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Since the outbreak of the COVID-19 global pandemic in 2019, monitoring COVID-19 infection status and trend through wastewater, known as wastewater-based epidemiology (WBE), has been widely used in many countries and regions. WBE consists of five steps:wastewater sample collection, viral concentration, viral nucleic acid extraction, quantification of virus using quantitative RT-PCR, and dissemination of the wastewater surveillance results. This method could be used for early warning of COVID-19 outbreak in a population, monitoring COVID-19 distributions and epidemic trend, prediction of COVID-19 prevalence rate, understanding of temporal trend of SARS-COV-2 variants, and simultaneous surveillance of multiple pathogens. WBE and clinical surveillance can be used concurrently and the former is a good complement to the latter.
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BackgroundAustralia implemented an mRNA-based booster vaccination strategy against the COVID-19 Omicron variant in November 2021. We aimed to evaluate the effectiveness and cost-effectiveness of the booster strategy over 180 days. MethodsWe developed a decision-analytic Markov model of COVID-19 to evaluate the cost-effectiveness of a booster strategy (administered 3 months after 2nd dose) in those aged [≥]16 years in Australia from a healthcare system perspective. The willingness-to-pay threshold was chosen as A$ 50,000. FindingsCompared with 2-doses of COVID-19 vaccines without a booster, Australias booster strategy would incur an additional cost of A$0.88 billion but save A$1.28 billion in direct medical cost and gain 670 quality-adjusted life years (QALYs) in 180 days of its implementation. This suggested the booster strategy is cost-saving, corresponding to a benefit-cost ratio of 1.45 and a net monetary benefit of A$0.43 billion. The strategy would prevent 1.32 million new infections, 65,170 hospitalisations, 6,927 ICU admissions and 1,348 deaths from COVID-19 in 180 days. Further, a universal booster strategy of having all individuals vaccinated with the booster shot immediately once their eligibility is met would have resulted in a gain of 1,599 QALYs, a net monetary benefit of A$1.46 billion and a benefit-cost ratio of 1.95 in 180 days. InterpretationThe COVID-19 booster strategy implemented in Australia is likely to be effective and cost-effective for the Omicron epidemic. Universal booster vaccination would have further improved its effectiveness and cost-effectiveness. FundingNational Natural Science Foundation of China. Bill and Melinda Gates Foundation
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【Objective】 To explore the relationship of health literacy with COVID-19 prevention and control knowledge， attitude and practice （KAP） in general population so as to contribute scientific evidence for strengthening health education and promoting health literacy to resist the threat of major infectious disease outbreaks. 【Methods】 In September 2020， a questionnaire survey was conducted in residents selected by a multi-stage random sampling across all the twelve counties/districts of Baoji city. The questionnaire， which was issued by the Chinese Health Education Center， consisted of a health literacy questionnaire and a COVID-19 prevention and control KAP questionnaire. According to the national unified scoring method， the participants were divided into two groups： those who met and those who failed to meet the overall standard of health literacy. The results of the answer to each KAP question were compared between the two groups by Chi-square test or rank sum test. Multivariate binary Logistic regression was used to control confounding effects of socio-demographic characteristics to draw relatively reliable conclusions. 【Results】 A total of 4 544 valid questionnaires were collected， in which 664 （14.60%） met the overall standard of health literacy， but 3 880 （85.40%） failed to do so. Compared with the unmet group， the met group had a higher correct answer rate in 10 of the 11 knowledge-related questions （all P<0.001）； showed more positive answer to each attitude-related question in the three aspects， namely， responsibility for the prevention and control of infectious disease transmission， evaluation for COVID-19-related information release and reporting， and evaluation for the government’s COVID-19 prevention and control results （all P<0.001）； and acted more actively in 6 of the 7 practice concerning appropriate self-prevention and control behaviors during the COVID-19 outbreak （all P<0.001）. Logistic regression analyses confirmed that achieving the overall standard of health literacy played a positive role in each of the contents of COVID-19 prevention and control KAP in study （ORs were between 1.44 and 4.09， all P<0.001）. Moreover， the absolute value of regression coefficient of the overall standard of health literacy was the largest compared with all the socio-demographic factors. Logistic regression was used to further analyze relationships between each of the six health dimensions of health literacy and COVID-19 prevention and control KAP， which revealed that the association with safety and first aid， infectious diseases prevention， and health information was the closest. 【Conclusion】 Health literacy is closely related to COVID-19 prevention and control KAP in the general population of Baoji city. Promoting residents' health literacy by targeted health education can play an important and positive role in dealing with the threat of major infectious diseases outbreaks.
