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上海市J区DIP医保支付方式改革进展及效果评价

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中国医院 2024年第9期28卷 15-18页

作者：张玉姝陈一凡邹作丽王颖李明复旦大学公共卫生学院/国家卫生健康委员会卫生技术评估重点实验室(复旦大学) 上海市200032 贵州医科大学公共卫生与健康学院贵州省贵阳市561113 上海市东方医院上海市200092

目的:了解上海市J区按病种分值付费改革进展,发现并解决实施中存在的问题,保证支付改革的顺利推进。方法:通过文献分析、关键知情人访谈和问卷调查,围绕区域年度预算结算、住院医保基金支出、实施进展以及患者受益4个维度进行研究。结果... 详细信息

目的:了解上海市J区按病种分值付费改革进展,发现并解决实施中存在的问题,保证支付改革的顺利推进。方法:通过文献分析、关键知情人访谈和问卷调查,围绕区域年度预算结算、住院医保基金支出、实施进展以及患者受益4个维度进行研究。结果:2019-2021年,区域年度预算结算总额的差值为负值,尚未达到收支平衡。较改革前相比,区域住院总费用增长幅度有所缓和,住院医保费用增幅有所控制。2022年至今全区适用病例入组占比保持高位水平,病种入组率高于市入组率均值。住院医保患者实际自付比例保持在30%左右,各项满意度均分在4.5分(5分)以上。结论:改革实施进程顺利推进,实际自付比例保持较低水平,患者满意程度高,但改革培训范围有限、信息系统问题凸显,需要扩大培训范围,加快DIP信息化建设。

关键词：按病种分值付费医保支付支付改革效果评价

Association of HBV DNA *** antiviral treatment outcomes in the patients with early-stage HBV-related hepatocellular carcinoma undergoing curative resection

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Chinese Journal of Cancer 2016年第5期35卷 236-249页

作者： Jian-lin Chen Xiao-Jun lin Qian Zhou ming Shi Sheng-Ping li Xiang-ming Lao Department of Hepatobiliary Oncology State Key Laboratory of Southern ChinaCollaborative Innovation Center for Cancer MedicineSun Yat-sen University Cancer Center Epidemiology Research Unit The First Affiliated Hospital of Sun Yat-sen University

Background:It remains unclear what the antiviral therapy affects disease-free survival(DFS) and overall survival(OS)of patients with hepatitis B virus(HBV)-related hepatocellular carcinoma(HCC) at different tumor stages and baseline HBV DNA *** this study,we analyzed the association of antiviral treatment with DFS and OS based on the stratification of baseline HBV DNA load in early-stage(stages Ⅰ and Ⅱ) HCC ***:We included 445 patients with early-stage HBV-related HCC who underwent curative resection,and then classified them into four subgroups based on baseline HBV DNA load and antiviral therapy *** KaplanMeier and Cox regression analyses were performed to determine the association of clinical characteristics with ***:The median follow-up period was 74 *** all patients,cumulative OS rates in the antiviral group were significantly higher than those in the non-antiviral group(log-rank test,P = 0.023),whereas no significant differences in DFS rates were *** baseline HBV DNA level was a risk factor associated with short DFS and OS in all *** patients with baseline HBV DNA levels ≥2000 lU/mL,antiviral treatment was significantly associated with prolonged DFS and OS(log-rank test,P = 0.041 and 0.001,respectively).In patients with HBV DNA levels line HBV DNA levels are associated with poor prognosis in the patients with early-stage HCC,and the antiviral treatment could generate survival benefits for the ***,antiviral treatment should be given for these ***,the effect of antiviral treatment on the patients with low viral load remains unclear,and further investigation is warranted.

关键词： Hepatocellular carcinoma, Resection, Hepatitis B virus, Prognosis, Antiviral therapy

A new C_(27)-steroidal glycoside from Ophiopogon japonicus

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Chinese Chemical Letters 2008年第1期19卷 82-84页

作者： Jian Zhong Wang li ming Ye Xiao Bing Chen West China College of Pharmacy Sichuan University Chengdu 610041 China

A new C27-steroidal glycoside with three known compounds were isolated from the tuber of Ophiopogonjaponicus （Thunb.） Ker-Gawl. Based on the spectral analysis, including HRMS, 1H NMR, 13C NMR, DEPT, 1H-1H COSY, HMQC and HMBC, their chemical structures were determined as pennogenin-3-O-α-L-rhamnopyranosyl-（1→ 2）-β-D-xylopyranosyl-（1→ 4）-13-D-gluco- pyranoside （1）, pennogenin-3-O-α-L-rhamnopyranosyl-（1→ 2）-β-D-glucopyranoside （2）, ophiopojaponin C （3） and ophiopogonin D （4）. 2007 Jian Zhong Wang. Published by Elsevier B.V. on behalf of Chinese Chemical Society. All rights reserved.

