Objective:To provide guidance for department operation and discipline development by analyzing the disease structure of the Department of Breast, Thyroid and Hernia Surgery in a Class-A tertiary hospital in Shandong Province.Methods:The inpatient medical record homepages of the Liaocheng People′s Hospital from January 1 to October 31, 2024, were collated, with a total of 113 857 medical records collected. Based on the International Classification of Diseases coding (ICD-10), and utilizing the Shanghai Lianzhong version Diagnosis-Related Group (DRG) grouper and the National Healthcare Security Diagnosis-Related Group (CHS-DRG) grouper version 1.1, combined with the performance evaluation indicators for national tertiary public hospitals (hereinafter referred to as the " National Evaluation" ), a four-quadrant analysis and analogy method were applied to study the disease structure, relative weight (RW), average profit/loss per case (average effective revenue per case), and the proportion of Level IV and minimally invasive surgeries in the Department of Breast, Thyroid, and Hernia Surgery.Results:Chemotherapy was the main disease type in the department, accounting for 43.25% of the total cases, but its RW was low, so it had no advantage in discipline development. Except for chemotherapy, thyroid surgery, abdominal external hernia surgery, and breast malignant tumor surgery were the main disease types, accounting for 39.73% of the total cases. Among them, thyroid surgery and breast malignant tumor surgery had advantages in discipline development in terms of the National Assessment system and medical insurance payment; in addition, grade IV surgeries were concentrated in thyroid surgery, and minimally invasive surgeries were concentrated in abdominal external hernia surgery.Conclusions:The characteristics of the disease structure of the Department of Breast, Thyroid and Hernia Surgery are initially grasped, the development direction of the department is clarified, the cost structure is optimized, and the disciplinary competitiveness is improved.

The ultrasound probe is the most important accessory in ultrasound equipment,which adopted the piezoelectric vibrator as its core component,and it can complete ultrasonic emission and receiving echoes.A deep understanding for the operational characteristics of the probe's array elements is important premise that user can accurately judge the running situation of the probe.This study employed pulse-echo technique to detect sensitivity and capacitance of the array elements of ultrasonic probe.The detected data of 60 probes at China-Japan Friendship Hospital were collected,and 75%of the 60 probes existed residual couplant,and 80%of them existed indentation or damage to the outer skin.The tested results of leakage current indicated that 1 probe(1.7%)existed excessively high leakage current.In test for array elements,2 probes(3.4%)displayed partial damage at array elements,and 6 probes(10.2%)were irreparably damaged.The preventive test for the diagnostic equipment with ultrasound is helpful to establish a quality control system for ultrasound,and to provide analysis materials with reliability in using diagnostic equipment with ultrasound,and to also provide decision-making basis for equipment departments and clinical department of using equipment in hospital.

Objective:In this study, we aimed to investigate the short-term efficacy and safety of perioperative administration of the PD-1 inhibitor tislelizumab combined with the SOX regimen (oxaliplatin plus S-1) in patients with locally advanced gastric cancer, and to identify factors influencing therapeutic outcomes.Methods:In this retrospective cohort study, we analyzed clinical data of 166 patients who had undergone perioperative therapy and D2 radical gastrectomy in the Department of General Surgery, First Medical Center of Chinese PLA General Hospital between September 2021 and September 2023. The cohort comprised 140 men and 26 women, of median age 62 years (range: 30-75). The patients were allocated to two groups: 62 receiving tislelizumab plus SOX (combination therapy group), and 104 SOX alone (chemotherapy-only group). Primary outcomes included pathological complete response rate, treatment-related adverse events, and complications of surgery. Secondary outcomes comprised major pathological response rate, tumor regression grade (Grades 1-2 denoting favorable response, Grade 3 moderate, and Grades 4-5 poor response), R0 resection rate, and short-term survival outcomes (1-year disease-free and overall survivals). Risk factors associated with pCR in the combination group were also analyzed.Results:The combination therapy group exhibited significantly higher rates of pCR (25.8% vs. 8.7%, χ 2=8.93, P=0.003) and Grade 1 tumor regression (25.8% vs. 16.3%, χ 2=15.32, P=0.001) than the chemotherapy-only group. There were no statistically significant differences in major pathological response rates (41.9% vs. 39.4%), R0 resection rates (96.8% vs. 97.1%,), treatment- related adverse events (48.4% vs. 42.3%,), surgical complications (9.7% vs. 12.5%), 1-year disease-free survival (82.3% vs. 78.8%), or 1-year overall survival (93.5% vs. 91.3%), There were no statistically significant differences (all P>0.05). Multivariate logistic analysis identified neural invasion as an independent risk factor for reduced pCR in the combination group (OR=0.10, 95%CI:0.01-0.85, P=0.035). Conclusions:Perioperative tislelizumab combined with SOX chemotherapy improves pathological response rates in patients with locally advanced gastric cancer and has favorable short-term efficacy and safety profiles. Neural invasion may diminish the therapeutic efficacy of immunotherapy.

