To achieve the national objectives of improving medical quality and safety,the Shanghai Shenkang Hospital Development Center has formulated a list of major targets,tasks,and key results based onthe Objective and Key Results (OKR) method.The primary approaches adopted include establishing an organizational structure to advance medical quality and safety supervision,setting up a series of quantitative indicators for medical quality and safety targets,formulating standardized management systems,building an information platform,and strengthening supervision.It argues that the adoption of OKR can effectively promote the implementation of national target management for improving medical quality and safety,establish a cross-institutional management network for medical quality and safety,strengthen process management,and effectively drive continuous improvement in medical quality and safety.

To achieve the national objectives of improving medical quality and safety,the Shanghai Shenkang Hospital Development Center has formulated a list of major targets,tasks,and key results based onthe Objective and Key Results (OKR) method.The primary approaches adopted include establishing an organizational structure to advance medical quality and safety supervision,setting up a series of quantitative indicators for medical quality and safety targets,formulating standardized management systems,building an information platform,and strengthening supervision.It argues that the adoption of OKR can effectively promote the implementation of national target management for improving medical quality and safety,establish a cross-institutional management network for medical quality and safety,strengthen process management,and effectively drive continuous improvement in medical quality and safety.

Objective: To analyze the status of colorectal cancer screening results in Shangcheng District, Hangzhou City from 2020 to 2022, so as to provide the evidence for developing prevention and control strategies for colorectal cancer. Methods: According to Colorectal Cancer Screening Program for Zhejiang Key Populations, residents registered in Shangcheng District and at ages of 50 to 74 years were recruited and screened using Zhejiang Provincial Questionnaires for Assessment of Risk of Colorectal Cancer Screening among High-risk Populations and fecal immunochemical test (FIT). Residents positive for questionnaires or FIT, or both positive for questionnaires and FIT were served as a positive screening and colonoscopy should be underwent. The rates of positive screening, compliance of colonoscopy and different pathological diagnosis results were analyzed. Results: Totally 118 227 residents were screened in Shangcheng District from 2020 to 2022, with a positive rate of 16.00%. The positive rates of questionnaires, FIT and both questionnaires and FIT were 8.14%, 6.46% and 1.40%, respectively. Colonoscopy was performed among 6 501 cases, with a compliance rate of 34.37%. Colonoscopy detected 3 689 cases with colorectal lesions, with a detection rate of 56.75%. The detection rates of colorectal cancer, pericancer lesions and other benign lesions were 1.12%, 9.15% and 46.47%, respectively. The detection rates of positive screening, colorectal lesions and pericancer lesions were higher in men (22.16%, 61.25% and 12.45%) than those in women (11.62%, 51.98% and 5.67%; all P<0.05). The detection rates of positive screening, colorectal lesions, colorectal cancer and pericancer lesions appeared a tendency towards a rise with age (all P<0.05). The detection rates of positive screening and colorectal lesions appeared a tendency towards a decline, and the compliance rate of colonoscopy appeared a tendency towards a rise from 2020 to 2022 (all P<0.05). The detection rate of pericancer lesions was higher among questionnaire and FIT positive residents (65.37%, P<0.05). Conclusions The detection rates of colorectal cancer and pericancer lesions in Shangcheng District from 2020 to 2022 were 1.12% and 9.15%, respectively. Men, the elderly, questionnaire and FIT positive residents are key populations, and the compliance of colonoscopy for the populations should be improved.

Objective:To establish virus culture method and full genome sequencing method for severe acute respiratory syndrome coronavirus (2019-nCoV), and to illuminate the variation of 2019-nCoV.Methods:The pharyngeal swab specimens were inoculated into Vero-E6 cells for isolation, and the cytopathic effect were observed day by day, and the result of virus isolation were confirmed by Real-Time RT-PCR. Some isolated viruses were diluted 10 times to detect the virus titer. Full-genome of 2019-nCoV was sequenced with the whole genome capture technology and next generation sequencing technology. Phylogenetic analysis and molecular characterization for obtained 2019-nCoV sequences were undertaken.Results:Twenty-two 2019-nCoV strains were isolated with Vero-E6 cell line in the Biosafety Level-3 Laboratory (BSL-3). Eighteen full-genome sequences obtained (almost 29 000 nucleotide) were analyzed with 99.94%~100% identity and 28 nucleotides and 20 amino acids variations. Phylogenetic analysis showed that the 2019-nCoV sequences belonged to different clades, including clade S and clade L with Europe lineage L. I and Europe lineage L. II.1. Furthermore, 5 of 18 2019-nCoV harbor the D614G mutation.Conclusions:2019-nCoV were successfully isolated with Vero-E6 cells, and partially illuminated the phylogenetic characteristics, which provided a basis for subsequent drug screening and biological characteristics research. Continuous monitoring and analysis of the sequences of new cases would be vital to understand the genetic evolution and rates of substitution of the 2019-nCoV.

