1.Correlation between hospital-acquired infections and medical resource consumption under the DRG payment method
Jinwen REN ; Jiaying ZHU ; Qilong GAO ; Wen ZHANG ; Gehong FAN ; Yan WU
Chinese Journal of Nosocomiology 2025;35(12):1866-1870
OBJECTIVE To analyze the impact of hospital-acquired infections on medical resource consumption un-der the diagnosis-related group(DRG)payment method.METHOD Medical record information and settlement lists of all discharged patients from Zhejiang Provincial People's Hospital from 2022 to 2023 were selected.Based on the Zhejiang Provincial Medical Insurance Bureau's diagnosis-related groups(ZJ-DRG)Edition 1.0,indicators such as time consumption index,cost consumption index,length of stay,total hospitalization costs and detailed cost breakdowns were used to analyze cases in the hospital-acquired infection group and the non-hospital-ac-quired infection group.RESULTS Among the 268 278 cases included in the study,2 186 were infected,with an in-fection rate of 0.81%.The infection rates for medical DRG disease group,surgical DRG disease group,and proce-dural DRG disease group were 0.86%(917/105 916),0.82%(1 069/131 112),and 0.64%(200/31 250),re-spectively.The time consumption index and cost consumption index were higher in the hospital-acquired infection group than in the non-hospital-acquired infection group(P<0.05).In the RW21 group,the length of stay,total hospitalization costs and detailed cost breakdowns were all higher in the hospital-acquired infection group than in the non-hospital-acquired infection group(P<0.05).Similarly,in the BB21 and GK11 groups,the hospital-ac-quired infection group had high length of stay,total hospitalization costs,medicine fees,treatment fees,material fees,laboratory fees,examination fees and other fees compared to the non-hospital-acquired infection group(P<0.05).Bone(joint)infections,respiratory infections,and infectious fever had a significant impact on the time consumption index,while respiratory infections,bone(joint)infections and urinary tract infections had a relative-ly great impact on the cost consumption index.CONCLUSIONS Hospital-acquired infections result in additional consumption of medical resources.By analyzing the consumption of medical resources related to DRG disease groups,key monitoring disease groups for nosocomial infection control can be identified,which can aid relevant departments and clinical departments in taking early intervention measures,strengthen key prevention efforts,re-duce the incidence of nosocomial infections,and shorten the length of stay.
2.Correlation between hospital-acquired infections and medical resource consumption under the DRG payment method
Jinwen REN ; Jiaying ZHU ; Qilong GAO ; Wen ZHANG ; Gehong FAN ; Yan WU
Chinese Journal of Nosocomiology 2025;35(12):1866-1870
OBJECTIVE To analyze the impact of hospital-acquired infections on medical resource consumption un-der the diagnosis-related group(DRG)payment method.METHOD Medical record information and settlement lists of all discharged patients from Zhejiang Provincial People's Hospital from 2022 to 2023 were selected.Based on the Zhejiang Provincial Medical Insurance Bureau's diagnosis-related groups(ZJ-DRG)Edition 1.0,indicators such as time consumption index,cost consumption index,length of stay,total hospitalization costs and detailed cost breakdowns were used to analyze cases in the hospital-acquired infection group and the non-hospital-ac-quired infection group.RESULTS Among the 268 278 cases included in the study,2 186 were infected,with an in-fection rate of 0.81%.The infection rates for medical DRG disease group,surgical DRG disease group,and proce-dural DRG disease group were 0.86%(917/105 916),0.82%(1 069/131 112),and 0.64%(200/31 250),re-spectively.The time consumption index and cost consumption index were higher in the hospital-acquired infection group than in the non-hospital-acquired infection group(P<0.05).In the RW21 group,the length of stay,total hospitalization costs and detailed cost breakdowns were all higher in the hospital-acquired infection group than in the non-hospital-acquired infection group(P<0.05).Similarly,in the BB21 and GK11 groups,the hospital-ac-quired infection group had high length of stay,total hospitalization costs,medicine fees,treatment fees,material fees,laboratory fees,examination fees and other fees compared to the non-hospital-acquired infection group(P<0.05).Bone(joint)infections,respiratory infections,and infectious fever had a significant impact on the time consumption index,while respiratory infections,bone(joint)infections and urinary tract infections had a relative-ly great impact on the cost consumption index.CONCLUSIONS Hospital-acquired infections result in additional consumption of medical resources.By analyzing the consumption of medical resources related to DRG disease groups,key monitoring disease groups for nosocomial infection control can be identified,which can aid relevant departments and clinical departments in taking early intervention measures,strengthen key prevention efforts,re-duce the incidence of nosocomial infections,and shorten the length of stay.
