1.Study on hospitalization benefit equity of the basic medical insurance programs in China
Yi YAO ; Yi CHEN ; Yuliang CHEN
Chinese Journal of Health Policy 2017;10(3):40-46
Objective: To analyze the equity of benefit for inpatient services under the three basic medical insurance programs in China.Methods: Using the baseline survey data collected by China Family Panel Studies (CFPS) in 2010, and the two-part model was applied to explore whether the insured groups with different income levels had different aspects on inpatient rate and the compensation of hospitalization expenses in health insurance coverage.Results: There was no significant difference in the inpatient service utilization rate for different income groups, but the highest and second highest income groups reimburse more expenses than the lowest income group, that is 36.5% and 26.3%, respectively.Specifically, the income level and the compensation amount are not significantly correlated in the Urban Employer Medical Insurance (UEMI) program;the compensation amounts to be paid by urban residents are basically increasing with the increase of the income level;and there is a moderate discrepancy between the highest and the lowest income groups in the New Rural Cooperative Medical System (NCMS).Conclusion: The benefit equity is obviously fair in terms of inpatient service utilization rate, but the benefit degree increases for higher income groups, which shows that there are unfair inequalities related to the income at the level of reimbursement.In terms of program comparison, the benefit degree equity is higher for the UEMI program, followed by the URMI program and the NCMS program is the worst.Besides, the impatient rate and reimbursement amounts are significantly lower for NCMS program participants.The government should merge URMI and NCMS programs, actively promote the integration of basic medical insurance system by strengthening the construction of the medical assistance system and improving the system of catastrophic disease medical expenditure insurance in order to achieve better benefit equity.
2.Clinical observations on treatment with Qingwen Baidu drink(清瘟败毒饮) for 120 cases with epidemic hemor-rhagic fever
Xiangchun HAO ; Sujuan MA ; Yuliang CHEN
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2001;8(1):45-46
Objective:To observe the clinically curative effects of Qingwen Baidu drink(清瘟败毒饮) on epidemic hemorrhagic fever (EHF).Methods:One hundred and eighty cases with EHF who were admitted to hospital within 5 days after onset were randomly divided into two groups.The control group (n=60) was treated with Ribavirin infused intravenously and liquid therapy,and treating complications simultaneously,meanwhile the treated group (n=120) based on the same therapy as control group treated with Qingwen Baidu drink number Ⅰ,Ⅱ or Ⅲtaken orally two times a day according to different course.Results:In treated group all the days of fever,polyuria,recovering platelet to normal,and transforming proteinuria to negative were significantly shorter than those in control group (both P<0.01),otherwise the overphase rates of oliguria and hypotension shock were higher than those in control group too (all P<0.01).The occurance rate of complications in treated group was lower than that in control group(P<0.05).Conclusions:The curative effects adding Qingwen Baidu drink on EHF are significant and worth spreading.
3.Study on Quality Standard of Jinwang Capsules
Yuliang SONG ; Jianzhen CHEN ; Guiyuan L
Chinese Traditional Patent Medicine 1992;0(09):-
Objective: To establish the quality standard of Jinwang Capsules.Methods: The technique of TLC was used to identify 10-Hydroxy-2-decylenic acid (10-HDA). Its content was determined by dual-wavelength UV spectrophotometry.Results: 10-HDA can be detected by TLC. The content of 10-HDA wasn't lower than 3.0mg per granule. Volatile alkalescent substance wasn't more 100mg per 100g.Conclusion: These methods are able to effectively control the quality of Jinwang Capsules.
