BACKGROUND Accurate measurement of energy expenditure(EE)is critical for optimizing nutritional support in critically ill patients.Indirect calorimetry(IC)is the reference method used,but its availability at the bedsi...BACKGROUND Accurate measurement of energy expenditure(EE)is critical for optimizing nutritional support in critically ill patients.Indirect calorimetry(IC)is the reference method used,but its availability at the bedside is limited.As a result,numerous predictive equations have been devised to estimate EE in critically ill patients,along with other more novel methods recently proposed.AIM To evaluate current methods of measuring EE in critical care,focusing on practical challenges,accuracy,feasibility,and limitations.We will also discuss how these methods contribute to improving nutrition support strategies for intensive care unit patients for a more personalised and effective solution.METHODS A comprehensive search was conducted in PubMed and EMBASE for studies published from December 2014 to December 2024.Eligible studies compared EE measurement methods in critically ill populations.Data extraction and quality assessment followed PRISMA guidelines.Adherence to reporting standards was assessed using the TRIPOD questionnaire and risk of bias was evaluated using the PROBAST tool.RESULTS Twenty five original studies met the inclusion criteria and were analysed.CONCLUSION Each method has unique strengths and limitations.We found that while IC remains the reference standard,less accurate predictive equations have greater accessibility and ease of implementation.Emerging technologies show promise for bedside applicability.Future research should address practical barriers and validate newer approaches.展开更多
In response to the critical need to balance fiscal expenditure governance with sustainable development,this study identifies the optimal level of fiscal expenditure decentralization that enhances sustainable outcomes....In response to the critical need to balance fiscal expenditure governance with sustainable development,this study identifies the optimal level of fiscal expenditure decentralization that enhances sustainable outcomes.The study aims to determine the optimal expenditure decentralization that maximizes sustainable development outcomes across these dimensions.Theoretically,we analyze the impact mechanism of expenditure decentralization on sustainable development and hypothesize that there is an inverted U-shaped relationship between them,along with the possibility of finding an optimal level of expenditure decentralization.We test this hypothesis by measuring sustainable development in the context of a panel data set for 52 countries covering the period 1991–2016 using the National Sustainable Development Index(NSDI).We find strong support for the inverted U-shaped relationship between expenditure decentralization and sustainable development in both the short and long run.Sustainable development is the coordination of economic,social,and environmental development to balance intergenerational welfare and maximize the total welfare of all generations.Excessive and insufficient expenditure decentralization can potentially negatively affect the efficiency of public goods provision and residents’utility,thereby adversely impacting total welfare and sustainable development.The results are robust to alternative specifications and to IV estimation to correct for potential endogeneity.The expenditure decentralization level most conducive to sustainable development lies between 30.9%and 34.5%.The optimal decentralization range was determined using the Lind–Mehlum method,supporting the main findings of this study.This research thus contributes to the literature by quantifying the complex relationship between fiscal decentralization policies and sustainable development,providing a clear,actionable pathway for policymakers seeking sustainable outcomes.展开更多
Objective:The number of liver cancer patients in China accounts for more than half of the world.However,China currently lacks national,multicenter economic burden data,and meanwhile,measuring the differences among dif...Objective:The number of liver cancer patients in China accounts for more than half of the world.However,China currently lacks national,multicenter economic burden data,and meanwhile,measuring the differences among different subgroups will be informative to formulate corresponding policies in liver cancer control.Thus,the aim of the study was to measure the economic burden of liver cancer by various subgroups.Methods:A hospital-based,multicenter and cross-sectional survey was conducted during 2012・2014,covering 39 hospitals and 21 project sites in 13 provinces across China.The questionnaire covers clinical information,sociology,expenditure,and related variables.All expenditure data were reported in Chinese Yuan(CNY)using 2014 values.Results:A total of 2,223 liver cancer patients were enrolled,of whom 59.61%were late-stage cases(III-IV),and 53.8%were hepatocellular carcinoma.The average total expenditure per liver cancer patient was estimated as 53,220 CNY,including 48,612 CNY of medical expenditures(91.3%)and 4,608 CNY of non-medical expenditures(8.7%).The average total expenditures in stage I,H,m and stage IV were 52,817 CNY,50,877 CNY,50,678 CNY and 54,089 CNY(P>0.05),respectively.Non-medical expenditures including additional meals,additional nutrition care,transportation,accommodation and hired informal nursing were 1,453 CNY,839 CNY,946 CNY,679 CNY and 200 CNY,respectively.The one-year out-of-pocket expenditure of a newly diagnosed patient was 24,953 CNY,and 77.2%of the patients suffered an unmanageable financial burden.Multivariate analysis showed that overall expenditure differed in almost all subgroups(P<0.05),except for sex,clinical stage,and pathologic type.Conclusions:There was no difference in treatment expenditure for liver cancer patients at different clinical stages,which suggests that maintaining efforts on treatment efficacy improvement is important but not enough.To fiirtherly reduce the overall economic burden from liver cancer,more effort should be given to primary and secondary prevention strategies.展开更多
It is widely recognized that developed countries have been spending more than developing countries on health care. Objective of the study is to examine determinants of health expenditure and what factors influence it....It is widely recognized that developed countries have been spending more than developing countries on health care. Objective of the study is to examine determinants of health expenditure and what factors influence it. Fifteen Asian countries and 30 OECD countries were chosen to explore the difference of their health expenditure structures. Model of health expenditure per person was estimated to be dependent on market demand, market supply, and other exogenous factors. A model with country specific and time effects of health expenditure was used and estimated. The study found a negative but insignificant relationship between price and health expenditure and a positive and significant relationship between GDP and health expenditure. Urban population density as proxy of urbanization was found to induce the health expenditure in the OECD. Out-of-pocket payment was also found to induce health expenditure for both the Asian and the OECD countries. A net effect of improvement in the health status or a lower mortality rate and a higher life expectancy caused an increase in the health expenditure among the Asian countries studied but decreased health expenditure in the OECD countries. In terms of income elasticity, it was found to be smaller than one in both groups of the countries. Since the income has changed faster than the other factors, the net effect of changes of all factors over period of time will cause rising in health care expenditure. Finally, the model indicated that both the Asian and OECD countries will continue to have a rising health expenditure per person over a period of time.展开更多
It is obvious that the change trend of our government expenditure scale declined constantly .The expenditure proportion of science, education, culture and hygiene increased fast, reflected the situation that the finan...It is obvious that the change trend of our government expenditure scale declined constantly .The expenditure proportion of science, education, culture and hygiene increased fast, reflected the situation that the finance of our country was transformed into “public finance” from “building type finance” gradually.The expenditure proportion of the local is higher than central authorities. This is disadvantageous for our country’s economy development and society stability.展开更多
