OBJECTIVE To observe the effects of Panax quinquefolium-Acorus calamus on learning and memory abilities in diabetes mellitus(DM) mice and investigate the mechanism of Panax quinquefolium-Acorus calamus in treating diabetic cognitive impairment(DCI) through network pharmacology and animal experiments. METHODS Diabetic mouse model was established by intraperitoneal injection of streptozotocin(80 mg·kg−1), followed by 8 weeks of oral administration and assessment of drug efficacy using the Morris water maze. The active ingredients and targets of Panax quinquefolium-Acorus calamus were collected using TCMSP, Swiss Target Prediction, and Gene Cards. The protein-protein interaction network of "Traditional Chinese Medicine-Ingredient-Disease targets" was constructed using the String platform and Cytoscape, visualized, and subjected to enrichment analysis using the Metascape database. The anti-DCI mechanism of Panax quinquefolium-Acorus calamus was examined through ELISA and Western blotting, while changes in hippocampal neurons of diabetic mice were observed using HE staining. RESULTS Panax quinquefolium-Acorus calamus reduced the escape latency of diabetic mice(P<0.05), without significant impact on swimming speed. Network pharmacology results indicated that the main components of Panax quinquefolium-Acorus calamus in treating DCI were ginsenoside Re, ginsenoside Rh2, and shanjin phenol, which regulated the Nrf2-Keap1 signaling pathway to treat DCI. Animal experiments demonstrated that Panax quinquefolium-Acorus calamus increased SOD activity(P<0.05), decreased MDA levels(P<0.01), enhanced the expression of HO-1, Keap1, Nrf2 in mouse brain(P<0.01), and alleviated the loosening of granule cell arrangement and nuclear condensation in the hippocampal CA1, CA3, and DG regions. CONCLUSION Using animal experiments combined with network pharmacology, this study preliminarily elucidates the potential targets and mechanisms of Panax quinquefolium-Acorus calamus in intervening DCI, and predictes the molecular basis for its intervention in DCI through molecular docking, providing insights for further in-depth research on Panax quinquefolium-Acorus calamus.

Objective:To investigate the expulsion rate of GyneFix postpartum intrauterine device (PPIUD) placed immediately after cesarean section within one year and its influencing factors.Methods:A prospective cohort study was conducted. Women who volunteered to use a GyneFix PPIUD placed immediately after cesarean section (within 10 min after placenta delivery) for postpartum contraception were recruited from September 2017 to November 2020. The relevant information was collected through questionnaires before, during and 24 h after cesarean section. Outpatient follow-up was conducted at 42 d, 3 months, 6 months and 12 months after delivery to obtain information on expulsion of GyneFix PPIUD and unwanted pregnancy. Life table and Cox regression model were used to analyze the cumulative expulsion rate and related influencing factors.Results:A total of 470 subjects were recruited and 461 (98%) subjects were eligible for this study. The cumulative expulsion rate of GyneFix PPIUD within one year after cesarean section was 8.4% (95% CI: 7.0%-9.8%). Multivariate Cox regression analysis showed that women aged >35 years had significantly lower risk of PPIUD expulsion than those aged <25 years ( HR=0.16, 95% CI: 0.04-0.64). The risk of GyneFix PPIUD was not statistically significantly associated with cesarean section history and breastfeeding mode (all P>0.05). Nevertheless, this risk was statistically significant between hospitals. The Pearl index of contraceptive failure of the device was 2.37 (95% CI: 1.09-4.50) per 100 person-years. The rate of contraceptive failure was not associated with maternal age, breastfeeding mode, and history of cesarean delivery (all P>0.05). Conclusion:The one-year cumulative expulsion rate of GyneFix PPIUD placed immediately after cesarean section is 8.4%. Young mothers were at a higher risk of expulsion than their older counterparts. The device users should be counseled regarding the signs of expulsion. In case of expulsion, women should be offered reinsertion or other contraceptive methods. The training of service skills of GyneFix PPIUD should be strengthened in order to mitigate the risk of the device expulsion.

