Analysis on the implementation effect of single disease payment policy for day surgery based on difference-in-differences model / 中华医院管理杂志

Objective:To analyze the implementation effect of single disease payment policy for day surgery (hereinafter referred to as the policy), for references for the reform of medical insurance payment.Methods:By collecting the information of inpatients from 2017 to 2019 in a tertiary hospital, the research group took patients with colorectal benign tumor and nodular goitre as the policy implementation group and the control group respectively. 2017-2018 was the pre implementation stage of the policy, and 2019 was the post implementation stage of the policy. The difference-in-differences (DID) model was used to analyze the changes in indicators such as length of stay and hospitalization expenses after policy implementation, under whether the policy is implemented or not, as well as before or after policy implementation.Results:A total of 2 419 patients were included, including 927 patients with nodular goiter in the control group and 1 492 patients with colorectal benign tumors in the policy implementation group (688 patients before the policy implementation and 804 patients after the policy implementation). The results of DID showed that the hospital days for patients with colorectal benign tumor decreased by 56.53%, the hospitalization expenses decreased by 26.51%, the out-of-pocket expenses decreased by 26.66%, the treatment expenses increased by 11.96%, the drug expenses decreased by 50.29% and the consumables expenses decreased by 20.23% after the implementation of the policy.Conclusions:The implementation of the policy could reduce length of stay, hospitalization expenses and out-of-pocket expenses, optimize the structure of hospitalization expenses, improve the efficiency of hospital diagnosis and treatment, and help the hospital realize its transformation from a size expansion to a quality and benefit expansion.

Study on related factors and effect relationship of hyperuricemia in health check-up participants / 中华内分泌代谢杂志

Objective:To investigate the influencing factors of hyperuricemia(HUA) and explore early intervention of metabolic diseases.Methods:A total of 70 523 participants were selected from the database of check-ups in 2016. Univariate analysis and logistic regression analysis were used to identify related factors of HUA. Correspondence analysis was performed for the aggregation of different levels of uric acid(UA) and related factors. The mediating effect of mean blood pressure(MBP) between abnormal metabolic indicators and abnormal renal function was tested.Results:The age, sex, occupation, body mass index(BMI), systolic blood pressure, diastolic blood pressure, blood urea nitrogen(BUN), creatinine(Cr), estimated glomerular filtration rate(eGFR), fasting plasma glucose(FPG), total cholesterol(TC), triacylglycerol(TG), high density lipoprotein-cholesterol(HDL-C), low density lipoprotein-cholesterol, plasma viscosity were significantly related to HUA( P<0.001). Logistic regression analysis showed that youth, male, hypertension, TC, TG, and Cr were risk factors for HUA, while HDL-C was a protective factor for HUA( P<0.001). Correspondence analysis showed that during the gradual increase of UA, TC was the first to appear abnormal, followed by hypertension and TG, and the increase of Cr appeared last. Mediating effect showed that in changes of UA, the mediating effects of MBP on TC, TG, and HDL-C were 36.35%, 12.63%, and 9.41%, respectively. In changes of eGFR, the mediating effects of MBP on TC, TG and HDL-C were 30.20%, 27.70%, and 6.13%, respectively. Conclusions:UA is positively correlated with blood pressure, TC, and TG, and inversely with HDL-C. TC and TG have an impact on renal impairment, in which MBP plays a mediating role.

Study on residents'acceptance and influencing factors of the hierarchical medical system in Xuzhou / 中华医院管理杂志

Objective To investigate the residents' acceptance and the influencing factors of the hierarchical medical system in Xuzhou, and to suggest on effective system implementation. Methods Xuzhou residents free of cognitive impairment and over 18 years old were sampled for questionnaire survey in July-August 2016, to study their acceptance of their basics and acceptance of the system. 1 550 questionnaires were distributed, and 1 473 valid ones were recovered. The count data were expressed as constituent ratio, and χ2test was used for single-factor analysis, with binary logistic regression analysis for multi-factor analysis. Results 71. 0% of the residents embraced this system. Their acceptance varies significantly with their age, place of residence, education, annual average monthly income, self-rated health status, physical examination experience, conditions of chronic diseases, medical visit experience at primary healthcare institutions, and their awareness of the system (P<0.05). Conclusions The acceptance of the system by Xuzhou residents needs to be elevated, by means of greater promotional efforts, capacity building for primary institutions, so as to fully leverage the system to serve the residents.

