A tertiary public general hospital in Guangdong has innovated its inpatient bed scheduling system by integra-ting multiple models,including"Hospital-Wide Bed Pooling,"outpatient chemotherapy,day surgery,pre-admission,and pre-discharge programs.Supported by policy guidance,this initiative optimizes clinical operations,enhances patient admission struc-tures and processes,and improves bed utilization efficiency through a multi-dimensional centralized bed management approach.By rationally allocating hospital-wide bed resources and maximizing their operational effectiveness,the hospital advances high-quality development in healthcare delivery.

A tertiary public general hospital in Guangdong has innovated its inpatient bed scheduling system by integra-ting multiple models,including"Hospital-Wide Bed Pooling,"outpatient chemotherapy,day surgery,pre-admission,and pre-discharge programs.Supported by policy guidance,this initiative optimizes clinical operations,enhances patient admission struc-tures and processes,and improves bed utilization efficiency through a multi-dimensional centralized bed management approach.By rationally allocating hospital-wide bed resources and maximizing their operational effectiveness,the hospital advances high-quality development in healthcare delivery.

Objective To enhance medical service efficiency and optimize healthcare resource utilization,our hospital developed a novel one-stop integrated medical service model combining pre-hospitalization with day surgery.Methods Starting in August 2022,a Class A Tertiary Hospital in Guangzhou implemented a multi-dimensional collaborative mechanism:1.Process reengineering:Standardized workflows shifted preoperative tests and anesthesia evaluations to pre-hospitalization.2.Resource in-tegration:Established a one-stop medical service center as a comprehensive service coordination hub,integrating deposit pay-ment,examination scheduling,testing,medical check-ups,bed allocation,and"one-click admission"into a unified diagnostic and treatment service chain.3.Closed-loop management:Streamlined workflow from outpatient evaluation to follow-up.Results By 2024 vs 2022:Increased annual discharges by 30,000+cases.Reduced preoperative hospitalization by 0.4 days.Im-proved bed occupancy(+10.72％)and turnover(+10.86％).Achieved 94％patient satisfaction.Conclusion This model enhances bed efficiency,reduces hospitalization delays,and offers a scalable framework for healthcare optimization,demonstra-ting both social and operational benefits.

Objective To enhance medical service efficiency and optimize healthcare resource utilization,our hospital developed a novel one-stop integrated medical service model combining pre-hospitalization with day surgery.Methods Starting in August 2022,a Class A Tertiary Hospital in Guangzhou implemented a multi-dimensional collaborative mechanism:1.Process reengineering:Standardized workflows shifted preoperative tests and anesthesia evaluations to pre-hospitalization.2.Resource in-tegration:Established a one-stop medical service center as a comprehensive service coordination hub,integrating deposit pay-ment,examination scheduling,testing,medical check-ups,bed allocation,and"one-click admission"into a unified diagnostic and treatment service chain.3.Closed-loop management:Streamlined workflow from outpatient evaluation to follow-up.Results By 2024 vs 2022:Increased annual discharges by 30,000+cases.Reduced preoperative hospitalization by 0.4 days.Im-proved bed occupancy(+10.72％)and turnover(+10.86％).Achieved 94％patient satisfaction.Conclusion This model enhances bed efficiency,reduces hospitalization delays,and offers a scalable framework for healthcare optimization,demonstra-ting both social and operational benefits.

