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Expenditure and financial burden for the diagnosis and treatment of colorectal cancer in China:a ***,multicenter,cross-sectional survey

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Chinese Journal of Cancer 2017年第8期36卷 352-366页

作者： Hui-Yao Huang Ju-Fang Shi Lan-Wei Guo Ya-Na Bai Xian-Zhen Liao Guo-iangLiu A-Yan Mao Jian-Song Ren Xiao-Jie Sun Xin-Yu Zhu Le Wang Bing-Bing Song Ling-Bin Du Lin Zhu Ji-Yong Gong Qi Zhou Yu-Qin Liu Rong Cao Ling Mai Li Lan Xiao-Hua Sun Ying Ren Jin-Yi Zhou Yuan-Zheng Wang Xiao Qi Pei-An Lou Dian Shi Ni Li Kai Zhang Jie He Min Dai Program office for Cancer Screening in Urban China National Cancer Center/Cancer HospitalChinese Academy of Medical SciencesPeking Union Medical College17 South Panjiayuan LaneChaoyang DistrictBeijing 100021P.R.China Department of Cancer Epidemiology Henan Cancer HospitalAffiliated Cancer Hospital of Zhengzhou UniversityZhengzhouHenan 450008P.R.China Institute of Epidemiology and health Statistics Lanzhou UniversityLanzhouGansu 730000P.R.China Hunan office for Cancer Control and Research Hunan Provincial Cancer HospitalChangshaHunan 410006P.R.China Department of health Economics School of Health ManagementHarbin Medical UniversityHarbinHeilongjiang 150081P.R.China Public health Information Research office Institute of Medical InformationChinese Academy of Medical SciencesBeijing 100020P.R.China Center for health Management and Policy Key Lab of Health Economics and PolicyShandong UniversityJinanShandong 250012P.R.China Heilongjiang office for Cancer Control and Research Affiliated Cancer Hospital of Harbin Medical UniversityHarbinHeilongjiang 150081P.R.China Zhejiang office for Cancer Control and Research Zhejiang Cancer HospitalHangzhouZhejiang 310022P.R.China Teaching and Research Department Affiliated Cancer Hospital of Xinjiang Medical UniversityürümqiXinjiang 830011P.R.China Science and Education Department of Public health Division Shandong Tumor HospitalJinanShandong 250117P.R.China Chongqing office for Cancer Control and Research Chongqing Cancer HospitalChongqing 400030P.R.China Cancer Epidemiology Research Center Gansu Provincial Cancer HospitalLanzhouGansu 730050P.R.China Department of health Policy and Economic Research Guangdong Provincial Institute of Public HealthGuangzhouGuangdong 511430P.R.China Department of Institute of Tumor Research Henan Cancer HospitalAffiliated Cancer Hospital of Zhengzhou UniversityZhengzhouHenan 450008P.R.China Institute of Chronic Disease Prevention and Control Harbin Center for Disease Control and PreventionHarbinHei

Background: The increasing prevalence of colorectal cancer(CRC) in China and the paucity of information about relevant expenditure highlight the necessity of better understanding the financial burden and effect of CRC diagnosis and treatment. We performed a survey to quantify the direct medical and non-medical expenditure as well as the resulting financial burden of CRC patients in ***: We conducted a multicenter, cross-sectional survey in 37 tertiary hospitals in 13 provinces across China between 2012 and 2014. Each enrolled patient was interviewed using a structured questionnaire. All expenditure data were inflated to the 2014 Chinese Yuan(CNY; 1 CNY = 0.163 USD). We quantified the overall expenditure and financial burden and by subgroup(hospital type, age at diagnosis, sex, education, occupation, insurance type, household income, clinical stage, pathologic type, and therapeutic regimen). We then performed generalized linear modeling to determine the factors associated with overall ***: A total of 2356 patients with a mean age of 57.4 years were included, 57.1 % of whom were men; 13.9% of patients had stage I cancer; and the average previous-year household income was 54,525 *** overall average direct expenditure per patient was estimated to be 67,408 CNY, and the expenditures for stage Ⅰ, Ⅱ, Ⅲ, and Ⅳ disease were 56,099 CNY, 59,952 CNY, 67,292 CNY, and 82,729 CNY, respectively. Non-medical expenditure accounted for 8.3%of the overall expenditure. The 1-year out-of-pocket expenditure of a newly diagnosed patient was 32,649 CNY, which accounted for 59.9% of their previous-year household income and caused 75.0% of families to suffer an unmanageable financial burden. Univariate analysis showed that financial burden and overall expenditure differed in almost all subgroups(P < 0.05), except for sex. Multivariate analysis showed that patients who were treated in specialized hospitals and those who were diagnosed with adenocarcinoma or diagno

