Objective:To investigate the views of doctors on the incidence and treatment tactics of mild progression after epithelial growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)treatment in lung adenocarcinoma and provide suggestions to optimize the counter-measure strategies.Methods:Convenience sampling was used to conduct an online questionnaire survey for doctors specializing in onco-logy and respiratory diseases.Results:584 valid questionnaires were collected,and all the doctors expressed concerns regarding mild tumor progression after EGFR-TKI treatment.The coping strategies included maintaining the original TKI treatment,adding other treatments to the original TKI,changing the regimen,and performing secondary tissue biopsy,among which,most doctors chose to add other treatments to the original TKI.Conclusions:Doctors have noticed the enlargement of target lesions in still stable disease(SD)and most frequently chose to add other treatments to the original TKI as a coping strategy.This finding can provide a reference for framing future guidelines for large sample prospective clinical studies that are needed to find the most effective synergistic treatment options.

Objective To discuss the safety and efficacy of hepatic arterial infusion chemotherapy(HAIC)combined with apatinib and carizolizumab in the treatment of hepatocellular carcinoma(HCC)with major portal vein tumor thrombosis(Vp4).Methods The clinical data of patients with HCC complicated by Vp4 from three certain Grade Ⅲ medical centers,who received HAIC combined with apatinib and carizolizumab(triple treatment group)or received HAIC alone(simple HAIC group)from July 2018 to December 2023,were retrospectively collected.Propensity score matching(PSM)was used to balance the general differences between groups,and the pre-PSM and post-PSM overall survival time(OS),progression-free survival time(PFS),and tumor response rate were compared between the two groups.Based on COX proportional hazards regression model the survival-related risk factors were identified.The clinical safety was evaluated by comparing the incidence of adverse reactions between different therapeutic regimens.Results In the overall cohort,the median OS and median PFS in the triple treatment group were 16.4 months and 9.1 months respectively,which in the simple HAIC group were 6.9 months and 4.2 months respectively(both P＜0.001).In the triple treatment group and the simple HAIC group,the objective response rate(ORR)was 41.2％and 15.2％respectively(P＜0.001),and the disease control rate(DCR)was 77.9％and 68.5％respectively(P=0.185).In the PSM cohort,the median OS and median PFS in the triple treatment group were 16.4 months and 9.1 months respectively,which were significantly longer than 7.4 months and 3.7 months respectively in the simple HAIC group.In the triple treatment group and the simple HAIC group,the ORR was 39.5％and 11.6％respectively(P=0.003),and the DCR was 81.4％and 62.8％respectively(P=0.054).Univariate and multivariate analyses showed that HAIC combined with apatinib and carizolizumab treatment was an independent factor influencing both OS and PFS.No statistically significant difference in the incidence of adverse reactions of all levels existed between the two groups,although the incidence of some adverse reactions in triple therapy group was higher than that in the simple HAIC group.Conclusion Compared with pure HAIC therapy,HAIC combined with apatinib and carizolizumab has better survival benefits and tumor response rate,it is clinically safe and effective,besides,the patients can well tolerate this treatment.Therefore,HAIC combined with apatinib and carizolizumab is a promising treatment option for patients with HCC complicated by Vp4.

Objective:To investigate the status quo of the salary status of Guangxi's village doctors under the background of the implementation of"Employed by Townships and Work in the Villages"Policy.Methods:A total of 142 village doctors'salary data were obtained and sorted out through field investigation.Village doctors'salary level was analyzed with Chi-square test,rank test and correlation analysis.Results:More than 70%of village doctors'annual salary in the surveyed counties exceeded 50 000 yuan.Performance allowance is the main component of village doctors'annual salary.There are differences between the implementation number of"Employed by Townships and Work in the Villages"Policy and village doctors'annual salary level in different urban areas(P＜0.05).The village doctors'service population was positively correlated with the allowance of basic public health service,the general medical service population and the annual salary level(P＜0.05).Conclusion:Under the"Employed by Townships and Work in the Villages"Policy,the salary level of Guangxi's village doctors has been improved,and the salary component could be further optimized.It is suggest that the"Employed by Townships and Work in the Villages"Policy should be promoted in accordance with the economic development conditions of different urban areas,the income standards that match village doctors'academic,professional ranks,professional qualifications and working years,and the performance evaluation standards linked to village doctors'subsidy standards should be improved.

