[Objective] To explore the effectiveness of applying the PDCA (Plan-Do-Check-Act) cycle to enhance the compatibility rate of five Rh blood group antigen phenotypes between donors and recipients across multiple hospital campuses. [Methods] Clinical blood transfusion data from May to July 2022 were selected. Specific improvement measures were formulated based on the survey results, and the PDCA cycle management model was implemented from August 2022. The post-intervention phase spanned from August 2022 to October 2023. The Rh phenotype compatibility rate, the detection rate of Rh system antibodies, and the proportion of Rh system antibodies among unexpected antibodies were compared between the pre-intervention phase (May to July 2022) and the post-intervention phase. [Results] After the continuous improvement with the PDCA cycle, the compatibility rate for the five Rh blood group antigen phenotypes between donors and recipients from August to October 2023 reached 81.90%, significantly higher than the 70.54% recorded during the pre-intervention phase (May to July 2022, P<0.01), and displayed a quarterly upward trend (β=0.028, P<0.05). The detection rate of Rh blood group system antibodies (β=-9.839×10^-5, P<0.05) and its proportion among all detected antibodies (β=-0.022, P<0.05) showed a quarterly decreasing trend, both demonstrating a negative correlation with the enhanced compatibility rate (r values of -0.981 and -0.911, respectively; P<0.05). [Conclusion] The implementation of targeted measures through the PDCA cycle can effectively increase the compatibility rate of five Rh blood group antigen phenotypes between donors and recipients, reduce the occurrence of unexpected Rh blood group antibodies, thereby lowering the risk of transfusion and enhancing the quality and safety of medical care.

Objective:To explore the core issues in the implementation of"packaged payment"in China's compact county medi-cal community,in order to provide useful references for the innovative reform of medical insurance payment methods in compact coun-ty medical community.Methods:By constructing the problem system through the macro model of the health system,analyzing the re-lated literature using multidimensional scale analysis and social network analysis,and comprehensively evaluating the results using the entropy-weighted TOPSIS method,it summarizes the core issues of"packaged payment"in compact county medical community.Results:There are core issues in China's compact county medical community,such as inadequate distribution of benefits and incen-tive and constraint mechanisms within the medical community(Ci= 1.000),lack of effective supervision and assessment mechanism for medical communities(Ci= 0.732),suppressed quality and efficiency of medical services(Ci= 0.652),lagging medical informatiza-tion construction(Ci= 0.595),and incomplete supporting policy measures(Ci= 0.579).Conclusion:The"packaged payment"of com-pact county medical community can be optimized from the following three aspects:a multi-level collaborative incentive mechanism should be improved to ensure the service quality and efficiency;optimize the total amount calculation method and improve the de-tailed supporting measures;accelerate information construction and strengthen supervision and assessment management.

This study was designed to investigate the potential protective effect of isopimpinelline against para-chlorophenylalanine(PCPA)-induced pineal gland damage in rats.Forty male Sprague-Dawley(SD)rats were divided into four groups(n=10 each):a normal group,a model group,a melatonin-treated group(10 mg/kg),and an isopimpinelline-treated group(1.5 mg/kg).All groups,except for the normal,received intraperitoneal injection of PCPA(450 mg/kg)to induce pineal gland damage.Subsequent treatments were administered orally for 7 days.Sleep latency and duration were evaluated on the sixth day using the pentobarbital sodium sleep synergy test.After the treatment period,serum melatonin levels and pineal gland inflammation markers were assessed alongside oxidative and antioxidative parameters.Histological examinations of the pineal gland were conducted,and the expression of proteins related to the Nrf2 and NF-κB signaling pathways were quantified.Data showed that isopimpinelline alleviates the structural damage in the pineal gland of model rats,significantly elevated serum melatonin levels,and markedly improved sleep latency and duration(P＜0.05).Isopimpinelline activated the Nrf2 signaling pathway by inhibiting Keap1 expression,which facilitated the nuclear translocation of Nrf2 and upregulated the antioxidant proteins NQO1 and HO-1,thereby mitigating oxidative stress in the pineal gland(P＜0.05).Furthermore,isopimpinelline significantly reduced the levels of pro-inflammatory cytokines IL-2,TNF-α and IL-6.Isopimpinelline also suppressed the NF-κB signaling pathway,reducing the expression of NF-κB p65,IKKβ,and p-IKKβ proteins,as well as the nuclear translocation of NF-κB p65(P＜0.05),thereby providing anti-inflammatory benefits.In conclusion,isopimpinelline could protect pineal gland from damage by activating the Nrf2 signaling pathway and inhibiting the NF-κB pathway.

