A study on knowledge, attitude, and vaccination behavior of herpes zoster vaccine among urban residents in selected areas of China / 中华流行病学杂志

Objective: To understand the knowledge, attitude, and current status of vaccination of herpes zoster vaccination among urban residents aged 25 years and above in China. Methods: In August to October 2022, a convenience sampling method was used to survey residents aged 25 years and above at 36 community centers in 9 cities across China. Questionnaires were used to collect basic information, knowledge, and attitude toward herpes zoster and its vaccination, as well as vaccination status and reasons for non-vaccination among residents. Results: A total of 2 864 urban residents were included in the study. The total score of residents' cognition of herpes zoster and its vaccine was 3.01±2.08, and the total score of their attitude was 18.25±2.76. Factors such as being male (β=-0.45, P<0.001), older than 40-59 years (β=-0.34, P=0.023) or ≥60 years (β=-0.68, P<0.001), married (β=-0.69, P=0.002) were negatively associated with knowledge score. The educational level of high school or secondary school (β=0.44, P=0.036), college (β=0.65, P=0.006), bachelor's degree and above (β=1.20, P<0.001), annual net household income ≥120 000 Yuan in 2021 (β=0.42, P=0.020), having urban employee medical insurance (β=0.62, P=0.030), having public or commercial medical insurance (β=0.65, P=0.033), and having a history of chickenpox (β=0.29, P=0.025) were positively associated with knowledge scores. Being male (β=-0.38, P=0.008) and not remembering a history of chickenpox (β=-0.49, P=0.012) were negatively associated with attitude scores. Annual net household income in 2021 was between 40 000-80 000 Yuan (β=0.44, P=0.032) or between 80 000-120 000 Yuan (β=0.62, P=0.002) or ≥120 000 Yuan (β=0.93, P<0.001), and a history of herpes zoster (β=0.59, P=0.004) were positively associated with attitude scores. Of the 2 864 residents surveyed, only 29 (1.01%) had received the herpes zoster vaccine, with a vaccination rate of 1.70% for those aged 50 years and above, with the main reason for non-vaccination being lack of knowledge about the herpes zoster vaccine, followed by the high price. 42.67% of the population said they would consider getting the herpes zoster vaccine in the future. Conclusion: Low knowledge of herpes zoster and its vaccine, positive attitudes towards the preventive effects of herpes zoster and its vaccine, and extremely low vaccination rates among the urban population in China call for multiple measures to strengthen health education and vaccination recommendations for residents, especially for the elderly, low-education and low-income populations.

Pregnancy outcomes of 532 cases of preeclampsia / 解放军医学杂志

Objective To investigate the pregnancy outcome of patients with preeclampsia (PE). Methods The data of 26 206 pregnant and lying-in women were retrospective analyzed who gave birth in Daping Hospital of the Army Medical University from Jan. 1, 2013 to Apr. 30, 2019, diagnosed with the 8th and 9th version of gynecology and obstetrics textbook. Excluding 62 cases of diabetes combined pregnancy, 445 cases of hypothyroidism combined pregnancy, 180 cases of polyhydramnios, 1592 cases of macrosomia (≥4 kg), 89 cases of chronic hypertension with PE, and 629 cases of multifetation. The remaining 23 209 cases, according to the final diagnosis, were divided into PE group (532 cases) which was divided again into mild-PE group (134 cases) and severe-PE groups (398 cases), and the 22 677 remainders acted as the control group. The age, gestational weeks, number of births, mode of delivery, pregnancy complications and neonatal status in the three groups were compared, and the thyroid function among the groups was analyzed in detail. Results The proportion of elderly parturients was higher in both mild-PE group (29.2%) and severe-PE groups (20.6%) than that in control group (12.4%). The rates of premature delivery and cesarean section were higher in both mild-PE group (19.7% and 55.0%) and severe-PE groups (70.1% and 94.2%) than those in control group (10.0% and 48.2%). The incidences of hypothyroidism during pregnancy, intrahepatic cholestasis of pregnancy (ICP) and infants younger than gestational age were higher in both mild-PE group (26.9%, 10.5% and 7.5%) and severe-PE groups (23.9%, 9.3% and 22.1%) than those in control group (17.5%, 3.5% and 2.9%); The incidences of placental abruption and stillborn foetus were obviously higher in severe-PE group (3.8% and 7.3%) than those in control group (0.6% and 0.7%). The incidence of gestational diabetes was significantly higher in mild-PE group (41.8%) than that in control group (30.0%), and of umbilical cord around neck was significantly lower in severe-PE group (17.6%) than that in control group (25.1%). Conclusions The incidences of complications and therapeutic premature delivery in PE patients is increased. Hypothyroidism during pregnancy is a potential risk factor and should be strenuously supervised.

