Objective:To analyze the comprehensive efficiency of resource allocation in urban public hospitals in 21cities of Guangdong Province from 2019 to 2023,aiming at providing empirical evidence for future medical policy makers and hospital managers in resource allocation and management.Methods:Using Data Envelopment Analysis and Malmquist index to evaluate the efficiency of health resource allocation in public hospitals in Guangdong.Results:From 2019 to 2023,the comprehensive efficiency of urban public hospitals in Guangdong Province was mildly ineffective,only 7 cities showing relative effectiveness,and there were significant regional differences in efficiency.Malmquist index analysis showed that the total factor productivity of health resource allocation in urban public hospitals in the province decreased from 2019 to 2020 and kept increasing from 2020 to 2023,mainly due to the increasing of the technological progress index and the scale efficiency index.Horizontally,the total factor productivity of 9 cities in the province has increased,while the total factor productivity of 12 cities has decreased,with significant regional differences.The input-output redundancy analysis shows that only 6 cities have no input-output redundancy.Conclusion:The overall efficiency of resource allocation in urban public hospitals in Guangdong Province from 2019 to 2023 is relatively low,with significant regional differences.In the future,it is necessary to coordinate and plan resource allocation,focus on refined management,strengthen talent training and technological improvement,improve the operational efficiency of existing resources,and promote high-quality development of hospitals.

Objective:To analyze the comprehensive efficiency of resource allocation in urban public hospitals in 21cities of Guangdong Province from 2019 to 2023,aiming at providing empirical evidence for future medical policy makers and hospital managers in resource allocation and management.Methods:Using Data Envelopment Analysis and Malmquist index to evaluate the efficiency of health resource allocation in public hospitals in Guangdong.Results:From 2019 to 2023,the comprehensive efficiency of urban public hospitals in Guangdong Province was mildly ineffective,only 7 cities showing relative effectiveness,and there were significant regional differences in efficiency.Malmquist index analysis showed that the total factor productivity of health resource allocation in urban public hospitals in the province decreased from 2019 to 2020 and kept increasing from 2020 to 2023,mainly due to the increasing of the technological progress index and the scale efficiency index.Horizontally,the total factor productivity of 9 cities in the province has increased,while the total factor productivity of 12 cities has decreased,with significant regional differences.The input-output redundancy analysis shows that only 6 cities have no input-output redundancy.Conclusion:The overall efficiency of resource allocation in urban public hospitals in Guangdong Province from 2019 to 2023 is relatively low,with significant regional differences.In the future,it is necessary to coordinate and plan resource allocation,focus on refined management,strengthen talent training and technological improvement,improve the operational efficiency of existing resources,and promote high-quality development of hospitals.

Background Diurnal temperature range (DTR) is closely associated with cardiovascular health in the elderly, but there is a lack of research on the relationship between DTR and ischemic heart disease (IHD) in the elderly. Objective To investigate the effect of DTR on daily hospital admissions for IHD in people 65 years and older in Wuhan. Methods The study obtained data on elderly inpatients with IHD from all secondary and tertiary hospitals in Wuhan between January 1, 2017 and December 31, 2018, along with synchronous meteorological and air pollution data. Daily DTR was calculated as the difference between the maximum and minimum temperatures in a day. We employed distributed lag nonlinear models based on quasi-Poisson distribution to analyze the association between DTR and hospitalization risk in individuals aged 60 years and above. We assessed the extreme effects of DTR by selected DTR percentiles (the 1st percentile, P₁: 1.8 ℃; the 5th percentile, P₅: 2.9 ℃; the 95th percentile, P₉₅: 14.3 ℃; and the 99th percentile, P₉₉: 16.2 ℃) on hospitalization for IHD in the elderly population. Additionally, we conducted stratified analyses by gender, age (60-74 years and ≥75 years) and different subtypes (acute IHD and chronic IHD) to investigate the effects of DTR on hospitalizations for IHD across different genders, ages, and subtypes. Results This study included a total of 64212 first-time IHD hospitalizations among individuals aged 65 years and above in Wuhan from 2017 to 2018. The results showed a "J"-shaped exposure-response relationship between DTR and the cumulative risk of IHD hospitalization with a lag of 7 d; the optimal DTR was 5.0 ℃, and as DTR increased or the lag time lengthened, the risk of hospitalization for IHD in the elderly population increased. Extremely high DTR (P₉₉: 16.2 ℃) had a significant impact on the day of exposure (lag 0), with a cumulative RR of 1.58 (95%CI: 1.25, 1.99) at a lag of 7 d. The overall effects of DTR on IHD for different genders, ages, and subtypes of IHD exhibited similar patterns to the effects for overall population. High DTR had a significantly higher impact on hospitalization for chronic IHD (RR=1.46, 95%CI: 1.20, 1.79), compared to acute IHD (RR=1.29, 95%CI: 1.04, 1.61). At a cumulative lag of 7 d, elderly individuals aged 60-74 (RR=1.78, 95% CI: 1.30, 2.42) were more affected by high DTR in terms of IHD hospitalizations compared to those aged ≥75 (RR=1.35, 95% CI: 1.08, 1.70). Conclusion High DTR significantly increases the risk of hospitalization for IHD among elderly individuals. The effect of high DTR is particularly pronounced in patients with chronic IHD and elderly individuals aged 60–74 years.

