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 assess the causal effect of schizophrenia on substance abuse and alcohol use disorder, to clarify the causal associations between diseases and behaviors, and to provide new ideas and protocols for improving clinical treatment and prognosis.
Methods Summary statistics from genome - wide association studies of schizophrenia, substance abuse, and alcohol
use disorder were used to exclude instrumental variables with confounding factors and directionally harmonize the data, provided that the three major assumptions of Mendelian randomization of instrumental variables were met. Two - sample Mendelian randomization of the data was performed using the inverse variance weighted method as the main analytical method, with the weighted median method, MR Egger method, simple mode and weighted mode as supplementary analytical methods. Sensitivity analyses were performed using Cochran Q test, MR - Egger intercept analysis and leave - one - out method to test for heterogeneity and pleiotropy and to assess the stability and reliability of the results.
Results In order to exclude the effect of weak instrumental variables and to make instrumental variables strongly correlated with exposure, a more stringent threshold than that of previous studies was used, and a total of 64 single nucleotide polymorphism loci were included as instrumental variables with the P - value threshold set at 5×10⁻¹⁰. The inverse variance weighted method estimated that the risk (OR) of developing substance abuse in schizophrenia was 1.19 times higher than that of the general population (95% CI: 1.126 - 1.261, P = 1.499×10⁻⁹), and the results of the other four analyses also indicated that schizophrenia increased the risk of substance abuse. For the data on
schizophrenia and two groups of alcohol use disorder, the inverse variance weighted method estimated that the risk (OR) of alcohol use disorder in patients with schizophrenia was 1.17 times (95% CI: 1.105 - 1.239, P = 7.398×10⁻⁸) and 1.13 times (95% CI:1.072 - 1.187, P = 3.124×10⁻⁶) that of the general population, respectively. The evaluation results of the weighted median method, simple mode and weighted mode also provided evidence that schizophrenia increased the risk of alcohol use disorder.
Conclusion The existence of a positive causal effect of schizophrenia with substance abuse and alcohol use disorders provides an important idea and basis for subsequent clinical research.

In February 2024, the International Agency for Research on Cancer team updated and published Global Cancer Statistics Report 2022 in the authoritative journal CA: A Cancer Journal for Clinicians under the American Cancer Society. This report covers updated data on the incidence and mortality of 36 types of cancer from 185 countries and regions worldwide, and analyzed the recent trends, potential influencing factors, and prospects for global cancer prevention and control of 10 major cancer types from 20 different regions worldwide. The report predicts the heavy burden of cancer by 2050 based on global population trends and emphasizes the urgency of investing in cancer prevention and control. The team from the Cancer Hospital of the First Affiliated Hospital of Xinxiang Medical University has reviewed the report and provided a brief interpretation based on the prevalence trends and disease burden of major cancers in China.

Objective To analyze the epidemiological characteristics of malignant tumors collected from the monitoring points of China′s cause of death surveillance system in 2021, to grasp the loss of life expectancy due to malignant tumors in China′s population and analyze the factors affecting it, and to estimate the burden of disease due to malignant tumors in China in.Methods The malignant tumour mortality rate and potential years of life lost of Chinese residents were calculated by different age and gender groups by using Excel 2021 and SPSS 26.0 software. Results The mortality rate of malignant neoplasms in our cause of death surveillance system in 2021 was 164.2/100000, and the median rate was 156.7/100000. The top 5 in potential years of life lost and mortality were lung, liver, stomach, colorectal, and esophageal cancers. The potential years of life lost due to cancer deaths in our population in 2021 totaled 4575932 person - years, resulting in a loss of 370.54 billion yuan in GDP for the whole society. Conclusion The burden of malignant tumors in China remains heavy, with obvious regional, age and gender differences in the burden of malignant tumors. Measures such as improving the cancer prevention and treatment system and promoting measures such as cancer screening and early diagnosis and treatment are crucial to reducing the burden of malignant tumors.

