1.Factors Influencing Inpatient Costs for Patients Undergoing Surgery for Intrauterine Lesions under DRG Payment
Yutong WANG ; Weiguo ZHU ; Xueqin SUN ; Jiali TONG ; Jingya ZHOU ; Qing ZHAO ; Bocheng LI ; Wei ZHANG ; Xiaokun LIU ; Rui DONG ; Chen XIE ; Ding HAN
Medical Journal of Peking Union Medical College Hospital 2024;15(5):1069-1076
To analyze the factors affecting the cost of hospitalization for patients and provide insights using the intrauterine lesion surgery group (DRG code NE19) as an example. This study was a retrospective cross-sectional study, with data from the first page of medical records of patients enrolled under NE19 at a comprehensive tertiary hospital in Beijing from March 15, 2022 to November 30, 2023. Influence factor selection and multifactorial linear regression analysis were conducted with hospitalization cost as the dependent variable, and patient's basic information, treatment information and key concern factors as independent variables. The profit and loss of medical records containing key factors and differences in indicators of hospitalization cost structure were analyzed in the context of clinical practice. A total of 2213 valid medical records (all female patients) were included, with patients predominantly young and middle-aged women under 45 years of age (72.12%), and with 931 day surgery medical records (42.07%). The diagnosis records included 334(15.09%) multiple uterine leiomyomas, and 246(11.12%) pelvic adhesions. A total of 150(6.78%) medical records involved ovary- and tubal-related surgeries or manipulations, with 160(7.23%) main operations being laparoscopic hysterectomy of diseased uterine lesions and 38(1.72%) mechanical rotational excision of abnormal uterine tissue using transhysteroscopy. Linear regression analysis showed that whether or not ovarian and tubal surgical operations were involved ( The NE19 group of hospitals in the study had a high loss rate, and factors such as the severity of the patient's condition and the use of new technologies affected hospitalization costs, suggesting that there is room for further optimization of the existing grouping scheme. Tiered payment standards can be set up for different tiers of healthcare institutions, and a sound and optimized exclusion mechanism can be used to promote the development of new technologies. The internal management of hospitals should encourage the development of daytime surgery to improve the efficiency of medical services.
2.Analysis of Data Interaction Technologies between Medical and Health Insurance Institutions from the Perspective of Patentometrics
Xiaokun LIU ; Yunqing XIAO ; Jieqing CHEN ; Panpan MA ; Weiguo ZHU
Journal of Medical Informatics 2024;45(5):59-64
Purpose/Significance To analyze relevant patented technologies,and to provide experience for medical and commercial health insurance institutions to break through the data interaction blocking point and construct a multi-level medical security system.Method/Process The patentometrics method is used to analyze the data interaction patent technology between medical and health insurance institutions from four aspects:time trend,regional distribution,category distribution and text clustering.Result/Conclusion China should pay attention to the role of data interaction in deepening cooperation between medical and insurance institutions,improve the declaration,authorization,application and protection of high-quality patents,pay attention to cross-border integration and technology-driven,and innovate patent layout to meet technological development and social needs.
3.Replacement Therapy for Hemophilia Patients Undergoing Cardiac Surgery: Report of Three Cases.
Xiaokun CHEN ; Qi MIAO ; Tie-Nan ZHU ; Chao-Ji ZHANG
Chinese Medical Sciences Journal 2022;37(1):79-81
Hemophilia is an X-linked recessive inherited bleeding disorder. Despite the improved treatment in recent years with the advent of replacement therapies, the progression of atherosclerosis is not slowed down after the reduction of clotting factors in hemophilia. As life expectancy increases, more hemophilia patients will suffer from age-related cardiovascular diseases. Since cardiac surgery needs heparinization and cardiopulmonary bypass (CPB), it is extremely challenging to balance hemostasis and coagulation in patients with hemophilia. Here we report three cases of hemophilia patients who underwent cardiac surgery successfully.
