Optimized pathways for operations management in public hospitals under the DIP payment system / 现代医院

As the comprehensive reform of public hospitals enters a more challenging phase,the conventional extensive operation management no longer fulfills the requirements of high-quality development.This article investigates the current challen-ges in hospital operation management under the DIP payment system,proposes an optimized pathway as well as an outline for practical implementation.The proposed pathway suggests implementing a closed-loop resource allocation strategy integrating budg-et and performance based on disease groups and scores,establishing a cost management mechanism for enhancing resource effi-ciency,and development of a performance distribution system for stimulating self-management motivation among personnel.Addi-tionally,the article suggests the establishment of a Management Information System,aiming to provide practical references for en-hancing operational management capabilities in public hospitals under the DIP payment mode.

Exploration of diagnosis-intervention packet cost analysis and refined management based on hospital intelligent agents / 中华医院管理杂志

Objective:To analyze the cost of diagnosis-intervention packet(DIP) in a certain hospital in 2021 based on hospital intelligent agents, so as to provide feasible ideas for refined management of DIP costs.Methods:On the basis of the construction of the hospital intelligent agent platform and the results of project cost accounting in the early stage, a total of 60 187 cases and 4 860 DIP diseases in the hospital in 2021 were selected as the research objects. The project superposition method was applied to calculate the unit cost of all DIP diseases in the hospital. Based on the results of DIP cost accounting, the ideas and methods of fine management of DIP costs were explored from the perspectives of DIP disease classification, management of all hospital diseases and medical insurance diseases, vertical and horizontal comparative analysis of DIP costs, and management of medical insurance cases and non medical insurance cases under the same DIP disease category.Results:Twenty-two advantageous DIP disease types, 67 key disease types, 1 590 potential disease types, and 3 181 disadvantageous disease types were identified. Introducing medical income as an intermediate indicator facilitated the classification of DIP disease types under medical insurance, 1 072 advantageous disease types, 917 key disease types, 458 potential disease types, and 815 disadvantageous disease types in medical insurance were identified. Through refined accounting, it was found that the average cost of non medical insurance cases under the same DIP disease category was generally higher than that of medical insurance cases, and there were differences in DIP costs at different levels during different time periods.Conclusions:By determining and analyzing the advantages and disadvantages of disease types in the entire hospital, common problems of disease types under the same category can be identified, and targeted control measures can be proposed. By analyzing the two dimensions of medical insurance surplus and medical surplus, the advantages and disadvantages of medical insurance diseases can be quickly determined, providing a lever for the control of medical insurance diseases. The horizontal and vertical comparative analysis of DIP costs, as well as the analysis of medical insurance cases and non medical insurance cases under the same DIP disease category, can provide feasible methods for hospitals to manage DIP costs at multiple levels and dimensions.

Analysis of influencing factors of medical insurance fund settlement in neonatology under DIP payment method / 中国卫生政策研究

Objective:To analyze the DIP medical insurance settlement situation of neonatology and its influencing factors,to optimize the medical insurance settlement rules of neonatology,and to promote the fine management of payment method reform.Methods:City Y,the pilot city of national DIP payment method,was selected as the case area,and the data of the whole sample of patients in neonatology department of City Y were analyzed by descriptive analysis,four-quadrant bubble chart,and multivariate linear regression methods,combined with qualitative data analysis and interview study.Results:There were 1 372 neonates in City Y in 2022,with a health insurance billing rate of 84.82%and 81.10%in tertiary care facilities.There were 718 unenrolled cases.Tertiary care institutions,not enrolled,low-birth-weight babies,higher days of hospitalization,lower days of birth,and lower settlement scores were the influencing factors for the low rate of health insurance settlement in neonatology(P<0.05).Conclusion:Neonatology medical insurance settlement rate was significantly lower than that of the city,and tertiary care institutions had higher deficits,which may lead to the risk of shirking critically ill neonatal patients.There were problems of insufficient grouping refinement and score distortion in neonatology.Recommendation:We should improve the management and adjustment mechanism of core elements,optimize the DIP grouping of neonatology,comprehensively consider the resource consumption characteristics of neonates,rationally and dynamically adjust the price of neonatal medical services,and scientifically set the neonatology markup coefficients,so as to achieve synergistic improvement in the development of neonatology and health insurance,and to push forward the connotative and refined development of the reform of the payment method of health insurance.

