Objective To investigate the mid- to long-term follow-up results of ascending aorta (AAO)-descending thoracic aorta (DTA) bypass grafting via median sternotomy incision for the treatment of complex aortic arch coarctation. Methods A retrospective analysis was conducted on the clinical data of patients with complex aortic arch coarctation who underwent AAO-DTA bypass grafting via median sternotomy incision at the First Hospital of Tsinghua University from August 2004 to May 2017. Results A total of 7 patients were enrolled, including 4 males and 3 females, aged (13.3±4.6) years, and weighted (40.2±12.2) kg. Six (85.7%) patients had concomitant upper limb hypertension. Four patients were aortic arch coarctation combined with intracardiac malformations, two were post-operative restenosis, and 1 was post-operative restenosis combined with intracardiac malformation. All patients underwent surgery under cardiopulmonary bypass. There were no perioperative deaths or major complications. The pre-operative upper-lower limb pressure difference was (39.3±19.2) mm Hg, which decreased to (2.9±2.7) mm Hg post-operatively (P<0.01). The follow-up period was (14.9±5.9) years. There were no long-term deaths or artificial graft-related complications. Except for one patient who still had mild hypertension, the blood pressure of the remaining patients returned to normal. Conclusion AAO-DTA bypass grafting via median sternotomy incision for the treatment of complex aortic arch coarctation can effectively reduce upper limb blood pressure and the upper-lower limb arterial pressure difference, has fewer complications, and demonstrates satisfactory mid- to long-term efficacy.

Objective:To explore the effects of isosorbide mononitrate injection combined with continuous renal replacement therapy (CRRT) in patients with uremia congestive heart failure (CHF) and the effects on renal function, cardiac function, and serum parathyroid hormone (PTH), and N terminal pro-B-type natriuretic peptide (NT-proBNP) levels.Methods:A total of 120 CHF patients with uremia who were treated in the First Affiliated Hospital of Shaoyang University from May 2020 to May 2022 were selected as the research objects, and they were divided into the CRRT group and the combined group by the random number table method, with 60 cases in each group. They were treated with CRRT and isosorbide mononitrate combined with CRRT, respectively. After treatment for 1 week, the total effective rate, renal function, cardiac function, serum PTH, NT-proBNP and adverse reactions of the two groups were compared.Results:After treatment for 1 week, the total effective rate in the combined group was higher than that in the CRRT group: 98.33%(59/60) vs. 85.00%(51/60), there was statistical diffenrence ( χ2 = 5.35, P<0.05). After treatment for 1 week, the levels of serum creatinine, blood urea nitrogen and β2 microglobulin-MG in the combined group were lower than those in the CRRT group: (670.83 ± 81.80)μmol/L vs. (706.88 ± 93.27) μmol/L, (10.62 ± 2.58) mmol/L vs. (12.80 ± 3.55) mmol/L, (13.16 ± 2.98) mg/L vs. (16.00 ± 2.84) mg/L, there were statistical differences ( P<0.05). After treatment for 1 week, the left ventricular end systolic diameter and left ventricular end diastolic diameter were lower than those in the CRRT group, and left ventricular ejection fraction was higher than that in the CRRT group: (42.88 ± 4.16) mm vs. (46.37 ± 6.55) mm, (51.57 ± 8.33) mm vs. (56.42 ± 7.55) mm, (49.50 ± 6.27)% vs.(44.68 ± 5.14)%, there were statistical differences ( P<0.05). After treatment for 1 week, the levels of PTH and NT-proBNP in the combined group were lower than those in the CRRT group: (50.16 ± 7.15) ng/L vs. (53.27 ± 6.46) ng/L, 281.52 (255.46, 304.50) mmol/L vs. 362.49 (331.88, 378.42) mmol/L, there were statistical differences ( P<0.05). There was no statistical difference in adverse reactions between the two groups ( P>0.05). Conclusions:Isosorbide mononitrate combined with CRRT has a good effect on improving cardiac and renal function and reducing cardiac load in patients with uremia CHF.

