1.Analysis of medical quality in psychiatric hospitals based on DRG evaluation
Yizhu PAN ; Moning GUO ; Yelong QIU ; Xiaohong LI ; Yongjun SHE ; Hao CHEN ; Cunli XIAO ; Xiuqi SUN ; Zhiwu LI
Chinese Journal of Hospital Administration 2023;39(1):22-26
Objective:To evaluate the medical service quality of psychiatric hospitals in Beijing based on diagnostic related group (DRG), analyze the evaluation effect, for refences to constructe a DRG performance evaluation system suitable for psychiatric hospitals.Methods:This study extracted data such as the number of DRG groups, etc. of hospitalized patients in 14 tertiary and secondary psychiatric hospitals in Beijing from 2018 to 2020 from the Beijing inpatient medical performance evaluation platform, and analyzed data on DRG performance evaluation indicators, as well as the average length of hospital stay and average cost of DRG enrolled cases. All data were analyzed using descriptive research methods, and inter group comparisons were conducted using the Mann Whitney U-test. Results:From 2018 to 2020, the average number of DRG groups in tertiary hospitals (28) was higher than that in secondary hospitals (10) ( P<0.05), and the average CMI values of both were the same(1.79); The average cost consumption index (1.15) of tertiary hospitals was higher than that of secondary hospitals (0.65) ( P<0.05), while the average time consumption index (1.11) was slightly lower than that of secondary hospitals (1.30); The mortality rate of the low-risk group in tertiary hospitals (0.01%) was generally lower than that in secondary hospitals (0.88%), and the average percentage of DRG admitted inpatients (82.8%) was significantly higher than that in secondary hospitals (27.3%) ( P>0.05). The average length of stay and cost per case for DRG enrolled inpatients in tertiary and secondary hospitals were lower than the overall hospital discharge cases ( P<0.05). Conclusions:The number of DRG groups, CMI value, and low-risk mortality rate could be used for evaluating the medical service capacity and safety of psychiatric hospitals, but the cost and time consumption index could not objectively reflect the efficiency of hospital medical services. DRG performance evaluation indicators are more suitable for evaluating short-term hospitalization of psychiatric patients. The proportion of DRG enrolled cases might be a potential indicator for evaluating the service quality of psychiatric hospitals.
2.In vitro and in vivo antimicrobial activity of pimozide against Staphylo-coccus aureus
Ti CHEN ; Yao DUAN ; Xiao-Jie ZHANG ; Peng-Fei SHE ; Ying-Jia LI
Chinese Journal of Infection Control 2023;22(12):1475-1482
Objective To explore the in vitro and in vivo antimicrobial activity of antipsychotic agent pimozide against Staphylococcus aureus(S.aureu).Methods The minimal inhibitory concentration(MIC)and minimum bactericidal concentration(MBC)of pimozide were determined by micro-dilution assay.Biofilm was cultured in 96-well cell culture plate,and the anti-biofilm activity of pimozide was detected by turbidimetry.The effect of pimozide on biofilm was further observed through laser confocal microscopy and SYTO9/PI staining.Combined antimicrobial effect of pimozide and other antimicrobial agents was detected by chessboard dilution method,and cytotoxicity of pimozide was detected by CCK-8 assay kit.A model of skin abscess was constructed,in vivo antimicrobial activity and toxicity of pimozide was tested.Results Pimozide showed significant dose-dependent antimicrobial activity against S.aureu,with a MIC of 8-16 μg/mL.It could significantly inhibit the formation of S.aureu biofilm and disperse the formed biofilm.The combination of pimozide and doxycycline has a synergistic antimicrobial effect in vitro,with a synergistic antimicrobial index of 0.5.It can significantly reduce the bacterial load in mouse abscess tissue in vivo,and reduce the live bacterial count from(8.25±0.13)lgarithmic value of CFU/abscess to(3.31± 0.81)logarithmic value of CFU/abscess(q=3.74,P<0.05).The cytotoxicity of pimozide was extremely low,with a half inhibitory concentration of 64 μg/mL on cells.Conclusion Pimozide exhibits significant antimicrobial activity in vitro and in vivo with extremely low toxicity,thus is promising for the treatment of S.aureu-related local infection in psychiatric patients.