In this present-day global pandemic that has not been completely resolved,health is a major concern among people,and correspondingly,people are demanding higher standards for public health products and services provid...In this present-day global pandemic that has not been completely resolved,health is a major concern among people,and correspondingly,people are demanding higher standards for public health products and services provided by the government.In this paper,we measure the technical efficiency of public health expenditure in each province by using the data envelopment analysis(DEA)model,and examine the impact of decentralization on the efficiency of public health expenditure under the fiscal decentralization system using the panel data from 31 provinces from 2012-2019 in a panel model subject to fixed effects.展开更多
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...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 China.Methods: 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 expenditure.Results: 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 CNY.The 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 diagnosed at a later stage were likely to spend more,whereas those with a lower household income and those who underwent surgery spent less(all P < 0.05).Conclusions: For patients in China, direct expenditure for the diagnosis and treatment of CRC seemed catastrophic,and non-medical expenditure was non-ignorable. The financial burden varied among subgroups, especially among patients with different clinical stages of disease, which suggests that, in China, CRC screening might be cost-effective.展开更多
Objective: A solid understanding of levels and trends of spending on cancer is important to evaluate whether our healthcare resources were wisely spent and to prioritize future resources for cancer treatment and preve...Objective: A solid understanding of levels and trends of spending on cancer is important to evaluate whether our healthcare resources were wisely spent and to prioritize future resources for cancer treatment and prevention. However, studies on economic burden of cancers in China are scant and the results are inconsistent. Methods: The Chinese hospital information database and nearly 350 million inpatient medical record data were used. As the ratios of cancer inpatient payments to total inpatient payments were mainly influenced by the grades and sites of hospitals, the estimates of payments of cancer inpatients in this study were stratified by hospital grades and provinces. Only the payments of cancer inpatients happened in grade 2, grade 3 and specialized cancer hospitals were included in the analyses. The total medical payments of cancers in China were estimated based on the ratios of outpatient payments to inpatient payments in specialized cancer hospitals. Results: From 2011 to 2015, the payments of cancer inpatients in China have increased by 84.1% and the total inpatient payments reached 177.1 billion RMB in 2015, accounting for 4.3% of the total health expenditure in China. Based on the ratio of outpatient payments to inpatient payments, the total payments on cancer treatments in China were estimated to be 221.4 billion RMB in 2015. Among different cancer types, the highest payments were the treatment of trachea, bronchus and lung cancer. The major cancer inpatient payments (67.1% in 2015) spent in grade 3 general hospitals and this ratio increased continually from 2011 to 2015. The expenditure of cancer treatments also varies by region with the major expenditure in the eastern region of China. Conclusions: This study estimated the total payments of cancer treatments in China and analyzed how the money was spent on cancer treatments in the recent 5 years, which would provide information for decision makings on the allocation of resources to service provisioning, prevention strategies, research funding, and assessing whether the economic burden of cancer is affordable to the governments.展开更多
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 dia...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 trends.Methods: 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 China.Results: 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 expenditure.Conclusions: 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.展开更多
The intervention of behaviors, including physical activity (PA), has become a strategy for many hospitals dealing with patients with chronic diseases. Given the limited evidence available about PA and healthcare use w...The intervention of behaviors, including physical activity (PA), has become a strategy for many hospitals dealing with patients with chronic diseases. Given the limited evidence available about PA and healthcare use with chronic diseases, this study explored the association between different levels of PA and annual hospital service use and expenditure for inpatients with coronary heart disease (CHD) in China. We analyzed PA information from the first follow-up survey (2013) of the Dongfeng-Tongji cohort study of 1460 CHD inpatients. We examined factors such as PA exercise volume and years of PA and their associations with the number of inpatient visits, number of hospital days, and inpatient costs and total medical costs. We found that the number of hospital days and the number of inpatient visits were negatively associated with intensity of PA level. Similarly, total inpatient and outpatient costs declined when the PA exercise volume levels increased. Furthermore, there were also significant associations between the number of hospital days, inpatient costs or total medical costs and levels of PA years. This study provides the first empirical evidence about the effects of the intensity and years of PA on hospital service use and expenditure of CHD in China. It suggests that the patients' PA, especially the vigorous PA, should be promoted widely to the public and patients in order to relieve the financial burden of CHD.展开更多
Objective:To describe the contemporary trends in total,inpatient,and outpatient expenditure on major subtypes of cancer in different classifications of hospitals in China's Mainland.Methods:Home page of Inpatient ...Objective:To describe the contemporary trends in total,inpatient,and outpatient expenditure on major subtypes of cancer in different classifications of hospitals in China's Mainland.Methods:Home page of Inpatient Medical Records(HIMRs)and Hospital Annual Reports(HARs)were used to estimate hospital care expenditure on cancer.Inpatient payments and their share of cancer were calculated with the top-down method.Kriging spatial interpolation methods were used at the county level and summed at the province level.Outpatient expenditure was estimated with inpatient expenditure and the ratios of outpatient to inpatient payments in specialized cancer hospitals,stratified by province.Total expenditure on cancer was the sum of both payments.Log-linear regression was applied to estimate annual percentage change(APC)of expenditure.Results:Total expenses for cancer of Chinese residents reached up to 304.84 billion Chinese Yuan(CNY)in2017,accounting for 5.8%of the total health expenses(THE).After adjusting for consumer price index(CPI),medical expenses for cancer have increased from 63.30 billion CNY in 2008 to 249.56 billion CNY in 2017[APC:15.2%,95%confidence interval(95%CI):13.4%-17.0%].The APC was slightly higher than THE around 2013,while was lower after 2013.During 2008-2017,the ratio of inpatient to outpatient costs for cancer decreased from4.3:1 to 3.8:1.The inpatient payments for cancer mainly happened in grade 3 general hospitals,East China,and among lung,colorectal,and stomach cancer;while the fastest increase was found in West China,and among thyroid,prostate,and colorectal cancer.Conclusions:During 2008-2017,the rapid growth trend of medical expenses for cancer has been effectively controlled with the continuous deepening of medical reform and improvements of residents’health care.More attention should be paid to potential increases of medical costs caused by technological progress and demand release.Socialized and multi-channel insurance financing modes should be explored in the future.展开更多
