1.Analysis of high-value medical supplies price setting policy under the disease fee payment system reform in China: A case of Endoscopic Retrograde Cholangio-Pancreatography (ECRP)
Yingmin WU ; Maojuan HUANG ; Tian REN ; Mei ZHANG
Chinese Journal of Health Policy 2017;10(6):49-53
This paper analyzes the ERCP price setting policy and its impact on the patient''s cost and it puts forward possible price setting policy recommendations, according to the current situation of the disease payment system reform and promotion prospects of ERCP.ERCP belongs to the low-price high-value medical supplies, but hospitalization expenses data of 9 types of diseases show that consumables accounted for 35.81~48.25%.The main factor hindering widely the application of ERCP lies in high-ratio self-payment and high medical cost, in other words, as the ERCP supplies are not included in the scope of medical insurance payments, the current rate of patients with high surgical expenses, medical costs are expensive.As per the analysis of this paper, the following are the policy recommendations to put forward 1)Paying attention to historical settlement data and scientific formulation of disease charges;2)Considering different treatment methods and allocate appropriate disease payment standards;3)Standardize operation code to ensure the information quality of accurate disease expenses calculation.
2.Quality specification of human embryo olfactory ensheathing cells from olfactory bulb
Yushui REN ; Guozhong TIAN ; Hongmei WANG ; Hongyun HUANG ; Lin CHEN
Chinese Journal of Tissue Engineering Research 2007;0(16):-
In order to control the quality of all parts of the process for culturing,preparing and using clinically the human embryo olfactory ensheathing cells (OECs),the conduct standard of culturing human OECs from olfactory bulb is formulated. Because the strict conduct process can reduce the human factor as much as possible and ensure the stability of the cell quality. Therefore,during the culturing process of human embryo OECs, as for the embryo sample of OECs from olfactory bulb,the standard of lab condition and cell culture must be set strictly. The key steps of conduct process must be regulated,the freezing and resuscitating process of OECs must be controlled,the test method for microbial contamination during cell culture must be proposed and the risk must be reduced,then the quality of the human OECs from olfactory bulb can be guaranteed during the clinical application.
3.Mutation analysis of GJB3 and GJB4 genes in two patients with erythrokeratodermia variabilis
Xin ZHOU ; Jun REN ; Xin TIAN ; Yanhua LIANG ; Sanquan ZHANG ; Zhenming HUANG ; Xiaokun LIU ; Meihua CHEN
Chinese Journal of Dermatology 2012;45(2):129-130
ObjectiveTo detect the mutations of GJB3 and GJB4 genes in two sporadic cases of erythrokeratodermia variabilis(EKV).MethodsGenomic DNA was extracted from two sporadic patients with EKV,their family members,and 100 normal human controls.All the exons and adjacent splice sites of GJB3 and GJB4 genes were amplified by PCR.Mutation scanning was carried out via direct bidirectional DNA sequencing.ResultsA G134C mutation was found at the GJB3 gene in patient 1,which caused a substitution of glycine by alanine at codon 45 (G45A).No mutation was found in the GJB4 gene in case 1 or GJB3 and GJB4 genes in case 2.ConclusionA missence mutation G45A in GJB3 gene is found in a patient with EKV.
4.Dosimetry-guided 131I therapy for differentiated thyroid carcinoma with diffuse pulmonary metastases
Bin, LIU ; Zhen, ZHAO ; Jian-tao, WANG ; Rui, HUANG ; Rong, TIAN ; Yu, ZENG ; An-ren, KUANG
Chinese Journal of Nuclear Medicine 2010;30(6):400-403
Objective To determine the activities of 131I for treating differentiated thyroid carcinoma with diffuse pulmonary metastases ( DTC-DPM ) from the perspective of internal radiation dosimetry.Methods According to Medical Internal Radiation Dosimetry (MIRD) schema, the activity constraint,from which the whole bdy retention at 48 h should not exceed 2.96 GBq (2.96 GBq rule), was converted to dose-rate constraint(DRC) to lungs at 48 h ( DRCLU ·48 h ) in 131I therapy for DTC-DPM. Based on the assumption of DRCLU·48 h at 48 h in lung, the fractions of whole body activities ( F48 ), the effective half times of 131I in lungs ( TLL ) and the remainder of body ( TRB ) were 0.6-0.9, 20- 120 h, and 10- 20 h, respectively. The maximum safe activities of 131I for different human phantoms from the Organ Level Internal Dose Assessment (OLINDA) software were calculated. Results According to MIRD schema and 2.96 GBq rule, DRCLU ·48 h should not exceed 46.4 mGy/h in 131I therapy for DTC-DPM. Depending on varying F48 h,TLL and TRB, the maximum safe activities of 131I were 6.77-81.36, 5.29-56.20, 5.08-55.19 and 3.87-40. 52 GBq for the male adult, female adult, 15-year-old, and 10-year-old patients with DTC-DPM, respec tively. Conclusion Dosimetry-guided 131I therapy for DTC-DPM considers adequately the differences of 131I kinetics in individual patients and can adjust administered activities of 131I on the precondition of avoiding radiological pneumonitis and pulmonary fibrosis.
