Objective To analyze the impact of tandem mass spectrometry(MS/MS)screening compared to the indanone-fluorescence method(hereinafter referred to as fluorescence analysis)on finance or health insurance in screening newborn genetic metabolic diseases in Shanghai,and provide policy recommendations for MS/MS reimbursement.Methods A budget impact analysis model was constructed using Microsoft Excel 2019,with a study period of 3 years(2025?2027).Newborns of 2025 to 2027 were predicted based on the birth data of newborns in Shanghai and the average decrease of newborns in Shanghai.Clinical screening data and cost data were derived from relevant statistical websites,literature,and hospital survey data.Additionally,consultations with experts were conducted to understand national and Shanghai-specific screening and reimbursement policies.Among these,the fluorescence-based analysis method is primarily used for screening phenylketonuria,while MS/MS can be used for screening a variety of newborn genetic and metabolic disorders.So we separately calculated the impact of MS/MS screening compared to the fluorescence-based method on Shanghai's fiscal budget and health insurance fund.Results The budget impact analysis on fiscal expenditures indicates that from 2025 to 2027,the fiscal expenditures for fluorescence analysis will be 1.58 million,1.48 million and 1.39 million yuan,respectively.In contrast,MS/MS fiscal expenditures will be 22.75 million,21.37 million,and 20.06 million yuan,respectively;compared with fluorescence analysis,the increased fiscal expenditures for MS/MS will be 21.18 million,19.88 million,and 18.67 million yuan,respectively,showing a decreasing trend annually.The budget impact on health insurance funds shows that from 2025 to 2027,the expenditures for fluorescence analysis will be 1.11 million,1.04 million and 0.97 million yuan,respectively;MS/MS health insurance fund expenditures will be 15.93 million,14.96 million and 14.04 million yuan,respectively.Compared with fluorescence analysis,the additional health insurance fund expenditures for MS/MS will be 14.82 million,13.92 million and 13.07 million yuan,respectively,also showing a decreasing trend annually.Policy-wise,the costs for tandem mass spectrometry screening are typically covered by fiscal payments or out-of-pocket by patients,with commercial insurance,charitable foundations,and other organizations serving as supplementary sources of funding.Conclusion The overall cost of expanding newborn screening for genetic metabolic diseases in Shanghai is controllable.To unify the payment standards and facilitate centralized management,it is recommended that the costs for tandem mass spectrometry screening in Shanghai be covered by government funding.

Objective To analyze the impact of tandem mass spectrometry(MS/MS)screening compared to the indanone-fluorescence method(hereinafter referred to as fluorescence analysis)on finance or health insurance in screening newborn genetic metabolic diseases in Shanghai,and provide policy recommendations for MS/MS reimbursement.Methods A budget impact analysis model was constructed using Microsoft Excel 2019,with a study period of 3 years(2025?2027).Newborns of 2025 to 2027 were predicted based on the birth data of newborns in Shanghai and the average decrease of newborns in Shanghai.Clinical screening data and cost data were derived from relevant statistical websites,literature,and hospital survey data.Additionally,consultations with experts were conducted to understand national and Shanghai-specific screening and reimbursement policies.Among these,the fluorescence-based analysis method is primarily used for screening phenylketonuria,while MS/MS can be used for screening a variety of newborn genetic and metabolic disorders.So we separately calculated the impact of MS/MS screening compared to the fluorescence-based method on Shanghai's fiscal budget and health insurance fund.Results The budget impact analysis on fiscal expenditures indicates that from 2025 to 2027,the fiscal expenditures for fluorescence analysis will be 1.58 million,1.48 million and 1.39 million yuan,respectively.In contrast,MS/MS fiscal expenditures will be 22.75 million,21.37 million,and 20.06 million yuan,respectively;compared with fluorescence analysis,the increased fiscal expenditures for MS/MS will be 21.18 million,19.88 million,and 18.67 million yuan,respectively,showing a decreasing trend annually.The budget impact on health insurance funds shows that from 2025 to 2027,the expenditures for fluorescence analysis will be 1.11 million,1.04 million and 0.97 million yuan,respectively;MS/MS health insurance fund expenditures will be 15.93 million,14.96 million and 14.04 million yuan,respectively.Compared with fluorescence analysis,the additional health insurance fund expenditures for MS/MS will be 14.82 million,13.92 million and 13.07 million yuan,respectively,also showing a decreasing trend annually.Policy-wise,the costs for tandem mass spectrometry screening are typically covered by fiscal payments or out-of-pocket by patients,with commercial insurance,charitable foundations,and other organizations serving as supplementary sources of funding.Conclusion The overall cost of expanding newborn screening for genetic metabolic diseases in Shanghai is controllable.To unify the payment standards and facilitate centralized management,it is recommended that the costs for tandem mass spectrometry screening in Shanghai be covered by government funding.

