The First Affiliated Hospital of Zhejiang University founded an online hospital campus leveraging the Internet-plus environment. Supported by the offline hospital, this campus made full use of Internet features and advantages in its attempts to optimize the distribution of medical resources,to improve the accessibility of medical service, to reduce medical costs, and to expand the service coverage among others. Meanwhile,this online system, via interconnection with the hospital′s HIS system, achieved online medical insurance payment,prescriptions checking and drug delivery service.

Objective To evaluate the effectiveness of a community-based acquired immunologic deficiency syndrome (AIDS) educational intervention in young adults.Methods A quasi-experimental design was used. Two townships in Kunshan county, matched by socioeconomic characteristics, were randomly assigned to intervention or control group. Eight hundred young adults aged 18-30 were recruited from the two townships as study subjects. A 12-month comprehensive educational intervention on AIDS prevention was conducted in the intervention group through local family planning services.Results After intervention, subjects in intervention significantly improved their knowledge on AIDS and attitudes related to AIDS prevention. Reported rate of condom use during the last episode of sexual intercourse increased from 8.5% at baseline to 14.4% after intervention (χ2=4.66, P=0.0308). No obvious change was observed among subjects in control group.Conclusion This study demonstrated the feasibility of integration of AIDS educational intervention into the existing family planning services. Integration of AIDS programs into family planning program should be considered as a realistic approach for AIDS control in China.

As the first domestically originated cell cycle protein-dependent kinase 4/6 inhibitor,dalpiciclib has been approved by the State Drug Ad-ministration for the treatment of hormone recep-tor-positive/human epidermal growth factor recep-tor 2-negative advanced or metastatic breast can-cer in combination with fulvestrant or aromatase inhibitors.This article focuses on the progress of dalpiciclib research in breast cancer,summarizing the drug's mechanism of action,phase Ⅰ-Ⅲ clinical trials,and drug safety issues.

Objective To observe the clinical effects of traditional Chinese medicine and foam dressing in the treatment of stageⅢ pressure sores. Methods A total of 94 patients with stageⅢ pressure sores in neurology department of Hangzhou Red Cross Hospital from January 2015 to December 2016 were recruited and randomly divided into control group (n=44) and observation group (n=50) by random number table method. Besides routine treatment and care of pressure sores, control group was given traditional Chinese medicine, while patients of observation group received traditional Chinese medicine combined with foam dressing treatment. The treatment effects of the two groups were observed and compared. Results The total effective rate of pressure sore in was 90.00% in the observation group and 86.36% in the control group, and there was no statistical difference (P>0.05). The average healing time of the observation group was (13.56±4.35) days, which was significantly shorter than that of the control group (21.45±3.47) days, and the difference was statistically significant (P< 0.01). Conclusions The effects of traditional Chinese medicine combined with foam dressing in the treatment of stageⅢ pressure ulcer is better than that of traditional Chinese medicine, which can improve the cure rate of pressure ulcer, shorten the healing time of pressure ulcer, and is worthy of clinical promotion.

bjective? To explore the effects of Daiwenjiu Gao combined with ear acupoint bean-pressing on migraine of deficiency of both qi and blood. Methods? From June 2015 to July 2017, we selected 111 outpatients with migraine of deficiency of both qi and blood in Hangzhou Red Cross Hospital. All of the patients were divided into three groups including group of Daiwenjiu Gao, group of ear acupoint bean-pressing and group of Daiwenjiu Gao combined with ear acupoint bean-pressing with the method of random number table, 37 cases in each group. There was a loss to follow-up in group of Daiwenjiu Gao and group of Daiwenjiu Gao combined with ear acupoint bean-pressing respectively, and there was a case refusing treatment in group of ear acupoint bean-pressing; there were 36 cases with valid data in each group finally. Group of ear acupoint bean-pressing received ear acupoint bean-pressing for migraine; group of Daiwenjiu Gao carried out ear acupoint application by Daiwenjiu Gao for migraine; group of Daiwenjiu Gao combined with ear acupoint bean-pressing combined two treatments for migraine; the intervention continued for four weeks in three groups. The Sun's criteria was used to evaluate the severity, duration, frequency of outbreak, accompanying symptoms of headache of patients one and six months after intervention. SPSS 17.0 was used to statistical analysis. Results? Among patients with migraine of deficiency of both qi and blood in three groups, there were statistical differences between group of Daiwenjiu Gao and group of Daiwenjiu Gao combined with ear acupoint bean-pressing (P＜0.01), and there were also statistical differences between group of ear acupoint bean-pressing and group of Daiwenjiu Gao combined with ear acupoint bean-pressing (P＜0.01) one and six months after intervention. Conclusions? Daiwenjiu Gao combined with ear acupoint bean-pressing is with a simple operation, few adverse reactions, and it has better effects for migraine of deficiency of both qi and blood than general treatments which is worth to be used widely in clinical application.

