OBJECTIVE To analyze the metabolites of Zhideke granules and speculate its metabolic pathway in rats in vivo. METHODS Male SD rats were randomly divided into blank group and administration group （Zhideke granules， 9.45 g/kg）； they were given ultrapure water or relevant medicine， twice a day， every 6-8 h， for 3 consecutive days. Serum， urine and feces samples of rats were collected， and their metabolites were identified by UPLC-Q-Exactive-MS technique after intragastric administration of Zhideke granules； their metabolic pathways were speculated. RESULTS After intragastric administration of Zhideke granules， 16 prototype components （i.g. irisflorentin， baicalin， chlorogenic acid） and 11 metabolites （i.g. hydration products of kaempferol or luteolin， methylation products of chlorogenic acid， and hydroxylation products of baicalin） were identified in serum， urine and feces of rats. Among them， 8 prototype components and 4 metabolites were identified in serum samples； 10 prototype components and 7 metabolites were identified in urine samples； 8 prototype components and 5 metabolites were identified in the fecal samples. CONCLUSIONS The metabolites of Zhideke granules in rats mainly include baicalin， irisflorentin，chlorogenic acid， and the main metabolic pathways included methylation， hydroxylation， glucuronidation.

Objective To investigate clinicians'practice and opinions on sedation therapy in end-stage patients at Peking Union Medical College Hospital.Methods From August,2022 to April,2023,an online questionnaire survey was conducted among clinicians involved in end-stage patient management.Results A total of 205 questionnaires were distributed,with an effective response rate of 56.1% .Among the clinicians,55.7% of them had experience of applying sedation therapy in end-stage patients;85.2% of clinicians believed that se-dation could relieve the suffering of terminal patients from physical refractory symptoms;75.7% of clinicians considered that sedation therapy could be used to relieve agony from psycho-existential distress.Most clinicians had concerns about sedation therapy due to the lack of legal support(86.1% )and the lack of understanding of patients or families(59.1% ).The majority(90.4% )of clinicians were willing to receive training on palliative sedation.Conclusions A majority of clinicians agree that sedation therapy could relieve the physical distress and psycho-existential distress in end-stage patients.However,most clinicians have concerns about the application of sedation therapy due to the lack of legal support.It is necessary to enhance the training on palliative sedation.

Objective To evaluate the fairness of the configuration of stroke centers in China,and to provide a reference basis for further standardizing and improving the treatment of stroke patients,ensuring medical quality and medical safety.Methods Gini coefficient,agglomeration and Lorenz curve were used to measure the equity of the current configuration of stroke centers in China.Spatial information was analyzed and processed through geographic information system(GIS)technology,combining visualization effects and geographic analysis functions to discover spatial differences in their distribution.Results Currently,there are 1 414 stroke centers in China.The Lorenz curves for the distribution of stroke center allocations by population in all 34 provincial administrative regions of China lie below the fair line.The Gini coefficients and Lorenz curves for the various provincial administrative regions of China show a large disparity in the inequity of resource allocation across the region,with more than half of the provincial administrative regions having stroke centers with an HRAD/PAD＜1,and the distribution of stroke centers relative to the agglomeration of Insufficient population.The nearest-neighbor indices of stroke centers were 0.58(P＜0.01)in China,respectively,which belonged to a typical aggregation pattern with significant zonal differences.Conclusion The planning of stroke centers in China has been effective,but it still needs to be continuously promoted.In response to the situation that demographic fairness is better than geographic,it should be optimized and adjusted in conjunction with urban planning and be adapted to the local conditions with preceding by education and awareness-raising,to cope with the significant differences in the fairness of the configurations of the different provincial administrative districts.

Objective To evaluate the fairness of the configuration of stroke centers in China,and to provide a reference basis for further standardizing and improving the treatment of stroke patients,ensuring medical quality and medical safety.Methods Gini coefficient,agglomeration and Lorenz curve were used to measure the equity of the current configuration of stroke centers in China.Spatial information was analyzed and processed through geographic information system(GIS)technology,combining visualization effects and geographic analysis functions to discover spatial differences in their distribution.Results Currently,there are 1 414 stroke centers in China.The Lorenz curves for the distribution of stroke center allocations by population in all 34 provincial administrative regions of China lie below the fair line.The Gini coefficients and Lorenz curves for the various provincial administrative regions of China show a large disparity in the inequity of resource allocation across the region,with more than half of the provincial administrative regions having stroke centers with an HRAD/PAD＜1,and the distribution of stroke centers relative to the agglomeration of Insufficient population.The nearest-neighbor indices of stroke centers were 0.58(P＜0.01)in China,respectively,which belonged to a typical aggregation pattern with significant zonal differences.Conclusion The planning of stroke centers in China has been effective,but it still needs to be continuously promoted.In response to the situation that demographic fairness is better than geographic,it should be optimized and adjusted in conjunction with urban planning and be adapted to the local conditions with preceding by education and awareness-raising,to cope with the significant differences in the fairness of the configurations of the different provincial administrative districts.