Analysis of the financing policy of integrating NCMS and URBMI:Based on the perspective of equity / 中国卫生政策研究

Objectives:This paper intends to analyze the financing policies of integrating NCMS and URBMI in terms of equity. Methods:Data on the financing of NCMS and URBMI from 2008 to 2015 were collected from the China health statistics yearbook (2009—2012) the China health and Family Planning Statistics yearbook(2013—2016),the National Handbook of NCMS Information(2008—2015),the China human resources and social security statistics year-book (2009—2016),and the China social security yearbook(2009—2015)."Ability to pay"approach was introduced to measure the inequity in health financing of medical insurance for urban and rural residents. The proportion of indi-vidual contributions as to NCMS and URBMI as a percentage of the per capita disposable income was used as an actual indicator to analyze the equity in health financing between rural and urban residents. Results:The URBMI had a finan-cing mechanism that was similar to that used by NCMS in that public finance accounted for more than three quarters of the pooling funds,and the individual contribution accounts for less than? of the per capita contribution amount. The scale of financing for NCMS was less than 5% of the per capita net income of rural residents and less than 2% of the per capita disposable income of urban residents for URBMI. Individual contributions to the NCMS and URBMI funds were less than 1% of their disposable and net incomes. The disparities in health financing between urban and rural resi-dents in China was not improved as expected with the introduction of NCMS and URBMI. Conclusions:The proportion of individual contributions to the URBMI and NCMS funds were small in terms of contributors'incomes. The equal financing per capita for URBMI and NCMS masks the inequality of urban and rural residents in the financing of medical insurance.

Economic burden and related factors on inpatients with HBV-related diseases in Shandong province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the economic burden of patients with acute and chronic hepatitis B, cirrhosis and liver cancer caused by hepatitis B virus (HBV).</p><p><b>METHODS</b>Cluster sampling was used on cases consecutively collected during the study period. Questionnaire survey was conducted and information on the expenses during hospitalization was collected from the hospital records and through interviewing those patients.</p><p><b>RESULTS</b>Yearly costs related to patients with acute hepatitis B, severe hepatitis B, chronic hepatitis B, cirrhosis, hepatocellular carcinoma were 66.7, 138.1, 127.4, 151.7 and 377.2 thousand Yuan, respectively.</p><p><b>RESULTS</b>from multiple linear regression model showed that the type of medical insurance scheme, annual days of hospitalization, classifications of HBV-related diseases and personal income were major influencing factors on the cost.</p><p><b>CONCLUSION</b>HBV infection caused considerable burden to families and the society, indicating that HBV infection control programs would bring huge potential benefits. The reform of insurance scheme should be administrated to promote social fairness.</p>

Single-lung transplantation for end-stage emphysema / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate operative technique, patient selection and perioperative management of single-lung transplantation for a patients with end-stage emphysema.</p><p><b>METHODS</b>A 56-year-old patient with end-stage emphysema underwent left-lung transplantation on September 28, 2002. The surgical technique used was similar to that mentioned in the literature. The donor lung was perfused by LPD solution with a cold ischemic time of 260 minutes. Cardiopulmonary bypass was not performed.</p><p><b>RESULTS</b>The patient weaned from a ventilator at the 93th hour after operation. Immunosuppressants included cyclosporine, mycophenolate mofetil and corticosteroid. Acute rejection occurred on the ninth day after operation and was cured by bolus methylprednisolone given intravenously. Lung function was improved significantly and the patient was discharged from the hospital on the 47th day after operation.</p><p><b>CONCLUSION</b>Single-lung transplantation for patients with end-stage emphysema is effective for long-term improvement of pulmonary function.</p>