1.The relationship of ultrafiltration with diurnal rhythm of blood pressure and cardiac function in hemodialyzed patients
Wenjing FU ; Yanbing SUN ; Qiang JIA
Clinical Medicine of China 2008;24(7):688-690
Objective To investigate the relationship among ultrafiltration (UF), diurnal rhythm of blood pressure (BP) and cardiac structure and function in hemodialyzed(HD) patients. Method 42 hemodialyzed patients were studied. Intensified UF during routine HD were given to them for 4 weeks. Before and after 4 weeks, everyone received 24 hours ambulatory blood pressure monitoring and cardiac doppler and recorded diameter of left atrium (LAD) ,left ventricle (LVEDD), thickness of posterior wall of left ventricle during end stage of diastolic period (LVPWT) ,thickness of interventricular septum(IVST) ,ejection fraction (EF). Result In hemodialyzed patients, non-dipper hypertension was much more than dippers (P < 0.05). There was significant difference between nocturnal BP and cardiac structure before and after 4 weeks of hemodialysis ( P < 0.05 ). Conclusion Nocturnal hyperten- sion of hemodialyzed patients is related to hypervolemia. Intensive ultrafihration can improve nocturnal hypertension and eardiac function.
2.Classification and operation of the occipital scale deformity
Long GAO ; Ribing YE ; Yanbing FU ; Wei TIAN ; Dajiang HAO
Chinese Journal of Primary Medicine and Pharmacy 2009;16(z2):3-4
Objective To explore classification methods and Surgical techniques of the squama occipitalis deformities.Methods A retrospective analysis from 2001 to 2008 treated 16 cases of squama occipitalis deformties,according to MR findings,put forward classification method of the squama occipitalis and diagnostic criteria of foramen magnum trailing edge and the occipital scale department hypertrophy.Results All patients after the use of median incision posterior fossa decompression,the clinical symptoms in patients with varying degrees to resume.Conclusion It is important to the squama occipitalis deformities on reasonable classification has obvious clinical instruction value on preoperative assessment and the operation.
3.Enlightenment of the DRG payment reform in the United States on the reform of China′s medical insurance payment methods
Yipei WANG ; Yanbing ZENG ; Kaihua GAO ; Wei FU ; Changxiao JIN
Chinese Journal of Hospital Administration 2023;39(2):93-96
In order to curb the excessive growth of medical expenses, the United States has initiated payment reform of diagnosis-related groups (DRG) since 1983, and developed a series of complementary measures to address issues such as overcoding and declining healthcare service quality which were exposed during the reform. The authors discussed the implementation of DRG payment reform in the United States, namely the case-mix specialization of medical institutions and the reduction of costs, as well as the relationship between the two. On this basis, the authors suggested that when implementing reforms to the medical insurance payment system in China, it is imperative to avoid such loopholes as overcoding by medical institutions and excessive pursuit of efficiency at the expense of quality control, as well as the decline of comprehensive rescue capability and quality of care incurred by the exacerbated specialization.