Objective To construct a comprehensive evaluation model for physician promotion in tertiary hospitals,which is systematic,scientific and operational.Methods Based on the physician competency model,a multi-level evaluation index system was constructed through literature review,policy analysis,and Delphi method.A simulation assessment was conducted using the CRITIC-TOPSIS method on 22 clinical physicians from a tertiary general hospital in Sichuan Province.Results The final evaluation model,established after two rounds of Delphi consultation,consisted of 4 first-level indicators,10 second-level indicators and 33 third-level indicators.The expert authority coefficient was 0.776,and the Kendall's W coefficients for the two rounds were 0.386 and 0.348(P＜0.01),respectively.The weights for clinical practice,teaching,research,and ethical conduct were 49.44%,18.82%,20.13%,and 11.61%,respectively.Simulation score results show that,the average relative proximity values of case physicians to be promoted to senior,associate senior,and intermediate titles were 0.50,0.43,and 0.39,respectively.Conclusion The model demonstrates scientific validity and reliability for evaluating physician promotion to intermediate and senior professional titles.Five supporting recommendations are proposed:talent development,standard optimization,health information system management,communication and feedback mechanism,and performance enhancement.

Background:To compare the efficacy and safety of monthly administrations of gonadotropin releasing hormone (GnRH) agonists LY01005 and Zoladex ? in Chinese patients with premenopausal breast cancer. Methods:From October 2020 to November 2021, 188 premenopausal breast cancer patients were enrolled in 34 hospitals and randomized 1:1 to receive either LY01005 or Zoladex ? every 28 days for a total of three injections. All patients concomitantly received oral tamoxifen (TAM). The primary efficacy endpoint was cumulative probability of maintaining menopausal level [oestradiol (E2) ≤30 pg/ml] from day 29 to day 85. The second efficacy endpoint included changes in E2, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) compared with the baseline. Pharmacokinetics (PK), pharmacodynamics (PD), and safety were analyzed. The study also evaluated the pharmacokinetic and pharmacodynamic characteristics of LY01005. Results:A total of 188 patients were randomised and 187 patients received either LY01005 or Zoladex ?. Cumulative probabilities of maintaining menopausal level (E2≤30 pg/ml) from day 29 to day 85 were 93.1% for LY01005 and 86.3% for Zoladex ?. The between-group difference was 6.8% (95% CI: -2.3%, 15.9%) and primary efficacy in the LY01005 group was not inferior to that in the Zoladex ? group. Changes in E2, LH, and FSH levels compared with the baseline were equivalent between the two groups (E2: 89.34% to 90.23% vs. 82.11% to 85.02%; LH: 88.89% to 95.52% vs. 89.70% to 97.02%; FSH: 75.36% to 80.85% vs.73.07% to 80.24%, respectively). After three consecutive doses of LY01005, the LH and FSH levels of the subjects showed a transient increase after the first dose, reached a peak on the second day and then started to decrease. The LH and FSH reached a lower level and remained at or below that level until the 85th day. Both treatments were well-tolerated. Conclusion:LY01005 is as effective as Zoladex ? in suppressing E2 to menopausal levels in Chinese patients with premenopausal breast cancer, with a similar safety profile.

To provide scientific guidance and standardization for perioperative clinical nursing practice in patients undergoing percutaneous renal biopsy, relevant evidence on percutaneous renal biopsy nursing care was systematically retrieved and synthesized through an evidence-based approach. After two rounds of Delphi expert consultation and expert panel discussions, expert consensus on perioperative clinical nursing standards for patients undergoing percutaneous renal biopsy (hereinafter referred to as the "Consensus") was developed. The Consensus includes three primary themes: preoperative care, intraoperative care, and postoperative care, encompassing 21 secondary themes. It is characterized by scientific rigor, practical applicability, and comprehensiveness, and serves as a valuable reference and guide for clinical nursing professionals across medical institutions.

