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【Objective】 To perform serological screening of K antigen in Qingdao area and analyze the results. 【Methods】 From March to June 2023, 16 201 samples of patients treated in our hospital and applied for blood grouping, and 4 153 samples of blood donors sent to the clinic by Blood Transfusion Department during the same period were detected for Rh and K antigen by Ortho BioVue System Rh/K Cassette. 【Results】 A total of 18 out of 16 201 patient samples and 8 out of 4 153 blood donor samples were positive for K antigen, with the positive rate at 0.127 7%. 【Conclusion】 There was K antigen in Qingdao population, and the positive frequency of K antigen was different from previous reports. It is of great significance to construct rare blood group bank in this area and formulate reasonable blood donation and transfusion strategy for population with K antigen, so as to avoid unexpected antibody production of Kell blood group system, prevent hemolytic disease of newborn and ensure the safety of blood use.
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【Objective】 To investigate the incidence and composition of adverse reactions to blood transfusion(ARBT) in Qingdao hospitals in recent years. 【Methods】 The "Statistical Table of Adverse Reactions to Blood Transfusion in Medical Institutions" issued by Qingdao Quality Control Center of Blood Transfusion throughout 2020 to 2021, involving 96 hospitals in the region, were collected and analyzed, including the number, proportion and types of ARBT, as well as the types of blood components transfused. 【Results】 From 2020 to 2021, 296 676 cases of blood transfusion in 96 hospitals occurred, and the incidence of ARBT was 0.27% (814/296 676), of which the incidence of ARBT involving plasma transfusion was 0.17% [accounting for 39.07% (318/814) of all transfusion reactions], involving platelet transfusion was 0.68% [31.08% (259/814)], involving erythrocyte transfusion was 0.11% [27.64% (225/814)] and cryoprecipitation transfusion 0.03% [1.47% (12/814)]. The types of ARBT were anaphylaxis 77.64% (632/814), fever 19.78% (161/814), transfusion-related dyspnea 1.47% (12/814), transfusion-related circulatory overload 0.37% (3/814), purpura 0.25% (2/814) and transfusion-related hypotension 0.25% (2/814), delayed hemolysis 0.12%(1/814) and acute hemolysis 0.12%(1/814), respectively. 【Conclusion】 In recent years, the incidence of ARBT in local medical institutions is lower than that of domestic general level, and the main reactions are anaphylaxis and fever following the transfusion of plasma or (and) platelets.The monitoring and control of ARBT should be strengthened in each hospital with accurate and timely report, and active preventive measures should be taken to control or reduce the incidence of ARBT effectively.
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@# Objective To analyze the status of health literacy and its relationship with chronic diseases and self-reported health among residents in Qingdao, discuss the influence of health literacy on health status and provide the scientific basis for the development of health education strategies and measures. Methods The stratified multistage and probability proportionate to population size sampling(PPS sampling) method was adopted in this investigation. In 2017, a questionnaire survey was conducted among 16 700 permanent residents aged 15-69 from 10 districts in Qingdao. Results The overall level of health literacy status was 15.92%, the prevalence rate of chronic diseases was 19.31%, the self-reported health proportion of good, fair and poor were 81.68%, 12.12% and 1.71% among residents in Qingdao. Logistic regression analysis showed that, after adjusting for urban and rural areas, gender, age, education, income and occupation, health literacy was a protective factor for people with chronic diseases and self-evaluated health(OR=1.232，P=0.003;OR=1.159，P=0.033). Three aspects of health literacy were correlated with chronic diseases and self-reported health among people (all P<0.05). Conclusions Health literacy is positively correlated with the health status of residents. The improvement of health literacy is an important way to enhance the health status of residents.
