Objective Taking a tertiary Traditional Chinese Medicine(TCM)hospital in Beijing as an example,it explores the differences in service quality perception among medical providers in Internet-based diagnostic services,aiming to provide robust support for the digital transformation of TCM medical services.Methods A questionnaire survey was conducted among 145 doctors who had diagnostic privileges on the Internet hospital platform of a certain hospital in September 2024.The survey focused on doctors'perceptions and satisfaction differences between online and offline medical service quality.Data processing and analysis were performed using EXCEL and SPSS 26.0 software,including descriptive analysis,reliability and validity tests,and rank-sum tests.Results 66.34%of the doctors recognized the Internet hospital platform established by the hospital,but the average satisfaction score(3.86)was still lower than that of offline outpatient service platforms,which was 4.59.Especially in the three dimensions of diagnosis and treatment,quality assurance,and psychosocial care,the perception of online service quality was significantly lower than that of offline services(P＜0.001).Despite this,82.76%of doctors were still inclined to recommend the internet-based diagnostic model to suitable patients.Conclusion Internet hospitals should establish a refined and intelligent platform system and rigorous service quality control standards to optimize doctors'online consultation processes.Comprehensive training for online consulting doctors should be strengthened.By improving the service quality of medical providers,the integration of online and offline services can be promoted to meet patients'demands for high-quality medical services.

Objective:To investigate the effects of hip replacement on human β-defensin 3 (HBd-3) and N-arachidonoylethanolamine (AEA) levels in older adult patients with intertrochanteric femoral fractures.Methods:This study was a retrospective analysis. A total of 110 older adult patients with intertrochanteric femoral fractures who received treatment at Xi'an Labor Union Hospital from March 2021 to December 2023. Based on the different treatment methods, patients were assigned to either the hip replacement group ( n = 55, hip replacement) or the control group ( n = 55, intramedullary nail fixation). The operation time, postoperative bed rest duration, hospital stay, and weight-bearing time were recorded for both groups. The levels of malondialdehyde, aldosterone, tumor necrosis factor-alpha, HBd-3, AEA, and calcitonin gene-related peptide were measured before and 3 days after surgery. Behaviors were evaluated using the 6-point behavioral rating scale before and 14 days after surgery. Hip function was evaluated using the Mayo hip function score before and 3 months after surgery. Complications were recorded for both groups. Results:The operation time in the hip replacement group was significantly longer than that in the control group [(75.58 ± 7.19) minutes vs. (60.03 ± 5.75) minutes, t = -12.53, P < 0.001]. However, postoperative bed rest duration, hospital stay, and weight-bearing time in the hip replacement group were (8.35 ± 1.63) days, (13.18 ± 2.32) days, and (6.19 ± 1.51) days, respectively, which were significantly shorter than those in the control group [(16.28 ± 2.02) days, (15.65 ± 3.15) days, (42.21 ± 6.67) days, t = 22.68, 4.68, 39.06, all P < 0.001]. The levels of malondialdehyde and aldosterone in the hip replacement group were (14.89 ± 3.06) U/L and (37.80 ± 3.80) ng/L, respectively, which were significantly lower than those in the control group [(16.73 ± 3.42) U/L, (40.85 ± 4.24) ng/L, t = 2.97, 3.97, both P < 0.05]. Additionally, the levels of tumor necrosis factor-α and HBd-3 in the hip replacement group were (18.85 ± 3.25) ng/L and (0.93 ± 0.15), respectively, which were significantly lower than those in the control group [(24.40 ± 4.43) ng/L, (1.22 ± 0.30), t = 7.49, 6.41, both P < 0.001]. The level of calcitonin gene-related peptide in the hip replacement group was significantly lower than that in the control group [(73.81 ± 12.26) ng/L vs. (89.39 ± 14.43) ng/L, t = 6.40, P < 0.001]. The level of anandamide in the hip replacement group was significantly higher than that in the control group [(112.65 ± 18.35) ng/L vs. (95.28 ± 14.07) ng/L, t = -5.57, P < 0.001]. The 6-point behavioral rating scale score in the hip replacement group was significantly lower than that in the control group [(1.05 ± 0.32) vs. (2.28 ± 0.67), t = 12.29, P < 0.05]. The Mayo hip function score for patients in the hip replacement group was significantly higher than that in the control group [(85.12 ± 4.33) vs. (79.38 ± 4.12), t = 7.12, P < 0.001]. The incidence of complications in the hip replacement group was significantly lower than that in the control group [1.82% (1/55) vs. 14.55% (8/55), χ2 = 4.36, P < 0.05]. Conclusions:Hip replacement therapy for older adult patients with intertrochanteric femoral fractures can shorten hospital stays, promote the reduction of postoperative stress responses and inflammation, downregulate HBd-3 and AEA levels, facilitate early functional rehabilitation, improve hip function, reduce complications, and enhance prognosis.

