Objective:To investigate the importance and clinical significance of breast reconstruction’s procedure classification and coding.Methods:By retrieving the medical record information system, the breast reconstruction cases with a diagnosis code (ICD-10) of C50 or Z85.3 and a procedure code (ICD-9-CM-3) of 85.33, 85.35, 85.53, 85.54, 85.55, 85.7, 85.95, or 85.96 were collected from Wuhan Union Hospital from Jan. 2016 to Dec. 2019. The reconstruction techniques and timing of the cases were counted according to the clinical procedure names in the operation notes and to the ICD codes verified by the content from operation notes and progress notes, respectively. The results were compared and analyzed by chi-square test with P<0.05 indicating statistically significant difference. Results:A total of 108 cases were included in the study. The difference between clinical procedure names and ICD codes regarding the reconstruction techniques is statistically significant ( P<0.05) with 51 clinical procedure naming ambiguities (47.2%) i. e., the names do not precisely indicate the reconstruction techniques. Similarly, the difference between clinical procedure names and ICD codes regarding the reconstruction timing is statistically significant ( P<0.05) with 29 clinical procedure name errors (26.9%). i. e., the reconstruction timing in the name does not correspond to its counterpart in reality. Conclusions:The clinical procedure names cannot accurately tell the reconstruction techniques or the timing of the procedure, affecting the correctness of the procedure coding and the diagnosis-related groups (DRGs) result. We suggest the reconstruction surgeons to learn some procedure classification and coding knowledge in a timely manner in order to enhance the correctness of the procedure names and coding and to get adapt to the medical insurance payment reform based on CHS-DRG.

Objective:To investigate the importance and clinical significance of breast reconstruction’s procedure classification and coding.Methods:By retrieving the medical record information system, the breast reconstruction cases with a diagnosis code (ICD-10) of C50 or Z85.3 and a procedure code (ICD-9-CM-3) of 85.33, 85.35, 85.53, 85.54, 85.55, 85.7, 85.95, or 85.96 were collected from Wuhan Union Hospital from Jan. 2016 to Dec. 2019. The reconstruction techniques and timing of the cases were counted according to the clinical procedure names in the operation notes and to the ICD codes verified by the content from operation notes and progress notes, respectively. The results were compared and analyzed by chi-square test with P<0.05 indicating statistically significant difference. Results:A total of 108 cases were included in the study. The difference between clinical procedure names and ICD codes regarding the reconstruction techniques is statistically significant ( P<0.05) with 51 clinical procedure naming ambiguities (47.2%) i. e., the names do not precisely indicate the reconstruction techniques. Similarly, the difference between clinical procedure names and ICD codes regarding the reconstruction timing is statistically significant ( P<0.05) with 29 clinical procedure name errors (26.9%). i. e., the reconstruction timing in the name does not correspond to its counterpart in reality. Conclusions:The clinical procedure names cannot accurately tell the reconstruction techniques or the timing of the procedure, affecting the correctness of the procedure coding and the diagnosis-related groups (DRGs) result. We suggest the reconstruction surgeons to learn some procedure classification and coding knowledge in a timely manner in order to enhance the correctness of the procedure names and coding and to get adapt to the medical insurance payment reform based on CHS-DRG.

Under the diagnosis-related groups(DRG) prospective payment system, innovative health technologies with high costs and risks may be limited to some extent. How to balance the increase of health care cost and the development of innovative health technology is a difficult problem to be solved in the current reform. By studying the relatively mature payment systems of innovative health technologies in the world, the authors found that countries generally adopted additional payment or compensation to encourage the development of new technologies. But at the same time, a relatively perfect health technology assessment and payment management mechanism had been established to ensure the standardized operation of payment plan. These international advanced experience and practice could provide references for China′s innovative health technology payment strategy under the DRG payment system. It is suggested to establish a scientific and reasonable assessment mechanism of innovative health technology, create a special access channel for innovative health technology with limited short-term evidence, and gradually form a long-term incentive mechanism of innovative health technology in DRG payment system.

