Objective:To review the health service system,personnel salary system and service model in Macao Special Administrative Region(Macao),and analyze the reference significance for the of the tightly-knit medical alliance construction.Methods:On-site visits were conducted to 2 hospitals,3 community health service centers and 1 nursing home in Macao.Interviews and focus group discussions were held with key informants.Literature review was carried out at the same time.Qualitative and quantitative analysis methods were used to analyze the collected data.Results:Macao has clearly defined the functional positioning of public hospitals and primary healthcare institutions,and has given full play to the supplementary role of private medical institutions,establishing a grid-based medical and health service system with clear division of labor and public-private cooperation.Macao has implemented a strict system of first diagnosis in primary health care and two-way referral,providing high-quality and efficient medical and health services to community residents.Macao has institutionalized the salary system for medical personnel,with only a small income gap between different types of institutions and personnel,establishing a homogenized high-level medical and health salary system.Conclusion:The mainland should strengthen the financial protection,and promote the coordinated management of staff,funds and properties.Institutionalize the income and responsibility system for medical personnel,and narrow the income gap between different types of institutions and personnel,strengthen the functional positioning of primary health care and services for key populations,and promote first diagnosis in primary health care and two-way referral.

Objective To explore the clinical value of a machine learning model constructed based on computed tomography (CT) imaging features and serological markers for predicting the risk of primary ovarian cancer. Methods We retrospectively collected the baseline data, imaging features, and laboratory indicators of 490 patients with ovarian lesions who visited the Department of Gynecology and Obstetrics at Nanjing Pukou People’s Hospital between March 2021 and January 2025, all confirmed by histopathological examination. The patients were randomly divided into a training set and a validation set in a 7∶3 ratio. Based on the pathological results, patients in each dataset were categorized into a benign lesion group and a primary ovarian cancer group for comparison. All data from the training set patients were included in LASSO regression to screen for optimal indicators. Machine learning algorithms were established based on eight classifiers to identify the best model. Data were then incorporated into this model to screen for independent predictors. The prediction model was subsequently evaluated, visualized, and internally validated using the validation set. Results LASSO regression selected 12 variables. Among the various machine learning models, the logistic regression model showed the best performance, with the highest area under the receiver operating characteristic curve (AUC) and F1 score). Binary logistic regression model analysis indicated that venous phase CT value, CT perfusion collateral index score, CA199 level, HE4 level, tumor margin features, and lymphocyte-to-monocyte ratio were all influencing factors for primary ovarian cancer (P < 0.05). The AUC of this prediction model was 0.89, while the AUC in the validation set was 0.80, indicating favorable clinical benefit. Conclusion The machine learning model based on the integration of CT imaging features and laboratory indicators demonstrates high performance in the prediction of primary ovarian cancer risk.

Objective:To compare the immobilization effect of two different immobilization methods in treatment with CyberKnife for intracranial tumors.Methods:A retrospective analysis was conducted on 48 patients with intracranial tumors who received treatment with CyberKnife in the Department of Radiotherapy at Peking Union Medical College Hospital from June 2023 to July 2024.Based on the different immobilization method,patients were divided into two groups:the Double Shell Positioning System(DSPS)group(n=22)and the Qfix group(n=26).The DSPS group was immobilized using an American full-body integrated positioning frame combined with a carbon fiber bracket and DSPS film,while the Qfix group was immobilized using an Encompass board and Qfix film.All patients were treated with 6 dimensions(6D)-skull tracking technique.During treatment,images were acquired as one times per 60 seconds,which were registered with digitally reconstructed radiograph(DRR)to record and compare the overall relative errors.The data of relative displacement error during treatment was calculated as|dx|=d1-d0,and differences between the two groups were compared.The maximum displacement(|d|=dmax-dmin)was also calculated,and difference in maximum displacement between the two kinds of immobilization methods was analyzed.Results:In the comparison of the overall relative errors between the two kinds of immobilization methods,the median values in the errors of superior-inferior(SI),anterior-posterior(AP),Roll,Pitch,and Yaw directions in the Qfix group were respectively 0.174,0.309,0.150,0.147,and 0.477,which were significantly less than those(0.224,0.316,0.175,0.221,and 0.584)of DSPS group,and the differences were statistically significant(Z=-4.358,-1.698,-2.595,-6.833,-5.371,P<0.05).The difference of the relative displacement errors between two kinds of immobilization methods was not significant(P>0.05),while the median values in all directions were not zero.The comparison of the maximum displacement value between the two kinds of immobilization methods indicated the displacement amounts of Qfix group was less than those of DSPS group on SI,left-right(LR),AP,roll,pitch,and yaw directions,and the differences of them were significant(Z=-3.373,-2.525,-2.488,-3.169,-5.130,-5.166,P<0.05).Conclusion:Both immobilization methods can meet the requirements of clinical treatment.The results of comparison indicate the immobilization effect of Qfix group is best,and the combination of Encompass board and Qfix film is recommended as the immobilization method of CyberKnife-based radiotherapy for intracranial tumors.

