Objective:To construct a dual performance management model based on data envelopment analysis (DEA),so as to assess the quality of metrological management of medical equipment,and formulate management countermeasures. Methods:The dual performance management model was constructed by adopting data envelopment analysis-banker-charnes-cooper (DEA-BCC). The evaluation indicator system was built from two dimensionalities included input performance and output performance,which can perform comprehensive evaluation meterring performance of equipment,so as to formulate three dimensional measure included improvement of management team,optimization of metrological process,and routine monitor and management for improving metrological management of equipment. A total of 183 used medical equipment of International Peace Maternity & Child Health Hospital of China welfare institute (IPMCH) from 2022 to 2023 were selected. The metrological management of 176 medical equipment from January to December 2022 adopted formulation of management countermeasures on the basis of subjective evaluation to perform management (subjective evaluation),and the metrological management of 177 medical equipment (included 170 equipment that were used in subjective evaluation) from January to December 2023 adopted formulation of management countermeasures on the basis of dual performance evaluation (dual performance evaluation). The self-made online survey questionnaire was used to investigate the recognition degree of 104 operators of clinical department,who used the equipment. Among of them,48 operators received the management method of subjective evaluation,and 56 operators received the dual performance evaluation. The metrological management performance,management effectiveness and clinical recognition degree of the two kinds of management methods for medical equipment were compared. Results:The values of standardized input performance,output performance and comprehensive performance of equipment,which adopted dual performance evaluation management,were respectively 87.74±3.61,97.19±1.70 and 1.11±0.04. Input performance of dual performance evaluation management was lower than that of subjective evaluation management method,and output performance and comprehensive performance of dual performance evaluation management were higher than these of subjective evaluation management method,and the differences of them between two methods were statistically significant (t=4.866,4.457,7.793,P<0.05). The average metrological pass rates of mechanics,thermodynamics,thermology,textiles and medical equipment of medical laboratory of using dual performance evaluation management were (97.99±1.14)％,(97.39±2.08)％,(97.43±1.87)％,(98.06±0.92)％ and (96.77±2.03)％,respectively. All of them were higher than these of using subjective evaluation management method,and the differences of them between two methods were statistically significant (t=4.431,3.232,3.324,4.928,3.352,P<0.05). The satisfaction rates of 56 operators of equipment,who adopted dual performance evaluation management,were respectively 98.21％,94.64％,96.43％,100.00％ and 98.21％ for the management system,metrological frequency,metrological items,metrological effect and service quality of metrological staffs of equipment,which were higher than these of subjective evaluation management method,and the differences of them between two methods were statistically significant (x2=7.240,5.660,6.296,6.128,12.735,P<0.05). Conclusion:The dual performance management model can control the input of metrological management of medical equipment,and enhance the output of metrological management of medical equipment,and promote the operation quality of medical equipment,and improve the level of clinical service of medical equipment.

Objective:To construct a dual performance management model based on data envelopment analysis (DEA),so as to assess the quality of metrological management of medical equipment,and formulate management countermeasures. Methods:The dual performance management model was constructed by adopting data envelopment analysis-banker-charnes-cooper (DEA-BCC). The evaluation indicator system was built from two dimensionalities included input performance and output performance,which can perform comprehensive evaluation meterring performance of equipment,so as to formulate three dimensional measure included improvement of management team,optimization of metrological process,and routine monitor and management for improving metrological management of equipment. A total of 183 used medical equipment of International Peace Maternity & Child Health Hospital of China welfare institute (IPMCH) from 2022 to 2023 were selected. The metrological management of 176 medical equipment from January to December 2022 adopted formulation of management countermeasures on the basis of subjective evaluation to perform management (subjective evaluation),and the metrological management of 177 medical equipment (included 170 equipment that were used in subjective evaluation) from January to December 2023 adopted formulation of management countermeasures on the basis of dual performance evaluation (dual performance evaluation). The self-made online survey questionnaire was used to investigate the recognition degree of 104 operators of clinical department,who used the equipment. Among of them,48 operators received the management method of subjective evaluation,and 56 operators received the dual performance evaluation. The metrological management performance,management effectiveness and clinical recognition degree of the two kinds of management methods for medical equipment were compared. Results:The values of standardized input performance,output performance and comprehensive performance of equipment,which adopted dual performance evaluation management,were respectively 87.74±3.61,97.19±1.70 and 1.11±0.04. Input performance of dual performance evaluation management was lower than that of subjective evaluation management method,and output performance and comprehensive performance of dual performance evaluation management were higher than these of subjective evaluation management method,and the differences of them between two methods were statistically significant (t=4.866,4.457,7.793,P<0.05). The average metrological pass rates of mechanics,thermodynamics,thermology,textiles and medical equipment of medical laboratory of using dual performance evaluation management were (97.99±1.14)％,(97.39±2.08)％,(97.43±1.87)％,(98.06±0.92)％ and (96.77±2.03)％,respectively. All of them were higher than these of using subjective evaluation management method,and the differences of them between two methods were statistically significant (t=4.431,3.232,3.324,4.928,3.352,P<0.05). The satisfaction rates of 56 operators of equipment,who adopted dual performance evaluation management,were respectively 98.21％,94.64％,96.43％,100.00％ and 98.21％ for the management system,metrological frequency,metrological items,metrological effect and service quality of metrological staffs of equipment,which were higher than these of subjective evaluation management method,and the differences of them between two methods were statistically significant (x2=7.240,5.660,6.296,6.128,12.735,P<0.05). Conclusion:The dual performance management model can control the input of metrological management of medical equipment,and enhance the output of metrological management of medical equipment,and promote the operation quality of medical equipment,and improve the level of clinical service of medical equipment.

