1.Exploration of Regional Differences in Benign Prostatic Hyperplasia Treatment Under DRG/DIP Reform
Huangang HU ; Xiaoyang SHI ; Jiaojiao ZHANG ; Weizheng GAO ; Furong DING ; Zhenying ZHAO
Herald of Medicine 2025;44(11):1860-1869
Objective To explore the impact of factors such as economic level,regional differences,and healthcare policies on the medical costs and the clinical treatment behaviors for benign prostatic hyperplasia(BPH)using big data technology.Methods A combination of qualitative and quantitative approaches was employed,including descriptive statistical analysis,central tendency analysis,comparative analysis,and structural analysis to explore regional differences in the treatment of BPH and the underlying causes.Results The mean medical cost per case in the provincial capital city(19 502 yuan)was significantly higher than that in the prefecture-level city(16 526 yuan),with a difference of 2 976 yuan(+18%).Moreover,the cost distribution was more dispersed in the provincial capital([8 370 yuan-26 344 yuan]vs.[9 687 yuan-21 974 yuan]in the prefecture-level city).However,the provincial capital demonstrated better hospitalization efficiency,with a significantly shorter mean length of stay(9.24 days vs 10.21 days,-10.5%).All these differences were statistically significant(P<0.01).Payment methods influenced surgical choices.In the provincial capital,43.99%of patients underwent transurethral resection of the prostate(TURP),with no cases of holmium laser enucleation of the prostate(HOLEP).In contrast,the prefecture-level city reported 22.71%of patients receiving plasmakinetic resection of the prostate(PKRP)and 19.19%undergoing HoLEP.Significant differences were observed in antibiotic utilization patterns.The most commonly used antibiotic in the provincial capital was piperacillin-tazobactam(19.96%),while cefotaxime dominated in the prefecture-level city(21.11%).Notably,ertapenem was frequently used in the provincial capital but rarely in the prefecture-level city,potentially due to cost considerations(P<0.05).Regional preferences were evident in antispasmodic medication;phloroglucinol injection was used in 80%of cases in the prefecture-level city,while anisodamine hydrobromide injection predominated in the provincial capital(P<0.05).For BPH-specific medications,although tamsulosin hydrochloride sustained-release capsules were the primary choice in both regions,the prefecture-level city showed significantly higher usage(80.11%vs 49.17%).Finasteride tablets were more commonly prescribed in the provincial capital(39.03%vs.14.14%,P<0.05).Conclusion Economic levels,healthcare policies,and different hospitals significantly influence clinical decision-making and medical expenses.Hospitals should enhance refined management,while healthcare policy reforms need to advance from multiple perspectives and levels to improve the efficiency and equity of healthcare services.
2.Exploration of Regional Differences in Benign Prostatic Hyperplasia Treatment Under DRG/DIP Reform
Huangang HU ; Xiaoyang SHI ; Jiaojiao ZHANG ; Weizheng GAO ; Furong DING ; Zhenying ZHAO
Herald of Medicine 2025;44(11):1860-1869
Objective To explore the impact of factors such as economic level,regional differences,and healthcare policies on the medical costs and the clinical treatment behaviors for benign prostatic hyperplasia(BPH)using big data technology.Methods A combination of qualitative and quantitative approaches was employed,including descriptive statistical analysis,central tendency analysis,comparative analysis,and structural analysis to explore regional differences in the treatment of BPH and the underlying causes.Results The mean medical cost per case in the provincial capital city(19 502 yuan)was significantly higher than that in the prefecture-level city(16 526 yuan),with a difference of 2 976 yuan(+18%).Moreover,the cost distribution was more dispersed in the provincial capital([8 370 yuan-26 344 yuan]vs.[9 687 yuan-21 974 yuan]in the prefecture-level city).However,the provincial capital demonstrated better hospitalization efficiency,with a significantly shorter mean length of stay(9.24 days vs 10.21 days,-10.5%).All these differences were statistically significant(P<0.01).Payment methods influenced surgical choices.In the provincial capital,43.99%of patients underwent transurethral resection of the prostate(TURP),with no cases of holmium laser enucleation of the prostate(HOLEP).In contrast,the prefecture-level city reported 22.71%of patients receiving plasmakinetic resection of the prostate(PKRP)and 19.19%undergoing HoLEP.Significant differences were observed in antibiotic utilization patterns.The most commonly used antibiotic in the provincial capital was piperacillin-tazobactam(19.96%),while cefotaxime dominated in the prefecture-level city(21.11%).Notably,ertapenem was frequently used in the provincial capital but rarely in the prefecture-level city,potentially due to cost considerations(P<0.05).Regional preferences were evident in antispasmodic medication;phloroglucinol injection was used in 80%of cases in the prefecture-level city,while anisodamine hydrobromide injection predominated in the provincial capital(P<0.05).For BPH-specific medications,although tamsulosin hydrochloride sustained-release capsules were the primary choice in both regions,the prefecture-level city showed significantly higher usage(80.11%vs 49.17%).Finasteride tablets were more commonly prescribed in the provincial capital(39.03%vs.14.14%,P<0.05).Conclusion Economic levels,healthcare policies,and different hospitals significantly influence clinical decision-making and medical expenses.Hospitals should enhance refined management,while healthcare policy reforms need to advance from multiple perspectives and levels to improve the efficiency and equity of healthcare services.
