Objective To investigate the expression of neutrophil extracellular traps (NETs) and phagocytic function in the peripheral blood of patients with hepatic alveolar echinococcosis (HAE), and to examine their correlations with clinical inflamma tory indicators and liver functions. Methods A total of 50 patients with HAE admitted to Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Qinghai University from August 2022 to June 2023 were enrolled, while 50 age- and gender-matched healthy individuals from the Centre for Healthy Examinations of the hospital during the same period served as controls. The levels of NETs markers neutrophil myeloperoxidase (MPO) and neutrophil elastase (NE) were measured using enzyme-linked immunosorbent assay (ELISA). Peripheral blood neutrophils were isolated using density gradient centrifugation, stimulated in vitro using phorbol 12-myristate 13 acetate (PMA), and the levels of MPO and citrullination histone H3 (CitH3) released by neutrophils were quantified using flow cytometry. The phagocytic functions of neutrophils were examined using flow cytometry. In addition, the correlations of MPO and NE levels with clinical inflammatory indicators and liver biochemical indicators were examined using Spearman correlation analysis among HAE patients. Results The peripheral blood plasma MPO［(417.15 ± 76.08) ng/mL vs. (255.70 ± 80.84) ng/mL; t = 10.28, P < 0.05］, NE［(23.16 ± 6.75) ng/mL vs. (11.92 ± 3.17) ng/mL; t = 10.65, P < 0.05］and CitH3 levels［(33.93 ± 18.93) ng/mL vs. (19.52 ± 13.89) ng/mL; t = 4.34, P < 0.05］were all significantly higher among HAE patients than among healthy controls, and a lower phagocytosis rate of neutrophils was detected among HAE patients than among healthy controls［(70.85 ± 7.32)% vs. (94.04 ± 3.90)%; t = 20.18, P < 0.05］, and the ability to produce NETs by neutrophils was higher among HAE patients than among healthy controls following in vitro PMA stimulation. Pearson correlation analysis showed that the phagocytosis rate of neutrophils correlated negatively with platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), interleukin-6 (IL-6) level and C-reactive protein (CRP) level (r_s = −0.515 to −0.392, all P values < 0.05), and the MPO and NE levels positively correlated with inflammatory markers NLR, PLR, CRP and IL-6 (r_s = 0.333 to 0.445, all P values < 0.05) and clinical liver biochemical indicators aspartic transaminase, alanine aminotransferase, direct bilirubin and total bilirubin among HAE patients (r_s = 0.290 to 0.628, all P values < 0.001). Conclusions Excessive formation of NETs is found among HAE patients, which affects the phagocytic ability of neutrophils and results in elevated levels of inflammatory indicators. NETs markers may be promising novel biomarkers for early diagnosis, monitoring, and severity assessment of liver disease.

Medical alliances are designed to encourage greater emphasis and resources to the primary care, and upgrade the overall efficacy of the entire healthcare system. To further implement the " Healthy China" initiative, it is imperative to center on population health in the coordination and deployment of resources, for safeguarding health of the Chinese people in an all dimensional and full life cycle manner. In this consideration, the authors proposed to develop health alliances centering on health, which penetrate the full life cycle of health management, prevention, healthcare, rehabilitation and aging care. Such an alliance orchestrates a variety of resources including space, time, information, human resources, materials and financial resources, and coordinates all the functionalities of accountabilities, management, interest and services. This initiative is designed to extend the health spectrum, to focus on the health needs of the people by all dimensions, to integrate health needs-supply model with multiple elements, and to improve the health support system in multiple fields. Health alliances are imperative socially and economically for promoting the positive cycle of regional health industry, secure greater life and health dividends, and minimize catastrophic health expenditure of poverty-stricken families.

Objective: To learn the technical efficiency and influencing factors of hospital beds in China′s hospitals from 2010 to 2016. Methods: The two-stage Network DEA-Tobit model was used to analyze the technical efficiency and influencing factors of hospital beds at all levels in China. Results: There was a big difference in the utilization status of hospital beds at all levels. The bed burden of tertiary hospitals was heavier, and their average bed occupancy rate was 102%, while the potential of primary and secondary hospital beds was relatively large. The average technical efficiency of the hospitals in the primary, secondary and tertiary hospitals was 0.99, 0.37 and 0.82, respectively. Over-investment of resources for beds in hospitals at all levels was found with insufficient output, and the utilization of bed resources in primary and secondary hospitals was seriously insufficient. The nurse-bed ratio, per capita medical expenses of hospitalized patients, per-bed income and financial subsidy to the technical efficiency of the hospital bed were statistically significant. The correlation coefficient between the guard bed ratio and the technical efficiency of the hospital bed was 3.106 409. Conclusions It is necessary to further implement the hierarchical medical system and clarify the functional positioning of hospitals at all levels. It is recommended to control the scale of investment and improve the utilization efficiency of existing bed resources, and it is also imperative to improve the medical technology level and diagnosis rate of hospitals at all levels, and promote the maximization of bed utilization efficiency.