Objective To evaluate the fairness of the configuration of stroke centers in China,and to provide a reference basis for further standardizing and improving the treatment of stroke patients,ensuring medical quality and medical safety.Methods Gini coefficient,agglomeration and Lorenz curve were used to measure the equity of the current configuration of stroke centers in China.Spatial information was analyzed and processed through geographic information system(GIS)technology,combining visualization effects and geographic analysis functions to discover spatial differences in their distribution.Results Currently,there are 1 414 stroke centers in China.The Lorenz curves for the distribution of stroke center allocations by population in all 34 provincial administrative regions of China lie below the fair line.The Gini coefficients and Lorenz curves for the various provincial administrative regions of China show a large disparity in the inequity of resource allocation across the region,with more than half of the provincial administrative regions having stroke centers with an HRAD/PAD＜1,and the distribution of stroke centers relative to the agglomeration of Insufficient population.The nearest-neighbor indices of stroke centers were 0.58(P＜0.01)in China,respectively,which belonged to a typical aggregation pattern with significant zonal differences.Conclusion The planning of stroke centers in China has been effective,but it still needs to be continuously promoted.In response to the situation that demographic fairness is better than geographic,it should be optimized and adjusted in conjunction with urban planning and be adapted to the local conditions with preceding by education and awareness-raising,to cope with the significant differences in the fairness of the configurations of the different provincial administrative districts.

Objective To evaluate the fairness of the configuration of stroke centers in China,and to provide a reference basis for further standardizing and improving the treatment of stroke patients,ensuring medical quality and medical safety.Methods Gini coefficient,agglomeration and Lorenz curve were used to measure the equity of the current configuration of stroke centers in China.Spatial information was analyzed and processed through geographic information system(GIS)technology,combining visualization effects and geographic analysis functions to discover spatial differences in their distribution.Results Currently,there are 1 414 stroke centers in China.The Lorenz curves for the distribution of stroke center allocations by population in all 34 provincial administrative regions of China lie below the fair line.The Gini coefficients and Lorenz curves for the various provincial administrative regions of China show a large disparity in the inequity of resource allocation across the region,with more than half of the provincial administrative regions having stroke centers with an HRAD/PAD＜1,and the distribution of stroke centers relative to the agglomeration of Insufficient population.The nearest-neighbor indices of stroke centers were 0.58(P＜0.01)in China,respectively,which belonged to a typical aggregation pattern with significant zonal differences.Conclusion The planning of stroke centers in China has been effective,but it still needs to be continuously promoted.In response to the situation that demographic fairness is better than geographic,it should be optimized and adjusted in conjunction with urban planning and be adapted to the local conditions with preceding by education and awareness-raising,to cope with the significant differences in the fairness of the configurations of the different provincial administrative districts.

Objective To evaluate the fairness of the configuration of stroke centers in China,and to provide a reference basis for further standardizing and improving the treatment of stroke patients,ensuring medical quality and medical safety.Methods Gini coefficient,agglomeration and Lorenz curve were used to measure the equity of the current configuration of stroke centers in China.Spatial information was analyzed and processed through geographic information system(GIS)technology,combining visualization effects and geographic analysis functions to discover spatial differences in their distribution.Results Currently,there are 1 414 stroke centers in China.The Lorenz curves for the distribution of stroke center allocations by population in all 34 provincial administrative regions of China lie below the fair line.The Gini coefficients and Lorenz curves for the various provincial administrative regions of China show a large disparity in the inequity of resource allocation across the region,with more than half of the provincial administrative regions having stroke centers with an HRAD/PAD＜1,and the distribution of stroke centers relative to the agglomeration of Insufficient population.The nearest-neighbor indices of stroke centers were 0.58(P＜0.01)in China,respectively,which belonged to a typical aggregation pattern with significant zonal differences.Conclusion The planning of stroke centers in China has been effective,but it still needs to be continuously promoted.In response to the situation that demographic fairness is better than geographic,it should be optimized and adjusted in conjunction with urban planning and be adapted to the local conditions with preceding by education and awareness-raising,to cope with the significant differences in the fairness of the configurations of the different provincial administrative districts.