Study on Impact of Diagnosis-Intervention Packet Reform on the Quality of Healthcare / 中国医院管理

Objective To analyze the change of healthcare quality after the Diagnosis-Intervention Packet(DIP)payment system reform and provide evidence for improving payment system reform in China.Methods It collected discharge records of hospitalized patients with employee basic medical insurance scheme in first DIP pilot hospitals of a city from July 2017 to June 2021.It included three death-related measures and two readmission-related mea-sures,which were all risk-adjusted considering the patient mix.It used t test to compare their differences before and after the DIP reform in July 2019.Results After the risk-adjustment,mortality rate of surgical patients,mortality rate of patients in low-risk DIP groups,all-cause readmission rate within 30 days after discharge and readmission rate with the same principal diagnosis within 30 days after discharge declined 0.06 percentage points(P=0.031),0.15 percentage points(P=0.001),0.47 percentage points(P＜0.001)and 0.72 percentage points(P＜0.001),respectively.Conclusion No current evidences indicated negative impacts of the DIP payment reform on the quality of healthcare in the city.Case-based payment pilot cities should closely monitor the change of healthcare quality after the reform.

The Therapeutic Effect on Finger Arthralgia by Keishikajutsubuto / 日本東洋医学雑誌

There are many reports that keisikajutsubuto is effective against inflammation of finger and wrist joints, such as from snapping the fingers or scleroderma. We prescribed keisikajutsubuto for 16 orthopedic outpatients with DIP joint arthralgia and pain (Heberden nodes) on the basis of this information. The 16 cases were all women, and the age ranged from 57 to 80 years with an average of 63.4 years. The disease period ranged from 6 months to 15 years with an average of 4 years and 6 months. Eleven cases were diagnosed with deficiency pattern indicating a weak constitution and poor circulation, and 5 cases were medium pattern. Seven of the 16 patients were thin with a BMI of 20 or less. In 4 cases the inflammation of a tendon sheath on the finger was complicated. It took 3 months (from 2 to 8 months) for joint pain to be reduced. Eight patients continued taking 2.5 g of keisikajutsubuto afterwards. The joint deformity was not worse in any case. In all patients, the pain completely disappeared, or partial recovery was obtained. In addition, the local feeling of heat in the joints disappeared in all cases. Keishikajutsubuto was an effective Kampo medicine against finger joint arthritis.

Hydroxyapatite Synthesis and Covering of Titanium Surfaces by Dip-Coating Method

Abstract This study developed and characterized a method for controlled deposition of thin films of hydroxyapatite on titanium surfaces. Thirty-three titanium cylinders were randomly divided: negative control/polished (A), acid etched (B) and coated by hydroxyapatite (C). Acid etch was performed in an aqueous solution of nitric acid. The cylinders were subjected to coating by a thin film of hydroxyapatite with dip-coating method. These cylinders were submitted to a pre-heat treatment 450°C/10 minutes and 800°C/2 hours. Scanning electron microscopy analysis demonstrated a homogeneous and smooth surface (A), an irregular and porous surface (B) and a crystalline deposition (C). The X-ray energy dispersive analysis showed characteristic elements of hydroxyapatite (C). Analysis by X-ray diffraction showed the presence of characteristic peaks of hydroxyapatite, corresponding to the structural composition of hydroxyapatite. Cell viability (MTT-assay in NIH-3T3-Cells) test demonstrated no differences between the groups. Titanium surfaces coated with a hydroxyapatite film by the dip-coating method suggest adequate control of deposition of thin films of hydroxyapatite and similar cell viability using mouse fibroblasts.

