1.Comparative Study on Intelligent Audit and Monitoring Repository of Focused Audit Violations under DRG Payment
Zhiguo ZHANG ; Qingqin LIU ; Chen XIANG ; Xiangping LIU
Chinese Hospital Management 2024;44(6):77-82
Objective Comparative analysis of rule categories,key audit behaviors,and the degree of correspon-dence between rules and behaviors through intelligent auditing of key audit violations and monitoring of the rule base.To provide reference for the improvement of intelligent audit and monitoring rule library for key audit violations under DRG payment in medical insurance fund.Methods Searching and collecting policy documents such as DRG payment management methods issued by local health insurance bureaus from May 20,2019 to December 31,2023 and the literature related to DRG payment smart audit monitoring rules in the database,and targeting the rules therein that are related to the focus on auditing irregularities under the DRG payment.Literature analysis and comparative analysis were used to summarize and analyze the rules related to key audit violations under DRG payment.Results The intelli-gent audit rules for key audit violations under DRG payment can be divided into two major categories:logical judg-ment and parameter index,and the degree of correspondence between audit rules and key audit behaviors varies.Conclusion(1)Unify the key audit rules nationwide to ensure the universality and comprehensiveness of the rules;(2)Deepen the current situation of regional illegal activities and strengthen local characteristics;(3)Improve the quality of logical judgment rules and increase the quantity of parameter indicator rules;(4)Strengthen scientific re-search on new types of violations,and establish more targeted regulatory rules.
2.Comparative Study on Intelligent Audit and Monitoring Repository of Focused Audit Violations under DRG Payment
Zhiguo ZHANG ; Qingqin LIU ; Chen XIANG ; Xiangping LIU
Chinese Hospital Management 2024;44(6):77-82
Objective Comparative analysis of rule categories,key audit behaviors,and the degree of correspon-dence between rules and behaviors through intelligent auditing of key audit violations and monitoring of the rule base.To provide reference for the improvement of intelligent audit and monitoring rule library for key audit violations under DRG payment in medical insurance fund.Methods Searching and collecting policy documents such as DRG payment management methods issued by local health insurance bureaus from May 20,2019 to December 31,2023 and the literature related to DRG payment smart audit monitoring rules in the database,and targeting the rules therein that are related to the focus on auditing irregularities under the DRG payment.Literature analysis and comparative analysis were used to summarize and analyze the rules related to key audit violations under DRG payment.Results The intelli-gent audit rules for key audit violations under DRG payment can be divided into two major categories:logical judg-ment and parameter index,and the degree of correspondence between audit rules and key audit behaviors varies.Conclusion(1)Unify the key audit rules nationwide to ensure the universality and comprehensiveness of the rules;(2)Deepen the current situation of regional illegal activities and strengthen local characteristics;(3)Improve the quality of logical judgment rules and increase the quantity of parameter indicator rules;(4)Strengthen scientific re-search on new types of violations,and establish more targeted regulatory rules.
3.Comparative Study on Intelligent Audit and Monitoring Repository of Focused Audit Violations under DRG Payment
Zhiguo ZHANG ; Qingqin LIU ; Chen XIANG ; Xiangping LIU
Chinese Hospital Management 2024;44(6):77-82
Objective Comparative analysis of rule categories,key audit behaviors,and the degree of correspon-dence between rules and behaviors through intelligent auditing of key audit violations and monitoring of the rule base.To provide reference for the improvement of intelligent audit and monitoring rule library for key audit violations under DRG payment in medical insurance fund.Methods Searching and collecting policy documents such as DRG payment management methods issued by local health insurance bureaus from May 20,2019 to December 31,2023 and the literature related to DRG payment smart audit monitoring rules in the database,and targeting the rules therein that are related to the focus on auditing irregularities under the DRG payment.Literature analysis and comparative analysis were used to summarize and analyze the rules related to key audit violations under DRG payment.Results The intelli-gent audit rules for key audit violations under DRG payment can be divided into two major categories:logical judg-ment and parameter index,and the degree of correspondence between audit rules and key audit behaviors varies.Conclusion(1)Unify the key audit rules nationwide to ensure the universality and comprehensiveness of the rules;(2)Deepen the current situation of regional illegal activities and strengthen local characteristics;(3)Improve the quality of logical judgment rules and increase the quantity of parameter indicator rules;(4)Strengthen scientific re-search on new types of violations,and establish more targeted regulatory rules.
