OBJECTIVE To evaluate the cost-effectiveness of cefiderocol versus best available therapy （BAT） or standard-of- care （SOC） for the treatment of confirmed or suspected carbapenem-resistant Gram-negative bacterial （CRGNB） serious infections from the perspective of the Chinese healthcare system， and to explore its reasonable pricing. METHODS A decision tree model was constructed based on data from two phase Ⅲ clinical trials （CREDIBLE-CR and GAME CHANGER） to simulate the cost- effectiveness of cefiderocol in two scenarios： salvage therapy for confirmed CRGNB infection （scenario 1） and empirical therapy for suspected CRGNB infection （scenario 2）. The primary outcome measure was the incremental cost-effectiveness ratio （ICER）. The willingness-to-pay （WTP） was set at 1 to 3 times China’s per capita GDP in 2024. To verify the robustness of the results， one- way and probabilistic sensitivity analyses were conducted， and based on these， a reasonable price range for cefiderocol in the Chinese market was explored. RESULTS The results for scenario 1 showed that the clinical cure rate in the cefiderocol group was higher than that in the BAT group （47.50% vs. 34.21%）， but its ICER was 415 065.03 yuan per cured case， exceeding three times China’s GDP per capita. Scenario 2 revealed that the ICER for cefiderocol relative to SOC was as high as 1 362 446.16 yuan per cured case， far exceeding the WTP. Sensitivity analysis indicated that the treatment duration and price of cefiderocol were key factors affecting its cost-effectiveness. In the two scenarios described above， the unit price of cefiderocol must fall below 683.47 and 242.00 yuan/g， respectively， to be considered cost-effective. CONCLUSIONS Based on the current market price， cefiderocol lacks sufficient cost-effectiveness for treating confirmed or suspected CRGNB serious infections within China’s healthcare system. To improve its accessibility， price negotiations or a tiered medical insurance payment strategy are required.

Objective To investigate the species of ticks in Suizhou City, Hubei Province, so as to provide insights into management of ticks and tick-borne diseases. Methods During the period between May 2023 and June 2024, livestock breeding farms and vegetation neighboring the place of residence of confirmed and suspected patients with tick-borne disease were selected as sampling points in rural areas from Yindian Township, Gaocheng Township, Wanhe Township, Wushan Township, Xiaolin Township, Xihe Township, Hedian Township and Beijiao Street in Suizhou City, Hubei Province, where confirmed and suspected cases with tick-borne diseases had been reported. The parasitic ticks on the body surface of free-range livestock were captured with tweezers in livestock breeding farms, and free ticks on the vegetation surface were captured with the flagging method. Morphological identification of tick samples was performed under a microscope, and the gender and developmental stage of ticks were determined. One engorged adult tick, 2 to 3 blood-feeding but non-engorged adult ticks, 10 to 15 unfed female ticks, 15 to 20 unfed male ticks, and 30 to 40 tick nymphs or larvae were assigned into a group, respectively. Genomic DNA was extracted from tick samples in each group, and mitochondrial 16S rRNA gene was amplified. Sequence analysis was performed with the DNASTAR software, and phylogenetic analysis was performed using the software MEGA 7.0. In addition, the phylogenetic tree was generated using the maximum likelihood method based on the Kimura 2 parameter model. Results A total of 2 438 ticks were captured from Suizhou City, Hubei Province during the period between May 2023 and June 2024, including 