OBJECTIVE To formulate an expert consensus on the prevention and control of respiratory infectious diseases in railway stations and trains in China,and to standardize the prevention and control of respiratory infec-tious diseases in railway stations and trains scientifically.METHODS The government authorities organized multi-ple prevention and control experts from transportation,medical care and prevention fields to conduct in-depth re-search through methods such as meetings and on-site investigations,and combined with their practical experi-ence in this field to formulate this expert consensus.RESULTS In-depth studies were conducted on the prevention and control strategies,measures and emergency response system construction of respiratory infectious diseases in railway stations and trains,and this expert consensus was formed.CONCLUSION This expert consensus supple-ments improves the existing prevention and control system for respiratory infectious diseases in railway stations and trains,and provides an important reference basis for the prevention and control of respiratory infectious disea-ses in railway stations and trains.

OBJECTIVE To formulate an expert consensus on the prevention and control of respiratory infectious diseases in railway stations and trains in China,and to standardize the prevention and control of respiratory infec-tious diseases in railway stations and trains scientifically.METHODS The government authorities organized multi-ple prevention and control experts from transportation,medical care and prevention fields to conduct in-depth re-search through methods such as meetings and on-site investigations,and combined with their practical experi-ence in this field to formulate this expert consensus.RESULTS In-depth studies were conducted on the prevention and control strategies,measures and emergency response system construction of respiratory infectious diseases in railway stations and trains,and this expert consensus was formed.CONCLUSION This expert consensus supple-ments improves the existing prevention and control system for respiratory infectious diseases in railway stations and trains,and provides an important reference basis for the prevention and control of respiratory infectious disea-ses in railway stations and trains.

Objective:To explore the relationship between serum osteopontin (OPN), annexin A2 (ANXA2) and recurrence after partial laryngectomy in patients with early-stage glottic laryngeal cancer (EGC).Methods:A retrospective study was conducted by collecting clinical data from EGC patients who underwent partial laryngectomy at Beijing Shijitan Hospital from June 2020 to May 2022. Serum levels of OPN and ANXA2 were measured at the time of admission. Clinical data during the perioperative period were also collected. The recurrence within 2 years after surgery was used as the endpoint event. Patients were divided into a recurrence group and a non-recurrence group based on the occurrence of recurrence. The data were compared between the groups, and Cox regression was used to analyze the correlation between recurrence after partial laryngectomy and key factors. Receiver operating characteristic (ROC) curve and decision curve were used to evaluate the predictive value of serum OPN and ANXA2 for recurrence within 2 years after surgery.Results:Among 167 EGC patients, 42 patients experienced recurrence within 2 years after surgery (recurrence group), with a median recurrence time of 16.00 (13.75, 19.25) months, and a recurrence rate of 25.15%; 125 patients did experience recurrence within 2 years after surgery (non-recurrence group). Compared to the non-recurrence group, the proportions of poorly differentiated tumors and anterior commissure invasion in the recurrence group were higher, the serum levels of OPN, ANXA2 and testosterone were higher: 52.38% (22/42) vs. 20.80% (26/125), 52.38% (22/42) vs. 20.00% (25/125), (24.26 ± 4.64) μg/L vs. (18.83 ± 4.17) μg/L, (37.62 ± 6.15) μg/L vs. (31.24 ± 5.56) μg/L, (27.26 ± 5.31) nmol/L vs. (22.85 ± 4.62) nmol/L, with significant differences ( P<0.05). Cox regression analysis result showed that recurrence after partial laryngectomy in EGC patients was potentially related to tumor differentiation, anterior commissure invasion, and abnormal serum expression of OPN, ANXA2 and testosterone ( P<0.05). ROC curve analysis revealed that serum OPN and ANXA2 had an area under the curve of 0.80 and 0.79, respectively, showing predictive value, with optimal cutoff values of 21.40 and 34.72 μg/L. Decision curve analysis indicated that serum OPN and ANXA2 had predictive significance for recurrence after partial laryngectomy in EGC patients, and the combined use of pathological grade, anterior commissure invasion, and testosterone improved the net benefit. Conclusions:Recurrence after partial laryngectomy in EGC patients may be associated with elevated serum OPN and ANXA2 levels, which could increase the risk of postoperative recurrence. Early detection of serum OPN and ANXA2 could be valuable for predicting recurrence after surgery in EGC patients.

