The pre-metabolic disease state is the body state of substance metabolism disorder that has not yet reached the physical and chemical indicators of the disease, and abnormal glucose metabolism is often the key link of metabolic disorder. In TCM, the healthy function of the spleen is the cornerstone of the production and distribution of fine substances. This article discussed the pre-metabolic disease state based on the theory of "overflow of Five Qi" in the Nei Jing, taking the loss of spleen preparedness as the starting point, in order to provide new ideas and directions for the prevention and treatment of clinical metabolic diseases.

Objective:To investigate the effects of early percutaneous coronary intervention (PCI) on myocardial perfusion and left ventricular function in patients with acute ST-segment elevation myocardial infarction (STEMI) after thrombolysis.Methods:A total of 108 patients with STEMI treated in the Second Hospital of Hebei Medical University from January 2020 to December 2022 were divided into early PCI following thrombolysis group ( n=65) and primary PCI (pPCI) group ( n=43). The general clinical data, and the parameters of routine echocardiography at 1 day after PCI and before discharge were compared between the two groups. Myocardial contrast echocardiography (MCE) was used to evaluate myocardial perfusion at 1 day after PCI and before discharge. Results:There were no significant differences in general clinical data between the early PCI following thrombolysis group and the pPCI group (all P>0.05). The left ventricular ejection fraction (LVEF) in the early PCI following thrombolysis group and pPCI group before discharge was significantly higher than that on the 1st day after PCI(both P<0.05). The difference of LVEF was significant between the early PCI following thrombolysis group and the pPCI group before discharge and 1 day after PCI ( P<0.05). Compared with 1 day after PCI, the global longitudinal strain (LVGLS) of left ventricle increased in early PCI following thrombolysis group and pPCI group before discharge(both P<0.05). The difference of LVGLS between early PCI following thrombolysis group and pPCI group before discharge and 1 day after discharge was statistically significant( P<0.05). There were no significant differences in left ventricular end-diastolic diameter (LVEDD), left ventricular end-diastolic volume (LVEDV), left atrial volume (LAV), ratio of mitral early diastolic velocity to late diastolic velocity (E/A), mean early diastolic velocity of mitral annulus (Em) and E/Em 1 day after PCI and before discharge between early PCI following thrombolysis group and pPCI group (all P>0.05). MCE showed that the MCE score index of early PCI following thrombolysis group and pPCI group before discharge was significantly lower than that of 1 day after PCI(both P<0.001). Compared to the 1 day after PCI, the early PCI following thrombolysis group showed a significant increase in the proportion of normal microvascular perfusion (nMVP) and a decrease in the proportion of delayed microvascular perfusion (dMVP) and microvascular obstruction (MVO) before discharge (all P<0.05). In contrast, the pPCI group demonstrated a significant decrease in the proportion of both nMVP and dMVP before discharge compared to the first day after PCI (all P<0.05). However, the decrease in the proportion of MVO was not statistically significant ( P>0.05). Conclusions:Early PCI following thrombolysis and pPCI can enhance left ventricular systolic function and myocardial perfusion in patients with acute ST-elevation myocardial infarction. Early PCI following thrombolysis may offer additional advantages in improving left ventricular systolic function and myocardial perfusion.

Objective:To explore the influencing factors of the incentives contract of the government for physicians in public hospitals to complete economic and public welfare tasks,and provide corresponding incentive strategies.Methods:Modeling method of multi task principal-agent theory are applied.Results:The optimal incentive coefficient of the government are negatively associated with the cost coefficient of physicians'efforts,physicians'risk attitudes and cost relevance.The uncertainty of the external environment has different effects.Conclusion:The realization of the incentive contract for physicians in public hospitals requires the government to timely adjust the corresponding incentive strategies according to the changes of parameters,so as to ensure the public welfare of medical services and the acquisition of long-term profits.

Objective:To study the influencing factors of the effort level and incentive coefficient of doctors in public hospitals under different fairness preferences,and provide suggestions for the design of the incentive mechanism for doctors in public hospi-tals.Methods:The equity preference theory,principal-agent theory and Matlab Software were used for analysis.Results:The doc-tor's effort level was negatively correlated with the cost coefficient,positively correlated with the fairness preference level,and the promotion effect of vertical fairness preference on the effort level was higher than that of horizontal fairness preference;the incentive coefficient was positively correlated with the doctor's vertical fairness preference and negatively correlated with the horizontal equity preference.Conclusion:The government and hospital managers should reduce the effort cost of doctors,fully understand the fair-ness preference of doctors,strengthen the supervision of doctors'work,adopt a comprehensive incentive strategy to intervene in the fairness preference of doctors,and transform the negative utility of doctors'equity preference into the enthusiasm for working hard.

