Objective To evaluate the effectiveness of implementing precise management for Da Vinci robotic surgical consumables under the Diagnosis Related Group(DRG)payment system.Methods This retrospective case-control study ana-lyzed 200 patients undergoing Da Vinci robotic lung resection surgery in a tertiary hospital:100 cases from May to June 2022 as the control group,and 100 cases from May to June 2023 with implemented precision management as the observation group.The control group did not implement the payment according to DRG,while the observers implemented payment according to DRG and optimized refined management of Da Vinci robotic surgical consumables.Hospitalization duration,intraoperative costs,and utili-zation of high-value consumables were compared between the two groups.Results No statistically significant differences(P＞0.05)were observed between the two groups in terms of gender,age,medical insurance status,operative time,or intraoperative blood loss.The observation group exhibited a significantly shorter hospitalization duration(8.29±4.13 vs.10.47±4.57 days;P＜0.05),and higher surgical costs[(11 366.81±2 504.23)RMB vs.(8 716.07.78±256.34)RMB,P＜0.05]compared with the control group.Conclusion DRG-oriented precision management optimizes resource utilization through shortened hospi-talization time and rationalizes cost allocation,and sustainable consumable consumption patterns,demonstrating effective balance between clinical quality and economic efficiency under healthcare payment reforms.

Objective To evaluate the clinical efficacy of stellate ganglion block(SGB)combined with intranasal dexmedetomidine for the treatment of insomnia.Methods A total of 64 patients aged 18 to 75 with insom-nia were randomly assigned to either the experimental group(DS group)or the control group(S group).The S group received SGB treatment for 14 consecutive days,whereas the DS group received an additional intranasal dexmedeto-midine spray at a dose of 100 μg,administered 30 minutes before bedtime on days 1 through 6,in conjunction with SGB.We measured and recorded the Pittsburgh Sleep Quality Index(PSQI),Self-Rating Depression Scale(SDS),Self-Rating Anxiety Scale(SAS)scores,and Psychomotor Vigilance Test(PVT)results for both groups at three time points:baseline(T1),the day after treatment(T2),and one month after treatment(T3).Results Intra-group Com-parison:In both the DS and S groups,PSQI scores and dimensionspecific scores at T2 and T3 were significantly lower compared to T1(P<0.05).SAS and SDS scores in both groups showed a significant reduction at T3 compared to T1 and T2(P<0.05),while PVT results exhibited no significant changes(P>0.05).Inter-group Comparison:The PSQI scores and dimensionspecific scores in the DS group at T2(8.44±2.99)and T3(8.22±2.60)were significantly lower than those in the S group at T2(10.88±2.56)and T3(10.88±2.84)(P<0.05).However,no significant differences were observed in SDS and SAS scores between the DS and S groups at T2 and T3(P>0.05).Conclusion Compared to standalone SGB,the combination of SGB with intranasal dexmedetomidine significantly enhances sleep quality in patients with insomnia,while not impacting their levels of anxiety,depression,or alertness.

Objective To evaluate the effectiveness of implementing precise management for Da Vinci robotic surgical consumables under the Diagnosis Related Group(DRG)payment system.Methods This retrospective case-control study ana-lyzed 200 patients undergoing Da Vinci robotic lung resection surgery in a tertiary hospital:100 cases from May to June 2022 as the control group,and 100 cases from May to June 2023 with implemented precision management as the observation group.The control group did not implement the payment according to DRG,while the observers implemented payment according to DRG and optimized refined management of Da Vinci robotic surgical consumables.Hospitalization duration,intraoperative costs,and utili-zation of high-value consumables were compared between the two groups.Results No statistically significant differences(P＞0.05)were observed between the two groups in terms of gender,age,medical insurance status,operative time,or intraoperative blood loss.The observation group exhibited a significantly shorter hospitalization duration(8.29±4.13 vs.10.47±4.57 days;P＜0.05),and higher surgical costs[(11 366.81±2 504.23)RMB vs.(8 716.07.78±256.34)RMB,P＜0.05]compared with the control group.Conclusion DRG-oriented precision management optimizes resource utilization through shortened hospi-talization time and rationalizes cost allocation,and sustainable consumable consumption patterns,demonstrating effective balance between clinical quality and economic efficiency under healthcare payment reforms.

