Objective To investigate the current situation of career growth of public hospital managers and analyse its influencing factors,in order to provide a reference basis for promoting the level of career growth of hospital managers.Methods A convenient sampling method was applied to select 276 managers from nine public secondary and tertiary public hospitals in Hubei Province as the respondents,and a General Information Questionnaire,Career Growth Scale,and Person-organisation Fit scale were used to conduct the survey.Descriptive statistics,ANOVA,Pearson correlation analysis,and multiple linear regression were used to complete the analysis of the current status of career growth and influencing factors.Results The overall score of hospital managers'career growth is 3.29±0.79;person-organisation fit scores were positively correlated with hospital managers'career growth scores(P＜0.05).Multiple linear regression results showed that the type of hospital,the gender,whether or not they were both hospi-tal functionaries and clinical operations personnel,and the person-organisation fit were the major factors influencing the career growth of hospital managers the(P＜0.05).Conclusion The career growth of hospital managers is general-ly at an intermediate level and is affected by a variety of factors.Hospitals should pay attention to the individual characteristics and job requirements of managers,and improve career growth by completing the performance evalua-tion system,creating a good and fair organisational atmosphere,and easing career promotion stress.

Objective:To investigate the association between different types of lung nodules and the risk of lung cancer in a population at high risk of lung cancer and to provide an epidemiologic basis for the comprehensive management of lung nodules.Methods:Using the free lung cancer screening program of low-dose CT (LDCT) in Wenling, Zhejiang Province, we collected baseline and imaging information of high-risk groups for lung cancer who underwent LDCT screening from April 2019 to October 2021 and patients with previous history of lung cancer, tuberculosis, pneumoconiosis, and silicosis were excluded. A total of 28 539 study subjects were included in the analysis, and the follow-up ended on 31 December 2023. Based on the characteristics of the detected pulmonary nodules, the study subjects were classified with no nodules, with solid nodules, with pure ground glass nodules, and with part solid nodules groups. The association between different characteristics of lung nodules and the risk of lung cancer development was analyzed using the Cox proportional hazard regression model with a new diagnosis of lung cancer during the follow-up period as the outcome.Results:The overall detection rate of lung nodules with a mean diameter of ≥3 mm was 76.5%, of which 53.7%, 18.2%, and 4.6% were detected in the solid nodule, pure ground glass nodule, and partially solid nodule groups, respectively. There were statistically significant differences between the different nodule groups in terms of age, gender, BMI, history of toxic exposure education level, smoking status, history of lung disease, and family history of lung cancer (all P<0.05). The median follow-up time of the study population was 3.4 years, and 485 new lung cancer cases were diagnosed during the follow-up period. After adjusting for covariates, the results of multifactorial Cox proportional hazard regression model analysis showed that the risk of lung cancer was higher in pure ground glass nodules and part solid nodules compared with solid nodules, with HR values (95% CI) of 1.89 (1.52-2.35) and 6.49 (5.18-8.14), respectively. The results of subgroup analysis showed that patients in the group of part solid nodules had the highest risk of lung cancer in all strata of the population, followed by patients with pure ground glass nodules. Patients in the solid nodule group who were older or had previous lung disease had a higher risk of lung cancer, and the risk of lung cancer in the part solid nodule group differed between genders. Conclusions:The proportion of lung nodules detected is high in the high-risk group of lung cancer, and among them, patients with pure ground glass and part solid nodules have a higher risk of developing lung cancer. Attention should be paid to the annual follow-up management for patients with solid nodules who are older or who have had lung diseases, as well as for female patients with part solid nodules.

BACKGROUND: Lung cancer is the leading malignancy in China in terms of both incidence and mortality. With increased health awareness and the widespread use of low-dose computed tomography (CT), early diagnosis rates have been steadily improving. Surgical intervention remains the primary treatment option for early-stage lung cancer, and video-assisted thoracoscopic surgery (VATS) has become a common approach due to its minimal invasiveness and rapid recovery. However, post-discharge recovery remains incomplete, underscoring the importance of postoperative care. Traditional follow-up methods, lack standardization, consume significant medical resources, and increase the burden of the patients. Artificial intelligence (AI)-driven disease management platforms offer a novel solution to optimize postoperative follow-up. This study followed 463 lung cancer surgery patients using an AI-based platform, aiming to identify common postoperative issues, propose solutions, improve quality of life, reduce recurrence-related costs, and promote AI integration in healthcare. METHODS: Using the AI disease management platform, this study integrated educational videos, collaboration between healthcare teams and AI assistants, daily health logs, health assessment forms, and personalized interventions to monitor postoperative recovery. The postoperative rehabilitation status of the patients was assessed by the Leicester Cough Questionnaire (LCQ-MC). Two independent t-test and one-way ANOVA were used to analyze the causes of postoperative cough in lung cancer. RESULTS: Most issues occurred within 7 d post-discharge, significantly declined on 14 d post-discharge. Factors such as gender, smoking history, and surgical approaches were found to influence cough recovery. The incidence of cough on 7 d post-discharge in females was higher than that in males (P<0.01), while the incidence of cough on 14 d post-discharge in elderly patients was lower than that in young patients (P=0.03). The AI-based platform effectively addressed cough, pain, and sleep disturbances through phased interventions. CONCLUSIONS The AI-based platform significantly enhanced postoperative management efficiency and the self-care capabilities of the patients, particularly in phased cough management. Future integration with wearable devices could enable more precise and personalized postoperative care, further advancing the application of AI technology across multidisciplinary healthcare domains.
Humans ; Lung Neoplasms/rehabilitation* ; Male ; Female ; Middle Aged ; Aged ; Patient Discharge ; Artificial Intelligence ; Adult ; Postoperative Care ; Postoperative Period ; Disease Management ; Quality of Life