Background and Aims:Preventive temporary stoma has been widely used in surgeries for rectal cancer as a simple and effective method to reduce the severity of postoperative anastomotic leakage.However,some patients with preventive temporary stomas cannot undergo reversal due to various factors,resulting in a permanent stoma.Permanent stomas remain a common adverse outcome in clinical practice,and the reasons behind this are not entirely clear.This study analyzes a continuous surgical sample from a single center to explore the risk factors for forming permanent stoma. Methods:The clinical data of patients who underwent anal-preserving rectal cancer surgery with preventive temporary stoma in Gastrointestinal Cancer Center Ⅲ of Peking University Cancer Hospital from January 2020 to March 2023,with over 12 months of follow-up,were retrospectively collected.The occurrence of permanent stoma was analyzed,and the clinical variables of patients with permanent stoma were compared to those who underwent stoma reversal,along with an analysis of the risk factors for permanent stoma formation.Permanent stoma was defined as ostomy reversal failure for more than 12 months. Results:A total of 299 patients were included,among which 268(89.63％)underwent stoma reversal(stoma closure group),and 31(10.37％)did not(permanent stoma group).Compared to the stoma closure group,the permanent stoma group had a higher incidence of distant organ metastasis at diagnosis(7.5％vs.25.85％,P=0.003)and also had higher proportions of T3 and T4 stages,N2 stage,and clinical stage Ⅳ(all P＜0.05)with an elevated overall postoperative complication rate(19.0％vs.41.9％,P=0.003)as well as a higher rate of severe complications(1.1％vs.9.7％,P=0.016)and an increased incidence of anastomotic leakage(4.9％vs.19.4％,P=0.006).Logistic regression analysis revealed that the presence of distant organ metastasis at diagnosis(OR=5.41,95％CI=1.80-16.27,P=0.003),and occurrence of anastomotic leakage(OR=4.44,95％CI=1.15-17.09,P=0.030)were independent risk factors for the formation of permanent stomas. Conclusion:At present,some patients still cannot undergo reversal of their preventive temporary stoma,resulting in permanent stoma.The formation of permanent stomas is closely related to a low tumor location,distant organ metastasis at diagnosis,and the occurrence of anastomotic leakage.

Hereditary spastic paraplegia type 58 is rare, caused by pathogenic variations in KIF1C gene. Here, a case diagnosed in Qilu Hospital, Shandong University, was reported. The 15-year-old female suffered tremor in bilateral upper limbs which was aggravated gradually since age 8. Cerebellar ataxia, positive pyramidal tract sign and dystonic tremor were prominent on physical examination. The brain magnetic resonance imaging showed T 2-hyperintense signals in bilateral pyramidal tracts, optic radiations and superior cerebellar peduncles, with mild cerebellar atrophy. Whole exon sequencing revealed the unreported homozygous c.425_426delTG (p.V142Gfs*10) mutation which was presumed pathogenic.

Objective     To analyze predictive factors, clinical implications and prognosis effects of new-onset conduction block after transcatheter aortic valve implantation (TAVI). Methods     The clinical data of 86 patients who underwent TAVI through transfemoral approach from 2019 to 2021 in Fujian Provincial Hospital were retrospectively analyzed, including 59 males and 27 females with an average age of 72.9±8.0 years. The patients were divided into a normal group and a new-onset conduction block group according to whether there was new-onset conduction block after operation, and then the new-onset conduction block group was subdivided into a left bundle branch block (LBBB) group (28 patients) and a complete atrioventricular block (CAVB) group (11 patients). We compared the hemodynamics and TAVI-related complications between the postoperative and early follow-up periods, and used the multivariate logistic regression models to identify risk factors for the new-onset conduction block. Results     The median EuroSCORE of all patients were 8 (2) points before the operation. In the postoperative and early follow-up periods, the hemodynamics and TAVI-related complications had no statistical difference between the new-onset conduction block group and the normal group (P>0.05). The incidence of permanent pacemaker implantation (81.8%, 9/11) and mortality due to cardiac causes (18.1%, 2/11) in the CAVB group were significantly higher than those in the normal group and theLBBB group (P<0.05). Female, severe calcification of the aortic valve, too large valve size and deep valve implants were the risk factors for new-onset conduction block after TAVI. Conclusion    The incidence of LBBB and CAVB is high after TAVI, however, both of them do not significantly effect the hemodynamics of the patients. Higher incidence of permanent pacemaker implantation is found in the CAVB group which affects the rate of rehospitalization and mortality. Female patients, severe calcification of the aortic valve, too large valve size and deep valve implants are the risk factors for the new-onset conduction block after TAVI.