Association between the glomerular filtration rate of renal dysfunction and metabolic syndrome: an age-stratified analysis / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the relationship between the renal dysfunction rate and metabolic syndrome(MS), stratified by age.</p><p><b>METHODS</b>People took part in physical check-up in a certain tertiary hospital from March 2010 to September 2012, were enrolled in this study. Estimated glomerular filtration rate (eGFR), -a renal dysfunction indicator, was calculated by modified MDRD equation [<60 ml/min(1.73 m(2))]. Associations between the renal dysfunction rate and factors as age, gender and MS traits, were assessed by stratified analysis.</p><p><b>RESULTS</b>Eligible data from 75 469 subjects were used. The prevalence rates of renal dysfunctions appeared to be 0.05%,0.20%, 1.68% in 18 to 44 year-olds (youth), 45 to 59 year-olds (middle) and 60 year-olds or above (old), respectively. Participants with MS showed a significantly higher risk than those without, in the elderly only (P < 0.05)but not in the other 2 groups (P > 0.05). Participants with 2 components of MS in middle-aged, 3 or 5 components of MS in the elderly showed a significantly high incidence (P < 0.05), but no significant differences seen in other subgroups (P > 0.05). Increasing trend was not seen in all the 3 groups (P > 0.05). Elevated blood pressure (BP+) in youth and middle-aged groups, decreased high density lipoprotein (HDL-C) in middle-aged and elderly groups and elevated fasting plasma glucose (FPG+) in elderly group could all cause the abnormality rate of eGFR which showed significantly high incidence rates in the subgroup analysis (P < 0.05). The maximum of population attributable risk proportion (PAR%) was 41.91% in youth when having elevated BP. Relationship between renal dysfunction rate and triglyceride (TG)/obesity was not identified.</p><p><b>CONCLUSION</b>The prevalence of renal dysfunction was found low, in Xuzhou. The incidence was not associated with the numbers but might relate to the nature of certain components of MS. Increased BP showed both short-term and mid-term effects. Decreased HDL-C, however, indicated both mid-term and long-term effects. The elevated FPG only appeared long-term effects. Increased TG and obesity did not show significant effects in these observed samples. PAR% of increased BP seemed to be the most important factors which might lead to renal dysfunction.</p>

Association between the glomerular filtration rate of renal dysfunction and metabolic syndrome:an age-stratified analysis / 中华流行病学杂志

Objective To explore the relationship between the renal dysfunction rate and metabolic syndrome(MS),stratified by age. Methods People took part in physical check-up in a certain tertiary hospital from March 2010 to September 2012,were enrolled in this study. Estimated glomerular filtration rate(eGFR),-a renal dysfunction indicator,was calculated by modified MDRD equation[<60 ml/min(1.73 m2)]. Associations between the renal dysfunction rate and factors as age,gender and MS traits,were assessed by stratified analysis. Results Eligible data from 75 469 subjects were used. The prevalence rates of renal dysfunctions appeared to be 0.05%,0.20%,1.68%in 18 to 44 year-olds(youth),45 to 59 year-olds(middle)and 60 year-olds or above(old),respectively. Participants with MS showed a significantly higher risk than those without,in the elderly only(P<0.05)but not in the other 2 groups(P>0.05). Participants with 2 components of MS in middle-aged, 3 or 5 components of MS in the elderly showed a significantly high incidence (P<0.05),but no significant differences seen in other subgroups(P>0.05). Increasing trend was not seen in all the 3 groups(P>0.05). Elevated blood pressure(BP+)in youth and middle-aged groups,decreased high density lipoprotein(HDL-C)in middle-aged and elderly groups and elevated fasting plasma glucose (FPG+)in elderly group could all cause the abnormality rate of eGFR which showed significantly high incidence rates in the subgroup analysis(P<0.05). The maximum of population attributable risk proportion (PAR%) was 41.91% in youth when having elevated BP. Relationship between renal dysfunction rate and triglyeride(TG)/obesity was not identified. Conclusion The prevalence of renal dysfunction was found low,in Xuzhou. The incidence was not associated with the numbers but might relate to the nature of certain components of MS. Increased BP showed both short-term and mid-term effects. Decreased HDL-C,however,indicated both mid-term and long-term effects. The elevated FPG only appeared long-term effects. Increased TG and obesity did not show significant effects in these observed samples. PAR%of increased BP seemed to be the most important factors which might lead to renal dysfunction.

