Investigation and analysis of information disclosure status and willingness of public hospitals based on social supervision / 中华医院管理杂志

Objective:To investigate the status and willingness of information disclosure based on social supervision in tertiary and secondary public hospitals, so as to provide reference for expanding information disclosure content.Methods:By using stratified cluster random sampling method, 66 tertiary public hospitals and 126 secondary public hospitals in 6 provinces were selected for questionnaire survey in April 2021. Thirty-one indicators in 3 categories and 5 groups were selected to obtain the information disclosure status and willingness. Chi-square test, variance analysis and paired t-test were used to conduct difference analysis. Results:The indicators with higher disclosure rates in public hospitals were drug prices and medical service price adjustments (93.9% in tertiary hospitals and 92.1% in secondary hospitals) and medical insurance reimbursement policies and compensation processes (90.9% in tertiary hospitals and 86.5% in secondary hospitals), while the indicators with lower disclosure rates were case fatality rates in low-risk groups (24.2% in tertiary hospitals and 26.2% in secondary hospitals), proportion of special needs medical services (27.3% in tertiary hospitals), and average daily outpatient visits per practitioner (27.3% in tertiary hospitals and 26.2% in secondary hospitals). The indicators that public hospitals thought could be disclosed at a higher rate were drug and medical service price adjustments, medical insurance reimbursement policies and compensation processes, and prices and medical insurance reimbursement of commonly used drugs and major medical consumables, while the indicators that were thought to be disclosed at a lower rate were some medical service safety indicators and hospital financial indicators.For all indicators, the percentage that the hospitals thought could be disclosed was higher than the percentage that had been disclosed.Conclusions:At present, China′s secondary and tertiary public hospitals have a low rate of disclosure about medical service efficiency, medical service safety, statistical summary cost and financial indicators. However, except for some medical service indicators and financial related indicators, the hospitals′ information disclosure willingness is relatively high, and the scope of information disclosure can be expanded in an orderly manner in steps.

Application of depth of anesthesia monitoring in predicting postoperative cognitive impairment in elderly cancer patients / 肿瘤研究与临床

Objective:To investigate the role of depth of anesthesia monitoring in predicting postoperative cognitive impairment in elderly cancer patients.Methods:The clinical data of 70 elderly cancer patients in Shanxi Province Cancer Hospital from February 2020 to February 2021 were retrospectively analyzed. According to the postoperative cognitive function, they were divided into the postoperative cognitive impairment group (20 cases) and the normal postoperative cognitive function group (50 cases). Statistical analyses of the mini mental state examination (MMSE) score of cognitive function, mean arterial pressure (MAP) and bispectral index score (BIS) before anesthesia (T 0), before skin incision (T 1), 1 h after skin incision (T 2), 2 h after skin incision (T 3), at the completion of surgery (T 4), and at the time point of extubation (T 5), as well as the levels of interleukin-6 (IL-6) and central nervous specific protein (S100-β) at 1 d before operation, immediately after surgery and 1 d after surgery between the two groups were performed. Results:The MMSE score of patients in the postoperative cognitive impairment group was lower than that in the normal postoperative cognitive function group [(21±3) points compared with (25±5) points], and the difference between the two groups was statistically significant ( t = 2.98, P < 0.05). The MAP of the two groups at T 1, T 2, T 3, T 4, and T 5 gradually increased (both P < 0.05), the MAP at T 1, T 2, T 3, T 4 was lower than that at T 0 (all P < 0.05), and the MAP at T 5 was higher than that at T 0 (both P < 0.05). There were no statistical differences in MAP between the two groups at T 0, T 1, T 2, T 3, T 4, and T 5 (all P > 0.05). BIS values of the two groups at T 0, T 1, T 2, and T 3 gradually decreased (both P < 0.05), BIS values at T 4 and T 5 gradually increased (both P < 0.05). At T 2 and T 3, BIS value of the postoperative cognitive impairment group was lower than that of the normal postoperative cognitive function group (both P < 0.05). The duration of BIS < 45 in the postoperative cognitive impairment group was longer than that in the normal postoperative cognitive function group [(44.1±7.7) min than (12.6±2.2) min], and the difference between the two groups was statistically significant ( t = 26.68, P < 0.001). The levels of IL-6 and S100-β in the two groups were gradually increased 1 d before surgery, immediately after surgery and 1 d after surgery (both P < 0.05). On the 1st day after surgery, the S100-β level in the postoperative cognitive impairment group was higher than that in the normal postoperative cognitive function group ( P < 0.05). Conclusions:The application of depth of anesthesia monitoring is of high value in predicting postoperative cognitive impairment in elderly cancer patients.

