Objective:The aims of this study were to compare the clinical effectiveness of an immunosuppressant(sintilimab)combined with different chemotherapy regimens(two-and three-drug regimens)in the neoadjuvant treatment of advanced gastric cancer and to explore the efficacy-associated clinical features.Methods:A retrospective analysis was conducted on patients with advanced gastric cancer who re-ceived treatment at Lanzhou University Second Hospital between August 2020 and February 2024.Overall,133 patients were included in the study and assigned into groups A(three-drug regimens)and B(two-drug regimens),according to the treatment regimen received.Recent ef-ficacy outcomes,including the pathological complete response rate(pCR),major pathological response rate(MPR),objective response rate(ORR),and disease control rate(DCR),as well as long-term efficacy outcomes,including overall survival(OS)and disease-free survival(DFS),were compared.Subgroup analyses were performed to identify clinical features associated with treatment efficacy.Results:The recent effic-acy outcomes were similar between groups A(two-drug regimen)and B(three-drug regimen),with pCRs of 18.46%and 27.94%,MPRs of 52.31%and 58.82%,ORRs of 76.92%and 76.47%,and DCRs of 87.69%and 95.59%,respectively.However,the three-drug regimen led to significantly improved OS and DFS,compared with the two-drug regimen(P<0.05).Subgroup analysis revealed that male patients and those with gastric antrum cancer,an ECOG score of 0,a T4 stage tumor,and no vascular or nerve invasion benefited more from the three-drug re-gimen.Conclusions:Sintilimab combined with the three-drug chemotherapy regimen demonstrated superior long-term efficacy in the neo-adjuvant treatment of advanced gastric cancer,compared with the combination with the two-drug regimen.Certain clinical features may predict greater benefit from the three-drug regimen.

Pulmonary electrical impedance tomography (EIT), a noninvasive, continuous, dynamic, and radiation-free bedside imaging technique for monitoring pulmonary ventilation, is now widely utilized in the diagnosis and management of critically ill patients. Beyond ventilation monitoring, hypertonic saline contrast-enhanced EIT for bedside pulmonary perfusion assessment has recently garnered significant attention. This article describes the application of hypertonic saline contrast-enhanced EIT to evaluate pulmonary perfusion in two patients following pulmonary endarterectomy, providing a reference for its perioperative application in such patients.

Objective:To analyze the prevalence and risk factors of blindness and moderate to severe visual impairment among Han and Kazakh residents aged 50 years and older in Tacheng City, Xinjiang Uygur Autonomous Region.Methods:This study is a cross-sectional survey conducted using cluster random sampling from October 2015 to June 2018 in Emin County, Tacheng City, Xinjiang Uygur Autonomous Region. The study included individuals aged 50 years and older to survey blindness and moderate to severe visual impairment. Ophthalmological examinations combined with questionnaires were conducted to gather basic information. The data collected from the questionnaires included general demographic information and health conditions. The results of the eye examinations were used to diagnose a total of 12 risk factors including cataracts, glaucoma, pterygium, suspected glaucoma, glaucoma, and refractive errors. These risk factors were analyzed in relation to blindness and moderate to severe visual impairment. Univariate analysis was conducted first, followed by logistic regression to identify the significant factors.Results:A total of 2 114 patients were included in the final analysis, among which the prevalence of moderate to severe visual impairment was 18.54% (392/2 114), and the prevalence of blindness was 2.74% (58/2 114). Univariate analysis showed that blindness and moderate to severe visual impairment were associated with age ( χ2 = 32.97, P < 0.05), hypertension ( χ2 = 3.48, P < 0.05), age-related cataract ( χ2 = 17.43, P < 0.05), glaucoma ( χ2 = 3.90, P < 0.05), macular degeneration ( χ2 = 16.04, P < 0.05), diabetes ( χ2 = 3.09, P < 0.05), pterygium ( χ2 = 2.57, P < 0.05), and fundus arteriosclerosis ( χ2 = 2.31, P < 0.05). Multivariate logistic regression analysis indicated that moderate to severe visual impairment was correlated with age (50 to < 60 years: OR = 2.91, 95% CI: 0.44-13.45; 60 to < 70 years: OR = 3.52, 95% CI: 0.73-8.77; 70 to < 80 years: OR = 4.31, 95% CI: 0.85-8.96), ethnicity ( OR = 4.45, 95% CI: 0.56-5.95), sex ( OR = 0.47, 95% CI: 0.34-0.64), age-related cataract ( OR = 1.67, 95% CI: 1.05-2.65), glaucoma ( OR = 2.97, 95% CI: 1.67-5.30), and coronary heart disease ( OR = 2.56, P < 0.05). Blindness was correlated with age (70-79 years: OR = 1.54, 95% CI: 1.12-2.11), sex ( OR = 0.67, 95% CI: 0.34-0.64), glaucoma ( OR = 1.65, 95% CI: 0.42-6.49), diabetes ( OR = 2.05, 95% CI: 1.35-3.09), and coronary heart disease ( OR = 1.92, 95% CI: 1.07-3.43). Among these, age (70-79 years), glaucoma, diabetes, and coronary heart disease were identified as risk factors for blindness, while sex was observed as a protective factor against blindness in this region. Based on univariate and multivariate analyses as well as clinical practice, it was concluded that age (50 to < 60 years: OR = 4.42, 95% CI: 1.31-14.92; 60 to < 70 years: OR = 4.49, 95% CI: 1.70-11.84; 70 to < 80 years: OR = 3.19, 95% CI: 1.29-7.87), age-related cataract ( OR = 1.67, 95% CI: 1.05-2.65), and glaucoma ( OR = 2.97, 95% CI: 1.67-5.30) were identified as significant risk factors for moderate to severe visual impairment. Glaucoma ( OR = 1.65, 95% CI: 0.42-6.49) and diabetes ( OR = 2.05, 95% CI: 1.35-3.09) were identified as the main risk factors for blindness in this region (both P < 0.05). Conclusions:In Tacheng City, Xinjiang Uygur Autonomous Region, the prevalence rates of moderate to severe visual impairment and blindness among Han and Kazakh residents are relatively high. Age-related cataracts and glaucoma are the primary causes, while age and diabetes are the main risk factors.

