Objective To study the effect and adverse reaction of lactulose oral solution on the treatment of postpartum constipation.Methods A total of 120 patients with postpartum constipation were randomly divided into treatment group (n=61) and control group (n=59).The treatment group received 15 mL lactulose oral solution,twice a day.The control group received wheat cellulose particles 3.5 g,twice a day.After the improvement of symptoms,the patient''s medication frequency was changed to 1 time a day,the course of treatment was 2 weeks long.The curative effect(including before treatment,period during the treatment,and the first week after finish the whole treatment) and the recurrence of constipation after treatment were observed.Results The frequency of defecation per week in the treatment group was(3.83±1.61)times,that in the control group was(3.09±1.53)times at the first week after treatment(P<0.05),those were(6.22±1.96)and(5.15±1.71)times respectively in the second week(P<0.01),and (6.43±1.87),(5.29±1.64)times respectively at the first week after treatment(P<0.05).The total recurrence rate in the two groups were 4.92% and 10.17% respectively(P>0.05) after follow-up to 60 d.The degree of drug acceptance in two groups was 100.00% and 76.27% respectively(P<0.01).There was no obvious adverse reaction in both two groups.Conclusion The effect of lactulose oral solution on the treatment of postpartum constipation is definite and with low recurrence rate.Lactulose oral solution has a good taste,easily to be taken and to be accepted,it is worthy of clinical application.

ObjectiveToobserve the regulating effect of acupuncture at Fengchi (GB20) and extraordinary points on tumor necrosis factor (TNF)-aand endothelin (ET) in hypertension.MethodTotally 150 patients with hypertension were randomized into two groups at a ratio of 1:1.In the control group, 75 subjects were intervened by acupuncture at bilateral Fengchi; in the treatment group, 75 subjects were intervened by acupuncture at bilateral Fengchi plus extraordinary points. The needles were manipulated once every 10 min duringthe 30-min session. The treatment was given once per day, 2 weeks as a treatment course. ResultDuring the intervention, the TNF-aand ET contents were decreased significantly in the treatment group (P<0.05); the TNF-aand ET contents were also decreased in the control group but without statistical significance (P>0.05). After 1 treatment course, the TNF-aand ET contents were decreased significantly in the treatment group (P<0.05); the TNF-aand ET contents were insignificantly decreased in the control group (P>0.05); there was a significant difference in comparing the TNF-aand ET contents between the two groups (P<0.05). There were also significant differences in comparing the TNF-aand ET contents inhypertension of various degrees between the two groups (P<0.01). The results showed that the TNF-aand ET contents in patients intervened by acupuncture at Fengchiand extraordinary points were lower than that in those intervened by acupuncture at Fengchialone, i.e. combination of Fengchi and extraordinary points produces a significant effect on regulating TNF-aand ET contents.Conclusion Acupuncture at Fengchi and extraordinary points can produce a more significant effect than acupuncture at Fengchi alone on regulating TNF-aand ET in patients with hypertension.

Objective To explore the relationship between skin photo reactions and structural pa-rameters. Methods Benzophenone-1, Benzophenone-2 and Benzophenone-3 were assessed by phototoxici-ty test and photoallergic test on guinea pig. And the phototoxicity index and photoallergic index were cal-culated after clinical assessment. Structural parameters of the three sunscreens like total energy, binding energy, electronic energy, heat of formation, dipole and sum of the net charges were also calculated by the soft of HyperChem7.0, respectively. Results The phototoxicity index rised with total energy, elec-tronic energy and sum of net charges increasing. And the photoallergy index rised only with binding ener-gy increasing. So there was some correlation between phototoxicity index and total energy, electronic en-ergy and sum of net charges (P<0.01). Significant relationship was only between the photoallergy index and binding energy (P<0.01). Conclusions The phototoxicity is correlated with total energy and e-lectronic energy, while photoallergy is related to binding energy. It is possible to establish a model evalua-ting the safety and structural parameters of benzophenone ramifications.

Objective The purpose of this study was to explore the early experience of elderly patients who had the Percutaneous Coronary Intervention (PCI) for the second time due to coronary restenosis, so as to provide targeted nursing interventions. Methods Nine elderly male patients underwent the second-time PCI were interviewed by using qualitative research method. Results The main experiences of these patients were as follows: obvious emotional disorder, rational intellectual curiosity, purposeful behavior modification and eager to obtain support from the family and society. Conclusions Nursing care for elderly male patients after the second-time PCI should involve mental care, knowledge, behavior, and family and social support.

Taking the reform of payment methods based on diagnosis related groups as an opportunity, implementing performance management based on disease groups is an important lever to promote the improvement of hospital diagnosis and treatment level and high-quality development. In 2023, a tertiary comprehensive hospital introduced benchmarking management into performance management, using the average days of stay, drug costs, and consumables costs of the disease group as cost benchmark indicators. The cost benchmark values for each disease group was determined based on the big data of the disease group of the tertiary comprehensive hospital in the region and the clinical pathway management goals of the hospital. Through multidimensional and multi-level comparative analysis of the hospital′s historical values and regional big data distribution values of the benchmark indicators for each disease group, the cost benchmark values for each disease group was determined. The hospital has established a performance reward and punishment mechanism based on the benchmark value of disease group costs, and at the same time, established a performance management communication mechanism to promote relevant departments and medical groups to improve their management against the benchmark. In addition, with changes in the external environment and internal practices, the cost benchmark value of the disease group was dynamically optimized, forming a closed-loop management system that included establishing benchmarks, comparing benchmarks, achieving benchmarks, and optimizing benchmarks. Since the implementation of performance management based on disease group cost benchmarking in March 2023, the hospital′s case mix index has increased from 1.52 in March to 1.54 in September; The average days of stay decreased from 6.22 days to 5.90 days; The monthly payment weight has increased from 18 103 to 18 558; The average hospitalization cost has decreased from 16 724 yuan/person to 15 278 yuan/person, mainly due to the decrease in drug and consumables costs. The proportion of drug costs has decreased from 27.45% to 26.32%, the proportion of consumables costs has decreased from 28.75% to 26.85%, and the proportion of medical service revenue has increased from 24.64% to 26.08%; The proportion of low magnification cases decreased from 9.09% to 8.24%; The medical insurance payment rate has increased from 99.3% to 107.0%; The job satisfaction of physicians has increased from 70.00% in 2022 to 76.77% in 2023, which can provide reference for performance management practices in other hospitals.