AIM To establish a UPLC method for the simultaneous content determination of chlorogenic acid,protocatechuic acid,protocatechualdehyde,cryptochlorogenic acid,syringic acid,1,3-dicaffeoylquinic acid,cynaroside,isochlorogenic acid B,neochlorogenic acid,isochlorogenic acid A,hesperidin,caffeic acid,isochlorogenic acid C and rosmarinic acid in Waigan Fengsha Granules.METHODS The analysis was performed on a 30℃ thermostatic Waters ACQUITY UPLC.HSS C18 column(2.1 mm×100 mm,1.8 μm),with the mobile phase comprising of acetonitrile-0.2%phosphoric acid flowing at 0.2 mL/min in a gradient elution manner,and the detection wavelengths were set at 275,327 nm.Subsequently,chemometric analysis was performed.RESULTS Fourteen constituents showed good linear relationships within their own ranges(r≥0.999 6),whose average recoveries were 95.68%-104.8%with the RSDs of 0.7%-3.0%.Seven batches of samples were clustered into two types,three principal components demonstrated the acumulative contribution rate of 93.031%.CONCLUSION This accurate and reliable method can be used for the quality control of Waigan Fengsha Granules.

Objective:To further improve the understanding of paroxysmal nocturnal hemoglobinuria (PNH), we retrospectively analyzed and summarized the clinical characteristics, treatment status, and survival status of patients with PNH in Zhejiang Province.Methods:This study included 289 patients with PNH who visited 20 hospitals in Zhejiang Province. Their clinical characteristics, comorbidity, laboratory test results, and medications were analyzed and summarized.Results:Among the 289 patients with PNH, 148 males and 141 females, with a median onset age of 45 (16-87) years and a peak onset age of 20-49 years (57.8% ). The median lactic dehydrogenase (LDH) level was 1 142 (604-1 925) U/L. Classified by type, 70.9% (166/234) were classical, 24.4% (57/234) were PNH/bone marrow failure (BMF), and 4.7% (11/234) were subclinical. The main clinical manifestations included fatigue or weakness (80.8%, 235/289), dizziness (73.4%, 212/289), darkened urine color (66.2%, 179/272), and jaundice (46.2%, 126/270). Common comorbidities were hemoglobinuria (58.7% ), renal dysfunction (17.6% ), and thrombosis (15.0% ). Moreover, 82.3% of the patients received glucocorticoid therapy, 70.9% required blood transfusion, 30.7% used immunosuppressive agents, 13.8% received anticoagulant therapy, and 6.3% received allogeneic hematopoietic stem cell transplantation. The 10-year overall survival (OS) rate was 84.4% (95% CI 78.0% -91.3% ) . Conclusion:Patients with PNH are more common in young and middle-aged people, with a similar incidence rate between men and women. Common clinical manifestations include fatigue, hemoglobinuria, jaundice, renal dysfunction, and recurrent thrombosis. The 10-year OS of this group is similar to reports from other centers in China.

Objective To design a portable intramedullary injection device to facilitate visualized precision puncture.Methods The portable intramedullary injection device was mainly composed of a holding shell,a display,a puncture needle,a controller and a power supply.The holding shell had a L-shaped structure,which was made of new high-performance thermoplastic resin and was provided with a polyethylene-vinyl acetate copolymer non-slip adhesive tape at its handle;the display was made of transparent nano-microcrystalline glass;the puncture needle consisted of an inner needle and an outer needle,which was made of austenitic stainless steel;a lithium iron phosphate battery was used for power supply.Results The portable intramedullary injection device facilitated safe and rapid puncture,and had the function of real-time monitoring of puncture pressure and depth.Conclusion The portable intramedullary injection device realizes visualized precision puncture with high convenience,portability,safety and durability,and contributes to enhancing the success rate for casualty treatment.[Chinese Medical Equipment Journal,2024,45(11):109-112]

