With the continuous evolution and refinement of the healthcare insurance system,there arises a heightened de-mand for the standardization and efficacy of healthcare insurance management.This paper takes a prominent public hospital in Guangzhou City as a case study to delve into the establishment and enhancement of an intelligent monitoring system for healthcare insurance.Initially,an analysis is conducted from the perspectives of the national,policy,and institutional levels to underscore the imperative and urgency of constructing an intelligent monitoring system for healthcare insurance.Subsequently,a comprehen-sive review of the current research landscape,both domestically and internationally,is presented,highlighting the challenges faced by domestic intelligent auditing systems in terms of their level of intelligence,the sophistication of hospital-level intelligent monitoring,and the standardization of rule libraries.Following this,the paper elaborates on the practical endeavors undertaken by large public hospitals in Guangzhou City regarding the construction and optimization of the intelligent monitoring system for healthcare insurance.This encompasses aspects such as the structure of the intelligent monitoring system,collaborative manage-ment in operational modes,and the standardization of rule libraries.Finally,the paper concludes by summarizing the positive im-pact of these practices on the regulation of medical service behaviors and the enhancement of efficiency in healthcare insurance quality management,while also offering insights into future research directions.

Objective To investigate the correlation between amide proton transfer-weighted(APTw)value derived from APTw imaging and Ki-67 expression in hepatocellular carcinoma.Methods Sixty patients with hepatic occupations underwent preoperative upper abdominal MRI scanning,including APTw and diffusion weighted imaging(DWI)sequences.Thirty-two patients with hepatocellular carcinoma proved by pathological results were enrolled in the prospective study.The APTw and apparent diffusion coefficient(ADC)values of the lesions were measured from the corresponding APTw and ADC images,respectively.Mann-Whitney U test or independent sample t test was used to analyze the differences in APTw and ADC values between the high and low Ki-67 expression groups.Pearson correlation analysis was used to evaluate the correlation between APTw value,ADC value and Ki-67 expression level of hepatocellular carcinoma.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of amide proton transfer(APT)parameter in differentiating high and low Ki-67 expression groups.Results The APTw values of high Ki-67 expression group(n=24)was higher than that of low Ki-67 expression group(n=8)[(1.33±0.77)％vs(0.64±0.58)％,P=0.026].There was no significant difference in ADC values between the two groups(0.82×10-3 mm2/s vs 0.86×10-3 mm2/s,P=0.679).The APTw values were positively correlated with Ki-67 expression(r=0.377,P=0.035),and the area under the curve(AUC)of APTw value＞1.24％for the diagnosis of high Ki-67 expression was 0.794,with a sensitivity of 67％and a specificity of 88％.Conclusion The APTw value of hepatocellular carcinoma is positively correlated with Ki-67 expression,which has certain diagnostic value for predicting the expression status of Ki-67.

According to understanding of the pathogenesis of acne, scholars have established animal models of acne inflammation, animal models of grafting human skin acne, and natural acne animal models. The acne inflammation model is mainly induced by bacterial infection, chemical drug application, and foreign matter injection. Natural acne animal models include animals that some are sensitivity to hormones and some have clinical symptoms of acne. It is necessary to select appropriate model animals and replicate model methods for the development of acne intervention products with different degrees and mechanisms. At present, there are only human evaluation standards of acne health functions in China, but no animal evaluation standards, which has affected the in-depth study of the pathogenesis of acne as well as the research and development progress of acne products. This article summarizes the conditions for the occurrence of acne, the characteristics of human skin, the bidirectional effect of Cutibacterium acnes on human skin, acne animal models, and commonly used observation and evaluation indicators, providing the reference for studying the pathogenesis of acne, promoting acne treatment and health care, and developing treatment products.

