Objective Investigate the research capacity and key discipline construction of 9 public hospitals of Hangzhou health system in the past three years,provide suggestions based on survey findings.Methods The questionnaire designed include following information:construction of talent team in key disciplines of medicine,laboratory infrastructure investment,research projects approval and funding,papers and monographs,work efficiency and financial income,NSF funding projects and awards,and comparison of input and output.Results Key disciplines of medicine in Hangzhou health system has more than 1 200 scientific research personnel,18 provincial or municipal key disciplines,the laboratory equipment area was more than 9 000 me and total investment in lab facilities was more than 69 million RMB,the national,provincial and municipal funded project of medical key disciplines accounted for total hospital project were 71.7％,66.1％ and 53.66％.1 842 papers in total were published in the medical key (specialized) disciplines of municipal hospital.Conclusions Hangzhou health system has invested a lot of resources in medical science and technology,but is still insufficient,and there are few ways to promote the construction of talent team in key disciplines of medicine and not many leading disciplines in the country.This situation shows that the core competitiveness is not strong,and the innovation system and management mechanism need to be improved.

Objective To obtain Hangzhou residents' awareness, understanding, demands, and intentions of health examination and explore the factors influencing health examination. Methods Totally 1 183 residents (male: 542, female: 641, aged from15 to 80 years) were investigated by mean of questionnaire which included demographic characteristics, health status, medical behavior and awareness, the subjective reasons of unwilling to take health examination, the intention of choosing an institution, and the data of questionnaire were analyzed using single factor Chi-square test and conditional logistic regression analysis. Results Single factor Chi-square test showed that the factors affecting health examination participation which have statistical significances were as follows, gender (χ2=11.61,P=0.000), age (χ2=9.09, P=0.028), residence registration (χ2=44.16,P=0.000), marital status (χ2=8.96,P=0.03), educational backgroud (χ2=17.33,P=0.000), employment status (χ2=7.97,P=0.005), personal monthly income (χ2=22.82, P=0.000), having any kinds of health insurance (χ2=16.08,P=0.000), and the health examination fees paid by company (χ2=44.78,P=0.000). Conditional logistic regress analysis showed that the related fators which affecting the peoples participating rates of taking health examination are gender (P=0.003, OR=1.782), residence registration (P=0.000, OR=2.208), personal monthly income (P=0.009, OR=1.307), taking any kinds of insurance (P=0.004,OR=2.913)and the company organizing and paying for the healthy examination or not (P=0.000,OR=1.923). Conclusion The participation rates of taking health examination were affected by the factors such as male, younger than 45 years old, divorce, temporary residents, the jobless, low educational diploma and income, not having any insurance, taking the health examinaiton at their own expense and so on.

Objective To explore the effect of using smart products (including smart phones, computers and other electronic products),as well as having hobbies on their cognitive function in pension agency elderly people,and analyze if there is certain protective effect on cognitive function by using smart products and having hobbies.So as to reduce the risk of mild cognitive impairment in the future. Methods By convenience sampling, 160 residents living in the nursing home of suzhou city (mean age 60 or higher) were selected, and demographic data were collected by using a homemade questionnaire, their cognitive function was investigated by using the Montreal Cognitive Assessment Scale. Results Single factor analysis showed that the score of the elderly who often use smart products in every cognitive field and overall cognitive function were superior to those who could not use smart products,the difference was statistically significant(t=-4.47--2.15,all P<0.05).The scores of the elderly with hobbies were higher in the overall cognitive function and the other six areas except the orientation, than those who had no hobby,and the differences were statistically significant(t=-6.80--1.81,all P<0.05).After adjusting for age,gender,body mass index(BMI),cultural level,often using smart products in total cognitive function in the elderly(t=4.842,P<0.01)and executive function(t=4.008,P<0.01),attention(t=3.045,P=0.003), abstract(t=2.135,P=0.034),delayed recall(t=3.759,P<0.01),the directional(t=2.866,P=0.005)of the five areas showed significant correlation. The total cognitive function of the elderly with hobbies (t=3.496, P = 0.001) and the visual spatial execution function (t=3.316, P = 0.001), naming (t=3.241, P =0.001), abstract (t=2.643, P = 0.009), and delayed recall (t=2.073, P= 0.04) were all significantly correlated.Conclusions Often using smart products and having certain hobbies are protective factors of cognitive function,build corresponding intervention plans for the future,by cultivating the elderly hobby, guiding the elderly using intelligent products and other measures to achieve successful aging, slow the cognitive decline,thus reducing the risk of mild cognitive impairment.