Objective:To explore the leading role and influence path of the coordinated development of the tight medical community service capacity and the high level of county economy,so as to provide a basis for its deepening reform and long-term development.Methods:Taking 39 pilot compact medical communities in Guangxi in 2022 as research samples,from the perspective of set and whole,the coupling coordination degree model and fuzzy set qualitative comparative analysis were used to analyze the coordinated development status and influence mechanism of their service capacity and county economic level.Results:High-level county economic structure is a necessary condition to promote coupling and coordinated development.Among the six configuration paths that affect the improvement of coupling and coordination degree,the core conditions are stable county economic foundation and sufficient health human resources or(and)health financial resources.The overall solution consistency is 0.996(≥0.8),and the coverage is 0.780(≥0.5).The model has strong explanatory power.Conclusion:Multi-factor internal and external cooperation to promote the coordinated development of the service capacity of the compact medical community and the county economy should focus on the county economic foundation and structure,further improve the income of the compact medical community and pay attention to the optimization and expansion of the talent team.

Objective:To explore the current situation of synergistic allocation of factors of production in China's medical research institutes,sort out the focuses and deficiencies of the existing policies,so as to provide references for the optimization of production factor and the new quality productivity formation in medical institutions.Methods:Based on the two-factor productivity theory,the index evaluation system is constructed,and the composite system synergy model is used to analyze the degree of order of production factors and the degree of synergy of the composite system,and explore the change of synergy degree of each sequential covariate;and the macro model of the health system is used in conjunction with the content analysis method to carry out the frequency counting of the policies to promote the enhancement of the capacity of each production factor of the main body of innovation of the medical scientific research institutes.Results:The synergistic degree of the production factors and the composite system of medical research institutions showed a non-synergistic development trend,with the worst synergistic level in 2021;number of personnel,number of institutions,building floor space,production factors and sequential coefficients were weakly synergized and in a state of non-synergistic development.Among the 43 policy texts,the internal submodular policy tools were used more,the external submodular policy tools were used less,and the use of internal and external policy tools is unbalanced.Conclusion:The number of personnel,institutions and building area of medical research institutions are constraints on the synergistic development of innovative entities.It is recommended to increase the training of innovative talents in medical research institutions,improve the construction of new institutions,coordinate the layout of large scientific devices and functional housing,introduce targeted systematic planning,improve the market of factors of production,and consolidate the technological foundation for future development.

Objective To analyse the characteristics of spatial distribution of bed resources and bed utilization efficiency of various types of medical and health institutions in Guangxi Province in 2018-2022,and to provide a reference basis for the allocation and management of bed resources of various types of medical and health institutions.Methods Spatial autocorrelation was used to analyse the status of bed allocation in various types of medical and health institutions,and the bed efficiency index and bed utilisation model were used to evaluate the efficiency of bed utilisation.Results Bed resources per 1 000 population vary considerably across types of healthcare organisations and regions.There is no spatial correlation in the overall distribution of bed resources per 1 000 population,but there are different types of aggregation,and there will be little change in the type of aggregation and the place of aggregation from 2018 to 2022.In terms of utilisation efficiency,the bed efficiency index of maternity and child healthcare hospitals is the highest,the bed efficiency index of specialist disease prevention and treatment hospitals(institutes and stations)is the lowest,general hospitals and maternity and child healthcare hospitals are operating at high efficiency,and all other healthcare institutions are operating at low efficiency;the utilisation of bed resources in various types of healthcare institutions exists in the form of efficiency-type,turn-around-type,bed-pressure-type,and unused-type hospitals at the same time.Conclusion There is an imbalance in the allocation of bed resources in various types of medical and health institutions,with large differences in the operational and utilisation efficiencies of beds;the allocation of bed resources should be continuously optimised.