Monitorización ambulatoria de presión arterial (MAPA): recomendaciones de la rama de nefrología pediátrica / Ambulatory blood pressure monitoring (ABPM): statement from chilean pediatric nephrology committee

Resumen: La monitorización ambulatoria de la presión arterial (MAPA) es una herramienta clínica útil para el diagnóstico y confirmación de hipertensión arterial en pediatría y permite igualmente el diagnóstico de condiciones especiales como la hipertensión de delantal blanco e hipertensión enmascarada. Exis ten recomendaciones internacionales para su realización e interpretación, sin embargo, aún quedan interrogantes por resolver. En esta guía se resume la bibliografía disponible y se intenta estandarizar, a través de consenso de especialistas nacionales, la aplicación de esta técnica. Se necesitan más estudios de investigación en niños que aporten nuevos valores de referencia y que determinen la relación de alteraciones en MAPA con resultados clínicos a largo plazo.

Abstract: Ambulatory blood pressure monitoring (ABPM) is a useful clinical tool for the diagnosis and confir mation of arterial hypertension in pediatrics, and also allows the diagnosis of special conditions such as white coat hypertension and masked hypertension. There are international recommendations for its implementation and interpretation, however, there are still unresolved questions. This guide summarizes the available literature and attempts to standardize, through consensus of national specia lists, the application of this technique. More research studies are needed that provide new reference values and determine the relationship of alterations in ABPM with long-term clinical results.

24-hour Ambulatory Blood Pressure in Normal Tension Glaucoma: Associations with Retinal Vessel Diameter and Visual Field Defect Progression

PURPOSE: To investigate the correlation between 24-hour ambulatory blood pressure (BP) monitoring and peripapillary retinal vessel width and visual field (VF) defect progression in normal tension glaucoma (NTG) patients. METHODS: All patients were classified by 24-hour ambulatory BP monitoring as non-dipper (nocturnal dip < 10%) and dipper (nocturnal dip ≥ 10%) group. Vessel diameter, mean deviation (MD) value by VF test and VF progression from Glaucoma Progression Analysis (GPA) were compared among non-dipper and dipper groups. RESULTS: Retinal arterial diameter was wider in the non-dipper group compared to the dipper group (p = 0.015), while retinal venous diameter had no significant relationship between the two groups (p = 0.131). The MD value at baseline and 2 years after was worse in the non-dipper group than the dipper group, respectively (p = 0.006, p = 0.030). But, there was no significant relationship between nocturnal dip and GPA progression (p = 0.658). CONCLUSIONS: There was a statistically significant correlation between nocturnal dips and retinal arterial diameter and MD values. These results suggest that non-invasive fundus photography can predict hemodynamic features like nocturnal dip.

Effect of DIP endoscopic marking scheme in evaluation of patients with chronic sinusitis endoscopic surgery / 中国基层医药

Objective To explore the effect of DIP endoscopic marking scheme in evaluation of patients with chronic sinusitis endoscopic surgery.Methods 96 patients with chronic sinusitis were chosen from July 2013 to September 2014.According to the random nmuber method,the patients were divided into observation group and control group,48 cases in each group.All patients were gvien Messerklinger surgery for chronic sinusitis endoscopic surgery. Preoperation and postoperative 3 months,the lateral nasal videos were recorded,the observation group DIP video was used in patients with endoscopic rating marking scheme,the control group patients were given the Land -Mackay CT rating marking scheme,and analyzed the grading results.At the same time,the treatment for each patient to be efficient and the correlation of two grades were studies.Results Before operation,Land -Mackay CT scoring and DIP endoscopic score showed positive correlation (r =0.937,P <0.05 ).3 months after operation,Land -Mackay CT score and DIP endoscopic score also showed a positive correlation (r =0.546,P <0.05).The grading of the observa-tion group and control group in preoperative surgery showed significantly lower,the difference was statistically signifi-cant (r =0.435,P <0.05).The effective rate of the observation group was 91.67%,which was obviously higher than 72.92% of the control group (χ2 =13.935,P <0.05).Conclusion DIP endoscopic marking scheme in patients with chronic sinusitis endoscopic surgery has a better evaluation result.

