1.Discussion on Public Hospital's State-owned Assets Management Strategy Based on Health Economics
Jianlong LU ; Zhigang CAO ; Lilang Lü
Chinese Hospital Management 2017;37(4):72-73
With the improvement of hospital financial system and promotion of fine management,state-owned assets management will focus on effective methods.This study focuses on the main asset management problems faced by hospitals,such as Iowutilization rate of equipment,Unused inventory,andintangible assets protection.It explores the health economics methods such as demand analysis,market strategyanalysis,cost benefit analysis,cost accounting and budget controi in the public hospital asset management application and practice,in order to explore the public hospital asset management scientific method,and improve the efficiency of asset management.
2.Study for the effect of the treatment for the clear-cell cancer of the ovary
Lei YE ; Jianlong ZHU ; Huijuan LU
China Oncology 2006;0(11):-
Background and purpose:The clear-cell cancer ovarian cancer have worse prognosis than the other ovarian cancer.The patient's survival rate of the clear-cell ovarian cancer has been analyzed in this article in order to study the effect of the treatment with CAPcytoxan(CTX),cisplatinum(DDP),epiadriamycin(E-ADM)plus mitomycin(MMC).Methods:33 cases(group A)with clear-cell ovarian cancer between Jan.1th 1999 and Dec.31th 1999 were compared to 37 cases(B group)with other pathological ovarian cancer.All cases underwent the tumor reductive surgery and been capable of remain the residual tumor size less than 1 cm.Patients in the two groups all underwent CAP based chemotherapy,and patients in group A with additional MMC chemotherapy at the same time.Group A had been compared with the clear-cell ovarian cancer with the CAP protocol(group C,stage Ⅰ/Ⅱ 15 cases,stage Ⅲ/Ⅳ 9 cases).Results:There was significant statistical different value of the CA125 in stage Ⅰ/Ⅱ before operation and no significant statistical difference for stage Ⅲ/Ⅳ between the two groups.There were significant decrease in the CA125 value for the stage Ⅰ/Ⅱ and no significant decrease for stage Ⅲ/Ⅳ between two groups after three and six courses chemotherapy.There were 11(33.33%)cases developed with endometriosis and 7(21.21%)with deep venous thrombosis(DVT),however the DVT had no direct correlation to the survival rate.The average survival time for stages Ⅰ/Ⅱ in group A and B was(38.3?2.4),and(38.3?2.7)months,compared to(20?3)and(34?4)months in stage Ⅲ/Ⅳ,respectively.There was no significant statistical difference(P=0.471)in four-year survival rate between groups A and B with stage Ⅰ/Ⅱ and there was significant statistical difference(P
3.Interleukin-17 and interleukin-23 mRNA expressions in peripheral blood of patients with psoriasis vulgaris and their correlations with disease severity
Tong SU ; Hong CHEN ; Lu LI ; Jianlong MEN ; Guizhen LI
Chinese Journal of Dermatology 2014;47(4):278-281
Objective To compare the mRNA expressions of interleukin (IL)-17 and IL-23 in peripheral blood of patients with psoriasis vulgaris versus healthy individuals,assess the relationship of these parameters with psoriasis area and severity index (PASI) score,and to investigate the therapeutic mechanisms of total glucosides of peony (TGP) for psoriasis vulgaris.Methods Fifty patients with psoriasis vulgaris and 40 healthy individuals were enrolled in this study.Of these patients,42 were treated with TGP of 600-900 mg twice a day for 8 weeks.Blood samples were obtained from all the healthy individuals,50 patients before treatment,42 patients after 4-week treatment,and 23 patients after 8-week treatment.Real-time fluorescence-based quantitative reverse transcription PCR (RT-PCR) was used to determine the mRNA expression levels of IL-17 and IL-23 in the blood samples.The severity of psoriasis was evaluated using PASI score before and after the treatment.Statistical analysis was done by t test,rank sum test,and Pearson correlation analysis using the SPSS16.0 software.Results The IL-17 and IL-23 mRNA expression levels (given in △Ct value) in the patients before treatment were significantly higher than those in the healthy controls (IL-17,-5.32 ± 0.80 vs.2.79 ± 0.76,t =47.71,P < 0.05; IL-23,-5.43 ± 0.68 vs.-3.77 ± 0.86,t =10.38,P < 0.05),and positively correlated with the PASI score (r =0.61,0.52 respectively,both P < 0.05).A significant decrease was observed in the mRNA expression levels of IL-17 and IL-23 as well as PASI score in the 42 patients after 4-week treatment with TGP compared with those before treatment(IL-17,-2.24 ± 0.61 vs.-5.30 ± 0.78,t =20.40,P < 0.05; IL-23,-1.97 ± 0.74 vs.-5.44 ± 0.68,t =21.69,P < 0.05; PASI,5.8 ± 2.7 vs.9.4 ± 4.2,t =4.68,P < 0.05),and in the 23 patients after 8-week treatment compared with those after 4-wek treatment(IL-17,-1.51 ± 0.78 vs.-2.21 ± 0.59,t =3.50,P < 0.05; IL-23,-1.27 ± 0.81 vs.-1.89 ± 0.72,t =2.70,P< 0.05; PASI,3.8 ± 1.8 vs.7.3 ± 2.5,t =5.47,P< 0.05).Conclusions It seems that both IL-17 and IL-23 are involved in the pathogenesis of psoriasis vulgaris,and TGP treatment can reduce the mRNA expression levels of IL-17 and IL-23 as well as PASI score in patients with psoriasis vulgaris.
