Vascular calcification is a crucial risk factor that affects the incidence and mortality of cardiovascular disease in chronic kidney disease patients.Modern medicine relies on calcium-phosphorus binding agents,calcium...Vascular calcification is a crucial risk factor that affects the incidence and mortality of cardiovascular disease in chronic kidney disease patients.Modern medicine relies on calcium-phosphorus binding agents,calcium mimetics,active vitamin D,and hemodialysis to prevent and treat vascular calcification,however,their efficacy is unsatisfactory and adverse reactions often occur.Medical plant therapy can act as an integrative regulator in patients with chronic kidney disease-associated vascular calcification,which can significantly improve patients’symptoms,but its specific mechanism has not been fully elucidated yet.In this paper,we reviewed the domestic and international theoretical studies on the pathogenesis mechanism of chronic kidney disease-associated vascular calcification in recent years,summarized eight active ingredients of medicinal plants as well as four compound formulas for improving chronic kidney disease-associated vascular calcification,and explored the mechanism of action of herbal medicine,which will provide a new strategy for promoting the prevention and treatment of vascular calcification.展开更多
Background:To systematically evaluate the efficacy and safety of activating blood and resolving stasis in patients with IgA nephropathy.Methods:From inception to May 2022,databases including PubMed,Embase,the Cochrane...Background:To systematically evaluate the efficacy and safety of activating blood and resolving stasis in patients with IgA nephropathy.Methods:From inception to May 2022,databases including PubMed,Embase,the Cochrane Library,Web of Science,WanFang database,Chinese Biomedical Database,VIP,and China National Knowledge Infrastructure were searched for randomized controlled trials about enhancing blood circulation and removing stasis for IgA nephropathy.For the articles that satisfied the requirements,quality assessment and meta-analysis were done.Results:Seventeen randomized controlled trials with a total of 1653 patients were included.Meta-analysis showed that activating blood and resolving stasis could increase therapeutic effectiveness(risk ratio(RR)=-0.47,95%confidence interval(CI)(-0.37,-0.2),P=0.0006)and decrease levels of serum creatinine(RR=-0.47,95%CI(-0.37,-0.2),P=0.0006),urea nitrogen(RR=0.85,95%CI(1.44,0.26),P=0.005),24-hour urinary protein quantification(RR=1.6,95%CI(2.44,0.95).P=0.00001),and urine red blood cell count(RR=1.7,95%CI(2.57,0.82),P=0.0001).There was no significant difference between the two groups in terms of security(RR=0.6,95%CI(0.36,1.01),P=0.05).Conclusion:Western medicine combined activating blood and resolving stasis is more efficient than Western medicine therapy alone in treating IgA nephropathy,but it still needs to be supported by additional large-scale,multi-center randomized controlled clinical trials due to the poor quality of the included trials.展开更多
Medical Data Mining published an article entitled Efficacy of activating blood and resolving stasis therapy for IgA nephropathy:a systematic review and meta-analysis on 16 January 2024.The author confirmed this articl...Medical Data Mining published an article entitled Efficacy of activating blood and resolving stasis therapy for IgA nephropathy:a systematic review and meta-analysis on 16 January 2024.The author confirmed this article’s proof on 15 January 2024 without any questions.But on 15 April 2024,the authors contacted the editorial office to state that the name of the corresponding author is mis-spelled as“Han-Qing Zang”.Hence the mis-spelled name“Han-Qing Zang”is corrected as“Han-Qing Zhang”.“Han-Qing Zhang”is the third author of this article.展开更多