Objective: Colorectal cancer(CRC) causes a substantial burden of disease in China and the evidence of economic burden triggered is fundamental for priority setting. The aim of this survey was to quantify medical expen...Objective: Colorectal cancer(CRC) causes a substantial burden of disease in China and the evidence of economic burden triggered is fundamental for priority setting. The aim of this survey was to quantify medical expenditures and the time trends for CRC diagnosis and treatment in China.Methods: From 2012 to 2014, a hospital-based multicenter retrospective survey was conducted in 13 provinces across China. For each eligible CRC patient diagnosed from 2002 to 2011, clinical information and expenditure data were extracted using a uniform questionnaire. All expenditure data were reported in Chinese Yuan(CNY)using 2011 values.Results: Of the 14,536 CRC patients included, the average age at diagnosis was 58.2 years and 15.8% were stageI cases. The average medical expenditure per patient was estimated at 37,902 CNY [95 % confidence interval(95%CI): 37,282-38,522], and the annual average increase rate was 9.2% from 2002 to 2011(P for trend <0.001), with a cumulative increase of 2.4 times(from 23,275 CNY to 56,010 CNY). The expenditure per patient in stages Ⅰ, Ⅱ, Ⅲ and Ⅳ were 31,698 CNY, 37,067 CNY, 38,918 CNY and 42,614 CNY, respectively(P<0.001). Expenditure significantly differed within various subgroups. Expenses for drugs contributed the largest proportion(52.6%).Conclusions: These conservative estimates illustrated that medical expenditures for CRC diagnosis and treatment in tertiary hospitals in China were substantial and increased rapidly over the 10 years, with drugs continually being the main expense by 2011. Relatively, medical expenditures are lower for CRC in the earlier stages. These findings will facilitate the economic evaluation of CRC prevention and control in China.展开更多
Objective To investigate the relationship between resting energy expenditure (REE) and patterns of obesity/regional fat parameters in Chinese adults. Methods Body mass index (BMI), fat mass (FM), fat-free mass (FFM) w...Objective To investigate the relationship between resting energy expenditure (REE) and patterns of obesity/regional fat parameters in Chinese adults. Methods Body mass index (BMI), fat mass (FM), fat-free mass (FFM) were assessed in 109 Chinese adults (52 men and 57 women), and their abdominal visceral adipose tissue area (VA) and subcutaneous fat area (SA) were measured using magnetic resonance imaging (MRI) measurements. REE was measured with indirect calorimetry and compared with normal and obese subjects. Multivariate analysis was used to study the factors related to REE. Results The resting energy expenditure per kilogram of body weight (REE/kg) was closely related with the area of abdominal visceral fat measured with MRI. REE/kg was significantly lower in overweight/obesity subjects than in normal-weighted subjects, and significantly lower in subjects with abdominal obesity (VA≥100 cm2) than in subjects with non-abdominal obesity (VA< 100 cm2, BMI≥25 kg/m2). In the stepwise regression analysis of REE/kg on regional fat parameters, VA in men and women and SA in women were independent factors reversely related to REE/kg. Conclusion REE/kg is associated with the visceral fat area and more prominent in men. REE/kg can be used as an index in the pathophysiology of intra-abdominal obesity.展开更多
Regulation of blood glucose levels and body fat is critical for survival.Leptin circulates freely in blood and controls body weight and food intake mainly through hypothalamic receptors and regulates glucose metabolis...Regulation of blood glucose levels and body fat is critical for survival.Leptin circulates freely in blood and controls body weight and food intake mainly through hypothalamic receptors and regulates glucose metabolism in the liver both directly through leptin receptors and indirectly via the hypothalamic receptors of central nervous system.Leptin affects food intake regulation and eventually glucose metabolism, lipometabolism,endocrine and immune functions, reproductive function, adipose tissue metabolism and energy expenditure.Leptin also exerts peripheral effects directly on glucose metabolism and gluconeogenesis.Most of obese human subjects have elevated plasma levels of leptin associated to the size of their total adipose tissue mass.Hence gluconeogenic function may be an essential factor in the regulation of nutritional intake and weight gain.The aim of this review is therefore to identify and module the possible effects of leptin with special application in gluconeogenesis.In addition, this review includes the study of fat consumption and energy expenditure in the body.Specific modulation of leptin receptors and adipose tissues functioning could have important inference on therapeutic strategies.展开更多
The potential risks of perfluorooctane sulfonate （PFOS） are of increasing ecological concern. Swimming performance is linked to the fitness and health of fish. However, the impacts of PFOS on swimming performance re...The potential risks of perfluorooctane sulfonate （PFOS） are of increasing ecological concern. Swimming performance is linked to the fitness and health of fish. However, the impacts of PFOS on swimming performance remain largely unknown. We investigated the ecotoxicological effects of acute exposure to PFOS on the swimming performance and energy expenditure of juvenile goldfish （Carassius auratus）. The fish were exposed to a range of PFOS concentrations （0, 0.5, 2, 8 and 32 mg/L） for 48 hr. The spontaneous swimming activity, fast-start swimming performance, critical swimming speed （Ucrit） and active metabolic rate （AMR） of the goldfish were examined after exposure to PFOS. PFOS exposure resulted in remarkable effects on spontaneous activity. Motion distance was reduced, and the proportion of motionless time increased with increasing concentrations of PFOS. However, no significant alterations in the fast-start performance-related kinematic parameters, such as latency time, maximum linear velocity, maximum linear acceleration or escape distance during the first 120 msec after stimulus, were observed after PFOS exposure. Unexpectedly, although PFOS exposure had marked influences on the swimming oxygen consumption rates and AMR of goldfish, the U crit of the goldfish was not significantly affected by PFOS. This may result in a noteworthy increase in the energetic cost of transport. The overall results indicate that, in contrast to spontaneous activity, underlying swimming capabilities are maintained in goldfish after short-term exposure to PFOS, but energy expenditure during the process of swimming is dramatically aggravated.展开更多
Social security has,as one of its primary aims,the provision of financial support to those deemed to be poor or facing the threat of poverty.Based on China's national statistical data covering social insurance,soc...Social security has,as one of its primary aims,the provision of financial support to those deemed to be poor or facing the threat of poverty.Based on China's national statistical data covering social insurance,social assistance,and social welfare between the period 1978–2018,this paper evaluates the effect of social security expenditure in reducing income inequality and rural poverty with cointegration analysis.It was found that there is a positive correlation between social security expenditure and the income gap of urban and rural residents in the long run,but the effect is very limited;nearly 99%of the changes of the urban–rural income gap come from its own contributions.Further research also shows that the elasticity of rural poverty incidence to social security expenditure is–0.2255,which indicates social security expenditure helps reduce rural absolute poverty.Based on these findings,the policy implications can be that much social security expenditure and a more equitable social security system should be encouraged.It will become one of the major anti-poverty strategies after 2020 in China when we win the battle against absolute poverty.展开更多
