1.Health economic analysis and medical cost analysis of children with severe hepatitis B in China: A retrospective study from 2016 to 2022
Qijun SHAN ; Xudong MA ; Yujie CHEN ; Guanghua ZHOU ; Sifa GAO ; Jialu SUN ; Fuping GUO ; Feng ZHANG ; Dandan MA ; Guoqiang SUN ; Wen ZHU ; Xiaoyang MENG ; Guiren RUAN ; Yuelun ZHANG ; Xutong TAN ; Dawei LIU ; Yi WANG ; Chang YIN ; Xiang ZHOU
Chinese Medical Journal 2025;138(5):562-567
Background::Hepatitis B poses a heavy burden for children in China, however, the national studies on the distributional characteristics and health care costs of children with severe hepatitis B is still lacking. This study aimed to analyze the disease characteristics, health economic effects, and medical cost for children with severe hepatitis B in China.Methods::Based on patient information in the Hospital Quality Monitoring System, cases with severe hepatitis B were divided into four groups according to age, and the etiology and symptoms of each group were quantified. The cost of hospitalization was calculated for cases with different disease processes, and severity of disease. The spatial aggregation of cases and the relationship with health economic factors were analyzed by Moran’s I analysis. Results::The total number of children discharged with hepatitis B from January 2016 to April 2022 was 1603, with an average age of 10.5 years. Liver failure cases accounted for 43.48% (697/1603) of total cases and cirrhosis cases accounted for 11.23% (180/1603). According to the grouping of disease progression, there were 1292 cases without associated complications, and the median hospitalization cost was $818.12. According to the spatial analysis, the aggregation of cases was statistically significant at the prefectural and provincial levels in 2019, 2020, and 2021 (all P <0.05). The number of severe cases was negatively correlated with gross domestic product (Moran’s I <0) and percentage of urban population (Moran’s I <0), and positively correlated with the number of pediatric beds per million population (Moran’s I >0). Conclusion::The number of severe hepatitis B cases is low in areas with high gross domestic product levels and high urban population ratios, and health care costs have been declining over the years.
2.Data-driven quality improvement in critical-value management:design and practice
Qijun SHAN ; Jun WANG ; Shaobo WANG ; Xie WANG ; Xutong TAN ; Feng ZHANG ; Xiang ZHOU
Modern Hospital 2025;25(11):1757-1760
Objective The digital transformation of healthcare has made data-driven approaches critical for improving the quality and efficiency of medical services.This study aims to improve the quality of critical value management by a data-driv-en intervention.Methods This study built an advanced digital platform to precisely record the time-stamp of each step,from de-tection to solution.This platform also delivered real-time notifications of patient critical value information to doctors' mobile de-vices,thereby optimizing the critical value management.Data were collected via this platform.A cohort study was designed:March 2024 data(pre-go-live)served as the control group and May 2024 data(post-go-live)as the intervention group.Comple-tion rate,processing time,and the proportion of in-patient critical values which were entered into the electronic progress were compared.Results The critical-value completion rate rose from 97.1%to 100.0%,and the proportion of values processed within 30 min increased from 80.91%to 83.42%.Among alerts that required ≥30 min,median(IQR)processing time fell from 100.27(230.09)min in March 2024 to 91.07(169.73)min in May 2024.Median processing time shortened for both e-mergency and out-patient alerts,with the out-patient reduction being statistically significant(median-45 min,P=0.042).Conclusion The data-driven platform not only improved the critical-value management,but also enhanced the transparency and traceability,providing clinical decision support and enhancing patient safety.