5.Progress in gene CaMDR1 mediating multidrug resistance of Candida albicans
Chinese Journal of Zoonoses 2017;33(9):837-840,844
Gene CaMDR1 is a member of the major facilitator superfamily (MFS),mediating multidrug resistance of Candida albicans,and can confer resistance to benomyl,fluconazole and so forth.In this review,the progress in structure and function of the protein code by gene CaMDR1 and the transcriptional regulation mechanisms of CaMDR1 are summarized.
6.MR Imaging of the Spine at 3.0T with T2-Weighted IDEAL Fast Recovery Fast Spin-Echo Technique.
Ai Jun REN ; Yong GUO ; Shu Ping TIAN ; Li Jing SHI ; Min Hua HUANG
Korean Journal of Radiology 2012;13(1):44-52
OBJECTIVE: To compare the iterative decomposition of water and fat with echo asymmetry and the least-squares estimation (IDEAL) method with a fat-saturated T2-weighted (T2W) fast recovery fast spin-echo (FRFSE) imaging of the spine. MATERIALS AND METHODS: Images acquired at 3.0 Tesla (T) in 35 patients with different spine lesions using fat-saturated T2W FRFSE imaging were compared with T2W IDEAL FRFSE images. Signal-to-noise ratio (SNR)-efficiencies measurements were made in the vertebral bodies and spinal cord in the mid-sagittal plane or nearest to the mid-sagittal plane. Images were scored with the consensus of two experienced radiologists on a four-point grading scale for fat suppression and overall image quality. Statistical analysis of SNR-efficiency, fat suppression and image quality scores was performed with a paired Student's t test and Wilcoxon's signed rank test. RESULTS: Signal-to-noise ratio-efficiency for both vertebral body and spinal cord was higher with T2W IDEAL FRFSE imaging (p < 0.05) than with T2W FRFSE imaging. T2W IDEAL FRFSE demonstrated superior fat suppression (p < 0.01) and image quality (p < 0.01) compared to fat-saturated T2W FRFSE. CONCLUSION: As compared with fat-saturated T2W FRFSE, IDEAL can provide a higher image quality, higher SNR-efficiency, and consistent, robust and uniform fat suppression. T2W IDEAL FRFSE is a promising technique for MR imaging of the spine at 3.0T.
Adult
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Aged
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Aged, 80 and over
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Female
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Humans
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Image Interpretation, Computer-Assisted
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Magnetic Resonance Imaging/*methods
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Male
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Middle Aged
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Signal-To-Noise Ratio
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Spinal Diseases/*diagnosis/pathology
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Statistics, Nonparametric
7.Erratum.
Ai Jun REN ; Yong GUO ; Shu Ping TIAN ; Li Jing SHI ; Min Hua HUANG
Korean Journal of Radiology 2012;13(2):256-256
No abstract available.
8.A cross-sectional study on liver diseases in the rural residents in southern Guangxi, China.
Tian-Ren HUANG ; Jia-Hua YU ; Ji-Lin LI ; Zhen-Quan ZHANG ; Wei DENG ; Chun-Yan ZHANG ; Sheng-Fa ZHAO
Chinese Journal of Preventive Medicine 2007;41 Suppl():123-126
OBJECTIVETo study the epidemiological characteristics of liver diseases in a rural population in Southern Guangxi, China.
METHODSThe enzyme immunoassays was used to detect of HBsAg and AFP. AFP positive serum samples were further examined for concentration of AFP by using a radio immunoassays. Liver morphological changes were measured with ultrasonography of type B.
RESULTSThe positive rates of HBsAg in the studied population was 17.8% (2800/15,701). The prevalence rates of viral hepatitis B, cirrhosis, primary liver cancer, clonorchiasis, fatty liver disease, alcoholic liver disease were 1.1% (173/15,701), 0.4% (63/15,701), 299.3 per 100,000 (47/15,701), 6.6% (1036/15,701), 4.8% (754/15,701) and 0.3% (47/15,701), respectively. The positive rates of HBsAg and the prevalence rates of viral hepatitis B, cirrhosis, primary liver cancer, clonorchiasis, fatty liver disease in male were significantly higher as compared with those in female (5.98 < or = chi(2) < or = 394.78, P < 0.01). No difference was observed in the prevalence rates of liver cavernous hemangioma and hepatic cysts between male and female. The prevalence rates of intrahepatic bile duct stones was significantly higher in female than in male (chi(2) = 30.80, P < 0.01). The positive rates of HBsAg and the prevalence rates of viral hepatitis B and clonorchiasis were decreased with age. But the prevalence rates of cirrhosis, primary liver cancer, fatty liver disease, alcoholic liver disease, liver cavernous hemangioma, hepatic cysts and intrahepatic bile duct stones were increased with age.
