AIM:To investigate alterations in the expression levels of inflammatory cytokines and subsets of CD8+ T cells in the peripheral blood of patients with diabetic retinopathy(DR).METHODS:Retrospective study. A total of 40 patients with type 2 diabetes admitted to Xi'an People's Hospital(Xi'an Fourth Hospital)from April to July 2022 were recruited for this study and categorized into two groups: 20 cases in the simple type 2 diabetes mellitus(DM)group, and 20 cases in the DR group. Additionally, 20 healthy individuals undergoing routine physical examinations served as the control group. The expression levels of cytokines, including interleukin(IL)-6, IL-8, and IL-10 in peripheral blood were quantified using ELISA. Flow cytometry was employed to analyze the expression of programmed cell death-1(PD-1), T cell immunoglobulin domain and mucin domain protein-3(TIM-3), CD28, and CD57 on CD8+ T cells.RESULTS:The peripheral blood expression of IL-6, IL-8, and IL-10 inflammatory cytokines were significantly elevated in DR patients as detected by ELISA(all P<0.001); flow cytometry analysis showed that the expression of PD-1, TIM-3, and CD57 were elevated in peripheral blood CD8+ T cells of DR patients(all P<0.001), and the expression of CD28 was decreased(all P<0.001).CONCLUSION:In DR patients, CD8+ T cells may undergo depletion and senescence as a result of elevated pro-inflammatory cytokines, including IL-6, IL-8, and IL-10.

Objective It analyzes the problems existing in the performance management system of public hospi-tals,and explores the optimization path oriented by public welfare and high-quality development.Methods Based on literature research and policy analysis,this paper focuses on the current situation of the internal performance man-agement system of public hospitals,analyzes the problems from five dimensions:performance appraisal objectives,indicators,methods,processes,and result application,and proposes systematic optimization strategies.Results At present,the performance management system of public hospitals has some problems,such as target deviation,unreasonable index setting,lagging method,rigid process,and single application of results.Conclusion Public hospi-tals need to take public welfare and high-quality development as the"two-wheel drive",and build a scientific,effi-cient and sustainable performance management system by reconstructing the indicator system,innovating assess-ment methods,optimizing processes,deepening the application of results,strengthening data governance,and in-tegrating patient experience and long-term value,so as to achieve the organic unity of social benefits and operatio nal efficiency.

Objective It analyzes the problems existing in the performance management system of public hospi-tals,and explores the optimization path oriented by public welfare and high-quality development.Methods Based on literature research and policy analysis,this paper focuses on the current situation of the internal performance man-agement system of public hospitals,analyzes the problems from five dimensions:performance appraisal objectives,indicators,methods,processes,and result application,and proposes systematic optimization strategies.Results At present,the performance management system of public hospitals has some problems,such as target deviation,unreasonable index setting,lagging method,rigid process,and single application of results.Conclusion Public hospi-tals need to take public welfare and high-quality development as the"two-wheel drive",and build a scientific,effi-cient and sustainable performance management system by reconstructing the indicator system,innovating assess-ment methods,optimizing processes,deepening the application of results,strengthening data governance,and in-tegrating patient experience and long-term value,so as to achieve the organic unity of social benefits and operatio nal efficiency.