Background::Hepatitis B poses a heavy burden for children in China, however, the national studies on the distributional characteristics and health care costs of children with severe hepatitis B is still lacking. This study aimed to analyze the disease characteristics, health economic effects, and medical cost for children with severe hepatitis B in China.Methods::Based on patient information in the Hospital Quality Monitoring System, cases with severe hepatitis B were divided into four groups according to age, and the etiology and symptoms of each group were quantified. The cost of hospitalization was calculated for cases with different disease processes, and severity of disease. The spatial aggregation of cases and the relationship with health economic factors were analyzed by Moran’s I analysis. Results::The total number of children discharged with hepatitis B from January 2016 to April 2022 was 1603, with an average age of 10.5 years. Liver failure cases accounted for 43.48% (697/1603) of total cases and cirrhosis cases accounted for 11.23% (180/1603). According to the grouping of disease progression, there were 1292 cases without associated complications, and the median hospitalization cost was $818.12. According to the spatial analysis, the aggregation of cases was statistically significant at the prefectural and provincial levels in 2019, 2020, and 2021 (all P <0.05). The number of severe cases was negatively correlated with gross domestic product (Moran’s I <0) and percentage of urban population (Moran’s I <0), and positively correlated with the number of pediatric beds per million population (Moran’s I >0). Conclusion::The number of severe hepatitis B cases is low in areas with high gross domestic product levels and high urban population ratios, and health care costs have been declining over the years.

Objective:To investigate the clinical performance of fecal syndecan 2(SDC2)/tissue factor pathway inhibitor 2(TFPI2)gene methylation assay in prospective colorectal cancer screening.Methods:The individuals who underwent routine physical examina-tion were enrolled as subjects,and their fecal samples were collected and tested with fecal SDC2/TFPI2 gene methylation assay.In addition,enteroscopy was recommended for the subjects with positive results.Results:A total of 1215 subjects received fecal SDC2/TFPI2 gene methylation assay,among whom there were 708 male subjects and 507 female subjects,with a mean age of(44.7±13.9)years.Among all subjects,28 had positive test results,resulting in a positive rate of 2.30%,and among these 28 subjects,27(96.43%)underwent enteroscopy,among whom 16(59.26%)had abnormal findings.With enteroscopy and/or pathological examination as diag-nostic criteria,fecal SDC2/TFPI2 gene methylation assay had a positive predictive value of 7.41%for colorectal cancer,22.22%for progressive precancerous lesion,and 7.41%for non-progressive precancerous lesion.Conclusion:Fecal SDC2/TFPI2 gene methyla-tion assay shows good clinical performance in prospective colorectal cancer screening and thus provides a noninvasive method for the screening and auxiliary diagnosis of colorectal cancer.

The chemical constituents such as polysaccharides, flavonoids and polyphenols in Sanghuangporus have anti-tumor, anti-inflammatory, anti-oxidation and immune regulation effects. Sanghuangporus and its chemical constituents have shown anti-tumor activity against lung cancer, gastric cancer, liver cancer, colorectal cancer, breast cancer, melanoma, glioma and other malignant tumor cells. The mechanism mainly includes blocking cell cycle, inducing apoptosis and autophagy, inhibiting cell metastasis, immune regulation, etc., and can cooperate with radiotherapy and chemotherapy, targeted therapy, by inducing tumor cell apoptosis, blocking cell cycle, inhibiting inflammatory response, alleviating oxidative stress, etc., in order to play a role in reducing toxicity and increasing efficiency. In the future, small molecules and monomers with anti-tumor activity in Sanghuangporus can be screened. The varieties, producing areas and cultivation methods of Sanghuang would be standardized, and the bioavailability is improved by the development of new dosage forms. Through modern molecular biology and multi-omics techniques, the specific mechanism and target of its anti-tumor effect would be comprehensively explored. Pharmacodynamic toxicology research and large-scale clinical trials would be combined to verify its safety, so as to provide more evidence for its clinical application.

