1.Research on the health performance of basic medical insurance for flexible employees
Fang-Teng FU ; Bao-Zhen DAI ; Peng MIAO
Chinese Journal of Health Policy 2024;17(7):25-34
This paper evaluates the impact of basic medical insurance on the health status of flexible employees based on the CFPS three-period balanced panel data from 2016 to 2020,using Ordered Probit Model and Two-way Fixed Effects Model.It is found that basic medical insurance significantly promotes the physical and mental health of flexible employees.Further heterogeneity analysis reveals that the health performance of basic medical insurance was particularly significant for middle-aged and old-aged,rural,east-central and better-educated flexible employees.In addition,the mediation effect analysis indicates that basic medical insurance promots the health of flexible employees through the mediation channels of improving the utilization of medical services and reducing the burden of disease costs.This paper suggests promoting the comprehensive participation of flexible employees;improving the medical insurance system for middle-aged and elderly flexible employees;accelerating the sinking of high-quality medical resources to rural and western areas;and actively exploring a new mode of participation in medical check-ups by flexible employees,with a view to lowering the incidence of serious illnesses and major illnesses among flexible employees and improving health performance.
2.Epidemiological distribution of genotypes and sub-genotypes of hepatitis B virus in 15 ethnic groups in China.
Xiao Qi GUO ; Shuang ZHANG ; Hui ZHENG ; Feng WANG ; Ning MIAO ; Qiu Dong SU ; Sheng Li BI ; Guo Min ZHANG ; Fu Zhen WANG ; Li Ping SHEN
Chinese Journal of Epidemiology 2023;44(5):759-764
Objective: To understand the distribution of genotypes and sub-genotypes of HBV in different ethnic groups in China. Methods: The HBsAg positive samples were selected by stratified multi-stage cluster sampling from the sample base of national HBV sero-epidemiological survey in 2020 for the amplification of S gene of HBV by nested PCR. A phylogeny tree was constructed to determine the genotypes and sub-genotypes of HBV. The distribution of genotypes and sub-genotypes of HBV were analyzed comprehensively by using laboratory data and demographic data. Results: A total of 1 539 positive samples from 15 ethnic groups were successfully amplified and analyzed, and 5 genotypes (B, C, D, I and C/D) were detected. The proportion of genotype B was higher in ethnic group of Han (74.52%, 623/836), Zhuang (49.28%, 34/69), Yi (53.19%, 25/47), Miao (94.12%, 32/34), Buyi (81.48%, 22/27). The proportions of genotype C were higher in ethnic groups of Yao (70.91%, 39/55). Genotype D was the predominant genotype in Uygur (83.78%, 31/37). Genotype C/D were detected in Tibetan (92.35%,326/353). In this study, 11 cases of genotype I were detected, 8 of which were distributed in Zhuang nationality. Except for Tibetan, sub-genotype B2 accounted for more than 80.00% in genotype B in all ethnic groups. The proportions of sub-genotype C2 were higher in 8 ethnic groups, i.e. Han, Tibetan, Yi, Uygur, Mongolian, Manchu, Hui and Miao. The proportions of sub-genotype C5 were higher in ethnic groups of Zhuang (55.56%, 15/27) and Yao (84.62%, 33/39). For genotype D, sub-genotype D3 was detected in Yi ethnic group and sub-genotype D1 was detected in both Uygur and Kazak. The proportions of sub-genotype C/D1 and C/D2 in Tibetan were 43.06% (152/353) and 49.29% (174/353). For all the 11 cases of genotype I infection, only sub-genotype I1 was detected. Conclusions: Five genotypes and 15 sub-genotypes of HBV were found in 15 ethnic groups. There were significant differences in the distribution of genotypes and sub-genotypes of HBV among different ethnic groups.