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Objective To investigate the association between the TM6SF2 rs58542926 polymorphism and non-alcoholic fatty liver disease (NAFLD) in Qingdao Han Population, and the molecular mechanism of TM6SF2 167 locus polymorphism affecting lipid metabolism. Methods We genotyped a cohort of NAFLD patients (NAFLD group) treated in Qingdao Municipal Hospital from Octorber 2016 to November 2017 and 451 healthy controls (control group) matched for age and sex by polymerase chain reaction and direct sequencing. Distribution of genotypes and allele frequencies of TM6SF2 rs58542926 and the relative risk of NAFLD were assessed. In addition, we concentrated the lentivirus of TM6SF2-mutant type and TM6SF2-wild type and transfected into Hepa1-6 cells. The concentration of lipid indicators and the expressions of SREBP-1c mRNA and protein were determined. Results There were significant differences in the genotype and allele frequencies of TM6SF2 rs58542926 polymorphism between the NAFLD and control group (P<0.001). Carriers of T allele had significantly increased susceptibility to NAFLD (OR=2.327, 95%CI: 1.542-3.513, P<0.001). Total cholesterol (TC) and triglyceride (TG) contents of the TM6SF2-mutant type group were both increased to high levels when compared with the TM6SF2-wild type group (P<0.001). Furthermore, the expression levels of sterol regulatory element-binding transcription factor 1c (SREBP-1c) mRNAs and protein of the TM6SF2-mutant type group were significantly increased when compared with either of the TM6SF2-wild type group (P<0.001). Conclusions The TM6SF2 rs58542926 polymorphism is associated with risk of NAFLD in Qingdao Han Population. Furthermore, the mutant T allele at TM6SF2 167 locus may regulate the hepatic lipid metabolism through increasing the expression of SREBP-1c.
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OBJECTIVE： To investigate the feasibility of multi-payment for drugs for rare diseases and also provide reference for rare disease treatment and the formulation of related policy. METHODS： Taking Gaucher’s disease in Qingdao as an example， the relevant medical insurance policies and drug supply were analyzed； according to the sources of financing， the economic burden of treatment drugs for patients with Gaucher’s disease in Qingdao was estimated. Based on the average total cost of patients with Gaucher’s disease in Qingdao， the drug cost burden of patients with Gaucher’s disease in the whole country was simulated according to the relevant epidemiological survey data， and the problems of medical insurance model for rare diseases in Qingdao were analyzed. RESULTS & CONCLUSIONS： A series of medical insurance policies were formulated in Qingdao. The financing mode of medical insurance includes social funds （from Qingdao Charity Federation， drugs are provided by pharmaceutical manufacturers）， medical insurance funds （used for personal self-payment assistance within the scope of medical insurance co-ordination） and civil assistance （used for assistance outside the scope of medical insurance co-ordination）. Imidase is currently the only approved specific drug for Gaucher’s disease in China. The designated physician， treatment and drug-taken system is adopted in Qingdao. By the end of 2017， the annual drug consumption of 8 patients in Qingdao was 38-170 bottles， totaling 686 bottles. The annual cost of treatment ranged from 786 600 to 3 519 000 yuan， totaling 1 420 200 yuan. The self-paid expenses ranged from 9 800 to 197 400 yuan （the self-paid ratio ranged from 0.46％ to 8.87％）， totaling 661 400 yuan. The reimbursement cost by supplementary medical insurance was 509 800 to 1 789 800 yuan （accounting for 54.59％ to 65.94％）， totaling 8 577 800 yuan. Three patients received civil assistance， the amount of which ranged from 23 100 to 13 000 yuan （accounting for 1.89％ to 4.18％）， totaling 241 400 yuan. According to the relevant epidemiological survey data （the prevalence rate was 0.15 per 100 000）， it is estimated that there are about 2 093 patients with Gaucher’s disease in China. Referring to Qingdao multi-payment model， it is estimated that the total cost of drugs for Gaucher's disease in China is about 3.715 billion yuan， charitable assistance can bear 1.238 billion yuan， while medical insurance expenditure is about 2.255 billion yuan， and individual self-payment is about 222 million yuan. From the point of view of drug cost burden， the multi-payment model in Qingdao has lightened the personal burden of patients’ has achieved significant results. There are problems in Qingdao’s multi-payment model， such as “medical insurance immigration”， low drug accessibility， drug price monopoly， three-level disease prevention needs to be strenghten， etc. The state or provinces and cities can refer to Qingdao model when formulating policies related to rare diseases. Great importance should be paid attention to the existing problems.
