1.Studying the Influence of Healthcare and Medical Insurance Policies on the Changes of Per Capita Inpatient Cost Based on the Medical Service Price Index
Shengzhen FAN ; Baorong YU ; Qingxu ZHU
Chinese Health Economics 2025;44(1):55-60
Objective:To study the interaction between the policy implementation and the changes of comprehensive medical service price index in this hospital,and to explore the influencing factors of the change of per capita inpatient cost.Methods:The comprehensive medical service price indexes of a county-level people's hospital in Tai'an City,Shandong Province during 2020-2022 were measured and observed.Breakpoint regression design was used to study the interaction between the implementation of Diagnosis-Intervention Packet(DIP)and the changes of the comprehensive medical service price indexes of the hospital.Results:The three output results of breakpoint regression were all significant at least 5%level,and the local average treatment effect were-21.579,-29.421 and-29.421,respectively.Conclusion:By shortening the average inpatient bed days,reducing excessive medical treatment items,optimizing the proportion of medical service costs and optimizing the hospital management mode,the implementation of DIP policy improved the efficiency of medical service,controlled the unreasonable growth of patients'medical economic burden,which ultimately leads to the decline of the comprehensive medical service price index of the hospital.
2.Studying the Influence of Healthcare and Medical Insurance Policies on the Changes of Per Capita Inpatient Cost Based on the Medical Service Price Index
Shengzhen FAN ; Baorong YU ; Qingxu ZHU
Chinese Health Economics 2025;44(1):55-60
Objective:To study the interaction between the policy implementation and the changes of comprehensive medical service price index in this hospital,and to explore the influencing factors of the change of per capita inpatient cost.Methods:The comprehensive medical service price indexes of a county-level people's hospital in Tai'an City,Shandong Province during 2020-2022 were measured and observed.Breakpoint regression design was used to study the interaction between the implementation of Diagnosis-Intervention Packet(DIP)and the changes of the comprehensive medical service price indexes of the hospital.Results:The three output results of breakpoint regression were all significant at least 5%level,and the local average treatment effect were-21.579,-29.421 and-29.421,respectively.Conclusion:By shortening the average inpatient bed days,reducing excessive medical treatment items,optimizing the proportion of medical service costs and optimizing the hospital management mode,the implementation of DIP policy improved the efficiency of medical service,controlled the unreasonable growth of patients'medical economic burden,which ultimately leads to the decline of the comprehensive medical service price index of the hospital.
3.Clinical significance of monitoring bone turnover markers changes before and after growth hormone treatment of prepubertal children with idiopathic short stature
Fei WANG ; Zhiying ZHU ; Qingxu LIU ; Jing XU ; Pin LI
Chinese Journal of Applied Clinical Pediatrics 2016;31(20):1541-1545
Objective To detect the levels and study the clinical significance of serum procollagen type Ⅰ amino-terminal propeptide (PINP) and β-C-telopeptides of type Ⅰ collagen (β-CTX) as bone turnover markers in recombinant human growth hormone (rhGH) treatment of prepuberty idiopathic short stature (ISS) children.Methods Forty patients of ISS (18 boys and 22 girls) had been collected and treated with GH 0.15 IU/(kg · d) injection every night.Serum levels of PINP,β-CTX,insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP3) were measured by electrochemiluminescence immunoassay in ISS before treatment and after 3,6 months,and they were also measured in 50 healthy children of the healthy control group,and the height,weight,body mass index,height standard difference score (HtSDS),bone age and growth rate were recorded.Results (1) In ISS group,the serum level of PINP[(479.51 ± 134.61) μg/L] was lower than that of the healthy control group [(651.31 ± 212.41) μg/L],the level of β-CTX[(0.84 ± 0.33) μg/L] was higher than that of the healthy control group [(0.50 ± 0.15) μg/L].The differences were statistically significant (t =2.276,-2.709,all P < 0.05).(2) The serum levels of PINP and β-CTX had no significant difference in 18 boys and 22 girls before and after GH treatment (P>0.05) of ISS.After 3 months of GH treatment,the serum levels of PINP[(736.15 ± 156.59) μg/L] and β-CTX [(1.08 ± 0.27) μg/L] were higher than those before treatment in 40 cases,and the difference was statistically significant (t =4.736,2.497,all P < 0.05),as the increase of PINP was particularly significant.HtSDS (-2.95 ±0.43),compared with before treatment (-2.69 ± 0.58),was significantly different (t =2.714,P < 0.05).However,after 6 months of GH treatment,the levels of PINP[(860.90 ±254.59) μg/L] and β-CTX[(0.94 ±0.32) μg/L] increased slowly (t =1.366,-0.831,all P > 0.05).HtSDS (-2.51 ± 0.54) showed no significant difference (t =1.609,P > 0.05) compared with 3 months of treatment.(3) The serum level of PINP was positively correlated with IGF-1 and IGFBP3 (r =0.636,0.673,all P < 0.05),and there was no correlation with β-CTX (r =0.336,P >0.05).PINP and β-CTX had significant correlation with HtSDS (r =0.655,0.782,all P < 0.05).Conclusions The serum PINP and β-CTX as bone turnover markers in serum can be used as one of the early supplementary indicators to predict GH response of ISS.
