Economic burden of irritable bowel syndrome in China

AIM To estimate annual direct and indirect costs for patients diagnosed with irritable bowel syndrome(IBS) and subtypes.METHODS Patients completed a standardized questionnaire concerning usage of healthcare resources, travel costs, meals, and productivity loss of patients when seeking treatment for IBS. Total annual costs per patient were calculated as the sum of direct(including medical and nonmedical) and indirect costs. Total annual costs per patient among various IBS subtypes were compared. Analysis of variance and bootstrapped independent sample t-tests were performed to determine differences between groups after controlling for IBS subtypes.RESULTS A total of 105 IBS patients(64.80% female), mean age of 57.12 years ± 10.31 years), mean disease duration of 4.31 years ± 5.40 years, were included. Total annual costs per patient were estimated as CNy18262.84(USD2933.08). Inpatient and outpatient healthcare use were major cost drivers, accounting for 46.41%and 23.36% of total annual costs, respectively. Productivity loss accounted for 25.32% of total annual costs. The proportions of direct and indirect costs were similarto published studies in other countries. Nationally, the total costs of managing IBS would amount to CNy123.83 billion(USD1.99 billion). Among the IBS subtypes, total annual costs per patient of IBS-M was highest at CNy18891.18(USD3034). Furthermore, there was significant difference in productivity loss among IBS subtypes(P = 0.031).CONCLUSION IBS imposes a huge economic burden on patients and healthcare systems, which could account for 3.3% of the total healthcare budget for the entire Chinese nation. More than two-thirds of total annual costs of IBS consist of inpatient and outpatient healthcare use. Among the subtypes, IBS-M patients appear to have the greatest economic burden but require further confirmation.

Protective effects of Salvia miltiorrhizae on the hearts of rats with severe acute pancreatits or obstructive jaundice

Objective： To investigate the therapeutic effects and mechanisms of Salvia miltiorrhizae （Danshen） in the treatment of severe acute pancreatitis （SAP）- or obstructive jaundice （OJ）-induced heart injury. Methods： A total of 288 rats were used for SAP- （n= 108） and O J-associated （n= 180） experiments. The rats were randomly divided into sham-operated, model control, and Salvia miltiorrhizae-treated groups. According to the difference of time points after operation, SAP rats in each group were subdivided into 3, 6 and 12 h subgroups （n=12）, whereas OJ rats were subdivided into 7, 14, 21, and 28 d subgroups （n=lS）. At the corresponding time points after operation, the mortality rates of the rats, the contents of endotoxin and phospholipase A2 （PLA：） in blood, and pathological changes of the hearts were investigated. Results： The numbers of dead SAP and OJ rats in the treated groups declined as compared with those in the model control group, but not significantly （P〉0.05）. The contents ofendotoxin （at 6 and 12 h in SAP rats and on 7, 14, 21, and 28 d in OJ rats, respectively） and PLA2 （at 6 and 12 h in SAP rats and on 28 d in OJ rats, respectively） in the treated group were significantly lower than those in the model control group （P〈0.01 and P〈0.001, respectively）. Besides, myocardial pathological injuries were mitigated in SAP and OJ rats. Conclusion： In this study, we found that Salvia rniltiorrhizae improved myocardial pathological changes, reduced the content of PLA2 in blood, and decreased the mortality rates of SAP and OJ rats, exerting protective effects on the hearts of the rats.