Object To investigate the constitution and expense of inpatient diseases in Jili Community Health Service Center (JCHSC) in Liuyang City of Hunan Province from 2008 to 2010, so as to provide baseline data for further study. Methods The questionnaire was applied and inpatient records in JCHSC between 2008 and 2010 were collected. The diseases were classified and standardized according to the International Classification of Disease, 10th Edition (ICD-10) based on the first diagnosis extracted from discharge records. Such information as general condition, discharge diagnosis and medical expenses etc. were analyzed by using statistic software of Microsoft Excel 2003 and SPSS 13.0. Results a) There were 9 chronic diseases and 6 acute ones among the top 15 single diseases, and both the average hospital stay and per-average hospitalization expense of chronic diseases were higher than those of acute ones (7.8 days vs. 5.6 days; ?2 733 vs. ?1551); b) Per-average expense of drugs as for both acute and chronic diseases accounted for nearly 50% of the total/general expense; c) There were 3 types of treatment models in JCHSC. Model A was only the internal medicine therapy, Model B was internal medicine assisted with surgery, and Model C was surgery assisted with internal medicine therapy; d) In detail, the total per-average expenses in JCHSC between 2008 to 2010 as for each single disease were as follows: coronary heart diseases (CHD, ?2 374 to ?2 680), urinary calculi (?3 268 to ?3 337), chronic bronchitis (?2 452 to ?2 488); e) Per-average hospitalization expenses in internal departments were ?1 719 to ?1 942 for acute diseases and ?2 386 and ?2 523 for chronic ones. Among surgical departments, the per-average hospitalization expenses as for acute diseases and chronic diseases were ?1 438 to ?1 579 and ?3 044 to ?3 607, respectively; and f) The average hospital stay for acute diseases in internal departments were 5.5 to 5.8 days for acute diseases and 6.9 to 7.3 days for chronic ones. By contrast, those in surgical departments were 5.9 to 6.2 days for acute diseases and 8.3 days for chronic ones, respectively. Conclusion a) In JCHSC, a total of 7 inpatient diseases among the top 15 single diseases in 2010 are all chronic with per-average total expense over ?2 000, which is higher than the average level of national CHSC (?2 357.6); b) According to the features of expense constitution models of the inpatient single diseases, the hospitalization expense should be controlled specifically; c) There are 3 kinds of diseases with yearly-increasing per-average total expenses as CHD, hypertension and pulmonary infection during recent 3 years; meanwhile, 4 diseases are with yearly-decreasing per-average total expenses as chronic bronchitis, cholecystolithias or accompanied with cholecystitis, diabetes and inguinal hernia; d) The per-average expenses of chronic diseases in surgical departments are higher than those in internal departments, but those of the acute diseases in surgical departments are lower. Meanwhile, the per-average total expenses as for both chronic and acute diseases in surgical departments present a decline trend year by year. Although the per-average expense on drugs as for both acute and chronic diseases in internal departments show a decline trend, the per-average total expenses indicate an ascending trend; and f) The average hospital stay of chronic diseases is longer than acute ones, while that of the surgical diseases is also longer than internal ones.
Objective Secondary osteoporosis is very common in patients with primary osteoporosis. Diabetes is a known cause of secondary osteoporosis. While type I diabetes has been clearly linked with diabetic osteoporosis, the effect of type II diabetes on bone health is controversial.Methods In the present study, we investigated the associations between type II diabetes and osteoporosis as well as fractures at different skeletal sites in Women’s Health Initiative participants.Results Common risk factors such as age, race, BMI, HRT use, and the history of fractures were significantly associated with osteoporosis and fractures in this study population. Diabetic women appeared to have a decreased risk of osteoporosis although it no longer remained significant after adjusting for other risk factors (crude HR=0.78, 95%CI 0.61 to 0.99; adjusted HR=0.93, 95%CI 0.73 to 1.19). The impact of diabetes on fractures varied at different body sites. There was a significant increase of risk of hip fracture (HR=2.54, 95%CI 1.14 to 5.66), but not spine fracture (HR=1.71, 95%CI 0.81 to 3.60) and arm fracture (HR=0.92, 95%CI 0.48 to 1.76) among the women with diabetes. Although the overall risk of fractures in diabetic women did not differ significantly from non-diabetic women (HR=1.37, 95%CI 0.89 to 2.09), the difference had a two-fold increase and was statistically significant after 2,000 days (HR=2.01, 95%CI 1.21 to 3.35), indicating a different hazard at different stages of diabetes.Conclusion Our findings suggest that type II diabetes may not be clearly associated with osteoporosis, it increases a site-specific fracture risk at least in the hip. In addition, the overall fracture risk appears to increase in a time-dependent manner.