Objective:To investigate the status quo of the salary status of Guangxi's village doctors under the background of the implementation of"Employed by Townships and Work in the Villages"Policy.Methods:A total of 142 village doctors'salary data were obtained and sorted out through field investigation.Village doctors'salary level was analyzed with Chi-square test,rank test and correlation analysis.Results:More than 70%of village doctors'annual salary in the surveyed counties exceeded 50 000 yuan.Performance allowance is the main component of village doctors'annual salary.There are differences between the implementation number of"Employed by Townships and Work in the Villages"Policy and village doctors'annual salary level in different urban areas(P＜0.05).The village doctors'service population was positively correlated with the allowance of basic public health service,the general medical service population and the annual salary level(P＜0.05).Conclusion:Under the"Employed by Townships and Work in the Villages"Policy,the salary level of Guangxi's village doctors has been improved,and the salary component could be further optimized.It is suggest that the"Employed by Townships and Work in the Villages"Policy should be promoted in accordance with the economic development conditions of different urban areas,the income standards that match village doctors'academic,professional ranks,professional qualifications and working years,and the performance evaluation standards linked to village doctors'subsidy standards should be improved.

Objective:To investigate the views of doctors on the incidence and treatment tactics of mild progression after epithelial growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)treatment in lung adenocarcinoma and provide suggestions to optimize the counter-measure strategies.Methods:Convenience sampling was used to conduct an online questionnaire survey for doctors specializing in onco-logy and respiratory diseases.Results:584 valid questionnaires were collected,and all the doctors expressed concerns regarding mild tumor progression after EGFR-TKI treatment.The coping strategies included maintaining the original TKI treatment,adding other treatments to the original TKI,changing the regimen,and performing secondary tissue biopsy,among which,most doctors chose to add other treatments to the original TKI.Conclusions:Doctors have noticed the enlargement of target lesions in still stable disease(SD)and most frequently chose to add other treatments to the original TKI as a coping strategy.This finding can provide a reference for framing future guidelines for large sample prospective clinical studies that are needed to find the most effective synergistic treatment options.

Objective:To explore the leading role and influence path of the coordinated development of the tight medical community service capacity and the high level of county economy,so as to provide a basis for its deepening reform and long-term development.Methods:Taking 39 pilot compact medical communities in Guangxi in 2022 as research samples,from the perspective of set and whole,the coupling coordination degree model and fuzzy set qualitative comparative analysis were used to analyze the coordinated development status and influence mechanism of their service capacity and county economic level.Results:High-level county economic structure is a necessary condition to promote coupling and coordinated development.Among the six configuration paths that affect the improvement of coupling and coordination degree,the core conditions are stable county economic foundation and sufficient health human resources or(and)health financial resources.The overall solution consistency is 0.996(≥0.8),and the coverage is 0.780(≥0.5).The model has strong explanatory power.Conclusion:Multi-factor internal and external cooperation to promote the coordinated development of the service capacity of the compact medical community and the county economy should focus on the county economic foundation and structure,further improve the income of the compact medical community and pay attention to the optimization and expansion of the talent team.