Objective:To explore the practical effect of applied talent training model based on the"Four Combinations"among students majoring in Traditional Chinese Medicine in a Medical College.Methods:The undergraduate students majoring in Traditional Chinese Medicine at a medical college from grade 2021 and 2022 were selected as the research subjects and divided into two groups.Experimental group were students who had participated in various extracurricular competitions and innovation and entrepreneurship projects,while control group were students who had not participated in any competitions or projects.The final intellectual education scores of the two groups of students were compared(excluding the scores of Marxist basic principles).A questionnaire survey was conducted on the satisfaction of talent cultivation models among the above undergraduate students,and the validity and satisfaction analysis of the survey results were conducted.Results:The experimental group had significantly higher intellectual education scores than the control group(P＜0.05).The results of factor analysis indicated that the sample suitability and the questionnaire validity seem plausible(KMO=0.874).The overall satisfaction score of students towards the"Four Combinations"talent cultivation model was 4.16±0.2(out of 5),reflecting their high recognition of the model.Conclusion:The construction of a"Four Combinations"characteristic Traditional Chinese Medicine applied talent cultivation model is beneficial for improving the quality of cultivating high-quality and composite applied talents in Traditional Chinese Medicine,so as to provide high-quality applied talents with solid theoretical foundation and practical innovation capabilities for the Liaoshen region.

Objective To explore the potential influencing factors of post-operative healthcare-associated infection(HAI)in colorectal cancer patients,as well as the mediating effect relationship between the influencing factors and the diagnosis-intervention packet(DIP)payment differentials.Methods Medical data of patients who underwent colorectal cancer surgery in a tertiary first-class cancer hospital in Guangzhou were retrospectively analyzed.According to HAI status,patients were divided into infection group and non-infection group.Baseline demographic information and differences in DIP payment differentials between two groups of patients were compared by rank sum test or chi-square test.The influence of each potential factor on the occurrence of HAI was analyzed by logistic re-gression.Mediating analysis was preformed by bootstrap method,and mediating effect of HAI and total hospitaliza-tion days on DIP payment differentials was evaluated.Results A total of 350 patients were included in analysis,50 were in the infection group and 300 in the non-infection group.The incidence of HAI was 14.29％.Logistic regres-sion analysis result showed that risk of HAI in patients with central venous catheterization ≥10.00 days was 13.558 times higher than that＜10.00 days(P＜0.001);risk of HAI in patients with urinary catheterization ≥3.00 days was 2.388 times higher than that＜3.00 days(P=0.022).There were all statistically significant differences in DIP payment differentials among patients with different ages,prognostic nutritional index(PNI),HAI status,total length of hospitalization stay,duration of surgery,central venous catheterization days,and catheterization days(all P＜0.05).The mediating analysis results showed that the occurrence of HAI resulted a change in DIP payment di-fferentials by affecting the total number of hospitalization days.The mediating effect value of total hospitalization days was 0.038,accounting for 35.68％of the total effect.Conclusion Medical institutions should pay attention to HAI resulting from prolonged central venous and urinary catheterization in patients underwent surgery for colorectal cancer,reducing the total length of hospital stay,thus reducing the overruns associated with the increased DIP pay-ment differentials.

Objective:To explore the best practices for the management of hospital medical consumables quantity-based procurement under the policy of quantity-based procurement for orthopedic medical consumables,and to promote the implementation of quantity-based procurement of orthopedic medical consumables.Methods:The relevant policies on quantity-based procurement of orthopedic medical consumables in recent years in China were sorted out,and the characteristics and management requirements of the policies were analyzed.The difficulties encountered by medical institutions in the practical process of quantity-based procurement of medical consumables in terms of procurement model,usage supervision and supply chain management were analyzed.A multi-departmental management collaboration model was established based on the two-tier management structure consisting of orthopedic clinical expert teams and quantity-based procurement medical consumable management teams of Peking Union Medical College Hospital,and a dynamic monitoring platform for medical consumables procurement data was built using information technology.The implementation of quantity-based procurement of orthopedic medical consumables for knee and hip joints in the implementation cycle of orthopedic medical consumables procurement based on the two-tier management structure of the hospital from 2022 to 2023 was evaluated.Results:In the execution cycle of quantity-based procurement based on the two-tier management structure,the completion of the quantity-based procurement medical consumables agreement could be monitored in real time.The agreement volume statistics time had been shortened from the original one week to real-time statistics,saving 83.6%of the medical consumables cost throughout the year.Conclusion:The quantity-based procurement management model for orthopedic medical consumables based on a two-tier management structure can strengthen the information monitoring means of medical consumables,improve the completion rate of quantity-based procurement agreements for orthopedic medical consumables,and promote the smooth and orderly implementation of quantity-based procurement of orthopedic medical consumables by building a dynamic monitoring platform for quantity-based procurement data for medical consumables.