CONCLUSIONThe rural areas in the southern Guangxi are high prevalence regions of liver illness, and the male resident are even at high risk.
Adult ; China ; epidemiology ; Cross-Sectional Studies ; Fatty Liver ; epidemiology ; Female ; Hepatitis B ; epidemiology ; Humans ; Liver Cirrhosis ; epidemiology ; Liver Diseases ; epidemiology ; Liver Neoplasms ; epidemiology ; Male ; Middle Aged ; Prevalence ; Rural Population
9.Risk factors analysis of initial high peritoneal solute transport status in peritoneal dialysis patients
Tao LIN ; Geping YU ; Jingyuan XIE ; Xiaomin HUANG ; Tian XU ; Li WANG ; Xiao LI ; Chunyan ZHANG ; Yaowen XU ; Hong REN ; Nan CHEN
Journal of Shanghai Jiaotong University(Medical Science) 2017;37(8):1090-1093
Objective · To investigate the clinical characteristics of initial peritoneal dialysis (PD) patients with different peritoneal transport status, and analyze risk factors of high peritoneal transport status in PD patients. Methods · A total of 455 consecutive PD patients newly starting PD between January 2007 to October 2015 were retrospectively analyzed. According to the results of the first sPET, patients were divided into H/HA (4h D/Pcr ≥ 0.65) and L/ LA (4h D/Pcr<0.65) groups. Clinical and biochemical characteristics between the two groups were compared. Multivariate logistic regression model was established to investigate risk factors of higher peritoneal transport status of incident PD patients. Results · The study included 372 incident PD patients. The L/LA group and H/HA group had 264 cases (71.2%) and 108 cases (28.8%) respectively. The H/HA group had higher proportion of male patients (63.0% vs 50.8%, P=0.03), lower residual renal function [RRF, (4.26±2.77) mL/min vs (5.79±4.53) mL/min, P<0.01], lower serum albumin level [(29.34±6.89) g/L vs (32.08±5.86) g/L, P=0.00], and more frequent diabetic nephropathy (19.4% vs 9.5%, P=0.00), compared with L/LA group. Univariate and multivariate logistic regression analysis showed that higher peritoneal transport status was associated with lower serum albumin level (OR=0.96, 95% CI 0.28-0.99; P=0.02), male (OR=1.92, 95% CI 1.19-3.12; P=0.00), presence of diabetic nephropathy (OR=2.52, 95% CI 1.26-5.05; P=0.00) and lower residual renal function (OR=0.90,95% CI 0.83-0.96; P=0.00). The level of hsCRP in patients with hypoalbuminemia was higher than that in patients with normal albumin level (1.69 mg/L vs 0.69 mg/L, P=0.00). Conclusion · Low and low average peritoneal transport status accounted for the majority of the patients in this study. Low serum albumin levels, male, diabetic nephropathy, RRF were risk factors of initial high peritoneal solute transport status. Chronic inflammatory status might partially explain for the correlation between hypoalbuminemia and high peritoneal solute transport status in PD patients.
10.Using spatial autocorrelation analysis to study spatial heterogeneity of liver cancer in Guangxi
Xian-Yan TANG ; Tian-Ren HUANG ; Xiao-Dong ZHU ; Mao-Qiong HU ; Jing XU ; Hong-Xia ZHOU
Chinese Journal of Epidemiology 2009;30(2):167-170
Objective To study the spatial distribution characteristics of liver cancer in Guangxi so as to provide evidence for the development of congol and prevention on liver cancer.Methods The average eight year morbidity was computed,using the rates of liver cancer in 2000-2007.The spatial statistics module of GIS was used to conduct spatial autocorrelation analysis.and the disease mapping Was drawn,using the Map Info 8.0 software.Results The average morbidity rate Was clustered in Guangxi in the past eight years.with Moran's I index as 0.34 and P value below 0.01.G index appeared to be 0.77 and the Pvalue Was below 0.01.Moran's I correlogram lifled up in four spaces,specifically,the cluster took place in both nlacro-scale(one to three spatial intervals,45 to 135 km real Scale)and micro-scale(16 to 18 spatial intervals,720 to 800 km real scale).When the spatial interval became 14 and real scale was 60 km.the spatial distribution of liver cancer showed the most intensive autocorrelation.Most of the regions with high morbidity would be clustered in the southwest and southern parts,along the Coastal areas of Guangxi while the regions with low morbidity clustered in the northern part of Guangxi.Conclusion Liver cancer was found un-randorely distributed and geographitally clustered in Guangxi in 2000-2007.