Objective:To explore the efficacy of Qingjin Huatan Decoction combined with conventional Western medicine for the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with phlegm-heat obstructing lung syndrome.Methods:A randomized controlled trial was conducted. Totally 90 hospitalized patients with AECOPD phlegm-heat obstructing lung syndrome in the respiratory department of Shunyi Hospital, Beijing Traditional Chinese Medicine Hospital from January 2023 to June 2024 were selected as the observation subjects. According to the simplified randomization method (single-double number method), the patients were divided into two groups, with 45 cases in each group. The conventional Western medicine group was given conventional Western medicine treatment, and the combined Chinese materia medica group was given Qingjin Huatan Decoction on the basis of the conventional Western medicine group. The treatment for both groups lasted for 7 d. TCM symptoms were scored before and after treatment; FEV 1 and FVC were detected by pulmonary function analyzer, PaO 2, PaCO 2, PaO 2/FiO 2 were detected by blood gas biochemical analyzer, CRP and PCT were detected by ELISA, and white blood cell count (WBC) was detected by automatic blood cell analyzer. Adverse reactions were recorded, and the clinical efficacy was evaluated. Results:The total effective rate was 93.33% (42/45) in the combined Chinese materia medica group and 77.78% (35/45) in the conventional Western medicine group, with statistical significance ( χ2=4.41, P=0.036). After treatment, the scores of cough, wheezing, chest tightness and shortness of breath and fever and the total score in the combined Chinese materia medica group were lower than those in the conventional Western medicine group ( t=4.83, 2.26, 5.36, 10.43, 5.27,respectively, P<0.01 or P<0.05); the levels of FEV 1 and FVC in the combined Chinese materia medica group were higher than those in the conventional Western medicine group ( t=3.03, 2.64, respectively, P<0.01); the levels of PaO 2 and PaO 2/FiO 2 in the combined Chinese materia medica group were higher than those in the conventional Western medicine group ( t=4.83, 5.36, P<0.01), while the level of PaCO 2 in the combined Chinese materia medica group was lower than that in the conventional Western medicine group ( t=2.26, P<0.05); the levels of CRP, PCT and WBC in the combined Chinese materia medica group were lower than those in the conventional western medicine group ( t=10.53, 11.29 and 2.59, respectively, P<0.01 or P<0.05). During the treatment, the incidence of adverse reactions was 6.67% (3/45) in the combined Chinese materia medica and 8.89% (4/45) in the conventional Western medicine group, without statistical significance ( χ2=0.16, P=0.694). Conclusion:Qingjin Huatan Decoction can effectively improve the lung function and blood gas indicators of AECOPD with phlegm-heat obstructing lung syndrome, and relieve the inflammation, with safety and effectiveness.

Under the new situation of healthcare reform and high-quality development,public hospitals are committed to explore an efficient and fair strategy for distributing position-based bonuses to all staff.Therefore,the innovative post classification evalua-tion coefficient method can effectively solve this problem.It discusses two kinds of hospital performance distribution management infra-structure:clinical and medical personnel performance management with RBRVS as the core and administrative logistics performance management guided by post evaluation.The general model of basic bonus post coefficient evaluation method is summarized and empiri-cal research is conducted.The results show that the average growth rate of hospital medical income in three years(2021-2023)is more than 35％,during the same period,the hospital achieves profit from loss,the"national examination"score jumps from C to B,and the patient satisfaction steadily increases to more than 97％.Therefore,it puts forward the strategy of hospital performance distribution based on post classification evaluation coefficient method:perfect performance management system provides basic guaran-tee for performance distribution;the establishment of hospital performance management objectives provides strategic support for per-formance distribution;the establishment of performance supervision and feedback mechanism continuously improves hospital perfor-mance distribution.

Under the new situation of healthcare reform and high-quality development,public hospitals are committed to explore an efficient and fair strategy for distributing position-based bonuses to all staff.Therefore,the innovative post classification evalua-tion coefficient method can effectively solve this problem.It discusses two kinds of hospital performance distribution management infra-structure:clinical and medical personnel performance management with RBRVS as the core and administrative logistics performance management guided by post evaluation.The general model of basic bonus post coefficient evaluation method is summarized and empiri-cal research is conducted.The results show that the average growth rate of hospital medical income in three years(2021-2023)is more than 35％,during the same period,the hospital achieves profit from loss,the"national examination"score jumps from C to B,and the patient satisfaction steadily increases to more than 97％.Therefore,it puts forward the strategy of hospital performance distribution based on post classification evaluation coefficient method:perfect performance management system provides basic guaran-tee for performance distribution;the establishment of hospital performance management objectives provides strategic support for per-formance distribution;the establishment of performance supervision and feedback mechanism continuously improves hospital perfor-mance distribution.

