Objective Exploring the influencing factors and coping strategies for Loss-Making Groups under DIP payment in public hospitals.Methods Using grounded theory,semi-structured interviews were conducted at a cardiovascular hospital in Henan Province from July to September 2023.The collected data were organized,coded,and integrated.Results Analysis of 19 interview transcripts yielded 54 initial concepts,13 initial categories,6 main categories and 3 core categories,leading to the construction of an optimization model for DIP loss-making groups in public hospitals.This model encompasses internal hospital control,incentive mechanisms,and support from health insurance policies.Conclusion It is recommended that hospitals enhance diagnostic and cost-control standards for DIP,establish a DIP-oriented performance evaluation system,and ensure reasonable reimbursement through health insurance policies.Additionally,policy measures should encourage innovation in new technologies to maximize resource efficiency and promote sustainable operations.

Objective To discuss the effect of interleukin-17A(IL-17A)and transforming growth factor-β1(TGF-β1)on the benign tracheal stenosis after tracheal injury in experimental dogs.Methods The trachea stenosis model of healthy Beagle dogs was established by burning the middle part of trachea with electric snare under bronchoscopy guidance.A total of 21 dogs were divided into normal group(n=3,receiving normal feeding),molding group(n=12,after airway modeling every 3 dogs were sacrificed each week for 4 weeks),IL-17A suppression group(n=3,receiving Secukinumab after airway modeling),and IL-17A inhibitor+TGF-β1 inhibitor group(n=3,receiving Secukinumab and SB43154 after airway modeling).Bronchoscopy and CT scan were performed once a week,and the stenosis degree was calculated.RT-qPCR,immunohistochemistry,and HE staining of the obtained tracheal tissues were performed.Results Within 1-4 weeks after molding,in module-making dogs the degree of stenosis of the injured trachea gradually increased,and the expressions of ECM-related proteins,TGF-β1 and IL-17A were up-regulated.After treatment with IL-17A inhibitors,the inflammatory infiltration and granulation tissue hyperplasia were reduced and the early tracheal stenosis was improved(P＜0.05).The combination use of IL-17A inhibitor and TGF-β1 inhibitor had a better remission effect(P＜0.05).Conclusion IL-17A and TGF-β1 may synergistically affect the formation of tracheal stenosis.

Objective Exploring the influencing factors and coping strategies for Loss-Making Groups under DIP payment in public hospitals.Methods Using grounded theory,semi-structured interviews were conducted at a cardiovascular hospital in Henan Province from July to September 2023.The collected data were organized,coded,and integrated.Results Analysis of 19 interview transcripts yielded 54 initial concepts,13 initial categories,6 main categories and 3 core categories,leading to the construction of an optimization model for DIP loss-making groups in public hospitals.This model encompasses internal hospital control,incentive mechanisms,and support from health insurance policies.Conclusion It is recommended that hospitals enhance diagnostic and cost-control standards for DIP,establish a DIP-oriented performance evaluation system,and ensure reasonable reimbursement through health insurance policies.Additionally,policy measures should encourage innovation in new technologies to maximize resource efficiency and promote sustainable operations.

Objective To measure and comprehensively analyze the operation efficiency of coronary heart disease Center of National Regional Medical Center for Cardiovascular Disease from the dimensions of department service in-come,department service quality,department service efficiency and department service benefit,and put forward targeted operation management optimization strategies based on the analysis results.Methods The operation effective-ness evaluation index of CHD centers in sample hospitals from 2020 to 2022 was measured by the empirical re-search method from the overall level of the center and the level of clinical departments,and the scores were com-pared and analyzed.Results From 2020 to 2022,the operation effectiveness evaluation index of CHD centers in sam-ple hospitals showed a good trend,increasing from 80.57 points to 82.86 points.The 3-year average score was 81.74;Among them,the score rate of department service benefit dimension is higher,the average is 96.64％;The score rate of department service efficiency was lower,with an average of 68.53％.The departments with the lowest operational efficiency scores from 2020 to 2022 are all A2 departments,with 74.39,72.41 and 75.89 scores respec-tively,mainly due to the relatively low scores of A2 departments in the dimensions of department service revenue and department service efficiency.Conclusion The results of clinical department operation effectiveness evaluation can provide the evidence-based basis for hospital operation management,and hospitals can establish benchmarking management departments according to the evaluation results and take targeted measures to improve the comprehen-sive operation efficiency of departments.

The basic theory of high power green laser equipment for prostate hyperplasia therapy and the components of the system developed are introduced. Considering the requirements of the clinical therapy, the working process of the high power green laser apparatus are designed and the laser with stable output at 120 W is achieved. The controlling hardware and application software are developed, and the safety step is designed. The high power green laser apparatus manufactured with characteristics of stable output, multifunctional and friendly interface provides a choices of prostate hyperplasia therapy for using nationalization instrument.
Humans ; Laser Therapy ; Lasers ; Male ; Patient Safety ; Prostatic Hyperplasia ; therapy ; Software

OBJECTIVETo investigate clinical and epidemiological characteristics of hospitalized severe acute respiratory illnesses (SARI) patients under 15 years old registered by sentinel hospitals at 10 cities and risk factors analysis of severe illness.