关键词： Ophiopogon japonicus C27-steroidal glycoside

A membrane separation technique for optimizing sample preparation of MALDI-TOF MS detection

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Chinese Chemical Letters 2019年第1期30卷 95-98页

作者： Zengnan Wu Ning Xu Weiwei li Jin-ming lin State Key Laboratory of Chemical Resource Engineering Beijing University of Chemical Technology Beijing Key Laboratory of Microanalytical Methods and Instrumentation Department of Chemistry Tsinghua University

The performance of matrix-assisted laser desorption/ionization time of flight mass spectrometry(MALDI-TOF-MS) is frequently compromised by the high limited of detection, heterogeneous distribution of matrix and analyte deposits and time-consuming drying time during the conventional drop drying procedure. Here, we describe a method based on membrane separation technology to assist in the drying of nanomaterials to rapidly make homogeneous sample spots and to enhance the mass signal. We demonstrate that the sample can be dried evenly in a few seconds and MS signal can be greatly optimized by using membrane separation technology. Enrichment with nanomaterials greatly enhances analyte signal strength while membrane separation method avoids the time-consuming requirements of searching for "sweet spots".

关键词： MALDI-MS Membrane separation Nanomaterial Mastoparan Insulin Cytochrome C

Endoscopic ultrasonographic features of gastric linitis plastica in fifty-five Chinese patients

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2013年第9期14卷 844-848页

作者： Guo-dong SHAN Guo-qiang XU You-ming li Department of Gastroenterology the First Affiliated HospitalSchool of MedicineZhejiang University

The objective of this study was to investigate the endosonographic appearance of gastric linitis plastica(GLP) and to study the usefulness of endoscopic ultrasonography(EUS) for the T and N staging of *** examinations of 55 patients with histologically proven GLP were retrospectively *** all patients,EUS showed that lesions involved at least one-third of the circumference of the *** on the findings of the EUS,the 55 patients were divided into two *** were 32(58.2%) patients in the first *** of this group showed that the five sonographic layers had disappeared and had been replaced by a hypoechogenic thickening of the gastric *** were 23(41.8%) patients in the second *** of this group showed that the first three sonographic layers were blurred and thickened,and the fourth layer was significantly *** full thickness of the gastric wall was significantly thicker in first than in the second group of patients(P<0.01).The incidence of perigastric lesions was significantly higher in the first than in the second group of patients(P<0.01).Results for the 15 patients following preoperative EUS were compared postoperatively with histopathologic findings for T and N *** overall diagnostic accuracy of the T stage was 73.3% and of the N stage was 60.0%.In eight patients,we used EUS to assess a therapeutic *** response was observed in five patients and a partial response in *** images of GLP are *** is helpful in diagnosing GLP and for assessing the T and N stages.

关键词： Gastric linitis plastica Endoscopic ultrasonography Diagnosis Differentiation Follow-up

烧伤患者围手术期焦虑状态评估及其影响因素分析

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解放军医学杂志 2024年第7期49卷 754-760页

作者：任舒婷李萌萌边雅楠徐雯顾国鑫孙雨冉明梓山西医科大学麻醉学院山西太原030000 解放军总医院第四医学中心麻醉科北京100048

目的评估烧伤患者围手术期焦虑状态并分析其影响因素。方法选择2022年2-8月解放军总医院第四医学中心拟在全身麻醉下择期手术的烧伤患者110例,术前1 d及术后1 d对患者进行焦虑自评量表(SAS)、焦虑视觉模拟量表(VAS-a)、疼痛视觉模拟量表... 详细信息

