Objective:To analyze the changes in the costs of hospital rehabilitation after the reform of health insurance payments in the past 6 years, and to identify relevant factors which can provide a reference for the reform of the health insurance payment system in rehabilitation department.Methods:Information on 16, 827 patients hospitalized in the rehabilitation department of The First Affiliated Hospital of Xi′an Jiaotong University between May 2018 and May 2024 was collected and subjected to non-parametric analysis.Results:The average hospitalization cost of rehabilitation department patients over the six years was Y14, 574.92±10, 524.79. During that time the proportion of the cost attributable to Western medicine decreased from 17.1% in 2018 to 7.6% in 2024. The proportion of the patients with hypertension was 51.94%, followed by diabetes mellitus (20.10%). Those with infections had the highest total hospitalization costs. Motor disorders were the most common dysfunction (59.02%), followed by speech disorders (17.45%). Patients with swallowing disorders had the highest hospitalization costs. After the payment system shifted from fee-for-service (FFS) to payment by diagnosis-related group (DRG) in 2023, the average daily inpatient expenditures for rehabilitation patients with all types of diseases gradually declined, reaching its lowest level in 2024.Conclusions:After the health insurance payments shifted from FFS to DRG, the proportion of in patients′ total drug costs decreased annually, and the average daily costs of patients with different types of diseases also decreased significantly, but the comprehensive service fee and diagnostic costs increased.

Objective:To analyze the changes in the costs of hospital rehabilitation after the reform of health insurance payments in the past 6 years, and to identify relevant factors which can provide a reference for the reform of the health insurance payment system in rehabilitation department.Methods:Information on 16, 827 patients hospitalized in the rehabilitation department of The First Affiliated Hospital of Xi′an Jiaotong University between May 2018 and May 2024 was collected and subjected to non-parametric analysis.Results:The average hospitalization cost of rehabilitation department patients over the six years was Y14, 574.92±10, 524.79. During that time the proportion of the cost attributable to Western medicine decreased from 17.1% in 2018 to 7.6% in 2024. The proportion of the patients with hypertension was 51.94%, followed by diabetes mellitus (20.10%). Those with infections had the highest total hospitalization costs. Motor disorders were the most common dysfunction (59.02%), followed by speech disorders (17.45%). Patients with swallowing disorders had the highest hospitalization costs. After the payment system shifted from fee-for-service (FFS) to payment by diagnosis-related group (DRG) in 2023, the average daily inpatient expenditures for rehabilitation patients with all types of diseases gradually declined, reaching its lowest level in 2024.Conclusions:After the health insurance payments shifted from FFS to DRG, the proportion of in patients′ total drug costs decreased annually, and the average daily costs of patients with different types of diseases also decreased significantly, but the comprehensive service fee and diagnostic costs increased.

Enterovirus 71 (EV71) infection is more likely to cause hand, foot and mouth disease (HFMD) in children, which can lead to neurogenic complications and higher mortality. As a commonly used clinical medicine, Reduning injection (RDN) helps to shorten the symptoms of patients with HFMD and facilitate the early recovery of children. However, the regulatory mechanism of RDN on the HFMD immune system disorder caused by EV71 remains to be discussed. This study collected detailed treatment data of 56 children with HFMD who entered the affiliated Children's Hospital of Nanjing Medical University during 2019. Retrospective analysis of clinical data showed that the symptoms of the RDN treatment group were improved compared with the untreated group. To explore its mechanism, the relevant detection indicators were detected by flow cytometry, enzyme-linked immunosorbent assay and real-time quantitative PCR. It was found that the number and function of innate immune (ILCs) and adaptive immunity (Th1, Th2 and secreted cytokines) were reduced, suggesting that RDN plays a role by regulating cellular immunity. The in vitro differentiation inhibition test further confirmed that RDN affected Th1 differentiation by inhibiting the expression of transcription factors on the basis of Th1 cell differentiation in vitro.