3.Clinical observation on different frequency of auricular bloodletting combined with auricular point sticking for acne vulgaris.
Ya-Yu GAO ; Man ZHANG ; Yan-Fen SHE ; Hao CHEN ; Xiao-Dan SONG ; Ming-Jian ZHANG ; Jin LIU ; Xi-Sheng FAN ; Jun-Cha ZHANG ; Xu-Liang SHI
Chinese Acupuncture & Moxibustion 2022;42(6):629-633
OBJECTIVE:
To observe the clinical efficacy of different treatment frequency of auricular bloodletting combined with auricular point sticking for acne vulgaris.
METHODS:
A total of 90 patients with acne vulgaris were randomized into a treatment group 1 (30 cases, 2 cases dropped off), a treatment group 2 (30 cases, 4 cases dropped off) and a treatment group 3 (30 cases, 5 cases dropped off). Combination therapy of auricular bloodletting and auricular point sticking at Fei (CO14), Shenmen (TF4), Neifenmi (CO18) and Shenshangxian (TG2p) were given once a week, twice a week and 3 times a week in the treatment group 1, the treatment group 2 and the treatment group 3 respectively, 4 weeks were as one course and totally 3 courses were required in the 3 groups. Before treatment and after 1, 2, 3 courses of treatment, the scores of global acne grading system (GAGS), skin lesion and quality of life-acne (QoL-Acne) were observed, the clinical efficacy was evaluated after 3 courses of treatment and the recurrence rate was evaluated in follow-up of 1 month after treatment in the 3 groups.
RESULTS:
Compared before treatment, the scores of GAGS and skin lesion were decreased at each time point in the 3 groups (P<0.05), the QoL-Acne scores were increased after 1 course of treatment in the treatment group 3 and after 2, 3 courses of treatment in the 3 groups (P<0.05). There were no statistical differences in scores of GAGS, skin lesion and QoL-Acne among the 3 groups (P>0.05). There were no statistical differences in effective rate and recurrence rate among the 3 groups (P>0.05).
CONCLUSION
Different frequency of auricular bloodletting combined with auricular point sticking have similar efficacy in treating acne vulgaris, all can improve the skin lesion and quality of life in patients with acne vulgaris, and have a cumulative effect and good long-term curative effect.
Acne Vulgaris/therapy*
;
Acupuncture Points
;
Acupuncture, Ear
;
Bloodletting
;
Humans
;
Quality of Life
;
Treatment Outcome
4.Early intervention of uric acid in elderly high risk population of coronary heart disease
Juan CHEN ; Xiao-feng MA ; Guang-dong SHE
Journal of Public Health and Preventive Medicine 2022;33(6):136-139
Objective To explore the clinical effect of early intervention of uric acid in elderly high-risk patients with coronary heart disease. Methods Patients who visited the Cardiovascular Department/Cardiology Department of our hospital from January 2017 to December 2019 were screened, and 456 patients who met the criteria were included in the study. The included patients were randomly divided into a control group and an observation group, with 228 cases in each group. The control group was given routine intervention, and the observation group was given early uric acid intervention. The levels of uric acid, cardiac function indexes, 2-year incidence of coronary heart disease and incidence of cardiovascular events were compared between the two groups before and after the intervention. Results After the intervention, the cognitive level of the two groups was significantly improved, and the understanding level of the observation group was significantly higher than that of the control group (P<0.001). Compared with the control group, the abnormal rate of uric acid level in the observation group was significantly lower (P<0.015). After intervention, the ejection fraction, cardiac output and total peripheral vascular resistance in the observation group had no significant changes (P>0.05). In the control group, ejection fraction and cardiac output decreased, total peripheral vascular resistance increased, and the difference was statistically significant (P<0.05). After 2 years of intervention, 94 cases (41.23%) of coronary heart disease in the control group and 48 cases in the observation group had the disease. (21.05%), the difference between the two groups was significant (P=0.002); within 2 years after the intervention, 78 cases/time (34.21%) of cardiovascular events occurred in the control group and 40 cases/time (17.54%) in the observation group, with a difference between the two groups (P=0.007).Conclusion Early intervention of uric acid in elderly high-risk coronary heart disease population can significantly reduce uric acid levels, stabilize cardiac function indicators, and reduce the 2-year incidence of coronary heart disease and cardiovascular events, which can provide a reference for clinical disease intervention in high-risk coronary heart disease populations.