Objective·To establish Downs cephalometric norms for the Han Chinese aged 18-25 with harmonious faces,and to analyze gender and regional characteristics.Methods·A stratified sampling approach was used to recruit participants from seven geographic regions across China.Over 30 000 volunteers were screened,and 883 participants with harmonious faces were ultimately included.Basic demographic data were collected,and lateral cephalometric radiographs were taken.Hard tissue measurements were performed with Downs analysis(using anatomical porion).The data were then statistically analyzed to compare gender and regional differences in dentofacial structures.Results·The gender differences in the four hard tissue measurements,the angle of convexity,A-B plane angle,mandibular plane angle,and occlusal plane angle,were statistically significant(P＜0.001).Females showed larger values for the angle of convexity,mandibular plane angle,and occlusal plane angle,but smaller values for the A-B plane angle,compared to males.The gender differences in the interincisal angle,L1 to occlusal plane,L1 to mandibular plane,and U1 to AP plane were not statistically significant.There were regional differences in all 10 measurements of Downs analysis,though some regions shared common features.Specifically,the northeastern,eastern,and southern coastal regions exhibited a smaller facial angle,and larger mandibular plane angle,angle of convexity,occlusal plane angle,and U1 to AP plane.It suggested that,compared to inland regions,individuals from coastal regions tended to have more retrusive chins,steeper mandibular planes,more prominent upper incisors,and more convex hard tissue profiles.Conclusion·Gender differences exist in the dentofacial hard tissue structures of Han Chinese adults with harmonious faces,primarily in skeletal measurements.Each region has its unique dentofacial characteristics,along with some common features.These differences should be taken into account in clinical diagnosis and treatment for the development of personalized and precise therapeutic strategies.

Objective:In this study, we aimed to investigate the short-term efficacy and safety of perioperative administration of the PD-1 inhibitor tislelizumab combined with the SOX regimen (oxaliplatin plus S-1) in patients with locally advanced gastric cancer, and to identify factors influencing therapeutic outcomes.Methods:In this retrospective cohort study, we analyzed clinical data of 166 patients who had undergone perioperative therapy and D2 radical gastrectomy in the Department of General Surgery, First Medical Center of Chinese PLA General Hospital between September 2021 and September 2023. The cohort comprised 140 men and 26 women, of median age 62 years (range: 30-75). The patients were allocated to two groups: 62 receiving tislelizumab plus SOX (combination therapy group), and 104 SOX alone (chemotherapy-only group). Primary outcomes included pathological complete response rate, treatment-related adverse events, and complications of surgery. Secondary outcomes comprised major pathological response rate, tumor regression grade (Grades 1-2 denoting favorable response, Grade 3 moderate, and Grades 4-5 poor response), R0 resection rate, and short-term survival outcomes (1-year disease-free and overall survivals). Risk factors associated with pCR in the combination group were also analyzed.Results:The combination therapy group exhibited significantly higher rates of pCR (25.8% vs. 8.7%, χ 2=8.93, P=0.003) and Grade 1 tumor regression (25.8% vs. 16.3%, χ 2=15.32, P=0.001) than the chemotherapy-only group. There were no statistically significant differences in major pathological response rates (41.9% vs. 39.4%), R0 resection rates (96.8% vs. 97.1%,), treatment- related adverse events (48.4% vs. 42.3%,), surgical complications (9.7% vs. 12.5%), 1-year disease-free survival (82.3% vs. 78.8%), or 1-year overall survival (93.5% vs. 91.3%), There were no statistically significant differences (all P>0.05). Multivariate logistic analysis identified neural invasion as an independent risk factor for reduced pCR in the combination group (OR=0.10, 95%CI:0.01-0.85, P=0.035). Conclusions:Perioperative tislelizumab combined with SOX chemotherapy improves pathological response rates in patients with locally advanced gastric cancer and has favorable short-term efficacy and safety profiles. Neural invasion may diminish the therapeutic efficacy of immunotherapy.

