OBJECTIVE To investigate the application status of prescription pre-review systems in healthcare institutions of Yunnan province， evaluate their system functions and management capabilities， and provide a practical basis for promoting rational drug use. METHODS A questionnaire survey was conducted among public healthcare institutions at or above the secondary level in Yunnan province to investigate the deployment status of the systems. A capability maturity assessment framework was constructed， encompassing 6 dimensions and 39 indicators， including real-time prescription review， prescription correlation review， rule setting， evidence-based information support， prescription authority management， and system operation management. This framework was then used to evaluate the institutions that had implemented the pre-review systems. RESULTS A total of 100 valid questionnaires were collected， with 37 institutions having adopted prescription pre-review systems， mainly tertiary hospitals. The system predominantly adopted a modular architecture and was embedded into the hospital information system through application programming interfaces and middleware， providing certain capabilities for real-time prescription risk identification. Evaluation results indicated that basic functions such as reviewing indications， contraindications， and drug compatibility performed well， while deficiencies remained in functions related to parenteral nutrition prescription， review of drug dosage for specific diseases， individual patient characteristic recognition， and rule setting. Moreover， the construction of review centers and establishment of management systems were also not well-developed. CONCLUSIONS The overall application rate of prescription pre-review systems in Yunnan province remains low. System functions and management mechanisms require further improvement. It is recommended to enhance information infrastructure in lower-level institutions and explore regionally unified review models to promote standardized and intelligent development of prescription review practices.

Objective This study aims to summarize the situation,development experiences,and existing problems in the development of Hospital S,and provide relevant suggestions as a reference for the high-quality development path of public hospitals.Methods Thirteen managers of Hospital S(including hospital leaders,functional departments,and clinical depart-ment heads)and eight experts in the field of hospital management were selected as research subjects.The phenomenological re-search method of qualitative research was used,and semi-structured interviews were conducted to collect relevant data.The Co-laizzi phenomenological data analysis method was used to analyze the interview data.Results Through the analysis of the inter-view data,four themes related to high-quality development were identified:medical care,scientific research and teaching,tal-ents,and disciplines.Each theme has specific areas that need priority and focused attention.Under the theme of medical care,there are four sub-themes:medical quality,medical safety,medical technology,and medical services.Scientific research and teaching,as a strategic support for promoting the hospital's sustained high-quality development,includes four sub-themes:re-search innovation,achievement transformation,teaching system,and mentor team.Talents,as the core competitiveness of the hospital,include three sub-themes:top-level design,high-level talents,and training system.The discipline theme includes four sub-themes:development ideas,development opportunities,development directions,and discipline leaders.Conclusion Public hospitals are facing new situations in high-quality development,and accelerating the improvement of medical service capabilities is a direct manifestation of high-quality development.It is necessary to promote key work such as research innovation,teaching management,talent team building,and discipline construction in a coordinated manner to achieve synchronous improvement in quality and efficiency.

Objective This study aims to summarize the situation,development experiences,and existing problems in the development of Hospital S,and provide relevant suggestions as a reference for the high-quality development path of public hospitals.Methods Thirteen managers of Hospital S(including hospital leaders,functional departments,and clinical depart-ment heads)and eight experts in the field of hospital management were selected as research subjects.The phenomenological re-search method of qualitative research was used,and semi-structured interviews were conducted to collect relevant data.The Co-laizzi phenomenological data analysis method was used to analyze the interview data.Results Through the analysis of the inter-view data,four themes related to high-quality development were identified:medical care,scientific research and teaching,tal-ents,and disciplines.Each theme has specific areas that need priority and focused attention.Under the theme of medical care,there are four sub-themes:medical quality,medical safety,medical technology,and medical services.Scientific research and teaching,as a strategic support for promoting the hospital's sustained high-quality development,includes four sub-themes:re-search innovation,achievement transformation,teaching system,and mentor team.Talents,as the core competitiveness of the hospital,include three sub-themes:top-level design,high-level talents,and training system.The discipline theme includes four sub-themes:development ideas,development opportunities,development directions,and discipline leaders.Conclusion Public hospitals are facing new situations in high-quality development,and accelerating the improvement of medical service capabilities is a direct manifestation of high-quality development.It is necessary to promote key work such as research innovation,teaching management,talent team building,and discipline construction in a coordinated manner to achieve synchronous improvement in quality and efficiency.