Asymptomatic Bacteriuriain Pregnant Women: Screening Bya Simple Method and Treatment with Single Dose Antimicrobial Therapy

The term asymptomatic bacteriuria in pregnancy indicates persistent actively multiplying bacteria within the urinary tract without showing any symptom in pregnancy. A total of 500 pregnant women were screened for the incidence of asymptomatic bacteriuria by comparing the reliability of urine dip stick evaluation for nitrites and leukocyte esterase activity with that of urine culture in diagnosing asymptomaticbacteriuria. The efficacy of single dose antimicrobial therapy (2 g of Cephalexin or 3 g of Amoxycillin) was evaluated for eradicating asymptomatic bacteriuria. The incidence was found to be 9.2% among the 500 cases in the study group. The dip stick screening could detect the bacteriuric patients correctly in 89.1% of cases. Single dose therapy cured 76.1% of asymptomatic bacteriuria patients. Amoxycillin was found to be more effective when compared to Cephalexin as a single dose antimicrobial therapy.

The Relationships among Delayed Recovery in Finger Temperature, Nocturnal Dip, and Glaucoma Progression

PURPOSE: To investigate the effects of a delay in finger temperature recovery rate on the hand cold provocation test (HCPT) and a nocturnal dip greater than 10% (dipper) on the progression of glaucomatous visual field (VF) defects in open-angle glaucoma patients when the intraocular pressure (IOP) was well controlled lower than the target pressure. METHODS: 30 patients (58 eyes) with normal tension glaucoma (NTG) and 13 patients (24 eyes) with primary open angle glaucoma, and 12 normal controls (24 eyes) were retrospectively enrolled in this study. We performed HCPT, 24 hour ambulatory blood pressure monitoring (24-hr ABPM), Goldmann applanation tonometer measurements, and VF tests on all subjects. The delay in finger temperature recovery rate was defined as a delay longer than 15% of the mean finger temperature of normal controls over 2 intervals among 5, 10, 15, and 20 minutes after the immersion of cold water. We examined the relationships among the delay in finger temperature recovery rate, dipper, and the progression of glaucomatous VF defects. RESULTS: The finger temperature recovery rate in NTG patients was significantly delayed more than that of normal controls at 5, 10, and 15 minutes after the immersion. The delay in finger temperature recovery rate significantly correlated with dipper in NTG patients. Glaucomatous VF defects were significantly progressed in the presence of dipper in NTG patients. Delay in finger temperature recovery rate was significantly related to the progression of glaucomatous VF defects in NTG patients. In the binary logistic regression test, delay in finger temperature recovery rate was the only factor that was strongly related to the progression of glaucomatous visual field in NTG patients. CONCLUSIONS: When glaucomatous VF defects progressed despite the IOP being well controlled, 24-hr ABPM and HCPT for detecting vascular dysregulation might be helpful for diagnosis and treatment of glaucoma.

Advances in recombinase polymerase amplification / 军事医学

Recombinase polymerase amplification (RPA) is a novel isothermal DNA amplification technology first re-ported in 2006 by Piepenburg et al.This technology has been shown to typically work at temperatures ranging from 25 to 43℃and can detect products within 5-20 min.RPA technology requires little instrumentation for the nucleic acid amplifi-cation reaction and can be performed not only in PCR tubes , but also in simple devices′such as paper .Combined with probe-based detection methods or lateral flow dipstick assay , it can perform quantitative or visual detection respectively . RPA is a technology that is potentially ideal for point-of-care diagnosis and disease prevention and control ,characterized by high sensitivity, high efficiency, high specificity and user-friendliness.This paper introduces the advantages and develop-ment of RPA technology in reaction conditions and product detection ,summarizes the current applications of this technolo-gy,and predicts the trend of application of RPA technology in point-of-care diagnosis and disease prevention and control .