OBJECTIVE To investigate the modulating effect of neotropics on form deprivation myopia(FDM)in guinea pigs.METHODS Tricolour guinea pigs were randomly divided into normal control group,FDM model group,FDM+saline group,FDM+atropine group,and FDM+neotropine group,with eight animals in each group.Except for the normal control group,the right eyes of the guinea pigs were covered for 14 d to establish a guinea pig FDM model.The drug administration groups were injected with 10 μL of saline,1%atropine,or 1%neotropine into the vitreous cavity once every other day.The changes in the refractive error and axial length of both eyes were recorded for 1 d before the intervention and for 14 d after the intervention.Then,the eyeballs of guinea pigs were taken from the right eyes.HE staining was used to evaluate the histopathological structure of the sclera while sirius red staining was used to detect the collagen protein content in the sclera.RT-qPCR was used to detect the mRNA expressions of transforming growth factor-β1(TGF-β1),matrix metalloproteinase(MMP-2)and tissue inhibitor of metalloproteinase(TIMP-2)in guinea pigs'sclera.The protein expression levels of collagen type Ⅰ(Col-Ⅰ)and TGF-β1 in guinea pig sclera were detected by Western blotting while those of MMP-2,TIMP-2 and Ki-67 were detected by immunohistochemical staining.RESULTS Compared with the nor-mal control group,eyes of guinea pig in the FDM model group showed a significantly lower refractive error(P<0.01),significant elongation of the ocular axis(P<0.01),scattered distribution of scleral fibre bundles,sparse collagen cells,reduced scleral thickness(P<0.01),and a significantly lower collagen protein content(P<0.01).The mRNA and protein expressions of TIMP-2 and TGF-β1 were lower(P<0.05,P<0.01),and MMP-2 was higher(P<0.01)in scleral tissue.The protein expression level of Col-Ⅰwas lower(P<0.05)while that of Ki-67 was elevated(P<0.01)in scleral tissue.Compared with the FDM model group,there were no significant changes in any of the indexes in the FDM+saline group.The refractive error of the right eyes of guinea pigs in the FDM+neotropium group and the FDM+atropium group were significantly higher(P<0.05),the length of the ocular axis was significantly shorter(P<0.05),the collagen fibres were arranged more tightly,the fibre bundles were distributed more orderly,the distribution of the collagen cells was more uniform,and the thickness of the sclera was significantly increased(P<0.01).Collagen protein contents were significantly higher(P<0.05,P<0.01),the mRNA and protein expressions of TIMP-2 and TGF-β1 were significantly higher(P<0.01),MMP-2 mRNA and protein expressions were significantly lower(P<0.05,P<0.01).The protein expression level of Col-Ⅰwas higher(P<0.05,P<0.01),and that of Ki-67 was lower(P<0.05,P<0.01)in scleral tissue.CONCLU-SION The muscarinic antagonist neotropine inhibits the development of myopia in guinea pigs in the FDM model by reversing both the down-regulation of TGF-β1 and the up-regulation of MMP-2 in scleral tissues and inhibiting the remodeling of the scleral extracellular matrix.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Liver fibrosis and cirrhosis are the common outcomes of various chronic liver diseases after progression,and studies have shown that liver fibrosis and early liver cirrhosis can be reversed.Compound traditional Chinese medicine prescriptions have a marked therapeutic effect in reversing liver fibrosis and early liver cirrhosis,and their mechanism of action remains unclear.By reviewing related articles in China and globally,this article summarizes the six main phenotypic mechanisms involved in the efficacy of compound traditional Chinese medicine prescriptions,i.e.,inhibiting liver inflammation and regulating liver immune response,regulating hepatic stellate cell activation and extracellular matrix(ECM)generation,promoting ECM degradation,reversing hepatic sinusoidal capillarization,regulating hepatocyte regeneration,and regulating gut microbiota,and in addition,this article also analyzes the advances and shortcomings in current studies on each phenotype.Future studies on compound traditional Chinese medicine prescriptions should focus on experimental exploration and rescue experiments to verify the above phenotypes and further explore the upstream and downstream signaling pathways with a marked effect.This article aims to help clarify the direction and ideas of studies on the therapeutic mechanism of compound traditional Chinese medicine prescriptions,in order to provide a basis for clarifying the scientific essence of compound traditional Chinese medicine prescriptions.

