目的利用疾病诊断相关分组(diagnosis related group,DRG)数据,分析大型公立医院重点科室病组结构及变化趋势,探究科室病组干预及优化重点,进而推动科室资源合理统筹。方法回顾性收集北京市某大型公立医院2个外科科室2017—2023年的DRG...目的利用疾病诊断相关分组(diagnosis related group,DRG)数据,分析大型公立医院重点科室病组结构及变化趋势,探究科室病组干预及优化重点,进而推动科室资源合理统筹。方法回顾性收集北京市某大型公立医院2个外科科室2017—2023年的DRG数据。在2个外科科室病例组合指数(case mix index,CMI)出现下降时,均及时采用绩效考核、科室宣教、院内公示等方式进行干预,观察CMI值变化,并分析其病组权重、时间消耗指数、费用消耗指数、低风险组死亡率等变化趋势。结果干预后,外科一权重较低的病组,如甲状腺大手术(KD1)收治比例明显降低,权重较高的病组,如结直肠恶性肿瘤手术(GB2)、胰腺恶性肿瘤手术(HB1)收治比例明显增加;外科二权重较低的病组,如化疗(RE1)收治比例明显降低,权重较高的病组,如肾、输尿管及膀胱恶性肿瘤的大手术(LA1)、肾上腺手术(KC1)、除恶性肿瘤大手术外的肾/输尿管/膀胱手术(LB1)、男性生殖器官恶性肿瘤手术(MA1)收治比例明显增加,2个科室均实现了CMI值上升的目标。从效率、费用、质量指标看,2个科室的时间消耗指数与费用消耗指数均显著低于1,低风险组死亡率均为0。结论大型公立医院立足实际、结合发展目标,通过合理干预,可实现CMI值提升与病组结构优化,提高医疗效率和资源合理利用。展开更多
文章提出一种基于变量强制配置表的控制器多变量强制方法,在分散控制系统(Distributed Control System,DCS)逻辑组态调试的过程中得以应用。该方法由上位机的组态工具生成变量强制配置表,并将其下发给控制器。控制器解析收到的配置表,...文章提出一种基于变量强制配置表的控制器多变量强制方法,在分散控制系统(Distributed Control System,DCS)逻辑组态调试的过程中得以应用。该方法由上位机的组态工具生成变量强制配置表,并将其下发给控制器。控制器解析收到的配置表,并在周期任务运算过程中生效。该方法无需对控制器内所有测点进行强制属性标记,减少了对内存空间的消耗,提高了控制器运行的稳定性,提升了低成本控制器的实际应用价值。展开更多
The surface solar radiation in most parts of the world has undergone a phenomenon known as global dimming and brightening,characterized by an initial decrease followed by an increase.As a result,the sunshine duration(...The surface solar radiation in most parts of the world has undergone a phenomenon known as global dimming and brightening,characterized by an initial decrease followed by an increase.As a result,the sunshine duration(SD)has decreased in the past 60 years.Against the backdrop of global dimming and brightening,SD has decreased to varying degrees in many regions of China.Using the observed data of SD,cloud amount(total cloud amount and low cloud amount,abbreviated as TCA and LCA),precipitation,and relative humidity(RH)from 34 meteorological stations in Chongqing during the period of 1961-2020,along with a digital elevation model(DEM)with a resolution of 90 m,this study analyzed the spatiotemporal variations and influencing factors of SD.The analysis employed methods such as linear regression,Mann-Kendall test,wavelet transformation,and DEM-based possible SD distributed model.The results showed that the annual SD in Chongqing has significantly decreased over the last 60 years,with a decreasing interannual trend rate(ITR)of 40.4 h/10a.Except for no obvious trend in spring,SD decreased significantly in summer,autumn and winter at the ITR of 21.1 h/10a,8.5 h/10a and 7.5 h/10a,respectively.An abrupt decrease in the annual SD was found in 1979.The difference before and after the abrupt decrease was 177.7 h.The difference before and after the abrupt decrease was 177.7 h.The annual SD possessed the oscillation period of 11a.The spatial heterogeneity of the mean annual SD during the last 60 years was obvious.The distribution of SD in Chongqing is high in the northeast and low in the southeast.In addition,about 73%of the total area in Chongqing showed a significant and very significant decreasing trend.The regions with significant changes are mainly concentrated in the regions with altitudes of 200~1000 m.The increasing LCA was the main cause of the decrease of the annual SD in the regions with 200-400 m altitude decreased the most and changed the most.Increasing LCA is the primary cause of the reduction in annual SD,showing a strong negative correlation coefficient of-0.7292.In Chongqing,PM2.5 concentration showed a significant decrease trend in annual,spring,autumn and winter during 2000-2020,but the significant correlation between PM2.5 concentration and SD was only in autumn and reached an extremely significant level.展开更多