Objective:The aims of this study were to compare the clinical effectiveness of an immunosuppressant(sintilimab)combined with different chemotherapy regimens(two-and three-drug regimens)in the neoadjuvant treatment of advanced gastric cancer and to explore the efficacy-associated clinical features.Methods:A retrospective analysis was conducted on patients with advanced gastric cancer who re-ceived treatment at Lanzhou University Second Hospital between August 2020 and February 2024.Overall,133 patients were included in the study and assigned into groups A(three-drug regimens)and B(two-drug regimens),according to the treatment regimen received.Recent ef-ficacy outcomes,including the pathological complete response rate(pCR),major pathological response rate(MPR),objective response rate(ORR),and disease control rate(DCR),as well as long-term efficacy outcomes,including overall survival(OS)and disease-free survival(DFS),were compared.Subgroup analyses were performed to identify clinical features associated with treatment efficacy.Results:The recent effic-acy outcomes were similar between groups A(two-drug regimen)and B(three-drug regimen),with pCRs of 18.46%and 27.94%,MPRs of 52.31%and 58.82%,ORRs of 76.92%and 76.47%,and DCRs of 87.69%and 95.59%,respectively.However,the three-drug regimen led to significantly improved OS and DFS,compared with the two-drug regimen(P<0.05).Subgroup analysis revealed that male patients and those with gastric antrum cancer,an ECOG score of 0,a T4 stage tumor,and no vascular or nerve invasion benefited more from the three-drug re-gimen.Conclusions:Sintilimab combined with the three-drug chemotherapy regimen demonstrated superior long-term efficacy in the neo-adjuvant treatment of advanced gastric cancer,compared with the combination with the two-drug regimen.Certain clinical features may predict greater benefit from the three-drug regimen.