Objective To analyze the main disease composition of inpatient deaths in a tertiary comprehensive hospital
from 2016 to 2022, and provide a basis for the hospital to further reduce case fatality rates. Methods Medical record data suchas name, gender, age, discharge diagnosis, disease code, etc. were extracted from the electronic medical record system of a tertiary comprehensive hospital from January 1, 2016 to December 31, 2022. According to the International Classification of Diseases (ICD - 10), Excel 2016 and SPSS 25.0 were used to perform statistical analysis on the data. Results From 2016 to 2022,the number of deaths was 3777, with the case fatality rate of 1.14%. Among them, the case fatality rate of male (1.60%) was higher than that of female (0.73%), and the difference was statistically significant (χ² ＝ 564.778, P ＜ 0.001). With the increase of age, the case fatality rate gradually increased, with the highest case fatality rate 5.09% for those aged 90 and above,and the highest number of deaths occurring in the 70 - 79 age group. The top three causes of death were tumors, circulatory system diseases, and respiratory diseases. Conclusion It is necessary to pay attention to the health status of male and elderly groups,and strengthen the promotion of health knowledge. Tumors, circulatory system diseases, and respiratory system diseases are the
main causes of death. It is necessary to strengthen talent development and technological innovation in corresponding departments to reduce case fatality rates.

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 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 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 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 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 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 classify hospitalized patients' diseases based on cost structure, and to provide data reference for controlling medical costs and optimizing the structure of medical income. Methods The first page information of inpatient cases from January 2023 to June 2024 in a tertiary hospital in Beijing was selected to extract inpatient expense details, and patients were categorized based on the ICD - 10 disease diagnosis codes of their primary discharge diagnoses. K - means clustering analysis was used to classify diseases according to cost structure, so as to analyze the characteristics of each category's cost structure. Results Based on cost structure, patient diseases were classified into four categories. Category 1 included diseases with high consumable costs, mainly comprising pyonephrosis, ureteral stones, and unstable angina pectoris; category 2 had the highest diagnostic fees, including unspecified liver cirrhosis, alcoholic liver cirrhosis, chronic hepatitis B without delta agent, etc.; category 3 featured balanced proportions across all fee types, including installation and adjustment of urinary devices, unspecified liver
malignancies, medical abortion without complications, etc.; category 4 had relatively higher medication costs, including other specified medical care, chronic liver failure, and chemotherapy sessions for tumors, among others.Conclusion Although high consumable or medication costs may be due to treatment requirements of certain diseases, it is still necessary to reduce expenses through multiple links such as procurement, usage, and management to effectively control medical costs and improve the quality of medical services.

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 internal composition and correlation of hospitalization expenses of negative difference cases in gynecological DRG disease group, so as to provide decision - making reference for hospitals to optimize the cost structure and realize the fine management. Methods The medical insurance year - end liquidation data of the DRG group (a total of 13 groups) with more than 100 cases of gynecological diseases in a tertiary hospital in 2023 were collected. The structural change degree method was used to analyze the changes in the internal composition of hospitalization expenses, and the new grey correlation analysis was used to evaluate the correlation between each subdivision cost and the total hospitalization cost.Results The proportion of negative balance in 8951 cases was 50.2%. There were 8 groups with more than 50% negative difference cases in each DRG group. The three groups with the highest degree of structural change were NZ13 (other diseases of female reproductive system with general complications and comorbidities), NB13 (female reproductive system reconstruction surgery with general complications and comorbidities), and RE13 (malignant proliferative diseases chemical and/or targeted, biological treatment with general complications and comorbidities). The contribution rate of inspection fee was higher in each group, followed by

operation fee. The top three of the correlation degree of the subdivision cost and the average cost with hospitalization expenses were operation cost (0.744), inspection cost (0.743) and drug cost (0.712). Conclusion It is necessary to pay attention to the fees of surgical items, carry out reasonable inspections, scientifically control the proportion of drug consumption and rationally adjust the cost structure, standardize the quality of the medical record home page,optimize the clinical pathway, and reduce the occurrence of negative difference cases through various measures.

Under the backdrop of the ‘Healthy China’ strategy, it is essential to evaluate and analyze health service productivity in China. This study aims to investigate the factors influencing health service productivity by systematically examining
and analyzing literatures from both domestic and international sources. Through a comprehensive review of the current state of measuring health production efficiency, influencing factors, and research methods, this study identifies gaps and obstacles in existing research. The goal of this paper is to offer a robust literature foundation and theoretical framework for a more precise evaluation of health service productivity efficiency, as well as for enhancing healthcare resource allocation and service quality.

