1.The Financial Mechanism of American Medicaid and the Medical Expenditure Expansion
Chinese Health Economics 2013;(12):117-119
Objective: Analysis on the financial influences of for Medicaid expenditure expansion. Methods: Using Economics analysis to study the relation between the method of Federal Medicaid grants and scope of States Medicaid. Results and Conclusion:The design of transfer payment motivated the states government to pursue maximizing Federal grants , which led to the medical expenditure expansion. The Policy aims on establishing unify Medicaid policy in the nation and all grants raised from the Federal government.
2.Observation on the effect of rice water on prevention of diarrhea in patients with traumatic head injury undergoing enternal nutrition
Jinling ZHOU ; Qunxiang LI ; Yinghe CHEN
Chinese Journal of Practical Nursing 2009;25(9):33-34
Objective To investigate the effect of rice water on prevention of diarrhea in patients with traumatic head injury undergoing enternal nutrition. Methods 110 patients with traumatic head injury in neurosurgery department were selected and randomly divided into the observation group and the control group.The observation group was fed with rice water in the early two days of entemal nutrition and then begun with nutrient solution on the third day, as to the control group,patients were fed with nutrient solution at the beginning of enternal nutrition. Incidence of diarrhea in these two groups were viewed and underwent χ2 test. Results The number of samples with diarrhea in the observation group(3 cases) was significantly less than that of the control group (12 cases). Conclusions Feeding with rice water can clean the intestine, regulate the function of gastrointestinal tract and reduce the incidence of diarrhea obviously in patients with traumatic head injury during the early period of enternal nutrition.
3.The role of Flexi Slice imaging by real time 3D transesophageal echocardiography in measurement of left atrial appendage in patients with atrial fibrillation
Hongning SONG ; Ruiqiang GUO ; Qing ZHOU ; Jinling CHEN ; Bo HU
Chinese Journal of Ultrasonography 2015;(7):558-561
Objective To measure left atrial appendage (LAA)in patients with atrial fibrillation using Flexi Slice imaging by real time 3D transesophageal echocardiography (TEE),and compare with common multiplane TEE.Methods Forty-six patients with atrial fibrillation were performed 2D and real time 3D TEE.Zero degree,45°,90° and 135° plane were acquired by 2D TEE and Flexi Slice remolding. Maximum and minimum values of ostium of left atrial appendage were acquired in the short axis view of LAA by Flexi Slice remolding.Results Compared with 2D TEE,values acquire by Flexi Slice in measurement of LAA ostium showed no significant difference(P >0.05).The depth measurement by Flexi Slicein 45° and 90° plane showed significant difference with 2D TEE (P-values were successively 0.045, 0.002),and in 0 and 135° plane showed no difference.All values measured by 2D TEE and Flexi Slices showed significant correlation.Bland-Altman plot showed that 94.29% of plots were among limits of agreement,which was (-2.5 mm,2.9 mm).The maximum values of LAA ostium values ranged from 30° to 160°,among which 87% (40/46 cases)distributed between 90° and 1 50°,and minimum values ranged from 0°to 160°,among which 85%(39/46 cases)distributed between 0°and 60°.Conclusions Measurement of LAA can be well achieved by Flexi Slice imaging,which showed significant advantage compared with 2D TEE.
4.Evaluation of left atrial systolic function with strain rate imaging in patients with coronary heart disease after coronary artery bypass grafting
Tian WU ; Ruiqiang GUO ; Jinling CHEN ; Qing ZHOU ; Honggang CHU
Chinese Journal of Medical Imaging Technology 2009;25(10):1789-1792
Objective To explore the changes of left atrial systolic function in patients with coronary heart disease after coronary artery bypass grafting (CABG). Methods Strain rate imaging (SRI) was performed on 23 patients with coronary heart disease before CABG, 1 week, 1 and 3 months after CABG to evaluate left atrial systolic function quantitatively. Results No significant change of left atrial systolic function was detected 1 week after CABG (P>0.05 ). E/A and LVEF increased, LAFS, AEF and SRa decreased 1 month after CABG compared with those before CABG (P<0.05). Three months after CABG, changes turned more significantly (P<0.01). Left ventricular ejection fraction (LVEF) increased 1 and 3 months after CABG, and its changing rate negatively correlated with those of Sra (r=-0.751,-0.783; all P<0.01). Conclusion Left atrial systolic function is affected by CABG, presenting as decrease of pump function. SRI can be used to evaluate the atrial systolic function quantitatively and monitor the changing of left atrial systolic function dynamically after CABG.
