Purpose: This study explored the performance of prenatal ultrasonography in the differential diagnosis of cystic biliary atresia (CBA) and choledochal cyst (CC). Methods: Fetuses diagnosed with hepatic hilar cyst in the second trimester were included in this study. A series of prenatal ultrasound examinations were performed in the second and third trimesters. The diameter of the gallbladder (GB) and hepatic cyst were measured, as well as the wall thickness of the GB. The GB-cyst connection, visibility of the right hepatic artery (RHA), and other concomitant abnormalities were carefully evaluated. A neonatal transabdominal ultrasound examination was performed within 1 week after birth, and clinical data were followed up to 6 months after birth. Results: Between January 1, 2016 and January 31, 2020, 53 fetuses diagnosed with hepatic hilar cyst were recruited. Eight were excluded because they were lost to follow-up. Among the 45 cases included in this study, 10 were diagnosed with CBA and 35 with CC after birth. Statistically significant differences were found in GB width, wall thickness, change in GB width, change in cyst length, GB-cyst connection, and RHA visibility between the CBA and CC groups. GB width showed the best diagnostic performance with an area under the curve (AUC) of 0.899. The combination of GB width, GB wall thickness, and GB-cyst connection yielded a comparable AUC of 0.971. Conclusion The GB should be carefully evaluated in fetuses with hepatic hilar cyst. Prenatal ultrasound findings could provide suggestive parameters for the differential diagnosis of CBA from CC.

Objective To deeply analyze the problems of public hospitals in medical service satisfaction,construct a more applicable and explanatory service satisfaction evaluation model,and provide reference for the improvement path of patients'medical service satisfaction.Methods Based on the ESCI model,this paper puts forward a research hypothesis,compiles the"Medical Service Satisfaction Evaluation Scale of Public Hospitals in S City",selects S public hospitals as the research object,and evaluates medical service satisfaction from the perspective of patients.Results At present,the main problems affecting the improvement of patients'satisfaction with medical service management in public hospitals in S city are as follows:it is urgent to improve the diagnosis and treatment technology in terms of hardware quality and optimize the environmental hygiene of public hos-pitals,and it is an urgent task to shorten the waiting time for medical treatment in software quality.The score of medical service satisfaction evaluation of S public hospitals was 3.76,and the satisfaction of patients in S public hospitals with their medical serv-ices was at a moderately low level.Conclusion In view of the above problems,it is recommended to strengthen the construction of key specialties,strengthen the construction of talent team,optimize the medical process,open digital linkage services,and strengthen service management,so as to promote the improvement of patients'satisfaction with medical services.

OBJECTIVETo observe the effect difference between fire needle combined with chemotherapy and fire needle on quality of life in patients with chemotherapy of non-small cell lung cancer (NSCLC).

METHODSWith randomized controlled method, a total of 60 patients with chemotherapy of NSCLC were divided into an observation group (fire-needle plus chemotherapy group) and a control group (chemotherapy group), 30 cases in each one. The observation group was treated with fire needle atpoints which consisted of Geshu (BL 17) and Danshu (BL 19), combined with chemotherapy selected from TP (paclitaxel+cisplatin)/GP (gemcitabine+cisplatin)/DP (docetaxel+cisplatin)/NP (vinorelbine+cisplatin) by the oncologist according to patients' condition. The fire needle was given once a day for 7 days, and chemotherapy was given for 21 days. The control group was treated with chemotherapy alone for 21 days. Before and after treatment, response evaluation criteria in solid tumors (RECIST) was applied for evaluation, and Karnofsky performance status (KPS) and functional assessment of cancer therapy-lung (FACT-L) were applied for evaluation of quality of life in patients with chemotherapy of NSCLC.

RESULTSThe effective rate was 20.0% (6/30) and the stability rate was 73.3% (22/30) in the observation group, which were insignificantly higher than 16.7% (5/30) and 63.3% (19/30) in the control group, respectively (both>0.05). The KPS after treatment was lower than that before treatment in the control group (<0.05); the KPS after treatment was similar to that before treatment in the observation group (>0.05); the KPS in the observation group after treatment was higher than that in the control group (<0.05). The total score and each item score of FACT-L after treatment were higher than those before treatment in the observation group (all<0.05); the physical score and emotional score of FACT-L after treatment were higher than those before treatment in the control group (both<0.05); the total score, physical score, functional score and subscale score in the observation group were significantly higher than those in the control group after treatment (all<0.05), while the social/family score and emotional score in the observation group were insignificantly higher than those in the control group (both>0.05). The differences of KPS total score before and after treatment in the two groups had moderate positive correlation with differences of FACT-L total score (<0.01).

CONCLUSIONFire needle can improve quality of life in patients of NSCLC chemotherapy.