1.Research on the impact of supply side policy coordination of medical insurance on cost control under DIP payment method
Kun-He LIN ; Ye-Sheng SHANGGUAN ; Ya-Qi RAO ; Jing PENG ; Yi CHEN ; Yi-Fan YAO ; Ying-Bei XIONG ; Li XIANG
Chinese Journal of Health Policy 2024;17(5):17-24
Objective:This study aims to explore the synergistic effects of DIP and other medical insurance supply-side policies.Method:City A that has piloted DIP reform was set as the treatment group,and City B without reform was set as the control group.A total of 1 120 public medical institution samples from 2019 to 2022 were collected.The total medical expenses during hospitalization and some structural expenses were analyzed using DID method.Result:DIP had a significant inhibitory effect on the medical expenses,and the expenses of checkups and examinations during hospitalization in city A,but had no impact on the drug and the material expenses during hospitalization.Conclusion:DIP played a significant cost control role and effectively controlled the total medical expenses during hospitalization.The synergistic effects of price adjustment of medical services policy and national centralized drug/material procurement policy on cost control were insufficient.DIP synergized with other supply-side policies to promote rational medical cost structure.It is suggested that medical insurance departments should focus on the synergistic effects of medical insurance supply-side policies to jointly improve the efficiency of medical insurance fund utilization.
2. Expression and clinical significance of phosphoglycerate kinase 1 in hepatocellular carcinoma based on bioinformatics methods
Cheng-Jian GUAN ; Hua-Jing YU ; Xiao-Dong ZHANG ; Quan RAO ; Wei-Tao ZHANG ; Kun LIU ; Hong-Wei WU ; Dong WANG ; Zhong-Tao ZHANG ; Wei GUO
Acta Anatomica Sinica 2022;53(6):744-753
Objective To investigate the role of phosphoglycerate kinase 1 (PGK1) in tumorigenesis and its potential post-translational modification sites were investigated by bioinformatics method and molecular biology experimental techniques, in order to provide evidence for PGK1 as a hepatocellular carcinoma ( HCC) diagnostic biomarker and therapeutic target. Methods From pan-cancer's point of view, 10 967 samples were obtained from the cancer genome database TCGAs, and the expression of PGK1 in different tumors was explored by using cBioPortal and UALCAN analysis tools; Focusing on HCC, the expression differences of PGK1 in hepatocellular carcinoma tumor tissues and normal tissues were further analyzed by using GEO database analysis, Real-time PCR, Western blotting and cell invasion assay;The String database was used to analyze the protein-protein interaction network and gene set enrichment analysis; The CSS-Palm database and bioinformatics method were used to predict protein post-translational modification sites on PGK1. Results The PGK1 gene was abnormally amplified and overexpressed in various solid tumors, including hepatocellular carcinoma, and overexpression of PGK1 was correlated with a poor prognosis in hepatocellular carcinoma. Multiple novel posttranslational modifications were existed on PGK1. Conclusion PGK1 is closely related to the occurrence and development of various cancers including HCC and glycolytic metabolism abnormalities. Epigenetic modifications can regulate PGK1 and affect its cellular function in HCC.
3.Mechanism of Modified Erzhiwan Combined with Epimedium for Atherosclerosis Based on Network Pharmacology
Xiao-qiang OU-YANG ; Lian RAO ; Min LEI ; Xiao-kun CHEN ; Chuang-xiong HONG
Chinese Journal of Experimental Traditional Medical Formulae 2020;26(3):175-182
Objective::In this study, a network pharmacology-based method was applied to analyze the mechanism of modified Erzhiwan combined with epimedium in treatment of atherosclerosis. Method::The compounds and targets of modified Erzhiwan combined with epimedium were screened in traditional Chinese medicine(TCM) systems pharmacology database and analysis platform (TCMSP) and bioinformatics analysis tool for molecular mechanism of TCM (BATMAN-TCM). Mang related databases were applied to find the target-related to atherosclerosis.The common targets of modified Erzhiwan combined with epimedium and atherosclerosis were got by venn diagrams.Cytoscape 3.6.1 was used to construct ingredients-disease-targets networks.Then protein-protein interaction (PPI) analysis of ingredients-disease-targets was builed in STRING database, and was visualized by Cytoscape 3.6.1, then important modules were analyzed with Moleculaar complex detection(MCODE). Biological information annotation databases (DAVID) was used to carry on gene ontology (GO) analysis and enrichment analysis of gene encyclopedia kyoto encyclopedia of genes and genomes (KEGG) pathway. Result::A total of 38 active ingredients and 266 potential targets of modified Erzhiwan combined with epimedium were obtained from TCMSP and BATMAN-TCM, 254 atherosclerosis-related targets were retrieved from disease database.Then 52 common targets were obtained and 14 core genes were screened.Biological processes were related to inflammatory response, regulation of insulin secretion, positive regulation of nitric oxide biosynthetic process, etc.The biological pathways mainly included tumor necrosis factor signaling pathway, NF-kappa B(NF-
4.Evolution of blood lipids and risk factors of dyslipidemia among people living with human immunodeficiency virus who had received first-line antiretroviral regimens for 3 years in Shenzhen.
