1.Development of a Prognostic Model for Overall Survival Adult Patients with Core Binding Factor Acute Myeloid Leukaemia
Lu-Yao SHI ; Ling-Ling LI ; Tao LI ; Ya-Fei LI ; Yan-Fang LIU ; Zhong-Xing JIANG ; Shu-Juan WANG ; Chong WANG
Journal of Experimental Hematology 2024;32(3):693-701
Objective:To analyze the factors affecting overall survival(OS)of adult patients with core-binding factor acute myeloid leukemia(CBF-AML)and establish a prediction model.Methods:A total of 216 newly diagnosed patients with CBF-AML in the First Affiliated Hospital of Zhengzhou University from May 2015 to July 2021 were retrospectively analyzed.The 216 CBF-AML patients were divided into the training and the validation cohort at 7:3 ratio.The Cox regression model was used to analyze the clinical factors affecting OS.Stepwise regression was used to establish the optimal model and the nomogram.Receiver operating characteristic(ROC)curve,calibration curve and decision curve analysis(DCA)were used to evaluate the model performance.Results:Age(≥ 55 years old),peripheral blood blast(≥80%),fusion gene(AML1-ETO),KIT mutations were identified as independent adverse factors for OS.The area under the ROC curve at 3-year was 0.772 and 0.722 in the training cohort and validation cohort,respectively.The predicted value of the calibration curve is in good agreement with the measured value.DCA shows that this model performs better than a single factor.Conclusion:This prediction model is simple and feasible,and can effectively predict the OS of CBF-AML,and provide a basis for treatment decision.
2.Research on the Development Status and Influencing Factors of Medical Insurance for Urban and Rural Residents from the Perspective of Common Wealth
Tao SHI ; Dawei QIN ; Lumin XING ; Siran WANG ; Jiahao ZHANG ; Lei NIE
Chinese Health Economics 2024;43(6):44-49
Objective:To analyze the status quo and influencing factors of the equity,accessibility and sustainability of the development of medical insurance for urban and rural residents in 2021,and provide a reference for improving the management and service level of medical insurance.Methods:Firstly,the"evaluation index system of medical insurance for urban and rural residents"was constructed,and the total index of the development level of medical insurance and its three subsystem indexes of equity,accessibility and sustainability were calculated.Secondly,the Theil index was used to measure the level differences of the three major regions in the east,central and west,and the spatial auto-correlation was used to analyze the spatial agglomeration and heterogeneity distribution pattern of the total index.Finally,a geographic weighted regression model was constructed to analyze the main influencing factors.Results:There were provincial differences in the development level of medical insurance,which showed a decreasing trend from east to west in geography and a random distribution pattern in space.Policy factors,economic factors,population structure,medical resource allocation and education level had a significant impact on the development level of medical insurance.Conclusions:It is proposed to promote the fairness at multiple levels,enhance the accessibility in all directions and dynamically improve the sustainability,and further explore the policy suggestions to improve the management and service level and enhance the residents'sense of experience,sense of gain and sense of happiness.
3.Research on the Development Status and Influencing Factors of Medical Insurance for Urban and Rural Residents from the Perspective of Common Wealth
Tao SHI ; Dawei QIN ; Lumin XING ; Siran WANG ; Jiahao ZHANG ; Lei NIE
Chinese Health Economics 2024;43(6):44-49
Objective:To analyze the status quo and influencing factors of the equity,accessibility and sustainability of the development of medical insurance for urban and rural residents in 2021,and provide a reference for improving the management and service level of medical insurance.Methods:Firstly,the"evaluation index system of medical insurance for urban and rural residents"was constructed,and the total index of the development level of medical insurance and its three subsystem indexes of equity,accessibility and sustainability were calculated.Secondly,the Theil index was used to measure the level differences of the three major regions in the east,central and west,and the spatial auto-correlation was used to analyze the spatial agglomeration and heterogeneity distribution pattern of the total index.Finally,a geographic weighted regression model was constructed to analyze the main influencing factors.Results:There were provincial differences in the development level of medical insurance,which showed a decreasing trend from east to west in geography and a random distribution pattern in space.Policy factors,economic factors,population structure,medical resource allocation and education level had a significant impact on the development level of medical insurance.Conclusions:It is proposed to promote the fairness at multiple levels,enhance the accessibility in all directions and dynamically improve the sustainability,and further explore the policy suggestions to improve the management and service level and enhance the residents'sense of experience,sense of gain and sense of happiness.