Objective:To compare the efficacy of the combination of abidol, lopinavir/ritonavir plus recombinant interferon α-2b (rIFNα-2b) and the combination of lopinavir/ritonavir plus rIFNα-2b for patients with COVID-19 in Zhejiang province.Methods:A multicenter prospective study was carried out to compare the efficacy of triple combination antiviral therapy and dual combination antiviral therapy in 15 medical institutions of Zhejiang province during January 22 to February 16, 2020. All patients were treated with rIFNα-2b (5 million U, 2 times/d) aerosol inhalation, in addition 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir/ritonavir (2 tablets, 1 time/12 h) (triple combination group) and 41 patients were treated with lopinavir/ritonavir (2 tablets, 1 time/12 h) (dual combination group). The patients who received triple combination antiviral therapy were further divided into three subgroups: <48 h, 3-5 d and >5 d according the time from the symptom onset to medication starting. The therapeutic efficacy was compared between triple combination group and dual combination group, and compared among 3 subgroups of patients receiving triple combination antiviral therapy. SPSS 17.0 software was used to analyze the data.Results:The virus nucleic acid-negative conversion time in respiratory tract specimens was (12.2±4.7) d in the triple combination group, which was shorter than that in the dual combination group [(15.0±5.0) d] ( t=6.159, P<0.01). The length of hospital stay in the triple combination group [12.0 (9.0, 17.0) d] was also shorter than that in the dual combination group [15.0 (10.0, 18.0) d] ( H=2.073, P<0.05). Compared with the antiviral treatment which was started within after the symptom onset of in the triple combination group, the time from the symptom onset to the viral negative conversion was 13.0 (10.0, 17.0), 17.0 (13.0, 22.0) and 21.0 (18.0, 24.0) d in subgroups of 48 h, 3-5 d and >5 d, respectively ( Z=32.983, P<0.01), while the time from antiviral therapy to viral negative conversion was (11.8±3.9), (13.5±5.1) and (11.2±4.3) d, respectively( Z=6.722, P<0.05). Conclusions:The triple combination antiviral therapy of abidol, lopinavir/litonavir and rIFNα-2b shows shorter viral shedding time and shorter hospitalization time, compared with the dual combination antiviral therapy; and the earlier starting triple combination antiviral therapy will result in better antiviral efficacy.

Objective: Comparing the benefit of Abidor, lopinavir/ritonavir and recombinant interferon α-2b triple combination antiviral therapy and lopinavir/ritonavir and interferon dual combination antiviral therapy to hospitalized novel coronavirus pneumonia 2019 in Zhejiang province. Methods: A multi-center prospective study was carried out to compare the effect of triple combination antiviral therapy with dual combination antiviral therapy in 15 medical institutions of Zhejiang Province. All patients were treated with recombinant interferon α-2b (5 million U, 2 times/d) aerosol inhalation. 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir / ritonavir (2 tablets, 1 time/12 h) as the triple combination antiviral treatment group. 41 patients were treated with lopinavir / ritonavir (2 tablets, 1 time/12 h) as the dual combination antiviral treatment group. The patients who received triple combination antiviral therapy were divided into three groups: within 48 hours, 3-5 days and > 5 days after the symptom onset. To explore the therapeutic effects of triple combination antiviral drugs and dual combination antiviral drugs, as well as triple combination antiviral drugs with different antiviral initiate time. SPSS17.0 software was used to analyze the data. Results: The time of virus nucleic acid turning negative was (12.2 ± 4.7) days in the triple combination antiviral drug group, which was shorter than that in the dual combination antiviral drug group [(15.0 ± 5.0) days] (t = 6.159, P < 0.01 ). The length of hospital stay [12 (9, 17) d] in the triple combination antiviral drug group was also shorter than that in the dual combination antiviral drug group [15 (10, 18) d] (H = 2.073, P < 0.05). Comparing the antiviral treatment which was started within 48 hours, 3-5 days and > 5 days after the symptom onset of triple combination antiviral drug group, the time from the symptom onset to the negative of viral shedding was 13 (10,16.8), 17 (13,22) and 21 (18-24) days respectively (Z = 32.983, P < 0.01), and the time from antiviral therapy to the negative of viral shedding was (11.8±3.9) , (13.5±5.1) and (11.2±4.3) d. The differences among the three groups were statistically significant (Z=32.983 and 6.722, P<0.01 or<0.05). Conclusions The triple combination antiviral therapy of Abidor, Lopinavir/Litonavir and recombinant interferon α-2b showed shorter viral shedding time and hospitalization time compared with the dual combination antiviral therapy. The earlier the time to initiate triple antiviral treatment, the shorter the time of virus shedding.