This paper aims to focus on and implement strategies for preventing and resolving medical complaints and dis-putes at their emergence.The hospital promptly compiled a summary of the main problems and concerns reported from patients o-ver the past few years.It combined medical practices with the characteristics of admitted patients with severe diseases,complex treatment plans,and high risks.Since 2020,this hospital has been actively engaging with intractable high-risk patients and de-veloped a scheme that engaging clinical departments,medical management,and dispute management departments together to con-duct preoperative/pre-treatment communication.With a focus on patient management,this hospital upholds the concept of the pa-tient-centered humanistic philosophy in the process of doctor-patient communication to enhance the quality of communication.Consequently,the hospital has benefited from the communication scheme,achieving satisfactory effect in ensuring a solid medical safety and reducing the incidence of medical disputes.

Objective:To study the longitudinal trends and spatial clustering characteristics of healthcare service efficiency in China and in North,Northeast,East,Central,South,Southwest,and Northwest China.Methods:The Malmquist index model is used to measure China's healthcare service efficiency from 2012 to 2021,the Dagum Gini coefficient as well as the decomposition method are used to measure the magnitude and source of regional gaps in healthcare service efficiency,and the Kernel density estimation is used to study the longitudinal trend of change and spatial agglomeration characteristics of China's healthcare service efficiency.Results:China's overall healthcare service efficiency is growing,and the inter-regional gap is gradually narrowing,characterized by a concentration trend;the gap in the level of healthcare service efficiency between regions did not widen during the period under examination,but it was found that the gap within some regions was still significant.Conclusion:The national health service efficiency is growing slightly,and the regional gap is generally decreasing,but the Gini coefficient shows that the inter-regional contribution is still the main source of the gap.National health service efficiency is generally concentrated,but some regions are less efficient,with significant internal disparities.

Objective To explore the role of an artificial intelligence(AI)model based on real-time object detection network in fetal facial ultrasound examination.Methods With the normal fetal facial ultrasound standard plane(FFUSP)at 20-24 weeks of gestation as the research object,a FFUSP recognition model based on real-time object detection network was constructed.The recognition accuracy of the model for FFUSP and the anatomical structures were analyzed,and the clinical value was evaluated by analyzing its performance in identifying FFUSP in 119 cases of fetal ultrasound images.Results The overall precision,recall rate,mAP@.5 and mAP@.5:.95 of the AI model were 97.8%,98.5%,98.1%and 61.0%,respectively.The clinical validation showed that the AI model had a sensitivity,specificity,positive predictive value,negative predictive value and accuracy of 100.0%,98.5%,87.4%,100.0%and 98.7%for facial anatomy recognition,and the results were highly consistent with the classification of fetal ultrasound experts(k=0.925,P<0.001).The recognition accuracy of the model for 3 types of standard planes reached 100%;and the average speed of dynamic video detection was 33.93 frames per second.Conclusion The FFUSP recognition model based on real-time object detection network exhibits excellent performance,and it can be applied to real-time ultrasound diagnosis,teaching and intelligent quality evaluation.

Objective:To study the longitudinal trends and spatial clustering characteristics of healthcare service efficiency in China and in North,Northeast,East,Central,South,Southwest,and Northwest China.Methods:The Malmquist index model is used to measure China's healthcare service efficiency from 2012 to 2021,the Dagum Gini coefficient as well as the decomposition method are used to measure the magnitude and source of regional gaps in healthcare service efficiency,and the Kernel density estimation is used to study the longitudinal trend of change and spatial agglomeration characteristics of China's healthcare service efficiency.Results:China's overall healthcare service efficiency is growing,and the inter-regional gap is gradually narrowing,characterized by a concentration trend;the gap in the level of healthcare service efficiency between regions did not widen during the period under examination,but it was found that the gap within some regions was still significant.Conclusion:The national health service efficiency is growing slightly,and the regional gap is generally decreasing,but the Gini coefficient shows that the inter-regional contribution is still the main source of the gap.National health service efficiency is generally concentrated,but some regions are less efficient,with significant internal disparities.

