Objective:To establish and validate a lipid parameter-based prognostic model for predicting recurrence free survival (RFS) in pancreatic cancer patients receiving postoperative adjuvant chemotherapy.Methods:A retrospective analysis was conducted on the clinical and pathological data of 155 patients who underwent pancreatic cancer resection followed by adjuvant chemotherapy at Affiliated Hospital of Qingdao University between January 2019 and December 2022. The patients were randomly divided into a training set ( n=108) and a validation set ( n=47) in a 7∶3 ratio. X-tile software was used to determine cutoff values for lipid parameters. Univariate and multivariate Cox regression analyses were performed to construct a model predicting RFS, which was then visualized using a nomogram. The model's predictive performance, accuracy and stability, and clinical application value were evaluated using the area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis (DCA), respectively. Individual risk scores for recurrence were calculated based on the nomogram model, and X-tile software was employed to identify optimal cutoff values for risk stratification, which was used to divide patients into low-risk and high-risk groups. Survival differences between two groups were analyzed using survival curves. Results:Among lipid parameters, patients with higher apolipoprotein A1 level had obviously longer RFS than those with low apolipoprotein A1 level (10.17 months vs 8.92 months, HR=0.397, 95% CI 0.237~0.664); patients with high total cholesterol level had obviously shorter RFS than those with low total cholesterol level (8.33 months vs 16.27months, HR=3.382, 95% CI 1.901~5.824) ; patients with high low-density lipoprotein level had obviously shorter RFS than those with low low-density lipoprotein level (8.53 months vs 11.43 months, HR=1.617, 95% CI 1.013~2.582) ; patients with high lipoprotein(a) had shorter RFS than those with low lipoprotein(a) (8.53 months vs 14.43 months, HR=2.640, 95% CI 1.514-4.604) ; and all the differences were statistical significant (all P value <0.05). Univariate Cox regression analysis identified advanced T stage, advanced N stage, high total cholesterol level, high low-density lipoprotein level, low apolipoprotein A1 level, high apolipoprotein B level, and high lipoprotein(a) level as risk factors for RFS. Multivariate Cox regression analysis revealed that tumors located in the pancreatic body or tail ( HR=0.63, 95% CI 0.36-0.86, P=0.042), advanced T stage ( HR=4.85, 95% CI 1.47-16.04, P=0.010), advanced N stage ( HR=0.48, 95% CI 0.26-0.87, P=0.015), elevated total cholesterol levels ( HR=3.61, 95% CI 1.46-8.91, P=0.005), high density lipoprotein levels ( HR=0.48, 95% CI 0.26-0.87, P=0.015), and elevated lipoprotein(a) levels ( HR=3.17, 95% CI 1.61-6.24, P<0.001) were independent risk factors for RFS. The nomogram model incorporating these six factors above demonstrated an AUC of 0.78 (95% CI 0.70-0.87) in the training set and 0.75 (95% CI 0.59-0.91) in the validation set. Calibration curves indicated a high degree of agreement between predicted and observed outcomes. DCA suggested that the model provides substantial clinical benefit. Kaplan-Meier survival curve analysis showed that patients in the high-recurrence risk group from training set and validation set both had significantly shorter RFS compared to those in the low-recurrence risk group (6.93 months vs 12.13 months, HR=4.024, 95% CI 2.594-6.243; 6.85 months vs 11.93 months, HR=2.314, 95% CI 1.227-4.362); and all the differences were statistical significant (all P value <0.05). Conclusions:The nomogram model based on lipid parameters can effectively predict recurrence free survival in patients undergoing adjuvant chemotherapy after pancreatic cancer surgery.

