Objective:To explore the trend of Out-of-Pocket as a proportion of total health expenditure in Heilongjiang Province from 2013 to 2022,assessing the medical economic burden on residents and the equitable distribution of health resources.Methods:It employs statistical description and comparative research methods,collecting data on total health expenditure and Out-of-Pocketfor medical care in Heilongjiang Province from 2013 to 2022.A horizontal comparative analysis is conducted,comparing these trends with other provinces in the Northeast region and at the national level.Results:The Out-of-Pocket proportion in total health expenditure in Heilongjiang Province decreased from 41.56％in 2013 to 28.88％in 2022,indicating a downward trend;however,it remains higher than the national average during the same period.Additionally,the proportion of government health expenditure and social health expenditure has gradually increased,reflecting greater investment in the health sector by both the government and society.Conclusion:Although the Out-of-Pocket proportion in total health expenditure in Heilongjiang Province has decreased,the medical economic pressure on residents remains significant.It is recommended that the government continue to enhance health investment,optimize the health financing model,improve the efficiency of health services,reduce the burden of personal health expenditure,and achieve a more equitable distribution of health resources.

Objective:To explore the trend of Out-of-Pocket as a proportion of total health expenditure in Heilongjiang Province from 2013 to 2022,assessing the medical economic burden on residents and the equitable distribution of health resources.Methods:It employs statistical description and comparative research methods,collecting data on total health expenditure and Out-of-Pocketfor medical care in Heilongjiang Province from 2013 to 2022.A horizontal comparative analysis is conducted,comparing these trends with other provinces in the Northeast region and at the national level.Results:The Out-of-Pocket proportion in total health expenditure in Heilongjiang Province decreased from 41.56％in 2013 to 28.88％in 2022,indicating a downward trend;however,it remains higher than the national average during the same period.Additionally,the proportion of government health expenditure and social health expenditure has gradually increased,reflecting greater investment in the health sector by both the government and society.Conclusion:Although the Out-of-Pocket proportion in total health expenditure in Heilongjiang Province has decreased,the medical economic pressure on residents remains significant.It is recommended that the government continue to enhance health investment,optimize the health financing model,improve the efficiency of health services,reduce the burden of personal health expenditure,and achieve a more equitable distribution of health resources.

Objective:To explore the trend of Out-of-Pocket as a proportion of total health expenditure in Heilongjiang Province from 2013 to 2022,assessing the medical economic burden on residents and the equitable distribution of health resources.Methods:It employs statistical description and comparative research methods,collecting data on total health expenditure and Out-of-Pocketfor medical care in Heilongjiang Province from 2013 to 2022.A horizontal comparative analysis is conducted,comparing these trends with other provinces in the Northeast region and at the national level.Results:The Out-of-Pocket proportion in total health expenditure in Heilongjiang Province decreased from 41.56％in 2013 to 28.88％in 2022,indicating a downward trend;however,it remains higher than the national average during the same period.Additionally,the proportion of government health expenditure and social health expenditure has gradually increased,reflecting greater investment in the health sector by both the government and society.Conclusion:Although the Out-of-Pocket proportion in total health expenditure in Heilongjiang Province has decreased,the medical economic pressure on residents remains significant.It is recommended that the government continue to enhance health investment,optimize the health financing model,improve the efficiency of health services,reduce the burden of personal health expenditure,and achieve a more equitable distribution of health resources.

Objective:To explore the trend of Out-of-Pocket as a proportion of total health expenditure in Heilongjiang Province from 2013 to 2022,assessing the medical economic burden on residents and the equitable distribution of health resources.Methods:It employs statistical description and comparative research methods,collecting data on total health expenditure and Out-of-Pocketfor medical care in Heilongjiang Province from 2013 to 2022.A horizontal comparative analysis is conducted,comparing these trends with other provinces in the Northeast region and at the national level.Results:The Out-of-Pocket proportion in total health expenditure in Heilongjiang Province decreased from 41.56％in 2013 to 28.88％in 2022,indicating a downward trend;however,it remains higher than the national average during the same period.Additionally,the proportion of government health expenditure and social health expenditure has gradually increased,reflecting greater investment in the health sector by both the government and society.Conclusion:Although the Out-of-Pocket proportion in total health expenditure in Heilongjiang Province has decreased,the medical economic pressure on residents remains significant.It is recommended that the government continue to enhance health investment,optimize the health financing model,improve the efficiency of health services,reduce the burden of personal health expenditure,and achieve a more equitable distribution of health resources.

