Reform of medical insurance payment methods,make DRG cost accounting an important part of hospi-tal management work.The choice of DRG cost accounting method affects the time of the accounting results to some extent,and also affects the accuracy of the accounting results,which turn affects the hospital's understanding of the surplus of medical insurance settlement and the corresponding control means.Taking a public hospital in Yunnan Province as an example,based on the theory of service unit superposition method,the DRG cost accounting method is improved,and the project cost accounting can be carried out synchron,which can produce the accounting results more simply and quickly,and lay the foundation for the further lean management of the hospital.

Reform of medical insurance payment methods,make DRG cost accounting an important part of hospi-tal management work.The choice of DRG cost accounting method affects the time of the accounting results to some extent,and also affects the accuracy of the accounting results,which turn affects the hospital's understanding of the surplus of medical insurance settlement and the corresponding control means.Taking a public hospital in Yunnan Province as an example,based on the theory of service unit superposition method,the DRG cost accounting method is improved,and the project cost accounting can be carried out synchron,which can produce the accounting results more simply and quickly,and lay the foundation for the further lean management of the hospital.

Objective To investigate the relationship between asymmetry of skin folds around the hip and developmental dysplasia of the hip(DDH).Methods A retrospective analysis was performed on 308 infants who underwent DDH screening at Xuzhou Children's Hospital Affiliated to Xuzhou Medical University from January 2017 to December 2022.According to screening reasons,they were divided into observation group(simple asymmetry of skin folds around the hip,n=116),clinical abnormality group(clinical manifestations such as hip snap,limited hip abduction,unequal length of lower limbs,n=92)and control group(simple hip screening,n=100).Clinical evaluation results and Graf hip ultrasonography results were analyzed,and the detection rate of pathological DDH in each group was compared.The positive predictive value,negative predictive value,sensitivity and specificity of pathological DDH were calculated.Results Five cases(4.31%)were detected as pathological DDH in observation group.Twenty-eight cases(30.43%)were detected as pathological DDH in clinical abnormality group.Four cases(4.00%)were detected with pathological DDH in control group.There was no significant difference in detection rate of pathological DDH between observation group and control group(χ2=0.909,P=0.592).The detection rate of pathological DDH in clinical abnormal group was significantly higher than that in control group(χ2=24.109,P<0.001).The positive predictive value,negative predictive value,sensitivity and specificity of asymmetry of skin folds around the hip for pathological DDH were 4.31%,96.00%,55.56%and 46.38%,respectively.The positive predictive value,negative predictive value,sensitivity and specificity of abnormal clinical manifestations for pathological DDH were 30.43%,96.00%,87.50%and 60.00%,respectively.Conclusion clinical signs to guide imaging screening of infants.

Objective: To analyze the molecular characteristics of Listeria monocytogenes strains from ready-to eat food in China. Methods: A total of 239 Listeria monocytogenes strains isolated from ready-to-eat food in 2017, all strains underwent whole-genome sequencing (WGS) , and comparisons uncovered population structure derived from lineages, clonal complex, serogroups, antimicrobial susceptibility and virulence, which were inferred in silico from the WGS data. Core genome multilocus sequence typing was used to subtype isolates. Results: All strains were categorized into three different lineages, lineage Ⅱ was the predominant types in food, and IIa was the main serogroups. CC8, CC101 and CC87 were the first three prevalent CCs among 23 detected CCs, accounting for 49.4%. Only 4.6% (11 isolates) of tested strains harbored antibiotic resistance genes, which were mostly trimethoprim genes (7 isolates, 2.9%). All strains were positive for LIPI-1, and only a part of strains harbored LIPI-3 and LIPI-4, accounting for 13.8% (33 isolates) and 14.2% (34 isolates), respectively. ST619 carried both LIPI-3 and LIPI-4. 51.5% (123 isolates) of strains carried SSI-1, and all CC121 strains harbored SSI-2. Different lineages, serogroups and CCs can be separated obviously through cgMLST analysis, and 24 sublineages were highly concordant with CCs. Conclusion Ⅱa was the main serogroups in ready-to-eat food isolates in China; CC8, CC101 and CC87 were the prevalent CCs, and CC87 isolates was hypervirulent isolates, cgMLST method can be adopted for prospective foodborne disease surveillance and outbreaks detection.