With the increasing incidence of chronic diseases,the research is conducted to actively explore out of hospital management models for chronic disease patients globally.Among them,virtual ward is a management model based on multidisciplinary team collaboration to provide professional medical and nursing services for unplanned hospitalization high-risk population.This model not only facilitates the transition of patients from inpatient settings to home environments,improving disease prognosis and reducing hospitalization risk,but also alleviates the bed burden on large hospitals.This article provides a review of the concept,development,construction of the operational system,and patient management processes of virtual wards,and offers insights and suggestions to provide references for the optimization and development of out of hospital management models for chronic disease patients in China.

With the increasing incidence of chronic diseases,the research is conducted to actively explore out of hospital management models for chronic disease patients globally.Among them,virtual ward is a management model based on multidisciplinary team collaboration to provide professional medical and nursing services for unplanned hospitalization high-risk population.This model not only facilitates the transition of patients from inpatient settings to home environments,improving disease prognosis and reducing hospitalization risk,but also alleviates the bed burden on large hospitals.This article provides a review of the concept,development,construction of the operational system,and patient management processes of virtual wards,and offers insights and suggestions to provide references for the optimization and development of out of hospital management models for chronic disease patients in China.

Objective:To investigate the association between different types of lung nodules and the risk of lung cancer in a population at high risk of lung cancer and to provide an epidemiologic basis for the comprehensive management of lung nodules.Methods:Using the free lung cancer screening program of low-dose CT (LDCT) in Wenling, Zhejiang Province, we collected baseline and imaging information of high-risk groups for lung cancer who underwent LDCT screening from April 2019 to October 2021 and patients with previous history of lung cancer, tuberculosis, pneumoconiosis, and silicosis were excluded. A total of 28 539 study subjects were included in the analysis, and the follow-up ended on 31 December 2023. Based on the characteristics of the detected pulmonary nodules, the study subjects were classified with no nodules, with solid nodules, with pure ground glass nodules, and with part solid nodules groups. The association between different characteristics of lung nodules and the risk of lung cancer development was analyzed using the Cox proportional hazard regression model with a new diagnosis of lung cancer during the follow-up period as the outcome.Results:The overall detection rate of lung nodules with a mean diameter of ≥3 mm was 76.5%, of which 53.7%, 18.2%, and 4.6% were detected in the solid nodule, pure ground glass nodule, and partially solid nodule groups, respectively. There were statistically significant differences between the different nodule groups in terms of age, gender, BMI, history of toxic exposure education level, smoking status, history of lung disease, and family history of lung cancer (all P<0.05). The median follow-up time of the study population was 3.4 years, and 485 new lung cancer cases were diagnosed during the follow-up period. After adjusting for covariates, the results of multifactorial Cox proportional hazard regression model analysis showed that the risk of lung cancer was higher in pure ground glass nodules and part solid nodules compared with solid nodules, with HR values (95% CI) of 1.89 (1.52-2.35) and 6.49 (5.18-8.14), respectively. The results of subgroup analysis showed that patients in the group of part solid nodules had the highest risk of lung cancer in all strata of the population, followed by patients with pure ground glass nodules. Patients in the solid nodule group who were older or had previous lung disease had a higher risk of lung cancer, and the risk of lung cancer in the part solid nodule group differed between genders. Conclusions:The proportion of lung nodules detected is high in the high-risk group of lung cancer, and among them, patients with pure ground glass and part solid nodules have a higher risk of developing lung cancer. Attention should be paid to the annual follow-up management for patients with solid nodules who are older or who have had lung diseases, as well as for female patients with part solid nodules.