3.Prognostic significance and biological implications of SM‑like genes in mantle cell lymphoma
Xue HE ; Changjian YAN ; Yaru YANG ; Weijia WANG ; Xiaoni LIU ; Chaoling WU ; Zimu ZHOU ; Xin HUANG ; Wei FU ; Jing HU ; Ping YANG ; Jing WANG ; Mingxia ZHU ; Yan LIU ; Wei ZHANG ; Shaoxiang LI ; Gehong DONG ; Xiaoliang YUAN ; Yuansheng LIN ; Hongmei JING ; Weilong ZHANG
Blood Research 2024;59():33-
Background:
SM-like (LSM) genes a family of RNA-binding proteins, are involved in mRNA regulation and can function as oncogenes by altering mRNA stability. However, their roles in B-cell progression and tumorigenesis remain poorly understood.
Methods:
We analyzed gene expression profiles and overall survival data of 123 patients with mantle cell lymphoma (MCL). The LSM index was developed to assess its potential as a prognostic marker of MCL survival.
Results:
Five of the eight LSM genes were identified as potential prognostic markers for survival in MCL, with particular emphasis on the LSM.index. The expression levels of these LSM genes demonstrated their potential utility as classifiers of MCL. The LSM.index-high group exhibited both poorer survival rates and lower RNA levels than did the overall transcript profile. Notably, LSM1 and LSM8 were overexpressed in the LSM.index-high group, with LSM1 showing 2.5-fold increase (p < 0.001) and LSM8 depicting 1.8-fold increase (p < 0.01) than those in the LSM.index-low group.Furthermore, elevated LSM gene expression was associated with increased cell division and RNA splicing pathway activity.
Conclusions
The LSM.index demonstrates potential as a prognostic marker for survival in patients with MCL. Elevated expression of LSM genes, particularly LSM1 and LSM8, may be linked to poor survival outcomes through their involvement in cell division and RNA splicing pathways. These findings suggest that LSM genes may contribute to the aggressive behavior of MCL and represent potential targets for therapeutic interventions.
4.Prognostic significance and biological implications of SM‑like genes in mantle cell lymphoma
Xue HE ; Changjian YAN ; Yaru YANG ; Weijia WANG ; Xiaoni LIU ; Chaoling WU ; Zimu ZHOU ; Xin HUANG ; Wei FU ; Jing HU ; Ping YANG ; Jing WANG ; Mingxia ZHU ; Yan LIU ; Wei ZHANG ; Shaoxiang LI ; Gehong DONG ; Xiaoliang YUAN ; Yuansheng LIN ; Hongmei JING ; Weilong ZHANG
Blood Research 2024;59():33-
Background:
SM-like (LSM) genes a family of RNA-binding proteins, are involved in mRNA regulation and can function as oncogenes by altering mRNA stability. However, their roles in B-cell progression and tumorigenesis remain poorly understood.
Methods:
We analyzed gene expression profiles and overall survival data of 123 patients with mantle cell lymphoma (MCL). The LSM index was developed to assess its potential as a prognostic marker of MCL survival.
Results:
Five of the eight LSM genes were identified as potential prognostic markers for survival in MCL, with particular emphasis on the LSM.index. The expression levels of these LSM genes demonstrated their potential utility as classifiers of MCL. The LSM.index-high group exhibited both poorer survival rates and lower RNA levels than did the overall transcript profile. Notably, LSM1 and LSM8 were overexpressed in the LSM.index-high group, with LSM1 showing 2.5-fold increase (p < 0.001) and LSM8 depicting 1.8-fold increase (p < 0.01) than those in the LSM.index-low group.Furthermore, elevated LSM gene expression was associated with increased cell division and RNA splicing pathway activity.
Conclusions
The LSM.index demonstrates potential as a prognostic marker for survival in patients with MCL. Elevated expression of LSM genes, particularly LSM1 and LSM8, may be linked to poor survival outcomes through their involvement in cell division and RNA splicing pathways. These findings suggest that LSM genes may contribute to the aggressive behavior of MCL and represent potential targets for therapeutic interventions.
