1. Investigation of inpatients with chronic kidney disease in a tertiary referral hospital in shanghai from 2011 to 2016
Academic Journal of Second Military Medical University 2018;39(1):13-18
Objective To analyze the demographic information and related costs of inpatients with chronic kidney disease (CKD) in a tertiary referral hospital in Shanghai from 2011 to 2016, so as to provide reference for further understanding and improving the current situation of medical treatment of patients with CKD in Shanghai. Methods We retrospectively reviewed the clinical data (age, gender, hospital stay, disease diagnosis, hospitalization expenses and so on) of inpatients with CKD in a tertiary referral hospital in Shanghai from 2011 to 2016. The general characteristics and disease diagnosis of the inpatients with CKD were statistically analyzed by calculating the proportion of each index using a simple statistical description method. The treatment, hospitalization expenses of the inpatients with CKD were compared between different groups by variance analysis and non-parametric test. Results The percent of inpatients from Jiangsu, Zhejiang, Anhui and Jiangxi provinces around Shanghai was 49.97% (10 033/20 079), surpassing that of inpatients from Shanghai (38.78%, 7 787/20 079). The proportion of inpatients with chronic renal failure was the highest (51.98%, 10 438/20 079), and more young people tended to suffer from the disease. The per capita hospitalization expense was increased annually, and the median hospitalization expense was 8 252.51 yuan in 2016. There were significant differences in per capita hospitalization expenses between the different year groups (P0.001). Conclusion Active and effective measures should be taken to deal with the problem of large numbers of nonlocal patients seeking medical services in Shanghai. It is necessary to popularize the knowledge about CKD in young people, and reduce the social and personal losses due to the illness. The economic burden caused by CKD needs to be further studied.
2. Time series analysis of per diem expense of inpatients with chronic kidney disease in a tertiary referral hospital in Shanghai
Academic Journal of Second Military Medical University 2018;39(1):29-36
Objective To study the tendency of per diem expense and drug cost ratio of inpatients with chronic kidney disease (CKD) and the top three diseases (chronic renal failure, nephrotic syndrome, and primary glomerulonephritis) in a tertiary referral hospital in Shanghai from 2011 to 2016, so as to predict the per diem expense and drug cost ratio of inpatients in 2017. Methods We analyzed the per diem expense, drug cost ratio and other general situation of inpatients with CKD, and conducted the modeling research by the expert modeler in SPSS 23.0 software time series analysis module. Firstly, the per diem expense and drug cost ratio of inpatients with CKD from Jan. 2011 to Dec. 2015 were used to build model, and then the per diem expense and drug cost ratio of the inpatients in 2016 predicted by the model were compared with the real data of the inpatients in 2016 and the values of the model were evaluated. Secondly, the per diem expense and drug cost ratio of inpatients with CKD in 2017 were predicted. Finally, according to the same principle, the per diem expense and drug cost ratio of inpatients with chronic renal failure, nephrotic syndrome and primary glomerulonephritis in 2017 were predicted. Results The per diem expense, per capita hospitalization expense and per capita drug expense of inpatients with CKD increased annually from 2011 to 2016, and the expenses were (1 506.89±1 003.34) yuan, 8 252.51 yuan and 2 009.88 yuan in 2016, respectively, with the growth rates being 62.38%, 41.62% and 14.44%, respectively. The drug cost ratio of the inpatients decreased annually, and the ratio reached 32.33% in 2016. The time series models established by the per diem expense and drug cost ratio of inpatients with CKD were Winters additive model and simple seasonal model, respectively. According to the time series model, the predicted per diem expense and drug cost ratio in 2016 were consistent with the real values in 2016. The per diem expense and drug cost ratio of inpatients with CKD in 2017 predicted by the time series model were about 1 600 yuan and 30%, respectively. The predicted per diem expenses of inpatients with chronic renal failure, nephrotic syndrome and primary glomerulonephritis in 2017 were about 1 700 yuan, 1 800 yuan and 1 600 yuan, respectively, and the predicted drug cost ratios were about 30%, 35% and 10%, respectively. Conclusion The hospital income structure is constantly optimized, and a real-time disease cost monitoring information platform should be established. The research based on the trend of single disease expense needs to be further studied.
