Objective: To analyze the internal composition and changes of the hospitalization costs of lung cancer surgery patients, explore the main influencing factors of hospitalization costs, predict the trend of hospitalization costs, and provide an empirical basis for reducing the hospitalization medical burden of lung cancer patients. Methods: The information on the front pages of the hospitalization medical records of lung cancer surgery patients in a certain third-level Class-A hospital from 2018 to 2022 was collected. The new grey correlation and structural change degree analysis methods were used to study the internal structural changes of hospitalization costs and the correlation degree among them. Through univariate analysis and multiple linear regression analysis, the main influencing factors of hospitalization costs were explored. The GM(1,1) model was used to predict the hospitalization costs from 2023 to 2025. Results: (1) From 2018 to 2022, the average hospitalization cost per case of lung cancer surgery patients in this hospital decreased year by year, with an average annual decrease of 6.67%. (2) Drug costs, diagnostic costs, and surgical treatment costs were the main factors for the structural changes of hospitalization costs, with a cumulative structural change degree of 33.76% and a cumulative contribution rate of 86.23%. (3) The top three in the correlation degree ranking were material costs (0.952), comprehensive medical service costs (0.843), and diagnostic costs (0.697) in turn. (4) Multiple linear regression analysis showed that higher age, more number of complications/accompanying diseases, the medical payment method of urban employee basic medical insurance, and more hospitalization days were the influencing factors for the increase of hospitalization costs of lung cancer surgery patients (P < 0.05); the marital status of being widowed or divorced and emergency admission were the influencing factors for the decrease of hospitalization costs of lung cancer surgery patients (P < 0.05). (5) The GM(1,1) model predicted that the hospitalization costs would further decrease in the next three years. Conclusion: The control of hospitalization costs for lung cancer surgery in this hospital has achieved certain results, especially in controlling drug costs. The costs of surgical treatment that reflect the labor value of medical staff have increased. Diagnostic costs and material costs are the key points for the hospital to further control hospitalization costs in the next step. Clinically, the hospitalization costs of lung cancer surgery patients can be further reduced by early detection, early diagnosis, early treatment, and scientifically reducing the number of hospitalization days. Comprehensive measures should be taken to optimize the composition of patients' hospitalization costs, strengthen the management of controllable factors, and reduce the hospitalization medical burden of lung cancer surgery patients.

The introduction of DIP (Diagnosis-Intervention Packet, paying by disease scores) and DRG (Diagnosis-Related Groups, paying by disease diagnosis related groups) payment models marks the transformation of China's medical insurance payment method from the traditional "post-payment" to the "pre-payment" model, which puts forward higher requirements for the financial management and budget management of public hospitals. This paper analyzes the impacts of DIP/DRG payment reform on aspects such as hospital financial management, medical record management, cost accounting and information systems, and points out that it promotes a systematic change in the hospital management model. Secondly, based on the process management theory, it explores the construction path of the comprehensive budget management system in public hospitals, mainly including the improvement of budget management systems, the clarification of budget objectives, the optimization of budget management processes, and the establishment of budget supervision and evaluation mechanisms. Through investigations and combing relevant literature, this paper proposes optimization strategies for the budget management system in view of the characteristics of DIP/DRG payment reform. The aim is to enhance the operational performance and financial management level of public hospitals under the new payment model and promote the high-quality development of hospitals.

Objective  To understand the current status and mode of Internet medical service charge in China. Methods  An online questionnaire survey on Internet medical service charge was conducted in Internet hospitals established by physical medical institutions in 8 provinces in China from October to November 2023. Descriptive analysis methods were used to analyze data of charging basis and standards of Internet hospitals. Results  The charges for Internet medical services in the 54 hospitals investigated were primarily determined by the type of consultation, hospital classification, and doctors' professional levels. In 78.4% of the hospitals, the online subsequent visit cost was 10 yuan or less per case. The costs of graphic, voice, and video health consultation for doctors of different ranks in various levels of hospitals primarily were less than 20 yuan. Approximately 44.4% of hospitals supported online medical insurance payment. Conclusion  It is imperative to establish a multi-tiered and comprehensive pricing mechanism for Internet medical services in China, enhance supervision over Internet medical charges, and comprehensively promote online payment for medical insurance to ensure the provision of high-quality and sustainable development of Internet medical services.

Objective: To analyze the current situation of the spatial layout of medical services in secondary and tertiary hospitals in Yantai City, and provide a reference for the further construction and planning of medical resources and the improvement of the accessibility of medical services for residents. Methods: Taking the secondary and tertiary hospitals in Yantai City as the center, the actual coverage of medical services was calculated according to the GIS network analysis model, Thiessen polygons and other methods. Results: On average, each tertiary hospital in Yantai City serves 30.15 residential areas, with an average shortest distance to seek medical treatment of 10.19 km, and 80.36% of the residential areas can be covered within 15 minutes. Each secondary hospital serves an average of 15.87 residential areas, with an average shortest distance to seek medical treatment of 4.28 km. The areas within 30 minutes can basically connect the junctions of various districts and counties, and the service range within 60 minutes covers the whole city. Conclusion: The relevant departments should attach importance to the weak areas in the spatial layout of medical services in secondary and tertiary hospitals, improve the current situation of the fragmented distribution of the service areas of tertiary hospitals, promote the rational distribution of medical resources, and form a new pattern of spatial development.

Objective To explore the risk factors of unplanned re-intubation in patients with acute respiratory failure treated with nasal high-flow oxygen therapy (HFNC), and to construct a risk prediction model based on independent risk factors to analyze the predictive value of these risk factors. Methods A total of 198 patients with acute respiratory failure who were hospitalized in our hospital and received HFNC treatment from September 2020 to August 2023 were retrospectively selected. According to whether there was unplanned re-intubation, the patients were divided into the re-intubation group (n = 37) and the non-re-intubation group (n = 161). Univariate analysis and multivariate logistic regression analysis were used to obtain independent risk factors. A risk prediction model was constructed based on the regression analysis method, and the predictive efficiency of the model was tested by the receiver operating characteristic curve and the calibration curve. In addition, 85 patients who were treated from September 2023 to June 2024 were selected as the validation set. The ROC curve and calibration curve were drawn using the data of the validation set to externally verify the predictive efficiency of the model. Results The results showed that age, smoking history, Acute Physiology and Chronic Health Evaluation II score (APACHE II score), duration of invasive mechanical ventilation, residual volume of secretions, high oxygen flow rate setting, and comorbid chronic lung disease were independent risk factors for unplanned re-intubation in patients with acute respiratory failure treated with HFNC (P < 0.05). The area under the curve of the constructed risk prediction model was 0.878, indicating good discrimination ability of the model. The mean absolute error of the calibration curve was 0.015, and the calibration curve was close to the ideal curve, suggesting that the model had good calibration performance and was reliable and stable. The results of the ROC curve and calibration curve of the validation set were good, indicating that the model had good external predictive efficiency. Conclusion The occurrence of unplanned re-intubation in patients with acute respiratory failure treated with HFNC is affected by risk factors such as age, smoking history, and APACHE II score. The risk prediction model constructed based on each independent risk factor has good predictive performance, which can provide a basis for preventing unplanned re-intubation clinically and rationally allocating medical resources.