ObjectiveTo summarize regional and body distributions, diagnosis, treatment, and prognosis of echinococcosis outside liver in China.
MethodsThe published literatures about echinococcosis outside liver in China (not including Hong Kong, Macao and Taiwan regions) from 2000 to 2015 were searched in the databases of CNKI and Wanfang. Data were extracted by using a standardized form and a retrospective clinical analysis was performed.
ResultsA total of 66 published literatures about echinococcosis outside liver and data of 884 cases reported were collected. The regional proportions of cases reported were different, five high regions were Xinjiang (68.73%), Tibet (8.77%), Ningxia (6.75%), Qinghai (6.41%), Gansu (5.62%). The organ distributions of cases reported were also different, five high organs were lung (61.09%), bone (9.95%), brain (9.73%), spleen (8.60%), and kidney (6.22%). The main clinical symptoms of patients with echinococcosis outside liver included general asymptoms and organ dysfunction, and the most common examinations were X-ray (30.77%), B ultrasound (7.47%),CT(17.43%), MR (1.59%), and laboratory (36.31%). The main therapy choice was operation (73.30%), and some patients were performed operation combined with drug therapy.
ConclusionRegional distribution of echinococcosis outside liver is almost the same as total echinococcosis, and distributed more in organs rich in blood supply, its clinical diagnosis mainly depends on imaging and immunology examination, and operation is still the main therapy choice.
Objective To systematically evaluate the efficacy and safety of iris-registration in wavefront-guided LASIK (IR+WG LASIK) versus conventional LASIK for correction of myopia accompanied with astigmatism. Methods Such databases as PubMed, EMbase, The Cochrane library (Issue 2, 2012), CBM, CNKI, VIP, and WangFang Data were searched to collect the randomized controlled trials (RCTs) and quasi-RCTs about IR+WG LASIK versus conventional LASIK for correction of myopia accompanied with astigmatism. The retrieval time was from inception to February 2012, and the language was in both Chinese and English. Two reviewers independently screened the literature, extracted the data and assessed the quality of the included studies. Then the meta-analysis was performed by using RevMan 5.1 software. Results A total of 9 studies involving 3 903 eyes were included. The results of meta-analysis showed that, compared with the conventional LASIK group, the IR+WG LASIK group had a higher ratio in patients with postoperative uncorrected visual acuity no less than 1.0 (RR=1.03, 95%CI 1.01 to 1.05, P=0.002), as well as in patients with best-corrected visual acuity gained over 1 line (RR=1.75, 95%CI 1.49 to 2.16, Plt;0.000 01); it was smaller in the postoperative high order aberration RMS (WMD=?0.16, 95%CI ?0.21 to ?0.11, Plt;0.000 01), coma-like RMS (WMD=?0.05, 95%CI ?0.11 to 0.00, P=0.07), spherical-like RMS (WMD=?0.15, 95%CI ?0.23 to ?0.07, P=0.000 2), and residual astigmatism (WMD=0.14, 95%CI 0.10 to 0.18, Plt;0.000 01); moreover, it was lower in the incidence of postoperative glare (RR=0.27, 95%CI 0.15 to 0.50, Plt;0.000 1), and it was higher in the subjective satisfaction of patients (RR=1.08, 95%CI 1.04 to 1.13, P=0.000 3). Conclusion Compared with conventional LASIK, IR+WG LASIK can more effectively reduce astigmatism, postoperative high order aberration RMS and spherical-like RMS. It can also get visual function including uncorrected visual acuity and best-corrected visual acuity, consequently increase patient’s satisfaction. But further studies are still required for its long-term effect.