4.Roles and regulation mechanism of miR-31 in human cutaneous squamous cell carcinoma growth
Kai CHEN ; Dongfang CHANG ; Shaokun DUAN ; Yuliang LI
Chinese Journal of Clinical Oncology 2014;(9):555-559
Objective:To investigate the roles and regulation mechanism of miR-31 in human cutaneous squamous cell carcino-ma (cSCC) growth. Methods:cSCC cells were transfected with the antisense oligonucleotide (ASO) of miR-31, and the cSCC growth was tested by colony formation and in vivo tumor formation assays. The target gene of miR-31 was validated by Western blot and green fluorescent protein (GFP) reporter assay. The cells were then transfected with the siRNA of the target gene, and the effect of the target gene on cell growth was preformed by colony formation assay. Finally, real-time PCR and immunohistochemistry were used for analy-sis of the expression of miR-31 and its target gene. Results:miR-31 ASO resulted in a low number of cell colonies and small tumor vol-ume (P<0.05). Western blot showed that the cells with miR-31 ASO had a higher protein level of large tumor suppressor homolog 2 (LATS2) than the control. The 3' UTR of LATS2 had a binding site with miR-31, and miR-31 ASO increased the GFP intensity con-trolled by LATS2 3' UTR, whereas no effect was observed on the mutant LATS2 3' UTR. Western blot showed that LATS2 siRNA inhib-ited the expression of LATS2 protein by about 80%. Knocking down of LATS2 increased the colony number by about 70%or 1.3-fold in cSCC cells. Real-time PCR showed that miR-31 was overexpressed in most cSCC tissues, compared with normal tissues. An inverse relationship existed between miR-31 and LATS2 expression levels. Immunohistochemistry validated that LATS2 was downregulated in cSCC tissues. Conclusion:miR-31, which functions as an oncogene, promotes cSCC growth by suppressing LATS2 expression. Our da-ta suggest that miR-31 is a potential miRNA-based therapeutic target for cSCC growth.
5.Effect of MMP-9 and MMP inhibitor on severe acute pancreatitis associated with lung injury in rats
Ping CHEN ; Leheng ZHAN ; Shiwen WANG ; Youcheng ZHANG ; Yuliang WANG
Chinese Journal of General Surgery 1997;0(06):-
Objective To investigate the effect of MMP-9 on severe acute pancreatitis(SAP) associated with lung injury,and the preventive function of MMP-9 inhibitor (BB-94) in SAP associated with lung injury in rats. Methods SD rats were randomly divided into three groups: Shamed-operated groups (control groups,n=10);SAP groups (n=14);SAP with MMP-9 inhibitor preconditioning groups (BB-94 group,n=15). The samples for test of the wet weigh index of lung,serum amylase level,white cell count,the number of cells and protein in bronchoalveolus lavage fluid,histologic scoring of lung injury and MMP-9 in lung were detected 24 hours after SAP models were set up.Results The parameters mentioned above in SAP group were significant higher than those in controll group and BB-94 group (P
6.Effects of cardiac resynchronization therapy on cardiac function and arrhythmia of patients with chronic heart failure
Zhihuan ZENG ; Shilin CHEN ; Yanqun ZHAO ; Wanxin ZHOU ; Wei ZHANG ; Yueqiong XIAO ; Jianyi ZHENG ; Yuliang ZHOU
The Journal of Practical Medicine 2015;(11):1775-1778
Objective To study the effect of cardiac resynchronization therapy (CRT) on the cardiac function and arrhythmias of patients with chronic heart failure and left ventricular systolic dyssynchrony. Methods Thirty-two cases of patients with chronic heart failure and left ventricular systolic dyssynchrony underwent CRT therapy. And LEVESV, LVEDV, LVEF, LVEDD, MRA, LAA, MRA/LAA were detected by echocardiography while the cardiac function was kept stable. Then the left ventricular systolic 12 segment peak time (Ts) was measurements by tissue doppler in all patients, the poor (Ts-maxD) and standard deviation (Ts-SD) were also calculated. The 24-hour ambulatory 12-lead ECG was took postoperation. All the patients were treated by anti-heart failure drugs after CRT pacemeker implantantion. All these indicators were assessed again at 12 weeks later. Results Compared with the previous CRT pacemaker implantation, LVEF, LV dp/dpsignificantly increased (P < 0.05). LEVESV, Ts-maxD, Ts-SD, MRA, MRA/LAA markedly declined (P < 0.05). But no statistical significance was found between the preoperative and postoperative CRT (P>0.05). Atrial premature beats and paroxysmal atrial tachycardia were significantly reduced in the preoperative CRT (P < 0.05). No significant differences were found in atrial fibrillation, ventricular premature beats and paroxysmal supraventricular tachycardia between the preoperative and postoperative CRT (P > 0.05). Conclusion CRT resynchronization therapy can improve left ventricular systolic function, and reduce the MRA and Ts. The mechanism may be associated with the improvement of left ventricular synchrony, reducing mitral regurgitation, and reducing the occurrence of atrial arrhythmias.