Effects of different medication forms of dexmedetomidine on cognitive function in elderly patients undergoing radical operation of stomach neoplasms and Ramsay sedation score / 肿瘤研究与临床

Objective:To evaluate effects of different medication forms of dexmedetomidine on perioperative cognitive function in elderly patients undergoing radical operation of gastric carcinoma, and Ramsay sedation score.Methods:A total of 150 patients aged 65 years and 75 years scheduled for elective radical operation of gastric carcinoma from December 2018 to December 2019 in Shanxi Provincial Cancer Hospital were enrolled, and they were divided into 3 groups according to random number table method: different medication forms of dexmedetomidine groups (group A, group B) and the control group (group C), 50 cases in each group. The patients in group A and group B continued to pump dexmedetomidine at a rate of 0.5 μg·kg -1·h -1 and 0.3 μg·kg -1·h -1 respectively for 15 min before induction of anesthesia. And the patients in group C were given intravenous pumping of an equal volume of 0.9% NaCl for 15 min. Subsequently, patients in group A and group B received continuous intravenous infusion of 0.3 μg·kg -1·h -1 for 30 min before the end of operation, the patients in group C received 0.9% NaCl infusion of equal volume until the end of operation. The cognitive function of the patients was measured by using the Monterey cognitive assessment scale (MoCA) the day before surgery and on day 1,3 and 7 after surgery, and the incidence of perioperative neurocognitive disorder (PND) was counted. Ramsay sedation score at 30 min, 24 h and 48 h after surgery was compared among the three groups. Results:There were 3 patients in group A and 3 patients in group C were excluded because they were transferred to ICU due to serious postoperative complications. There were significant differences in MoCA score among the three groups on day 1, 3, 7 after operation (all P < 0.01); MOCA score of group A, B and C on day 7 after operation was (26.9±0.7) scores, (26.6±1.0) scores, (26.3±1.2) scores, respectively, and the difference between group A and group C was statistically significant ( P < 0.01). The incidence of PND among the three groups on day 1, 3, 7 after surgery had statistically significant differences (all P < 0.05), and the incidence of PND in group A was lower than that in group B and C (all P < 0.05). Ramsay sedation score among the three groups at 30 min and 24 h, 48 h after operation showed statistically significant differences (all P < 0.01), and that in group C was lower than that in group A and group B, and the differences were statistically significant (all P < 0.01). Ramsay sedation score at 24 h after operation in group A was high than that in group B and group C (all P < 0.01). Conclusions:Dexmedetomidine assisted with anesthesia can reduce the incidence of PND in elderly patients undergoing radical operation of gastric carcinoma and enhance the sedative effect. What's more, the most obvious effect is the infusion of 0.5 μg·kg -1·h -1 before anesthesia induction.

Decomposition of life expectancy among respiratory disease of death in China from 2010 to 2015 / 中华疾病控制杂志

@#Objective To analyze the regional and age-specific differences in the effects of mor- tality from respiratory diseases on life expectancy in China form 2010 to 2015． Methods We used na- tional bureau of statistics 2010 to 2015 population census，the " Chinese cause of death monitoring data set" published by China center for disease control and prevention and center for health statistics and infor- mation，national health and family planning commission． Abridged life table and arriaga method were used to explain life expectancy increment in different age groups and different regions． Ｒesults The mortality rate of respiratory diseases in China decreased from 2010 to 2015． The life expectancy after elimination of respiratory disease increased by 2. 0 years and 1. 6 years in 2010 and 2015，respectively． The contribution of the decreased mortality from respiratory diseases accounted for 15. 4 percent of life expectancy in the eastern region，12. 5 percent in the central region and 55. 6 percent in the western region． In terms of age，declines in mortality in the 0-5 and over 70 age groups contributed the most to life expectancy． Con- clusions The decline in life expectancy due to respiratory diseases was 20. 0% across the country from 2010 to 2015，showing significant regional differences． Chronic lower respiratory diseases had the greatest impact on life expectancy，but contributed less to the increment of life expectancy． Pneumonia contributed significantly to the increase in life expectancy，and the improvement of pneumonia in people aged 0-10 years promoted the increase of life expectancy．

Experiment and achievement of the unified payment platform in the reform of hospital mobile payment system / 中华医院管理杂志

With the development of smart phones, mobile payments have become increasingly popular in all areas of our daily life. Hospitals at large have introduced mobile payments to provide quality service to patients via online and offline means. However, popular use of mobile payments has also brought new challenges to hospitals in the areas of financial management and information management. In this regard, the authors introduced the measures taken by Stomatology Hospital Zhejiang University School of Medicine, by means of building a unified payment system for refined management. These measures safeguard payment and financial data security while offering better patient medical experience.

Periodic revalidation of autoverification for blood analysis and its suitability evaluation of application / 中华检验医学杂志