Humans
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Asian People
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China/epidemiology*
;
Ethnicity
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Genotype
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Gerbillinae
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Hepatitis B virus/genetics*
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Hepatitis B/virology*
3.Clinical Efficacy of Jiwei Huangqi Guizhi Wuwutang Combined with Xingnao Kaiqiao Acupuncture on Shouder-hand Syndrome
Fu-ming WAN ; Miao-yan ZHOU ; Wei-zhen LI ; Shu-qiang DING
Chinese Journal of Experimental Traditional Medical Formulae 2020;26(12):133-138
Objective:To observe the clinical efficacy of Jiwei Huangqi Guizhi Wuwutang combined with Xingnao Kaiqiao acupuncture on shouder-hand syndrome (SHS), and its effect on neurogenic inflammatory factors and hemorheology. Method:One hundred and forty-eight patients were randomly divided into control group and observation group (74 cases). Both groups' patients got rehabilitation measures, such as diclofenac sodium sustained release tablets for two to four weeks, 75 min/time, 1 time/day, and patients with apparent swelling got prednisone acetate tablets for one to two weeks, 10 min/time, 1 time/day. And patients in control group got Xingnao Kaiqiao acupuncture, 1 time/day, 6 times/week. Control grouporal Naoxintong capsule 4 tablets/time,3 times/day, patients in observation group were added with Jiwei Huangqi Guizhi Wuwutang, 1 dose/day. The courses of treatment were 4 weeks. Before and after treatment, shoulder hand syndrome scale (SHSS), the upperextremities of the Fugl-meyer movement assessment (U-FMA), ability of daily life activities (ADL), Qi deficiency and blood stasis syndrome and clinical efficacy were scored, disappearing time of pain and swelling were recorded, and levels of calcitonin gene related peptide (CGRP), substance P (SP), bradykinin (BK) and hemorheology were detected. Result:The clinical efficacy in observation group was better than that in control group (
4.Sexual Quality of Life in Patients with Cervical Cancer Undergoing Radiotherapy.
Hong Nan ZHEN ; Yuan TIAN ; Jing SHEN ; Jia Bin MA ; Wenx Bin WANG ; Hui GUAN ; Zheng MIAO ; Yuan ZHANG ; Ke HU ; Fu Quan ZHANG
Acta Academiae Medicinae Sinicae 2019;41(4):501-505
To investigate the sexual quality of life and its influencing factors in patients with cervical cancer undergoing radiotherapy. Methods Totally 205 patients with cervical cancer who received radiotherapy in Peking Union Medical College Hospital from December 2013 to December 2018 were enrolled in this study.The Female Sexual Function Index(FSFI)scale was used to assess the sexual quality of life of these patients.The demographic data(including age,education level,marital status,family status,and occupation)and clinical data(including tumor stage and treatment method)were collected.Mann-Whitney test and Kruskal-Wallis test were used to analyze the influence of various factors on the sexual quality of life. Results Female sexual dysfunction was common among patients with cervical cancer undergoing radiotherapy.The total FSFI score was 5.5(3.6,16.3),and the scores of subscales were as follows:desire,1.20(0,1.80);sexual arousal,0.90(0,1.80);vaginal lubrication,0.30(0,3.30);orgasm,0(0,2.80);satisfaction,2.40(1.60,3.60);and sexual pain,0(0,2.80).Age(=0.010),duration of radiotherapy(=0.008),marital status(=0.020),family status(=0.010),and occupation(=0.024)were influential factors of sexual quality of life in cervical cancer patients undergoing radiotherapy. Conclusions The sexual quality of life of patients with cervical cancer undergoing radiotherapy is affected by multiple factors.Instructions on treatment,mental status,and post-treatment sexual life should be offered in an individualized way to improve the sexual quality of life of these patients.
Female
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Humans
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Quality of Life
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Sexual Dysfunction, Physiological
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Surveys and Questionnaires
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Uterine Cervical Neoplasms
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radiotherapy
5.Information Needs and Quality among Cervical Cancer Patients.
