Recruitment is a critical part of human resource management.Conducting recruitment with competency models can significantly enhance match candidates to positions.This paper outlines the theoretical support for competency models.By analyzing the construction process of competency models in public hospitals and their application in recruitment,it aims to explore problems in the implementation of competency models in recruitment and provide suggestions.

Recruitment is a critical part of human resource management.Conducting recruitment with competency models can significantly enhance match candidates to positions.This paper outlines the theoretical support for competency models.By analyzing the construction process of competency models in public hospitals and their application in recruitment,it aims to explore problems in the implementation of competency models in recruitment and provide suggestions.

Objective To predict the lymphovascular invasion(LVI)status of breast cancer patients based on digital breast tomo-synthesis(DBT)intratumoral and peritumoral radiomics nomogram.Methods A total of 192 breast cancer patients from 2 institu-tions were retrospectively selected,in which institution 1 was used for train(n=113)and test(n=49),while institution 2 was used for external validation(n=30).Radiomics features were extracted and selected based on intratumoral and peritumoral 1 mm regions from DBT images.Different machine learning algorithms were used to construct intratumoral,peritumoral,and combined intratumoral and peritumoral models,respectively.Patient clinical data were analyzed by both univariate and multivariate logistic regression analy-ses to identify independent risk factors for the clinical imaging model.The performance of the models was evaluated using the receiver operating characteristic(ROC)curve.The radiomics features with the optimal diagnostic performance and the selected clinical imaging features were combined to construct a comprehensive clinical-radiomics model,and a nomogram was drawn.Results The combined intratumoral and peritumoral model was the optimal radiomics model.Maximum tumor diameter[odds ratio(OR)=1.486,P=0.014],suspicious malignant calcifications(OR=2.898,P=0.015),and axillary lymph node(ALN)metastasis(OR=3.615,P<0.001)were independent risk factors for LVI positive.Furthermore,the area under the curve(AUC)of the comprehensive clinical-radiomics model in the training set,test set and external valida-tion set was 0.889,0.916,and 0.862,respectively,which was higher than those of the combined intratumoral and peritumoral model(0.858,0.849,0.844)and the clinical imaging model(0.743,0.759,0.732).Conclusion The predictive nomogram,derived from both radiomics and clinical imaging features,is relatively accurate in identifying future LVI occurrence in breast cancer,demonstra-ting its potential as an assistive tool for clinicians to devise individualized treatment regimes.

Objective To predict the lymphovascular invasion(LVI)status of breast cancer patients based on digital breast tomo-synthesis(DBT)intratumoral and peritumoral radiomics nomogram.Methods A total of 192 breast cancer patients from 2 institu-tions were retrospectively selected,in which institution 1 was used for train(n=113)and test(n=49),while institution 2 was used for external validation(n=30).Radiomics features were extracted and selected based on intratumoral and peritumoral 1 mm regions from DBT images.Different machine learning algorithms were used to construct intratumoral,peritumoral,and combined intratumoral and peritumoral models,respectively.Patient clinical data were analyzed by both univariate and multivariate logistic regression analy-ses to identify independent risk factors for the clinical imaging model.The performance of the models was evaluated using the receiver operating characteristic(ROC)curve.The radiomics features with the optimal diagnostic performance and the selected clinical imaging features were combined to construct a comprehensive clinical-radiomics model,and a nomogram was drawn.Results The combined intratumoral and peritumoral model was the optimal radiomics model.Maximum tumor diameter[odds ratio(OR)=1.486,P=0.014],suspicious malignant calcifications(OR=2.898,P=0.015),and axillary lymph node(ALN)metastasis(OR=3.615,P<0.001)were independent risk factors for LVI positive.Furthermore,the area under the curve(AUC)of the comprehensive clinical-radiomics model in the training set,test set and external valida-tion set was 0.889,0.916,and 0.862,respectively,which was higher than those of the combined intratumoral and peritumoral model(0.858,0.849,0.844)and the clinical imaging model(0.743,0.759,0.732).Conclusion The predictive nomogram,derived from both radiomics and clinical imaging features,is relatively accurate in identifying future LVI occurrence in breast cancer,demonstra-ting its potential as an assistive tool for clinicians to devise individualized treatment regimes.