Objective The digital transformation of healthcare has made data-driven approaches critical for improving the quality and efficiency of medical services.This study aims to improve the quality of critical value management by a data-driv-en intervention.Methods This study built an advanced digital platform to precisely record the time-stamp of each step,from de-tection to solution.This platform also delivered real-time notifications of patient critical value information to doctors' mobile de-vices,thereby optimizing the critical value management.Data were collected via this platform.A cohort study was designed:March 2024 data(pre-go-live)served as the control group and May 2024 data(post-go-live)as the intervention group.Comple-tion rate,processing time,and the proportion of in-patient critical values which were entered into the electronic progress were compared.Results The critical-value completion rate rose from 97.1％to 100.0％,and the proportion of values processed within 30 min increased from 80.91％to 83.42％.Among alerts that required ≥30 min,median(IQR)processing time fell from 100.27(230.09)min in March 2024 to 91.07(169.73)min in May 2024.Median processing time shortened for both e-mergency and out-patient alerts,with the out-patient reduction being statistically significant(median-45 min,P=0.042).Conclusion The data-driven platform not only improved the critical-value management,but also enhanced the transparency and traceability,providing clinical decision support and enhancing patient safety.

Objective The digital transformation of healthcare has made data-driven approaches critical for improving the quality and efficiency of medical services.This study aims to improve the quality of critical value management by a data-driv-en intervention.Methods This study built an advanced digital platform to precisely record the time-stamp of each step,from de-tection to solution.This platform also delivered real-time notifications of patient critical value information to doctors' mobile de-vices,thereby optimizing the critical value management.Data were collected via this platform.A cohort study was designed:March 2024 data(pre-go-live)served as the control group and May 2024 data(post-go-live)as the intervention group.Comple-tion rate,processing time,and the proportion of in-patient critical values which were entered into the electronic progress were compared.Results The critical-value completion rate rose from 97.1％to 100.0％,and the proportion of values processed within 30 min increased from 80.91％to 83.42％.Among alerts that required ≥30 min,median(IQR)processing time fell from 100.27(230.09)min in March 2024 to 91.07(169.73)min in May 2024.Median processing time shortened for both e-mergency and out-patient alerts,with the out-patient reduction being statistically significant(median-45 min,P=0.042).Conclusion The data-driven platform not only improved the critical-value management,but also enhanced the transparency and traceability,providing clinical decision support and enhancing patient safety.

Background::Hepatitis B poses a heavy burden for children in China, however, the national studies on the distributional characteristics and health care costs of children with severe hepatitis B is still lacking. This study aimed to analyze the disease characteristics, health economic effects, and medical cost for children with severe hepatitis B in China.Methods::Based on patient information in the Hospital Quality Monitoring System, cases with severe hepatitis B were divided into four groups according to age, and the etiology and symptoms of each group were quantified. The cost of hospitalization was calculated for cases with different disease processes, and severity of disease. The spatial aggregation of cases and the relationship with health economic factors were analyzed by Moran’s I analysis. Results::The total number of children discharged with hepatitis B from January 2016 to April 2022 was 1603, with an average age of 10.5 years. Liver failure cases accounted for 43.48% (697/1603) of total cases and cirrhosis cases accounted for 11.23% (180/1603). According to the grouping of disease progression, there were 1292 cases without associated complications, and the median hospitalization cost was $818.12. According to the spatial analysis, the aggregation of cases was statistically significant at the prefectural and provincial levels in 2019, 2020, and 2021 (all P <0.05). The number of severe cases was negatively correlated with gross domestic product (Moran’s I <0) and percentage of urban population (Moran’s I <0), and positively correlated with the number of pediatric beds per million population (Moran’s I >0). Conclusion::The number of severe hepatitis B cases is low in areas with high gross domestic product levels and high urban population ratios, and health care costs have been declining over the years.