Hong Nan ZHEN ; Zheng MIAO ; Xin LIAN ; Ke HU ; Jing SHEN ; Jia Bin MA ; Hui GUAN ; Fu Quan ZHANG
Acta Academiae Medicinae Sinicae 2019;41(3):388-395
Objective To investigate the demand for scientific information among cervical cancer patients and to evaluate the quality of the relevant information available for these patients.Methods The demand for medical science information among patients with cervical cancer was investigated via questionnaire.The Discernn scoring system was used to score the cervical cancer science articles retrieved by Baidu and Sogou.A model was established to analyse the reading difficulty of these articles.Results Nearly half(53.6%)of the respondents searched for online science information at least weekly.The main target readings were the etiology and risk factors of diseases,symptoms,treatment options,adverse reactions of treatments,and prognosis.Most respondents(96.4%)thought that the network science information was reliable.Of the 104 search results included in the sample bank,13(12.5%)met the inclusion criteria,91(87.5%)were not selected,including 32 duplicates(30.8%),6 non-text webpages(5.8%),18 short texts(less than 300 Chinese characters)(17.3%),7 advertisements(6.7%),3 news articles(2.9%),22 forum posts(21.2%),and 3 academic articles(2.9%).According to the Discern scoring system,the reliability(=0.728, <0.001),the quality of treatment-related information(=0.431, <0.001),and the overall scores(=0.559,<0.001)of the enrolled 13 publications were consistent,as evaluated by two professional physicians.The mean overall score was 3.A lower score(less than 3)in the reliability assessment was due to the source of the content,generation methods,sponsors,citations,and the undefined parts.During the evaluation of treatment information,the average score was below 3 for each item.Analysis of the reading difficulty showed that,among these 13 articles,4 were at postgraduate thesis level(level 5),4 at undergraduate thesis level(level 4),0 at high school textbook level(level 3),and 8 was higher than middle school level(≥level 3).Eight articles(61.5%)were suitable for readers with an education background of higher middle school and only 5 articles(38.5%)were suitable for readers with an education background of middle school or lower(≤ level 2).Conclusions The vast majority of patients with cervical cancer search for clinical information through the Internet and trust their reliability.Chinese search engines have lower detection rates for high-quality medical science articles.The currently available high-quality medical science articles are small in number and difficult to read.More physicians are urged to write easy-to-read high-quality articles for these patients.
Female
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Health Services Needs and Demand
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Humans
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Information Seeking Behavior
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Internet
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Reproducibility of Results
;
Search Engine
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Surveys and Questionnaires
;
Uterine Cervical Neoplasms
6.A comparison of curriculum design for undergraduate education of rehabilitation therapy in mainland China and Taiwan area
Yuanwen LIU ; Cuihuan PAN ; Rui YU ; Ping MIAO ; Nan HU ; Maohua FAN ; Zhen FU ; Changlin XIAO
Chinese Journal of Medical Education Research 2018;17(3):310-315
Undergraduate education started late in rehabilitation medicine in mainland China.At present,there are some shortcomings in current undergraduate education for rehabilitation medicine in mainland China,mainly due to the shortage of teachers,the poor pertinence of professional subjects,the broad and superficial knowledge,and the lack of close connection with the necessary professional knowledge of rehabilitation technologies.The Department of Rehabilitation in Taiwan starts its undergraduate education earlier.The curriculum has been sub-professionally oriented.Its subjects are highly targeted and detailed in content.At the same time,it emphasizes forward-looking education such as "statistics".In view of this,the mainland colleges and universities should standardize the undergraduate education of rehabilitation therapies,strengthen the training of professional teachers,pay attention to the cross-mutualism of theory and practice in the teaching plan,enrich the number of professional courses,the appropriate introduction of teaching methods of scientific research,standardize the teaching management system.
7.Analysis of acne animal model based on Chinese and western medicine clinical symptoms characteristic.
Zhen-Na FU ; Ting WANG ; Ming BAI ; Ming-San MIAO
China Journal of Chinese Materia Medica 2018;43(6):1289-1291
This paper aimed to analyze the existing acne animal model based on the characteristics of acne clinical symptoms between Chinese and western medicine, in order to provide reference for the establishment of the rational acne animal model. Relevant literatures at home and abroad in recent years were reviewed to summarize the research progress of diagnostic criteria and drug treatment of acne with Chinese and western medicine, and analyze the existing acne animal model. The animal acne models were pathological models, and mainly reflected the clinical indicators of western medicine. Their evaluation was based on western medicine standard, with the standard of Chinese medicine for reference. More improved ideas and methods to establish acne animal models based on clinical study were put forward, so as to establish the reasonable quantitative standard for acne animal model. Furthermore, the animal model based on the combination of disease and syndrome was formed to provide a reliable experimental method for further study of acne. Rational acne animal model shall be selected according to the pathogenesis of acne, in order to improve the consistency between animal model and clinical symptoms, and lay a foundation for further study of acne.