Objective Doubly labeled water （DLW） method is the gold standard for measuring total energy expenditure （TEE）. We used this method to measure TEE in Chinese young men. Methods Sixteen healthy young men age 23±...Objective Doubly labeled water （DLW） method is the gold standard for measuring total energy expenditure （TEE）. We used this method to measure TEE in Chinese young men. Methods Sixteen healthy young men age 23±1 recruited. TEE was measured by the DLW method, by indirect calorimetry. We also conducted 24-h estimate energy requirements of the subjects. years with body mass index 22.0±1.4 kg/m2 were and basal energy expenditure （BEE） was determined activity, energy balance and factorial approach to Results TEE of subjects by DLW method was 9.45±0.57 M J/day （2258±180 kcal/day）. The 24-h activity was 10.80±0.33 M J/day （2582±136 kcal/day）. The energy requirement, derived from energy balance observations, was 9.93±1.32 M J/day （2373±315 kcal/day）. The BEE of 6.65±0.28 M J/day （1589±67 kcal/day）, calculated by the adjusted Schofield equation, was significantly higher （P〈O.O01） than that measured by indirect calorimetry, 5.99-±0.66 M J/day （1433-±158 kcal/day）. The TEE derived from the factorial approach was 10.31-±0.43 M J/day （2463±104 kcal/day）. Conclusion The TEE of Chinese young men measured by the DLW method was about 10% lower than the current recommended nutrient intake （RNI）, suggesting that the RNI for Chinese men maybe overestimated. Further studies are warranted to determine the value of the estimated energy requirement.展开更多
Traditional Chinese medicines(TCMs)are commonly used in China,and some of them have been proved to be effective against infection caused by certain pathogenic bacteria.In the present study,we aimed to describe the tre...Traditional Chinese medicines(TCMs)are commonly used in China,and some of them have been proved to be effective against infection caused by certain pathogenic bacteria.In the present study,we aimed to describe the trends of antibacterial-effect traditional Chinese medicine(AeTCM)consumption and expenditure in secondary and tertiary hospitals in China using pharmaceutical sales data from January 2011 to December 2015.Aggregated monthly surveillance data on AeTCM sales in China’s hospitals were retrospectively analyzed.Population weighted daily define doses,which are the recommended daily amounts based on dosage regimen recommended in the manufacturers’instructions,were adopted.The AeTCM consumption was expressed in DDD per 1000 inhabitants per day(DID).The AeTCM expenditure was expressed in US dollars.A compound annual growth rate(CAGR)was used to describe the growth of AeTCM consumption and expenditure.A total of 1293 AeTCMs were matched and analyzed from 468 tertiary hospitals and 114 secondary hospitals from 28 provinces.The total AeTCM consumption and expenditure demonstrated a significant upward trend during the study period from 4.07 DID to 6.82 DID with a CAGR of 13.75%,and 839.75 million US dollars to 1276.82 million US dollars with a CAGR of 11.04%,respectively.Compared with eastern provinces,the consumption of AeTCMs was higher in the central and western provinces.Parenteral AeTCMs accounted for 7.20%of the total Ae TCM consumption,but nearly 45%of the total AeTCM expenditure.The AeTCM use in China demonstrated a rapid growth,which could be the result of the substitutional effect from antimicrobial stewardship and brought a potential risk of overuse.More studies are needed to further explore the potential efficacy of AeTCMs as an alternative approach towards infection treatment and to help confine antimicrobial resistance.展开更多
Based on the account of the vital role which the national finance played in supporting agriculture,the thesis presents the current situation of financial support for agriculture in China,in terms of the limited scale ...Based on the account of the vital role which the national finance played in supporting agriculture,the thesis presents the current situation of financial support for agriculture in China,in terms of the limited scale and irrational structure of financial support expenditure in agriculture.On the basis of the brief introduction of the current level of Chinese farmers' income,the thesis discusses the effects of scale and irrational structure of financial support expenditure in agriculture on the farmers' income,according to the related data of financial support expenditure in agriculture and rural per capita net income.The results indicate that the calculating regression equation has a remarkable explanation power,reflecting the positive role of financial support expenditure in agriculture played by national finance in increasing the farmers' income.As regards the structure of financial support expenditure in agriculture at present,according to the proportion from high to low,the expenditure primarily consists of three parts from high to low in sequence as follows:productive expenditure and funds for public undertakings,capital construction expenditure,and rural relief expenditure plus science and technology funds.Such sequence deviates from the marginal production effects of financial support expenditure in agriculture and the correlation of farmers' income,which demonstrates the severe irrationality of the structure of financial support expenditure in agriculture.Corresponding countermeasures are put forward as follows:on one hand,we should continue intensifying the efforts to support agriculture financially in order to form a regular increase mechanism;on the other hand,we should adjust and optimize the structure of financial support expenditure in agriculture,and further crystallize the investment flows.展开更多
Objective： We analyzed the proportion of cancer-caused hospitalization expenses in total hospitalization expenses from national authoritative data and explored influencing factors of the proportion so as to provide e...Objective： We analyzed the proportion of cancer-caused hospitalization expenses in total hospitalization expenses from national authoritative data and explored influencing factors of the proportion so as to provide effective data information for more rational utilization of health resources.Methods： Two-level lineal regression model was used to explore influencing factors of ratios of the cancer inpatient expenditure over the total inpatient expenditure of hospitals in China in 2015. A total of 40.76 million inpatient medical records were used to generate the outcome variables, while the explanatory variables were from hospital information database and China Health and Family Planning Statistical Yearbook and literatures.Results： Inpatient expenditure pattern for cancer（IEPC） varied largely across provinces, ranging from 3.03% to19.61%. The major sources of variability were from the differences of hospital level and number of beds. There was homogeneity within a province, while heterogeneity between the provinces. Rising one level of the hospital led to the increase of 0.475 natural logarithm units of IEPC averagely. The number of beds increasing 1,000 each made the natural logarithm of IEPC increase one unit averagely.Conclusions： Our study showed that a considerable proportion of IEPC variation could be explained by the differences of hospital level and number of beds. It implied that it is possible to estimate disease-specific ratio of inpatient expense taking into account key influencing factors in China. Furthermore, this study is an input to economic and financial analyses and provides evidence for future study on the national economic burden of cancer.展开更多
文摘BACKGROUND Accurate measurement of energy expenditure(EE)is critical for optimizing nutritional support in critically ill patients.Indirect calorimetry(IC)is the reference method used,but its availability at the bedside is limited.As a result,numerous predictive equations have been devised to estimate EE in critically ill patients,along with other more novel methods recently proposed.AIM To evaluate current methods of measuring EE in critical care,focusing on practical challenges,accuracy,feasibility,and limitations.We will also discuss how these methods contribute to improving nutrition support strategies for intensive care unit patients for a more personalised and effective solution.METHODS A comprehensive search was conducted in PubMed and EMBASE for studies published from December 2014 to December 2024.Eligible studies compared EE measurement methods in critically ill populations.Data extraction and quality assessment followed PRISMA guidelines.Adherence to reporting standards was assessed using the TRIPOD questionnaire and risk of bias was evaluated using the PROBAST tool.RESULTS Twenty five original studies met the inclusion criteria and were analysed.CONCLUSION Each method has unique strengths and limitations.We found that while IC remains the reference standard,less accurate predictive equations have greater accessibility and ease of implementation.Emerging technologies show promise for bedside applicability.Future research should address practical barriers and validate newer approaches.