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Objective To investigate the epidemic situation and its epidemic characteristics of malaria in Qingdao City from 2012 to 2017, so as to provide the evidence for the prevention and control of malaria in this city. Methods The data of cases and epidemiological characteristics of malaria in Qingdao City, 2012–2017 were collected from the China’s disease prevention and control system infectious disease report information management system and parasitic disease prevention and control information management system, and analyzed. Results A total of 103 cases of malaria were reported in Qingdao City from 2012 to 2017, and all of them were imported. Among them, 98 (95.15%) were imported from Africa and 5 (4.85%) from Asia. There were 92 laboratory confirmed cases (89.32%) and 11 (10.68%) clinically diagnosed cases. The highest incidence occurred in 2016 (0.28/105) . According to the classification of cases, there were 87 falciparum malaria cases (84.47%), 13 vivax malaria cases (12.62%), and 3 ovale malaria cases (2.91%) . These patients were mainly young men, and the male to female ratio was 19.6∶1. There were malaria case reports in each month, and the peak onset season was not obvious. Newly diagnosed and confirmed units were mainly municipal medical institutions; the median of onset-definite diagnosis was 4 days. There was one death case, but there were no recurrence, reburning, and imported secondary cases. Conclusion There were no local malaria cases in Qingdao City from 2012 to 2017. The prevention and control of imported malaria is the focus of the future work.
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OBJECTIVE: To analyze carbapenemases genotype of imipenem-resistant Gram-negative bacilli in intensive care unit (ICU) of 3 third grade class A hospitals from Qingdao area, so as to provide reference for drug-resistant bacteria infection prevention and treatment in clinic. METHODS: From Jan. 2013 to Jun. 2016, each 60 strains of imipenem-resistant Klebsiella pneumoniae (IRKP), imipenem-resistant Pseudomonas aeruginosa (IRPA) and imipenem-resistant Acinetobacter baumanii (IRAB) were collected from 3 third grade class A hospitals from Qingdao area. Drug sensitivity test was performed by using Kirby-Bauer method. Phenotypes of carbapenemases were determined by Carba NP trial. PCR was applied to amplify carbapenemase gene; Sanger seqnencing method was adopted for bi-directional sequencing; Blast comparison with GenBank database was conducted. RESULTS: Three kinds of imipenem-resistant Gram-negative bacilli showed high drug resistance to majority commonly used antibiotics as piperacillin, cefazolin, imipenem and cilastatin sodium, gentamicin, etc., but were sensitive to polymyxin B (resistance rate of 0). Among 180 drug-resistant strains, there were 52 strains of class A carbapenems, 13 strains of class B carbapenems and 39 strains of class D carbapenems; the detection rates of them were 28. 89％, 7. 22％ and 21. 67％, respectively. There were 52 strains of KPC-2 gene (IRKP), 4 strains of IMP-1 gene (IRPA), 8 strains of VIM-2 gene (7 strains of IRPA, 1 strain of IRAB), 39 strains of OXA-23 gene (IRAB); the detection rates of them were 28. 89％, 2. 22％, 4. 44％, 21. 67％; all strains were not detected 1MP-2, VIM-1, NDM-1, OXA-24, OXA-58 genes. Results of Blast comparison showed that above detected genes were absolutely homology with the corresponding genes in GenBank database. CONCLUSIONS: Drug resistance of imipenem-resistant Gram-negative bacilli in ICU of 3 third grade class A hospitals is serious in this region, which are nearly no-sensitive to most of commonly used antibiotics in clinic. Main genotypes included KPC-2 (K. pneumoniae), OXA-23 (A. baumanii) and IMP-1 and VIM-2 (P. aeruginosa).
