Biological function and regulatory mechanism of epithelial-mesenchymal transition-related long non-coding RNAs in liver cancer / 临床肝胆病杂志

Liver cancer has a high degree of malignancy, and many oncogenes and tumor suppressor genes play an important regulatory role in the development and progression of liver cancer. Epithelial-mesenchymal transition (EMT) is a biological process in which epithelial cells transform into mesenchymal cells, which can increase the migration and invasion abilities of tumor cells. Long non-coding RNAs (lncRNAs) can regulate EMT process in various ways. This article reviews the research advances in the main biological functions and regulatory mechanisms of EMT-related lncRNAs in liver cancer.

Biological function and regulatory mechanism of epithelial-mesenchymal transition-related long non-coding RNAs in liver cancer / 临床肝胆病杂志

Liver cancer has a high degree of malignancy, and many oncogenes and tumor suppressor genes play an important regulatory role in the development and progression of liver cancer. Epithelial-mesenchymal transition (EMT) is a biological process in which epithelial cells transform into mesenchymal cells, which can increase the migration and invasion abilities of tumor cells. Long non-coding RNAs (lncRNAs) can regulate EMT process in various ways. This article reviews the research advances in the main biological functions and regulatory mechanisms of EMT-related lncRNAs in liver cancer.

Effect of health insurance on direct hospitalisation costs for in-patients with ischaemic stroke in China.

Objectives The aim of the present study was to determine the direct medical costs of hospitalisations for ischaemic stroke (IS) in-patients with different types of health insurance in China and to analyse the demographic characteristics of hospitalised patients, based on data supplied by the China Health Insurance Research Association (CHIRA). Methods A nationwide and cross-sectional sample of IS in-patients with International Classifications of Diseases 10th Revision (ICD-10) Code I63 who were ensured under either the Basic Medical Insurance Scheme for Employees (BMISE) or the Basic Medical Insurance Scheme for Urban Residents (BMISUR) was extracted from the CHIRA claims database. A retrospective analysis was used with regard to patient demographics, total hospital charges and costs. Results Of the 49588 hospitalised patients who had been diagnosed with IS in the CHIRA claims database, 28850 (58.2%) were men (mean age 67.34 years) and 20738 (41.8%) were women (mean age 69.75 years). Of all patients, 40347 (81.4%) were insured by the BMISE, whereas 8724 (17.6%) were insured by the BMISUR; the mean age of these groups was 68.55 and 67.62 years respectively. For BMISE-insured in-patients, the cost per hospitalisation was RMB10131 (95% confidence interval (CI) 10014-10258), the cost per hospital day was RMB787 (95% CI 766-808), the out-of-pocket costs per patient were RMB2346 (95% CI 2303-2388) and the reimbursement rate was 74.61% (95% CI 74.48-74.73%). For BMISUR-insured in-patients the cost per hospitalisation was RMB7662 (95% CI 7473-7852), the cost per hospital day was RMB744 (95% CI 706-781), the out-of-pocket costs per patient were RMB3356 (95% CI 3258-3454) and the reimbursement rate was 56.46% (95% CI 56.08-56.84%). Conclusions Costs per hospitalisation, costs per hospital day and the reimbursement rate were higher for BMISE- than BMISUR-insured in-patients, but BMISE-insured patients had lower out-of-pocket costs. The financial burden was higher for BMISUR- than BMISE-insured in-patients. For BMISUR-insured in-patients, the out-of-pocket payment was 43.54% of total expenses, which means the government should increase the financial investment, raise reimbursement rates and set up differential reimbursements to meet the health needs of in-patients with different income levels. What is known about the topic? Cardiovascular and cerebrovascular diseases are major non-communicable diseases affecting the health of the Chinese population. The China Health Statistics Yearbook (2013) reported that across all in-patients, 195million (5.82%) had been discharged with a diagnosis of cerebrovascular disease. Of these, 118million had IS, accounting for 60.51% of all in-patients with cerebrovascular disease and 54.97% of hospitalisation costs for all cerebrovascular disease in-patients. After the two basic insurance systems, namely the BMISE and BMISUR, had been established, the out-of-pocket expenses for patients were reduced. However, to date there have been no studies investigating how the different types of health insurance (i.e. the BMISE and the BMISUR) affected the costs of treatment of IS in-patients in China. What does this paper add? This paper reports the direct costs for patients diagnosed with IS based on data supplied by the CHIRA. Direct hospitalisation costs depending on the type of insurance cover, age and gender were also evaluated. What are the implications for practitioners? The present study found that the personal financial burden of disease treatment was higher for in-patients insured under the BMISUR than BMISE. For in-patients insured under the BMISUR, the out-of-pocket payment was 43.54% of total expenses, which means the government should increase the financial investment, raise reimbursement rates and set up differential reimbursement rates to meet the health needs of patients with different incomes.