Objective:To conduct periodic revalidation of the 15 items and 43 terms autoverification rules of blood analysis after 1 year of application, analyze the application suitability and make the rules improved.Methods:Track the results of 528 010 blood analysis samples of our hospital from August 1, 2019 to January 31, 2020, and analyze the pass rate and interception rate of autoverification; 600 specimens in total were selected randomly for microscope examination, including 300 specimens which touched autoverification rules (1 012 items of autoverification rules) and were intercepted by autoverification and 300 specimens which untouched autoverification rules and were released by autoverification. The abnormal characteristics and unacceptable Delta check of the specimens also need to be concerned at the same time.The false negative rate and false positive rate, true negative rate, true positive rate and pass correct rate of autoverification were verified and compared with the rate of the second phase verification when the autoverification rule was established. The false negative rate, false positive rate, true negative rate and true positive rate of the Delta check rule which 54 716 specimens touched were calculated and compared with the second phase verification rate when the autoverification rule was established.The results of microscopic examination were used as the gold standard for the calculation of the rates, and P<0.05 was considered as a significant difference. The false positive and true positive of 1 012 autoverification rules were analyzed item by item.The false positive and true positive of 108 specimens which touched blast cell autoverification rule were analyzed terms by terms. The mean TAT and median TAT of 528 010 specimens and 193 750 outpatient specimens were calculated respectively, and the report percentages of 528 010 samples that TAT<30, 30-60　and>60 min were calculated respectively. Analyze and evaluate the application suitability of autoverification rules to juge whether they meet the needs of doctors and laboratory. The design process and the rules and application process of autoverification were optimized and improved.Results:The autoverification pass rate was 63.06% (332 971/528 010), the interception rate was 36.94% (195 039/528 010). The false negative rate was 1.00% (1/600), the false positive rate was 12.67% (76/600), the true negative rate was 49% (294/600), the true positive rate was 37.33% (224/600), and the correct rate was 98% (294/300). The pass rate, true negative rate, true positive rate and correct rate of the periodic reverification group were higher than the second phase verification group, the false negative rate and false positive rate were lower than that the second phase verification group. The false negative rate and true positive rate of the Delta check of periodic verification group were lower than that the second phase verification group, the false positive rate and true negative rate were higher than the second phase verification group, there were significant differences in the comparition results. The mean TAT of 528 010 specimens was25 min, and the median TAT was 22 min. The mean TAT of 193 750 outpatient specimens was 23 min, and the median TAT was 20 min. The report percentages of 528 010 samples that TAT<30 min, 30 min-60 min and>60 min were 83.30% (439 819/528 010), 8.00% (42 250/528 010) and 8.70% (45 941/528 010), respectively.Conclusion:The results of periodic revalidation of autoverification after 1 years application show that the 15 items and 43 terms autoverification rules of blood analysis could meet requirements about the accuracy and efficiency of the laboratory, and have a good suitability for application.

Analysis on the age of menarche and associated factors of Han, Zhuang and Yao nationality female students in Guangxi / 中国学校卫生

Objective@#To explore age of menarche and associated factors of Han nationality, Zhuang nationality and Yao nationality girl in Guangxi, and to provide reference for the development of adolescent health education in schools.@*Methods@#The 7-, 10- and 13-year-old girls of Han, Zhuang, Yao nationality were chosed from three counties of Guangxi, and height, weight and other physical indicators were measured for three consecutive years, and age of menarche was inquired. 448 cases of with compete data in the three consecutive years of monitoring. The influencing factors were investigated through questionnaire.@*Results@#Age of menarche of the whole sample was 11.83(95%CI=11.69-11.96)years old, and that of the Han, Zhuang,Yao nationality was 11.87(95%CI=11.64-12.09), 11.44(95%CI=11.25-11.64)and 12.42(95%CI=12.14-12.70)years old respectively, the difference was statistically significant(P<0.05). Height, sitting height, weight of menarche group in 12 and 13 years old were significantly higher those of the group without menarche(P<0.05). Logistic regression analysis primary sitting height,the chest circumference,intake of seafood,duration of sleep in the night and school exercise time were the primary factors for age at menarche(P<0.01).@*Conclusion@#There are ethnic differences in age of menarche among girls in Guangxi, and it is related to sleep,physical activity and dietary structure. Puberty recated health education for girls might start at the fourth grade of primary school, focusing on the education of health life patten, balanced dietary habits, regularly routine, with the goal of growth and development promotion.

Study on Anti-synovial Angiogenesis Mechanism of Licorice and Aconite Decoction in the Treatment of Adjuvant Arthritis Model Mice / 中国药房

OBJECTIVE： To investigate the therapeutic effect of Licorice and aconite decoction in the treatment of adjuvant arthritis （AA） model mice through anti-synovial angiogenesis pathway. METHODS： Totally 48 male Balb/c mice were randomly divided into normal group， model group， Licorice and aconite decoction group and tripterygium glycosides group （positive drug group）， with 12 mice in each group. Except for normal group， AA model was established by intradermal injection of Freund’s complete adjuvant into the left hind toe of mice. 12 d after modeling， normal group and model group were given same volume of water intragastrically； Licorice and aconite decoction group （7.8 g/kg，by total amount of crude drug） and tripterygium glycosides group （0.01 g/kg） were given relevant medicine 20 mL/kg intragastrically， once a day， for consecutive 18 d. The joint lesions of mice were observed and recorded， and the foot swelling degree of mice was measured by water volume method. HE staining was used to observe the pathological change of ankle joint in mice. The protein levels of platelet endothelial cell adhesion molecule-1 （CD31） and vascular endothelial growth factor （VEGF） were determined by immunofluorescence assay. The protein expressions of nuclear factor κB（NF-κB） and zinc finger transcription factor GATA4 （GATA4） were detected by Western blotting assay. RESULTS： Compared with normal group， ankle joint of model group mice was markedly reddened and swollen， and foot swelling degree increased significantly （P＜0.05）. Synovial tissue of ankle joint proliferated， pannus increased significantly， and a large number of inflammatory cells and joint erosion were observed. The protein expression of CD31， VEGF， NF-κB and GATA4 in synovial tissue of mice were increased significantly （P＜0.05）. Compared with model group， the redness and swelling of ankle joint in mice were alleviated， and the foot swelling degree was significantly reduced in Licorice and aconite decoction group （P＜0.05）. Pannus in synovial tissue decreased and other pathological symptoms were improved. The protein expression of CD31， VEGF， NF-κB and GATA4 were decreased significantly in synovial tissue （P＜0.05）. CONCLUSIONS： Licorice and aconite decoction can decrease the protein expression of VEGF，NF-κB and GATA4 in synovial tissue， reduce the generation of pannus in synovial tissue and effectively inhibit the angiogenesis in synovial tissue so as to prevent bone destruction and protect joint of AA model mice.