595 free ticks and 1 483 parasitic ticks. Three developmental stages of ticks were captured, including larvae, nymphs, and adults, and 75.18% (1 899/2 438) of captured ticks were adult, in which 79.04% (1 501/1 899) were female. Morphological and molecular biological assays identified one family, three genera and four species of captured ticks, including 2 425 Haemaphysalis longicornis ticks (99.47%) and one H. flava tick (0.04%) of the genus Haemaphysalis, 11 Rhipicephalus microplus ticks (0.45%) of the genus Rhipicephalus, and one Ixodes sinensis tick (0.04%) of the genus Ixodes in the family Ixodidae. Phylogenetic analysis revealed that the H. longicornis sequence (SZ49) in this study was clustered with sequences from Yunnan Province (GenBank accession number: MH024510.1), Hebei Province (GenBank accession number: MK450606.1) and Henan Province (GenBank accession number: MZ230645.1) into a clade, and the H. flava sequence (SZ19) in this study was clustered with sequences from Japan (GenBank accession number: MW064044.1), South Korea (GenBank accession number: ON629585.1), and Jiangsu Province (GenBank accession number: PP494741.1) and Hebei Province of China (GenBank accession number: MH520685.1) into a clade, while the R. microplus sequence (SZ8) in this study was clustered with the sequences from India (GenBank accession number: MK621328.1), and Henan Province (GenBank accession number: MT555307.1) and Guizhou Province of China (GenBank accession number: PP446801.1) into a clade. The sequence of I. sinensis (SZ23) in this study had 99.51% homology with that (GenBank accession number: OM368265.1) of ticks sampled from Wuhan City, Hubei Province. Conclusion There are four tick species of H. longicornis, H. flava, R. microplus and I. sinensis in Suizhou City, Hubei Province, and H. longicornis is the dominant species. H. flava is firstly recorded in Suizhou City.

Objective To evaluate the efficacy,safety,and economic efficiency of toripalimab therapy for advanced esophageal cancer by rapid health technology assessment(rHTA),so as to provide clinical reference for drug use.Methods PubMed,Embase,Cochrane Library,CNKI,WanFang Data,VIP databases and official websites of health technology assessment institutions were electronically searched to collect high-quality clinical evidence and economic evaluation literature of toripalimab therapy for advanced esophageal cancer from inception to September 30,2025.Two reviewers independently identified studies,extracted data,assessed the quality of included studies,then the results were summarised and analysed using qualitative descriptive methods.Results A total of 18 articles were included,including 9 systematic reviews/Meta-analysis and 9 economic studies.In terms of efficacy,compared with the simple chemotherapy regimen,the combination chemotherapy regimen of toripalimab could significantly prolong the overall survival(OS)and progression free survival(PFS)of patients with advanced esophageal cancer,while improving the objective response rate(ORR)of patients.In terms of safety,there was no significant difference in the incidence of serious adverse events and overall adverse events between combination chemotherapy with toripalimab and chemotherapy alone.Moreover,compared with other immunotherapy combination therapies,the incidence of adverse events in combination chemotherapy with toripalimab was lower.In terms of economy,the combination of toripalimab and chemotherapy not only improves the clinical symptoms of advanced esophageal cancer patients,but also offers economic advantages.Conclusion Toripalimab is effective,safe and economical in the treatment of advanced esophageal cancer.