Objective:To establish and validate a lipid parameter-based prognostic model for predicting recurrence free survival (RFS) in pancreatic cancer patients receiving postoperative adjuvant chemotherapy.Methods:A retrospective analysis was conducted on the clinical and pathological data of 155 patients who underwent pancreatic cancer resection followed by adjuvant chemotherapy at Affiliated Hospital of Qingdao University between January 2019 and December 2022. The patients were randomly divided into a training set ( n=108) and a validation set ( n=47) in a 7∶3 ratio. X-tile software was used to determine cutoff values for lipid parameters. Univariate and multivariate Cox regression analyses were performed to construct a model predicting RFS, which was then visualized using a nomogram. The model's predictive performance, accuracy and stability, and clinical application value were evaluated using the area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis (DCA), respectively. Individual risk scores for recurrence were calculated based on the nomogram model, and X-tile software was employed to identify optimal cutoff values for risk stratification, which was used to divide patients into low-risk and high-risk groups. Survival differences between two groups were analyzed using survival curves. Results:Among lipid parameters, patients with higher apolipoprotein A1 level had obviously longer RFS than those with low apolipoprotein A1 level (10.17 months vs 8.92 months, HR=0.397, 95% CI 0.237~0.664); patients with high total cholesterol level had obviously shorter RFS than those with low total cholesterol level (8.33 months vs 16.27months, HR=3.382, 95% CI 1.901~5.824) ; patients with high low-density lipoprotein level had obviously shorter RFS than those with low low-density lipoprotein level (8.53 months vs 11.43 months, HR=1.617, 95% CI 1.013~2.582) ; patients with high lipoprotein(a) had shorter RFS than those with low lipoprotein(a) (8.53 months vs 14.43 months, HR=2.640, 95% CI 1.514-4.604) ; and all the differences were statistical significant (all P value <0.05). Univariate Cox regression analysis identified advanced T stage, advanced N stage, high total cholesterol level, high low-density lipoprotein level, low apolipoprotein A1 level, high apolipoprotein B level, and high lipoprotein(a) level as risk factors for RFS. Multivariate Cox regression analysis revealed that tumors located in the pancreatic body or tail ( HR=0.63, 95% CI 0.36-0.86, P=0.042), advanced T stage ( HR=4.85, 95% CI 1.47-16.04, P=0.010), advanced N stage ( HR=0.48, 95% CI 0.26-0.87, P=0.015), elevated total cholesterol levels ( HR=3.61, 95% CI 1.46-8.91, P=0.005), high density lipoprotein levels ( HR=0.48, 95% CI 0.26-0.87, P=0.015), and elevated lipoprotein(a) levels ( HR=3.17, 95% CI 1.61-6.24, P<0.001) were independent risk factors for RFS. The nomogram model incorporating these six factors above demonstrated an AUC of 0.78 (95% CI 0.70-0.87) in the training set and 0.75 (95% CI 0.59-0.91) in the validation set. Calibration curves indicated a high degree of agreement between predicted and observed outcomes. DCA suggested that the model provides substantial clinical benefit. Kaplan-Meier survival curve analysis showed that patients in the high-recurrence risk group from training set and validation set both had significantly shorter RFS compared to those in the low-recurrence risk group (6.93 months vs 12.13 months, HR=4.024, 95% CI 2.594-6.243; 6.85 months vs 11.93 months, HR=2.314, 95% CI 1.227-4.362); and all the differences were statistical significant (all P value <0.05). Conclusions:The nomogram model based on lipid parameters can effectively predict recurrence free survival in patients undergoing adjuvant chemotherapy after pancreatic cancer surgery.

Objective It analyzes the equity of pharmacists'allocation in China's healthcare organizations from 2012 to 2021,in order to provide reference for improving the service accessibility of pharmacists.Methods Based on the degree of agglomeration,analyzing the current situation and changing trend of pharmacists'allocation in healthcare organizations among different areas and provinces.Results The current allocation of pharmacists in China's healthcare organizations has not met the requirements.The situation in the eastern economically developed areas is better than that in other areas of the country either by geography or by population.While the western areas are large and sparsely populated,so the accessibility of pharmacist service is poor based on geographical allocation,but the equity is good based on population allocation.In the central area,the accessibility of pharmacist service is better when the allocation is based on geographical,but the equity is worse when the allocation is based on population.Conclusion China should further enrich the team of pharmacists in healthcare organizations to promote the coordinated development of different provinces.Furthermore,it also helps to promote the equity of pharmacists'allocation in China's healthcare organizations.

Objective It analyzes the equity of pharmacists'allocation in China's healthcare organizations from 2012 to 2021,in order to provide reference for improving the service accessibility of pharmacists.Methods Based on the degree of agglomeration,analyzing the current situation and changing trend of pharmacists'allocation in healthcare organizations among different areas and provinces.Results The current allocation of pharmacists in China's healthcare organizations has not met the requirements.The situation in the eastern economically developed areas is better than that in other areas of the country either by geography or by population.While the western areas are large and sparsely populated,so the accessibility of pharmacist service is poor based on geographical allocation,but the equity is good based on population allocation.In the central area,the accessibility of pharmacist service is better when the allocation is based on geographical,but the equity is worse when the allocation is based on population.Conclusion China should further enrich the team of pharmacists in healthcare organizations to promote the coordinated development of different provinces.Furthermore,it also helps to promote the equity of pharmacists'allocation in China's healthcare organizations.

Objective It analyzes the equity of pharmacists'allocation in China's healthcare organizations from 2012 to 2021,in order to provide reference for improving the service accessibility of pharmacists.Methods Based on the degree of agglomeration,analyzing the current situation and changing trend of pharmacists'allocation in healthcare organizations among different areas and provinces.Results The current allocation of pharmacists in China's healthcare organizations has not met the requirements.The situation in the eastern economically developed areas is better than that in other areas of the country either by geography or by population.While the western areas are large and sparsely populated,so the accessibility of pharmacist service is poor based on geographical allocation,but the equity is good based on population allocation.In the central area,the accessibility of pharmacist service is better when the allocation is based on geographical,but the equity is worse when the allocation is based on population.Conclusion China should further enrich the team of pharmacists in healthcare organizations to promote the coordinated development of different provinces.Furthermore,it also helps to promote the equity of pharmacists'allocation in China's healthcare organizations.

