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.Protective effect of gangliosides on neurons after spinal cord injury in rats
Yanchao MA ; Yayi XIA ; Yonggang CHEN ; Xu WANG ; Bin GENG ; Yuliang WANG ; Shuanke WANG
Chinese Journal of Trauma 2011;27(8):756-761
ObjectiveTo investigate the protective effect and mechanism of monosialotetrahexosyl gangliosides ( GM-1 ) on neurons after spinal cord injury (SCI) in rats by observing the effect of GM1 on the expression and motor function of microtubule-associated protein 2 (MAP-2) and Choline acetyltransterase (ChAT). MethodsSixty-six adult female Wistar rats (weighing 260-300 g) were enrolled in the study and six were selected randomly as the normal control group. The rest were divided into GM1 group (group A, n =30) and normal saline control group (group B, n =30) after acute contusion injury was made at T10 level according to the improved Allen's method. At days 1,3, 7, 14 and 28 after operation, the neurological function of the low extremities was assessed with the improved Tarlov scale. Then,the rats were sacrificed to obtain the spinal cord tissues. There were six rats in each group at different time points. The expressions of MAP-2 and ChAT were detected with immunohistochemistry after SCI in rats. ResultsThe improved Tarlov scale in the Group A was higher than that in the Group B after SCI since the 7th day after operation, with statistical difference at day 7, 14 and 28 after operation ( P <0. 05). The expressions of MAP-2 and ChAT in the Group A were higher than that in the Group B after SCI ( P < 0.05 ). ConclusionsThe neurological function recovery of the low extremities has some correlations with the expressions of MAP-2 and ChAT after SCI in the rats. GM-1 can protect the neurons by promoting the expressions of MAP-2 and ChAT after SCI.
7.Activation status of T lymphocytes and expressions of OX40,OX40L mRNA in peripheral blood from patients with systemic lupus erythematosus
Guizhen LI ; Heng ZHANG ; Junfang ZHAO ; Xuewen CHEN ; Rong WANG ; Yuliang WANG
Chinese Journal of Dermatology 2012;(11):818-819
Objective To evaluate the activation status of T lymphocytes and to measure the expression of OX40 and OX40L mRNA in peripheral blood from patients with systemic lupus erythematosus(SLE).Methods Peripheral blood was collected from 30 patients with SLE and 15 healthy controls.The expression of CD38 and CD3 on peripheral blood T lymphocytes were quantified by using a two-color fluorescence activated cell sorter.Fluorescence-based quantitative reverse transcription PCR was performed to determine the expression levels of OX40 and OX40L mRNA in peripheral blood mononuclear cells(PBMCs).Results The coexpression levels of CD38 and CD3 were significantly increased in patients with SLE compared with healthy controls(t =3.12,P < 0.05).Increased expression levels of OX40 and OX40L mRNA were observed in patients with active SLE compared with those with inactive SLE and healthy controls(F =4.13,3.12,both P < 0.01).The level of OX40 mRNA was positively correlated with SLE disease activity index(SLEDAI)score in the patients(r =0.35,P < 0.05).Conclusion Abnormally activated T lymphocytes and upregulated expression of OX40 and OX40L mRNA may play a certain role in the initiation and progression of SLE.
8.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.
