Objective To develop a symptom and function assessment scale for patients after Nuss procedure for pectus excavatum and to test its reliability and validity. Methods Following the principles and procedures of patient-reported outcome (PRO) scale development stipulated by the U.S. Food and Drug Administration, an initial draft was formed through literature analysis, qualitative interviews, and Delphi expert consultation. The preliminary draft was used to conduct a pre-survey on patients who underwent Nuss procedure for pectus excavatum at Guangdong Provincial People's Hospital, and the reliability and validity of the scale were tested. Results A preliminary PRO-based symptom and function scale was constructed, covering two domains: symptoms and impact on daily functions. The symptom dimension included six items: chest tightness, palpitations, pain, shortness of breath, foreign body sensation of the steel plate, and distress; while the impact on daily functions included four items: difficulty in getting out of bed or lying down, raising arms, bending over, and standing or sitting for a long time. A total of 73 patients who underwent Nuss procedure for pectus excavatum were included in the questionnaire survey, with 70 valid questionnaires collected, including 64 males and 6 females, with 56 patients aged 12-17 years and 14 patients ≥18 years. Through exploratory factor analysis, two common factors were extracted, with a cumulative variance contribution rate of 70%. The Cronbach’s α coefficient of the scale was 0.917. Conclusion The scale developed in this study has good reliability and validity, high reliability and stability, and can be used as an evaluation tool for the recovery status of patients after Nuss procedure for pectus excavatum.

OBJECTIVE To investigate the current status of infection control departments setting,allocation of in-fection control professionals and their position competence in the secondary,tertiary traditional Chinese medi-cine institutions of Beijing.METHODS The questionnaire survey was conducted for all of the secondary and tertiary traditional Chinese medicine institutions in Beijing by Beijing Traditional Chinese Medicine Hospital Infection Man-agement Quality Control Center from Feb.17,2023 to Apr.11,2023.The content of the survey involved the in-formation of the hospitals,setting information of infection control departments and allocation of infection control professionals.RESULTS Totally 59 traditional Chines medicine medical institutions were involved in the survey,35(59.32％)were tertiary hospitals.The median of opened beds was 331(155,479)in the first quarter of 2023.The median of equipped infection control professionals was 4(3,5).The number of infection control professional e-quipped in 67.80％of the medical institutions conformed to requirements of"Notice regarding to further strength-en the management of infection control professionals allocation in medical institutions"released by The Joint Pre-vention and Control Mechanism of the State Council for the Response to the Novel Coronavirus Pneumonia Epi-demic in Aug.2021,with the ratio of infection control professionals to beds 1∶94.20.The principals in charge of the infection control department who had the qualifications for senior professional and technical position and en-gaged in infection control for more than 5 years accounted for 20.00％.Among the infection control professionals,nurses accounted for 49.17％,doctors 41.67％,other professionals 9.17％.CONCLUSIONS There is relatively adequate quantity of the infection control professional equipped in the secondary and tertia-ry medical institutions of Beijing,however,the principals in charge of the infection control department who had the qualifications for senior professional and technical position and engaged in infection control for more than 5 years are very scarce.It is necessary to further optimize the structure of the infection control professionals.

International studies have established that electrons, X-rays, protons, and heavy ions can all be utilized in ultra-high dose-rate radiotherapy. Among these modalities, megavoltage X-ray ultra-high dose-rate radiotherapy holds particularly broad clinical promise. With its long-term expertise in high-intensity pulsed radiation sources, the Institute of Applied Electronics at the China Academy of Engineering Physics has pioneered global solutions for generating and measuring megavoltage X-rays ultra-high dose-rate radiotherapy, positioning China at the forefront of this field. Herein, we review the development history, current status, and future trends in ultra-high dose-rate X-ray generation, measurement, and protection. The insights provided aim to serve as a reliable reference for clinical and preclinical research, equipment development, and standardization, thereby enabling more precise and reliable megavoltage ultra-high dose-rate X-ray production and measurement. We hope this work will significantly support further research and clinical translation of ultra-high dose-rate radiotherapy technology.

Objective:To establish a rapid and precise dose measurement method with EBT4 film and ensure its measurement accuracy to be within the required range through strict operational procedures for the purpose of addressing the two essential issues of poor measurement accuracy and timeliness of EBT film under FLASH conditions.Methods:After storing under different humidity conditions for a certain period of time, the film was exposed to radiation for analyzing the influence of air humidity on the intrinsic performance of EBT film. By means of repeated scanning operations and the film angle rotation, the influences of repeated scanning and film placement angle were analuzed. Parabolic correction method was used to reduce the spatial position influence during the scanning process. By analying the relationship between net optical density (netOD) and absorbed dose through the comparison of three fitting method, the optimal fitting curve was selected. After irradiation of the same batch of films for 5 min and 24 h, the film doses were calibrated and then compared with ionization chamber-measured result. The rapid and precise film dosimetry method was used to measure both the percentage depth dose from X-rays at ultra-high dose rate and the dose distribution at a depth of 2 cm in water.Results:Air humidity had the greatest influence on the intrinsic performance of EBT film (approximately 20%). The average deviation of repeated scans is within 0.5%. The angle at which the film is placed significantly affected the readouts of the film with the maximum influence approximately 70%. The net optical density combined with polynomial fitting can control the fitting residuals of 1-16 Gy within 3%. The change rate of light channels at 5 min already mostly met the requirements of the rapid mode (< 0.5%). Compared with the measurement result obtained using the reference ionization chamber, the deviations of the 5 min or 24 h dose calibration curves were all within 2%.Conclusions:The EBT4 film can be employed as a precise dosimeter to quickly measure the FLASH radiation dose. Rapid and precise FLASH dose measurements can meet the stringent requirements of both preclinical and clinical FLASH research.