Objective:To investigate the expulsion rate of GyneFix postpartum intrauterine device (PPIUD) placed immediately after cesarean section within one year and its influencing factors.Methods:A prospective cohort study was conducted. Women who volunteered to use a GyneFix PPIUD placed immediately after cesarean section (within 10 min after placenta delivery) for postpartum contraception were recruited from September 2017 to November 2020. The relevant information was collected through questionnaires before, during and 24 h after cesarean section. Outpatient follow-up was conducted at 42 d, 3 months, 6 months and 12 months after delivery to obtain information on expulsion of GyneFix PPIUD and unwanted pregnancy. Life table and Cox regression model were used to analyze the cumulative expulsion rate and related influencing factors.Results:A total of 470 subjects were recruited and 461 (98%) subjects were eligible for this study. The cumulative expulsion rate of GyneFix PPIUD within one year after cesarean section was 8.4% (95% CI: 7.0%-9.8%). Multivariate Cox regression analysis showed that women aged >35 years had significantly lower risk of PPIUD expulsion than those aged <25 years ( HR=0.16, 95% CI: 0.04-0.64). The risk of GyneFix PPIUD was not statistically significantly associated with cesarean section history and breastfeeding mode (all P>0.05). Nevertheless, this risk was statistically significant between hospitals. The Pearl index of contraceptive failure of the device was 2.37 (95% CI: 1.09-4.50) per 100 person-years. The rate of contraceptive failure was not associated with maternal age, breastfeeding mode, and history of cesarean delivery (all P>0.05). Conclusion:The one-year cumulative expulsion rate of GyneFix PPIUD placed immediately after cesarean section is 8.4%. Young mothers were at a higher risk of expulsion than their older counterparts. The device users should be counseled regarding the signs of expulsion. In case of expulsion, women should be offered reinsertion or other contraceptive methods. The training of service skills of GyneFix PPIUD should be strengthened in order to mitigate the risk of the device expulsion.

Objective:In order to cope with the rising risk pressure on the economic operation of public hospitals,it aims to re-search and construct a comprehensive economic operation evaluation index,and improve the comprehensiveness,scientific and dynamic nature of monitoring and analysis of the economic operation of public hospitals.Methods:Literature research,expert consultation and hierarchical analysis were adopted.Results:A comprehensive evaluation model of public hospitals'economic operation covering 5 dimensions and 25 indexes,including structural optimization,controllable risk,efficiency enhancement,smooth operation and sustain-able development,has been constructed;empirical analyses of the overall index,sub-indexes and monthly indexes have been carried out on the data of some of the tertiary hospitals in Shanghai,which have verified the validity of the above index model in enhancing the monitoring,analysis and evaluation of the hospitals'economic operation,and revealed the role of the above index model in the changes of the economic conditions of the hospitals and the factors.Conclusion:Constructing a comprehensive evaluation index can effectively complement management such as comprehensive assessment and evaluation of public hospitals and traditional financial descriptive analysis.

Objective:Explore the retention situation, possible health problems, and difficulties in removal of intrauterine device (IUD) in women who are perimenopausal in China.Methods:We have searched published literature related to IUD removal of perimenopausal and postmenopausal women in China from databases including CNKI, WanFang data, CBM, PubMed and other Chinese and foreign databases. Totaly fifteen studies were included according the criteria of study inclusion and exclusion and these studies were assessed the quality and their results were summarized.Results:The mentioned problems of IUD retention were the difficulty of IUD removal and psychological problems with the increase of women's menopause time. At the same time, perimenopausal IUD retention is associated with back pain, low abdominal pain and postmenopausal bleeding. Timely and safely removal of IUD after menopause can help to release the back pain and psychological problems in women, and can effectively avoid the difficulty of IUD removal in the later period.Conclusion:Perimenopausal women may have IUD retention. This problem may not only cause difficulties of IUD removal, but also cause a series of women's mental health issues. Timely removal of IUD after menopause is a urgent needs f for reproductive health and family planning ongoing services.

Objective:Explore the retention situation, possible health problems, and difficulties in removal of intrauterine device (IUD) in women who are perimenopausal in China.Methods:We have searched published literature related to IUD removal of perimenopausal and postmenopausal women in China from databases including CNKI, WanFang data, CBM, PubMed and other Chinese and foreign databases. Totaly fifteen studies were included according the criteria of study inclusion and exclusion and these studies were assessed the quality and their results were summarized.Results:The mentioned problems of IUD retention were the difficulty of IUD removal and psychological problems with the increase of women's menopause time. At the same time, perimenopausal IUD retention is associated with back pain, low abdominal pain and postmenopausal bleeding. Timely and safely removal of IUD after menopause can help to release the back pain and psychological problems in women, and can effectively avoid the difficulty of IUD removal in the later period.Conclusion:Perimenopausal women may have IUD retention. This problem may not only cause difficulties of IUD removal, but also cause a series of women's mental health issues. Timely removal of IUD after menopause is a urgent needs f for reproductive health and family planning ongoing services.