Under the new situation of healthcare reform and high-quality development,public hospitals are committed to explore an efficient and fair strategy for distributing position-based bonuses to all staff.Therefore,the innovative post classification evalua-tion coefficient method can effectively solve this problem.It discusses two kinds of hospital performance distribution management infra-structure:clinical and medical personnel performance management with RBRVS as the core and administrative logistics performance management guided by post evaluation.The general model of basic bonus post coefficient evaluation method is summarized and empiri-cal research is conducted.The results show that the average growth rate of hospital medical income in three years(2021-2023)is more than 35％,during the same period,the hospital achieves profit from loss,the"national examination"score jumps from C to B,and the patient satisfaction steadily increases to more than 97％.Therefore,it puts forward the strategy of hospital performance distribution based on post classification evaluation coefficient method:perfect performance management system provides basic guaran-tee for performance distribution;the establishment of hospital performance management objectives provides strategic support for per-formance distribution;the establishment of performance supervision and feedback mechanism continuously improves hospital perfor-mance distribution.

Under the new situation of healthcare reform and high-quality development,public hospitals are committed to explore an efficient and fair strategy for distributing position-based bonuses to all staff.Therefore,the innovative post classification evalua-tion coefficient method can effectively solve this problem.It discusses two kinds of hospital performance distribution management infra-structure:clinical and medical personnel performance management with RBRVS as the core and administrative logistics performance management guided by post evaluation.The general model of basic bonus post coefficient evaluation method is summarized and empiri-cal research is conducted.The results show that the average growth rate of hospital medical income in three years(2021-2023)is more than 35％,during the same period,the hospital achieves profit from loss,the"national examination"score jumps from C to B,and the patient satisfaction steadily increases to more than 97％.Therefore,it puts forward the strategy of hospital performance distribution based on post classification evaluation coefficient method:perfect performance management system provides basic guaran-tee for performance distribution;the establishment of hospital performance management objectives provides strategic support for per-formance distribution;the establishment of performance supervision and feedback mechanism continuously improves hospital perfor-mance distribution.

Under the new situation of healthcare reform and high-quality development,public hospitals are committed to explore an efficient and fair strategy for distributing position-based bonuses to all staff.Therefore,the innovative post classification evalua-tion coefficient method can effectively solve this problem.It discusses two kinds of hospital performance distribution management infra-structure:clinical and medical personnel performance management with RBRVS as the core and administrative logistics performance management guided by post evaluation.The general model of basic bonus post coefficient evaluation method is summarized and empiri-cal research is conducted.The results show that the average growth rate of hospital medical income in three years(2021-2023)is more than 35％,during the same period,the hospital achieves profit from loss,the"national examination"score jumps from C to B,and the patient satisfaction steadily increases to more than 97％.Therefore,it puts forward the strategy of hospital performance distribution based on post classification evaluation coefficient method:perfect performance management system provides basic guaran-tee for performance distribution;the establishment of hospital performance management objectives provides strategic support for per-formance distribution;the establishment of performance supervision and feedback mechanism continuously improves hospital perfor-mance distribution.

Under the new situation of healthcare reform and high-quality development,public hospitals are committed to explore an efficient and fair strategy for distributing position-based bonuses to all staff.Therefore,the innovative post classification evalua-tion coefficient method can effectively solve this problem.It discusses two kinds of hospital performance distribution management infra-structure:clinical and medical personnel performance management with RBRVS as the core and administrative logistics performance management guided by post evaluation.The general model of basic bonus post coefficient evaluation method is summarized and empiri-cal research is conducted.The results show that the average growth rate of hospital medical income in three years(2021-2023)is more than 35％,during the same period,the hospital achieves profit from loss,the"national examination"score jumps from C to B,and the patient satisfaction steadily increases to more than 97％.Therefore,it puts forward the strategy of hospital performance distribution based on post classification evaluation coefficient method:perfect performance management system provides basic guaran-tee for performance distribution;the establishment of hospital performance management objectives provides strategic support for per-formance distribution;the establishment of performance supervision and feedback mechanism continuously improves hospital perfor-mance distribution.