关键词： Colorectal neoplasms Direct expenditure Financial burden China

Medical expenditure for esophageal cancer in China:a 10-year multicenter retrospective survey(2002-2011)

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Chinese Journal of Cancer 2017年第11期36卷 548-559页

作者： Lan-Wei Guo Hui-Yao Huang Ju-Fang Shi Li-Hong Lv Ya-Na Bai A-Yan Mao Xian-Zhen Liao Guo-Xiang Liu Jian-Song Ren Xiao-Jie Sun Xin-Yu Zhu Jin-Yi Zhou Ji-Yong Gong Qi Zhou Lin Zhu Yu-Qin Liu Bing-Bing Song Ling-Bin Du Xiao-Jing Xing Pei-An Lou Xiao-Hua Sun Xiao Qi Shou-Ling Wu Rong Cao Li Lan Ying Ren Kai Zhang Jie He Jian.Gong Zhang Min Dai Department of Cancer Epidemiology Henan Office for Cancer Control and Research The Affiliated Cancer Hospital of Zhengzhou University Henan Cancer Hospital No. 127 Dongming Road Zhengzhou 450008 Henan P. R China Program office for Cancer Screening in Urban China Cancer Hospital Chinese Academy of Medical Sciences (CAMS) Peking Union Medical College National Cancer Center of China No. 17 Panjiayuannanli Chaoyang District Beijing 100021 P. R. China Department of Human Resources The Affiliated Cancer Hospital of Zhengzhou University Henan Cancer Hospital Zhengzhou 450008 Henan P. R. China Institute of Epidemiology and health Statistics Lanzhou University Lanzhou 730000 Gansu P. R. China Public health Information Research office Institute of Medical Information Chinese Academy of Medical Sciences (CAMS) Beijing 100020 P. R. China Hunan office for Cancer Control and Research Hunan Provincial Cancer Hospital Changsha 410006 Hunan P. R. China Department of health Economics School of health Management Harbin Medical University Harbin 150081 Heilongjiang P. R. China Center for health Management and Policy Key Lab of Health Economics and Policy Shandong University Jinan 250012 Shandong P. R. China Institute of Chronic Non.Communicable Diseases Prevention and Control Jiangsu Provincial Center for Disease Control and Prevention Nanjing 210009 Jiangsu P. R. China Science and Education Department Public health Division Shandong Tumor Hospital Jinan 250117 Shandong P. R. China Chongqing office for Cancer Control and Research Chongqing Cancer Hospital Chongqing 400030 P. R. China Teaching and Research Department Affiliated Cancer Hospital of Xinjiang Medical University ürümqi 830011 Xinjiang P. R. China Cancer Epidemiology Research Center Gansu Provincial Cancer Hospital Lanzhou 730050 Gansu P. R. China Heilongjiang office for Cancer Control and Research Affiliated Cancer Hospital of Harbin Medical University Harbin 150081 Heilongjiang P R. China Zhejiang office for Cancer

Background: Esophageal cancer is associated with substantial disease burden in China, and data on the economic burden are fundamental for setting priorities in cancer interventions. The medical expenditure for the diagnosis and treatment of esophageal cancer in China has not been fully quantified. This study aimed to examine the medical expenditure of Chinese patients with esophageal cancer and the associated ***: From 2012 to 2014, a hospital-based multicenter retrospective survey was conducted in 37 hospitals in 13 provinces/municipalities across China as a part of the Cancer Screening Program of Urban China. For each esophageal cancer patient diagnosed between 2002 and 2011, clinical information and expense data were extracted by using structured questionnaires. All expense data were reported in Chinese Yuan(CNY; 1 CNY = 0.155 USD) based on the2011 value and inflated using the year-specific health care consumer price index for ***: A total of 14,967 esophageal cancer patients were included in the analysis. It was estimated that the overall average expenditure per patient was 38,666 CNY, and an average annual increase of 6.27% was observed from 2002(25,111 CNY) to 2011(46,124 CNY). The average expenditures were 34,460 CNY for stage Ⅰ,39,302 CNY for stage Ⅱ,40,353 CNY for stage Ⅲ, and 37,432 CNY for stage IV diseases(P < 0.01). The expenditure also differed by the therapy type, which was 38,492 CNY for surgery, 27,933 CNY for radiotherapy, and 27,805 CNY for chemotherapy(P < 0.05).Drugs contributed to 45.02% of the overall ***: These conservative estimates suggested that medical expenditures for esophageal cancer in China substantially increased in the last 10 years, treatment for early-stage esophageal cancer costs less than that for advanced cases, and spending on drugs continued to account for a considerable proportion of the overall expenditure.

