Authors described characteristics of medical service performance evaluation,and strategy options for scientifically evaluating such performance,and systematically presented the conditions and methodology of DRGs-based evaluation of medical service performance.Six evaluation indicators were cited in terms of the capacity,efficiency and medical safety of medical service providers,with detailed introduction to the computation process of such indicators.Cases in hand indicate that the first-page data completeness and accuracy of medical records are preconditions for using DRGs in medical service performance evaluation.

This article reviewed the connotation,developing process and utilization theory of diagnosis related groups (DRGs).DRGs,which is one of ease mix systems,is now used widely in healthcare management.DRGs classify inpatient based on diagnose and procedure.Practices have shown that it has relative high capacity for the risk adjustment of acute care cases; therefore,it can improve the efficiency of expenditure and performance management of inpatient services.Currently,there are more than 30 countries and regions using DRGs,and the theories and methodologies of DRGs get mature.China's new round healthcare reform have developed in depth.The study and development of DRGs related health management tool will promote China' s healthcare system becoming more scientific,normalized and systematic.

Objective To study the effects of keto-valine-calcium and keto-isoleucine-calcium on(human mesangial cells)HMCs. Method HMCs were stimulated by keto-valine-calcium and keto-isoleucine-calcium. The AT1R and TGF-β1 were detected. MTr method was used to measure the proliferation of HMCs, and cell cycle was studied by flow cytometry. Results The expression of AT1R and TGF-β1was increased in the experiment groups compared with negative and DMSO control groups. Cell cycle G1 attest and cell apoptosis were observed in the experiment groups. Conclusions 10mM keto-valine-calcium and keto-isoleueine-calcium have multiple effects on HMCs in vitro, which not only increased the expression of AT1R,but also the expression of TGF-β1.Furthermore,keto-valine-calcium and keto-isoleucine-calcium can induce cell cycle G1 arrest and cell apoptosis.

Objective To study the relevance of 1iver fibrosis at Kasai procedure with age, degree of pathological changes of liver tissue, header bile ductuler proliferation and pathological feature of portal fibrous tissue in biliary atresia patients. Methods From January 2013 to June 2016, 48 biliary atresia patients accepted Kasai procedure, and liver tissue biopsy and portal fibrous tissue excision was done. Level of liver fibrosis was evaluated under microscope using Masson trichrome staining and HE staining, and extent of ductular reaction was evaluated using CKl9 immunohistochemistry staining with image analysis technology. Based on classification of Okamoto severity degree of liver fibrosis, forty eight patients were divided into two groups:low-grade liver fibrosis group (23 patients)and severe liver fibrosis group (25 patients). The relevance of age at Kasai procedure, liver pathological changes, header bile ductuler proliferation, portal fibrous tissue in volume and bile ductuler proliferation, inflammation reaction with severity degree of liver fibrosis was analyzed with SPSSl6.0 software statistically. Results Age of severe 1iver fibrosis group at Kasai procedure were 38- 89 d, and the mean age was (62.64 ± 14.92) d. Age of low-grade 1iver fibrosis group were 18- 92 d, and the mean age was (53.13 ± 16.89) d. There was significant difference (t=2.071, P=0.044). Mean number of patients with header bile ductuler proliferation at Kasai procedure in severe 1iver fibrosis group and low-grade 1iver fibrosis group were (17.28 ± 4.31) cases and (11.39 ± 4.00) cases, and there was significant difference (t=4.900, P=0.000). There was significant difference in degree of hepatocellular pathological changes at Kasai procedure between groups (χ2 =4.691, P=0.030). There were no significant differences in the volume of portal fibrous tissue in volume (t=0.276, P=0.784), portal bile ducts proliferation (t=0.53, P=0.60) and inflammation reaction (χ2=3.074, P=0.080) between groups. Conclusions There is significant relevance between the degree of 1iver fibrosis in biliary atresia patients at Kasai procedure and age, level of hepatocellular pathological change and degree of header bile ductuler proliferation , The more older the age, the more sever the hepatocellular pathological change and the bile ductuler proliferation, the more sever the liver fibrous.

