OBJECTIVE To analyze the prevalence of hospital-associated carbapenem-resistant Enterobacter(CRE)infections among the elderly intensive care unit(ICU)patients with respiratory system diseases based on the Chinese healthcare security diagnosis-related groups(CHS-DRG)and the case mix index(CMI)and assess the economic burden and consumption of healthcare insurance funds.METHODS The key departments with high isola-tion rate of CRE and high incidence of hospital-associated infections were found out by using CMI.The data were collected from 56 elderly patients with major diagnostic category E(MDCE)who had hospital-associated Enter-obacter infection and were treated in 10 ICUs of the Second People's Hospital of Changzhou from 2021 to 2023.The length of hospital stay,economic burden and consumption of healthcare insurance funds were observed and compared between the CRE infection group and the carbapenem-sensitive Enterobacter(CSE)infection group.RESULTS The general ICU(Yanghu campus)ranked the top 3 isolation rate of CRE and incidence of hospital-associated in-fections after the adjustment of CMI value.EJ1(other respiratory system surgeries)and ES2(respiratory sys-tem infection/inflammation)were the core codes of major Enterobacter infection.The average length of hospital stay of the CRE group was 10 days larger than the CSE group,the self-funded amount was 20,777.65 yuan more in the CRE group than in the CSE group;the consumption of healthcare insurance funds was 39,631.64 yuan more in the CRE group than in the CSE group(P＜0.05).Of the patients encoded with ES2,the average length of hospital stay was 6.5 days more in the CRE group than in the CSE group,and the fund expense on pay-ment of severe diseases was greater in the CRE group than in the CSE group(P＜0.05).CONCLUSIONS The CRE infection may increase the length of hospital stay,economic burden and consumption of healthcare insurance funds of the elderly ICU patients with respiratory system diseases.Under the CHS-DRG payment mode,it is nec-essary to take targeted prevention and control strategies according to the characteristics of patients with different DRG codes so as to control the wide spread of CRE.

OBJECTIVE To analyze the prevalence of hospital-associated carbapenem-resistant Enterobacter(CRE)infections among the elderly intensive care unit(ICU)patients with respiratory system diseases based on the Chinese healthcare security diagnosis-related groups(CHS-DRG)and the case mix index(CMI)and assess the economic burden and consumption of healthcare insurance funds.METHODS The key departments with high isola-tion rate of CRE and high incidence of hospital-associated infections were found out by using CMI.The data were collected from 56 elderly patients with major diagnostic category E(MDCE)who had hospital-associated Enter-obacter infection and were treated in 10 ICUs of the Second People's Hospital of Changzhou from 2021 to 2023.The length of hospital stay,economic burden and consumption of healthcare insurance funds were observed and compared between the CRE infection group and the carbapenem-sensitive Enterobacter(CSE)infection group.RESULTS The general ICU(Yanghu campus)ranked the top 3 isolation rate of CRE and incidence of hospital-associated in-fections after the adjustment of CMI value.EJ1(other respiratory system surgeries)and ES2(respiratory sys-tem infection/inflammation)were the core codes of major Enterobacter infection.The average length of hospital stay of the CRE group was 10 days larger than the CSE group,the self-funded amount was 20,777.65 yuan more in the CRE group than in the CSE group;the consumption of healthcare insurance funds was 39,631.64 yuan more in the CRE group than in the CSE group(P＜0.05).Of the patients encoded with ES2,the average length of hospital stay was 6.5 days more in the CRE group than in the CSE group,and the fund expense on pay-ment of severe diseases was greater in the CRE group than in the CSE group(P＜0.05).CONCLUSIONS The CRE infection may increase the length of hospital stay,economic burden and consumption of healthcare insurance funds of the elderly ICU patients with respiratory system diseases.Under the CHS-DRG payment mode,it is nec-essary to take targeted prevention and control strategies according to the characteristics of patients with different DRG codes so as to control the wide spread of CRE.