OBJECTIVE:Percutaneous sacroiliac screw internal fixation has become the main surgical procedure for the treatment of posterior pelvic ring fractures;however,the unassisted closure operation requires high operator experience and repeated fluoroscopy increases the radiation hazard for patients and medical personnel.This article compares the clinical efficacy of robot-assisted versus unassisted percutaneous sacroiliac screw placement for posterior pelvic ring fractures by meta-analysis. METHODS:Computer searches of CNKI,WanFang,VIP,CBM,PubMed,Embase,Cochrane Library and ClinicalTrials.gov were conducted from the time of database inception to December 2022.The literature on the clinical efficacy of robot-assisted versus freehand percutaneous sacroiliac screw placement in the treatment of posterior pelvic ring fractures was collected in and outside China.The data were independently screened and extracted by two investigators according to the inclusion and exclusion criteria,respectively.The quality of randomized controlled trials was evaluated using Cochrane risk assessment criteria.The quality of included cohort studies was assessed using the Newcastle-Ottawa Scale.Meta-analysis was performed using RevMan 5.4 software for inclusion metrics.Outcome metrics included operative time,intraoperative bleeding,fluoroscopy time,fluoroscopy frequency,number of holes drilled,Majeed postoperative function score,the excellent and good rates of Matta fracture reduction,the excellent and good rates of Gras screw position,fracture healing time and complications. RESULTS:(1)A total of 13 publications were included,2 were randomized controlled trials both referring to randomized methods,11 non-randomized controlled studies were evaluated for quality of literature according to the Newcastle-Ottawa Scale,1 scored 8,9 scored 7;and 1 scored 6;the quality of literature was good.A total of 748 patients were included,including 430 in the robot-assisted group and 318 in the freehand group.(2)The results of the meta-analysis showed that the operative time(MD=-28.30,95%CI:-40.20 to-16.40),intraoperative bleeding(MD=-6.36,95%CI:-10.06 to-2.66),intraoperative fluoroscopy time(MD=-12.13,95%CI:-19.54 to-4.72),intraoperative fluoroscopy frequency(MD=-17.39,95%CI:-29.00 to-5.78),number of intraoperative needle drillings(SMD=-9.50,95%CI:-14.27 to-4.73)and the excellent and good rates of Gras screw position(OR=8.65,95%Cl:3.26-22.92)in the robot-assisted group were significantly better than those in the freehand group(P<0.05).(3)In the robot-assisted group,the overall postoperative complication rate was significantly reduced(OR=0.10,95%Cl:0.02-0.48,P<0.05).(4)No significant difference was detected in fracture healing time(MD=-0.08,95%CI:-0.21,0.06),the excellent and good rates of Matta fracture repositioning rate(OR=2.06,95%Cl:0.97-4.39),and Majeed functional score(MD=0.91,95%CI:-0.31-2.13)between both groups(P>0.05). CONCLUSION:Compared with freehand sacroiliac joint nailing,robotic assistance shortens the operative time,reduces intraoperative bleeding,decreases radiation damage to patients and medical staff,improves the excellent and good rate of screw position,and reduces the overall incidence of postoperative complications in patients,but there was no significant improvement in fracture reduction quality,fracture healing time,and postoperative function.In the future,more large-sample,multicenter,and high-quality randomized controlled trials are still needed to verify.

Objective To observe the value of 3D Res2Net deep learning model for predicting volume doubling time(VDT)of solid pulmonary nodule.Methods Chest CT data of 734 patients with solid pulmonary nodules were retrospectively analyzed.The patients were divided into progressive group(n=218)and non-progressive group(n=516)according to whether lung nodule volume increased by ≥25％during follow-up or not,also assigned into training set(n=515)and validation set(n=219)at a ratio of 7∶3.Then a clinical model was constructed based on clinical factors being significantly different between groups,CT features model was constructed based on features of nodules on 2D CT images using convolutional neural network,and 3D Res2Net model was constructed based on Res2Net network using 3D CT images as input.Receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated.Taken actual VDT as gold standard,the efficacy of the above models for predicting solid pulmonary nodule'VDT≤400 days were evaluated.Results No significant difference of predicting efficacy for solid pulmonary nodule'VDT≤400 days was found among clinical model,CT feature model and 3D Res2Net model,the AUC of which was 0.689,0.698 and 0.734 in training set,0.692,0.714 and 0.721 in validation set,respectively.3D Res2Net model needed 5-7 s to predict VDT of solid pulmonary nodules,with an average time of(5.92±1.08)s.Conclusion 3D Res2Net model could be used to predict VDT of solid pulmonary nodules,which might obviously reduce manual interpreting time.

