Objective: To examine the effect of diagnosis-related groups (DRGs) point payment on hospitalization costs of parturition among lying-in women, so as to provide the evidence for alleviating the burdens and saving medical resources among lying-in women. Methods: Lying-in women's age, gestational age, parity, duration of hospital stay, DRGs grouping and hospitalization costs were collected from the Inpatient Medical Record System and DRG Operation Analysis System in a tertiary women and children's hospital in Ningbo City from 2020 to 2021. The changes of hospitalization costs of parturition were compared among lying-in women before and after DRGs point payments, and the association between DRGs point payments and gross hospitalization costs of parturition was examined among lying-in women using a multivariable logistic regression analysis. Results: A total of 11 505 lying-in women after DRGs point payments, including 6 216 women at age of 30 years and below (54.03%), and 10 871 lying-in women before DRGs point payments, including 6 208 women at age of 30 years and below (57.11%), were enrolled. The median (interquartile range) gross hospitalization expenses, material expenses and laboratory testing expenses of parturition were 8 519.19 (2 456.61), 881.38 (816.16) and 939.00 (310.00) Yuan among lying-in women after DRGs point payments, which were significantly lower than those [9 123.13 (2 660.33), 915.57 (825.26), 1 036.00 (385.00) Yuan] among lying-in women before DRGs point payments (Z=-21.971,-16.061 and -27.199, all P<0.001). Multivariable logistic regression analysis showed that DRGs point payment was statistically associated with lower gross hospitalization expenses of parturition among lying-in women after adjustment for age, duration of hospital stay, gestational age, parity, type of delivery and development of complications (OR=0.462, 95%CI: 0.432-0.494). Conclusion DRGs point payment is beneficial to reduce the hospitalization cost of parturition among lying-in women.

Patient satisfaction reflects the patients' subjective feelings which are subject to several factors.The physician-patient relationship is the critical factor of patients' satisfaction with the hospital.Harmonious doctor-patient relationship is the bridge of promoting mutual understanding,trust,and communication,and also improves patients' satisfaction and loyalty with the hospital.The establishment of effective mechanisms for the management in improving patient satisfaction will be an important link with the harmonious doctor-patient relationship,at the same time raise the reputation of hospital to build up a harmonious society.

Objective Through adverse event reporting module in hospital nursing manage-ment system, research group screened out the fall incidence higher departments to explore the effect of workshop mode in tralning nurses' prevention of falls of hospitalized patients. Methods A tralning team was set up under the guidance of hospital nursing department, to determine the content of the project and implementation process. 176 registered nurses were received tralning of fall-prevention by workshop mode, compared the differences in fall prevention knowledge level of nurses before and after tralning. Likert's 5-points were used in the investigation for satisfaction of participants. Results Aver-age score of after tralning was (18.66 ±1.32). The previous increase was (2.42 ±2.06). The differences was statistically significant (P=0.000). The comprehensive evaluation of the tralning mode from the participants was over 92.00%, except for the tralner was 89.77%. Participants were satisfied with the workshop mode . Conclusion Application of workshop in tralning program can improve nurses' knowledge of fall-prevention and guarantee patient safety.

Adult ; Child ; Endoscopy ; Fibrous Dysplasia of Bone ; pathology ; surgery ; Humans ; Male ; Nose ; surgery ; Orbit ; pathology