ObjectiveMetabolic syndrome is the inherent phenotype of many diseases， which seriously endangers the cardio-cerebrovascular system. Prunellae Spica can regulate lipid metabolism disorder in high-fat mice and inhibit the metabolic disorder of liver injury. This study analyzed the effect of Prunellae Spica on metabolic syndrome and its mechanism， and it is of great significance to find potential safe drugs from natural products. MethodIn this study， the metabolic syndrome model was induced by fructose. The metabolomics method based on gas chromatography-mass spectrometry （GC-MS） was used to explore the effect and mechanism of Prunellae Spica on rats with metabolic syndrome. ResultPharmacological results showed that Prunellae Spica significantly reduced the body weight， blood lipid level and lipid peroxidation level and inhibited the release of tumor necrosis factor-α （TNF-α） in rats with metabolic syndrome. Thus， Prunellae Spica protected the liver and maintained its normal functions. Multivariate statistical analysis revealed that metabolites in the serum of rats with metabolic syndrome changed significantly， which was improved after Prunellae Spica treatment. Compared with the metabolites in normal group， 11 differential metabolic markers were found in rats with metabolic syndrome. Compared with model group， Prunellae Spica group had 8 significantly different metabolic markers， among which phosphate， pyruvic acid and succinic acid were common markers. Pathway analysis indicated that the regulatory effect of Prunellae Spica was mainly related to citrate cycle， glycolysis and gluconeogenesis， serine/threonine and glycine metabolic pathways. ConclusionPrunellae Spica can be used as a potential natural source for the treatment of metabolic syndrome. It can regulate the metabolic disorder in metabolic syndrome via energy and amino acid metabolism.

Objective: To investigate the acute and long-term outcome of catheter ablation for the treatment of ventricular tachycardia (VT) in patients with arrhythmogenic left ventricular cardiomyopathy (ALVC). Methods: This retrospective, cross-sectional study enrolled ALVC patients undergoing radiofrequency ablation for the treatment of VT at the First Affiliated Hospital of Nanjing Medical University from January 2011 to December 2018 and collected their clinical characteristics and intraoperative electrophysiological examination. Patients were followed up every 6 months after radiofrequency ablation until August 2021. Echocardiographic results and VT recurrence post radiofrequency ablation were analysed. Results: Totally 12 patients were enrolled (mean age: (42±15) years, 11 males(11/12)). The mean of left ventricular end diastolic diameter (LVDd) and left ventricular ejection fraction (LVEF) were (51±5)mm and (65±5)%, respectively. Twelve VTs were induced in 10 patients during the electrophysiological study, and the mean tachycardia cycle length was (293±65) ms. Three-dimensional substrate mapping revealed the diseased area at endocardial site in one patient, at epicardial sites in the other 11 patients (involved endocardial sites in 2 cases) with the basal part near the mitral annulus being the predilection for the substrate (10/11). After the catheter ablation at the endocardial and epicardial sites respectively, the complete procedure endpoint was achieved in all patients (VT cannot be induced post ablation). The median follow-up time was 65 (25, 123) months. One patient was lost to follow-up, and the other 11 patients survived without VT. No significant cardiac function deterioration was detected by the echocardiographic examination ((51±5)mm vs. (52±5)mm, P>0.05 for LVDd, (65±5)% vs. (60±6)%, P>0.05 for LVEF) at the end of follow-up. Conclusion: After radiofrequency ablation, the complete procedure endpoint is achieved in ALVC patients, and the catheter ablation provides long-term ventricular tachycardia control during the long-term follow-up.
Adult ; Cardiomyopathies ; Catheter Ablation ; Cross-Sectional Studies ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Pericardium/surgery* ; Recurrence ; Retrospective Studies ; Stroke Volume ; Tachycardia, Ventricular/surgery* ; Treatment Outcome ; Ventricular Function, Left