OBJECTIVE：To evaluate guidelines f or health technology assessment （HTA）at home and abroad ，and to provide reference for scientific formulation of HTA guidelines in China. METHODS ：Databases including PubMed ，Embase，Guidenlines International Network and 83 official websites from 26 countries governments and academic organizations were searched to collect HTA guidelines from inception to April 2020. Two reviewers independently screened literature and extracted data ，including basic characteristics， content of guideline and assessment content. Then a descriptive analysis was conducted. RESULTS & CONCLUSIONS：A total of 19 guidelines published during 2001 to 2018 were included ，7 guidelines（36.8％）were published in 2015-2020；in addition to 1 guideline from WHO ，14 guidelines （73.7％）were published in Europeand ，2 guidelines（10.5％） in North America and 1 guideline each from South America and Asia （5.3％）. There were 11 guidelines（57.9％）developed by academic organizations and 8 guidelines（42.1％）by health administration ；11 guidelines（57.9％）were evidence-based ，while the others weren ’t evidence- based （42.1％）. The purpose ，content and object of assessment are demonstrated in 19 guidelines；18 guidelines specified the assessment method （94.7％），and 16 guidelines（84.2％）defined the subject of assessment ；14 guidelines （73.7％）specified the HTA assessment process ；12 guidelines（63.3％）mentioned the conflict of interest in HTA assessment process；7 guidelines（36.8％）mentioned the application of assessment results. There are some differences in the formulation methods and contents of HTA guidelines in foreign countries ，but the core contents ar e basically the same. At present ，there is a lack of HTA guidelines in China. We can refer to foreign guidelines，and establish applicable HTA guidelines which aresuitable for national conditions ，so as to provide scientific guidance for HTA research.

Medication safety officer (MSO) is an expert and manager of medication safety. Management of medication safety by MSO has been popularized and plays an important role in the medical institutions of the United States (US)and the United Kingdom (UK). The results of systematic search and analysis of literature showed that the setting of MSO in US and UK was mainly based on various characteristics of the adverse drug events (for example,the large number,high possibility for patient damage and economic loss,poor quality of the reports,inadequate management and preventability),and aimed to reduce its occurrence and then to guarantee the medication safety in patients. In US and UK,the MSOs mainly worked in large hospitals or large health care provider organizations,while the position level was not clearly defined. Responsibilities of MSOs mainly included the formulation and practice of a medication safety program,supervision and improvement of medication safety system,providing professional advice on medication safety,management and reporting of medication safety information in internal medical institution, receiving and transmitting medication safety information outside and carrying out medication safety training. In addition,the US put forward some specific qualification requirements for the position,including educational background,practicing qualification,related training experience,etc. The setting of MSO may be one of the effective measures to solve the problem of medication safety. It is suggested to set up a MSO management system in China′s medical institutions and actively explore a novel management mode of medication safety in China.

Medication safety officer (MSO) is an expert and manager of medication safety. Management of medication safety by MSO has been popularized and plays an important role in the medical institutions of the United States (US)and the United Kingdom (UK). The results of systematic search and analysis of literature showed that the setting of MSO in US and UK was mainly based on various characteristics of the adverse drug events (for example,the large number,high possibility for patient damage and economic loss,poor quality of the reports,inadequate management and preventability),and aimed to reduce its occurrence and then to guarantee the medication safety in patients. In US and UK,the MSOs mainly worked in large hospitals or large health care provider organizations,while the position level was not clearly defined. Responsibilities of MSOs mainly included the formulation and practice of a medication safety program,supervision and improvement of medication safety system,providing professional advice on medication safety,management and reporting of medication safety information in internal medical institution, receiving and transmitting medication safety information outside and carrying out medication safety training. In addition,the US put forward some specific qualification requirements for the position,including educational background,practicing qualification,related training experience,etc. The setting of MSO may be one of the effective measures to solve the problem of medication safety. It is suggested to set up a MSO management system in China′s medical institutions and actively explore a novel management mode of medication safety in China.

BACKGROUND: Skin reproducing membrane is a biomaterial used directly in contact with skin defects, so its toxicity to the body must be taken into consideration. OBJECTIVE: To systematical y evaluate the biocompatibility of skin reproducing membrane of medical fibroin. METHODS: Skin irritation test: the skin defect of New Zealand white rabbit was covered with the skin reproducing membrane of medical fibroin, formaldehyde or normal saline, respectively, and erythema and edema were observed at 24 and 72 hours after treatment. Acute systematic toxicity test: the mice were given extracts of skin reproducing membrane of medical fibroin, phenol and normal saline via tail vein injection; then status of mice, toxicity grade and death were recorded at 24, 48 and 72 hours after injection. Cytotoxicity test: L-929 cel s were co-cultured with 100%, 50%, 25%, 10% skin reproducing membrane of medical fibroin extracts, and absorbance values were detected by ultraviolet spectrophotometry at 2, 4 and 7 days after culture, as wel as by MTT assay after 48 hours of culture, respectively. Besides, L-929 cel s were co-cultured with 100% skin reproducing membrane of medical fibroin extracts, and mRNA expression of fibronectin was determined by qPCR technology after 48-hour culture. RESULTS AND CONCLUSION: Skin reproducing membrane of medical fibroin has no adverse reaction, acute cytotoxicity, skin irritation and systemic toxicity, and additional y, it does not affect mRNA expression of fibronectin. In general, skin reproducing membrane of medical fibroin has good biocompatibility.