Objective: To study the current situation and relevant risk factors for disability and dementia among the elderly in urban areas of Jiangsu province. Methods: A stratified cluster sampling method was used to select representative elderly people aged 60 years and over in urban areas in Jiangsu Province, and a face-to-face questionnaire survey was conducted.The activities of daily living(ADL)scale and mini-mental state examination(MMSE)were used to assess the status of disability and dementia.And the relevant risk factors for disability and dementia were analyzed by univariate and multivariate Logistic regression methods. Results: A total of 1 600 elderly people were investigated and 1 514 valid questionnaires were recovered.The effective recovery rate was 94.6%.The rates of disability and dementia were 17.9%(271/1 514)and 8.5%(129/1 514)respectively in the elderly in Jiangsu urban areas.Univariate analysis showed that age, marital status, education level, empty-nest, whether or not to suffer from chronic diseases, health status, medication, and whether or not to have dementia were significantly related with the disability in the elderly(P<0.01). And age, gender, marital status, education level, whether or not to suffer from chronic diseases, health status, medication, and whether or not to have disability were significantly related with the dementia in the elderly(P<0.01). Multivariate analysis showed that the risk factors associating with increasing disability in the elderly were advanced age(OR=16.371), non-marriage(OR=1.917), chronic disease(OR=2.256), poor health condition(OR=23.214), dementia(OR=4.067)and insufficient income(OR=1.607)(P<0.05). And the factors associating with increasing risks for dementia in the elderly were advanced age(OR=2.864), female(OR=1.610), poor health condition(OR=3.097), empty nest(OR=1.607)and disability(OR=4.026)(P<0.05). Therefore, comprehensive measures should be taken for intervention of disability and dementia in the elderly. Conclusions The incidence of disability and dementia is high among the elderly in urban areas of Jiangsu Province.Disability and dementia are the results of the interaction effect of health, family and social factors.Therefore, comprehensive measures against risk factors should be taken for intervention of disability and dementia in the elderly.

Objective To study the health status ,the current health service needs and the influencing factors concerning the rural elderly population in Northern Jiangsu. Methods Multi-stage stratified cluster sampling was conducted in elderly people over 60 in Xuzhou ,Lianyungang ,and Suqian.Participants were face-to-face interviewed with questionnaires.Information on health status and health service needs was collected and analyzed. Results A total of 2655 elderly people were enrolled in this study ,including 1252 males (47.2%)and 1403 (52.8%)females with a mean age of (70.9 ± 6.7)years.Self-assessed health was generally poor ,with the two-week morbidity at 26.6%and the prevalence of chronic diseases at 60.1%;46.5% of the participants regularly took medications ;4.1% of them had physical disability ;8.2% had impaired daily activities ;The two-week hospital visit rate was 29.4%;The one-year hospitalization rate was 18.5%;The rate of non-hospitalization for people in need of hospitalization was 27.6%.Multivariate analysis showed that old age(OR＝5.51) ,adequate income(OR＝2.29)and short journey to a medical institution (OR＝7.90) were associated with high two-week hospital visit rates ;old age(OR ＝ 1.76) ,female gender(OR ＝1.36) ,empty-nest(OR＝ 1.37 ) ,family harmony (OR＝ 1.91 ) ,having chronic diseases (OR＝ 3.49 ) , and high frequency in taking medications (OR＝1.69)were correlated with high hospitalization rates. Conclusions The elderly population in rural areas of Northern Jiangsu shows poor health ,has high needs for health services ,and lacks sufficient service utilization.

Objective To investigate the efficacy of microsurgical subinguinal varicocelectomy for unilateral varicocele.Methods One hundred and five cases with left side varicocele were enrolled from August 2012 to October 2016.Thirty one cases suffered from varicocele in Ⅱ degree,and other seventy four cases in Ⅲ degree.Clinical data including operation time,sperm quality,testosterone level,complications and natural pregnoncy rate were retrospectively analyzed.The measurement data were expressed by (x) ± s.Sperm concentration,sperm motility,the rate of sperm normal morphology and serum testosterone levels were compared before and after operation with paired t test.Results The average operative time of varieocele was (58 ± 9) minutes in the outer ring of the microscope.Compared with preoperation's,sperm concentration,sperm motility,the rate of sperm normal morphology was remarkable improved after 3 month.However,serum testosterone levels were steady.In the outpatient follow-up,there were no complications,such as orchiatrophy,hydrocele of tunica vaginalis or recurrence of varicocele.The rate of natural pregnoncy in one year was 46.7％.Conclusions Microsurgical subinguinal varicocelectomy can remarkably improve sperm quality for patients,who suffer from varicocele in Ⅱ or Ⅲ degree.The complication of microsurgical subinguinal varicocelectomy is rare.Male infertility patients resulted from varicocele will get favorable natural pregnoncy rate.