The composition and influencing factors of hospitalization expenses for insured patients with cardiovascular and cerebrovascular diseases / 公共卫生与预防医学

Objective To analyze the composition and influencing factors of the hospitalization expenses of patients with cardiovascular and cerebrovascular diseases who has participated in basic medical insurance, and to provide evidence for controlling excessive increase in the hospitalization expenses and reducing the financial burden of patients. Methods The hospitalization information of 14,271 insured patients with cardiovascular and cerebrovascular diseases from January 1, 2019 to December 31, 2019 in Xianning City, Hubei Province was retrospectively collected. The basic information of the patients and the composition of their hospitalization expenses were descriptively analyzed, and the influencing factors of hospitalization expenses of the patients were analyzed by univariate analysis and logistic regression analysis. Results Among the patients included in the study, coronary heart disease, cerebral infarction, cerebral hemorrhage and essential hypertension were the four main types of cardiovascular and cerebrovascular diseases with the largest proportion of hospitalization expenses, accounting for 26.18%, 20.29%, 11.82% and 9.94%, respectively. The largest proportion of hospitalization expenses was treatment expenses and drug expenses, accounting for 44.09% and 32.52%, respectively. Logistic regression analysis showed that age, length of stay, type of insurance, type of cardiovascular and cerebrovascular diseases, whether there were other comorbidities or complications, and whether they visited tertiary medical institutions were the influencing factors of hospitalization expenses for patients with cardiovascular and cerebrovascular diseases. Conclusion It is necessary to strengthen the disease prevention and control for the elderly and patients with cardiovascular and cerebrovascular diseases such as coronary heart disease, cerebral infarction, cerebral hemorrhage and essential hypertension, accelerate the integration of the basic medical insurance system, scientifically and reasonably shorten the length of hospital stay, and strengthen the promotion of the hierarchical medical system.

Clinical efficacy of simple obesity treated by catgut implantation at acupoints / 中国结合医学杂志

<p><b>OBJECTIVE</b>To observe the clinical effificacy of treatment with catgut implantation at acupoints on simple obesity.</p><p><b>METHODS</b>Following the theory of Chinese medicine (CM), pattern identification (PI) and treatment was based on the patient's symptoms and signs. Patients were observed during three courses and one year following treatment through self-comparison before and after six or seven acupoints catgut implantation. Obesity was divided into fifive types based on PI: (1) Stomach (Wei) and Intestine excess-heat, (2) Spleen (Pi) defificiency and phlegmwet stagnancy, (3) Liver (Gan)-qi stagnation, (4) Spleen-Kidney (Shen) yang deficiency, and (5) Liver-Kidney yin defificiency. Changes in the following measurements were recorded in 820 patients: body weight, body girth, skinfold thickness, body mass index (BMI), fat percentage (F%) and waist/hip ratio (WHR) and in the following blood values: leptin (LP), insulin (INS), blood lipids, fasting blood sugar (FBS), and insulin sensitive index (ISI) before and after the treatment. Values were compared with those of healthy controls (normal group).</p><p><b>RESULTS</b>Catgut implantation showed effificacy with all fifive types of obesity. Effificacy was greater in males than in females. There was no signifificant difference between the different types by Kruskal-Wallis H test, but the effect was best and of the highest number in patients with Stomach and Intestine excess-heat. Skin-fold thickness, body weight, waist circumference, F%, BMI, and WHR in all 820 cases decreased after treatment (at 90 days and one year), with signifificant differences before and after treatment (P<0.01). Improved metabolism of blood lipids was also seen. Following treatment, LP, INS, and FBS decreased signifificantly (P<0.01) and ISI increased signifificantly (P<0.05).</p><p><b>CONCLUSION</b>Catgut implantation at acupoints provided effective and persistent results, convenience, safety, painlessness, and prolonged effect with no side effects, resulting in reduced body weight and fat and improvement in body shape.</p>

Clinical study on female obesity complicated with climacteric syndrome treated by acupuncture / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the mechanism of acupuncture in treating obesity complicated with climacteric syndrome (OCCS).</p><p><b>METHODS</b>Thirty female OCCS patients were treated by acupuncture, combination of body and auricular acupuncture, according to the treating principle based on syndrome differentiation. The changes in symptoms, signs, obesity index, Kupperman index, vegetative nerve system equilibrium index (Y value), levels of estradiol (E2), luteinizing hormone (LH), follicle stimulating hormone (FSH), gonadotropin releasing hormone (GnRH), leptin (LP), insulin (INS), nitric oxide (NO), nitric oxide synthase (NOS) and insulin activation index (IAI) in patients were observed.</p><p><b>RESULTS</b>The obesity index, Kupperman index, Y value, and levels of LH, FSH, GnRH, LP, and INS increased, while levels of E2, NO, NOS and IAI decreased in OCCS patients. After acupuncture treatment, in the same time of obtaining promising effect in reducing weight, reversing effect was shown in all the above-mentioned parameters (P < 0.05 or P < 0.01) .</p><p><b>CONCLUSION</b>Acupuncture has favorable regulatory effect on Kupperman index, Y value, E2, LH, FSH, GnRH, NO, NOS, LP, INS and IAI in OCCS patients, its effect in improving the hypothalamic-pituitary-gonad axis, vegetative nerve function and vasomotor dysfunction, and adjusting the resistance to leptin and insulin may be the important mechanisms.</p>