Objective:To investigate the expression of CD56 antigen in leukemia cells of the patients with acute myeloid leukemia (AML)and its relationship with the prognosis of AML, and to clarify the role of CD5 6 antigen expression in predicting the prognosis of the AML patients.Methods:171 AML (non-M3)patients aged from 14 to 60 years old,who received a IA Regimen as the first time inducing chemotherapy were chosen.Flow cytometric analysis was used to evaluate the CD56 expression in leukemia cells.COX proportional regression analysis was used to select the prognostic factors,and bivariable analysis was used to study the relationship between the positive rate of CD56 and overall survival (OS).The CD56+ group (n=52),including CD56≥50% expression group (n=39) and CD56<50% expression group (n=13),and CD56- group (n=119)were identified by the expression of CD56 antigen.The complete remission rate (CRR), the relapse rate, the median OS, the median disease-free survival (DFS)and the survival rate of patients were compared.Results:The medium OS of the patients in CD56+ group (14.2 months)was shorter than that in CD56- group (39.4 months)(P<0.05).Moreover,the medium OS in CD56≥50% group was shorter than that in CD56<50% group (11.7 months vs 20.3 months,P<0.05).The 1-year and 2-year survival rates of the patients in CD56+ group (61.5%,46.2%)were lower than those in CD56-group (75.6%,63.9%)(P<0.05).The 1-year survival rate had no significant difference between CD56≥50%group and CD56<50% group (53.8%vs 84.6%,P>0.05),while the 2-year survival rate in CD56≥50% group was lower than that in CD56<50% group (41.0%vs 61.5%,P<0.05).There were no significant differences of the CRR between CD56+ group (76.9%)and CD56- group (68.9%)as well as CD56≥50% group (58.9%)and CD56<50% group (63.5%)(P>0.05).The relapse rate and first year relapse rate of patients in CD56+ group (64.3% and 37.5%)were significantly higher than those in CD56- group (34.3% and 17.9% )(P<0.05). However,there were no significant differences of the relapse rate and first year relapse rate between CD56≥50%group (75.0% and 42.9%)and CD56<50% group (37.5% and 16.7%)(P>0.05).The DFS in CD56+ group was shorter than that in CD56- group (P<0.05).The same DFS result was also found between CD56≥50%group and CD56<50% group (P<0.05).Conclusion:The expression of CD56 antigen in leukemia cells predicts a bad prognosis in the AML patients,and the higher expression of CD56 indicates the worse prognosis.

A method for simultaneous determination of PCDDs, dl-PCBs, BFRs and PBDD/Fs in flue gas from stationary source was developed. The sample was extracted by Soxhlet apparatus with toluene, and followed by purification through sulfuric acid partition and multi-layer silica gel column separation. The target compounds were then all separated by passing through the active carbon-dispersed silica gel column and reversal eluting. Gas chromatography coupled with a thermostable capillary column ( short length, thin stationary phase film) was operated at pulse injection mode. High resolution mass spectrometry set at low-electron-energy ionization was used for quantification. The high- and low-brominated compounds were determined simultaneously. The detection limits of this method were 0. 081-1. 2 pg for PCDD/Fs, 0. 10-0. 32 pg for dl-PCBs, 0. 14-12 pg for PBDEs, 0. 26-16 pg for new BFRs, 0. 44-3. 6 pg for tetra- to hepta-BDD/Fs and 8. 2-12 pg for OBDD/F. Recoveries ( RSDs) in spiked flue gas samples were 88%-115%(2. 9%-6. 1%) for PCDD/Fs, 84%-118% (3. 2%-10%) for dl-PCBs, 71%-135% (2. 1%-18%) for PBDEs, 71%-114% (2. 9%-7. 4%) for new BFRs, 83%-127% (5. 2%-10%) for tetra-to hepta-BDD/Fs and 52%-149% ( 23%-24%) for OBDD/F. All quality control data fell within the acceptable range specified in analysis standards for flue gas.

This paper systematically introduced the clinical learning environment review ( CLER) from the U.S.in the aspects of background, initiation, progression, priority and procedure of evaluation as well as the status quo of its implementation.Therefore, reference and theoretical evidence will be provided for development of residential training system and fellowship training system as well as improvement for the training site review system in China.