Objective:To construct three photosensitive fusion proteins between protein G C3 domain and Avitag for site-spe-cific biotinylation of goat IgG.Methods:DNA sequences of protein G C3 domain with amber codon mutation and C-terminal containing 1,2,3 Avitag were obtained by chemical synthesis,respectively,and sub-cloned into pTXB1 plasmid to construct three fusion pro-tein expression vectors.Three plasmids and pEVOL-pBpF plasmid were co-transformed into competent bacterium E.coli BL21,respec-tively.Target fusion proteins CBpa-Avitag,CBpa-(Avitag)2 and CBpa-(Avitag)3 were prepared using genetic codon extension technology,and were purified by His Trap Chelating HP column,then biotinylated by Avitag/BirA system.Photo-conjugation efficiency,crosslink site and antigen-binding activity of photo-conjugates were investigated by SDS-PAGE,control experiment,and competitive ELISA.Results:Three expression vectors were successfully constructed,and three designed photoactivatable fusion proteins CBpa-Avitag,CBpa-(Avitag)2 and CBpa-(Avitag)3 were successfully expressed with molecular weights consistent with their theoretical values.Heavy-chain conjugation efficiencies of biotinylated fusion protein with goat IgG were 85%with Fc-specific conjugation,and conjugates maintained its antigen-binding activity after photo-conjugation.Conclusion:CBpa-Avitag,CBpa-(Avitag)2 and CBpa-(Avitag)3 fusion proteins are successfully prepared,and mediates by those photosensitive fusion proteins,biotins molecules are conjugated to Fc fragment of goat IgG,results site-specific biotinylation of goat IgG.

Objective:To assess the efficacy and safety profile of antaitasvir phosphate combined with yiqibuvir in the treatment of chronic hepatitis C (CHC) of various genotypes, without cirrhosis or with compensated cirrhosis.Methods:394 cases with CHC from 22 centers were collected from October 2021 to April 2023. They were randomly assigned to receive either the experimental drugs (antaitasvir phosphate 100 mg+yiqibuvir 600 mg) or placebo treatment in a 3∶1 ratio. The patients were administered drugs once a day for 12 consecutive weeks, and then followed up for 24 weeks after treatment cessation. All subjects were unblinded at the four-week follow-up following drug discontinuation, with the experimental drug group continuing to complete subsequent post-discontinuation follow-up. The placebo group was switched to receive the experimental drugs for a repeated 12-week treatment period and followed up for another 24 weeks after discontinuation of the drug (placebo delayed treatment phase).The sustained virologic response rate (SVR12) was observed for subjects in the double-blind phase and the placebo delayed-treatment phase at 12 weeks after treatment cessation.Virological resistance analysis was performed on subjects who failed treatment. The primary efficacy endpoint was SVR12. The number and percentage of subjects who achieved "HCV RNA