Objective:To investigate the clinicopathological features and pathological diagnosis methods of calcifying fibrous tumor (CFT) of the stomach.Methods:The clinicopathological data of 9 patients with gastric CFT in the Second Hospital of Hebei Medical University from August 2015 to May 2020 were retrospectively analyzed, immunohistochemistry was used to detect the immunophenotypic characteristics of gastric CFT, and the relevant literature was reviewed.Results:Among 9 patients with gastric CFT, 1 case was male and 8 cases were female, with a median age of 53 years old (18-63 years old). There were 7 cases occurred in the body of the stomach, while 2 cases in the fundus. All cases were single solid nodule with the cut surface gray-white or gray-red in colour and hard and tough in texture. Maximum diameter of tumor ranged from 0.6 cm to 1.5 cm. Observation under the microscope showed the spindle-shaped tumor cells were sparsely distributed in a large amount of collagenized stroma with scattered lymphocytes and plasma cells infiltration. Calcification or gravel formation was detected in all cases. The tumor cells in 9 cases expressed Vimentin, 3 cases expressed CD34, none of them expressed PDGFRA, SMA, SMMS-1, Desmin, ALK, DOG-1, CD117, S-100, β-catenin, CKpan and calponin; Ki-67 positive index was 1%-3%.Conclusions:Gastric CFT is more common in middle-aged and elderly people, which is characterized by gastric body with smaller volume. The diagnosis of gastric CFT mainly depends on pathological morphology and immunohistochemical examination. It needs to be differentiated from a variety of spindle cell tumors more commonly found in the stomach.

Objective:To investigate the current status of hospitalized neonatal death of different gestational ages in Shaanxi Province.Methods:All neonatal deaths in six hospitals in Shaanxi Province from 2016 to 2020 were retrospectively analyzed, and the differences in perinatal complications, the causes of death, and the age at death were compared using Chi-square (or Fisher's exact ) test. Results:(1) Totally, 220 488 neonates were delivered in the obstetric department of the six hospitals during the study period; 71 782 out of them were admitted to the neonatal department. While 424 neonatal death was reported, giving the total hospitalized neonates mortality rate of 5.5‰ (394/71 782), which included 152 deaths of transferred patients ( n=9 103, 16.7‰), 226 premature (53.3%), 196 term (46.2%), and two post-term infants (0.5%). (2) Among mothers of dead neonates, 73.6% were found to have at least one perinatal complication. The most common one was fetal distress (146 cases, 34.4%), followed by gestational diabetes mellitus (113 cases, 26.7%), amniotic fluid abnormalities ( n=73, 17.2%), maternal infectious diseases ( n=71, 16.8%), and hypertensive disorders in pregnancy (HDP) ( n=52, 12.3%). The lower the gestational age, the higher the proportion of multiple pregnancies and assisted reproduction technology applied (Fisher exact test, P<0.05). On the contrary, the higher the gestational age, the higher the cesarean section rate ( χ 2=26.69, P<0.001). HDP was more likely to occur in the gestational age of 28-31 +6 and 32-34 +6 weeks ( χ 2=37.16, P<0.001), and amniotic fluid abnormalities were more likely to occur in those over 37 weeks ( χ 2=27.47, P<0.001). (3) The five leading causes of neonatal death were neonatal respiratory distress syndrome (NRDS, n=100, 23.6%), neonatal asphyxia ( n=88, 20.8%), maternal infectious diseases ( n=80, 18.9%), and birth defects ( n=54, 12.7%), and pulmonary hemorrhage ( n=22, 5.2%). The first three causes of death in term and post-term infants were neonatal asphyxia ( n=65, 32.8%), birth defects ( n=42, 21.2%), and infectious diseases ( n=26, 13.1%). NRDS ( n=83, 36.7%), infectious diseases ( n=54, 23.9%), and neonatal asphyxia ( n=23, 10.2%) were the three leading causes of death of premature babies. (4) Out of the 326 (76.9%) neonatal deaths within seven days after birth, 162 (38.2%) died within 24 h after birth and 164 cases (38.7%) between one to seven days after birth. Conclusions:Most neonatal deaths occurred among preterm ones and within seven days after birth, whose mothers suffered perinatal complications. The causes of neonatal death vary among different gestational age groups.