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In China, the survival rate of liver cancer remains low while the mortality rate is high. Effectively reducing the burden of liver cancer is still a major challenge in the field of public health and chronic disease prevention in the Chinese population. Optimizing screening strategies for liver cancer remains a profound approach to secondary prevention worthy of continuous exploration. To address this pressing issue, the Bureau of Disease Control and Prevention of the National Health Commission commissioned this guideline. The National Cancer Center of China initiated the guideline development and convened a multidisciplinary expert panel and working groups. Following the World Health Organization Handbook for Guideline Development, this guideline integrated the most up-to-date evidence of liver cancer screening, China's national conditions, and existing practical experience in liver cancer screening. Evidence-based recommendations on the target population, screening technologies, surveillance strategies, and other key points across the process of liver cancer screening and surveillance management were provided. This guideline would help standardize the practice of liver cancer screening in China.
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BACKGROUND@#Family clustering of esophageal cancer (EC) has been found in high-risk areas of China. However, the relationships between cancer family history and esophageal cancer and precancerous lesions (ECPL) have not been comprehensively reported in recent years. This study aimed to provide evidence for identification of high-risk populations.@*METHODS@#This study was conducted in five high-risk areas in China from 2017 to 2019, based on the National Cohort of Esophageal Cancer. The permanent residents aged 40 to 69 years were examined by endoscopy, and pathological examination was performed for suspicious lesions. Information on demographic characteristics, environmental factors, and cancer family history was collected. Unconditional logistic regression was applied to evaluate odds ratios between family history related factors and ECPL.@*RESULTS@#Among 33,008 participants, 6143 (18.61%) reported positive family history of EC. The proportion of positive family history varied significantly among high-risk areas. After adjusting for risk factors, participants with a family history of positive cancer, gastric and esophageal cancer or EC had 1.49-fold (95% confidence interval [CI]: 1.36-1.62), 1.52-fold (95% CI: 1.38-1.67), or 1.66-fold (95% CI: 1.50-1.84) higher risks of ECPL, respectively. Participants with single or multiple first-degree relatives (FDR) of positive EC history had 1.65-fold (95% CI: 1.47-1.84) or 1.93-fold (95% CI: 1.46-2.54) higher risks of ECPL. Participants with FDRs who developed EC before 35, 45, and 50 years of age had 4.05-fold (95% CI: 1.30-12.65), 2.11-fold (95% CI: 1.37-3.25), and 1.91-fold (95% CI: 1.44-2.54) higher risks of ECPL, respectively.@*CONCLUSIONS@#Participants with positive family history of EC had significantly higher risk of ECPL. This risk increased with the number of EC positive FDRs and EC family history of early onset. Distinctive genetic risk factors of the population in high-risk areas of China require further investigation.@*TRIAL REGISTRATION@#ChiCTR-EOC-17010553.
Subject(s)
Humans , Case-Control Studies , China/epidemiology , Esophageal Neoplasms/pathology , Precancerous Conditions/pathology , Risk Factors , Stomach NeoplasmsABSTRACT
In China, the survival rate of liver cancer remains low while the mortality rate is high. Effectively reducing the burden of liver cancer is still a major challenge in the field of public health and chronic disease prevention in the Chinese population. Optimizing screening strategies for liver cancer remains a profound approach to secondary prevention worthy of continuous explora-tion. This guideline was commissioned by the Bureau of Disease Control and Prevention of the National Health Commission. The National Cancer Center of China initiated the guideline develop-ment and convened a multidisciplinary expert panel and working group. Following the World Health Organization Handbook for Guideline Development, this guideline integrated the most up-to-date evidence of liver cancer screening, China′s national conditions, and existing practical experience in liver cancer screening. Evidence-based recommendations on the target population, screening technologies, surveillance strategies, and other key points across the process of liver cancer screening and surveillance management were provided. This guideline would help to standardize the practice of liver cancer screening in China.
