The prevalence of Helicobacter pylori infection is high worldwide, while numerous research has focused on unraveling the relationship between H. pylori infection and extragastric diseases. Although H. pylori infection has been associated with thyroid diseases, including thyroid nodule (TN), the relationship has mainly focused on potential physiological mechanisms and has not been validated by large population epidemiological investigations. Therefore, we thus designed a case-control study comprising participants who received regular health examination between 2017 and 2019. The cases and controls were diagnosed via ultrasound, while TN types were classified according to the guidelines of the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS). Moreover, H. pylori infection was determined by C14 urea breath test, while its relationship with TN type risk and severity was analyzed using binary and ordinal logistic regression analyses. A total of 43,411 participants, including 13,036 TN patients and 30,375 controls, were finally recruited in the study. The crude odds ratio (OR) was 1.07 in Model 1 (95% CI = 1.03–1.14) without adjustment compared to the H. pylori non-infection group. However, it was negative in Model 2 (OR = 1.02, 95% CI = 0.97–1.06) after being adjusted for gender, age, body mass index (BMI), and blood pressure and in Model 3 (OR = 1.01, 95% CI = 0.97–1.06) after being adjusted for total cholesterol, triglyceride, low-density lipoprotein, and high-density lipoprotein on the basis of Model 2. Control variables, including gender, age, BMI, and diastolic pressure, were significantly correlated with the risk of TN types. Additionally, ordinal logistic regression results revealed that H. pylori infection was positively correlated with malignant differentiation of TN (Model 1: OR = 1.06, 95% CI = 1.02–1.11), while Model 2 and Model 3 showed negative results (Model 2: OR = 1.01, 95% CI = 0.96–1.06; Model 3: OR = 1.01, 95% CI = 0.96–1.05). In conclusion, H. pylori infection was not significantly associated with both TN type risk and severity of its malignant differentiation. These findings provide relevant insights for correcting possible misconceptions regarding TN type pathogenesis and will help guide optimization of therapeutic strategies for thyroid diseases.
Background The purpose of this study was to explore the impact of extreme precipitation on the risk of outpatient visits for depression and to further explore its associated disease burden and vulnerable population. Methods A quasi-Poisson generalized linear regression model combined with distributed lag non-linear model (DLNM) was used to investigate the exposure-lag-response relationship between extreme precipitation (≥95th percentile) and depression outpatient visits from 2017 to 2019 in Suzhou city, Anhui Province, China. Results Extreme precipitation was positively associated with the outpatient visits for depression. The effects of extreme precipitation on depression firstly appeared at lag4 [relative risk (RR): 1.047, 95% confidence interval (CI): 1.005–1.091] and lasted until lag7 (RR = 1.047, 95% CI: 1.009–1.087). Females, patients aged ≥65 years and patients with multiple outpatient visits appeared to be more sensitive to extreme precipitation. The attributable fraction (AF) and numbers (AN) of extreme precipitation on outpatient visits for depression were 5.00% (95% CI: 1.02–8.82%) and 1318.25, respectively. Conclusions Our findings suggested that extreme precipitation may increase the risk of outpatient visits for depression. Further studies on the burden of depression found that females, aged ≥65 years, and patients with multiple visits were priority targets for future warnings. Active intervention measures against extreme precipitation events should be taken to reduce the risk of depression outpatient visits.
