Objective:To retrospectively analyze the efficacy of arterial switch operation in infants with transposition of the great arteries and to explore the prognostic related factors.Methods:The clinical data of 381 children with transposition of the great arteries from October 2001 to December 2017 were collected, including anatomical diagnosis, age of surgery, preoperative status, coronary artery malformation, aortic arch disease, etc. The relevant factors of postoperative mortality and reintervention were analyzed.Results:The overall mortality rate is about 4.5%, and the reintervention rate is about 3.7%. The postoperative mortality of every 100 cases droped significantly ( P<0.05), early surgery did not increase the risk of surgical death, but the mortality rate in the emergency surgery group was higher than that in the non-emergency surgery group. The mortality in the combined coronary artery abnormality group was significantly higher than that in the normal coronary artery group. Patients with Taussig-Bing anomaly and abnormal aortic arch were significantly more likely to get worse outcomes than those without aortic arch abnormality. In the whole group, 14 patients were re-intervened due to pulmonary valve or supra-valvular stenosis, aortic arch constriction, left ventricular outflow obstruction, and new aortic valve regurgitation. One patient died after operation. There was no coronary reintervention in the middle and long-term follow-up. Conclusion:The clinical outcome of early diagnosis and treatment of transposition of great arteries was good, preoperative status affects the outcome of surgery, coronary artery malformation, Taussig-Bing combined with aortic arch abnormalities were associated with increased operative mortality.

Objective:To understand the incentive effect and influencing factors of the current economic incentive policy for medical alliances in Longhua District of Shenzhen(the alliance for short) on doctors′ willingness to work at primary medical institutions(the primary for short) from the perspective of mental account, and to explore the economic incentive effect of different economic incentive distribution methods on doctors′ willingness to work at the primary.Methods:The questionnaire was designed based on mental account theory. Random sampling was made in November 2019 for a questionnaire survey among doctors in two district-level medical institutions of the alliance in Longhua District of Shenzhen. The purpose was to analyze their inclination to work at the primary and their selection preferences for economic incentive distribution methods under the current economic incentive policy. The data were analyzed by descriptive analysis, and the influencing factors of doctors′ willingness to work at the primary were analyzed by χ2 test and binary logistic regression. Results:A total of 254 valid questionnaires were collected with an effective recovery rate of 90.7%. Among the respondents, 189(74.4%) were willing to work at the primary, 168(66.1%) chose to receive the economic incentives specifically for working at the primary, and 148 people(58.3%) hoped to receive such economic incentives immediately. Education background, self-rated economic income level of doctors and different payment methods of economic incentive for working at the primary had significant effects on their willingness to work at the primary( P<0.05). Conclusions:The current economic incentive policy of the alliance can meet the demands for economic incentives in terms of doctors′ material accounts, and doctors′ overall inclination to work at the primary was strong. If the amount of economic incentives is constant, doctors preferred to receive the economic incentives specifically, mainly affected by income accounts and additional income accounts. In addition, education and self-assessment of economic income level were important factors affecting the willingness of doctors to work at the primary, which may be affected by mental accounts other than material accounts.