9.Predictive value of plasma copeptin level for the outcomes in patients with acute ischemic stroke
Xiangming YI ; Yuan WANG ; Yuliang WANG ; Xiaomeng DONG ; Yaozhi HU ; Jinbo CHEN
International Journal of Cerebrovascular Diseases 2015;(9):657-661
Objective To investigate the predictive value of plasma copeptin level for the outcomes in patients with acute ischemic stroke. Methods Consecutive patients with acute ischemic stroke were enroled in the study. Enzyme-linked immunosorbent assay was used to detect the plasma copeptin level. The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate baseline stroke severity. The outcome was evaluated at 90 days with the modified Rankin Scale (mRS), and the good outcome was defined as mRS 0 - 2. Results A total of 160 patients with acute ischemic stroke were enroled, 121 had good outcome and 39 had poor outcome. The age (71. 87 ± 6. 11 years vs. 66. 19 ± 9. 39 years; t =- 3. 540, P = 0. 001), serum levels of C-reactive protein (6. 84 ± 2. 80 mmol/L vs. 5. 84 ± 2. 89 mmol/L;t = - 2. 459, P = 0. 023) and copeptin (143. 12 ± 34. 02 pmol/L vs. 50. 78 ± 18. 62 pmol/L; t = 21. 564, P <0. 001), NIHSS score (12. 00 ± 4. 00 vs. 6. 00 ± 3. 00; t = - 7. 861, P < 0. 001), as wel as proportions of patients with hypertension (79. 5% vs. 60. 3% ; χ2 = 4. 758, P = 0. 029), atrial fibrilation (20. 51% vs. 7. 44% ; χ2 = 4. 022, P = 0. 045), and large artery atherosclerotic stroke (43. 59% vs. 22. 31% ; χ2 = 6. 696, P = 0. 010) in the poor outcome group were significantly higher than those in the good outcome group, but diastolic blood pressure was significantly lower (89 ± 12 mmHg vs. 95 ± 9 mmHg, 1 mmHg = 0. 133 kPa;t = 3. 323, P = 0. 001). Multivariate logistic regression analysis showed that the plasma copeptin level (odds ratio 2. 332, 95% confidence interval 1. 725 - 3. 153; P < 0. 001) was an independent risk factor for the poor outcome in patients with acute ischemic stroke. Person correlation analysis showed that the plasma copeptin level and baseline NIHSS score showed a significant positive correlation (r = 0. 895, P < 0. 001). Receiver operating characteristic (ROC) analysis showed that plasma copeptin level has a significant predictive value for the poor outcome at day 90 after acute ischemic stroke (area under the ROC curve = 0. 740, 95%confidence interval 0. 623 - 0. 783; P < 0. 01). When plasma copeptin level > 104. 3 pmol/L was used as the cutoff value, the sensitivity and specificity for predicting the poor outcomes at day 90 after onset were 86. 8% and 40. 2% , respectively. Conclusions The plasma copeptin level may be a good predictor for neurological outcome at day 90 after onset in patients with acute ischemic stroke.
10.Comparison of efficacy of different sedation depths of monitored anesthesia care in vitrectomy
Ruiqiang SUN ; Xuesong GAO ; Quan WANG ; Shuzhen WANG ; Song CHEN ; Yuliang XUE
Chinese Journal of Anesthesiology 2016;36(1):68-70
Objective To compare the efficacy of different sedation depths of monitored anesthesia care (MAC) in vitrectomy.Methods Ninety-six patients of both sexes,aged 40-64 yr,with body mass index ≤ 35 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective vitrectomy,were randomly divided into 2 groups (n =48 each) using a random number table:mild sedation group (group Ⅰ) and profound sedation group (group Ⅱ).Anesthesia was induced with iv midazolam 0.02 mg/kg and sufentanil 0.15 μg/kg.Anesthesia was maintained with iv infusion of propofol 0.5-2.0 mg · kg-1 · h-1 maintaining bispectral index (BIS) value>80 in group Ⅰ,or with iv infusion of propofol 2-6 mg · kg-1 · h-1 maintaining BIS value at 65-80 in group Ⅱ.The occurrence of unexpected head movement,SPO2<90%,snoring,and oculocardiac reflex during the procedure,postoperative nausea and vomiting,and the time when the patients in supine position were turned to prone position were recorded after surgery.Results Compared with group Ⅰ,the incidence of unexpected head movement,SpO2 <90%,and snoring was significantly increased,and the time when the patients in supine position were turned to prone position was prolonged (P<0.05),and no significant difference was found in the incidence of postoperative nausea and vomiting and oculocardiac reflex during the procedure in group Ⅱ (P>0.05).Conclusion Mild sedation of MAC (BIS value ≥ 80) provides better efficacy than profound sedation (BIS value 65-80) when used for vitrectomy.