7.Preoperative dosimetric comparison between non-coplanar and coplanar template-assisted 125I seed implantation for pancreatic cancers
Haitao SUN ; Junjie WANG ; Yuliang JIANG ; Zhe JI ; Fuxin GUO ; Yi CHEN ; Jinghong FAN
Chinese Journal of Radiological Medicine and Protection 2021;41(1):42-45
Objective:To compare preoperative planning parameters between non-coplanar and coplanar template-assisted radioactive seed implantation in the treatment of pancreatic cancers, in order to guide clinical application.Methods:Patients with pancreatic cancers who received external irradiation in the Peking University Third Hospital from Jan 2017 to May 2019 were selected.Their image information was imported into the brachytherapy planning system, and the non-coplanar plan and coplanar plan were designed individually.Each patient′s prescription dose was set to 110 Gy, and the activity of the radioactive seeds were 0.4 mCi(1 Ci=3.7×10 10Bq), respectively.For the two plans, the dose distribution was optimized and dosimetric parameters were compared, including the implantation needle number, the implanted seed number, the minimum prescription doses delivered to 90% and 100% of the target volume ( D90 and D100), mean percentages of volume receiving 100%, 150% and 200% of the prescription doses ( V100, V150 and V200), conformity index (CI), external index (EI), and homogeneity index (HI) of the target volume, as well as the doses of 2 cm 3 and 5 cm 3 ( D2 cm 3 and D5 cm 3) of the surrounding normal organs such as the small intestines, colon, duodenum, stomach, and spinal cord. Results:The implantation needle number in the coplanar plan was slightly higher than that in the non-coplanar plan, namely 18.63 vs. 16.45 ( t=-3.239, P <0.05). The implanted seed number was equivalent, namely 90.2 vs. 91.01, with no statistical difference ( P>0.05). There was no significant difference between D90, D100, V100, V150, V200, CI, EI, and HI in the target area of the two plans ( P>0.05). Meanwhile, there was no obvious difference in D2 cm 3 and D5 cm 3 of normal organs including the small intestines, colon, duodenum, stomach, and spinal cord ( P>0.05). Conclusions:With both the coplanar plan and the non-coplanar plan, the prescription doses can be achieved and meanwhile, there are very small differences in the doses of normal organs.Given that 3D-printing non-coplanar and coplanar templates have their own characteristics, it is necessary to choose them according to specific situations.
8.The clinical outcome of measured resection combined with gap balancing technique in total knee arthroplasty
Zhiyuan QI ; Xiumin CHEN ; Zaibin WANG ; Zhisheng JIANG ; Guangbin LI ; Peng HAN ; Yuliang LI ; Xianchuang LU
Chinese Journal of Orthopaedics 2021;41(9):541-551
Objective:To explore the clinical outcome of measured resection combined with gap balancing technique in total knee arthroplasty (TKA).Methods:From January 2016 to October 2017, 61 cases of varus knee joint flexion deformity were applied the procedure of measured resection combined with gap balancing technique in primary total knee arthroplasty, including 24 male and 37 female; the average age was 66.80±8.2 years old (range from 60 to 78 years old). All patients underwent antero-medial incision of knee joint,medial parapatellar approach and posterior stabilized prosthesis. Measurement osteotomy technique was used to localize osteotomy. Gap balancing technique was vitrificated flexion and extension. Operation time, surgical blood loss and osteotomy volume were recorded. Radiographic evaluation included alignment of lower extremity, knee joint linedistance, tibiofemoral joint angle, rotation angle of femoral prothesis and posterior condylar offset (PCO). Joint functions were assessed including KSS scores, ROM and patient satisfaction.Results:The average operation time was 54±12 min (range from 45 to 65 min). The average postoperative drainage was 140±26 ml (range from 120 to 180 ml). The difference in hemoglobin values were 22±8.5 g/L(range from 20 to 30 g/L) between preoperative and postoperative 5 days. The lateral proximal tibial bone mass was 10.2±1.5 mm (range from 9.2 to 11.5 mm). The lateral distal femoral bone mass was 9.1±1.5 mm (range from 8.8 to 10 mm). The bone mass of posterior lateral condyle of femur was 8.6±1.5 mm (range from 7.8 to 10 mm). The bone mass of posterior medial condyle of femur was 9.2±1.2 mm (range from 8.6 to 10 mm), compared with the bone mass of posterior lateral condyle of femur, and the difference was statistically significant ( t=2.44, P=0.006). The intraoperative angle between osteotomy line of gap balanced osteotomy technique (line B) and connecting line of screw hole in measure osteotomy (line A) was 1.15°±0.47° (range from 1.02° to 2°). The external rotation angle was27.8%, the internal rotation angle was72.2%. There was no significant difference between preoperative knee joint line distance 40.55±4.32 mm and postoperative knee prosthesis joint line distance 40.99±3.86 mm. Postoperative knee straight and bent-knee 90° stress X-ray demonstrated that medial-lateral tibiofemoral joint angle showed no significant difference ( P >0.05). Cross-sectional CT of knee joint post operation, rotation angle of femoral prosthesis ≤±2°. Most of them were mainly concentrated in the internal rotation angle. There was no significant difference between preoperative PCO 31.55±3.18 mm and postoperative PCO 31.55±3.18 mm ( P>0.05). The KSS score and patient satisfaction score post operationwere significantly higher than those preoperation. The KSS score and patient satisfaction score at 3 months after operation were 89.2±9.4 points and 7.2±2.6 points, which were higher than that at 1 month after operation (78.0±3.5 points and 5.2±1.8 points), with statistically significant differences ( t=1.897, P=0.026; t=1.753, P=0.038). The KSS score was above 90 at 6 months after operation. The knee ROM after 1 month (94.7°±10.6°) had no statistical significance compared with that preoperation (91.9°±12.5°) ( t=1.286, P=0.245). The knee ROM at 3 months after surgery (105.8°±14.7°) was significantly higher than that before operation (91.9°±12.5°) ( t=1.924, P=0.041). There was no significant difference between the scores of the follow-up time points and those of 3 months after operation ( P >0.05). Conclusion:TKA were performed by using measured resection combined with gap balancing technique. Not only can good alignment of lower extremity be restored, but also flexion-extension gap balance can be obtained. Equal osteotomy with less soft tissue release. There are better ROM of knee and KSS functional scores in the early postoperative period. However, it is easy to cause femoral pseudointernal rotation.
9.The study on screening the differences of serum proteins in ulcerative colitis
Yinglei MIU ; Lifang CHEN ; Yan DU ; Hongna LI ; Yanping ZHU ; Yuliang XIAO
Chinese Journal of Digestion 2010;30(12):898-901
Objective To search for the differences of serum proteins expression in ulcerative colitis (UC) by proteomics method and to preliminary explore the potential biological markers of ulcerative colitis. Method The serum of 30 ulcerative colitis patients and 30 healthy individuals were collected. The equal amounts of proteins in pooled serum were separated by two-dimensional gel electrophoresis (2-DE) and then compared and analyzed by image analysis software to recognize the differences of protein expression. Some spots of proteins with different expression were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS).Result There was no statistic significant in age, weight index, smoking and alcohol taking between UC group and control (P > 0.05 respectively). Thirty-nine proteins with significant different expression between UC patients and healthy individuals were preliminary screened out. Nine of those spots were selected, after analyzed by MALDI-TOF-MS, it was found that the expression of haptoglobin, heat shock factor protein 2, receptor tyrosine kinase, aldehyde reductase,apolipoproteinC-Ⅲ, pericentriol material 1 increased in ulcerative colitis patients, keratinl, filamin A interacting protein 1 and tropomyosin 3 decreased. Conclusions With proteomics 2-DE and spectrometry methods, nine UC associated serum proteins were screened out and identified, which provide new molecular markers for the research of UC biological behavior.
10.CT-guided percutaneous nephrostomy and ureteroscopic holmium laser lithotripsy in treatment of complex renal calculi: a report of 32 cases
Yuliang CHEN ; Haibin YU ; Xinghua LUO ; Huaijun TANG ; Tianyi XIE ; Aijun SUN
Chinese Journal of General Practitioners 2010;09(10):716-717
From August 2007 to January 2009 a total of 95 patients with complex renal calculi were treated with CT ( n = 32 ), X-ray ( n = 33 ) or ultrasound ( n = 30 ) guided percutaneous nephrostomy and ureteroscopic holmium laser lithotripsy respectively. The CT guided procedure had lower positioning time,positioning failure rate, complication rate and residual stone rate than those of X-ray and ultrasound localization, particularly had advantages in the stone clearance rate and complications rate ( all P < 0. 05 ).CT guided localization can be chosen in the following conditions: higher kidney position, large staghorn calculi or renal pelvis stones without hydronephrosis, with congenital renal malformations or failure of ultrasound or X-ray localization.