Objective To explore the effects of muscle mass and muscle strength on frailty in patients with maintenance hemodialysis (MHD).Methods MHD patients at The First Affiliated Hospital of Xi’an Jiaotong University were investigated from January to May 2024. Their frailty was evaluated using the Frailty Assessment Scale, and muscle mass (SMI) and muscle strength (HGS) were assessed with a body composition analyzer and a grip strength meter. Relevant data including sociodemographic characteristics, clinical medical information, and personal lifestyle habits were collected. Logistic regression analysis was utilized to analyze the impacts of muscle mass and muscle strength on frailty, and the masking effect of muscle strength between muscle mass and frailty was explored based on the path analysis method.Results A total of 340 MHD patients were surveyed. The prevalence rates of frailty, low SMI, and low HGS were 43.5%, 41.8%, and 39.1%, respectively. Among the 148 frail MHD patients, 45.3% had both low HGS and low SMI. After adjusting for confounding factors, muscle strength was a protective factor against frailty. In the overall population, the masking effect between SMI→HGS→frailty was significant, with a masking effect value of −0.068 (95% CI: −0.102 to −0.041). Subgroup analysis showed a masking effect value of −0.069 (95% CI: −0.112 to −0.035) in males; in females, the effect of muscle mass on frailty was completely masked by muscle strength, with a masking effect value of −0.074 (95% CI: −0.149 to −0.007).Conclusion Increasing muscle strength is significantly associated with reduced frailty in MHD patients. Grip strength, as a marker of muscle strength, is more significant than muscle mass. Muscle strength plays a masking role between muscle mass and frailty.

Objective To understand the hospitalization situation of diabetic patients in Tianjin and the changing trends of the composition of their hospitalization expenses before and after the implementation of the DRG payment reform policy, and to analyze the effectiveness of the DRG policy reform and the possible existing problems. Methods Based on the medical insurance settlement data in Tianjin before and after the implementation of DRG from 2021 to 2023, the degree of structure variation (DSV), grey correlation analysis (GRA) and interrupted time series (ITS) analysis were used to study the impact of the DRG policy on the hospitalization situation and expenses of diabetic patients. Results Compared with before the reform, the emergency admission rate of hospitalized diabetic patients increased after the reform ($P < 0.001$), while the length of hospital stay, hospitalization expenses, comprehensive medical service fees, drug fees, health material fees and individual out-of-pocket expenses all decreased ($P < 0.001$). The results of DSV and GRA analysis showed that the main factors affecting the hospitalization expenses of diabetic patients were examination fees, laboratory test fees, comprehensive medical service fees and drug fees. The results of ITS analysis showed that after the DRG reform, the average inpatient expense per visit decreased by 281.50 yuan ($P < 0.001$), and the monthly growth rate reversed from 56.15 yuan before the reform to -42.51 yuan ($P < 0.001$), and the reduction rate of individual out-of-pocket expenses increased ($P < 0.001$). Except for the examination fees, the growth trends of the composition of various hospitalization expenses all reversed ($P < 0.001$). Among them, the comprehensive medical service fees had the largest reduction, and the monthly growth rate reversed from 21.68 yuan before the reform to -17.23 yuan ($P < 0.001$), followed by drug fees, laboratory test fees and health material fees. Conclusion The DRG payment method reform in Tianjin has achieved remarkable results, with obvious achievements in reducing costs and increasing efficiency, effectively reducing the economic burden on patients. However, the increase in the emergency admission rate and the still unreasonable expense structure suggest that the DRG reform still needs further optimization.

Objective To construct a medical mental damage compensation model based on Ordinary Least Squares (OLS) regression, so as to analyze the influencing factors of mental damage compensation in medical damage liability dispute cases. Methods Taking 830 medical damage dispute cases as the research objects, relevant factors were included in the OLS regression analysis through analysis of variance, and a linear regression model was constructed. Results The medical mental damage compensation model showed that the western and northeastern regions in the factor of "region" were negatively correlated with mental damage compensation (P < 0.05), while hospital liability, claimed compensation amount, and disability grade were positively correlated with mental damage compensation (P < 0.05). Conclusion The medical mental damage compensation model is simple with simplified indicators, which is convenient for judges to refer to the data. It is helpful for the pre-litigation settlement of medical disputes and further plays the role of people's mediation in doctor-patient disputes.

Objective  To analyze the changes in the structure of outpatient and inpatient costs in a public hospital in Binzhou under the background of new medical reform, and provide references and theoretical basis for further implementing healthcare reform policies in Binzhou. Methods  Outpatient and inpatient cost data from a public hospital in Binzhou City from 2013 to 2022 were collected, and grey correlation method and structural change degree were used to analyze the indicators. Results  Grey relational analysis revealed that, from 2013 to 2022, the top three correlated factors in outpatient expenses were medication expenses, examination fees, and laboratory fees; in inpatient expenses, medication expenses, health material fees, and examination fees were the top three expenses. The results of the structural correlation analysis showed that in both outpatient and inpatient expenses, the change in medication expenses was the largest contributor with a negative change. Conclusion  Under the background of the new medical reform, there have been initial achievements in controlling medication expenses. However, examination fees and health material fees have shown an upward trend and accounted for a relatively high proportion, which requires attention. Technical service fees have been increasing annually but still have a relatively low proportion.

Objective To construct a prediction model for dysphagia in elderly patients with chronic obstructive pulmonary disease (COPD) based on the BP neural network method. Methods A retrospective analysis was conducted on 313 COPD patients who were treated in the Second People's Hospital of Pingxiang City from June 2021 to June 2024, among whom 58 had dysphagia. SPSS was used for propensity score matching, with gender, the same age (±3 years), and the same Modified Barthel Index (MBI) (±1 point) as the matching factors. Among them, 13 patients with dysphagia did not find matching objects, and the clinical data of 40 patients without dysphagia were missing. Finally, 45 patients were included in the dysphagia group and 155 patients were included in the non-dysphagia group. Questionnaires and surveys were used to collect the general information of the patients. Univariate and logistic regression analyses were used to analyze the significant influencing factors, and a prediction model for dysphagia in COPD patients was constructed based on the BP neural network method.Results The results of logistic regression analysis showed that smoking history, nutritional status, number of missing teeth, whether to concentrate on eating, eating posture, partial pressure of carbon dioxide, types of medications, degree of dyspnea, and severity of the disease were influencing factors of dysphagia in COPD patients (all P < 0.05). When constructing the BP neural network, the prediction accuracy of the modeling set was 88.10%, and the prediction accuracy of the validation set was 89.40%. The area under the curve (AUC) of the model was 0.926 (95% CI: 0.892-0.966), the sensitivity was 80.00%, the specificity was 90.30%, and the Youden index was 0.703. Among them, the degree of dyspnea (100.00%), the severity of the disease (91.80%), and the number of missing teeth (74.60%) were the top three influencing factors in terms of the importance ranking of independent variables. Conclusion The prediction model for dysphagia in elderly COPD patients constructed based on the BP neural network method has good fitting performance and can provide a reference for relevant clinical studies.