Paeoniflorin inhibits activation of raw 264.7 macrophages induced by high glucose via JAK2/STAT3 signaling pathway / 中国药理学通报

Aim To investigate whether paeoniflorin ( PF) inhibits the activation of RAW 264. 7 macropha-ges induced by high glucose (HG) via JAK2/STAT3 signaling pathway. Methods RAW264. 7 macrophages were cultured in vitro. HG was used as the stimulator. PF and JAK2/STAT3 gene silencing interfered with macrophage activation. All cells were divided into nine groups; LG, HG, HG + PF, LG + JAK2 siRNA, JAK2 siRNA + HG, JAK2 siRNA + HG + PF, LG + STAT3 siRNA,STAT3 siRNA + HG,STAT3 siRNA + HG + PF. Macrophage proliferation, chemotaxis, expression and secretion of inflammatory cytokines, J A K2 and STAT3 protein expression and the phosphorylation levels were detected respectively. Results Compared with LG group,in HG group,the macrophages' chcmo- taclic function significantly increased {P <0. 05) ,the mRNA expression of iNOS,TNF-a, IL-lp and MCP-1 and the secretion of inflammatory cytokines (TNF-a, IL-IP,MCP-1) in cell culture medium were markedly elevated ( P < 0. 05 , P < 0. 01 ) , and the phosphorylation of JAK2 and STAT3 protein significantly increased ( P < 0. 05 ). JAK2 and STAT3 gene silencing could suppress the HG-induced the mRNA expression of iN- OS,TNF-a, 1L-IP and MCP-1 and the secretion inflammatory cytokines in cell culture medium as well as the phosphorylation of JAK2 and STA'13 protein ( P < 0. 05,/' <0. 01 ). PF could significantly inhibit HG-induced macrophage chemokine and migration,inflammatory cytokine production and secretion, and JAK2, STAT3 protein phosphorylation (/'<0. 01). Conclusion HG can stimulate macrophage activation by inducing JAK2/STAT3 signaling pathway,and PF inhibits the activation of Raw 264. 7 macrophages induced by high glucose via JAK2/STAT3 pathway suppression.

Effect of Gancao Fuzitang on Synovial Fibroblast-like Cell Proliferation in Adjuvant Arthritis Mice Model / 中国实验方剂学杂志

Objective:To investigate the effect of Gancao Fuzitang on the proliferation of fibroblast-like synoviocytes (FLS) in synovial tissue of mice with adjuvant-induced arthritis (AA). Method:The 48 male Balb/c mice were randomly divided into 4 groups:normal control group, model group(arthritis induced through injection with adjuvant), Gancao Fuzitang group and triptolide group. The normal control group and the model control group were orally given physiological saline. After the successful modeling, the mice of the other two groups were treated with Gancao Fuzitang or triptolide orally for 18 days. Then the animals were euthanized, the paw edema of the animals was measured, and arthritic ankles were observed by histological examination. Tumor necrosis factor (TNF)-α was examined by immunoassays. The proliferation of synovial cells of foot joints was detected by immunohistochemical expressions of Vimentin. The expressions of Cyclin D1, proliferating cell nuclear antigen (PCNA), p53 and p21 were detected by Western blot. Result:Compared with the normal control group, the mice of synovial hyperplasia and bone erosion in model group were obvious. The joint swelling degree, TNF-α level and proliferation of FLS were increased (P1,PCNA were up-regulated(PPα, cell cycles (Cyclin D1 and PCNA), and increased protein expressions of p53 and p21 (PConclusion:Gancao Fuzitang has a therapeutic effect on AA mice, and the mechanism might be associated with its anti-inflammatory effect and the effects in regulating Cyclin D1, PCNA, p53 and p21 expressions and inhibiting FLS proliferation.

Effect of enterostomy on analgesic pattern in patients with advanced digestive tract cancer / 中华胃肠外科杂志

