Objective To analyze the service efficiency and changes of county-level public hospitals in Shandong Province from 2017 to 2023,and to provide references for improving the service efficiency of county-level public hospitals.Methods Based on the deta envelopment analysis method,BCC model was used to evaluate the static service efficiency of county-level public hospitals in 16 cities in Shandong Province in 2023,and to dynamically track the change trend of efficiency from 2017 to 2023 based on Malmquist index model.Results In 2023,the average comprehensive efficiency of county-level public hospitals in Shandong Province is 0.971,and the efficiency value of county-level public hospitals in 8 of the 16 cities is 1,which is in DEA effective state;From 2017 to 2023,the average total factor productivity of county-level public hospitals in Shandong Province was 0.906,with an overall decline of 9.4%in service efficiency.Conclusion The overall service efficiency of county-level public hospitals in Shandong Province is high,but regional differences are obvious,and the technical progress index is the key to further indicate the service efficiency.Local governments need to reasonably control the scale of county-level public hospitals,continuously improve their technical level,and strengthen their internal management,so as to improve their service efficiency.

Objective To analyze the service efficiency and changes of county-level public hospitals in Shandong Province from 2017 to 2023,and to provide references for improving the service efficiency of county-level public hospitals.Methods Based on the deta envelopment analysis method,BCC model was used to evaluate the static service efficiency of county-level public hospitals in 16 cities in Shandong Province in 2023,and to dynamically track the change trend of efficiency from 2017 to 2023 based on Malmquist index model.Results In 2023,the average comprehensive efficiency of county-level public hospitals in Shandong Province is 0.971,and the efficiency value of county-level public hospitals in 8 of the 16 cities is 1,which is in DEA effective state;From 2017 to 2023,the average total factor productivity of county-level public hospitals in Shandong Province was 0.906,with an overall decline of 9.4%in service efficiency.Conclusion The overall service efficiency of county-level public hospitals in Shandong Province is high,but regional differences are obvious,and the technical progress index is the key to further indicate the service efficiency.Local governments need to reasonably control the scale of county-level public hospitals,continuously improve their technical level,and strengthen their internal management,so as to improve their service efficiency.

Objective To analyse the 24 h ambulatory blood pressure monitoring(ABPM)character-istics and effect of health education in children with orthostatic hypertension (OHT)retrospectively.Methods A total of 19 children[1 1 males and 8 females with mean age of (1 1.26 ±2.16)years]who were outpa-tients or had been hospitalized in the Second Xiangya Hospital of Central South University due to unexplained syncope,presyncope,and finally diagnosed as OHT after head up tilt test(HUTT).HUTT and ABPM were reexamined at 12 ~190(47 ±48 )days after receiving health education (including psychological guidance, avoiding sudden changes in posture,increasing the amount of water,avoiding syncope inducement,etc). Results (1 )ABPM parameters:there were no significant differences of ABPM parameters before and after health education respectively(P ﹥0.05,respectively).(2)After the health education,HUTT 3 min diastolic pressure[(71.89 ±1.60)mmHg vs.(76.47 ±8.49)mmHg,1 mmHg =0.133 kPa,t =2.785,P ﹤0.05]and diastolic blood pressure change[(7.37 ±4.98)mmHg vs.(12.42 ±3.27)mmHg,t =3.560,P ﹤0.05]de-creased than those before health education.(3 )Blood pressure pattern changes:after the health education,“dipper blood pressure”increased and “non-dipper blood pressure”decreased[42.1 %(8 /19)vs.31.6%(6 /19)and 57.9%(1 1 /19)vs.68.4%(13 /19),χ2 =0.452,P ﹥0.05,respectively].(4)OHT cure rate:after health education,to review the HUTT,within 3 minutes in HUTT,blood pressure changes of 14 cases were normal range.The cure rate was 73.7%.Conclusion OHT children's blood type is given priority to with “non-dipper blood pressure”,and the ratio of“dipper blood pressure”increase and the HUTT 3 min di-astolic pressure and diastolic blood pressure change decrease after health education.It suggests that the health education of OHT children has a certain clinical effect.

Objective To investigate the different radioprotective effects of total flavonoids of Astragalus (TFA) on human normal mesenchymal stem cells(hMSCs) and hepatoma cells injured by 60 Coγ-ray radiation.Methods hMSCs and HepG-2 cells were cultured and randomly divided into TFA-treated and untreated groups.The cells of different groups were irradiated with 60 Co γ-rays at the dose of 6 Gy.MTT method was utilized to detect the survival rates of the hMSCs and HepG-2 cells pretreated or untreated with TFA before irradiation.Cell clone formation test was used to measure the cellular radiosensitivity.The apoptosis rates of different groups were determined by flow cytometer assay.The expression rates of the apoptosis-promoting proteins Fas and Bax and the apoptosis-inhibiting protein Bcl-2 were analyzed by Western blotting.Results MTT showed that the survival rates of hMSCs pretreated by TFA were 1.15-1.95 times higher than that of the pure irradiation group.On the contrary,the survival rates of the TFA pretreated HepG-2 cells were only 0.53-0.23 times that of the pure irradiation group.There was a good dose-effect relationship between the cell survival rate and the TFA concentration.Cell clone formation rate indicated that combined treatment of TFA and radiation inhibited the cell proliferation more effectively than single TFA or pure radiation.Flow cytometry showed that 6,24 and,48 h post-irradiation to 6 Gy,the apoptosis rates of the hMSCs were 23.3% ,11.2% ,and 2.9% ,respectively in the TFA pretreated group and were 29.3% ,24.9% ,and 13.6% in the pure radiation group.However,the apoptosis rates of the HepG-2 cells at 6,24,and 48 h post-irradiation to 6 Gy were 11.6% ,17.3% ,and 20.1% ,respectively in the TFA pretreated group and were 6.9% ,9.3% ,and 15.8% ,respectively in the direct radiation group.Western blotting showed that the expression levels of Fas and Bax proteins in the HepG-2 cells were significantly higher in the TFA pretreated group than in the pure radiation group.On the contrary,the expression level of the apoptosis inhibiting protein Bcl-2 was significantly lower in the TFA pretreated group than in the pure radiation group.Conclusions TFA has obvious effects of radiological protection on human hMSCs and has no effects of radiological protection but effects of apoptosis enhancement on hepatoma cells.The promotion of apoptosis of TFA on hepatoma cells is primarily through increasing the expression of apoptotic proteins such as Fas and Bax and reducing the expression of anti-apoptotic protein Bcl-2.