按疾病诊断相关分组(diagnosis related groups,DRG)付费是国际公认较为先进和科学的支付方式之一。实践证明,DRG的引入能够增强医疗服务的可比性,提高医疗服务效率、降低医疗服务成本[1~4]。近年来,国家医保局加快推进医保支付方式改...按疾病诊断相关分组(diagnosis related groups,DRG)付费是国际公认较为先进和科学的支付方式之一。实践证明,DRG的引入能够增强医疗服务的可比性,提高医疗服务效率、降低医疗服务成本[1~4]。近年来,国家医保局加快推进医保支付方式改革。北京市作为国家医疗保障疾病诊断相关分组(China health-care security DRG,CHS-DRG)国家试点城市于2022年3月15日启动66家试点医院的实际付费。展开更多
In tea plants,the abundant flavonoid compounds are responsible for the health benefits for the human body and define the astringent flavor profile.While the downstream mechanisms of flavonoid biosynthesis have been ex...In tea plants,the abundant flavonoid compounds are responsible for the health benefits for the human body and define the astringent flavor profile.While the downstream mechanisms of flavonoid biosynthesis have been extensively studied,the role of chalcone synthase(CHS)in this secondary metabolic process in tea plants remains less clear.In this study,we compared the evolutionary profile of the flavonoid metabolism pathway and discovered that gene duplication of CHS occurred in tea plants.We identified three CsCHS genes,along with a CsCHS-like gene,as potential candidates for further functional investigation.Unlike the CsCHS-like gene,the CsCHS genes effectively restored flavonoid production in Arabidopsis chs-mutants.Additionally,CsCHS transgenic tobacco plants exhibited higher flavonoid compound accumulation compared to their wild-type counterparts.Most notably,our examination of promoter and gene expression levels for the selected CHS genes revealed distinct responses to UV-B stress in tea plants.Our findings suggest that environmental factors such as UV-B exposure could have been the key drivers behind the gene duplication events in CHS.展开更多
目的建立骨科医用耗材一体化管理体系,帮助公立医院更好地适应国家医疗保障疾病诊断相关分组(China Healthcare Security-Diagnosis Related Groups,CHS-DRG)政策落地实施。方法运用系统法、归纳法分析骨科医用耗材的管理难点和风险点,...目的建立骨科医用耗材一体化管理体系,帮助公立医院更好地适应国家医疗保障疾病诊断相关分组(China Healthcare Security-Diagnosis Related Groups,CHS-DRG)政策落地实施。方法运用系统法、归纳法分析骨科医用耗材的管理难点和风险点,探讨骨科耗材的精细化管理举措,通过严格准入管理、建立骨科耗材信息化管理系统、建设骨科耗材二级库,实现耗材信息互联互通,以及高值耗材准入、采购、使用、追溯等各个环节的一体化管理。结果管理体系应用后,提高了医院的管理效率和效果,使得医院骨科医用耗材的管理水平实现了整体提升。医院骨科DRG盈余例数占比逐渐增加,从88.94%提升至91.00%,亏损金额占比从10.02%逐渐降低至6.70%,大部分骨科科室实现了盈余。结论CHS-DRG实施后,对医院的长期运营发展将会产生重要影响。本研究针对骨科医用耗材提出清晰的管理思路和科学的管理方法,能够进行适当推广,帮助大型公立医院的管理者更加科学地进行决策,尤其是在DRG落地的初期,能够帮助医院降低运营成本,减少亏损。展开更多
基金supported by the National Natural Science Foundation of China(U21A20232,32372756,and 32202551).
文摘In tea plants,the abundant flavonoid compounds are responsible for the health benefits for the human body and define the astringent flavor profile.While the downstream mechanisms of flavonoid biosynthesis have been extensively studied,the role of chalcone synthase(CHS)in this secondary metabolic process in tea plants remains less clear.In this study,we compared the evolutionary profile of the flavonoid metabolism pathway and discovered that gene duplication of CHS occurred in tea plants.We identified three CsCHS genes,along with a CsCHS-like gene,as potential candidates for further functional investigation.Unlike the CsCHS-like gene,the CsCHS genes effectively restored flavonoid production in Arabidopsis chs-mutants.Additionally,CsCHS transgenic tobacco plants exhibited higher flavonoid compound accumulation compared to their wild-type counterparts.Most notably,our examination of promoter and gene expression levels for the selected CHS genes revealed distinct responses to UV-B stress in tea plants.Our findings suggest that environmental factors such as UV-B exposure could have been the key drivers behind the gene duplication events in CHS.
文摘目的建立骨科医用耗材一体化管理体系,帮助公立医院更好地适应国家医疗保障疾病诊断相关分组(China Healthcare Security-Diagnosis Related Groups,CHS-DRG)政策落地实施。方法运用系统法、归纳法分析骨科医用耗材的管理难点和风险点,探讨骨科耗材的精细化管理举措,通过严格准入管理、建立骨科耗材信息化管理系统、建设骨科耗材二级库,实现耗材信息互联互通,以及高值耗材准入、采购、使用、追溯等各个环节的一体化管理。结果管理体系应用后,提高了医院的管理效率和效果,使得医院骨科医用耗材的管理水平实现了整体提升。医院骨科DRG盈余例数占比逐渐增加,从88.94%提升至91.00%,亏损金额占比从10.02%逐渐降低至6.70%,大部分骨科科室实现了盈余。结论CHS-DRG实施后,对医院的长期运营发展将会产生重要影响。本研究针对骨科医用耗材提出清晰的管理思路和科学的管理方法,能够进行适当推广,帮助大型公立医院的管理者更加科学地进行决策,尤其是在DRG落地的初期,能够帮助医院降低运营成本,减少亏损。
