Objective To systematically evaluate the ICD coding data on the front page of inpatient medical records filed out by clinicians,and to analyze the quality of ICD codes reasonably,objectively and comprehensively by employing the 3×3 Da-ta Quality Assessment(3×3 DQA)model.Methods A total of 1 410 medical records from a tertiary women and children's hospital between June 2021 to July 2024 were randomly selected.Based on the 3×3 DQA model,the data quality of ICD codes for diagnosis and surgical procedures on the front pages filed out by clinicians was assessed.Results Among 1,410 medical re-cords reviewed,778 had defects,resulting in a total defect rate of 55.18％,including a completeness defect rate of 32.98％and an accuracy defect rate of 30.57％.Totally,a total of 9 302 ICD codes were reviewed,among which 1 254 had defects,with a total defect rate of 13.48％.The defect rates for the principal diagnosis,other diagnosis,principal operation,and other operation were 22.20％,17.72％,4.53％and 4.92％,respectively.For diagnostic ICD codes,the completeness defect rate was relative-ly high,while for surgical ICD codes,the accuracy defect rate was higher.In terms of specialties,there were statistically signifi-cant differences in the overall defect rates among gynecology,obstetrics,and pediatrics,with pediatrics and gynecology having defect rates higher than the overall average.Conclusion The quality of ICD code data on the front page of medical records filed out by clinicians is suboptimal,and there are differences in data quality across different specialties and ICD categories.There-fore,it is still necessary to conduct research on the supervision and improvement measures for ICD data quality in hospital medical record management.

Objective To systematically evaluate the ICD coding data on the front page of inpatient medical records filed out by clinicians,and to analyze the quality of ICD codes reasonably,objectively and comprehensively by employing the 3×3 Da-ta Quality Assessment(3×3 DQA)model.Methods A total of 1 410 medical records from a tertiary women and children's hospital between June 2021 to July 2024 were randomly selected.Based on the 3×3 DQA model,the data quality of ICD codes for diagnosis and surgical procedures on the front pages filed out by clinicians was assessed.Results Among 1,410 medical re-cords reviewed,778 had defects,resulting in a total defect rate of 55.18％,including a completeness defect rate of 32.98％and an accuracy defect rate of 30.57％.Totally,a total of 9 302 ICD codes were reviewed,among which 1 254 had defects,with a total defect rate of 13.48％.The defect rates for the principal diagnosis,other diagnosis,principal operation,and other operation were 22.20％,17.72％,4.53％and 4.92％,respectively.For diagnostic ICD codes,the completeness defect rate was relative-ly high,while for surgical ICD codes,the accuracy defect rate was higher.In terms of specialties,there were statistically signifi-cant differences in the overall defect rates among gynecology,obstetrics,and pediatrics,with pediatrics and gynecology having defect rates higher than the overall average.Conclusion The quality of ICD code data on the front page of medical records filed out by clinicians is suboptimal,and there are differences in data quality across different specialties and ICD categories.There-fore,it is still necessary to conduct research on the supervision and improvement measures for ICD data quality in hospital medical record management.

Objective To analyze the correlation between T lymphocyte subsets,neutrophil/lymphocyte ratio(NLR),procalcitonin(PCT)and the severity of sepsis.Methods A prospective research method was adopted.A total of 78 sepsis patients admitted to the department of intensive care medicine of Zibo Central Hospital from January 2021 to December 2022 were selected as the research subjects.Patients were divided into a septic shock group(37 cases)and a sepsis group(41 cases)based on the severity of their condition,with 40 healthy examinees from our hospital as the healthy control group.Using flow cytometry to measure the levels of CD4+ T lymphocytes count(CD4+ T)and CD8+ T lymphocytes count(CD8+ T)in three groups of subjects,calculate the CD4+ T/CD8+ T lymphocyte ratio(CD4+ T/CD8+ T)and NLR.The levels of PCT and interleukin-6(IL-6)were measured using electrochemiluminescence immunoassay,and the levels of C-reactive protein(CRP)were measured using immunoassay turbidimetry.Acute physiology and chronic health evaluationⅡ(APACHEⅡ)score within 24 hours was recorded for the two groups of patients,and the differences in lymphocyte subsets and various inflammatory indicators were compared between the groups.Pearson correlation analysis was used to analyze the correlation between various indicators and APACHEⅡscore.Results The CD4+ T,CD8+ T,and CD4+T/CD8+T levels in the septic shock and sepsis groups were significantly lower than those in the healthy control group[CD4+ T(×106/L):168.27±76.68,266.08±131.57 vs.789.60±173.78,CD8+ T(×106/L):156.50±68.37,205.81±75.60 vs.636.42±90.59,CD4+ T/CD8+ T:1.09±0.39,1.27±0.34 vs.1.44±0.38,all P<0.01],NLR,PCT,CRP and IL-6 were significantly higher than those in the healthy control group[NLR:25.85±11.62,15.94±8.72 vs.2.68±1.31,PCT(μg/L):21.82±15.28,9.09±4.96 vs.0.13±0.10,CRP(mg/L):158.65±62.33,106.97±51.49 vs.6.48±2.08,IL-6(ng/L):1 344.64±899.21,245.31±176.99 vs.3.25±1.83,all P<0.01].The APACHEⅡscore in the septic shock group was significantly higher than that in the sepsis group(32.00±1.00 vs.22.01±1.09,P<0.05).Correlation analysis showed that the levels of CD4+ T,CD8+ T,CD4+ T/CD8+ T in two groups of sepsis patients were negatively correlated with the APACHEⅡscore(r values were-0.571,-0.506,and-0.555,respectively,all P<0.01),while the levels of NLR,PCT,CRP,and IL-6 were positively correlated with the APACHEⅡscore(r values were 0.711,0.709,0.777,and 0.707,respectively,all P<0.01).Conclusions As the levels of T lymphocyte subsets decrease,inflammatory indicators like NLR and PCT rise,indicating a more severe sepsis condition.Therefore,T lymphocyte subsets and levels of various inflammatory indicators can serve as markers for evaluating the severity of sepsis.