Objective To compare the efficacy of different analgesia regimens in elderly patients with femoral neck fracture undergoing posture changing during epidural anesthesia. Methods Ninety patients (35 males,55 females,aged 65-90 years,48-78 kg)with femoral neck fracture who would be treated with artificial femoral head replacement were randomly divided into 3 groups (n = 30 each):femoral nerve block group (group FNB),fascia iliaca compartment block group (group FIC)and intravenous group (group IV).Femoral nerve block or fascia iliaca compart-ment block was performed 30 min before epidural anesthesia (EA)in FNB group or FIC group re-spectively.Fentanyl 0.5 μg/kg was injected intravenously 3 min before EA.In the three groups,addi-tional 0.25 μg/kg fentanyl was administrated intravenously to keep the VAS scores <4 before posi-tioning.EA was performed between L1-2 in a position of troubled leg upper,and patients returned to supine position after epidural catheterization.The VAS scores at T0 (after entering the operation room),T1 (in supine posture before EA),T2 (before posture changing),T3 (while supine from lateral posture after EA),T4 (3 min after T3 ),the time for achieving EA,the fentanyl consumption, the cases of cardiovascular events and hypoxemia was recorded.Results Compared with group IV, VAS scores at T1 ,T2 ,the fentanyl consumption,time for achieving EA,and incidence of cardiovas-cular events and hypoxemia in group FNB and group FIC decreased significantly (P <0.05 or 0.01). There was no significant difference between group FNB and group FIC.Conclusion Preemptive anal-gesia regimens through both femoral nerve block and fascia iliaca compartment block during epidural anesthesia can reduce the fentanyl consumption,as well as decrease the incidence of cardiovascular e-vents and hypoxemia.

OBJECTIVETo study the characteristics of phenylalanine hydroxylase gene (PAH) mutations in patients with PAH deficiency in Fujian population.

METHODSPeripheral blood samples of 36 patients and their parents with classical type phenylketouria (PKU) were collected. Genomic DNA was extracted. Following PCR amplification, DNA sequencing was carried out to identify the origins of mutations.

RESULTSTwenty types mutations were identified in 63 of the 72 alleles. The most common mutations were R241C, R408Q and Ex6-96A>G, which respectively accounted for 15.9%, 12.7% and 11.1% of all mutant alleles. The c.189_190dupTGAC mutation was first reported. R241C was associated with 28% of mild hyperphenylalaninemia and R408Q is associated with 25% of classical PKU.

CONCLUSIONThere is a specific spectrum of PAH gene mutation in Fujian region. R241C, R408Q and Ex6-96A>G are the most common mutations.

Adolescent ; Alleles ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; Child ; Child, Preschool ; China ; Female ; Genotype ; Humans ; Male ; Molecular Sequence Data ; Mutation ; Phenylalanine Hydroxylase ; genetics ; Phenylketonurias ; enzymology ; genetics

Avian Myeloblastosis Virus ; enzymology ; Escherichia coli ; genetics ; metabolism ; Genome, Bacterial ; MicroRNAs ; metabolism ; RNA-Directed DNA Polymerase ; genetics ; metabolism ; Real-Time Polymerase Chain Reaction ; Sequence Analysis, RNA

BACKGROUND/AIMS: Gastroesophageal reflux disease (GERD), functional dyspepsia (FD), and peptic ulcer disease (PUD) impact the daily lives of affected individuals. The aim of this study was to compare the risk factors and impacts on life quality of overlapping FD or PUD in patients with GERD. METHODS: Data from patients diagnosed with GERD were collected between January and November 2009. FD was defined using the Rome III diagnostic criteria. The overlapping GERD-FD or GERD-PUD groups were classified as concomitant GERD and FD or peptic ulcers. The characteristics of these individuals were analyzed. RESULTS: There were 63, 48, and 60 patients in the GERD only, overlapping GERD-FD, and overlapping GERD-PUD groups, respectively. Significantly younger age, female gender, lower body weight and body mass index, and higher rates of tea consumption were noted in the GERD-FD group. Patients in the GERD-FD group exhibited the lowest quality of life scores, both with respect to physical and mental health, on the Short Form 36 domains. CONCLUSIONS: Patients with concomitant GERD and FD were more likely to be younger and female. Overlapping GERD and FD had the worst impact on the quality of life of the affected individuals.
Adult ; Age Factors ; Dyspepsia/*complications ; Female ; Gastroesophageal Reflux/*complications ; Humans ; Life Style ; Male ; Middle Aged ; Peptic Ulcer/*complications ; Quality of Life ; Questionnaires ; Risk Factors

