[Estimation of economic burden of bacillus Calmette-Guérin lymphadenitis in Shandong Province based on compensation for abnormal reaction to vaccination].

Objective: To investigate the economic burden of bacillus Calmette-Guérin (BCG) lymphadenitis in Shandong Province. Methods: From May 2011 to December 2019, 304 patients applying for the province-level compensation of BCG lymphadenitis was selected from Shandong Province in this study. The basic situation, vaccination, outpatient (inpatient) records, cost and relevant information of those patients were collected to calculate the direct economic burden (including direct medical costs and direct non-medical costs), indirect economic burden and total economic burden. Comparison of the difference of economic burden of cases with different characteristics was taken. Results: The M(Q1,Q3) of age of BCG lymphadenitis patients was 3 (2, 4) months, among which 239 cases (78.6%) were male, 71 cases (23.4%) had lymphadenopathy, and 227 cases (74.7%) underwent surgery.The number of outpatient only, inpatient only and outpatient then inpatient was 25.7% (78 cases), 7.2% (22 cases) and 67.1% (204 cases), respectively. The M(Q1,Q3) of direct, indirect and total economic burden of single case after discount was 9 910 (5 713, 16 074), 2 081 (1 547, 3 122) and 12 262 (7 694, 18 571) yuan, respectively.The direct medical expenses accounted for 89.4% of the direct economic burden, the direct economic burden accounted for 84.9% of the total economic burden, the total economic burden of 80.0% cases accounted for only about 20.0% of the compensation amount, and the total economic burden of only 2.3% cases accounted for more than 60.0% of the compensation amount.The direct, indirect and total economic burden of patients with inpatient only and outpatient then inpatient was higher than that of patients with outpatient only; the direct, indirect and total economic burden of patients with operation was higher than that of patients with non-operation; the direct and total economic burden of patients with unulcerated lymph node was higher than that of patients with ulcerated lymph node(all P values<0.05). Conclusion: The economic burden of BCG lymphadenitis cases in Shandong Province is influenced by the mode of diagnosis and treatment, with direct medical expenses as the predominant component.

[Value of bedside echocardiography in diagnosis and risk assessment of in-hospital death for patients with Stanford type A aortic dissection].

Objective: To investigate the value of bedside echocardiography in diagnosis and risk assessment of in-hospital death of patients with Stanford type A aortic dissection. Methods: The clinical data of 229 patients with Stanford type A aortic dissection diagnosed by CT angiography in Zhongshan Hospital affiliated to Fudan University between January 2009 and January 2016 were retrospectively analyzed. The patients were divided into survival group(191 cases)and non-survival group(38 cases)according to presence or absence of in-hospital death. The bedside echocardiography features were analyzed, and influence factors of in-hospital death were determined by multivariate logistic regression analysis. Results: (1) Compared with the survival group, the non-survival group had lower surgery rate (60.52%(23/38) vs. 85.34%(163/191), P<0.01). Age, gender and Debakey classification were similar between survival group and death group (all P>0.05). (2) The bedside echocardiography results showed that prevalence of aortic valve involvement(65.79%(25/38) vs.34.03%(65/191), P<0.01) and severe aortic regurgitation (44.74%(17/38) vs. 14.14%(27/191), P<0.01) were significantly higher in non-survival group than in survival group. The non-survival group had larger aortic root diameter than the survival group ((55.5±6.4)mm vs. (42.3±7.8)mm, P<0.01). There were no significant differences in pericardial effusion, expansion of aortic sinus, and left ventricular ejection fraction between survival group and non-survival group (all P>0.05). (3) The multivariate logistic regression analysis showed that aortic valve involvement(OR=3.275, 95%CI 1.290-8.313, P<0.05), aortic root diameter(OR=1.202, 95%CI 1.134-1.275, P<0.01), and surgery (OR=0.224, 95%CI 0.079-0.629, P<0.01) were independent risk factors for in-hospital death in patients with Stanford type A aortic dissection. Conclusions: Bedside echocardiography has significant diagnostic value for Stanford type A aortic dissection. Aortic valve involvement, enlargement of aortic root diameter and without surgery are independent risk factors for patients with Stanford type A aortic dissection.

Surface anatomical profile of the cerebral cortex in obsessive-compulsive disorder: a study of cortical thickness, folding and surface area.