Analysis of Choroidal Thickness Measured Using RTVue and Associated Factors in Open-Angle Glaucoma

PURPOSE: To compare the macular choroidal thickness, ganglion cell complex thickness, peripapillary choroidal thickness and retinal nerve fiber layer thickness among normal, primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) patients using RTVue (Fourier-domain optical coherence tomography; Optovue, Fremont, CA, USA). METHODS: A retrospective analysis of 32 normal controls, 32 POAG and 52 NTG patients was performed. Choroidal thickness, ganglion cell complex thickness and retinal nerve fiber layer thickness were compared among normal controls, POAG and NTG subjects. Additionally, the factors influencing choroidal thickness (age, axial length, spherical equivalent, central corneal thickness, mean deviation, nocturnal dip, blood pressure variability) were analyzed. RESULTS: A total of 32 normal controls, 32 POAG and 52 NTG patients were enrolled in this study. Macular and peripapillary choroidal thicknesses were significantly thinner in the NTG patients. In NTG subjects, the significant influencing factors associated with macular and peripapillary choroidal thicknesses were age, axial length, nocturnal dip (diastolic blood pressure), diastolic blood pressure variability and ganglion cell complex thickness. In POAG patients, significant influencing factors associated with macular and peripapillary choroidal thicknesses were age and axial length. CONCLUSIONS: Choroidal thickness was significantly thinner in NTG patients compared with normal controls and POAG patients. Factors influencing choroidal thickness in NTG patients were age, axial length, nocturnal dip (diastolic blood pressure), diastolic blood pressure variability and ganglion cell complex thickness. In POAG patients, significant factors influencing choroidal thickness were age and axial length.

Analysis of Choroidal Thickness Measured Using RTVue and Associated Factors in Open-Angle Glaucoma

PURPOSE: To compare the macular choroidal thickness, ganglion cell complex thickness, peripapillary choroidal thickness and retinal nerve fiber layer thickness among normal, primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) patients using RTVue (Fourier-domain optical coherence tomography; Optovue, Fremont, CA, USA). METHODS: A retrospective analysis of 32 normal controls, 32 POAG and 52 NTG patients was performed. Choroidal thickness, ganglion cell complex thickness and retinal nerve fiber layer thickness were compared among normal controls, POAG and NTG subjects. Additionally, the factors influencing choroidal thickness (age, axial length, spherical equivalent, central corneal thickness, mean deviation, nocturnal dip, blood pressure variability) were analyzed. RESULTS: A total of 32 normal controls, 32 POAG and 52 NTG patients were enrolled in this study. Macular and peripapillary choroidal thicknesses were significantly thinner in the NTG patients. In NTG subjects, the significant influencing factors associated with macular and peripapillary choroidal thicknesses were age, axial length, nocturnal dip (diastolic blood pressure), diastolic blood pressure variability and ganglion cell complex thickness. In POAG patients, significant influencing factors associated with macular and peripapillary choroidal thicknesses were age and axial length. CONCLUSIONS: Choroidal thickness was significantly thinner in NTG patients compared with normal controls and POAG patients. Factors influencing choroidal thickness in NTG patients were age, axial length, nocturnal dip (diastolic blood pressure), diastolic blood pressure variability and ganglion cell complex thickness. In POAG patients, significant factors influencing choroidal thickness were age and axial length.