Objective To analyze the clinical and immunological manifestations of antiphospholipid syndrome(APS)in a cohort of 100 patients.Methods The clinical and serologic features of APS(Sapporo preliminary criteria)in 100 patients were analyzed retrospectively.Results The cohort consisted of 79 female patients and 21 male patients witb a mean age of 36?13 years at diagnosis.Primary APS was presented in 37% of patients;APS was secondary to systemic lupus erythematosus(SLE)in 46%,lupus-like syndrome in 14%. Eighty percent of the patients had thrombosis,43(54%)patients had venous thrombosis,18(22%)had arterial thrombosis,15(19%)had both arterial and venous thrombosis.4(5%)had thrombosis of microcirculation. Forty-two(52%)patients presented thrombosis at a single site,26(32%)at two sites,12(15%)at three or more sites.Forty-five(56%)patients experienced one thrombotic episode,20(25%)patients had only one re- currence,and 15(19%)had more thrombosis.The most common manifestations of thrombosis were deep vein thrombosis(36%),pulmonary embolism(30%)and stroke(26%),with heart,kidney,gastrointestinal tract and other organs involvements.Thirty-four(51%)female patients had spontaneous fetal losses including intrauter- ine fetus death and recurrent spontaneous abortion.Seventy-one(71%)patients developed thromboeytopenia. The presence of antieardiolipin antibody(ACL)was detected in 84 patients(84%).Among 90 patients with APS,alone ACL was detected in 38 patients(42%),both ACL and lupus anticoagulant(LA)were detected in 36(40%),LA alone in 16(18%).Patients with APS associated with SLE or lupus-like syndrome had higher frequency of arthritis,leukopenia,antinuclear antibodies(ANA)and low complement levels.Female patients had a higher frequency of leukopenia,ANA and ACL.Male patients had a higher prevalence of deep venous thrombosis in the lower limbs and LA.Conclusion APS is an autoimmune disorder characterized by recurrent arterial and venous thrombosis,fetal loss,or thrombocytopenia with the presence of ACL and/or LA.In APS secondary to with SLE,the patient's sex can modify the disease expression and define specific subsets of APS.

Objective To learn the plague's host animals and parasitic flea composition, and to investigate the natural foci of plague in Xiji county in order to provide basic information for plague prevention and control. Methods The Citellus alaschanicus density, nocturnal rodents, the body flea, the burrow track flea, the nest flea were investigated in 8 townships (town) of Xiji county from June 11 2007 to July 25 2007. Specimens of small mammalian, fleas were collected for bacteriological and serological testing. Results The average density of the main host Citellus alaschanicus was 0.85 per hectare. The nocturnal mouse capture rate was 0.80%(24/2987).The survey found 16 species of small mammals that belonging to 3 orders, 9 families and 16 species with Citellus alaschanicus the dominant species. The Citellus alaschanicus had 2.84 fleas per body. Four families and 16 species of fleas were identified in the areas. The Citellus alaschanicus and Citellophilus Tesquorum Mongolicus were the dominant species. Plague bacteriology and serology tests were negative. Conclusions The study shows that the area is suitable for the formation of natural foci of Citellus alaschanicus plague. Surveillance is an important measure for prevention and control of the plague.

Objective To study the effects of mild hypothermia on cardiomyocyte contractility improvement after ischemia-repeffusion injury and on the preservation of well-functioning mitochondrial respiratory capability.Methods A total of 50 newborn SD rats 1 ～ 2 days after delivery were sacrificed and their hearts taken to preserved in 4 ℃ cold D-hanks buffer solution with 0.12％ pancreatic proteinase and collagenase and then processed with 37 ℃ water bath to collect the cardiomyocytes cultured in DMEM medium with 10％ FBS for 5 days.The cardiomyocytes of rats were subjected to ischemia/reperfusion,in vitro,by oxygen and glucose deprivation(OGD)/oxygen and glucose restoration(OGR).The cardiomyocytes of rats after ischemia/reperfusion were divided into three groups:control group,hypothemia group and normothermia group.Contractile frequency and velosity were determined before OGD and 0 h,0.5h,1 h,1.5 h and 2 h after OGR.Ultrastructure changes of cardiomyocytes and mitochondrion were observed under transmission electron microscope(TEM)0 h and 2 h after OGR as well as assessment ot respiratory rate and respiratory control rate(RCR)with Clark oxygen electrode in each group.All data were analyzed with statistical software of SPSS 13.0.Results Contractile function of cardiomyocytes in hypothermia group and normothermia group declined to nadir at 0 h after OGR(P =0.000)and the contractile function of cardiomyocytes in hypothermia group was improved one hour later,compared with the normothermia group(P =0.000).Obvious swelling of mitochondrion was observed under TEM in normothermia group with little alteration after OGR.The RCR assessments indicated respiratory function in normothermia group was impaired after OGR(P =0.000)and this may be responsible for contractility dysfunction.Conclusions Mild hypothemia used after ischaemia can optimize the contractility of cardiomyocytes after a normothermia OGR,and the well-functioning respiratory capability of mitochondrion may be preserved in this process.