文摘目的利用疾病诊断相关分组(diagnosis related group,DRG)数据,分析大型公立医院重点科室病组结构及变化趋势,探究科室病组干预及优化重点,进而推动科室资源合理统筹。方法回顾性收集北京市某大型公立医院2个外科科室2017—2023年的DRG数据。在2个外科科室病例组合指数(case mix index,CMI)出现下降时,均及时采用绩效考核、科室宣教、院内公示等方式进行干预,观察CMI值变化,并分析其病组权重、时间消耗指数、费用消耗指数、低风险组死亡率等变化趋势。结果干预后,外科一权重较低的病组,如甲状腺大手术(KD1)收治比例明显降低,权重较高的病组,如结直肠恶性肿瘤手术(GB2)、胰腺恶性肿瘤手术(HB1)收治比例明显增加;外科二权重较低的病组,如化疗(RE1)收治比例明显降低,权重较高的病组,如肾、输尿管及膀胱恶性肿瘤的大手术(LA1)、肾上腺手术(KC1)、除恶性肿瘤大手术外的肾/输尿管/膀胱手术(LB1)、男性生殖器官恶性肿瘤手术(MA1)收治比例明显增加,2个科室均实现了CMI值上升的目标。从效率、费用、质量指标看,2个科室的时间消耗指数与费用消耗指数均显著低于1,低风险组死亡率均为0。结论大型公立医院立足实际、结合发展目标,通过合理干预,可实现CMI值提升与病组结构优化,提高医疗效率和资源合理利用。
文摘文章提出一种基于变量强制配置表的控制器多变量强制方法,在分散控制系统(Distributed Control System,DCS)逻辑组态调试的过程中得以应用。该方法由上位机的组态工具生成变量强制配置表,并将其下发给控制器。控制器解析收到的配置表,并在周期任务运算过程中生效。该方法无需对控制器内所有测点进行强制属性标记,减少了对内存空间的消耗,提高了控制器运行的稳定性,提升了低成本控制器的实际应用价值。
基金the National Key R&D Program(Grant No.2019YFE0115200)Natural Science Foundation of China(Grants No.42071217).
文摘The surface solar radiation in most parts of the world has undergone a phenomenon known as global dimming and brightening,characterized by an initial decrease followed by an increase.As a result,the sunshine duration(SD)has decreased in the past 60 years.Against the backdrop of global dimming and brightening,SD has decreased to varying degrees in many regions of China.Using the observed data of SD,cloud amount(total cloud amount and low cloud amount,abbreviated as TCA and LCA),precipitation,and relative humidity(RH)from 34 meteorological stations in Chongqing during the period of 1961-2020,along with a digital elevation model(DEM)with a resolution of 90 m,this study analyzed the spatiotemporal variations and influencing factors of SD.The analysis employed methods such as linear regression,Mann-Kendall test,wavelet transformation,and DEM-based possible SD distributed model.The results showed that the annual SD in Chongqing has significantly decreased over the last 60 years,with a decreasing interannual trend rate(ITR)of 40.4 h/10a.Except for no obvious trend in spring,SD decreased significantly in summer,autumn and winter at the ITR of 21.1 h/10a,8.5 h/10a and 7.5 h/10a,respectively.An abrupt decrease in the annual SD was found in 1979.The difference before and after the abrupt decrease was 177.7 h.The difference before and after the abrupt decrease was 177.7 h.The annual SD possessed the oscillation period of 11a.The spatial heterogeneity of the mean annual SD during the last 60 years was obvious.The distribution of SD in Chongqing is high in the northeast and low in the southeast.In addition,about 73%of the total area in Chongqing showed a significant and very significant decreasing trend.The regions with significant changes are mainly concentrated in the regions with altitudes of 200~1000 m.The increasing LCA was the main cause of the decrease of the annual SD in the regions with 200-400 m altitude decreased the most and changed the most.Increasing LCA is the primary cause of the reduction in annual SD,showing a strong negative correlation coefficient of-0.7292.In Chongqing,PM2.5 concentration showed a significant decrease trend in annual,spring,autumn and winter during 2000-2020,but the significant correlation between PM2.5 concentration and SD was only in autumn and reached an extremely significant level.