Relationship among Water-Shed Zone, Nocturnal Dip and Visual Field Progression in Open Angle Glaucoma

PURPOSE: To investigate the influence of water-shed zone (WSZ) and nocturnal dip (ND) on the progression of the glaucomatous visual field (V/F) defects in open-angle glaucoma (OAG) patients when the intraocular pressure (IOP) was maintained under the target pressure. METHODS: We performed fluorescence angiography (FAG), 24-hour ambulatory blood pressure monitoring (24-hr ABPM), and V/F tests. We examined the relationships among WSZ in early-FAG, ND over 10% (dip), and the progression of the glaucomatous V/F defects using chi-square, Fisher's exact, and multivariate logistic regression tests. A p-value < 0.05 was considered statistically significant. RESULTS: When considering the correlation between WSZ and dip, statistical significance was found in OAG (p = 0.024, odds ratio (OR) = 3.308) and normal tension glaucoma (NTG) (p = 0.029, OR = 4.364) patients. In patients with dip, glaucomatous V/F defects significantly progressed (OAG: p = 0.003, OR = 5.938, NTG: p = 0.005, OR = 13.929). In patients with WSZ, the glaucomatous V/F defects progressed in all groups (OAG: p = 0.002, OR = 5.156, NTG: p = 0.024, OR = 4.750, primary open angle glaucoma (POAG): p = 0.021, OR = 8.750). In the patients with WSZ involving optic nerve head, the glaucomatous V/F defects had progressed in OAG (p = 0.004, OR = 5.958) and NTG (p = 0.009, OR = 8.333) groups. Based on binary logistic regression analysis, dip (p = 0.010, OR = 6.227) significantly affected V/F progression only in OAG patients. CONCLUSIONS: In the OAG and NTG groups, ND over 10% influenced the progression of the glaucomatous V/F defects. The patients with WSZ tended to have ND over 10% in OAG and NTG groups and glaucomatous V/F defects progressed in all patients. Therefore, performing early FAG and 24-hr ambulatory blood pressure monitoring may be helpful for glaucoma patients with progressing glaucomatous V/F defects even when the IOP was maintained under the target pressure.

Risk for oral cancer associated to smoking, smokeless and oral dip products.

Oral cancer is one of the most common life threatening diseases in India. Tobacco and alcohol are considered to be the most risk factors for oral cancer. This study was conducted to investigate the association of tobacco and poly-ingredient oral dip products with oral cancer. A case-control study of 350 cases and 350 controls, over a period of 19 months, between February 2005 and September 2006 was carried out in Pune, India. The self-reported information about the consumption of tobacco, poly-ingredient oral dip products, alcohol, dietary habits and demographic status were collected by a researcher made questionnaire. Univariate and multivariate analysis were used to identify the risk of substances abuse. The frequency of smoking, smokeless and oral dip products in cases were significantly higher than controls (P < 0.0001). Among smoking types, bidi (P < 0.0001, OR = 4.1 95% CI = 2.4 - 6.9), of smokeless types, chewing tobacco (P < 0.0001, OR = 8.3, 95% CI = 5.4 - 13.0) and mishiri (P < 0.0001, OR = 3.3, 95% CI =2.1 - 5.4), and of oral dip products, consumption of gutkha (P < 0.0001, OR = 12.8, 95% CI =7.0 - 23.7) and supari (P < 0.0001, OR = 6.6, 95% CI =3.0 - 14.8) indicated strong association with oral cancer upon adjustment. This study provides strong evidence that gutkha, supari -areca nut- chewing tobacco (tobacco flakes), bidi smoking and mishiri (tobacco powder, which applied as a tooth and gum cleaner) are independent risk for oral cancer.

Bioactive compounds of thai red hot chili dip (nam prik ta dang) and effects on antioxidant activities and lipid peroxidation in rats (in vitro and in vivo models).