4.Comparative Study on Intelligent Audit and Monitoring Repository of Focused Audit Violations under DRG Payment
Zhiguo ZHANG ; Qingqin LIU ; Chen XIANG ; Xiangping LIU
Chinese Hospital Management 2024;44(6):77-82
Objective Comparative analysis of rule categories,key audit behaviors,and the degree of correspon-dence between rules and behaviors through intelligent auditing of key audit violations and monitoring of the rule base.To provide reference for the improvement of intelligent audit and monitoring rule library for key audit violations under DRG payment in medical insurance fund.Methods Searching and collecting policy documents such as DRG payment management methods issued by local health insurance bureaus from May 20,2019 to December 31,2023 and the literature related to DRG payment smart audit monitoring rules in the database,and targeting the rules therein that are related to the focus on auditing irregularities under the DRG payment.Literature analysis and comparative analysis were used to summarize and analyze the rules related to key audit violations under DRG payment.Results The intelli-gent audit rules for key audit violations under DRG payment can be divided into two major categories:logical judg-ment and parameter index,and the degree of correspondence between audit rules and key audit behaviors varies.Conclusion(1)Unify the key audit rules nationwide to ensure the universality and comprehensiveness of the rules;(2)Deepen the current situation of regional illegal activities and strengthen local characteristics;(3)Improve the quality of logical judgment rules and increase the quantity of parameter indicator rules;(4)Strengthen scientific re-search on new types of violations,and establish more targeted regulatory rules.
5.Comparative Study on Intelligent Audit and Monitoring Repository of Focused Audit Violations under DRG Payment
Zhiguo ZHANG ; Qingqin LIU ; Chen XIANG ; Xiangping LIU
Chinese Hospital Management 2024;44(6):77-82
Objective Comparative analysis of rule categories,key audit behaviors,and the degree of correspon-dence between rules and behaviors through intelligent auditing of key audit violations and monitoring of the rule base.To provide reference for the improvement of intelligent audit and monitoring rule library for key audit violations under DRG payment in medical insurance fund.Methods Searching and collecting policy documents such as DRG payment management methods issued by local health insurance bureaus from May 20,2019 to December 31,2023 and the literature related to DRG payment smart audit monitoring rules in the database,and targeting the rules therein that are related to the focus on auditing irregularities under the DRG payment.Literature analysis and comparative analysis were used to summarize and analyze the rules related to key audit violations under DRG payment.Results The intelli-gent audit rules for key audit violations under DRG payment can be divided into two major categories:logical judg-ment and parameter index,and the degree of correspondence between audit rules and key audit behaviors varies.Conclusion(1)Unify the key audit rules nationwide to ensure the universality and comprehensiveness of the rules;(2)Deepen the current situation of regional illegal activities and strengthen local characteristics;(3)Improve the quality of logical judgment rules and increase the quantity of parameter indicator rules;(4)Strengthen scientific re-search on new types of violations,and establish more targeted regulatory rules.
6.Comparative Study on Intelligent Audit and Monitoring Repository of Focused Audit Violations under DRG Payment
Zhiguo ZHANG ; Qingqin LIU ; Chen XIANG ; Xiangping LIU
Chinese Hospital Management 2024;44(6):77-82
Objective Comparative analysis of rule categories,key audit behaviors,and the degree of correspon-dence between rules and behaviors through intelligent auditing of key audit violations and monitoring of the rule base.To provide reference for the improvement of intelligent audit and monitoring rule library for key audit violations under DRG payment in medical insurance fund.Methods Searching and collecting policy documents such as DRG payment management methods issued by local health insurance bureaus from May 20,2019 to December 31,2023 and the literature related to DRG payment smart audit monitoring rules in the database,and targeting the rules therein that are related to the focus on auditing irregularities under the DRG payment.Literature analysis and comparative analysis were used to summarize and analyze the rules related to key audit violations under DRG payment.Results The intelli-gent audit rules for key audit violations under DRG payment can be divided into two major categories:logical judg-ment and parameter index,and the degree of correspondence between audit rules and key audit behaviors varies.Conclusion(1)Unify the key audit rules nationwide to ensure the universality and comprehensiveness of the rules;(2)Deepen the current situation of regional illegal activities and strengthen local characteristics;(3)Improve the quality of logical judgment rules and increase the quantity of parameter indicator rules;(4)Strengthen scientific re-search on new types of violations,and establish more targeted regulatory rules.