MicroRNAs (miRNAs) are endogenously expressed small, non-coding transcripts that regulate protein expression. Substantial evidences suggest that miRNAs are enriched in central nervous system, where they are hypothesized to play pivotal roles during neural development. In the present study, we analyzed miRNAs expression in mice cerebral cortex and hippocampus at different developmental stages and found miR-29a increased dramatically at postnatal stages. In addition, we provided strong evidences that miR-29a is enriched in mature neurons both in vitro and in vivo. Further investigation demonstrated that the activation of glutamate receptors induced endogenous miR-29a level in primary neurons. Moreover, we showed that miR-29a directly regulated its target protein Doublecortin (DCX) expression, which further modulated axon branching in primary culture. Together, our results suggested that miR-29a play an important role in neuronal development of mice cerebrum.
Animals ; Axons ; metabolism ; physiology ; Hippocampus ; growth & development ; metabolism ; Mice ; MicroRNAs ; genetics ; metabolism ; Microtubule-Associated Proteins ; genetics ; Neurogenesis ; Neurons ; metabolism ; Neuropeptides ; genetics ; Primary Cell Culture

The mechanism underlying T cell-mediated fulminant hepatitis is not fully understood. In this study, we investigated whether myeloid derived suppressor cells (MDSCs) could prevent the concanavalin A (ConA)-induced hepatitis through suppressing T cell proliferation. We observed an increase in the frequencies of MDSCs in mouse spleen and liver at early stage of ConA treatment, implicating that the MDSCs might be involved in the initial resistance of mice against ConA-mediated inflammation. Subpopulation analysis showed that the MDSCs in liver of ConA-induced mice were mainly granulocytic MDSCs. Adoptive transfer of the bone marrow-derived MDSCs into ConA-treated mice showed that the MDSCs migrated into the liver and spleen where they suppressed T cell proliferation through ROS pathway. In addition, the frequencies of MDSCs in mice were also significantly increased by the treatment with immune suppressor glucocorticoids. Transfer of MDSCs into the regulatory T cell (Treg)-depleted mice showed that the protective effect of MDSCs on ConA-induced hepatitis is Treg-independent. In conclusion, our results demonstrate that MDSCs possess a direct protective role in T cell-mediated hepatitis, and increasing the frequency of MDSCs by either adoptive transfer or glucocorticoid treatment represents a potential cell-based therapeutic strategy for the acute inflammatory disease.
Adoptive Transfer ; Animals ; Blotting, Western ; Bone Marrow Cells ; immunology ; CD11b Antigen ; immunology ; metabolism ; Cell Movement ; immunology ; Cell Proliferation ; Chemical and Drug Induced Liver Injury ; etiology ; immunology ; prevention & control ; Concanavalin A ; toxicity ; Dexamethasone ; pharmacology ; Flow Cytometry ; Glucocorticoids ; pharmacology ; Liver ; immunology ; pathology ; Male ; Mice, Inbred C57BL ; Mitogens ; administration & dosage ; toxicity ; Myeloid Cells ; immunology ; metabolism ; transplantation ; Receptors, Chemokine ; immunology ; metabolism ; Spleen ; immunology ; pathology ; T-Lymphocytes ; immunology ; T-Lymphocytes, Regulatory ; immunology

Humans ; Interferon-gamma ; analysis ; Lymphohistiocytosis, Hemophagocytic ; diagnosis ; microbiology