Study on the hospitalization cost and its influencing factors of imported malaria patients in Guangxi Zhuang Autonomous Region and Yunnan Province / 中国血吸虫病防治杂志

Objective To analyze the hospitalization cost and its influencing factors of imported malaria patients in Guangxi Zhuang Autonomous Region and Yunnan Province, so as to provide insights into the evaluation of the economic burden due to imported malaria, and the guiding of malaria control and the rational allocation of medical resources. Methods The data pertaining to the hospitalization costs of imported malaria patients admitted to Shanglin County People’s Hospital in Guangxi Zhuang Autonomous Region during the period from January 1 through December 31, 2019, and Tengchong Municipal People’s Hospital in Yunnan Province from January 1, 2015 to December 31, 2019, were collected, and the epidemiological data of these imported malaria patients were extracted from the Information Management System for Parasitic Diseases Control and Prevention, China. The composition of the hospitalization expenses was analyzed using a descriptive method. In addition, the factors affecting the hospitalization expenses of imported malaria patients were identified using a univariate analysis and a recursive system model. Results A total of 206 imported malaria patients were included in this study, including 194 men (94.17%) and 12 women (5.83%). The mean length of hospital stay was 5.00 days per patient and the median hospitalization expenses were 2 813.07 Yuan per time, in which the expenses for laboratory examinations were the highest (45.31%, 1 274.62/2 813.07). Univariate analysis showed that hospital (z = 5.43, P < 0.01), type of malaria (χ2 = 34.86, P < 0.01) and type of payment (χ2 = 7.72, P < 0.05) were factors affecting the hospitalization expenses of imported malaria patients. Recursion system modeling revealed that the total effects on hospitalization expenses of imported malaria patients included length of hospital stay (0.78), selection of hospital (0.34), basic medical insurance for urban and rural residents (0.19), new rural cooperative medical care (0.17), Plasmodium falciparum malaria (0.15), gender (0.11) and P. vivax malaria (0.09). Conclusions The hospitalization expenses of imported malaria patients are affected by multiple factors in Guangxi Zhuang Autonomous Region and Yunnan Province, in which the length of hospital stay is the most predominant influencing factor. A reduction in the length of hospital stay is effective to decrease the hospitalization expenses of imported malaria patients.

Method establishment and preliminary application of sandwich ELISA for detecting Cryptosporidium parvum antigen / 中国人兽共患病学报

We established the method of Sandwich ELISA to detect Cryptosporidium parvum antigen.Purified anti-Cryp-tosporidium IgG and IgY were used as a capture antibody and detection antibody respectively to develop sandwich ELISA.A checkerboard titration study was carried out to determine the optimal conditions of ELISA.The PCR based on 18SrRNA was used to evaluate the pre-treatment effect of three methods (saturated sucrose solution floating,saturated salt water floating and PBST detergent washing).The optimum concentration of coated antibody,antigen,detection antibody and enzyme-labelled an-tibody were 1:800,2.5 μg/mL,1:100 and 1:5 000 respectively.The coating condition,antigen antibody reaction,opti-mum reaction time of enzyme-labelled antibody were 4 ℃ through the night after 37 ℃,incubated at 37 ℃ for 30 min and 45 min respectively;the optimal termination condition was 2 mol/L H2SO4,50 μL/well;TMB developed 10 minutes at room temperature.The developed sandwich ELISA has no cross reaction with the eggs/oocyts of Nematode,Coccidium and Asca-rid;coefficient of variation of intra-assay and inter-assay were all less than 10%.The results showed that the total coincidence rate of the three pre-treatment methods with nested PCR were 95.83%,91.67% and 83.33%,respectively,and the Saturated Sucrose Floatation method was the best one among the three methods,the sensitivity of the method was lower than the Cry p-tosporidium detection kit of IDEXX(6×103/mL),and whole test process was longer than the kit.While,its specificity and reproducibility were consistent with that of IDEXX kit,and the developed method was more economical.The method is simple,rapid,sensitive,and can be used for clinical epidemio-logical investigation of Cryptosporidiosis or pathogen detection.