Objective:To explore the trend of Out-of-Pocket as a proportion of total health expenditure in Heilongjiang Province from 2013 to 2022,assessing the medical economic burden on residents and the equitable distribution of health resources.Methods:It employs statistical description and comparative research methods,collecting data on total health expenditure and Out-of-Pocketfor medical care in Heilongjiang Province from 2013 to 2022.A horizontal comparative analysis is conducted,comparing these trends with other provinces in the Northeast region and at the national level.Results:The Out-of-Pocket proportion in total health expenditure in Heilongjiang Province decreased from 41.56％in 2013 to 28.88％in 2022,indicating a downward trend;however,it remains higher than the national average during the same period.Additionally,the proportion of government health expenditure and social health expenditure has gradually increased,reflecting greater investment in the health sector by both the government and society.Conclusion:Although the Out-of-Pocket proportion in total health expenditure in Heilongjiang Province has decreased,the medical economic pressure on residents remains significant.It is recommended that the government continue to enhance health investment,optimize the health financing model,improve the efficiency of health services,reduce the burden of personal health expenditure,and achieve a more equitable distribution of health resources.

Objective:To explore the trend of Out-of-Pocket as a proportion of total health expenditure in Heilongjiang Province from 2013 to 2022,assessing the medical economic burden on residents and the equitable distribution of health resources.Methods:It employs statistical description and comparative research methods,collecting data on total health expenditure and Out-of-Pocketfor medical care in Heilongjiang Province from 2013 to 2022.A horizontal comparative analysis is conducted,comparing these trends with other provinces in the Northeast region and at the national level.Results:The Out-of-Pocket proportion in total health expenditure in Heilongjiang Province decreased from 41.56％in 2013 to 28.88％in 2022,indicating a downward trend;however,it remains higher than the national average during the same period.Additionally,the proportion of government health expenditure and social health expenditure has gradually increased,reflecting greater investment in the health sector by both the government and society.Conclusion:Although the Out-of-Pocket proportion in total health expenditure in Heilongjiang Province has decreased,the medical economic pressure on residents remains significant.It is recommended that the government continue to enhance health investment,optimize the health financing model,improve the efficiency of health services,reduce the burden of personal health expenditure,and achieve a more equitable distribution of health resources.

Objective:To explore the trend of Out-of-Pocket as a proportion of total health expenditure in Heilongjiang Province from 2013 to 2022,assessing the medical economic burden on residents and the equitable distribution of health resources.Methods:It employs statistical description and comparative research methods,collecting data on total health expenditure and Out-of-Pocketfor medical care in Heilongjiang Province from 2013 to 2022.A horizontal comparative analysis is conducted,comparing these trends with other provinces in the Northeast region and at the national level.Results:The Out-of-Pocket proportion in total health expenditure in Heilongjiang Province decreased from 41.56％in 2013 to 28.88％in 2022,indicating a downward trend;however,it remains higher than the national average during the same period.Additionally,the proportion of government health expenditure and social health expenditure has gradually increased,reflecting greater investment in the health sector by both the government and society.Conclusion:Although the Out-of-Pocket proportion in total health expenditure in Heilongjiang Province has decreased,the medical economic pressure on residents remains significant.It is recommended that the government continue to enhance health investment,optimize the health financing model,improve the efficiency of health services,reduce the burden of personal health expenditure,and achieve a more equitable distribution of health resources.

Objective:To explore the trend of Out-of-Pocket as a proportion of total health expenditure in Heilongjiang Province from 2013 to 2022,assessing the medical economic burden on residents and the equitable distribution of health resources.Methods:It employs statistical description and comparative research methods,collecting data on total health expenditure and Out-of-Pocketfor medical care in Heilongjiang Province from 2013 to 2022.A horizontal comparative analysis is conducted,comparing these trends with other provinces in the Northeast region and at the national level.Results:The Out-of-Pocket proportion in total health expenditure in Heilongjiang Province decreased from 41.56％in 2013 to 28.88％in 2022,indicating a downward trend;however,it remains higher than the national average during the same period.Additionally,the proportion of government health expenditure and social health expenditure has gradually increased,reflecting greater investment in the health sector by both the government and society.Conclusion:Although the Out-of-Pocket proportion in total health expenditure in Heilongjiang Province has decreased,the medical economic pressure on residents remains significant.It is recommended that the government continue to enhance health investment,optimize the health financing model,improve the efficiency of health services,reduce the burden of personal health expenditure,and achieve a more equitable distribution of health resources.

