Objective To develop measurement instruments of dynamic capabilities for public hospitals,providing a reference for the evaluation and enhancement of their dynamic capabilities.Methods The initial construction of the measurement instruments of dynamic capabilities for public hospitals was based on literature review and focused group discussions.Two rounds of expert consultation were conducted using the Delphi method,and the reliability and validity of the questionnaire was initially examined through pre-survey.Results The effective response rates for both rounds of consultation were above 85％,with high positive coefficient,the authority coefficients greater than 0.8,and variation coefficients less than 0.25,indicating a high level of consensus among experts.Furthermore,the reliability and validity are acceptable.After integrating expert feedback,the measurement instruments of dynamic capabilities for public hospitals were finalized,encompassing four dimensions:sensing,learning,integration capability,and innovation capabilities.Conclusion The measurement instruments of dynamic capabilities for public hospitals,developed based on the Delphi method,can be applied in the practice of evaluating and enhancing the dynamic capabilities of public hospitals.

Based on 490 national-level policy documents directly related to hospital construction and development issued since the founding of the People's Republic of China,it divides the evolution of hospital construction and development into four stages:the foundational period,it the exploratory period of the healthcare reform,the acceleration period of the new healthcare reform,and the critical period of deepening medical reform.Applying on policy feedback theory,it analyzes the internal logic underlying the evolution of hospital construction and development in China.The findings reveal that past policies influence future policy-making through four mechanisms:interpretive,resource,evolutionary and learning effects.It suggests that policy optimization should integrate a historical perspective into the policy process to advance the modernization of hospital governance systems and capacities at the public policy level.

Objective To develop measurement instruments of dynamic capabilities for public hospitals,providing a reference for the evaluation and enhancement of their dynamic capabilities.Methods The initial construction of the measurement instruments of dynamic capabilities for public hospitals was based on literature review and focused group discussions.Two rounds of expert consultation were conducted using the Delphi method,and the reliability and validity of the questionnaire was initially examined through pre-survey.Results The effective response rates for both rounds of consultation were above 85％,with high positive coefficient,the authority coefficients greater than 0.8,and variation coefficients less than 0.25,indicating a high level of consensus among experts.Furthermore,the reliability and validity are acceptable.After integrating expert feedback,the measurement instruments of dynamic capabilities for public hospitals were finalized,encompassing four dimensions:sensing,learning,integration capability,and innovation capabilities.Conclusion The measurement instruments of dynamic capabilities for public hospitals,developed based on the Delphi method,can be applied in the practice of evaluating and enhancing the dynamic capabilities of public hospitals.

Based on 490 national-level policy documents directly related to hospital construction and development issued since the founding of the People's Republic of China,it divides the evolution of hospital construction and development into four stages:the foundational period,it the exploratory period of the healthcare reform,the acceleration period of the new healthcare reform,and the critical period of deepening medical reform.Applying on policy feedback theory,it analyzes the internal logic underlying the evolution of hospital construction and development in China.The findings reveal that past policies influence future policy-making through four mechanisms:interpretive,resource,evolutionary and learning effects.It suggests that policy optimization should integrate a historical perspective into the policy process to advance the modernization of hospital governance systems and capacities at the public policy level.

Health Technology Assessment(HTA)was introduced to China in the 1990s,and its development has now reached the stage of exploring its role in providing recommendations for policy making.In recent years,health technology assessment has been paid much more attention from the aspect of macro policy.Health technology assessment focuses on health and medical insurance decision making and is playing an increasingly important role.However,as time goes by,analysis based on old data may be not suitable for guiding new decisions.It is necessary to construct Living HTA to update HTA results in time and reduce uncertainty of decision-making.It introduces methods and challenges for constructing Living HTA,and proposes directions for exploration based on the current state of HTA development in China.

Objective:To explore the health economic evaluation methods of disease screening,providing insights for scholars conducting related research.Methods:By integrating relevant content from modem epidemiology,health statistics,and health economics,it investigates the differences in conducting health economic evaluations of disease screening using authenticity indicators(sensitivity,specificity)and predictive value indicators(positive predictive value,negative predictive value),and combines empirical studies with cases from the literature.Results:Authenticity indicators(sensitivity,specificity)are intrinsic measures of diagnostic tests,unaffected by the disease prevalence in the sample population,making them more suitable for conducting health economic evaluations of disease screening.Moreover,authenticity indicators are easy to obtain,and the model calculations are straightforward and convenient.Case study results demonstrate that compared to risk score screening,the Incremental Cost-Effectiveness Ratio(ICER)of fasting plasma glucose(FPG)testing for type 2 diabetes is 626,indicating that for every additional diabetic patient identified through risk score screening,an extra 626 yuan is spent.Conclusion:It is recommended to use authenticity indicators for conducting health economic evaluations of disease screening,standardize the path methods for model selection,and continuously improve the evidence quality of health economic evaluations of disease screening in China.

