In recent years, the potential hepatotoxicity of green tea extract (GTE) has attracted more and more attention. With reference to the current studies on liver injury caused by GTE and the latest drug hepatotoxicity classification, this article systematically elaborates on the objectivity and causal mechanisms of liver injury caused by GTE. Based on the main risk factors for liver injury caused by GTE, this article also proposes recommendations for safe and rational use of such products, so as to provide valuable insights for in-depth research on the mechanism of liver injury caused by GTE and risk prevention and control, and meanwhile, it also provides an important reference for the therapeutic use of GTE to improve health conditions.

Objective:To comprehensively evaluate the service capacity of tertiary maternal and child health institutions in S province based on the entropy weight TOPSIS method, for references for relevant policy formulation.Methods:Data on service capacity of 23 tertiary maternal and child health institutions in S Province in 2021 were collected for national perfomance appraisal subsystem of maternal and child health institution. Through literature analysis, five primary indexes, including management, service provision, operational efficiency, sustainable development, and satisfaction evaluation, as well as 10 secondary indexes and 20 tertiary indexes, were selected to construct a comprehensive evaluation index system for service capacity of tertiary maternal and child health institutions. The entropy weight TOPSIS method was used to comprehensively evaluate the service capacity and first level indexes level of tertiary maternal and child health institutions in S Province.Results:Jurisdictional management, sustainable development, and service provision were important first level indexes that affect the service capacity of institutions, with higher weights of 36.16%, 25.12%, and 24.30%, respectively. The service capabilities of institutions were ranked based on their relative closeness( C value), the top 5 institutions ( C value≥0.345) included 1 provincial-level institution, 3 prefecture level institutions, and 1 county-level institution, as well as the bottom 5 institutions ( C value≤0.174) included 1 prefecture level institution and 4 county-level institutions. From the perspective of first level indexe, the average C value of Jurisdictional management was the lowest(0.173), and the satisfaction evaluation′s C value was the highest (0.612). Moreover, the ranking of primary indexe in provincial institutions were generally higher than that of prefecture level institutions and county-level institutions. Conclusions:The development of the service capacity of the third level maternal and child health institutions in S Province was uneven, and the overall service capacity of county-level institutions was relatively weak, especially in terms of jurisdictional management, service provision, and sustainable development. It was recommended to further optimize the allocation of maternal and child health resources, strengthen personnel construction, promote science popularization and health education, and promote the development of specialties.

Objective:To study the correlation of serum tenascin C (TNC) and bronchopulmonary dysplasia (BPD) comorbid pulmonary hypertension (PH) in preterm infants.Methods:From January 2017 to June 2020, preterm infants (gestational age<32 weeks) diagnosed of severe BPD admitted to the Neonatal Intensive Care Unit of our hospital were prospectively studied. Comorbidity of PH was evaluated using echocardiography and the infants were assigned into PH (+) group and PH (-) group. At the same time, serum TNC was examined and the correlation between serum TNC level and PH in infants with severe BPD was analyzed.Results:A total of 59 infants with severe BPD were enrolled, including 21 cases comorbid PH (35.6%). The serum TNC level in the PH (+) group was significantly higher than the PH (-) group [(123.7±41.1) ng/ml vs. (78.2±20.2) ng/ml, P<0.05]. Correlation analysis showed a positive correlation between the serum TNC level and systolic pulmonary artery pressure (sPAP) ( r=0.861, P<0.001).The area under the receiver operating characteristic curve of serum TNC predicting BPD comorbid PH was 0.884. The sensitivity and specificity of serum TNC predicting BPD comorbid PH were 84.0% and 76.9% with TNC≥87.7 ng/ml as the cut-off. Conclusions:Severe BPD comorbid PH is common. The serum TNC level in infants with severe BPD comorbid PH is increased and positively correlated with sPAP. The serum TNC level has certain clinical value in predicting and evaluating the severity of BPD comorbid PH.

Objective :To analyze correlation among fasting (FBL) and postprandial blood lipids (PBL) ,blood lipid fluctuation (absolute value of PBL‐FBL) and severity of coronary artery disease .Methods :Cross‐sectional study was performed among 264 patients undergoing coronary angiography (CAG) in our hospital .According to percutaneous coronary intervention (PCI) or not based on CAG results ,patients were divided into plaque group (n＝128) and PCI group (n＝136).Gensini score was used to assess severity of coronary artery disease .Blood lipid levels and its fluctu‐ation were compared between two groups .Correlation among blood lipid levels ,blood lipid fluctuation and severity of coronary artery disease were analyzed .Results :Compared with plaque group ,there were significant rise in per‐centages of men and smokers ,waist circumference ,levels of postprandial‐fasting (P‐F ) serum LDL‐C (ΔLDL‐C ) and P‐F plasma apolipoprotein B (ΔApoB ) , and significant reduction in plasma level of P‐F apolipoprotein A1 (ΔApoA1) in PCI group , P＜0. 05 or ＜ 0. 01. Pearson correlation analysis indicated that serum fasting and post‐prandial HDL‐C levels ,plasma fasting and postprandial levels of ApoA1 and ΔApoA1 were significant inversely cor‐related with Gensini score ( r＝ －0. 130～ －0.218 , P＜0. 05 or ＜0. 01) ,and levels of plasma fasting lipoprotein a (Lp (a)) ,serum fasting and postprandial levels of free fatty acid (FFA) ,serum P‐F FFA (Δ FFA) were significant positively correlated with Gensini score ( r＝0. 139－0. 176 , P＜0.05 or ＜0.01).Multifactor linear regression anal‐ysis indicated that postprandial serum HDL‐C was protective factor for Gensini score (B＝ －22.274 , P＝0.002 ) , while postprandial serum FFA ,Δ FFA ,waist circumference and hyperlipidemia history were its influencing factors (B＝0. 388～24. 135 , P＜0. 05 or ＜0.01).Conclusion :Measurements of fasting and postprandial blood lipid levels and their fluctuation contribute to more comprehensively and objectively assessing blood lipid levels and severity of coronary disease in patients with coronary artery disease .