Objective To study some related factors of effect on gluteus muscle contraction and provide the therapeutic basis. Methods The curative effect was assessed in 154 patients who were classified by age, patient’s condition, orthopedic degree in operation and rehabilitation with an average follow-up period of 25 months(ranging from 5 to 36 months).Results The excellent rate of 18-24 years old (25/30) was lower than that of 5 -17 years old(120/124) (Plt;0.05); the excellent rate of slight patients was higher (107/109) than that of serious patients (38/45) (Plt;0.01); the excellent rate from higher orthopedic degree was higher(111/113) than that from lower orthopedic degree(34/41) (Plt;0.01); and the excellent rate of rehabilitation was much higher (107/110) than that of general treatment (38/44) （Plt;0.05）. Conclusion Age, patient’s condition, orthopedic degree in operation and rehabilitation are important factors to affect the curative effect on gluteu muscle contraction.
ObjectiveTo provide scientific evidence for the prevention and control of infectious diseases in hospitals through analyzing the data of notified infectious diseases collected in one general comprehensive hospital from 2009 to 2014.
MethodsDescriptive method was used to analyze the data of infectious diseases reported through the reporting system in 6 years in the hospital, and then the incidence, diseases classification and transmission route were summarized.
ResultsA total of 15 847 cases, covering 32 notified infectious diseases, were reported between 2009 and 2014, including 15 144 category-B (95.56%) and 703 category-C (4.44%) infectious disease cases, among which the top four were syphilis, hepatitis B, tuberculosis and acquired immune deficiency syndrome (AIDS), with AIDS showing upward trend year by year. There were also 38 H1N1 cases of emerging infectious disease cases. In the view of the trend, there was an upward trend from 2009 to 2012, while there was a downward trend from 2012 to 2014. There were cases for all age groups, and most cases occurred among patients at an age of 40 to 44, accounting for 11.25% of the total cases. Eighteen occupations were involved, and the top five in terms of the number of infections accounted for 63.96% of all the cases.
ConclusionCategory-B infections have been the major diseases reported in our hospital from 2009 to 2014. Therefore, the priority of our job in the future should be focused on prevention and control of syphilis, hepatitis B, tuberculosis and AIDS.
ObjectiveTo explore the distribution and rule of pathogen strains in the third quarter and fourth quarter of 2012, and to provide the basis for clinical medication.
MethodsTo retrospectively analyze the bacterial culture and drug susceptibility test results in the third quarter and the fourth quarter of 2012.
ResultsThere were isolated 932 plants in the third quarter, and 915 plants isolated in the fourth quarter. Heavy drug resistance rates of detection of Pseudomonas aeruginosa decrease slightly. There was more multiple drug resistance of A. baumanii, Escherichia coli, Klebsiella pneumoniae, and methicillin-resistant Staphylococcus aureus in the fourth quarter than in the third one.
ConclusionThe resistant strain increases in the fourth quarter. We should attach importance to the clinical examination, bacterial drug resistance monitoring, and rational use of antimicrobial agents.
ObjectiveTo explore the family function on patients with depression and its influential factors, in order to provide a basis for family support treatment for the patients.
MethodsA total of 122 depressed patients from Mental Health Center of West China Hospital between February 2012 and June 2013, and one of their family members were chosen to be the study subjects. Another 122 non-clinical controls and one of their family members were recruited from a community near Sichuan University were regarded as the controls. All the subjects were asked to finish the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Family Assessment Device (FAD). Additionally, the patients received a diagnostic interview to provide the features of their depression.
