Bottom-up strategy of multi-level structured boron-doped diamond for the durable electrode in water purification.

Long-term exposition of electrodes to aqueous media inevitably results in biofouling and adhesion of bacteria, reducing the electrolysis efficiency of electrodes for water treatment. To ensure technically efficient antifouling of materials for durable electrodes, hierarchical micro-/nano structured boron-doped diamond (BDD) electrodes were designed and synthesized. Multi-level structured BDD was coated on titanium mesh by a bottom-up strategy, based on a combination of self-assembly seeding and hot filament chemical vapor deposition (HFCVD) growth. The morphology of the BDD coating can be controlled by manipulating the seeding density and boron doping concentration. The designed micro/nano hierarchical structure of the BDD electrode suppressed bacterial adhesion greatly and exhibited excellent anti-biofouling efficiency with an antibacterial rate of âˆ¼ 93 %, which entails simplified self-cleaning and durable BDD-coated electrodes. The BDD-coated electrodes were employed to electrochemically treat Escherichia coli-contaminated water, killing virtually all bacteria (≥99.9 %) in 1 min. Finally, real river water was electrochemically treated, reducing the chemical oxygen demand (COD) down to 5 mg/L in 4 h. The excellent performance shows the great potential of the structured BDD electrodes for long-term water purification.

Incidence, patterns and risk factors for readmission following knee arthroplasty in China: A national retrospective cohort study.

BACKGROUND: Limited data exist on readmission following knee arthroplasty (KA) in countries without well-established referral or extended care systems. This study aimed to investigate the incidence, patterns and risk factors for readmission following KA in China. MATERIAL AND METHODS: In this national retrospective cohort study, we reviewed 167,265 primary KAs registered in the Hospital Quality Monitoring System in China between 2013 and 2018. Readmissions after KA within 30 and 90 days were evaluated. The causes for readmission were identified and classified as surgical or medical. The potential risk factors of readmission were assessed using multivariable logistic regression. RESULTS: 4017 (2.4%) patients readmitted within 30 days, and 7258 (4.3%) patients readmitted within 90 days. The readmission rate exhibited a downward trend during the period from 2013 to 2018 (2.7%-2.3% for 30-day readmission; 4.5%-4.2% for 90-day readmission). Surgical causes contributed to 54.3% readmissions within 30 days and 47.3% readmissions within 90 days. Wound infection/complication, joint pain, and thromboembolism were the most frequently reported reasons for surgical readmission. Older age, male sex, single marital status, non-osteoarthritis indication, a high comorbidity index, non-provincial hospitals, low hospital volume, and longer length of stay were associated with an increased risk of readmission. The geographic regions of hospitals contributed greatly to the variety of readmissions. CONCLUSION: The readmission rate following KA decreased from 2013 to 2018. Surgery-related causes, especially wound infection/complication and pain, accounted for a large proportion. Both patient and hospital factors were associated with readmissions. Improved primary care and targeted measures are needed to help further prevent readmissions and optimize resource utilization.

Healthcare resource utilisation for chronic kidney disease and other major non-communicable chronic diseases in China: a cross-sectional study.

OBJECTIVE: To evaluate the healthcare resource utilisation for chronic kidney disease (CKD) and other major non-communicable chronic diseases (NCDs) in China. DESIGN: A cross-sectional study. SETTING: A national inpatient database of tertiary hospitals in China. PARTICIPANTS: The study included a total of 19.5 million hospitalisations of adult patients from July 2013 to June 2014. Information on CKD and other major NCDs, including coronary heart disease (CHD), stroke, hypertension, diabetes, chronic obstructive pulmonary disease (COPD) and cancer, was extracted from the unified discharge summary form. OUTCOME MEASURES: Cost, length of hospital stay and in-hospital mortality. RESULTS: The percentages of hospitalisations with CKD, CHD, stroke, hypertension, diabetes, COPD and cancer were 4.5%, 9.2%, 8.2%, 18.8%, 7.9%, 2.3% and 19.4%, respectively. For each major NCD, the presence of CKD was independently associated with longer hospital stay, with increased percentages ranging from 7.69% (95% CI 7.11% to 8.28%) for stroke to 21.60% (95% CI 21.09% to 22.10%) for CHD. Hospital mortality for other NCDs was also higher in the presence of CKD, with fully adjusted relative risk ranging from 1.91 (95% CI 1.82 to 1.99) for stroke to 2.65 (95% CI 2.55 to 2.75) for cancer. Compared with other NCDs, CKD was associated with the longest hospital stay (22.1% increase) and resulted in the second highest in-hospital mortality, only lower than that of cancer (relative risk, 2.23 vs 2.87, respectively). CONCLUSIONS: The presence of diagnosed CKD alongside each major NCD was associated with an additional burden on the healthcare system. Healthcare resource utilisation and prognosis of CKD were comparable with those of other major NCDs, which highlights the importance of CKD as a major public health burden.