OBJECTIVE: To explore the clinical effect of warming-needle moxibustion with different lengths of moxa stick for asthenospermia with kidney deficiency and liver depression. METHODS: A total of 240 patients with asthenospermia of kidney deficiency and liver depression were randomly divided into a 4-cm group (moxibustion with 4-cm moxa stick, 60 cases, 3 cases dropped off), a 3-cm group (moxibustion with 3-cm moxa stick, 60 cases, 4 cases dropped off), a 2-cm group (moxibustion with 2-cm moxa stick, 60 cases, 2 cases dropped off) and an acupuncture group (60 cases, 3 cases dropped off). All patients were treated with warming-needle moxibustion with different lengths of moxa stick or conventicnal acupuncture at Zhongwan (CV 12), Guanyuan (CV 4), Zhongji (CV 3), Guilai (ST 29), Yaoyangguan (GV 3), Guanyuanshu (BL 26), etc., once a day, five times a week; 4-week treatment was taken as one course, a total of two courses of treatment were given. The semen routine indexes, seminal plasma biochemical indexes, sex hormone levels and TCM syndrome score were compared before and after treatment among the 4 groups. RESULTS: After treatment, the sperm density, sperm viability, ratio of grade A sperm, ratio of grade A and B sperm, seminal plasma fructose and neutral α-glucosidase were higher than those before treatment (P<0.05, P<0.01), and the sperm deformity rates were lower than those before treatment in the 4-cm group and the 3-cm group (P<0.01, P<0.05). The ratio of grade A sperm, ratio of grade A and B sperm, seminal plasma fructose and neutral α-glucosidase in the 4-cm group were higher than the other three groups (P<0.05, P<0.01), and the sperm deformity rate was lower than the other three groups (P<0.05). After treatment, except for dizziness and tinnitus score, each-domain score and total scores of TCM syndrome scale in the 4-cm group and the 3-cm group were lower than those before treatment (P<0.01, P<0.05). The each-domain score of depression, weak waist and knees, low sexual function and total score in the 4-cm group were lower than those in the other three groups (P<0.05, P<0.01). The total effective rate was 87.7% (50/57) in the 4-cm group, which was higher than 78.6% (44/56) in the 3-cm group, 77.6% (45/58) in the 2-cm group and 70.2% (40/57) in the acupuncture group (P<0.05, P<0.01). CONCLUSION The warming-needle moxibustion with 4-cm moxa stick could effectively improve quality and motility of sperm and clinical symptoms in patients with asthenospermia of kidney deficiency and liver depression, which is superior to moxibustion with 3-cm, 2-cm moxa sticks and conventional acupuncture.
Acupuncture Points ; Acupuncture Therapy ; Depression ; Fructose ; Humans ; Kidney ; Liver ; Male ; Moxibustion ; Semen ; Treatment Outcome ; alpha-Glucosidases