3.Experimentally investigating the effect of buccal acupuncture on analgesic time-effect characteristics and monoamine neurotransmitters
Rui-Sheng PU ; Xiao-Li FANG ; Wang-Jun JIE ; Ding-Long LIU ; Cheng-Hong SU ; Yan-Ping YANG
Journal of Acupuncture and Tuina Science 2018;16(4):229-235
Objective:To investigate the analgesic time-effect characteristics and changes in concentrations of rabbit's hypothalamic 5-hydroxytryptamine (5-HT) and noradrenaline (NE) caused by buccal acupuncture in the rheumatoid arthritis (RA) rabbits,and to reveal the analgesic central mechanism of buccal acupuncture,thereby providing a theoretical basis for the treatment of pain by buccal acupuncture.Methods:Forty rabbits were randomly divided into a normal group,a model group,a body acupuncture group,and a buccal acupuncture group,with 10 rabbits in each group.No model was established in the normal group,while equal dose of normal saline was injected at the matched site and time point;rabbits in other groups were subjected to the establishment of RA models using egg protein.From the 27th day of the experiment,rabbits in each group received the designated intervention.Rabbits in the normal group and the model group were fixed for 30 min every day using the same method as those in the other groups.In the acupuncture group,Dubi (ST 35) and Zusanli (ST 36) on bilateral hind limbs were selected.Perpendicular needling (using the needles with 0.25 mm in diameter and 25 mm in length) was performed with twirling manipulation for 15 s at intervals of 5 min.The needles were retained for 30 min and acupuncture was performed once a day.In the buccal acupuncture group,the knee point in the buccal acupuncture and needles with a diameter of 0.25 mm and a length of 15 mm were selected.Oblique needling was performed with twirling manipulation for 15 s at intervals of 5 min.The needles were retained for 30 min and acupuncture was performed once a day.The thermal pain thresholds at the 0,5,15,30,60,120 and 240 min after the 1st and 10th acupuncture therapy were measured with a PL-200 thermal-inducing pain meter.After the 10th acupuncture therapy,rabbit's hypothalamus was removed,and the 5-HT and NE concentrations in the hypothalamus at the peak point of the acupuncture pain threshold curve were determined by high performance liquid chromatography (HPLC).Results:The analgesic effect was obvious at 5 min after buccal acupuncture started,peaked at 30 min,and decreased to the lowest value at 240 min.Rabbits in the body acupuncture group began to show significant analgesic effect at 15 min,which was peaked at 30 min,and began to decline at 60 min.The pain threshold at 240 min was still higher than that at 0 min.Compared with the model group,the concentrations of hypothalamic 5-HT in the buccal acupuncture group and the body acupuncture group was significantly increased,and the between-group differences were statistically significant (both P<0.05).The NE/5-HT ratios in hypothalamus in the buccal acupuncture group and the body acupuncture group were significantly lower than the ratio in the model group,and the differences were statistically significant (both P<0.05);difference in the decrease was statistically significant between the buccal acupuncture group and the body acupuncture group (P<0.05).Conclusion:The analgesic effect of buccal acupuncture shows an obvious time-dependent curve.It is characterized by rapid onset of pain relief,rapid increase and decline in pain threshold.5-HT and NE levels in rabbit's hypothalamus can be affected by buccal acupuncture,with increased 5-HT concentration and reduced NE/5-HT ratio.
4.Isolation of Endophytic Bacteria from Glycyrrhiza and Identifying of Antagonistic Bacteria
Xiao-Li RAO ; De-Long SHEN ; Jun LI ; Xin JIANG ; Li LI ; Min ZHANG ; Rui-Hua FENG ;
Microbiology 1992;0(04):-
98 endophytic bacteria strains were isolated from different internal tissues of Glycyrrhiza uralensis plants collected from Innermongolia region. Results indicated that the population densities of endophytic bacteria ranged from 5.0?104cfu/g~2.9?107cfu/g fresh weight although it varied depending on tissue of the plant. Among these strains, Bacillus sp. was the most prevalent endophytic bacterium, which was amount to 30%.Of the 98 isolates, 6 strains exhibited extensive antagonistic activities against pathogenic bacteria. Characterization showed that these bacteria were Bacillus atrophaeus、Paenibacillus polymyxa、Bacillus subtilis、Paenibacillus ehimensis. This study indicated that selected 6 endophytic bacteria strains have potential for biological control of plant disease.