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To prevent the catastrophic health and economic consequences from COVID-19 epidemics, some nations have aimed for no community transmission outside of quarantine. To achieve this, governments have had to respond rapidly to outbreaks with public health interventions. But the exact characteristics of an outbreak that trigger these measures differ and are poorly defined. We used existing data from epidemics in Australia to establish a practical model to assist stakeholders in making decisions about the optimal timing and extent of interventions. We found that the number of reported cases on the day that interventions commenced strongly predicted the size of the outbreaks. We quantified how effective interventions were at containing outbreaks in relation to the number of cases at the time the interventions commenced. We also found that containing epidemics from novel variants that had higher transmissibility would require more stringent interventions that commenced earlier. In contrast, increasing vaccination coverage would enable more relaxed interventions. Our model highlights the importance of early and decisive action in the early phase of an outbreak if governments aimed for zero community transmission, although new variants and vaccination coverage may change this.
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BackgroundThe SARS-CoV-2 Alpha variant B.1.1.7 became prevalent in the United States (US). We aimed to evaluate the impact of vaccination scale-up and potential reduction in the vaccination effectiveness on the COVID-19 epidemic and social restoration in the US. MethodsWe extended a published compartmental model and calibrated the model to the latest US COVID-19 data. We estimated the vaccine effectiveness against B.1.1.7 and evaluated the impact of a potential reduction in vaccine effectiveness on future epidemics. We projected the epidemic trends under different levels of social restoration. ResultsWe estimated the overall existing vaccine effectiveness against B.1.1.7 to be 88.5% (95%CI: 87.4-89.5%) and vaccination coverage would reach 70% by the end of August, 2021. With this vaccine effectiveness and coverage, we anticipated 498,972 (109,998-885,947) cumulative infections and 15,443 (3,828-27,057) deaths nationwide over the next 12 months, of which 95.0% infections and 93.3% deaths were caused by B.1.1.7. Complete social restoration at 70% vaccination coverage would only slightly increase cumulative infections and deaths to 511,159 (110,578-911,740) and 15,739 (3,841-27,638), respectively. However, if the vaccine effectiveness were reduced to 75%, 50% or 25% due to new SARS-CoV-2 variants, we predicted 667,075 (130,682-1,203,468), 1.7m (0.2-3.2m), 19.0m (5.3-32.7m) new infections and 19,249 (4,281-34,217), 42,265 (5,081-79,448), 426,860 (117,229-736,490) cumulative deaths to occur over the next 12 months. Further, social restoration at a lower vaccination coverage would lead to even greater future outbreaks. ConclusionCurrent COVID-19 vaccines remain effective against the B.1.1.7 variant, and 70% vaccination coverage would be sufficient to restore social activities to a pre-pandemic level. Further reduction in vaccine effectiveness against SARS-CoV-2 variants would result in a potential surge of the epidemic in the future.
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BackgroundMultiple candidates of COVID-19 vaccines have entered Phase III clinical trials in the United States (US). There is growing optimism that social distancing restrictions and face mask requirements could be eased with widespread vaccine adoption soon. MethodsWe developed a dynamic compartmental model of COVID-19 transmission for the four most severely affected states (New York, Texas, Florida, and California). We evaluated the vaccine effectiveness and coverage required to suppress the COVID-19 epidemic in scenarios when social contact was to return to pre-pandemic levels and face mask use was reduced. Daily and cumulative COVID-19 infection and death cases were obtained from the Johns Hopkins University Coronavirus resource center and used for model calibration. ResultsWithout a vaccine, the spread of COVID-19 could be suppressed in these states by maintaining strict social distancing measures and face mask use levels. But relaxing social distancing restrictions to the pre-pandemic level without changing the current face mask use would lead to a new COVID-19 outbreak, resulting in 0.8-4 million infections and 15,000-240,000 deaths across these four states over the next 12 months. In this scenario, introducing a vaccine would partially offset this negative impact even if the vaccine effectiveness and coverage are relatively low. However, if face mask use is reduced by 50%, a vaccine that is only 50% effective (weak vaccine) would require coverage of 55-94% to suppress the epidemic in these states. A vaccine that is 80% effective (moderate vaccine) would only require 32-57% coverage to suppress the epidemic. In contrast, if face mask usage stops completely, a weak vaccine would not suppress the epidemic, and further major outbreaks would occur. A moderate vaccine with coverage of 48-78% or a strong vaccine (100% effective) with coverage of 33-58% would be required to suppress the epidemic. Delaying vaccination rollout for 1-2 months would not substantially alter the epidemic trend if the current interventions are maintained. ConclusionsThe degree to which the US population can relax social distancing restrictions and face mask use will depend greatly on the effectiveness and coverage of a potential COVID-19 vaccine if future epidemics are to be prevented. Only a highly effective vaccine will enable the US population to return to life as it was before the pandemic.