8.Classical drug resistance mutations of HepG2.2.15 cells persistently induced by appropriate concentrations of adefovir
Qi LI ; Yuan YANG ; Le LI ; Shao-Ping CAI ; Fu-Zhen MIAO ; Wei-Jie LI ; Yan LIU ; Dong-Ping XU
Medical Journal of Chinese People's Liberation Army 2017;42(9):753-758
Objective To observe whether the classic drug-resistant mutations can be induced in various concentrations of adefovir (ADV)-treated HepG2.2.15 cells persistently and explore the mechanism for emergence of drug resistance.Methods HepG2.2.15 cells were cultured continually in 12-well plates with medium containing 0,0.01,0.1,1.0μmol/L concentration of ADV,and passaged every 3 days up to the 110th generations.The intracellular and supernatant HBV DNA was extracted every 10 generations.Intracellular HBV cccDNA was amplified by plasmid-safe ATP dependent DNase (PSAD) digestion in combination with rolling circle amplification and gap-spanning semi-nested PCR assay.And the RT region of supernatant HBV DNA was amplified by one-tube nested PCR assay.Then the classic drug-resistant mutations of the RT region of intracellular cccDNA and supernatant HBV DNA were analyzed using direct PCR sequencing combined with clonal sequencing (more than 20 clones/sample).Results HBV DNA stably replicated in ADV-untreated cells (control group).The intracellular total DNA and cccDNA levels,supernatant HBV DNA level decreased continuously with the prolonged ADV culture duration in 0.01 μmol/L and 0.1μmol/L ADV group.Drug resistant mutations were not detected up to the 110th generation in 0.01 μmol/L ADV group;while rtA181V+N236T mutations were detected at the110th generation in 0.1μmol/L ADV group.The 1.0μmol/L ADV group was ceased of culture at the 15th generation due to inhibited cell growth.Conclusion HBV cccDNA exists in HepG2.2.15 cells,and the classical drug-resistant mutations of rtA181V+N236T could be induced by proper concentration of ADV.
9.A single nucleotide polymorphism in the Epstein-Barr virus genome is strongly associated with a high risk of nasopharyngeal carcinoma.
Fu-Tuo FENG ; Qian CUI ; Wen-Sheng LIU ; Yun-Miao GUO ; Qi-Sheng FENG ; Li-Zhen CHEN ; Miao XU ; Bing LUO ; Da-Jiang LI ; Li-Fu HU ; Jaap M MIDDELDORP ; Octavia RAMAYANTI ; Qian TAO ; Su-Mei CAO ; Wei-Hua JIA ; Jin-Xin BEI ; Yi-Xin ZENG
Chinese Journal of Cancer 2015;34(12):563-572
BACKGROUNDEpstein-Barr virus (EBV) commonly infects the general population and has been associated with nasopharyngeal carcinoma (NPC), which has a high incidence in certain regions. This study aimed to address how EBV variations contribute to the risk of NPC.
METHODSUsing logistic regression analysis and based on the sequence variations at EBV-encoded RPMS1, a multi-stage association study was conducted to identify EBV variations associated with NPC risk. A protein degradation assay was performed to characterize the functional relevance of the RPMS1 variations.