Objective By comparison with the surgical resection,to evaluate the relapse-free survival(RFS),overall survival(OS),and clinical safety of transcatheter hepatic arterial chemoembolization(TACE)combined with microwave ablation(MWA)in the treatment of early primary hepatocellular carcinoma(HCC).Methods From January 2013 to January 2018 at authors'hospital,51 HCC patients received TACE combined with MWA(TACE+MWA group)and 58 HCC patients received surgical resection(RES group).The HCC lesions were single tumor with diameter ≤7 cm or multiple tumors with stage Ⅰ a-Ⅱ a meeting the"up-to-7"criteria.The postoperative RFS,OS,and clinical safety were compared between the two groups.Results The one-,3-and 5-year RFS in the TACE+MWA group were 84.3％,37.3％and 13.7％respectively,which in the RES group were 67.2％,27.6％and 13.8％respectively.The difference in the one-year RFS between the two groups was statistically significant(P=0.039),and the differences in the 3-and 5-year RFS between the two groups were not statistically significant(P=0.281 and P=0.992,respectively).The one-,3-and 5-year survival rates in the TACE+MWA group were 98％,62.7％and 45.1％respectively,which in the RES group were 94.8％,75.9％and 44.8％respectively,and the differences between the two groups were not statistically significant(P=0.704,P=0.137 and P=0.977 respectively).No treatment-related death occurred in both groups.In the TACE+MWA group,the main complications included transient embolism syndrome,abdominal pain during ablation procedure,and mild to moderate transient elevation of transaminase after treatment.In the RES group,the main postoperative complications included fever,pleural effusion,abdominal effusion,and intraoperative bleeding;and in one patient the postoperative liver function impairment worsened to Child grade C.The average cost of hospitalization in the TACE+MWA group was(39 834.98±6 717.38)Chinese yuan,which in the RES group was(49 042.59±11 810.69)Chinese yuan,the difference between the two groups was statistically significant(P=0.017).The hospitalization length in the TACE+MWA group was 23 days(19-28 days),which in the RES group was 21 days(17-25 days),and the difference between the two groups was not statistically significant(P=0.196).Conclusion For the treatment of early HCC,TACE combined with MWA has reliable curative effect,and also has the advantages of being safe and economical.Therefore,this therapy can be used as a preferred option of non-surgical treatment for single tumor with ≤7 cm diameter or multiple tumors with stage Ⅰ a-Ⅱa meeting"up-to-7"criteria.(J Intervent Radiol,2024,33:488-494)

Objective To evaluate the efficacy and safety of fluorouracil and leucovorin and oxaliplatin(FOLFOX)regimen hepatic artery infusion chemotherapy(HAIC)combined with lenvatinib(LEN)and immune checkpoint inhibitors(ICIs)in treating patients with hepatocellular carcinoma(HCC)after the occurrence of transcatheter arterial chemoembolization(TACE)refractoriness.Methods The clinical data of 54 HCC patients who developed TACE refractoriness,were admitted to the Jiangsu Provincial Cancer Hospital of China to receive FOLFOX-HAIC combined with LEN and ICIs therapy between January 2019 and December 2022,were retrospectively analyzed.The modified Response Evaluation Criteria in Solid Tumors(mRECIST)was used to statistically analyze the clinical efficacy,the Common Terminology Criteria For Adverse Events version 5.0(CTCAE 5.0)was adopted to record and evaluate the treatment-related adverse events(TRAEs).The primary endpoints were progression-free survival(PFS)and overall survival(OS),the secondary endpoints were objective response rate(ORR),disease control rate(DCR),and safety.Results The median PFS was 11.7 months(95％CI:8.124-15.276 months),the median OS was 23.1 months(95％CI:19.508-26.692 months),the ORR was 46.3％,and the DCR was 87.0％.The most common TRAE at all levels was elevated alanine aminotransferase(51.9％),and the most common TRAE of grade 3/4 was hypertension(9.3％).No treatment-related death occurred.Conclusion For the treatment of HCC patients who developed TACE refractoriness,FOLFOX-HAIC combined LEN and ICIs is clinically safe and effective.(J Intervent Radiol,2024,33:610-615)

