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.

Objective:To analyze the prognostic factors in patients with sepsis, and the value of admission blood magnesium in evaluating the prognosis.Methods:The clinical data of 197 patients with sepsis from January 2020 to December 2022 in the First Affiliated Hospital of Anhui University of Chinese Medicine were retrospectively analyzed. Among them, 71 patients died in the hospital (death group), and 126 patients survived (survival group). The basic information, mechanical ventilation, using vasoactive drug, length of hospital stay, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), sequential organ failure score (SOFA), blood routine, blood gas analysis, blood biochemical indexes and inflammatory factor levels were compared. Multivariate unconditioned Logistic regression was used to analyze the independent risk factors. The efficacy of relevant indexes in predicting the death in patients with sepsis was evaluated by the receiver operating characteristics (ROC) curve.Results:The heart rate, platelet count, blood magnesium, blood calcium, total cholesterol and D-dimmer in death group were significantly lower than those in survival group: 86.0 (75.0, 105.0) times/min vs. 91.5 (80.0, 115.7) times/min, (125.86 ± 67.58) × 10 9/L vs. (165.67 ± 75.83) × 10 9/L, 0.64 (0.57, 0.71) mmol/L vs. 0.76 (0.69, 0.86) mmol/L, 2.21 (2.19, 2.29) mmol/L vs. 2.34 (2.22, 2.39) mmol/L, 3.40 (2.68, 3.91) mmol/L vs. 3.68 (2.99, 4.39) mmol/L and 1.23 (0.65, 2.76) mg/L vs. 1.77 (0.79, 4.79) mg/L, the APACHE Ⅱ, SOFA, red blood cell volume distribution width (RDW) and triglycerides were significantly higher than those in survival group: 21 (18, 24) scores vs. 19 (17, 22) scores, 7 (6, 8) scores vs. 5 (4, 6) scores, 0.164 (0.152, 0.171) vs. 0.143 (0.132, 0.154) and 1.37 (0.94, 1.78) mmol/L vs. 1.14 (0.82, 1.59) mmol/L, and there were statistical differences ( P<0.05 or <0.01); there were no statistical difference in gender composition, age, body temperature, hypertension, diabetes, mechanical ventilation, using vasoactive drug, length of hospital stay, pH value, lactic acid, white blood cell count, neutrophil count, lymphocyte count, hematocrit, total bilirubin, alanine aminotransferase, aspartate aminotransferase, blood sodium, blood potassium, albumin, urea nitrogen, creatinine, brain natriuretic peptide, procalcitonin, C-reactive protein, heparin binding protein and amyloid A between the two groups ( P>0.05). Multivariate unconditioned Logistic regression analysis results showed that high SOFA, RDW and low platelet count, total cholesterol, blood magnesium were independent risk factors of death in patients with sepsis ( OR = 5.655, 2.011, 0.985, 0.380 and 3.160; 95% CI 2.495 to 12.816, 1.215 to 3.327, 0.970 to 0.995, 0.162 to 0.892 and 1.221 to 8.314; P<0.01 or <0.05). Among the 197 patients, 84 patients had normal blood magnesium, 113 patients (57.36%) had hypomagnesemia. The mortality rate in patients with hypomagnesemia was significantly higher than that in patients with normal blood magnesium: 52.21% (59/113) vs. 14.29% (12/84), and there was statistical difference ( χ2 = 30.07, P<0.01). ROC curve analysis result showed that RDW, SOFA, platelet count and blood magnesium had certain value in predicting death in patients with sepsis (the areas under the curves were 0.818, 0.888, 0.787 and 0.783, respectively). The optimal cutoff value of blood magnesium was 0.61 mmol/L, with a sensitivity of 70.6% and a specificity of 89.6%. Conclusions:The incidence of hypomagnesemia is high in patients with sepsis, and blood magnesium is an independent risk factor for death, which can be used as an index to evaluate the prognosis of sepsis patients.