Objective@#To explore the effect of enterostomy on analgesic pattern in advanced digestive tract cancer.@*Methods@#A retrospective cohort study was carried out, which was approved by the Ethics Committee of the Sixth Affiliated Hospital of Sun Yat-sen University (E2018026). Inclusion criteria were as follows: (1)age and gender were not limited; (2) all the gastrointestinal malignancies were confirmed histologically, and local recurrence or metastasis were confirmed by CT or MR; (3) numerical rating scale (NRS) ≥4 points, opioid analgesic drugs were required; (4) informed consents were signed by patients of their own. Exclusion criteria were as follows: (1) malignancies of early stage; (2) suspicious adverse mental states which might lead to poor administration compliance; (3) hypersensitivity or allergic reactions to opioids. Clinical data of patients with advanced gastrointestinal cancer receiving comprehensive treatment at the Medical Oncology Department of the Sixth Affiliated Hospital of Sun Yat-sen University from September 2016 to April 2017 were retrospectively collected. The patients were divided into the stoma group and the non-stoma group. The clinical findings of two groups were analyzed, including age, sex, ostomy status, pain location, presence or absence of intestinal obstruction, pain characteristics, selection of opioid analgesic agents, treatment of side effects of analgesics. Pain was assessed using brief pain inventory(BPI) table and NRS score. Strong opioids were prescribed for patients of NRS ≥4. Patients who were intolerant to opioids required opioid titration. The titration drugs included oral or IV morphine and oxycodone. After achievement of adequate pain control, long-acting opioids were administered, which included sustained-release morphine tablets, controlled release oxycodone and transdermal fentanyl. Criteria for pain relief included NRS≤3, breakthrough pain <3 times/day and duration of adequate pain control >3 days. The χ2 test and the Wilcoxon signed rank sum test (nonparametric test) were used to analyze the clinical features of patients in the stoma and non-stomach groups. In order to find the factors associated with maintenance therapy and the use of laxatives, the variables were compared as well as in multivariate analysis with multiple regression models. For all the statistical tests, a value of P<0.05 in a two-tailed test was established as the alpha significance level.@*Result@#A total of 123 patients were enrolled in this study, including 79 males (64.2%) and 44 females (35.8%) with a median age of 51 years. Fifty-two patients were in stoma group, including 30 (24.4%) of ileostomy and 22 (17.9%) of colostomy, and 71 patients were in non-stoma group. Pain of 40 (76.9%) patients in stoma group located in abdomenopelvic site while the pain of 44 (62.0%) patients in non-stoma group located in other sites. Compared with non-stoma group, cases in stoma group complained more abdominopelvic pain (73% vs. 62.0%, P<0.001).The median NRS pain score before treatment in the stoma group and the non-stoma group was 5.7 and 5.6, respectively, without statistically significant difference (P=0.741). After analgesic management, the above scores reduced to 2.1 and 2.3, respectively, without statistically significant difference as well (P=0.092). Analgesic treatment was effective in 111 cases (90.2%), including 49 cases (94.2%) in the stoma group, and 62 cases (87.3%) in the non-stoma group, and there was no statistically significant difference between the two groups (P=0.202). There was more application of fentanyl transdermal patch [34.6%(18/52) vs. 9.8%(7/71)] in the stoma group, while more application of lactulose laxative [78.9%(56/71) vs. 61.5%(32/52)](χ2=10.023, P=0.002) in the non-stoma group. Multivariate analysis revealed that ostomy (OR=0.290, 95%CI: 0.102-0.824, P=0.009) and pain site (OR=5.691, 95%CI:1.709-18.948, P=0.005) were independent factors affecting the choice of the first line opioid sustained release agent. Of the 123 patients with maintaining analgesia, 98 had available data of laxative use, of whom 46 used laxatives to prevent or treat constipation, and the proportion of laxatives in stoma group (21.2%, 11/52) was significantly lower than that in non-stoma group (49.3%, 35/71) (χ2=6.957, P=0.008). Multivariate analysis of the application of laxative use showed that age (OR=0.281, 95% CI: 0.123-0.684, P=0.010) and ostomy (OR=2.621, 95% CI: 1.033-6.687, P=0.045) were independent factors affecting the use of lactulose laxatives.@*Conclusions@#Enterostomy may affect the analgesic pattern in advanced digestive tract cancer. Patients with stoma are more likely to use fentanyl transdermal patches and younger patients with stoma do not need prophylactic use of laxatives.

Epidemiological analysis on mortality of cancer in China, 2015 / 中华流行病学杂志

Objective To understand the distribution of cancer deaths in China in 2015 and provide reference for the prevention and control of cancer.Methods Based on the results of Global Burden of Disease 2015,the cancer death distributions in different age groups,sex groups,provinces or by different malignant tumor in Chinese were described.Results The age-standardized mortality rate of cancer was 159.01/100 000 in China in 2015.The mortality rate was highest in age group ≥70 years (1 102.73/100 000),and lowest in age group 5-14 years (5.40/100 000).The mortality rate in males was 2.15 times higher than that in females.The first 5 provinces with high cancer mortality rate were Anhui,Qinghai,Sichuan,Guangxi and Henan.Lung cancer,liver cancer,stomach cancer,esophageal cancer and colorectal cancer ranked 1-5 in term of mortality rate.Conclusion The cancer mortality differed with age,gender,area and different malignant tumors,suggesting the necessity to develop targeted prevention and control strategies.

Epidemiological analysis on mortality of cancer in China, 2015 / 中华流行病学杂志

Objective To understand the distribution of cancer deaths in China in 2015 and provide reference for the prevention and control of cancer.Methods Based on the results of Global Burden of Disease 2015,the cancer death distributions in different age groups,sex groups,provinces or by different malignant tumor in Chinese were described.Results The age-standardized mortality rate of cancer was 159.01/100 000 in China in 2015.The mortality rate was highest in age group ≥70 years (1 102.73/100 000),and lowest in age group 5-14 years (5.40/100 000).The mortality rate in males was 2.15 times higher than that in females.The first 5 provinces with high cancer mortality rate were Anhui,Qinghai,Sichuan,Guangxi and Henan.Lung cancer,liver cancer,stomach cancer,esophageal cancer and colorectal cancer ranked 1-5 in term of mortality rate.Conclusion The cancer mortality differed with age,gender,area and different malignant tumors,suggesting the necessity to develop targeted prevention and control strategies.