Objectives:To explore the prognostic factors of primary central nervous system lymphoma(PCNSL) and to analyze the efficacy of different treatment methods.Methods:Clinical data of 4 812 patients with PCNSL in SEER database from January 1975 to December 2016 were retrospectively analyzed.Among them, 2 831 were male and 1 981 were female, the ratio of male to female was 1.4∶1.0.There were 2 236 cases(46.47%) under 60 years old, 1 718 cases(35.70%) aged 60 to 74 years old, and 858 cases(17.83%) aged 75 years old or above. Two thousand four hundred and seventeen cases(50.23%) had supratentorial tumors, 299 cases (6.21%) had infratentorial tumors, and 554 cases(11.51%) had multiple brain tumors, 1 542 cases (32.04%) were other or unspecified location.Three thousand five hundred and thirteen cases(73.00%) had diffuse large B-cell lymphoma (DLBCL), 234 cases(4.86%) had non DLBCL, 1 065 cases (22.13%) had other or unspecified types of tumor.The treatment included 2 011 cases (41.77%) of biopsy, 61 cases (1.27%) of subtotal resection(STR), 54 cases (1.12%) of gross total resection(GTR), 2 384 cases (49.54%) of biopsy and chemotherapy, 159 cases (3.30%) of STR and chemotherapy, 144 cases (3.00%) of GTR and chemotherapy.Univariate and multivariate Cox regression models were used to analyze the prognostic factors affecting the overall survival of the patients.Fine-Gray test and competitive risk model were used to analyze the prognostic factors affecting cancer-specific survival.Kaplan-Meier method and Log-rank test was used for survival analysis.Results:Univariate and multivariate Cox regression analyses showed that age, race, marital status, tumor site, pathological subtype, surgery, chemotherapy, combined with other malignant tumors, and HIV infection were the independent prognostic factors affecting the overall survival of PCNSL patients.The results of Fine-Gray test and competitive risk model analyses showed that age, race, marital status, tumor location, pathological subtype, surgical method, chemotherapy, combined with other malignant tumors, and HIV infection were independent prognostic factors affecting cancer-specific survival, while gender and radiotherapy had no significant correlation with cancer-specific survival.Compared with biopsy, PCNSL patients may benefit from surgical resection (STR: HR=0.805, 95% CI:0.656?0.989, P=0.04; GTR: HR=0.521, 95% CI:0.414?0.656, P<0.01).Kaplan-Meier survival analysis showed that the median survival time of biopsy+chemotherapy group was 28 months (95% CI:24.497?31.503), 2 months (95% CI:1.756?2.244) in the biopsy group, 2 months (95% CI:1.410-2.590) in the STR group, 19 months ( 95%CI:0?39.311) in the biopsy+chemotherapy group, 67 months (95% CI:46.187-87.813) in the STR+chemotherapy group, 84 months (95% CI:57.448?110.552) in the GTR+chemotherapy group.The median survival time of patients with different treatment methods was statistically significant ( P<0.01). Conclusions:Surgical resection may improve the prognosis of some PCNSL patients.Patients who have access to receive GTR or STR combined with chemotherapy may have prolonged Cancer-specific survival.

Programmed cell death ligand 1 (PD-L1)/programmed cell death protein 1 (PD-1) cascade is an effective therapeutic target for immune checkpoint blockade (ICB) therapy. Targeting PD-L1/PD-1 axis by small-molecule drug is an attractive approach to enhance antitumor immunity. Using flow cytometry-based assay, we identify tubeimoside-1 (TBM-1) as a promising antitumor immune modulator that negatively regulates PD-L1 level. TBM-1 disrupts PD-1/PD-L1 interaction and enhances the cytotoxicity of T cells toward cancer cells through decreasing the abundance of PD-L1. Furthermore, TBM-1 exerts its antitumor effect in mice bearing Lewis lung carcinoma (LLC) and B16 melanoma tumor xenograft