3.Clinical Significance of the Expression of Tim-3 and Galectin-9 and Tumor T Cell Immunity in Nasopharyngeal Carcinoma
Geng SU ; Qijun WANG ; Angru ZOU
Journal of Medical Research 2025;54(2):182-187
Objective To investigate the expression of T cell immunoglobulin mucin molecule(Tim-3)and Galectin-9 and their clinical significance in tumor T cell immunity in nasopharyngeal carcinoma.Methods The expression of Tim-3 in various tumor tissues in the TCGA database was searched,and Tim-3 and its ligand Galectin-9,which were closely related to the immune system of nasopha-ryngeal carcinoma patients were selected as the research genes;the data on the changes in peripheral blood T cell subsets detected by im-mune cell pathology chip technology before and after radiotherapy from 65 nasopharyngeal carcinoma patients with tumor tissues,65 naso-pharyngeal inflammatory specimens during the same period,and corresponding nasopharyngeal carcinoma patients admitted to Guangxi Zhuang Autonomous Region Ethnic Hospital from March 2018 to March 2022 were collected,and follow-up observation were conducted.Results Bioinformatics analysis of sequencing data from nasopharyngeal carcinoma in the TCGA database showed that Tim-3 was highly expressed in most tumor tissues and significantly upregulated in nasopharyngeal carcinoma tissues compared to normal adjacent tissues.The expression of Tim-3 and its ligand Galectin-9 was positively correlated in cancer tissues;Immunohistochemical results showed that the expression levels of Tim-3 and Galectin-9 in nasopharyngeal carcinoma tissue were significantly higher than that in nasopharyngeal inflammatory tissue(P<0.05);the high expression of Tim-3 and Galectin-9 were closely related to lymph node involvement(P<0.05)and later TNM stage(P<0.05);the expression levels of Tim-3 and Galectin-9 were not related to factors such as age,gender,and EB virus infection(P>0.05);the expression of Tim-3 and Galectin-9 was positively correlated in nasopharyngeal carcinoma(r=0.313,P=0.011);follow-up revealed that high expression of Tim-3 and Galectin-9 may be associated with poor prognosis in naso-pharyngeal carcinoma;the T lymphocyte subpopulation measurements of nasopharyngeal carcinoma patients 3days before and 7days after radiotherapy showed a significant decrease in CD4+and CD4+/CD8+ratios compared to before radiotherapy(P<0.05),there was no significant difference in the changes of CD3+and CD8+(P>0.05).The radiotherapy sensitivity of Tim-3 and Galectin-9 protein posi-tive groups was significantly higher than that of Tim-3 and Galectin-9 negative groups(P<0.05).Conclusion The Tim-3/Galectin-9 signaling pathway plays an important role in the occurrence,development,and metastasis of nasopharyngeal carcinoma,and T cell immuni-ty plays an important role in the treatment of nasopharyngeal carcinoma.The joint detection of changes in Tim-3,Galectin-9 and T cell subsets in nasopharyngeal carcinoma tissue may provide new parameters for clinical evaluation of tumor monitoring and tumor immunotherapy.
4.Establishment of a rapid diagnostic method to detect the presence of intracellular infection with Staphylococcus aureus
Luyao WEN ; Minghang LI ; Qijun ZHOU ; Jianhui WANG ; Shuai LIAN ; Rui WU ; Jianfa WANG
Chinese Journal of Veterinary Science 2025;45(9):1937-1943
Staphylococcus aureus has the ability to invade bovine mammary epithelial cells and cause persistent intracellular infections.For diagnosing mastitis in cows caused by the bacterial in-fections,it is necessary to determine whether there is a persistent intracellular infection by S.au-reus within mammary epithelial cells,and to establish scientific treatment strategies and imple-ment proactive management decisions.The content of this study is the establishment of a brand new diagnostic method aimed at confirming this type of bovine disease efficiently and cost-effec-tively.The diagnostic procedure is as follows:Add 100 μL S.aureus liquid culture with a concentra-tion of 8.5 ×1010 CFU/mL to the well-grown bovine mammary epithelial cell line and co-culture at 37 degrees Celsius for 2 h to establish an intracellular infection model;After the co-cultivation is completed,add 100 μL of lysostaphin to the dish to thoroughly eliminate extracellular S.aureus.It can be confirmed that the model has been successfully established that black spherical bacteria with a diameter of approximately 1μm are observed within the sample cells using a transmission e-lectron microscope.Intracellular infection is evidenced by the observation of DNA-staining positive material within the cytoplasm of DAPI-stained sample cells,as observed through a laser confocal microscope.The sample is subjected to gram staining after being treated with 200 μL of 0.5%Tri-tonX-100 for 15 min,and intracellular infection is observed within the cytoplasm of the sample cells with Gram-positive results under oil immersion microscopy.The results of the novel"Tri-tonX-100 & gram staining method"validate that the presence of Staphylococcus aureus individu-als within bovine mammary epithelial cells is consistent with images observed under transmission electron microscopy and laser confocal microscopy.The verification results indicate that the"Tri-tonX-100 & gram staining method"is suitable for the diagnosis of S.aureus persistent intracellu-lar infection in bovine mastitis.Later,somatic cells from milk were extracted by gradient centrifu-gation and purified to obtain bovine mammary epithelial cells for clinical testing of 70 S.aureus positive mastitis cattle,which showed a positive rate of 82.9%and a negative rate of 17.1%.