METHODSThe objects of this study were 2 937 SARI patients under 15 years old registered by sentinel surveillance in internal wards, pediatrics wards and intensive care units (ICU) of 10 sentinel hospitals in 10 cities during the period from December 2009 to June 2014. We also collected case report form (CRF) of them and their throat swabs for influenza testing. The inclusion criteria was hospitalized patients who were admitted by surveillance departments, registered by SARI surveillance system, under 15 years old, meeting SARI case definition and with complete CRF. Rank-sum test was used to compare the difference of age, the duration including from onset to admission, hospital stay and from onset to discharging/death between mild illness and severe illness. Chi-square test was used to compare the difference of demographic characteristics, influenza psoitive rate, vaccination rate of influenza, chronic medical conditions and clinical characteristics between mild illness and severe illness. Logistic regression was used to analysis risk factors associated with severe illness by two stratifications from SARI surveillance protocol (< 2 years old and ≥ 2 years old).

RESULTSAmong 2 937 SARI patients under 15 years old, 97.7% (2 872/2 937) was mild illnesses, and 2.3% (65/2 937) was severe illnesses. 78.8% (2 315/2 937) was under 5 years old. The median ages of severe illness and mild illness were 0.4 and 2.0 years old (U = -6.23, P < 0.001). The proportions of severe illness and mild illness with at least one chronic medical condition were 32.3% (21/65) and 8.4% (240/2 872) (χ² = 45.03, P < 0.001). The positive rate of influenza virus was 6.5% (190/2 937), which was 6.5% (186/2 858) for mild illness and 6.2% (4/65) for severe illness (χ² = 0.08, P = 0.961). The proportion of seasonal influenza vaccination was 1.5% (42/2 853), which was 1.5% (42/2 788) for mild illness and higher than that for severe illness (0) (χ² = 6.09, P = 0.048). For under 2 years old patients, age < 11 months and with at least one chronic medical condition were risk factors for severe SARI illness, and the risk for SARI patients who was 12-23 months and without medical condition was 14.71 (5.35-40.44) and 5.61 (2.96-10.63). For ≥ 2 years old patients, age, with at least one chronic medical condition and seasonal influenza vaccination history have no association with severe illness, OR (95% CI) was 0.92 (0.80-1.05), 0.67 (0.09-5.05) and 0.85 (0.31-2.35), respectively.

CONCLUSIONMost of SARI patients registered by 10 urban sentinel hospitals were patients under 5 years old. Age < 11 months and with at least chronic medical conditions were possible risk factors of severe illness of SARI patients.

Adolescent ; Child ; Child, Preschool ; China ; Chronic Disease ; Cities ; Hospitalization ; Hospitals ; Humans ; Infant ; Influenza, Human ; Orthomyxoviridae ; Respiratory Tract Diseases ; Risk Factors ; Sentinel Surveillance ; Vaccination

The basic theory of high power green laser equipment for prostate hyperplasia therapy and the components of the system developed are introduced. Considering the requirements of the clinical therapy, the working process of the high power green laser apparatus are designed and the laser with stable output at 120 W is achieved. The controling hardware and application software are developed, and the safety step is designed. The high power green laser apparatus manufactured with characteristics of stable output, multifunctional and friendly interface provides a choices of prostate hyperplasia therapy for using nationalization instrument.

Animals ; Cell Nucleus Size ; genetics ; Cell Proliferation ; genetics ; Embryo Loss ; genetics ; pathology ; Embryo, Mammalian ; metabolism ; pathology ; Embryonic Stem Cells ; cytology ; Endoplasmic Reticulum ; genetics ; Homologous Recombination ; Mice ; rab GTP-Binding Proteins ; deficiency ; genetics ; metabolism

Introduction to the theories on improving coordination level of the new rural cooperative medical system,including the risk theory,great number rule,fair theory,demand theory and supply theory which are cornerstones of enhancing the NRCMS improving the pooling level.The paper also probed into the practices of improving the pooling level of the NRCMS,including the models of high level,middle level and low level pooling.These theories and practices can help the localities better design and manage the pooling level of the NRCMS.

To evaluate the value of Doppler tissue imaging(DTI) to assess left ventricular systolic and diastolic function by determining motion frequency of the mitral annulus in acute myocardial ischemia and myocardial infarction. The left anterior descending coronary artery(LAD) was ligated in 10 pigs and systolic motion velocity(Sa), early diastolic velocity(Ea), late diastolic velocity(Aa) and Ea/Aa of lateral mitral annulus in apical 4 chamber view using DTI velocity model before and after ligation of LAD were determined.The results were compared with routine Doppler. In basal state, Ea/Aa was positively correlated with VE/VA (the ratio of early and late diastolic velocity of mitral flow) with Doppler imaging (?=0.82). After the ligation of LAD, Sa, Ea and Ea/Aa significantly decreased, while there was no difference in Aa. DTI is simple and easy for determining mitral annulus motion. It is a new quantitative and non invasive method to evaluate left ventricular function. [HS(2*2/3]