BACKGROUND: Studying the distribution of anatomical abnormalities over the entire cortical surface can help to identify key neural circuits implicated in generating symptoms of neuropsychiatric disorders. There is a significant inconsistency among studies investigating the neuroanatomy of obsessive-compulsive disorder (OCD) because of the confounding influence of co-morbid depression and medication use and the lack of unbiased estimation of whole-brain morphometric changes. It is also unknown whether the distinct surface anatomical properties of thickness, surface area and gyrification, which collectively contribute to grey matter volume (GMV), are independently affected in OCD. Method The cortical maps of thickness, gyrification and surface areal change were acquired from 23 unmedicated OCD patients and 20 healthy controls using an unbiased whole-brain surface-based morphometric (SBM) method to detect regional changes in OCD. Subcortical structures were not assessed in this study. RESULTS: Patients showed a significant increase in the right inferior parietal cortical thickness. Significant increases in gyrification were also noted in the left insula, left middle frontal and left lateral occipital regions extending to the precuneus and right supramarginal gyrus in OCD. Areal contraction/expansion maps revealed no significant regional differences between the patients and controls. In patients, gyrification of the insula significantly predicted the symptom severity measured using Yale-Brown Obsessive-Compulsive Scale (YBOCS). CONCLUSIONS: An alteration in the cortical surface anatomy is an important feature of OCD seen in unmedicated samples that relates to the severity of the illness. The results underscore the presence of a neurodevelopmental aberration underlying the pathophysiology of OCD.

Development of rapid immunoassays for the detection of ractopamine in swine urine.

The monoclonal antibodies (mAbs) against ractopamine (Rac) were prepared and their properties identified by indirect competitive enzyme-linked immunoabsorbant assay (ELISA). The IC(50) of mAbs was 2.7 ng ml(-1) towards Rac or 9.3 ng ml(-1) towards Rac-glucuronides and no cross-reactivity (CR) towards other competitors except dobutamine (CR: 3.76%). Based on the mAbs, the Rac-kit (kit) and Rac-strip (strip) were developed to detect Rac residues in swine urine. The strip and kit assay could be performed within 5-10 min and 2 h, respectively, allowing the analysis of urine samples without the need for sample clean-up. The detection limits were 1 ng ml(-1) for kit and 3 ng ml(-1) with the unaided eye, and 0.2 ng ml(-1) with the Strip Reader for strip. The correlation coefficients (R(2)) were 0.988 for kit in the range 0-128.0 ng ml(-1), and 0.987 for strip in the range 0-10.8 ng ml(-1). Comparing the gas chromatography-mass spectrometry (GC-MS) with the kit or strip in swine urine spiked with Rac standards, the differences ranged from 1.4% to 4.5% for kit and 1.0% to 4.7% for strip. However, the differences were greater than 54% for the kit and 55% for the strip test for the analysis of urine from swine treated with Rac. The results obtained from GC-MS using hydrolysed urine samples were generally in good agreement with those obtained from strip or kit using non-hydrolysed urine samples.

Preclinical assessment of hypocrellin B and hypocrellin B derivatives as sensitizers for photodynamic therapy of cancer: progress update.

Hypocrellins are perylenequinone pigments with substantial absorption in the red spectral region and high singlet oxygen yield. They are available in pure monomeric form and may be derivatized to optimize properties of red light absorption, tissue biodistribution and toxicity. In vitro screening of synthetic derivatives of the naturally occurring compound, hypocrellin B (HB), for optimal properties of cyto-(dark) toxicity and phototoxicity resulted in selection of three compounds for preclinical evaluation: HBEA-R1 (ethanolaminated HB), HBBA-R2 (butylaminated HB) and HBDP-R1 [2-(N,N-dimethylamino)-propylamine-HB]. Extinction coefficients at 630 nm (epsilon 630) are 6230, 6190 and 4800, respectively; and 1O2 quantum yields, phi, 0.60, 0.32 and 0.42. Intracellular uptake is essentially complete within 2 h (HBEA-R1, HBBA-R2) and 20 h (HBDP-R1). Greatest uptake is associated with lysosomes and Golgi. The HBEA-R1 and HBBA-R2 elicit phototoxicity in vitro primarily via the type II mechanism, with some type I activity under stringently hypoxic conditions. Transcutaneous phototherapy with HBEA-R1 permanently ablates EMT6/Ed tumors growing in the flanks of Balb/c mice, with minimal cutaneous effects. The HBBA-R2 does not elicit mutagenic activity in strains TA98 and TA100 of Salmonella typhimurium. Further development of selected hypocrellin derivatives as photosensitizers for photodynamic therapy is warranted.