Objective:To analyze the differences in heart size，shape and function between fetuses with tetralogy of Fallot（TOF）and fetuses with malalignment ventricular septal defect（VSD）and pulmonary stenosis（PS）（named as，mild TOF）by fetal heart quantification（fetal HQ）and multi-parameter fetal echocardiography.Methods:From June 2021 to June 2023，50 fetuses with TOF（TOF group）diagnosed by fetal echocardiography at the Department of Diagnostic Ultrasound & Echocardiography Sir Run Run Shaw Hospital，Zhejiang University College of Medicine and 34 fetuses with VSD and PS matched to gestational age（mild TOF group）were retrospectively selected. Cardiovascular parameters were measured by 2D echocardiography，M-mode echocardiography and fetal HQ，including aortic dimension（AO）and its Z-score（AO Z-score），pulmonary artery diameter（PA）and its Z-score（PA Z-score），PA/AO ratio，main pulmonary artery diameter（MPA）and its Z-score（MPA Z-score），left pulmonary artery diameter（LPA）and its Z-score（LPA Z-score），right pulmonary artery diameter（RPA）and its Z-score（RPA Z-score），McGoon index（MGI），tricuspid annular diameter（TV）and its Z-score（TV Z-score），mitral annular diameter（MV）and its Z-score（MV Z-score），and MV/TV ratio. Measurements of global ventricular morphologic parameters included cardiac axis，left and right ventricular transverse diameters（LVW，RVW）and their ratio（LVW/RVW），left and right ventricular long diameters（LVL，RVL）and LVL/RVL ratio，left and right ventricular areas（LVA，RVA）and LVA/RVA ratio，global spherical index（GSI）and its Z-score，four chamber view transverse diameter（4CV-Width-ED），four chamber view end-diastolic longitudinal diameter（4CV-Length-ED），four chamber view end-diastolic area（4CV-Area-ED）. Measurements of left and right global ventricular functional parameters included fractional left ventricular and right ventricular area changes（LVFAC，RVFAC），left ventricular ejection fraction（LVEF），left ventricular and right ventricular global longitudinal strains（LVGLS，RVGLS）；end diastolic width diameter（Width-ED），SI and fractional shortening rate（FS）of 24 segments of left and right ventricles. The differences of the above parameters between the two groups were analyzed and compared，and the relationships between absolute values of GLS in left and right ventricles of TOF fetus and PA Z-score，MPA Z-score and PA/AO were analyzed. Binary Logistic regression model was used to select the best variables，and ROC curve was adopted to analyze the predictive values of ultrasonic parameter variables on TOF.Results:There were statistically significant differences in MV，TV，RVW，RVL，LVL，LVA，RVA，4CV-Length-ED，LVGLS，RVGLS，RVFAC，PA/AO，MPA，RPA，LPA，MGI，PA and PA Z-score between TOF group and mild TOF group（all P<0.05）. The Width-ED values of all segments of left ventricle were statistically different between TOF group and mild TOF group（all P<0.05）. There were statistical differences in SI between LV segments 4~6 and 8~24，and RV segments 1~21（all P<0.05）. The FS values between the 8th and 10th to 18th segments of RV revealed statistical differences（all P<0.05）. There were no statistical differences in the other parameters（all P>0.05）. The absolute value of LVGLS in TOF fetuses was positively correlated with PA Z-score，MPA Z-score and PA/AO（ r = 0.313，0.344，0.304，all P<0.05），and the absolute value of RVGLS was positively correlated with PA Z-score，MPA Z-score，and PA/AO（ r = 0.323，0.334，0.357，all P<0.05）. Binary Logistic regression model analysis confirmed that LVGLS，RVFAC and PA/AO were predictive variables. ROC curve analysis showed that the areas under the curves of LVGLS，RVFAC and PA/AO for predicting TOF were 0.746，0.693 and 0.849 respectively. The combined prediction efficiency was higher，and the area under the curve was 0.906. Conclusions:Fetal HQ combined with multiple fetal echocardiographic quantification indices can evaluate the differences in fetal heart size，shape and function between TOF and mild TOF. It is expected to provide important reference information in prenatal diagnosis and consultation for fetuses with TOF and mild TOF.

Under the background of the integrated development of the Guangdong-Hong Kong-Macao Greater Bay Area,the demand for medical services from Hong Kong and Macao residents in Guangdong continues to grow.As the main force in pro-viding medical services in Guangdong,public hospitals play a crucial role.This article aims to explore the current situation of the development of medical services for Hong Kong and Macao residents in Guangdong and propose development strategies from the perspective of hospitals to contribute to the integrated development of the Greater Bay Area.The SWOT method is used to system-atically evaluate the strengths,weaknesses,opportunities,and threats of Guangdong public hospitals in the development of medi-cal services for Hong Kong and Macao residents.A SWOT matrix is then constructed to formulate development countermeasures.The analysis shows that Guangdong public hospitals have advantages such as convenient transportation,cultural affinity,abundant medical resources,high service efficiency,and relatively low costs.However,they also face challenges such as inadequate cover-age of cross-border medical insurance,immature specialized services,inconsistent service standards,and insufficient exploration of cross-border medical care.At the same time,there are opportunities provided by national strategic support and strong market demand,while fierce market competition and slow integration of medical regulations among the three regions pose external threats.Based on the analysis,this article proposes countermeasures and suggestions,including strengthening publicity and innovative in-dustry cooperation,phased development of business,striving for policy coverage,enhancing business coordination,accelerating cooperation with the Hong Kong and Macao in medical care,and promoting international accreditation of hospitals.These sugges-tions provide decision-making references for the development of medical services for Hong Kong and Macao residents in Guang-dong's public hospitals.