Objective To compare the effect of different size needle gauges to the degenerative response in rat caudal discs.Methods A total of 40 Sprague Dawley (SD) rats,level 5/6,7/8 and 9/10 interverbral discs of rat caudal spine were punctured with 18 or 21 or 25-gauge needles respectively.Radiographs and magnetic resonance imaging (MRI) were obtained at 1,2,4 and 6 weeks postsurgery.At each time point,ten rats from each group were sacrificed for histological analysis.Real-time fluorescent quantitative polymerase chain reaction (qPCR) was used to examine mRNA expression level.Results Significant differences were identified in the disc height index (DHI ％) and MRI grade between 18 G and normal group,MRI grade,histological score between 21 G and normal group at 2,4,and 6 weeks postsurgery.Significant differences were also identified in the histological score and mRNA expression levels between 18 G and normal group,alcian blue stain and hypoxia inducible factor-1α (HIF-1 α) mRNA expression level between 21G and normal group at all time point postsurgery.Significant differences existed in DHI％,type Ⅱ collagen and aggrecan mRNA expression levels between 21 G and normal group,all type mRNA expression levels between 25 G and normal group at 4,6 weeks.There were significant differences in MRI grade and histological score between 25 G and normal group at 6 weeks.Significant differences existed in almost all parameters compared between 18 G and 25 G at all time point.There were significant differences in DHI％,MRI grade,histological score and HIF-1α mRNA expression levels between 18 G and 21 G at 4,6 weeks.There were significant differences in type Ⅱ collagen and aggrecan mRNA expression levels between 18 G and 21 G at all time point.Significant differences exist in DHI％ and HIF-1α mRNA expression level between 21 G and 25 G at 6 weeks.Compared with the 25 G group,the DHI％ and Pfirrmann scores and the pathological score of each time at 2,4 and 6 weeks after operation in 18 G group have significant difference (P ＜ 0.05).Conclusions The middle size needle (21G) is better to induce disc degeneration.The 2-week time point may be the better time frame to further experimental treatments.

BACKGROUND:Statins can promote the mRNA expression of bone morphogenetic protein 2, aggrecan and type II col agen in intervertebral disc cel s, and they also can reverse the phenotype of dedifferentiated nucleus pulposus cel s to slow disc degeneration process. OBJECTIVE:To review the research progress of simvastatin modulating the biological characteristics and mobilizing endogenous stem cel s for the repair of intervertebral disc degeneration. METHODS:The first author retrieved the PubMed and CNKI databases for relevant articles published before January 2016 using the key words of“disc degeneration factor, Simvastatin AND stem cel s, endogenous stem cel s AND disc degeneration”in English and Chinese, respectively. Initial y, 102 relevant articles were retrieved, but only 48 articles were included in result analysis fol owing elimination of duplicate studies.RESULTS AND CONCLUSION:By summarizing a large number of studies on the treatment of intervertebral disc degeneration worldwide, we found that simvastatin may modulate the biological characteristics and function of nucleus pulposus mesenchymal stem cel s via promoting the expression of hypoxia-inducible factor 1αfor the endogenous stem cel-based therapy of intervertebral disc degeneration.

Objective To explore the early clinical effects of lumbar discectomy associated with annulus repair in the treatment of lumbar disc herniation.Methods A prospective study was conducted to review 56 patients with lumbar disc herniation who accepted discectomy surgery in Subei People's Hospital of Jiangsu Province from January 2014 to September 2015,including 28 cases of discectomy associated with annulus repair (repair group) and 28 cases of discectomy (control group).Oswestry disability index and visual analog scale scores were recorded.Simultaneously,incision length,operative time,blood loss,hospitalization time,surgical complications,and postoperative recurrence of lumbar disc herniation were recorded.Results All patients completed the follow-up for 12 to 18 months (14.5 ± 1.3).There was no difference between the repair and control groups in the incision length,blood loss and hospitalization time (P ＞ 0.05).The operative time of the repair group was longer than that of the control group,but the difference was not statistically significant (P ＞ 0.05).The Oswestry disability index and visual analog scale scores for lumbar and lower limb pain significantly decreased in both groups after surgery (P ＜ 0.05).The visual analog scale scores at 24 hours and 3 days after surgery in the repair group were less than that in the control group (P ＜ 0.05).The satisfactory rate of treatment in the repair group was slightly higher than that in the control group,but the difference was not statistically significant (P ＞ 0.05).There was no recurrence in the repair group,but 2 recurrence cases in the control group (P ＞ 0.05).Conclusions These findings indicate that discectomy associated with annulus repair is a safe and reliable method to obtain remarkable early clinical results and can reduce the recurrent rate in the treatment of lumbar disc herniation.