Objective:To understand the current situation of the layout of the national science and technology innovation platform in the medical field, and provides a basis for departments to improve the formulation of scientific and technological innovation policies and promote the reform of the mechanism.Methods:The report and the evaluation list of the official websites are the main reference, supplemented by the public information of each platform and the information retrieval and mining of database, select quantitative statistical indicator to analyze data.Results:Platforms rely on a rich variety of units, mainly concentrated in Beijing, Shanghai and other areas with strong research ability, including major disease areas, covering many key medical disciplines.Conclusions:The regional layout is not balanced, and the layout of the type of disease at the subdivision level needs to be further complemented and improved.

Objective:To compare the efficacy of minimally invasive steel plate combined with percutaneous hollow nail fixation through the sinus tarsi incision versus "L"-shaped incision steel plate fixation in the treatment of calcaneal fractures.Methods:A retrospective analysis was conducted on 103 cases of Sanders type II-IV calcaneal fractures treated with minimally invasive steel plate combined with percutaneous hollow nail fixation through sinus tarsi incision from January 2017 to March 2024 at the orthopedic department of Hangzhou Sir Run Run Shaw Hospital (minimally invasive group). An additional 103 cases treated with "L"-shaped incision steel plate fixation during the same period were included as controls (open group). The preoperative hospital stay, surgical time, postoperative hidden blood loss, postoperative hospital stay, postoperative infection rate, postoperative Bohler angle, Gissane angle, calcaneal mid-width, sustentacular effective fixation rate, and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score at 6 and 12 months postoperatively were compared between the two groups.Results:There were no statistically significant differences in age, gender, diabetes, smoking history, and body mass index between the minimally invasive group and the open group ( P>0.05). In the minimally invasive group, the preoperative hospital stay (3.1±1.5 days), postoperative hospital stay (3.5±1.5 days), hidden blood loss (293.3±71.4 ml), surgical time (64.4±13.2 min), and AOFAS score at 6 months postoperatively (79.9±3.9) were superior to those in the open group (7.1±0.7 days, 5.6±0.9 days, 408.3±101.7 ml, 91.5±24.3 min, and 70.5±6.1, respectively) ( P<0.05), with no significant difference in AOFAS score at 1 year postoperatively ( P>0.05). Additionally, the preoperative hospital stay (3.7±1.5 days), postoperative hospital stay (4.0±2.0 days), hidden blood loss (336.3±75.3 ml), and AOFAS score at 6 months postoperatively (77.4±3.8) in the minimally invasive group were superior to those in the open group (7.6±0.9 days, 8.2±2.6 days, 441.3±89.2 ml, and 64.6±8.4, respectively) ( P<0.05), with no significant difference in surgical time and AOFAS score at 1 year postoperatively ( P>0.05). Within-group comparisons indicated that as fracture severity increased, preoperative ( P<0.05) and postoperative hospital stays ( P<0.05) increased in the open group, while surgical time increased in the minimally invasive group ( P<0.05). AOFAS scores at 6 months postoperatively varied between complex and simple fractures in both groups ( P<0.05). There were no statistically significant differences in postoperative Bohler angle, Gissane angle, and calcaneal mid-width between the two groups ( P>0.05). The sustentacular effective fixation rate in the minimally invasive group was 85.4%, superior to 47.4% in the open group for simple fractures ( P<0.05), with no statistically significant difference for complex fractures ( P>0.05). The incision infection rate was 0 in the minimally invasive group compared to 3 cases (3%) in the open group, with no statistically significant difference ( P=0.246). Conclusion:Minimally invasive steel plate combined with percutaneous hollow nail fixation through sinus tarsi incision for calcaneal fractures offers the advantages of shorter hospital stay, reduced surgical trauma, lower incision infection rate, and better short-term efficacy compared to open incision. It is suitable for most Sanders type II-IV calcaneal fractures.

The teleconsultation model of the National Telemedicine and Connected Health Center is cited as an example, to study the pricing formulation of video teleconsultation. This refers to the pricing composed of such four parties as the inviter′s hospital, invitee′s hospital, technical support, and business operation. Based on such pricing standard, teleconsultation charges can be collected. From 2015 to 2017, the annual applications of teleconsultation is on the rise year by year. Such pricing has been accepted by patients at large, as it embodies the value of each party, and ensures the long-term running of telemedicine system. Therefore, this pricing formulation could be a referable model for the localities to formulate their teleconsultation pricing.