5.Evaluation of consistency between V-plane imaging and tissue Doppler imaging for systolic synchronicity in patients with dilated cardiomyopathy
Hongning SONG ; Qing ZHOU ; Zhenying QIN ; Jinling CHEN ; Ruiqiang GUO
Chinese Journal of Ultrasonography 2014;23(7):558-561
Objective To evaluate left ventricular systolic synchronicity in patients with dilated cardiomyopathy by V-plane imaging and compare with clinical commonly used tissue Doppler imaging (TDI),evaluate the relevance and consistency between these two parameters.Methods 20 patients diagnosed with DCM and 20 healthy controls were enrolled,2D images,V-plane imaging and TDI waveform were acquired.Time to peak velocity of left ventricular 12 segments were measured by TDI and the standard deviation (TDI_SD) were calculated.Displacement time to peak were measured by V-plane and the standard deviation (V-plane_SD) were calculated.Results Compared with control group,TDI_SD and V-plane_SD increased significantly (P < 0.01),TDI time to peak increased and V-plane time to peak decreased significantly(P <0.01).In the two group,12 segment time to peak measured by V-plane were significantly higher than TDI(P < 0.01).There was a significant correlation between TDI_SD and V-plane_SD (r =0.925,P <0.001).Bland-Altman plot showed that 95% plots of ratio of TDI_SD and V-plane_SD were among limits of agreement,which was (0.50,1.36).Conclusions Left ventricular systolic synchronicity in DCM patients can be observed by V-plane imaging.V-plane has significant relevance and consistency with TDI,and can overcome the limitations of TDI that 12 segments can not be displayed in the same cardiac cycle.
6.Report of a survey results of iodine deficiency disorders in Lianyungang, Jiangsu Province in 2013
Yanmin MAO ; Xiaomei ZHOU ; Jinling WANG ; Zhongshun ZHAO ; Zhiliang CHEN
Chinese Journal of Endemiology 2015;34(2):123-126
Objective To investigate the current status of iodine deficiency disorders in Lianyungang,Jiangsu Province,and to evaluate the effectiveness of prevention and control measures.Methods Using population probability proportional to size sampling method (PPS),in Lianyungang City,30 townships (towns) were selected,one primary school was selected in each township (town),fifty 8-10 years old students (half male and half female,uniformly distributed in age groups) were selected in each school,and goiter was examined; one random urine sample was collected to survey the urinary iodine content; household salt sample was collected to survey the salt iodine content.At the same time,30 students from Grade 5 in each school were selected,and health education questionnaire survey was conducted.In the village where the primary school located,5 housewives were selected and a questionnaire survey was conducted; salt samples were collected and salt iodine level was tested by semi quantitative detection on site; 2-5 drinking water samples were collected and the water iodine level was determined in the village.One random urine sample from twenty pregnant women and 10 lactating women in the township (town)was selected and urinary iodine was determined.The goiter was examined by palpation; urinary iodine was detected by arsenic cerium catalytic spectrophotometry (WS/T 107-2006); salt iodine was detected by direct titration,Sichuan salt and other fortified edible salt were tested by arbitration law (GB/T 13025.7-2012); water iodine was detected by the method suitable for iodine deficiency and high iodine areas (recommended method of reference laboratory of national iodine deficiency disorders).Results One thousand and five hundred children aged 8-10 years old were examined by palpation,18 children had goiter,and the goiter rate was 1.20% (18/1 500).One thousand and five hundred urine samples of children aged 8-10 years old were tested,and the median of urinary iodine was 239.62 μg/L.A total of 1 500 salt samples were tested; the coverage rate of iodized salt was 96.73% (1 451/1 500); the rate of qualified iodized salt was 93.53% (1 403/1 500); and the non-iodized salt rate was 3.27% (49/1 500).The number of question of the questionnaire survey of health education about iodine deficiency disorders among students and housewives was 2 697,450; the number of correct answer was 2 542,410; the pass rates were 94.25% and 91.11%,respectively.Sixty-six drinking water samples were collected,water iodine median was 13.5 μg/L.Six hundred and one,two hundred and ninety-eight urine samples of pregnant women and lactating women were monitored,and the median of urinary iodine was 176.12 and 150.03 μg/L,respectively.Conclusion The status of iodine nutrition among residents in Lianyungang City has improved,the control effect of iodine deficiency disorders is significant,and the achievements are stable.