Li-Qin SUN ; Jia-Ye LIU ; Yun HE ; Yang ZHOU ; Liu-Mei XU ; Lu-Kun ZHANG ; Fang ZHAO ; Xiao-Ning LIU ; Ying SONG ; Ting-Zhi CAO ; Yi-Mei TIAN ; Man RAO ; Hui WANG
Chinese Medical Journal 2020;133(23):2808-2815
BACKGROUND:
Lipid abnormalities are prevalent among people living with human immunodeficiency virus (HIV) (PLWH) and contribute to increasing risk of cardiovascular events. This study aims to investigate the incidence of dyslipidemia and its risk factors in PLWH after receiving different first-line free antiretroviral regimens.
METHODS:
PLWH who sought care at the Third People's Hospital of Shenzhen from January 2014 to December 2018 were included, and the baseline characteristics and clinical data during the follow-up were collected, including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). The risk factors of dyslipidemia after antiretroviral therapy were analyzed with the generalized estimating equation model.
RESULTS:
Among the 7623 PLWH included, the mean levels of TC, HDL-C and LDL-C were 4.23 ± 0.85 mmol/L, 1.27 ± 0.29 mmol/L and 2.54 ± 0.65 mmol/L, respectively, and the median TG was 1.17 (IQR: 0.85-1.68) mmol/L. Compared with that in PLWH receiving tenofovir disoproxil fumarate (TDF) + lamivudine (3TC) + ritonavir-boosted lopinavir (LPV/r), zidovudine (AZT) + 3TC + efavirenz (EFV), and AZT + 3TC + LPV/r, the incidence of dyslipidemia was lower in PLWH receiving TDF + 3TC + EFV. In multivariate analysis, we found that the risks of elevations of TG, TC, and LDL-C were higher with TDF + 3TC + LPV/r (TG: odds ratio [OR] = 2.82, 95% confidence interval [CI]: 2.55-3.11, P < 0.001; TC: OR = 1.24, 95% CI: 1.14-1.35, P < 0.001; LDL: OR = 1.06, 95% CI: 1.00-1.12, P = 0.041), AZT + 3TC + EFV (TG: OR = 1.41, 95% CI: 1.28-1.55, P < 0.001; TC: OR = 1.43, 95% CI: 1.31-1.56, P < 0.001; LDL: OR = 1.18, 95% CI: 1.12-1.25, P < 0.001), and AZT + 3TC + LPV/r (TG: OR = 3.08, 95% CI: 2.65-3.59, P < 0.001; TC: OR = 2.40, 95% CI: 1.96-2.94, P < 0.001; LDL: OR = 1.52, 95% CI: 1.37-1.69, P < 0.001) than with TDF + 3TC + EFV, while treatment with TDF + 3TC + LPV/r was less likely to restore HDL-C levels compared with TDF + 3TC + EFV (OR = 0.95, 95% CI: 0.92-0.97, P < 0.001). In addition to antiretroviral regimens, antiretroviral therapy duration, older age, overweight, obesity and other traditional factors were also important risk factors for dyslipidemia.
CONCLUSION
The incidence of dyslipidemia varies with different antiretroviral regimens, with TDF + 3TC + EFV having lower risk for dyslipidemia than the other first-line free antiretroviral regimens in China.
