Objective To analyze the impact of the basic medical insurance outpatient mutual aid policy on the utilization of medical services.Methods Data indicators related to the utilization of medical services from a tertiary hospital in Wuhan,Hubei Province,from January 2022 to December 2023 were collected.Interrupted time series analysis was used to examine the changing trends of outpatient visits,hospitalizations,and average cost per outpatient visit before and after the implementation of the outpatient mutual aid policy.The Granger causality test and vector autoregressive model were also used to analyze the association between outpatient and inpatient services.Results The outpatient mutual aid policy significantly increased the number of outpatient visits,hospitalizations,and day surgeries in the sample medical institutions(P＜0.05),but had limited impact on the average cost per outpatient visit and hospitalization.Conclusion Outpatient mutual aid can effectively promote the utilization of outpatient services,but attention needs to be paid to potential moral hazard issues and strengthen the supervision of medical insurance funds.

To enhance the trustworthiness,security,and convenience of research data management and pro-mote the deep utilization of clinical research data,it introduces core technologies such as data sandboxing,ze-ro-trust architecture,elastic resource scheduling in cloud computing,and data lakes to construct a clinical research trusted data space with trusted management,resource interaction,and value co-creation capabilities.This trusted data space provides a secure and efficient platform for data processing and analysis through strict network access control,dynamic authentication,data anonymization,and digital watermarking technologies.It ensures the secure flow and precise traceability of research data throughout its lifecycle,effectively facilitating resource interaction and value co-creation.The implementation offers a valuable technical reference and practical guidance for other hospitals aiming to build trusted research data platforms.

Objective To analyze the impact of the basic medical insurance outpatient mutual aid policy on the utilization of medical services.Methods Data indicators related to the utilization of medical services from a tertiary hospital in Wuhan,Hubei Province,from January 2022 to December 2023 were collected.Interrupted time series analysis was used to examine the changing trends of outpatient visits,hospitalizations,and average cost per outpatient visit before and after the implementation of the outpatient mutual aid policy.The Granger causality test and vector autoregressive model were also used to analyze the association between outpatient and inpatient services.Results The outpatient mutual aid policy significantly increased the number of outpatient visits,hospitalizations,and day surgeries in the sample medical institutions(P＜0.05),but had limited impact on the average cost per outpatient visit and hospitalization.Conclusion Outpatient mutual aid can effectively promote the utilization of outpatient services,but attention needs to be paid to potential moral hazard issues and strengthen the supervision of medical insurance funds.

To enhance the trustworthiness,security,and convenience of research data management and pro-mote the deep utilization of clinical research data,it introduces core technologies such as data sandboxing,ze-ro-trust architecture,elastic resource scheduling in cloud computing,and data lakes to construct a clinical research trusted data space with trusted management,resource interaction,and value co-creation capabilities.This trusted data space provides a secure and efficient platform for data processing and analysis through strict network access control,dynamic authentication,data anonymization,and digital watermarking technologies.It ensures the secure flow and precise traceability of research data throughout its lifecycle,effectively facilitating resource interaction and value co-creation.The implementation offers a valuable technical reference and practical guidance for other hospitals aiming to build trusted research data platforms.

The price supervision of medical services can affect the whole process of medical order issuance,treatment op-eration,inspection and examination execution,surgical anesthesia,nursing management,etc.It plays an important role in provi-ding standardized diagnosis and treatment services and saving treatment costs.This article analyzes the current status of hospital price management,sorts out price supervision policies,and uses the pre-remind,intervening and post-event supervision functions of the intelligent price monitoring platform to solve the problem of unreasonable charges such as repeated charges and over-restrict-ed frequency charges,so as to screen and rectify illegal diagnosis and excessive medical treatment.Take the price intelligent su-pervision platform as the starting point,let information and data go more widely,optimize related business processes,promote the satisfaction of both patients and hospital staff,and further improve the hospital management level and service level.

In order to promote the high-quality development of public hospitals and ensure the safety and health of the people, it is important toachieve full traceability and refined management of high-value consumables throughout their entire life cycle.The author designed and implemented a refined management of high-value consumables in orthopedics based on one item, one code. In the closed-loop management process, hospital staff labelled high value orthopedic consumables, achieving the integration of disinfection traceability code, product qualification certificate, and billing traceability code; Three parties, including the chief surgeon, circulating nurse, and handwashing nurse, should sign and confirm the code, ensuring that the item code could not be separated; And real-time intraoperative billing, postoperative counting, and case tracking were used. At the same time, the design utilized a hospital consignment warehouse. The comprehensive promotion of this practice by the hospital saved costs, improved the overall efficiency of the entire business process of orthopedic high-value consumables, and met the requirements of relevant policy supervision and hospital refined management.

Novel coronavirus pneumonia, which has emerged in Wuhan since the end of 2019, has posed a huge challenge for medical institutions in the city. Rapid completion of a number of cabin hospitals plays a vital role in preventing further spreading of the epidemic, by means of collecting and treating mild patients of the disease. This paper presents the key process of Tongji Hospital in its rapid informatization since it took over a cabin hospital. Based on the network architecture of the Tongji cloud platform, the shared service center is used to share data and integrate services between the cabin hospital and Tongji hospital. This practice can prevent cross-infection and improve service efficiency as well, hence offering a reference for future information infrastructure development of cabin hospitals.