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BackgroundNew York City (NYC) was the epicenter of the COVID-19 pandemic in the United States. On April 17, 2020, the State of New York implemented an Executive Order that requires all people in New York to wear a face mask or covering in public settings where social distancing cannot be maintained. It is unclear how this Executive Order has affected the spread of COVID-19 in NYC. MethodsA dynamic compartmental model of COVID-19 transmission among NYC residents was developed to assess the effect of the Executive Order on face mask use on infections and deaths due to COVID-19 in NYC. Data on daily and cumulative COVID-19 infections and deaths were obtained from the NYC Department of Health and Mental Hygiene. ResultsThe Executive Order on face mask use is estimated to avert 99,517 (95% CIs: 72,723-126,312) COVID-19 infections and 7,978 (5,692-10,265) deaths in NYC. If the Executive Order was implemented one week earlier (on April 10), the averted infections and deaths would be 111,475 (81,593-141,356) and 9,017 (6,446-11,589), respectively. If the Executive Order was implemented two weeks earlier (on April 3 when the Centers for Disease Control and Prevention recommended face mask use), the averted infections and deaths would be 128,598 (94,373-162,824) and 10,515 (7,540-13,489), respectively. ConclusionsNew Yorks Executive Order on face mask use is projected to have significantly reduced the spread of COVID-19 in NYC. Implementing the Executive Order at an earlier date would avert even more COVID-19 infections and deaths.
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BackgroundThe Chinese government implemented a metropolitan-wide quarantine of Wuhan city on 23rd January 2020 to curb the epidemic of the coronavirus COVID-19. Lifting of this quarantine is imminent. We modelled the effects of two key health interventions on the epidemic when the quarantine is lifted. MethodWe constructed a compartmental dynamic model to forecast the trend of the COVID-19 epidemic at different quarantine lifting dates and investigated the impact of different rates of public contact and facial mask usage on the epidemic. ResultsWe estimated that at the end of the epidemic, a total of 65,572 (46,156-95,264) individuals would be infected by the virus, among which 16,144 (14,422-23,447, 24.6%) would be infected through public contacts, 45,795 (32,390-66,395, 69.7%) through household contact, 3,633 (2,344-5,865, 5.5%) through hospital contacts (including 783 (553-1,134) non-COVID-19 patients and 2,850 (1,801-4,981) medical staff members). A total of 3,262 (1,592-6,470) would die of COVID-19 related pneumonia in Wuhan. For an early lifting date (21st March), facial mask needed to be sustained at a relatively high rate ([≥]85%) if public contacts were to recover to 100% of the pre-quarantine level. In contrast, lifting the quarantine on 18th April allowed public person-to-person contact adjusted back to the pre-quarantine level with a substantially lower level of facial mask usage (75%). However, a low facial mask usage (<50%) combined with an increased public contact (>100%) would always lead a significant second outbreak in most quarantine lifting scenarios. Lifting the quarantine on 25th April would ensure a smooth decline of the epidemics regardless of the combinations of public contact rates and facial mask usage. ConclusionThe prevention of a second epidemic is viable after the metropolitan-wide quarantine is lifted but requires a sustaining high facial mask usage and a low public contact rate.