4.Research on the Development Status and Influencing Factors of Medical Insurance for Urban and Rural Residents from the Perspective of Common Wealth
Tao SHI ; Dawei QIN ; Lumin XING ; Siran WANG ; Jiahao ZHANG ; Lei NIE
Chinese Health Economics 2024;43(6):44-49
Objective:To analyze the status quo and influencing factors of the equity,accessibility and sustainability of the development of medical insurance for urban and rural residents in 2021,and provide a reference for improving the management and service level of medical insurance.Methods:Firstly,the"evaluation index system of medical insurance for urban and rural residents"was constructed,and the total index of the development level of medical insurance and its three subsystem indexes of equity,accessibility and sustainability were calculated.Secondly,the Theil index was used to measure the level differences of the three major regions in the east,central and west,and the spatial auto-correlation was used to analyze the spatial agglomeration and heterogeneity distribution pattern of the total index.Finally,a geographic weighted regression model was constructed to analyze the main influencing factors.Results:There were provincial differences in the development level of medical insurance,which showed a decreasing trend from east to west in geography and a random distribution pattern in space.Policy factors,economic factors,population structure,medical resource allocation and education level had a significant impact on the development level of medical insurance.Conclusions:It is proposed to promote the fairness at multiple levels,enhance the accessibility in all directions and dynamically improve the sustainability,and further explore the policy suggestions to improve the management and service level and enhance the residents'sense of experience,sense of gain and sense of happiness.
5.Research on the Development Status and Influencing Factors of Medical Insurance for Urban and Rural Residents from the Perspective of Common Wealth
Tao SHI ; Dawei QIN ; Lumin XING ; Siran WANG ; Jiahao ZHANG ; Lei NIE
Chinese Health Economics 2024;43(6):44-49
Objective:To analyze the status quo and influencing factors of the equity,accessibility and sustainability of the development of medical insurance for urban and rural residents in 2021,and provide a reference for improving the management and service level of medical insurance.Methods:Firstly,the"evaluation index system of medical insurance for urban and rural residents"was constructed,and the total index of the development level of medical insurance and its three subsystem indexes of equity,accessibility and sustainability were calculated.Secondly,the Theil index was used to measure the level differences of the three major regions in the east,central and west,and the spatial auto-correlation was used to analyze the spatial agglomeration and heterogeneity distribution pattern of the total index.Finally,a geographic weighted regression model was constructed to analyze the main influencing factors.Results:There were provincial differences in the development level of medical insurance,which showed a decreasing trend from east to west in geography and a random distribution pattern in space.Policy factors,economic factors,population structure,medical resource allocation and education level had a significant impact on the development level of medical insurance.Conclusions:It is proposed to promote the fairness at multiple levels,enhance the accessibility in all directions and dynamically improve the sustainability,and further explore the policy suggestions to improve the management and service level and enhance the residents'sense of experience,sense of gain and sense of happiness.