December 2019 witnessed the outbreak of COVID-19 in Wuhan and spread of the epidemic across the country. As a provincial designated hospital for critical patients, the First Affiliated Hospital of Zhejiang University responded rapidly since then by advocating the four-concentration principles, namely " concentrating patients, experts, resources and treatment" . In its rescue of critical patients, the hospital formulated comprehensive emergency plans, optimized hospital-wide resources, effectively arranged rescue spacing, established medical echelons, and implemented multi-disciplinary strategy. These efforts ensured efficient rescue and treatment, achieving a cure rate up to 98.7% of such patients, with no deaths.

ObjectiveTo analyze the monitoring results and trends of Oncomelania in Songjiang District of Shanghai from 2007 to 2023， and to provide reference for future monitoring work. MethodsThe data of snail monitoring in Songjiang District from 2007 to 2023 were collected， including the location of snail spots， the number of survey frames， the area with snails， the number of frames with snails， the total number of snails， etc. The density of living snails and the occurrence rate of living snail frames were calculated. ResultsFrom 2007 to 2023， a total of 158 snail spots were found in 22 administrative villages in 4 towns in Songjiang District， including 131 emerging snail habitats （82.91%） and 27 reemerging snail habitats （17.09%）. The total snail area was 175 980 m²， the number of snail frames was 10 061， and 33 302 snails were captured. The highest density was 260/0.11 m²， and 15 662 snails were dissected. No positive snails were found. The average density of living snails was 0.60/0.11 m² and the average occurrence rate of living snail frames was 17.99%. The snail areas in different areas were Yexie Town 126 000 m² （71.60%）， Maogang Town 26 470 m² （15.04%）， Xinbang Town 17 040 m² （9.68%）， and Shihudang Town 6 470 m² （3.68%）. The average density of living snails in different areas was 0.89/0.11 m² in Yexie Town， 0.65/0.11 m² in Maogang Town， 0.26/0.11 m² in Shihudang Town and 0.24/0.11 m² in Xinbang Town. The snail areas of different snail habitats were as follows： woodland 151 250 m²（85.95%）， river 13 810 m²（7.85%）， ditch 6 910 m²（3.93%）， farmland 4 010 m²（2.28%）. The average density of living snails in different snail habitats： ditch 1.01/0.11 m²， beach 0.86/0.11 m²， woodland 0.57/0.11 m²， river 0.40/0.11 m². The occurrence rate of living snail frames in different regions and different snail environment types showed a downward trend and the difference was statistically significant. ConclusionAlthough the snail monitoring indicators such as snail area， average living snail density and average living snail frame occurrence rate in Songjiang District are still at its historically low level， the average living snail density and average living snail frame occurrence rate are still high compared with other regions or the national average. We should focus on the upper reaches and tributaries of the Huangpu River， especially the key areas of seedling transplantation， and strengthen monitoring and supervision to reduce the risk of snail input.