Compensatory sweating after restricting or lowering the level of sympathectomy: a systematic review and meta-analysis

OBJECTIVE: To compare compensatory sweating after lowering or restricting the level of sympathectomy. METHOD: A systematic review and meta-analysis were conducted of all randomized controlled trials published in English that compared compensatory sweating after lowering or restricting the level of sympathectomy. The Cochrane collaboration tool was used to assess the risk of bias, and the Mantel-Haenszel odds ratio method was used for the meta-analysis. RESULTS: A total of 11 randomized controlled trials were included, including a total of 1079 patients. Five of the randomized controlled trials studied restricting the level of sympathectomy, and the remaining six studied lowering the level of sympathectomy. CONCLUSIONS: The compiled randomized controlled trial results published so far in the literature do not support the claims that lowering or restricting the level of sympathetic ablation results in less compensatory sweating. .

Utility of the combination of serum highly-sensitive C-reactive protein level at discharge and a risk index in predicting readmission for acute exacerbation of COPD, / Utilidade de se combinar o nível sérico de proteína C reativa de alta sensibilidade no momento da alta com um índice de risco para prever a reinternação por exacerbação aguda da DPOC

OBJECTIVE: Frequent readmissions for acute exacerbations of COPD (AECOPD) are an independent risk factor for increased mortality and use of health-care resources. Disease severity and C-reactive protein (CRP) level are validated predictors of long-term prognosis in such patients. This study investigated the utility of combining serum CRP level with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) exacerbation risk classification for predicting readmission for AECOPD. METHODS: This was a prospective observational study of consecutive patients hospitalized for AECOPD at Peking University Third Hospital, in Beijing, China. We assessed patient age; gender; smoking status and history (pack-years); lung function; AECOPD frequency during the last year; quality of life; GOLD risk category (A-D; D indicating the greatest risk); and serum level of high-sensitivity CRP at discharge (hsCRP-D). RESULTS: The final sample comprised 135 patients. Of those, 71 (52.6%) were readmitted at least once during the 12-month follow-up period. The median (interquartile) time to readmission was 78 days (42-178 days). Multivariate analysis revealed that serum hsCRP-D ≥ 3 mg/L and GOLD category D were independent predictors of readmission (hazard ratio = 3.486; 95% CI: 1.968-6.175; p < 0.001 and hazard ratio = 2.201; 95% CI: 1.342-3.610; p = 0.002, respectively). The ordering of the factor combinations by cumulative readmission risk, from highest to lowest, was as follows: hsCRP-D ≥ 3 mg/L and GOLD category D; hsCRP-D ≥ 3 mg/L and GOLD categories A-C; hsCRP-D < 3 mg/L and GOLD category D; hsCRP-D < 3 mg/L and GOLD categories A-C. CONCLUSIONS: Serum hsCRP-D and GOLD classification are independent predictors of readmission for AECOPD, and their predictive value increases when they are used in combination. .

OBJETIVO: Reinternações frequentes por exacerbações agudas da DPOC (EADPOC) são um fator de risco independente para maior mortalidade e uso de recursos de saúde. A gravidade da doença e o nível de proteína C reativa (PCR) são preditores validados do prognóstico em longo prazo para tais pacientes. Investigamos a utilidade da combinação do nível sérico de PCR com a classificação de risco de exacerbação da Global Initiative for Chronic Obstructive Lung Disease (GOLD) para predizer a reinternação por EADPOC. MÉTODOS: Estudo observacional prospectivo de pacientes consecutivos hospitalizados por EADPOC no Peking University Third Hospital, in Pequim, China. Avaliamos a idade; gênero, história e carga tabágicas (anos-maço), função pulmonar, frequência de EADPOC no último ano; qualidade de vida; categoria de risco GOLD (A-D, D indicando maior risco); e nível sérico de PCR de alta sensibilidade na alta (PCRas-A). RESULTADOS: A amostra final consistiu em 135 pacientes. Desses, 71 (52,6%) foram reinternados ao menos uma vez durante o período de seguimento de 12 meses. A mediana (intervalo interquartílico) do tempo de reinternação foi de 78 dias (42-178 dias). A análise multivariada revelou que PCRas-A sérico ≥ 3 mg/L e categoria GOLD D foram preditores independentes de reinternação (razão de risco = 3,486; IC95%: 1,968-6,175; p < 0,001 e razão de risco = 2,201; IC95%: 1,342-3,610; p = 0,002, respectivamente). A ordem das combinações dos fatores por risco cumulativo de readmissão, da maior para a menor foi a seguinte: PCRas-A ≥ 3 mg/L e categoria GOLD D; PCRas-A ≥ 3 mg/L e categorias GOLD A-C; PCRas-A < 3 mg/L e categoria GOLD D; e PCRas-A < 3 mg/L e categorias GOLD A-C. CONCLUSÕES: ...