BACKGROUND: China has the world's largest tea plantation area in the world. To sustain high yields of the tea, multiple pesticides are used on tea crops to control pests. Organophosphorus (OP) pesticides are among the most widely used types of agricultural pesticides in China. As tea is a significant potential source of exposure to pesticide residues, the public concern has increased in relation to pesticide residues found in tea in China. The aim of the study was to estimate cumulative dietary exposure to OP residues from tea infusion for Chinese tea consumers to determine whether exposure to OP residues from tea infusion is a cause of health concern for tea consumers in China. METHODS: OP residue data were obtained from the China National Monitoring Program on Food Safety (2013-2014), encompassing 1687 tea samples from 12 provinces. Tea consumption data were obtained from the China National Nutrient and Health Survey (2002), comprising 506 tea consumers aged 15-82 years. The transfer rates of residues from tea leaves into tea infusions were obtained from the literature. The relative potency factor (RPF) approach was used to estimate acute cumulative exposure to 20 OP residues from tea infusion using methamidophos as the index compound. Dietary exposure was calculated in a probabilistic way. RESULTS: For tea consumers, the mean and the 99.9th percentile (P99.9) of cumulative dietary exposure to OP residues from tea infusion equalled 0.08 and 1.08 μg/kg bw/d. When compared with the acute reference dose (ARfD), 10 μg/kg bw/d for methamidophos, this accounts for 0.8 and 10.8% of the ARfD. CONCLUSIONS Even when considering OP residues from vegetables, fruits and other foods, there are no health concerns based on acute dietary exposure to OP residues from tea infusion. However, it is necessary to strengthen the management of the OP pesticides used on tea in China to reduce the risk of chronic dietary exposure to OPs from tea infusion.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; China ; Dietary Exposure ; analysis ; Female ; Humans ; Male ; Middle Aged ; Organophosphorus Compounds ; analysis ; Pesticide Residues ; analysis ; Risk Assessment ; methods ; Tea ; chemistry ; Young Adult

Objective: To analyze liquid milk exposure of thiocyanate among Chinese population and preliminarily assess its health risk. Methods: A total of 2 059 raw milk samples were collected during 2013 and 2014 from 12 Chinese provinces, New Zealand and Netherlands. Farms were chosed according to the main sources of dairy companies, the distribution of farms and the yield of milk. Content of thiocyanate were detected by ion chromatography. Liquid milk consumption data were taken from Chinese beverage and alcoholic beverage consumption survey in 18 cities or counties in 9 provinces, including 16 775 subjects older than 3. A simple distribution model was used to estimate the exposure of thiocyanate from liquid milk. The tolerable daily intake (TDI) of thiocyanate was made 0.08 mg·kg^-1·d^-1. Then the exposures of different age groups were compared with TDI. Results: Finally, 1 331 samples out of 2 059 were detected to contain thiocyanate. The detection rate was 65%. The average concentration of thiocyanate was 2.11 mg/kg, with a range of 0.10-16.20 mg/kg. The general population's consumption of thiocyanate by drinking liquid milk was 0.001 mg · kg^-1 · d^-1, which was lower than TDI. The P₉₅ of general population and consumers were 0.009 mg · kg^-1 · d^-1 and 0.020 mg·kg ^-1·d^-1 respectively, which were also lower than TDI. Mean exposures of population aged 3-6, 7-12, 13-17, 18-59 as well as elderly aged 60 and above were 0.007, 0.003, 0.002, 0.001 and 0.001 mg · kg^-1·d^-1 respectively, which were all lower than TDI. Conclusion The results suggested that the health risk of thiocyanate exposure by drinking liquid milk among Chinese population was at a low level. However, milk products for children deserve more concern.

OBJECTIVETo assess dietary exposure of diethylhexyl phthalate(DEHP) among Chinese population, including general population, children aged 2-6 years, adolescent aged 7-12, young people aged 13-17, adults aged 18-59 years old as well as older people aged 60 and above and its health risk.

METHODSA total of 6 650 food samples were collected during 2011 to 2013 from 140 local markets of 14 provinces in China, which covered major foods in China. Samples were detected by GC-MS and categorized into 22 food groups. Food consumption data were taken from China National Nutrition and Health Survey performed in 2002 including 68 959 subjects. Mean concentrations of DEHP in food were combined with individual food consumption data to estimate dietary exposure, and food contributors to dietary DEHP intake were also calculated. Then, the exposure was compared with the tolerable daily intake (TDI, 50 µg·kg(-1)-d(-1)) of DEHP.

RESULTSDEHP level in foods (n = 6 650) was in the range of not detected to 43.80 mg/kg. Mean dietary intakes of DEHP in general population was 2.07 (95% CI: 0.06-4.09) µg·kg(-1)·d(-1), accounting for 4.14 percent of TDI (50 µg·kg(-1)·d(-1)). Mean dietary intake for population aged 2-6, 7-12, 13-17, 18-59 as well as elderly aged 60 and above were 3.92 (95% CI: 0.83-7.01), 3.02 (95% CI: 0.69-5.36), 2.17 (95% CI: 0.54-3.81), 1.83 (95% CI: 0.46-3.21) and 1.66 (95% CI: 0.38-2.94) µg·kg(-1)·d(-1) respectively. The 97.5 percentile intakes in the general populations was 4.73 µg·kg(-1)·d(-1), accounting for 9.46% of TDI. Main food sources of DEHP were rice (28.4% (0.59/2.07)), melon solanaceous vegetables (14.7% (0.30/2.07)) and flour (13.2% (0.27/2.07)) for the general population.