Objective: To explore the association between self-reported gingival bleeding and prevalent hypertension among adults in Zhejiang with a cross-sectional study. Methods: After excluding participants with self-reported, physician-diagnosed heart diseases, stroke, diabetes, cancer, and those who never or rarely brush their teeth at baseline study, 48 625 participants aged 30-79 in the China Kadoorie Biobank (CKB) study from Tongxiang, Zhejiang were included for the final analysis. Three multivariable logistic regression models were used to estimate the odds ratios (ORs) for the associations of self-reported gingival bleeding with prevalent hypertension. Results: The mean age of women was (51.2±9.2) years, and 42.9% of participants had prevalent hypertension. The percentage of self-reported frequent gingival bleeding was 6.56% (95%CI: 6.38%-6.75%), significantly higher among women (8.08%, 95%CI: 7.82%-8.35%) than among men (4.36%, 95%CI: 4.12%-4.60%) (P<0.001). After adjusting for socio-demographic factors, behavioral lifestyle, sleep duration, BMI, waist circumference, snoring, in comparison with men whose gingivae never or rarely bleed while brushing teeth, the odds ratio (95%CI) of hypertension for those with occasional, and frequent gingival bleeding were 1.04 (0.96-1.12) and 1.18 (1.02-1.37), respectively (trend P =0.038). The corresponding figures for women were 0.96 (0.91-1.02) and 0.95 (0.86-1.05), respectively (trend P=0.344). Conclusion: Frequent gingival bleeding was positively associated with prevalent hypertension among men.
Adult ; China/epidemiology* ; Cross-Sectional Studies ; Female ; Gingival Hemorrhage ; Humans ; Hypertension/epidemiology* ; Male ; Middle Aged ; Risk Factors ; Self Report

Objective: To explore the association between chronic hepatitis B virus infection and diabetes among adults. Methods: The baseline data of China Kadoorie Biobank ( CKB ) study from Tongxiang of Zhejiang Province was used for analysis. Community residents were investigated in the study from August 2004 to May 2008, including questionnaire survey, physical measurement and biological sample test. Univariate and multivariate logistic regression models were used to estimate the association of chronic hepatitis B virus infection with diabetes. Results: Totally 52 888 participants were included in the final analysis. The overall prevalence of HBsAg-positive was 3.55% ( N=1 877 ). The overall prevalence of diabetes was 5.17% ( N=2 733 ). The prevalence of HBsAg-positive in diabetic patients was 3.51% ( N=96 ). Both univariate and multivariate logistic regression models indicated that there was no association between chronic hepatitis B virus infection and diabetes（ P>0.05 ）. Conclusion No significant association has been found between chronic hepatitis B virus infection and diabetes among adults.

OBJECTIVE: From the perspective of clinical application to analyze the effectiveness and reliability of CPC/PMMA bone cement in percutaneous kyphoplasty (PKP) for the treatment of elderly patients with osteoporotic thoracolumbar fractures. METHODS: A retrospective analysis was performed on 62 patients with osteoporotic compression fracture of single-vertebral thoracic or lumbar segment who underwent PKP surgery and had a bone density less than or equal to -3.0 SD from February 2016 to December 2016. Among them, 23 patients were in CPC/PMMA group, with an average age of (77.6±2.2) years old, 39 patients in PMMA group, with an average age of (77.1±1.1) years old. The indexes between two groups were compared, including the visual analogue scale (VAS), height ratio of anterior vertebra (AVHR), local Cobb angle, cement leakage, new adjacent vertebral fracture(NAVF). RESULTS: There were no significant difference in gender, age, follow-up time and preoperative VAS, AVHR, local Cobb angle between two groups (>0.05), at the 1 day after operation, VAS, AVHR, local Cobb angle in all patients got obvious improvement (<0.05), which was no significant difference at 1 day after operation and final follow-up (>0.05). At the same time, there was no statistically significant difference in the incidence of new adjacent vertebral fracture and cement leakage (>0.05). The pain in both groups continued to improve at follow up after operation (<0.05), the local Cobb angle increased (<0.05) and AVHR decreased slightly (<0.05). However, the images of conventional methods (X-ray or CT) could not find signs about CPC degeneration and new bone ingrowth. CONCLUSION CPC/PMMA composite bone cement is safe and reliablein PKP for treatment of elderly patients with osteoporotic thoracolumbar fractures, which can effectively relieve pain and maintain vertebral body stability. It has the same curative effect as PMMA bone cement. It was worthy to research more in future, although no direct evidences support the CPC/PMMA composite bone cement can reduce the incidence of adjacent vertebral fracture, CPC degeneration or new bone ingrowth.
Aged ; Bone Cements ; Dinucleoside Phosphates ; Fractures, Compression ; Humans ; Kyphoplasty ; Osteoporotic Fractures ; Polymethyl Methacrylate ; Reproducibility of Results ; Retrospective Studies ; Spinal Fractures ; Treatment Outcome ; Vertebroplasty

