1.Quantitative Study on the Development of Basic Medical Insurance Schemes in China: A Mixed Model Based on Universal Health Coverage
Haichao LEI ; Xuan CHENG ; Zhinan ZHOU
Chinese Health Economics 2017;36(4):23-28
Objective:Based on the perspective of Universal Health Coverage(UHC),a mathematical model was developed to conduct quantitative study on the development status of Basic Medical Insurance Schemes(BMIS) in China.Methods:A mixed model was developed to conduct quantitative study on the development of BMIS in the period of 2003-2015 from five dimensions:coverage of population,benefit package,reimbursement rate,risk pooling level and unity of the schemes.Sensitivity analysis was also performed.Results:The UHC scores for BMIS in China from 2003 to 2015 fluctuated obviously.Given the range of 0-100 percent,the UHC score in 2003 was 52.2%,28.5% in 2006,23.9% in 2010 and 26.5% in 2015.The integration and equalization of BMIS and scaling up the risk pooling levels were shown to contribute significantly to UHC.Conclusion:The construction of mixed models was developed to provide a new calculation assessment tool for measuring the UHC,which consisted of completed evaluation tool package with addition model and multiplication model.Considering the future development of UHC,there is a still long way to go for BMIS in China.Emphases should be given to integration and equalization of BMIS as well as scaling up the risk polling to provincial and national level.
2.Correlation Study Between Serum Soluble ST2 Level and the Early Clinical Prognosis in Patients With Acute ST-elevation Myocardial Infarction
Lei HE ; Jian PENG ; Xuan ZHENG ; Chengwei LIU ; Xi SU
Chinese Circulation Journal 2017;32(1):41-45
Objective: To preliminarily investigate the relationship between the baseline level of serum soluble ST2 (sST2) and 30-day MACE occurrence rate in patients with ST-elevation myocardial infarction (STEMI).
Methods: A total of 121 patients with confirmed diagnosis of STEMI in our hospital from 2015-05-01 to 2015-07-30 were consecutively enrolled. According to baseline sST2 level, the patients were divided into 2 groups:Low sST2 group, the patients with sST2≤56.68 ng/ml, n=61 and High sST2 group, the patients with sST2>56.68 ng/ml, n=60. Clinical condition and 30-day MACE (defined as death and new onset of congestive heart failure) occurrence rate were compared between 2 groups.
Results: ① The systolic blood pressure (SBP), Killip class≥II grade, blood levels of cTNI, NT-proBNP, hs-CRP and LVEF were different between 2 groups, all P<0.05. ② Baseline sST2 level was positively related to heart rate (r=0.271, P=0.003), Hs-CRP (r=0.359, P=0.000), cTNI (r=0.324, P=0.000) and NT-proBNP (r=0.425, P=0.000);negatively related to SBP (r=-0.226, P=0.013) and LVEF (r=-0.406, P=0.000).③30-day MACE occurrence rate was different between 2 groups (8.2%vs 30%, P=0.002). ④ Multivariate Cox regression analysis presented that sST2>56.68 ng/ml was the risk factor for 30-day MACE occurrence (HR=1.152, 95%CI 1.078-1.231, P=0.000).
Conclusion: Increased baseline level of sST2 implied the higher incidence of death and new onset of congestive heart failure in STEMI patients.
3.The effect of early enteral nutrition on post-operation recovery of patients undergone liver transplantation
Bin ZHANG ; Xuan WANG ; Zengcai LI ; Tao JIANG ; Lei LU
Parenteral & Enteral Nutrition 1997;0(04):-
Objective: To explore the effect of early enteral nutrition on post-operation recovery of patients undergone liver transplantation.Methods:86 patients undergone liver transplantation were enrolled,among which 37 cases undertook early enteral feeding and 49 cases were mainly giren parenteral nutrition.The infection rate,metabolism condition and immunol function of post-operation were compared.Results:Patients in EN group had a high lever of blood globulin and a lower infection rate,and their liver function recovery,rise of pre-albumin and decrease of CRP were much quick than those of PN group.Conclusion:Early enteral nutrition in post-operation patients can reduce stress reaction,promote synthesis metabolism,improve the recovery of liver cell and decrease the chances of infection.
