[Objective] To validate and optimize the platelet transfusion refractoriness (PTR) prediction model for patients with hematological disorders established by our center. [Methods] The data of patients with hematological diseases who received platelet transfusions from December 2021 to December 2022 were used as the training set, and data from January 2023 to December 2023 as the validation set. The validation set data was used to validate the predictive model constructed on the training set. Relevant risk factors for PTR were collected through literature review and preliminary studies。 The patients were divided into effective and ineffective groups according to the corrected count increment (CCI) of platelet counts. Predictive factors were screened using univariate and multivariate logistic regression. The calibration of the model were assessed via calibration curves, while discrimination, accuracy, sensitivity, and specificity were evaluated using receiver operating characteristic (ROC) curves Clinical utility was further analyzed with decision curve analysis (DCA). [Results] The Hosmer-Lemeshow (H-L) goodness-of-fit test for the validation set yielded S: P=0.000, indicating that the original model needs optimization. Baseline comparisons and logistic regression identified the number of red blood cell units (RBCU) and platelet units (PLT-U) transfused as key predictors for the optimized model. The H-L goodness-of-fit test S: P values for the training and validation sets were 0.930 and 0.056, respectively; the ROC areas were 0.793 5 and 0.809 4, specificities 90.95% and 84.21%, sensitivities 59.26% and 70.04%, and accuracies 78.14% and 74.10%, respectively. DCA demonstrated clinical net benefit within a prediction probability threshold range of 0.2-0.8. [Conclusion] Transfusion volumes of RBC-U and PLT-U were inversely associated with PTR in hematological patients. The resulting PTR prediction model exhibits moderate predictive efficacy and clinical benefit.

Cardiovascular disease is the leading cause of death among Chinese residents, and non-invasive imaging technology has important value in the diagnosis and treatment of cardiovascular disease. Cardiac magnetic resonance (CMR) can characterize cardiac pathophysiological information from multiple dimensions, including cardiac structure, function, tissue characteristics, and microstructure, through multi parameter and multi sequence " one-stop" imaging. This article will focus on new technologies such as CMRT1 mapping, feature tracking, and diffusion tensor imaging, and explain their applications and progress in the diagnosis, efficacy monitoring, and prognosis prediction of various myocardial lesions such as non ischemic heart disease and ischemic heart disease.

Objective:To apply cardiovascular magnetic resonance (CMR) to quantitatively evaluate the morphology and tissue characteristics of thoracic skeletal muscle (TSM) in patients with Danon disease and hypertrophic cardiomyopathy (HCM), in order to provide auxiliary differential diagnostic information.Methods:A retrospective study was conducted on 15 Danon disease patients (Danon disease group) who completed CMR examination, and 15 HCM patients (HCM group) and 15 healthy volunteers (control group) who were matched by gender and age were compared. TSM (pectoralis major, pectoralis minor, erector spinae, and subscapularis) area index (TSMAi), T1 relaxation time of four groups, and extracellular volume (ECV) of skeletal muscles of two groups (pectoralis major and subscapularis) were measured for all subjects. Single factor analysis of variance and KruskalWallis test were used to compare three sets of values.Results:The total TSMAi of the Danon disease group was lower than that of the HCM group and the control group [(15.37±3.28)cm 2/m 2 vs (23.02±3.88)cm 2/m 2 vs (22.33±4.67)cm 2/m 2, P<0.001], and the TSMAi of each TSM was also lower than that of the HCM group and the control group (all P<0.05). There was no statistically significant difference in TSMAi between the HCM group and the control group (all P>0.05). The native T1 values of the pectoralis major muscle in the Danon disease group and HCM group were higher than those in the control group (all P<0.05). The ECV of the pectoralis major muscle and subscapularis muscle in the Danon disease group were higher than those in the HCM group and control group, and the enhanced T1 values were lower than those in the HCM group and control group (all P<0.05); There was no statistically significant difference in ECV and the enhanced T1 values between the HCM group and the control group ( P>0.05). Conclusions:The application of CMR can effectively evaluate the changes in TSM morphology and tissue characteristics in Danon disease patients. Compared with HCM patients, Danon disease patients showed significant atrophy of TSM with increased extracellular volume. CMR provides a quantitative reference for TSM in the differential diagnosis of the two.