Objective:To explore the influencing factors of the incentives contract of the government for physicians in public hospitals to complete economic and public welfare tasks,and provide corresponding incentive strategies.Methods:Modeling method of multi task principal-agent theory are applied.Results:The optimal incentive coefficient of the government are negatively associated with the cost coefficient of physicians'efforts,physicians'risk attitudes and cost relevance.The uncertainty of the external environment has different effects.Conclusion:The realization of the incentive contract for physicians in public hospitals requires the government to timely adjust the corresponding incentive strategies according to the changes of parameters,so as to ensure the public welfare of medical services and the acquisition of long-term profits.

Objective:To study the influencing factors of the effort level and incentive coefficient of doctors in public hospitals under different fairness preferences,and provide suggestions for the design of the incentive mechanism for doctors in public hospi-tals.Methods:The equity preference theory,principal-agent theory and Matlab Software were used for analysis.Results:The doc-tor's effort level was negatively correlated with the cost coefficient,positively correlated with the fairness preference level,and the promotion effect of vertical fairness preference on the effort level was higher than that of horizontal fairness preference;the incentive coefficient was positively correlated with the doctor's vertical fairness preference and negatively correlated with the horizontal equity preference.Conclusion:The government and hospital managers should reduce the effort cost of doctors,fully understand the fair-ness preference of doctors,strengthen the supervision of doctors'work,adopt a comprehensive incentive strategy to intervene in the fairness preference of doctors,and transform the negative utility of doctors'equity preference into the enthusiasm for working hard.

Objective:To explore the influencing factors of the incentives contract of the government for physicians in public hospitals to complete economic and public welfare tasks,and provide corresponding incentive strategies.Methods:Modeling method of multi task principal-agent theory are applied.Results:The optimal incentive coefficient of the government are negatively associated with the cost coefficient of physicians'efforts,physicians'risk attitudes and cost relevance.The uncertainty of the external environment has different effects.Conclusion:The realization of the incentive contract for physicians in public hospitals requires the government to timely adjust the corresponding incentive strategies according to the changes of parameters,so as to ensure the public welfare of medical services and the acquisition of long-term profits.

Objective:To study the influencing factors of the effort level and incentive coefficient of doctors in public hospitals under different fairness preferences,and provide suggestions for the design of the incentive mechanism for doctors in public hospi-tals.Methods:The equity preference theory,principal-agent theory and Matlab Software were used for analysis.Results:The doc-tor's effort level was negatively correlated with the cost coefficient,positively correlated with the fairness preference level,and the promotion effect of vertical fairness preference on the effort level was higher than that of horizontal fairness preference;the incentive coefficient was positively correlated with the doctor's vertical fairness preference and negatively correlated with the horizontal equity preference.Conclusion:The government and hospital managers should reduce the effort cost of doctors,fully understand the fair-ness preference of doctors,strengthen the supervision of doctors'work,adopt a comprehensive incentive strategy to intervene in the fairness preference of doctors,and transform the negative utility of doctors'equity preference into the enthusiasm for working hard.

Objective:To explore the influencing factors of the incentives contract of the government for physicians in public hospitals to complete economic and public welfare tasks,and provide corresponding incentive strategies.Methods:Modeling method of multi task principal-agent theory are applied.Results:The optimal incentive coefficient of the government are negatively associated with the cost coefficient of physicians'efforts,physicians'risk attitudes and cost relevance.The uncertainty of the external environment has different effects.Conclusion:The realization of the incentive contract for physicians in public hospitals requires the government to timely adjust the corresponding incentive strategies according to the changes of parameters,so as to ensure the public welfare of medical services and the acquisition of long-term profits.

Objective:To study the influencing factors of the effort level and incentive coefficient of doctors in public hospitals under different fairness preferences,and provide suggestions for the design of the incentive mechanism for doctors in public hospi-tals.Methods:The equity preference theory,principal-agent theory and Matlab Software were used for analysis.Results:The doc-tor's effort level was negatively correlated with the cost coefficient,positively correlated with the fairness preference level,and the promotion effect of vertical fairness preference on the effort level was higher than that of horizontal fairness preference;the incentive coefficient was positively correlated with the doctor's vertical fairness preference and negatively correlated with the horizontal equity preference.Conclusion:The government and hospital managers should reduce the effort cost of doctors,fully understand the fair-ness preference of doctors,strengthen the supervision of doctors'work,adopt a comprehensive incentive strategy to intervene in the fairness preference of doctors,and transform the negative utility of doctors'equity preference into the enthusiasm for working hard.