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Introduction: A retrospective review conducted in three hospitals of Guangdong and Hainan, China. To analyze the variation tendency of mean hospitalization costs and length of stay (LOS) in naval hospitals over nine years, paying special attention to the factors affecting hospitalization costs and LOS to provide a reference base for health resource allocation in naval hospitals.Materials and Methods: A total of 21,375 cases of military patients who were hospitalized and treated in three naval hospitals between January 2008 to December 2016 were extracted from the military health system. There were 16,278 complete and effective cases during those nine years. The situation, trends, and factors influencing hospitalization costs and LOS were analyzed using descriptive statistics, Mann-Whitney U test, Kruskal-Wallis H test, and multiple linear regressions.Results: The following factors showed statistically significant differences in hospitalization costs: special care, primary care, year, military rank, critical illness, allergies, and condition (p < 0.0001); and number of hospitalizations, gender, and age (p < 0.01). The following factors showed statistically significant differences in hospital LOS: year, number of hospitalizations, outcomes, military rank, special care, severity of illness, and condition (p < 0.0001); allergy (p < 0.01); and service and gender (p < 0.05). LOS between 2008-2016 showed a decreasing tendency, while hospitalization costs showed an increasing trend. There were 6 factors that affected Abstract (or Structured Summary) both the cost of hospitalization and LOS: special care, year, military rank, condition, allergy, and gender.Conclusions: The results suggest that improving efficiency of military hospital require strengthening hierarchical referrals and controlling hospital LOS. Shortening LOS, optimizing clinical pathways, and reasonably controlling the costs associated with medicines and surgery can help reduce hospitalization costs for military patients. Controlling the growth of hospitalization costs can help avoid the physical and psychological burden of medical over-treatment on patients and may also optimize the allocation of military health resources. [ABSTRACT FROM AUTHOR]

Stichopus monotuberculatus is one of the most valuable tropical sea cucumbers, with high edible, medical and ecological values. In this study, the spawning of S. monotuberculatus was induced by a modified low-temperature stimulation method. Gonadal maturation, and embryonic, larval and juvenile development were described in detail, and larval breeding was improved by diets supplemented with multiple digestive enzymes. July-September resulted as the optimal breeding period of S. monotuberculatus in Hainan Province, China. Low-temperature stimulation was more suitable than traditional dry stimulation as a method for artificially inducing S. monotuberculatus spawning since its low mortality, whose fertilized eggs took approximately 21 days to develop into juveniles. Compared to the control group, the diets with 2 mg/L α-amylase, 2 mg/L cellulase and 5 μL/L trehalase added increased the larval survival rates at 6 days by 21.37 ± 0.054%, 22.57 ± 0.088% and 29.83 ± 0.105%, respectively, and at 10 days by 24.2 ± 0.094%, 30.02 ± 0.152% and 36.44 ± 0.052%, respectively. For the larval settlement rate, supplement of 1 mg/L α-amylase, 1 mg/L cellulase and 5 μL/L trehalase in the diet could cause 5.30 ± 0.521-fold, 2.86 ± 0.521-fold and 4.66 ± 0.656-fold improvements relative to the control group, respectively. This study may contribute an advanced method for the large-scale artificial breeding and sustainable artificial culture of S. monotuberculatus. • July-September is the optimal breeding period of S. monotuberculatus in China. • Embryonic and larval development was recorded in detail. • Low-temperature stimulation was better than dry stimulation in induced spawning. • Larvae survival and settlement rates were increased by adding digestive enzymes in diets. [ABSTRACT FROM AUTHOR]