Objective:To investigate the effects of hip replacement on human β-defensin 3 (HBd-3) and N-arachidonoylethanolamine (AEA) levels in older adult patients with intertrochanteric femoral fractures.Methods:This study was a retrospective analysis. A total of 110 older adult patients with intertrochanteric femoral fractures who received treatment at Xi'an Labor Union Hospital from March 2021 to December 2023. Based on the different treatment methods, patients were assigned to either the hip replacement group ( n = 55, hip replacement) or the control group ( n = 55, intramedullary nail fixation). The operation time, postoperative bed rest duration, hospital stay, and weight-bearing time were recorded for both groups. The levels of malondialdehyde, aldosterone, tumor necrosis factor-alpha, HBd-3, AEA, and calcitonin gene-related peptide were measured before and 3 days after surgery. Behaviors were evaluated using the 6-point behavioral rating scale before and 14 days after surgery. Hip function was evaluated using the Mayo hip function score before and 3 months after surgery. Complications were recorded for both groups. Results:The operation time in the hip replacement group was significantly longer than that in the control group [(75.58 ± 7.19) minutes vs. (60.03 ± 5.75) minutes, t = -12.53, P < 0.001]. However, postoperative bed rest duration, hospital stay, and weight-bearing time in the hip replacement group were (8.35 ± 1.63) days, (13.18 ± 2.32) days, and (6.19 ± 1.51) days, respectively, which were significantly shorter than those in the control group [(16.28 ± 2.02) days, (15.65 ± 3.15) days, (42.21 ± 6.67) days, t = 22.68, 4.68, 39.06, all P < 0.001]. The levels of malondialdehyde and aldosterone in the hip replacement group were (14.89 ± 3.06) U/L and (37.80 ± 3.80) ng/L, respectively, which were significantly lower than those in the control group [(16.73 ± 3.42) U/L, (40.85 ± 4.24) ng/L, t = 2.97, 3.97, both P < 0.05]. Additionally, the levels of tumor necrosis factor-α and HBd-3 in the hip replacement group were (18.85 ± 3.25) ng/L and (0.93 ± 0.15), respectively, which were significantly lower than those in the control group [(24.40 ± 4.43) ng/L, (1.22 ± 0.30), t = 7.49, 6.41, both P < 0.001]. The level of calcitonin gene-related peptide in the hip replacement group was significantly lower than that in the control group [(73.81 ± 12.26) ng/L vs. (89.39 ± 14.43) ng/L, t = 6.40, P < 0.001]. The level of anandamide in the hip replacement group was significantly higher than that in the control group [(112.65 ± 18.35) ng/L vs. (95.28 ± 14.07) ng/L, t = -5.57, P < 0.001]. The 6-point behavioral rating scale score in the hip replacement group was significantly lower than that in the control group [(1.05 ± 0.32) vs. (2.28 ± 0.67), t = 12.29, P < 0.05]. The Mayo hip function score for patients in the hip replacement group was significantly higher than that in the control group [(85.12 ± 4.33) vs. (79.38 ± 4.12), t = 7.12, P < 0.001]. The incidence of complications in the hip replacement group was significantly lower than that in the control group [1.82% (1/55) vs. 14.55% (8/55), χ2 = 4.36, P < 0.05]. Conclusions:Hip replacement therapy for older adult patients with intertrochanteric femoral fractures can shorten hospital stays, promote the reduction of postoperative stress responses and inflammation, downregulate HBd-3 and AEA levels, facilitate early functional rehabilitation, improve hip function, reduce complications, and enhance prognosis.

Objective Taking a tertiary Traditional Chinese Medicine(TCM)hospital in Beijing as an example,it explores the differences in service quality perception among medical providers in Internet-based diagnostic services,aiming to provide robust support for the digital transformation of TCM medical services.Methods A questionnaire survey was conducted among 145 doctors who had diagnostic privileges on the Internet hospital platform of a certain hospital in September 2024.The survey focused on doctors'perceptions and satisfaction differences between online and offline medical service quality.Data processing and analysis were performed using EXCEL and SPSS 26.0 software,including descriptive analysis,reliability and validity tests,and rank-sum tests.Results 66.34%of the doctors recognized the Internet hospital platform established by the hospital,but the average satisfaction score(3.86)was still lower than that of offline outpatient service platforms,which was 4.59.Especially in the three dimensions of diagnosis and treatment,quality assurance,and psychosocial care,the perception of online service quality was significantly lower than that of offline services(P＜0.001).Despite this,82.76%of doctors were still inclined to recommend the internet-based diagnostic model to suitable patients.Conclusion Internet hospitals should establish a refined and intelligent platform system and rigorous service quality control standards to optimize doctors'online consultation processes.Comprehensive training for online consulting doctors should be strengthened.By improving the service quality of medical providers,the integration of online and offline services can be promoted to meet patients'demands for high-quality medical services.