关键词： Esophageal neoplasms Medical expenditure Diagnosis and treatment China

Threefold Increase in the Number of Drug Resistant TB Cases after Introduction of Universal Drug Susceptibility Testing: Experiences from Two South India districts

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Journal of Tuberculosis Research 2020年第2期8卷 42-52页

作者： Sanath Kumar Gurram Krishnamurthy Sharath Burugina Nagaraja Tanu Anand Karuna D. Sagili Cheluve Gowda Shailaja Basavaraj Poojar Srinath Satyanarayana Department of health and Family Tumkur District Karnataka India Department of Community Medicine ESIC Medical College and PGIMSR Bengaluru India Department of Community Medicine North Delhi Municipal Corporation Medical College Hindu Rao Hospital Delhi India Department of TB and Communicable Diseases the Union South East Asia Office New Delhi India Department of Community Medicine Sri Siddhartha Medical College Tumkur Karnataka India Department of health and Family Belgaum District Karnataka India Department of Pharmacology Kasturba Medical College Mangalore Manipal Academy of Higher Education Manipal India The Union South East Asia Office New Delhi India

Background: In India, tuberculosis (TB) is a major public health problem, and the advent of drug resistance TB (DR-TB) has worsened the situation. The Revised National TB Control Programme (RNTCP) has introduced universal drug susceptibility testing (UDST) for all diagnosed TB cases in 2018. We conducted this study to know the advantage of implementing UDST when compared to selective testing existent in 2017 on key diagnostic cascade parameters and to identify the challenges in the implementation of UDST. Methods: The study was conducted in two districts of Karnataka, India during January 2017-December 2018. The quantitative part consisted of before-and-after design and the qualitative part consisted of descriptive design. Results: In 2017 (during selective testing/“before” period) out of the 2440 TB patients, 80 (3%) were diagnosed with Isoniazid and Rifampicin resistance patients;in contrast in 2018 (during UDST/“after” period) of the 5129 TB patients 258 (5%) were diagnosed with Isoniazid and Rifampicin resistance. However, the proportion of eligible patients tested for rifampicin resistance during the “after” period was 60% when compared to 100% during the “before” period and median turnaround time for testing was also longer during the “after” period when compared to the “before” period (32.5 days vs 27.5 days). Major reasons for these two gaps were found to be difficulties in collecting sputum specimens and transportation. Conclusion: The rollout of UDST has led to a three-fold increase in a number of DR-TB cases detected in the region. There is a need for the programme to increase the proportion tested for DST by increasing the laboratory capacity and address the challenges in sputum collection and transportation.

关键词： Operational Research Criteria C Line Probe Assay Universal Drug Susceptibility Testing Culture and Drug Susceptibility Testing

Evaluation of menopausal status among breast cancer patients with chemotherapy-induced amenorrhea

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Chinese Journal of Cancer Research 2018年第4期30卷 468-476页

作者： Bailin Zhang Jinqi Wu Rongshou Zheng Qian Zhang Margaret Zhuoer Wang Jun Qi Haijing Liu Yipeng Wang Yang Guo Feng Chen Jing Wang Wenyue Lyu Jidong Gao Yi Fang Wanqing Chen Xiang Wang Department of Breast Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Department of Breast Surgery Cancer Hospital of Huanxing Chaoyang District Beijing office for Cancer Registry National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Department of Epidemiology National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Pritzker School of Medicine University of Chicago Department of Clinical Laboratory National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Pharmacy Department Kailuan General Hospital Surgery Department Maternal and Child Health Care Hospital of Yanqing District Beijing office of Cancer Screening National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College