Objective To construct a comprehensive evaluation model for physician promotion in tertiary hospitals,which is systematic,scientific and operational.Methods Based on the physician competency model,a multi-level evaluation index system was constructed through literature review,policy analysis,and Delphi method.A simulation assessment was conducted using the CRITIC-TOPSIS method on 22 clinical physicians from a tertiary general hospital in Sichuan Province.Results The final evaluation model,established after two rounds of Delphi consultation,consisted of 4 first-level indicators,10 second-level indicators and 33 third-level indicators.The expert authority coefficient was 0.776,and the Kendall's W coefficients for the two rounds were 0.386 and 0.348(P＜0.01),respectively.The weights for clinical practice,teaching,research,and ethical conduct were 49.44%,18.82%,20.13%,and 11.61%,respectively.Simulation score results show that,the average relative proximity values of case physicians to be promoted to senior,associate senior,and intermediate titles were 0.50,0.43,and 0.39,respectively.Conclusion The model demonstrates scientific validity and reliability for evaluating physician promotion to intermediate and senior professional titles.Five supporting recommendations are proposed:talent development,standard optimization,health information system management,communication and feedback mechanism,and performance enhancement.

To provide scientific guidance and standardization for perioperative clinical nursing practice in patients undergoing percutaneous renal biopsy, relevant evidence on percutaneous renal biopsy nursing care was systematically retrieved and synthesized through an evidence-based approach. After two rounds of Delphi expert consultation and expert panel discussions, expert consensus on perioperative clinical nursing standards for patients undergoing percutaneous renal biopsy (hereinafter referred to as the "Consensus") was developed. The Consensus includes three primary themes: preoperative care, intraoperative care, and postoperative care, encompassing 21 secondary themes. It is characterized by scientific rigor, practical applicability, and comprehensiveness, and serves as a valuable reference and guide for clinical nursing professionals across medical institutions.

Background:To compare the efficacy and safety of monthly administrations of gonadotropin releasing hormone (GnRH) agonists LY01005 and Zoladex ? in Chinese patients with premenopausal breast cancer. Methods:From October 2020 to November 2021, 188 premenopausal breast cancer patients were enrolled in 34 hospitals and randomized 1:1 to receive either LY01005 or Zoladex ? every 28 days for a total of three injections. All patients concomitantly received oral tamoxifen (TAM). The primary efficacy endpoint was cumulative probability of maintaining menopausal level [oestradiol (E2) ≤30 pg/ml] from day 29 to day 85. The second efficacy endpoint included changes in E2, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) compared with the baseline. Pharmacokinetics (PK), pharmacodynamics (PD), and safety were analyzed. The study also evaluated the pharmacokinetic and pharmacodynamic characteristics of LY01005. Results:A total of 188 patients were randomised and 187 patients received either LY01005 or Zoladex ?. Cumulative probabilities of maintaining menopausal level (E2≤30 pg/ml) from day 29 to day 85 were 93.1% for LY01005 and 86.3% for Zoladex ?. The between-group difference was 6.8% (95% CI: -2.3%, 15.9%) and primary efficacy in the LY01005 group was not inferior to that in the Zoladex ? group. Changes in E2, LH, and FSH levels compared with the baseline were equivalent between the two groups (E2: 89.34% to 90.23% vs. 82.11% to 85.02%; LH: 88.89% to 95.52% vs. 89.70% to 97.02%; FSH: 75.36% to 80.85% vs.73.07% to 80.24%, respectively). After three consecutive doses of LY01005, the LH and FSH levels of the subjects showed a transient increase after the first dose, reached a peak on the second day and then started to decrease. The LH and FSH reached a lower level and remained at or below that level until the 85th day. Both treatments were well-tolerated. Conclusion:LY01005 is as effective as Zoladex ? in suppressing E2 to menopausal levels in Chinese patients with premenopausal breast cancer, with a similar safety profile.