3.Clinical features and prognostic factors of small cell lung cancer: A retrospective study in 148 patients.
Qian CAI ; Hong-Lan LUO ; Xi-Can GAO ; Chun-Jin XIONG ; Fan TONG ; Rui-Guang ZHANG ; Yu HU ; Gang WU ; Xiao-Rong DONG
Journal of Huazhong University of Science and Technology (Medical Sciences) 2016;36(6):916-922
To better understand the outcomes of small cell lung cancer (SCLC), we examined the clinical features and prognostic factors of SCLC in this study. A total of 148 patients who were diagnosed as having SCLC between January 2009 and December 2013 in Cancer Center of Union Hospital, Wuhan, China, were enrolled and their clinical features and prognostic factors were retrospectively analyzed. Log-rank test and Cox regression model were employed for analysis of prognostic factors. The 1- and 2-year overall survival (OS) rates were 59.7% and 25.7%, respectively, for limited disease (LD) patients whose median survival time (MST) was 16 months. The 1- and 2-year OS rates were 29.5% and 5.3%, respectively, for extensive disease (ED) patients whose MST was 10 months. The univariate analysis and multivariate analysis revealed that age, tumor stage, serum CEA and Ki-67 antigen were significantly correlated to the outcomes of SCLC, and they were significant prognostic factors for SCLC.
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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Ki-67 Antigen
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blood
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Lung Neoplasms
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blood
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epidemiology
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pathology
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Male
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Middle Aged
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Neoplasm Staging
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Small Cell Lung Carcinoma
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blood
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epidemiology
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pathology
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Survival Analysis
4.Establishment of mitochondrial DNA depleted A549 cell line and the change of its radiosensitivity
Wei HE ; Fuxiang ZHOU ; Hui XU ; Huangang JIANG ; Liu HU ; Conghua XIE ; Yunfeng ZHOU
Chinese Journal of Radiological Medicine and Protection 2014;34(4):255-258
Objective To establish the mitochondrial DNA depleted cell line (ρ0 cells) of lung cancer cell A549 and to observe the radiosensitivity difference between ρ0 cells and normal A549 cells (ρ + cells).Methods The ρ0 cells were depleted of mitochondrial DNA by culturing chronically in the presence of low concentration of ethidium bromide (EB),and then the cell model was confined.Radiosensitivity of both ρ0 cells and ρ + cells was detected using the cologenic formation assay.After 6 MV X-ray irradiation in vitro,cell cycle distribution and reactive oxygen species (ROS) level were analyzed by flow cytometry and fluorescence microplate reader,respectively.Results A ρ0 cell line was successfully established and had a lower radiosensitivity than ρ + cells (t =12.57,P < 0.01).After irradiation with a dose of 8 Gy,compared to ρ+ cells,ρ0 cells showed prolonged G2 arrest with less cells in G2 (t =6.82,P < 0.01) and had lower increase of ROS level (t =14.51,P < 0.01).Conclusions ρ0 cells have a lower radiosensitivity than ρ + cells,in which the reduction of ROS production and the prolongation of G2 arrest post-irradiation may be involved.
5.The Ku80 inhibition cell model in telomerase-negative tumor cell lines U2OS and its relation to telomere and radiosensitivity
Qinqin WU ; Fuxiang ZHOU ; Liu HU ; Huangang JIANG ; Wei HE ; Baiyu LI ; Conghua XIE ; Yunfeng ZHOU
Chinese Journal of Radiological Medicine and Protection 2012;32(5):460-464
Objective To construct the KU80 inhibition cell model by RNAi in U2OS cell and to explore the relationship between the Ku80,telomeres and radiosensitivity in telomerase-negative tumor cells.Methods U2OS cells were transfected with the recombinant plasmids of pshRNA-K80 by the lipofectamine,and the stable transfected cell clones were selected by G418.After the selection,the cells were collected and analyzed by the flow cytometry.RT-PCR and Western blot were used to measure the expression of Ku80 and Real-time PCR was used to detect the length of telomeres.The radiosensitivity of U2OS was determined by clone formation array.Results The transfection efficiency of the positive cell clones detected by the flow cytometry was (83.23 ± 7.63) %.The inhibition rate of the Ku80 gene transcription in the cell group with recombinant plasmid was(68.09 ± 1.16)% and the inhibition rate of the Ku80 protein expression in the same group was (11.03 ± 2.45) %.The results of Real-time PCR showed that the telomere length of the cell group with recombinant plasmid (1.07 ± 0.07) was significantly shorter than that of the control group (4.42 ± 1.30,F =38.58,P < 0.05) and that of the empty plasmid group (4.11 ±0.84,F =38.58,P < 0.05).Compared to the control group,the telomere length of the empty plasmid group did not changed(4.42 ±0.84 vs.4.11 ±0.84).U2OS cells with Ku80 expression suppressed had lower SF2 than that of the control cells (F =1089.61,P <0.05),and resulted in the SER of 1.47.Conclusions The Ku80 inhibition cell model in telomerase-negative U2OS cell line is successfully established which has the shorter telomere length,and is more sensitive to radiation.Telomere shortening caused by pshRNA-of Ku80 is likely to be one of the mechanisms of radiosensitization in this kind of cell model.

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