Objective  To explore the risk factors of 30-day survival after cardiac arrest (CA) and return of spontaneous circulation (ROSC) in the emergency department and to establish a nomogram prediction model. Methods  A dual center retrospectively observational study was conducted. The patients with CA admitted to the emergency departments of two hospitals were enrolled, including Affiliated Jinhua Hospital, Zhejiang University School of Medicine and Wucheng District of Jinhua Municipal Central Hospital. A modified Utstein template was applied to collect information about these patients, including general data, CA related data, arterial blood gas analysis after ROSC, and the 30-days survival rate. The influence factors of 30-days survival rate were screened with logistic regression analysis. A nomogram prediction model was established to evaluate the value in predicting 30 days survival after CA and ROSC.Results  A total of 150 patients with ROSC were enrolled, 40 cases survived within 30 days (26.7%), and only 22 cases survived to hospital discharge with good neurological prognosis (14.7%). The survival group patients were younger, with higher ratio of in-hospital cardiac arrest (IHCA), cardiogenic cardiac arrest, initial shockable rhythm and higher pH value than the death group (P < 0.025). The ROC curve showed that the cut-off value of age was 60.5 years old, and pH was 7.05. Multivariate logistic regression analysis showed that patients′ age < 60 years old (OR = 11.30, 95% CI 1.76-72.63, P = 0.011), cardiogenic cardiac arrest (OR = 10.78, 95% CI 1.55-75.16, P = 0.016) and pH > 7.05 (OR = 15.25, 95% CI 2.46-94.49, P = 0.003) were independent influencing factors of 30-day survival. The negative predictive value of pH > 7.05 for 30 day survival was 91.1%. The AUC of nomogram prediction model was 0.929 (95% CI 0.874-0.985), the sensitivity was 0.95, and the specificity was 0.75. The calibration curve showed that the predicted probability was basically consistent with the actual probability. The analysis of the decision curve confirmed that the nomogram prediction model had good clinical usability. Conclusion  The nomogram model based on age, cardiogenic cardiac arrest, location of CA, initial shockable rhythm and pH could predict the 30-day survival of patients after ROSC in the emergency department rapidly, and pH was the most significant prognostic factor.

Objective To analyze and summarize the research literature on the integration of medical care and elderly care in China, and provide theoretical support for the healthy and orderly development of the integration of medical care and elderly care in China. Methods Taking the literature from domestic core journals included in CNKI, Wanfang, and VIP databases as the data source, CiteSpace and Excel software were used to analyze the number of published papers, authors, research institutions, and keywords of the research on the integration of medical care and elderly care in China from 2014 to 2024. Results The overall number of published papers on the integration of medical care and elderly care in China showed a trend of first increasing and then decreasing; the teams engaged in the research on the integration of medical care and elderly care were concentrated in various universities and scientific research institutes, and many productive authors emerged; in terms of regional distribution, they were mostly concentrated in economically developed regions such as Beijing, Shanghai, Nanjing, Zhejiang, and Wuhan; however, there was a lack of cooperation among institutions and authors, and no authoritative research institutions and authors had been formed yet; the research in the field of the integration of medical care and elderly care in China involved many aspects such as the service subjects, service contents, service objects, and service models of the integration of medical care and elderly care; the analysis combining keyword clustering and burst keywords showed that the field of the integration of medical care and elderly care in China was roughly divided into three stages: the main research stage (2014-2017), the reflection stage (2018-2020), and the deepening stage (2021-2024). Conclusion Certain achievements have been made in the research field of the integration of medical care and elderly care in China, and the academic community has conducted in-depth research on various aspects of this field. However, there is a lack of authoritative research institutions and authors.

Objective To improve the theoretical level and practical application ability of medical postgraduate students in multivariate statistical analysis, so as to meet the demand for medical practitioners to master statistical analysis methods due to the growth of medical data. Methods By comprehensively using literature resources, a computer simulation case database, a structured case database for data analysis, and an open case database for medical applications were established at multiple levels respectively. The application and implementation of the case database were carried out in the way of "classroom demonstration of simulation case database + structured case guidance in class and after class + open case expansion after class", and various teaching methods were used. At the same time, formative evaluation was adopted. Results Through simulation experiment cases, students' understanding and application ability of the theory of multivariate statistical methods were promoted; through the structured case database, students' statistical analysis ability was improved; through the open case database, students' ability to comprehensively use statistical knowledge to solve complex practical problems was cultivated. In the application and implementation of the case database, students deepened their understanding and application of knowledge by preparing cases in advance, having classroom discussions and completing reports after class. Teachers discovered and solved students' problems in a timely manner through formative evaluation. Conclusion Case databases at different levels complement each other. Through this teaching method, students can be systematically trained to achieve learning goals, and the ability and quality of medical postgraduate students to use multivariate statistical methods to solve practical problems can be improved.

Objective To explore the influencing factors of incision infection after open reduction and internal fixation (ORIF) of tibial fractures, develop an individualized nomogram prediction model and verify it. Methods The clinical data of 180 patients with tibial plateau fractures who received ORIF treatment in our hospital from February 2021 to September 2022 were retrospectively analyzed, and the occurrence of postoperative incision infection in these patients was analyzed. The potential warning indicators of incision infection after ORIF of tibial fractures were preliminarily screened by lasso regression; the influencing factors of postoperative incision infection were analyzed by multivariate binary logistic regression; an individualized nomogram prediction model was constructed; the goodness of fit, calibration degree and clinical applicability of the individualized nomogram prediction model were evaluated by Hosmer-Lemeshow test, calibration curve and decision curve; and the receiver operating characteristic (ROC) curve of the model was drawn. In addition, 180 patients with tibial plateau fractures who received ORIF treatment in our hospital from October 2022 to May 2024 were selected for external verification. Results Among 180 patients with tibial plateau fractures who received ORIF treatment, 38 cases had incision infection, with an incidence rate of 21.11%, including 14 cases (7.78%) of deep infection and 24 cases (13.33%) of superficial infection. Compared with the non-infected group, the infected group had a higher body mass index (BMI), a longer operation time, and a higher proportion of smoking, diabetes mellitus, open injury, and American Society of Anesthesiologists (ASA) grade III-IV (P < 0.05). BMI, smoking, diabetes mellitus, open injury, ASA grade, and operation time were potential warning indicators of incision infection after ORIF of tibial plateau fractures. BMI, smoking, diabetes mellitus, open injury, ASA grade, and operation time were influencing factors of incision infection after ORIF of tibial plateau fractures. The Hosmer-Lemeshow test (χ² = 3.998, P = 0.857) suggested that the individualized nomogram prediction model had a high goodness of fit. The calibration and decision curves indicated a high calibration degree and good clinical net benefit. The ROC curve showed that the area under the curve (AUC) was 0.918, the 95% confidence interval (CI) was 0.868-0.954, the sensitivity was 81.58%, and the specificity was 88.73%, suggesting that the individualized nomogram model had a high predictive efficiency. External verification showed that the prediction model established based on the data of the modeling group had good discrimination and consistency. Conclusion The individualized nomogram prediction model constructed in this study based on BMI, smoking, diabetes mellitus, open injury, ASA grade, and operation time can effectively predict the occurrence of incision infection after ORIF of tibial plateau fractures, which is helpful to reduce the occurrence of postoperative incision infection and promote the rapid recovery and good prognosis of patients.