In the past few decades,acute kidney injury(AKI),characterized by an abrupt decrease in kidney filtration rate,has become a public health issue affecting between 1%and 15%of the population,which causes high morbidity ...In the past few decades,acute kidney injury(AKI),characterized by an abrupt decrease in kidney filtration rate,has become a public health issue affecting between 1%and 15%of the population,which causes high morbidity and death.There is mounting evidence that miRNAs are noncoding single-stranded RNAs with a short length of about 20 nucleotides and have been highly conserved through evolution.Through targeting mRNAs,miRNA may mediate intercellular communication during AKI’s physiological and pathological processes.It is interesting to note that natural products can improve AKI by regulating miRNA expression,which might represent a potentially innovative therapeutic strategy.This review aims at providing an overview of the new data obtained on miRNAs in the treatment and diagnosis of AKI,summarizing studies on natural products improving AKI through regulating miRNAs’expression;in the same time,it will shed new light on AKI risk biomarkers and therapeutic intervention as well.We summarized the roles of miRNAs involved in AKI progression or protection against renal injury in 32 articles;we found five natural products can improve AKI by regulating miRNA expression,which will potentially provide a reference for clinical treatment.Natural products might represent a potentially innovative therapeutic strategy;in the same time,miRNAs will shed new light on AKI risk biomarkers and therapeutic intervention.展开更多
Background： Tertiary hospitals serve as the medical service center within the region and play an important role in the medical and health service system. They are also the key targets of public hospital reform in the...Background： Tertiary hospitals serve as the medical service center within the region and play an important role in the medical and health service system. They are also the key targets of public hospital reform in the new era in China. Through the reform of health system, the public hospital efficiency has changed remarkably. Therefore, this study aimed to provide some advice for efficiency assessment of public hospitals in China by comparing and analyzing the consistency of results obtained by three commonly used methods for examining hospital efficiency, that is, ratio analysis （RA）, stochastic frontier analysis （SFA）, and data envelopment analysis （DEA）. Methods： The theoretical basis, operational processes, and the application status of RA, SFA, and DEA were learned through literature analysis. Then, the empirical analysis was conducted based on measured data from 51 tertiary public hospitals in Beijing from 2009 to 2011. Results： The average values of hospital efficiency calculated by SFA with index screening and principal component analysis （PCA） results and those calculated by DEA with index screening results were relatively stable. The efficiency of specialized hospitals was higher than that of general hospitals and that of traditional Chinese medicine hospitals. The results obtained by SFA with index screening results and the results obtained by S FA with PCA results showed a relatively high correlation （r-value in 2009, 2010, and 2011 were 0.869, 0.753, and 0.842, respectively, P 〈 0.01）. The correlation between results obtained by DEA with index screening results and PCA results and results obtained by other methods showed statistical significance, but the correlation between results obtained by DEA with index screening results and PCA results was lower than that between results obtained by SFA with index screening results and PCA results. Conclusions： RA is not suitable for multi-index evaluation of hospital efficiency. In the given conditions, SFA is a stable efficiency analysis method. In the evaluation of hospital efficiency, DEA combined with PCA should be adopted with caution due to its poor stability.展开更多
Background：In recent years,the prevalence of type 2 diabetes among Chinese population has been increasing by years,directly leading to an average annual growth rate of 19.90% of medical expenditure.Therefore,it is ur...Background：In recent years,the prevalence of type 2 diabetes among Chinese population has been increasing by years,directly leading to an average annual growth rate of 19.90% of medical expenditure.Therefore,it is urgent to work on strategies to control the growth of medical expenditure on type 2 diabetes on the basis of the reality of China.Therefore,in this study,we explored the feasibility of implementing bundled payment in China through analyzing bundled payment standards of type 2 diabetes outpatient services.Methods：This study analyzed the outpatient expenditure on type 2 diabetes with Beijing Urban Employee＆#39;s Basic Medical Insurance from 2010 to 2012.Based on the analysis of