基金supported by Zhejiang Province Philosophy and Social Science Planning Fund(24NDQN090YB)Hangzhou City Philosophy and Social Science Planning Fund(Z23JC041)the Major program project of the National Social Science Fund of China(No:19ZDA055).
文摘In response to the critical need to balance fiscal expenditure governance with sustainable development,this study identifies the optimal level of fiscal expenditure decentralization that enhances sustainable outcomes.The study aims to determine the optimal expenditure decentralization that maximizes sustainable development outcomes across these dimensions.Theoretically,we analyze the impact mechanism of expenditure decentralization on sustainable development and hypothesize that there is an inverted U-shaped relationship between them,along with the possibility of finding an optimal level of expenditure decentralization.We test this hypothesis by measuring sustainable development in the context of a panel data set for 52 countries covering the period 1991–2016 using the National Sustainable Development Index(NSDI).We find strong support for the inverted U-shaped relationship between expenditure decentralization and sustainable development in both the short and long run.Sustainable development is the coordination of economic,social,and environmental development to balance intergenerational welfare and maximize the total welfare of all generations.Excessive and insufficient expenditure decentralization can potentially negatively affect the efficiency of public goods provision and residents’utility,thereby adversely impacting total welfare and sustainable development.The results are robust to alternative specifications and to IV estimation to correct for potential endogeneity.The expenditure decentralization level most conducive to sustainable development lies between 30.9%and 34.5%.The optimal decentralization range was determined using the Lind–Mehlum method,supporting the main findings of this study.This research thus contributes to the literature by quantifying the complex relationship between fiscal decentralization policies and sustainable development,providing a clear,actionable pathway for policymakers seeking sustainable outcomes.
基金This study was supported by the State Key Projects Specialized on Infectious Diseases(No.2O17ZX1O2O12O1-008-002,No.2O17ZX1O2O12O1-OO6-OO3)Sanming Project of Medicine in Shenzhen(No.SZSM201911015)+2 种基金the National Natural Science Foundation of China(No.81974492,No.81773521)Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(No.2019-I2M-2-004)the Natural Science Foundation of Guangdong Province(No.2020A151501478).
文摘Objective:The number of liver cancer patients in China accounts for more than half of the world.However,China currently lacks national,multicenter economic burden data,and meanwhile,measuring the differences among different subgroups will be informative to formulate corresponding policies in liver cancer control.Thus,the aim of the study was to measure the economic burden of liver cancer by various subgroups.Methods:A hospital-based,multicenter and cross-sectional survey was conducted during 2012・2014,covering 39 hospitals and 21 project sites in 13 provinces across China.The questionnaire covers clinical information,sociology,expenditure,and related variables.All expenditure data were reported in Chinese Yuan(CNY)using 2014 values.Results:A total of 2,223 liver cancer patients were enrolled,of whom 59.61%were late-stage cases(III-IV),and 53.8%were hepatocellular carcinoma.The average total expenditure per liver cancer patient was estimated as 53,220 CNY,including 48,612 CNY of medical expenditures(91.3%)and 4,608 CNY of non-medical expenditures(8.7%).The average total expenditures in stage I,H,m and stage IV were 52,817 CNY,50,877 CNY,50,678 CNY and 54,089 CNY(P>0.05),respectively.Non-medical expenditures including additional meals,additional nutrition care,transportation,accommodation and hired informal nursing were 1,453 CNY,839 CNY,946 CNY,679 CNY and 200 CNY,respectively.The one-year out-of-pocket expenditure of a newly diagnosed patient was 24,953 CNY,and 77.2%of the patients suffered an unmanageable financial burden.Multivariate analysis showed that overall expenditure differed in almost all subgroups(P<0.05),except for sex,clinical stage,and pathologic type.Conclusions:There was no difference in treatment expenditure for liver cancer patients at different clinical stages,which suggests that maintaining efforts on treatment efficacy improvement is important but not enough.To fiirtherly reduce the overall economic burden from liver cancer,more effort should be given to primary and secondary prevention strategies.
文摘It is widely recognized that developed countries have been spending more than developing countries on health care. Objective of the study is to examine determinants of health expenditure and what factors influence it. Fifteen Asian countries and 30 OECD countries were chosen to explore the difference of their health expenditure structures. Model of health expenditure per person was estimated to be dependent on market demand, market supply, and other exogenous factors. A model with country specific and time effects of health expenditure was used and estimated. The study found a negative but insignificant relationship between price and health expenditure and a positive and significant relationship between GDP and health expenditure. Urban population density as proxy of urbanization was found to induce the health expenditure in the OECD. Out-of-pocket payment was also found to induce health expenditure for both the Asian and the OECD countries. A net effect of improvement in the health status or a lower mortality rate and a higher life expectancy caused an increase in the health expenditure among the Asian countries studied but decreased health expenditure in the OECD countries. In terms of income elasticity, it was found to be smaller than one in both groups of the countries. Since the income has changed faster than the other factors, the net effect of changes of all factors over period of time will cause rising in health care expenditure. Finally, the model indicated that both the Asian and OECD countries will continue to have a rising health expenditure per person over a period of time.
文摘It is obvious that the change trend of our government expenditure scale declined constantly .The expenditure proportion of science, education, culture and hygiene increased fast, reflected the situation that the finance of our country was transformed into “public finance” from “building type finance” gradually.The expenditure proportion of the local is higher than central authorities. This is disadvantageous for our country’s economy development and society stability.