Objective:To analyze the prevalence and risk factors of blindness and moderate to severe visual impairment among Han and Kazakh residents aged 50 years and older in Tacheng City, Xinjiang Uygur Autonomous Region.Methods:This study is a cross-sectional survey conducted using cluster random sampling from October 2015 to June 2018 in Emin County, Tacheng City, Xinjiang Uygur Autonomous Region. The study included individuals aged 50 years and older to survey blindness and moderate to severe visual impairment. Ophthalmological examinations combined with questionnaires were conducted to gather basic information. The data collected from the questionnaires included general demographic information and health conditions. The results of the eye examinations were used to diagnose a total of 12 risk factors including cataracts, glaucoma, pterygium, suspected glaucoma, glaucoma, and refractive errors. These risk factors were analyzed in relation to blindness and moderate to severe visual impairment. Univariate analysis was conducted first, followed by logistic regression to identify the significant factors.Results:A total of 2 114 patients were included in the final analysis, among which the prevalence of moderate to severe visual impairment was 18.54% (392/2 114), and the prevalence of blindness was 2.74% (58/2 114). Univariate analysis showed that blindness and moderate to severe visual impairment were associated with age ( χ2 = 32.97, P < 0.05), hypertension ( χ2 = 3.48, P < 0.05), age-related cataract ( χ2 = 17.43, P < 0.05), glaucoma ( χ2 = 3.90, P < 0.05), macular degeneration ( χ2 = 16.04, P < 0.05), diabetes ( χ2 = 3.09, P < 0.05), pterygium ( χ2 = 2.57, P < 0.05), and fundus arteriosclerosis ( χ2 = 2.31, P < 0.05). Multivariate logistic regression analysis indicated that moderate to severe visual impairment was correlated with age (50 to < 60 years: OR = 2.91, 95% CI: 0.44-13.45; 60 to < 70 years: OR = 3.52, 95% CI: 0.73-8.77; 70 to < 80 years: OR = 4.31, 95% CI: 0.85-8.96), ethnicity ( OR = 4.45, 95% CI: 0.56-5.95), sex ( OR = 0.47, 95% CI: 0.34-0.64), age-related cataract ( OR = 1.67, 95% CI: 1.05-2.65), glaucoma ( OR = 2.97, 95% CI: 1.67-5.30), and coronary heart disease ( OR = 2.56, P < 0.05). Blindness was correlated with age (70-79 years: OR = 1.54, 95% CI: 1.12-2.11), sex ( OR = 0.67, 95% CI: 0.34-0.64), glaucoma ( OR = 1.65, 95% CI: 0.42-6.49), diabetes ( OR = 2.05, 95% CI: 1.35-3.09), and coronary heart disease ( OR = 1.92, 95% CI: 1.07-3.43). Among these, age (70-79 years), glaucoma, diabetes, and coronary heart disease were identified as risk factors for blindness, while sex was observed as a protective factor against blindness in this region. Based on univariate and multivariate analyses as well as clinical practice, it was concluded that age (50 to < 60 years: OR = 4.42, 95% CI: 1.31-14.92; 60 to < 70 years: OR = 4.49, 95% CI: 1.70-11.84; 70 to < 80 years: OR = 3.19, 95% CI: 1.29-7.87), age-related cataract ( OR = 1.67, 95% CI: 1.05-2.65), and glaucoma ( OR = 2.97, 95% CI: 1.67-5.30) were identified as significant risk factors for moderate to severe visual impairment. Glaucoma ( OR = 1.65, 95% CI: 0.42-6.49) and diabetes ( OR = 2.05, 95% CI: 1.35-3.09) were identified as the main risk factors for blindness in this region (both P < 0.05). Conclusions:In Tacheng City, Xinjiang Uygur Autonomous Region, the prevalence rates of moderate to severe visual impairment and blindness among Han and Kazakh residents are relatively high. Age-related cataracts and glaucoma are the primary causes, while age and diabetes are the main risk factors.

