Objective To evaluate the impact of medical service price adjustment policies on the economic operations of public hospitals.Methods Utilizing operational data from a provincial tertiary hospital in Anhui Province spanning December 2022 to December 2024,an interrupted time series analysis(ITS)was conducted,with the price adjustment policy implemented in December 2023 as the intervention node.This study quantified trends in surgical income,laboratory income,and cost structure changes before and after the policy implementation.Sensitivity analysis was performed to validate the robustness of findings.Results Following the surgical service price adjustment,income surged by 6.125 million(11.72％)in the first month,with adjusted items contributing 42.5％to this increase.The long-term monthly growth rate rose to 78.9 thousand,and the proportion of technical labor income increased from 6.1％to 10.1％.For laboratory services,the price adjustment led to an initial income decline of 10.324 million(P＜0.001).However,through domestic consumable substitution(provincially centralized procure-ment of testing reagents achieved an average price reduction of 53.9％)and process automation(reducing 30％-40％ of repeti-tive labor in testing personnel),the monthly decline narrowed to 195 thousand driving a transition toward technology-driven labo-ratory services.Conclusion The price adjustment policy optimized public hospital revenue structures through dual mechanisms of"technical value compensation"and"separation of technical services from consumables",effectively addressing the issue of"consumable-dependent revenue models".Public hospitals should enhance refined management,establish a technical labor val-ue-oriented pricing system,and coordinate with dynamic policy adjustments to achieve synergistic improvements in economic effi-ciency and healthcare quality.

Objective To evaluate the impact of medical service price adjustment policies on the economic operations of public hospitals.Methods Utilizing operational data from a provincial tertiary hospital in Anhui Province spanning December 2022 to December 2024,an interrupted time series analysis(ITS)was conducted,with the price adjustment policy implemented in December 2023 as the intervention node.This study quantified trends in surgical income,laboratory income,and cost structure changes before and after the policy implementation.Sensitivity analysis was performed to validate the robustness of findings.Results Following the surgical service price adjustment,income surged by 6.125 million(11.72％)in the first month,with adjusted items contributing 42.5％to this increase.The long-term monthly growth rate rose to 78.9 thousand,and the proportion of technical labor income increased from 6.1％to 10.1％.For laboratory services,the price adjustment led to an initial income decline of 10.324 million(P＜0.001).However,through domestic consumable substitution(provincially centralized procure-ment of testing reagents achieved an average price reduction of 53.9％)and process automation(reducing 30％-40％ of repeti-tive labor in testing personnel),the monthly decline narrowed to 195 thousand driving a transition toward technology-driven labo-ratory services.Conclusion The price adjustment policy optimized public hospital revenue structures through dual mechanisms of"technical value compensation"and"separation of technical services from consumables",effectively addressing the issue of"consumable-dependent revenue models".Public hospitals should enhance refined management,establish a technical labor val-ue-oriented pricing system,and coordinate with dynamic policy adjustments to achieve synergistic improvements in economic effi-ciency and healthcare quality.

Objective: To investigate the difference between bronchoalveolar lavage fluid (BALF) and tracheal aspirate (TA) on the use of antibiotics in patients with severe pneumonia. Methods: Patients with severe pneumonias admitted to the Department of General Intensive Care Unit of Second Affiliated Hospital of Zhejiang University School of Medicine, between December 2014 and March 2019 were retrospectively analyzed. The difference of effects of BLAF and TA on the use of antibiotics in patients with severe pneumonia were compared and analyzed, as well as the effects of antibiotic de-escalation on patient’s mortality were evaluated. The quantitative data were analyzed by independent sample t test, and the enumeration data were determined by Chi-square test or Fisher exact probability method. Results: Among the 120 patients, more bacteria were detected in BALF than in TA (82 vs 60, P<0.05). More fungi were detected in BALF than in TA (20 vs 3, P<0.05). Compared with TA, BALF results were more likely to guide the adjustment of antibiotic regimens (41 vs 16, P<0.05), including guidance for antibiotics de-escalation (27 vs 9, P<0.05). There was no significant difference in the 14-day mortality, 28-day mortality, hospital stay and duration of mechanical ventilation between the two groups (all P<0.05). Conclusions Compared with TA, BALF, as a pathogens detection method for severe pneumania, has more advantages in guiding antibiotics administration, including antibiotic de-escalation, which will not increase the mortality of patients.

Objective To explore the effect of Tanshinone IIA on apoptosis and expression of Drp-1 and TRPM7 in a rat model of focal cerebral ischemia and reperfusion. Methods Rats were pretreated with high or low dose of tanshinone IIA before 2 h-focal cerebral ischemia plus 24 h-reperfusion. Cerebral blood flow in the middle cerebral artery was moni-tored during reperfusion. TTC, TUNEL and western blotting were used to detect the volume of cerebral infarction, apopto-sis and the protein expression of Drp-1 as well as TRPM7, respectively. Results Compared with control group, pretreat-ment with Tanshinone IIA could significantly down-regulate the expression of protein Drp-1 and TRPM7 (P<0.05), attenu-ate apoptosis (P<0.05), and reduce the volume of ischemia infarction. The volumes of right middle cerebral artery blood flow were(31.80%± 2.49%),(54.8%± 3.27%), and(58.8%± 3.03%)in controls, low-dose and high dose of tanshinone, respectively. Both low-dose and high-dose tanshinones improved cerebral blood flow. (tanshinone vs. control;all P<0.05). However, there was no statistical difference between low-dose and high-dose Tanshinone IIA groups in all measured out-comes (P>0.05). Conclusions Tanshinone IIA can inhibit ischemia-induced neuronal apoptosis and mitochondrial fission probably through improving cerebral artery blood flow and reducing the overexpression of Drp-1,TRPM7.