As the reform of the medical and health system continues to advance,cost accounting plays a crucial role in the efficient operation of public hospitals.In the context of the full-cost accounting implementation,it takes the work practice of a hospital as case study,in constructing an integrated system of full-cost accounting as a reference to explore the specific implementation path of full-cost accounting in public hospitals under the background of the new health care reform,and to provide new ideas and methods for public hospitals in China to carry out full-cost accounting work.The implementation of full-cost accounting in public hospitals promotes the transformation of public hospitals from the original revenue-centered episodic scale development to the connotative development centered on refined cost management,promotes the improvement of the overall operational efficiency of hospitals,helps to enhance the management effectiveness and comprehensive competitiveness of hospitals,and finds a new way out of the reform in order to promote the high-quality development of public hospitals.

As the reform of the medical and health system continues to advance,cost accounting plays a crucial role in the efficient operation of public hospitals.In the context of the full-cost accounting implementation,it takes the work practice of a hospital as case study,in constructing an integrated system of full-cost accounting as a reference to explore the specific implementation path of full-cost accounting in public hospitals under the background of the new health care reform,and to provide new ideas and methods for public hospitals in China to carry out full-cost accounting work.The implementation of full-cost accounting in public hospitals promotes the transformation of public hospitals from the original revenue-centered episodic scale development to the connotative development centered on refined cost management,promotes the improvement of the overall operational efficiency of hospitals,helps to enhance the management effectiveness and comprehensive competitiveness of hospitals,and finds a new way out of the reform in order to promote the high-quality development of public hospitals.

Objective:To investigate the role of dietary fiber in the intestinal rehabilitation for patients with ultra-short bowel syndrome.Methods:This study included 34 inpatients diagnosed with ultra-short bowel syndrome in the General Surgery Department of the Eastern Theater General Hospital of the People's Liberation Army from January 2012 to October 2023. Patients were grouped based on whether they received intestinal rehabilitation and whether dietary fiber was added to the treatment plan, and were divided into three groups: nutritional therapy group (11 cases), growth hormone + glutamine intestinal rehabilitation treatment group (10 cases) and growth hormone injection + glutamine + dietary fiber intestinal rehabilitation treatment group (13 cases). The therapeutic regimen and its changes, pre- and post-treatment parameters of hematology, nutrition, intestinal absorption, fecal consistency, and quality of life were recorded and compared, and the impact of different treatment regimens on clinical outcomes was analyzed.Results:Compared with nutrition treatment group and growth hormone + glutamine intestinal rehabilitation treatment group, growth hormone injection + glutamine + dietary fiber intestinal rehabilitation treatment group, the increase of enteral nutritional fluid, the decrease of parenteral nutritional energy, the increase of intestinal moisture absorption, the decrease of defecation times and the appreciation of hemoglobin were significantly increased, and the difference was statistically significant ( P<0.05). At the same time, the levels of insulin-like growth factor 1 and insulin-like growth factor binding protein were significantly increased after treatment ( P<0.01). Conclusions:Nutritional support combined with intestinal rehabilitation can significantly improve the nutritional status and intestinal absorption rate of ultra-short bowel syndrome patients. The use of dietary fiber in the intestinal rehabilitation regimen for ultra-short bowel syndrome patients yields more significant benefits, as evidenced by improved clinical outcomes.

Objective:To investigate whether intestinal rehabilitation therapy (IRT)could optimize the effectiveness of IRT in patients with short bowel syndrome (SBS) caused by acute mesenteric ischemia (AMI) with chronic multivessel lesions.Methods:Clinical data of 18 hospitalized patients diagnosed with AMI leading to SBS and undergoing IRT at the Eastern Theater General Hospital of the People's Liberation Army from Jan 2012 to Oct 2023 was retrospectively analyzed.Result:Following IRT, the revascularization group showed significantly greater increases in ASMI and grip strength compared to the control group [(0.28±0.26) kg/m 2vs. (0.02±0.21) kg/m 2, P=0.033, and (0.97±0.33) kg vs. (0.48±0.34) kg, P=0.007, respectively]. Similarly, the increase in EN intake was significantly higher in the revascularization group compared to the control group [(572.5±93.6) ml/d vs. (375.2±176.3) ml/d, P=0.012], accompanied by a greater improvement in intestinal nitrogen absorption rate [(25.06±14.06)% vs. (13.84±4.62)%, P=0.034] and a more substantial decrease in GSRS scores [(-15.88±3.94) vs. (-6.33±5.13), P=0.030]. Moreover, there were significant differences in the composition of EN formulations between the two groups after IRT ( P=0.046). Additionally, SF-36 scores at discharge were significantly higher in the revascularization group than that in the control group for five indicators including BP, GH, VT, SF, and MH ( P<0.05). Conclusions:For patients with SBS resulting from AMI by chronic multivessel lesions, revascularization therapy may not leading to higher growth in weight and hematological nutritional indicators during IRT, but it is beneficial for improving muscle function, improving EN absorption, increasing the likelihood of PN independence, relieving gastrointestinal symptoms, and enhancing overall quality of life.

BACKGROUND:Diffusion tensor imaging aad fiber tractography(DT-FT)is the only method to identify cerebral white matter fiber organization in vivo.OBJECTIVE:To observe the changes in brain areas with language function and the fiber stucture in patients with Broca aphasia.DESIGN,TIME AND SETTING:Comparative observation was performed at First Hospital of Kunming Medical College and Tiantan Hospital of Capital Medical University between November 2003 and February 2005.PARTICIPANTS:Thirty patients(9 females,21 males,aged 17-63 years)with Broca aphasia of different degree were selected.They were diagnosed by a set of Chinese aphasia examinations of Research Laboratory of Neuropsychology,First Hospital of Beijing Medical University,following by further classification according to the subitems.METHODS:3T super-high field magnetic resonance scanner was used for the data collection and processing of the entire brain.Brodmann areas 45,44,areas 22 and 39(Wernicke area),and the corresponding brain areas in the right hemisphere are selected as areas with language function.The primary commissure,commissural fibers(arcuate fasciculus,internal capsule,external capsule)that are closely correlated with language function were regarded as region of interest of fiber tracking.The neural fiber tracking was conducted.MAIN OUTCOME MEASUIURES:The tracking and distribution of neural fiber tracts,and its correlation with other brain areas,and changes under pathological conditions.All data were compared with normal brain.RESULTS:Thirty patients with Broca aphasia were included in final analysis.The mean fractional anisotropy of fiber tracts in left Brodmann areas 45 and 44 was significantly lower than that in normal Brodmann areas(t=-2.683 65,-5.300 55,P＜0.05).The inferior fiber tracts in Broca area showed interruption or displacement,loosely connected even separate from the frontal arcuate fasciculus.The fibers of precentral gyrus and medial frontal lobe were decreased.The separation of arcuate fasciculus from Broca area caused by the integrity disruption and displacement of fiber tracts of arcuate fasciculus was the main alteration of arcuate fasciculus in Broca aphasia.The number of fiber tracts of left arcuate fasciculus and the mean fractional anisotropy in Broca aphasia were significantly less than normal people(P＜0.05).CONCLUSION:The lesions of cerebral cortex and its fiber pathway in Broca area can result in Broca aphasia.

Adolescent ; Adult ; Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Laser Coagulation ; Male ; Middle Aged ; Phytotherapy ; Retinal Detachment ; drug therapy ; surgery