RESULTSBased on EBV-encoded RPMS1 variations, a single nucleotide polymorphism (SNP) in the EBV genome (locus 155391: G>A, named G155391A) was associated with NPC in 157 cases and 319 healthy controls from an NPC endemic region in South China [P < 0.001, odds ratio (OR) = 4.47, 95% confidence interval (CI) 2.71-7.37]. The results were further validated in three independent cohorts from the NPC endemic region (P < 0.001, OR = 5.20, 95% CI 3.18-8.50 in 168 cases vs. 241 controls, and P < 0.001, OR = 5.27, 95% CI 4.06-6.85 in 726 cases vs. 880 controls) and a non-endemic region (P < 0.001, OR = 7.52, 95% CI 3.69-15.32 in 58 cases vs. 612 controls). The combined analysis in 1109 cases and 2052 controls revealed that the SNP G155391A was strongly associated with NPC (P(combined) < 0.001, OR = 5.27, 95% CI 4.31-6.44). Moreover, the frequency of the SNP G155391A was associated with NPC incidence but was not associated with the incidences of other EBV-related malignancies. Furthermore, the protein degradation assay showed that this SNP decreased the degradation of the oncogenic RPMS1 protein.
CONCLUSIONSOur study identified an EBV variation specifically and significantly associated with a high risk of NPC. These findings provide insights into the pathogenesis of NPC and strategies for prevention.
Adult ; Aged ; Carcinoma ; Case-Control Studies ; China ; epidemiology ; Epstein-Barr Virus Infections ; complications ; epidemiology ; virology ; Female ; Genetic Association Studies ; Genome, Viral ; Herpesvirus 4, Human ; genetics ; isolation & purification ; Humans ; Incidence ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; epidemiology ; virology ; Neoplasm Proteins ; genetics ; Pilot Projects ; Polymorphism, Single Nucleotide ; Risk Assessment ; methods ; Tumor Cells, Cultured ; Viral Proteins ; genetics
10.Effect of Intravascular Ultrasound-assisted Thoracic Endovascular Aortic Repair for "Complicated" Type B Aortic Dissection.
Bao-Lei GUO ; Zhen-Yux SHI ; Da-Qiao GUO ; Li-Xin WANG ; Xiao TANG ; Wei-Miao LI ; Wei-Guo FU ;
Chinese Medical Journal 2015;128(17):2322-2329
BACKGROUNDIntravascular ultrasound (IVUS) examination can provide useful information during endovascular stent graft repair. However, its actual clinical utility in thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (type B-AD) remains unclear, especially in complicated aortic dissection. We evaluated the effect of IVUS as a complementary tool during TEVAR.
METHODSFrom September 2011 to April 2012, we conducted a prospective cohort study of 47 consecutive patients with "complicated" type B-AD diagnosed. We divided the patients into two groups: IVUS-assisted TEVAR group and TEVAR using angiography alone group. The general procedure of TEVAR was performed. We evaluated the perioperative and follow-up events. Patient demographics, comorbidities, preoperative images, dissection morphology, details of operative strategy, intraoperative events, and postoperative course were recorded.
RESULTSA total of 47 patients receiving TEVAR were enrolled. Among them (females, 8.51%; mean age, 57.38 ± 13.02 years), 13 cases (27.66%) were selected in the IVUS-assisted TEVAR group, and 34 were selected in the TEVAR group. All patients were symptomatic. The average diameter values of IVUS measurements in the landing zone were greater than those estimated by computed tomography angiography (31.82 ± 4.21 mm vs. 30.64 ± 4.13 mm, P < 0.001). The technique success rate was 100%. Among the postoperative outcomes, statistical differences were only observed between the IVUS-assisted TEVAR group and TEVAR group for total operative time and the amount of contrast used (P = 0.013 and P < 0.001, respectively). The follow-up ranged from 15 to 36 months for the IVUS-assisted TEVAR group and from 10 to 35 months for the TEVAR group (P = 0.646). The primary endpoints were no statistical difference in the two groups.
CONCLUSIONSIntraoperative IVUS-assisted TEVAR is clinically feasible and safe. For the endovascular repair of "complicated" type B-AD, IVUS may be helpful for understanding dissection morphology and decrease the operative time and the amount of contrast used.
Adult ; Aged ; Aneurysm, Dissecting ; surgery ; Aorta, Thoracic ; surgery ; Aortic Aneurysm, Thoracic ; surgery ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Stents

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