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Objective@#As the prevention and control of COVID-19continues to advance, the active nucleic acid test screening in the close contacts of the patients has been carrying out in many parts of China. However, the false-positive rate of positive results in the screening has not been reported up to now. But to clearify the false-positive rate during screening is important in COVID-19 control and prevention.@*Methods@#Point values and reasonable ranges of the indicators which impact the false-positive rate of positive results were estimated based on the information available to us at present. The false-positive rate of positive results in the active screening was deduced, and univariate and multivariate-probabilistic sensitivity analyses were performed to understand the robustness of the findings.@*Results@#When the infection rate of the close contacts and the sensitivity and specificity of reported results were taken as the point estimates, the positive predictive value of the active screening was only 19.67%, in contrast, the false-positive rate of positive results was 80.33%. The multivariate-probabilistic sensitivity analysis results supported the base-case findings, with a 75% probability for the false-positive rate of positive results over 47%.@*Conclusions@#In the close contacts of COVID-19 patients, nearly half or even more of the 'asymptomatic infected individuals’ reported in the active nucleic acid test screening might be false positives.
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Objective@#Using Meta analysis to evaluate the test results of five indicators and main infection patterns for hepatitis B virus (HBV) of college freshmen in mainland China.@*Methods@#In this paper, "college students", "college freshmen", "hepatitis b virus" and "HBV" were used to search systematically for cross-sectional data of the results of five indicators for HBV of entrants from 2006-2015 through CNKI, Wanfang Data, VIP as well as Pubmed and Web of Science. Then Combie's standard for cross-sectional study was used to assess the qualities of the articles included, and Stata 14.0 software and Meta analysis method (including performing heterogeneity test, calculating combined detection rates and carrying out sensitivity analysis and publication bias test) were used to analyze and evaluate the epidemiological significance of the results above.@*Results@#Sixteen studies containing 82 144 cases were included. The result of heterogeneity test showed that there was significant heterogeneity (P<0.001), hence random effects model was adopted. The Meta analysis resulted in total positive rate for surface antigen (HBsAg) of 7.0% (95%CI: 6.0%-8.0%), surface antibody positive rate (HBsAb) of 46.0% (95%CI: 42.0%-49.0%), and positive rate for HBsAg, core antibody (HBcAb) combined with E antigen (HBeAg) or E antibody (HBeAb) of 3.0% (95%CI: 2.0%-3.0%) and 3.0% (95%CI: 2.0%-3.0%), respectively; whereas the negative rate of all indicators was 41.0% (95%CI: 35.0%-46.0%). Sensitivity analysis showed that the results were highly heterogeneous (P<0.001), while the result of Egger's regression indicated that there were publication bias of all indicators (P<0.05), except for HBsAb (P=0.436).@*Conclusion@#The positive rates of HBsAg and HBsAb of college students are lower than those of general population, while the positive rates of HBsAg, HBcAb combined with HBeAg or HBeAb and the all-negative rate of HBV count for a considerable proportion among entrants.
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AIM To investigate the effect of Supplemented Buyang Huanwu Decoction (Astragali Radix,Angelica tail,Paeoniae Radix rubra,etc.) on blood glucose in diabetic rats and its antioxidant activity.METHODS The diabetic rat model induced by streptozotocin (STZ) was established,with metformin as positive control group.After intragastric administration with Supplemented Buyang Huanwu Decoction,the fasting blood glucose,superoxide dismutase (SOD) activity and malondialdehyde (MDA) content in serum and tissues (heart,kidney and pancreas) in rats were detected.HPLC was used to determine the contents of antioxidant constituents (calycosin-7-O-β-D-glucoside and peoniflorin) in plasma,whose pharmacokinetic parameters were then calculated.RESULTS Compared with the model group,the hypoglycemic activity in the Supplemented Buyang Huanwu Decoction group was obvious (P ＜ 0.05),the SOD activity in serum and various issues (except for pancreas) was significantly enhanced,together with significantly reduced MDA level (P ＜ 0.05).The pharmacokinetic behavior of two constituents (calycosin-7-O-3-D-glucoside and peoniflorin) accorded with two-compartment open model,whose blood concentrations reached the highest within 50-70 min,and showed no obvious changes within 180-720 min.CONCLUSION Supplemented Buyang Huanwu Decoction can reduce the blood glucose in diabetic rats and improve the antioxidant activities in heart and kidney.The fast absorption and slow metabolism of calycosin-7-O-3-D-glucoside and peoniflorin in decoction are beneficial to related treatment.