5.Prognostic significance and biological implications of SM‑like genes in mantle cell lymphoma
Xue HE ; Changjian YAN ; Yaru YANG ; Weijia WANG ; Xiaoni LIU ; Chaoling WU ; Zimu ZHOU ; Xin HUANG ; Wei FU ; Jing HU ; Ping YANG ; Jing WANG ; Mingxia ZHU ; Yan LIU ; Wei ZHANG ; Shaoxiang LI ; Gehong DONG ; Xiaoliang YUAN ; Yuansheng LIN ; Hongmei JING ; Weilong ZHANG
Blood Research 2024;59():33-
Background:
SM-like (LSM) genes a family of RNA-binding proteins, are involved in mRNA regulation and can function as oncogenes by altering mRNA stability. However, their roles in B-cell progression and tumorigenesis remain poorly understood.
Methods:
We analyzed gene expression profiles and overall survival data of 123 patients with mantle cell lymphoma (MCL). The LSM index was developed to assess its potential as a prognostic marker of MCL survival.
Results:
Five of the eight LSM genes were identified as potential prognostic markers for survival in MCL, with particular emphasis on the LSM.index. The expression levels of these LSM genes demonstrated their potential utility as classifiers of MCL. The LSM.index-high group exhibited both poorer survival rates and lower RNA levels than did the overall transcript profile. Notably, LSM1 and LSM8 were overexpressed in the LSM.index-high group, with LSM1 showing 2.5-fold increase (p < 0.001) and LSM8 depicting 1.8-fold increase (p < 0.01) than those in the LSM.index-low group.Furthermore, elevated LSM gene expression was associated with increased cell division and RNA splicing pathway activity.
Conclusions
The LSM.index demonstrates potential as a prognostic marker for survival in patients with MCL. Elevated expression of LSM genes, particularly LSM1 and LSM8, may be linked to poor survival outcomes through their involvement in cell division and RNA splicing pathways. These findings suggest that LSM genes may contribute to the aggressive behavior of MCL and represent potential targets for therapeutic interventions.
6.Advances in research on neoadjuvant chemoradiotherapy combined with immune checkpoint inhibitors for locally advanced rectal cancer
Shuangshuang HOU ; Lufeng CHEN ; Gehong ZHANG ; Juan MA ; Xianfeng LI
Chinese Journal of Radiological Medicine and Protection 2024;44(8):718-724
Neoadjuvant chemoradiotherapy (nCRT) followed by total mesorectal excision (TME) and adjuvant chemotherapy serves as a traditional standard treatment for locally advanced rectal cancer (LARC). However, such treatment suffers low pathological complete response (pCR) rates, which are merely less than 15%, and low anal-preservation rates, failing to meet the demand of patients for high quality of life. Recently, total neoadjuvant therapy (TNT) whereby postoperative adjuvant chemotherapy is performed preoperatively has further increased the pCR rate, gradually becoming a novel therapeutic approach. Nevertheless, the pCR rate of TNT remains below 30%. Presently, immune checkpoint inhibitors (ICIs) have been proved to be highly successful in treating various solid tumors, yet they are scarcely employed to treat LARC. In recent years, many clinical trials have been conducted to explore the application of nCRT combined with ICIs in the treatment of LARC. This paper reviews the advances in research on this therapy.
7.Diagnostic value of liquid-based cytology targeted FISH for urothelial carcinoma of the bladder
Yongjin HUANG ; Zhibin LIU ; Gehong DONG ; Xuanyan CHE ; Yong ZHANG
Journal of Modern Urology 2024;29(6):505-509
Objective To explore the diagnostic value of urinary liquid-based cytology(LBC)targeted fluorescence in situ hybridization(FISH)for urothelial carcinoma of the bladder.Methods Nuclear matrix protein 22(NMP22)detection,urinary LBC and FISH were performed in 128 patients.The sensitivity and specificity of the three kinds of tests were analyzed with postoperative pathological results as the gold standard.Results The sensitivity of NMP22,urinary LBC and FISH was 61.11%,79.17%and 82.46%,the specificity was 57.14%,73.21%and 86.67%,respectively.The sensitivity of NMP22 and urinary LBC in detecting high BUC was better than that of low BUC,and the difference was statistically significant(P=0.01,P=0.03).There was no significant difference in the sensitivity of the three tests for the diagnosis of muscle-invasive bladder cancer and non muscle-invasive bladder cancer(P≥0.05).Conclusion Urinary LBC targeted FISH has high sensitivity and specificity in the diagnosis of urothelial carcinoma of the bladder and low-grade urothelial carcinoma.It can be an important method for the early screening and diagnosis of bladder cancer.