Cardiac Surgical Procedures/adverse effects*
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Cardiopulmonary Bypass
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Hemophilia A/complications*
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Humans
4.Antivirus activity of Zedoary Turmeric Oil Injection against SARS-CoV-2 in vitro and in vivo
Yuanyuan Zhou ; Zhijuan Dai ; Shujun Zhang ; Yuechun Li ; Yuanrong Dai ; He Wang ; Hailin Wu ; Mengqing Feng ; Xiaokun Li ; Xiaohui Huang ; Guanghui Zhu
Acta Universitatis Medicinalis Anhui 2022;57(4):664-667,672
Abstract
To study the antiviral effect ofZedoary TurmericOil Injection on novel coronavirus, SARS-CoV-2 viroid cell lines were preparedin vitroand treated with different concentrations of Zedoary Oil. The cell number and relative fluorescence value(RLU) were observed and measured, and the 50% effective inhibitory concentration(IC 50) was calculated. Four patients with Coronavirus Disease 2019 were clinically included, including 2 in the control group and 2 in the experimental group. The control group received conventional treatment, and the experimental group receivedZedoary TurmericOil Injection in addition to conventional treatment. The nucleic acid conversion rate, conversion time, pulmonary imaging changes, fever reduction time, clinical improvement time and adverse events of the patients were observed.In vitroexperiment, the relative fluorescence value decreased with increasing concentration ofZedoary TurmericOil, which was significantly different from that of the control group(P<0.05). The IC50 was 0.26 μg/ml.In vivostudy, the novel coronavirus nucleic acid in stool of case 1 in the test group turned negative in 3 days, the cough symptom of case 2 was significantly relieved, and there was obvious absorption in pulmonary imaging. The negative conversion time of novel coronavirus nucleic acid in the control group was 5 and 7 days respectively. No adverse events occurred in the experimental group.Zedoary TurmericOil had strong inhibitory effect on SARS-COV-2 virusin vitrowhich was dose-dependent.In vivotreatment of COVID-19,Zedoary TurmericOil Injection combined with conventional treatment can improve the cough caused by SARS-COV-2 infection, promote SARS-COV-2 to turn negative, promote absorption of lung lesions, and reduce lung injury, with no obvious adverse events.
5.Understanding the phase separation characteristics of nucleocapsid protein provides a new therapeutic opportunity against SARS-CoV-2.
Dan ZHAO ; Weifan XU ; Xiaofan ZHANG ; Xiaoting WANG ; Yiyue GE ; Enming YUAN ; Yuanpeng XIONG ; Shenyang WU ; Shuya LI ; Nian WU ; Tingzhong TIAN ; Xiaolong FENG ; Hantao SHU ; Peng LANG ; Jingxin LI ; Fengcai ZHU ; Xiaokun SHEN ; Haitao LI ; Pilong LI ; Jianyang ZENG
Protein & Cell 2021;12(9):734-740
6. The effect of rock salt aerosol on the prevention of silicosis in rats
Shuang WANG ; Xiaokun ZHAO ; Jiali ZHU ; Qiumin XU ; Xinying LI ; Jinsong ZHANG ; Xiaohui HAO ; Lingli GUO ; Heliang LIU
China Occupational Medicine 2020;47(02):147-153
OBJECTIVE: To investigate the preventive effect of rock salt aerosol on the development of silicosis in rats. METHODS: The specific pathogen free adult male SD rats were randomly divided into normal control group, rock salt control group, silicosis model group and rock salt intervention group, 18 rats in each group. Rats in the silicosis model group and the salt rock intervention group were treated with silica dust at the concentration of 2 000.0 mg/m~3 by dynamic dusting method for 3 hours daily. Rats in the rock salt control group and the rock salt intervention group inhaled the rock salt aerosols with the mass concentration of 20.0 mg/m~3 for 30 minutes daily. The normal control group was not treated with the dust or rock salt aerosol. At the time points of 14, 28 and 56 days after exposure to dust or rock salt aerosol, 6 rats were randomly selected from each group and samples were collected. The pathological change of lung was observed, the total cell count in the bronchoalveolar lavage fluid(BALF) was performed, the enzyme-linked immunosorbent assay was used to detect the change of transforming growth factor-β(TGF-β) in BALF, surfactant D(SP-D) and superoxide dismutase(SOD) in lung tissue. RESULTS: The results of hematoxylin-eosin and Masson staining showed that the inflammatory changes of lung tissue and the pulmonary interstitial fibrosis in the rock salt intervention group were less severer than that in the silicosis model group. At 14, 28, and 56 days after dust exposure, the total cell counts in BALF and SP-D levels in lung tissue of rats in silicosis model group and rock salt intervention group were higher(P<0.05), the SOD activities in lung tissue were lower(P<0.05), as well as the TGF-β levels in BALF in silicosis model group were higher(P<0.05),compared with the normal control group and rock salt control group. The total cell counts and TGF-β levels in BALF, and SP-D levels in lung tissue of rock salt intervention group were lower(P<0.05), the SOD activities in lung tissue were higher(P<0.05), compared with the silicosis model group. CONCLUSION: Rock salt aerosol intervention may delay the pathogenesis of silicosis by improving the inflammatory response, regulating oxidative stress and reducing interstitial fibrosis of lungs.