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Objective To evaluate the effect of psychological nursing intervention on the quality of life of AIDS patients.Methods The experimental studies about the influence of psychological nursing intervention on the quality of life of AIDS patients were systematically retrieved in the following databases:PubMed,Web of Science,Cochrane Library,Chinese biomedical literature database (CBM),China journal full text database (CNKI),Wanfang database and VIP Chinese science and technology periodical database (VIP).The SF-36 scale scores in 8 dimensions were combined with Review Manager 5.3,the weighted mean difference and 95％ CI of the value of the combined effects were calculated.Results In addition to the dimension of physiological function,the differences in weighted mean of the remaining seven dimensions of SF-36 scales were significant,among which the average score of physiological function increased to 6.48,but the average score of emotional function increased up to 19.90.It can be considered that in addition to the dimension of physiological function,the score of the other dimensions were improved after the psychological nursing intervention.The results of sensitivity analysis showed that the differences in weighted means of the eight dimensions of SF-36 scale were significant,indicating that the quality of life of the observation group was higher than that of the control group.Conclusion Psychological nursing intervention can improve the quality of life of AIDS patients,and it is suggested to use it in clinical practice.
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Objective Less surveys on the economic burden of hepatitis B (HB)-related diseases have been conducted in China,so the socioeconomic harm caused by the diseases is not clear and the key parameters for economic evaluation of hepatitis B prevention and treatment are lacking.This study aimed to analyze the direct,indirect and intangible expenditures of hospitalized patients with HB-related diseases during hospitalization and during a year in different areas of China.Methods The hospitals for infectious diseases and the large general hospitals in 12 areas in China were selected in the study.All the inpatients with HB-related diseases were surveyed by cluster sampling of consecutive cases.The direct expenditure included direct medical cost and direct non-medical cost.The indirect expenditure,including work loss of patients and caregivers,were calculated by using human capital method for urban and rural populations in 12 areas.The intangible expenditure were reflected by willing to pay and stochastic tournament.The influencing factors of direct and indirect costs were identified by stepwise linear multi-variation regression analysis.Results A total of 27 hospitals in 12 areas were included in the survey.A total of 4 718 cases were surveyed,the overall response rate was 77.7％.The average hospital stay was 29.2 days (27-34) and the hospitalization expenditure was averagely 16 832.80 yuan (RMB) per case,in which the highest proportion (61.2％)was medicine fees [10 365.10 yuan (RMB)].The average direct expenditure and indirect expenditure were consistent with the severity of illness,which were 18 336.10 yuan (RMB) and 4 759.60 yuan (RMB) respectively,with the ratio of 3.85:1.The direct medical expenditure [17 434.70 yuan (RMB)] were substantially higher than the direct non-medical expenditure [901.40 yuan (RMB)].It was found that the hospitalization expenses was highest in direct medical expenditure and the transportation expenses was highest in direct non-medical expenditures.Among the average indirect expenditure,the loss of income for the patients [3 832.50 yuan (RMB)] was higher than that for the caregivers [927.20 yuan (RMB)],The total direct and indirect expenditure was highest for liver transplantation,followed by severe hepatitis,hepatocellular carcinoma and decompensated cirrhosis,acute hepatitis B,compensated cirrhosis and chronic hepatitis B.The influencing factors for both direct and indirect expenditure were high hospital level,severity of hepatitis B,living in urban area,antiviral therapy,long hospitalization and monthly income of family.For average 3.74 outpatient visits and 1.51 hospitalization,the average annual direct,indirect and intangible expenditure for HB-related diseases were 30 135.30,6 253.80 and 44 729.90 yuan (RMB) [totally 81 119.00 yuan (RMB)],accounting for 37.3％,7.7％ and 55.0％,respectively.Of the annual direct medical expenditure [28 402.80 yuan (RMB)],which were much higher than non-medical expenditure [1 732.50 yuan (RMB)],hospitalization expenditure [26 074.20 yuan (RMB)] was higher than outpatient visit expenditure [4 061.10 yuan (RMB)].The annual indirect expenditures for outpatient visit and hospitalization were 763.60 and 5 490.10 yuan (RMB),respectively.Of the annual intangible expenditure,the highest was that for/primary hepatocellular carcinoma,followed by cirrhosis,chronic hepatitis B,severe hepatitis B,liver transplantation and acute hepatitis B.Conclusions A heavy economic burden has been caused by HB-related diseases in China,and patients are more likely to rely on medical service rather than non-medical service.It is necessary to take effective treatment measures to prevent the adverse outcome of HB related diseases and achieve significant economic benefits.The influence of HB related diseases on mental health of the people can be reflected by an economics term,intangible expenditure.