OBJECTIVE To investigate the current status of infection control departments setting,allocation of in-fection control professionals and their position competence in the secondary,tertiary traditional Chinese medi-cine institutions of Beijing.METHODS The questionnaire survey was conducted for all of the secondary and tertiary traditional Chinese medicine institutions in Beijing by Beijing Traditional Chinese Medicine Hospital Infection Man-agement Quality Control Center from Feb.17,2023 to Apr.11,2023.The content of the survey involved the in-formation of the hospitals,setting information of infection control departments and allocation of infection control professionals.RESULTS Totally 59 traditional Chines medicine medical institutions were involved in the survey,35(59.32％)were tertiary hospitals.The median of opened beds was 331(155,479)in the first quarter of 2023.The median of equipped infection control professionals was 4(3,5).The number of infection control professional e-quipped in 67.80％of the medical institutions conformed to requirements of"Notice regarding to further strength-en the management of infection control professionals allocation in medical institutions"released by The Joint Pre-vention and Control Mechanism of the State Council for the Response to the Novel Coronavirus Pneumonia Epi-demic in Aug.2021,with the ratio of infection control professionals to beds 1∶94.20.The principals in charge of the infection control department who had the qualifications for senior professional and technical position and en-gaged in infection control for more than 5 years accounted for 20.00％.Among the infection control professionals,nurses accounted for 49.17％,doctors 41.67％,other professionals 9.17％.CONCLUSIONS There is relatively adequate quantity of the infection control professional equipped in the secondary and tertia-ry medical institutions of Beijing,however,the principals in charge of the infection control department who had the qualifications for senior professional and technical position and engaged in infection control for more than 5 years are very scarce.It is necessary to further optimize the structure of the infection control professionals.

Objective:To evaluate the early efficacy and safety of transnasal endoscopic surgical resection of orbital cavernous hemangioma (OCH) at orbital resection by intranasal technique (ORBIT) stage Ⅲ.Methods:A retrospective study was conducted on 20 patients (20 eyes) who underwent nasal endoscopic surgery to remove ORBIT stage Ⅲ OCH at the Third Hospital of Peking University from July 2021 to July 2024. The cohort were included 10 males and 10 females, aged from 25 to 59 years, with a mean follow-up time of (5.10±4.51) months. Preoperative symptoms included visual field defects in 19 patients (95%), decreased visual acuity in 18 patients (90%), exophthalmos in 2 patients (10%), diplopia in 2 patients (10%), headache in 2 patients (10%), ocular pain in 2 patients (10%), and color vision abnormalities in 1 patient (5%). Data on patient demographics, medical history, imaging data, surgical approach, and postoperative outcomes were collected. Pre-and post-surgical outcomes including best corrected visual acuity (BCVA), visual field, proptosis, and intraocular pressure were compared. Surgical approaches included transnasal endoscopic OCH resection (12 cases, 60%) and transnasal endoscopic combined conjunctival approach OCH resection (8 cases, 40%). The results of the postoperative 2-week review were used as the postoperative short-term efficacy data, and those at 3 months were used for postoperative therapeutic efficacy analysis. SPSS 26.0 statistical software was applied for statistical analysis.Results:In 20 patients, all OCH were completely resected, and the BCVA, visual field, and exophthalmos were significantly improved post-operatively. The differences were statistically significant before and after surgery ( t values were 3.169, 5.127, and 3.350, respectively, all P<0.05). There were no serious complications in the short term after surgery. The short-term complications after endoscopic surgery alone were mainly new-onset diplopia in 1 case (1/12), and the short-term complications after combined approach were new-onset diplopia in 5 cases (5/8) and pupil dilation in 2 cases (2/8). All short-term complications recovered within 3 months, and no serious or permanent complications occurred in the long-term follow. Conclusion:The endoscopic transnasal surgery is a safe and effective approach for complete resection of ORBIT stage Ⅲ OCH, with promising early results.

Children with cancer represent a distinct patient population, and decisions regarding hospice care preferences are primarily made by their parents. This article examines parental preferences concerning the location and goals of hospice care for their children with cancer, discusses the advantages and disadvantages associated with these choices, and identifies factors influencing parental preferences for hospice care. The aim is to provide a reference for clinical healthcare professionals in delivering high-quality hospice care services for children with cancer that align with parental preferences.