Objective:This study aims to explore the possible development path of hospital research assistants in China based on the cognition of the demand and management status quo from research management personnel in tertiary hospitals.Methods:62 scientific research management personnel from all over the country were surveyed, data about their cognition and the current status of scientific research assistants, that including the willingness of employ, position cognition, eligibility and competence, quantity and efficiency, management implementation, influencing factors and difficulties in team development, were collected and analyzed. Regarding to the practical needs and management status, the results were described by frequency, percentage and average score, and the rank sum test was used to verify whether there was any difference in the employment intention between the management department and the project team in the cognition of the survey subjects.Results:From the perspective of scientific research managers, there is a strong willingness at hospital level to employ the research assistant, positions require applicants with bachelor′s degree or above in medicine or other related majors. The most urgent needs are management of project funds, equipment and consumables, research integrity and ethics.The interviewees who work with research assistants think that the effect of research assistants on improving scientific research efficiency is obvious.However, the percentage of formulation of research assistants management measures is less than 40%, and the percentages of uniformly organized training and assessment are relatively low. There are still problems and challenges, such as incomplete cognition of the positioning and function, incomplete functional and vocational system, imperfect incentive mechanism and insufficient support for ability cultivation and improvement.Conclusions:It′s necessary to strengthen the top-down design of the development of scientific research assistant team and the construction of career system, improve the management basis and implementation mechanism, supporting resources should be in place, and promote capacity building system in order to develop a long-term mechanism of mutual promotion between the team building of scientific research assistants and the innovation of hospital scientific research management.

Public hospitals in China are categorized as level II public benefit Institutions, in which the permanent employment has become the icon of the physicians. The authors systematically analyzed the HR characteristics of physicians of public hospitals, problems in physicians′ HR system and the relevant reform practices in China. They also draw on the physician practice administrative systems and experiences from the U. S., the U. K., Germany and Japan, providing insight and suggestions for the reform of physician HR system reform in China.

Objective:To investigate the mediating effect of social interaction on the relationship between internet use and the health status of the elderly.The findings of this research can potentially contribute new insights into improving the health status of the elderly population.Methods:Based on the data from the Chinese General Social Survey(CGSS)in 2021, a total of 2 675 elderly individuals aged 60 and above were included in the study.The researchers analyzed the linear regression relationship between Internet use, social interaction, and the health status of the elderly using a hierarchical regression model.Additionally, a mediation effect test was conducted using the Bootstrap test.Furthermore, heterogeneity analysis of the mediation effect was performed considering factors such as gender, place of residence, working conditions, and physical exercise among the elderly participants.Results:The total effect value was 0.170.The direct effect of Internet use on the health status of older adults was 0.160(95% CI: 0.078-0.240), accounting for 93.66% of the effect value.The indirect effect of social interaction was 0.011(95% CI: 0.003-0.021), accounting for 6.34% of the effect value.The mediating effect of social interaction on the health status of older adults varied among different groups.Among female elderly, rural elderly, elderly who are currently unemployed, and those who are physically active, the mediating effects were 5.16%, 7.86%, 10.18%, and 9.91%, respectively. Conclusions:The impact of internet use and social interaction on the health status of the elderly is notably positive.Additionally, social interaction partially mediates the relationship between internet use and the health status of the elderly.

Objective To probe into the total number and development status of respiratory physicians in China, and to analyze existing problems, for reference in making strategy and policy decisions in professional development of respiratory physicians in the country. Methods The basic information of China′s healthcare institutions and healthcare manpower in 2015 were provided by the Statistics Center of the National Health Commission. The number of respiratory specialists and their profile, drawn from such basic information, were subject to descriptive statistics. Results In 2015, there were 2.729 million medical practitioners ( including assistant doctors ) nationwide, 30.3 thousand among whom being respiratory physicians, accounting for 1.11% of the total. Among these respiratory physicians, practicing respiratory physicians account for 87.1% , respiratory physicians with a master degree and above account for only 19.7% , respiratory physicians with over 10 years of working experience account for 65.8% , respiratory physicians with senior titles account for only 21.4% , and 89.4% of the respiratory physicians work in general hospitals. Conclusions By the criteria of specializing in respiratory specialty over five years and being attending or above, the number approximates 14. 6 thousand nationwide. If practicing ( assistant) physicians specializing in respiratory specialty are also included, the number may hit 30. 3 thousand. Such a number, compared with other specialties, may be sufficient, yet their competence is far from satisfactory. Therefore it is imperative to build a standardized pulmonary medicine fellowship training system for their competence improvement.