Study on the Data Mining of Prescription Rules of Chinese Medicine Compound in Treating Liver Cirrhosis Based on the Theory of Toxin, Phlegm, Blood Stasis and Deficiency / 世界科学技术-中医药现代化

Objective: To explore the prescription rules in treating liver cirrhosis's based on poison phlegm blood stasis and deficiency. Method: Clinical data of patients, who had been diagnosed with liver cirrhosis, was gathered. The data had been extracted, transformed and loaded through data integration and remittance, then, the data was analyzed by data classification, association, clustering and other large data analysis methods. Results: The prescription rules based on poison phlegm blood stasis and deficiency showed that according to medication frequency, detoxification drugs commonly used ArtemisiacapillarisThunb, Coptis chinensis Franch, Forsythia suspensa, Hedyotis diffusa Willd, and Scutellaria baicalensis Georgi, eliminating phlegm drugs commonly used Semen Coicis, Citrus aurantium L, Pinellia ternate, Pericarpium Citri Reticulatae and Trichosanthes kirilowii Maxim, removeing blood stasis drugs commonly used Radix Salviae Miltiorrhiae, Radix Curcumae, Rhizoma Curcumae, Herba Lycopi and Pollen Typhae, reinforcing deficiency drugs commonly used Poria, Carapax Trionycis, Rhizoma Atractylodis Macrocephalae, Radix Astragali seu Hedysari and Radix Codonopsis (Radix Pseudostellariae) . The selection of herbal medicine for poison in traditional Chinese medicine (TCM) is not only cold in property, bitter in flavor, but also converges to liver, gallbladder, spleen and stomach channel.The selection of herbal medicine for phlegm in TCM is not only warm in property, pungent in flavor, but also converges to spleen and lung channel. The selection of herbal medicine for blood stasis in TCM is not only cold in property, bitter in flavor, but also converges to liver, heart and spleen channel. The selection of herbal medicine for deficiency in TCM is not only mild in property, sweet in flavor, but also converges to spleen, liver and kidney channel. Conclusion: The syndrome differentiation and treatment of liver cirrhosis in Liver Institute of Hubei Provincial Hospital of Traditional Chinese are mainly based on poison phlegm blood stasis and deficiency.

Analysis of Direct Economic Burden and Average Hospitalization Cost of Lung Cancer in China in 2011 -2015 / 中国卫生统计

Objective To analyze the direct economic burden and average hospitalization cost of lung cancer in China from 2011 to 2015, to provide data support for the prevention and control of lung cancer and health insurance policies. Methods By using inpatient medical record home page dataset to estimate the total hospital expenses of lung cancer. Using the outpatient hospitalization cost ratio of cancer specialized hospitals to estimate the overall medical expenses of lung cancer. Based on the inpatient medical record home page dataset, and analyzed the average hospitalization cost of lung cancer. Results The total cost of lung cancer in China reached 24.31 billion yuan in 2015, accounting for about 0.6％ of the total health expenses; from 2011 to 2015, lung cancer medical costs have concentrated in the grade 3 general hospitals; people over 60 consumed the major medical costs of lung cancer and the proportion was still rising year by year; the average hospitalization cost of lung cancer was reduced in 2015; drug proportion in various hospitals declined steadily from 2011 to 2015; the average hospitalization cost was the highest in the 18 -40 age group. Conclusion The effect of health care reform was gradually revealed, and the increase of medical expenses was controlled within the tolerable range. Notably, we should accelerate the improvement of the price compensation mechanism, and at the same time, we should aim to improve the level of catastrophic health care for the elderly.