基金supported by the Foshan Social Science Planning Project in 2022,based on“How to Improve the Enterprise Service System and Promote the Reform of the Foshan Business Enabling Environmental System”(Project Number:2022-ZDA01)Foshan Social Science Planning Major Project in 2022,Foshan Social Science Federation,2022(5)the Student Academic Foundation of Foshan University in 2022,based on“Cultivating a Refreshing‘Soft Environment’to Build‘Hard Power’for Development:A Study on the Influencing Factors and Enhancement of Business Environment in Foshan Oriented on Entrepreneurial Satisfaction”(Project Number:xsjj202214zsa02),Communist Youth League Foshan University Committee,2022(6).
文摘In this present-day global pandemic that has not been completely resolved,health is a major concern among people,and correspondingly,people are demanding higher standards for public health products and services provided by the government.In this paper,we measure the technical efficiency of public health expenditure in each province by using the data envelopment analysis(DEA)model,and examine the impact of decentralization on the efficiency of public health expenditure under the fiscal decentralization system using the panel data from 31 provinces from 2012-2019 in a panel model subject to fixed effects.
基金supported by the grants from the Beijing Hope Run Special Fund(#LC2012YF44)National Natural Science Foundation of China(No.81402740)+1 种基金Specialized Research Fund for the Doctoral Program of Higher Education(No.20131106120014)The National Health and Family Planning Committee of P.R.China
文摘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 China.Methods: 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 expenditure.Results: 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 CNY.The 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 diagnosed at a later stage were likely to spend more,whereas those with a lower household income and those who underwent surgery spent less(all P < 0.05).Conclusions: For patients in China, direct expenditure for the diagnosis and treatment of CRC seemed catastrophic,and non-medical expenditure was non-ignorable. The financial burden varied among subgroups, especially among patients with different clinical stages of disease, which suggests that, in China, CRC screening might be cost-effective.
基金supported by National Natural Science Foundation of China (No.71403189)
文摘Objective: A solid understanding of levels and trends of spending on cancer is important to evaluate whether our healthcare resources were wisely spent and to prioritize future resources for cancer treatment and prevention. However, studies on economic burden of cancers in China are scant and the results are inconsistent. Methods: The Chinese hospital information database and nearly 350 million inpatient medical record data were used. As the ratios of cancer inpatient payments to total inpatient payments were mainly influenced by the grades and sites of hospitals, the estimates of payments of cancer inpatients in this study were stratified by hospital grades and provinces. Only the payments of cancer inpatients happened in grade 2, grade 3 and specialized cancer hospitals were included in the analyses. The total medical payments of cancers in China were estimated based on the ratios of outpatient payments to inpatient payments in specialized cancer hospitals. Results: From 2011 to 2015, the payments of cancer inpatients in China have increased by 84.1% and the total inpatient payments reached 177.1 billion RMB in 2015, accounting for 4.3% of the total health expenditure in China. Based on the ratio of outpatient payments to inpatient payments, the total payments on cancer treatments in China were estimated to be 221.4 billion RMB in 2015. Among different cancer types, the highest payments were the treatment of trachea, bronchus and lung cancer. The major cancer inpatient payments (67.1% in 2015) spent in grade 3 general hospitals and this ratio increased continually from 2011 to 2015. The expenditure of cancer treatments also varies by region with the major expenditure in the eastern region of China. Conclusions: This study estimated the total payments of cancer treatments in China and analyzed how the money was spent on cancer treatments in the recent 5 years, which would provide information for decision makings on the allocation of resources to service provisioning, prevention strategies, research funding, and assessing whether the economic burden of cancer is affordable to the governments.
基金supported by the National Health and Family Plan Commission of P. R. China
文摘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 trends.Methods: 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 China.Results: 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 expenditure.Conclusions: 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.
文摘The intervention of behaviors, including physical activity (PA), has become a strategy for many hospitals dealing with patients with chronic diseases. Given the limited evidence available about PA and healthcare use with chronic diseases, this study explored the association between different levels of PA and annual hospital service use and expenditure for inpatients with coronary heart disease (CHD) in China. We analyzed PA information from the first follow-up survey (2013) of the Dongfeng-Tongji cohort study of 1460 CHD inpatients. We examined factors such as PA exercise volume and years of PA and their associations with the number of inpatient visits, number of hospital days, and inpatient costs and total medical costs. We found that the number of hospital days and the number of inpatient visits were negatively associated with intensity of PA level. Similarly, total inpatient and outpatient costs declined when the PA exercise volume levels increased. Furthermore, there were also significant associations between the number of hospital days, inpatient costs or total medical costs and levels of PA years. This study provides the first empirical evidence about the effects of the intensity and years of PA on hospital service use and expenditure of CHD in China. It suggests that the patients' PA, especially the vigorous PA, should be promoted widely to the public and patients in order to relieve the financial burden of CHD.
基金supported by the National Key Research and Development Program of China(No.2018YFC 1311704)。
文摘Objective:To describe the contemporary trends in total,inpatient,and outpatient expenditure on major subtypes of cancer in different classifications of hospitals in China's Mainland.Methods:Home page of Inpatient Medical Records(HIMRs)and Hospital Annual Reports(HARs)were used to estimate hospital care expenditure on cancer.Inpatient payments and their share of cancer were calculated with the top-down method.Kriging spatial interpolation methods were used at the county level and summed at the province level.Outpatient expenditure was estimated with inpatient expenditure and the ratios of outpatient to inpatient payments in specialized cancer hospitals,stratified by province.Total expenditure on cancer was the sum of both payments.Log-linear regression was applied to estimate annual percentage change(APC)of expenditure.Results:Total expenses for cancer of Chinese residents reached up to 304.84 billion Chinese Yuan(CNY)in2017,accounting for 5.8%of the total health expenses(THE).After adjusting for consumer price index(CPI),medical expenses for cancer have increased from 63.30 billion CNY in 2008 to 249.56 billion CNY in 2017[APC:15.2%,95%confidence interval(95%CI):13.4%-17.0%].The APC was slightly higher than THE around 2013,while was lower after 2013.During 2008-2017,the ratio of inpatient to outpatient costs for cancer decreased from4.3:1 to 3.8:1.The inpatient payments for cancer mainly happened in grade 3 general hospitals,East China,and among lung,colorectal,and stomach cancer;while the fastest increase was found in West China,and among thyroid,prostate,and colorectal cancer.Conclusions:During 2008-2017,the rapid growth trend of medical expenses for cancer has been effectively controlled with the continuous deepening of medical reform and improvements of residents’health care.More attention should be paid to potential increases of medical costs caused by technological progress and demand release.Socialized and multi-channel insurance financing modes should be explored in the future.
