Objective To analyze the correlation between the Patellotrochlear index at different knee flexion angles and recurrent patellar dislocation,and to find the optimal knee flexion angle and the best diagnostic cut-off value for predicting recurrent patellar dislocation.Methods A total of 35 patients clinically diagnosed with recurrent patellar dislocation(study group)were selected.The lengths of the central sagittal plane of the patellar cartilage and the corresponding femoral trochlear cartilage were measured at knee flexion angles ranging from 0° to 70°,in 10° increments.The Patellotrochlear index was calculated and compared with the MRI data from 55 healthy volunteers(control group).Results The Patellotrochlear index in the study group and the control group showed a positive correlation with the knee flexion angle(r=0.935 and 0.909,P＜0.001).Statistically significant differences were found between the two groups at knee flexion angles of 0°,10°,20°,30°,and 40°(t=7.480,5.742,5.200,3.558,4.271,P＜0.05).The predictive efficacy of the Patellotrochlear index for recurrent patellar dislocation varied at different knee flexion angles,with the area under the curve(AUC)and the best diagnostic cut-off values of 0.891,0.834,0.778,0.710,0.741 and 0.195,0.323,0.486,0.606,0.712,respectively.Conclusion There are significant differences in the Patellotrochlear index at different knee flexion angles.A knee flexion angle of 0° is the optimal knee flexion angle for the Patellotrochlear index to predict recurrent patellar dislocation,with a recommended best diagnostic cut-off value of 0.195.

Operation management is an important tool to promote the high-quality development of public hospitals in China.Since the founding of New China,based on China's economic and social development and medical and health system reform,the evolution of operation management of public hospitals in China can be divided into four stages,the system building stage(1949-1978),the liberalization and revitalization stage(1979-1996),the operation mechanism reform stage(1997-2020),and the new stage of high-quality development(2021 present).The development trend of public hospital operation management in future should deepen the public welfare-oriented public hospital operation management,explore the value-oriented medical operation management model based on high-quality development and the refined operation and management model of public hospitals,so as to promote the high-quality development of public hospitals in China.

Objective To investigate the level 4 surgical safety management in tertiary public hospitals in Sichuan Province.Methods A combination of questionnaires and qualitative interviews was used to investigate the basic situation of four-level surgery performed,the volume of surgery,and the management of surgery in 34 tertiary public hospitals in Sichuan Province.Results Among the 34 tertiary public hospitals surveyed,the percentage of patients discharged with level Ⅳ surgery in 2023 was 18.96％,which was lower than the level of the percentage of patients discharged with level Ⅳ surgery did not establish a leading group for level Ⅳ surgery (17.65％),a system for preoperative multidisciplinary discussion of level Ⅳ surgery(14.71％),and a system for preoperative multidisciplinary discussion of level Ⅳ surgery with various department-related expert pool(41.18％),multidisciplinary joint examination room(23.53％),and the monitoring and evaluation mechanism for the completion of preoperative multidisciplinary discussion for level 4 surgery(20.59％).Conclusion The volume of level Ⅳ surgeries in tertiary public hospitals in Sichuan Province needs to continue to be improved,and the establishment of a standardized management system for level Ⅳ surgeries is imperative.

Objective:To investigate the computed tomography (CT) imaging features of patients with chronic hydrocephalus after intracerebral hemorrhage surgery and the difference between endoscopic third ventriculostomy (ETV) and ventricular peritoneal shunt (VPS).Methods:A total of 158 patients with intracerebral hemorrhage who received surgical treatment in the Department of Neurosurgery of the People′s Hospital of Jinan from January 2021 to June 2023 were retrospectively selected as the study objects, including 78 patients with chronic hydrocephalus after surgery as the hydrocephalus group, and 80 patients with no hydrocephalus after surgery as the non-hydrocephalus group, and the CT imaging data of the patients were statistically analyzed. Hydrocephalus group was divided into ETV group (42 cases) and VPS group (36 cases) according to different treatment methods. The efficacy and quality of life of the two groups were compared, and the incidence of complications in the two groups were counted.Results:There was no significant difference between hydrocephalus group and non-hydrocephalus group in the site of cerebral hemorrhage, hematoma morphology and the proportion of patients with mixed signs, lobular signs and black hole signs (all P>0.05). The proportion of patients with ventricular dilation and hematoma enlargement in hydrocephalus group was significantly higher than that in non-hydrocephalus group (all P<0.05). The National Institute of Health Stroke Scale (NIHSS) scores of hydrocephalus patients in the two groups were measured continuously at different time points, and there was no significant difference in NIHSS scores between the ETV group and the VPS group before treatment, at 2 weeks and 4 weeks of treatment (all P>0.05). There was no significant difference between the ETV group and the VPS group ( P>0.05). The recurrence rate of the ETV group was lower than that of the VPS group ( P<0.05). The quality of life scores of patients in ETV group were higher than those in the VPS group at 3 months and 6 months after surgery ( P<0.05). Conclusions:CT examination of patients with chronic hydrocephalus after intracerebral hemorrhage will show obvious characteristics of hematoma enlargement and ventricle enlargement. The efficacy of ETV and VPS in the treatment of chronic hydrocephalus after intracerebral hemorrhage surgery is similar, but the former has a lower recurrence rate and a higher postoperative quality of life.