Objective:To explore the relationship between serum osteopontin (OPN), annexin A2 (ANXA2) and recurrence after partial laryngectomy in patients with early-stage glottic laryngeal cancer (EGC).Methods:A retrospective study was conducted by collecting clinical data from EGC patients who underwent partial laryngectomy at Beijing Shijitan Hospital from June 2020 to May 2022. Serum levels of OPN and ANXA2 were measured at the time of admission. Clinical data during the perioperative period were also collected. The recurrence within 2 years after surgery was used as the endpoint event. Patients were divided into a recurrence group and a non-recurrence group based on the occurrence of recurrence. The data were compared between the groups, and Cox regression was used to analyze the correlation between recurrence after partial laryngectomy and key factors. Receiver operating characteristic (ROC) curve and decision curve were used to evaluate the predictive value of serum OPN and ANXA2 for recurrence within 2 years after surgery.Results:Among 167 EGC patients, 42 patients experienced recurrence within 2 years after surgery (recurrence group), with a median recurrence time of 16.00 (13.75, 19.25) months, and a recurrence rate of 25.15%; 125 patients did experience recurrence within 2 years after surgery (non-recurrence group). Compared to the non-recurrence group, the proportions of poorly differentiated tumors and anterior commissure invasion in the recurrence group were higher, the serum levels of OPN, ANXA2 and testosterone were higher: 52.38% (22/42) vs. 20.80% (26/125), 52.38% (22/42) vs. 20.00% (25/125), (24.26 ± 4.64) μg/L vs. (18.83 ± 4.17) μg/L, (37.62 ± 6.15) μg/L vs. (31.24 ± 5.56) μg/L, (27.26 ± 5.31) nmol/L vs. (22.85 ± 4.62) nmol/L, with significant differences ( P<0.05). Cox regression analysis result showed that recurrence after partial laryngectomy in EGC patients was potentially related to tumor differentiation, anterior commissure invasion, and abnormal serum expression of OPN, ANXA2 and testosterone ( P<0.05). ROC curve analysis revealed that serum OPN and ANXA2 had an area under the curve of 0.80 and 0.79, respectively, showing predictive value, with optimal cutoff values of 21.40 and 34.72 μg/L. Decision curve analysis indicated that serum OPN and ANXA2 had predictive significance for recurrence after partial laryngectomy in EGC patients, and the combined use of pathological grade, anterior commissure invasion, and testosterone improved the net benefit. Conclusions:Recurrence after partial laryngectomy in EGC patients may be associated with elevated serum OPN and ANXA2 levels, which could increase the risk of postoperative recurrence. Early detection of serum OPN and ANXA2 could be valuable for predicting recurrence after surgery in EGC patients.

Objective:To study the safety and efficacy of laparoscopic cholecystectomy (LC) in treatment of T2a and lower stages of gallbladder carcinoma.Methods:A retrospective study was performed on patients who were diagnosed with gallbladder cancer and underwent surgical treatment from January 2016 to January 2021 at Hunan Provincial People's Hospital. These patients were divided into the simple treatment group and the radical treatment group based on the surgical methods used. The simple treatment group consisted of 64 patients who underwent LC for accidental gallbladder cancers. The radical treatment group consisted of 30 patients who underwent laparoscopic radical cholecystectomy (LRC). The baseline characteristic of the two groups of patients were matched in a 1∶1 ratio using propensity score matching. After matching, there were 26 patients in each of the 2 groups. There were 7 males and 19 females in the simple group, with mean ± s. d. age of (60.6±9.6) years. There were 8 males and 18 females, with mean ± s. d. age (60.9±9.1) years in the radical treatment group. Blood loss, operation time, postoperative hospital stay, biliary leakage, acute pulmonary embolism, and incisional infection were compared between the two groups.Results:In the simple group, the operative time was (78.7±62.9) min, intraoperative blood loss was (10.7±11.6) ml and postoperative hospital stay was (4.4±2.6) d. These results were significantly better than those in the radical group with operative time (298.7±101.3) min, intraoperative blood loss (161.9±96.7) ml and postoperative hospital stay (9.9±4.0) d (all P<0.05). There were no significant difference in the postoperative complications and disease free survival rates between the two groups (both P>0.05). Conclusion:LC was safe and effective for treatment of T2a and lower stages of gallbladder cancer, and it could achieve a similar disease-free survival rate as LRC.