The integrated approach: important reforms in China's family planning work.

PIP: A review of the integrated approach to family planning, which was initiated in 1994 by the Chinese State Family Planning Commission, found that cadres and the people viewed the approach as effective for linking family planning with socioeconomic development. The recent world population conferences offered some enlightened plans of action. The Chinese leadership was made aware of the broader, more comprehensive approach to developing the economy, ending poverty, protecting the environment, promoting family planning, and expanding social development. The integrated program in China is taken by Chinese state authorities to be a follow-up to the UN plan of action. Chinese program effort in integration of family planning with poverty alleviation began during the 1970s and 1980s in some areas, such as Jinzhai County of Anhui Province, Yingshan County of Hubei Province, Wangcang County of Sichuan Province, and Nanzheng County of Shaanxi Province. Other integrated planning did not occur until the 1990s in places such as Jilin, Jiangsu, and Shaanxi provinces. A prominent characteristic of the Chinese integrated approach is the active involvement of governments. The program in Sichuan province illustrates this involvement. Rural households, who practice family planning, are granted by the provincial government help with funding or skills in the proper techniques of production. As income increases, acceptance of family planning is enthusiastic. Integrated programs also improve educational opportunities for women and children in poor areas. In underdeveloped areas, programming aims to quickly increase income and reduce fertility, to promote IEC, and to popularize contraceptive knowledge. More developed areas use quality improvements and "scientific management" as effective program efforts. The integrated approach is designated by different language in each province (New Family Plan, the Three Integrations, or Double Three Golden Bridge Program). The exposure to integrated family planning experiences nationwide occurred during the national family planning conference in Chengdu on October 22-26, 1995. This conference was the first of its kind in China.^ieng

China: women benefit from the family planning programme.

PIP: This statement was made by the director of CPIRC in China. Opening remarks focused on the admirable achievement in the reduction of births over 20 years by about 300 million, which is more than the combined populations of Canada and the USA. Family planning programs are considered as providing the means for couples to have fewer children and as promoting social progress and the advancement of women. IEC programming for family planning is extensive and country wide. Home visitation for family planning is part of programming within the All China Women's Federation and the China Family Planning Association. IEC programs include information about population, reproductive health, and family planning for millions of families. The opportunity is available for Chinese women to acquire knowledge and make decisions that balance individual needs with social responsibility and to have access to information on modern methods, on healthy childrearing patterns, and on maternal health. Chinese women are considered able to have an equal say with their husbands in determining the size and spacing of children. The maternal and child health (MCH) and family planning network is described as including 374 MCH hospitals, over 2800 MCH clinics and stations, 2300 county family planning service stations, and millions of medical professionals in mobile medical teams. Jiangsu is identified as a particularly successful province in achievement of health and family planning. State family planning policy and related regulations are understood within the context of integrated programs combining family planning with economic development, poverty alleviation, popularization of modern scientific knowledge, and betterment of social security systems. The example is given of Henan province where girls are enthusiastic about learning and bring productive skills as a form of dowry to the marriage. Rural women are encouraged to participate in training, and urban women are encouraged to serve as public role models. Family planning acceptance has not occurred evenly across the country, and some old social traditions of son preference still prevail. China is described as committed to programs for sustainable development, the protection of women's rights, and the enhancement of women's status.^ieng

Integration of population with development: China's practice.