With the increasing average life expectancy and the growing global aging population, cognitive frailty in the elderly has emerged as a new concept and a key focus of research in geriatrics.Cognitive frailty shows potential for reversibility, and early screening and intervention can have a positive impact on either recovering or slowing down cognitive decline in older adults, making it a promising target for promoting healthy aging.However, research on cognitive frailty is still in its nascent stages, and there is no consensus on its definition and screening criteria.This review provides an overview of the current research progress on the definition, epidemiological status, assessment tools, influencing factors, and intervention strategies for cognitive frailty.The aim is to enhance healthcare professionals' understanding of cognitive frailty in the elderly and improve diagnostic, treatment, and prevention approaches.

Objective To explore the association of (cardiometabolic index , CMI ) and ( lipid accumulation product , LAP ) with the prevalence of hypertension in adults in Pingshan District, Shenzhen, and to evaluate the predictive value of CMI and LAP for the prevalence of hypertension. Methods A cross-sectional survey was conducted, in which 1000 permanent residents aged 18-69 years in Pingshan District, Shenzhen were randomly selected as survey subjects. The data were collected using questionnaires, physical measurements and blood tests, and the relationship between CMI, LAP and hypertension prevalence was analyzed using logistic regression models. Results A total of 987 subjects were included in the analysis, including 471 (47.72%) males and 516 (52.28%) females, with an average age of 40.9 ± 11.1 years. Subjects of different genders were divided into groups Q1 to Q4 according to quartiles of CMI and LAP, and the prevalence of hypertension increased with increasing levels of CMI and LAP in both men and women (P for trend < 0.001). Logistic regression analysis revealed that after adjusting for variables such as age and occupation, the OR for hypertension was 1.251 (1.025-1.526) and 1.685 (1.001-2.836) for men and women, respectively, for each standard deviation increase in CMI; the OR for hypertension was 3.519 (1.343-9.222) for men in the Q4 group, compared to the CMI subgroup Q1. For each standard deviation increase in LAP, the ORs for hypertension were 1.355 (1.089-1.686) and 1.825 (1.023-3.254) for men and women, respectively; compared to LAP subgroup Q1, the ORs for hypertension in the male Q3 and Q4 groups were 2.554 (1.103-5.909) and 5.322 (2.393-11.834), while the OR for hypertension in the female Q4 group was 2.906 (1.096-7.703). ROC analysis revealed that the area under the curve (AUC) for CMI, LAP, and BMI was 0.671, 0.704, and 0.702 for males, and 0.660, 0.722, and 0.697 for females, respectively. The AUC for LAP was greater than that for CMI for different genders (P < 0.01). Conclusion The greater the CMI and LAP values in adults in Pingshan District, Shenzhen , the higher the prevalence of hypertension. CMI and LAP have certain values in predicting the prevalence of hypertension.

Objective To explore the standardized management mode of the Ethics Committee for organ donation after citizen’s death in hospitals. Methods The situations of ethical review before and after the standardized adjustment of the Ethics Committee of human organ donation in the First Affiliated Hospital of Chongqing Medical University were retrospectively analyzed. Baseline data of donors before and after standardized adjustment of the Ethics Committee of human organ donation were compared. The influence of standardized adjustment of the Ethics Committee on the attendance rate of committee members and duration of ethical review were analyzed. Results No significant differences were observed in donors' ethical review data, such as gender, age and death determination, before and after standardized adjustment of Ethics Committee structure (all P>0.05). Significant difference was noted regarding the cause of death in ethical review (P<0.05). Univariate analysis showed that there were significant differences in the impact of Ethics Committee standardization adjustment and cause of death on the attendance rate of committee members (both P<0.05). Multivariate analysis revealed that gender, cause of death and standardized adjustment of the Ethics Committee were the influencing factors of the attendance rate of committee members, and the attendance rate of committee members after standardized adjustment was higher than that before adjustment (P<0.05). Univariate analysis showed that there were statistically significant differences in the effects of Ethics Committee standardized adjustment, attendance rate of committee members and cause of death on the duration of ethical review (all P<0.05). Multivariate analysis indicated that standardized adjustment of the ethics committee was the influencing factor of the duration of ethical review, and the duration of ethics review after standardized adjustment was shorter than that before adjustment (P<0.05). Conclusions Appropriate arrangement of the total number of ethics committee members and standardizing the review process may improve the efficiency of ethical review. Scientific evaluation mechanism for ethical committee members should be established by dynamically adjusting the ethical committee members, clarifying the responsibilities and tasks of members and secretaries, aiming to further improve standardized management level of ethical review for organ donation after citizen’s death.

