.

CONCLUSIONDelayed hospitalization would cause the situation of SARS patient to deteriorate, losing the best chance for treatment and increase case fatality. In terms of control program on SARS, emphasize should be paid on decreasing the panic of patients to the disease so as to get early hospitalization.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Male ; Middle Aged ; Prognosis ; Severe Acute Respiratory Syndrome ; epidemiology ; mortality ; pathology ; Severity of Illness Index ; Survival Rate ; Time Factors

AIMTo compare the efficacy and complications of extracorporeal shock-wave lithotripsy (SWL) and pneumatic ureteroscopic lithotripsy (URS) in the treatment of lower ureteral calculi.

METHODSFrom August 1997 to June 1999, 210 patients with calculi in the distal third of the ureter were treated with SWL and the other 180 with URS. The stones were fragmented with either HB-ESWL-V lithotripter or JML-93 pneumatic lithotripter through Wolf 7.5 approximately 9.0 Fr ureteroscope. The outcome was assessed in terms of stone clearance rate, re-treatment rate and complication incidence.

RESULTSThe stone clearance rate was 78.1 % with SWL and 93.3 % with URS (P<0.05). SWL had a re-treatment rate of 11.9 %, vs 2.2 % in the URS group (P<0.05). URS caused ureteral perforation in 3.3% of patients, while it was 0 with SWL (P<0.05). The differences in the incidence of other complications such as infection and stricture between the two groups were insignificant.

CONCLUSIONThough the selection of these two options depends on equipments available and the expertise of the operator, we recommend URS as the optimal treatment for distal ureteral calculi.

Adolescent ; Adult ; Aged ; Female ; Humans ; Lithotripsy ; adverse effects ; methods ; Male ; Middle Aged ; Treatment Outcome ; Ureteral Calculi ; therapy

Global Health ; History, 20th Century ; Humans ; Influenza A Virus, H2N2 Subtype ; genetics ; isolation & purification ; Influenza, Human ; epidemiology ; history ; transmission ; virology

Salvianolic acid is the water soluble extract of Salvia miltiorrhiza,and it can improve the blood circulation of the brain and improve the cognitive disorder of depression,anti-inflammation,anti-tumor and so on.At present,the research on its technology is relatively less.This particle will mainly review the research progress of analytical methods,extraction and purification technology of salvianolic acids.The main analysis methods used for salvianolic acids include UV spectrophotometry,near-infrared spectroscopy,quantitative analysis of multi-components by single marker (QAMS),colorimetry and so on.The extraction process is mainly heating reflux extraction and warm soaking method,percolation method,enzymatic extraction,etc.The purification process is macroporous resin purification,ZnCl2 precipitation method,ultrafiltration and so on.

Objective To study the clinical characteristics,diagnosis and surgical managements of the parapharyngeal space tumors. Methods A retrospective study of 40 patitents with primary parapharyngeal space tumors treated from January 2006 to December 2008 in Chinese PLA General Hospital was performed.Among the 40 patients,there were male 22 patients,female 18 patients,age ranged from 1 - 77,median 42 years old.CT scan combined with MRI was helpful to diagnose the parapharyngeal space tumor and make surgical plan. The surgical approaches include: trans-oral in 1 patient,trans-cervical approach in 22,transcervical-parotid approach in 8,vertical ramusosteotomy approach in 1,tanscervicalpartial bone resection in the angle of mandible in 4,transparotid approach in 2,and transcervical in combination with post auricle craniotomy approach in 2.Results All 40 patients had undergone surgical treatment.Postoperative histopathology showed benign in 28 patients and malignant in 12 patients.The tumors originating from salivary glands were in 15 patients,neurogenic tumors in 12 patients and tumors originating from other tissues were in 13 patients.Among 28 patients with benign tumors,23 had been cured with one operation,without recurrence during following-up of 13 -47 months,with a median of 39 months.Among 12 patients with malignant tumors,6 patients alive( with following-up of 24 -50 months and a median of 36 months ),3 patients died in half year after operation and 3 patients lost. The post-operative complication included cerebrospiral fluid leak in one patient,operative field infection in 2 patients,and vagus nerve injury in 3 patients.Conclusions Surgery is the first choice for parapharyngeal space tumors.Transcervical approach alone can apply to most tumors and a broader approach is indicated for malignant or large benign tumors.The prognosis is good for the benign lesions,but poor for the malignant tumors.