4.The effect of preoperative chemotherapy in stage Ⅰ_(b2) cervical cancer
Jianlong ZHU ; Lingda FENG ; Lei WENG ; Huijuan LU
China Oncology 2006;0(07):-
Background and purpose:The greastest diameter of cervical cancer with stage Ⅰ_(b2) disease was more than 4 cm in diameter. surgery as the fi rst priority was diffi cult in these patients, bleeding was the most frequent adverse effect. This article studied the effect of the cervical cancer with stage Ⅰ_(b2) disease underwent neoadjuvant chemotherapy with gemcitabin plus cisplatinum(DDP). Methods:23 cases (A groups) stage Ⅰ_(b2) cervical cancer were treated with gemcitabin 1.5 g/m2 iv infusion at d1, plus cisplatinum(DDP) 20 mg/m2 iv infusion at d1-3. The interval between the two cycles was two weeks.19 cases (B groups) were treated with cisplatinum(DDP) 20 mg/m2 iv infusion at d1-3,plus VCR 1.5 g/m2 iv infusion at d1, and BLM 10 mg/m2 im at d1-3, The interval between the two cycles was three weeks. The assessment for clinical effect and side effect were conducted for the patients with completion of at least two cycles of chemotherapy. Results:42 cases were enrolled in this trial. There was signifi cant(P=0.004) difference between the two groups with the shrinkage of the greatest diameter after neoadjuvant chemotherapy. The main toxicities were myelosuppression. There was signifi cant (P
5.Analysis on the present deployment of large medical equipments in China
Jianlong LU ; Lilang LYU ; Zhigang CAO ; Dongyang ZHAO ; Xiaohua YING
Chinese Journal of Hospital Administration 2017;33(5):377-380
Objective To analyze the overall deployment of Class-A large medical equipments in China.Methods Data of Class A large medical equipments deployed from 2007 to 2015 were collected and classified regionally,for the purpose of measuring the overall deployment,growth level and plan performance.Results There were 403 large medical equipments in China,a rapid rise of deployment,yet still far below developed countries in terms of per capita deployment.Regional differences were significant.With PET-CT as an example,the plan performance in the east(92.19%)was much higher than the west of China(68.57%);plan performance of Class-A equipments was better,conducive to regulating the increase and distribution.Conclusions The deployment level of Class-A equipments in China is low in general,and calls for better regulation regardless of the planning and management progress.
6.Follow-up research and dosage correlation analysis in patient with clopidogrel hypo-responsiveness after percutaneous coronary intervention
Min LU ; Tao FAN ; Jianlong ZHOU ; Xiaoqi JIN ; Xiaodong SHENG
Chinese Journal of Interventional Cardiology 2016;24(4):216-220
Objective To depermine if a double mainpenance dose of clopidogrel can improve phe clinical oupcome in papienps who have clopidogrel htpo-responsiveness ( CH) afper percupaneous coronart inpervenpion (PCI) and analtze correlapive risk facpors of CH. Methods We had enrolled 134 consecupive papienps undergoing PCI for spable coronart arpert disease in our cenper bepween Januart 2014 po June 2015. CH was depermined bt plapelep aggregapion measured bt phrombelaspographt ( TEG). Blood samples were paken 24 h and 3 monphs afper PCI procedure. All subjecps were divided inpo 2 groups (i. e phe CH group and phe clopidogral sensipive group) according po pheir responsiveness bt TEG. The CH group (n = 45) received a double mainpenance dose of clopidogrel as 150 mg/ d and phe clopidogrel sensipive group (n = 89) received a spandard mainpenance dose as 75 mg/ d. Changes in clopidogrel responsiveness and correlapive risk facpors were observed afper 3 monphs of clopidogrel preapmenp. Major adverse cardiac evenps (MACEs) and bleeding incidenps were recorded during follow-up lease 6 monphs. Results The clopidoprel htpo-responsive rape decreased from 33. 6% (45 / 134 papienps) po 11. 9% (16 / 134 papienps) afper 3 monphs of preapmenp. No spapispical difference found bepween phe 2 groups in morpalipt rape and non-fapal mtocardial infarcpion ( P >0. 05). Rapes of overall MACE (33. 3% vs. 22. 5% ), rehospipalizapion (26. 7% vs. 16. 9% ) and pargep vessel revascularizapion (11. 1% vs. 6. 7% ) were significanp higher in phe CH group ( all P < 0. 05) . Mulpivariape regression analtsis showed: smoking ( OR 4. 498, 95% CI 1. 378 - 4. 018, P = 0. 036), diabepes (OR 4. 385, 95% CI 1. 370 - 7. 552,P = 0. 026) and clopidogrel dosage ( OR 0. 597, 95% CI 1. 005 - 2. 676, P = 0. 019 ) were phe risk facpors for CH. Conclusions For papienp wiph htpo-responsiveness po clopidogrel afper PCI, a higher mainpenance dose of clopidogrel as 150 mg/ d for 3 monphs can provide equivalenp clinical benefip in serious adverse evenp (including morpalipt and non-fapal mtocardial infarcpion) compared po spandard mainpenance dose for clopidogrel responsive papienps.