5.Establishment of a rapid diagnostic method to detect the presence of intracellular infection with Staphylococcus aureus
Luyao WEN ; Minghang LI ; Qijun ZHOU ; Jianhui WANG ; Shuai LIAN ; Rui WU ; Jianfa WANG
Chinese Journal of Veterinary Science 2025;45(9):1937-1943
Staphylococcus aureus has the ability to invade bovine mammary epithelial cells and cause persistent intracellular infections.For diagnosing mastitis in cows caused by the bacterial in-fections,it is necessary to determine whether there is a persistent intracellular infection by S.au-reus within mammary epithelial cells,and to establish scientific treatment strategies and imple-ment proactive management decisions.The content of this study is the establishment of a brand new diagnostic method aimed at confirming this type of bovine disease efficiently and cost-effec-tively.The diagnostic procedure is as follows:Add 100 μL S.aureus liquid culture with a concentra-tion of 8.5 ×1010 CFU/mL to the well-grown bovine mammary epithelial cell line and co-culture at 37 degrees Celsius for 2 h to establish an intracellular infection model;After the co-cultivation is completed,add 100 μL of lysostaphin to the dish to thoroughly eliminate extracellular S.aureus.It can be confirmed that the model has been successfully established that black spherical bacteria with a diameter of approximately 1μm are observed within the sample cells using a transmission e-lectron microscope.Intracellular infection is evidenced by the observation of DNA-staining positive material within the cytoplasm of DAPI-stained sample cells,as observed through a laser confocal microscope.The sample is subjected to gram staining after being treated with 200 μL of 0.5%Tri-tonX-100 for 15 min,and intracellular infection is observed within the cytoplasm of the sample cells with Gram-positive results under oil immersion microscopy.The results of the novel"Tri-tonX-100 & gram staining method"validate that the presence of Staphylococcus aureus individu-als within bovine mammary epithelial cells is consistent with images observed under transmission electron microscopy and laser confocal microscopy.The verification results indicate that the"Tri-tonX-100 & gram staining method"is suitable for the diagnosis of S.aureus persistent intracellu-lar infection in bovine mastitis.Later,somatic cells from milk were extracted by gradient centrifu-gation and purified to obtain bovine mammary epithelial cells for clinical testing of 70 S.aureus positive mastitis cattle,which showed a positive rate of 82.9%and a negative rate of 17.1%.
6.Data-driven quality improvement in critical-value management:design and practice
Qijun SHAN ; Jun WANG ; Shaobo WANG ; Xie WANG ; Xutong TAN ; Feng ZHANG ; Xiang ZHOU
Modern Hospital 2025;25(11):1757-1760
Objective The digital transformation of healthcare has made data-driven approaches critical for improving the quality and efficiency of medical services.This study aims to improve the quality of critical value management by a data-driv-en intervention.Methods This study built an advanced digital platform to precisely record the time-stamp of each step,from de-tection to solution.This platform also delivered real-time notifications of patient critical value information to doctors' mobile de-vices,thereby optimizing the critical value management.Data were collected via this platform.A cohort study was designed:March 2024 data(pre-go-live)served as the control group and May 2024 data(post-go-live)as the intervention group.Comple-tion rate,processing time,and the proportion of in-patient critical values which were entered into the electronic progress were compared.Results The critical-value completion rate rose from 97.1%to 100.0%,and the proportion of values processed within 30 min increased from 80.91%to 83.42%.Among alerts that required ≥30 min,median(IQR)processing time fell from 100.27(230.09)min in March 2024 to 91.07(169.73)min in May 2024.Median processing time shortened for both e-mergency and out-patient alerts,with the out-patient reduction being statistically significant(median-45 min,P=0.042).Conclusion The data-driven platform not only improved the critical-value management,but also enhanced the transparency and traceability,providing clinical decision support and enhancing patient safety.
