[Study on calculating the curative care expenditure of injury in Gansu Province based on "A System of Health Accounts 2011"].

Objective: To study the distribution and related factors of curative care expenditure (CCE) of injury in Gansu Province in 2017. Methods: Based on the "A System of Health Accounts 2011 (SHA 2011)", the curative care expenditure of injury in Gansu Province was calculated and analyzed. The five-stage stratified cluster sampling method was adopted to extract 149 medical and health institutions, 120 township hospitals (including community health service centers), 150 individual clinics and 600 village clinics (including community health service stations). The top-down allocation method was used to calculate the cost of injury treatment in Gansu Province, and the influencing factors were analyzed by multiple linear regression. Results: In 2017, the CCE of injury in Gansu province was 3.831 billion yuan, and the expense in general hospitals was 2.708 billion yuan. Among them, the cost of lower limb injury and head injury were 1.090 and 0.847 billion yuan. People aged 40 to 69 years old spent 1.901 billion yuan on injury treatment, and the CCE of injury treatment for men and women were 2.422 and 1.409 billion yuan respectively. The results of multiple linear regression showed that hospitalization expenditure was significantly associated with length of stay, operation, hospital grade, age, payment method and gender (P<0.001). Conclusion: The economic burden of injury in Gansu Province is relatively heavy, so it is necessary to focus on preventions for different groups and costly injury sites.

Effect of reflux ratio on COD and nitrogen removals from coke plant wastewaters.

A laboratory-scale anaerobic-anoxic-aerobic-moving bed biofilm reactor (A1-A2-O-MBBR) system was undertaken to treat coke plant wastewaters from two different factories (wastewater A and B). Wastewater B had higher BOD5/COD ratio and COD/TN ratio than wastewater A. The effects of reflux ratios on COD, TN and NH3-N removals were studied. Results indicated that, with the reflux ratio increased from 2 to 5, COD removals of wastewater A and wastewater B increased from 57.4% to 72.6% and 78.2% to 88.6%, respectively. Meanwhile, TN removals were also increased accompanying reflux ratio rise, from 53.1% to 74.4% for wastewater A and 64.2% to 83.5% for wastewater B. At the same reflux ratio, compared with wastewater A, higher COD and TN removal efficiencies were observed in wastewater B, which had higher BOD5/COD and COD/TN ratio. Reflux ratio had no significant influence on NH3-N removal; 99.0% of the overall NH3-N removal efficiency was achieved by the system for both coke plant wastewaters at any tested reflux ratio. MBBR was effective in NH3-N removal, and about 95% of the NH3-N was removed in the MBBR.