Objective:To explore the core issues in the implementation of"packaged payment"in China's compact county medi-cal community,in order to provide useful references for the innovative reform of medical insurance payment methods in compact coun-ty medical community.Methods:By constructing the problem system through the macro model of the health system,analyzing the re-lated literature using multidimensional scale analysis and social network analysis,and comprehensively evaluating the results using the entropy-weighted TOPSIS method,it summarizes the core issues of"packaged payment"in compact county medical community.Results:There are core issues in China's compact county medical community,such as inadequate distribution of benefits and incen-tive and constraint mechanisms within the medical community(Ci= 1.000),lack of effective supervision and assessment mechanism for medical communities(Ci= 0.732),suppressed quality and efficiency of medical services(Ci= 0.652),lagging medical informatiza-tion construction(Ci= 0.595),and incomplete supporting policy measures(Ci= 0.579).Conclusion:The"packaged payment"of com-pact county medical community can be optimized from the following three aspects:a multi-level collaborative incentive mechanism should be improved to ensure the service quality and efficiency;optimize the total amount calculation method and improve the de-tailed supporting measures;accelerate information construction and strengthen supervision and assessment management.

Objective:To explore the leading role and influence path of the coordinated development of the tight medical community service capacity and the high level of county economy,so as to provide a basis for its deepening reform and long-term development.Methods:Taking 39 pilot compact medical communities in Guangxi in 2022 as research samples,from the perspective of set and whole,the coupling coordination degree model and fuzzy set qualitative comparative analysis were used to analyze the coordinated development status and influence mechanism of their service capacity and county economic level.Results:High-level county economic structure is a necessary condition to promote coupling and coordinated development.Among the six configuration paths that affect the improvement of coupling and coordination degree,the core conditions are stable county economic foundation and sufficient health human resources or(and)health financial resources.The overall solution consistency is 0.996(≥0.8),and the coverage is 0.780(≥0.5).The model has strong explanatory power.Conclusion:Multi-factor internal and external cooperation to promote the coordinated development of the service capacity of the compact medical community and the county economy should focus on the county economic foundation and structure,further improve the income of the compact medical community and pay attention to the optimization and expansion of the talent team.

Objective:To explore the leading role and influence path of the coordinated development of the tight medical community service capacity and the high level of county economy,so as to provide a basis for its deepening reform and long-term development.Methods:Taking 39 pilot compact medical communities in Guangxi in 2022 as research samples,from the perspective of set and whole,the coupling coordination degree model and fuzzy set qualitative comparative analysis were used to analyze the coordinated development status and influence mechanism of their service capacity and county economic level.Results:High-level county economic structure is a necessary condition to promote coupling and coordinated development.Among the six configuration paths that affect the improvement of coupling and coordination degree,the core conditions are stable county economic foundation and sufficient health human resources or(and)health financial resources.The overall solution consistency is 0.996(≥0.8),and the coverage is 0.780(≥0.5).The model has strong explanatory power.Conclusion:Multi-factor internal and external cooperation to promote the coordinated development of the service capacity of the compact medical community and the county economy should focus on the county economic foundation and structure,further improve the income of the compact medical community and pay attention to the optimization and expansion of the talent team.

Objective:To explore the leading role and influence path of the coordinated development of the tight medical community service capacity and the high level of county economy,so as to provide a basis for its deepening reform and long-term development.Methods:Taking 39 pilot compact medical communities in Guangxi in 2022 as research samples,from the perspective of set and whole,the coupling coordination degree model and fuzzy set qualitative comparative analysis were used to analyze the coordinated development status and influence mechanism of their service capacity and county economic level.Results:High-level county economic structure is a necessary condition to promote coupling and coordinated development.Among the six configuration paths that affect the improvement of coupling and coordination degree,the core conditions are stable county economic foundation and sufficient health human resources or(and)health financial resources.The overall solution consistency is 0.996(≥0.8),and the coverage is 0.780(≥0.5).The model has strong explanatory power.Conclusion:Multi-factor internal and external cooperation to promote the coordinated development of the service capacity of the compact medical community and the county economy should focus on the county economic foundation and structure,further improve the income of the compact medical community and pay attention to the optimization and expansion of the talent team.