Objective To investigate the current situation of career growth of public hospital managers and analyse its influencing factors,in order to provide a reference basis for promoting the level of career growth of hospital managers.Methods A convenient sampling method was applied to select 276 managers from nine public secondary and tertiary public hospitals in Hubei Province as the respondents,and a General Information Questionnaire,Career Growth Scale,and Person-organisation Fit scale were used to conduct the survey.Descriptive statistics,ANOVA,Pearson correlation analysis,and multiple linear regression were used to complete the analysis of the current status of career growth and influencing factors.Results The overall score of hospital managers'career growth is 3.29±0.79;person-organisation fit scores were positively correlated with hospital managers'career growth scores(P＜0.05).Multiple linear regression results showed that the type of hospital,the gender,whether or not they were both hospi-tal functionaries and clinical operations personnel,and the person-organisation fit were the major factors influencing the career growth of hospital managers the(P＜0.05).Conclusion The career growth of hospital managers is general-ly at an intermediate level and is affected by a variety of factors.Hospitals should pay attention to the individual characteristics and job requirements of managers,and improve career growth by completing the performance evalua-tion system,creating a good and fair organisational atmosphere,and easing career promotion stress.

Objective To evaluate the dose distribution and execution accuracy of intensity-modulated radiation therapy(IMRT)plans with different minimum segment widths for patients with primary liver cancer,thereby providing reference for the radiotherapy planning.Methods A retrospective study was conducted on 30 patients with primary liver cancer.With the other optimization condition unchanged,5 IMRT plans with minimum segment widths of 0.6,0.8,1.0,1.2 and 1.5 cm were made for each patient,and the dose distribution,execution efficiency and gamma passing rate of the 5 plans were compared.Results The monitor units and delivery time of the 5 plans decreased with increasing minimum segment width,while the gamma passing rates at 3 mm/3%and 2 mm/2%tended to increase,with statistical differences(P<0.05).Conclusion The 5 plans in the study can be used for clinical treatment.While meeting the clinical requirements,reasonably setting the minimum segment width in IMRT plan can reduce monitor units,shorten delivery time,and improve treatment accuracy.

Since the National Health Commission launched the pilot work of " Internet+ nursing service" in 2019, medical institutions at all levels in China keep innovating their nursing service models to provide targeted high-quality care for discharged patients or special groups suffering from diseases and poor mobility. In April 2021, a tertiary hospital in Qingdao carried out the " Internet+ " whole course management practice with specialized nurses as the main service subjects, which center on discharged patients as the main service objects. By estabusing a management team and the construction of " Internet+ " information exchange platform, the hospital implemented the whole course of disease management process including patients′ pre-hospital management, in-hospital estimate, and post-hospital follow-up rehabilitation, to provide specialized nursing services such as PICC dressing change care, stoma care, and mother and infant care for patients at home. By February 2022, the " Internet+ " whole course management service had expanded to 50 kilometers away from hospital, with a total of 1 181 specialized nursing services. This management highlighted the characteristics of specialized nursing services in tertiary hospitals, accurately matched the needs of patients, reflected the concept of holistic care, and provided references for the rapid promotion of the development of " Internet+ nursing service" in China.

Objective:To evaluate the possible mediation effect of smoking and healthy diet score on the association between educational level and the risk of lung cancer incidence.Methods:After excluding individuals with missing educational levels and cancer information at baseline, 446?772 participants in the UK Biobank (UKB) prospective cohort study were included. Cox regression models were used to investigate the associations of educational level and smoking and healthy diet score with the incidence of lung cancer. Mediating effect analysis was conducted to analyze the mediating effect of smoking and healthy diet score on the correlation between educational level and lung cancer.Results:During a median follow-up of 7.13 years, 1?994 new- onset lung cancer cases were observed. Per 1 standard deviation (5 years) increase in educational level was associated with a 12% lower risk of lung cancer ( HR=0.88, 95% CI: 0.84-0.92). The corresponding level 1-5 in the International Standard Classification for Education (ISCED) were mapped to UKB self‐report highest qualification to estimate the educational level. A higher rank means a higher educational level. Compared with level ISCED-1, the HR(95% CI) of level ISCED-2, ISCED-3, ISCED-4 and ISCED-5 were respectively 0.83 (0.72-0.94), 0.67 (0.53-0.85), 0.76 (0.65-0.89) and 0.72 (0.64-0.80) for lung cancer. Education years were negatively correlated with smoking, with β coefficients (95% CI) being -0.079 (-0.081- -0.077), but positively correlated with healthy diet score ( β=0.042, 95% CI: 0.039-0.045). Analysis of mediating effect indicated that the association of educational level with lung cancer risk was mediated by smoking and healthy diet score, the proportions of mediating effect were 38.952% (95% CI: 31.802%-51.659%) and 1.784% (95% CI: 0.405%-3.713%), respectively. Conclusion:Smoking and healthy diet score might mediate the effect of educational level on the incidence of lung cancer, indicating that improving the level of education can reduce the risk of lung cancer by changing lifestyles such as smoking and diet.