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.

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.

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.

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.

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.

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.

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.

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.

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.

Objective:To investigate the correlations between albumin globulin ratio (AGR) , platelet lymphocyte ratio (PLR) , neutrophil lymphocyte ratio (NLR) and efficacy of chemotherapy for patients with metastatic colorectal cancer (mCRC) .Methods:The clinical data of 107 mCRC patients who were treated at the First Hospital of Shanxi Medical University for chemotherapy from January 2016 to September 2020 were selected, and the values of AGR, NLR and PLR before chemotherapy and after 3 cycles of chemotherapy were collected for retrospective analysis. After 3 cycles, patients were divided into three groups according to efficacy evaluation: partial response (PR) group, stable disease (SD) group and progressive disease (PD) group. The changes of AGR, PLR and NLR values before and after chemotherapy, and the relationships between the degrees of changes and the therapeutic effects were analyzed.Results:There were 18 cases in the PR group, 53 cases in the SD group and 36 cases in the PD group. There were no significant differences in age, sex, distant metastasis site, cancer site, T stage and N stage among the three groups ( F=0.33, P=0.721; χ2=2.94, P=0.230; χ2=2.34, P=0.674; χ2=0.80, P=0.669; χ2=5.68, P=0.224; χ2=2.06, P=0.375) . The AGR, PLR and NLR values before chemotherapy in the PR group were 1.57±0.19, 180.05±102.77 and 5.19 (4.50, 5.83) , and they were 1.45±0.23, 115.81±55.79 and 1.83 (1.06, 2.84) after chemotherapy, with statistically significant differences ( t=2.32, P=0.033; t=2.84, P=0.011; Z=-2.94, P=0.003) . In the SD group, AGR, PLR and NLR values before chemotherapy were 1.66 (1.40, 1.77) , 158.18 (103.81, 236.26) , 2.41 (1.75, 4.07) , and they were 1.35 (1.15, 1.60) , 123.85 (94.86, 176.44) , 1.49 (1.27, 2.33) after chemotherapy, with statistically significant differences ( Z=-4.51, P<0.001; Z=-3.31, P=0.001; Z=-3.90, P<0.001) . The AGR, PLR and NLR values in the PD group before chemotherapy were 1.60 (1.48, 1.87) , 122.07 (77.14, 175.72) , 2.37 (1.28, 4.20) , and they were 1.26 (1.08, 1.40) , 176.39 (139.89, 280.64) and 4.71 (3.71, 6.96) after chemotherapy, with statistically significant differences ( Z=-4.49, P<0.001; Z=-3.42, P=0.001; Z=-4.18, P<0.001) . The differences in AGR ( OR=3.66, 95% CI: 1.29-10.39, P=0.015) , PLR ( OR=0.99, 95% CI: 0.99-1.00, P<0.001) and NLR ( OR=0.59, 95% CI: 0.49-0.70, P<0.001) before and after chemotherapy were related to clinical efficacy. The greater the difference of AGR, the worse the short-term efficacy. The greater the difference of PLR and NLR, the better the short-term efficacy. The correlation between the changes in AGR, PLR and NLR before and after treatment and the clinical efficacy was sorted in descending order Δ NLR>Δ PLR>Δ AGR ( r=-0.68, P<0.001; r=-0.51, P<0.001; r=0.25, P=0.009) . Conclusion:The changes in the levels of AGR, NLR and PLR before and after chemotherapy are correlated with the short-term efficacy of mCRC, and it has certain significance for monitoring the curative effects of patients and further optimizing the treatment plan.