Objective To detect the expression of serum microRNA (miR)-192 in diabetic nephropathy (DN) patients and investigate its effects on DN. Methods The serum levels of miR-192 and miR-210 in DN patients,diabetic patients without renal injury and healthy people were detected by real-time quantitative PCR.Down-stream target genes were predicted using TargetScan software and further confirmed by gain of function and loss of function studies in vitro.Mesangial cells were treated with different concentrations of TGF-β1,then miR-192 expressions of cells and supernatant were examined as well. Results Serum miR-192 level significantly decreased in DN patients compared with healthy people (0.41 ±0.09 vs 1.00±0.00,P＜0.01) and diabetic patients without renal injury,while the serum miR-210 levels were not significantly different among three groups.Bioinformatics analysis results showed that some target genes were involved in TGF-β signal pathway.ZBP1,IGF-1 and type Ⅰ collagen (Col Ⅰ ) were chosen and confirmed by Western blotting,which were regulated by miR-192.TGF-β1 decreased the expression of miR-192 in both cells and cell culture supematants. Conclusion Serum miR-192 may promote the progress of DN by regulating TGF-β1 signaling pathway and may be used as a potential biomarker in the diagnosis of DN depending on its certain specificity.

Australian AR-DRGs is formed after the introduction and localized reform of the USA AP-DRGs,its classification of diagnosis is based on the tenth edition of International Classification of Diseases Australian version,the ICD-10-AM.Surgical operation procedures are in accordance with original Australian Coding of Surgical Operations.This paper introduced the main content and structure of ARDRGs,how a DRGs project team establishes method of systematic classification by analyzing AR-DRGs,as well as the DRGs classification result based on actual data of several hospitals,and some points which should be paid more attention in the process of location of DRG were drawn out.All this information providing guidance for domestic DRGs related researches.

With building up a clinical modification system model by upgrading the standard disease classification system architecture,to collect those huge amount of diagnosis names and codes in use,based on the model to screen and coordinate the relation of them,the tenth revision of the International Classification of Disease Clinical Modification of Beijing is implemented.This standard has been successfully applied for two years in all those secondary and above level hospitals in Beijing.It could well support the work of deploying Diagnosis Related Groups in Beijing and support not only those traditional applications of disease classification but also those new and advance requirements of information processing.

Diagnosis related groups (DRGs)have been widely used in many countries and regions.The versions of DRGs in different regions are modified according to the local circumstances and conditions.Beijing version DRGs (BJ-DRGs)is the first DRGs system in Chinese,which was developed locally based on the conditions of medical information system and health relative policies in Beijing.This paper introduced the grouping principles,logic and methodology of BJ-DRGs.Taking“ear,nose,mouth and throat disorders”for example,this paper demonstrated the grouping process of BJ-DRGs.

Objective To explore the neural basis of the visual illusory motion using the event-related potential(ERP).Methods One hundred trials(each duration 2 000 ms)of a visual illusory motion figure,rippling wheat pattern made by Akiyoshi Kitaoka,and a visual static figure made of modified rippling wheat pattern were randomly presented with equal probability.Ten healthy right handed undergraduate students as subjects were asked to judge the stimulus whether motional or not.The EEG was recorded from 128 scalp sites using with electrodes mounted in HydroCel GSN cap(Electrical Geodesics Incorporated,Oregon,USA).Results 1)The C1 component of ERP could be evoked by both visual illusory motion pattern and static pattern in POz.The peak of C1 component was presented about 75 ms after each stimulus.C1 component evoked with visual illusory motion was negative,but it's static pattern to be positive.2)P100 and P200 components could be obviously evoked by both kinds of stimuli,but in O2 the amplitudes of P100 evoked by different stimuli were significant different and in T3 the amplitudes of P200 were significant different too.Conclusion The visual illusory motion is formed at the primary visual cortex.It may be related to the organized mode of perception.

Objective To investigate the effect of anisodamine on calbindin-D28K(CaBP) expression in the ethanol-induced brain damage in rat cerebellum.Methods2 months aged male Sprague-Dawley rats were injected intraperitoeally with ethanol,normal saline,saline+anisodamine and ethanol+anisodamine respectively for 8 d.They were evaluated with Morris water maze.The counts,average area and density of CaBP positive neurons in cerebellum were measured with immunohistochemical technique and image analytical system.Results The latency of Morris water maze was significantly longer in the ethanol group than in the others(P<0.05),while the distance was significantly longer in the ethanol group than in the saline group and saline+anisodamine group(P<0.05).There is not significant difference between ethanol group and ethanol+anisodamine group(P>0.05),but is seemed some longer.The counts,average area and density of CaBP positive Purkinje cell were all significantly less in ethanol group than in the others(P<0.05).There Pwas not significant difference among ethanol+anisodamine group,saline group and saline+anisodamine group(P>0.05) in the counts,but the average areas and density in ethanol+anisodamine group were less than those in saline group and saline+anisodomine group(P<0.05).Conclusion The ethanol can reduce the CaBP expression in the Purkinje cells of the rats cerebellum.Anisodamine can protect the rats cerebellum from it.