Objective： In patients with chemotherapy-induced amenorrhea （CIA）, the menopausal status is ambiguous anddifficult to evaluate. This study aimed to establish a discriminative model to predict and classify the menopausalstatus of breast cancer patients with ***： This is a single center hospital-based study from 2013 to 2016. The menopausal age distribution andaccumulated incidence rate of CIA are described. Multivariate models were adjusted for established and potentialconfounding factors including age, serum concentration of estradiol （E2） and follicle-stimulating hormone （FSH）,feeding, pregnancy, parity, abortions, and body mass index （BMI）. The odds ratio （OR） and 95% confidenceinterval （95% CI） of different risk factors were ***： A total of 1,796 breast cancer patients were included in this study, among whom, 1,175 （65.42%） werepremenopausal patients and 621 （34.58%） were post-menopause patients. Five hundred and fifty patients wereincluded in CIA analysis, and a cumulative CIA rate of 81.64% was found in them. Age （OR： 1.856, 95% CI：1.732-1.990）, serum concentration of E2 （OR： 0.976, 95% CI： 0.972-0.980） and FSH （OR： 1.060, 95% CI：1.053-i.066）, and menarche age （OR： 1.074, 95% CI： 1.009-1.144） were found to be associated with the patients＇menopausal status. According to multivariate analysis, the discriminative model to predict the menopausal status isLogit （P）=-28.396＋0.536Age-0.014E2＋0.031FSH. The sensitivities for this model were higher than 85%, and itsspecificities were higher than 89%.Conclusions： The discriminative model obtained from this study for predicting menstrual state is important forpremenopausal patients with CIA. This model has high specificity and sensitivity and should be prudently used.

关键词： Breast neoplasms drug therapy amenorrhea menopause logistic models

GIS-Based Situational Analysis of Cutaneous Leishmaniasis Disease (CLD) in Sri Lanka

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Journal of Geoscience and Environment Protection 2023年第3期11卷 70-86页

作者： Sampath Arunashantha Mangala Jayarathne Saseeka Wijesekera Nishan Sakalasooriya Charuni Kottage Department of Geography University of Kelaniya Kelaniya Sri Lanka Regional health Services office Polonnaruwa Sri Lanka

Cutaneous Leishmaniasis (CL) is a severe health problem and a parasitic disease on human dermal and widely pervades tropical and subtropical developing counties. The study is mainly focused on Geographic Information System (GIS) based Situational Analysis (SA). The clinically recorded 394 CL patients’ information was obtained from the district General Hospital of Polonnaruwa (DGHP) for 2017 and 2018. The spatial distribution of these patients was collected using Global Positing System (GPS). Moran’s I Index spatial autocorrelation technique and Getis-Ord Gi were used to identify the study site’s hot spot and cold spot areas. More than 75% of the CL patients’ population were highly involved with agricultural activities, and they are the highly exposed group of the CL in the study area. Also, 75% of the CL population were men, and the highly vulnerable age group was 35 - 39 men and 40 - 44 women. The generated Moran’s I Index indicates 0.0321, representing a randomly distributed pattern of CL patients over the district, and the Getis-Ord Gi Z Score value was >1.96 (p < 0.05). It is revealed that, during and in the post-harvesting periods of paddy cultivation, farmers are highly exposed to sandflies becoming CL patients. Due to this situation, the researchers observed that the highest number of patients have reported in May of both years and the infection period is two to four weeks earlier than the reported month. Hence to prevent the disease spread, it is essential to implement an awareness program regarding sandflies’ behaviour and CLD.

关键词： Sandflies Disease Geoinformatics Techniques Environmental Factors Dry Zone

Climate Influence on Rice, Maize and Wheat Yields and Yield Variability in Nepal

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Journal of Agricultural Science and Technology(B) 2014年第1期4卷 38-48页

作者： Mahadeb Prasad Poudel Shwu-En Chen Wen-Chi Huang district Agriculture Development office under the Ministry of Agriculture Development Triyuga Municipality Udayapur Nepal Department of Agribusiness Management National Pingtung University of Science and Technology Pingtung 912 Taiwan

The weather has a significant influence on yield fluctuations in Nepal, particularly for grains. This study examined the effect of seasonal precipitation, maximum and minimum temperatures and extreme climatic variables on yield levels and variability of rice, maize and wheat yields. The authors applied a stochastic production function approach as suggested by Just-Pope for panel data at the district level. The estimation results indicated that climate trends in Nepal had a significant influence on crop yield levels and variances in various magnitudes and directions. The results showed an increase in precipitation negatively influenced maize yield levels and positively influenced wheat yield levels; however, a positive influence was found to reduce yield variability in rice and wheat. Similarly, an increase in maximum temperature apparently led to decreased maize and increased wheat yield levels, respectively, and also led to increased yield variability in rice and maize. Likewise, the minimum temperature was helpful to increase yield levels for all crops and to decrease the yield variability in rice and maize. Moreover, the extreme climates such as low precipitation and high maximum temperatures significantly influenced the reduction in yield levels of rice and maize, respectively that could be used to design an index insurance product for Nepal.