Objective:To analysis the possible behavior of coders in the reform of Diagnosis Related Groups(DRG)payment mode.Methods:To collect through questionnaires the possible coders'behaviors,and extract the common factors of possible behaviors according to factor analysis,and cluster the coders by the K-means clustering method.Results:Classify the possible coders'behaviors into positive behaviors such as following coding norms and standards,and negative behaviors such as directly coding without detailed reading of medical records.Less than 25 years old were more inclined to adopt negative behaviors,and associate senior titles and higher cognitive level of DRG were more inclined to adopt positive behaviors.The coders are divided into"positive group"who tend to take positive behaviors and"negative group"who take negative behaviors.Conclusion:Coders are more likely to adopt positive behavior,and we should be pay attention to the impact of different demographic characteristics on coders.To adopt different management strategies for different categories of coders,and strengthen training through hierarchical classification,and enhance coders'cognitive of DRG are more conducive to the selection of positive behaviors.

Objective:To evaluate the early efficacy and safety of the exclusively transnasal endoscopic approach and the combined transconjunctival-endoscopic approach in the resection of benign orbital apex lesions.Methods:A retrospective analysis was conducted on 51 patients who underwent transnasal endoscopic resection of benign lesions in the orbital apex at Peking University Third Hospital from May 2021 to December 2024. The study population was composed of 17 males and 34 females, with the age of (39.4±12.4) years (range: 4 to 65 years). Pathology diagnoses were identified as orbital cavernous hemangioma (OCH, n=38), schwannoma ( n=8), solitary fibrous tumor ( n=1), mucocele ( n=1), optic nerve sheath meningioma ( n=1), pseudotumor ( n=1), and organized hematoma ( n=1). Two surgical approaches were compared as the exclusively transnasal endoscopic resection ( n=27) and the combined transconjunctival-endoscopic approach (combined approach, n=24). Preoperative and postoperative evaluations were conducted for the best corrected visual acuity (BCVA), visual field, intraocular pressure (IOP), and exophthalmos before and after surgery. Demographic characteristics, tumor features, and postoperative complications were analyzed between the two surgical groups. Differences in Orbital Resection by Intranasal Technique (ORBIT) stage between the two surgical approaches were analyzed. SPSS 27.0 software was used for statistical analysis. Results:Among the 51 patients, 3 schwannomas underwent intracapsular resection (1 via exclusively transnasal endoscopic approach, and 2 via combined approach), and the remaining 48 patients underwent complete tumor resection. Significant postoperative improvements were observed in BCVA, visual field, IOP and exophthalmos ( t value was 2.96, 4.34, 4.85, and 4.63, respectively, all P<0.05). The combined approach required longer operative time but showed comparable intraoperative blood loss. Tumors resected via the combined approach were larger in volume, though not statistically significant. Postoperative complications (e.g., diplopia, mydriasis) were more frequent in the combined approach group but resolved within a short-term period. There was no significant difference in ORBIT stage between the two groups ( P=0.178). Conclusions:Both exclusively transnasal and combined transconjunctival-endoscopic approaches prove safe and effective for benign orbital apex lesions resection. The combined approach ensures complete tumor removal.

Objective:To evaluate the early efficacy and safety of the exclusively transnasal endoscopic approach and the combined transconjunctival-endoscopic approach in the resection of benign orbital apex lesions.Methods:A retrospective analysis was conducted on 51 patients who underwent transnasal endoscopic resection of benign lesions in the orbital apex at Peking University Third Hospital from May 2021 to December 2024. The study population was composed of 17 males and 34 females, with the age of (39.4±12.4) years (range: 4 to 65 years). Pathology diagnoses were identified as orbital cavernous hemangioma (OCH, n=38), schwannoma ( n=8), solitary fibrous tumor ( n=1), mucocele ( n=1), optic nerve sheath meningioma ( n=1), pseudotumor ( n=1), and organized hematoma ( n=1). Two surgical approaches were compared as the exclusively transnasal endoscopic resection ( n=27) and the combined transconjunctival-endoscopic approach (combined approach, n=24). Preoperative and postoperative evaluations were conducted for the best corrected visual acuity (BCVA), visual field, intraocular pressure (IOP), and exophthalmos before and after surgery. Demographic characteristics, tumor features, and postoperative complications were analyzed between the two surgical groups. Differences in Orbital Resection by Intranasal Technique (ORBIT) stage between the two surgical approaches were analyzed. SPSS 27.0 software was used for statistical analysis. Results:Among the 51 patients, 3 schwannomas underwent intracapsular resection (1 via exclusively transnasal endoscopic approach, and 2 via combined approach), and the remaining 48 patients underwent complete tumor resection. Significant postoperative improvements were observed in BCVA, visual field, IOP and exophthalmos ( t value was 2.96, 4.34, 4.85, and 4.63, respectively, all P<0.05). The combined approach required longer operative time but showed comparable intraoperative blood loss. Tumors resected via the combined approach were larger in volume, though not statistically significant. Postoperative complications (e.g., diplopia, mydriasis) were more frequent in the combined approach group but resolved within a short-term period. There was no significant difference in ORBIT stage between the two groups ( P=0.178). Conclusions:Both exclusively transnasal and combined transconjunctival-endoscopic approaches prove safe and effective for benign orbital apex lesions resection. The combined approach ensures complete tumor removal.