AIM:To explore the effect of HbA1c level in the patients with type 2 diabetes mellitus (T2DM) on the rheological properties of erythrocytes and the structure of hemoglobin (Hb).METHODS:The patients with T2DM were classified into 3 groups:the patients with good glycaemic control (group A, HbA1c<7.0%), the patients with poor glycaemic control (group B, 7.0%≤HbA1c<9.0%) and the patients with persistent hyperglycemia (group C, HbA1c≥9.0%) .The rheological properties of a single living erythrocyte were analyzed by the techniques of static imaging and anal -ysis.Ultraviolet-visible spectroscopy was used to study the structure of Hb .RESULTS: Compared with group H , the roundness effect factor (REF) of erythrocytes, which was positively related with HbA1c level, was significantly increased in groups A, B and C (P<0.05).The contact area of erythrocytes in group B and all the morphological parameters of erythrocytes in group C were significantly higher than those in group H ( P <0.05 ) .There were significant differences among groups A , B and C in deformation capacity and elastic parameters of the cell membrane ( P<0.05 ) , but with no difference in the long axis and short axis between group A and group B .Compared with group H , no obvious change in the spectral pattern and spectrum peak of Hb in groups A , B and C was observed.However, the absorbance of Hb, which showed a trend of gradual decline with the increase in HbA 1c level, in group B and group C was significantly decreased as compared with group H (P<0.01), and the Hb absorbance in group C were also lower than that in group A (P<0.05). CONCLUSION:With the increase in HbA1c level, the morphology along with the deformation function of erythrocytes in T2DM changes and declines gradually , and the structure of Hb may also change .

Objective Analyze the implementation effects of the specialized disease management policy(hereinafter re-ferred to as the policy)to provide reference for strengthening operational management and enhancing the integration of business and finance in public hospitals.Methods Patient information of inpatients from a large comprehensive tertiary hospital from Jan-uary 2022 to June 2023 was collected.Four out of ten single diseases focused on by the national tertiary public hospital perform-ance assessment were included in the study group for specialized disease management,while the remaining six were used as the control group.A difference-in-differences model was adopted to analyze the changes in relevant indicators such as per capita inpa-tient expenses,average length of stay,per capita drug expenses,per capita consumable expenses,and per capita examination and treatment expenses before and after the policy implementation.Additionally,the effects of policy implementation were further analyzed based on different medical insurance types.Results A total of 22 457 patients were included,with 5 879 patients in the study group(3 164 cases before policy implementation and 2 715 cases after policy implementation),and 19 741 patients in the control group.The difference-in-differences model analysis showed that after the policy implementation,per capita inpatient expenses for specialized disease management patients decreased by 32.7％,average length of stay decreased by 31.4％,drug ex-penses decreased by 49.5％,consumable expenses decreased by 24.2％,and examination and treatment expenses decreased by 29.2％.Moreover,compared to patients under non-Wuhan medical insurance,patients under Wuhan medical insurance experi-enced a greater reduction in related indicators.Conclusion The implementation of the policy effectively reduces the burden on patients seeking medical care,improves medical treatment efficiency,contributes to hospital refined management methods,deep-ens the integration of business and finance,and facilitates the transition towards leaner operations.