Objective:To analyze the prognostic factors in patients with sepsis, and the value of admission blood magnesium in evaluating the prognosis.Methods:The clinical data of 197 patients with sepsis from January 2020 to December 2022 in the First Affiliated Hospital of Anhui University of Chinese Medicine were retrospectively analyzed. Among them, 71 patients died in the hospital (death group), and 126 patients survived (survival group). The basic information, mechanical ventilation, using vasoactive drug, length of hospital stay, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), sequential organ failure score (SOFA), blood routine, blood gas analysis, blood biochemical indexes and inflammatory factor levels were compared. Multivariate unconditioned Logistic regression was used to analyze the independent risk factors. The efficacy of relevant indexes in predicting the death in patients with sepsis was evaluated by the receiver operating characteristics (ROC) curve.Results:The heart rate, platelet count, blood magnesium, blood calcium, total cholesterol and D-dimmer in death group were significantly lower than those in survival group: 86.0 (75.0, 105.0) times/min vs. 91.5 (80.0, 115.7) times/min, (125.86 ± 67.58) × 10 9/L vs. (165.67 ± 75.83) × 10 9/L, 0.64 (0.57, 0.71) mmol/L vs. 0.76 (0.69, 0.86) mmol/L, 2.21 (2.19, 2.29) mmol/L vs. 2.34 (2.22, 2.39) mmol/L, 3.40 (2.68, 3.91) mmol/L vs. 3.68 (2.99, 4.39) mmol/L and 1.23 (0.65, 2.76) mg/L vs. 1.77 (0.79, 4.79) mg/L, the APACHE Ⅱ, SOFA, red blood cell volume distribution width (RDW) and triglycerides were significantly higher than those in survival group: 21 (18, 24) scores vs. 19 (17, 22) scores, 7 (6, 8) scores vs. 5 (4, 6) scores, 0.164 (0.152, 0.171) vs. 0.143 (0.132, 0.154) and 1.37 (0.94, 1.78) mmol/L vs. 1.14 (0.82, 1.59) mmol/L, and there were statistical differences ( P<0.05 or <0.01); there were no statistical difference in gender composition, age, body temperature, hypertension, diabetes, mechanical ventilation, using vasoactive drug, length of hospital stay, pH value, lactic acid, white blood cell count, neutrophil count, lymphocyte count, hematocrit, total bilirubin, alanine aminotransferase, aspartate aminotransferase, blood sodium, blood potassium, albumin, urea nitrogen, creatinine, brain natriuretic peptide, procalcitonin, C-reactive protein, heparin binding protein and amyloid A between the two groups ( P>0.05). Multivariate unconditioned Logistic regression analysis results showed that high SOFA, RDW and low platelet count, total cholesterol, blood magnesium were independent risk factors of death in patients with sepsis ( OR = 5.655, 2.011, 0.985, 0.380 and 3.160; 95% CI 2.495 to 12.816, 1.215 to 3.327, 0.970 to 0.995, 0.162 to 0.892 and 1.221 to 8.314; P<0.01 or <0.05). Among the 197 patients, 84 patients had normal blood magnesium, 113 patients (57.36%) had hypomagnesemia. The mortality rate in patients with hypomagnesemia was significantly higher than that in patients with normal blood magnesium: 52.21% (59/113) vs. 14.29% (12/84), and there was statistical difference ( χ2 = 30.07, P<0.01). ROC curve analysis result showed that RDW, SOFA, platelet count and blood magnesium had certain value in predicting death in patients with sepsis (the areas under the curves were 0.818, 0.888, 0.787 and 0.783, respectively). The optimal cutoff value of blood magnesium was 0.61 mmol/L, with a sensitivity of 70.6% and a specificity of 89.6%. Conclusions:The incidence of hypomagnesemia is high in patients with sepsis, and blood magnesium is an independent risk factor for death, which can be used as an index to evaluate the prognosis of sepsis patients.

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.