ABSTRACT
Objective@#Involuntary admission to psychiatric inpatient care can protect both patients with severe mental illnesses and individuals around them. This study analyzed annual healthcare costs per person for involuntary psychiatric admission and examined categories of mental disorders and other factors associated with mortality. @*Methods@#This retrospective cohort study collected 1 million randomly sampled beneficiaries from the National Health Insurance Database for 2002–2013. It identified and matched 181 patients with involuntary psychiatric admissions (research group) with 724 patients with voluntary psychiatric admissions (control group) through 1:4 propensity-score matching for sex, age, comorbidities, mental disorder category, and index year of diagnosis. @*Results@#Mean life expectancy of patients with involuntary psychiatric admissions was 33.13 years less than the general population. Average annual healthcare costs per person for involuntary psychiatric admissions were 3.94 times higher compared with voluntary admissions. The general linear model demonstrated that average annual medical costs per person per compulsory hospitalization were 5.8 times that of voluntary hospitalization. Survival analysis using the Cox proportional hazards model found no significant association between type of psychiatric admission (involuntary or voluntary) and death. @*Conclusion@#This study revealed no significant difference in mortality between involuntary and voluntary psychiatric admissions, indicating involuntary treatment’s effectiveness.
ABSTRACT
Objective:To screen the active components of sovereign medicinal Achyranthis Bidentatae Radix in Rongjin Niantong formula based on bioinformatics and network pharmacology and observe their effects on therapeutic targets of osteoarthritis （OA） in <italic>in vivo</italic> and <italic>in vitro</italic> animal experiments. Method:The main active components and therapeutic targets of Achyranthis Bidentatae Radix were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP）， and the differentially expressed genes relevant to OA from the Gene Expression Omnibus （GEO） database for cross analysis. The effects of main active components in Achyranthis Bidentatae Radix on enriched therapeutic targets of rats with OA <italic>in vivo </italic>and <italic>in vitro</italic> were detected by real-time polymerase chain reaction （Real-time PCR） and Western blot. Result:There were 20 active components for Achyranthis Bidentatae Radix against OA， with quercetin being an important one. Among the three target genes， osteopontin （OPN） and plasminogen activator inhibitor-1（PAI-1） were the key ones in the network. Gene Ontology （GO） analysis yielded 227 related terms， involving the regulation of physiological response to trauma （GO： 1903034）， negative regulation of trauma response （GO： 1903035）， etc. Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway analysis revealed 12 related pathways， involving extracellular matrix receptor interaction （hsa04512） and so on. In animal experiments， compared with the normal group， the model group exhibited increased gene and protein expression of OPN and PAI-1. Compared with the model group， the quercetin group displayed decreased gene and protein expression of OPN and PAI-1 （<italic>P</italic><0.05）. In cell experiments， the OPN and PAI-1 protein expression levels in the model group were increased as compared with those in the normal group， while the Collagen Ⅱ protein expression was decreased. The OPN and PAI-1 protein expression levels in the quercetin group and the inhibitor group were down-regulated in contrast to those in the model group， whereas the Collagen Ⅱ protein expression levels were up-regulated significantly （<italic>P<</italic>0.05）. Conclusion:Achyranthis Bidentatae Radix<italic> </italic>inhibits cartilage degeneration and exerts the preventive and therapeutic effects against OA， which is possibly due to the efficacy of its active component quercetin in down-regulating the expression of OPN and PAI-1 in chondrocytes and up-regulating the Collagen Ⅱ protein expression.