Objective:To analyze the efficacy and safety of standard chemotherapy and immune checkpoint inhibitors (CI) combined with radiotherapy (RT) in driver-gene negative (wild-type) oligometastatic non-small cell lung cancer (NSCLC) patients with central nervous system involvement.Methods:In this multicenter retrospective cohort study, oligometastatic NSCLC patients receiving first-line chemo-immunotherapy-based therapy were analyzed. Between January 2017 and January 2023, a total of 98 eligible patients were enrolled from the National Cancer Center/Cancer Hospital (Beijing/Shenzhen) and Shanxi Province Cancer Hospital. All participants were divided into chemo-immunotherapy (CI) group (28.6%, n=28) and chemo-immuno-radiotherapy (CIR) group (71.4%, n=70) according to whether receiving radiotherapy. Baseline characteristics were well-balanced between two groups, with no statistically significant differences (all P>0.05). The primary endpoint of the study was overall survival (OS), while progression-free survival (PFS) was designated as a key secondary endpoint. Qualitative data were compared by Chi-square test. Survival analysis was conducted using Kaplan-Meier method, and prognostic analysis was performed by multivariate Cox regression models. Results:The median PFS in the CIR and CI groups was 21.8 and 11.5 months, respectively, and the difference was not statistically significant ( P=0.211). The median OS in the CIR group was significantly better ( P=0.036) than 25.3 months in the CI group. The median OS in the CIR group was not reached. The 2-year local regional control rates for the whole brain radiotherapy patients, stereotactic radiotherapy / stereotactic radiosurgery patients and CI groups were 33.3% ,100% and 83.4%, respectively. Multivariate analysis showed that brain radiotherapy was an independent protective factor for OS in patients with oligometastatic brain metastases at baseline ( HR=0.47, 95% CI=0.22-0.99, P=0.047). Subgroup analysis revealed that patients with 1-3 metastatic lesions benefited from radiotherapy (PFS: HR=0.47, 95% CI=0.22-1.03, P=0.060; OS: HR=0.34, 95% CI=0.12-0.98, P=0.046). Conclusions:For central nervous system involved oligometastatic NSCLC patients, the integration of chemo-immunotherapy with radiotherapy is well tolerated and can improve the efficacy, particularly among those with a limited number of metastatic lesions.

Based on the viewpoint of "sweat pore-qi and liquid-kidney collaterals"， it is believed that children's nephrotic syndrome is caused by the core mechanism of sweat pore constraint and closure， qi and liquid imbalance， and kidney collaterals impairment， and it is proposed that the treatment principle is to nourish the sweat pore， regulate qi and fluid， and supplement the kidney and unblock the collaterals. In clinic， guided by sequential therapy and according to the different disease mechanism characteristics of the four stages， including early stage of the disease， hormone induction stage， hormone reduction stage， hormone maintenance stage， the staged dynamic identification and treatment was applied. For early stage of the disease with edema due to yang deficiency， modified Zhenwu Decoction （真武汤） was applied to warm yang and drain water； for hormone induction stage with yin deficiency resulting in effulgent fire， modified Zhibai Dihuang Pill （知柏地黄丸） plus Erzhi Pill （二至丸） was used to enrich yin and reduce fire； for hormone reduction stage with qi and yin deficiency， modified Shenqi Dihuang Decoction （参芪地黄汤） was used to boost qi and nourish yin； for hormone maintenance stage， modified Shenqi Pill （肾气丸） was used to supplement yin and yang. Meanwhile， the treatment also attaches importance to the combination of vine-based or worm medicinals to dredge collaterals， so as to providing ideas for clinical treatment.