7.Vulnerable carotid plaque: imaging evaluation and risk prediction of ischemic stroke
Lin ZHU ; Haiwei BAI ; Xiaokun MI ; Chang LIU ; Qingrui LIU
International Journal of Cerebrovascular Diseases 2020;28(2):140-144
Stroke has become the leading cause of death in China, and carotid atherosclerosis is an important risk factor for ischemic stroke. In current carotid atherosclerosis diagnosis and treatment guidelines, patients are stratified based on the degree of vascular stenosis. However, the presence of carotid atherosclerotic vulnerable plaques can cause ischemic stroke at any time, regardless of the degree of carotid stenosis. The development of MRI technology, especially the advent of high-resolution MRI, enables non-invasive assessment of carotid plaque structure and properties, and provides optimized treatment strategies for high-risk stroke population in the early stage to achieve the goal of prevention and treatment of stroke.
8.Pilot surveillance and evaluation of influenza-like illness based on automatic computer analysis of electronic medical record in sentinel hospital
Aiqin ZHU ; Jianhua LIU ; Chengzhong XU ; Hao ZHANG ; Xiaokun YANG ; Hongting ZHAO ; Zhili LI ; Liping WANG ; Luzhao FENG ; Yaming ZHENG ; Ying QIN ; Zhongjie LI
Chinese Journal of Preventive Medicine 2020;54(6):691-695
Objective:To compare the accuracy of influenza-like illness (ILI) surveillance by automatic computer analysis based on electronic medical records and by doctor’s report.Methods:A total of 3 542 patients who presented to Yichang Central Hospital fever clinic, respiratory department or emergency department between April to October 2019 with an ICD-10 code for acute respiratory illness (J00-J22) and complete electronic medical information of ILI related syndromes were drawn as the study sample. Taking the classification of the study sample according to the ILI case definition by influenza surveillance professionals as the gold standard, draw the receiver operating characteristic (ROC) curve and calculate sensitivity, specificity, diagnostic consistency to compared the accuracy of ILI surveillance by automatic computer analysis and by doctor's report.Results:Median age of 3 542 cases was 30 (24, 38) years old; 1 179 cases (33.29%) compliance with the case definition, ILI reported by doctors was 1 306 cases (36.87%), and computer automatic identification ILI were 1 150 cases (32.47%); 1 391 (39.27%) cases were men. The results of automatic computer analysis and doctor report consistency of kappa values with gold standard judgment were 0.97 and 0.66 respectively; area under the ROC curve was 0.98 and 0.84, respectively. And the sensitivity and specificity of automatic computer analysis were higher than that of doctor's report (all P values were <0.001), the sensitivity was 96.95% and 82.27%, and the specificity was 99.70% and 85.78%, respectively. Conclusion:The automatic computer analysis based on electronic medical records can identified ILI cases with good sensitivity and specificity in ILI case surveillance.
