Cost analysis of radical resection of malignant breast tumors under the China Healthcare Security Diagnosis Related Groups payment system

BACKGROUND Breast cancer is one of the most common malignant tumors in women worldwide and poses a severe threat to their health.Therefore,this study examined patients who underwent breast cancer surgery,analyzed hospitalization costs and structure,and explored the impact of China Healthcare Security Diagnosis Related Groups(CHS-DRG)management on patient costs.It aimed to provide medical institutions with ways to reduce costs,optimize cost structures,reduce patient burden,and improve service efficiency.AIM To study the CHS-DRG payment system’s impact on breast cancer surgery costs.METHODS Using the CHS-DRG(version 1.1)grouping criteria,4073 patients,who underwent the radical resection of breast malignant tumors from January to December 2023,were included in the JA29 group;1028 patients were part of the CHS-DRG payment system,unlike the rest.Through an independent sample t-test,the length of hospital stay as well as total hospitalization,medicine and consumables,medical,nursing,medical technology,and management expenses were compared.Pearson’s correlation coefficient was used to test the cost correlation.RESULTS In terms of hospitalization expenses,patients in the CHS-DRG payment group had lower medical,nursing,and management expenses than those in the diagnosis-related group(DRG)non-payment group.For patients in the DRG payment group,the factors affecting the total hospitalization cost,in descending order of relevance,were medicine and consumable costs,consumable costs,medicine costs,medical costs,medical technology costs,management costs,nursing costs,and length of hospital stay.For patients in the DRG nonpayment group,the factors affecting the total hospitalization expenses in descending order of relevance were medicines and consumable expenses,consumable expenses,medical technology expenses,the cost of medicines,medical expenses,nursing expenses,length of hospital stay,and management expenses.CONCLUSION The CHS-DRG system can help control and reduce unnecessary medical expenses by controlling medicine costs,medical consumable costs,and the length of hospital stay while ensuring medical safety.

China-Japan Security Relations and China＇s Countermeasures

Security relations are crucial in China-Japan relations. Since the"nationalization"of the Diaoyu Islands by Japan in 2012, mutual trust between China and Japan has been declining, and bilateral security relations have reached a low point. China-Japan security relations are typified by ongoing dispute over the Diaoyu Islands, lack of mutual trust exacerbated by various actions by Japan, and the delay of China-Japan security dialogues. The evolution of China-Japan security relations derived from the Diaoyu Islands dispute is clearly beyond the scope of the dispute itself, with deep-rooted internal and external factors. In the near future,China-Japan security relations will face more challenges than opportunities. China should take measures, including enhancing mutual trust in politics and security between the two countries, to impose necessary pressure on Japan to change course, to win over neighboring countries so as to avoid pretext for Japan's intervention in regional issues,and to strengthen interpersonal communication and understanding between people of the two countries in order to stabilize security relations.

A Novel Database Watermarking Technique Using Blockchain as Trusted Third Party

With widespread use of relational database in various real-life applications,maintaining integrity and providing copyright protection is gaining keen interest of the researchers.For this purpose,watermarking has been used for quite a long time.Watermarking requires the role of trusted third party and a mechanism to extract digital signatures(watermark)to prove the ownership of the data under dispute.This is often inefficient as lots of processing is required.Moreover,certain malicious attacks,like additive attacks,can give rise to a situation when more than one parties can claim the ownership of the same data by inserting and detecting their own set of watermarks from the same data.To solve this problem,we propose to use blockchain technology—as trusted third party—along with watermarking for providing a means of rights protection of relational databases.Using blockchain for writing the copyright information alongside watermarking helps to secure the watermark as changing the blockchain is very difficult.This way,we combined the resilience of our watermarking scheme and the strength of blockchain technology—for protecting the digital rights information from alteration—to design and implement a robust scheme for digital right protection of relational databases.Moreover,we also discuss how the proposed scheme can also be used for version control.The proposed technique works with nonnumeric features of relational database and does not target only selected tuple or portion(subset)from the database for watermark embedding unlike most of the existing techniques;as a result,the chances of subset selection containing no watermark decrease automatically.The proposed technique employs zerowatermarking approach and hence no intentional error(watermark)is added to the original dataset.The results of the experiments proved the effectiveness of the proposed scheme.