Objective To observe the clinical efficacy of fasudil combined with fibrinogenase for injection on sudden sensorineural hearing loss of old people. Methods Ninety old patients with sudden sensorineural hearing loss were randomly divided into fasudil group, fibrinogenase group and combined group (n=30 in each group).After the treatment, improvement of deafness and tinnitus were compared among the three groups. Hemorrheology, coagulation function, blood routine examination, liver and kidney function profile, and blood lipid were compared before and after the treatment. Results The total effective rate of deafness was significantly higher in the combined group ( 93. 3%) than in the fasudil group ( 90. 0%) and the fibrinogenase group (86.7%) (both P<0.05).The total effective rate of tinnitus was significantly higher in the combined group (93.3%) than in the fasudil group (83.3%) and the fibrinogenase group (80.0%) (both P<0.05).After the treatment, blood viscosity and coagulation function were significantly improved in the three groups (all P<0.05).As compared with the fasudil group and the fibrinogenase group, blood viscosity was significantly improved in the combined group (both P<0.05). Conclusion Fasudil combined with the fibrinogenase for injection for sudden sensorineural hearing loss of the old people has preferable curative efficacy, and can effectively improve clinical symptom, blood viscosity and coagulation function of sudden sensorineural hearing loss.

Prolyl-4-hydroxylase domain (PHDs) family is one of the most important regulatory factors in hypoxic stress. PHD2 plays a critical role in cells and tissues adaptation to the low oxygen environment. Its hydroxylation activity regulates the stability and transcriptional activity of the hypoxia-inducible factor 1 (HIF-1), which is the key factor in response to hypoxic stress. Subsequently, PHD2 acts as an important factor in oxygen homeostasis. Studies have shown that PHD2, through its regulation on HIF-1, plays an important role in the post-ischemic neovascularization. Furthermore, under hypoxic condition, PHD2 also regulates other pathways that positively regulate angiogenesis factors HIF-1 independently. Moreover, recently, several evidences have also shown that PHD2 also affects tumor growth and metastasis in a tumor microenvironment. Based on these facts, PHD2 have been considered as a potential therapeutic target both in treating ischemic diseases and tumors. Here, we review the molecular regulation mechanism of PHD2 and its physiological and pathological functions. We focus on the role of PHD2 in both therapeutic angiogenesis for ischemic disease and tumor angiogenesis, and the current progress in utilizing PHD2 as a therapeutic target.

OBJECTIVE: To investigate the influence of endoscopic variceal ligation (EVL) on liver function and analyze the risk factors of rebleeding after EVL. METHODS: A total of 137 cirrhotic patients with esophageal varices who received EVL were retrospectively analyzed, and divided into group A, B, and C according to the Child-Pugh scores of liver function. We compared the liver function 1 week preoperatively and postoperatively. The patients were further divided into a rebleeding group and a non-rebleeding group after the EVL, and risk factors about rebleeding were analyzed. RESULTS: There was no significant difference on ALT, AST, T-Bil, and D-Bil either preoperatively or postoperatively in group A, B, and C (P>0.05). Thirteen patients (9.49%) rebled after the EVL. The course of disease, liver function, prothrombin time, and mass ascites were the risk factors of rebleeding. CONCLUSION EVL has no obvious effect on liver function, and the course of disease, liver function, prothrombin time and mass ascites are risk factors of rebleeding after EVL.
Adult ; Endoscopy ; methods ; Esophageal and Gastric Varices ; etiology ; surgery ; Female ; Gastrointestinal Hemorrhage ; etiology ; prevention & control ; surgery ; Humans ; Ligation ; methods ; Liver ; physiopathology ; Liver Cirrhosis ; complications ; etiology ; physiopathology ; Logistic Models ; Male ; Middle Aged ; Recurrence ; Risk Factors ; Secondary Prevention