Objective:To analyze the impact and mechanism of grassroots Party building in public hospitals on departmental business, and to provide reference for promoting the integration and mutual promotion of Party building and business.Methods:In November 2023, a self-designed questionnaire was used to survey clinical medical staff in a tertiary hospital in Wuhan. A cluster random sampling method was employed to investigate the evaluation of grassroots Party building work by clinical medical staff and the role of grassroots Party building in departmental business. Descriptive quantitative analysis was conducted on the questionnaire data. From November to December 2023, typical sampling was used to select Party branch committee members from clinical and medical technology departments of the hospital for semi-structured interviews. The interview content included the status of grassroots Party building work, its role in departmental business development, and the underlying mechanisms. Grounded theory was used for three-level coding of the interview data, and role theory was applied to analyze the mechanism by which grassroots Party building promotes business development.Results:A total of 1 124 valid questionnaires were collected, covering personnel from various sequences, including medical, nursing, technical, and pharmacy staff. Over 95% of the respondents rated the Party branch work highly, and more than 94% believed that grassroots Party building had a positive impact on the department′s medical care, teaching, research, talent team building, management, and cultural construction. The analysis using grounded theory and role theory revealed that the promotion of departmental business by grassroots Party building mainly originated from three aspects of standardization and normalization construction of Party branches, participation of Party branches in departmental management, and the development of characteristic activities based on Party building carriers. These three aspects enhanced personal responsibility, discipline, and service awareness through five personal-level targets (correcting work attitudes, leading by example among Party members, strengthening integrity in professional practice, improving professional skills, and improving working methods). This, in turn, facilitated medical staff to better identify their role positioning, standardize role behavior, and enhance role learning. At the departmental level, seven targets (expanding channels for departmental transparency, emphasizing practical performance, Party branch involvement in important departmental matters, enhancing external communication, increasing emotional identification, improving internal communication, and strengthening integrity building) were identified to promote fairness and justice, democratic decision-making, external cooperation, unity, and a clean atmosphere within the department. This further improved role evaluation, created an atmosphere conducive to role learning, helped strengthen role identification, and guided role standardization.Conclusions:Grassroots Party building of public hospital has a positive impact on department business work and is widely recognized by clinical medical staff. Different Party building activities have different pathways of influence. It is recommended to conduct targeted Party building activities based on actual needs.

Objective:To analyze the impact and mechanism of grassroots Party building in public hospitals on departmental business, and to provide reference for promoting the integration and mutual promotion of Party building and business.Methods:In November 2023, a self-designed questionnaire was used to survey clinical medical staff in a tertiary hospital in Wuhan. A cluster random sampling method was employed to investigate the evaluation of grassroots Party building work by clinical medical staff and the role of grassroots Party building in departmental business. Descriptive quantitative analysis was conducted on the questionnaire data. From November to December 2023, typical sampling was used to select Party branch committee members from clinical and medical technology departments of the hospital for semi-structured interviews. The interview content included the status of grassroots Party building work, its role in departmental business development, and the underlying mechanisms. Grounded theory was used for three-level coding of the interview data, and role theory was applied to analyze the mechanism by which grassroots Party building promotes business development.Results:A total of 1 124 valid questionnaires were collected, covering personnel from various sequences, including medical, nursing, technical, and pharmacy staff. Over 95% of the respondents rated the Party branch work highly, and more than 94% believed that grassroots Party building had a positive impact on the department′s medical care, teaching, research, talent team building, management, and cultural construction. The analysis using grounded theory and role theory revealed that the promotion of departmental business by grassroots Party building mainly originated from three aspects of standardization and normalization construction of Party branches, participation of Party branches in departmental management, and the development of characteristic activities based on Party building carriers. These three aspects enhanced personal responsibility, discipline, and service awareness through five personal-level targets (correcting work attitudes, leading by example among Party members, strengthening integrity in professional practice, improving professional skills, and improving working methods). This, in turn, facilitated medical staff to better identify their role positioning, standardize role behavior, and enhance role learning. At the departmental level, seven targets (expanding channels for departmental transparency, emphasizing practical performance, Party branch involvement in important departmental matters, enhancing external communication, increasing emotional identification, improving internal communication, and strengthening integrity building) were identified to promote fairness and justice, democratic decision-making, external cooperation, unity, and a clean atmosphere within the department. This further improved role evaluation, created an atmosphere conducive to role learning, helped strengthen role identification, and guided role standardization.Conclusions:Grassroots Party building of public hospital has a positive impact on department business work and is widely recognized by clinical medical staff. Different Party building activities have different pathways of influence. It is recommended to conduct targeted Party building activities based on actual needs.

Childhood household dysfunction(CHD)is a common adverse childhood experience,which brings the heavy physical and mental afflictions to children and adolescents.Trauma-focused cognitive behavioral therapy(TF-CBT)is an evidence-based psychotherapy that helps children and adolescents who have experienced childhood trauma with traumatic memories.It aims to enhance the coping abilities of CHD children and adolescents,thereby improving the negative effects caused by trauma and effectively reducing psychological burden.TF-CBT can effectively improve post-traumatic stress disorder,emotional and behavioral problems,and family function in children and adolescents with CHD.It is recommended to conduct high-quality original research in the future,develop targeted TF-CBT intervention plans based on potential predictive factors,adopt a combination of online and offline methods,and construct TF-CBT interventions suitable for the Chinese CHD population to meet the mental health service needs of CHD children and adolescents.

