1.Factors affecting hospitalization costs among stroke patients in Nanshan District
ZOU Quan ; ZHAO Xinxing ; CHEN Hong' ; en ; WU Lanlan ; LIANG Xiaofeng ; WU Jing ; WANG Changyi
Journal of Preventive Medicine 2024;36(4):328-332,337
Objective:
To analyze the influencing factors for hospitalization costs among stroke patients with different subtypes, so as to provide the reference for reducing the economic burden of patients.
Methods:
Data of patients with hemorrhagic or ischemic stroke who were discharged from hospitals in Nanshan District, Shenzhen City from January 1, 2016 to December 31, 2021 were collected through Hospital Information System. Hospitalization costs were analyzed between hemorrhagic and ischemic stroke patients, and factors affecting hospitalization costs among stroke patients with different subtypes were identified using a structural equation model.
Results:
A total of 10 298 patients with stroke were recruited, including 2 820 patients with hemorrhagic stroke (27.38%) and 7 478 patients with ischemic stroke (72.62%). The patients with hemorrhagic stroke had a median duration of hospital stay of 19.00 (interquartile range, 18.00) d, and a median hospitalization cost of 26 759.48 (interquartile range, 51 000.87) Yuan. The patients with ischemic stroke had a median duration of hospital stay of 12.00 (interquartile range, 10.00) d, and a median hospitalization cost of 12 199.87 (interquartile range, 13 290.20) Yuan. Structural equation model analysis showed that department of hospitalization, discharge status, ways of leaving hospital, surgery and hypertension had direct effects on hospitalization costs and indirect effects on hospitalization costs through duration of hospital stay among hemorrhagic stroke patients, and duration of hospital stay had the highest total effect (0.684), followed by surgery (0.632). Employment status, admission route, department of hospitalization, ways of leaving hospital, payment mode, surgery and dyslipidemia had direct effects on hospitalization costs and indirect effects on hospitalization costs through duration of hospital stay among ischemic stroke patients, and duration of hospital stay (0.746), surgery (0.424) and department of hospitalization (0.151) ranked the top three in total effects.
Conclusion
The hospitalization cost is relatively high among stroke patients in Nanshan District, and duration of hospital stay and surgery have great influence on hospitalization costs among stroke patients with different subtypes.
2.Security of newborn fathers and its related factors
Chaofeng LI ; Hengxu WANG ; Dan CHEN ; Yingying FAN ; Changyi ZHU ; Yi HUANG ; Yuwei WU
Chinese Mental Health Journal 2024;38(10):923-928
Objective:To understand the security status of newborn fathers and analyze its related factors.Methods:A total of 256 fathers(aged 22-49 years old)of newborns born within 1 week were select-ed.They were assessed with the self-designed general information questionnaire,Parents'Postnatal Sense of Securi-ty(father version),Emotional Inhibition Scale,and Marriage Satisfaction Subscale of Enrich Marital Inventory.Results:The average score of security was(36.0±4.4).Multiple linear regression analysis showed that the security scores were positively correlated with residence area(β=0.35),education level(β=0.25),preterm birth(β=0.11)and the marital satisfaction scores(β=0.25);and were negatively associated with daily crying time(β=-0.28)and the EIS scores(β=-0.18).Conclusion:The sense of security of postpartum fathers is moderate,and it is associated with residence area,education level,preterm birth,marital satisfaction,daily crying time and emotional inhibition.
3.Trend in incidence of stroke in Nanshan District from 2010 to 2021
Xinxing ZHAO ; Hong' ; en CHEN ; Xiao DONG ; Quan ZOU ; Xiaofeng LIANG ; Jing WU ; Changyi WANG
Journal of Preventive Medicine 2023;35(3):200-204
Objective:
To investigate the trend in incidence of stroke in Nanshan District, Shenzhen City from 2010 to 2021, so as to provide the evidence for formulating the integrated strategy for stroke control.
Methods:
The data of stroke morbidity in Nanshan District from 2010 to 2021 were collected through Shenzhen Chronic Disease Prevention and Control Management System. The incidence of stroke was calculated, and standardized by the population of the Chinese Sixth National Census in 2010. The trends in stroke incidence were evaluated in Nanshan District from 2010 to 2021 using annual percent change (APC) and average annual percent change (AAPC), and gender-, age- and subtype-specific incidence of stroke was descriptively analyzed.