6.Research on the Development Status and Influencing Factors of Medical Insurance for Urban and Rural Residents from the Perspective of Common Wealth
Tao SHI ; Dawei QIN ; Lumin XING ; Siran WANG ; Jiahao ZHANG ; Lei NIE
Chinese Health Economics 2024;43(6):44-49
Objective:To analyze the status quo and influencing factors of the equity,accessibility and sustainability of the development of medical insurance for urban and rural residents in 2021,and provide a reference for improving the management and service level of medical insurance.Methods:Firstly,the"evaluation index system of medical insurance for urban and rural residents"was constructed,and the total index of the development level of medical insurance and its three subsystem indexes of equity,accessibility and sustainability were calculated.Secondly,the Theil index was used to measure the level differences of the three major regions in the east,central and west,and the spatial auto-correlation was used to analyze the spatial agglomeration and heterogeneity distribution pattern of the total index.Finally,a geographic weighted regression model was constructed to analyze the main influencing factors.Results:There were provincial differences in the development level of medical insurance,which showed a decreasing trend from east to west in geography and a random distribution pattern in space.Policy factors,economic factors,population structure,medical resource allocation and education level had a significant impact on the development level of medical insurance.Conclusions:It is proposed to promote the fairness at multiple levels,enhance the accessibility in all directions and dynamically improve the sustainability,and further explore the policy suggestions to improve the management and service level and enhance the residents'sense of experience,sense of gain and sense of happiness.
7.Research on the Development Status and Influencing Factors of Medical Insurance for Urban and Rural Residents from the Perspective of Common Wealth
Tao SHI ; Dawei QIN ; Lumin XING ; Siran WANG ; Jiahao ZHANG ; Lei NIE
Chinese Health Economics 2024;43(6):44-49
Objective:To analyze the status quo and influencing factors of the equity,accessibility and sustainability of the development of medical insurance for urban and rural residents in 2021,and provide a reference for improving the management and service level of medical insurance.Methods:Firstly,the"evaluation index system of medical insurance for urban and rural residents"was constructed,and the total index of the development level of medical insurance and its three subsystem indexes of equity,accessibility and sustainability were calculated.Secondly,the Theil index was used to measure the level differences of the three major regions in the east,central and west,and the spatial auto-correlation was used to analyze the spatial agglomeration and heterogeneity distribution pattern of the total index.Finally,a geographic weighted regression model was constructed to analyze the main influencing factors.Results:There were provincial differences in the development level of medical insurance,which showed a decreasing trend from east to west in geography and a random distribution pattern in space.Policy factors,economic factors,population structure,medical resource allocation and education level had a significant impact on the development level of medical insurance.Conclusions:It is proposed to promote the fairness at multiple levels,enhance the accessibility in all directions and dynamically improve the sustainability,and further explore the policy suggestions to improve the management and service level and enhance the residents'sense of experience,sense of gain and sense of happiness.
8.Research on the Development Status and Influencing Factors of Medical Insurance for Urban and Rural Residents from the Perspective of Common Wealth
Tao SHI ; Dawei QIN ; Lumin XING ; Siran WANG ; Jiahao ZHANG ; Lei NIE
Chinese Health Economics 2024;43(6):44-49
Objective:To analyze the status quo and influencing factors of the equity,accessibility and sustainability of the development of medical insurance for urban and rural residents in 2021,and provide a reference for improving the management and service level of medical insurance.Methods:Firstly,the"evaluation index system of medical insurance for urban and rural residents"was constructed,and the total index of the development level of medical insurance and its three subsystem indexes of equity,accessibility and sustainability were calculated.Secondly,the Theil index was used to measure the level differences of the three major regions in the east,central and west,and the spatial auto-correlation was used to analyze the spatial agglomeration and heterogeneity distribution pattern of the total index.Finally,a geographic weighted regression model was constructed to analyze the main influencing factors.Results:There were provincial differences in the development level of medical insurance,which showed a decreasing trend from east to west in geography and a random distribution pattern in space.Policy factors,economic factors,population structure,medical resource allocation and education level had a significant impact on the development level of medical insurance.Conclusions:It is proposed to promote the fairness at multiple levels,enhance the accessibility in all directions and dynamically improve the sustainability,and further explore the policy suggestions to improve the management and service level and enhance the residents'sense of experience,sense of gain and sense of happiness.