Objective To analyze the main practices of capitation payment system reform in the case areas and put forward enlightenments and suggestions in this regard. Methods The implementation practices of the case areas were summarized, and descriptive statistical analysis was carried out on the implementation effects. Results By analyzing the effectiveness of the case areas′reform, it was found that the case areas are curbing the excessive growth of medical expenses (for example, outpatient fees per visit of Dingyuan county-level hospitals decreased from 245.11 yuan in 2015 to 218.40 yuan in 2017), increasing the actual compensation ratio of residents ( for example, the actual compensation ratio of Funan increased from 59.80% in 2015 to 63.28% in 2017), forming a medical treatment pattern within the county (for example, out-of-county compensation ratio in Dingyuan decreased from 37.38% in 2015 to 31.13% in 2017), achieving double-way referrals (for example, the number of referrals to superior hospitals of Jimo increased from 98 in 2015 to 328 in 2017), improving the subsidence of quality services, and controlling the risks of medical insurance funds. Conclusions At present, the reform of the case areas has been implemented steadily and achieved results. It is recommended to further improve such aspects as reform coordination, insurance standard setting, incentive mechanism establishment, and leadership to ensure the reform progress.

Pilot areas have achieved initial success in capitation reform. On the other hand, challenges remain unsolved in terms of practical pathways, change of national medical insurance management system, related measures, incentives and allocative mechanism for implement of the reform. With the concerning on progress, practice, effects and challenges of typical areas, this article established an institutional framework. On such basis, we propose to design and refine a scheme in terms of 5 aspects, namely strengthening the basic medical care packages′financing, setting contents and standard of the basic medical care packages rationally, establishing effective evaluation system and formulating supporting measures.

Objective To evaluate the impacts of DRGs payment reform on patients, medical insurance fund and hospitals, then to steadily promote the payment reform. Methods The reimbursement data of inpatients covered by NCMS yet beyond the single-disease payment were collected from two DRGs pilot hospitals from January 2016 to June 2018. Such means as descriptive statistics, t test and method of interrupted time series analysis were used to compare the changes found in the average out-of-pocket payment, actual reimbursement rate, average per-hospitalization compensation, average length of stay, and average hospitalization expense before and after the DRGs payment reform. Results After the reform, the average out-of-pocket payment and average length of stay began to fall slightly instead of the increasing trend (β3 were -72.79,-0.11, respectively, and P<0.01), the upward trend of average hospitalization expense slowed down ( β3 was -113. 55, and P<0.01), actual reimbursement rate and the average per-hospitalization compensation stayed the original growth trend (β3 were 0.10,-31.15, respectively, and P values were 0.08, 0.09, respectively). Conclusions DRGs encourages the hospitals to curb the average hospitalization expenses, with the growth trend kept at a slower pace. The payment reform does not increase the financial burden of patients, and tends to ease such pressure on funds, but the long-term effect remains to be seen.

Discordance, such as overlap, repetition and inconsistent, of standards is one of the major problems in current standardization affair in China. Therefore, improving the unity and authority of standards through reduction of overlap, repetition and inconsistency has become the main goal of deepening standardization reform in China. This paper summarizes the discordance in public health standards in China, analyzes the major reasons and provides specific strategic suggestions through case analysis of public health standards in the ways of comparisons of same kind standards of other deparments and standards in administration documents and guidelines or technical specifications of academic associations or societies.

Objective To understand the influence of the disease-based hierarchical medical system on inpatients flow covered by the new rural cooperative medical system ( NRCMS) , and that on the funding diversion and medical costs so incurred. Methods One county was selected from the eastern, central and western regions of China respectively, where the disease-based hierarchical medical system has been in place. Policy documents of the three counties were reviewed to analyze such changes as NRCMS inpatients flow, inpatients subsidy diversion, NRCMS fund surplus rate of the current year and medical costs per hospitalization before and after the system was in place. Results A comparison with 2014 found a 1. 26%drop of the out-of-county inpatients of county W of the western region, a 2. 00% increase of township hospitals inpatients of county D in the middle region, and the same ratio of out-of-county and in-county inpatients in county F of the eastern region in 2015. Compared with 2014, the fund surplus rate of county W increased 10. 46%, and the inpatient subsidy ratio of county D decreased 2. 51% for those in out-of-county medical institutions in 2015. Thanks for the quota payment of specific diseases under global budget in county W, the inpatient medical costs per hospitalization dropped at both county and township medical institutions. Conclusions The disease-based hierarchical medical system could optimize the NRCMS inpatients distribution among various medical institutions, conducive for establishment and operation of such a system.