BACKGROUND:Metal ions play an important role in the human body.With the progress of material synthesis and processing technology,a variety of metal ions that can be used in bone tissue engineering have been developed,such as magnesium(Mg2+),zinc(Zn2+),manganese(Mn2+),strontium(Sr2+),and copper(Cu2+). OBJECTIVE:To summarize the research progress and development direction of metal ions in bone tissue engineering. METHODS:The literature collected by CNKI,PubMed and WanFang databases from 2014 to 2022 was retrieved.The Chinese and English key words were"metal ions,bone tissue engineering,osteogenic activity,magnesium ions,zinc ions,manganese ions,strontium ions,copper ions,calcium ions,lithium ions,cobalt ions". RESULTS AND CONCLUSION:Different metal ions will be released to varying degrees after the materials are implanted into the body,which can change the tissue microenvironment,thus improving the ability of materials to form blood vessels and bones.Compared with growth factors,metal ions are easier to control the release rate,have lower cost,and can also improve the mechanical properties of implant materials.The application of metal ions in bone tissue engineering is full of prospects.Although some metal ions can already be used to treat bone defects,the mechanism of action of many metal ions in the human body is not completely clear,and the application effect is a lack of clinical experiment verification.Further exploration is needed before clinical application.

Radical cystectomy combined with pelvic lymph node dissection is the standard procedure for the treatment of muscle invasive bladder cancer and complex non-muscle invasive bladder cancer.Our department has routinely carried out laparoscopic radical cystectomy(ELRC)through the extraperitoneal approach in 340 cases.This article summarizes the establishment of the peritoneal space,the expansion of the peritoneal space,the operation steps of bladder resection and lymph node dissection through the peritoneal channel,and how to shorten the operation time and reduce the difficulty of the operation.During the surgery,the bladder is removed periperitoneally without destroying the peritoneum to preserve the functions of peritoneum support,secretion,protection and lubrication,which has little impact on the abdominal organs,reduces the incidence of complications,and provides favorable conditions for subsequent treatment.

Objective:To explore the cost control effect and cost-shifting effect of Diagnosis-Intervention Packet(DIP)payment reform on inpatient coronary heart disease patients.Methods:Z City,a national pilot city for DIP,is taken as a case study.It utilizes inpatient claims data and the propensity scoring matching-difference in differences method to evaluate the impact of DIP payment reform on total medical expenses,Out-of-Pocket(OOP),the OOP proportion,self-paid Category B expenses,the proportion of self-paid Category B expenses,Category C expenses,and the proportion of Category C expenses for coronary heart disease inpatients.Results:After the DIP reform,the total medical expenses per inpatient coronary heart disease patient significantly decreased(β=-0.127,P＜0.01).Regarding cost-shifting,the OOP expenses(β=0.108,P＜0.05),the OOP proportion(β=0.055,P＜0.01),self-paid Category B expenses(β=0.239,P＜0.01),the proportion of self-paid Category B expenses(β=0.030,P＜0.01),and the proportion of Category C expenses significantly increased(β=0.026,P＜0.01),while there was no significant change in Category C expenses.Conclusion:The DIP reform significantly reduced the total medical expenses per inpatient case of coronary heart disease.At the same time,the reform shifted costs from within the scope of the insurance policy to outside the policy's coverage,with a stronger shift observed from Category B to Category C expenses.

Objective:To explore the cost control effect and cost-shifting effect of Diagnosis-Intervention Packet(DIP)payment reform on inpatient coronary heart disease patients.Methods:Z City,a national pilot city for DIP,is taken as a case study.It utilizes inpatient claims data and the propensity scoring matching-difference in differences method to evaluate the impact of DIP payment reform on total medical expenses,Out-of-Pocket(OOP),the OOP proportion,self-paid Category B expenses,the proportion of self-paid Category B expenses,Category C expenses,and the proportion of Category C expenses for coronary heart disease inpatients.Results:After the DIP reform,the total medical expenses per inpatient coronary heart disease patient significantly decreased(β=-0.127,P＜0.01).Regarding cost-shifting,the OOP expenses(β=0.108,P＜0.05),the OOP proportion(β=0.055,P＜0.01),self-paid Category B expenses(β=0.239,P＜0.01),the proportion of self-paid Category B expenses(β=0.030,P＜0.01),and the proportion of Category C expenses significantly increased(β=0.026,P＜0.01),while there was no significant change in Category C expenses.Conclusion:The DIP reform significantly reduced the total medical expenses per inpatient case of coronary heart disease.At the same time,the reform shifted costs from within the scope of the insurance policy to outside the policy's coverage,with a stronger shift observed from Category B to Category C expenses.