OBJECTIVE: To construct the RNAi targeting tumor necrosis factor receptor associated factor (TRAF1) gene, and to explore the effect of interference targeting TRAF1 on the biological behavior of gastric cancer cells. METHODS: We detected the expression of TRAF1 in BGC823, SGC7901, and MGC803 gastric cancer cell lines through the real-time PCR and Western blot; then we constructed three pLVXshRNA- TRAF1-shRNAs expression vector targeting TRAF1. When TRAF1 was interfered successfully, we selected the strongest interference efficiency ShRNA by real-time PCR and Western blot. Based on interference targeting TRAF1 on gastric cancer, we tested the cell proliferation activity and apoptosis through MTT assay and flow cytometry, and the cell migration by transwell migration assay. RESULTS: The expression of TRAF1 was increased in BGC823, SGC7901, and MGC803 gastric cancer cell lines compared with gastric epithelial cells (P<0.05), and the highest expression was in BGC823 gastric cell line. In the three TRAF1 shRNAs, the strongest interference efficiency shRNA was pLVX-shRNA-TRAF1-shRNA2. When the gene TRAF1 of BGC823 was interfered, the cell growing power was weakened and the apoptosis rate increased, and the cell migration had no difference. CONCLUSION The expression of TRAF1 is up-regulated in gastric cancer cell lines BGC823, SGC7901, and MGC803, and the most obvious one is BGC823. The interference targeting TRAF1 can successfully inhibit the expression of TRAF1 in gastric cancer cell line BGC823. TRAF1 can inhibit the apoptosis of BGC823 cells.
Apoptosis ; genetics ; Base Sequence ; Cell Line, Tumor ; Humans ; Molecular Sequence Data ; RNA Interference ; RNA, Small Interfering ; genetics ; Stomach Neoplasms ; genetics ; metabolism ; pathology ; TNF Receptor-Associated Factor 1 ; genetics ; metabolism ; Transfection ; Up-Regulation ; genetics

OBJECTIVE: To explore the effect of different Helicobacter pylori (H.pylori) clinical strains on the proliferation and apoptosis of gastric epithelial cells, and to observe the effect of H.pylori on gastric mucosa by Mongolian gerbil model infected H.pylori. METHODS: H.pylori isolates harvested from pathologically documented gastric carcinoma (GC, n=10) or chronic gastritis specimens (CG, n=10) were co-cultured with GES-1 cells individually. MTT assay and flow cytometry were used to determine the proliferation and apoptosis of GES-1 cells induced by H.pylori isolates. Mongolian gerbils were infected by the most (A strain) and the least (B strain) significantly proliferated H.pylori strains. Results When co-cultured with the cell/bacteria concentration ratio 1:1 and 1:50 for 12 h and the cell/bacteria concentration ratio 1:50 for 24 h, H.pylori clinical strains isolated from patients with gastric cancer promoted the proliferation of GES-1 cells, and there was significant difference in the absorbance compared with the group of gastritis strains(P<0.05). The apoptosis rate of the GC and CG groups increased significantly (P<0.05) compared with the control group when co-cultured with the cell/bacteria concentration ratio 1:50 and 1:200, and there was no significant difference between the GC group and the CG group (P>0.05). The incidences of intestinal metaplasia and dysplasia in the A strain group were significantly higher than those in the B strain group (P<0.05). CONCLUSION H.pylori strains from different disease sources have different effects on the proliferation of GES-1 cells. H.pylori isolated from gastric cancer can promote the proliferation of cells to different degrees and directly induce gastric precancerosis and gastric cancer.
Animals ; Apoptosis ; Cell Line ; Cell Proliferation ; Chronic Disease ; Gastric Mucosa ; cytology ; microbiology ; pathology ; Gastritis ; microbiology ; pathology ; Gerbillinae ; Helicobacter Infections ; pathology ; Helicobacter pylori ; pathogenicity ; Humans ; Metaplasia ; pathology ; Precancerous Conditions ; microbiology ; pathology ; Stomach Neoplasms ; microbiology ; pathology