OBJECTIVE: To study effects of postoperative regular training of core muscle strength guided by the concept of enhanced recovery after surgery (ERAS) on the rehabilitation of elderly patients with osteoporotic lumbar vertebral compression fracture after vertebroplasty (PVP) and kyphoplasty(PKP). METHODS: Ninety-four elderly patients with osteoporotic lumbar compression fractures who underwent PKP or PVP from January 2016 to January 2018 and met inclusion criteria were divided into observation group and control group. All the patients were treated with routine anti osteoporosis therapy after operation. There were 47 patients in the observationgroup, including 18 males and 29 females, with an average age of (62.62±3.21) years old;in the control group, there were 47 cases, including 17 males and 30 females, with an average age of (62.38±2.84) years old. The patients in the control group were trained by traditional way, and the patients in observation group were instructed to conduct regular training of core muscle strength according to ERAS concept. The patients were followed up for 1, 3 and 6 months after operation. Patients' conditions were quantitatively evaluated according to Barthel scale, JOA low back pain score and Oswestry Disability Index, and the differences in treatment effects between two groups were statistically analyzed and compared. RESULTS: All the patients were followed up, and the Barthel scale, JOA low back pain score and Oswestry Disability Index score of the observation group were all better than those of the control group on the 1st and the 3rd months after surgery( CONCLUSION Early regular core strength training has a positive effect on early functional recovery and improvement of life ability after PKP or PVP for elderly patients with osteoporotic lumbar compression fractures, which is in line with the concept of accelerated rehabilitation surgery.
Aged ; Enhanced Recovery After Surgery ; Female ; Fractures, Compression/surgery* ; Humans ; Kyphoplasty ; Male ; Middle Aged ; Osteoporotic Fractures/surgery* ; Spinal Fractures/surgery* ; Treatment Outcome ; Vertebroplasty

Objective:To evaluate the effects of aquatic exercise on lower-limb motor function and activities of daily living for patients with stroke. Methods:The randomized controlled trials (RCTs) about effects of aquatic therapeutic exercise on stroke patients were recalled from the databases of Cochrane Library, PEDro, PubMed, EMBASE, Web of Knowledge, Web of Science, OVID, EBSCO, CMCI, CNKI, Wanfang and VIP. The methodological quality of the included RCTs was evaluated. The data were extracted, and analysed with RevMan 5.3. Results:A total of 23 RCTs that represented 861 participants were evaluated. Compared with the control group, aquatic exercise significantly improved the performance of Berg Balance Scale (WMD = 2.69, 95%CI 1.21 to 4.16,P < 0.001), Timed Up and Go Test (WMD = -1.56, 95%CI -3.07 to -0.05,P < 0.05), Functional Reach Test (WMD = 2.69, 95%CI 1.21 to 4.16,P < 0.001), sway velocity of center of pressure (SVCOP) (left/right) (WMD = -1.38, 95%CI -2.72 to -0.05,P < 0.05), SVCOP (anteroposterior) (WMD = -1.64, 95%CI -3.10 to 　-0.18,P < 0.05), walking speed (SMD = 0.33, 95%CI 0.07 to 0.58,P < 0.05), Two Minute Walk Test (WMD = 12.75, 95%CI 4.17 to 21.34,P < 0.01), Functional Ambulation Category (WMD = 0.94, 95%CI 0.67 to 1.20,P < 0.001), muscle strength of knee extensor (WMD = 4.30, 95%CI 1.53 to 7.07,P < 0.01), muscle strength of knee flexor (WMD = 4.80, 95%CI 0.29 to 9.32,P < 0.05), and Functional Independence Measurement (WMD = 6.12, 95%CI 3.98 to 8.27,P < 0.001), but not significantly in the score of modified Barthel Index (WMD = 2.92, 95%CI -6.74 to 12.58,P = 0.55). Conclusion:Aquatic exercise can improve balance, walking and muscle strength of lower extremities of stroke patients, but do not for activities of daily living.