Results:
A total of 30 377 cases with stroke were reported in Nanshan District from 2010 to 2021, with a crude incidence rate of 190.45/105 and a standardized incidence rate of 405.65/105. The crude incidence rate of stroke appeared a tendency towards a rise in Nanshan District from 2010 to 2021 (APC=5.38%, t=4.678, P=0.001), and a higher crude incidence rate of stroke was seen among men than among women (227.57/105 vs. 148.40/105; χ2=1 309.580, P<0.001). The incidence of stroke appeared a tendency towards a rise with age (χ2trend =435.717, P<0.001), and there was a tendency towards a rise in stroke incidence among residents under 40 years of age (APC=2.89%, t=2.538, P=0.029). The crude incidence of ischemic stroke was 151.24/105, which was higher than that of hemorrhagic stroke (39.21/105) (χ2=10 521.000, P<0.001).
Conclusions
The incidence of stroke appeared a tendency towards a rise in Nanshan District from 2010 to 2021, with ischemic stroke as the predominant subtype of stroke. Males and middle-aged and elderly residents should be given a high priority for stroke prevention and treatment.
4.Effect of RORγ gene on proliferation and migration of colon cancer cells
Changyi Fang ; Xiaofei Pan ; Changjun Yu ; Ping Wu ; Benxin Chen ; Bao Li ; Gan Zhang ; Yuyong Gong ; Yang Li
Acta Universitatis Medicinalis Anhui 2023;58(4):603-608
Objective:
To investigate the effects of retinoid-related orphan receptor γ (RORγ) gene on proliferation and metastasis of human colon cancer cells.
Methods:
RORγ knockdown cell lines were constructed and the knockdown efficiency was detected by RT-qPCR and Western blot assays ; MTT,colony formation,Transwell and wound healing assays were used to detect cell proliferation and metastasis ; the expression of epithelial-mesenchymal transition (EMT) related proteins was detected by Western blot.The relationship between RORγ gene expression and immune cell infiltration in tumor microenvironment was analyzed using TIMER 2. 0 database.
Results :
The knockdown of RORγ enhanced the viability (F = 157. 40,P<0. 01) ,clonogenesis (F = 61. 35,P<0. 01) ,migration (F = 13. 00,P<0. 01) ,invasion (F = 21. 26,P<0. 01) and wound healing ability (F = 877. 2,P<0. 01) of colon cancer cells,inhibited the expression of E-Cadherin,and promoted the expression of vimentin and N-Cadherin.TIMER 2. 0 database analysis showed that RORγ expression in colon adenocarcinoma ( COAD) tissues was associated with multiple immune cell infiltrates.
Conclusion
Downregulation of RORγ expression promoted the proliferation and metastasis of colon cancer cells.
5.Case-control study on association of female reproductive factors with risk of papillary thyroid cancer
Tianfeng WU ; Meixia LIU ; Pinqing BAI ; Zhengyuan WANG ; Jiajie ZANG ; Changyi GUO ; Xueying CUI ; Hui HU ; Xiaodong JIA ; Fan WU
Journal of Environmental and Occupational Medicine 2021;38(11):1173-1178
Background Papillary thyroid cancer is the result of a variety of pathogenic factors. The prevalence of papillary thyroid cancer varies greatly in different regions, and the disease is more harmful to women. Objective This study aims to explore the relationship between reproductive factors and papillary thyroid cancer, and to provide basic data for prevention and control of the disease. Methods A 1∶1 age (±3 years) matched case-control study was conducted in 331 pairs of newly confirmed papillary thyroid cancer cases and controls from two hospitals in Shanghai from November 2012 to December 2013. Comparisons were made in the history of menstruation, pregnancy, gynecological and breast diseases, and other variables between the two groups. Results The results of univariate analysis indicated that the proportions of education below bachelor degree, married, and mainly manual workers in the case group were significantly higher than those in the control group (P<0.05); the proportion of those with a family history of thyroid diseases in the case group was significantly higher than that in the control group (P<0.05); the proportions of the cases with irregular menstruation (77.34%), a history of using oral contraceptive or hormone drugs (24.77%), a history of benign gynecological diseases (31.72%), and a history of gynecological surgery (9.67%) were significantly higher than the proportions in the control group (P<0.05). After adjusting potential confounding factors such as history of CT examination, age, kinds of family salt, total iodine intake every day, education level, occupation, marital status, body mass index, and family history of thyroid diseases, the results of multiple logistic regression analysis showed that irregular menstruation (OR=1.767, 95%CI: 1.122-2.782; P=0.014), surgical menopause (OR=12.787, 95%CI: 3.202-51.057; P<0.001), pregnancy >1 time (OR =2.490, 95%CI: 1.196-5.184; P=0.015), and the history of using oral contraceptive or hormone drugs (OR=2.389, 95%CI: 1.338-4.268; P=0.003) were the risk factors of papillary thyroid cancer. Conclusion Irregular menstruation, surgical menopause, history of pregnancy, and history of using oral contraceptive or hormone drugs might be the risk factors of papillary thyroid cancer. To reduce the incidence of papillary thyroid cancer, strengthened health education and rational use of contraceptives are recommended.