outpatient expenditure and its influential factors,we adopted decision tree approach to conduct a case-mix analysis.In the end,we built a case-mix model to calculate the standard expenditure and the upper limit of each combination.Results：We found that age,job status,and whether with complication were significant factors that influence outpatient expenditure for type 2 diabetes.Through the analysis of the decision tree,we used six variables （complication,age,diabetic foot,diabetic nephropathy,cardiac-cerebrovascular disease,and neuropathy） to group the cases,and obtained 11 case-mix groups.Conclusions：We argued that it is feasible to implement bundled payment on type 2 diabetes outpatient services.Bundled payment is effective to control the increase of outpatient expenditure.Further improvements are needed for the implementation of bundled payment reimbursement standards,together with relevant policies and measures.展开更多
Background： Medical misuse of antibiotics is associated with the acquisition and spread of antibiotic resistance, resulting in a lack of effective drugs and increased health-care cost. Nevertheless, inappropriate ant...Background： Medical misuse of antibiotics is associated with the acquisition and spread of antibiotic resistance, resulting in a lack of effective drugs and increased health-care cost. Nevertheless, inappropriate antibiotic use in China remains common and the situation requires urgent improvement. Here, we analyzed the prescriptions of antibiotics and evaluated the rationality of antibiotic use among outpatients in Beijing general hospitals during 2015. Methods： We collected basic medical insurance claim data from January 1, 2015 to December 31, 2015 in 507 general hospitals of Beijing. A descriptive analysis of outpatient antibiotic prescribing was performed. The Anatomical Therapeutic Chemical Classification/ defined daily doses system was used to evaluate the rationality of antibiotic use. Results： Over the study, an estimated 721,930, 613,520, and 822,480 antibiotics were dispensed in primary, secondary, and tertiary general hospitals corresponding to 5.09%, 5.06%, and 2.53% of all prescriptions, respectively. Antibiotic combinations represented 2.95%, 7.74%, and 10.18% of the total antibiotic prescriptions, respectively. Expenditure for the top twenty antibiotics in primary, secondary, and tertiary general hospitals was RMB 42.92, 65.89, and 83.26 million Yuan, respectively. Cephalosporins were the most frequently prescribed class of antibiotic in clinical practice. The antibiotics used inappropriately included azithromycin enteric-coated capsules, compound cefaclor tablets and nifuratel nysfungin vaginal soft capsules in primary hospitals, amoxicilliu and clavulanate potassium dispersible tablets （7：1 ） and cefonicid sodium for injection in secondary hospitals, cefminox sodium for injection and amoxicillin sodium and sulbactam sodium for injection in tertiary hospitals. Conclusions： Antibiotic use in Beijing general hospitals is generally low; however, inappropriate antibiotic use still exists. Inappropriately used antibiotics should be subject to rigorous control and management, and public policy initiatives are required to promote the judicious use of antibiotics.展开更多
文摘Vascular calcification is a crucial risk factor that affects the incidence and mortality of cardiovascular disease in chronic kidney disease patients.Modern medicine relies on calcium-phosphorus binding agents,calcium mimetics,active vitamin D,and hemodialysis to prevent and treat vascular calcification,however,their efficacy is unsatisfactory and adverse reactions often occur.Medical plant therapy can act as an integrative regulator in patients with chronic kidney disease-associated vascular calcification,which can significantly improve patients’symptoms,but its specific mechanism has not been fully elucidated yet.In this paper,we reviewed the domestic and international theoretical studies on the pathogenesis mechanism of chronic kidney disease-associated vascular calcification in recent years,summarized eight active ingredients of medicinal plants as well as four compound formulas for improving chronic kidney disease-associated vascular calcification,and explored the mechanism of action of herbal medicine,which will provide a new strategy for promoting the prevention and treatment of vascular calcification.