Association between the glomerular filtration rate of renal dysfunction and metabolic syndrome:an age-stratified analysis / 中华流行病学杂志

Objective To explore the relationship between the renal dysfunction rate and metabolic syndrome(MS),stratified by age. Methods People took part in physical check-up in a certain tertiary hospital from March 2010 to September 2012,were enrolled in this study. Estimated glomerular filtration rate(eGFR),-a renal dysfunction indicator,was calculated by modified MDRD equation[<60 ml/min(1.73 m2)]. Associations between the renal dysfunction rate and factors as age,gender and MS traits,were assessed by stratified analysis. Results Eligible data from 75 469 subjects were used. The prevalence rates of renal dysfunctions appeared to be 0.05%,0.20%,1.68%in 18 to 44 year-olds(youth),45 to 59 year-olds(middle)and 60 year-olds or above(old),respectively. Participants with MS showed a significantly higher risk than those without,in the elderly only(P<0.05)but not in the other 2 groups(P>0.05). Participants with 2 components of MS in middle-aged, 3 or 5 components of MS in the elderly showed a significantly high incidence (P<0.05),but no significant differences seen in other subgroups(P>0.05). Increasing trend was not seen in all the 3 groups(P>0.05). Elevated blood pressure(BP+)in youth and middle-aged groups,decreased high density lipoprotein(HDL-C)in middle-aged and elderly groups and elevated fasting plasma glucose (FPG+)in elderly group could all cause the abnormality rate of eGFR which showed significantly high incidence rates in the subgroup analysis(P<0.05). The maximum of population attributable risk proportion (PAR%) was 41.91% in youth when having elevated BP. Relationship between renal dysfunction rate and triglyeride(TG)/obesity was not identified. Conclusion The prevalence of renal dysfunction was found low,in Xuzhou. The incidence was not associated with the numbers but might relate to the nature of certain components of MS. Increased BP showed both short-term and mid-term effects. Decreased HDL-C,however,indicated both mid-term and long-term effects. The elevated FPG only appeared long-term effects. Increased TG and obesity did not show significant effects in these observed samples. PAR%of increased BP seemed to be the most important factors which might lead to renal dysfunction.

The preliminary study of incorporating tetrapod-like zinc oxide whisker on the antibacterial activity of soft denture liners / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To research the effects of incorporating tetrapod-like zinc oxide whisker (T-ZnOw) of different proportions on the antibacterial activity of different kinds of soft denture liners.</p><p><b>METHODS</b>The minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of T-ZnOw against Saccharomyces albicans (S. albicans) were examined by the broth dilution test. Add T-ZnOw 0%, 1%, 2%, 3% to Silagum soft denture liners and soft denture liners respectively. The antimicrobial rate of S. albicans was determined by the membrane covering method.</p><p><b>RESULTS</b>The MIC of T-ZnOw against S. albicans was 78 microg mL(-1) and the MBC was 156 microg mL(-1). Comparing 1%, 2%, 3% T-ZnOw group with control group, the results showed significant difference (P<0.05). And as the T-ZnOw antibacterial agent added ratio increased, antibacterial increased significantly.</p><p><b>CONCLUSION</b>The soft denture liners incorporating with 1%, 2%, 3% of T-ZnOw can improve antibacterial activity. Following the increased proportions of T-ZnOw, antibacterial rate was significantly increasing.</p>

The evaluation on effectiveness of psychological health intervention in elderly urban residents living on minimum subsistence allowances / 中华老年医学杂志

Objective To evaluate the effectiveness of psychological health intervention in the elderly urban residents living on minimum subsistence allowances, and to search for a suitable psychological health intervention strategy. Methods The 112 elderly persons living on minimum subsistence allowances in Xuzhou were selected by stratified cluster sampling, and they were matched with 112 controls. The elderly persons living on minimum subsistence allowances were divided into intervention group and control group. A general intervention based on community involved psychological health and care lecture, psychodrama treatment and psychological consultancy was made on the intervention. The SCL-90 was used to evaluate the psychological health status and effectiveness of psychological health intervention. Results The elderly persons living on minimum subsistence allowances had higher SCL-90 scores compared with other residents, and their psychological health status was serious. After the psychological health intervention, the SCL-90 scores were all lower in intervention group than in control group [ interpersonal relationship sensitiveness: (1.13 ± 0. 39) vs.(1.26±0.26), t=2.12, P=0.04; gloom: (1.23±0.66) vs. (1.43±0.24), t=2.08, P=0.04;anxiety: (1. 18±0.50) vs. (1.38±0.34), t=2.17, P=0.03; hostility: (1.24±0.49) vs. (1.40±0.28), t=2.03, P=0.04; other factor: (1. 31±0.56) vs. (1.49±0.31), t=2.04, P=0.04; total score: (115.89± 17.21) vs. (122.64± 10.41), t=2.42, P=0.02]. Conclusions The psychological health parameters are improved by psychological health intervention.