Objective To investigate the factors affecting the prognosis of patients with malignant obstructive jaundice(MOJ)after receiving biliary stent placement combined with intraluminal brachytherapy with 125I seed-strip implantation.Methods The clinical data of 52 patients with MOJ,who received biliary stent placement combined with intraluminal brachytherapy with 125I seed-strip implantation at the Jiangsu Provincial Cancer Hospital of China between January 2019 and January 2023,were retrospectively analyzed.The difference value between preoperative and postoperative number of lymphoid immune cells was recorded as△X.X-tile software was used to calculate the optimal cut-off value of △X,based on which the patients were divided into two groups.Univariate and multivariate analysis were used to determine the risk factors for overall survival(OS).Results The mean survival time of the 52 patients was(201.0±32.1)days.Univariate analysis indicated that postoperative TACE,preoperative ALT,preoperative AST,△lymphocyte cell,△CD3+T cell,△CD8+T cell,△natural killer cell(NK)and △regulatory cell(Treg)were significantly associated with OS,the differences were statistically significant(all P＜0.05).Multivariate analysis revealed that △lymphocyte cell(P=0.007)and △Treg(P=0.038)were the independent risk factors for OS.Conclusion For MOJ patients whose△lymphocyte is ≥0.237 or △Treg is ≥0.21,a longer OS can be expected after receiving the treatment of biliary stent placement combined with intraluminal brachytherapy with 125I seed-strip implantation.

Objective:To develop a risk assessment tool for chemotherapy induced nausea and vomiting after transcatheter arterial chemoembolization in patients with primary liver cancer, and to verify its predictive efficiency, so as to provide reference for risk assessment and nursing intervention of nausea and vomiting in patients with primary liver cancer.Methods:A cross-sectional survey was used. The risk assessment tool was compiled by using literature analysis, Delphi expert consultation and analytic hierarchy process. 153 patients with primary liver cancer who underwent transcatheter arterial chemoembolization in the Department of Intervention, Jiangsu Cancer Hospital from May 2022 to April 2023 were selected for assessment by using convenience sampling method. Receiver operating characteristic curve, sensitivity, specificity and Youden index were used to test the prediction efficiency of risk assessment tools.Results:Among 153 patients, there were 78 males, 75 females, aged (48.44 ± 7.76) years old. The expert positive coefficient of the three rounds of inquiry letters was all 100%, the expert authority coefficient was 0.936, 0.950 and 0.960 respectively, and the Kendall harmony coefficient was 0.490, 0.327 and 0.414 respectively (all P<0.01). The risk assessment tool for chemotherapy induced nausea and vomiting after transcatheter arterial chemoembolization in patients with primary liver cancer included 14 items. The results of prediction efficiency analysis showed that the area under the receiver operating characteristic curve was 0.938 (95% CI 0.903-0.974, P<0.01). When the cut-off score was 56.2, the sensitivity, specificity and Youden index of the risk assessment tool were 0.926, 0.881 and 0.807, which had the best prediction efficiency. Conclusions:The risk assessment tool for chemotherapy induced nausea and vomiting after transcatheter arterial chemoembolization in patients with primary liver cancer has high scientificity, predictive efficiency and practicability, and is suitable for the risk assessment for chemotherapy induced nausea and vomiting after transcatheter arterial chemoembolization in patients with primary liver cancer in China.

The SWOT model of management was used to analyze the advantages(S),disadvantages(W),opportunities(O)and challenges(T)of the transformation of scientific and technological achievements in a large general hospital in Shandong Province.According to the matrix form,four kinds of strategies are formed,including SO strategy using internal advantages to seize opportunities,ST strategy using internal advantages to resist external threats,WO strategy using external opportunities to o-vercome internal weaknesses and WT strategy overcoming internal weaknesses to avoid external threats,and effective strategies to promote the transformation of scientific and technological achievements in large general hospitals are discussed.

The SWOT model of management was used to analyze the advantages(S),disadvantages(W),opportunities(O)and challenges(T)of the transformation of scientific and technological achievements in a large general hospital in Shandong Province.According to the matrix form,four kinds of strategies are formed,including SO strategy using internal advantages to seize opportunities,ST strategy using internal advantages to resist external threats,WO strategy using external opportunities to o-vercome internal weaknesses and WT strategy overcoming internal weaknesses to avoid external threats,and effective strategies to promote the transformation of scientific and technological achievements in large general hospitals are discussed.

Objective To establish a method for measurement of ²³⁹Pu in fecal samples based on inductively coupled plasma-mass spectrometry (ICP-MS), and to provide a novel method for assessing the internal exposure of workers. Methods Fecal samples were collected from workers and labeled. The samples were pretreated with carbonization ashing and microwave digestion devices, purified on TEVA resin, and measured using ICP-MS. Results The detection limit of ²³⁹Pu in fecal samples based on ICP-MS was 1.91 × 10⁻⁴ Bq. Conclusion In the routine monitoring of class S substances characterized by a 5 μm aerodynamic diameter during 12 months, the committed effective dose corresponding to the detection limit is 0.17 mSv. This value meets the requirements of relevant national standards and ICP-MS can be used as a novel means for accurate evaluation of internal exposure for workers.