Background and objectiveAppendicitis resection is one of the most common surgical procedures in China. Hospitalization expenses are a major determinant of appendicitis treatment. This study explored the factors influencing hospitalization expenses of appendicitis surgery patients in Anhui province and provided a scientific basis for reasonably controlling medical expenses.MethodsA multi-stage random cluster sampling method was used to collect case information on 2,164 patients who underwent appendicitis surgery at 6 county-level public hospitals in Anhui province, China. Path analysis was used to study the factors influencing hospitalization expenses of appendicitis surgery patients.ResultsThe average length of stay (LOS) was 5.62 ± 2.64 days, with a median of 5 days; the average hospitalization expenses were 6,109.60 ± 2,109.44 CNY, with a median of 5,511.93 CNY. The direct effect of LOS was 0.535, which was the most important direct factor affecting hospitalization expenses, and the remaining path coefficient was 0.699. surgical grades, surgical methods, and chronic appendicitis directly affected hospitalization expenses, with direct effects of 0.149, 0.081, and -0.037; surgical costs, anesthesia costs, disease outcomes, age, acute simple appendicitis, and operative duration (OD) not only directly affected hospitalization expenses, but also indirectly affected hospitalization expenses through the LOS, and the total effects were 0.283, 0.045, 0.200, 0.202, -0.162, and 0.062, respectively. The total number of surgeons and assistants only indirectly affected the hospitalization expenses through the LOS, and the indirect effect was 0.020.ConclusionsThe LOS is the most important factor affecting hospitalization expenses. Controlling hospitalization expenses is an effective method of reducing the economic burden of patients undergoing appendicitis surgery and decreasing hospital medical expenditures. Based on controlling the average LOS, combined with other comprehensive measures such as decreasing the OD and health education, strengthening controllable factors, and effectively managing the unreasonable increase in hospitalization expenses.
Background: Lancet gave a 99-point high score to the comprehensive level of diagnosis and treatment of inguinal hernia in China, and more than half of the inguinal hernia surgery procedures were completed in primary hospitals. At present, the hospitalization costs of inguinal hernia surgery patients in primary hospitals, the influencing factors, and the path between the factors are unclear. Innovative methods are needed to quantify the research and evaluation of hospitalization costs for inguinal hernia surgery patients to emphasise the impact of relevant measures on surgeons and hospital cost-control mechanisms. Methods: A retrospective method was used to collect data from inguinal hernia surgery patients. The relationships between hospitalization costs and the following factors (age, gender, surgery, surgical method, surgical time, preoperative bed stay, postoperative bed stay, length of stay, and surgical costs) were analyzed using Spearman’s correlation analyzes, and how these factors influenced hospital expenditure was explored through structural equation modelling. Results: According to Spearman’s rank correlation analysis, the hospitalization costs were related to the eight selected indicators (rs = -0.084 - 0.549, p < 0.01), and the surgical time was most relevant. The total effect of the surgical time on the hospitalization costs (total effect = 0.459) ranked first in the structural equation model, which means that the risk of hospitalization costs was higher with a longer surgical time.The choice of surgical method had a direct effect on the hospitalization costs (total effect = 0.291), and the effect was second only to the surgical time. Other research factors also had an indirect or direct impact on the hospitalization costs. Conclusion: It is necessary to understand the hospitalization costs of inguinal hernia surgery patients and their influencing factors and interactions to form a scientific price incentive system and cost-control mechanism.
Background and objective Appendicitis resection is one of the most common surgical procedures. Hospitalization expenses are a major determinant of appendicitis treatment. This study explored the factors influencing hospitalization expenses of appendicitis patients in Anhui province and provided a scientific basis for reasonably controlling medical expenses. Methods A multi-stage random cluster sampling method was used to collect case information on 2,164 patients who underwent appendicitis surgery at 6 county-level public hospitals in Anhui province, China. Path analysis was used to study the factors influencing hospitalization expenses of appendicitis patients. Results The average length of stay was 5.62 ± 2.64 days, with a median of 5 days; the average hospitalization expenses were 6,109.60 ± 2,109.44 CNY, with a median of 5,511.93 CNY. The direct effect of length of stay was 0.535. Surgical grades, surgical methods, and chronic appendicitis directly affected hospitalization expenses, with direct effects of 0.149, 0.081, and -0.037; surgical costs, anesthesia costs, disease outcomes, age, acute simple appendicitis, and operative duration not only directly affected hospitalization expenses, but also indirectly affected hospitalization expenses, the total effects were 0.283, 0.045, 0.200, 0.202, -0.162, and 0.062, respectively. The total number of surgeons and assistants only indirectly affected hospitalization expenses, with indirect effect of 0.020. Conclusions The length of stay is the most important factor affecting hospitalization expenses. Based on controlling the average length of stay, combined with shortening operative duration, conducting health education, strengthening controllable factors, and other comprehensive measures can effectively reduce the economic burden of patients and hospitals.
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