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In order to compare the setting of difference coefficients in DRG point payment in different cities in Zhejiang province, the implementation rules of DRG point payment issued by 11 cities in Zhejiang province were comprehensively analyzed. It was found that the difference coefficients in different cities could be divided into three categories, including hospital coefficients alone, hospital coefficients and grade coefficients weighted, and weighted by hospital coefficients, grade coefficients, personal burden levels, case mix indexes, and head-to-time ratio. Its setting differences included four aspects: connotation composition, weight distribution, threshold value, and classification of medical institutions. The authors suggested that the adjustment cycle should be set scientifically to dynamically adjust the difference coefficient, and the scientific setting of the difference coefficient should be promoted through provincial coordination.
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One hundred and eighty two outpatients with functional dyspepsia (FD)were enrolled.The cognitive questionnaire and the short form Nepean Dyspepsia Index (NDI) were used for survey.Spearman analysis showed that the cognitions of symptoms affected by emotion (r =0.284,P =0.006),somatisation symptoms induced by other diseases (r =0.211,P =0.045),and fears of cancer (r =0.217,P =0.039) were positively correlated with NDI scores.Multiple linear regression analysis demonstrated that cognition of symptoms affected by emotion (β =3.709,P =0.009),somatisation symptoms induced by other diseases (β =3.259,P =0.020),need of hospitalization (β =4.533,P =0.006),and need of medication for several years (fβ =-3.207,P =0.029) were associated with NDI scores.These results suggest that the quality of life might be effected by cognitive factors,and the correction of cognitive mistakes may improve quality of life of FD patients.
ABSTRACT
Functional dyspepsia( FD)is a common functional gastrointestinal disorder,its pathogenesis has not been fully clarified. Recent studies showed that gastrointestinal mucosal low-grade inflammation had been found in patients with FD,and impaired mucosal integrity,psychological factor and abnormal brain-gut axis may promote the inflammation formation,which may also contribute to the onset and persistence of FD. This article reviewed the advances in study on gastrointestinal mucosal low-grade inflammation in FD.
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Objective To explore somatic symptoms of patients with functional dyspepsia (FD) and effects of combined anti somatisation therapy on the quality of life in patients with FD.Methods Two hundred and nineteen patients with FD were enrolled.Patient Health Questionnaire-15 (PHQ-15) and Nepean Dyspepsia Index (NDI) were completed,and the relation between them was analyzed.Lansoprazole,mosapride and flupentixol melitracen (the anti-somatisation medication) were taken for four weeks by 131 FD patients who had poor response to four-week conventional treatment with proton pump inhibitors (PPI) and/or prokinetic medication and who got more than 4 scores in PHQ 15.And then therapeutic effects were observed and the changes of NDI before and after treatment were analyzed.The t test,chi-square test,Spearman's correlation and linear regression were performed for statistical analysis.Results The total PHQ-15 and NDI score of 219 patients with FD were 5.7±3.4 and 42.0± 10.4,and there was positive correlation between them (r=0.493,P＜0.05).Stomach pain,headache,chest pain,dizziness,shortness of breath,fatigue,sleeping disorder,thirst and so on were positively correlated with totalNDIscore (r=0.262,0.230,0.241,0.243,0.352,0.385,0.266,0.281,all P＜0.05).Chest pain,stomach pain,shortness of breath,dizziness and fatigue were the influence factors of NDI (t=2.340,2.488,5.278,2.167,2.443,all P＜0.05).Among 131 patients with FD who received anti somatisation combination therapy,six patients did not complete the therapy because of the side effects,and finally 125 patients were enrolled and analyzed.Before and four weeks after the treatment,the total PHQ-15 scores of 125 patients with FD were 7.3±3.2 and 2.9±2.2,respectively; and the difference was statistically significant (t =12.653,P＜0.01).There were significant differences in the influence of stomach pain,headache,chest pain,dizziness,shortness of breath,fatigue,sleeping disorder and thirst before and after the treatment (not bothered at all,bothered a little,bothered a lot) (x2=39.231,6.796,6.693,15.520,6.698,51.572,44.390 and 16.506,all P＜0.05).The total NDI score before and after the treatment were 44.3 ± 11.7 and 29.2 ± 6.9,and the difference was statistically significant (t=12.503,P＜0.01).Conclusions The quality of life in patients with FD is affected by somatic symptoms such as chest pain,stomach pain,shortness of breath,dizziness,fatigue and so on.For FD patients with poor response to conventional treatment,the quality of life could be improved by the combination of anti-somatisation therapy and the conventional therapy.
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Objective To evaluate the preventive and therapeutic effects of heparin on dextron sulphate sodium (DSS)-induced colitis in mice. Methods The normal mice (n=16) which had been received DSS orally for 7 days were randomized into two groups, the preventive group with heparin subcutaneous administration, and the control group with normal saline subcutaneous administration. The DSS-induced colitis mice (n=16) were randomized into two groups, the treatment group with heparin and the control group with normal saline subcutaneous injection for 7 days. The preventive and therapeutic effects of heparin were assessed by disease activity index (DAI), histological score, TNF-? mRNA expression using hybridization in situ, and Martius scarlet blue (MSB) fibrin staining used to identify microvascular thrombi. Results Microvascular thrombi in the prevention group significantly decreased compared with those in the controls. Microvascular thrombi were positive in 4 of 8 controls, none in the prevention group (P=0.038). Histological score and TNF-? mRNA in the treatment group significantly decreased compared with those in the controls. Histological score of rectum and transverse colon, and expression of TNF-? mRNA in the treatment group and those in the controls were 1.33 and 1.85(P