Objective Probing into the changes of medical expenses by medical institutions for references to harnessing such expenses.Methods By means of the time sequence method,analyzing the dynamic changes of medical expenses of district of Beijing from 2004 to 2007,with a comparison for hospitals by levels.Results The study found that between 2004 and 2007,the medical expense per person of outpatients in 26 hospitals fell from 72.73 yuan to 70.09,with a relative ratio with a fixed base being-3.64%;the hospitalization expense per capital rose to 3044.35 yuan,with the same ratio being 13.15%;the percentage of pharmaceuticals sales among total income fell from 40.56% to 40.03%.Conclusions It is feasible to harness the rapid growth of medical expenses by means of normalizing medical charges,restricting the percentage of pharmaceuticals among total expense,improving hospital services at all levels,and promoting health education and health itself.

Objective? To study the value of failure mode and effect analysis (FMEA) in patients undergoing digestive endoscopy. Methods? By convenience sampling, a total of 96 cases undergoing endoscopy admitted in Xinxiang Central Hospital from March 2017 to February of 2019 were selected as the study subjects. The 48 patients enrolled from March 2017 to February 2018 were taken as the control group and given conventional nursing management mode; the other 48 patients enrolled from March 2018 to February 2019 were taken as the observation group and given FMEA management. The two groups were analyzed in the average waiting time for endoscopy examination, recovery time of enterological function after simple examination and compared in terms of the incidence of adverse events regarding nursing safety. Results? The RPN value of 12 main failure modes in the observation group after FMEA management was lower than that before FMEA Management with statistical significance (P＜0.01). The average waiting time of endoscopy, the recovery time of gastrointestinal function after endoscopy, the recovery time of gastrointestinal function after endoscopy and the hospitalization time of simple examination in the observation group were shorter than those in the control group, and the differences were statistically significant (P＜ 0.01). The incidence of nursing safety adverse events in the observation group was 4.17% (2/48), lower than 18.75% (9/48) in the control group, the difference was statistically significant (P＜0.05); among them, the observation group nursing safety adverse events were mostly drug and diet, while the control group was mainly drug and other categories. Conclusions? After FMEA intervention, RPN value of failure mode items decreased significantly, which could promote early recovery of gastrointestinal function, shorten hospitalization time, and reduce the incidence of nursing safety adverse events in the process of endoscopy.

A close relationship between fatty acid metabolism and cancer development is well-established.The hydroxyacyl-coenzyme a dehydrogenase(HADH),a key enzyme in fatty acid beta-oxidation,has recently been identified as an anti-oncogenic factor in various cancers and an oncogenic factor in conditions like acute myeloid leukemia.In cancer cells,HADH not only directly catalyzes fatty acid beta-oxidation but also indirectly influences multiple signaling pathways such as PPAR,TNF-α,JAK-STAT3,PI3K/Akt,IFN-γ,MAPK,and non-canonical Wnt signaling pathways,affecting cancer cell proliferation and migration.HADH shows promise as a potential tumor biomarker for diagnosis,treatment,and prognosis in different cancer types,holding significant clinical value.

Objective To study the diagnostic value of miR-571 for liver fibrosis by detecting miR-571 expression in the peripheral blood of patients with liver fibrosis.Methods From December 2022 to September 2023,40 patients with liver fibrosis,40 patients with chronic hepatitis,and 40 healthy controls were chosen as research subjects.The expression level of miR-571 in peripheral blood was detected using a real-time quantitative polymerase chain reaction,and the relative expression of miR-571 in each group was evaluated.The Spearman correlation method was utilized to examine the relationship between miR-571 and clinical detection indices.To assess the capacity of miR-571 and the multivariate diagnostic model to identify liver fibrosis,binary logistic regression was used to create a multivariate diagnostic model,and ROC curves were generated.Results The expression of miR-571 was significantly higher in the liver fibrosis group than in the healthy control and hepatitis groups,and the difference was statistically significant(P<0.001).The expression level of miR-571 was positively connected with ALT,APRI score,and FIB-4 index(r = 0.23,0.30,0.22,P<0.05)and negatively correlated with PLT(r =-0.19,P<0.05)according to Spearman correlation analysis.Logistic regression research revealed that miR-571 and the FIB-4 index were independent risk factors for liver fibrosis.The AUC for miR-571 to diagnose fibrosis was 0.91(95%CI:0.85～0.96),while the AUC for miR-571 paired with the FIB-4 index was 0.94(95%CI:0.90～0.98).Conclusion MiR-571 expression was shown to be considerably higher in the peripheral blood of hepatic fibrosis patients,and the combined FIB-4 index offers some clinical diagnostic value for hepatic fibrosis.