OBJECTIVE:To establish capillary electrophoresis method for the determination of imperatorin and isoimperatorin in Yuanhu zhitong tablet. METHODS:The separation was performed on a uncoated fused silica capillary (55 cm?75 ?m ID,effective length of 47 cm) with 20 mmol?L-1 NaH2PO4+100 mmol?L-1 SDS+80%formamide as buffer solution (pH=7.12). The separation voltage was 15 kV and the sample was injected by gravity (5 s,15 cm). The detection wavelength was 254 nm. RESULTS:The linear range of imperatorin and isoimperatorin were 8.0～40.0 ?g?mL-1(r=0.998 7) and 4.0～20.0 ?g?mL-1(r=0.999 0). The average recovery was 101.3% for imperatorin (RSD=3.24%,n=6) and 100.2% for isoimperatorin(RSD=1.44%,n=6). CONCLUSION:The method is convenient,rapid and accurate for the quality control of Yuanhu zhitong tablet.

OBJECTIVE:To study the effects of tilianin(TIL)on brain tissue in rats with cerebral ischemia-reperfusion injury. METHODS:Totally 120 male SD rats were randomly divided into sham operation group(0.9% sodium chloride solution),model group(0.9% sodium chloride solution),nimodipine group(32 mg/kg)and TIL low-dose and medium-dose,high-dose groups(4, 8,16 mg/kg),with 20 rats in each group. The rats were given relevant medicine intragastrically,once a day,for consecutive 7 d. 15 min after last medication,cerebral ischemia-reperfusion injury model was established by reforming suture-occluded method. The neurological deficit score in rats were evaluated, and percentage of cerebral infarction volume of rats was determined. Histopathological changes of brain tissue were observed by HE staining. The activities of SOD,CAT and LDH,MDA content in cerebral tissue of rats were determined. The expression of calcitonin gene-related peptide(CGRP)and peripheral vascular endothelial growth factor receptor 2 (VEGFR2) protein were determined by Western blot assay. RESULTS:Compared with sham operation group,neurological deficit score and percentage of cerebral infarction volume of model group were increased significantly(P＜0.01);the nerve cells in brain tissue were significantly reduced and the interstitial edema was obvious. SOD and CAT activities were decreased significantly,LDH activity was increased significantly,MDA content was decreased significantly,protein expression of CGRP and VEGFR2were increased significantly(P＜0.05 or P＜0.01). Compared with model group,neurological deficit score of nimodipine group,TIL medium-dose and high-dose groups were decreased significantly;percentage of cerebral infarction volume was decreased significantly (P＜0.05 or P＜0.01);above pathological conditions of cerebral tissue in rats were relieved significantly;SOD and CAT activities were strengthened significantly,MDA content and LDH activities were decreased significantly,protein expression of CGRP and VEGFR2were increased significantly (P＜0.05 or P＜0.01). CONCLUSIONS: TIL has certain protective effects on cerebral ischemia-reperfusion injury model rats,and its mechanism may be related to the up-regulation of CGRP and VEGFR2expression.

Objective:To understand the commonalities and characteristics of provincial-level performance appraisal plan of tertiary public hospitals, and to provide reference for improving and promoting their performances.Methods:The provincial plans introduced from January 31, 2019 to March 31, 2020 matched with the performance appraisal of the national tertiary public hospitals were retrieved through portal websites of the provincial people′s government and health commission, and 19 programs supplemented with local indicators on the basis of the National assessment index were selected as the research objects. The key information such as release time, issuing authority, evaluation object, implementation subject and index system of the plans were extracted, and content analysis method was used to analyze the characteristics and commonalities.Results:Ten out of 19 plans were released during June to July of 2019, and 12 plans were issued by the general office of the provincial people′s government, and the main body of assessment was the provincial-level health commission. Two first-level indicators of Party building and social benefits were added. The supplement of second-level indicators mainly focused on mandatory tasks, quality and safety, primary-level organization construction, service process and moral culture construction. A total of 241 third-level indicators were added, of which qualitative indicators accounted for 65.15%(157 indicators). The top five provinces with the most supplementary indicators were Guizhou, Jilin, Heilongjiang, Liaoning and Zhejiang. Seven provincial-level regions of Shanghai, Ningxia, Guangxi, Qinghai, Guizhou, Anhui and Yunnan clarified the grading standards and methods for performance appraisal results.Conclusions:The supplementary indicators of provincial-level performance appraisal plans for tertiary public hospitals focus on social benefits, Party building, and quality of medical care. The proportion of qualitative indicators is high, the classification of assessment objects is not clear enough, the characteristics of localized supplementary indicators are obvious, and the grading and result of performance appraisal index need to be optimized.