The ultrasound probe is the most important accessory in ultrasound equipment,which adopted the piezoelectric vibrator as its core component,and it can complete ultrasonic emission and receiving echoes.A deep understanding for the operational characteristics of the probe's array elements is important premise that user can accurately judge the running situation of the probe.This study employed pulse-echo technique to detect sensitivity and capacitance of the array elements of ultrasonic probe.The detected data of 60 probes at China-Japan Friendship Hospital were collected,and 75%of the 60 probes existed residual couplant,and 80%of them existed indentation or damage to the outer skin.The tested results of leakage current indicated that 1 probe(1.7%)existed excessively high leakage current.In test for array elements,2 probes(3.4%)displayed partial damage at array elements,and 6 probes(10.2%)were irreparably damaged.The preventive test for the diagnostic equipment with ultrasound is helpful to establish a quality control system for ultrasound,and to provide analysis materials with reliability in using diagnostic equipment with ultrasound,and to also provide decision-making basis for equipment departments and clinical department of using equipment in hospital.

Objective·To establish Downs cephalometric norms for the Han Chinese aged 18-25 with harmonious faces,and to analyze gender and regional characteristics.Methods·A stratified sampling approach was used to recruit participants from seven geographic regions across China.Over 30 000 volunteers were screened,and 883 participants with harmonious faces were ultimately included.Basic demographic data were collected,and lateral cephalometric radiographs were taken.Hard tissue measurements were performed with Downs analysis(using anatomical porion).The data were then statistically analyzed to compare gender and regional differences in dentofacial structures.Results·The gender differences in the four hard tissue measurements,the angle of convexity,A-B plane angle,mandibular plane angle,and occlusal plane angle,were statistically significant(P＜0.001).Females showed larger values for the angle of convexity,mandibular plane angle,and occlusal plane angle,but smaller values for the A-B plane angle,compared to males.The gender differences in the interincisal angle,L1 to occlusal plane,L1 to mandibular plane,and U1 to AP plane were not statistically significant.There were regional differences in all 10 measurements of Downs analysis,though some regions shared common features.Specifically,the northeastern,eastern,and southern coastal regions exhibited a smaller facial angle,and larger mandibular plane angle,angle of convexity,occlusal plane angle,and U1 to AP plane.It suggested that,compared to inland regions,individuals from coastal regions tended to have more retrusive chins,steeper mandibular planes,more prominent upper incisors,and more convex hard tissue profiles.Conclusion·Gender differences exist in the dentofacial hard tissue structures of Han Chinese adults with harmonious faces,primarily in skeletal measurements.Each region has its unique dentofacial characteristics,along with some common features.These differences should be taken into account in clinical diagnosis and treatment for the development of personalized and precise therapeutic strategies.

Objective:To provide guidance for department operation and discipline development by analyzing the disease structure of the Department of Breast, Thyroid and Hernia Surgery in a Class-A tertiary hospital in Shandong Province.Methods:The inpatient medical record homepages of the Liaocheng People′s Hospital from January 1 to October 31, 2024, were collated, with a total of 113 857 medical records collected. Based on the International Classification of Diseases coding (ICD-10), and utilizing the Shanghai Lianzhong version Diagnosis-Related Group (DRG) grouper and the National Healthcare Security Diagnosis-Related Group (CHS-DRG) grouper version 1.1, combined with the performance evaluation indicators for national tertiary public hospitals (hereinafter referred to as the " National Evaluation" ), a four-quadrant analysis and analogy method were applied to study the disease structure, relative weight (RW), average profit/loss per case (average effective revenue per case), and the proportion of Level IV and minimally invasive surgeries in the Department of Breast, Thyroid, and Hernia Surgery.Results:Chemotherapy was the main disease type in the department, accounting for 43.25% of the total cases, but its RW was low, so it had no advantage in discipline development. Except for chemotherapy, thyroid surgery, abdominal external hernia surgery, and breast malignant tumor surgery were the main disease types, accounting for 39.73% of the total cases. Among them, thyroid surgery and breast malignant tumor surgery had advantages in discipline development in terms of the National Assessment system and medical insurance payment; in addition, grade IV surgeries were concentrated in thyroid surgery, and minimally invasive surgeries were concentrated in abdominal external hernia surgery.Conclusions:The characteristics of the disease structure of the Department of Breast, Thyroid and Hernia Surgery are initially grasped, the development direction of the department is clarified, the cost structure is optimized, and the disciplinary competitiveness is improved.