CONCLUSIONThe results suggested that dietary exposure to DEHP among Chinese population was lower than tolerable daily intake of DEHP and there were no health concerns based on generally accepted exposure limits. Rice, melon solanaceous vegetables and flour were main food contributors of DEHP dietary intake for Chinese populations.

Adolescent ; Adult ; Aged ; Asian Continental Ancestry Group ; Child ; Child, Preschool ; China ; Diet ; Diet Surveys ; Diethylhexyl Phthalate ; Flour ; Food ; Food Contamination ; Gas Chromatography-Mass Spectrometry ; Humans ; Middle Aged ; Oryza ; Risk Assessment ; Vegetables

Adipocyte fatty acid-binding protein ( FABP4 ) is abundantly expressed in adipocytes and macrophages, and the physiologic function of this lipid chaperone is involved in the intracellular trafficking and targeting of fatty acids inside cell. Studies have shown that FABP4 plays a significant role in cholesterol metabolism. FABP4 can affect some key gene expression for cholesterol metabolism, thus regulate the metabolism, storage, and trafficking of cholesterol. As the development of FABP4 inhibitors, drugs targeting FABP4 are possible and can lead to a novel therapeutic strategy to prevent and treat obesity, type 2 diabetes, hypercholesterolemia, and atherosclerosis.

OBJECTIVETo develop a RT-PCR method for a rapid and sensitive detection of Salmonella in poultry samples.

METHODSThe RT-PCR method was established and its specificity was testified on the basis of invA gene. Serial 10-fold diluted pure suspension culture of CMCC 50041 was detected by RT-PCR, the standard curve was constructed and the amplification efficiency was calculated. Artificially contaminated experiment was done, six artificially-inoculated samples containing final concentration of Salmonella CMCC 50041 (1, 10, 10(2), 10(3), 10(4), 10(5) and 10(6) CFU per 25 g poultry samples) were prepared respectively. All the samples were incubated for 0, 4, 8, 12 and 18 h and the DNA was extracted for RT-PCR detection, meanwhile by PCR detection and the traditional method. The sensitiveness and specificity were compared among the three methods. At the same time, 16 samples of retail whole poultry were collected from markets and detected by the above three methods as well, and thereby to further compare the positive detection among the three methods.

RESULTSThe established RT-PCR method was specific for the detection of Salmonella. The sensitivity was 5.2×10(3) CFU/ml for pure Salmonella culture without enrichment. Correlation coefficients of standard curves constructed using the Ct versus log value of concentration of Salmonella showed good linearity over a 8-log dynamic range (5.2×10(3)-5.2×10(10) CFU/ml), with the R(2) at 0.999. RT-PCR detection limit for artificially contaminated samples after enriching for 12 h was 1 CFU/25 g sample, which was the same with the limit of PCR and 10 times more sensitive than the limit of traditional method. Standard curve of sample after enrichment for 12 h was established. Seven of 16 samples were detected positive by RT-PCR, which were also tested positive by PCR, while only five samples were positive by traditional method. The positive ones were quantitatively analyzed using standard curve of sample and determined the initial Salmonella numbers of CFU/25 g.

CONCLUSIONThe established RT-PCR technology was simple, rapid, sensitive and specific, which was suitable to quickly detect Salmonella in poultry samples.

Animals ; Bacterial Proteins ; Food Microbiology ; Poultry ; Real-Time Polymerase Chain Reaction ; methods ; Salmonella ; Sensitivity and Specificity

Objective To characterize the baseline status of Chinese diabetic patients based on data derived from Chinese cohort from SOLVETM study.Methods Patients with type 2 diabetes initiating basal insulin detemir at the decision of the physician were eligible for the study.Data on demographics,medical history,glycemic profile and treatment regimen at baseline were collected by physicians.Results A total of 3272 patients [female 42％,male 58％,mean age (56.2 ± 10.8) years] were included in the study.Their BMI was (25.3 ± 3.3) kg/m2.The duration of diabetes was 4.0 (0.1-27.0) years,and the duration of treatment with oral antidiabetic drugs (OADs) was 3.0(0.0-20.2) years.The proportions of subjects with diabetic macro-and micro-vascular complications were 15.8％ (515 cases) and 27.1％ (866 cases),respectively.The hemoglobin Al c (HbAl c) at baseline was (8.33 ± 1.70) ％,and the fasting blood glucose (FPG) was (9.5 ± 2.6) mmol/L.Conclusions A large proportion of patients with type 2 diabetes remain in poor glycemic control,and the prevalence of diabetic complications is high,which requires optimal therapeutic strategy for the patients with suboptimal glycemic control.