目的评估烧伤患者围手术期焦虑状态并分析其影响因素。方法选择2022年2-8月解放军总医院第四医学中心拟在全身麻醉下择期手术的烧伤患者110例,术前1 d及术后1 d对患者进行焦虑自评量表(SAS)、焦虑视觉模拟量表(VAS-a)、疼痛视觉模拟量表(VAS-p)、简易精神状态检查量表(MMSE)和Ramsay镇静评分评估,并记录入院时(T_(0))、麻醉诱导前(T_(1))、插管后2 min(T_(2))、手术开始后15 min(T_(3))、术中(T_(4))、手术结束(T_(5))和离开手术室即刻(T_(6))的平均动脉压(MAP)和心率(HR),分析烧伤患者围手术期焦虑发生情况,并采用单因素及多因素logistic回归分析烧伤患者围手术期焦虑状态的影响因素。结果烧伤患者术前及术后焦虑发生率为29.1%和22.3%。单因素logistic回归分析结果显示,性别(P=0.002)、烧伤时间(P=0.046)、烧伤面积(P=0.005)、烧伤部位(P=0.035)及术前疼痛程度(P=0.001)与烧伤患者术前焦虑状态有关;烧伤时间(P=0.030)、烧伤面积(P=0.001)、烧伤部位(P=0.016)、术前疼痛程度(P=0.021)及术前焦虑状态(P0.05),但HR均加快(P<0.05),且术中舒芬太尼、瑞芬太尼及丙泊酚用量明显增加(P<0.05)。结论烧伤患者术前焦虑发生率明显高于术后,焦虑患者术中麻醉药物用量增加,但与手术类型、手术次数无关;性别、术前疼痛程度及术前焦虑状态为烧伤患者围手术期焦虑状态的独立影响因素,针对相关因素进行早期干预,有利于患者快速康复。

关键词：烧伤围手术期焦虑疼痛

Recent Significant Tornadoes in China

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Advances in Atmospheric Sciences 2016年第11期33卷 1209-1217页

作者： ming XUE Kun ZHAO mingjung WANG Zhaohui li Yongguang ZHENG Key Laboratory of Mesoscale Severe Weather/Ministry of Education and School of Atmospheric SciencesNanjing University Center for Analysis and Prediction of Storms and School of Meteorology University of Oklahoma Fushan Tornado Research Center Fushan Meteorological Service National Meteorological Center China Meteorological Administration

*** Compared with the United States,whose annual number of tornadoes can exceed 1000,the average number of tornadoes per year in China over the past half a century is estimated to be fewer than 100（Fan and Yu,2015）,... 详细信息

关键词： LST Recent Significant Tornadoes in China

Composites of graphene and encapsulated silicon for practically viable high-performance lithium-ion batteries

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Nano Research 2014年第10期7卷 1429-1438页

作者： Xin Zhao Minjie li Kuo-Hsin Chang Yu-ming lin Bluestone Global Tech 169 Myers Corners Road Wappingers Falls NY 12590 USA

A facile and scalable approach to synthesize silicon composite anodes has been developed by encapsulating Si particles via in situ polymerization and carbonization of phloroglucinol-formaldehyde gel, followed by incorporation of graphene nanoplatelets. As a result of its structural integrity, high packing density and an intimate electrical contact consolidated by the conductive networks, the composite anode yielded excellent electrochemical performance in terms of charge storage capability, cycling life and coulombic efficiency. A half cell achieved reversible capacities of 1,600 mAh·g-1 and 1,000 mAh·g-1 at 0.5 A·g-1 and 2.1 A·g-1, respectively, while retaining more than 70% of the initial capacities over 1,000 cycles. Complete lithium-ion pouch cells coupling the anode with a lithium metal oxide cathode demonstrated excellent cycling performance and energy output, representing significant advance in developing Si-based electrode for practical application in high-performance lithium-ion batteries.

关键词： silicon nanoparticles graphene nanoplatelets phloroglucinol-formaldehyde gel lithium-ion batteries

A new interpretation of the Himalayan or ogenic belt

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Chinese Science Bulletin 1998年第1期43卷 83-84页

作者： Yucheng Chai ming li Zhengwen Wu Jie Hao Jiliang li Department of Earth Sciences National Natural Science Foundation of China Beijing China Institute of Petroleum Exploration and Development China National Petroleum Corporation Beijing China China University of Geosciences Beijing China Institute of Geology Chinese Academy of Sciences Beijing China

Focuses on the interpretation of the Himalayan orogenic belt. Seismic reflection profile of Pali-Kangma; Characterization of the Yarlung Zangbo fault; Existence of culmination structures; Formation of culmination stru... 详细信息

关键词： A new interpretation of the Himalayan or ogenic belt