Objective:To learn about the current medical security level of hospitalization expenses for rural children in Xiantao City, Hubei Province through the analysis of the inpatient service demand and the actual medical insurance compensation level. Methods:Access to hospitalization information for children through institutional survey;Focus group interview;Using Excel 2010 and SPSS19. 0 software to analyze data. Results:The hospitalization rate for children aged 0~4 reaches 25. 5%. Their actual inpatient reimbursement rate, which is only 44. 7%, is lower than the total population. The proportion of the expenditures out of the reimbursement directory is almost equal between the children and total population. Conclusion:This paper suggests to reduce the deductibles and increase the reimbursement rate of children's medical securi-ty, improve the settlement on ecdemic medical care, and increase the investment of pediatric medical resources.

OBJECTIVETo analyze the clinical features and potential mutations of the SLC25A13 gene in a boy affected with neonatal intrahepatic cholestasis.

METHODSClinical data and peripheral venous blood sample of the child, and peripheral venous blood samples of both parents, were collected. All coding exons of the SLC25A13 gene were amplified with PCR and subjected to direct DNA sequencing.

RESULTSThe boy was found to be a compound heterozygote carrying c.851_854delGTAT and IVS16ins3kb mutations of the SLC25A13 gene, which were respectively inherited from his mother and father.

CONCLUSIONBased on its clinical and genetic features, the patient was diagnosed with neonatal intrahepatic cholestasis caused by citrin deficiency.

Base Sequence ; Cholestasis, Intrahepatic ; etiology ; genetics ; Citrullinemia ; complications ; DNA Mutational Analysis ; Family Health ; Female ; Heterozygote ; Humans ; Infant ; Infant, Newborn ; Male ; Mitochondrial Membrane Transport Proteins ; genetics ; Mutagenesis, Insertional ; Mutation ; Sequence Deletion

OBJECTIVE：To provide reference for further improving the establishment of drug registration applicant compliance management organizations in China. METHODS ：Through introducing and analyzing the establishment ，responsibility configuration and operation mechanism of drug registration applicant compliance management organizations in the United States ，the suggestions were put forward for improving the establishment of drug registration applicant compliance management institutions in China. RESULTS & CONCLUSIONS ：There were two levels of compliance management organizations for drug registration applicant in the United States ；at Office of the Commissioner of FDA level ，the Compliance Policy Council was responsible for ensuring consistency in the implementation of all compliance policies in the FDA regulated area ；at the level of Center for Drug Evalution and Research （CDER）and Office of Regulatory Affairs （ORA），the compliance management function was mainly undertaken by Office of New Drugs （OND），Office of Generic Drugs （OGD），Office of Compliance （OC） and Office of Communication （OCOMM）under CDER ，as well as Office of Policy and Risk Management （OPRM），OC，Office of Bioresearch Monitoring Operations（OBIMO）and Office of Pharmaceuticl Quality Operations （OPQO）under ORA ，which were responsible for developing compliance documents and procedures ，carrying out compliance education ，compliance guidance ，compliance inspection and punishment for violations. Before submission stage of drug registration application ，the compliance education function of OC and the compliance guidance function of OND/OGD played an important role ；in the application submission stage ，OND/OGD was responsible for the compliance review of application materials ；in the stage of reviewing the application materials ，OND/OGD and OC of CDER ensured drug compliance through collaboration with OC ，OBIMO and OPQO of ORA. The establishment of drug registration compliance management institutions in China was still in the preliminary exploration stage. It is suggested that China can learn from the relevant experience of the United States ，establish a multi-level or ganization structure ，set up an independent compliance education department ， and strengthen thecooperation between evaluation department and compliance inspection department ，and to improve the level of compliance management of drug registration applicants in China.

Under the diagnosis-related groups(DRG) prospective payment system, innovative health technologies with high costs and risks may be limited to some extent. How to balance the increase of health care cost and the development of innovative health technology is a difficult problem to be solved in the current reform. By studying the relatively mature payment systems of innovative health technologies in the world, the authors found that countries generally adopted additional payment or compensation to encourage the development of new technologies. But at the same time, a relatively perfect health technology assessment and payment management mechanism had been established to ensure the standardized operation of payment plan. These international advanced experience and practice could provide references for China′s innovative health technology payment strategy under the DRG payment system. It is suggested to establish a scientific and reasonable assessment mechanism of innovative health technology, create a special access channel for innovative health technology with limited short-term evidence, and gradually form a long-term incentive mechanism of innovative health technology in DRG payment system.

Objective:To investigate the importance and clinical significance of breast reconstruction’s procedure classification and coding.Methods:By retrieving the medical record information system, the breast reconstruction cases with a diagnosis code (ICD-10) of C50 or Z85.3 and a procedure code (ICD-9-CM-3) of 85.33, 85.35, 85.53, 85.54, 85.55, 85.7, 85.95, or 85.96 were collected from Wuhan Union Hospital from Jan. 2016 to Dec. 2019. The reconstruction techniques and timing of the cases were counted according to the clinical procedure names in the operation notes and to the ICD codes verified by the content from operation notes and progress notes, respectively. The results were compared and analyzed by chi-square test with P<0.05 indicating statistically significant difference. Results:A total of 108 cases were included in the study. The difference between clinical procedure names and ICD codes regarding the reconstruction techniques is statistically significant ( P<0.05) with 51 clinical procedure naming ambiguities (47.2%) i. e., the names do not precisely indicate the reconstruction techniques. Similarly, the difference between clinical procedure names and ICD codes regarding the reconstruction timing is statistically significant ( P<0.05) with 29 clinical procedure name errors (26.9%). i. e., the reconstruction timing in the name does not correspond to its counterpart in reality. Conclusions:The clinical procedure names cannot accurately tell the reconstruction techniques or the timing of the procedure, affecting the correctness of the procedure coding and the diagnosis-related groups (DRGs) result. We suggest the reconstruction surgeons to learn some procedure classification and coding knowledge in a timely manner in order to enhance the correctness of the procedure names and coding and to get adapt to the medical insurance payment reform based on CHS-DRG.

Objective:To investigate the importance and clinical significance of breast reconstruction’s procedure classification and coding.Methods:By retrieving the medical record information system, the breast reconstruction cases with a diagnosis code (ICD-10) of C50 or Z85.3 and a procedure code (ICD-9-CM-3) of 85.33, 85.35, 85.53, 85.54, 85.55, 85.7, 85.95, or 85.96 were collected from Wuhan Union Hospital from Jan. 2016 to Dec. 2019. The reconstruction techniques and timing of the cases were counted according to the clinical procedure names in the operation notes and to the ICD codes verified by the content from operation notes and progress notes, respectively. The results were compared and analyzed by chi-square test with P<0.05 indicating statistically significant difference. Results:A total of 108 cases were included in the study. The difference between clinical procedure names and ICD codes regarding the reconstruction techniques is statistically significant ( P<0.05) with 51 clinical procedure naming ambiguities (47.2%) i. e., the names do not precisely indicate the reconstruction techniques. Similarly, the difference between clinical procedure names and ICD codes regarding the reconstruction timing is statistically significant ( P<0.05) with 29 clinical procedure name errors (26.9%). i. e., the reconstruction timing in the name does not correspond to its counterpart in reality. Conclusions:The clinical procedure names cannot accurately tell the reconstruction techniques or the timing of the procedure, affecting the correctness of the procedure coding and the diagnosis-related groups (DRGs) result. We suggest the reconstruction surgeons to learn some procedure classification and coding knowledge in a timely manner in order to enhance the correctness of the procedure names and coding and to get adapt to the medical insurance payment reform based on CHS-DRG.