Objectives:To explore the prognostic factors of primary central nervous system lymphoma(PCNSL) and to analyze the efficacy of different treatment methods.Methods:Clinical data of 4 812 patients with PCNSL in SEER database from January 1975 to December 2016 were retrospectively analyzed.Among them, 2 831 were male and 1 981 were female, the ratio of male to female was 1.4∶1.0.There were 2 236 cases(46.47%) under 60 years old, 1 718 cases(35.70%) aged 60 to 74 years old, and 858 cases(17.83%) aged 75 years old or above. Two thousand four hundred and seventeen cases(50.23%) had supratentorial tumors, 299 cases (6.21%) had infratentorial tumors, and 554 cases(11.51%) had multiple brain tumors, 1 542 cases (32.04%) were other or unspecified location.Three thousand five hundred and thirteen cases(73.00%) had diffuse large B-cell lymphoma (DLBCL), 234 cases(4.86%) had non DLBCL, 1 065 cases (22.13%) had other or unspecified types of tumor.The treatment included 2 011 cases (41.77%) of biopsy, 61 cases (1.27%) of subtotal resection(STR), 54 cases (1.12%) of gross total resection(GTR), 2 384 cases (49.54%) of biopsy and chemotherapy, 159 cases (3.30%) of STR and chemotherapy, 144 cases (3.00%) of GTR and chemotherapy.Univariate and multivariate Cox regression models were used to analyze the prognostic factors affecting the overall survival of the patients.Fine-Gray test and competitive risk model were used to analyze the prognostic factors affecting cancer-specific survival.Kaplan-Meier method and Log-rank test was used for survival analysis.Results:Univariate and multivariate Cox regression analyses showed that age, race, marital status, tumor site, pathological subtype, surgery, chemotherapy, combined with other malignant tumors, and HIV infection were the independent prognostic factors affecting the overall survival of PCNSL patients.The results of Fine-Gray test and competitive risk model analyses showed that age, race, marital status, tumor location, pathological subtype, surgical method, chemotherapy, combined with other malignant tumors, and HIV infection were independent prognostic factors affecting cancer-specific survival, while gender and radiotherapy had no significant correlation with cancer-specific survival.Compared with biopsy, PCNSL patients may benefit from surgical resection (STR: HR=0.805, 95% CI:0.656?0.989, P=0.04; GTR: HR=0.521, 95% CI:0.414?0.656, P<0.01).Kaplan-Meier survival analysis showed that the median survival time of biopsy+chemotherapy group was 28 months (95% CI:24.497?31.503), 2 months (95% CI:1.756?2.244) in the biopsy group, 2 months (95% CI:1.410-2.590) in the STR group, 19 months ( 95%CI:0?39.311) in the biopsy+chemotherapy group, 67 months (95% CI:46.187-87.813) in the STR+chemotherapy group, 84 months (95% CI:57.448?110.552) in the GTR+chemotherapy group.The median survival time of patients with different treatment methods was statistically significant ( P<0.01). Conclusions:Surgical resection may improve the prognosis of some PCNSL patients.Patients who have access to receive GTR or STR combined with chemotherapy may have prolonged Cancer-specific survival.

Objective: To analyze the treatment effect of patients with glioblastoma (GBM) and explore prognostic factors. Methods: The clinical data of 635 patients diagnosed as GBM at Neurosurgical Oncology Department Ⅳ of Beijing Tiantan Hospital, Capital Medical University from January 2007 to March 2018 were retrospectively reviewed. There were 386 males and 249 females with an age of (48.7±11.8) years (range: 18-75 years). Patients were divided into three groups according to the time of admission: 2007-2010 group(n=174), 2011-2014 group (n=237) and 2015-2018 group (n=224). Kaplan-Meier plot was used to analyze the effects of different treatment periods, treatment schemes and clinical factors on the survival of patients with GBM. Cox proportion hazard regression analysis was used to identify independent prognostic factors. Results: The median progression-free survival (PFS) and overall survival (OS) of patients in 2007-2010 group, 2011-2014 group, 2015-2018 group was 9.0 months (95% CI: 7.5-10.5), 10.0 months (95% CI: 8.8-11.2), 12.0 months (95% CI: 10.7-13.3) and 17.0 months (95% CI: 13.2-20.8), 20.0 months (95% CI: 16.9-23.1), 23.0 months(95% CI: 17.5-28.5), respectively. The PFS and OS of patients improved significantly over the years (χ²=9.693, P=0.008 and χ²=8.616, P=0.013). Multivariate survival analysis showed that age, extent of resection, radiotherapy and tumor distant dissemination were independent prognostic factors (all P<0.05). Conclusions With the continuous development of clinical treatment regimen, the therapeutic effect of Chinese GBM patients has improved remarkably. Age, extent of resection, radiotherapy and tumor distant dissemination are independent prognostic factors associated with survival time.

Glioblastoma (GBM) is the most malignant primary brain tumor, and it has very poor prognosis. In recent years, the immunotherapy has become a hot issue in the treatment of malignancies. The traditional treatment regimen combined with immunotherapy might make a progress in the diagnosis and treatment of GBM. This paper reviews the explanation of the traditional chemoradiotherapy affecting the body's anti-tumor and immunity mechanism, and the current achievement of standard chemoradiotherapy combined with immunotherapy, to explore the potential benefits to GBM patients.

Objective To investigate the relationship between the expression of Pin1 and Ki67 and the clinicopathologic features of gastrointestinal stromal tumors (GIST).Methods 40 paraffin-embeded specimens of surgical resected GIST from Jan.2013 to May.2015 in Pathology Department of Yuhuangding Hospital Affiliated to Qingdao University were retrieved and expressions of Pin1 and Ki67 were detected by immunohistochemical methods.Results The positivity rate of Pin1 and Ki67 in GIST was 80％ and 32.5％ respectively.The expression of Pin1 was associated with malignancy of GIST,tumor location,tumor size and mitotic counts.The expression of Ki67 is associated with malignancy of GIST,tumor location,tumor size,mitotic counts and tumour necrosis.Pin1 expression was positively related with Ki67 expression.Conclusion Pin1 and Ki67 is closely related with malignancy of GIST,which may be potential factors in predicting prognosis of GIST.