Background AIDS (acquired immune deficiency syndrome) has become the most devastating disease which humankind has ever encountered. Human immune-deficiency virus (HIV) is transmitted through blood, sexual behavior and mother-to-baby, with more efficient transmission through blood transfusion. HIV risk among blood transfusion was severe due to lack of effective and correctly applied screening method and rigorous management, especially in some developing countries. Since the first HIV screening reagent was approved by FDA to screen the blood in 1985, the fourth generation test has been produced till now. Initially, HIV test was primarily used to screen the blood supply, it also became an important aspect of HIV prevention, especially screening among people donating blood. Today, HIV testing is seen as an integral part of both the nation’s prevention and treatment efforts. Objective To assess the effectiveness of any intervention tests for HIV screening among people donating blood, and find appropriate tests for HIV screening to decrease the risk of HIV transmission by blood transfusion. Search strategy MEDLINE, Cochrane Controlled Trials Register (CENTRAL/CCTR), AIDSLINE, EMBASE, CBM were be searched with the terms: "HIV", "AIDS", "screening", "test", "blood donor", "blood bank" and the detailed screening method. The websites of WHO, UNAIDS, CDC, FDA, and their related links were searched. Letters were mailed to various agencies and experts in this field to acquire unpublished reports. Inclusion criteria RCT and CCT for screening HIV among blood. donors will be included. Observational studies such as cohort studies, cased-control studies, and historical controlled studies will be used for sensitivity analysis. Method of the review According to the principles of Cochrane Review, selection of trials for inclusion, quality assessment of studies, data extraction and syntheses were conducted by reviewers.
Objective To evaluate the correlation between hyperuricemia (HUA) and benign prostatic hyperplasia (BPH). Methods A total of 666 elderly male patients, who had been admitted to the West China Hospital for routine physical examination in May, 2010, were included in this study. All the following indexes were collected: blood pressure, waistline, medical history, international prostatic symptom score (IPSS), serum uric acid (UA), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), 2-hour postprandial blood glucose (PBG-2), prostate-specific antigen (PSA), and prostate volume (PV) measured by ultrasound. Patients with higher level of UA more than 420 μmol/L were included into the HUA group (n=151) while the other patients with normal UA (NUA) were in the NUA group (n=515). Both the metabolic and prostate related indexes in the two groups were compared, and the correlation between HUA and each indexes were analyzed using logistic regression model. Results HUA was significantly associated with abdominal obesity (OR=1.575, 95%CI 1.059 to 2.340), hypertriglyceridemia (OR=2.78, 95%CI 1.877 to 4.118), metabolic syndrome (CDS2007) (OR=1.912, 95%CI 1.267 to 2.885), BPH (OR=1.464, 95%CI 1.465 to 1.635) and lower urinary tract symptoms (LUTS) rating (OR=1.782, 95%CI 1.173 to 1.522). Conclusion HUA is correlated with BPH, meanwhile it is highly accompanied with other risk factors of cardioascular diseases. Hereby, comprehensive medical screening should be considered when treating such patients.
Background 410 Hospital, a hospital in an undeveloped city, identified the first three SARS cases in February, and three more cases in April in Sichuan province. After April 25, it was designated to treat the SARS cases. Objectives This study aims to assess the expenditure for prevention and control of SARS in designated hospital and the impact of SARS on hospital management. Methods With the perspective of SARS designated hospital, a retrospective study was designed. The measures for benefit was healing rate. Medical expenditures of SARS treatment was evaluated, total expenditare were included for assessment in SARS control and management in designated hospital. Sensitivity analysis was applied to explore the range of expenditures when hospital infection rate and healing rate varied. Results All five SARS cases and six suspected cases were cured. The treatment expenditure for SARS confirmed and suspected cases were 7 866 and 4 273 RMB, and their medical expenditures were 14 983.86 and 5 494.92 RMB. Except the expenditure of supporting drugs, no statistical significance was identified in expenditures between confirmed and suspected cases. The total expenditure for designated hospital in control and management of SARS was 1.744 5 million RMB. After designation, the total income of the hospital decreased 33.45 percent compared that before designated. The hospital visits in out-patient and in-patient departments drop 43.62 and 47.33 percent. Conclusions The expenditure of treatment of confirmed and suspected SARS cases were 14 983.86 and 5 490.92 RMB. After designation, the hospital would be great influenced in its management and income.
Health insurance system has been proved to be an effective way to promote the quality of health service in many countries. However, how to control health expenditure under health insurance system remains a problem to be resolved. Some developed countries like UK, Canada and Sweden linked their health technology assessment results with decision making and health insurance management, and made prominent achievements in both expenditure control and quality improvement. China is carrying out its health system reform and running a new health insurance project. Using the experiences of other countries is undoubtedly of great importance in developing and managing our health insurance system.
【摘要】 目的 研究以万珂为主化学疗法方案提高多发性骨髓瘤初发患者自体外周血造血干细胞采集的作用。 方法 回顾性分析2006年1月-2010年11月4例初发多发性骨髓瘤患者在万珂治疗后自体外周血造血干细胞采集的临床资料。疗效判定依据国际骨髓瘤工作组2006年疗效判断标准。 结果 经过万珂为主化学疗法方案治疗3~6个疗程（平均4个疗程）后，3例获得CR及以上疗效，均顺利实施了外周血造血干细胞采集；3例采集次数仅1次，1例为2次；平均获得CD34+细胞8.43×106/kg，完全达到采集要求。 结论 万珂为主化学疗法方案起效快、疗效好，可以提高初发多发性骨髓瘤患者的干细胞采集率。【Abstract】 Objective To explore the improvement of autologous stem cells collection in patients with newly-diagnosed multiple myeloma after Velcade-based chemotherapy. Methods The clinical data of four patients with multiple myeloma who underwent Velcade-based chemotherapy between January 2006 and November 2010 were retrospectively analyzed. The therapeutic effect was observed. Results After 3-6 courses (mean 4 courses) of Velcade-based chemotherapy, 3 patients obtained complete remission (CR) and above response, and the sufficient peripheral blood hematopoietic stem cells were collected successfully. The peripheral blood hematopoietic stem cells were collected once in three patients and twice in one patient. Sufficient number of hematopoietic stem cells (mean CD34 positive-cell 8.43×106/kg) were collected which fully met the collection requirements. Conclusion Velcade-based chemotherapy has advantages of fast action and good therapeutic effect, which can improve the collection of autologous stem cells in patients with newly-diagnosed multiple myeloma.