Objective:To analyze the efficacy and safety of standard chemotherapy and immune checkpoint inhibitors (CI) combined with radiotherapy (RT) in driver-gene negative (wild-type) oligometastatic non-small cell lung cancer (NSCLC) patients with central nervous system involvement.Methods:In this multicenter retrospective cohort study, oligometastatic NSCLC patients receiving first-line chemo-immunotherapy-based therapy were analyzed. Between January 2017 and January 2023, a total of 98 eligible patients were enrolled from the National Cancer Center/Cancer Hospital (Beijing/Shenzhen) and Shanxi Province Cancer Hospital. All participants were divided into chemo-immunotherapy (CI) group (28.6%, n=28) and chemo-immuno-radiotherapy (CIR) group (71.4%, n=70) according to whether receiving radiotherapy. Baseline characteristics were well-balanced between two groups, with no statistically significant differences (all P>0.05). The primary endpoint of the study was overall survival (OS), while progression-free survival (PFS) was designated as a key secondary endpoint. Qualitative data were compared by Chi-square test. Survival analysis was conducted using Kaplan-Meier method, and prognostic analysis was performed by multivariate Cox regression models. Results:The median PFS in the CIR and CI groups was 21.8 and 11.5 months, respectively, and the difference was not statistically significant ( P=0.211). The median OS in the CIR group was significantly better ( P=0.036) than 25.3 months in the CI group. The median OS in the CIR group was not reached. The 2-year local regional control rates for the whole brain radiotherapy patients, stereotactic radiotherapy / stereotactic radiosurgery patients and CI groups were 33.3% ,100% and 83.4%, respectively. Multivariate analysis showed that brain radiotherapy was an independent protective factor for OS in patients with oligometastatic brain metastases at baseline ( HR=0.47, 95% CI=0.22-0.99, P=0.047). Subgroup analysis revealed that patients with 1-3 metastatic lesions benefited from radiotherapy (PFS: HR=0.47, 95% CI=0.22-1.03, P=0.060; OS: HR=0.34, 95% CI=0.12-0.98, P=0.046). Conclusions:For central nervous system involved oligometastatic NSCLC patients, the integration of chemo-immunotherapy with radiotherapy is well tolerated and can improve the efficacy, particularly among those with a limited number of metastatic lesions.

Objective:To analyze the consecutive pregnancy outcomes in women with different times of tubal pregnancy (TP) history.Methods:The data of 415 patients with a history of TP≥1 times admitted in Gynecology Department of Obstetrics & Gynecology Hospital of Fudan University from January 2019 to April 2023 were retrospectively analyzed. They were divided into two groups: the first TP group ( n=359) and the second TP group ( n=56). Clinical data and consecutive pregnancy outcomes were collected and the differences of TP rate between patients treated by retaining fallopian tubes and those treated by salpingectomy were analyzed. Patients with a second TP were divided into two subgroups: ipsilateral recurrence subgroup and contralateral recurrence subgroup, and difference of TP rate between the two subgroups was assessed. Risk factors for recurrent TP were assayed by binary logistic analysis. Results:Intrauterine pregnancy rate in the first TP group was higher than that in the second TP group [66.0% (237/359) vs. 48.2% (27/56), P=0.008]. Salpingectomy resulted in significantly lower rate of intrauterine pregnancy [35.7% (35/98)] compared with treatment with methotrexate or salpingotomy or extrusion of fallopian tubes in the first TP group, 77.0% (97/126), 78.2% (93/119), 90.0% (9/10), respectively; all P<0.001]. There was no difference of intrauterine pregnancy rate among patients treated by expectant management or methotrexate or salpingectomy or salpingotomy in the second TP group (all P>0.05). There were 24 cases in the ipsilateral recurrent subgroup and 32 cases in the contralateral recurrent subgroup. The rates of recurrent intrauterine pregnancy, ipsilateral ectopic pregnancy and contralateral ectopic pregnancy were not different between the two subgroups (all P>0.05). Logistic regression analysis suggested time interval from prior TP to next pregnancy ≥36 months were positively correlated with occurrence of the second TP ( OR=5.012, 95% CI: 2.525-9.949, P<0.001). Patients concept by in vitro fertilization and embryo transfer (IVF-ET) after the first TP had higher rate of intrauterine pregnancy compared with natural conception [91.4% (53/58) vs. 61.1% (184/301), P<0.001] and IVF-ET significantly decreased the occurrence of the second TP ( OR=9.666, 95% CI: 3.303-28.287, P<0.001). Patients concepted by IVF-ET after the second TP had higher rate of intrauterine pregnancy compared with natural conception [76.5% (13/17) vs. 35.9% (14/39), P<0.001] and IVF-ET significantly decreased the occurrence of the third TP ( OR=5.987, 95% CI: 1.529-23.447, P=0.010). Conclusion:For patients who experience first-time TP, preserving the fallopian tube can help them gain the opportunity for intrauterine pregnancy. For patients with recurrent ipsilateral fallopian TP, there is currently insufficient evidence to support the benefit of removing the affected fallopian tube. Whether it is the first or the second TP, IVF-ET can help patients achieve a higher intrauterine pregnancy rate.

