目的通过对南平市某二甲医院歧义病案产生的原因分析,提高疾病诊断相关分组(diagnosis related groups,DRGs)的正确入组率。方法回顾性调查2023年1—4月南平市某二甲医院7675份病案,依据国际疾病分类(international classification of d...目的通过对南平市某二甲医院歧义病案产生的原因分析,提高疾病诊断相关分组(diagnosis related groups,DRGs)的正确入组率。方法回顾性调查2023年1—4月南平市某二甲医院7675份病案,依据国际疾病分类(international classification of diseases,ICD-10)和手术操作分类(international classification of diseases clinical modificationof9threvisionoperationsandprocedures,ICD-9-CM-3)的编码规则以及国家医疗保障疾病诊断相关分组(China healthcare security diagnosis related groups,CHS-DRG)细分组方案(1.1版),分析歧义病案产生的影响因素。结果7675份住院病案首页参与分组病案6923份,共有异常分组病案205份,其中空白病组病案3份;歧义病案202份,占分组病案的2.92%。产生歧义病案的主要因素有:主要诊断选择错误、主要手术选择有误、主要手术与主要诊断不在同一主要诊断大类(major diagnostic category,MDC)、同次住院多疾病共治等。结论针对歧义病案产生的主要原因应加强临床医师和编码员住院病案首页填报和DRG相关知识的培训,做好病案首页质量事前控制工作,提高病案正确入组率。展开更多
Nitrate(NO_(3)^(-))and ammonium(NH_(4)^(+))are two main inorganic nitrogen(N)sources during crop growth.Here,we enhanced the expression of OsAMT1.1,which encodes a NH_(4)^(+)transporter,using the NO_(3)^(-)-inducible ...Nitrate(NO_(3)^(-))and ammonium(NH_(4)^(+))are two main inorganic nitrogen(N)sources during crop growth.Here,we enhanced the expression of OsAMT1.1,which encodes a NH_(4)^(+)transporter,using the NO_(3)^(-)-inducible promoter of OsNAR2.1 and an ubiquitin promoter in transgenic rice plants.Under field condition of 120 kg/hm2 N,agronomic N use efficiency,N recovery efficiency and N transport efficiency,and grain yield of the pOsNAR2.1:OsAMT1.1 transgenic lines were increased compared with those of the wild type(WT)and the pUbi:OsAMT1.1 transgenic plants.Under 2.0 mmol/L NO_(3)^(-)+0.5 mmol/L NH_(4)^(+)and 0.5 mmol/L NO_(3)^(-)+2.0 mmol/L NH_(4)^(+)conditions of hydroponic culture,compared with the WT,both biomass and total N content were increased in the pOsNAR2.1:OsAMT1.1 transgenic lines.However,biomass was significantly reduced in pUbi:OsAMT1.1 transgenic plants under 0.5 mmol/L NO_(3)^(-)+2.0 mmol/L NH_(4)^(+)condition.The lines expressing pOsNAR2.1:OsAMT1.1 exhibited increased OsAMT1.1 expression and 15NH_(4)^(+)influx in roots under both 2.0 mmol/L NO_(3)^(-)+0.5 mmol/L NH_(4)^(+)and 0.5 mmol/L NO_(3)^(-)+2.0 mmol/L NH_(4)^(+)conditions.Our study showed that expression of OsAMT1.1 can be promoted when driven by the OsNAR2.1 promoter,especially under high-level nitrate condition,leading to enhancement of NH_(4)^(+)uptake,N use efficiency and grain yield.展开更多
文摘目的通过对南平市某二甲医院歧义病案产生的原因分析,提高疾病诊断相关分组(diagnosis related groups,DRGs)的正确入组率。方法回顾性调查2023年1—4月南平市某二甲医院7675份病案,依据国际疾病分类(international classification of diseases,ICD-10)和手术操作分类(international classification of diseases clinical modificationof9threvisionoperationsandprocedures,ICD-9-CM-3)的编码规则以及国家医疗保障疾病诊断相关分组(China healthcare security diagnosis related groups,CHS-DRG)细分组方案(1.1版),分析歧义病案产生的影响因素。结果7675份住院病案首页参与分组病案6923份,共有异常分组病案205份,其中空白病组病案3份;歧义病案202份,占分组病案的2.92%。产生歧义病案的主要因素有:主要诊断选择错误、主要手术选择有误、主要手术与主要诊断不在同一主要诊断大类(major diagnostic category,MDC)、同次住院多疾病共治等。结论针对歧义病案产生的主要原因应加强临床医师和编码员住院病案首页填报和DRG相关知识的培训,做好病案首页质量事前控制工作,提高病案正确入组率。
基金financially supported by the National Natural Science Foundation of China(Grant No.32061143039)Guangdong Basic and Applied Basic Research Foundation,China(Grant No.2022A1515012381)+1 种基金Shenzhen Science and Technology Program,China(Grant No.JCYJ20210324124409027)the Fundamental Research Funds for the Central Universities,Sun Yat-sen University,China.
文摘Nitrate(NO_(3)^(-))and ammonium(NH_(4)^(+))are two main inorganic nitrogen(N)sources during crop growth.Here,we enhanced the expression of OsAMT1.1,which encodes a NH_(4)^(+)transporter,using the NO_(3)^(-)-inducible promoter of OsNAR2.1 and an ubiquitin promoter in transgenic rice plants.Under field condition of 120 kg/hm2 N,agronomic N use efficiency,N recovery efficiency and N transport efficiency,and grain yield of the pOsNAR2.1:OsAMT1.1 transgenic lines were increased compared with those of the wild type(WT)and the pUbi:OsAMT1.1 transgenic plants.Under 2.0 mmol/L NO_(3)^(-)+0.5 mmol/L NH_(4)^(+)and 0.5 mmol/L NO_(3)^(-)+2.0 mmol/L NH_(4)^(+)conditions of hydroponic culture,compared with the WT,both biomass and total N content were increased in the pOsNAR2.1:OsAMT1.1 transgenic lines.However,biomass was significantly reduced in pUbi:OsAMT1.1 transgenic plants under 0.5 mmol/L NO_(3)^(-)+2.0 mmol/L NH_(4)^(+)condition.The lines expressing pOsNAR2.1:OsAMT1.1 exhibited increased OsAMT1.1 expression and 15NH_(4)^(+)influx in roots under both 2.0 mmol/L NO_(3)^(-)+0.5 mmol/L NH_(4)^(+)and 0.5 mmol/L NO_(3)^(-)+2.0 mmol/L NH_(4)^(+)conditions.Our study showed that expression of OsAMT1.1 can be promoted when driven by the OsNAR2.1 promoter,especially under high-level nitrate condition,leading to enhancement of NH_(4)^(+)uptake,N use efficiency and grain yield.