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 The study aimed to sort out the research hotspots and development trend in this field in the past 10 years, and to provide reference for the research of cancer prognosis prediction model, through the econometric statistics and
visual analysis of the related research of cancer prognosis prediction model. Methods Web of Science, PubMed, and CNKI databases were used as the search sources, and the literature on cancer prognosis prediction model published in the Chinese and English search sources from Jan. 1st, 2013 to June 15th, 2024 was analyzed and visualized based on CiteSpace, VOSviewer software, and the bibliometrix package of the R language.Results A total of 1341 Chinese articles were retrieved through the CNKI database, with 1322 valid articles remaining after duplication. From the WOS and PubMed databases, 2069 and 3284 English articles were retrieved, respectively. After merging and duplication, 4908 valid English articles were retained. The overall trend of publications from 2013 to 2024 was upward. The country with the most publications in English literature was China (2270 articles), the institution with the most publications was Fudan University (268 articles), and the institution with the most publications in Chinese literature had only five articles. The authors who have published the most Chinese literatures were Wang Debin (5 articles), Chai Jing (5 articles), and Liu Yang (5 articles), and the author who published the most English literature was Wang Wei (24 articles). The high - strength emerging words in both Chinese and English literature were breast cancer (Chineseemergent strength: 8.95, English emergent strength: 11.06), and the clustering results showed that the related studies of colorectal cancer, bladder cancer, prostate cancer, machine learning were more prominent. Conclusion Cancer prognostic prediction modeling is receiving more and more attention from experts and scholars, covering more cancer types and richer research methods. Machine learning algorithms are being used more often, and the nomogram visualizes the results to better guide clinical practice. The application of genome - wide association analysis in the field of cancer prognosis prediction is expected to be a potentially promising research direction. Universal collaboration among countries, institutions, and authors has not yet been established, and there is a need to further strengthen the cooperation for deeper academic cross - fertilization. The cancer - suppressive mechanisms of
iron death and copper death have received more attention and have a broad clinical research prospect.

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 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 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 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 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 explore the reasons for the behavior of uploading minor diagnostics with no resource consumption, analyze the impact of this behavior on medical insurance payment, improve the awareness and attention of medical institutions to this problem, and seek targeted solutions from two aspects of hospital management and medical insurance supervision.Methods By comparing medical record filling information and DRG enrollment results, quality control was carried out on randomly selected medical insurance settlement lists, and theoretical research was carried out on cases that received more medical insurance payments. The process of the behavior of uploading minor diagnostics with no resource consumption was sorted out to analyze the deep causes. Results The behavior of uploading minor diagnostics with no resource consumption is prominent, and the high - score group leads to high medical insurance payment. This problem is even more pronounced in comprehensive medical institutions, but existing regulatory instruments are not working well. Conclusion The key to solving this problem is, on the one hand, to strengthen training management in these hospitals, and on the other hand, to solve the practical problems of medical institutions and steer in the right direction.

Objective To explore the ICD - 10 coding of pheochromocytoma and paraganglioma.Methods By introducing the different pathological characteristics of tumors and three clinical cases, a retrospective analysis was conducted on cases of incorrect coding. The coding ideas and methods of tumors were sorted out, and the reasons for coding errors were summarized.Results The classification of pheochromocytoma / paraganglioma is complex and the morphology is variable. It is easily confused with other tumors or the benign and malignant tumors cannot be distinguished, resulting in coding errors.Conclusion Coders should strictly follow the coding rules and steps of the International Classification of Diseases, carefully read medical records, and actively communicate with clinical and pathological doctors to ensure coding quality and improve the accuracy of their disease coding.

Objective To explore the problems and countermeasures of medical staff in public hospitals in dealing with public health emergencies, in order to provide valuable reference for improving the emergency response capacity of public hospitals. Methods A stratified sampling method was used to randomly select 593 medical staff from 33 wards of 7 departments in a public Grade Three general hospital in Shandong Province, which were closely related to public health. In order to improve comparability and assess the overall performance level more accurately, this study converted scores into grades, so as to analyze the current situation and influencing factors of public hospital medical staff in responding to public health emergencies, and put forward improvement measures and suggestio.Results The participation rate of medical staff in emergency drills, emergency training and emergency handling in response to public health emergencies was 45.14%, and the qualified rate was 58.40%, both at a low level. The qualified rate of medical staff who did not participate in such activities was only 40.78%, compared with 79.83% who participated in activities, the difference was statistically significant (P < 0.05). The overall score rate of these three aspects was 56.11%, indicating that the level of emergency ability was low, and the average score was (2.81 ± 0.88), which
was significantly lower than the qualified score (P < 0.001). Among the three dimensions, the score rate of emergency rescue ability was the highest (75.34%), followed by personal emergency attitude (73.52%), and the ability to master emergency knowledge was the lowest (65.23%). Conclusion In response to public health emergencies, medical staff in the public hospital need to improve their participation in emergency practice activities, ability to grasp emergency knowledge, personal monitoring and early warning ability, and mental health. It is suggested to strengthen the training of basic emergency knowledge and practical skills of medical staff, improve the monitoring and early warning system, and improve the psychological intervention ability of medical staff.