Objective:To sort out the situation,content and practical experience of the"four sinkings"in the construction of tightly-knit county medical communities,and provide references and basis for the promotion of policies in various regions.Methods:Quantitative description methods were used to analyze the development trends of the number of health technicians and medical services in primary healthcare facilities.Literature research methods were used to analyze policy content.Case analysis methods were used to summarize and analyze the implementation content and support mechanisms of the"four sinkings"in Youxi County of Fujian Province,Dongyang City of Zhejiang Province,Dongtai City of Jiangsu Province and Suixi County of Anhui Province.Results:From 2010-2022,more health technicians and medical services still flew to hospitals,indicating that personnel is an important impact factor for service sinking.The task of personnel and service sinking to the primary healthcare level is still arduous.From 2023 to 2024,China has issued multiple national policies to clarify the content of the"four sinkings",among which personnel sinking is the core,technology sinking is the means,management sinking is the support,and service sinking is the goal.Case analysis result shows that typical regions have established a long-term mechanism to promote the"four sinkings"through talent pool constrution,economic incentives,medical insurance support and informatization construction.Conclusion and Suggestions:It is needed to enhance the understanding of the"four sinkings",and promote them as important policy measures;promote the experience of typical regions,with a focus on the establishment of a long-term mechanism;and strengthen trace study and monitoring and evaluation to ensure the implementation of the"four sinkings".

Objective:To construct three photosensitive fusion proteins between protein G C3 domain and Avitag for site-spe-cific biotinylation of goat IgG.Methods:DNA sequences of protein G C3 domain with amber codon mutation and C-terminal containing 1,2,3 Avitag were obtained by chemical synthesis,respectively,and sub-cloned into pTXB1 plasmid to construct three fusion pro-tein expression vectors.Three plasmids and pEVOL-pBpF plasmid were co-transformed into competent bacterium E.coli BL21,respec-tively.Target fusion proteins CBpa-Avitag,CBpa-(Avitag)2 and CBpa-(Avitag)3 were prepared using genetic codon extension technology,and were purified by His Trap Chelating HP column,then biotinylated by Avitag/BirA system.Photo-conjugation efficiency,crosslink site and antigen-binding activity of photo-conjugates were investigated by SDS-PAGE,control experiment,and competitive ELISA.Results:Three expression vectors were successfully constructed,and three designed photoactivatable fusion proteins CBpa-Avitag,CBpa-(Avitag)2 and CBpa-(Avitag)3 were successfully expressed with molecular weights consistent with their theoretical values.Heavy-chain conjugation efficiencies of biotinylated fusion protein with goat IgG were 85%with Fc-specific conjugation,and conjugates maintained its antigen-binding activity after photo-conjugation.Conclusion:CBpa-Avitag,CBpa-(Avitag)2 and CBpa-(Avitag)3 fusion proteins are successfully prepared,and mediates by those photosensitive fusion proteins,biotins molecules are conjugated to Fc fragment of goat IgG,results site-specific biotinylation of goat IgG.

Objective:To sort out the situation,content and practical experience of the"four sinkings"in the construction of tightly-knit county medical communities,and provide references and basis for the promotion of policies in various regions.Methods:Quantitative description methods were used to analyze the development trends of the number of health technicians and medical services in primary healthcare facilities.Literature research methods were used to analyze policy content.Case analysis methods were used to summarize and analyze the implementation content and support mechanisms of the"four sinkings"in Youxi County of Fujian Province,Dongyang City of Zhejiang Province,Dongtai City of Jiangsu Province and Suixi County of Anhui Province.Results:From 2010-2022,more health technicians and medical services still flew to hospitals,indicating that personnel is an important impact factor for service sinking.The task of personnel and service sinking to the primary healthcare level is still arduous.From 2023 to 2024,China has issued multiple national policies to clarify the content of the"four sinkings",among which personnel sinking is the core,technology sinking is the means,management sinking is the support,and service sinking is the goal.Case analysis result shows that typical regions have established a long-term mechanism to promote the"four sinkings"through talent pool constrution,economic incentives,medical insurance support and informatization construction.Conclusion and Suggestions:It is needed to enhance the understanding of the"four sinkings",and promote them as important policy measures;promote the experience of typical regions,with a focus on the establishment of a long-term mechanism;and strengthen trace study and monitoring and evaluation to ensure the implementation of the"four sinkings".