7.Clinical Significance of the Expression of Tim-3 and Galectin-9 and Tumor T Cell Immunity in Nasopharyngeal Carcinoma
Geng SU ; Qijun WANG ; Angru ZOU
Journal of Medical Research 2025;54(2):182-187
Objective To investigate the expression of T cell immunoglobulin mucin molecule(Tim-3)and Galectin-9 and their clinical significance in tumor T cell immunity in nasopharyngeal carcinoma.Methods The expression of Tim-3 in various tumor tissues in the TCGA database was searched,and Tim-3 and its ligand Galectin-9,which were closely related to the immune system of nasopha-ryngeal carcinoma patients were selected as the research genes;the data on the changes in peripheral blood T cell subsets detected by im-mune cell pathology chip technology before and after radiotherapy from 65 nasopharyngeal carcinoma patients with tumor tissues,65 naso-pharyngeal inflammatory specimens during the same period,and corresponding nasopharyngeal carcinoma patients admitted to Guangxi Zhuang Autonomous Region Ethnic Hospital from March 2018 to March 2022 were collected,and follow-up observation were conducted.Results Bioinformatics analysis of sequencing data from nasopharyngeal carcinoma in the TCGA database showed that Tim-3 was highly expressed in most tumor tissues and significantly upregulated in nasopharyngeal carcinoma tissues compared to normal adjacent tissues.The expression of Tim-3 and its ligand Galectin-9 was positively correlated in cancer tissues;Immunohistochemical results showed that the expression levels of Tim-3 and Galectin-9 in nasopharyngeal carcinoma tissue were significantly higher than that in nasopharyngeal inflammatory tissue(P<0.05);the high expression of Tim-3 and Galectin-9 were closely related to lymph node involvement(P<0.05)and later TNM stage(P<0.05);the expression levels of Tim-3 and Galectin-9 were not related to factors such as age,gender,and EB virus infection(P>0.05);the expression of Tim-3 and Galectin-9 was positively correlated in nasopharyngeal carcinoma(r=0.313,P=0.011);follow-up revealed that high expression of Tim-3 and Galectin-9 may be associated with poor prognosis in naso-pharyngeal carcinoma;the T lymphocyte subpopulation measurements of nasopharyngeal carcinoma patients 3days before and 7days after radiotherapy showed a significant decrease in CD4+and CD4+/CD8+ratios compared to before radiotherapy(P<0.05),there was no significant difference in the changes of CD3+and CD8+(P>0.05).The radiotherapy sensitivity of Tim-3 and Galectin-9 protein posi-tive groups was significantly higher than that of Tim-3 and Galectin-9 negative groups(P<0.05).Conclusion The Tim-3/Galectin-9 signaling pathway plays an important role in the occurrence,development,and metastasis of nasopharyngeal carcinoma,and T cell immuni-ty plays an important role in the treatment of nasopharyngeal carcinoma.The joint detection of changes in Tim-3,Galectin-9 and T cell subsets in nasopharyngeal carcinoma tissue may provide new parameters for clinical evaluation of tumor monitoring and tumor immunotherapy.