Objective:To analyze the causes of postoperative stricture of biliary-enteric anastomotic for congenital choledochal cysts.Methods:These 28 patients underwent salvage operation on an average 15 years (0.2-25 years) after initial surgeries at the Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital from Jan 2014 to Jun 2018.Results:In 26 patients the biliary-enteric anastomotic stenosis was benign, and in 2 the stricture was caused by cancerration. In 26 cases the Roux-en-Y hepaticojejunostomy was redone,among them 8 cases underwent concurrent hepatectomy for a better exposure of the intrahepatic bile duct. In 2 cases the anastomotic stenosis was found to be caused by canceration with extensive intraabdominal metastasis ,an external drainage was adopted. There were no inhospital deaths, and no serious complications. The postoperative follow-up time was 6-67 months. Two cancerated patients died within half a year, and the remaining patients had no long-term complications.Conclusions:Biliary-enteric anastomotic stenosis is one of the serious complications in postoperative patients for congenital choledochal cysts. Hence a wide, tension free biliary-enteric anastomosis performed by a experienced hand is necessary.

Taking the occurrence and development of general consent as the research object, this paper compared the differences between the ethical characteristics of broad consent and informed consent of specific research through the analysis of the content revision process of broad consent in the U.S. Broad Rules, and tried to explore the feasibility of implementing broad consent in Chinese medical institutions.

Objective: To investigate the self-reported prevalence, clinical characteristics, complications of allergic rhinitis (AR) and the sensitization of outdoor air pollen allergens in children in the Inner mongolia grassland region. Methods: A multistage, stratified and random clustered sampling with a face-to-face interview survey study in children from 0 to 17 years old was performed together with 10 common allergen skin prick tests (SPT) and measurements of the daily pollen count in 6 regions in the Inner mongolia grassland region from May to August of 2015. SAS 9.4 software was used for data analysis. Results: A total of 2 443 subjects completed the study. The self-reported prevalence of AR was 26.6%. The prevalence of boys was higher than that of girls (28.8% vs 24.3%, χ²=6.157, P<0.05). Subjects from urban areas showed higher prevalence than rural areas (34.7% vs 18.8%, χ²=79.107, P<0.05). There was significant regional difference in the prevalence of AR among the six areas investigated (χ²=221.416, P<0.05). The main clinical symptoms of AR were sneezing (88.2%) and nasal congestion (78.6%). Among combined diseases, asthma accounted for 16.5% (107/650), rhinoconjunctivitis accounted for 47.9% (311/650). The peak season of AR was April and July, with the top SPT positive allergens of Artemisia species and chenopodium in this area. Conclusions The prevalence AR in children in the Inner mongolia grassland region is extremely high. Sneezing is the main clinical symptom. Rhinoconjunctivitis is the most common combined disease. High summer and autumn pollen exposure is the main cause of AR.

Efficient measurement of administrative departments at public hospitals is key to performance appraisal for such units. The authors analyzed the current situation and problems of performance management of such departments of public hospitals, and made case studies for the formulating and implementing process of the performance appraisal system.Furthermore, they probed into appraisal methods for these departments and presented a performance appraisal model of " expectation-response" . Combined with the practice of the case hospitals, the authors recommended an annual personalized evaluation indicator system. Based on analysis of the operation process of the case hospitals from 2016 to 2018, namely theory study-practical exploration-experience summary-program readjustment for further practice. These efforts studied the implementation framework of performance management for these departments, summarized the by-stage practice experiences of the appraisal from the " basic version" to " specialized version" . Thus the paper provided references for their performance management of these hospitals.

Objective: To evaluate the implementation effectiveness of performance management for administrative departments. Methods: By means of questionnaires, the authors made a comparative analysis of the performance perception of service recipients of these departments before and after the implementation of the scheme, and the change of external performance appraisal results of the case hospital was analyzed through third-party evaluation. Then face to face interviews were used to conduct performance communication with the management staff. Results: Questionnaire results showed that the satisfaction of those served by these administrative departments for their work improvement and work results was generally elevated, scoring 4.31 for their satisfaction elevation(higher than 3.0 of the neutral attitude). A third party external performance appraisal indicated a capability enhancement as shown by the hospital in the appraisal indicators by the hospital′s authorities, scoring 91.52 in 2018 as compared to 82.34 in 2016. In-depth interviews exhibited that the ranking of the total scoring of performance appraisal of these departments was more in line with the staff′s psychological feelings. These departments also agreed with the appraisal system, the algorithm of performance scoring and the appraisal results. Conclusions The performance management of these departments of the hospital had achieved the goal of effective implementation and elementarily improved the efficiency of the hospital′s internal management.