Objective:To analyze the research hotspots and development directions of medical device information management,and to provide reference for the research of medical device information management.Methods:A total of 5434 articles related to information management in the field of medical devices were retrieved from the China National Knowledge Infrastructure(CNKI)database from January 1,2000 to December 31,2023.After screening,1618 valid articles were finally included in the study.Bibliometric methods were used to analyze the publication volume,keywords,journals,and author affiliations,and CiteSpace software was used to visualize the results.Results:The number of literature in the field of medical device information management showed a linear increase from 2000 to 2023,with an average of 70.34 publications per year.The keywords of"medical equipment,""medical consumables,""medical devices,""information systems,"and"management"have the highest centrality.The most representative keywords in cluster analysis are"medical equipment","medical consumables","quality control","management",and"Internet of Things".Conclusion:The research on medical device information management has gone through the initial stage,development stage,integration and integration stage,and the keyword"Internet of Things"has quickly become a research hotspot since its first appearance,and medical device information management has become the main development direction.The medical device management system has effectively improved the service quality and management level of medical institutions with the integration application of various information technologies and management tools and met the growing demand for statistical analysis.

Objective:To compare the predictive values of the Global Registry of Acute Coronary Events (GRACE) risk scores, the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) trial scores, and the Thrombolysis In Myocardial Infarction (TIMI) scores for major adverse cardiac events (MACEs) in patients with acute ST segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention.Methods:A retrospective analysis was conducted on 80 STEMI patients diagnosed at the Affiliated People's Hospital of Ningbo University from January 2018 to January 2022, all of whom received percutaneous coronary intervention. The patients were followed up for 1-15 months with a median time of 7.5 months. MACEs, mainly including target vessel reconstruction, recurrent myocardial infarction, new heart failure, malignant arrhythmia, and cardiac death, were recorded.Results:Of the 80 patients, MACEs occurred in 18 cases (22.5%, 18/80) after percutaneous coronary intervention. Univariate analysis found that patients in the MACEs group had an increase in age, multiple vessel lesions, stent implantation length, peak and duration of troponin I, and total ischemia time > 6 hours, which were significantly different from those in the non-MACEs group ( P < 0.05). The MACEs group showed a significant increase in GRACE score [(136.5 ± 30.4) scores], modified CADILLAC score [(11.2 ± 3.4) score], and TIMI score [(5.7 ± 1.5) scores] at 7 days after surgery. The percentage of patients with GRACE score high-risk [12/18 (66.67%)], CADILLAC score high-risk [13/18 (72.22%)], and TIMI score high-risk [11/18 (61.11%)] increased significantly ( χ2 = 23.22, 21.35, 24.42, all P < 0.05). Increasing age, total ischemia time > 6 hours, GRACE score high-risk, CADILLAC score high-risk and TIMI score high-risk were all independent risk factors for MACEs at 1-year follow-up in STEMI patients ( HR values were 1.079, 2.037, 3.562, 3.421, and 3.236, respectively). The receiver operating characteristic curve showed that the area under the curve of GRACE score high-risk, CADILLAC score high-risk, and TIMI score high-risk for predicting MACEs were 0.816, 0.823 and 0.803 respectively, with no statistically significant differences ( P > 0.05). Conclusion:The use of GRACE score, modified CADILLAC score, and TIMI score after percutaneous coronary intervention in STEMI patients has predictive value for major cardiac adverse events after percutaneous coronary intervention, and all three scores have good accuracy in predicting the risk of MACEs at 1-year follow-up.