Objective To evaluate the efficacy,safety,and economic efficiency of toripalimab therapy for advanced esophageal cancer by rapid health technology assessment(rHTA),so as to provide clinical reference for drug use.Methods PubMed,Embase,Cochrane Library,CNKI,WanFang Data,VIP databases and official websites of health technology assessment institutions were electronically searched to collect high-quality clinical evidence and economic evaluation literature of toripalimab therapy for advanced esophageal cancer from inception to September 30,2025.Two reviewers independently identified studies,extracted data,assessed the quality of included studies,then the results were summarised and analysed using qualitative descriptive methods.Results A total of 18 articles were included,including 9 systematic reviews/Meta-analysis and 9 economic studies.In terms of efficacy,compared with the simple chemotherapy regimen,the combination chemotherapy regimen of toripalimab could significantly prolong the overall survival(OS)and progression free survival(PFS)of patients with advanced esophageal cancer,while improving the objective response rate(ORR)of patients.In terms of safety,there was no significant difference in the incidence of serious adverse events and overall adverse events between combination chemotherapy with toripalimab and chemotherapy alone.Moreover,compared with other immunotherapy combination therapies,the incidence of adverse events in combination chemotherapy with toripalimab was lower.In terms of economy,the combination of toripalimab and chemotherapy not only improves the clinical symptoms of advanced esophageal cancer patients,but also offers economic advantages.Conclusion Toripalimab is effective,safe and economical in the treatment of advanced esophageal cancer.

Under the background of the integrated development of the Guangdong-Hong Kong-Macao Greater Bay Area,the demand for medical services from Hong Kong and Macao residents in Guangdong continues to grow.As the main force in pro-viding medical services in Guangdong,public hospitals play a crucial role.This article aims to explore the current situation of the development of medical services for Hong Kong and Macao residents in Guangdong and propose development strategies from the perspective of hospitals to contribute to the integrated development of the Greater Bay Area.The SWOT method is used to system-atically evaluate the strengths,weaknesses,opportunities,and threats of Guangdong public hospitals in the development of medi-cal services for Hong Kong and Macao residents.A SWOT matrix is then constructed to formulate development countermeasures.The analysis shows that Guangdong public hospitals have advantages such as convenient transportation,cultural affinity,abundant medical resources,high service efficiency,and relatively low costs.However,they also face challenges such as inadequate cover-age of cross-border medical insurance,immature specialized services,inconsistent service standards,and insufficient exploration of cross-border medical care.At the same time,there are opportunities provided by national strategic support and strong market demand,while fierce market competition and slow integration of medical regulations among the three regions pose external threats.Based on the analysis,this article proposes countermeasures and suggestions,including strengthening publicity and innovative in-dustry cooperation,phased development of business,striving for policy coverage,enhancing business coordination,accelerating cooperation with the Hong Kong and Macao in medical care,and promoting international accreditation of hospitals.These sugges-tions provide decision-making references for the development of medical services for Hong Kong and Macao residents in Guang-dong's public hospitals.