The application of artificial neural network in studying landless farmer's mental health problems / 中华流行病学杂志

To introduce a method of classification with high precision-the artificial neural network (ANN),and to compare the results using logistic method. Using data from 1070 landless peasants'mental health survey,the artificial neural network models and logistic regression model were built and compared on their advantages and disadvantages of the two models.The prediction accuracy for artificial neural network was 94.229% and for logistic regression it was 51.028%. ANN appeared to have had good ability on generalization. ANN displayed advantages when conditions of classical statistical techniques could not be met or the predictive effect appeared to be unsatisfactory. Hence, ANN would make a better facture of its application in medical researche.

Study of large medical equipment allocation in Xuzhou / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>OBJECTIVE</b>To investigate the allocation and management of large medical equipment (LME) in Xuzhou, Jiangsu Province, China, in order to make the best use of LME to meet the medical needs of local people.</p><p><b>METHODS</b>The research collected data from all hospitals that have LME in Xuzhou using questionnaire; 38 (97.4%) hospitals returned the questionnaire.</p><p><b>RESULTS</b>In Xuzhou, there are a total of 71 pieces of LME, each serving 126 600 people in an area of 163 km(2). Sixty-two percent of them are allocated in urban areas, with Gini coefficient at 0.52, indicating imbalance and biased allocation of LME.</p><p><b>CONCLUSION</b>The allocation of LME in Xuzhou is out of control and unfairly allocated.</p>

Discussion of Teaching Reform in Undergraduate Course for Health Service Management / 中华医学教育探索杂志

To bring up teaching quality of health service management and students' integrated ability,the author advanced his thoughts and opinions for teaching reform in teaching contents,teaching methods,examination modes and teachers ability based on the characteristics of health service management and combined with teaching practice.

Guidance to the Test Result Analysis Software of Medical College / 中华医学教育探索杂志

Xuzhou Medical Collage developed a set of test result analysis software.It uses Visual Basic for Application(VBA)and statistics function in database Excel2000.It is simple to use and powerful in function.A brief introduction was given below to help you to use it.

On the Traditional Chinese Superior Ethic Values from the Health Education on AIDS Prevention / 中国医学伦理学

Traditional Chinese superior ethics has significant social value to keeping AIDS within limits.Evil lewdness means lust thought and behavior out of regular institution of marriage.The risk degree of AIDS infection is classified by moral concept and the contamination degree by Evil lewdness thoughts,not by age and wealth.Traditional Chinese superior ethics holds evil lewdness as the most malicious thing of all.It is still the golden standard today.Parents are the first in responsibility for teen-agers′ sex education,who educate a child not to move forward to lust field,not to explore the lust things.Controlling lust thoughts should completely eradicate masturbation,being chaste and undefiled.Sexual behavior is strictly included within marriage,and boycott the sexual behavior before or out of marriage conscientiously.Correct view of love means that passion could not break the rules of etiquette with happiness but no obscene.AIDS patients should be treated as average persons with kindheartedness.All of these are the spirit resource of taking precautions against AIDS.Therefore,excavating traditional Chinese superior ethics is precious spiritual resources for healthy education,and will certainly help to create a new situation of healthy education of AIDS.

CT Value in Examining Intestinal Tumor Obstruction / 实用放射学杂志

Objective To analyze the CT features of intestinal tumor obstruction, and explore its CT value.Methods CT manifestation and clinical materials of intestinal tumor obstruction proved by surgical findings or endoscopy biopsy in 35 cases were analyzed restrospectively, and compared with the results of surgery-pathology and endoscopy. Results CT findings were consistence with the results of surgery-pathology and endoscopy in 33 of 35 cases. The CT diagnostic accuracy of intestinal obstruction was 100%. And the accuracy of the cause was 94%, including colon carcinoma in 25, lyphoma in 5, gastrointestinal stromal tumor in 2, and lipoma in 3.Conclusion CT has unique advantage in examining intestinal tumor obstruction, not only for definiting the existence of the obstruction, but also locating the site of obstruction diagnosing the cause and chosing the appropriate treatment.

Performance analysis of CT in Xuzhou / 医疗卫生装备

Objective To know the performance of CT in Xuzhou, and provide references for the allocation optimization of medical resources in effective using of CT in Xuzhou. Methods All hospitals that have large medical equipment in Xuzhou were investigated and the cost, payment and benefit of 42 CT are analyzed. Results The median of cost is 142.6 yuan per person. The median of payment is 277.0 yuan per person. The median of annual net profit is 652 thousand yuan per CT. Conclusion The payment is higher than the cost of CT in Xuzhou. The ratio of profit is 120.8%, but half of CT can't take back of the investment in regular time.