6.Case-control study on relationship between diet quality and thyroid nodules
Wei ZHOU ; Zhengyuan WANG ; Qian XIA ; Xiaodong JIA ; Jiajie ZANG ; Xueying CUI ; Xiangting LI ; Changyi GUO ; Fan WU
Journal of Environmental and Occupational Medicine 2021;38(11):1192-1198
Background Both domestic and foreign studies on the diet quality of patients with thyroid nodules are rare at present, and the relationship between thyroid nodules and diet quality is still unclear. Objective This study aims to evaluate the diet quality of thyroid nodules with the China Healthy Diet Index (CHDI) and to explore the relationship between diet quality and thyroid nodules. Methods We conducted a hospital-based case-control study in which 387 patients with thyroid nodules were matched individually (1∶1) by gender and age (±3 years) to the controls who ordered a routine physical examine and with negative thyroid nodules reported by B-ultrasound in the same hospital. A structured questionnaire was applied to collect data on general characteristics and diet. CHDI was employed to evaluate the diet quality of the two groups. CHDI is based on the Dietary Guidelines for Chinese Residents and the recommended food intake in the balanced diet pagoda, combined with the dietary nutritional status of Chinese population. The index contains 13 scoring components, and the highest total score is 100, with a higher score representing better dietary quality. CHDI scores < 60, 60-<80, and ≥80 are recognized as unqualified, qualified, and good diet quality, respectively. Results The scores of the thyroid nodule cases were lower than the scores of the controls in total vegetables, dark vegetables, fruits, and fish/shrimps (all Ps<0.05). The nonparametric test results found that there were significant differences in the distributions of scores in total vegetables, dark vegetables, fruits, soybeans, and fish/shrimps between the case and the control groups (all Ps<0.05). The percentages reaching the full scores in food variety, meat and eggs, and empty calories in both groups exceeded 60%, while the percentages reaching the full scores in whole grains/beans/tubers, dairy, soybeans, and sodium were lower than 30% in the two groups. The median CHDI scores of the thyroid nodule cases and the controls were 69.1 and 72.9, respectively; the cases' CHDI score was lower than the controls' (P<0.05). The proportions of unqualified diet in the case and the control groups accounted for 23.0% and 13.7% respectively (P=0.001). After being adjusted for education level, marital status, occupation, monthly household income per capita, body mass index, hypertension/diabetes, energy, and iodine intake, the results of logistic regression analysis showed that the risk for thyroid nodules was negatively associated with CHDI score (CHDI qualified group vs. CHDI unqualified group, OR=0.484, 95%CI: 0.291-0.804; CHDI good dietary quality group vs. CHDI unqualified group, OR=0.414, 95%CI: 0.230−0.746). Conclusion The diet quality of patients with thyroid nodules is lower than that of the control group, as the former reported lower consumptions of total vegetables, dark vegetables, fruits, and fish/shrimps. Those who have good or qualified diet quality show a reduced risk of thyroid nodules than those with unqualified dietary quality.
7.The role of nicotinamide-adenine dinucleotide phosphate oxidase NOX family in acute lung injury
Dan LI ; Zhukai CONG ; Xiangpeng LYU ; Changyi WU ; Yifan TAO ; Xi ZHU
Chinese Critical Care Medicine 2019;31(2):244-247
Acute?lung?injury?(ALI)?and?its?severe?form,?acute?respiratory?distress?syndrome?(ARDS),?are?common?critical?syndromes.?The?causes?of?the?syndrome?are?complex?and?diverse.?The?main?pathological?features?are?the?diffuse?inflammatory?and?protein-rich?pulmonary?edema?caused?by?destruction?of?the?blood-air?barrier.?Reactive?oxygen?species?(ROS)?mediate?oxidative?damage?by?oxidizing?bio-macromolecules,?including?lipids,?proteins?and?nucleic?acid.?Among?many?systems?producing?ROS,?nicotinamide-adenine?dinucleotide?phosphate?(NADPH)?oxidase-mediated?ROS?is?the?main?source,?and?its?functional?subunit?is?the?transmembrane?subunit?NOX?family.?The?distribution?of?NOX?family?proteins?in?lung?tissue?is?cell?type?dependent.?NOX-derived?ROS?is?involved?in?the?defense?function?of?lung?tissue?and?related?to?the?occurrence?and?development?of?ALI/ARDS.?This?review?mainly?describes?the?cell?distribution,?activation?factors,?and?its?relationship?with?the?occurrence?and?development?of?ALI?of?the?NOX?family.