6.Altered systemic iron metabolism in welders exposed to manganese.
Ling LU ; Long-lian ZHANG ; Guo-jun LI ; Wen-rui GUO ; Wan-nian LIANG ; Zheng WEI
Chinese Journal of Industrial Hygiene and Occupational Diseases 2006;24(1):31-34
OBJECTIVETo investigate the systemic changes of iron metabolism following manganese exposure.
METHODSNinety-seven welders and 91 workers with no history of exposure to manganese were recruited from the same factory in Beijing serving as the exposure group and the control group respectively. The welding rods used were type J422. The concentration of the manganese in the air of the work place was determined respectively with the national standard method. The serum iron and manganese, ferritin, transferrin and transferrin receptors were measured with the graphite furnace atomic absorption spectrophotometry and ELISA in both groups.
RESULTSThe permissible concentration-STEL of ambient Mn in welders' breathing zone ranged from 0.53 mg/m(3) to 2.19 mg/m(3), while the permissible concentration-TWA of ambient Mn was between 0.29 mg/m(3) and 0.92 mg/m(3) in the breathing zone of the workplace. Serum Mn and Fe concentrations in welders were about 1.40 times (P < 0.0l) and 1.2 times (P < 0.01), respectively, higher than those of control subjects. At the same time, the transferrin concentrations in serum were significantly higher (about 1.2 times, P < 0.05) in welders than in controls. In contrast, transferrin receptors were significantly lower (about 1.2 times) in exposed subjects than controls (P = 0.001). There was no difference in serum ferritin between the two groups (P = 0.112). Although there was no significant trend, the serum ferritin level was increased by 18% in comparison with that of the control. The abnormal percentage of serum Fe and Serum Mn in welders were 55.67% and 67.01% respectively, higher than those of control subjects. In addition, the correlations between all indicators and the duration of employment were not observed.
CONCLUSIONThe long term exposure to the manganese can induce the disorder of the iron metabolism, which is found in the expression of increase of the serum iron and transferrin as well as the decrease of transferrin receptors.
Female ; Ferritins ; blood ; Humans ; Iron ; metabolism ; Iron Metabolism Disorders ; chemically induced ; Male ; Manganese ; adverse effects ; Occupational Exposure ; adverse effects ; Receptors, Transferrin ; blood ; Transferrin ; analysis ; Welding
7.Screening of proteins interacting with hepatitis C virus NS3 from T7-phage display library.
Ying HUANG ; Xue-fei CAI ; Mao-rui HE ; Jun ZHANG ; Ai-long HUANG
Chinese Journal of Hepatology 2006;14(8):561-564
OBJECTIVETo screen and identify proteins that interact with hepatitis C virus NS3 by means of T7-phage display system.
METHODSHepatitis C virus NS3 was expressed by prokaryotic expression and used as a selected molecule to biopan the T7 select human liver cDNA library; the selected positive clones were identified using DNA sequencing and analyzed with BLAST program in GenBank.
RESULTSAfter BLAST analysis in all the positive clones, the proteins which interacted with the hepatitis C virus NS3 were found to be serpin peptidase inhibitor, clade A, member 1 (SERPINA1) and cyclophilin-LC.
CONCLUSIONT7-phage display system is a convenient, rapid and effective method for screening interacting proteins. The proteins thus selected will provide an important means for studying the pathogenesis and carcinogenesis of HCV.
Cell Line ; Gene Library ; Hepacivirus ; metabolism ; Humans ; Peptide Library ; Protein Interaction Mapping ; methods ; Viral Fusion Proteins ; genetics ; isolation & purification ; metabolism ; Viral Nonstructural Proteins ; genetics ; metabolism
8.Influence of Xinqin tablets on guinea-pig nasal hypersensitivity.
Rong ZHANG ; Yan YU ; Jun-rong DU ; Jian LIU ; Jie ZHANG ; Ting WEI ; Xin LI ; Jiang LI ; Rui LONG
China Journal of Chinese Materia Medica 2005;30(10):785-788
OBJECTIVETo study the influence of Xinqin tablets on guinea-pig nasal hypersensitivity.
