In the dynamic process of organizational development,organizations tend to exhibit a tendency towards organizational inertia by maintaining its original behavior patterns.It introduces organizational inertia theory into the medical management.Based on the concept of organizational inertia,the concept of organizational inertia in medical quality and safety management was proposed.From the perspective of connotation of organizational inertia in medical quality and safety management,its essence was the failure of medical institutions to implement or achieve continuous improvement in medical standardized behavior.From the perspective of denotation,it includes six categories:structural inertia,institutional inertia,resource inertia,technological inertia,employee inertia,and cultural inertia.In addition,it explored how to overcome organizational inertia in medical quality and safety management,which can provide new ideas for sustainably improvement research and practice in medical quality and safety management.

In the dynamic process of organizational development,organizations tend to exhibit a tendency towards organizational inertia by maintaining its original behavior patterns.It introduces organizational inertia theory into the medical management.Based on the concept of organizational inertia,the concept of organizational inertia in medical quality and safety management was proposed.From the perspective of connotation of organizational inertia in medical quality and safety management,its essence was the failure of medical institutions to implement or achieve continuous improvement in medical standardized behavior.From the perspective of denotation,it includes six categories:structural inertia,institutional inertia,resource inertia,technological inertia,employee inertia,and cultural inertia.In addition,it explored how to overcome organizational inertia in medical quality and safety management,which can provide new ideas for sustainably improvement research and practice in medical quality and safety management.

Based on the management by objectives and developmental performance appraisal,Shanghai Tenth People's Hospital explored the performance appraisal scheme for attending,including disease-specific complexity,disease-specific difficulty,clinical risk-taking and comprehensive quality.Assessment and feedback work was imple-mented by the medical management department,which format a set of independent budget of the physician perfor-mance assessment system.It introduced incentive measures to encourage attending to treat difficult and critical cases,provided high quality medical services,and eventually enhance hospital management effectiveness to attending.

Objective To understand the distribution and antimicrobial resistance of bacteria isolated from bronchoalveolar lavage fluid (BALF) in Sichuan Province over a five-year period,and provide a reference for antimicrobial therapy.Methods Bacteria were identified and subjected to antimicrobial susceptibility testing (including disk diffusion and automated systems) according to the protocol of the China Antimicrobial Resistance Surveillance System (CARSS).The results were interpreted according to the breakpoints recommended in CLSI M100 (2022 Edition).Results A total of 26575 strains of bacteria were included in this study,of which 83.2％ were Gram-negative bacteria and 16.8％ were Gram-positive bacteria.The top bacteria species were Klebsiella pneumoniae (19.8％),Pseudomonas aeruginosa (18.5％),Acinetobacter baumannii (12.3％),Staphylococcus aureus (7.7％),and Stenotrophomonas maltophilia (6.7％).None of S.aureus strains were resistant to vancomycin,teicoplanin,or linezolid.The prevalence of methicillin-resistant S.aureus (MRSA) was 32.5％.The resistance rate of Streptococcus pneumoniae to penicillin was 1.5％,and the resistance rate to erythromycin and clindamycin was>90％.The prevalence of β-lactamase-producing strains was 63.3％ in Haemophilus influenzae,while>90％ of H.influenzae strains were susceptible to levofloxacin.Less than 5％ of E.coli strains were resistant to carbapenems,and less than 15％ of the strains were resistant to cefoperazone-sulbactam and piperacillin-tazobactam.The resistance rate of K.pneumoniae to carbapenems increased year by year,from 11.1％ in 2019 to 19.1％ in 2023.The resistance rate of A.baumannii to most antimicrobial agents was>50％.The resistance rate of P.aeruginosa to carbapenems was about 15％.Conclusions The main bacteria isolated from BALF specimens in Sichuan Province are Gram-negative bacteria.The antimicrobial resistance of the bacterial isolates is on the rise.For the patients suspected of lower respiratory tract infection,clinical practitioners should collect more high-quality BALF specimens for microbiology testing.Surveillance of the distribution and antimicrobial susceptibility of the pathogens in respiratory tract infections can inform better empirical treatment.

