Healthcare reform in mainland China: The relationship of healthcare reform and economic development in Chinese rural and urban areas

A healthcare system is a major part of any social system that plays a vital role in both developed and developing countries. It is the system that supports our health, environment, life expectancy, and hygiene. A successful healthcare system can bring positive impact to society. For the last few decades, most developed countries have had an organized healthcare system to provide sufficient medical resources to patients. This helps to increase life expectancy and improve hygiene. On the other hand, a better healthcare system also brings negative consequences for the society because an aging population becomes a topic of controversy around the world. Mainland China, the most populous country in the world, has gradually become a superpower in Asia. The Chinese government invests a large amount of its financial resources for economic development, often neglecting the healthcare system. This makes healthcare a controversial topic in Asia. The Chinese healthcare system received criticisms for failing to improve the quality of healthcare services and professionalism in the field during the healthcare reform of the 1990s. The early healthcare reforms and local healthcare insurance schemes in the 1990s supported patients and workers from several provinces, but the gap between urban and rural areas was widened after the 1990s. The outbreak of SARS in 2003 tested the effectiveness of the Chinese healthcare system at the start of millennium. The system was unable to maintain equal access among those in the upper, middle, and working classes in the social structure. The results of healthcare reform in the 1990s and early 2000s demonstrated that the system is unable to support its citizens. Thus, it is important to re-evaluate the healthcare system and public policy in mainland China

Subject-relevant Document Recommendation: A Reference Topic-Based Approach

Knowledge-intensive workers, such as academic researchers, medical professionals or patent engineers, have a demanding need of searching information relevant to their work. Content-based recommender system (CBRS) makes recommendation by analyzing similarity of textual contents between documents and users’ preferences. Although content-based filtering has been one of the promising approaches to document recommendations, it encounters the over-specialization problem. CBRS tends to recommend documents that are similar to what have been in user’s preference profile. Rationally, citations in an article represent the intellectual/affective balance of the individual interpretation in time and domain understanding. A cited article shall be associated with and may reflect the subject domain of its citing articles. Our study addresses the over-specialization problem to support the information needs of researchers. We propose a Reference Topic-based Document Recommendation (RTDR) technique, which exploits the citation information of a focal user’s preferred documents and thereby recommends documents that are relevant to the subject domain of his or her preference. Our primary evaluation results suggest the outperformance of the proposed RTDR to the benchmarks

A Microcantilever-based Gas Flow Sensor for Flow Rate and Direction Detection

The purpose of this paper is to apply characteristics of residual stress that causes cantilever beams to bend for manufacturing a micro-structured gas flow sensor. This study uses a silicon wafer deposited silicon nitride layers, reassembled the gas flow sensor with four cantilever beams that perpendicular to each other and manufactured piezoresistive structure on each micro-cantilever by MEMS technologies, respectively. When the cantilever beams are formed after etching the silicon wafer, it bends up a little due to the released residual stress induced in the previous fabrication process. As air flows through the sensor upstream and downstream beam deformation was made, thus the airflow direction can be determined through comparing the resistance variation between different cantilever beams. The flow rate can also be measured by calculating the total resistance variations on the four cantilevers.Comment: Submitted on behalf of EDA Publishing Association (http://irevues.inist.fr/handle/2042/16838

Outcomes in Neonates with Pulmonary Atresia and Intact Ventricular Septum Underwent Pulmonary Valvulotomy and Valvuloplasty Using a Flexible 2-French Radiofrequency Catheter

Purpose : Outcomes in 6 neonates with pulmonary atresia and intact ventricular septum (PAIVS) Undergoing radiofrequency pulmonary valvulotomy and valvuloplasty (RPVV) were reported to identify the factors favorable for RPVV as the treatment of choice. Materials and Methods: From May 2000 to January 2008, 6 patients with PAWS were included in this retrospective study. They were aged I day to 90 days old. Study modalities included review of recordings of presentations and profiles of chest radiography, electrocardiography, echocardiography, and cardiac catheterization with angiography. Hemodynamic profiles from the echocardiography and the cardiac catheterization were analyzed. Results: Echocardiography showed severe tricuspid regurgitation, membranous atresia of the pulmonary valve, intact ventricular septum, patent ductus arteriosus, and hypoplastic right ventricle in 6 patients. The pulmonary valve annulus were 4.2 to 6.9 mm in diameters, and those of the tricuspid valve were 7.1 to 10.1 mm. Elevated serum level of cardiac enzymes were found in 1 patient with ventriculocoronary communication (VCC). At cardiac catheterization, the ratio of systolic pressure of the right ventricle to that of the left ventricle ranged from 1.43 to 2.33 before RPVV, and from 0.54 to 1.15 after RPVV ((p=0. 027). The pressure gradients ranged from 76 to 136 mmHg before RPVV, and from 15 to 39 mmHg after RPVV (p=0.028). The echocardiographic gradients ranged from 16 to 32 mmHg within 24 hours after RPVV, and from 15 to 50 mmHg at the follow-ups. Conclusion: RPVV can be a treatment of choice for neonates with PAIVS, if there is patent infundibulum, no right-ventricular dependent coronary circulation, and adequate tricuspid valve and pulmonary valve

Association of metabolic syndrome with erosive esophagitis and Barrett’s esophagus in a Chinese population