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Objective To evaluate the effect of psychological nursing intervention on the quality of life of AIDS patients.Methods The experimental studies about the influence of psychological nursing intervention on the quality of life of AIDS patients were systematically retrieved in the following databases:PubMed,Web of Science,Cochrane Library,Chinese biomedical literature database (CBM),China journal full text database (CNKI),Wanfang database and VIP Chinese science and technology periodical database (VIP).The SF-36 scale scores in 8 dimensions were combined with Review Manager 5.3,the weighted mean difference and 95％ CI of the value of the combined effects were calculated.Results In addition to the dimension of physiological function,the differences in weighted mean of the remaining seven dimensions of SF-36 scales were significant,among which the average score of physiological function increased to 6.48,but the average score of emotional function increased up to 19.90.It can be considered that in addition to the dimension of physiological function,the score of the other dimensions were improved after the psychological nursing intervention.The results of sensitivity analysis showed that the differences in weighted means of the eight dimensions of SF-36 scale were significant,indicating that the quality of life of the observation group was higher than that of the control group.Conclusion Psychological nursing intervention can improve the quality of life of AIDS patients,and it is suggested to use it in clinical practice.
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Objective Less surveys on the economic burden of hepatitis B (HB)-related diseases have been conducted in China,so the socioeconomic harm caused by the diseases is not clear and the key parameters for economic evaluation of hepatitis B prevention and treatment are lacking.This study aimed to analyze the direct,indirect and intangible expenditures of hospitalized patients with HB-related diseases during hospitalization and during a year in different areas of China.Methods The hospitals for infectious diseases and the large general hospitals in 12 areas in China were selected in the study.All the inpatients with HB-related diseases were surveyed by cluster sampling of consecutive cases.The direct expenditure included direct medical cost and direct non-medical cost.The indirect expenditure,including work loss of patients and caregivers,were calculated by using human capital method for urban and rural populations in 12 areas.The intangible expenditure were reflected by willing to pay and stochastic tournament.The influencing factors of direct and indirect costs were identified by stepwise linear multi-variation regression analysis.Results A total of 27 hospitals in 12 areas were included in the survey.A total of 4 718 cases were surveyed,the overall response rate was 77.7％.The average hospital stay was 29.2 days (27-34) and the hospitalization expenditure was averagely 16 832.80 yuan (RMB) per case,in which the highest proportion (61.2％)was medicine fees [10 365.10 yuan (RMB)].The average direct expenditure and indirect expenditure were consistent with the severity of illness,which were 18 336.10 yuan (RMB) and 4 759.60 yuan (RMB) respectively,with the ratio of 3.85:1.The direct medical expenditure [17 434.70 yuan (RMB)] were substantially higher than the direct non-medical expenditure [901.40 yuan (RMB)].It was found that the hospitalization expenses was highest in direct medical expenditure and the transportation expenses was highest in direct non-medical expenditures.Among the average indirect expenditure,the loss of income for the patients [3 832.50 yuan (RMB)] was higher than that for the caregivers [927.20 yuan (RMB)],The total direct and indirect expenditure was highest for liver transplantation,followed by severe hepatitis,hepatocellular carcinoma and decompensated cirrhosis,acute hepatitis B,compensated cirrhosis and chronic hepatitis B.The influencing factors for both direct and indirect expenditure were high hospital level,severity of hepatitis B,living in urban area,antiviral therapy,long hospitalization and monthly income of family.For average 3.74 outpatient visits and 1.51 hospitalization,the average annual direct,indirect and intangible expenditure for HB-related diseases were 30 135.30,6 253.80 and 44 729.90 yuan (RMB) [totally 81 119.00 yuan (RMB)],accounting for 37.3％,7.7％ and 55.0％,respectively.Of the annual direct medical expenditure [28 402.80 yuan (RMB)],which were much higher than non-medical expenditure [1 732.50 yuan (RMB)],hospitalization expenditure [26 074.20 yuan (RMB)] was higher than outpatient visit expenditure [4 061.10 yuan (RMB)].The annual indirect expenditures for outpatient visit and hospitalization were 763.60 and 5 490.10 yuan (RMB),respectively.Of the annual intangible expenditure,the highest was that for/primary hepatocellular carcinoma,followed by cirrhosis,chronic hepatitis B,severe hepatitis B,liver transplantation and acute hepatitis B.Conclusions A heavy economic burden has been caused by HB-related diseases in China,and patients are more likely to rely on medical service rather than non-medical service.It is necessary to take effective treatment measures to prevent the adverse outcome of HB related diseases and achieve significant economic benefits.The influence of HB related diseases on mental health of the people can be reflected by an economics term,intangible expenditure.