Objective It analyzes the equity of pharmacists'allocation in China's healthcare organizations from 2012 to 2021,in order to provide reference for improving the service accessibility of pharmacists.Methods Based on the degree of agglomeration,analyzing the current situation and changing trend of pharmacists'allocation in healthcare organizations among different areas and provinces.Results The current allocation of pharmacists in China's healthcare organizations has not met the requirements.The situation in the eastern economically developed areas is better than that in other areas of the country either by geography or by population.While the western areas are large and sparsely populated,so the accessibility of pharmacist service is poor based on geographical allocation,but the equity is good based on population allocation.In the central area,the accessibility of pharmacist service is better when the allocation is based on geographical,but the equity is worse when the allocation is based on population.Conclusion China should further enrich the team of pharmacists in healthcare organizations to promote the coordinated development of different provinces.Furthermore,it also helps to promote the equity of pharmacists'allocation in China's healthcare organizations.

Objective It analyzes the equity of pharmacists'allocation in China's healthcare organizations from 2012 to 2021,in order to provide reference for improving the service accessibility of pharmacists.Methods Based on the degree of agglomeration,analyzing the current situation and changing trend of pharmacists'allocation in healthcare organizations among different areas and provinces.Results The current allocation of pharmacists in China's healthcare organizations has not met the requirements.The situation in the eastern economically developed areas is better than that in other areas of the country either by geography or by population.While the western areas are large and sparsely populated,so the accessibility of pharmacist service is poor based on geographical allocation,but the equity is good based on population allocation.In the central area,the accessibility of pharmacist service is better when the allocation is based on geographical,but the equity is worse when the allocation is based on population.Conclusion China should further enrich the team of pharmacists in healthcare organizations to promote the coordinated development of different provinces.Furthermore,it also helps to promote the equity of pharmacists'allocation in China's healthcare organizations.

Objective It analyzes the equity of pharmacists'allocation in China's healthcare organizations from 2012 to 2021,in order to provide reference for improving the service accessibility of pharmacists.Methods Based on the degree of agglomeration,analyzing the current situation and changing trend of pharmacists'allocation in healthcare organizations among different areas and provinces.Results The current allocation of pharmacists in China's healthcare organizations has not met the requirements.The situation in the eastern economically developed areas is better than that in other areas of the country either by geography or by population.While the western areas are large and sparsely populated,so the accessibility of pharmacist service is poor based on geographical allocation,but the equity is good based on population allocation.In the central area,the accessibility of pharmacist service is better when the allocation is based on geographical,but the equity is worse when the allocation is based on population.Conclusion China should further enrich the team of pharmacists in healthcare organizations to promote the coordinated development of different provinces.Furthermore,it also helps to promote the equity of pharmacists'allocation in China's healthcare organizations.

Objective It analyzes the equity of pharmacists'allocation in China's healthcare organizations from 2012 to 2021,in order to provide reference for improving the service accessibility of pharmacists.Methods Based on the degree of agglomeration,analyzing the current situation and changing trend of pharmacists'allocation in healthcare organizations among different areas and provinces.Results The current allocation of pharmacists in China's healthcare organizations has not met the requirements.The situation in the eastern economically developed areas is better than that in other areas of the country either by geography or by population.While the western areas are large and sparsely populated,so the accessibility of pharmacist service is poor based on geographical allocation,but the equity is good based on population allocation.In the central area,the accessibility of pharmacist service is better when the allocation is based on geographical,but the equity is worse when the allocation is based on population.Conclusion China should further enrich the team of pharmacists in healthcare organizations to promote the coordinated development of different provinces.Furthermore,it also helps to promote the equity of pharmacists'allocation in China's healthcare organizations.

Objective It analyzes the equity of pharmacists'allocation in China's healthcare organizations from 2012 to 2021,in order to provide reference for improving the service accessibility of pharmacists.Methods Based on the degree of agglomeration,analyzing the current situation and changing trend of pharmacists'allocation in healthcare organizations among different areas and provinces.Results The current allocation of pharmacists in China's healthcare organizations has not met the requirements.The situation in the eastern economically developed areas is better than that in other areas of the country either by geography or by population.While the western areas are large and sparsely populated,so the accessibility of pharmacist service is poor based on geographical allocation,but the equity is good based on population allocation.In the central area,the accessibility of pharmacist service is better when the allocation is based on geographical,but the equity is worse when the allocation is based on population.Conclusion China should further enrich the team of pharmacists in healthcare organizations to promote the coordinated development of different provinces.Furthermore,it also helps to promote the equity of pharmacists'allocation in China's healthcare organizations.