The single-layer latticed cylindrical shell is one of the most widely adopted space-fl'amed structures.In this paper,free vibration properties and dynamic response to horizontal and vertical seismic waves of singl...The single-layer latticed cylindrical shell is one of the most widely adopted space-fl'amed structures.In this paper,free vibration properties and dynamic response to horizontal and vertical seismic waves of single-layer latticed cylindrical shells are analyzed by the finite element method using ANSYS software.In the numerical study,where hundreds of cases were analyzed,the parameters considered included rise-span ratio,length-span ratio,surface load and member section size.Moreover,to better define the actual behavior of single-layer latticed shells,the study is focused on the dynamic stress response to both axial forces and bending moments.Based on the numerical results,the effects of the parameters considered on the stresses are discussed and a modified seismic force coefficient method is suggested.In addition,some advice based on these research results is presented to help in the future design of such structures.展开更多
目的探讨疾病诊断相关分组(diagnosis related groups,DRG)和按病种分值付费(diagnosis-intervention packet,DIP)融合下设立医院临床路径的方法,并分析其实际效果。方法选取2021年3月—2023年6月山东第一医科大学第二附属医院收治的阑...目的探讨疾病诊断相关分组(diagnosis related groups,DRG)和按病种分值付费(diagnosis-intervention packet,DIP)融合下设立医院临床路径的方法,并分析其实际效果。方法选取2021年3月—2023年6月山东第一医科大学第二附属医院收治的阑尾炎接受腹腔镜下阑尾切除术者。其中观察组纳入268份病历,对照组纳入270份病历。对照组阑尾炎患者采取临床路径入组,观察组实施DRG与DIP融合下的综合管理路径进行管理,统计2组临床路径入组情况,比较2组次均药物、耗材、总住院费用以及2组住院时间及病种医保结余费用,分析2组时间及费用消耗指数变化情况。结果观察组临床路径入组例数为263例,多于对照组的217例,临床路径完成率为98.13%,高于对照组的80.37%(P<0.05)。观察组次均药物费用、耗材费用及总住院费用均显著低于对照组(P<0.05)。观察组总住院时间低于对照组,病种医保结余费用多于对照组(P<0.05)。观察组时间消耗指数和费用消耗指数均显著低于对照组(P<0.05)。结论DRG与DIP融合下临床路径管理可提高临床路径入组率,降低医疗费用,缩短总住院时间,降低医保支付费用。展开更多
基金National Natural Science Foundation of China,Grant No.59895410
文摘The single-layer latticed cylindrical shell is one of the most widely adopted space-fl'amed structures.In this paper,free vibration properties and dynamic response to horizontal and vertical seismic waves of single-layer latticed cylindrical shells are analyzed by the finite element method using ANSYS software.In the numerical study,where hundreds of cases were analyzed,the parameters considered included rise-span ratio,length-span ratio,surface load and member section size.Moreover,to better define the actual behavior of single-layer latticed shells,the study is focused on the dynamic stress response to both axial forces and bending moments.Based on the numerical results,the effects of the parameters considered on the stresses are discussed and a modified seismic force coefficient method is suggested.In addition,some advice based on these research results is presented to help in the future design of such structures.
文摘目的探讨疾病诊断相关分组(diagnosis related groups,DRG)和按病种分值付费(diagnosis-intervention packet,DIP)融合下设立医院临床路径的方法,并分析其实际效果。方法选取2021年3月—2023年6月山东第一医科大学第二附属医院收治的阑尾炎接受腹腔镜下阑尾切除术者。其中观察组纳入268份病历,对照组纳入270份病历。对照组阑尾炎患者采取临床路径入组,观察组实施DRG与DIP融合下的综合管理路径进行管理,统计2组临床路径入组情况,比较2组次均药物、耗材、总住院费用以及2组住院时间及病种医保结余费用,分析2组时间及费用消耗指数变化情况。结果观察组临床路径入组例数为263例,多于对照组的217例,临床路径完成率为98.13%,高于对照组的80.37%(P<0.05)。观察组次均药物费用、耗材费用及总住院费用均显著低于对照组(P<0.05)。观察组总住院时间低于对照组,病种医保结余费用多于对照组(P<0.05)。观察组时间消耗指数和费用消耗指数均显著低于对照组(P<0.05)。结论DRG与DIP融合下临床路径管理可提高临床路径入组率,降低医疗费用,缩短总住院时间,降低医保支付费用。