8.Health economic analysis and medical cost analysis of children with severe hepatitis B in China: A retrospective study from 2016 to 2022
Qijun SHAN ; Xudong MA ; Yujie CHEN ; Guanghua ZHOU ; Sifa GAO ; Jialu SUN ; Fuping GUO ; Feng ZHANG ; Dandan MA ; Guoqiang SUN ; Wen ZHU ; Xiaoyang MENG ; Guiren RUAN ; Yuelun ZHANG ; Xutong TAN ; Dawei LIU ; Yi WANG ; Chang YIN ; Xiang ZHOU
Chinese Medical Journal 2025;138(5):562-567
Background::Hepatitis B poses a heavy burden for children in China, however, the national studies on the distributional characteristics and health care costs of children with severe hepatitis B is still lacking. This study aimed to analyze the disease characteristics, health economic effects, and medical cost for children with severe hepatitis B in China.Methods::Based on patient information in the Hospital Quality Monitoring System, cases with severe hepatitis B were divided into four groups according to age, and the etiology and symptoms of each group were quantified. The cost of hospitalization was calculated for cases with different disease processes, and severity of disease. The spatial aggregation of cases and the relationship with health economic factors were analyzed by Moran’s I analysis. Results::The total number of children discharged with hepatitis B from January 2016 to April 2022 was 1603, with an average age of 10.5 years. Liver failure cases accounted for 43.48% (697/1603) of total cases and cirrhosis cases accounted for 11.23% (180/1603). According to the grouping of disease progression, there were 1292 cases without associated complications, and the median hospitalization cost was $818.12. According to the spatial analysis, the aggregation of cases was statistically significant at the prefectural and provincial levels in 2019, 2020, and 2021 (all P <0.05). The number of severe cases was negatively correlated with gross domestic product (Moran’s I <0) and percentage of urban population (Moran’s I <0), and positively correlated with the number of pediatric beds per million population (Moran’s I >0). Conclusion::The number of severe hepatitis B cases is low in areas with high gross domestic product levels and high urban population ratios, and health care costs have been declining over the years.
9.Neuroimaging findings of common types of neurodegenerative dementias
Qijun LI ; Junshan WANG ; Jing YUAN ; Ruixue CUI
Basic & Clinical Medicine 2024;44(12):1741-1745
Neurodegenerative dementias are a group of clinical syndromes manifested with impairment of cognitive functions with various pathological etiologies.Neuroimaging along with clinical presentations can make etiological diagnoses and support differentiate diagnosis of various dementias.In this article,we briefly introduced the MRI,PET and SPECT differential patterns in the three most common neurodegenerative dementias including Alzheimer's disease,frontotemporal lobe dementia and Lewy body dementia.
10.A comparison of neuroendoscopic minimally invasive surgery and traditional extraventricular drainage for severe hypertensive intraventricular hemorrhage:a single-center retrospective study
Xian XIAO ; Jiayi SUN ; Qijun YUAN ; Fang XU ; Kun LU ; Haihui LIANG ; Zhipeng CHEN ; Songqing WANG
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2024;31(3):300-303
Objective To analyze the safety and efficacy of neuroendoscopic minimally invasive surgery and traditional extraventricular drainage in the treatment of severe hypertensive intraventricular hemorrhage.Methods The clinical data of 50 cases with neuroendoscopic ventricular hematoma evacuation(endoscopy group)and 44 cases with traditional ventricles external puncture drainage(drainage group)from July 2020 to July 2023 were retrospectively analyzed,and the hematoma clearance rates,classification of activities of daily living(ADL)scale,incidence of hydrocephalus,secondary bleeding,intracranial infection,and pulmonary infection were observed between the two groups of patients.Results After surgery,the proportion of patients with hematoma clearance rate>60%and ADL grades Ⅰ,Ⅱ,and Ⅲ in the endoscopy group were significantly higher than those in the drainage group[the proportion of patients with hematoma clearance rate>60%:88.0%(44/50)vs.47.7%(21/44),χ2=17.794,P<0.001;the proportion of individuals with ADL grades Ⅰ,Ⅱ,and Ⅲ:94.0%(47/50)vs.77.3%(33/44),respectively,χ2=5.459,P=0.019],the incidence of complications in endoscopy group was significantly lower in the drainage group[8.0%(4/50)vs.34.1%(15/44),χ2=9.879,P=0.002].Conclusion Compared with traditional ventricular puncture drainage surgery,neuroendoscopic minimally invasive surgery for the treatment of severe hypertensive intracerebral hemorrhage with ventricular casting can achieve better treatment outcomes,a higher hematoma clearance rate,and fewer postoperative complications.

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