Objective This study aims to investigate the influence of glucose regulated protein(GRP)78 on osteo-blast differentiation in periodontal ligament fibroblasts(PDLFs)under cyclic mechanical stretch and determine the under-lying mechanism.Methods FlexCell 5000 cell mechani-cal device was applied to simulate the stress environment of orthodontic teeth.GRP78High and GRP78Low sub-population were obtained by flow sorting.Gene transfec-tion was performed to knockdown GRP78 and c-Src ex-pression and overexpress c-Src.Western blot analysis was used to detect the protein expression of Runt-related gene 2(RUNX2),Osterix,osteocalcin(OCN),and osteopontin(OPN).Immunoprecipitation assay was used to determine the interaction of GRP78 with c-Src.The formation of cellular mineralized nodules was determined by alizarin red staining.Results GRP78 was heterogeneously expressed in PDLFs,and GRP78High and GRP78Low subpopulations were obtained by flow sorting.The osteogenic differentiation ability and phosphorylation level of c-Src kinase in the GRP78High subpopulation were significantly increased com-pared with those in GRP78Low subpopulation after cyclic mechanical stretch(P<0.05).GRP78 interacted with c-Src in PDLFs.The overexpression c-Src group showed significantly increased osteogenic differentiation ability than the vector group(P<0.05),and the sic-Src group showed significantly decreased osteogenic differentiation ability(P<0.05)after cy-clic mechanical stretch.Conclusion GRP78 upregulates c-Src expression by interacting with c-Src kinase and pro-motes osteogenic differentiation under cyclic mechanical stretch in PDLFs.

Based on the management by objectives and developmental performance appraisal,Shanghai Tenth People's Hospital explored the performance appraisal scheme for attending,including disease-specific complexity,disease-specific difficulty,clinical risk-taking and comprehensive quality.Assessment and feedback work was imple-mented by the medical management department,which format a set of independent budget of the physician perfor-mance assessment system.It introduced incentive measures to encourage attending to treat difficult and critical cases,provided high quality medical services,and eventually enhance hospital management effectiveness to attending.

Based on the management by objectives and developmental performance appraisal,Shanghai Tenth People's Hospital explored the performance appraisal scheme for attending,including disease-specific complexity,disease-specific difficulty,clinical risk-taking and comprehensive quality.Assessment and feedback work was imple-mented by the medical management department,which format a set of independent budget of the physician perfor-mance assessment system.It introduced incentive measures to encourage attending to treat difficult and critical cases,provided high quality medical services,and eventually enhance hospital management effectiveness to attending.

Based on the management by objectives and developmental performance appraisal,Shanghai Tenth People's Hospital explored the performance appraisal scheme for attending,including disease-specific complexity,disease-specific difficulty,clinical risk-taking and comprehensive quality.Assessment and feedback work was imple-mented by the medical management department,which format a set of independent budget of the physician perfor-mance assessment system.It introduced incentive measures to encourage attending to treat difficult and critical cases,provided high quality medical services,and eventually enhance hospital management effectiveness to attending.

Based on the management by objectives and developmental performance appraisal,Shanghai Tenth People's Hospital explored the performance appraisal scheme for attending,including disease-specific complexity,disease-specific difficulty,clinical risk-taking and comprehensive quality.Assessment and feedback work was imple-mented by the medical management department,which format a set of independent budget of the physician perfor-mance assessment system.It introduced incentive measures to encourage attending to treat difficult and critical cases,provided high quality medical services,and eventually enhance hospital management effectiveness to attending.

Based on the management by objectives and developmental performance appraisal,Shanghai Tenth People's Hospital explored the performance appraisal scheme for attending,including disease-specific complexity,disease-specific difficulty,clinical risk-taking and comprehensive quality.Assessment and feedback work was imple-mented by the medical management department,which format a set of independent budget of the physician perfor-mance assessment system.It introduced incentive measures to encourage attending to treat difficult and critical cases,provided high quality medical services,and eventually enhance hospital management effectiveness to attending.