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 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 investigate the influencing pathways and effects of spatial partition on doctors' work interruptions and work engagement under the open work environment. Methods From July to September 2021, a convenience sampling

survey was carried out for doctors from 10 clinical departments of a public hospital in Guangzhou. Data about office space partitions, work interruptions and work engagement of participants were collected via an online self - reported questionnaire. Spatial partition patterns were classified as non - partitioned, half - partitioned and full - partitioned according to the number of partitions and architectural features. Descriptive analysis and multivariate analysis were conducted, and the influencing pathways and effects of spatial partition and work interruption, work engagement were examined with the structural equation mode.Results A total of 128 doctors were included, with 58, 40 and 30 respondents worked in non - partitioned, half - partitioned or full - partitioned space,respectively. The mean levels of work interruptions in the full - partitioned group were lower than those in the non - partitioned and half - partitioned groups, but for a higher mean score of work engagement (P < 0.05). Compared with the non - partitioned pattern,

full - partition had a direct positive effect on work engagement (β = 0.583, P = 0.005), as well as an indirect effect on work engagement through work interruptions (β = 0.225, P = 0.020). The mediating effect accounted for 27.8% of the total effect.Conclusion Under an open space work environment, there is an association between physicians' work engagement and spatial partition pattern, work interruptions, and work interruptions plays a partial mediating role among them. The full - partition pattern is beneficial for enhancing doctors' work engagement level.

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 explore the correlation between professional self - concept and personal career planning of undergraduate nursing students. Methods Convenience sampling method was used to select 191 nursing undergraduate students from a nursing college in Shandong Province as the survey subjects. The questionnaire survey was conducted by using a general information questionnaire, a professional self - concept scale, and a personal career planning scale. Results The average score of the professional self - concept scale items for undergraduate nursing students was (2.99 ± 0.37), which was above the average; the average score of the items in the personal career planning scale was (3.56 ± 0.54), which was at a moderate level; there was a positive correlation between the two groups (the typical correlation coefficients were 0.661 and 0.412, respectively); and professional self - concept, learning status, and relationships with classmates were the main influencing factors of personal career planning (P < 0.05), jointly explaining 44.2% of the total variation in personal career planning for undergraduate nursing students.
Conclusion The personal career planning of undergraduate nursing students is above the medium level. Education managers and nursing students themselves should attach importance to the cultivation of professional self - concept to improve their personal career planning level.

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 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 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 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 explore the application of time - series decomposition method in predicting the number of outpatient cases of schizophrenia and to provide a basis for rational allocation of medical resources.Methods Schizophrenia cases with a first outpatient visit to a hospital from January 2013 to December 2022 were included in our study. Seasonal analysis was performed by using the seasonal decomposition module in SPSS 26.0 software, and a seasonal trend model was developed to evaluate the predictive performance of the model by using the outpatient data of the hospital from January to June 2023.Results The number of outpatient cases of schizophrenia in this study showed a decreasing trend year by year, with slight seasonal fluctuations characterized by a few months, but none of them exceeded the 20％ limit, and there was no obvious seasonal phenomenon. The model verification showed that the predicted value was basically consistent with the actual number of outpatient cases in the same period.Conclusion In recent years, the number of outpatient cases of schizophrenia has shown a significant long - term decreasing trend, and the disease has no obvious seasonal phenomenon. The time - series decomposition method can be used to predict the number of outpatients with schizophrenia.

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 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 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.

Objective To explore the feasibility of the application of mobile percentile control chart method in the monitoring and early warning of device - associated infection in the intensive care unit, so as to provide guidance for the monitoring and early warning for healthcare - associated infection. Methods Monthly incidence data of device - associated infection in the intensive care unit of a tertiary hospital in southern Jiangsu Province were collected from 2017 to 2022, and the early warning models were established by using control chart method. The optimal thresholds were selected through establishing a control chart model based on different boundary values. Results By comparing the results of sensitivity, specificity, positive predictive value, Youden index and the figure of receiver operating characteristic curve, the optimal warning thresholds of central line associated - bloodstream infection, ventilator - associated pneumonia and catheter - associated urinary tract infection were P85, P90 and P75, respectively, and the corresponding Youden indices were 0.91, 1.00 and 0.80, respectively. Conclusion Control chart method could be applied in the monitoring and early warning of device - associated infections, conveniently, practically and efficiently.