文摘Background:To systematically evaluate the efficacy and safety of activating blood and resolving stasis in patients with IgA nephropathy.Methods:From inception to May 2022,databases including PubMed,Embase,the Cochrane Library,Web of Science,WanFang database,Chinese Biomedical Database,VIP,and China National Knowledge Infrastructure were searched for randomized controlled trials about enhancing blood circulation and removing stasis for IgA nephropathy.For the articles that satisfied the requirements,quality assessment and meta-analysis were done.Results:Seventeen randomized controlled trials with a total of 1653 patients were included.Meta-analysis showed that activating blood and resolving stasis could increase therapeutic effectiveness(risk ratio(RR)=-0.47,95%confidence interval(CI)(-0.37,-0.2),P=0.0006)and decrease levels of serum creatinine(RR=-0.47,95%CI(-0.37,-0.2),P=0.0006),urea nitrogen(RR=0.85,95%CI(1.44,0.26),P=0.005),24-hour urinary protein quantification(RR=1.6,95%CI(2.44,0.95).P=0.00001),and urine red blood cell count(RR=1.7,95%CI(2.57,0.82),P=0.0001).There was no significant difference between the two groups in terms of security(RR=0.6,95%CI(0.36,1.01),P=0.05).Conclusion:Western medicine combined activating blood and resolving stasis is more efficient than Western medicine therapy alone in treating IgA nephropathy,but it still needs to be supported by additional large-scale,multi-center randomized controlled clinical trials due to the poor quality of the included trials.
文摘Medical Data Mining published an article entitled Efficacy of activating blood and resolving stasis therapy for IgA nephropathy:a systematic review and meta-analysis on 16 January 2024.The author confirmed this article’s proof on 15 January 2024 without any questions.But on 15 April 2024,the authors contacted the editorial office to state that the name of the corresponding author is mis-spelled as“Han-Qing Zang”.Hence the mis-spelled name“Han-Qing Zang”is corrected as“Han-Qing Zhang”.“Han-Qing Zhang”is the third author of this article.
文摘In the past few decades,acute kidney injury(AKI),characterized by an abrupt decrease in kidney filtration rate,has become a public health issue affecting between 1%and 15%of the population,which causes high morbidity and death.There is mounting evidence that miRNAs are noncoding single-stranded RNAs with a short length of about 20 nucleotides and have been highly conserved through evolution.Through targeting mRNAs,miRNA may mediate intercellular communication during AKI’s physiological and pathological processes.It is interesting to note that natural products can improve AKI by regulating miRNA expression,which might represent a potentially innovative therapeutic strategy.This review aims at providing an overview of the new data obtained on miRNAs in the treatment and diagnosis of AKI,summarizing studies on natural products improving AKI through regulating miRNAs’expression;in the same time,it will shed new light on AKI risk biomarkers and therapeutic intervention as well.We summarized the roles of miRNAs involved in AKI progression or protection against renal injury in 32 articles;we found five natural products can improve AKI by regulating miRNA expression,which will potentially provide a reference for clinical treatment.Natural products might represent a potentially innovative therapeutic strategy;in the same time,miRNAs will shed new light on AKI risk biomarkers and therapeutic intervention.
文摘Background： Tertiary hospitals serve as the medical service center within the region and play an important role in the medical and health service system. They are also the key targets of public hospital reform in the new era in China. Through the reform of health system, the public hospital efficiency has changed remarkably. Therefore, this study aimed to provide some advice for efficiency assessment of public hospitals in China by comparing and analyzing the consistency of results obtained by three commonly used methods for examining hospital efficiency, that is, ratio analysis （RA）, stochastic frontier analysis （SFA）, and data envelopment analysis （DEA）. Methods： The theoretical basis, operational processes, and the application status of RA, SFA, and DEA were learned through literature analysis. Then, the empirical analysis was conducted based on measured data from 51 tertiary public hospitals in Beijing from 2009 to 2011. Results： The average values of hospital efficiency calculated by SFA with index screening and principal component analysis （PCA） results and those calculated by DEA with index screening results were relatively stable. The efficiency of specialized hospitals was higher than that of general hospitals and that of traditional Chinese medicine hospitals. The results obtained by SFA with index screening results and the results obtained by S FA with PCA results showed a relatively high correlation （r-value in 2009, 2010, and 2011 were 0.869, 0.753, and 0.842, respectively, P 〈 0.01）. The correlation between results obtained by DEA with index screening results and PCA results and results obtained by other methods showed statistical significance, but the correlation between results obtained by DEA with index screening results and PCA results was lower than that between results obtained by SFA with index screening results and PCA results. Conclusions： RA is not suitable for multi-index evaluation of hospital efficiency. In the given conditions, SFA is a stable efficiency analysis method. In the evaluation of hospital efficiency, DEA combined with PCA should be adopted with caution due to its poor stability.