Refractory angina is characterized by recurrent and persistent angina with a duration of not less than three months， which is related to reversible ischemia and hypoxia caused by coronary stenosis and obstruction. It mainly involves obstructive coronary artery disease and non-obstructive coronary artery disease with coronary artery spasm and coronary microvascular dysfunction. “Stasis and toxin” play an important role in the pathogenesis of cardiovascular diseases. The pathogenesis of stasis and toxin is stubborn filthy turbidity featured by slow accumulation and sudden onset，and rapid changes，which coincides with the characteristics of refractory angina which is complex and changeable，prolonged and difficult to cure. The pathogenesis of refractory angina involves a combination of underlying deficiency and excessive manifestation， with "stasis and toxin" playing a crucial role as an important pathological factor in the whole process of refractory angina. Traditional Chinese medicine （TCM） employs a holistic approach known as "activating blood circulation and removing toxins"， which is supplemented by various methods to tonify Qi and warm Yang， nourish the kidneys and invigorate the spleen， clear heat and transform phlegm. This approach applies anti-inflammatory measures， regulates lipid metabolism， inhibits oxidative stress and thrombus formation， protects endothelial function in blood vessels， as well as establishes collateral circulation for the prevention and treatment of refractory angina. Therefore，based on the theory of "stasis and toxin"，combined with TCM theory and modern medical research，this paper discusses the pathogenesis of refractory angina and the prevention and treatment strategy of TCM，and elucidates the reasons for the difficulty in curing refractory angina and the relationship between refractory angina and common angina pectoris，coronary microvascular dysfunction，coronary artery spasm and obstructive coronary artery disease，hoping to provide certain theoretical basis and clinical ideas for the prevention and treatment of refractory angina with TCM.

Objective:To investigate the impact of short-term exposure to atmospheric pollutants on the number of acute stroke daily admissions in Taiyuan, China.Methods:The case data of patients with stroke from three large hospitals in different regions of Taiyuan, Shanxi Province from January 1, 2018 to December 31, 2019 were collected. The daily average concentrations of atmospheric pollutants and meteorological data in Taiyuan during the same period were collected. Spearman rank correlation was used to analyze the correlation between meteorological factors and atmospheric pollutants, and a generalized additive model (GAM) based on time series research and analysis was used to investigate the impact and lag effect of air pollutants on the number of stroke daily admissions. Stratified analysis was performed based on different genders and ages (≤64 years, 65-74 years, and ≥75 years).Results:Between 2018 and 2019, a total of 4 921 patients with acute stroke were collected from three large hospitals, with a daily average of 6.74 stroke admissions. Among them, 4 310 patients (87.6%) had ischemic stroke, 521 (10.6%) had cerebral hemorrhage, and 90 (1.8%) had subarachnoid hemorrhage. GAM analysis showed that there was a significant correlation between short-term exposure to PM 2.5, PM 10, and SO 2 and the number of stroke daily admissions. All three had a significant impact on the number of stroke daily admissions on the day of onset and 3 days later. The maximum effect value was reached on the day of onset, and when the average concentrations of PM 2.5, PM 10, and SO 2 increase by 10 μg/m 3, the number of stroke daily admissions increased by 1.48% (95% confidence interval [ CI] 0.46%-2.53%), 0.80% (95% CI 0.25%-1.36%), and 2.80% (95% CI 0.76%-4.88%), respectively. Stratified analysis showed that exposure to PM 2.5, PM 10, SO 2, and CO had a more significant impact on the number of stroke daily admissions in male patients, while only PM 10 showed positive results in females. Age stratified analysis showed that PM 2.5 significantly increased the number of stroke daily admissions in individuals aged ≥75 years. Conclusion:Short-term exposure to atmospheric pollutants (PM 2.5, PM 10, SO 2, and CO) will to some extent increase the number of stroke daily admissions among residents of Taiyuan, especially among males and those aged ≥75 years.