Objective:To explore the cost control effect and cost-shifting effect of Diagnosis-Intervention Packet(DIP)payment reform on inpatient coronary heart disease patients.Methods:Z City,a national pilot city for DIP,is taken as a case study.It utilizes inpatient claims data and the propensity scoring matching-difference in differences method to evaluate the impact of DIP payment reform on total medical expenses,Out-of-Pocket(OOP),the OOP proportion,self-paid Category B expenses,the proportion of self-paid Category B expenses,Category C expenses,and the proportion of Category C expenses for coronary heart disease inpatients.Results:After the DIP reform,the total medical expenses per inpatient coronary heart disease patient significantly decreased(β=-0.127,P＜0.01).Regarding cost-shifting,the OOP expenses(β=0.108,P＜0.05),the OOP proportion(β=0.055,P＜0.01),self-paid Category B expenses(β=0.239,P＜0.01),the proportion of self-paid Category B expenses(β=0.030,P＜0.01),and the proportion of Category C expenses significantly increased(β=0.026,P＜0.01),while there was no significant change in Category C expenses.Conclusion:The DIP reform significantly reduced the total medical expenses per inpatient case of coronary heart disease.At the same time,the reform shifted costs from within the scope of the insurance policy to outside the policy's coverage,with a stronger shift observed from Category B to Category C expenses.

Objective:To explore the cost control effect and cost-shifting effect of Diagnosis-Intervention Packet(DIP)payment reform on inpatient coronary heart disease patients.Methods:Z City,a national pilot city for DIP,is taken as a case study.It utilizes inpatient claims data and the propensity scoring matching-difference in differences method to evaluate the impact of DIP payment reform on total medical expenses,Out-of-Pocket(OOP),the OOP proportion,self-paid Category B expenses,the proportion of self-paid Category B expenses,Category C expenses,and the proportion of Category C expenses for coronary heart disease inpatients.Results:After the DIP reform,the total medical expenses per inpatient coronary heart disease patient significantly decreased(β=-0.127,P＜0.01).Regarding cost-shifting,the OOP expenses(β=0.108,P＜0.05),the OOP proportion(β=0.055,P＜0.01),self-paid Category B expenses(β=0.239,P＜0.01),the proportion of self-paid Category B expenses(β=0.030,P＜0.01),and the proportion of Category C expenses significantly increased(β=0.026,P＜0.01),while there was no significant change in Category C expenses.Conclusion:The DIP reform significantly reduced the total medical expenses per inpatient case of coronary heart disease.At the same time,the reform shifted costs from within the scope of the insurance policy to outside the policy's coverage,with a stronger shift observed from Category B to Category C expenses.

Objective:To explore the cost control effect and cost-shifting effect of Diagnosis-Intervention Packet(DIP)payment reform on inpatient coronary heart disease patients.Methods:Z City,a national pilot city for DIP,is taken as a case study.It utilizes inpatient claims data and the propensity scoring matching-difference in differences method to evaluate the impact of DIP payment reform on total medical expenses,Out-of-Pocket(OOP),the OOP proportion,self-paid Category B expenses,the proportion of self-paid Category B expenses,Category C expenses,and the proportion of Category C expenses for coronary heart disease inpatients.Results:After the DIP reform,the total medical expenses per inpatient coronary heart disease patient significantly decreased(β=-0.127,P＜0.01).Regarding cost-shifting,the OOP expenses(β=0.108,P＜0.05),the OOP proportion(β=0.055,P＜0.01),self-paid Category B expenses(β=0.239,P＜0.01),the proportion of self-paid Category B expenses(β=0.030,P＜0.01),and the proportion of Category C expenses significantly increased(β=0.026,P＜0.01),while there was no significant change in Category C expenses.Conclusion:The DIP reform significantly reduced the total medical expenses per inpatient case of coronary heart disease.At the same time,the reform shifted costs from within the scope of the insurance policy to outside the policy's coverage,with a stronger shift observed from Category B to Category C expenses.