4.Expression and clinical significance of moesin and E-cadherin in invasive carcinoma of breast, no specific type
Xiaojuan PEI ; Xiufen XUE ; Yingling ZHU ; Shaojie LIU ; Anjia HAN ; Qingxu YANG
Chinese Journal of Pathology 2016;45(8):550-555
Objective To investigate the correlation of moesin and E-cadherin with biological behavior of breast cancer and its mechanism by comparing expression of moesin and E-cadherin in breast invasive carcinoma of no specific type (BIC-NST),breast ductal carcinoma in situ (BDCIS) and normal breast tissues adjacent to carcinoma.Methods Breast cancer cases of the Huizhou Municipal Center People Hospital were collected between Jan 2008 and Dec 2010,expression of moesin and E-cadherin in 104 cases of BIC-NST,84 cases of BDCIS and 53 cases of normal breast tissues adjacent to carcinoma were detected by tissue-microarray and SP immunohistochemical staining.Western blot was used to detect moesin expression of 16 BIC-NST fresh tissues.Results Expression rate of moesin in BIC-NST and BDCIS were significantly higher than normal tissues(P < 0.01),but the expression rate of E-cadherin in BIC-NST and BDCIS were significantly lower than those of normal tissues(P < 0.01).Expression rate of moesin in BIC-NST grade Ⅲ group was significantly higher than that of the grade Ⅰ group.There was a significantly positive correlation between histological grade and moesin expression(P < 0.05).However,E-cadherin expression rate in BICNST grade Ⅲ group was significantly lower than that in grade Ⅰ group,and there was a significantly negative correlation between histological grade and E-cadherin expression (P < 0.05).Moreover,no significant correlation was observed between moesin and E-cadherin expression in BDCIS tissues.Expression of moesin in clinical stage Ⅱ + Ⅲ BIC-NST was significantly higher than that in stage Ⅰ (P < 0.01).Expression of moesin was significantly associated with lymph node metastasis (P < 0.01).But no significant correlation was observed between moesin expression and age,tumor size and vascular invasion.However,expression of E-cadherin in clinical stage Ⅱ + Ⅲ BIC-NST was significantly lower than that in stage Ⅰ (P < 0.01).Expression of E-cadherin was significantly associated with lymph node metastasis and vascular invasion (P < 0.01).But no significant correlation was observed between E-cadherin expression,age and tumor size.There was a negative correlation between expression of moesin and E-cadherin in BIC-NST(P =0.021)and BDCIS(P =O.032).Conclusion Higher moesin and lower E-cadherin signal transduction is closely related to the recurrence and development of breast carcinoma,therefore moesin and E-cadherin might provide new targets for gene therapy in breast carcinoma.
5.Clinicopathological analysis of clear cell meningioma.
Tongtong WU ; Qingxu YANG ; Zhi LI ; Fang CAI ; Shuling ZHU ; Faren ZHANG
Journal of Southern Medical University 2012;32(1):131-134
We present two cases of clear cell meningioma (CCM) in the intracranial and intraspinal region with anaplastic features. On histological examination, both the tumors exhibited unusual anaplastic appearances with nuclear pleomorphism, a high mitotic activity and necrosis, which were different from classical CCMs. The tumor cells were immunoreactive to epithelial membrane antigen (EMA) and vimentin with a high MIB-1 index of 40%. Total excision of the tumors was performed in both cases. The male patient was found to have local recurrence and lateral ventricle metastasis 3 months after the total excision. We reviewed the clinicopathological features, disagnosis and prognosis of the disease. We recommend that postoperative adjuvant radiotherapy or chemotherapy be performed after total tumor excision, and MRI scan every 3-6 months is mandatory during the initial follow-up period.
Adult
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Aged
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Female
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Follow-Up Studies
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Humans
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Male
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Meningeal Neoplasms
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immunology
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pathology
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therapy
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Meningioma
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immunology
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pathology
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therapy
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Mucin-1
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immunology
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Vimentin
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immunology
6.Effect of subtotal splenectomy with retroperitoneal splenic transposition and devascularization on portal hypertensive gastropathy
Enshan LI ; Liande ZHAO ; Lidong ZHU ; Qingxu SUN ; Zhengping LI ; Yuankai ZHANG
Chinese Journal of General Surgery 2001;0(08):-
Objective To study the effect of the modality of subtotal splenectomy with retroperitoneal splenic transposition combined with devascularization on portal hypertensive gastropahy(PHG). Methods Subtotal splenectomy with retroperitoneal splenic transposition combined with devascularization was performed in 48 cirrhotic patients with portal hypertension. Forty seven patients were followed up for 2 years to 13 years (average 91 months). PHG were observed by gastroscopy.Results At 2 months postoperation ,PHG was significantly aggravated compared with that of preoperation (P

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