"Everyone′s access to healthcare service" is established as the ultimate goal of the healthcare reform,which manifests the principle of impartiality.The practice of impartiality principle is not only the duty-bound responsibility of public hospitals,but also the important orientation of public hospitals′ reform,thus should be performed through out the whole process of healthcare reform,in order to explore a management system of public hospitals consistent with the Chinese current condition.

By analyzing the situation of market competition by modern hospitals, the paper identifies the core competitiveness of the hospital as the key force to be nurtured and promoted by the hospital in its competition in the medical services market; the basic force that spaces out service levels and profits of hospitals at the same level; the unique cultural force shaped by the hospital in a long period of time; the dynamic force rising constantly to mans needs for medical and health care; the main force driving the sustainable development of the hospital in market competition. The paper also proposes five major core competitive capacities to be especially nurtured and promoted by the hospital, viz. the integrative capacity in management, the influencing capacity of specialized fields, the fighting capacity of the team, the cohesive capacity of culture, and the scheming capacity for marketing.

Objective The purpose of this study was to investigate the differences in the anti cyclic fatigue perfor-mance of Woride KS(WKS),Proteper Gold(PTG),and Hyflex CM(HCM)nickel titanium instruments with different tip diameters in curved root canal models,and to provide reference for the targeted selection of suitable nickel titanium in-struments in clinical preparation of curved root canals.Methods Three kinds of new nickel titanium files with 20#and 25#(0.20 mm and 0.25 mm)tip diameters were selected,including WKS(20/0.06),WKS(25/0.06),PTG(20/0.07),PTG(25/0.08),HCM(20/0.06),and HCM(25/0.06),each with 20 files.According to the recommended speed and torque of the motor,the anti cycle fatigue performance of the nickel titanium file was tested in 30° and 60° stainless steel root canal models.The time from rotation to fatigue fracture(TTF)of the nickel titanium file was recorded with a camera and timer,and the fragment length(FL)was measured and recorded with a Vernier scale.Results Com-parison of TTF of the same type of file.① WKS:the TTF of files with the same tip diameter in a 30° curved root canal was longer than 60°(P＜0.05);The TTF of 25# nickel titanium files in the same angle curved root canal was longer than that of 20# nickel titanium files(P＜0.05).②PTG:the 20# nickel titanium files had a TTF longer than 60° in a 30° curved root canal(P＜0.05),while the 25# nickel titanium files had no statistically significant difference in TTF be-tween the 30° curved root canal and 60° curved root canal(P＞0.05);In a 30° curved root canal,the TTF of 20# nickel titanium files was longer than that of 25# nickel titanium files(P＜0.05).In a 60° curved root canal,there were no sta-tistically significant difference between the TTF of 20# nickel titanium files and 25# nickel titanium files(P＞0.05).③HCM:the TTF of files with the same tip diameter in a 30° curved root canal was longer than 60°(P＜0.05);The TTF of 20# nickel titanium files in the same angle curved root canal is longer than that of 25# nickel titanium filea.Compari-son of TTF of different files:in a 30° curved root canal,there was no statistically significant difference in TTF among the three types of 20# nickel titanium files(P＞0.05).The TTF of 25# WKS was longer than that of other files(P＜0.05);In a 60 ° curved root canal,the TTF of 20# HCM was longer than other files with the same tip diameter(P＜0.05),and the TTF of 25# WKS was longer than HCM with the same tip diameter(P＜0.05).The FL of 20# PTG,25#PTG,and 20# HCM in the 30° curved root canal model is significantly longer than that of 60°(P＜0.05),while there is no statistical difference in FL among 20# WKS,25# WKS,and 25# HCM in the 30° and 60° curved root canal models.Conclusion The anti cyclic fatigue performance of WKS is significantly superior to PTG and HCM in a 30° curved root canal.In a 60° curved root canal,20# HCM had a significant advantage in terms of anti cyclic fatigue performance compared to other files,while only 25# WKS had a significant advantage in anti cyclic fatigue performance compared to HCM.

Objective To systematically analyze the literature on ABO-incompatible(ABOi)organ transplantation and explore the research hotspots and trends in this field.Methods CiteSpace software was used for visual analysis of ABOi organ transplantation literature collected from the China National Knowledge Infrastructure,VIP web,Wanfang Data,and the Web of Science Core Collection database from January 1,2013 to December 31,2023 after cleaning,including the volume of literature published,authors,countries,institution and keywords.Results A total of 588 valid foreign-language author publications and 85 valid Chinese-language author publications were included.Since 2021,the volume of foreign literature publications has shown a downward trend,while the volume of domestic literature published has generally shown a upward trend.The top two core Chinese authors are Wang Yi and Zhu Zhijun;the top three core authors in foreign literature are Nakatani Tatsuya,Tanabe Kazunari,and Uchida Junji.The most active institution in China is Huazhong University of Science and Technology,followed by Zhejiang University and Sichuan University,with relatively insufficient closeness in cooperation between related institutions.The institutions with the most publications abroad are Ulsan University,Seoul National University and Tokyo Women's Medical University in Japan.The top three countries in English-language literature publications are Japan,Republic Korea,and the United States,and China ranked 5th.Keyword cluster analysis shows that the research focus of at home and abroad is mainly on nine topic clusters including ABOi organ transplantation,cryoprecipitation,kidney transplantation,liver transplantation,blood type antigen detection technology and post-transplant complications.Conclusions At present,The research in the field of ABOi organ transplantation is mainly concentrated on kidney transplantation and liver transplantation,showing an overall positive development trend.In the future,it is expected to further promote development of this field by strengthening international cooperation,expanding research investment and promoting the application of advanced technologies.

Objective To analyze and discuss the epidemiological characteristics and drug resistance of pathogenic bacteria of infective endocarditis in Nanjing in the past five years, and to provide reference for the prevention and treatment of infective endocarditis. Methods A total of 220 infective endocarditis cases in Nanjing area from 2015 to 2020 were included in the analysis. The distribution characteristics of pathogens were collected and analyzed. Information on drug resistance was also collected, and the potential relationship between pathogen distribution and drug resistance was explored. Statistical analysis was performed using SPSS 19.0. Results The ratio of male to female patients included in this study was 143:77, and most of them were aged from 41 to 60 years old. There were 195 patients with underlying cardiac diseases (88.64%). A total of 1132 pathogenic bacteria were detected in the blood samples of all 220 patients, among which 1 007 were mainly gram-positive bacteria (88.96%): 725 strains of Streptococcus viridans (725/1 132, 64.05%), 124 strains of Staphylococcus aureus (124/1 132, 10.95%), 96 strains of Staphylococcus epidermidis (96/1 132, 8.48%), and 62 strains (62/1 132, 5.48%) of others (Staphylococcus human, etc.); the main gram-negative bacteria ( a total of 125 strains , 11.04%) were 73 strains of Pseudomonas aeruginosa (73/1 132, 6.45%) and 52 strains of Escherichia coli (52/1 132, 4.59%). Among the strains isolated from subjects of different ages and genders, the distribution difference was consistent with the total trend, and there was no significant difference (all P>0.05). Among gram-positive bacteria, Streptococcus was sensitive to antibiotics such as penicillin, oxacillin, and vancomycin. Staphylococcus aureus and S. epidermidis were sensitive to vancomycin and resistant to oxacillin and penicillin. Gram-negative bacteria were less resistant to amikacin and meropenem. All these differences were statistically significant (all P<0.05). Conclusion For patients with infective endocarditis, antibiotics should be selected reasonably according to the type of pathogenic bacteria and the corresponding drug resistance characteristics.