7.Detection different coronary artery stenosis by integrated backscatter combined with dobutamine stress echocardiography
Qing ZHOU ; Ruiqiang GUO ; Jinling CHEN ; Lan LIU ; Lidan HAO
Chinese Journal of Ultrasonography 2003;0(07):-
Objective To investigate whether the sensitivity and specificity of detecting different coronary artery stenosis could be improved by cyclic variation of integrated backscatter(CVIB) under dobutamine stress echocardiography (DSE).Methods Thirty-two patients with suspected coronary artery disease underwent DSE before selected coronary angiography.CVIB of the left ventricular myocardial segments supplied by three coronary branches was analyzed at the baseline and the stages of DSE.Results Comparing with the value of baseline and low dose stages,in ischemic myocardium,CVIB decreased under high dose.While in non-ischemic myocardium,CVIB showed no difference at all stages of DSE.Taking CVIB
8.Clinic study of strain rate and dobutamine stress echocardiography in the diagnosis of coronary heart disease
Ruiqiang GUO ; Jiaqi HU ; Qing ZHOU ; Lidan HAO ; Jinling CHEN
Chinese Journal of Ultrasonography 1993;0(04):-
Objective To explore the value of strain rate and dobutamine stress echocardiography(DSE) in the diagnosis of coronary heart disease. Methods High-dose DSE was performed in 18 patients with coronary heart disease and 10 healthy persons, proved by selected coronary angiography. Ten patients had single coronary lesion, and the other 8 patients had more. By strain rate technology, systolic peak strain rate(SR_ SYS ) was measured in 12 segments of healthy persons and ischemic segments of patients. Results SR_ SYS of healthy subjects enhanced by the increasement of dose of DSE. In patients with single coronary lesion, SR_ SYS enhanced on the first states of baseline, 10 and 20 ?g?kg -1 ?min -1 ,while SR_ SYS changed non-significantly on 30 ?g?kg -1 ?min -1 , and began to decrease on 40 ?g?kg -1 ?min -1 . However in patients with more than one coronary lesions, SR_ SYS of 10 ?g?kg -1 ?min -1 became larger than that of baseline, while SR_ SYS didn't increase any longer on 20 ?g?kg -1 ?min -1 , and fell significantly on 40 ?g?kg -1 ?min -1 . Conclusions Combining stain rate and DSE to quantify local myocardial motion is valuable to offer many important clinic messages, and improves the diagnosis of coronary heart disease.
9.Value of predicting functional improvement of viable myocardium after percutaneous transluminal coronary angioplasty by dobutamine strain rate imaging
Ruiqiang GUO ; Wenli JIANG ; Qing ZHOU ; Jinling CHEN ; Lidan HAO
Chinese Journal of Ultrasonography 2003;0(05):-
Objective To evaluate the value of predicting functional improvement of viable myocardium after percutaneous transluminal coronary angioplasty(PTCA) by strain rate imaging(SRI) combining with low-dose dobutamine stress echocardiography(LDDSE).Methods PTCA was performed in 20 patients with old myocardial infarction and 72 segments of resting dyskinetic wall motion at baseline were observed.Peak systolic strain rate(SSR) and systolic peak velocity(Vs) were measured in abnormal walls at baseline and SRI combined with LDDSE one day before PTCA.Increment of SSR and Vs was defined during stress echocardiography(?SSR% and ?V_S%).The follow-up analysis was performed 6 weeks after PTCA.Results The dyskinetic motion of 48/72 segments was improved according to the follow-up echocardiography 6 weeks after PTCA while that of 24/72 segments was not.Considering ?SSR%≥(2.02%),?V_S%≥(8.5%) in 5 ?g?kg~(-1)?min~(-1) stress and ?SSR%≥(24.7%),?V_S%≥(28.5%) in 10 ?g?kg~(-1)?min~(-1)stress as cut-offs for motion improvement of the left ventricular dyskinetic segments,the sensitivities were(93.8%),(89.6%) and(95.8%),(91.7%),respectively.At baseline SSRs of two groups were significantly different while Vs did not have significant difference.Conclusions Combined with LDDSE,SRI can more accuratly predict the motion improvement of viable myocardium than tissue velocity imaging can.
10.Detection of viable myocardium by using quantiative tissue velocity imaging in low dose dobutamine stress test
Jinling CHEN ; Ruiqiang GUO ; Qing ZHOU ; Lidan HAO ; Congxin HUANG
Chinese Journal of Ultrasonography 2003;0(07):-
Objective To detect viable myocardium in patients with old myocardial infarction(OMI) by using quantitative tissue velocity imaging(QTVI) in low dose dobutamine stress test(LDDSE).Methods(Twenty-five) patients with OMI were accepted QTVI examination including 2-chamber,4-chamber apical view.QTVI indices included peak velocity in isovolumic contraction(V_(IVC)),peak velocity in systolic(V_S) and time of isovolumic contraction(T_(IVC)).Results Two hundred segments were divided into the normal(group N,72 segments),viable myocardium(group V,77 segments) and non-viable myocardium(group NV,51 segments).At baseline,compared with group N,V_(IVC),V_S of group V and group NV decreased significantly(P