Objective:To compare the immobilization effect of two different immobilization methods in treatment with CyberKnife for intracranial tumors.Methods:A retrospective analysis was conducted on 48 patients with intracranial tumors who received treatment with CyberKnife in the Department of Radiotherapy at Peking Union Medical College Hospital from June 2023 to July 2024.Based on the different immobilization method,patients were divided into two groups:the Double Shell Positioning System(DSPS)group(n=22)and the Qfix group(n=26).The DSPS group was immobilized using an American full-body integrated positioning frame combined with a carbon fiber bracket and DSPS film,while the Qfix group was immobilized using an Encompass board and Qfix film.All patients were treated with 6 dimensions(6D)-skull tracking technique.During treatment,images were acquired as one times per 60 seconds,which were registered with digitally reconstructed radiograph(DRR)to record and compare the overall relative errors.The data of relative displacement error during treatment was calculated as|dx|=d1-d0,and differences between the two groups were compared.The maximum displacement(|d|=dmax-dmin)was also calculated,and difference in maximum displacement between the two kinds of immobilization methods was analyzed.Results:In the comparison of the overall relative errors between the two kinds of immobilization methods,the median values in the errors of superior-inferior(SI),anterior-posterior(AP),Roll,Pitch,and Yaw directions in the Qfix group were respectively 0.174,0.309,0.150,0.147,and 0.477,which were significantly less than those(0.224,0.316,0.175,0.221,and 0.584)of DSPS group,and the differences were statistically significant(Z=-4.358,-1.698,-2.595,-6.833,-5.371,P<0.05).The difference of the relative displacement errors between two kinds of immobilization methods was not significant(P>0.05),while the median values in all directions were not zero.The comparison of the maximum displacement value between the two kinds of immobilization methods indicated the displacement amounts of Qfix group was less than those of DSPS group on SI,left-right(LR),AP,roll,pitch,and yaw directions,and the differences of them were significant(Z=-3.373,-2.525,-2.488,-3.169,-5.130,-5.166,P<0.05).Conclusion:Both immobilization methods can meet the requirements of clinical treatment.The results of comparison indicate the immobilization effect of Qfix group is best,and the combination of Encompass board and Qfix film is recommended as the immobilization method of CyberKnife-based radiotherapy for intracranial tumors.

Objective:To review the health service system,personnel salary system and service model in Macao Special Administrative Region(Macao),and analyze the reference significance for the of the tightly-knit medical alliance construction.Methods:On-site visits were conducted to 2 hospitals,3 community health service centers and 1 nursing home in Macao.Interviews and focus group discussions were held with key informants.Literature review was carried out at the same time.Qualitative and quantitative analysis methods were used to analyze the collected data.Results:Macao has clearly defined the functional positioning of public hospitals and primary healthcare institutions,and has given full play to the supplementary role of private medical institutions,establishing a grid-based medical and health service system with clear division of labor and public-private cooperation.Macao has implemented a strict system of first diagnosis in primary health care and two-way referral,providing high-quality and efficient medical and health services to community residents.Macao has institutionalized the salary system for medical personnel,with only a small income gap between different types of institutions and personnel,establishing a homogenized high-level medical and health salary system.Conclusion:The mainland should strengthen the financial protection,and promote the coordinated management of staff,funds and properties.Institutionalize the income and responsibility system for medical personnel,and narrow the income gap between different types of institutions and personnel,strengthen the functional positioning of primary health care and services for key populations,and promote first diagnosis in primary health care and two-way referral.