PIP: The director and professor of the China Population Information and Research Center discussed the determinants of fertility decline in China as due to political commitment, integration of population with social and economic development, timely effective technical services, voluntary participation of the public, and extensive information, education, and communication (IEC). There has been broad national and international acknowledgement of the success of family planning programs since the 1970s in bringing about rapid fertility decline in China. Integrated social and economic development has varied within the country, and population growth is still high in poverty-stricken areas, ethnically inhabited areas, and landlocked areas. Successful integration means meeting the population's basic needs for food and clothing, promoting the notion of an improved quality of life, and providing the opportunity for common prosperity. The national target is to contain population at 1.3 billion by the year 2000 by improving the quality of human resources and instituting a compulsory 9 years of education. National laws have been passed to facilitate fertility decline, but family planning regulations must be applied locally due to disparities in level of development. The national population plan includes strategies for controlling growth in over 2000 specific counties. There is the political integration of family planning agencies and plans within the Central Committee of the Communist Party and the State Party. Local family planning groups have been established in 29 provinces. The integrated strategy has been successful in changing people's ideas about marriage and childbearing, promoting the improvement in women's status, improving educational status, and establishing a social security system. However, China has not yet completed its fertility transition. There is agreement between Chinese leaders and the population that population growth issues are development issues, and the solution is to increase production and simultaneously implement the family planning program. A comprehensive and committed approach to growth and environmental protection will contribute to sustainable development. All social and economic policies should support fertility decline. Family planning implementation must respect the basic rights of individuals and couples while stressing social responsibility and duties. IEC should be used instead of coercive practices.^ieng

Education and fertility in two Chinese provinces: 1967-1970 to 1979-1982.

PIP: The rapid fertility decline in China during the 1970s coincided with rapid rises in the educational attainment of Chinese women, raising questions about the relative importance of educational change to fertility trends. To examine this association, fertility declines in the period 1967-70 to 1979-81 were compared in 2 Chinese provinces--Liaoning, and economically advanced province, and Sichuan, a relatively backward province. Data were derived from the large-scale One-per-Thousand Population Fertility Sampling Survey of 1982. The decline of fertility in the period under review occurred in both provinces in each of the educational subgroups and in the rural and urban sectors. However, the rate of decline was greater in Sichuan than in Liaoning; the total fertility rate fell by 55% in Sichuan compared to 23% in Liaoning, despite the fact that educational differentials between the 2 provinces persisted throughout the period. As a result of these rapid changes, by 1979-82, the total fertility rate and the total marriage-duration-specific fertility rate in Sichuan were lower than or equal to those of Liaoning in each rural educational subgroup and the overall urban fertility measures were also lower for Sichuan. Over the entire study period, changes in the percentage married at young ages could account for the majority of the fertility decline in the 15-24-year age group, with the educational differentials playing a small role. On the other hand, in the older age groups, marital fertility declines were the predominant factor. It is concluded that the magnitude of the fertility declines in both provinces across educational strata resulted from unusually powerful family planning program efforts, especially in Sichuan.^ieng

A million-person population control survey.

PIP: A brief report on a sample survey that was carried out in China in late 1982 and that covered over one million people is presented. In the course of the survey, 310,462 women between the ages of 15 and 67 were questioned in person concerning age, marital status, children, occupation, education, birth control measures, abortion, whether they have only one child, and related topics. The survey, which took three months to complete, involved 3,676 investigators and is estimated by the authors to be the largest survey of this kind ever attempted. Sampling was done by strata, systems, and population clusters, and the error rate in recording data from questionnaires is estimated at about 1.07 per 1,000. The survey results indicate that although fertility has, until recently, declined substantially, China has not yet reached the level necessary for population control. In addition to an increase in the proportion of women of childbearing age, the survey indicates that approximately 21 million out of the 170 million eligible women have not yet adopted birth control measures. However, 33 million women have only one child, and 14 million have pledged not to have a second child.^ieng

[The present task of family planning as suggested by the findings of the National Sample Survey of Fertility].

PIP: Results from the 1982 census show great progress has been made in the field of family planning because of close cooperation between the people and the government. Under the influence of the high birth rate in the 1950s and 1960s, a large number of youths are reaching the age for marriage each year, and they are bringing heavy pressure on the population growth. As a result of this situation, family planning work is still urgently needed. A great difference exists between cities and rural areas in family planning work. Economic conditions, cultural and educational levels, occupational characteristics, living environments, and concepts of population growth have contributed to this difference. Henceforth, special emphasis should be placed on family planning work in rural areas, so that the large scale population groth in the countryside may be brought under control. In areas of scientific management, propaganda and education, and technical measures for family planning, modern and and progressive methods should be used in order to reach the national goal of controlling population growth.^ieng