BACKGROUND: Percutaneous vertebroplasty has been gradual y used to treat Kümmel disease because of less trauma and quick pain relief, but there is stil a high rate of bone cement leakage. OBJECTIVE: To investigate the clinical efficacy of percutaneous vertebroplasty with high-viscosity bone cement plus hyperextension position reset for treatment of Kümmel ’s disease. METHODS: The clinical data of 17 patients with Kümmel ’s disease were retrospectively analyzed, including 5 males and 12 females, aged 55-83 years, and al underwent percutaneous vertebroplasty with high-viscosity bone cement plus hyperextension position reset. The visual analog scale, Oswestry disability index score, vertebral body height and vertebral kyphosis angle were determined. The bone cement leakage, pulmonary embolism, adjacent vertebral fractures and other complications were recorded. RESULTS AND CONCLUSION: At the 12th Oswestry disability index scores and vertebral kyphosis angle of patients were significantly lower than those before treatment (P < 0.05), the vertebral body height was significantly higher than that before month of follow-up, the visual analog scale scores, treatment (P < 0.05). After treatment, there were three cases of bone cement leakage, which had no special discomfort and neurological symptoms, and one case of new fractures. These results demonstrate that hyperextension position reset combined with percutaneous vertebroplasty with high-viscosity bone cement in treatment of Kümmel ’s disease can effectively relieve back pain, improve function of the lower back, partial y restore vertebral height and reduce kyphosis angle.

OBJECTIVE: To evaluate the prescription behavior for outpatients in primary health care institutions of Yiyang and to provide scientific basis for promoting the rational use of drugs.
 METHODS: A multi-stage random sampling method was conducted in 21 primary health care institutions from Yiyang. Fifteen prescriptions were randomly selected in every month from each institution and a total of 3780 prescriptions were eventually collected in a year.
 RESULTS: Both the number of drugs and percentage of injection in a prescription were greater than the international standards. Children were more likely to be prescribed by multiple prescriptions, antibiotics prescriptions, hormones and injections prescriptions. The utilization of essential drug was more frequent in female. Antibiotics and hormones were more frequently used in summer and autumn season. Polypharmacy, antibiotics, injections and essential drugs were more frequently used in hospitals of small town. The skin and subcutaneous tissue diseases were often treated with multiple prescriptions, while the respiratory diseases were often treated with antibiotics, hormones and injections. Most primary health care institutions were at the upper limit of rational drug use.
 CONCLUSION The usage of prescription drug in most primary health care is rational, but some still surpass international standards. Thus, primary health care physicians should strictly control their prescriptions behavior.
Anti-Bacterial Agents ; Drug Prescriptions ; statistics & numerical data ; Drug Utilization Review ; Drugs, Essential ; Hormones ; Humans ; Injections ; Outpatients ; Practice Patterns, Physicians' ; Primary Health Care

Our primary health care institution began to implement national essential medicine system in 2009. In past fi ve years, the goal of national essential medicine system has been initially achieved. For examples, medicine price is steadily reducing, the quality of medical services is improving and residents' satisfaction is substantial increasing every year. However, at the same time, we also found some urgent problems needed to be solved. For examples, the range of national essential medicine is limited, which is difficult to guarantee the quality of essential medication. In addition, how to compensate the primary health care institution is still a question.
China ; Health Services Needs and Demand ; Primary Health Care ; organization & administration

BACKGROUND:Vertebroplasty and kyphoplasty have been widely applied in the treatment of osteoporotic thoracolumbar compression fracture. However, cement leakage is a major problem in the application of this technology, especial y for the vertebral posterior wal ruptured patients. OBJECTIVE:To investigate the therapeutic efficacy of high viscosity bone cement and vertebroplasty in the treatment of osteoporotic thoracolumbar compression fracture. METHODS:A retrospective study was conducted in 20 cases receiving high viscosity bone cement and vertebroplasty surgery for osteoporotic thoracolumbar compression fracture. Clinical outcomes were evaluated mainly with use of Visual Analog Scale for lower back pain. Function of lower back pain was assessed using Oswestry Disability Index questionnaire. Quality of life was evaluated using 36-Item Short Form Health Survey and Frankel score was applied to evaluate neurological function. The anterior vertebral height of the fractured vertebrae was assessed with X-ray. The bone cement leakage, pulmonary embolism, incidence of nearby vertebral fractures and other complications were evaluated during fol ow-up. RESULTS AND CONCLUSION:Al patients were fol owed up for 12-18 months. The anterior vertebral height of the fractured vertebrae, the lower back pain and function, and quality of life were improved significantly after treatment (P<0.05). Al patients got the same neurological symptoms before surgery. The bone cement dispersion was good after treatment, detected by X-ray and CT scan, only two cases appeared with bone cement leakage, but no clinical symptoms were found. There was no cement toxicity or al ergic complications, pulmonary embolism, infection, nerve injury or new fractures. The high viscosity bone cement used in the treatment of osteoporotic thoracolumbar vertebral compression fractures can significantly relieve thoracic back pain, improve lower back function and quality of life, and greatly reduce the risk of bone cement leakage.