Objective To compare the changes of physiological parameters after cardiac arrest caused by asphyxia with that of cardiac arrest induced by ventricular fibrillation in rats and assess the values of the parameters on predicting ROSC and 24 h survival rate. Method Two groups of Sprague-Dwaley rats, which randomly (ramdom number) included 30 animals in each group, were investigated. Cardiac arrest were induced by asphyxia (AS group) or ventricular fibrillation(VF group). PETCO2, aortic pressure, left ventricular pressure and ECG of limb lead Ⅱ were recorded continuously, dP/dt4o was calculated with the windaq software. The parameters were compared between the two groups at baseline, precordial compression(PC) 10 s, PC 1 min, PC 3 min, ROSC 1 h and ROSC 2 h. The relations were explored between the parameters and ROSC/24 h survival rate. Results PETCO2,aortic pressure, left ventricular pressure and ECG have distinctive changes in the two groups. In group VF, PETCO2 of ROSC rats at BL, PC 1 min and PC 3 min were higher than those of Non-ROSC rats (P ＜ 0.05); PETCO2of 24 h survival rats at ROSC 1 h and ROSC 2 h were higher than those of 24 h death rats (P ＜ 0.05), which were not observed in the group AS. dP/dt40 and - dP/dt40 at ROSC 1 h and ROSC 2 h in group VF were higher than those in group AS (P ＜ 0.05). Conclusions Physiological parameters after cardiac arrest caused by asphyxia or that of cardiac arrest induced by ventricular fibrillation in rats have unique features respectively. PETCO2 in cardiac arrest caused by ventricular fibrillation may predict ROSC and 24 h survival rate. Researchers have to select the appropriate cardiac arrest model according their research purposes and clinical requirments.

Adenocarcinoma ; pathology ; Adenocarcinoma, Papillary ; pathology ; Aged, 80 and over ; Carcinoma, Renal Cell ; pathology ; Duodenal Neoplasms ; pathology ; Humans ; Kidney Neoplasms ; pathology ; Lung Neoplasms ; pathology ; Male ; Neoplasms, Multiple Primary ; pathology ; Sarcoma ; pathology ; Stomach Neoplasms ; pathology

Objective To evaluate the curative effect and safety of mild hypothermia on patients with traumatic brain injury. Methods According to the cochrane systematic review methods , the data bases such as Cochrane, Pubmed, Embase, CBM, CNKI, Wanfang and VIP database were searched. The quality of included documents were assessed to extract meta analysis data. Results Compared to the control group, there was no statistically significant difference in patients treated by hypothermia for 3 days or less in mortality , but the difference was statistically significant after the summary [RR=0.74, 95%CI 0.64~0.85,P<0.000 1]; And there was no statistically significant difference in improving neural function of patients treated by hypothermia for < 3 days , but hypothermia improves the prognosis after the summary [RR=1.40,95%CI 1.24~1.59,P<0.000 01]. The difference was statistically significant in the incidence of pneumonia (P=0.007), there was no statistically significant difference in the incidence of arrhythmia (P=0.06), but the difference was statistically significant after sensitivity analysis. Conclusions Patients treated by hypothermia for < 3 days is not valid for clinical outcomes , the duration of the treament up to 3 days may not reduce mortality rates, but can improve the prognosis, lasts longer than 3 days or until the pressure back to normal, reducing the mortality rate, improve the neurological prognosis;but increased incidence of pneumonia, whether to increase the rate of cardiac arrhythmias have yet to be determined.