ResultsThe general average score of Q-LES-Q in families with depressed patients was significantly lower than that in the control families (t=-6.243, P<0.01). The general average score of each dimension in FAD for families with depressed patients was significantly higher than that for control families (t=3.644, 3.872, 2.694, 3.369, 5.369, 4.941, 5.241; P<0.01). According to FAD health division scoring, the unhealthy proportion in terms of communication, emotional reaction, emotional link, behavioral control and general function for families with depressed patients was significantly higher than that for control families (χ2=6.778, 23.698, 26.580, 39.875, 17.123, 10.712; P<0.05). The Q-LES-Q scores and the five FAD dimensional scores (except role and affective involvement) were negatively correlated (r=-0.388, -0.188, -0.200, -0.276, -0.370; P<0.05). The scores of perceived social support for families with depressed patients had significant positive correlations with the scores of all FAD dimensions except affective involvement (r=0.363, 0.345, 0.244, 0.418, 0.328, 0.457; P<0.05). The risk factors for unhealthy family function included: female (OR=1.141, P<0.05), poor education (OR=0.948, P<0.01), first-episode (OR=1.416, P<0.05), suicidal attempt (OR=1.014, P<0.05), incomplete suicide (OR=1.367, P<0.01) and depression episode number (OR=1.035, P<0.05).
ConclusionDepression is associated with impaired family function in Chinese families. Female, poor education, first episode of depression, suicidal attempt, incomplete suicide and depression episode number are the influential factors for family function on patients with depression.
Objective To conduct bibliometric analysis of systematic review and meta-analysis published in the Chinese Journal of Evidence-based Medicine. Methods Based on the Chinese academic periodical network as a data pool, literature on systematic reviews (involving meta-analysis) and clinical decision-making researches were retrieved in the Chinese Evidence-Based Medicine Magazine from 2001 to 2010, screened and categorized by the medical and hygienic standards of Chinese Library Classification (fourth edition), and then were counted and sorted. Results There were 425 articles about systematic reviews (involving meta-analyses) and clinical decision-making studies in the Chinese Evidence-Based Medicine Magazine, with an yearly increasing number. Basically, those articles involved all subjects such as clinical medicine, preclinical medicine, hygenics, pharmacy, and traditional Chinese medicine. Conclusion Development levels of evidence-based research in medical subjects are different, each of which has its own feature. Also, some systematic reviews do not strictly follow the Cochrane Handbook. Therefore, high-quality systematic review is still needed in each subject.
Objective
To analyze the expression of apoptosis-related genes of retinal blood vessel in early diabetic rats by gene chip technology.
Methods
To make diabetic rat model by intraperitoneal injection of streptozotocin (STZ). On the 6th week after blood pressure increased, 10 rats were executed in Diabetic group and normal control group respectively. 20 retinal blood vessels were extracted and the RNA was isolated. The probe was made of alpha;-32 P-deoxyadenosine triphosphate (dATP)-labeled sample which hybridized 1176 nylon chips, and then analyzed by software. Three different expression genes were selected to verify by reverse transcription polymerase chain reaction (RT-PCR).
Results
On the 6th week, 136 （11.5％） genes were differentially expressed ［up-regulated genes were 90(7.6%), down-regulated genes were 46(3.9%)］in diabetic group. These genes involved into different groups according to their function. Especially in 72 apoptosis-related genes, 15 genes were differentially expressed. The up-regulated genes were some TNF receptor family members such as TNFRSF12, TRAIL, TNFRSF9, FADD；Bcl-2 family members such as bcl-w, bax, bak1 and AKT. The down-regulated genes were FAF1 which related to fas.
Conclusions
The expression of retinal vascular gene in early diabetic rats has been changed complicatedly. In particular, the multiple apoptosis-related genes have been changed in early diabetic, and most of them are at the upstream of apoptosis pathway. These findings indicate that the development of diabetic retinopathy is associated with multiple signaling pathways leading to apoptosis, while the alterations on the level of molecular biochemistry are still limited in apoptosis induction period.
（Chin J Ocul Fundus Dis，2008，24：244-248）
