ABSTRACT
Objective:To clarify the immediate administration issues faced by hospitals in China in their implementing the diagnosis-related groups(DRG) payment as a reference for the reform.Methods:By using " DRG" , " hospital" , and " administration" as search terms, the authors systematically retrieved literature data from CNKI, Wanfang Data, PubMed, Embase and Web of Science from the establishment of the database to April 30, 2022. Based on such data, administration issues pertaining to the reform process were extracted and built into a co-word matrix. The social network analysis was used to measure the network density and network centrality of these administration issues. The entropy weight-technique for order preference by similarity to ideal solution(TOPSIS) method was used to comprehensively evaluate the indicator results of network centrality indicators.Results:Of the 32 literatures included, 25 issues in hospital administration during the reform of DRG payment method were extracted. As shown in the social network analysis, the network density was 0.717, while the top issues ranking by degree centrality, betweenness centrality and closeness centrality, were inappropriate main diagnosis selection(68, 8.842, 25), imperfect DRG grouping device setting(54, 8.361, 26), imprecise recording of other disease diagnosis and surgical operations(60, 6.885, 26), and poor professional knowledge of medical record managers(54, 6.991, 25). The top four issues as shown in the entropy weight-TOPSIS analysis were inappropriate main diagnosis selection(1.000), imperfect DRG grouping device setting(0.871), imprecise recording of other disease diagnosis and surgical operations(0.803), and poor professional knowledge of medical record managers(0.787).Conclusions:Fill-out errors of medical record homepage, imperfect formulation of DRG grouping plans and poor professional knowledge of medical record manage team, rank the tope administration issues of high priority in implementing the reform of DRG payment methods. It is imperative to strengthen quality control of the medical record homepages, to scientifically formulate the DRG grouping plans, and to improve the construction of medical records professional team, in an effort to the further smooth and orderly implementation of the reform.
ABSTRACT
Objective To investigate the difference of gene expression in the visceral adipose tissue of the lean type 2 diabetic rats. Methods The difference bands were generated by the representational difference analysis ( cDNA RDA) ; the final difference products was ligated into the pUC-18 vector, subcloned and sequenced, and the obtained expressed sequence tags ( ESTs) were given bioinformatics analysis, and then the expression level of known gene was verified by semi-quantitative RT-PCR preliminarily. Results Six novel ESTs and 1 known gene [ rat lipoprotein lipase ( LPL) gene) were obtained in visceral adipose tissue of rat. One of the ESTs was partially similar to mouse musculus ERA-like GTPase (Era) gene. LPL gene was up-regulated in the visceral adipose tissue of the lean type 2 diabetic rats and those fed with fat-enriched food. Conclusion Six novel ESTs and 1 known gene in high expression are obtained from visceral adipose tissue of rat. LPL gene among them is up-regulated and may be related to the high fat and high calorie diet, hyperlipidemia, insulin resistance and molecular pathogenesis of the lean type 2 diabetic rat.