基金co-supported by the National Natural Science Foundation of China (No. 81773521)CAMS Innovation Fund for Medical Sciences (No. 2017-I2M-1006, No. 2016-12M-2-004)+4 种基金the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences (No. 2018RC330001)the National Key Projects of Research and Development of China (No. 2018 YFC1315000)China Scholarship Council (No. 201908110180)the Sanming Project of Medicine in Shenzhen (No. SZSM201911015)the Cancer Screening Program in Urban China funded by National Health Commission of People’s Republic of China
文摘Objective: Colorectal cancer(CRC) causes a substantial burden of disease in China and the evidence of economic burden triggered is fundamental for priority setting. The aim of this survey was to quantify medical expenditures and the time trends for CRC diagnosis and treatment in China.Methods: From 2012 to 2014, a hospital-based multicenter retrospective survey was conducted in 13 provinces across China. For each eligible CRC patient diagnosed from 2002 to 2011, clinical information and expenditure data were extracted using a uniform questionnaire. All expenditure data were reported in Chinese Yuan(CNY)using 2011 values.Results: Of the 14,536 CRC patients included, the average age at diagnosis was 58.2 years and 15.8% were stageI cases. The average medical expenditure per patient was estimated at 37,902 CNY [95 % confidence interval(95%CI): 37,282-38,522], and the annual average increase rate was 9.2% from 2002 to 2011(P for trend <0.001), with a cumulative increase of 2.4 times(from 23,275 CNY to 56,010 CNY). The expenditure per patient in stages Ⅰ, Ⅱ, Ⅲ and Ⅳ were 31,698 CNY, 37,067 CNY, 38,918 CNY and 42,614 CNY, respectively(P<0.001). Expenditure significantly differed within various subgroups. Expenses for drugs contributed the largest proportion(52.6%).Conclusions: These conservative estimates illustrated that medical expenditures for CRC diagnosis and treatment in tertiary hospitals in China were substantial and increased rapidly over the 10 years, with drugs continually being the main expense by 2011. Relatively, medical expenditures are lower for CRC in the earlier stages. These findings will facilitate the economic evaluation of CRC prevention and control in China.
文摘Objective To investigate the relationship between resting energy expenditure (REE) and patterns of obesity/regional fat parameters in Chinese adults. Methods Body mass index (BMI), fat mass (FM), fat-free mass (FFM) were assessed in 109 Chinese adults (52 men and 57 women), and their abdominal visceral adipose tissue area (VA) and subcutaneous fat area (SA) were measured using magnetic resonance imaging (MRI) measurements. REE was measured with indirect calorimetry and compared with normal and obese subjects. Multivariate analysis was used to study the factors related to REE. Results The resting energy expenditure per kilogram of body weight (REE/kg) was closely related with the area of abdominal visceral fat measured with MRI. REE/kg was significantly lower in overweight/obesity subjects than in normal-weighted subjects, and significantly lower in subjects with abdominal obesity (VA≥100 cm2) than in subjects with non-abdominal obesity (VA< 100 cm2, BMI≥25 kg/m2). In the stepwise regression analysis of REE/kg on regional fat parameters, VA in men and women and SA in women were independent factors reversely related to REE/kg. Conclusion REE/kg is associated with the visceral fat area and more prominent in men. REE/kg can be used as an index in the pathophysiology of intra-abdominal obesity.
基金supported by Higher Education Commission,Islamabad,Pakistan(Tracking Id:213-58222-2BM2-162)
文摘Regulation of blood glucose levels and body fat is critical for survival.Leptin circulates freely in blood and controls body weight and food intake mainly through hypothalamic receptors and regulates glucose metabolism in the liver both directly through leptin receptors and indirectly via the hypothalamic receptors of central nervous system.Leptin affects food intake regulation and eventually glucose metabolism, lipometabolism,endocrine and immune functions, reproductive function, adipose tissue metabolism and energy expenditure.Leptin also exerts peripheral effects directly on glucose metabolism and gluconeogenesis.Most of obese human subjects have elevated plasma levels of leptin associated to the size of their total adipose tissue mass.Hence gluconeogenic function may be an essential factor in the regulation of nutritional intake and weight gain.The aim of this review is therefore to identify and module the possible effects of leptin with special application in gluconeogenesis.In addition, this review includes the study of fat consumption and energy expenditure in the body.Specific modulation of leptin receptors and adipose tissues functioning could have important inference on therapeutic strategies.
基金supported by the Natural Science Foundation Project of Chongqing (No. CSTC2011jjA20006)the Research Project of Chongqing Education Committee (No. KJ110606)the projects of Chongqing Normal University (No. 2011XLZ11, 10XLB037)
文摘The potential risks of perfluorooctane sulfonate （PFOS） are of increasing ecological concern. Swimming performance is linked to the fitness and health of fish. However, the impacts of PFOS on swimming performance remain largely unknown. We investigated the ecotoxicological effects of acute exposure to PFOS on the swimming performance and energy expenditure of juvenile goldfish （Carassius auratus）. The fish were exposed to a range of PFOS concentrations （0, 0.5, 2, 8 and 32 mg/L） for 48 hr. The spontaneous swimming activity, fast-start swimming performance, critical swimming speed （Ucrit） and active metabolic rate （AMR） of the goldfish were examined after exposure to PFOS. PFOS exposure resulted in remarkable effects on spontaneous activity. Motion distance was reduced, and the proportion of motionless time increased with increasing concentrations of PFOS. However, no significant alterations in the fast-start performance-related kinematic parameters, such as latency time, maximum linear velocity, maximum linear acceleration or escape distance during the first 120 msec after stimulus, were observed after PFOS exposure. Unexpectedly, although PFOS exposure had marked influences on the swimming oxygen consumption rates and AMR of goldfish, the U crit of the goldfish was not significantly affected by PFOS. This may result in a noteworthy increase in the energetic cost of transport. The overall results indicate that, in contrast to spontaneous activity, underlying swimming capabilities are maintained in goldfish after short-term exposure to PFOS, but energy expenditure during the process of swimming is dramatically aggravated.