Antihepatocarcinoma effect of Celecoxib by inhibiting COX-2 and PD-1 / 中国免疫学杂志

Objective:To investigate the role of celecoxib in inhibiting liver cancer and to explore the potential molecular mech-anisms.Methods:A total of 65 cases of patients with primary hepatocellular carcinoma(HCC) underwent surgical treatment in our hospital from February 2012 to June 2016 were recruited as study object.Another 15 cases of normal liver tissue offered by the department of hepatobiliary surgery were selected as control.Immunohistochemical staining(IHC) was used to detect the expression level of COX-2 and PD-1 in tumor and normal tissue samples.Pearson correlation analysis were used to evaluate the correlation between COX-2 and PD-1 in HCC patients.Construction of H22 hepatoma cells bearing BALB/c mice model,randomly divided them into control group,celecoxib group and PD-1 antibody group(15 mice for each group).Sacrificed all mice alive at the end of the 4th weeks after the treatment and removed the tumors then.The tumor growth curves and survival curves were drawn to observe the anti-tumor effect.IHC were used to evaluate the expression of COX-2,PD-1 as well as the number of CD8+T and foxp3 positive Treg cells in tumor tissue.Flow cytometry were used to determine the number of CD8+T and CD4+CD25+Treg cells in peripheral blood.The peripheral blood mononuclear cell(PBMC) of BALB/c mice were separated and scramble or PD-1 siRNA were transfected then,Western blot analysis were used to detected the level of COX-2,PD-1,CD8 and Foxp3 after the treatment of celecoxib.Results:IHC results showed that the expression level of COX-2 and PD-1 in tumor tissue of HCC patients were significant higher than control(P<0.001).Pearson correlation analysis showed COX-2 were both positive correlated with PD-1 in the tumor tissue of HCC patients(R2=0.673,P<0.001).The tumor growth curves and survival curves in celecoxib or PD-1 antibody groups were significant better than in control group (P<0.05).There were no significant difference of tumor growth curves and survival curves between celecoxib group and PD-1 antibody group(P>0.05).IHC and flow cytometry analysis showed that celecoxib treatment significant decreased the expression level of PD-1(P<0.05).Both celecoxib and PD-1 antibody treatment significant increased the number of CD8+T cells while decreased the number of Treg cells in the tissue or the peripheral blood(P<0.05).Western blot analysis showed that celecoxib significant decreased the level of COX-2,PD-1,CD8 and Foxp3 in PBMCs,while it did not affect the level of CD8 and Foxp3 in PD-1 siRNA transfected PBMCs.Conclusion:The expression level of COX-2 and PD-1 were increased in the tumor tissue of HCC patients.Celecoxib may inhibit liver cancer by regulating PD-1 mediated tumor immune via inhibiting COX-2.

Analysis on safety and preliminary efficacy of dose-modified regimen of 5-fluorouracil plus oxaliplatin and irinotecan (FOLFOXIRI) in advanced colorectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the safety and preliminary efficacy of dose-modified regimen of 5-fluorouracil plus oxaliplatin and irinotecan (mFOLFOXIRI) for patients with advanced colorectal cancer (CRC).</p><p><b>METHODS</b>Data of 312 CRC patients confirmed by pathology receiving triplet drug alone or combined with target therapy between October 2012 and December 2016 at the Sixth Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. CRC patients who had previously completed adjuvant therapy (or neoadjuvant therapy) within 6 months or palliative chemotherapy were excluded, meanwhile those with poor general condition (ECOG score > 2) or grade 2 neuropathy and allergy to oxaliplatin were excluded as well. Regimen of mFOLFOXIRI: oxaliplatin 85 mg/m² dissolved in 5% glucose solution 500 ml by intravenous infusion for 2 h; irinotecan 150 to 165 mg/m² dissolved in 0.9% sodium chloride 250 ml by intravenous infusion for 90 min; following intravenous infusion of leucovorin 400 mg/m² for 2 h, day 1; 5-FU 2800 mg/m², 48-h continuous intravenous infusion; once every 2 weeks. Therapy could be combined with a targeted drug, bevacizumab 5 mg/kg every two weeks; cetuximab 500 mg/m² every two weeks. Side effect was graded using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE 4.0.3). The objective response rate was evaluated according to the Response Evaluation Criteria in Solid Tumors (RECIST 1.1) after administering at least four cycles of chemotherapy.</p><p><b>RESULTS</b>The median age was 52 years (range 16-73) in the whole group; 113 patients (36.2%) had locally advanced CRC, and 199 (63.8%) had metastatic CRC. Most patients (274/312, 87.8%) did not receive any treatment earlier. There were a total of 1651 chemotherapy cycles in the whole group, with a median of 6(1-19) cycles. Of these 1651 cycles, 124 cycles of chemotherapy(7.5%) were dose-adjusted; 176 cycles of chemotherapy(10.7%) were delayed for median 5(3-13) days; 124 cycles(7.5%) required dose decrease. The overall relative dose intensity was >90%; the specific drug dose intensity was 93.6%(2620 mg×m⁻²×d⁻¹) for fluorouracil, 97.8%(83 mg×m⁻²×d⁻¹) for oxaliplatin, and 94.2%(155 mg×m⁻²×d⁻¹) for irinotecan. Twenty-three patients (7 of intestinal perforation, 7 of intestinal obstruction, 1 of grade 4 hematologic toxicity, and 8 of grade 3 fatigue) refused subsequent chemotherapy due to intolerable toxicity. Main grade 3 or 4 adverse events in patients were neutropenia in 69 cases (22.1%), fatigue in 35 cases (11.2%), and anemia in 28 cases (8.9%). Twenty serious adverse events (6.4%) occurred, including 13 patients of febrile neutropenia (4.2%), 7 patients of intestinal perforation (2.2%, 4 patients in upper rectum, 2 in sigmoid colon, and 1 in transverse colon cancer), and 9 of them had subsequent sepsis (2.9%). All the patients with intestinal perforation underwent emergency operation. No treatment-related deaths occurred. In 199 patients with metastatic CRC, because 22 patients did not receive image evaluation, the preliminary efficacy of 177 patients was actually evaluated. A total of 113 objective response events were observed. The overall response rate was 63.8%(113/177), partial response rate was 61.6%(109/177), clinically complete response rate was 2.3%(4/177), stable disease was 29.9% (53/177), progressive disease was 6.2%(11/177), and the disease control rate was 93.8%(166/177). In 127 patients receiving triplet drug, objective response rate was 40.9% for those with less than four cycles and 81.1% for those with more than four cycles (P<0.001).</p><p><b>CONCLUSION</b>The mFOLFOXIRI regimen with reduced dose can be safely used in advanced CRC and has achieved promising results in terms of short-term efficacy.</p>