Aged
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Anti-HIV Agents/adverse effects*
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China/epidemiology*
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Dyslipidemias/epidemiology*
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HIV
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HIV Infections/drug therapy*
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Humans
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Lamivudine/therapeutic use*
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Lipids
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Risk Factors
5.Establishing an animal model to investigate depression with coronary heart disease
Guo CHUN-XIA ; Zheng FEI ; Feng YI-RAN ; Rao YU-DONG ; Zhang YING ; Ma ZONG-REN ; Zeng YAN-FANG ; Zhou HAO ; Yang KUN-RONG ; Ni WEI ; Zhang XUE-YA
Chinese Medical Journal 2019;132(24):3021-3023
6.Analysis on risk factors constituent in 680 cases of nosocomial infection
Yulin DAI ; Kun RAO ; Yang LIAO ; Hong FAN
Chongqing Medicine 2018;47(14):1904-1907
Objective To explore the risk factors of nosocomial infections to provide a reference for prevention and control of nosocomial infection.Methods The data of 680 patients with nosocomial infection in this hospital from January 2015 to December 2016 were retrospectively collected.The characteristics of nosocomial infection were analyzed from the aspects of age,hospitalization department,infection site,etc.Results A total of 680 cases of nosocomial infection accounted for 1.67%(680/40 657) of all hospitalization patients,including 316 cases(nosocomial infection rate was 2.47%) of 61-80 years old.The infection rate was the highest in ICU(24.90%),followed by the nephrology department(4.99%).For infection sites,the maximal cases-times in infection site was lower respiratory tract(413 case-times),followed by urinary tract and superficial incision(each 68 case-times).The pathogenic detection rate was 45.03%,and 190 strains of pathogens were detected.The top five places were Escherichia coli(47 strains),Klebsiella pneumoniae(28 strains),Pseudomonas aeruginosa (23 strains),Staphylococcus aureus (22 strains) and Bauman Acinetobacter (16 strains).Logistic regression analysis showed that age larger than 60 years old,hospitalization time longer than 60 d,indwelling urinary catheter,peripherally inserted central catheter(PICC),tracheotomy and enteral nutrition were the risk factors for nosocomial infection occurrence.Conclusion Hospital should put the emphasis on preventing nosocomial infection of lower respiratory tract and strengthen the nosocomial infection management of key departments like ICU.
7.In vitro release and in situ gastrointestinal absorption of evodiamine butyryl derivative-loaded solid lipid nanoparticles
Lan YANG ; Kun WAN ; Jian-Bo YANG ; Sheng-Lei YAN ; Qi-Rao ZHANG ; Jing-Qing ZHANG ; Xue-Yuan HU
Chinese Pharmacological Bulletin 2018;34(5):724-728
Aim To prepare evodiamine butyryl deriva-tive (EBD) and evodiamine butyryl derivative-loaded solid lipid nanoparticles (EBDLN), and study its re-lease in vitro,and to investigate its in situ gastrointesti-nal absorption. Methods EBD was prepared by a one-step synthetized method, and then EBDLN was prepared by a film dispersion method. Dynamic dialy-sis was used to evaluate drug release in vitro,and sin-gle-pass gastrointestinal perfusion was employed to study the gastrointestinal absorption of EDM,EBD and EBDLN. Results In identical release media, there were identical drug release tendencies of EBD and EB-DLN, but the release rate of EBDLN was faster than EBD. Compared with EDM and EBD, the Kavalues and Pappvalues of EBDLN in every perfusion segment increased significantly. The Kaof EBDLN in stomach, duodenum, jejunum, ileum and colon was 110.14-fold,56.70-fold,51.23-fold,45.70-fold and 127.23-fold of free EDM respectively. The Pappvalue of EB-DLN was 9.74-fold, 4.48-fold, 3.82-fold and 11.3-fold of that of free EDM. Conclusion EBDLN has sustained effect and can enhance the gastrointestinal absorption of EDM and EBD.