Objective To construct a nomogram model to predict the risk of delirium during ICU admission in alcohol withdrawal patients.Methods Data were extracted from the Medical Information Mart for Intensive Care (MIMIC-IV version 2.2) on patients admitted to the ICU for alcohol withdrawal and were randomly divided into training and validation sets based on a 7:3 ratio. Lasso regression analysis combined with logistic regression analysis was used to select the best variables to construct the model for visualization in the form of the nomogram.Results Five optimal variables were screened as independent risk factors for delirium during ICU admission in alcohol withdrawal patients in this study, which were mean heart rate (OR=0.967, 95%CI: 0.953-0.982), SOFA score (OR=1.151, 95%CI: 1.054-1.257), OASIS score (OR=1.131, 95%CI: 1.089-1.174), use of propofol (OR=2.453, 95%CI: 1.187-5.071) and LMR (OR=0.876, 95%CI: 0.774-0.991). The area under the ROC curve (AUC) of the column-line graphical model constructed on the basis of these five optimal variables was 0.852 (95%CI: 0.820-0.885); the accuracy of the model was 0.706, the precision was 0.743, the recall was 0.690, the F1 score was 0.716, and the Brier score was 0.157; the mean absolute error of the calibration curve was 0.014; clinical decision curve analysis (DCA) showed a large net benefit at threshold probabilities of 0.07-0.95.Conclusion The nomogram model developed in this study can accurately predict the risk of delirium during ICU admission in patients with alcohol withdrawal and can be useful for early clinical prevention, intervention, and graded care.

Objective To construct a machine learning model for predicting intraoperative blood transfusion, guide clinical blood transfusion strategies, and promote the informatization construction of clinical anesthesia. Methods The characteristics potentially related to blood transfusion of patients undergoing elective surgeries in a hospital in Ji'an City from January 2020 to March 2023 were retrospectively collected. Data analysis was carried out based on Python, R language, and SPSS. Feature screening was performed through logistic regression, lasso regression, and Boruta algorithm. Twelve basic models were constructed by balancing the data set with the Borderline Synthetic Minority Over-sampling Technique (Borderline SMOTE) and the undersampling technique of removing pairs of too-close samples (Tomek Links) algorithm. The final model was selected and explained using SHAP values. Results A total of 12,906 patients were finally included in the study. Age, preoperative hemoglobin, albumin, operation duration, intraoperative blood loss, ASA grade, and body weight were selected as the final features. A prediction model was constructed by combining the Gradient Boosting Decision Tree, Borderline SMOTE, and Tomek Links. The area under the curve was 0.955, the recall rate was 0.947, the specificity was 0.932, the precision was 0.365, the accuracy was 0.925, the negative predictive value was 0.997, the F1 score was 0.527, and the average accuracy was 0.700. An online application program was constructed based on the Streamlit framework. Conclusion This study has constructed a simple, convenient, accurate, and interpretable risk prediction model for intraoperative blood transfusion, providing a theoretical basis for promoting intelligent preoperative anesthesia assessment.

Objective To systematically evaluate the efficacy and safety of Chinese herbal decoctions containing Astragalus membranaceus and Poria cocos (HF-D) in the treatment of nephrotic syndrome (NS). 

Methods Databases including VIP, CNKI, WanFang, CBM, PubMed, Embase, and Cochrane were searched for clinical randomized controlled trials (RCTs) on HF-D for NS published between 2010 and 2023. Literature quality was assessed using the Cochrane Risk of Bias Tool, and data were analyzed with ReviewManager 5.3, Stata 12.0, and R software. 

Results Following PRISMA 2020 guidelines, 15 RCTs involving 1,538 patients were included. Meta-analysis showed: Efficacy outcomes: - The trial group had a significantly higher total response rate than the control group [RR=1.21, 95%CI: (1.13, 1.29), P<0.01].  The recurrence rate was significantly lower in the trial group [RR=0.38, 95%CI: (0.22, 0.66), P<0.01]. Laboratory indices: The trial group exhibited significantly lower levels of 24-hour urinary protein [MD=−1.20, 95%CI: (−1.43, −0.97), P<0.01], serum creatinine [MD=−7.13, 95%CI: (−13.15, −1.10), P<0.05], blood urea nitrogen [MD=−0.55, 95%CI: (−1.04, −0.06), P<0.05], total cholesterol [MD=−1.51, 95%CI: (−2.11, −0.91), *P*<0.01], and triglycerides [MD=−0.74, 95%CI: (−1.11, −0.36), P<0.01] compared to the control group. Serum albumin levels were significantly higher in the trial group [MD=5.65, 95%CI: (4.03, 7.27), P<0.01]. Safety outcomes: The incidence of adverse events was significantly lower in the trial group [RR=0.41, 95%CI: (0.28, 0.62), P<0.01]. Publication bias analysis: Egger’s test showed good symmetry in the funnel plot for 24-hour urinary protein (P>|t|=0.7), but trim-and-fill analysis for total response rate indicated potential unavoidable publication bias. 

Conclusion HF-D demonstrates promising efficacy and safety in treating NS, though further large-sample, high-quality RCTs are needed for validation.

Objective  To analyze the change trend on the number of radiological examinations with time-series in a children′s hospital in Hangzhou from 2021 to 2023, and to provide data support for strengthening the management level and service quality of the radiology department in the hospital. Methods  A retrospective study was conducted on 374303 radiological examinations in the radiology department of the hospital, from January 1, 2021 to December 31, 2023. The seasonal index analysis with time series was used to analyze the change trend of the number of radiological examinations in three years.Results  The total number of radiological examinations in the radiology department of the hospital was 374303 times from 2021 to 2023. The average highest peak on the number of radiological examinations was the fourth quarter (autumn, 37105 times), and the lowest was the first quarter (winter, 25166 times). The peak months of radiological examinations were July, August, October, November and December (total of 5 months), and the average highest peak month was October, with 13225 times, accounting for 10.6% of the radiological examinations during the year. The minimun number of the radiological examinations occurred from January to May (total of 5 months), and the number of the radiological examinations was the least in February, with 6487 times, accounting for 5.2% of the radiological examinations during the year. The peak periods in daytime on the number of radiological examinations were from 10∶00 to 12∶00 and from 13∶30 to 15∶30. The number of the radiological examinations in the night-time from 17∶30 to 1∶30 was 10.1 times that in the night-time from 1∶30 to 8∶00. Conclusion  The number of radiological examinations in the radiology department of the hospital varies seasonally. Analyzing the peak and low periods of the radiological examinations can provide a basis for allocating medical resources reasonably, which can effectively improve the diagnostic capabilities and the level of medical service in the radiology department of the hospital.

Objective To study the application and software implementation of the Bland-Altman method and the ATE/LE R region method in evaluating the consistency of two quantitative measurement methods. Methods The theories and applicable conditions of the Bland-Altman method and the ATE/LE R region method were introduced. Taking the example data of two quantitative measurement methods as examples, these two methods were used for consistency evaluation. The statistical analysis software MedCalc was used to demonstrate the Bland-Altman method, and SAS was used to demonstrate the ATE/LE R region method. Results The consistency of the contents of biochemical index (X) in 32 cerebrospinal fluid samples detected by methods A and B was good, and the analysis results of the two evaluation methods, the Bland-Altman method and the ATE/LE R region method, were consistent. Conclusion When evaluating the consistency of two quantitative measurement methods, in order to avoid the limitations brought by the evaluation of a single method, multiple methods can be used for combined evaluation simultaneously, and the Bland-Altman method and the ATE/LE R region method are preferentially considered.