关键词： Climate change extreme climate stochastic production function yield variability Nepal.

Analysis of Soil Anti-erosion Characteristics under Artificial Rainfall Conditions

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Meteorological and Environmental Research 2013年第11期4卷 55-57页

作者： Yuanjing Zhang Pingcang Zhang Yasong Li Chao Li Institute of Hydrogeology and Environmental Geology Chinese Academy of Geological Sciences Yangtze River Scientific Research Institute Weiqiao Management office in Shijin Irrigation district of Hebei Province

[ Objective] The study aimed to discuss the anti-erosion characteristics of different soils under artificial rainfall conditions. [ Method] Through artificial rainfall experiments, the characteristics of surface runoff and sediment yield of loess, black soil, purple soil and red soil wee cont- rastively studied under the same experimental conditions. [ Resultl Under the same conditions, red soil had the best anti-erosion ability, fallowed by purple soil, black soil and loess. In practice, soil and water conservation measures should be adopted according to erosion characters of different soils. [ Conclusion] The research could provide scientific references for the establishment of soil and water conservation measures in soil erosion ar- eas of China.

关键词： Simulated rainfall Soil erosion Loess Black soil Purple soil Red soil

Factors Associated with Increased Walleye Production in Lined Compared to Earthen-Substrate Ponds

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Open Journal of Animal Sciences 2021年第1期11卷 50-61页

作者： Matthew J. Ward Brian G. Blackwell South Dakota Department of Game Fish and Parks Blue Dog State Fish Hatchery Waubay USA South Dakota Department of Game Fish and Parks District Office Webster USA

Walleye (Sander vitreus) fingerling production can be enhanced when the pond substrate is altered from earthen soils to an exposed liner;however, few differences in water chemistry, prey densities, and food habits have been identified that could potentially explain this production difference. Lack of an explanation led to further comparison of walleye fingerling culture between substrate types during 2016. Two ponds of each type were stocked with 1- to 3-day-old walleye fry, but lined ponds received an additional 104,166 fry/ha and were stocked 1 or 2 days later than earthen ponds (May 10). Walleyes in lined ponds achieved a growth advantage on May 31 (+2.5 mm) and on June 6 (+3.3 mm), but lengths were not significantly different at harvest (June 15). Lined ponds increased walleye yield and number 1.8-fold while not reducing individual fish size at harvest compared to earthen ponds. Walleye food habits were generally similar between pond types with a greater number of zooplankton being consumed through June 6 followed by an increase in larval chironomid consumption at harvest (June 15). After May 30, lined ponds exhibited lower dissolved oxygen and higher ammonia-nitrogen concentrations even though earthen ponds received additional (157 kg/ha) alfalfa (Medicago sativa) meal fertilize

关键词： Walleye Fingerling Culture Pond-Substrate Type

Walleye Egg Survival Was Unaffected by Four Semen Inclusion Techniques during Artificial Fertilization

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Open Journal of Animal Sciences 2023年第2期13卷 199-204页

Improving the percent hatch during artificial spawning of walleye (Sander vitreus) could save agencies substantial resources. Semen inclusion techniques used to artificially fertilize walleye eggs may have a subsequent influence on the percent hatch. We compared walleye egg survival to the early embryo stage across four semen inclusion techniques used during fertilization to determine if one or more of the techniques would result in a higher percent hatch. Six mL of freshly collected (within 2 h) semen was presented to common pools of walleye eggs separated into 250 mL lots by either 1) pouring semen on top of the eggs before sperm activation, 2) placing 3 mL of semen below and above the eggs before sperm activation, 3) pouring 3 mL of semen on top of the eggs, activating sperm, and adding the remaining 3 mL of semen after 30 s, or 4) activating the sperm by adding semen to 1 L of water, mixing and pouring the solution on the eggs within 3 s. All treatments received 1 L of filtered lake water for sperm activation and fertilization. Mean egg survival was similar ranging from 49.5% to 56.7% among the four techniques and was not significantly different across methods. These results suggest that any of the semen inclusion techniques will likely provide a similar percent hatch for walleye eggs when 250 mL of eggs, 6 mL of semen, and 1 L of water are used during fertilization.

关键词： Walleye Egg Collection Walleye Propagation Walleye Spawning Operations