Association between use of Qingfei Paidu Tang and mortality in hospitalized patients with COVID-19: A national retrospective registry study.

BACKGROUND: Qingfei Paidu Tang (QPT), a formula of traditional Chinese medicine, which was suggested to be able to ease symptoms in patients with Coronavirus Disease 2019 (COVID-19), has been recommended by clinical guidelines and widely used to treat COVID-19 in China. However, whether it decreases mortality remains unknown. PURPOSE: We aimed to explore the association between QPT use and in-hospital mortality among patients hospitalized for COVID-19. STUDY DESIGN: A retrospective study based on a real-world database was conducted. METHODS: We identified patients consecutively hospitalized with COVID-19 in 15 hospitals from a national retrospective registry in China, from January through May 2020. Data on patients' characteristics, treatments, and outcomes were extracted from the electronic medical records. The association of QPT use with COVID-19 related mortality was evaluated using Cox proportional hazards models based on propensity score analysis. RESULTS: Of the 8939 patients included, 28.7% received QPT. The COVID-19 related mortality was 1.2% (95% confidence interval [CI] 0.8% to 1.7%) among the patients receiving QPT and 4.8% (95% CI 4.3% to 5.3%) among those not receiving QPT. After adjustment for patient characteristics and concomitant treatments, QPT use was associated with a relative reduction of 50% in-hospital COVID-19 related mortality (hazard ratio, 0.50; 95% CI, 0.37 to 0.66 p < 0.001). This association was consistent across subgroups by sex and age. Meanwhile, the incidences of acute liver injury (8.9% [95% CI, 7.8% to 10.1%] vs. 9.9% [95% CI, 9.2% to 10.7%]; odds ratio, 0.96 [95% CI, 0.81% to 1.14%], p = 0.658) and acute kidney injury (1.6% [95% CI, 1.2% to 2.2%] vs. 3.0% [95% CI, 2.6% to 3.5%]; odds ratio, 0.85 [95% CI, 0.62 to 1.17], p = 0.318) were comparable between patients receiving QPT and those not receiving QPT. The major study limitations included that the study was an observational study based on real-world data rather than a randomized control trial, and the quality of data could be affected by the accuracy and completeness of medical records. CONCLUSIONS: QPT was associated with a substantially lower risk of in-hospital mortality, without extra risk of acute liver injury or acute kidney injury among patients hospitalized with COVID-19.

Liver transplantation in mainland China: the overview of CLTR 2011 annual scientific report.

China Liver Transplant Registry (CLTR) is the official national liver transplant registry in Mainland China that has been authorized by the National Health and Family Planning Commission of the People's Republic of China (NHFPC) and serves for both regulatory and scientific purposes. The CLTR 2011 annual scientific reports released national statistics describing current status of liver transplant (LT) in China. This article, as an accompanying document of CLTR 2011 annual scientific report, provides an overview of scientific results for LT in China. Up to December 2011, a total number of 20,877 LT performed during 1980-2011 in 81 certified transplant centers had been reported to CLTR. Of these donated livers, 92.63% were procured from deceased donors (N=19,338) and 7.37% were from living donors (N=1,539). In March 2010, the pilot project of the new deceased organ donation was initiated. From the initiation of the pilot program to the end of 2011, there were 115 LT (0.55% of all LT) using the liver grafts from Chinese categories donors. The recipient post-transplant survival had been significantly improved over years. The median post-transplant follow-up was 14.74 months, of which the longest follow-up time was 192.47 months. The 1-year, 3-year and 5-year cumulative survival rate for all recipients was 77.97%, 65.38% and 60.53%, respectively.