Objective To retrospectively analyze the inpatient death cases in a tertiary general hospital, so as to understand and master the death situation and causes of inpatients in the hospital in recent years, and provide a scientific and reasonable management basis for the hospital. Methods The inpatient death cases in a tertiary general hospital from 2021 to 2023 were collected and retrospectively analyzed from the aspects of age, gender, department, and disease diagnosis at death. Results There were 819 death cases in this hospital from 2021 to 2023, with a total inpatient mortality rate of 0.58%. The male-female ratio was 1.96:1, and those aged 60 and above accounted for 82.42%. The departments with the most deaths were mainly ICU, Department of Cardiology, Department of Respiratory Medicine, and Department of Neurosurgery. The top three diseases were tumors, circulatory system diseases, and respiratory system diseases. Conclusion With the aggravation of population aging, tumors, circulatory system diseases, and respiratory system diseases have become the main causes of inpatient death in this hospital, and elderly patients are the key objects that need attention.

Objective  To systematically evaluate the effect of dapagliflozin on glucose and lipid metabolism in patients with stage Ⅲ of diabetic nephropathy (DN-Ⅲ). Methods  Randomized controlled studies (RCTs) on the effect of dapagliflozin on glucose and lipid metabolism in patients with DN-Ⅲ were retrieved. Literature was screened, the data were extracted, and RevMan 5.4.1. was used for quality evaluation. Results  A total of 2107 patients were included in 23 studies. Meta results showed that compared with the control group, dapagliflozin significantly reduced HbA1c, FBG, PBG, HOME-IR and significantly increased HOME-β in patients with DN-Ⅲ, but it had little impact on ΔFIns; compared with the control group, dapagliflozin significantly reduced TC, TG, LDL-c and significantly increased HDL-c in patients with DN-Ⅲ; compared with the control group, dapagliflozin significantly reduced SBP and DBP in patients with DN-Ⅲ. In addition, compared with the control group, dapagliflozin could significantly reduce BMI, but there was no significant difference in the incidence of ADR. Conclusion  Dapagliflozin can improve the glucose and lipid metabolism in patients with DN-Ⅲ, and it is safe and effective. However, in view of the limitations of the inclusion study, it still needs to be verified by a well-designed large-scale clinical randomized controlled study.

Objective: To calculate the utilization efficiency of medical resources and services in 10 districts and counties of Suzhou City from 2017 to 2023, analyze the differences in service efficiency among different regions and the changing trend of the overall efficiency in the city, so as to provide a reference for improving the management policies of medical institutions. Methods: Based on the weighting completed by the entropy method, the TOPSIS method was used to calculate the relative closeness degree $C_i$ value, rank each region, and analyze the results of 2017 and 2023. Results: 1. From 2017 to 2023, the population receiving medical services in Suzhou City increased by 2.69%, and the total number of practicing physicians increased by 44.05%, which exceeded the growth rate of the service population. The investment in financial appropriation increased by 112%. 2. In terms of the five service quantity indicators, there were significant differences among the 10 districts and counties in 2017. District and county J led far ahead in various diagnosis and treatment quantities; districts and counties A, B, and D completed a relatively large amount of services. In 2023, all service quantity indicators of Suzhou City increased significantly, among which the number of surgeries increased by 97.40%. 3. In 2017, the top five in the city's medical service efficiency were districts and counties J, B, D, A, and E. There were obvious gaps in medical service efficiency among different regions, and the region with the highest service efficiency was 8.94 times that of the last-ranked region. In 2023, the top five regions in service efficiency were basically the same as those in 2017; the region with the highest service efficiency was 13.4 times that of the last-ranked region. 4. The medical service efficiency values of Suzhou City in 2017 and 2023 were 0.4106 and 0.6402 respectively, with an increase rate of 18.68%. Compared with 2017, the city's medical service efficiency was significantly improved in 2019, 2021, 2022, and 2023. Conclusion: From 2017 to 2023, the allocation of medical resources in 10 districts and counties of Suzhou City was unbalanced, and there were differences in service efficiency. From 2017 to 2023, the medical service efficiency of Suzhou City showed an increasing trend.

Objective To linearly weight the results of inverse distance weighted interpolation (IDW), ordinary Kriging interpolation (OK) and thin plate spline interpolation (TPS), and fit a comprehensive model of ensemble interpolation to objectively and comprehensively reveal the spatial pattern of diseases. Methods Taking the mortality rate of liver cancer at county level in Guangxi for example, we revealed the death risk via IDW, OK and TPS interpolation models, and compared the mean prediction error (MPE), root - mean - square prediction error (RMSE), R - square (R2) value and the fitting smoothness of spatial interpolation maps between the IDW model, the OK model and the TPS model. Then, we used the RMSE of above specific models to generate weights to linearly weight single interpolation models, and estimated the death risk of liver cancer across Guangxi by a comprehensive model of ensemble interpolation.
Results The fitting indicators of IDW, OK and TPS models were somewhat inconsistent, and each model had its advantages and disadvantages. Specifically, from small to large, the MPE was TPS (0.002), OK (0.004) and IDW (0.020), respectively, and the accuracy of TPS was better than that of OK. From small to large, RMSE was OK (0.349), TPS (0.362) and IDW (0.390), respectively, and the variability of OK was better than that of TPS. From small to large, R2 was OK (0.47), TPS (0.44) and IDW (0.37), respectively, and OK was better than TPS in fitting accuracy. The comprehensive model of ensemble interpolation integrated the advantages of above three models and overcame the instability of specific models, with MPE, RMSE and R2 being 0.005, 0.352 and 0.43, respectively. Conclusion IDW, OK and TPS interpolation models have their own advantages in estimating the spatial patterns of diseases, but findings of different models are inconsistent to some extent. The comprehensive model of ensemble interpolation reduces the uncertainty of each single model, balances the advantages and disadvantages of each single model and generated a comprehensive evidence to reveal the spatial pattern of diseases, via weighting above three single models.

Objective To analyze the changes in the disease spectrum of discharged patients in a psychiatric specialized hospital from 2013 to 2022, with a focus on exploring the impact of the COVID-19 pandemic on a specific mental disorder, F98, which usually onset during childhood and adolescence, so as to provide a reference for the prevention and treatment of mental diseases and the management of the hospital. Methods The information on the front pages of inpatient medical records of discharged patients from the psychiatry department of a psychiatric specialized hospital from January 1, 2013 to December 31, 2022 was exported through the medical record statistical management system of medical institutions in Guangdong Province. The constituent ratios, changing trends of the main discharge diagnoses of patients in each year, and the differential changes related to the pandemic were analyzed. Results Schizophrenia (F20) ranked first in the disease spectrum for 10 consecutive years. The number of male patients with schizophrenia reached its peak in the age group of 26-35 years old. It is particularly noteworthy that since the pandemic, the number of cases of F98, which usually onset during childhood and adolescence, has significantly increased, especially among female patients, and this increase is statistically significant. Conclusion The hospital should adjust its specialty settings according to the changes in the disease spectrum and the growth of the number of inpatients, and focus on strengthening the construction of the departments of mental disorders, affective disorders, clinical psychology, and the adolescent sub-specialty. At the same time, targeted mental health support should be provided for female adolescents, and public health policies and the education system should be promoted to strengthen mental health education and early intervention to alleviate the long-term impact of the pandemic.

