Objective:To analysis the possible behavior of coders in the reform of Diagnosis Related Groups(DRG)payment mode.Methods:To collect through questionnaires the possible coders'behaviors,and extract the common factors of possible behaviors according to factor analysis,and cluster the coders by the K-means clustering method.Results:Classify the possible coders'behaviors into positive behaviors such as following coding norms and standards,and negative behaviors such as directly coding without detailed reading of medical records.Less than 25 years old were more inclined to adopt negative behaviors,and associate senior titles and higher cognitive level of DRG were more inclined to adopt positive behaviors.The coders are divided into"positive group"who tend to take positive behaviors and"negative group"who take negative behaviors.Conclusion:Coders are more likely to adopt positive behavior,and we should be pay attention to the impact of different demographic characteristics on coders.To adopt different management strategies for different categories of coders,and strengthen training through hierarchical classification,and enhance coders'cognitive of DRG are more conducive to the selection of positive behaviors.

Aptamers are a class of short DNA/RNA single strand oligonucleotides that can bind to target molecules with high affinity specificity. They have the advantages of high affinity specificity, low molecular weight and low immunogenicity, and have been widely used in biomedical research, clinical diagnosis and therapy, and biosensor development. Systematic evolution of ligand by exponential enrichment (SELEX) is an in vitro screening technique, which enriches the aptamers with high affinity and specific binding to the target through multiple cycles of screening, and has a wide range of applications in tumor therapy.

Objective:To analysis the possible behavior of coders in the reform of Diagnosis Related Groups(DRG)payment mode.Methods:To collect through questionnaires the possible coders'behaviors,and extract the common factors of possible behaviors according to factor analysis,and cluster the coders by the K-means clustering method.Results:Classify the possible coders'behaviors into positive behaviors such as following coding norms and standards,and negative behaviors such as directly coding without detailed reading of medical records.Less than 25 years old were more inclined to adopt negative behaviors,and associate senior titles and higher cognitive level of DRG were more inclined to adopt positive behaviors.The coders are divided into"positive group"who tend to take positive behaviors and"negative group"who take negative behaviors.Conclusion:Coders are more likely to adopt positive behavior,and we should be pay attention to the impact of different demographic characteristics on coders.To adopt different management strategies for different categories of coders,and strengthen training through hierarchical classification,and enhance coders'cognitive of DRG are more conducive to the selection of positive behaviors.

Objective Intracranial hemorrhage(ICH),the second most common subtype of stroke,exacerbates the disruption of the blood-brain barrier(BBB),leading to vasogenic edema,plasma protein extravasation,and infiltration of neurotoxic substances.The clearance capacity of the brain plays a crucial role in maintaining BBB homeostasis and facilitating patient recovery after hemorrhage.This study aimed to investigate the effect of circadian rhythms on BBB function,neuronal damage,and clearance capabilities. Methods The transwell model and hemoglobin were co-cultured to simulate the BBB environment after ICH.After intervention with different light groups,neuronal apoptosis was determined,glial phagocytosis was analyzed,the expression of endogenous clearing-related proteins aquaporin 4(AQP4)and low-density lipoprotein receptor-related protein 1(LRP1)was detected by western blotting and immunofluorescence dual standard method,and the expression of the tight junction protein occludin and melatonin receptor 1A(MTNR1A)was quantitatively analyzed. Results Circadian rhythms play a key role in maintaining the integrity of the BBB,reducing oxidative stress-induced neuronal damage,and improving microglial phagocytosis.Meanwhile,the expression of occludin and MTNR1A in neurovascular unit(NVU)co-cultured with hemoglobin improved the expression of AQP4 and LRP1,the key proteins in the NVU's endogenous brain clearance system. Conclusion Circadian rhythm(alternating black and white light)protects the NVU BBB function after ICH,promotes the expression of proteins related to the clearance of the hematoma,provides new evidence for the clinical treatment of patients recovering from ICH,and improves the circadian rhythm to promote brain metabolism and hematoma clearance.

Objective: To explore the relationship between different serum albumin and lymphocyte levels in patients with 2019-novel coronavirus (2019-nCoV) pneumonia (COVID-19). Methods: A retrospective study was performed to identify the characteristics of the clinical data of 205 COVID-19 patients who were hospitalized in the Happy Street of Hanchuan People's Hospital, Xiaogan, Hubei Province from January 24 to February 12, 2020, including their general information, serum albumin (ALB) levels, lymphocyte counts (LYM), percentage of lymphocytes (LYM%) and other laboratory parameter levels. Low ALB group and normal ALB group were demarcated by the concentration of 35g/L, further to identify the differences of LYM and LYM% levels and the incidence of LYM and LYM% decline at different ALB levels between groups,as well as the correlation between ALB and LYM, LYM% levels in hypoalbuminemia conditions . Results: 17.5% of COVID-19 patients were associated with hypoalbuminemia. The levels of LYM and LYM% in the low ALB group were significantly lower than those in the normal ALB group (P <0.001). The incidence of LYM and LYM% decline in the low ALB group was significantly higher than those in the normal ALB group (P <0.001). The levels of LYM and LYM% in the low ALB group were significantly positively correlated with serum ALB concentrations (P <0.05). Conclusions The decrease of lymphocyte levels in COVID-19 patients may be correlated to hypoalbuminemia. COVID-19 patients complicated by hypoalbuminemia should be actively intervened to maintain serum albumin in the normal range.

Liver transplantation is the most effective treatment for patients with hepatocellular carcinoma (HCC),however,postoperative tumor recurrence severely hampers its efficacy.With the development of precision medicine and liquid biopsy,the diagnosis and treatment of patients undergoing liver transplantation for liver cancer might be updated.On the basis of "safety,effectiveness and precision",investigating the novel recurrence-related prognostic factors,improving the current indications of liver transplantation for patients with HCC,selecting optimal local regional treatments preoperatively and providing effective interventions for recurrent liver cancer after liver transplantation,may improve the long-term survival and therapeutic results of liver transplantation in patients with HCC.