OBJECTIVETo investigate the clinicopathologic features and differential diagnoses of non-involuting congenital hemangioma (NICH) in children.

METHODSThe clinical, morphologic and immunophenotypic characteristics of 22 cases of NICH were retrospectively analyzed.

RESULTSThe mean patients' age at diagnosis was 4.2 years, with a male to female ratio of 1.75:1. The tumors were located in the head and face (5 cases), neck (3 cases), body (6 cases), upper limbs (5 cases), and lower limbs (3 cases). Histologically, the tumor was dominated by rather large lobules of small vessels that were mostly rounded, curved, small and thin-walled, and were lined by endothelial cells surrounded by one or more layers of pericytes. The center of the lobules was occupied by one or more thin or thick walled vessels, which were surrounded by fibrous and fatty tissue, which contained abnormal arterial and venous structures. At the edge of the lobules there were lymphatic vessels. Immunohsitochemical study showed that tumor cells in NICH were positive for CD34 (22/22), CD31 (22/22), SMA (22/22), vimentin (22/22) and Glut1 (0/22). D2-40 expression was located at the edge of the capillary lobules.

CONCLUSIONSNICH is a benign lesion. Clinically and pathologically, it needs to be differentiated from rapidly involuting congenital hemangioma, infantile hemangiomas, tufted angioma, vascular malformation, and others.

Biomarkers, Tumor ; Child, Preschool ; Diagnosis, Differential ; Female ; Hemangioma, Capillary ; congenital ; diagnosis ; Humans ; Male ; Retrospective Studies

Objective To evaluate the multi-spiral CT(MSCT)imaging features and classification of renal pelvis carcinoma.Meth-ods 76 patients of renal pelvis carcinoma proved pathologically were analyzed retrospectively,and divided into different types ac-cording to the MSCT features.The MSCT differences for different types were analyzed.Results Most of the tumors showed iso-density or slight hyperdensity (95%)on un-enhanced images,and persistent mild-to-moderate enhancement (91%)in enhanced im-ages.All cases were divided into three types:pelvic mass type in 30 cases (39%),substance invasion type in 25 cases (33%),wall thickening type in 21 cases (28%).All cases were also divided into two types:substance invasion type(25 cases,33%)and renal pelvis type(5 1 cases,67%).The occurrence rate of local low enhancement,whole kidney low enhancement,hydronephrosis,lymph node metastasis and vein tumor thrombus were 80%,20%,48%,52%,1 6% in substance invasion type cases,and 4%,42%, 75%,4%,6% in the renal pelvis type cases,respectivily.Conclusion MSCT multiphase enhancement scanning shows important valuation in the diagnosis and classification of renal pelvis carcinoma.Obvious differences of CT features are showed for different types.The diagnosis accuracy may be improved by the knowledge of substance invasion type.

Objective To investigate the clinicopathologic features and differential diagnoses of non-involuting congenital hemangioma ( NICH ) in children.Methods The clinical , morphologic and immunophenotypic characteristics of 22 cases of NICH were retrospectively analyzed.Results The mean patients′age at diagnosis was 4.2 years, with a male to female ratio of 1.75∶1.The tumors were located in the head and face (5 cases), neck (3 cases), body (6 cases), upper limbs (5 cases), and lower limbs (3 cases).Histologically, the tumor was dominated by rather large lobules of small vessels that were mostly rounded, curved, small and thin-walled, and were lined by endothelial cells surrounded by one or more layers of pericytes.The center of the lobules was occupied by one or more thin or thick walled vessels , which were surrounded by fibrous and fatty tissue , which contained abnormal arterial and venous structures.At the edge of the lobules there were lymphatic vessels.Immunohsitochemical study showed that tumor cells in NICH were positive for CD34 ( 22/22 ) , CD31 ( 22/22 ) , SMA ( 22/22 ) , vimentin ( 22/22 ) and Glut1 (0/22).D2-40 expression was located at the edge of the capillary lobules.Conclusions NICH is a benign lesion.Clinically and pathologically , it needs to be differentiated from rapidly involuting congenital hemangioma ,infantile hemangiomas ,tufted angioma ,vascular malformation ,and others.