Objective:To investigate the hemodynamic changes in the ascending aorta (AAo) before and after interventricular septal myocardial resection in obstructive hypertrophic cardiomyopathy (HOCM) using cardiac magnetic resonance four-dimensional blood flow (CMR 4D Flow) technology.Methods:HOCM patients who underwent interventricular septal myocardial resection at Guangdong Provincial People′s Hospital from May 2021 to September 2022 were prospectively included. Age and gender matched healthy volunteers (control group) were included during the same period. Both the control group and HOCM patients underwent CMR examination (including cine sequence and 4D Flow sequence) before and 6 months after surgery. CMR 4D flow technology was used to evaluate changes in AAo preoperative and postoperative blood flow patterns (eddy currents, spiral flow), maximum energy loss (EL max), and average energy loss (EL avg). HOCM patients underwent laboratory tests, including N-terminal pro-brain natriuretic peptide (N-pro BNP) and high-sensitivity troponin T (hsTnT). At the same time, the correlation between postoperative energy loss in HOCM patients and the degree of improvement in laboratory biomarkers was explored. Results:A total of 15 HOCM patients and 15 healthy volunteers were included. (1) In terms of blood flow patterns, the preoperative spiral flow degree of HOCM patients was significantly higher than that of the control group ( P=0.001), but the postoperative difference was not statistically significant ( P=0.059). The degree of eddy currents in HOCM patients before and after surgery was higher than that in the control group (all P<0.05). (2) In terms of energy loss, the preoperative EL max [21.17(14.30-28.10)mW vs 10.17(7.66-13.07)mW, P<0.001] and EL avg [4.87(3.46-5.77)mW vs 2.27(2.19-2.27)mW, P=0.023] of HOCM patients were higher than those of the control group, but there was no statistically significant difference between the postoperative and control groups (all P>0.05). Compared with preoperative, the postoperative EL max [12.33(8.70-17.41)mW] and EL avg [3.10(2.25-4.40)mW] of AAo in HOCM patients were significantly reduced (mean P=0.001). (3) Correlation analysis showed that there was a positive correlation ( r=0.587, P=0.021) between the EL max of AAo and the degree of improvement in hsTNT after interventricular septum myocardial resection, but no significant correlation ( r=0.229, P=0.413) with the degree of improvement in NT-pro BNP. Conclusions:The degree of postoperative AAo blood flow disorder in HOCM patients is reduced, and EL max and EL avg are significantly reduced. The EL max of postoperative AAo is positively correlated with the degree of improvement in hsTNT, suggesting that EL max may be applicable for prognostic evaluation of patients.

Objective To construct the performance evaluation index system of public hospitals,and provide reference for promoting the high-quality development of public hospitals.Methods Delphi method and analytic hierarchy process were used to determine the performance evaluation index system of public hospitals based on performance prism model.Results It established a public hospital performance evaluation system including 5 first-level indicators,16 second-level indicators and 40 third-level indicators of government,staff,patients,suppliers and regulatory agencies.The weights of the five first-level indicators are 0.254 8,0.476 8,0.154 4,0.073 4 and 0.040 6,respectively.Among the 16 second-level indicators,salary,quality and safety,practice environment,medical quality and operation efficiency rank the top 5.The combined weights were 0.268 5,0.174 3,0.165 4,0.080 9 and 0.060 6,respectively.Among the 40 tertiary indicators,the satisfaction of medical staff,the quality control index of single disease,organizational support,the intensity of antibacterial drug use and the case mortality of the low-risk group were investigated.The combined weights were 0.212 0,0.110 0,0.107 0,0.064 3 and 0.0624,respectively.Conclusion The performance evaluation index system of public hospitals based on the performance prism model established is helpful to guide hospitals to think about hospital strategic reform,process optimization and capacity improvement from the multi-dimensional perspective of internal and external stakeholders,so as to improve development performance and promote social harmonious development,and to improve performance,promote high-quality development.