Objective: To analyze the correlation between circumcision and incidence and clearance of male genital HPV infection. Methods: From May to July 2014, 18-55 year old men who had sexual behavior history were recruited from the general population in Liuzhou, Guangxi to set up a cohort. Totally, 113 circumcised and 560 uncircumcised men were enrolled and interviewed using a questionnaire (including information on demographic characteristics and sexual behaviors), then they were followed-up with 6-month interval for 2 times. On each visit, specimens of male external genitalia were collected and genotyped for HPV DNA. The differences of incidence and clearance of genital HPV infections between circumcised and uncircumcised men were analyzed by Log-rank test. Cox regression was used to analyze the relationship between circumcision and incidence and clearance of HPV infection. Results: The median age (P₂₅, P₇₅) of circumcised and uncircumcised men were 28 (24, 35) and 32 (24, 31), respectively. The incidences of any HPV infections were 9.1 (95%CI: 2.4-15.7) and 8.4 (95% CI: 5.6-11.2) per 1 000 person-months (χ²=0.10, P=0.758), respectively. The clearance of circumcised men [136.3 (95%CI: 70.0-202.7) per 1 000 person-months] was higher than that in uncircumcised men [89.6 (95%CI: 65.9-113.3) per 1 000 person-months] (χ²=8.19, P=0.004). In multivariate COX regression analysis, compared with uncircumcised men, circumcised men had higher possibility to clear any HPV infections (HR: 2.41, 95%CI: 1.30-4.46). Compared with men having one sexual partner, people having more than 4 sexual partners had lower possibility to clear any HPV infections (HR: 0.49, 95%CI: 0.25-0.96). Compared with 18-25 years old men, men aged 26-35 years old had higher possibility to clear high-risk HPV infections (HR: 2.14, 95%CI: 1.08-4.23). Conclusion Circumcised and uncircumcised men had similar incidence of genital HPV infection, whereas, men conducted circumcision and having fewer sexual partners could increase the clearance of genital HPV infections.

Objective To revalue the post-marketing safety of Xiyanping injection. Methods The research was carried out by prospective hospital based monitoring method. The leading organizations were Guangdong Medicine Adverse Reaction Monitoring Center and Chinese of Basic Research in Clinical Medicine Institute. The participants were 21 hospitals in 6 provinces/municipality directly under the Central Government which located in Northeast China,Central China,South China,and Southwest China. Monitoring objects were all patients who used Xiyanping injection when they were hospitalized. The set sample size was not fewer than 30 000 cases. Every patient who used Xiyanping injection filled in Xiyanping injection screening card(screening card)by research staff manually. The patient who developed adverse reactions(ADR)after using Xiyanping injection filled in Xiyanping injection monitoring table(monitoring table)by clinical pharmacist manually. All the hospital should report the screening card and the monitoring table to Guangdong Provincial Drug Reevaluation Report Management System(Reevaluation Report Management System)every month.The monitoring study ended when the number of screening cardrunning up to 30 000. The reported data were collected and the incidence rate of Xiyanping injection were calculated. The clinical characteristics of adverse reactions were analyzed. Results Data were collected through the Reevaluation Report Management System till January 23,2015. The monitoring study ended. Five hospitals stopped participation in the monitoring study because of discontinuity of cases′ data from March to August, 2013. A total of 30 759 screening cards and 23 monitoring tables which were from 16 hostipals were collected finally. There were 18 295(59.48%)male and 12 464(40.52%)female in 30 759 patients. Of them the number of patients whose age <4 years were 16 501(53.64%). The patients′primary diseases were mainly respiratory disease,infectious disease,parasitic disease,and digestive system disease. All the patients used Xiyanping injection with standard doses according to the instructions. Two thousands and eight hundred-ten (9.02%)patients did not use prescriptive menstruums. There were 28 353 patients(90.98%)who were treated with combined drugs at the same time. The top 4 combined drugs were antimicrobial agents, electrolyte acid-base balance and nutrition drugs,respiratory system drugs,and digestive system drugs successively. Twenty-three of 30 759 patients developed ADR related to Xiyanping injection,the ADR incidence rate was 0.75‰,95% confidence interval(CI)was 0.47‰ to 1.12‰. The results of deciding the relevance of ADR with Xiyanping injection as "in all probability","possible" and "unable to judge"were 12(51.27%),10(43.48%)and 1(4.35%)cases,respectively. Thirty-four ADR soccurred in 23 patients.The main clinical manifestations of ADR were erythra(19 cases),pruritus(7 cases),shiver with cold(4 cases),fever(3 cases),and cyanotic lips(1 case). The degree of adverse reactions were all general.Nineteen patients improved or recurred on the same day of drug withdrawal and treatment of antianaphylaxis. Three patients improved or recured within 2 days. One patient improved on the day 14 of drug withdrawal and treatment of antianaphylaxis. Conclusion The incidence of ADR due to Xiyanping injection from 2012 to 2015 were lower and have better safety.