5.Prevalence of hepatic steatosis and metabolic associated fatty liver disease among female breast cancer survivors.
Shen TIAN ; Hao LI ; Renhua LI ; Liang RAN ; Shu LI ; Juan WU ; Zhou XU ; Xinyu LIANG ; Yuling CHEN ; Jun XIAO ; Jiaying WEI ; Chenyu MA ; Jingyu SONG ; Ruiling SHE ; Kainan WU ; Lingquan KONG
Chinese Medical Journal 2022;135(19):2372-2374
6.Comparative study on the academic thought of bloodletting for expelling pathogens between Jin-Yuan Dynasties and Ming-Qing Dynasties.
Hao CHEN ; Yan-Fen SHE ; Ya-Yu GAO ; Xiao-Dan SONG ; Xi-Sheng FAN ; Xu-Liang SHI ; Shang-Pu DONG ; Jing LV
Chinese Acupuncture & Moxibustion 2021;41(7):813-817
The relevant provisions of bloodletting for expelling pathogens are collected from the works of the medical representative scholars in Jin-Yuan Dynasties and Ming-Qing Dynasties respectively to construct the databases of bloodletting for expelling pathogens of Jin-Yuan Dynasties and Ming-Qing Dynasties. Using frequency analysis, the bloodletting device, bloodletting location, bloodletting volume, the related pathogens and indications are compared between these two times so that the evidences could be provided for the inheritance and development of the academic thought of bloodletting for expelling pathogens. It is found that the three-edge needle is the most commonly used device for bloodletting in Jin-Yuan Dynasties and Ming-Qing Dynasties and
Acupuncture Points
;
Bloodletting
;
China
;
Medicine, Chinese Traditional
;
Meridians
;
Needles
7.Clinical and mechanism research on functional erectile dysfunction treated with moxibustion and
Hua ZHANG ; Zi-Xue SUN ; Bo MEN ; Xiao-Jun FU ; Jian-She CHEN
Chinese Acupuncture & Moxibustion 2021;41(12):1325-1330
OBJECTIVE:
To observe the clinical therapeutic effect on functional erectile dysfunction (FED) of kidney deficiency and liver stagnation treated by
METHODS:
A total of 120 patients with FED were randomized into an observation group (60 cases, 2 cases dropped off) and a control group (60 cases, 4 cases dropped off). In the control group, the patients were treated with oral
RESULTS:
After treatment, the scores of IIEF5, EHS and EDITS were all increased as compared with the values before treatment (
CONCLUSION
The combined therapy of
Drugs, Chinese Herbal/therapeutic use*
;
Erectile Dysfunction/therapy*
;
Humans
;
Male
;
Moxibustion
;
Vascular Endothelial Growth Factor A
8.Study on the acupoints belonging to the three yin meridians of foot reflecting the variation pattern of uterine qi and blood in women with moderate constitution
Xiao-Dan SONG ; Fei YANG ; Yan-Fen SHE ; Ya-Yu GAO ; Hao CHEN ; Xi-Sheng FAN ; Ao-Tian YU ; Man ZHANG ; Zhi-Fang ZHANG ; Li-Jia PAN ; Bing-Cheng WANG ; Xu-Liang SHI
Journal of Acupuncture and Tuina Science 2020;18(6):411-417
Objective: To observe the blood perfusion volume variation pattern in the body surface microcirculation at the Yuan-Primary and the Xi-Cleft points during the menstrual cycle in female college students with moderate constitution under normal physiological state of the uterus; to explore the specific laws of the body surface microcirculation at the Yuan-Primary and Xi-Cleft points in response to the uterine qi and blood changes under normal physiological conditions, and to provide the experimental basis for the specificity of acupoints reflecting the uterine function. Methods: Forty-three healthy and moderate constitution female college students with regular menstrual cycles, without dysmenorrhea and not yet giving birth were recruited. Bilateral Yuan-Primary points [Taichong (LR 3), Taibai (SP 3) and Taixi (KI 3)] and Xi-Cleft points [Zhongdu (LR 6), Diji (SP 8) and Shuiquan (KI 5)], belonging to the three yin meridians of foot and adjacent to the spinal cord segment of the uterus, were selected as the detection acupoints; the