ObjectiveTo explore the possible mechanism of Chuanxiong （Rhizoma Chuanxiong） & Tianma （Rhizoma Gastrodiae） herbal pair in treating migraines based on AMP-activated protein kinase （AMPK）/transient receptor potential A1 channel （TRPA1） pathway. MethodsForty-eight healthy male SD rats were randomly divided into control group， model group， and Chuanxiong Tianma medication group， with 16 rats in each group. The control group and model group were given 10 ml/kg of normal saline by gavage， while the Chuanxiong Tianma medication group was given 0.675 g/kg of Chuanxiong Tianma herbal pair by gavage， once daily for 8 consecutive days in both groups. Migraime model was performed before the last administration， with subcutaneous injection of 10 ml/kg of normal saline in the control group， and subcutaneous injection of 10 ml/kg of nitroglycerin in the model group and Chuanxiong Tianma medication group. The Von Frey filament was used to measure the periorbital mechanical pain threshold of rats. The enzyme-linked immunosorbent assay （ELISA） was used to determine the levels of calcitonin gene-related peptide （CGRP） in rat serum and cerebrospinal fluid. The nitric oxide （NO） assay kit was used to determine the NO level in serum and cerebrospinal fluid. RT-PCR was usedto detect the mRNA expression levels of immediate-early genes in the trigeminal ganglion of rats （c-Fos）， CGRP， transient receptor potential V1 channel （TRPV1）， AMPK alpha subunit （PRKAA）， and TRPA1. Immunofluorescence was used to detect the number of c-Fos-positive cells in the trigeminal cervical complex （TCC） and the protein expression levels of phosphorylated AMPK （pAMPK） and TRPA1 in the trigeminal ganglion. ResultsCompared to those in the control group， the mechanical stimulation threshold and pAMPK protein expression in the model group decreased， while the levels of CGRP and NO in serum， c-Fos， CGRP， TRPV1 and TRPA1 mRNA levels in the trigeminal ganglion， TRPA1 protein expression， and the number of c-Fos-positive cells in the TCC significantly increased （P＜0.05）. Compared to those in the model group， the mechanical stimulation threshold and pAMPK protein expression in the Chuanxiong Tianma medication group significantly increased， while the levels of CGRP and NO in serum， c-Fos， CGRP， TRPV1 and TRPA1 mRNA levels in the trigeminal ganglion， TRPA1 protein expression， and the number of c-Fos-positive cells in the TCC significantly decreased （P＜0.05）. ConclusionChuanxiong Tianma herbal pair may improve migraine symptoms by regulating the AMPK/TRPA1 pathway in the trigeminal ganglion and increasing the mechanical pain threshold.

Objective To construct the performance evaluation index system of public hospitals,and provide reference for promoting the high-quality development of public hospitals.Methods Delphi method and analytic hierarchy process were used to determine the performance evaluation index system of public hospitals based on performance prism model.Results It established a public hospital performance evaluation system including 5 first-level indicators,16 second-level indicators and 40 third-level indicators of government,staff,patients,suppliers and regulatory agencies.The weights of the five first-level indicators are 0.254 8,0.476 8,0.154 4,0.073 4 and 0.040 6,respectively.Among the 16 second-level indicators,salary,quality and safety,practice environment,medical quality and operation efficiency rank the top 5.The combined weights were 0.268 5,0.174 3,0.165 4,0.080 9 and 0.060 6,respectively.Among the 40 tertiary indicators,the satisfaction of medical staff,the quality control index of single disease,organizational support,the intensity of antibacterial drug use and the case mortality of the low-risk group were investigated.The combined weights were 0.212 0,0.110 0,0.107 0,0.064 3 and 0.0624,respectively.Conclusion The performance evaluation index system of public hospitals based on the performance prism model established is helpful to guide hospitals to think about hospital strategic reform,process optimization and capacity improvement from the multi-dimensional perspective of internal and external stakeholders,so as to improve development performance and promote social harmonious development,and to improve performance,promote high-quality development.