Objective:To analyze the differences in heart size，shape and function between fetuses with tetralogy of Fallot（TOF）and fetuses with malalignment ventricular septal defect（VSD）and pulmonary stenosis（PS）（named as，mild TOF）by fetal heart quantification（fetal HQ）and multi-parameter fetal echocardiography.Methods:From June 2021 to June 2023，50 fetuses with TOF（TOF group）diagnosed by fetal echocardiography at the Department of Diagnostic Ultrasound & Echocardiography Sir Run Run Shaw Hospital，Zhejiang University College of Medicine and 34 fetuses with VSD and PS matched to gestational age（mild TOF group）were retrospectively selected. Cardiovascular parameters were measured by 2D echocardiography，M-mode echocardiography and fetal HQ，including aortic dimension（AO）and its Z-score（AO Z-score），pulmonary artery diameter（PA）and its Z-score（PA Z-score），PA/AO ratio，main pulmonary artery diameter（MPA）and its Z-score（MPA Z-score），left pulmonary artery diameter（LPA）and its Z-score（LPA Z-score），right pulmonary artery diameter（RPA）and its Z-score（RPA Z-score），McGoon index（MGI），tricuspid annular diameter（TV）and its Z-score（TV Z-score），mitral annular diameter（MV）and its Z-score（MV Z-score），and MV/TV ratio. Measurements of global ventricular morphologic parameters included cardiac axis，left and right ventricular transverse diameters（LVW，RVW）and their ratio（LVW/RVW），left and right ventricular long diameters（LVL，RVL）and LVL/RVL ratio，left and right ventricular areas（LVA，RVA）and LVA/RVA ratio，global spherical index（GSI）and its Z-score，four chamber view transverse diameter（4CV-Width-ED），four chamber view end-diastolic longitudinal diameter（4CV-Length-ED），four chamber view end-diastolic area（4CV-Area-ED）. Measurements of left and right global ventricular functional parameters included fractional left ventricular and right ventricular area changes（LVFAC，RVFAC），left ventricular ejection fraction（LVEF），left ventricular and right ventricular global longitudinal strains（LVGLS，RVGLS）；end diastolic width diameter（Width-ED），SI and fractional shortening rate（FS）of 24 segments of left and right ventricles. The differences of the above parameters between the two groups were analyzed and compared，and the relationships between absolute values of GLS in left and right ventricles of TOF fetus and PA Z-score，MPA Z-score and PA/AO were analyzed. Binary Logistic regression model was used to select the best variables，and ROC curve was adopted to analyze the predictive values of ultrasonic parameter variables on TOF.Results:There were statistically significant differences in MV，TV，RVW，RVL，LVL，LVA，RVA，4CV-Length-ED，LVGLS，RVGLS，RVFAC，PA/AO，MPA，RPA，LPA，MGI，PA and PA Z-score between TOF group and mild TOF group（all P<0.05）. The Width-ED values of all segments of left ventricle were statistically different between TOF group and mild TOF group（all P<0.05）. There were statistical differences in SI between LV segments 4~6 and 8~24，and RV segments 1~21（all P<0.05）. The FS values between the 8th and 10th to 18th segments of RV revealed statistical differences（all P<0.05）. There were no statistical differences in the other parameters（all P>0.05）. The absolute value of LVGLS in TOF fetuses was positively correlated with PA Z-score，MPA Z-score and PA/AO（ r = 0.313，0.344，0.304，all P<0.05），and the absolute value of RVGLS was positively correlated with PA Z-score，MPA Z-score，and PA/AO（ r = 0.323，0.334，0.357，all P<0.05）. Binary Logistic regression model analysis confirmed that LVGLS，RVFAC and PA/AO were predictive variables. ROC curve analysis showed that the areas under the curves of LVGLS，RVFAC and PA/AO for predicting TOF were 0.746，0.693 and 0.849 respectively. The combined prediction efficiency was higher，and the area under the curve was 0.906. Conclusions:Fetal HQ combined with multiple fetal echocardiographic quantification indices can evaluate the differences in fetal heart size，shape and function between TOF and mild TOF. It is expected to provide important reference information in prenatal diagnosis and consultation for fetuses with TOF and mild TOF.