Objective:To explore the cost control effect and cost-shifting effect of Diagnosis-Intervention Packet(DIP)payment reform on inpatient coronary heart disease patients.Methods:Z City,a national pilot city for DIP,is taken as a case study.It utilizes inpatient claims data and the propensity scoring matching-difference in differences method to evaluate the impact of DIP payment reform on total medical expenses,Out-of-Pocket(OOP),the OOP proportion,self-paid Category B expenses,the proportion of self-paid Category B expenses,Category C expenses,and the proportion of Category C expenses for coronary heart disease inpatients.Results:After the DIP reform,the total medical expenses per inpatient coronary heart disease patient significantly decreased(β=-0.127,P＜0.01).Regarding cost-shifting,the OOP expenses(β=0.108,P＜0.05),the OOP proportion(β=0.055,P＜0.01),self-paid Category B expenses(β=0.239,P＜0.01),the proportion of self-paid Category B expenses(β=0.030,P＜0.01),and the proportion of Category C expenses significantly increased(β=0.026,P＜0.01),while there was no significant change in Category C expenses.Conclusion:The DIP reform significantly reduced the total medical expenses per inpatient case of coronary heart disease.At the same time,the reform shifted costs from within the scope of the insurance policy to outside the policy's coverage,with a stronger shift observed from Category B to Category C expenses.

In recent years， the potential anti-tumor effects of metformin have attracted widespread attention in the field of cancer treatment. This article summarizes the research progress of metformin in the treatment of malignant tumors，finding its potential application in the treatment of malignant tumors in the digestive system （biliary tract cancer，gastric cancer，esophagus cancer，colorectal cancer，pancreatic cancer，liver cancer） and reproductive system （prostate cancer，ovarian cancer，breast cancer， cervical cancer），non-small cell lung cancer，renal cell carcinoma，and melanoma. Metformin can inhibit the proliferation of tumor cells and extend the overall survival of patients. Its mechanisms of action include，but are not limited to，inhibiting the activity of mitochondrial complex Ⅰ，activating adenosine monophosphate-activated protein kinase/p53 signaling pathway，and blocking the cell cycle. Additionally，the combined use of metformin with chemotherapy drugs has shown potential for reducing toxicity and enhancing efficacy. It can enhance the sensitivity of biliary tract cancer，ovarian cancer，and melanoma cells to chemotherapy drugs， improve the drug resistance of gastric and colorectal cancer cells to chemotherapy，and reduce the toxic reactions of breast cancer patients during chemotherapy. Metformin is also used as an immunomodulator，applied in the immunotherapy of patients with esophagus cancer，colorectal cancer，cervical cancer，non-small cell lung cancer，and melanoma.

Objective:To explore the cost control effect and cost-shifting effect of Diagnosis-Intervention Packet(DIP)payment reform on inpatient coronary heart disease patients.Methods:Z City,a national pilot city for DIP,is taken as a case study.It utilizes inpatient claims data and the propensity scoring matching-difference in differences method to evaluate the impact of DIP payment reform on total medical expenses,Out-of-Pocket(OOP),the OOP proportion,self-paid Category B expenses,the proportion of self-paid Category B expenses,Category C expenses,and the proportion of Category C expenses for coronary heart disease inpatients.Results:After the DIP reform,the total medical expenses per inpatient coronary heart disease patient significantly decreased(β=-0.127,P＜0.01).Regarding cost-shifting,the OOP expenses(β=0.108,P＜0.05),the OOP proportion(β=0.055,P＜0.01),self-paid Category B expenses(β=0.239,P＜0.01),the proportion of self-paid Category B expenses(β=0.030,P＜0.01),and the proportion of Category C expenses significantly increased(β=0.026,P＜0.01),while there was no significant change in Category C expenses.Conclusion:The DIP reform significantly reduced the total medical expenses per inpatient case of coronary heart disease.At the same time,the reform shifted costs from within the scope of the insurance policy to outside the policy's coverage,with a stronger shift observed from Category B to Category C expenses.