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ObjectiveTo compare and analyze the "same disease, same price" policy in the regionsimplementing diagnosis related group(DRG) payment reform, and to provide recommendations for further policy optimization and extension.MethodsDRG policies published on official website of healthcare security bureaus from all provinces and 190 cities between 1 January 2019 to 31 May 2024 were collected. Microsoft excel was applied to collect the information, and the comparative analysis method was used to summarize and analyze the DRG polices from three dimensions: region, healthcare facility, and disease groups coverage.ResultsThe regions where the "same disease, same price" policy in DRG payment was implemented were limited and unevenly distributed. The policy has been implemented in 76 cities across 16 provinces, 2 municipalities, and 3 autonomous regions, accounting for 40% of the cities implementing DRG payment. The pilot cities were mainly concentrated in eastern China. Coverage of healthcare facilities varied across regions. This policy covered all levels of healthcare institutions in most of the pilot cities, while it was primarily implemented in secondary and tertiary hospitals in some regions. The selection criteria for primary disease groups were generally consistent: the common diseases with mature diagnostic, treatment techniques and stable medical costs. However, the number, relative weight, and distribution of primary disease groups varied across regions, with the number ranging from 3 to 117 and relative weight ranging from 0.16 to 1.57. The primary diseases were mainly concentrated in internal diseases, with asthma and hypertension being the most common disease groups.ConclusionIt is recommended to expand the scope of region coverage, determine the scope of hospital coverage according to local capacities, expand the scope of disease groups by stages, and evaluate the effect of policy implementation.

Objective To investigate the regulatory mechanism of apurnic/apyrimidinic endonuclease 1(APE1) in the transformation of chronic intestinal inflammation to colitis-associated colorectal cancer (CAC). Methods C64S mutant (APE1C64S) mice and APE1 wild type (APE1WT) mice were randomly divided into experimental group and control group.In vivo CAC model was established by azoxymethane (AOM) and dextran sulfate sodium salt (DSS) solution.Immunohistochemistry (IHC) and multiple IHC (mIHC) assays were used to observe the expression of APE1 and immune cell infiltration in colon tissues of each group.A mouse colon cancer cell line MC38 with stable knockdown of APE1 was constructed by lentivirus transfection, and subcutaneous tumor bearing experiments were performed in APE1WT and APE1C64S mice to confirm that tumor cell-derived APE1 caused immunosuppressive tumor microenvironment.The expression of APE1 and CXCL1[chemokine (C-X-C motif) ligand 1]and the infiltration of immune cells in tumor-bearing specimens were analyzed by IHC and mIHC assays.The tumor specimens of a 28-year-old female patient with CAC from Army Medical Center of PLA were analyzed for the expression of APE1 and CXCL1 and the infiltration of immune cells in the tumor and adjacent inflammatory tissues by IHC and mIHC assays. Results Compared with the control group and APE1WT erperimental group, APE1C64S erperimental group had significantly reduced disease activity index and tumor formation, polymorphonuclear myeloid-derived suppressor cells (PMN-MDSCs) infiltration, and CD4+ and CD8+T cells (P < 0.05).No significant differences were observed in tumor growth and immune cells between APE1WT and APE1C64S mice bearing subcutaneous tumors.However, in the tumor-bearing experiment using tumor cells with knockdown of APE1, the tumor growth was significantly lower and the number of infiltrated PMN-MDSCs was reduced, while those of CD4+ and CD8+T cells were significantly increased (P < 0.05).Furthermore, high expression of APE1 and increased infiltration of PMN-MDSCs were found in the tumor tissues of the young CAC patient, and CD8+T cells were significantly reduced in the tumor tissues compared with the inflammatory tissues (P < 0.05). Conclusion APE1-redox in tumor cells can promote the infiltration of PMN-MDSCs and reduce the number of T cells, thereby forming an immunosuppressive tumor microenvironment and mediating the occurrence and development of CAC.

This paper summarized the experience of acupotomy therapy and nursing for a patient with lumbar disc herniation and pain. Primarily, it is required to enhance the preoperative preparation, intraoperative cooperation and vital signs assessment. Moreover, consideration should be taken on care of puncture sites, health education and exercise guidance after surgery. Implementation of systematic and scientific nursing interventions is able to relieve patients’ negative emotion and improve the treatment compliance and postoperative recovery. (本文总结脊柱针刀治疗1例腰椎间盘突出症伴疼痛患者的护理经验。术前做好准备工作; 术中积极配合、密切观察; 术后加强穿刺点的护理、开展健康宣教、指导患者进行相关锻炼。通过科学的护理, 有助于缓解患者不良情绪, 提高术中依从性, 促进患者早日康复。)