Objective:To explore the value of high frequency ultrasound combined with serum alpha-fetoprotein (AFP) in the accurate qualitative diagnosis of pediatric testicular tumors.Methods:The ultrasound characteristics (physical properties, calcification, alder blood flow classification) and AFP levels of 47 testicular tumors confirmed by operation and pathology were analyzed retrospectively. The tumors were further divided into two ways: malignant tumor group and benign tumor group, yolk sac tumor group and non yolk sac tumor group. The characteristics of ultrasound and the accurate qualitative diagnosis efficiency of AFP in testicular tumors were analyzed by receiver operating characteristic curve (ROC).Results:18 cases of yolk sac tumor showed solid or almost solid mass, which may be accompanied by several small anechoic areas without calcification. The Alder blood flow grade were grade 3. 29 cases of nonyolk sac tumor showed cystic, solid or mixed mass, most of them have calcification and some of them showed honeycomb echo. Alder blood flow grade were 0-3 grade. ROC curve analysis showed that the area under the curve, sensitivity and specificity of the ultrasound characteristics and AFP in the diagnosis of pediatric testicular malignancies were: solid or almost solid mass (0.894, 83.3%, 95.5%), and no calcification (0.904, 94.4%, 86.4%), Alder blood flow level 3 (0.941, 88.9%, 95.5%), AFP by best cut-off value 18.8 ng/ml (0.972, 100%, 95.5%), ultrasound features combined with AFP (0.992, 100%, 90.9%). All the testicular malignancies, such as yolk sac tumor, immature teratoma, teratoma combined with yolk sac tumor, can be identified by ultrasound features combined with AFP. Further analysis showed that the sensitivity and specificity of the diagnosis of yolk sac tumor with combined solid or almost solid and no calcification were both 100.0%, which can accurately distinguish all cases of yolk sac tumor.Conclusions:Pediatric testicular yolk sac tumor has specific ultrasound performance, high-frequency ultrasound can make a relatively accurate diagnosis, combined with serum AFP can further make a relatively accurate qualitative diagnosis of other malignant tumors of the testis in children.

Objective In the context of expanding in size and improving the quality of medical consumables,the"one product,one policy"approach has brought challenges to the management of consumables in public hospitals.This study investi-gated the potential management problems in the process of centralized procurement with volume of medical consumables in a pub-lic tertiary hospital in Guangdong Province,and accordingly worked out the corresponding management countermeasures and then assessed their implementation effects.Methods The fishbone diagrams was applied to systematically analyze the potential prob-lems in the implementation process of centralized procurement with volume of medical consumables.Targeted measures were worked out from May to July 2023 in the hospital.The time series data of centralized procurement of coronary stents,pacemak-ers,tubular/end-to-end anastomoses,and spinal products from December 2022 to December 2023 were analyzed.Changes in the monthly implementation rate and contract completion volume pre-and post-intervention were measured to evaluate the effectiveness of the intervention.Results The fishbone diagrams analysis revealed that the primary factors impeding procurement implementa-tion were internal system flaws,personnel management inadequacy,supply issues,and an absence of an information system.Post-intervention,the monthly implementation rate(t=-4.19,P＜0.05)and contract completion(t=-2.38,P＜0.05)significantly improved.Conclusion The implementation of intervention management for centralized procurement with volume of medical consumables can effectively promote the related implementation effect in the department.In the context of centralized pro-curement,clinical and health management personnel need to bolster their professionalism to ensure the procurement management efficiency and quality.It is crucial to deepen policy understanding and implementation,enhance production and distribution process supervision and disciplinary mechanisms,ensure multi-departmental coordination for supply security,and improve hospi-tal information systems and procurement platforms.

Objective:To describe the epidemiological characteristics of bladder cancer in 2015 and temporal trends in China.Methods:From 501 cancer registries in China, we collected data of cancer new cases, deaths and populations in 2015. After qualified, sex-specific, area-specific, age-specific and overall incidence/mortality rates (including age-standardized rates by Chinese standard population and by world standard population) and estimated cases of bladder cancer were calculated. Annual Percent Change (APC)/Average Annual Percent Change (AAPC) fitted from Log-line model was applied to evaluate the temporal trends of bladder cancer incidence/mortality rates from 1998 to 2015.Results:Bladder cancer is the 13 th most common cancer in China. The crude, age-standardized by China standard population and by world standard population rates were 5.80/10 5, 3.60/10 5 and 3.57/10 5 for incidence, and 2.37/10 5, 1.31/10 5 and 1.32/10 5 for mortality, respectively. The incidence of bladder cancer ranked 7 th in male. The incidence and mortality of male were 3.8 and 4.0 times as high as those of female. Bladder cancer incidence in urban area was 1.4 times as high as that in rural area. Incidence in western areas and middle areas of China were similar, which were lower than that in eastern areas. Geographical distribution characteristics of mortality was along with incidence.Both incidence and mortality remained low before 45 and 55 years old, then they increased rapidly and peaked at 80-84 and over 85 years old age group. Temporal trend analysis suggested that bladder cancer incidence in China increased in 1998-2007 (APC=2.58, P<0.001), while decreased from 2007 to 2015 (APC=-3.82, P<0.001). Bladder cancer mortality declined gradually, with APCs for 1998-2003 and 2003-2015 of 3.65% ( P=0.002) and 1.42% ( P<0.001). Conclusions:Bladder cancer is one of the main cancers in China. Its epidemiological distributions varies among different sex, area and age group. Both incidence and mortality of bladder cancer decline. More efforts on tobacco control should be made, and awareness of early diagnosis and early treatment could be enhanced for the middle-aged and elderly.