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Objective To quantitatively analyze the fund theses published in the Journal of Practical Radiology(JPR)and Chinese Journal of Radiology(CJR)in order to detect effective approaches to the improvement of the journal quality and academic level of the JPR.Methods The number of funds-supported theses published,the ratio of fund theses,grade,regional,source of institutions and publication time-lag distribution of the fund theses were statistically analyzed by using bibliometrics in the two journals in 2013.Re-sults Six hundred and eighteen theses were published in JPR in 2013,the total number of fund theses were 137(accounted for 22.2% of total articles),the ratio of fund theses were 0.22,the provincial and municipal fund theses accounted for 59.2%.All fund theses were from 23 regions and 82 institutions throughout the country.The average of publication time-lag was 235.6 days.Three hundred and thirteen theses were published in CJR in 2013,the total number of fund theses were 97(accounted for 31.0% of total articles),the ratio of fund theses were 0.31,the provincial and municipal fund theses accounted for 32.0%.All fund theses were from 18 regions and 70 institutions throughout the country.The average of publication time-lag was 228.4 days.Conclusion JPR has its own superi-ority,meanwhile,it also has a significant disparity and insufficiency comparing to CJR.In order to further promote the quality conno-tations and the academic level of JPR,efforts should be made on subject selection and planning,initiative collection of manuscripts, priority publishment to excellent manuscripts,shortening publication time-lag,etc.Additionally,a database of core authors and ex-perts should be established.
ABSTRACT
Objective To evaluate the cost-effectiveness of current universal infant rotavirus vaccination strategy,in China.Methods Through constructing decision tree-Markov model,we simulated rotavirus diarrhea associated cost and health outcome on those newborns in 2012 regarding different vaccination programs as:group with no vaccination,Rotavirus vaccination group and Rotateq vaccination group,respectively.We determined the optimal program,based on the comparison between incremental cost-effectiveness ratio (ICER) and China' s 2012 per capital gross domestic product (GDP).Results Compared with non-vaccination group,the Rotavirus vaccination and Rotateq vaccination groups had to pay 3 760 Yuan and 7 578 Yuan (both less than 2012 GDP per capital) to avert one disability adjusted life years (DALY) loss,respectively.Results from sensitivity analysis indicated that both results were robust.Compared with Rotavirus vaccination program,the Rotateq vaccination program had to pay extra 81 068 Yuan (between 1 and 3 times GDP per capital) to avert one DALY loss.Data from the sensitivity analysis indicated that the result was not robust.Conclusion From the perspective of health economics,both two-dose Rotarix vaccine and three-dose's Rotateq vaccine programs were highly cost-effective,when compared to the non-vaccination program.It was appropriate to integrate rotavirus vaccine into the routine immunization program.Considering the large amount of extra cost that had to spend on Rotateq vaccination program,results from the sensitivity analysis showed that it was not robust.Rotateq vaccine required one more dose than the Rotarix vaccine,to be effective.However,it appeared more difficult to practice,suggesting that it was better to choose the Rotarix vaccine,at current stage.