Objective:To analyze the output efficiency of medical services in clinical departments, so as to provide a breakthrough point for rational allocation of resources and improvement of service efficiency.Methods:The classic BCC model of data envelopment analysis(DEA) was used to evaluate the medical service efficiency of 44 clinical departments in a hospital, and the comprehensive efficiency, pure technical efficiency, scale efficiency and scale benefits were analyzed. The input indicators were the number of medical staff, medical costs and the number of beds at the end of the period. The output indicators were diagnosis-related group(DRG) indicators, including the number of DRG groups, total weight, case mix index, cost consumption index, time consumption index and mortality rate of low-risk group.Results:The average values of comprehensive efficiency, pure technical efficiency and scale efficiency of the whole hospital in 2018 were 0.897, 0.920 and 0.975 respectively. DEA was relatively effective in 16 departments(36%), weakly effective in 7 departments(16%), and ineffective in 21 departments(48%). In the case of constant output, the redundancy rates of the actual beds, medical staff and medical business expenditure of non DEA effective departments were 17.3%, 20.3% and 17.1% respectively; under the same input, the output of non DEA effective departments was insufficient.Conclusions:The comprehensive efficiency of medical services in this hospital is ideal, but the proportion of non DEA effective departments is relatively high. It is suggested to improve the efficiency of medical services by optimizing resource input, strengthening discipline construction, and strengthening cost control.

Objective:To conduct a position evaluation of functional departments directors by means of Hay guide-chart profile (Hay) and international position evaluation (IPE) for heads of public hospital departments, and a comparative analysis of the results, for reference in reforming the performance-related pay system of the functional departments.Methods:From July to August of 2021, positions of ten functional department directors of a public tertiary general hospital were selected, and expert groups within and out of the hospital were invited for a position evaluation using both Hay and IPE. Cronbach α and intraclass correlation coefficient were used in the reliability and consistency evaluation. Technique for order preference by similarity to ideal solution (TOPSIS) was conducted to compare the differences between results of both methods, with the position value ranked by quartiles. Results:22 position evaluation forms were issued and 20 were recovered (12 for in-hospital experts and 8 for extramural experts). In Hay evaluation, the scores of medical affairs department and hospital head office were higher, averaging 757.30 and 727.21 respectively, and those of logistics management department were the lowest, being 279.94. In-hospital experts scored lower than those extramural experts on the posts of directors of scientific research management department, Party committee office and medical insurance department, while the scores of the directors of the hospital head office were higher than those extramural experts. In IPE evaluation, the position values of hospital head office and medical affairs department were the highest, averaging 680.25 and 621.00 respectively, and the score of the logistics management department was the lowest, being 365.05. In-hospital experts scored lower than those extramural experts on the posts of directors of Party committee office, scientific research management department and logistics management department, while the scores of the directors of the hospital head office were higher than those of extramural experts. The Cronbach α coefficients of position value scoring of functional department heads evaluated by two evaluation methods were 0.943 (Hay) and 0.800 (IPE) respectively. The hospital head office and medical affairs department ranked the first quartile, the Party committee office and nursing department ranked the second, while the medical insurance department and logistics department ranked the third and fourth respectively. In addition, the ranking differences of the information technology department, human resource department, financial department and scientific research management department were within one quartile. Conclusions:The position evaluation results of Hay and IPE are consistent, but the former is more sensitive. Ranking of position values by quartiles via TOPSIS can support the reform of performance-related pay system of functional departments of public hospitals.