7.Retrospective analysis of clinical application of BF-XP60 micro-bronchoscopy
Ye LU ; Huifang CUI ; Cuihua WU ; Xujun CHEN ; Jianlong HUANG ; Huilong YE ; Faguang JIN
Chinese Journal of Primary Medicine and Pharmacy 2015;22(9):1281-1283
Objective To retrospectively analyze of clinical application of BF-XP60 micro-bronchoscopy.Methods 135 clinical data of patients who adopted ultrafine micro-bronchoscopy and intervention were collected and analyzed for the complications.Results The frequency of local rhinomusoca damaging and errhysis was in 3 cases,the mucous of the glottis damaging and errhysis was in 2 cases,local mucous of the tracheal bronchus errhysis was in 3 cases.After intervention,the frequency of fever was in 13 cases,massive haemorrhage was in 1 case,pneumothorax was in 1 case,chest pain was in 2 cases,part fiber of inner untrafine micro-bronchoscopy broken was in 2 cases,check failure due to ultrafine micro-bronchoscopy broken in trachea was in 4 cases,and arrhythmia,asphyxia,and death were in 0 case.The overall incidence of side effects was 22.9% (31/135).Conclusion Application of ultrafine micro-bronchoscopy was contributed to find the lesions within the bronchioles and around the lungs,moreover,it could evaluate the distal bronchus of airway obstruction which was planned to adopt intervention.The topic that how to reduce the incidence of the side effects of the micro-brohchoscopy and improve the success rate and safety of inspection and intervention was worth to be concerned.
8.Comparative analysis of effect of two kinds of biological agents in volume-reduced bullae
Huifang CUI ; Xujun CHEN ; Wenqiao HUANG ; Yi SHU ; Yiqun WU ; Jianlong HUANG ; Huimin CHEN ; Ye LU
Chinese Journal of Primary Medicine and Pharmacy 2014;(20):3054-3056
Objective To retrospectively analyze the effect of two kinds of biological agents in volume -re-duced bullae .Methods 11 patients who suffered from bullae were operated under large C-arm locating ,and infused two kinds of biological agents through micro catheter of fibreoptic bronchoscopy .All of them were randomly divided into the two groups .The biological agents in group A were fibrinogen and diluent thrombin , and that of group B was Porcine Fibrin Sealant Kit .In group A,the micro catheter with diameter of micro thread less than 1.2mm was placed in bullae through fibreoptic bronchoscope ,and then the 2mL lidocaine,5 ml fibrinogen,and double of 500u diluent thrombin were inproperorder injected through micro catheter .In group B,the Porcine Fibrin Sealant Kit was injected at the same method,and then the suspension fluid was exacted .The operation time was recorded ,and then the clinical efficacy and incidence rate of complications were compared .Results The operation time of group A was 5-15 minutes, and that of group B was 6-20 minutes.For all the patients ,4 cases were totally effective ,2 cases were significantly effective,and 2 cases were totally non-effective.The total effective rate was 81.82%(9/11).The incidence rates of common complications in group A and B were 52.38%(22/42),58.33%(14/24),respectively,the difference was not significant (χ2 =0.22,P>0.05).Moreover,there were no serious complications in all cases .Conclusion The security and effect of two kinds of biological agents might be well enough ,but in view of less cases ,they were worth to further popularized and applied in clinical practice .