Objective To evaluate the fairness of the configuration of stroke centers in China,and to provide a reference basis for further standardizing and improving the treatment of stroke patients,ensuring medical quality and medical safety.Methods Gini coefficient,agglomeration and Lorenz curve were used to measure the equity of the current configuration of stroke centers in China.Spatial information was analyzed and processed through geographic information system(GIS)technology,combining visualization effects and geographic analysis functions to discover spatial differences in their distribution.Results Currently,there are 1 414 stroke centers in China.The Lorenz curves for the distribution of stroke center allocations by population in all 34 provincial administrative regions of China lie below the fair line.The Gini coefficients and Lorenz curves for the various provincial administrative regions of China show a large disparity in the inequity of resource allocation across the region,with more than half of the provincial administrative regions having stroke centers with an HRAD/PAD＜1,and the distribution of stroke centers relative to the agglomeration of Insufficient population.The nearest-neighbor indices of stroke centers were 0.58(P＜0.01)in China,respectively,which belonged to a typical aggregation pattern with significant zonal differences.Conclusion The planning of stroke centers in China has been effective,but it still needs to be continuously promoted.In response to the situation that demographic fairness is better than geographic,it should be optimized and adjusted in conjunction with urban planning and be adapted to the local conditions with preceding by education and awareness-raising,to cope with the significant differences in the fairness of the configurations of the different provincial administrative districts.

Objective To evaluate the fairness of the configuration of stroke centers in China,and to provide a reference basis for further standardizing and improving the treatment of stroke patients,ensuring medical quality and medical safety.Methods Gini coefficient,agglomeration and Lorenz curve were used to measure the equity of the current configuration of stroke centers in China.Spatial information was analyzed and processed through geographic information system(GIS)technology,combining visualization effects and geographic analysis functions to discover spatial differences in their distribution.Results Currently,there are 1 414 stroke centers in China.The Lorenz curves for the distribution of stroke center allocations by population in all 34 provincial administrative regions of China lie below the fair line.The Gini coefficients and Lorenz curves for the various provincial administrative regions of China show a large disparity in the inequity of resource allocation across the region,with more than half of the provincial administrative regions having stroke centers with an HRAD/PAD＜1,and the distribution of stroke centers relative to the agglomeration of Insufficient population.The nearest-neighbor indices of stroke centers were 0.58(P＜0.01)in China,respectively,which belonged to a typical aggregation pattern with significant zonal differences.Conclusion The planning of stroke centers in China has been effective,but it still needs to be continuously promoted.In response to the situation that demographic fairness is better than geographic,it should be optimized and adjusted in conjunction with urban planning and be adapted to the local conditions with preceding by education and awareness-raising,to cope with the significant differences in the fairness of the configurations of the different provincial administrative districts.

Objective To evaluate the fairness of the configuration of stroke centers in China,and to provide a reference basis for further standardizing and improving the treatment of stroke patients,ensuring medical quality and medical safety.Methods Gini coefficient,agglomeration and Lorenz curve were used to measure the equity of the current configuration of stroke centers in China.Spatial information was analyzed and processed through geographic information system(GIS)technology,combining visualization effects and geographic analysis functions to discover spatial differences in their distribution.Results Currently,there are 1 414 stroke centers in China.The Lorenz curves for the distribution of stroke center allocations by population in all 34 provincial administrative regions of China lie below the fair line.The Gini coefficients and Lorenz curves for the various provincial administrative regions of China show a large disparity in the inequity of resource allocation across the region,with more than half of the provincial administrative regions having stroke centers with an HRAD/PAD＜1,and the distribution of stroke centers relative to the agglomeration of Insufficient population.The nearest-neighbor indices of stroke centers were 0.58(P＜0.01)in China,respectively,which belonged to a typical aggregation pattern with significant zonal differences.Conclusion The planning of stroke centers in China has been effective,but it still needs to be continuously promoted.In response to the situation that demographic fairness is better than geographic,it should be optimized and adjusted in conjunction with urban planning and be adapted to the local conditions with preceding by education and awareness-raising,to cope with the significant differences in the fairness of the configurations of the different provincial administrative districts.