Objective To analyze the correlation between the Patellotrochlear index at different knee flexion angles and recurrent patellar dislocation,and to find the optimal knee flexion angle and the best diagnostic cut-off value for predicting recurrent patellar dislocation.Methods A total of 35 patients clinically diagnosed with recurrent patellar dislocation(study group)were selected.The lengths of the central sagittal plane of the patellar cartilage and the corresponding femoral trochlear cartilage were measured at knee flexion angles ranging from 0° to 70°,in 10° increments.The Patellotrochlear index was calculated and compared with the MRI data from 55 healthy volunteers(control group).Results The Patellotrochlear index in the study group and the control group showed a positive correlation with the knee flexion angle(r=0.935 and 0.909,P＜0.001).Statistically significant differences were found between the two groups at knee flexion angles of 0°,10°,20°,30°,and 40°(t=7.480,5.742,5.200,3.558,4.271,P＜0.05).The predictive efficacy of the Patellotrochlear index for recurrent patellar dislocation varied at different knee flexion angles,with the area under the curve(AUC)and the best diagnostic cut-off values of 0.891,0.834,0.778,0.710,0.741 and 0.195,0.323,0.486,0.606,0.712,respectively.Conclusion There are significant differences in the Patellotrochlear index at different knee flexion angles.A knee flexion angle of 0° is the optimal knee flexion angle for the Patellotrochlear index to predict recurrent patellar dislocation,with a recommended best diagnostic cut-off value of 0.195.

Objective To analyze the expression levels of miR-27a-3p mRNA and Yes-associated protein 1(YAP1)mRNA in breast cancer,and to explore their relationships with clinicopathological features and the survival prognosis of patients.Methods A total of 130 breast cancer patients who underwent mastectomy in our hospital between January 2019 and January 2021 were enrolled.The expression levels of miR-27a-3p and YAP1 mRNA in breast tumor tissues and adjacent normal breast tissues were assessed by qRT-PCR.Furthermore,the relationships between their expression and clinicopathological features,as well as the survival prognosis of patients,were investigated.Results Compared with adjacent normal breast tissues,the expression of miR-27a-3p mRNA in breast tumor tissues was lower(P＜0.05),while that of YAP1 mRNA was higher(P＜0.05).A negative correlation was observed between the expression of miR-27a-3p mRNA and YAP1 mRNA in breast tumor tissues(r=-0.456,P＜0.05).The expression of miR-27a-3p mRNA was correlated with tumor diameter,histological grade,tumor staging by the TNM system,lymph node metastasis,and vascular invasion in patients with breast cancer(P＜0.05).The YAP1 mRNA expression was correlated with histological grade,tumor staging by the TNM system,lymph node metastasis,and vascular invasion(P＜0.05).Kaplan-Meier survival analysis revealed that the 3-year overall survival rate of the miR-27a-3p low-expression group was 71.60％(48/67),which was lower than the 91.50％(54/59)of the miR-27a-3p high-expression group(log-rank x2=8.211,P=0.004).The 3-year overall survival rate of the YAP1 high-expression group was 73.80％(45/61),lower than that of the YAP1 low-expression group(87.70％,57/65)(log-rank x2=4.429,P=0.035).Multivariate regression analysis indicated that lymph node metastasis(hazard ratio[HR]=1.409;95％CI,1.057-1.644;P=0.046),vascular invasion(HR=1.541;95％CI,1.076-1.869;P=0.045),low miR-27a-3p mRNA expression(HR=0.593;95％CI,0.388-0.925;P=0.018),and high YAP1 mRNA expression(HR=0.628;95％CI,0.405-0.912;P=0.022)were relevant factors affecting the 3-year overall survival of patients with breast cancer.Conclusion A significant downregulation of miR-27a-3p mRNA and upregulation of YAP1 mRNA are observed in breast tumor tissues.The low expression of miR-27a-3p mRNA and the high expression of YAP1 mRNA are associated with adverse clinicopathological features and poor survival prognosis,and are risk factors affecting the 3-year overall survival of patients with breast cancer.They show promise as new potential therapeutic targets for breast cancer.