This study aimed to study the efficacy of Thai Red hot chili dip (Nam Prik Ta Dang) on antioxidant activity and lipid peroxidation inhibitor in vitro and in vivo models. Healthy recipe of Nam Prik Ta Dang (NPTD) was developed by Institute of Nutrition, Mahidol University used in this study. Fresh NPTD was determined for some bioactive compounds, and the antioxidant activities were evaluated by two different methods as oxygen radical absorbance capacity (ORAC) and ferric reducing antioxidant power (FRAP). The result showed that NPTD contained total polyphenol and also carotenoids such as beta-carotene and lutein. In vitro antioxidant activity values of NPTD was 204.3 ± 8.5 and 17.2 ± 2.7 micromole Trolox equivalent/gram for ORAC and FRAP, respectively. Freeze-dried NPTD was used for evaluating antioxidant activity and antilipid peroxidation in healthy rats. Daily administration of normal diet mixed NPTD for 2 months, serum ORAC significantly increased to compare with control group (p < 0.01). Lipid peroxidation marker as serum Thiobarbituric acid reactive substances (TBARS) significantly decreased to compare with control group (p < 0.05). In conclusion, healthy recipes of Thai red hot chili dip or Nam Prik TA Dang obtained various bioactive compounds which exhibited significantly antioxidant activities in vitro and in vivo. Moreover, daily consumption of NPTD showed the efficacy in inhibiting lipid peroxidation. Further study, it could be studied in oxidative stress condition and human clinical trials.

Correlation Between Nocturnal Dip and Progression of Glaucoma

PURPOSE: To investigate the effect of nocturnal dip influence on the progression of glaucomatous visual field defect. METHODS: We performed 24hr ABPM and V/F tests on patients diagnosed with NTG (140 patients, 280 eyes) and POAG (84 patients, 168 eyes). Nocturnal dips below 10% were classified as non-dippers, and those above 10% were noted as dippers. The correlations among nocturnal dip, progression of glaucomatous visual field defect, and hypertension treatment were examined. RESULTS: In NTG, dippers in both systolic and diastolic blood pressure furthered glaucomatous visual field defects, with a relative risk of approximately three times that of non-dippers. Hypertension treatment was not influenced by the progression of glaucomatous visual field defect but was influenced by dips in the systolic and diastolic pressures in NTG and in diastolic pressure in POAG. Nocturnal dips were more frequent in the group with progression of the visual field compared to those in the group with non-progression of the visual field in NTG. CONCLUSIONS: Dipper caused a progression of glaucomatous visual field defects in NTG and was influenced by hypertension treatment in NTG and POAG. Performing 24hr ABPM should be helpful for glaucoma patients with progression of a glaucomatous visual field defect even when the IOP is less than the target pressure. In addition, hypertension treatment should be considered an important factor in the treatment of glaucoma.

Extended Functions and Design of Medical Data Integration Platform / 医疗卫生装备

Obiective To expand the functions of the original data integration platform combined business process to achieve cross-system integration in hospital, Methods On the basis of efficient data interaction for every medical information system in hospital, more related function modules for the DIP were added. Results The new function modules can satisfy DIP multiple needs in the hospital daily work and make the DIP more powerful. Conclusion The applicability and rationality of DIP are improved by extended function.

Treatment of Mallet Finger Fracture by Extension Block K-wire Fixation / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to evaluate the outcomes of the extension block fixation technique for a bony mallet finger. MATERIALS AND METHODS: Thirty-five patients that received extension block fixation for bony mallet finger were enrolled in this study between July 2001 and October 2005. The fracture type was classified by the Wehbe and Schneider method. The average follow up period was 15 months, ranging between 12-52 months. The results were classified by the Crawford criteria. RESULTS: There was 30 cases of type I, 5 cases of type II and no cases of type III, with 11 cases of subtype A, 22 cases of subtype B, and 2 cases of subtype C. The average time from injury to operation was 12 days, which included three cases of over 28 days. The K-wire was removed 30 days after the operation, and joint exercises were initiated immediately. There were 10 cases with excellent outcomes, 18 cases with good outcomes, 4 cases with fair outcomes, and 3 cases with poor outcomes. The poor outcome had complications such as subluxation of the DIP joint, lag between injury to operation time (more than 4 weeks), and more than 1 mm displacement. CONCLUSION: The extension block technique for the treatment of bony mallet finger is relatively simple and results in satisfactory bone union.