Objective To evaluate the therapeutic effect of acupuncture combined with rehabilitation training on children with cerebral palsy. Methods A total of 68 children with cerebral palsy who met the inclusion criteria were randomly divided into two groups, 34 in each group. The control group was treated with Bobath therapy combined with Vojta therapy for rehabilitation training, while the observation group was treated with acupuncture on the basis of the control group. Both groups were treated for 12 weeks. Modified Ashworth method was used to assess the muscular tension of lower limbs, the gross motor function scale was used to assess the gross motor function, and the Fugl-Meyer motor function evaluation method was used to evaluate the limb motor function of children. And the serum levels of vascular endothelial growth factor and creatine kinase brain isoenzyme (CK-BB) were detected by ELISA. Results After treatment, the muscle tension score (1.3 ± 0.3 vs. 1.7 ± 0.4, t=4.108) in the observation group was significantly lower than that in the control group, while the GMFM score (55.7 ± 13.7 vs. 37.8±11.4, t=5.881) significantly higher than that in the control group (P<0.01). The serum VEGF (145.67 ± 19.78 ng/L vs. 171.35 ± 22.54 ng/L, t=4.993) in the observation group were significantly lower than those of the control group (P<0.01). The levels of CK-BB (71.46 ± 17.62 U/L vs. 95.76 ± 19.65 U/L, t=5.368) in the observation group were significantly lower than those of the control group (P<0.01). The total effective rate was 94.1% (32/34) in the observation group and 73.5% (25/34) in the control group. There were significant differences between the two groups (χ2=5.314, P=0.021). Conclusions Acupuncture combined with rehabilitation training can improve the muscle tension and gross motor function of children with cerebral palsy, reduce the levels of VEGF and CK-BB in serum of children with cerebral palsy, and improve the clinical effect.

Objective To investigate the expressions of miR-21 in clinical lung tissues,serum of lung cancer patients and X-ray irradiated A549 cells in vitro and in vivo.Methods A549 cells were irradiated with 2 and 4 Gy X-rays,and pulmonary metastasis model of lung cancer in nude mice was established to detect the expression of miR-21 in vitro and in vivo,as well as in clinical lung tissues of different pathological types serum sample of lung cancer patients and NSCLC patients whether or not received radiotherapy.The survival rate was further analyzed in the above mention NSCLC patients.Results The miR-21 expressions was up-regulated in 60.0％ of tissue samples of NSCLC patients,and it was up-regulated in 50.5％ serum samples of lung cancer patients (52 out of 103).The miR-21 expressions in lung adenocarcinoma and squamous cell carcinoma had significant difference (x2 =5.766,P ＜ 0.05).In the serum samples of 87 NSCLC patients,miR-21 was detected in 66.7％ samples from the patients of radiotherapy but only 39.6％ of patients without radiotherapy (x2 =6.321,P ＜ 0.05).Kaplan-Meier curves showed that the survival rate of patients with low miR-21 expression was higher than that with high miR-21 expression (P ＜ 0.05).Multivariate Cox regression analysis demonstrated that the miR-21 expression,regional lymph node metastasis and radiotherapy were independent prognostic factors for NSCLC patients.The expression of miR-21 was up-regulated significantly in X-ray irradiated A549 cells at different time-points after irradiation (t =-7.552--1.206,P ＜ 0.05).Furthermore,the expression of miR-21was up-regulated in the serum and lung of nude mice (t =-47.845--2.356,P ＜ 0.05).Conclusions The X-ray irradiation could up-regulate the expression of miR-21 in A549 cells in vitro and in vivo,which might be correlated with the enhanced metastasis of A549 cells.

OBJECTIVETo investigate the epidemiological characteristics of hand-foot-mouth disease.

METHODSA total of 589 children from Xianju county, Zhejiang province with hand-foot-mouth disease in 2013 were recruited in the study and the diagnosis went through clinical and laboratory confirmation. Attributes that were analyzed included gender, age, month of occurrence, regional distribution and clinical presentation.

RESULTSThe incidence rate of hand-foot-mouth disease in Xianju county for the year was 102.72/100 000, with 12 severe cases but no death. There were clearly more boys than girls, with a male to female ratio of 1.29 :1, which was statistically significant (χ(2) = 14.274, P < 0.001). The vast majority of patients were 0-3 years old, representing 94.74% of the patients. The occurrences were concentrated in the period from April to August and November, with April as the high-incidence season. High incidence areas were the countryside and suburbs, making up 45.50% and 30.73%, respectively, of all cases. Most patients were in preschools or scattered home care environments, accounting for 51.10% and 40.92% , respectively. Clinical presentation was characterized by fever and various kinds of vesicles or papules at the hand, foot, mouth or buttocks.

CONCLUSIONMost of hand-foot-mouth disease cases occur in younger children in areas with inadequate knowledge of hygiene, with seasonal variation.

Child ; Child, Preschool ; China ; epidemiology ; Female ; Hand, Foot and Mouth Disease ; epidemiology ; Humans ; Infant ; Male