"Double-driven" teacher professional development is a transformation from a novice teacher to an expert teacher through both internal and external driving pathway based on education ecology and teacher encouragement theory. The internal driving pathway of teacher professional development includes socialist belief, professional conscience, and professional consciousness, while the external driving pathway includes standardized management system, school-based teaching and research activities, medicine-education cooperation, and campus positive culture.

Objective:To explore the risk factors of hypotension in patients with hemodialysis-related superior vena cava diseases.Methods:This was a retrospective cohort study. The maintenance hemodialysis patients diagnosed as superior vena cava stenosis ≥50% or occlusion in West China Hospital of Sichuan University from January 1, 2019 to March 31, 2022 were selected. The patients were divided into hypotensive group and non-hypotensive group according to the occurrence of hypotension during non-dialysis period. The differences of general clinical data, cardiac ultrasound parameters and blood biochemical indexes between the two groups were compared. Multivariate logistic regression model was used to analyze the risk factors of hypotension in patients with hemodialysis-related superior vena cava lesions.Results:A total of 202 patients with hemodialysis-related superior vena cava lesions were included, of whom 84 patients (41.6%) developed hypotension during non-dialysis. Compared with the non-hypotensive group, patients in the hypotensive group had longer dialysis age ( Z=2.093, P=0.036), shorter left atrial diameter ( t=2.316, P=0.022), lower aortic valve orifice flow rate ( t=3.702, P=0.001) and serum calcium ( t=2.320, P=0.021), thicker left ventricular posterior wall ( t=3.042, P=0.003), lower proportions of hypertension history ( χ2=9.125, P=0.003), and higher proportion of residual superior vena cava ≤30% or occlusion ( χ2=8.940, P=0.003) and azygous vein opening ( χ2=11.067, P=0.001). Multivariate logistic regression analysis results showed that no history of hypertension ( OR=0.383, 95% CI 0.156-0.943, P=0.037), slow aortic valve orifice flow ( OR=0.207, 95% CI 0.062-0.695, P=0.011) and low blood calcium ( OR=0.236, 95% CI 0.066-0.841, P=0.026) were the independent influencing factors of hypotension in patients with hemodialysis-related superior vena cava diseases. Conclusions:Hemodialysis patients with severe stenosis or occlusion of the superior vena cava during non-dialysis have a higher risk of hypotension. No history of hypertension, slow aortic valve orifice flow, and low blood calcium are the independent risk factors of hypotension in patients with hemodialysis-related superior vena cava diseases.

Objective To explore the influencing factors of coal workers''''cognitive function. Meth-ods There was a physical examination on 3205 workers in the coal mine enterprise.The physical examina-tion included height,weight,blood pressure,blood routine examination and routine urine test,and Mini Men-tal State Examination (MMSE) was used to evaluate the cognitive function.The coal workers were divided in-to cognitive dysfunction group (84 cases) and cognitive function normal group (3121 cases) according to MMSE scores.Logistic regression analysis was used to explore the influencing factors of cognitive function. Results The prevalence of cognitive dysfunction was 2. 62％ in coal workers. The age of the cognitive dys-function group(47.27±8.24) was significantly higher than that in the cognitive function normal group (41.39 ±8.65)(P<0.05),and the degree of culture in cognitive dysfunction group was significantly lower than those in the cognitive function normal group (χ2= 46. 610, P<0. 01 ) . The low density lipoprotein cholesterol ((2.72±0.65)mmol/L),urine pH(5.54±1.51) in the cognitive dysfunction group were significantly lower than those in the cognitive function normal group((2.89±0.73)mmol/L,(5.92±1.28))(P<0.05). The lo-gistic regression analysis showed that age, culture level, BMI, low density lipoprotein cholesterol, urine pH were the impacting factors of cognitive dysfunction. Conclusion Cognitive dysfunction is influenced by age, culture level,BMI and low density lipoprotein cholesterol. The higher of the age and the lower of the culture level,BMI,low density lipoprotein cholesterol,urine pH,the more vulnerable to cognitive dysfunction.

Objective To establish quality standards for stem leaf ofAstragali Radix.Methods A method of TLC identification was used for qualitative discrimination. The moisture, total ash and extracts contents of the stem leaf of Astragali Radix were determined by pharmacopoeia method. Total contents of astragaloside and astragalus polysaccharide were measured by colorimetry. The astragalosideⅣ and calycosin-7-O-β-D-glucoside contents were detected by HPLC.Results The spots of TLC were round and clear with good repeatability. The moisture contents of the stem leaf ofAstragali Radix were between 6.24%–12.24%; the total ash was between 8.21%–10.55%; the water- solubility extracts were between 12.12%–27.30%; alcohol-solubility extracts were between 6.89%–10.28%; the total contents of astragaloside were between 23.74–26.52 mg/g; astragalus polysaccharide were between 23.31–45.70 mg/g; the astragalosideⅣ contents were between 0.047%–0.18%; the calycosin-7-O-β-D-glucoside were 0.21%–0.26%. Conclusion The method is convenient, fast and repeatable, and the results are accurate and reliable, which can be used to control the quality of the stem leaf ofAstragali Radix effectively, and as the main index of the quality standard.