7.Reference values of carotid intima-media thickness and arterial stiffness in Chinese adults based on ultrasound radio frequency signal: A nationwide, multicenter study
Changyang XING ; Xiujing XIE ; Yu WU ; Lei XU ; Xiangping GUAN ; Fan LI ; Xiaojun ZHAN ; Hengli YANG ; Jinsong LI ; Qi ZHOU ; Yuming MU ; Qing ZHOU ; Yunchuan DING ; Yingli WANG ; Xiangzhu WANG ; Yu ZHENG ; Xiaofeng SUN ; Hua LI ; Chaoxue ZHANG ; Cheng ZHAO ; Shaodong QIU ; Guozhen YAN ; Hong YANG ; Yinjuan MAO ; Weiwei ZHAN ; Chunyan MA ; Ying GU ; Wu CHEN ; Mingxing XIE ; Tianan JIANG ; Lijun YUAN
Chinese Medical Journal 2024;137(15):1802-1810
Background::Carotid intima-media thickness (IMT) and diameter, stiffness, and wave reflections, are independent and important clinical biomarkers and risk predictors for cardiovascular diseases. The purpose of the present study was to establish nationwide reference values of carotid properties for healthy Chinese adults and to explore potential clinical determinants.Methods::A total of 3053 healthy Han Chinese adults (1922 women) aged 18-79 years were enrolled at 28 collaborating tertiary centers throughout China between April 2021 and July 2022. The real-time tracking of common carotid artery walls was achieved by the radio frequency (RF) ultrasound system. The IMT, diameter, compliance coefficient, β stiffness, local pulse wave velocity (PWV), local systolic blood pressure, augmented pressure (AP), and augmentation index (AIx) were then automatically measured and reported. Data were stratified by age groups and sex. The relationships between age and carotid property parameters were analyzed by Jonckheere-Terpstra test and simple linear regressions. The major clinical determinants of carotid properties were identified by Pearson’s correlation, multiple linear regression, and analyses of covariance.Results::All the parameters of carotid properties demonstrated significantly age-related trajectories. Women showed thinner IMT, smaller carotid diameter, larger AP, and AIx than men. The β stiffness and PWV were significantly higher in men than women before forties, but the differences reversed after that. The increase rate of carotid IMT (5.5 μm/year in women and 5.8 μm/year in men) and diameter (0.03 mm/year in both men and women) were similar between men and women. For the stiffness and wave reflections, women showed significantly larger age-related variations than men as demonstrated by steeper regression slopes (all P for age by sex interaction <0.05). The blood pressures, body mass index (BMI), and triglyceride levels were identified as major clinical determinants of carotid properties with adjustment of age and sex. Conclusions::The age- and sex-specific reference values of carotid properties measured by RF ultrasound for healthy Chinese adults were established. The blood pressures, BMI, and triglyceride levels should be considered for clinical application of corresponding reference values.
8.Differential Diagnosis of Conventional Ultrasound in Ureteral Polyps and Ureteral Carcinoma via Continuous Observation
Liang MU ; Hao CHEN ; Shuliang NAN ; Li LIU ; Xiangping GUAN ; Qiuyang LI
Chinese Journal of Medical Imaging 2024;32(6):610-615
Purpose To evaluate the differential diagnostic value of conventional ultrasound in the ureteral polyps and ureteral carcinoma via continuous observation.Materials and Methods The conventional ultrasound of patients with ureteral polyps and ureteral carcinoma treated in Shaanxi Provincial People's Hospital were retrospectively analyzed from June 2015 to June 2022.According to the pathological results,all participants were divided into the ureteral polyp group(98 cases)and the ureteral carcinoma group(151 cases).All clinical and ultrasound data were recorded,and the differences of echo,blood flow and peristalsis were compared between the two groups.Results There were significant differences in ureteral peristalsis,color Doppler flow distribution,periureteral tissue thickening,increased echo,and hydronephrosis(χ2=197.50,138.89,26.97,36.13,all P<0.05)between the two groups.Low echo was predominant in both groups[67(68.37)vs.114(75.50)],with no significant difference(χ2=1.52,P>0.05).In the ureteral polyp group,67 cases were found in the upper ureter,89 cases were observed continuously with common peristalsis,and 73 cases with color blood flow were mostly central blood flow,while in the ureteral cancer group,85 cases were found in the middle and lower ureter,148 cases showed almost no peristalsis,and 122 cases with color blood flow were mostly peripheral blood flow.Conclusion There are some differences in clinical features such as the location as well as whether hydronephrosis between ureteral polyps and carcinoma.Peristalsis can provide the differential diagnosis for ureteral polyps and ureteral carcinoma via continuous observation.