9.Blood coagulation biomarkers for postoperative venous thromboembolism diagnosis in orthopedic traumatic patients:a case control study
Ying MENG ; Ning LIU ; Bingrong XUE ; Jianlong LIU ; Shan LU ; Xu WANG ; Huiru ZHAO ; Meng WEN ; Jun WU
Chinese Journal of Laboratory Medicine 2016;39(10):751-755
Objective To evaluate the value of blood coagulation biomarkers in orthopaedic traumatic patients after surgery and analyze its diagnostic values for venous thrombosis embolism.Methods In thiscase control study, we consecutive enrolled 108 traumatic patients after surgery.54 patients have thrombosis and other 54 patients have no thrombosis.Blood was taken 3 -4 days after surgery.Routine coagulation screening test , FDP(fibrinogen/fibrin degradation products) , D dimer and new item such as TM( thrombomodulin) , TAT( thrombin-anti-thrombin complex) , t-PAIC( tissue-type plasminogen activator-plasminogen activator inhibitor complex),PIC(plasmin-anti-plasmin complex) were tested.The difference between groups of these biomarkers was compared, and then the receiver operation curve ( ROC) was drew to determine the diagnostic cut-off point and diagnostic performance.Results ALL blood coagulation biomarkers in orthopaedic traumatic patients after surgery were significantly increased.The group of patients with thrombosis have higher TM(9.04 ±2.06) IU/ml,t-PAIC(10.15 ±4.23) ng/ml, PIC(1.15 ±0.70)μg/ml, D dimer(5.31 ±5.10) ng/ml than group without thrombosis TM(7.50 ±1.70) IU/ml, t-PAIC (6.97 ±2.56)ng/ml, PIC(0.93 ±0.84)μg/ml,D dimer(2.35 ±2.12)ng/ml,and P=0.000 2,<0.000 1,<0.000 1,<0.000 1, respectively.However, TAT(4.79 ±4.32)ng/ml, (6.51 ±5.92)ng/ml, FDP (8.87 ±7.68 )μg/ml, ( 4.91 ±4.67 )μg/ml showed no difference between thrombosis groupand no thrombosis group, (P=0.212 3,0.050 8; respectively).The area under the ROC curve of TM, t-PAIC, PIC and D-dimer were 0.718 5,0.741 6,0.648 0,0.670 0, respectively; P values were <0.000 1,<0.000 1, 0.009 3,0.004 1, respectively; cut-off values were 11.15 IU/ml, 10.65 ng/ml, 1.36 μg/ml, 7.69 ng/ml, respectively;positive likelihood ratios were 9.00,11.29,3.66,14.60, respectively;specificity were 98.15%,96.23%, 90.20%, 97.96%, respectively; the diagnostic rates were 20.3%, 46.3%, 35.8%, 25.9%, respectively.Conclusions There were coagulation and fibrinolysis system activated in orthopaedic traumatic patients after surgery.TM, t-PAIC, PIC, D dimer were good biomarkers for the diagnosis of thrombosis after trauma surgery.TAT was not fit for screening thrombosis after surgery because of influence of anti-coagulation.
10.Sub-Health Status Survey and Influential Factor Analysis in Chinese during Coronavirus Disease 2019 Pandemic
Yanbin PAN ; Jianlong YAN ; Wanxian LU ; Miaohang SHAN
Journal of Korean Academy of Nursing 2021;51(1):5-14
Purpose:
This study aimed to investigate sub-health status (SHS) of people living in China during the Coronavirus disease 2019 (COVID-19) COVID-19 pandemic. COVID-19 is a severe acute respiratory syndrome coronavirus (SARS-CoV) infection-induced acute infectious disease, which is featured by universal susceptibility and strong infectivity, and SHS (a status of low quality health) refers to a status of low-quality health. COVID-19 has gradually developed into a global pandemic, making the public in a high stress situation in physiological, psychological and social states in the short term.
Methods:
From March 6 to 11, 2020, a large-scale cross-sectional survey was conducted by convenient sampling, and SHS assessment scale was used in the questionnaire. The ordinal logistic regression analysis was used to identify the factors affecting SHS.
Results:
In this study, 17,078 questionnaires were delivered with 16,820 effective questionnaires collected, and 10,715 subjects (63.7%) were found with SHS, with moderate SHS primarily. Physiological sub-scale scored the highest, followed by psychological and social sub-scales. Ordinal logistic regression analysis indicated that man, only-child, workers and farmers were risk factors of SHS. Protective factors of SHS included living in rural areas and townships, laid-off retirees and education degree.
Conclusion
It shows many people in China place in a poor health status during COVID-19 pandemic. It is necessary that relevant departments pay more attention to people with poor health such as men, only-child, urban people, workers and farmers, and groups with high education degree during and after pandemic stabilization.