METHOD2,4-Toluene Diisocyanate (TDI) was selected as antigen and used in nose to establish guinea-pig allergic rhinitis. The effects of Xinqin tablets on symptoms of nasal hypersensitivity in guinea-pigs, histamine content of nasal mucosa and activity of nitric oxide synthase (NOS) were examined.
RESULTXinqin tablets could significantly relieve the pathological symptoms of nasal hypersensitivity in guinea-pig, reduce histamine content of nasal mucosa and inhibit the activity of nitric oxide synthase.
CONCLUSIONXinqin tablets have significant effect on nasal hypersensitivity, and prevent the occurrence of allergic rhinitis.
Animals ; Asarum ; chemistry ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; pharmacology ; Guinea Pigs ; Histamine ; metabolism ; Male ; Nasal Mucosa ; drug effects ; metabolism ; pathology ; Nitric Oxide Synthase ; metabolism ; Phytotherapy ; Plants, Medicinal ; chemistry ; Rhinitis, Allergic, Perennial ; chemically induced ; metabolism ; pathology ; Scutellaria ; chemistry ; Toluene 2,4-Diisocyanate
9.High-frequency color Doppler ultrasonography: valuable for diagnosis of polyorchidism.
Gang WU ; Jian-Jun YUAN ; Qiang WU ; Tao DU ; Rui-Jin ZHOU ; Long YANG
National Journal of Andrology 2010;16(8):716-720
OBJECTIVETo investigate the application value of high-frequency color Doppler ultrasonography in the diagnosis of polyorchidism.
METHODSWe retrospectively studied 6 cases of polyorchidism diagnosed by ultrasound, 5 of which were pathologically confirmed, and analyzed the sonographic and clinical findings.
RESULTSAll the 6 cases were triorchidism, 4 located in the scrotum, and 2 in the same groin with indirect hernia. The supernumerary testis was linked to the epididymis in 3 cases, 1 accompanied with repeated epididymis and vas deferens, and 2 connected to no vas deferens and epididymis. Color Doppler ultrasonography revealed blood flow signals in 4 cases, but not in the other 2.
CONCLUSIONPolyorchidism has typical sonographic appearances, and high-frequency color Doppler ultrasonography plays an important role in its diagnosis.
Adolescent ; Adult ; Child ; Child, Preschool ; Humans ; Male ; Retrospective Studies ; Testicular Diseases ; diagnostic imaging ; Testis ; abnormalities ; diagnostic imaging ; Ultrasonography, Doppler, Color
10.Analysis on the hierarchical medical system of regional longitudinal medical consortium based on system dynamics
Zi-Xue SUN ; Jun-Rui LONG ; Guang-Feng DUAN ; Wen-Hua TIAN
Chinese Journal of Health Policy 2018;11(10):20-28
Objective: To analyze the change in community first diagnosis and two-way referral rate under the condition of the regional longitudinal medical consortium implementation in the country at large. According to the simulation results,some suggestions for hierarchical medical system were put forward. Methods : The community first diagnosis and two-way referral rates were determined using the literature meta-analysis, and were simulated under different conditions by means of the system dynamics. Results :The analysis results confirmed that simply increasing the financial subsidies can increase the community first diagnosis rate within a range from 0.08% to 0. 17%. For in case increases are made by the government in technical financial input to enhance the technical level of the community health service centers and in compensatory financial input to reduce the higher hospitals dependence on the light disease, results showed that the lower conversion rate increased within the range of 0.33%~0.45% in terms of the two-way referral rating. On the contrary, when technical financial input is increased to improve the technical level of community health service centers, the rate of change was in the range of 7.52% '- 12.61% - Conclusions : Firstly, the diversified strategy should be used to promote the achievement of graded diagnosis and treatment. Secondly, the Health Commission plays a key role in the promotion of themedical consortiumconstruction. Thirdly, medical insurance reimbursement differential strategy should be implemented and the supply-side reform should be strengthened. At last,attention should be paid to the rational development of existing referrals, especially the upper and lower ones.