Deaths and life expectancy losses attributable to diet high in sodium in China / 中华流行病学杂志

Objective To quantitatively estimate the deaths and life expectancy losses attributable to diet high in sodium in China,and examine the gains and shifts under different control scenarios of sodium consumption.Methods Based on data from the cause-of-death through the National Mortality Surveillance System,and 24 hours urinary sodium values from Global Burden of Disease study on Chinese's estimates,population attributable fractions with the framework of comparative risk assessment were used to analyze the deaths and life expectancy losses due to diet high in sodium.The same methods were followed to examine the gains and shifts under different control scenarios of sodium consumption.Results In 2013,1 430 (940 for men and 490 for women)thousand deaths were attributable to diet high in sodium,accounting for 15.6％ (17.4％ for men and 13.0％ for women) of all-cause deaths in China,which causing 2.17 (2.49 for men and 1.71 for women) years of life expectancy loss.Diet with high sodium in 2013 caused 1 200,50 and 180 thousand deaths from cardiovascular disease,chronic kidney disease and stomach cancer respectively,accounting for 31.5％,30.8％ and 64.8％ of those specific causes.Comparing to the baseline in 2013,if the targets of 10％ decrease of sodium consumption by 2020 and 15％ by 2030 for Chinese chronic disease prevention and treatment planning,and 30％ decrease by 2030 for WHO non-communicable disease monitoring framework are achieved,220,340 and 730 thousand deaths will be averted,which may gain 0.30,0.45 and 0.95 years of life expectancy,respectively.Conclusions As one of the leading risk factors,diet high in sodium had caused heavy burden of disease from cardiovascular disease,chronic kidney disease and stomach cancer on Chinese residents.Intervention programs on sodium-reductionare urgently needed in China and related cost-effectiveness is highly expected.

Life expectancy and influence on disease in China, 2013 / 中华流行病学杂志

Objective To analyze the characteristics of life expectancy and influencing factors in Chinese population in different areas and provide scientific evidence for policy-making on disease managements,medical care and risk factor intervention.Methods Based on the national census data from National Bureau of Statistics and the death registration data from the National Health and Family Planning Commission,we used exponential model,under-report adjustment model and abbreviated life tables to estimate the life expectancy and influence on disease in Chinese population in 2013.Results The Chinese life expectancy was 75.8 years in 2013,1 year higher than that in 2010.The life expectancy in urban area was 77.4 years,while it was 75.1 years that in rural area with the gap between the rural area and urban area was 2.3 years.The life expectancy was 77.2 years in the eastern area,75.8 years in middle area and 73.5 years in western area,the gap between the east and west was 3.6 years.In 2013,the first 10 leading diseases causing the life expectancy lost were cerebrovascular disease,ischemic heart disease,chronic obstructive pulmonary disease,lung cancer,road injury,liver cancer,stomach cancer,hypertensive heart disease,lower respiratory infection,esophagus cancer,resulting in 7.97 years of life expectancy lost.Conclusion The life expectancy in Chinese has already reached a relative high level,while the gap between different areas still exists.Different policies on disease management,medical care and risk factor interventions targeting different areas are needed to increase the life expectancy and improve the quality of life.

Deaths and life expectancy losses attributable to diet high in sodium in China / 中华流行病学杂志

Objective To quantitatively estimate the deaths and life expectancy losses attributable to diet high in sodium in China,and examine the gains and shifts under different control scenarios of sodium consumption.Methods Based on data from the cause-of-death through the National Mortality Surveillance System,and 24 hours urinary sodium values from Global Burden of Disease study on Chinese's estimates,population attributable fractions with the framework of comparative risk assessment were used to analyze the deaths and life expectancy losses due to diet high in sodium.The same methods were followed to examine the gains and shifts under different control scenarios of sodium consumption.Results In 2013,1 430 (940 for men and 490 for women)thousand deaths were attributable to diet high in sodium,accounting for 15.6％ (17.4％ for men and 13.0％ for women) of all-cause deaths in China,which causing 2.17 (2.49 for men and 1.71 for women) years of life expectancy loss.Diet with high sodium in 2013 caused 1 200,50 and 180 thousand deaths from cardiovascular disease,chronic kidney disease and stomach cancer respectively,accounting for 31.5％,30.8％ and 64.8％ of those specific causes.Comparing to the baseline in 2013,if the targets of 10％ decrease of sodium consumption by 2020 and 15％ by 2030 for Chinese chronic disease prevention and treatment planning,and 30％ decrease by 2030 for WHO non-communicable disease monitoring framework are achieved,220,340 and 730 thousand deaths will be averted,which may gain 0.30,0.45 and 0.95 years of life expectancy,respectively.Conclusions As one of the leading risk factors,diet high in sodium had caused heavy burden of disease from cardiovascular disease,chronic kidney disease and stomach cancer on Chinese residents.Intervention programs on sodium-reductionare urgently needed in China and related cost-effectiveness is highly expected.