crossing point of the three yin meridians of foot [Sanyinjiao (SP 6)], the uterus-related meridian acupoint [Xuehai (SP 10)], the uterus-non-related meridian acupoint [Xuanzhong (GB 39)], and the non-meridian non-acupoint point were selected as the control points. The laser speckle blood flow imaging technique was used to monitor the blood perfusion volume in skin microcirculation at the above points at the menstrual, follicular, ovulatory, and luteal phases of the subjects. Results: The blood perfusion volume in the body surface microcirculation at the right Zhongdu (LR 6) at the ovulatory phase was higher than that at the menstrual, follicular and luteal phases (all P<0.05); there was no significant difference in the microcirculation blood perfusion volume at the other points among different phases (all P>0.05). Conclusion: The blood perfusion volume in the body surface microcirculation at Zhongdu (LR 6), the Xi-Cleft point of the Liver Meridian, shows a specific response to qi and blood changes in the uterus of women with moderate constitution.
9.A conceived model of "physician scientist" cultivation: exploring the double degrees of MD-PhD program.
Wei-Jiang DONG ; Wen-Bin LIU ; Hui-Lin GONG ; Yan-Bin CHENG ; Ming ZHANG ; Yi LYU ; Xiao-Jian WU ; Xiao-Jun MENG ; She-Min LYU ; Li-Na CHEN ; Qian GUO ; Jin-Song ZHOU ; Hong YAN
Chinese Medical Journal 2020;133(13):1620-1622
10.Comparison of follow-up methods on compliance and prognosis of non-selective beta blockers for prevention of esophagogastric variceal bleeding
Qian SHE ; Mingkai CHEN ; Jin ZHANG ; Yong XIAO ; Jing ZHOU ; Jiao LI
Chinese Journal of Digestive Endoscopy 2020;37(3):185-189
Objective:To compare the different follow-up methods on compliance and prognosis of non-selective beta blockers (NSBBs) for out-patients with secondary prevention of esophagogastric variceal bleeding (EGVB).Methods:A total of 72 patients with portal hypertension and esophageal gastric varices (EGV), who were admitted to the department of gastroenterology, Renmin Hospital of Wuhan University from July 2018 to April 2019 were randomly included in the traditional outpatient follow-up group (group A, 24), remote platform follow-up group (group B, 23) and combined follow-up group (group C, 25) according to the random number table. The patient′s medication compliance, heart rate response, condition change and treatment were recorded. NSBBs medication compliance, influencing factors and prognosis of patients in different groups were analyzed.Results:Forty (40/72, 55.6%) patients had good compliance with NSBBs, among which 34 (34/40, 85.0%) achieved heart rate response. The medication compliance of the group B (15/23, 65.2%) and the group C (17/25, 68.0%) was higher than that of the group A (8/24, 33.3%; χ2=4.778, P=0.029; χ2=5.889, P=0.015, respectively). There was no significant difference in the medication compliance between the group B and the group C ( χ2=0.042, P=0.838). In the group A, the subgroup of good compliance had higher proportion of local patients than that of poor compliance subgroup [7/8 VS 37.5% (6/16), P=0.033]. Patients with good drug compliance had higher proportion of gastroscopy review than that of poor compliance patients [75.0% (30/40) VS 21.9% (7/32), χ2=20.085, P<0.001] and less patients with EGVB [5.0% (2/40) VS 21.9% (7/32), P=0.073]. Conclusion:Patients with portal hypertension and EGV have poor compliance with NSBBs. Remote platform follow-up is a better way to improve compliance of drug prevention. Patients with good NSBBs compliance have a higher compliance of gastroscopy review. The risk assessment of variceal bleeding and endoscopic sequential therapy based on the results of gastroscopy review are expected to reduce the risk of EGVB.


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