Objective To understand the construction and operation of Internet hospitals in China and provide a reference for improving relevant policies and developing Internet hospitals.Methods A questionnaire survey was conducted on 136 medical institutions in 8 provinces in China to collect operational data in 2022 of Internet hospitals and entity hospitals they were based on. SPSS 26.0 software was used to analyze the data, and the Mann-Whitney U test was used to compare Internet hospitals of different grades.Results Among the 136 medical institutions, 54 have established Internet hospitals, accounting for 39.7%. Among the 54 Internet hospitals, 27.8% have received government investment, 40.7% have set up independent management departments, and 85.2% have reached effective operation. In 2022, the median number of Internet hospitals in effective operation was 20000, which had a large gap compared with the median number of entity hospitals, which was 1.37 million. The top three business systems with the highest construction ratio in Internet hospitals were online diagnosis and treatment system, e-prescription and online medical order system, prescription review and drug distribution system, accounting for 83.3%, 75.9% and 75.9%, respectively.Conclusion In China, Internet hospitals have not established a relatively mature management and operation system, and the financial support is insufficient. Compared with the scale of offline hospitals, the promotion and application of Internet hospitals in China need to be further strengthened. It is necessary to strengthen policy guidance, give full play to the subjective initiative of hospitals, ensure capital investment, standardize the Internet operation and management system, and optimize the construction of information platforms, so as to enhance patients’ experience and satisfaction of Internet hospitals.

Objective To analyze the effect of group narrative psychological intervention on non-suicidal self-injury behavior (NSSI) in adolescent depression patients.Method A total of 118 adolescent depression patients treated in a certain hospital from January 2022 to June 2023 were randomly divided into two groups: the control group of 59 patients and the observation group of 59 patients. The control group received routine nursing care, while the observation group received group narrative psychological intervention besides routine nursing care. The occurrence of NSSI in two groups of patients was statistically analyzed to compare their levels of depression, psychological resilience, and self-esteem before and after the intervention.Results Three months after the intervention, the frequency of NSSI and the degree of injury in the observation group patients were significantly reduced and lower than those in the control group patients (P<0.05). Before and after the intervention, the differences in SDS score, HAMD score, CD-RISC score, and SES score in the control group were 10.01±2.15, 6.91±1.78, 9.45±2.54, and 7.08±1.53, respectively, while the differences in the observation group were 16.14±3.02, 10.08±2.06, 15.10±2.86, and 11.75±2.12, respectively. The differences of the observation group were higher than those of the control group (P<0.05).Conclusion Group narrative psychological intervention can improve the depression situation of adolescent depression patients, reduce NSSI, and is worthy of clinical application.

This paper analyzes the filling and coding quality of the main diagnosis and main surgery in the medical records of intestinal polyps in the Gastroenterology Department, and explores its impact on DRG grouping. Combining with the DRG grouping results, it analyzes the possible problems in coding and explores the changes in DRG grouping before and after code correction. The study finds that the main reasons for coding errors include that clinical doctors do not pay attention to the selection and filling of the main diagnosis, coders lack clinical knowledge and coding skills, and the return time of pathological reports lags. Therefore, it is recommended to strengthen the standardized training of clinical doctors on filling the front page of medical records, improve the professional level of coders, strengthen the hospital quality control process, and establish a supervision and feedback mechanism, etc., so as to improve the accuracy of coding and the correct rate of DRGs grouping, and provide accurate data information for DRGs payment and the hospital.

Objective Through a systematic analysis of the current situation of the professional identity of integrated medical and elderly care talents and its influencing factors, to provide social support for enhancing the professional identity of relevant talents in integrated medical and elderly care and promoting their professional development. Methods Based on the social interaction theory, a self-designed questionnaire was combined with relevant literature. The survey was carried out around three dimensions of the research objects, namely professional cognitive evaluation, interaction influence, and future choices. Results Currently, the overall professional identity of integrated medical and elderly care talents is not high. There are statistically significant differences in the dimensions of professional cognitive evaluation and future choices in terms of age, the possession of old-age care worker certificates, and educational attainment. Conclusion It is necessary to improve the professional identity of integrated medical and elderly care talents by further strengthening social interaction, improving the professional development mechanism for integrated medical and elderly care talents, and providing personalized guidance and services.

Objective To study the fairness of health resource allocation in China's maternal and child health hospitals and provide a reference for further optimizing resource allocation, as maternal and child health hospitals have gradually become an influential part of the medical institutions in China and play a significant role in comprehensively improving the health level of women and children.Methods The Lorenz curve, Gini coefficient, and agglomeration degree were used to analyze the fairness of health resource allocation in China's maternal and child health hospitals from three dimensions: population, economy, and geography.Results (1) The total amount of health resources in China's maternal and child health hospitals is showing an increasing trend; (2) the fairness of resource allocation based on population is better than that based on economy and geographic area; (3) there is a significant regional gap in the health resources of maternal and child health hospitals in China. In terms of geographical distribution fairness, densely populated areas are superior to areas with average or sparse populations; in terms of population distribution fairness, areas with an average population are better than areas with dense or sparse populations.
Conclusion The gap between the supply and demand of health resources in China's maternal and child health hospitals still needs to be filled; it is necessary to focus on improving the fairness of health resource allocation in China's maternal and child health hospitals in terms of geographic dimensions and narrowing the gap in regional health resource allocation.

Objective To compare the clinical characteristics, skin care habits in the half year before the first visit, and emotional states in the half year before the first visit of adolescent acne patients of different genders, so as to seek clinical evidence and new ideas for the individualized prevention and treatment of acne. Methods A questionnaire survey was conducted on adolescent acne patients in the dermatology outpatient departments of two Class III Grade A general hospitals in Shandong from December 2023 to March 2024. The questionnaire content included general information, clinical data, skin care habits in the half year before the first visit, emotional states in the half year before the first visit, etc., and the differences among adolescent acne patients of different genders were compared. Results There were statistically significant differences in the age of initial onset and skin care habits in the half year before the first visit among adolescent acne patients of different genders (P < 0.05), while there were no statistically significant differences in the acne affected areas, family history of inheritance, and emotional states in the half year before the first visit (P > 0.05). Conclusion The age of the first visit and the age of initial onset of adolescent acne patients are younger in males than in females. In terms of skin care habits in the half year before the first visit, there are significant differences in skin care methods between males and females. There are no obvious gender differences in the emotions of stress, anxiety, and depression in adolescent acne patients in the half year before the first visit.

Objective To investigate the impact of medication adherence on blood pressure control in community-dwelling hypertensive patients. 