Objective It conducted a rapid health technology assessment to evaluate the comparative safety,efficacy and economy of tumor treating fields(TTFields)combined with temozolomide treatment versus temozolomide(TMZ)alone for patients with glioblastoma(GBM).Methods It provided an extensive electronic search of databases,including PubMed,Embase,Cochrane Library,CNKI,and WanFang Data,to collect clinical evidence and health economic evaluations related to the,safety,efficacy,and economy of TTFields for Glioblastoma patients.The search covered literature from inception to July,2023,and assessed the risk of bias in the included studies.Descriptive analyses and data summaries were performed.Results A total of 19 references were included,comprising 5 randomized controlled trials,3 retrospective studies,8 systematic reviews or meta-analyses,and 3 cost-effectiveness analysis(CEA)studies.The quality of the literature evidence was heterogeneous.Recent meta-analyses mostly support the conclusion that TTFields combined with TMZ treatment provides a survival benefit compared to standard TMZ alone.However,the cost-effectiveness analysis literature from 2 countries showed different results,likely due to differences in socioeconomic levels,health systems,and heterogeneity in sources,model selection,and parameter selection.The majority of evidence supports the benefits of TTFields combined with TMZ for the treatment of GBM patients,but the results of CEAs tend to favor the view that this therapy is not cost-effective.Conclusion Current evidence indicates that TTFields combined with TMZ treatment have better safety and efficacy.However,there is still no consensus on whether it is cost-effective.

Metabolic heterogeneity plays a central role in sustaining uncontrolled cancer cell proliferation and shaping the tumor microenvironment(TME),which significantly compromises the clinical outcomes and responses to therapy in head and neck squamous cell carcinoma(HNSCC)patients.This highlights the urgent need to delineate the intrinsic heterogeneity and biological roles of metabolic vulnerabilities to advance precision oncology.The metabolic heterogeneity of malignant cells was identified using single-cell RNA sequencing(scRNA-seq)profiles and validated through bulk transcriptomes.Serine-glycine-one-carbon(SGOC)metabolism was screened out to be responsible for the aggressive malignant properties and poor prognosis in HNSCC patients.A 4-SGOC gene prognostic signature,constructed by LASSO-COX regression analysis,demonstrated good predictive performance for overall survival and therapeutic responses.Patients in the low-risk group exhibited greater infiltration of exhausted CD8+T cells,and demonstrated better clinical outcomes after receiving immunotherapy and chemotherapy.Conversely,high-risk patients exhibited characteristics of cold tumors,with enhanced IMPDH1-mediated purine biosynthesis,resulting in poor responses to current therapies.IMPDH1 emerged as a potential therapeutic metabolic target.Treatment with IMPDH inhibitors effectively suppressed HNSCC cell proliferation and metastasis and induced apoptosis in vitro and in vivo by triggering GTP-exhaustion nucleolar stress.Our findings underscore the metabolic vulnerabilities of HNSCC in facilitating accurate patient stratification and individualized precise metabolic-targeted treatment.

In vitro diagnostic technology is an important aid for disease prevention,treatment,and prognostic monitoring.The de-velopment of its new technologies,methods and products is of great significance for improving medical quality and protecting public health.On the basis of exploring the mechanism of health impact of in vitro diagnostic technology,it takes dry chemical method and wet chemical method as an example,and compares the economy of the two diagnostic technologies for hyperkalemia diagnosis from the perspective of health system,with a view to draw references for the practical application and evaluation of new in vitro diagnostic techniques,methods and products in the future.

Objective To analyze the structural changes and reasons for hospitalization expenditure among patients with thyroid cancer,so as to provide a reference basis for reasonable control of medical costs,making the structure of hospitalisation costs for patients undergoing surgery for thyroid cancer more rational.Methods The degree of structural change and the grey correlation method were used to quantitatively analyze the changes in the structure of hospitalization expenses and the degree of correlation of patients with thyroid cancer surgery in a hospital in Shanxi Province from 2017 to 2022.Results From 2017 to 2022,the hospitalization expenses of thyroid cancer surgery patients in the hospital showed a decreasing trend,and drug fees and consumables fees accounted for a large proportion.Consumables fees and treatment fees showed positive contribution changes,drug fees and diagnosis fees showed negative contribution changes.Nursing fees and general medical service fees showed positive contribution changes,but were not obvious.During the 6-year period,the top two related factors affecting the hospitalization expenses of thyroid cancer patients were drug fees and consumables fees.Conclusion The structure of hospitalization expenses of per thyroid cancer patients tends to be reasonable,but there is still a large room for improvement.It is suggested to continue to strengthen the control of drugs and medical consumables,and clarify the value composition of technical labor and material consumables,so as to further optimize the structure of hospitalization expenses.