Objective:To explore the clinical efficacy of ceftazidime/avibactam(CZA)plus aztreonam(ATM)for New Delhi metallo-β-lactamase(NDM)carbapenem-resistant Klebsiella pneumoniae(CRKP)infection after kidney transplantation.Methods:Clinical data are retrospectively reviewed for 11 RT recipients infected with NDM metallo-β-lactamase CRKP admitted into First Affiliated Hospital of Xi 'an Jiaotong University and Affiliated Renji Hospital of Shanghai Jiao Tong University from November 2018 to December 2019.Based upon treatment protocol, they are divided into two groups of ceftazidime/avibactam plus aztreonam(CZA-ATM, 5 cases)and other effective antibiotics(OAA, 6 cases).Age, gender, infection type, drug resistance gene, changes in body temperature and leucocyte count, treatment course and prognosis are summarized.Results:A total of 11 patients with NDM-producing CRKP infection after RT are recruited.There are seven males and four females with an age range of(19~66)(38.9±14.4)years.There are mixed pulmonary and urinary tract infections(3 cases), urinary tract infection(2 cases), pulmonary infection(1 case)and perirenal infection(5 cases).All isolates harbore NDM carbapenemase gene, 5 isolates carry Klebsiella pneumoniae carbapenemase(KPC)gene and 1 isolate contained both imipenemase metallo-β-lactamase(IMP)and verona integron-encoded metallo-β-lactamase(VIM)gene concurrently.Ceftazidime-avibactam plus aztreonam(CZA-ATM)is prescribed in five patients while the remainders receive OAA.No adverse reactions occurred in individuals on CZA-ATM and 2 cases on OAA have adverse reactions with a poor appetite and diarrhea.After 30-day infection, the curative cases of CZA-ATM and OAAs groups reach 4 and 5 respectively.No death occurred in neither groups at Day 30.And 90-day mortality is 0 and 1 respectively.Conclusions:For RT patients infected with NDM-producing CRKP, CZA-ATM combination therapy may be another effective treatment.

Objective To observe clinical effects of Baixuan xiatare capsules combined with Baskin and compound Flumetasone on elderly patients with chronic eczema .Methods 160 elderly patients with chronic eczema were randomly divided into observation group and control group ,80 cases in each group , the observation group with XTR combined with Baskin , compound Flumetasone treatment , control group using Baskin combined with compound Flumetasone treatment for 4 weeks,the clinical efficacy was compared between the two groups .Results In the obser-vation group,the effective rate was 94.7%,the effective rate of control group was 82.1%,two groups have statistical significance with the efficiency difference (χ2 =5.862,P<0.05).Conclusion The XTR combined with Baskin and compound Flumetasone have better clinical effects than Baskin combined with compound flumetasone treatment with elderly patients with chronic eczema .

Objective:To analyze the effect of MCT/LCT fat emulsions at different doses on the growth and development of prema-ture and low birth weight infants. Methods: Totally 76 cases of preterm or low birth weight infants were divided into the treatment group (40 cases) and the control group (36 cases), both groups were given MCT/LCT fat emulsions, amino acid and glucose injec-tions in 12-24 h after the birth. The initial dose of MCT/LCT fat emulsions in the treatment group was 2. 0 g·kg-1 ·d-1 and the dose was gradually increased to 3. 0 g·kg-1 ·d-1 with 0. 5 g·kg-1 ·d-1 progressive increase. The initial dose of MCT/LCT fat emulsions in the control group was 0. 5 g·kg-1 ·d-1 , and the dose was increased to 3. 0 g·kg-1 ·d-1 with 0. 5 g·kg-1 ·d-1 progressive in-crease. The treatment course was 7 days. The neonatal weight, serum total bilirubin, direct bilirubin, alanine aminotransferase, total cholesterol, triacylglycerol and blood glucose were monitored in the two groups. Results:The born body mass recovery time of the ob-servation group was (4. 38+0. 93) d, which was significantly shorter than that in the control group [(6. 81+1. 90) d]. After the re-covery, the body weight growth rate of the observation group was (30. 41+1. 81) g·kg-1 ·d-1 , which was significantly higher than that of the control group [(18. 21 +2. 08) g·kg-1 ·d-1, P <0. 05]. After the 7-day treatment, the blood biochemical indices showed no statistically significant difference between the two groups (P>0. 05). Conclusion:Early application of MCT/LCT fat emul-sions at high dose is beneficial to the improvement of nutritional status in premature infants.