Objective:To propose suggestions for the revision of quality standard of steviol glycosides through research on its major manufacturer's products.Methods:The inspection items in the current quality standards were inspected,with domestic and international quality standard of steviol glycosides.Results:Specific rotation was from-33.39° to-39.50°,pH was from 5.3 to 6.7,impurity absorbency was lower than 0.096 0,while the contents of weight loss on drying were lower than 5.0％,residue on ignition were lower than 0.043％,methanol residual were lower than 0.01％,ethanol residual were lower than 0.06％,residue on arsenic were lower than 0.000 054％,lead wasn't detected.The content of rebaudioside A and 13 kinds of steviol glycosides were 8.23％-68.48％and 85.78％-96.13％.Conclusion:The main components of the commercial steviol glycosides products were rebaudioside A and stevioside,with low safety risk of elemental impurities and solvent residues.It provided suggestions for the revision of quality standard of steviol glycosides in the Chinese Pharmacopoeia.

Objective This study aims to explore the impacts of short-term insemination and early rescue intracytoplasmic sperm injection (E-RICSI) on clinical and neonatal outcomes for IVF patients. Methods A retrospective analysis was conducted on the clinical data from the patients who underwent fresh embryo transfer at the Reproductive Center from January 2019 to December 2023. Patients were divided into four groups based on fertilization method:short-term IVF group (n=204),conventional IVF group (n=208),E-RICSI group (n=13) and conventional ICSI group (n=92). The fertilization rates,embryo development,pregnancy outcomes,and neonatal outcomes were compared between the short-term IVF and conventional IVF groups,and between the E-RICSI and conventional ICSI groups. Results There were no statistically significant differences in embryo development,clinical pregnancy,miscarriage,ectopic pregnancy,live birth rates,neonatal sex,and birth weight between the short-term IVF group and conventional IVF group. Similarly,no significant differences were observed in the E-RICSI group compared to the conventional ICSI group (P>0.05). However,the fertilization rate (79.11％ vs. 84.39％,P<0.001) and the rate of 2PN zygotes (63.98％ vs. 70.83％,P<0.001) were significantly lower in the short-term IVF group compared to the conventional IVF group;The fertilization rate (65.49％ vs. 91.68％,P<0.001) and the rate of 2PN zygotes (57.75％ vs. 88.35％,P<0.001) were significantly lower in the E-RICSI group compared to the conventional ICSI group. Conclusions Although the fertilization rate of short-term insemination and E-RICSI is lower than that of conventional IVF and ICSI,it has no effect on embryonic development,preg-nancy outcome and neonatal outcome. Short-term insemination combined with early rescue ICSI is an effective and safe technology to prevent complete fertilization failure.

Objective:To propose suggestions for the revision of quality standard of steviol glycosides through research on its major manufacturer's products.Methods:The inspection items in the current quality standards were inspected,with domestic and international quality standard of steviol glycosides.Results:Specific rotation was from-33.39° to-39.50°,pH was from 5.3 to 6.7,impurity absorbency was lower than 0.096 0,while the contents of weight loss on drying were lower than 5.0％,residue on ignition were lower than 0.043％,methanol residual were lower than 0.01％,ethanol residual were lower than 0.06％,residue on arsenic were lower than 0.000 054％,lead wasn't detected.The content of rebaudioside A and 13 kinds of steviol glycosides were 8.23％-68.48％and 85.78％-96.13％.Conclusion:The main components of the commercial steviol glycosides products were rebaudioside A and stevioside,with low safety risk of elemental impurities and solvent residues.It provided suggestions for the revision of quality standard of steviol glycosides in the Chinese Pharmacopoeia.

Objective To investigate the level 4 surgical safety management in tertiary public hospitals in Sichuan Province.Methods A combination of questionnaires and qualitative interviews was used to investigate the basic situation of four-level surgery performed,the volume of surgery,and the management of surgery in 34 tertiary public hospitals in Sichuan Province.Results Among the 34 tertiary public hospitals surveyed,the percentage of patients discharged with level Ⅳ surgery in 2023 was 18.96％,which was lower than the level of the percentage of patients discharged with level Ⅳ surgery did not establish a leading group for level Ⅳ surgery (17.65％),a system for preoperative multidisciplinary discussion of level Ⅳ surgery(14.71％),and a system for preoperative multidisciplinary discussion of level Ⅳ surgery with various department-related expert pool(41.18％),multidisciplinary joint examination room(23.53％),and the monitoring and evaluation mechanism for the completion of preoperative multidisciplinary discussion for level 4 surgery(20.59％).Conclusion The volume of level Ⅳ surgeries in tertiary public hospitals in Sichuan Province needs to continue to be improved,and the establishment of a standardized management system for level Ⅳ surgeries is imperative.