8.Lee-Silverman voice treatment for stroke survivors with dysarthria
Zijian PANG ; Yi HE ; Gehong JIA ; Qingsu ZHANG ; Bo WANG
Chinese Journal of Physical Medicine and Rehabilitation 2024;46(12):1096-1101
Objective:To observe the clinical effect when Lee Silverman voice therapy (LSVT) is used to treat stroke survivors with dysarthria.Methods:Forty-nine stroke survivors with dysarthria were randomly divided into a control group ( n=25) and a treatment group ( n=24). The control group received conventional treatment, while the treatment group received daily one-hour sessions of LSVT, 4 times per week for 4 weeks. Before and after the treatment, both groups were given a speech intelligibility (SI) test, a Frenchay dysarthria assessment (FDA), and acoustic analysis including intensity, pitch, triangular vowel space area (tVSA), vowel articulation index (VAI), and formant centralization ratio (FCR). Their maximum phonation time (MPT) was measured and a voice handicap index (VHI) was assigned. Results:Before and after treatment, there were significant differences in VHI observed in the observation group, as well as significant differences in their average SI, FDA, MPT, tVSA, VAI and FCR values. In the control group the significant changes were limited to the VAI, FDA, MPT and FCR measurements. However, after the intervention, no significant differences were found between the two groups in VAI, nor in their SI, FDA, VHI, MPT, intensity, pitch, tVSA and FCR scores.Conclusions:LSVT has similar therapeutic effects to conventional treatment in relieving voice impairment, improving speech intelligibility, improving the motor functioning of articulation organs and improving the articulation accuracy of stroke survivors with dysarthria. Therefore, it is worthy of clinical application.
9.Lee-Silverman voice treatment for stroke survivors with dysarthria
Zijian PANG ; Yi HE ; Gehong JIA ; Qingsu ZHANG ; Bo WANG
Chinese Journal of Physical Medicine and Rehabilitation 2024;46(12):1096-1101
Objective:To observe the clinical effect when Lee Silverman voice therapy (LSVT) is used to treat stroke survivors with dysarthria.Methods:Forty-nine stroke survivors with dysarthria were randomly divided into a control group ( n=25) and a treatment group ( n=24). The control group received conventional treatment, while the treatment group received daily one-hour sessions of LSVT, 4 times per week for 4 weeks. Before and after the treatment, both groups were given a speech intelligibility (SI) test, a Frenchay dysarthria assessment (FDA), and acoustic analysis including intensity, pitch, triangular vowel space area (tVSA), vowel articulation index (VAI), and formant centralization ratio (FCR). Their maximum phonation time (MPT) was measured and a voice handicap index (VHI) was assigned. Results:Before and after treatment, there were significant differences in VHI observed in the observation group, as well as significant differences in their average SI, FDA, MPT, tVSA, VAI and FCR values. In the control group the significant changes were limited to the VAI, FDA, MPT and FCR measurements. However, after the intervention, no significant differences were found between the two groups in VAI, nor in their SI, FDA, VHI, MPT, intensity, pitch, tVSA and FCR scores.Conclusions:LSVT has similar therapeutic effects to conventional treatment in relieving voice impairment, improving speech intelligibility, improving the motor functioning of articulation organs and improving the articulation accuracy of stroke survivors with dysarthria. Therefore, it is worthy of clinical application.
10.Predictive value of biomarkers in immunotherapy of advanced non-small cell lung cancer
Journal of International Oncology 2022;49(12):739-744
Immunotherapy, especially immune checkpoint inhibitor, has revolutionized the treatment mode of advanced non-small cell lung cancer. The predictive effect of programmed death-ligand 1 and tumor mutation burden for treatment response has been fully proved. Neither of which can avoid some problems, including tumor heterogeneity, inconsistent detection methods and identification standards. The studies have found that some novel biomarkers are related to the efficacy of immunotherapy, such as mismatch repair deficiency and microsatellite instability, driver gene mutation, routine peripheral blood biomarkers, circulating tumor cells, circulating tumor DNA and so on. Further research on the predictive value of biomarkers in tumor tissue and peripheral blood in immunotherapy of advanced non-small cell lung cancer can provide a reference for instituting clinical treatment plan.

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