4.The clinical characteristics and risk factors of pelvic insufficiency fracture in patients with cervical cancer after radiotherapy
Xianmin LI ; Ge WANG ; Wei HU ; Xuan HE ; Lin LEI
Chongqing Medicine 2014;(9):1095-1097
Objective To analyse the clinical features of pelvic insufficiency fractures (PIF) in patients with cervical cancer after radiotherapy and explore the risk factors affecting its occurrence .Methods 55 cases of patients with cervical cancer that used radia-tion therapy as a single treatment were chosen in our hospital from February 2007 to May 2010 and the clinical features were ana-lysed;The fractures of spine ,sacrum ,sacroiliac joint ,ilium and pubis and femoral were observed and the density of fifth lumbar (L5 ) vertebrae ,left and right sacrum were detected via the CT or MRI (Hounsfield Unit)after 2-year follow-up ,the different factors on the incidence of PIF were explored .Results 12 cases (19 sites) of patients in 55 patients occured PIF after follow-up 2years ,the cumulative incidence was 21 .82% ;the distribution of PIF parts were followed :lumbar vertebrae had 5 cases ,sacral had 5 cases ,pu-bis had 4 cases ,sacroiliac joint had 2 cases ,iliac had 2 cases and femoral head had 1 case .The incidence rate of PIF that density of fifth lumbar vertebrae was ≤130 HU and >130 HU were 16 .36% and 5 .45% respectively ,the PIF′incidence rate that density of left side of sacrum was≤ -35 HU and > -35 HU were 18 .18% and 3 .64% respectively ,the incidence rate of PIF that density of right side of sacrum was ≤ -35 HU and > -35 HU were 20 .00% and 1 .82% respectively ,the density of the three parts all had statistical difference on the incidence of PIF (P<0 .05) .Univariate analysis showed that menopausal status and the average density of CT had statistical effects on PIF (P<0 .05);Multiple analysis showed that the average density of CT was the independent factors affecting PIF′incidence after radiotherapy .Conclusion The patients with cervical cancer may occur pelvic insufficiency fracture af-ter radiotherapy ,and its incidence is related to menopausal status and bone mineral density .
5.Distribution and Resistance Variance Analysis of Pathogenic Bacteria Isolated from Blood Specimens
Yingpeng CUI ; Lei TANG ; Bing TANG ; Yan ZENG ; Jianmei XUAN
Chinese Journal of Nosocomiology 2006;0(02):-
OBJECTIVE To investigate the distribution and the resistance variance tendency of the pathogenic bacteria isolated from the blood cultureing specimens collected during the period of 2002-2005.METHODS A retrospective analysis was made to the blood cultureing results during the period of 2002-2005 with WHONET 5.1 software.RESULTS Gram-negative rods were the predominant bacteria which caused sepsicemia,the isolated rates of Escherichia coli,Klebsiella pneumoniae and Staphylococcus aureus were the most high during the period of 2002-2004 but the S.epidermidis and S.hominis were also the important pathogenic ones which caused blood stream infection.Vancomycin and the teicoplanin were the most effective to the Gram-positive bacteria,and the imipenem and the cefepime were the most effective to the Gram-negative ones.CONCLUSIONS It′s important to strengthen the blood cultureing for blood stream infection patient.
6.Study of drug distribution in tissue during treatment with targeting and continuous interstitial chemotherapy in the oral squamous cell carcinoma
Yunze XUAN ; Lei ZHENG ; Jianguo ZHANG ; Jie ZHANG ; Yan GAO
Journal of Practical Stomatology 2000;0(05):-
Objective:To study the drug distribution in the local tissues and lymph nodes treated with targeting and continuous interstitial chemotherapy for the oral squamous cell carcinoma before operation. Methods:8 patients with oral squamous cell carcinoma were treated by implanting the sustain-released cisplatin around and into the primary lesion. Drug distribution in tissue were studied by the graphite furnace atomic absorption spectrometry. Results:The drug concentration in the center of the tumor,1 cm and 2 cm from the tumor fringe were (34.877 1?15.720 8),(20.690 0 ?15.688 6) and (6.635 7?3.862 3) ?g/g, respectively. The drug concentration within lymph nodes of the sub-mental and submandibular area, deep cervical lymph nodes for the upper,middle and lower were(2.991 4?3.055 7),(4.026 0 ?3.692 0), (7.192 0 ? 8.958 7) and (5.028 5?3.484 3)?g/g, respectively. Conclusion:Targeting and continuous interstitial chemotherapy for the oral squamous cell carcinoma by implanting sustain-released cisplatin can increase drug concentration in the local tissues and the lymph nodes, to attain good efficacy of targeting chemotherapy.