Objective To analyze the relationship between serum microRNA(miR)-204 and miR-200b lev-els and clinical efficacy in patients with oral submucosal fibrosis(OSF).Methods A total of 110 patients with OSF who visited Affiliated Hospital of Hebei Engineering University from December 2021 to December 2022 were collected as the study group,another 50 healthy people who underwent physical examination during the same period were collected as the control group.The quantitative real-time PCR(qRT-PCR)method was ap-plied to detect and compare the serum levels of miR-204 and miR-200b in the study group and the control group.The study group was divided into miR-204 high expression group and low expression group,and miR-200b high expression group and low expression group.The clinical efficacy,transforming growth factor β1(TGF-β1),interleukin-6(IL-6),clinical pathological features,and visual analogue scale(VAS)of patients with different levels of serum miR-204 and miR-200b were compared,and Spearman and Pearson methods were applied to analyze the correlation between serum miR-204 and miR-200b levels and various indicators in the study group.Results The serum level of miR-204 and miR-200b in the study group was obviously lower than those in the control group,and the difference was statistically significant(P＜0.05).The total effective rates of patients in the high expression group of miR-204 and the high expression group of miR-200b were both 100.00％,which were higher than the total effective rates of the low expression group of miR-204 and the low expression group of miR-200b(86.79％and 88.89％)respectively,and the differences were statisti-cally significant(P＜0.05).The results of univariate analysis showed that the serum levels of miR-204 and miR-200b in OSF patients with chewing betel nut,mouth opening degree≤28 mm,oral mucosal lesion area＞4 cm2,and VAS score＞3 points were obviously lower than those with non chewing betel nut,mouth opening degree＞28 mm,oral mucosal lesion area≤4 cm2,and VAS score≤3 points,and the differences were statis-tically significant(P＜0.05).The levels of TGF-β1 and IL-6 in patients with high expression of miR-204 and miR-200b were obviously lower than those in patients with low expression of miR-204 and miR-200b,and the differences were statistically significant(P＜0.05).The correlation analysis results showed that the serum levels of miR-204 and miR-200b in patients with OSF were negatively correlated with oral mucosal lesion are-a,VAS score,TGF-β1,IL-6(P＜0.05),and positively correlated with mouth opening degree(P＜0.05).Conclusion The serum levels of miR-204 and miR-200b in patients with OSF are closely related to clinical ef-ficacy,and when the serum levels of miR-204 and miR-200b increase,OSF patients have better clinical efficacy.

Objective:To analyze clinical characteristics of acromegaly patients who have discordant growth hormone(GH) or insulin-like growth factor-1(IGF-1) levels and evaluate impact of different GH cut-offs on discordance rate.Methods:A retrospective analysis was conducted on data from 66 acromegaly patients treated at Nanjing Drum Tower Hospital from November 2017 to March 2023. Patients were categorized based on the nadir GH(GHn) and IGF-1 levels at the last follow-up into four groups: controlled, high GH, high IGF-1, and active. Clinical and metabolic parameters were compared across these groups, and impact of different GHn and fasting growth hormone(GHf) cut-offs on discordance rate was evaluated.Results:No statistically significant differences were observed among groups in age, duration of follow-up, imaging characteristics(all P>0.05). High IGF-1 group had higher fasting insulin and homeostasis model assessment for β cell function compared to controlled and high GH group(all P<0.05), while these parameters did not differ between high GH and controlled group. High IGF-1 group had higher carboxy-terminal cross-linked telopeptide of type 1 collagen, osteocalcin and procollagen type 1 N-terminal propeptide compared to controlled and high GH group, but differences were not statistically significant(all P>0.05). These parameters also did not differ between high GH and controlled group. Discordance rate was not significantly different when GHn cut-offs was 1.0 μg/L or 0.4 μg/L(30.3% vs 21.3%, P=0.146). Compared to 2.5 μg/L, discordance rate was lower when GHf cut-off was 1.0 μg/L(39.4% vs 24.3%, P=0.041). Conclusion:The discordance rate in treated acromegaly patients during follow-up is approximately 30%. Different GH measurement timings and cut-offs significantly impact discordance rate. Patients with normal GH and elevated IGF-1 levels are at potential risk of active disease, and require closer follow-up. This study provides a valuable reference for treatment of patients with discordant GH and IGF-1 levels.