Lean six sigma (LSS) emphasizes patient demand-oriented, and continuously optimizing prolesses to achieve efficiency and standardization in medical services. Starting in 2021, a specialized children′s hospital (comprising one main campus and three branch campuses) introduced the LSS management method. Through define, measure, analyze, improve, and control, the hospital utilized tools such as questionnaire surveys, SIPOC models, and fishbone diagrams to identify pain points in the building of multi-campus child-friendly hospital and develop improvement measures.To address the main issues of insufficient cross-campus collaboration, significant disparities in service quality among different campuses, unclear functional positioning of each campus, and inadequate integration with social security mechanisms, the hospital implemented a " homogeneity-differentiation-coordination" management mode. The hospital implemented unified diagnosis and treatment standards and clinical pathways, carried out remote consultations and expert rotations, completed mutual recognition of examination and testing results, optimized child friendly labeling and child friendly environment, and built a " hospital-to-hospitals, hospital to medical schools, and hospital to community health centers" linkage platform, etc., to promote the standardization of diagnosis and treatment processes, clear functional positioning of the hospital area, and efficient resource allocation. Through practice, the outpatient appointment rate and patient satisfaction rate in the main hospital had increased from 86.72% and 98.64% in January December 2021 to 91.87% and 99.72% in January December 2024, respectively; The patient waiting time had been shortened from 26.54 minutes to 21.94 minutes, and the efficiency of medical treatment and service experience had been significantly improved. As of 2024, mutual recognition of 214 inspection and testing items had been achieved cross hospital campuses, forming a collaborative pattern of " main hospital leading, campuses support, and resource complementarity", and significantly improving the level of collaboration and child friendly connotation among multi-campus. This practice explored the integration path of multi-campus collaborative governance and child-friendly services, which could provide reference and inspiration for the similar hospitals.

Lean six sigma (LSS) emphasizes patient demand-oriented, and continuously optimizing prolesses to achieve efficiency and standardization in medical services. Starting in 2021, a specialized children′s hospital (comprising one main campus and three branch campuses) introduced the LSS management method. Through define, measure, analyze, improve, and control, the hospital utilized tools such as questionnaire surveys, SIPOC models, and fishbone diagrams to identify pain points in the building of multi-campus child-friendly hospital and develop improvement measures.To address the main issues of insufficient cross-campus collaboration, significant disparities in service quality among different campuses, unclear functional positioning of each campus, and inadequate integration with social security mechanisms, the hospital implemented a " homogeneity-differentiation-coordination" management mode. The hospital implemented unified diagnosis and treatment standards and clinical pathways, carried out remote consultations and expert rotations, completed mutual recognition of examination and testing results, optimized child friendly labeling and child friendly environment, and built a " hospital-to-hospitals, hospital to medical schools, and hospital to community health centers" linkage platform, etc., to promote the standardization of diagnosis and treatment processes, clear functional positioning of the hospital area, and efficient resource allocation. Through practice, the outpatient appointment rate and patient satisfaction rate in the main hospital had increased from 86.72% and 98.64% in January December 2021 to 91.87% and 99.72% in January December 2024, respectively; The patient waiting time had been shortened from 26.54 minutes to 21.94 minutes, and the efficiency of medical treatment and service experience had been significantly improved. As of 2024, mutual recognition of 214 inspection and testing items had been achieved cross hospital campuses, forming a collaborative pattern of " main hospital leading, campuses support, and resource complementarity", and significantly improving the level of collaboration and child friendly connotation among multi-campus. This practice explored the integration path of multi-campus collaborative governance and child-friendly services, which could provide reference and inspiration for the similar hospitals.

Objective To analyze the changes of serum levels ofαII-spectrin breakdown products (SBDPs)in traumatic brain inj ury (TBI)patients,and further to investigate the clinical diagnosis value of SBDPs for patients with TBI,especially with mTBI.Methods The serum levels of SBDPs were examined in 43 severe TBI (sTBI)patients,43 mild TBI (mTBI)patients and 43 healthy controls using enzyme linked immunosorbent assay (ELISA).The diagnostic usefulness of SBDPs for TBI patients were assessed by Receiver Operating Characteristic (ROC)curves analysis.Results There was no significant difference of SBDP145 among the three groups (F=1.340,P>0.05).Serum levels of SBDP120 in controls,mTBI and con-trols were 7.06±2.23,11.67±9.14 and 12.64±11.44 ng/ml,respectively.Compared with controls,serum levels of SB-DP120 were significantly higher in patients with sTBI (F=9.873,P=0.001)and mTBI (F=9.873,P=0.008),while there was no significant difference of SBDP120 between sTBI patients and mTBI patients (F=9.873,P=0.515>0.05). The area under ROC curve (AUC)of SBDP120 for TBI patients was 0.781 (95% CI:0.690~0.872,P<0.001).For mTBI patients,the area under ROC curve was 0.736 (95% CI:0.624~0.848,P<0.001).And for discriminating TBI patients with CT negative or positive,the area under ROC curve was 0.709 (95% CI:0.582~0.837,P=0.007<0.01).Conclusion The serum levels of SBDP120 were significantly increased in TBI patients,especially mTBI patients.And the serum levels of SBDP120 can be used as potential non-invasive biomarker for mTBI patients.

MicroRNAs ( miRNAs) play an important role in regulating various life activities .It has been confirmed that circulat-ing miRNAs are new biomarkers for the diagnosis of many diseases and closely related with their occurrence and progression .In recent years, miRNAs are found to exist stably in blood and other body fluids in forms of being encapsulated in microvesicle or binding with proteins.Their origins, existence forms and functions have become a hotspot of research in this field .This article reviews the recent studies on the origin , existence form and function of circulating miRNAs associated with cardiovascular disease , aiming to provide some evidence for miRNAs as the biomarker and target of cardiovascular disease .

The microbial transformation of buflomedil by Cunninghamella blakesleana AS 3.153 was studied, as well as a microbial model which can be used to mimic metabolism of buflomedil in mammal was established. Experiments were conducted to screen the capabilities of four strains of Cunninghamella species to transform buflomedil, in which C. blakesleana AS 3.153 was selected for a preparative biotransformation. Furthermore, the microbial model was established based on the transformation condition optimization. The parent drug and its metabolites produced by C. blakesleana AS 3.153 were detected by liquid chromatography-mass spectrometry method and three metabolites were identified while two of them were new found metabolites. Two major metabolites, para-O-desmethyl buflomedil and 12-C-oxidated buflomedil, were isolated by semi-preparative HPLC. Based on the comparison between different species, the microbial transformation of buflomedil by C. blakesleana AS 3.153 is more similar to the metabolism of buflomedil in human and Beagle dog than that in rat.