Objective To revalue the post-marketing safety of Xiyanping injection. Methods The research was carried out by prospective hospital based monitoring method. The leading organizations were Guangdong Medicine Adverse Reaction Monitoring Center and Chinese of Basic Research in Clinical Medicine Institute. The participants were 21 hospitals in 6 provinces/municipality directly under the Central Government which located in Northeast China,Central China,South China,and Southwest China. Monitoring objects were all patients who used Xiyanping injection when they were hospitalized. The set sample size was not fewer than 30 000 cases. Every patient who used Xiyanping injection filled in Xiyanping injection screening card(screening card)by research staff manually. The patient who developed adverse reactions(ADR)after using Xiyanping injection filled in Xiyanping injection monitoring table(monitoring table)by clinical pharmacist manually. All the hospital should report the screening card and the monitoring table to Guangdong Provincial Drug Reevaluation Report Management System(Reevaluation Report Management System)every month.The monitoring study ended when the number of screening cardrunning up to 30 000. The reported data were collected and the incidence rate of Xiyanping injection were calculated. The clinical characteristics of adverse reactions were analyzed. Results Data were collected through the Reevaluation Report Management System till January 23,2015. The monitoring study ended. Five hospitals stopped participation in the monitoring study because of discontinuity of cases′ data from March to August, 2013. A total of 30 759 screening cards and 23 monitoring tables which were from 16 hostipals were collected finally. There were 18 295(59.48%)male and 12 464(40.52%)female in 30 759 patients. Of them the number of patients whose age <4 years were 16 501(53.64%). The patients′primary diseases were mainly respiratory disease,infectious disease,parasitic disease,and digestive system disease. All the patients used Xiyanping injection with standard doses according to the instructions. Two thousands and eight hundred-ten (9.02%)patients did not use prescriptive menstruums. There were 28 353 patients(90.98%)who were treated with combined drugs at the same time. The top 4 combined drugs were antimicrobial agents, electrolyte acid-base balance and nutrition drugs,respiratory system drugs,and digestive system drugs successively. Twenty-three of 30 759 patients developed ADR related to Xiyanping injection,the ADR incidence rate was 0.75‰,95% confidence interval(CI)was 0.47‰ to 1.12‰. The results of deciding the relevance of ADR with Xiyanping injection as "in all probability","possible" and "unable to judge"were 12(51.27%),10(43.48%)and 1(4.35%)cases,respectively. Thirty-four ADR soccurred in 23 patients.The main clinical manifestations of ADR were erythra(19 cases),pruritus(7 cases),shiver with cold(4 cases),fever(3 cases),and cyanotic lips(1 case). The degree of adverse reactions were all general.Nineteen patients improved or recurred on the same day of drug withdrawal and treatment of antianaphylaxis. Three patients improved or recured within 2 days. One patient improved on the day 14 of drug withdrawal and treatment of antianaphylaxis. Conclusion The incidence of ADR due to Xiyanping injection from 2012 to 2015 were lower and have better safety.