9.Impact of surgical approach on the efficacy and safety of patients with primary central nervous system lymphoma
Dai XIANGPING ; Xue LEI ; Xu QIANWEN ; Hu YAN ; Chen YUANLU ; Wang XINGBING
Chinese Journal of Clinical Oncology 2024;51(8):413-417
Objective:To investigate the effects of different surgical approaches on the efficacy and safety of patients with primary central nervous system lymphoma(PCNSL).Methods:The clinical data of 130 PCNSL patients admitted to The First Affiliated Hospital of University of Science and Tecnology of China between July 2012 and May 2023 were retrospectively analyzed.Patients were assigned into resection and biopsy groups according to the surgical approach.The safety and efficacy of the two groups were compared,including the objective re-sponse rate(ORR),overall survival(OS),and progression-free survival(PFS)after chemotherapy.Results:ORR and 2-year OS and PFS rates of the resection group were not significantly different from those of the biopsy group(ORR:63.2%vs.62.8%;2-year OS rate:68.6%vs.73.7%;2-year PFS rate:35.2%vs.40.7%,all P>0.05).The incidence of postoperative complications was significantly higher in the resection group than in the biopsy group(29.3%vs.11.4%,P=0.04).The difference in the length of hospitalization between the two groups was not statistic-ally significant.Treatment of the biopsy group was less expensive(P<0.01).Conclusions:In patients with PCNSL,biopsy and resection had comparable efficacy;however,the safety profile was better,and hospitalization was less costly in biopsy than in resection.
10.Establishment and evaluation of RT-RAA combined with CRISPR/Cas12a for rapid detection of SARS-CoV-2
Taichan ZHANG ; Yuchuan CHE ; Xueyan LIANG ; Huagui WEI ; Xiangping FAN ; Chengshi HUANG ; Min LIN ; Jiangtao CHEN
Chinese Journal of Clinical Laboratory Science 2024;42(4):246-251
Objective To establish and evaluate a rapid detection method for SARS-CoV-2 based on reverse transcriptase-recombinase aided amplification(RT-RAA)combined with the clustered regularly interspaced short palindromic repeats(CRISPR)/Cas12a system.Methods RT-RAA primers and CRISPR-derived RNA(crRNA)were designed based on the nucleocapsid(N)gene of SARS-CoV-2 from NCBI database.The detection system was optimized with magnesium acetate(MgAc)concentration,RT-RAA reaction tempera-ture and time and LbCas12a reaction temperature.The sensitivity and specificity of the method were evaluated using recombinant plas-mids(100-106 copies/μL)and other respiratory pathogens.The RT-RAA-CRISPR/Cas12a method was compared with RT-PCR by tes-ting 70 clinical samples in parallel.Results The optimized RT-RAA-CRISPR/Cas12a assay could detect SARS-CoV-2 within 50 min at 37 ℃.The limit of detection was 10 copies/μL for the fluorescence-based method and 1×102 copies/μL for the lateral flow assay.The method specifically detected SARS-CoV-2 without cross-reactivity to other respiratory pathogens.The results of testing 70 clinical samples using RT-RAA-CRISPR/Cas12a showed agreement of 100%with those of RT-PCR.Conclusion The established RT-RAA-CRISPR/Cas12a assay for SARS-CoV-2 detection is rapid,cost-effective,highly sensitive and specific.It can be performed by less experienced personnel and no expensive equipment is required,thus it may provide a new approach for rapid clinical diagnosis and large-scale on-site screening of SARS-CoV-2.

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