Objective:To describe the epidemiological characteristics of bladder cancer in 2015 and temporal trends in China.Methods:From 501 cancer registries in China, we collected data of cancer new cases, deaths and populations in 2015. After qualified, sex-specific, area-specific, age-specific and overall incidence/mortality rates (including age-standardized rates by Chinese standard population and by world standard population) and estimated cases of bladder cancer were calculated. Annual Percent Change (APC)/Average Annual Percent Change (AAPC) fitted from Log-line model was applied to evaluate the temporal trends of bladder cancer incidence/mortality rates from 1998 to 2015.Results:Bladder cancer is the 13 th most common cancer in China. The crude, age-standardized by China standard population and by world standard population rates were 5.80/10 5, 3.60/10 5 and 3.57/10 5 for incidence, and 2.37/10 5, 1.31/10 5 and 1.32/10 5 for mortality, respectively. The incidence of bladder cancer ranked 7 th in male. The incidence and mortality of male were 3.8 and 4.0 times as high as those of female. Bladder cancer incidence in urban area was 1.4 times as high as that in rural area. Incidence in western areas and middle areas of China were similar, which were lower than that in eastern areas. Geographical distribution characteristics of mortality was along with incidence.Both incidence and mortality remained low before 45 and 55 years old, then they increased rapidly and peaked at 80-84 and over 85 years old age group. Temporal trend analysis suggested that bladder cancer incidence in China increased in 1998-2007 (APC=2.58, P<0.001), while decreased from 2007 to 2015 (APC=-3.82, P<0.001). Bladder cancer mortality declined gradually, with APCs for 1998-2003 and 2003-2015 of 3.65% ( P=0.002) and 1.42% ( P<0.001). Conclusions:Bladder cancer is one of the main cancers in China. Its epidemiological distributions varies among different sex, area and age group. Both incidence and mortality of bladder cancer decline. More efforts on tobacco control should be made, and awareness of early diagnosis and early treatment could be enhanced for the middle-aged and elderly.

Objective: To estimate the incidence and mortality of colorectal cancer (CRC) in China, providing basic information of treatment and prevention in CRC. Methods: In 2016, National Central Cancer Registry (NCCR) collected registration data in 2013 from local cancer registries and assessed the data according to the auditing methods and evaluation criteria formulated by NCCR. 347 cancer registries submitted data of 2013 to NCCR. Qualified data from 255 registries was pooled, analyzed and stratified by area (urban/rural), gender, and age. CRC incidence and mortality were estimated using national population in 2013. Results: In 2013, the estimate of new cases diagnosed with CRC in China was 347.9 thousands, with 9.45% of new cancer cases. The crude incidence of CRC was 25.57/100, 000 (28.64/100, 000 for male and 22.34/100, 000 for female, 30.92/100, 000 in urban areas and 19.35/100, 000 in rural areas), ranking fourth in all cancer. The age-standardized rates by China population and by world population were 17.45/100, 000 and 17.20/100, 000, respectively. Cumulative incidence of CRC in China was 2.05%. The estimated CRC deaths of China was 164, 900 in 2013, accounting for 7.39% of overall cancer deaths. The crude mortality rate for CRC was 12.11/100, 000 (13.49/100, 000 for male and 10.67/100, 000 for female, 14.41/100, 000 in urban and 9.45/100, 000 in rural), ranking fifth in all cancer. The age-standardized rates by China population and by World population for mortality were 7.87/100, 000 and 7.76/100, 000, respectively. Cumulative mortality rate of CRC in China was 0.82%. For both of incidence and mortality, males had much higher rates than females, while urban areas had much higher rates than rural areas. The incidence and mortality rates of CRC increased greatly with age, especially after 35 or 40 years old, and reached the peak in the age group of 80 or 85+ year old. Conclusion The disease burden of CRC was still serious in China. Primary prevention and early detection of CRC in China is crucial.