Objective:To analyze the consecutive pregnancy outcomes in women with different times of tubal pregnancy (TP) history.Methods:The data of 415 patients with a history of TP≥1 times admitted in Gynecology Department of Obstetrics & Gynecology Hospital of Fudan University from January 2019 to April 2023 were retrospectively analyzed. They were divided into two groups: the first TP group ( n=359) and the second TP group ( n=56). Clinical data and consecutive pregnancy outcomes were collected and the differences of TP rate between patients treated by retaining fallopian tubes and those treated by salpingectomy were analyzed. Patients with a second TP were divided into two subgroups: ipsilateral recurrence subgroup and contralateral recurrence subgroup, and difference of TP rate between the two subgroups was assessed. Risk factors for recurrent TP were assayed by binary logistic analysis. Results:Intrauterine pregnancy rate in the first TP group was higher than that in the second TP group [66.0% (237/359) vs. 48.2% (27/56), P=0.008]. Salpingectomy resulted in significantly lower rate of intrauterine pregnancy [35.7% (35/98)] compared with treatment with methotrexate or salpingotomy or extrusion of fallopian tubes in the first TP group, 77.0% (97/126), 78.2% (93/119), 90.0% (9/10), respectively; all P<0.001]. There was no difference of intrauterine pregnancy rate among patients treated by expectant management or methotrexate or salpingectomy or salpingotomy in the second TP group (all P>0.05). There were 24 cases in the ipsilateral recurrent subgroup and 32 cases in the contralateral recurrent subgroup. The rates of recurrent intrauterine pregnancy, ipsilateral ectopic pregnancy and contralateral ectopic pregnancy were not different between the two subgroups (all P>0.05). Logistic regression analysis suggested time interval from prior TP to next pregnancy ≥36 months were positively correlated with occurrence of the second TP ( OR=5.012, 95% CI: 2.525-9.949, P<0.001). Patients concept by in vitro fertilization and embryo transfer (IVF-ET) after the first TP had higher rate of intrauterine pregnancy compared with natural conception [91.4% (53/58) vs. 61.1% (184/301), P<0.001] and IVF-ET significantly decreased the occurrence of the second TP ( OR=9.666, 95% CI: 3.303-28.287, P<0.001). Patients concepted by IVF-ET after the second TP had higher rate of intrauterine pregnancy compared with natural conception [76.5% (13/17) vs. 35.9% (14/39), P<0.001] and IVF-ET significantly decreased the occurrence of the third TP ( OR=5.987, 95% CI: 1.529-23.447, P=0.010). Conclusion:For patients who experience first-time TP, preserving the fallopian tube can help them gain the opportunity for intrauterine pregnancy. For patients with recurrent ipsilateral fallopian TP, there is currently insufficient evidence to support the benefit of removing the affected fallopian tube. Whether it is the first or the second TP, IVF-ET can help patients achieve a higher intrauterine pregnancy rate.