8.Value of ADAM12-S in early diagnosis of ectopic pregnancy of pregnant women
Jinmei CHENG ; Xiangxue TIAN ; Yonghong RAO ; Kun LI
Chinese Journal of Biochemical Pharmaceutics 2014;37(7):161-163,166
Objective To determine the values and variation tendency of a disintegrin and metalloprotease 12-S(ADAM12-S)of early pregnancy, and discuss the value of ADAM12-S to the ectopic pregnancy in the first trimester.Methods 150 early pregnancy cases (from the 5th to 10th week of pregnancy)were selected in Huanggang Women &Children's Healthcare Hospital.There were 102 cases of normal pregnancy,48 cases of ectopic pregnancy.The AutoDELFIA immunoassay platform was used to measure the value of ADAM12-S in the serum.Results Of the 102 normal pregnancies, the values of ADAM12-S in 5th-10th week of pregnancy linearly increase with gestationalage.The correlation coefficient was 0.9217 (P<0.05).While the values of ADAM12-S in the ectopic pregnancy group were significantly lower than the normal pregnancy group and not linearly increased with gestationalage.The correlation coefficient was 0.2817.There was statistically significant difference between the two groups (P<0.05).Conclusion The values of ADAM12-S is stable in the first trimester of normal pregnancy,while it is much more lower in abnormal pregnancy.ADAM12-S has great significance in the diagnosis of ectopic pregnancy of the first trimester.
9.Identification of the related substances in docetaxel injection by LC-MS/MS.
Ya-Kun RAO ; Meng WANG ; Li DING ; Bing LIU ; Cheng JI ; Zheng-Yu YAN
Acta Pharmaceutica Sinica 2012;47(6):779-784
The related substances in docetaxel injection were identified by LC-MS/MS. Ethyl acetate was used to extract the injection to remove the pharmaceutical excipients. HPLC separation was carried out on a Hedera ODS-2 column (150 mm x 2.1 mm, 5 microm) with a mobile phase consisting of acetonitrile - 0.1% acetate acid aqueous solution (40: 60). Electrospray ionization source was set in the positive mode for the LC-ESI-MS/MS, and the ion monitoring modes were full scan and product ion scan. According to the mass spectra of the related substances, the fragment profiles were explained, and the chemical structures were elucidated. Docetaxel and its main related substances were well separated. Nine related substances in docetaxel injection were detected by LC-MS/MS. Their chemical structures were proposed, and four of them were identified in the docetaxel injection for the first time. The established LC-MS/MS method is effective in the separation and identification of the related substances in docetaxel injection. The test results are useful for its quality control.
Antineoplastic Agents
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administration & dosage
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analysis
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chemistry
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Chromatography, High Pressure Liquid
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Drug Contamination
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Injections
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Molecular Weight
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Quality Control
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Spectrometry, Mass, Electrospray Ionization
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Tandem Mass Spectrometry
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Taxoids
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administration & dosage
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analysis
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chemistry
10.Health risk factors and presenteeism: a look into employees at two enterprises in China
Yunliang QIAN ; Zheng-lai WU ; Jian-shi HUANG ; Xiao-qian DENG ; Bin LIU ; Kun-rao JIANG ; Tao LUO ; Chun-fang ZHANG
Chinese Journal of Health Management 2012;06(2):104-107
Objective To analyze the effects of health risk factors on presenteeism in enterprise employees.Methods A hospital in Jinan of Shandong province and a publishing enterprise in Beijing were selected as target settings of this cross-sectional study. Questionnaire survey was carried out to collect information on demographic data,health condition and presenteeism,and multiple logistic regression was used to analyze the influence of health risk factors on labor-related presenteeism.Results Insufficient physical activity was found in 42% percent of the participants,and those with heavy-loaded pressure,overweight or obesity,high blood pressure and unhealthy diet habit accounted for 46%,41%,40% and 34%,respectively. Proportions of employees with presenteeism varied with age ( x2 =10.1665,P =0.0377),occupation ( x2 =35.3579,P < 0.05 ) and education level ( x2 =50.5377,P < 0.05 ).Female employees ( P =0.0323,OR =1.728,95% CI 1.047 to 2.850),graduates ( P < 0.05,OR =6.159,95% CI 2.510 to 15.109),overweight or obesity individuals ( P =0.0076,OR =1.673,95% CI 1.147 to 2.44) and adults with poor self-perception of health ( P =0.0049,OR =2.284,95% CI 1.285 to 4.060)seemed to be more likely to be presenteeism.Conclusions Overweight or obesity and poor self-perception of health may be associated with labor-related presenteeism.

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