Objective To evaluate the clinical efficacy of stellate ganglion block(SGB)combined with intranasal dexmedetomidine for the treatment of insomnia.Methods A total of 64 patients aged 18 to 75 with insom-nia were randomly assigned to either the experimental group(DS group)or the control group(S group).The S group received SGB treatment for 14 consecutive days,whereas the DS group received an additional intranasal dexmedeto-midine spray at a dose of 100 μg,administered 30 minutes before bedtime on days 1 through 6,in conjunction with SGB.We measured and recorded the Pittsburgh Sleep Quality Index(PSQI),Self-Rating Depression Scale(SDS),Self-Rating Anxiety Scale(SAS)scores,and Psychomotor Vigilance Test(PVT)results for both groups at three time points:baseline(T1),the day after treatment(T2),and one month after treatment(T3).Results Intra-group Com-parison:In both the DS and S groups,PSQI scores and dimensionspecific scores at T2 and T3 were significantly lower compared to T1(P<0.05).SAS and SDS scores in both groups showed a significant reduction at T3 compared to T1 and T2(P<0.05),while PVT results exhibited no significant changes(P>0.05).Inter-group Comparison:The PSQI scores and dimensionspecific scores in the DS group at T2(8.44±2.99)and T3(8.22±2.60)were significantly lower than those in the S group at T2(10.88±2.56)and T3(10.88±2.84)(P<0.05).However,no significant differences were observed in SDS and SAS scores between the DS and S groups at T2 and T3(P>0.05).Conclusion Compared to standalone SGB,the combination of SGB with intranasal dexmedetomidine significantly enhances sleep quality in patients with insomnia,while not impacting their levels of anxiety,depression,or alertness.

Objective To investigate the effect of informationalized monitoring processing system in prevention and control of pressure ulcer. Methods The informationalized monitoring processing system was constructed to collect information. The nursing department sent it to the ulcer treatment group and they worked together to treat and control the ulcers in patients in a dynamic and real-time way. The effect was compared before and after application. Results After use of the system, the pressure ulcers incidence in the hospital was significantly decreased as compared with pre-construct of the system. The reporting and improvement rates were significantly improved than those before(P<0.05). Conclusion The use of the informationalized monitoring processing system makes the reporting of pressure ulcers timely and accurate, helping control the occurrence and treatment of ulcers dynamically, so that the quality of pressure ulcer prevention and control is improved.

Objective To investigate the correlation between the frustration tolerance and personality of medical college students and to discuss its promoting strategies.Methods Totally 460 college students were selected randomly.Questionnaire of frustration tolerance and scale of Eysenck personality inventory(EPQ) were used and the measurement data were compared with correlation analysis and regression analysis of SPSS 13.0.Results Correlation was significant between frustration tolerance (total score and 6 inducing factors) and personality (EPQ factors) of college students ； personality (EPQ factors)of students could predict their frustration tolerance and corresponding t value was -4.85,P ＜ 0.01 (psychoticism),6.93,P ＜ 0.01 (extraversion),-11.15,P ＜ 0.01 (neuroticism).Conclusions Personality of college students are greatly influenced by their frustration tolerance.Targeted anti-frustration ability training should be conducted according to the different personality characteristics.

ObjectiveTo compare the safety and efficacy of ligature between traditional ligation way in gastrectomy.Methods60 patients with gastrointestinal cancioma were selected and randomly divided into two groups,30cases of ligature(treatment group),30 cases of ligation (traditional group).ResultsThe operative time,blood loss,postoperative hospital stay,complications and treatment costs was compared between the two groups.Compared with the traditional group,there were shorter treatment time,reduced bleeding,shorter hospital stay,fewer complications,reduced treatment costs in treatment group.ConclusionLigature gastrectomy is safe and effective.

OBJECTIVE:To establish a method for determination of Morphine in Pipazhike soft capsules by using SPE-HPLC.METHODS:SPE condition:C18 cartridge.15mL MeOH-water(3∶ 1)and 5mL water were used as elution solvent.RESULTS:Morphine had a good linearity in the rang of 0.233 5～ 1.868 0? g(r=0.999 9).The average recovery rate was 97.6%(RSD=1.2%,n=5).CONCLUSION:This method is simple,accurate,and reproducible,and can be used to effectively control the content of Morphine in Pipazhike soft capsules.

OBJECTIVE:To investigate the condition of ESBLs produced by E.coli isolated from urinary tract and the drug resistance of ESBLs-producing E.coli.METHODS:The identification of bacteria was performed using ATB-Expression analysator(France);the susceptibility test was performed using K-B method,and ESBLs were detected using disc diffusion confirmatory test.RESULTS:The detection rate of ESBLs-producing E.coli was 31.8%.All(100%)of the 107 strains of ESBLs-producing E.coli were sensitive to imipenem,however,in which different degree of resistance to other antibiotics was noted.The resistance rate was significantly higher in ESBLs-producing strains than in non-ESBLs-producing strains.CON-CLUSION:In view of the high antibiotic resistance of ESBLs-producing E.coli,great importance should be attached to the detection of the ESBLs.Antibiotics should be used rationally based on the results of susceptibility test.