Objective:To investigate the diagnostic value of thyroid imaging report and data system (TIRADS) combined with BRAF V600E mutation detection in differentiating uncertain thyroid nodules by using fine needle aspiration cytology (FNAC), and to analyze the role of TIRADS classification in screening the nodules needed to be routinely detected for BRAF V600E mutation.Methods:The clinicopathological data of 337 thyroid nodules patients diagnosed with TIRADS classification, FNAC Bethesda classification, BRAF V600E mutation detection and postoperative histopathology from the Second Hospital of Hebei Medical University between January 2018 and August 2021 were retrospectively analyzed. The role of TIRADS classification, FNAC Bethesda classification and BRAF V600E mutation detection alone and the combined detection in the differentiation of benign and malignant thyroid nodules was also analyzed.Results:The postoperative histopathological result was regarded as the gold standard. The sensitivity of TIRADS classification, FNAC Bethesda classification and BRAF V600E mutation for thyroid cancer diagnosis was 76.0%, 88.1% and 80.4% respectively, and the corresponding specificity was 84.0%, 96.0% and 100.0%, respectively. Histologically, 37 (62.7%) of 59 nodules with FNAC uncertainty were malignant nodules after the surgery. The sensitivity and accuracy of BRAF V600E mutation detection in the diagnosis of FNAC uncertain nodules were 51.4% and 69.5%, respectively, while the sensitivity and accuracy of BRAF V600E mutation detection combined with TIRADS classification were 86.5% and 84.7%, respectively. The sensitivity and accuracy of BRAF V600E mutation detection combined with TIRADS classification were both improved ( P values were 0.002 and 0.049, respectively). The positive rate of BRAF V600E mutation in thyroid nodules increased step by step with the rise of risk degree in TIRADS classification, and the type 3 cases were lower than those in type 4a cases [14.3% (1/7) vs. 68.6% (24/35), P = 0.012], and there were no statistically significant differences among the adjacent groups above 4a (all P > 0.05). Conclusions:TIRADS combined with BRAF V600E mutation detection can improve the sensitivity and accuracy in the diagnosis of FNAC uncertain thyroid nodules. The BRAF V600E mutation rate of TIRADS 4a and above nodules is high, so routine detection is recommended.

Purpose To investigate the cell components in different tumor lineages of multiple synchronous pituitary neuro-endocrine tumors(PitNETs)/neuroendocrine tumors(MSPs)and to carry out accurate histological typing,which provides an important basis for determining the follow-up plan and adjuvant therapy after surgery.Methods The clinical data of 855 pa-tients with PitNETs were collected and reclassified according to the new WHO standard.The clinicopathological features of 13 patients diagnosed as MSPs were analyzed retrospectively.The immunohistochemical EnVision two-step method was used to de-tect the expression of PIT-1,SF-1,T-PIT,GH,PRL,TSH,LH,FSH,ACTH,etc.,and related literatures were reviewed.Methods A total of 855 cases of pituitary neuroendocrine tumor from the second hospital of the Chinese Hebei Medical U-niversity were collected and reclassified according to the new WHO standard,and review the literature.Results(1)The age of patients were 39-68 years with median age of 55 years.7 cases were female and 6 were male;(2)Imaging findings:There was 1.2～3.8 cm(mean 2.5 cm)in maximum tumor di-ameter.13 patients were large adenomas,neither MSPs nor sin-gle lineage PitNETs could not assessed on imaging;(3)Clinical manifestations:3 cases had hyperprolactinemia which all contai-ning PitNETs components of PRL,one case was immature PIT-1 polyhormone cell tumor,one was dense granular prolactinoma,and one case was eosinophilic stem tumor.One patient had Cushing's disease and contained a Crook cell tumor component;two had elevated ACTH,and one had an adrenocorticotropic ad-enomatous component.In the two patients with no evidence of hormone excess,all contained gonadotropin cell tumor compo-nents;(4)Combination form:11 cases of the combination of the two cell lineages(5 cases of combination of SF-1 lineage and PIT-1 lineage;4 cases of combination of T-PIT lineage and PIT-1 lineage;1 case of null cell tumor and PIT-1 lineage;1 case of plurihormonal PitNETs and SF-1 lineage);Two cases of three cell combinations(null cell tumor,PIT-1 lineage,and T-PIT lineage);Among them,13 cases were PIT-1 lineage tumors,46.2％(6/13)were gonadotropin cell tumor,38.5％(5/13)were prolactinoma;(5)The presence of high-risk lineage tumors in the 10 patient combinations:3 immature PIT-1-lineage tumor,1 Crooke cell PitNETs,1 acidophil stem cells tumor,3 zero-cell PitNETs,and 4 silent-type sparse granular adrenocorti-cotropic hormone PitNETs;Two of them were combinations of two high-risk subtypes.Conclusion MSPs in our center are large adenomas,although their incidence is only 1.5％of Pit-NETs,2/3 cases have high-risk lineage tumor components,and the use of pituitary cell lineage transcription factors and adeno-hypophyseal hormones plays an important role in distinguishing and clarifying the different components of MSPs.