Methods A follow-up study was conducted on hypertensive patients managed by the Community Health Service Center of Sanxiang Town, Zhongshan City, Guangdong Province, from January 2022 to December 2023. Participants were provided with home blood pressure monitors to collect self-measured blood pressure data, and antihypertensive prescription information was obtained from local community clinics. Two time periods were set: T₁ (2022) and T₂ (2023). Annual medication adherence indicators and blood pressure control effect indices were extracted for each participant. A cross-lagged model was used to analyze the longitudinal associations and predictive relationships between medication adherence and blood pressure control. 

Results A total of 305 patients were included. In the autoregressive path, the associations between medication adherence and blood pressure control at T₁ and T₂ were statistically significant (P < 0.01), both showing positive correlations. In the cross-lagged path, medication adherence at T₁ predicted blood pressure control at T₂ (β₁ = -0.068, P < 0.05), indicating that better medication adherence was associated with reduced severity of blood pressure exceeding the target level. 

Conclusion Both medication adherence and blood pressure control exhibited certain stability, and medication adherence had a definite predictive significance for subsequent good blood pressure control.

Objective To explore the potential profile classification of cognitive function in patients with obstructive sleep apnea hypopnea syndrome (OSAHS), and analyze the influencing factors of different cognitive function classifications.Methods A convenient sampling of 210 OSAHS patients treated in the First People’s Hospital of Yongkang City from April 2021 to April 2024 was conducted to score cognitive function by using the Montreal Cognitive Assessment Scale (MoCA), and the optimal number of cognitive function categories were analyzed and named by potential profile. Clinical data of patients were collected by using hospital electronic medical record system, and the influencing factors of cognitive function classification were analyzed with univariate analysis and multifactor logistic regression.Results The cognitive function of 210 active OSAHS patients could be classified into three potential categories: 54 cases (25.71%) of low cognitive function, 86 cases (40.95%) of middle cognitive function-low memory, 70 cases (33.33%) of high cognitive function. Multivariate logistic regression analysis showed that age (OR=1.043, 95%CI=1.001-1.088), OSAHS severity (OR=1.694, 95%CI=1.069-2.685), and HSP70 (OR=1.589, 95%CI=1.006-2.509) were independent factors of middle cognitive function-low memory type in OSAHS patients with high cognitive function as reference. Age (OR=1.117, 95%CI=1.055-1.183), smoking history (OR=6.893, 95%CI=2.518-18.867), drinking history (OR=4.972, 95%CI=1.893-13.064), OSAHS severity (OR=2.668, 95%CI=1.441-4.942), HSP70 (OR=2.769, 95%CI=1.484-5.168), GABA (OR=0.940, 95%CI=0.910-0.970) were independent factors of low cognitive function type in OSAHS patients (P<0.05).Conclusion There is a certain heterogeneity in the classification of potential profiles of cognitive function in OSAHS patients. Medical staff can focus on OSAHS patients’ age, lifestyle, condition, HSP70 and GABA levels to classify patients and take appropriate measures to reduce cognitive function impairment.

Objective To evaluate the risk level of adverse drug reactions (ADRs) of antidepressant drugs in a Class III Grade A psychiatric specialized hospital by using the risk matrix method and Borda ordinal value method, and screen out the antidepressant drug varieties with higher risks in this hospital, so as to provide a reference for the safe use of clinical antidepressant drugs. Methods A total of 99 ADR reports of antidepressant drugs submitted to the National Adverse Drug Reaction Monitoring Center from 2021 to 2023 in this psychiatric specialized hospital were selected. Taking the incidence rate of ADRs and the severity of ADRs as the risk evaluation elements, the risk matrix method and Borda ordinal value method were used to rank the 14 kinds of antidepressant drugs involved in the reports according to the level of risk, and screen out the antidepressant drug varieties with higher ADR risks. Results Among the 14 kinds of antidepressant drugs, the top three in terms of ADR risk were Mirtazapine Tablets, Mianserin Hydrochloride Tablets and Duloxetine Hydrochloride Enteric-coated Capsules. Among them, Mirtazapine Tablets and Mianserin Hydrochloride Tablets often affected the nervous system, with dizziness being the most common; Duloxetine Hydrochloride Enteric-coated Capsules often affected the digestive system, with nausea being the most common. Conclusion The risk evaluation method based on the risk matrix method and Borda ordinal value method can scientifically reflect the ADR risks of antidepressant drugs.

Objective To investigate the association between the triglyceride-glucose index (TyG) and renal function with the incidence of depression. 

Methods The study population comprised middle-aged and older adults without baseline depression from the UK Biobank database. Exposure variables were the TyG index and renal function. Traditional and additive Cox proportional hazards models were used to estimate the associations between the TyG index, renal function, and depression incidence. 

Results A total of 383,860 eligible participants were included, among whom 20,711 (5.40%) were diagnosed with depression during follow-up. The results showed: - Compared with the lowest TyG quartile (Q1), higher TyG quartiles were associated with a significantly increased risk of depression (HR_Q4 = 1.42, 95%CI: 1.36–1.47; HR_Q3 = 1.27, 95%CI: 1.22–1.32; HR_Q2 = 1.13, 95%CI: 1.09–1.18). - Compared with the normal renal function group, the renal dysfunction group had a significantly higher risk of incident depression (HR_{moderate-severe dysfunction} = 2.14, 95%CI: 1.96–2.33; HR_{mild dysfunction} = 1.32, 95%CI: 1.28–1.36). - No additive (RERI = 0.01, 95%CI: –0.05–0.07) or multiplicative (HR = 0.99, 95%CI: 0.95–1.04) interaction was observed between the TyG index and renal function in relation to depression incidence. 

Conclusion Middle-aged and older adults with a high baseline TyG index or renal dysfunction have a higher risk of depression. Monitoring the TyG index and estimated glomerular filtration rate (eGFR) is recommended for early prevention of depression in this population.

Objective To analyze the effect of tobacco control interventions among rural residents in Tongxiang City, Zhejiang Province, and provide a basis for formulating tobacco control strategies in Tongxiang City. Methods A stratified multi-stage random sampling method was used to select 640 rural permanent residents aged 15–69 years from 4 towns in Tongxiang City as the survey subjects. Tobacco control health interventions were implemented, and the intervention effects were analyzed. 

Results Correct rate of knowledge about tobacco hazards: The correct rate increased from 43.29% before intervention to 68.32% after intervention, with a statistically significant difference (χ²=81.297, P<0.001).Correct rate of knowledge about smoking cessation skills: The correct rate increased from 55.98% before intervention to 72.39% after intervention, with a statistically significant difference (χ²=37.469, P<0.001). Correct rate of knowledge about secondhand smoke handling: The correct rate increased from 29.69% before intervention to 54.69% after intervention, with a statistically significant difference (χ²=82.002, P<0.001). Smoking rate: The smoking rate decreased from 22.97% before intervention to 17.34% after intervention, with a statistically significant difference (χ²=6.291, P=0.012). 

Conclusion After health interventions, the awareness rate of tobacco control knowledge among rural residents significantly increased, and the smoking rate significantly decreased, indicating that the intervention measures are effective and worthy of further promotion.

