Search

Introduction Evaporative dry eye (EDE) is common and can lead to ocular pain, decreased visual quality and reduced quality of life. Intense pulsed light (IPL) and 3% diquafosol ophthalmic solution have been found to be beneficial in reducing signs and symptoms of dry eye.Methods and analysis A randomised clinical trial will be performed at He Eye Specialist Hospital in Shenyang. 360 dry eye disease patients will be equally divided randomly into the IPL group, DQS group (3% diquafosol ophthalmic solution eye-drops) and IPL+group (IPL combined with 3% diquafosol eye-drops). All groups will be followed up for 4 weeks. The primary outcome measures will be the non-invasive tear break-up time and the Ocular Surface Disease Index change from the baseline. The secondary outcome measures willincludeconjunctival and cornea staining with fluorescein and lissamine, meibomian gland function and secretion quality, tear film lipid layer score, tear meniscus height, conjunctival hyperemia (redness score) changes . Adverse events also will be monitored and documented.Discussion This study aimed to assess whether the combination of IPL with 3% diquafosol ophthalmic solution (study group), IPL+ (study group), is more effective than IPL (active control group) or DQS (active control group) in participants with EDE.Ethics and dissemination Management of dry eye with IPL combined with 3% diquafosol ophthalmic solution, registered on 23 January 2023. Ethics approval number: IRB (2022) K029.01. The study’s findings will be shared regardless of the effect’s direction.Trial registration number NCT05694026.

Objective To evaluate the efficiency of county public hospitals in Shandong Province following China’s new medical reform and compare the efficiency of hospitals with different bed sizes for improving efficiency.Design and setting This was a cross-sectional study on the efficiency and size of 68 county public hospitals in China in 2017.Outcome measures Data envelopment analysis was used to calculate the efficiency scores of hospitals and to analyse the slack values of inefficient hospitals. The actual number of open beds, doctors, nurses and total expenditure were selected as inputs, and the total number of annual visits, discharges and total income were selected as outputs. The Kruskal-Wallis H test was employed to compare the efficiency of hospitals with different bed sizes. The χ2 test was used to compare the returns to scale (RTS) of hospitals with different bed sizes.Results Twenty (29.41%) hospitals were efficient. There were 27 hospitals with increasing returns to scale, 23 hospitals with constant returns to scale and 18 hospitals with decreasing returns to scale (DRS). The differences in technical efficiency (p=0.248, p>0.05) and pure technical efficiency (p=0.073, p>0.05) were not statistically significant. However, the differences in scale efficiency (p=0.047, p