基金financially supported by the National Social Science Fund of China(16ZDA021)the Humanities and Social Sciences Research Fund of the Ministry of Education of China(18YJA630135)。
文摘Social security has,as one of its primary aims,the provision of financial support to those deemed to be poor or facing the threat of poverty.Based on China's national statistical data covering social insurance,social assistance,and social welfare between the period 1978–2018,this paper evaluates the effect of social security expenditure in reducing income inequality and rural poverty with cointegration analysis.It was found that there is a positive correlation between social security expenditure and the income gap of urban and rural residents in the long run,but the effect is very limited;nearly 99%of the changes of the urban–rural income gap come from its own contributions.Further research also shows that the elasticity of rural poverty incidence to social security expenditure is–0.2255,which indicates social security expenditure helps reduce rural absolute poverty.Based on these findings,the policy implications can be that much social security expenditure and a more equitable social security system should be encouraged.It will become one of the major anti-poverty strategies after 2020 in China when we win the battle against absolute poverty.
基金supported by the projects of National Natural Science Foundation of China (No.30771811)the National Technology Research and Development Program in the Eleventh Five-Year Plan of China(No.2008BAI58B01)
文摘Objective Doubly labeled water （DLW） method is the gold standard for measuring total energy expenditure （TEE）. We used this method to measure TEE in Chinese young men. Methods Sixteen healthy young men age 23±1 recruited. TEE was measured by the DLW method, by indirect calorimetry. We also conducted 24-h estimate energy requirements of the subjects. years with body mass index 22.0±1.4 kg/m2 were and basal energy expenditure （BEE） was determined activity, energy balance and factorial approach to Results TEE of subjects by DLW method was 9.45±0.57 M J/day （2258±180 kcal/day）. The 24-h activity was 10.80±0.33 M J/day （2582±136 kcal/day）. The energy requirement, derived from energy balance observations, was 9.93±1.32 M J/day （2373±315 kcal/day）. The BEE of 6.65±0.28 M J/day （1589±67 kcal/day）, calculated by the adjusted Schofield equation, was significantly higher （P〈O.O01） than that measured by indirect calorimetry, 5.99-±0.66 M J/day （1433-±158 kcal/day）. The TEE derived from the factorial approach was 10.31-±0.43 M J/day （2463±104 kcal/day）. Conclusion The TEE of Chinese young men measured by the DLW method was about 10% lower than the current recommended nutrient intake （RNI）, suggesting that the RNI for Chinese men maybe overestimated. Further studies are warranted to determine the value of the estimated energy requirement.
基金National Natural Science Foundation of China(Grant No.81973294,81861138048 and 71774005)China Medical Board(Grant No.17-270)。
文摘Traditional Chinese medicines(TCMs)are commonly used in China,and some of them have been proved to be effective against infection caused by certain pathogenic bacteria.In the present study,we aimed to describe the trends of antibacterial-effect traditional Chinese medicine(AeTCM)consumption and expenditure in secondary and tertiary hospitals in China using pharmaceutical sales data from January 2011 to December 2015.Aggregated monthly surveillance data on AeTCM sales in China’s hospitals were retrospectively analyzed.Population weighted daily define doses,which are the recommended daily amounts based on dosage regimen recommended in the manufacturers’instructions,were adopted.The AeTCM consumption was expressed in DDD per 1000 inhabitants per day(DID).The AeTCM expenditure was expressed in US dollars.A compound annual growth rate(CAGR)was used to describe the growth of AeTCM consumption and expenditure.A total of 1293 AeTCMs were matched and analyzed from 468 tertiary hospitals and 114 secondary hospitals from 28 provinces.The total AeTCM consumption and expenditure demonstrated a significant upward trend during the study period from 4.07 DID to 6.82 DID with a CAGR of 13.75%,and 839.75 million US dollars to 1276.82 million US dollars with a CAGR of 11.04%,respectively.Compared with eastern provinces,the consumption of AeTCMs was higher in the central and western provinces.Parenteral AeTCMs accounted for 7.20%of the total Ae TCM consumption,but nearly 45%of the total AeTCM expenditure.The AeTCM use in China demonstrated a rapid growth,which could be the result of the substitutional effect from antimicrobial stewardship and brought a potential risk of overuse.More studies are needed to further explore the potential efficacy of AeTCMs as an alternative approach towards infection treatment and to help confine antimicrobial resistance.
基金Supported by Liaoning Academy of Social Sciences
文摘Based on the account of the vital role which the national finance played in supporting agriculture,the thesis presents the current situation of financial support for agriculture in China,in terms of the limited scale and irrational structure of financial support expenditure in agriculture.On the basis of the brief introduction of the current level of Chinese farmers' income,the thesis discusses the effects of scale and irrational structure of financial support expenditure in agriculture on the farmers' income,according to the related data of financial support expenditure in agriculture and rural per capita net income.The results indicate that the calculating regression equation has a remarkable explanation power,reflecting the positive role of financial support expenditure in agriculture played by national finance in increasing the farmers' income.As regards the structure of financial support expenditure in agriculture at present,according to the proportion from high to low,the expenditure primarily consists of three parts from high to low in sequence as follows:productive expenditure and funds for public undertakings,capital construction expenditure,and rural relief expenditure plus science and technology funds.Such sequence deviates from the marginal production effects of financial support expenditure in agriculture and the correlation of farmers' income,which demonstrates the severe irrationality of the structure of financial support expenditure in agriculture.Corresponding countermeasures are put forward as follows:on one hand,we should continue intensifying the efforts to support agriculture financially in order to form a regular increase mechanism;on the other hand,we should adjust and optimize the structure of financial support expenditure in agriculture,and further crystallize the investment flows.
基金supported by National Natural Science Foundation of China (No. 71403189)
文摘Objective： We analyzed the proportion of cancer-caused hospitalization expenses in total hospitalization expenses from national authoritative data and explored influencing factors of the proportion so as to provide effective data information for more rational utilization of health resources.Methods： Two-level lineal regression model was used to explore influencing factors of ratios of the cancer inpatient expenditure over the total inpatient expenditure of hospitals in China in 2015. A total of 40.76 million inpatient medical records were used to generate the outcome variables, while the explanatory variables were from hospital information database and China Health and Family Planning Statistical Yearbook and literatures.Results： Inpatient expenditure pattern for cancer（IEPC） varied largely across provinces, ranging from 3.03% to19.61%. The major sources of variability were from the differences of hospital level and number of beds. There was homogeneity within a province, while heterogeneity between the provinces. Rising one level of the hospital led to the increase of 0.475 natural logarithm units of IEPC averagely. The number of beds increasing 1,000 each made the natural logarithm of IEPC increase one unit averagely.Conclusions： Our study showed that a considerable proportion of IEPC variation could be explained by the differences of hospital level and number of beds. It implied that it is possible to estimate disease-specific ratio of inpatient expense taking into account key influencing factors in China. Furthermore, this study is an input to economic and financial analyses and provides evidence for future study on the national economic burden of cancer.