8.Survey on energy and major nutrients intake of high school students in Shanghai
WANG Zhengyuan, ZHU Zhenni, ZANG Jiajie, LUO Baozhang, JIA Xiaodong, GUO Changyi, WU Fan
Chinese Journal of School Health 2019;40(3):339-343
Objective:
To understand the energy and major nutrients intake of high school students in Shanghai, and to provide basis for formulating target nutritional interventions and health education.
Methods:
The probability-proportional-to-size sampling technique was used to select 19 high schools, from which 9 boys and 9 girls from same class were randomly recruited for each grade. A total of 900 high school students were surveyed on their energy and major nutrients intake.
Results:
The medians of intake of energy, protein, fat, carbohydrate, calcium, sodium, iron, vitamin A, vitamin B-1, vitamin B-2, vitamin C and dietary fiber were 2 353 kcal/d, 97.3 g/d, 95.4 g/d, 265.4 g/d, 602.1 mg/d, 4 373 mg/d, 24.3 mg/d, 495.6 μgRE/d, 1.08 mg/d,1.21 mg/d, 83.2 mg/d and 1.01 g/d, respectively. Among of them, the medians of intake of energy, calcium, vitamin A, vitamin B-1, vitamin B-2, vitamin C and dietary fiber for boys and girls were lower than reference standard(P<0.05). The medians of intake of energy and major nutrients in high school students who lived in countryside were less than those lived in suburban and urban(P<0.05), except carbohydrates and iron. The percentages of energy supplied byprotein, fat and carbohydrate were 16.9%, 37.2%and 46.0%, respectively.
Conclusion
The energy and calorigenic nutrients intake can meet the demand of daily consumption in high school students in Shanghai, but the intake of dietary fiber, some minerals and vitamins have a various degrees of deficiency. The proportion of energy supplied bycalorigenic nutrients is unbalanced.
9.Diagnostic value of CT thin-section target reconstruction technique in patients with pulmonary small size ground glass nodules
Biao WU ; Changyi MA ; Yixiu HAO ; Liebin HUANG ; Yueyue LI ; Jintang CHEN ; Wansheng LONG ; Xiangmeng CHEN ; Enming CUI
Journal of Practical Radiology 2018;34(5):769-772
Objective To investigate the diagnostic value of CT thin-section target reconstruction technique in patients with pulmonary small size groud glass nodules (sGGN).Methods A total of 109 patients with pulmonary sGGN certified post-operation and/or follow up were analyzed retrospectively,and the clinical and CT images of all patients were completely collected.There were 23 cases of benign group,21 cases of adenocarcinoma in situ group,29 cases of minimally invasive adenocarcinoma group and 36 cases of invasive adenocarcinoma group,respectively.The differential diagnostic value using CT thin-section target reconstruction technique was analyzed between the benign and malignant pulmonary sGGN groups,and the CT feature detection rates were compared between CT thin section target and common reconstruction techniques.Results The CT thin-section target reconstruction technique had improved the diagnostic efficiency of pulmonary sGGN.The diagnostic accuracy,area under curve(AUC),sensitivity and specificity were 85.32 %,0.679,90.80 %,63.64 % in malignant group and 77.06%,0.764,83.72%,52.17% in benign pulmonary sGGN group,respectively.The CT features as solid component in whole nodule,"halo sign",speculation sign,pleural retraction sign,lobulation sign were more detected by using the thin-section target reconstruction technique than that by using the common reconstruction among adenocarcinoma in situ group,minimally invasive adenocarcinoma group and invasive adenocarcinoma group (P<0.05) but not speculation sign in the invasive adenocarcinoma group(P=0.126).Conclusion The CT thin section target reconstruction technique can improve the diagnostic value of pulmonary sGGN.
10.Application of rotation record in a surgical residency in anesthesiology rotation period
Chengmei SHI ; Huili LIU ; Min LI ; Xiangyang GUO ; Jun WANG ; Mao XU ; Changyi WU
Chinese Journal of Medical Education Research 2015;(9):946-948
Anesthesiology rotation is an important part in resident standardization training of surgery. However, there are many problems in the teaching process. For example, the key points of teaching is not clear, the process of teaching is not coherent, and teachers and students lack interaction. The Rotation Record is introduced in order to solve those problems. The Rotation Record effectively reflects the fundamental process and major learning point of anesthesiology department which contains three items: the usage and recording of instrument; the communication and the basic knowledge and operating skills of anesthesia. The Rotation Record can initiate learning activity, emphasize important contents, supervise and urge teaching and improve the learning effect. By introducing Rotation Record, the assessment results in the surgical residency in anesthesiology has greatly improved compared to the previous ones, and has effectively improved the teaching quality of anesthesia.


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