BACKGROUND:Previous studies have confirmed that ethanol can promote adipogenic differentiation of bone marrow mesenchymal stem cells (BMSCs), and up-regulate the expression of PPARγ and aP2 in the tumor necrosis factor α (TNF-α) signaling pathway. As a member of the ZIP protein family, Zrt/Irt-like protein 1 (ZIP1) is closely related to bone metabolism and osteogenic differentiation.OBJECTIVE:To study the effect of BMSCs transfected by ZIP1 on TNF-α signaling pathway in the process of adipogenic differentiation.METHODS:The BMSCs from rabbits were isolated and cultured under different concentrations of alcohol (0.03, 0.09,0.15, 0.21 mol/L), followed by transfection by ZIP1 siRNA and ZIP1 expression vector.RESULTS AND CONCLUSION:After culture in alcohol, the expression levels of aP2 and PPARγ proteins were both significantly increased (P < 0.05), and the level of triglyceride was increased in all alcohol groups except for 0.03 mol/L alcohol group (P < 0.05). After siRNA transfection, the expression levels of aP2 and PPARγ as well as the level of triglyceride were increased significantly in all the alcohol groups (P < 0.05); however, ZIP1 transfection decreased the expression levels of aP2 and PPARγ proteins (P < 0.05). To conclude, ZIP1 siRNA could promote the adipogenic differentiation of BMSCs through the activation of TNF-α signaling pathway.

BACKGROUND: With the increasing number of patients undergoing knee arthroplasty in China, the complications caused by the mismatch of prosthesis with anatomical parameters arouse extensive attentions.OBJECTIVE: To measure the anatomical parameters of the knee joints in healthy Zhuang ethnic group from Guangxi Zhuang Autonomous Region, China, using three-dimensional (3D) reconstruction technology, thus providing reference for the design and placement of the hip prosthesis.METHODS: Sixty-eight individuals, including 30 females and 38 males, were selected from 217 healthy people undergoing CT examination. All data were imported into Mimics 15.0 software used for 3D reconstruction, and then the knee parameters were then measured and analyzed.RESULTS AND CONCLUSION: There was no significant difference in the parameters of the bilateral femur and tibia (P > 0.05). The femoral parameters had significant differences between genders (P < 0.05). The width of tibial platform, sagittal length of lateral tibial platform, distance between medial tibial plateau and fibular head, and posterior slope of tibial plateau showed no significant differences between genders (P > 0.05), while there were significant differences in the width of medial/lateral tibial platform, and sagittal length of medial tibial platform between genders (P < 0.05). The sagittal length of medial femoral condyle was negatively correlated with age, and all femoral parameters were positively correlated with height; while only the width of medial and lateral tibial platform were positively correlated with height. To conclude, 3D reconstruction technology is available for research on the morphology of the knee joint in the Zhuang ethnic group from Guangxi Zhuang Autonomous Region, which provides references for prosthesis design and research appropriate for the Zhuang ethnic group.

Objective To observe the effect of glycosides on serum indexes in elderly patients with primary nephrotic syndrome.Methods A total of 280 elderly patients with primary nephrotic syndrome were randomly divided into control group and observation group,140 cases in each group.Patients in the control group were treated with conventional western medicine,and those in the observation group were treated with additional glycosides.The efficacy and 24 h urinary protein,serum adiponectin,serum albumin,serum creatinine and immunological parameters,carbohydrate antigen levels before and after treatment were compared between two groups.Results The clinical control rate and total effective rate in the observation group were significantly higher than those in the control group (P ＜ 0.05).4,8 weeks after treatment,24 h urinary protein,serum adiponectin,serum creatinine of observation group were significantly lower than those of the control group,while the serum albumin was significantly higher than the control group (P ＜ 0.05).The serum levels of IgA,IgG and IgG/IgM in the observation group were significantly higher than those in the control group,while the IgM level was significantly lower than that in the control group (P ＜ 0.05).The serum levels of CA125,CA153 and CA199 in the observation group were significantly lower than those in the control group (P ＜ 0.05).Conclusion Glycosides can effectively increase the clinical remission rate of primary nephrotic syndrome in elderly patients,reduce the loss of albumin and protect renal function,and delay the progression of NS.

Objective To observe the effect of glycosides on serum indexes in elderly patients with primary nephrotic syndrome.Methods A total of 280 elderly patients with primary nephrotic syndrome were randomly divided into control group and observation group,140 cases in each group.Patients in the control group were treated with conventional western medicine,and those in the observation group were treated with additional glycosides.The efficacy and 24 h urinary protein,serum adiponectin,serum albumin,serum creatinine and immunological parameters,carbohydrate antigen levels before and after treatment were compared between two groups.Results The clinical control rate and total effective rate in the observation group were significantly higher than those in the control group (P ＜ 0.05).4,8 weeks after treatment,24 h urinary protein,serum adiponectin,serum creatinine of observation group were significantly lower than those of the control group,while the serum albumin was significantly higher than the control group (P ＜ 0.05).The serum levels of IgA,IgG and IgG/IgM in the observation group were significantly higher than those in the control group,while the IgM level was significantly lower than that in the control group (P ＜ 0.05).The serum levels of CA125,CA153 and CA199 in the observation group were significantly lower than those in the control group (P ＜ 0.05).Conclusion Glycosides can effectively increase the clinical remission rate of primary nephrotic syndrome in elderly patients,reduce the loss of albumin and protect renal function,and delay the progression of NS.