Under the new situation of healthcare reform and high-quality development,public hospitals are committed to explore an efficient and fair strategy for distributing position-based bonuses to all staff.Therefore,the innovative post classification evalua-tion coefficient method can effectively solve this problem.It discusses two kinds of hospital performance distribution management infra-structure:clinical and medical personnel performance management with RBRVS as the core and administrative logistics performance management guided by post evaluation.The general model of basic bonus post coefficient evaluation method is summarized and empiri-cal research is conducted.The results show that the average growth rate of hospital medical income in three years(2021-2023)is more than 35％,during the same period,the hospital achieves profit from loss,the"national examination"score jumps from C to B,and the patient satisfaction steadily increases to more than 97％.Therefore,it puts forward the strategy of hospital performance distribution based on post classification evaluation coefficient method:perfect performance management system provides basic guaran-tee for performance distribution;the establishment of hospital performance management objectives provides strategic support for per-formance distribution;the establishment of performance supervision and feedback mechanism continuously improves hospital perfor-mance distribution.

Under the new situation of healthcare reform and high-quality development,public hospitals are committed to explore an efficient and fair strategy for distributing position-based bonuses to all staff.Therefore,the innovative post classification evalua-tion coefficient method can effectively solve this problem.It discusses two kinds of hospital performance distribution management infra-structure:clinical and medical personnel performance management with RBRVS as the core and administrative logistics performance management guided by post evaluation.The general model of basic bonus post coefficient evaluation method is summarized and empiri-cal research is conducted.The results show that the average growth rate of hospital medical income in three years(2021-2023)is more than 35％,during the same period,the hospital achieves profit from loss,the"national examination"score jumps from C to B,and the patient satisfaction steadily increases to more than 97％.Therefore,it puts forward the strategy of hospital performance distribution based on post classification evaluation coefficient method:perfect performance management system provides basic guaran-tee for performance distribution;the establishment of hospital performance management objectives provides strategic support for per-formance distribution;the establishment of performance supervision and feedback mechanism continuously improves hospital perfor-mance distribution.

Objective:To investigate the feasibility and clinical efficacy of posterior vertebral column resection (PVCR) combined with polymethylmethacrylate-augmented pedicle screw instrumentation and shortening of spinal column for stage Ⅲ Kümmell's disease with very severe collapse of fractured vertebra.Methods:From January 2017 to September 2021, 9 patients with stage Ⅲ Kümmell's disease with very severe collapse of fractured vertebra underwent PVCR combined with polymethylmethacrylate-augmented pedicle screw instrumentation and shortening of spinal column. Their medical records were retrospectively analyzed. There were 1 male and 8 females, aged (66.9±5.8) years. The injured vertebra was located at T 11 in 2 patients, at T 12 in 4, at L 1 in 2 and at L 2 in 1. X-ray, CT and MRI were performed before operation. The posterior intervertebral heights of adjacent vertebral bodies of the fractured vertebra in the median sagittal position were measured on CT or MRI to evaluate the shortening of the spinal column before PVCR. Recorded were intraoperative bleeding volume, operation time, complications, bone graft fusion, and American Spinal Injury Association (ASIA) grading at preoperation and the last follow-up. The visual analogue scale (VAS) pain scores, Oswestry disability index (ODI) scores, and kyphotic cobb angles at preoperation, 1 week and 3 months postoperation, and the last follow-up were compared to evaluate the clinical efficacy of PVCR. Results:All patients underwent surgery successfully, with tight closure of adjacent vertebrae after resection of the injured vertebra and bone grafting. Operation time was (240.6±23.2) min and intraoperative bleeding (505.6±95.0) mL. The 9 patients were followed up for (17.3±5.6) months. No worsening symptoms of nerve injury, cerebrospinal fluid leakage, or other serious complications were found after operation, nor such complications as loosening or breakage of internal fixation or adjacent vertebral fractures. Bone fusion was achieved at the bone graft sites in all patients by the last follow-up. The VAS and ODI scores and cobb angles at 1 week and 3 months postoperation and at the last follow-up were significantly decreased compared with preoperation ( P<0.05). There were no significant differences in VAS scores or cobb angles among postoperative 1 week and 3 months and the last follow-up ( P>0.05), but pairwise comparisons between different time points after operation showed significant differences in ODI, with postoperative 1 week > postoperative 3 months > the last follow-up ( P<0.05). The ASIA grading at the last follow-up was improved from preoperative grade C to grade D in 2 cases, from preoperative grade C to grade E in 1 case and from preoperative grade D to grade E in 5 cases. Conclusion:PVCR combined with polymethylmethacrylate-augmented pedicle screw instrumentation and shortening of spinal column is a feasible and effective surgical treatment for stage Ⅲ Kümmell's disease with very severe collapse of fractured vertebra, leading to good clinical efficacy.