9.Pilot surveillance and evaluation of influenza-like illness based on automatic computer analysis of electronic medical record in sentinel hospital
Aiqin ZHU ; Jianhua LIU ; Chengzhong XU ; Hao ZHANG ; Xiaokun YANG ; Hongting ZHAO ; Zhili LI ; Liping WANG ; Luzhao FENG ; Yaming ZHENG ; Ying QIN ; Zhongjie LI
Chinese Journal of Preventive Medicine 2020;54(6):691-695
Objective:To compare the accuracy of influenza-like illness (ILI) surveillance by automatic computer analysis based on electronic medical records and by doctor’s report.Methods:A total of 3 542 patients who presented to Yichang Central Hospital fever clinic, respiratory department or emergency department between April to October 2019 with an ICD-10 code for acute respiratory illness (J00-J22) and complete electronic medical information of ILI related syndromes were drawn as the study sample. Taking the classification of the study sample according to the ILI case definition by influenza surveillance professionals as the gold standard, draw the receiver operating characteristic (ROC) curve and calculate sensitivity, specificity, diagnostic consistency to compared the accuracy of ILI surveillance by automatic computer analysis and by doctor's report.Results:Median age of 3 542 cases was 30 (24, 38) years old; 1 179 cases (33.29%) compliance with the case definition, ILI reported by doctors was 1 306 cases (36.87%), and computer automatic identification ILI were 1 150 cases (32.47%); 1 391 (39.27%) cases were men. The results of automatic computer analysis and doctor report consistency of kappa values with gold standard judgment were 0.97 and 0.66 respectively; area under the ROC curve was 0.98 and 0.84, respectively. And the sensitivity and specificity of automatic computer analysis were higher than that of doctor's report (all P values were <0.001), the sensitivity was 96.95% and 82.27%, and the specificity was 99.70% and 85.78%, respectively. Conclusion:The automatic computer analysis based on electronic medical records can identified ILI cases with good sensitivity and specificity in ILI case surveillance.
10.Protective effects of carnosic acid on retinal ganglion cells in acute ocular hypertension rats model
Liye HE ; Liang LIANG ; Mengnan ZHU ; Changyi XIAO ; Xiaokun TU
Chinese Journal of Experimental Ophthalmology 2018;36(4):254-258
Objective To observe the protective effects of carnosic acid on retinal ganglion cells (RGCs) in acute ocular hypertension rats model.Methods Sixty male SPF SD rats (8-12 weeks) were randomly assigned to normal control group,carnosic-acid treated group and model control group with 20 rats for each group.The acute ocular hypertension animal model was induced by the perfusion of normal saline solution into anterior chamber of eyes to elevate the intraocular pressure (IOP) to 110 mmHg for 60 minutes in the rats of the carnosic-acid treated group and model control group,and then the carnosic-acid (dissolving in DMSO) was intraperitoneally injected for consecutive 7 days in the carnosic-acid treated group,and only DMSO was injected in the same way in the model control group.The rates were sacrificed 2 weeks after experiment and retinal sections were prepared for histopathological and apoptotic retinal ganglion cells (RGCs) examination by hemotoxylin & eosin staining and TUNEL staining,and immunofluorescence was employed to examine the survival cell number of RGCs.This study protocol was approved by the Ethic Committee for Experimental Animal of Three Gorges University.Results The retinal morphology and structure were clear in the normal control group.The edema of retinal tissue,loosely arranged RGCs and swollen nucleus were seen in the model control group.In the carnosic-acid treated group,the retinal morphology and structure were regular.The retinal nerve fiber layer (RNFL) thickness was (32.96±1.63),(58.96± 1.57) and (50.11±2.37)μm,and the apoptotic cell number was (6.92±2.96),(29.85±6.40) and (14.69± 2.98)/field,and the survived cell number was (2 363.17± 148.45),(1 308.67 ±106.02) and (1 614.17 ±96.39) / 0.235 mm2 in the normal control group,model control group and carnosic-acid treated group,respectively,with significant differences among the groups (F =339.284,81.583,122.68,all at P<0.01).Compared with the normal control group,the RNFL thickness was thickened,the number of apoptotic RGCs was much more and the number of survived RGCs was decreased in the model control group,with significant differences (all at P<0.01).In the carnosic-acid treated group,the RNFL thickness was thinner,the number of apoptotic RGCs was reduced and the number of survived RGCs was increased in comparison with the normal control group,with significant differences (all at P<0.01).Conclusions Carnosic-acid plays a protective effect on RGCs by inhibiting the cell apoptosis in acute ocular hypertension rats.


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