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Objective To investigate the epidemic situation and its epidemic characteristics of malaria in Qingdao City from 2012 to 2017, so as to provide the evidence for the prevention and control of malaria in this city. Methods The data of cases and epidemiological characteristics of malaria in Qingdao City, 2012–2017 were collected from the China’s disease prevention and control system infectious disease report information management system and parasitic disease prevention and control information management system, and analyzed. Results A total of 103 cases of malaria were reported in Qingdao City from 2012 to 2017, and all of them were imported. Among them, 98 (95.15%) were imported from Africa and 5 (4.85%) from Asia. There were 92 laboratory confirmed cases (89.32%) and 11 (10.68%) clinically diagnosed cases. The highest incidence occurred in 2016 (0.28/105) . According to the classification of cases, there were 87 falciparum malaria cases (84.47%), 13 vivax malaria cases (12.62%), and 3 ovale malaria cases (2.91%) . These patients were mainly young men, and the male to female ratio was 19.6∶1. There were malaria case reports in each month, and the peak onset season was not obvious. Newly diagnosed and confirmed units were mainly municipal medical institutions; the median of onset-definite diagnosis was 4 days. There was one death case, but there were no recurrence, reburning, and imported secondary cases. Conclusion There were no local malaria cases in Qingdao City from 2012 to 2017. The prevention and control of imported malaria is the focus of the future work.
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The system of long-term care insurance,which is one supportive system for the increasing long-term care needs of the elderly in China will be the highlight for the construction of social security system during the 13th Five-Year Plan period.This paper focuses on the current background,models feature and system design of regional practice of long-term care insurance in Qingdao and Nantong,and makes a comparison between them.On the basis of the summarized experience and inspiration,and the existing problems as well as the experience in advanced countries,the author puts forward the corresponding suggestions,in the hope of providing valuable references for the toplevel design of the long-term care insurance system.
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The system of long-term care insurance,which is one supportive system for the increasing long-term care needs of the elderly in China will be the highlight for the construction of social security system during the 13th Five-Year Plan period.This paper focuses on the current background,models feature and system design of regional practice of long-term care insurance in Qingdao and Nantong,and makes a comparison between them.On the basis of the summarized experience and inspiration,and the existing problems as well as the experience in advanced countries,the author puts forward the corresponding suggestions,in the hope of providing valuable references for the toplevel design of the long-term care insurance system.
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Objective To understand the status of Toxoplasma gondii(TOX)infection in pregnant women in Qingdao area. Methods Antibody capture ELISA was used to detect the TOX-IgM,IgG and TOX-DNA in 1 341 pregnant women and 201 infer-tility,miscarriage,stillbirth pregnant women from June 2011 to July 2013. Results Among 201 abnormal pregnant women,43 cases were TOX antibody positive,accounting for 22.39%,and among the normal pregnant women,84 cases were TOX antibody positive,accounting for 6.26%,and there was a significant difference(χ2 =10.60,P<0.05). The TOX positive rate of 20-29 years old women was higher than that of the women aged over 30 years(χ2=21.9,P<0.05). The TOX antibody positive rates of families with pets and families without pets were 26.63%and 8.77%respectively(χ2=10.93,P<0.05). The TOX antibody posi-tive rates were 10.94%(22/201)in unemployed women,3.98%(8/201)in farmers,3.98%(8/201)in staff,and 3.48%(7/201)in workers. Conclusions The TOX infection rate in abnormal pregnant women is significantly higher than that in normal pregnancy women;therefore,the health education should be strengthened. In addition,in young women,especially 20-29 years old women, and some special occupation women,the control measures should be enhanced.
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Objective To investigate urban residents’ willingness-to-pay (WTP) for ambient air pollution control to avoid the adverse health effects in Qingdao, China. Methods A contingent valuation method (CVM) was employed and a sample of 1 050 residents was randomly chosen, 21st to 27th January, 2007. A series of hypothetical, open-ended scenario questions were designed to elicit the respondents’ WTP with face-to-face interviews. A Probit model on the probability of a positive WTP and a stepwise regression model were established to find the relationship between endogenous variables and WTP. Results 1 008 valid questionnaires were obtained. 73.9% respondents believe that air pollution had adverse effects on health. 54.6% respondents cost 100 to 500 Chinese Yuan (CNY) on treatment of respiratory diseases for their whole family. 94.2% respondents were able to express positive WTP and the median WTP was 600 Chinese Yuan (CNY) per household per year. Conclusion Urban residents’ aggregate WTP accounted for 1.25% of annual household income and 11.9% of government investments for air pollution control in 2005. Residents’ age, job and household income variables had significant influence on the probability of a positive WTP. Residents’ household income, education level, expenditure on treatment of respiratory diseases and age significantly influence WTP value.