7.Model organism C.elegans applications in the complex-system drug activity evaluation
Xinpei WANG ; Xuan YU ; Fan LEI ; Dongming XING ; Lijun DU
Chinese Journal of Comparative Medicine 2015;(3):67-72
Caenorhabditis elegans (C.elegans), has developed into an useful model for biomedical research, particularly in the targets of novel drugs and the related mechanism.C.elegans, combining with cost-effective cultivation, simple biological structure, make for high-throughput screenings in vivo model.In this review, we explore the feasibility of C.elegans in drug activity evaluation of complex systems.Because of the body independence of C.elegans, it provided good platform for the efficacy and mechanism of research on new drugs as well as Chinese herbal extract in vivo, showing a good prospect.
8.Analysis and Determination of the Composition of Monosaccharide in Polysaccharide from Leaves and Twigs of Morus nigra from Xinjiang
Lian SUN ; Lei MENG ; Yan WANG ; Xuan ZHANG
China Pharmacy 2007;0(36):-
OBJECTIVE:To analyze and determine the compositions of monosaccharide in polysaccharide from leaves and twigs of Morus nigra from Xinjiang.METHODS:The polysaccharides in leaves and twigs of M.nigra were extracted by water and precipitated by ethanol then hydrolyzed into monosaccharide by using 2 mol?L-1 H2SO4.The monosaccharide was derivatized with 1-phenyl-3-methyl-5-pyrazolone(PMP) and determined by RP-HPLC. RESULTS:The polysaccharide in leaves and twigs of M.nigra were composed of mannose,rhamnose,glucuronic acid,galacturonic acid,glucose,galactose and arabinose etc. All the 7 monosaccharides were well-separated within 25 min. CONCLUSION:The method is simple and sensitive with accurate results,and it can be used for the quality control of leaves and twigs of M.nigra from Xinjiang.
9.Implement Continuous Quality Improvement and Improve the Satisfaction of Nursing Quality
Hongzhen ZHOU ; Yafang ZHU ; Qingmei LEI ; Xuan LI ; Honglei YU
Chinese Medical Ethics 2017;30(2):220-223
Objective:To explore the effect of continuous quality improvement theory on patients' satisfaction and nurses'perception of working environment.Methods:Quality nursing service satisfaction survey was conducted in 450 patients,at the same time,100 nurses were investigated for the situation of working environment.Patients' satisfaction and the status of nurses' perception of their own work environment were compared before and after the implementation of continuous quality improvement theory.Results:After the implementation of continuous quality improvement theory,both patients' satisfaction and nurses' perception of working environment were significantly improved (P < 0.05).Gonclusions:Continuous quality improvement theory can improve the satisfaction of patients with high quality nursing service,and enhance the nurses' perception of their working environment.
10.Clinicopathological characteristics of colorectal cancer presenting at young age
Junping LEI ; Guangyan JI ; Jia FU ; Xuan ZHANG ; Zhengqiang WEI
Chongqing Medicine 2015;(32):4517-4518,4521
Objective The aim of this study was to analyse characteristics of CRC in a cohort under the age of 40 .Methods Using single center retrospective cohort study ,we reviewed the prospectively collected database of 2 897 colorectal cancer patients who had undergone curative CRC resections in Chongqing Medical University between 2010 and 2014 .175 patients (5 .8% ) were under 40 ,in which six patients for various reasons (including recurrent colorectal cancer hospital ,incomplete information ,etc .) were excluded .A group of 180 consecutive patients over the age of 40 undergoing surgery for colorectal cancer in the same centre was used as control .Results There had no difference in tumor classification and tumor location between the younger group (<40) and the older group(>40) ,but the lymph node positive rate in younger group was higher ,unable to accurately grasp the preopera‐tive lymph node status ,lead to lack of preoperative staging ,and that made it difficult to preoperative treatment options .Conclusion Therefore ,to young people in colorectal preoperative neoadjuvant chemoradiation indications and the assurance of intraoperative re‐section range ,we need to do more consideration.