Objective:To study the longitudinal trends and spatial clustering characteristics of healthcare service efficiency in China and in North,Northeast,East,Central,South,Southwest,and Northwest China.Methods:The Malmquist index model is used to measure China's healthcare service efficiency from 2012 to 2021,the Dagum Gini coefficient as well as the decomposition method are used to measure the magnitude and source of regional gaps in healthcare service efficiency,and the Kernel density estimation is used to study the longitudinal trend of change and spatial agglomeration characteristics of China's healthcare service efficiency.Results:China's overall healthcare service efficiency is growing,and the inter-regional gap is gradually narrowing,characterized by a concentration trend;the gap in the level of healthcare service efficiency between regions did not widen during the period under examination,but it was found that the gap within some regions was still significant.Conclusion:The national health service efficiency is growing slightly,and the regional gap is generally decreasing,but the Gini coefficient shows that the inter-regional contribution is still the main source of the gap.National health service efficiency is generally concentrated,but some regions are less efficient,with significant internal disparities.

Objective:To study the longitudinal trends and spatial clustering characteristics of healthcare service efficiency in China and in North,Northeast,East,Central,South,Southwest,and Northwest China.Methods:The Malmquist index model is used to measure China's healthcare service efficiency from 2012 to 2021,the Dagum Gini coefficient as well as the decomposition method are used to measure the magnitude and source of regional gaps in healthcare service efficiency,and the Kernel density estimation is used to study the longitudinal trend of change and spatial agglomeration characteristics of China's healthcare service efficiency.Results:China's overall healthcare service efficiency is growing,and the inter-regional gap is gradually narrowing,characterized by a concentration trend;the gap in the level of healthcare service efficiency between regions did not widen during the period under examination,but it was found that the gap within some regions was still significant.Conclusion:The national health service efficiency is growing slightly,and the regional gap is generally decreasing,but the Gini coefficient shows that the inter-regional contribution is still the main source of the gap.National health service efficiency is generally concentrated,but some regions are less efficient,with significant internal disparities.

Objective:To study the longitudinal trends and spatial clustering characteristics of healthcare service efficiency in China and in North,Northeast,East,Central,South,Southwest,and Northwest China.Methods:The Malmquist index model is used to measure China's healthcare service efficiency from 2012 to 2021,the Dagum Gini coefficient as well as the decomposition method are used to measure the magnitude and source of regional gaps in healthcare service efficiency,and the Kernel density estimation is used to study the longitudinal trend of change and spatial agglomeration characteristics of China's healthcare service efficiency.Results:China's overall healthcare service efficiency is growing,and the inter-regional gap is gradually narrowing,characterized by a concentration trend;the gap in the level of healthcare service efficiency between regions did not widen during the period under examination,but it was found that the gap within some regions was still significant.Conclusion:The national health service efficiency is growing slightly,and the regional gap is generally decreasing,but the Gini coefficient shows that the inter-regional contribution is still the main source of the gap.National health service efficiency is generally concentrated,but some regions are less efficient,with significant internal disparities.

Objective:To study the longitudinal trends and spatial clustering characteristics of healthcare service efficiency in China and in North,Northeast,East,Central,South,Southwest,and Northwest China.Methods:The Malmquist index model is used to measure China's healthcare service efficiency from 2012 to 2021,the Dagum Gini coefficient as well as the decomposition method are used to measure the magnitude and source of regional gaps in healthcare service efficiency,and the Kernel density estimation is used to study the longitudinal trend of change and spatial agglomeration characteristics of China's healthcare service efficiency.Results:China's overall healthcare service efficiency is growing,and the inter-regional gap is gradually narrowing,characterized by a concentration trend;the gap in the level of healthcare service efficiency between regions did not widen during the period under examination,but it was found that the gap within some regions was still significant.Conclusion:The national health service efficiency is growing slightly,and the regional gap is generally decreasing,but the Gini coefficient shows that the inter-regional contribution is still the main source of the gap.National health service efficiency is generally concentrated,but some regions are less efficient,with significant internal disparities.