Association between statins use and liver injury based on prescription sequence symmetry analysis / 中华流行病学杂志

Objective To study the association between statins use and liver-injury through prescription sequence symmetry analysis (PSSA) and evaluate the feasibility of the method to be used in Chinese Medical Insurance Database.Methods The data of the patients who prescribed both statins and liver-proactive drugs in Chinese Basic Medical Insurance Database in 2013 were selected as study subjects to calculate the adjusted sequence ratio (ASR) with signal detection methods to determine the study parameters and investigate the potential association between statins use and liver-injury.Results In 5 649 individuals which met the inclusion criteria,the washout period was set as one month and interval period was set as 60 days.The overall ASR of statins was 1.471(95％CI:1.395-1.550),the ASR of atorvastatin was 1.419 (95％CI:1.335-1.508),the ASR of simvastatin was 1.307 (95％CI:1.164-1.467).The positive signal was strong in 30 days interval period.Conclusions PSSA indicated that there might be potential association between statins use and liver-injury,especially the uses of atorvastatin and simvastatin.This signal detection method may be a fast and effective method in drug safety evaluation and can be used in Chinese Medical Insurance Database.

Association between statins use and liver injury based on prescription sequence symmetry analysis / 中华流行病学杂志

Objective To study the association between statins use and liver-injury through prescription sequence symmetry analysis (PSSA) and evaluate the feasibility of the method to be used in Chinese Medical Insurance Database.Methods The data of the patients who prescribed both statins and liver-proactive drugs in Chinese Basic Medical Insurance Database in 2013 were selected as study subjects to calculate the adjusted sequence ratio (ASR) with signal detection methods to determine the study parameters and investigate the potential association between statins use and liver-injury.Results In 5 649 individuals which met the inclusion criteria,the washout period was set as one month and interval period was set as 60 days.The overall ASR of statins was 1.471(95％CI:1.395-1.550),the ASR of atorvastatin was 1.419 (95％CI:1.335-1.508),the ASR of simvastatin was 1.307 (95％CI:1.164-1.467).The positive signal was strong in 30 days interval period.Conclusions PSSA indicated that there might be potential association between statins use and liver-injury,especially the uses of atorvastatin and simvastatin.This signal detection method may be a fast and effective method in drug safety evaluation and can be used in Chinese Medical Insurance Database.

Analysis of Medicine Utilization Variation of Inpatient Participated Insurance after Implementing the 2009 Edition of National Reimbursement Drug List / 中国卫生经济

Objective:To understand the impact of adjusting national drug reimbursement list(NDRL) have on the benefits of patient covered by Basic Health Insurance ( BHI ) , medical insurance fund expenditure and specific drug marketing . Methods: Based on the survey data of medical service utilization situation of national inpatients participated BHI, to summarize and analyze the change of drug usage from 2009 to 2011. Results: In 2011, the drug expense of the national inpatient covered by BHI is approximately 132.7 billion yuan, increased by 37% compared to that of 2009; among which, the expense of entry drug accounts for about 76% out of the total drug use. In 2011, new increased expense on drug use is 13.5 billion, which increased to 98% compared to that of 2009. Conclusion:Adjustment of NDRL had little effect on total drug expenses increasing, but lead changes of the drug expense structure; and expense on some new entry drugs increased obviously. The focus of future adjustment of NRDL could gradually transfer from guaranteeing on basic medicine use to the promotion on clinical rational drug use.

Study on resectability of advanced gastric cancer based on gastroscopic and CT examination / 中国普通外科杂志

Objective To explore the use of gastroscopy and CT for staging and clinical guiding to the surgical therapy of advanced gastric cancer.Methods The preoperative gastroscopic and CT classification and the results of operative classfication of 182 cases of advanced gastric carcinoma were compared.Results The resection rate for low and undifferentiated adenocarcinoma and mucinous carcinoma on gastroscopic biopsy was low(64.1%),and the rate for diffuse infiltrative gastric carcinoma(6.7%)was significantly lower than that of mass tumor type(66.7%)and ulcerative type(61.8%).The total accuracy rate of CT staging was 91.21%.Sensitivity rate of CT diagnosis of perigastric invasion and/or metastasis was 72.22%.For lymph node staging the accuracy rate of CT was 74.2%,sensitivity rate was 74.1% and specificity rate was 74.3%.CT diagnosis of lymph node groups was blur.Conclusions Gastroscopy has an unreplaceable role in the final diagnosis of advanced gastric cancer and has significance for gross tumor grading,histologic biopsy diagnosis can be as a guide to dicide the treatment modality of advanced gastric cancer.CT has high degree of value for accuracy of clinical staging,and diagnosis of invasion of adjacent organs and lymph node metastasis.CT is superior to gastroscopy for judgement of resectability.Therefore,preoperative CT is a valuable guide for surgical treatment of advanced gastric cancer.