Objective To establish and optimize the evaluation indexes system of hospitals' technical efficiency in China.Methods Delphi method was used along with experts opinion to build the indexes system.Results The expert positive coefficient was over 80% in three rounds of consultation, and the coordination coefficients were 0.144, 0.302 and 0.533 respectively, proving the difference as statistically significant.In the end an evaluation indexes system of hospitals' technical efficiency had taken shape, comprising three level-1 indexes, 13 level-2 indexes and 114 level-3 indexes.Conclusions The evaluation indexes system of hospitals' technical efficiency established with Delphi method can contribute to optimizing resources allocation and promote efficiency of hospital service.

Objective To assess the technical efficiency and subsystem technical efficiency of the healthcare institutions in China,including that of management system and medical system.Methods Panel data of 31 provinces' healthcare institutions were selected,and Network DEA was adopted to assess such input indicators as managerial staff and health technical personnel,and such output indicators as medical revenue and number of medical visits.Results The technical efficiency of healthcare institutions is as lower as an efficiency mean of 0.853 in five year.Provinces of Zhejiang,Shandong,Henan,Guangdong and Tibet have maintained a higher level.The healthcare system breaks down into two independent subsystems of the management subsystem and medical subsystem.The mean of the former one is 0.937,higher than 0.783 of the latter.The number of medical revenue and that of patients in the non-effective provinces were relatively inadequate.Conclusions Healthcare resources allocation in China needs to be optimized.It is imperative to adjust the input-output ratio,improve medical service quality via scientific management.

Objective To measure and predict the hospital resources to be saved by reducing one day of stay in average in China,predict its future impacts,and to probe into the importance of less average days of stay for hospital resource deployment.Methods A mathematical model was used for quantitative analysis of the actual impacts of one less day of stay in China′s hospitals for the hospital resources,and the gray forecasting model was used to predict the hospital resources so saved by achieving so during 2013 to 2025.Results One hospital day less could save 9.41% of a hospital′s total bed resources.According to the growing trend of hospital beds in China and the deployment relationship,it is predicted that more hospital resources will be saved by one hospital day less in average from 2013 to 2025.Conclusions Shorter average days of stay and optimal deployment of hospital resources,should be based on quality of care.Less ineffective waiting time to shorten average days of stay can be breakthrough to improve the comprehensive efficiency of health resources.

Our research is focused on the emerging public health management supported by big-data,which has just come into horizon in this field.We thoroughly analyzed and compared the big-data technology as well as the latest development on theories and methods in public health management. Stream processing,batch processing,distributed database and non-relational database were applied to solve problems and meet demands and challenges in public health management.Furthermore,it should become the strategic choice of innovative public health management driven by big-data.

Objective For an analysis and evaluation of the technical efficiency of tertiary hospitals in Tianjin.Methods Data Envelopment Analysis of different combinations of indicators and Spearman Rank Correlation Analysis were used for a study of the relative efficiency between 28 tertiary hospitals and the correlation between the indictors.Results The study showed that 12 hospitals reached DEA efficient,effective rate of 42.86%,and there is a correlation between the five sets of indicators. Conclusion Regulators of Tianjin hospitals should pay attention to efficiency calculations,make full use of medical resources,strengthen scientific management,and enhance the competitiveness of the hospital.

Objective To probe into the varying efficiency of public hospitals and recommend on efficiency improvement.Methods By means of DEA method including CCR model,BCC model and Malmquist index,to study the static and dynamic changes of operating efficiency of hospitals in Tianjin from 2008 to 2012.Results The overall efficiency of these 24 hospitals is not high,and the efficiency of the tertiary hospitals (0.900)is higher than the second-level hospitals(0.828).There exist problems that the size of the second-level hospitals is either too big or too small,a lot of health resources can be saved by managing the non-DEA efficient hospitals.The trends of the total factor productivity of 24 hospitals in Tianjin from 2008 to 2012 are increased.Thanks to the advanced technology and innovation, the overall efficiency of tertiary hospitals is improved.Through improving organizational management level,the overall efficiency of second-level hospitals is improved.Conclusion Hospital managers should introduce the high-level medical workers,enhance technological innovation,improve and standardize the hospital management and service system,optimize the allocation of medical resources and select the appropriate size of the hospital with the hospital's own situation to improve the operating efficiency of the public hospitals.

Objective To analyze allocation of health resources and utilization of health services,and evaluate the equity of health resources allocation and health services utilization.Methods Concentration curve and concentration index(CI)were used to evaluate the equity of health resources allocation in terms of health professionals,hospital beds,medical institutions,outpatient visits and hospitalizations in China.Results The CI for health professionals,hospital beds,and medical institutions is 0.038,-0.012,and-0.116 respectively.That for outpatient visits and hospitalizations is 0.111 and -0.023 respectively.Conclusion Health resources allocation in hospital beds and health professionals is fair,while the equity of medical institutions and outpatient service utilization needs to be improved.