AbstractBackgroundMetabolic syndrome has been highlighted as a risk factor for several gastrointestinal diseases, including gastroesophageal reflux disease and Barrett’s esophagus (BE). The aim of this study was to investigate the association of metabolic syndrome with erosive esophagitis (EE) and BE.MethodsData were retrospectively collected from patients who visited the Medical Screening Center at Taichung Veterans General Hospital, Taichung, Taiwan from January 2006 to December 2009. All patients underwent an open-access transoral upper gastrointestinal endoscopy, and serum laboratory data were collected. The exclusion criteria included prior gastric surgery, or presence of esophageal varices or peptic ulcers. These patients were assigned to groups according to their endoscopic findings as follows: (1) normal group; (2) EE group; and (3) BE group. Metabolic syndrome was diagnosed based on the International Diabetes Federation criteria.ResultsThere were 560/6499 (8.6%) patients, 214/1118 (9.6%) patients, and 19/95 (20%) patients with metabolic syndrome in the normal, EE, and BE groups, respectively. There was a significantly higher percentage of cases with hypertriglyceridemia in the EE group (67%) compared with the other groups. The BE group had significantly higher rates of central obesity (33%) and hypertension (29.5%) compared with rates in the normal and EE groups. After adjusting for confounders, the positive association with metabolic syndrome still existed in both the EE group (adjusted odds ratio=2.43; 95% confidence interval=1.02–3.44) and the BE group (adjusted odds ratio=2.82; 95% confidence interval=2.05–3.88).ConclusionOur research indicated that in fact there is a greater risk of concurrent metabolic syndrome in patients with EE or BE

Accuracy of hysteroscopic biopsy, compared to dilation and curettage, as a predictor of final pathology in patients with endometrial cancer

AbstractObjectiveTo compare the methods of transcervical resectoscopy versus dilation and curettage (D&C) for endometrial biopsy and to compare these methods for the percentage of histological upgrades at the final posthysterectomy pathology findings in endometrial cancer.Materials and methodsWe retrospectively reviewed 253 cases of uterine cancer diagnosed from May 1995 to January 2014. Included in the study were patients who received transcervical resectoscopy (TCR) or D&C biopsy as the diagnostic method and underwent laparoscopic staging at our institution. The International Federation of Gynecologists and Obstetricians (FIGO) grade in the pathological report of the biopsy and final hysterectomy were recorded. The extrauterine risk was stratified using the initial FIGO grade and depth of myometrium invasion. It was compared to the actual risk using final pathological findings.ResultsWe identified 203 cases of endometrial cancer; 18 (8.9%) patients had a higher histological grade at the final hysterectomy. Among the 203 patients, 76 patients underwent TCR biopsy and 127 underwent D&C biopsy. The histological grade was upgraded in two (2.6%) patients in the TCR group. Three (3.9%) patients had positive peritoneal washings. In the D&C group, 16 (12.6%) patients with three (2.4%) positive peritoneal washings were upgraded.ConclusionTranscervical resectoscopy could provide more precise grading information, compared to D&C (2.6% vs. 12.6%). Doctors could therefore make a more accurate staging plan, based on the preoperative risk evaluation

Have the Chinese Older Adults Received Adequate Healthcare Services since the 2009 Health Reform? Examining the Socioeconomic Disparity in Receiving Adequate Healthcare

China launched a comprehensive health reform in 2009, as part of the central government’s plan to improve its healthcare system. This study investigates the associations of socioeconomic status with receiving adequate healthcare services among Chinese older adults following the 2009 health reform. Using the 6th and the 7th waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a repeated cross-sectional study design was adopted (n = 9305). Firth’s logistic regression models were used for statistical analysis. In the fully adjusted model, being non-married was negatively associated with adequate healthcare services (adjusted odds ratio (AOR) = 0.68, 95% confidence interval (CI): 0.54, 0.86). Higher levels of income were positively associated with adequate healthcare services (all ps \u3c 0.05). Participants who relied on non-urban social insurance plans all had lower odds of receiving adequate healthcare services (all ps \u3c 0.01), compared with older adults who used the urban employment basic medical insurance (UEBMI). However, disparities regarding education and urban-rural differences were not observed in the full model. As China is pushing for further reforms, vulnerable population groups, such as non-married or more impoverished older adults, should be assisted in receiving adequate healthcare services

Associations of staple food consumption and types of cooking oil with waist circumference and body mass index in older Chinese men and women: a panel analysis

Background: The dietary landscape has changed rapidly in China in the past few decades. This research investigates the associations of older adults’ choices and consumption of staple foods and cooking oils with obesity related measurements. Methods: Panel data were extracted from the Chinese Longitudinal Health Longevity Survey from3253 older participants with 6506 observations. Ordinary least squares and ordered logistic regression models were estimated with the outcomes of obesity determined by waist circumference (WC) and body mass index (BMI), respectively. Results: Older men who consumed wheat had wider WCs (β=2.84 [95% confidence interval {CI} 1.55 to 4.13], p\u3c0.01) and higher BMIs (adjusted odds ratio 1.74 [95% CI 1.40 to 2.17], p\u3c0.01) than those who preferred rice. Female participants who used animal-based cooking oil had lower WCs and BMIs than their counterparts who consumed vegetable-based cooking oil. Increased consumption of staple foods was associated with increased rates of obesity in both sexes. Conclusion: Dieticians and nutritionists should design appropriate dietary plans to help reduce obesity and chronic diseases among older Chinese adults. Further clinical trials are needed to continue investigating this topic