文摘Background：In recent years,the prevalence of type 2 diabetes among Chinese population has been increasing by years,directly leading to an average annual growth rate of 19.90% of medical expenditure.Therefore,it is urgent to work on strategies to control the growth of medical expenditure on type 2 diabetes on the basis of the reality of China.Therefore,in this study,we explored the feasibility of implementing bundled payment in China through analyzing bundled payment standards of type 2 diabetes outpatient services.Methods：This study analyzed the outpatient expenditure on type 2 diabetes with Beijing Urban Employee＆#39;s Basic Medical Insurance from 2010 to 2012.Based on the analysis of outpatient expenditure and its influential factors,we adopted decision tree approach to conduct a case-mix analysis.In the end,we built a case-mix model to calculate the standard expenditure and the upper limit of each combination.Results：We found that age,job status,and whether with complication were significant factors that influence outpatient expenditure for type 2 diabetes.Through the analysis of the decision tree,we used six variables （complication,age,diabetic foot,diabetic nephropathy,cardiac-cerebrovascular disease,and neuropathy） to group the cases,and obtained 11 case-mix groups.Conclusions：We argued that it is feasible to implement bundled payment on type 2 diabetes outpatient services.Bundled payment is effective to control the increase of outpatient expenditure.Further improvements are needed for the implementation of bundled payment reimbursement standards,together with relevant policies and measures.
文摘Background： Medical misuse of antibiotics is associated with the acquisition and spread of antibiotic resistance, resulting in a lack of effective drugs and increased health-care cost. Nevertheless, inappropriate antibiotic use in China remains common and the situation requires urgent improvement. Here, we analyzed the prescriptions of antibiotics and evaluated the rationality of antibiotic use among outpatients in Beijing general hospitals during 2015. Methods： We collected basic medical insurance claim data from January 1, 2015 to December 31, 2015 in 507 general hospitals of Beijing. A descriptive analysis of outpatient antibiotic prescribing was performed. The Anatomical Therapeutic Chemical Classification/ defined daily doses system was used to evaluate the rationality of antibiotic use. Results： Over the study, an estimated 721,930, 613,520, and 822,480 antibiotics were dispensed in primary, secondary, and tertiary general hospitals corresponding to 5.09%, 5.06%, and 2.53% of all prescriptions, respectively. Antibiotic combinations represented 2.95%, 7.74%, and 10.18% of the total antibiotic prescriptions, respectively. Expenditure for the top twenty antibiotics in primary, secondary, and tertiary general hospitals was RMB 42.92, 65.89, and 83.26 million Yuan, respectively. Cephalosporins were the most frequently prescribed class of antibiotic in clinical practice. The antibiotics used inappropriately included azithromycin enteric-coated capsules, compound cefaclor tablets and nifuratel nysfungin vaginal soft capsules in primary hospitals, amoxicilliu and clavulanate potassium dispersible tablets （7：1 ） and cefonicid sodium for injection in secondary hospitals, cefminox sodium for injection and amoxicillin sodium and sulbactam sodium for injection in tertiary hospitals. Conclusions： Antibiotic use in Beijing general hospitals is generally low; however, inappropriate antibiotic use still exists. Inappropriately used antibiotics should be subject to rigorous control and management, and public policy initiatives are required to promote the judicious use of antibiotics.