9.Research on the Development Status and Influencing Factors of Medical Insurance for Urban and Rural Residents from the Perspective of Common Wealth
Tao SHI ; Dawei QIN ; Lumin XING ; Siran WANG ; Jiahao ZHANG ; Lei NIE
Chinese Health Economics 2024;43(6):44-49
Objective:To analyze the status quo and influencing factors of the equity,accessibility and sustainability of the development of medical insurance for urban and rural residents in 2021,and provide a reference for improving the management and service level of medical insurance.Methods:Firstly,the"evaluation index system of medical insurance for urban and rural residents"was constructed,and the total index of the development level of medical insurance and its three subsystem indexes of equity,accessibility and sustainability were calculated.Secondly,the Theil index was used to measure the level differences of the three major regions in the east,central and west,and the spatial auto-correlation was used to analyze the spatial agglomeration and heterogeneity distribution pattern of the total index.Finally,a geographic weighted regression model was constructed to analyze the main influencing factors.Results:There were provincial differences in the development level of medical insurance,which showed a decreasing trend from east to west in geography and a random distribution pattern in space.Policy factors,economic factors,population structure,medical resource allocation and education level had a significant impact on the development level of medical insurance.Conclusions:It is proposed to promote the fairness at multiple levels,enhance the accessibility in all directions and dynamically improve the sustainability,and further explore the policy suggestions to improve the management and service level and enhance the residents'sense of experience,sense of gain and sense of happiness.
10.Cohort study on the incidence,mortality and risk factors of malignant tumors in the middle-aged and elderly population in Chengguan district of Lanzhou
Xing-Wen SHI ; Hong-Tao YIN ; Jin-Jin LIU ; Yan MA ; Ting SUN ; Gao-Peng TIAN ; Jing-Jing XIE ; Dong-Hu ZHEN
Medical Journal of Chinese People's Liberation Army 2024;49(7):761-769
Objective To analyze the incidence and mortality of malignant tumors among the middle-aged and elderly population in Chengguan district of Lanzhou from 2011 to 2021,and to discuss the related risk factors.Methods Using the research data of REACTION in Lanzhou,an epidemiological survey was conducted through cluster sampling in three communities in Chengguan district of Lanzhou since April 2011.The target population was middle-aged and elderly residents over 40 years old.Two follow-up surveys were carried out in 2014-2016 and 2021 successively,and 6543 people with complete follow-up data were finally included.The incidence and mortality rates of malignant tumors were calculated,as well as their age standardized rates with reference to the age composition of Segi's world standard population.Multivariate Cox regression analysis was used to screen the risk factors affecting the incidence and mortality of malignant tumors.Results After an average follow-up of 10.6 years,314 new cases of malignant tumors were found in middle-aged and elderly residents in Chengguan district of Lanzhou,with an incidence rate and age standardized incidence rate of 454.30/100 000 and 128.93/100 000,respectively.A total of 158 deaths were attributed to malignant tumors,with a mortality rate and age standardized rate of 228.41/100 000 and 607.9/100 000,respectively;The age standardized incidence rate and mortality rate of malignant tumors males were both higher than those females(P<0.05).During the follow-up period,the age standardized incidence rate of malignant tumors in the general population showed an significant upward trend(P<0.05),whereas the age standardized mortality rate gradually decreased after a brief increase(P<0.05).Lung cancer,colorectal cancer,gastric cancer,and liver cancer were the main types of malignant tumors ranking in the top five in terms of incidence and mortality by gender.Multivariate Cox regression results indicate that male,age≥60 years old,college education level or above,smoking history,drinking history,having been hit by major stressful events,central obesity,hypertension,and coronary heart disease are risk factors for the onset or death of malignant tumors(HR>1).Married,with family size≥4,frequent consumption of fresh fruit,frequent consumption of fresh vegetables,frequent consumption of grains and tubers are protective factors for the onset or death of malignant tumors(HR<1).Conclusion The incidence of malignant tumors among middle-aged and elderly people in Chengguan district of Lanzhou from 2011 to 2021 showed an increasing trend,while the overall mortality was decreasing.Our study indicates early cancer screening in elderly populations,maintaining a healthy lifestyle and strengthening the management of chronic diseases are crucial for the prevention and treatment of malignant tumors.

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