Trauma is the leading cause of death for people under 40 years old in the world. At present, the rescue and treatment system of trauma patients in China is not yet well established, and the mortality of trauma patients is higher than those in the developed countries. Improving the treatment system is the key to reducing the trauma mortality. In order to innovate the service mode of trauma first aid, further promote the establishment of regional trauma first aid system, improve the ability of trauma treatment, reduce the mortality and disability rate of trauma patients in Jiangxi Province, recently Health Commission of Jiangxi Province and the First Affiliated Hospital of Nanchang University have reached a consensus on the establishment of Jiangxi trauma first aid center. In order to provide reference for the construction of trauma treatment system, the author analyzes the following aspects including functional positioning, basic requirements, organization management, and evaluation of core indicators.

ObjectiveTo determine thallium in whole blood by atomic absorption detection method, and to investigate the eliminating effect of hemoperfusion (HP) for thallium in blood.Methods The blood of Beagle dogs which had not exposed to thallium before were obtained for preparation of thallium nitrate (TlNO3)-containing solution in three concentrations according to the conversion formula based on animal weight and volume of blood. HP was performed in the simulated in vivo environment. The content of TlNO3 in blood of the next group was determined on the amount of TlNO3 for the last HP of the former dose group. Thallium quantity in different samples was measured with atomic absorption spectrometer blood samples before and after HP. Finally, the thallium concentration in blood was analyzed statistically.Results Thallium concentrations showed a good linear relationship in the range of 0-200μg/L (r = 0.998 4). The intra-day precision (RSD) was lower than 4.913%, the intra-day recovery rate was 96.2%-111.9%; the inter-day precision (RSD) was lower than 7.502%, the inter-day recovery rate was 89.6%-105.2%. The concentration of thallium in blood was significantly reduced after HP per time in high, middle, and low dose groups [(453.43±27.80) mg/L to (56.09±14.44) mg/L in high dose group,F = 8.820,P = 0.003;(64.51±13.60) mg/L to (3.19±0.23) mg/L in middle dose group,F = 36.312,P = 0.000; (5.40±0.98) mg/L to (0.38±0.25) mg/L in low dose group,F = 46.240,P = 0.000]. The adsorption rate of four times of HP in high, middle and low dose group were (87.63±2.48)%, (95.06±1.54)% and (92.76±4.87)%, respectively, without significant difference (F = 4.231,P = 0.070 ).Conclusions The method for measuring thallium was established, and it shows a very stable, simple, sensitive for determination of thallium. HP can effectively remove thallium from blood. Thallium concentration can be reduced by 90% after four times of HP. HP is also effective even when thallium concentration is not high.

BACKGROUND:Simple pedicle screw fixation for thoracolumbar fractures has better outcomes, but there are some deficiencies, such as poor applicability for severe compression or burst fractures, strong vertebral pain, easy to cause vertebral wound denervation and paraspinal muscle injury, and slow recovery. OBJECTIVE:To investigate the clinical effects of pedicle screw fixation combined with artificial bone graft for the treatment of thoracolumbar fractures. METHODS:A total of 126 patients with thoracolumbar vertebral compression fractures, who had undergone pedicle screw fixation without bone graft (control group,n=62) and with bone graft (test group,n=64) were enroled. The fracture healing, anterior vertebral height ratio, sagittal Cobb angle, and loss rate of vertebral height after 6 months were observed by X-ray in the two groups. RESULTS AND CONCLUSION:Al patients were folowed up, and had complete fracture healing after 12-16 months. The anterior vertebral height and Cobb angle were both improved in the two groups at 1 week after operation (P < 0.01), but there was no difference between the two groups (P > 0.05). New bone formation was observed in the test group at 6 months after operation, and patients were pain-free; but the speed of bone formation was slower in the control group, and patients stil suffered from painful thoracolumbar fractures. There was no difference in the loss of anterior vertebral height and Cobb angle between the two groups (P> 0.05). These findings indicate that pedicle screw fixation combined with artificial bone graft lead to a better recovery in thoracolumbar fractures.