Objective To construct the performance evaluation index system of public hospitals,and provide reference for promoting the high-quality development of public hospitals.Methods Delphi method and analytic hierarchy process were used to determine the performance evaluation index system of public hospitals based on performance prism model.Results It established a public hospital performance evaluation system including 5 first-level indicators,16 second-level indicators and 40 third-level indicators of government,staff,patients,suppliers and regulatory agencies.The weights of the five first-level indicators are 0.254 8,0.476 8,0.154 4,0.073 4 and 0.040 6,respectively.Among the 16 second-level indicators,salary,quality and safety,practice environment,medical quality and operation efficiency rank the top 5.The combined weights were 0.268 5,0.174 3,0.165 4,0.080 9 and 0.060 6,respectively.Among the 40 tertiary indicators,the satisfaction of medical staff,the quality control index of single disease,organizational support,the intensity of antibacterial drug use and the case mortality of the low-risk group were investigated.The combined weights were 0.212 0,0.110 0,0.107 0,0.064 3 and 0.0624,respectively.Conclusion The performance evaluation index system of public hospitals based on the performance prism model established is helpful to guide hospitals to think about hospital strategic reform,process optimization and capacity improvement from the multi-dimensional perspective of internal and external stakeholders,so as to improve development performance and promote social harmonious development,and to improve performance,promote high-quality development.

Objective To construct the performance evaluation index system of public hospitals,and provide reference for promoting the high-quality development of public hospitals.Methods Delphi method and analytic hierarchy process were used to determine the performance evaluation index system of public hospitals based on performance prism model.Results It established a public hospital performance evaluation system including 5 first-level indicators,16 second-level indicators and 40 third-level indicators of government,staff,patients,suppliers and regulatory agencies.The weights of the five first-level indicators are 0.254 8,0.476 8,0.154 4,0.073 4 and 0.040 6,respectively.Among the 16 second-level indicators,salary,quality and safety,practice environment,medical quality and operation efficiency rank the top 5.The combined weights were 0.268 5,0.174 3,0.165 4,0.080 9 and 0.060 6,respectively.Among the 40 tertiary indicators,the satisfaction of medical staff,the quality control index of single disease,organizational support,the intensity of antibacterial drug use and the case mortality of the low-risk group were investigated.The combined weights were 0.212 0,0.110 0,0.107 0,0.064 3 and 0.0624,respectively.Conclusion The performance evaluation index system of public hospitals based on the performance prism model established is helpful to guide hospitals to think about hospital strategic reform,process optimization and capacity improvement from the multi-dimensional perspective of internal and external stakeholders,so as to improve development performance and promote social harmonious development,and to improve performance,promote high-quality development.

Objective To construct the performance evaluation index system of public hospitals,and provide reference for promoting the high-quality development of public hospitals.Methods Delphi method and analytic hierarchy process were used to determine the performance evaluation index system of public hospitals based on performance prism model.Results It established a public hospital performance evaluation system including 5 first-level indicators,16 second-level indicators and 40 third-level indicators of government,staff,patients,suppliers and regulatory agencies.The weights of the five first-level indicators are 0.254 8,0.476 8,0.154 4,0.073 4 and 0.040 6,respectively.Among the 16 second-level indicators,salary,quality and safety,practice environment,medical quality and operation efficiency rank the top 5.The combined weights were 0.268 5,0.174 3,0.165 4,0.080 9 and 0.060 6,respectively.Among the 40 tertiary indicators,the satisfaction of medical staff,the quality control index of single disease,organizational support,the intensity of antibacterial drug use and the case mortality of the low-risk group were investigated.The combined weights were 0.212 0,0.110 0,0.107 0,0.064 3 and 0.0624,respectively.Conclusion The performance evaluation index system of public hospitals based on the performance prism model established is helpful to guide hospitals to think about hospital strategic reform,process optimization and capacity improvement from the multi-dimensional perspective of internal and external stakeholders,so as to improve development performance and promote social harmonious development,and to improve performance,promote high-quality development.