Objective To investigate the changes in distribution of Oncomelania hupensis snails in forestlands in Songjiang District, Shanghai Municipality from 2009 to 2023, so as to provide insights into formulation of O. hupensis snail surveillance programs. Methods The reports on O. hupensis snail surveillance in Songjiang District, Shanghai Municipality from 2009 to 2023 were collected, and the snail surveillance data in forestlands were extracted. The trends in the proportion of areas with snails in forestlands in total areas with snails, occurrence of frames with living snails and density of living snails were evaluated using a Joinpoint regression model in Songjiang District from 2009 to 2023, and the annual percent change (APC) and average annual percent change (AAPC). Results A total of 40 sites with snails were found in forestlands in 14 administrative villages of 4 townships, Songjiang District, Shanghai Municipality from 2009 to 2023. A total of 39 065 frames were surveyed for snails in settings covering an area of 609 600 m², and there were 6 084 frames with snails, covering 151 250 m² snail habitats. A total of 22 210 snails were captured, with the highest density of 260.00 snails/0.1 m², and 6 262 snails were dissected, with no Schistosoma japonicum infection identified in snails. The proportion of areas with snails in forestlands in total areas with snails appeared a tendency towards a rise in forestlands in Songjiang District, Shanghai Municipality from 2009 to 2023 (APC = AAPC = 24.9%, P > 0.05); however, there were no turning points in the trend curve, with the highest proportion seen in 2009 (53.81%), the lowest in 2011 and 2023 (both 0) and a mean proportion of 24.81%. The occurrence of frames with living snails appeared a tendency towards a rise from 2009 to 2023 (APC = AAPC = 41.5%, P > 0.05); however, there were no turning points in the trend curve, with the highest occurrence in 2009 (53.81%), the lowest in 2011 and 2013 (both 0), and the mean occurrence of 15.57%. In addition, the density of living snails appeared a tendency towards a rise from 2009 to 2023 (APC = AAPC = 55.0%, P > 0.05); however, there were no turning points in the trend curve, with the highest density in 2023 (0.96 snails/0.1 m²), the lowest in 2011 and 2013 (both 0), and a mean density of 0.57 snails/0.1 m². Conclusions The difficulty in O. hupensis snail control and risk of imported snails appeared a tendency towards a rise in forestlands in Songjiang District, Shanghai Municipality over years from 2009 to 2023. Supervision and assessment prior to seedling transplantation and intensified surveillance post-transplantation are recommended to reduce the risk of O. hupensis snail importation and spread.

Objective To explore the safety of minimally invasive esophagectomy (MIE) with three-field lymphadenectomy (3-FL) for esophageal squamous cell carcinoma (ESCC) by comparing the short-term outcomes between the 3-FL and the two-field lymphadenectomy (2-FL) in MIE. Methods The clinical data of patients with ESCC who underwent minimally invasive McKeown esophagectomy in our hospital from July 2015 to March 2022 were collected retrospectively. Patients were divided into a 3-FL group and a 2-FL group according to lymph node dissection method. And the clinical outcomes and postoperative complications were compared between the two groups. Results A total of 257 patients with ESCC were included in this study. There were 211 males and 46 females with an average age of 62.2±8.1 years. There were 109 patients in the 3-FL group and 148 patients in the 2-FL group. The operation time of the 3-FL group was about 20 minutes longer than that of the 2-FL group (P<0.001). There was no statistical difference between the two groups in the intraoperatve blood loss (P=0.376). More lymph nodes (P<0.001) and also more positive lymph nodes (P=0.003) were obtained in the 3-FL group than in the 2-FL group, and there was a statistical difference in the pathological N stage between the two groups (P<0.001). But there was no statistical difference in the incidence of anastomotic leak (P=0.667), chyle leak (P=0.421), recurrent laryngeal nerve injury (P=0.081), pulmonary complications (P=0.601), pneumonia (P=0.061), cardiac complications (P=0.383), overall complications (P=0.147) or Clavien-Dindo grading (P=0.152) between the two groups. Conclusion MIE 3-FL can improve the efficiency of lymph node dissection and the accuracy of tumor lymph node staging, but it does not increase the postoperative complications, which is worthy of clinical application.