To explore screening tools for children with autism spectrum disorder (ASD), which are convenient for primary hospitals, it can provide basic data for formulating ASD prevention policies. This was a cross-sectional study by cluster sampling. Huyi District and Xincheng District were extracted for investigation in Xi′an City. From July 2021 to September 2022, all children aged from 3 months to 36 months who live in the two districts were subjected to primary screening. The child care physician used the routine screening tool "warning signs checklist for screening psychological, behavioral and developmental problems of children" and cartoon pictures of "early high-risk warning signs of autism", the children who were positive in the initial screening were referred to the district level maternal and child health hospital for re-screening, and those who were positive in the re-screening were referred to Xi ′an Children′s Hospital for diagnosis. The results showed that a total of 17 905 children aged from 3 months to 36 months were initially screened in the two districts, including 10 588 children aged from 18 months to 36 months, 50 children who were positive in the initial screening and 50 children who were re-screened. 23 children (18 boys and 5 girls) were diagnosed with ASD. The prevalence rate of ASD in children was 2.17‰ (95% confidence interval:1.29‰-3.06‰). 42 children were positive for "warning signs checklist" at the preliminary screening, and 19 were confirmed as ASD. 27 children were positive for "cartoon pictures" in the preliminary screening, and 23 were confirmed with ASD. The "cartoon pictures" in the preliminary screening and diagnosis of consistent rate was higher than the "warning signs checklist", two kinds of screening methods comparison were statistically significant difference in the odds of consistent (χ 2=11.01, P=0.001). In conclusion, relying on the three-level network of maternal and child health care, it is conducive to the whole process management of screening and diagnosis of children with ASD, and to guide the formulation of prevention policies. The cartoon pictures of "early high-risk warning signs of autism" can assist the identification of children with ASD based on the "warning signs checklist", which is simple, effective and suitable for promotion in the community health care.

Objective:To retrospectively analyze the clinical characteristics and prognosis of 85 newly diagnosed patients with follicular lymphoma (FL), as well as the prognostic value of comprehensive geriatric assessment (CGA) in patients with FL aged ≥ 60 years old.Methods:The clinical data and prognosis of 85 newly diagnosed FL patients admitted from August 2011 to June 2022 were collected. The clinical features, laboratory indicators, therapeutic efficacy, survival and prognostic factors of patients were statistically analyzed, and the prognosis of patients was stratified using various geriatric assessment tools.Results:① The patients with FL were mostly middle-aged and older, with a median age of 59 (20-87) years, including 41 patients (48.2%) aged ≥60 years. The ratio of male to female was 1∶1.36. Overall, 77.6% of the patients were diagnosed with Ann Arbor stage Ⅲ-Ⅳ, and 17 cases (20.0%) were accompanied by B symptoms. Bone marrow involvement was the most common (34.1%). ②Overall, 71 patients received immunochemotherapy. The overall response rate was 86.6%, and the complete recovery rate was 47.1% of 68 evaluated patients. Disease progression or relapse in the first 2 years was observed in 23.9% of the patient. Overall, 14.1% of the patients died during follow-up. ③Of the 56 patients receiving R-CHOP-like therapies, the 3-year and 5-year progression-free survival (PFS) rates were 85.2% and 72.8%, respectively, and the 3-year and 5-year overall survival (OS) rates were 95.9% and 88.8%, respectively. The univariate analysis showed that age ≥60 years old ( HR=3.430, 95% CI 1.256-9.371, P=0.016), B symptoms ( HR=5.030, 95% CI 1.903-13.294, P=0.016), Prognostic Nutritional Index (PNI) <45.25 ( HR=3.478, 95% CI 1.299-9.310, P=0.013), Follicular Lymphoma International Prognostic Index (FLIPI) high-risk ( HR=2.918, 95% CI 1.074-7.928, P=0.036), and PRIMA-prognostic index (PRIMA-PI) high-risk ( HR=2.745, 95% CI 1.057-7.129, P=0.038) significantly predicted PFS. Moreover, age ≥60 years old and B symptoms were independent risk factors for PFS. Progression of disease within 24 months (POD24) significantly predicted OS in the univariate analysis. Conclusions:FL is more common among middle-aged and older women. Age, B symptoms, PNI score, FLIPI high-risk, PRIMA-PI high-risk, and POD24 influenced PFS and OS. The CGA can be used for treatment selection and risk prognostication in older patients with FL.