Aims Tocomparethepharmacokineticsof ephedra alkaloids,cinnamic acid and cinnamic alcohol in Ephedrae, Cinnamomi and Ephedrae-Cinnamomi herb couple through UPLC-MS/MS in rats respective-ly,and to investigate the effect of combination on phys-iologicaldisposition.Methods Plasmasampleswere collected at different times after oral administration of Ephedrae,Cinnamomi and Ephedrae-Cinnamomi herb couple extracts.The concentrations of ephedra alka-loids,cinnamic acid and cinnamic alcohol in plasma samples were determined by UPLC-MS/MS.DAS 3. 0 was used to calculate pharmacokinetic parameters.The differences of samples in two groups were conducted with univariate statistical analysis using SPSS 13. 0. Results ComparedwithEphedraegroup,theCmaxof norephedrine hydrochloride, norpseudoephedrine hydrochloride,ephedrine hydrochloride,pseudoephed-rine hydrochloride,and methylephedrine hydrochloride in Ephedrae-Cinnamomi herb couple group were signif-icantly greater (P<0. 05 );the AUC0-t of norpseudo-ephedrine hydrochloride was significantly greater (P<0. 05 );the MRT0-t of norephedrine hydrochloride, phedrine hydrochloride, pseudoephedrine hydrochlo-ride,and methylephedrine hydrochloride were signifi-cantly less (P <0. 05 );the T1/2z of norephedrine hydrochloride,phedrine hydrochloride,and methyl-ephedrine hydrochloride were significantly less (P <0. 05 ).The AUC0-t and MRT0-t of cinnamic acid and cinnamic alcohol were significantly greater than those inCinnamomigroup(P<0.05).Conclusion The combination of Ephedrae and Cinnamomi improves the absorption concentration of five ephedra alkaloids, Slows down the elimination of norephedrine hydrochlo-ride,phedrine hydrochloride,pseudoephedrine hydro-chloride,and methylephedrine hydrochloride,and in-creases the bioavailability of cinnamic acid and cin-namic alcohol.

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.