Objective  To analyze the influencing factors of type 2 diabetes mellitus complicated with nephropathy based on biochemical indexes and construct Nomogram prediction model. Methods The data of patients in the complication group and non-complication group were observed to analyze the relevant factors affecting type 2 diabetes mellitus complicating nephropathy; Nomogram prediction model was constructed and validated. Results Compared with patients in the non-complicated group, the patients in the complicated group had higher levels of BMI, disease duration, CysC, HbA1c, BUN, Cr, hs-CRP, UA, lower levels of FCP, HDL-C, UA, and a higher percentage of the presence of insulin resistance (P < 0.05); the AUC of BMI, disease duration, FCPCysC, HDL-C, HbA1c, BUN, Cr, and hs-CRP were 0.702, 0.696, 0.609, 0.690, 0.626, 0.806, 0.647, 0.607, 0.689, 0.655, respectively (P < 0.05); BMI, disease duration, HbA1c, UA, and insulin resistance were the patients with co-morbid nephropathy (P < 0.05); Nomogram model was constructed based on risk variables to predict the risk of comorbid ne-phropathy in patients with type 2 diabetes mellitus with a C-index of 0.753 (95% CI: 0.712-0.769), and the risk threshold of this model was > 0.15; Analysis of the ROC curve based on the validation set showed an AUC of 0.902 (0.844-0.960); H-L goodness-of-fit test showed: χ² = 14.918, P = 0.061 (P > 0.05). Conclusion BMI, disease duration, HbA1c, UA, insulin re-sistance are the influencing factors of type 2 diabetes mellitus patients with comorbid nephropathy, and the constructed Nomogram model has good predictive ability and clinical practical value. It helps to individualize and quantify the assessment of patients with comorbid nephropathy.

Objectives To explore the long-term trends in demographic characteristics and survival rates of lung cancer patients in a Grade A tertiary oncology hospital in Guangdong Province from 2000 to 2015, so as to provide epidemiological evidence for lung cancer prevention and control strategies. Methods Information of patients first diagnosed with lung cancer in a large Grade A tertiary oncology hospital from 2000 to 2015 was extracted from the hospital's medical record information system, including demographic data, diagnosis and treatment information, and follow-up data up to December 31, 2020. Stratified analysis was conducted according to diagnosis year (2000-2003, 2004-2006, 2007-2009, 2010-2012, and 2013-2015), gender, and age (<45 years, 45-54 years, 55-64 years, 65-74 years, and ≥75 years). Trend chi-square test was used to analyze the changing trends of the composition ratio of patients in different groups during the observation period; life table method was adopted for survival analysis to evaluate the 5-year survival rate and median survival time of patients; weighted least squares regression model was used to analyze the changing trends of survival rate and median survival time. Results A total of 20,685 patients were included in the final analysis, with 71.0% being male and 29.0% being female. The composition ratio of female patients gradually increased from 24.9% in 2000-2003 to 31.5% in 2013-2015 (χ²=49.449, P<0.001). The overall 5-year survival rate of lung cancer patients increased from 20.3% (95%CI: 18.7%-21.9%) in 2000-2003 to 47.6% (95%CI: 46.0%-49.2%) in 2013-2015, with an average increase of 6.8% every 3 years (95%CI: 4.1%-9.4%). The 5-year survival rate of female patients increased more significantly, from 21.4% (95%CI: 18.1%-24.7%) to 56.3% (95%CI: 53.7%-59.0%), with an average increase of 8.8% every 3 years (95%CI: 6.1%-11.6%); the survival rate of male patients increased from 19.9% (95%CI: 18.1%-21.7%) to 43.3% (95%CI: 41.4%-45.2%), with an average increase of 5.5% every 3 years. Age-stratified analysis showed that the 5-year survival rate of young patients increased more significantly; the median survival time of lung cancer patients in different gender and age groups showed an upward trend, with the median survival time increasing from 1.58 years (2000-2003) to 4.90 years (2013-2015) (P<0.05). Conclusions From 2000 to 2015, the 5-year survival rate and median survival time of lung cancer patients in a Grade A tertiary oncology hospital in Guangdong Province increased significantly. Among them, female and young lung cancer patients had higher 5-year survival rates and a greater annual increase, which was attributed to the continuous improvement of lung cancer diagnosis and treatment quality in Guangdong Province. However, the gradual increase in the composition ratio of female lung cancer patients suggests that further research on the pathogenesis of lung cancer and related influencing factors is needed to provide a basis for the formulation of lung cancer prevention and control strategies.

Objective：To explore methods for accurately describing the transition state of disease patterns, facilitating the analysis of related impacts caused by disease pattern transitions. 

Methods：Based on the theory of multidimensional vector similarity and distance metrics, a Disease Pattern Distance Index (DPI) was constructed. Using the disease structure data of inpatients in Shenzhen from 2007 to 2022, the study analyzed the changes in disease patterns and their relationship with the average cost per hospitalization. 

Results：Taking 2007 as the baseline, the in-hospital disease pattern distance index in Shenzhen gradually increased, reaching 20.93 by 2022, indicating a gradual change in disease patterns. Among them, the proportions of trauma/toxicity, pregnancy/delivery, and infectious diseases decreased, while the proportions of tumors, urogenital diseases, and musculoskeletal and connective tissue diseases significantly increased. A positive correlation was found between the Disease Pattern Distance Index and the average cost per hospitalization (r = 0.9929, P < 0.01). 

Conclusion：Disease patterns can be characterized by multidimensional vectors, and the method of measuring vector distances can describe the relative relationships between disease patterns.

Objective To scientifically formulate budget targets, integrate the Diagnosis-Related Groups (DRG) tool into budget management, develop a budget preparation method that matches the medical insurance payment method, and improve the level of budget management. Methods Based on 282,701 DRG-related cases from 2022 to 2023, SPSS 25.0 software was used for statistical analysis. An income budget prediction model was established through analysis of variance and regression analysis. Results According to the model prediction, the Case Mix Index (CMI) in 2024 could reach 1.31, the total weight increased by 9.8%, the unit price per weight decreased from 24,662 yuan to 21,570 yuan, the total budgeted income increased by 6.90%, and the average cost increased by 4.67%. Conclusion Integrating medical services into comprehensive budget management in the form of DRG data realizes the refinement of budget management, promotes the transformation of public hospitals' operation mode to value-based healthcare, and contributes to the achievement of strategic goals. 

Objective To analyze the correlation between psychological resilience and job burnout of nursing staff in the rehabilitation department. Methods From February 26 to May 31, 2024, 102 nursing staff engaged in nursing work in the rehabilitation department were selected as the research subjects. A general information questionnaire, Connor-Davidson Resilience Scale (CD-RISC), and Maslach Burnout Inventory-General Survey (MBI-GS) were used for the survey. Spearman correlation analysis (rs value) was applied to explore the correlation between psychological resilience and job burnout of the nursing staff. Results Among the 102 nursing staff in the rehabilitation department, the total score of CD-RISC (psychological resilience) was 69 (64, 81) [median (interquartile range)], and the total score of MBI-GS (job burnout) was 3 (3, 4) [median (interquartile range)]. The total score of CD-RISC and its dimensions were negatively correlated with the total score of MBI-GS and its dimensions (P < 0.05). Conclusion Psychological resilience of nursing staff in the rehabilitation department is negatively correlated with their job burnout.