Objective:To explore the leading role and influence path of the coordinated development of the tight medical community service capacity and the high level of county economy,so as to provide a basis for its deepening reform and long-term development.Methods:Taking 39 pilot compact medical communities in Guangxi in 2022 as research samples,from the perspective of set and whole,the coupling coordination degree model and fuzzy set qualitative comparative analysis were used to analyze the coordinated development status and influence mechanism of their service capacity and county economic level.Results:High-level county economic structure is a necessary condition to promote coupling and coordinated development.Among the six configuration paths that affect the improvement of coupling and coordination degree,the core conditions are stable county economic foundation and sufficient health human resources or(and)health financial resources.The overall solution consistency is 0.996(≥0.8),and the coverage is 0.780(≥0.5).The model has strong explanatory power.Conclusion:Multi-factor internal and external cooperation to promote the coordinated development of the service capacity of the compact medical community and the county economy should focus on the county economic foundation and structure,further improve the income of the compact medical community and pay attention to the optimization and expansion of the talent team.

Objective:To explore the current situation of synergistic allocation of factors of production in China's medical research institutes,sort out the focuses and deficiencies of the existing policies,so as to provide references for the optimization of production factor and the new quality productivity formation in medical institutions.Methods:Based on the two-factor productivity theory,the index evaluation system is constructed,and the composite system synergy model is used to analyze the degree of order of production factors and the degree of synergy of the composite system,and explore the change of synergy degree of each sequential covariate;and the macro model of the health system is used in conjunction with the content analysis method to carry out the frequency counting of the policies to promote the enhancement of the capacity of each production factor of the main body of innovation of the medical scientific research institutes.Results:The synergistic degree of the production factors and the composite system of medical research institutions showed a non-synergistic development trend,with the worst synergistic level in 2021;number of personnel,number of institutions,building floor space,production factors and sequential coefficients were weakly synergized and in a state of non-synergistic development.Among the 43 policy texts,the internal submodular policy tools were used more,the external submodular policy tools were used less,and the use of internal and external policy tools is unbalanced.Conclusion:The number of personnel,institutions and building area of medical research institutions are constraints on the synergistic development of innovative entities.It is recommended to increase the training of innovative talents in medical research institutions,improve the construction of new institutions,coordinate the layout of large scientific devices and functional housing,introduce targeted systematic planning,improve the market of factors of production,and consolidate the technological foundation for future development.

Objective To analyse the characteristics of spatial distribution of bed resources and bed utilization efficiency of various types of medical and health institutions in Guangxi Province in 2018-2022,and to provide a reference basis for the allocation and management of bed resources of various types of medical and health institutions.Methods Spatial autocorrelation was used to analyse the status of bed allocation in various types of medical and health institutions,and the bed efficiency index and bed utilisation model were used to evaluate the efficiency of bed utilisation.Results Bed resources per 1 000 population vary considerably across types of healthcare organisations and regions.There is no spatial correlation in the overall distribution of bed resources per 1 000 population,but there are different types of aggregation,and there will be little change in the type of aggregation and the place of aggregation from 2018 to 2022.In terms of utilisation efficiency,the bed efficiency index of maternity and child healthcare hospitals is the highest,the bed efficiency index of specialist disease prevention and treatment hospitals(institutes and stations)is the lowest,general hospitals and maternity and child healthcare hospitals are operating at high efficiency,and all other healthcare institutions are operating at low efficiency;the utilisation of bed resources in various types of healthcare institutions exists in the form of efficiency-type,turn-around-type,bed-pressure-type,and unused-type hospitals at the same time.Conclusion There is an imbalance in the allocation of bed resources in various types of medical and health institutions,with large differences in the operational and utilisation efficiencies of beds;the allocation of bed resources should be continuously optimised.

Objective:To explore the leading role and influence path of the coordinated development of the tight medical community service capacity and the high level of county economy,so as to provide a basis for its deepening reform and long-term development.Methods:Taking 39 pilot compact medical communities in Guangxi in 2022 as research samples,from the perspective of set and whole,the coupling coordination degree model and fuzzy set qualitative comparative analysis were used to analyze the coordinated development status and influence mechanism of their service capacity and county economic level.Results:High-level county economic structure is a necessary condition to promote coupling and coordinated development.Among the six configuration paths that affect the improvement of coupling and coordination degree,the core conditions are stable county economic foundation and sufficient health human resources or(and)health financial resources.The overall solution consistency is 0.996(≥0.8),and the coverage is 0.780(≥0.5).The model has strong explanatory power.Conclusion:Multi-factor internal and external cooperation to promote the coordinated development of the service capacity of the compact medical community and the county economy should focus on the county economic foundation and structure,further improve the income of the compact medical community and pay attention to the optimization and expansion of the talent team.