ABSTRACT
Objective:To comprehensively analyze the medical resources and services supply in the cancer field of China.Methods:Data of 2018 were sampled from 41 tertiary public cancer hospitals in China, and the factor analysis method was used to extract common factors in resources or services, scoring respectively. Pearson correlation analysis was used in the collinearity test of the variables of both groups of common factors, while the second-order clustering method was used to analyze characteristic differences between the hospitals, and category difference was compared with t test. Results:Resource evaluation covered the two dimensions of basic resources(medical service and basic assurance resources)and high-end resources(high-end talents and academic resources). Service evaluation covered the two dimensions of medical service assurance(clinical services and basic assurance)and disciplinary sphere of influence(discipline construction and clinical efficiency). The factor of basic manpower and beds was significantly correlated with that of medical service and basic assurance( r=0.811, P<0.001), while the factor of high-end talents and academic resources was significantly correlated with that disciplinary construction and resource efficiency( r=0.906, P<0.001). The second-order cluster analysis found the 41 cancer hospitals as two categories, with the first category of five in Guangdong, Shanghai, Beijing and Tianjin, and the second category of the rest 36 hospitals. Significant differences were found between the two categories in terms of resource scoring, service scoring, high-end resources and disciplinary sphere of influence( P<0.001). Meanwhile, the GDP per capita of the cities in which these hospitals are located also had significant differences( P<0.001). Conclusions:Development of public tertiary cancer hospitals in China was imbalanced, as their differences were mainly found in levels of disciplinary development and efficiency of clinical services, which were closely related to the high-end talents and academic resources of the hospital in question.Furthermore, high quality medical care was mostly located in regions of higher development. The authors recommend to take a balanced consideration of the differences and distribution of cancer care services in China, in terms of performance classification of public hospitals and establishment of regional cancer centers of the country.
ABSTRACT
Objective To evaluate the relationship between genetic polymorphism of transforming growth factor (TGF)-β1 and susceptibility of liver cirrhosis after hepatitis B virus infection in Chinese population. Methods CBM, VIP, CNKI, Wanfang technological periodical full-text databases and Pubmed from set up to July, 2013 were electronically searched to identify case-control studies on the relationship between genetic polymorphism of TGF-β1 promoter 509 site, co-don 869 site and liver cirrhosis after hepatitis B virus infection. The data were quantitatively analyzed by RevMan 5.1 soft-ware after assessing the quality of included studies. Results Six case-control studies were selected for Meta-analysis based on our inclusion and exclusion standards. The results of Meta-analysis showed that the pooled OR value for liver cir-rhosis among Chinese patients after hepatitis B virus infection with T allele of TGF-β1 gene at promoter 509 was 1.02 (95%CI:0.67-1.54), the pooled OR values for patients with TT and CT genotypes were 0.80 (95%CI:0.36-1.78). OR values for pa-tients with C allele of TGF-β1 gene at codon 869 was 1.05 (95%CI:0.69-1.62), the pooled OR values for patients with CC and CT genotypes were 0.98 (95%CI:0.48-2.00). No significant publication bias was found. Conclusion The genetic poly-morphism of TGF-β1 at promoter 509 and codon 869 showed no association with susceptibility of liver cirrhosis after hepati-tis B virus infection in Chinese population.