An analysis of the etiologies and economic indexes of inpatients with stage 5 chronic kidney disease in North China.

Objective: The aim of this study was to analyze the epidemiological characteristics of the causes of chronic kidney disease (CKD) stage 5 patients in North China and to investigate the economic burden of those on hemodialysis (HD) or peritoneal dialysis (PD), as well as the associated influencing factors. Methods: General clinical information, etiological categories, and hospitalization costs for HD or PD were collected from 1,515 patients hospitalized with stage 5 CKD at the Affiliated Hospital of Hebei University from 2016 to 2018. Logistic regression analysis was used to analyze the independent influencing factors affecting patients' financial burden. Results: The highest rate of DN was found in patients aged 70 years or older (27.0%) and the highest incidence of primary glomerulopathy was found in patients aged <50 years (24.3%). Age, type of dialysis, and type of health insurance were independent influences on the total financial burden of patients, and the results of multifactorial logistic regression analysis showed that age [OR (95% CI): 1.009 (1.002, 1.020)] and type of dialysis [OR (95% CI): 1.746 (1.149, 2.659)] would increase the total financial burden. The type of health insurance would reduce the total financial burden [OR (95% CI): 0.222 (0.108, 0.418)]. Conclusion: Chronic kidney disease, with its complex etiology and the heavy financial burden required for treatment, remains a more serious public health problem globally, and it is therefore necessary to further improve medical coverage for dialysis patients, increase management efforts, broaden pro-poor policies and increase the accessibility of medical services in low- and middle-income areas.

"An integrated system, three separated responsibilities", a new fever clinic management model, in prevention and control of novel coronavirus pneumonia.

BACKGROUND: Since December 2019, there have been many new cases of coronavirus pneumonia in Wuhan, Hubei Province, which has gradually spread throughout the country. AIM: To explore our hospital's innovative management system to ensure the efficient operation of fever clinics during the epidemic, since controlling the spread of disease is an important way to prevent and control the epidemic. METHODS: In total, 200 outpatients with fever at our hospital between November 2019 and July 2020 were selected and allocated into two groups. RESULTS: The fever clinic in our hospital operated smoothly, and infection with the novel coronavirus disease (COVID-19) has not been reported in our hospital. Additionally, we did not have any cases of missed diagnosis. The awareness regarding COVID-19 infection sources, transmission routes, early symptoms, and preventive measures was significantly higher in our fever clinic than in those of the pre-management group. CONCLUSION: "An integrated system, three separate responsibilities" ensured the efficient functioning of our fever outpatient clinic and early screening of COVID-19 cases, which effectively curbed the transmission of COVID-19 and hence prevented COVID-19 pneumonia epidemic in our hospital, ultimately achieving the maximum effect of epidemic prevention and control.

Molecular investigation of infection sources and transmission chains of brucellosis in Zhejiang, China.

In the present study, a total of 7793 samples from 5 different types of hosts were collected and tested, with a seroprevalence of 2.4% (184/7793). Although the seroprevalence of human and animal brucellosis is relatively low, numbers of human brucellosis cases reported have increased continuously from 2004 to 2018. A total of 118 Brucella strains containing 4 biotypes were obtained, including Brucella melitensis bv.1 (n = 8) and bv.3 (n = 106), Brucella abortus bv.3 (n = 3) and bv.7 (n = 1). Twenty-one shared MLVA-16 genotypes, each composed of 2 to 19 strains obtained from different hosts, suggest the occurrence of a brucellosis outbreak epidemic with multiple source points and laboratory infection events. Moreover, 30 shared MLVA-16 genotypes were observed among 59.6% (68/114) B. melitensis isolates from Zhejiang and strains from other 21 different provinces, especially northern provinces, China. The analysis highlighted the imported nature of the strains from all over the northern provinces with a dominant part from the developed areas of animal husbandry. These data revealed a potential transmission pattern of brucellosis in this region, due to introduced infected sheep leading to a brucellosis outbreak epidemic, and eventually causing multiple laboratory infection events. It is urgent to strengthen the inspection and quarantine of the introduced animals.

[Diagnosis and Treatment for Four Cases of Sparganosis mansoni].

The data of 4 sparganosis mansoni cases were collected from January 2010 to September 2014, and analyzed by descriptive epidemiological methods. Among the cases, 3 cases had a history of eating raw frogs, and 1 case had a history of eating half-cooked frogs and drinking unboiled water. All cased and 3 out of 7 persons eating raw frogs together with case 3 were positive for anti-Sparganum mansoni antibody. 2 patients were cured by operation removal and praziquantel+alhendazole treatment, and the other 2 cases were cured by drugs only.

Repair of segmental long bone defect in a rabbit radius nonunion model: comparison of cylindrical porous titanium and hydroxyapatite scaffolds.

A segmental long bone defect in a rabbit radius nonunion model was repaired using cylindrical porous titanium (Ti) and hydroxyapatite (HA) scaffolds. Each scaffold was produced using the same method, namely, a slurry foaming method. Repairing ability was characterized using x-radiographic score 12 and 24 weeks postprocedure; failure load of the radius-ulna construct, under three-point bending, 12 weeks postprocedure; and the percentage of newly formed bone within the implant, 12 and 24 weeks after postprocedure. For each of these parameters, the difference in the results when porous Ti scaffold was used compared with when HA scaffolds were used was not significant; both porous scaffolds showed excellent repairing ability. Because the trabecular bone is a porous tissue, the interconnected porous scaffolds have the advantages of natural bone, and vasculature can grow into the porous structure to accelerate the osteoconduction and osteointegration between the implant and bone. The porous Ti scaffold not only enhanced the bone repair process, similar to porous HA scaffolds, but also has superior biomechanical properties. The present results suggest that porous Ti scaffolds may have promise for use in the clinical setting.

[Histological and biomechanical study of repairing rabbit radius segmental bone defect with porous titanium].

OBJECTIVE: To investigate the therapeutic effects of porous titanium (Ti) on the recovery of rabbit radial bone defect. METHODS: Bone defects were artificially made in 30 New Zealand rabbits by resecting the 1 cm substantial osseo with periosteum of both radii. The left anterior limbs were implanted with porous titanium, while the right anterior limbs with porous hydroxyapatite (HA). The rabbits were sacrificed at three time points. Both the radii healing statuses were observed by histology and histomorphometry analyses by means of computer graphic processing at the end of 8, 12 and 24 weeks, and biomechanical analyses at the end of 12 and 24 weeks. RESULTS: The histology examination showed that mass newly formed bone had grown into most pores of both the specimens. Along with prolongation of times after operation, the ingrowths of bone cells and effects of bone remodeling in the research side were nearly the same as those in the control side at the end of 12 and 24 weeks. The interface between the new bone and implants showed tight contact in both the groups without an obvious fibrous tissue. The results of histomorphometrical analyses showed that a statistically significant difference was not obtained for % bone area (bone area/ gross implant) between both the groups (P>0.05).However, the results of maximum failure load for the Ti group and the HA group were (107.34±27.44) N and (93.42±21.18) N at the end of 12 weeks, (118.56±24.65) N and (102.15±23.37) N at the end of 24 weeks, respectively. Biomechanical properties of the Ti group was stronger than that of the HA group, however, a statistically significant difference was not obtained between both the groups (P=0.102). CONCLUSION: Porous titanium scaffold can promote the formation of new bone, which contributes to the healing of long tubular bone defect. The porous titanium can enhance the bone repairing effect on segmental bone defect nearly the same as porous hydroxyapatite .