Entinostat plus exemestane in hormone receptor-positive (HR+) advanced breast cancer (ABC) previously showed encouraging outcomes. This multicenter phase 3 trial evaluated the efficacy and safety of entinostat plus exemestane in Chinese patients with HR + ABC that relapsed/progressed after ≥1 endocrine therapy. Patients were randomized (2:1) to oral exemestane 25 mg/day plus entinostat (n = 235) or placebo (n = 119) 5 mg/week in 28-day cycles. The primary endpoint was the independent radiographic committee (IRC)-assessed progression-free survival (PFS). The median age was 52 (range, 28-75) years and 222 (62.7%) patients were postmenopausal. CDK4/6 inhibitors and fulvestrant were previously used in 23 (6.5%) and 92 (26.0%) patients, respectively. The baseline characteristics were comparable between the entinostat and placebo groups. The median PFS was 6.32 (95% CI, 5.30-9.11) and 3.72 (95% CI, 1.91-5.49) months in the entinostat and placebo groups (HR, 0.76; 95% CI, 0.58-0.98; P = 0.046), respectively. Grade ≥3 adverse events (AEs) occurred in 154 (65.5%) patients in the entinostat group versus 23 (19.3%) in the placebo group, and the most common grade ≥3 treatment-related AEs were neutropenia [103 (43.8%)], thrombocytopenia [20 (8.5%)], and leucopenia [15 (6.4%)]. Entinostat plus exemestane significantly improved PFS compared with exemestane, with generally manageable toxicities in HR + ABC (ClinicalTrials.gov #NCT03538171).

Objective:To investigate the correlation between activities of daily living and hemoglobin level in patients with acute ischemic stroke (AIS).Methods:A retrospective analysis was performed in 190 patients with acute ischemic stroke from August 2015 to April 2017. The hemoglobin (Hb) levels at admission were analyzed . According to the Barthel index (BI) score, the patients were divided into good improvement group ( n=119) and poor improvement group ( n=71). Spearman correlation analysis was used to study the relationship between hemoglobin level and short-term activities of daily living in patients with acute ischemic stroke. Results:(1)The short-term activities of daily living was improved in 119 patients. Among them, 62 (52.1%) were under 65 years old and 57 (47.9%) were over 65 years old, 9 (7.56%) male patients with hemoglobin <120 g/L and 39 (32.77%) male patients with hemoglobin > 150 g/L. There were 71 patients with poor short-term activities of daily living. Among them, 23(32.39%)were under 65 years old and 48(67.61%)were over 65 years old, 1(1.41%)male patients with hemoglobin <120 g/L and 12(16.9%) male patients with hemoglobin > 150 g/L. There were significant differences in age (χ 2= 6.985, P=0.008) and male hemoglobin level (χ 2= 8.069, P=0.005) between patients with good activities of daily living and patients with poor activities of daily living.(2)Regression analysis showed that age > 65 years ( β =1.386, OR=4.000, 95% CI=1.189-3.461, P=0.025) and abnormal hemoglobin levels in men (Hb<120 g/L or > 150 g/L) ( β =1.089, OR=2.972, 95% CI=1.383-6.388, P=0.005) were the influencing factors of poor short-term quality of life in patients with acute ischemic stroke.(3)Spearman correlation analysis showed that abnormal hemoglobin levels in men (Hb<120 g/L or>150 g/L) were positively correlated with poor short-term activities of daily living in patients with acute ischemic stroke( r=0.244, P=0.004). Conclusion:Abnormal hemoglobin level is associated with poor short-term activities of daily living improvement in patients with acute ischemic stroke.

Objective:To investigate the correlation between serum 25-hydroxyvitamin D (serum 25(OH)D) and Meige syndrome.Methods:A retrospective analysis was performed on 47 patients with Meige syndrome (Meige syndrome group) treated in Yuquan Hospital of Tsinghua University admitted from August 2012 to July 2018 in our hospital.In the same period, 69 healthy people of the same age group were selected as the healthy control group.The difference of serum 25(OH)D concentration among different subtypes of Meige syndrome (type I, II, III) was compared.Logistic regression analysis was used to analyze the correlation between serum 25(OH)D level and Meige syndrome.Results:The serum 25(OH)D concentration in patients with Meige syndrome was (12.68±6.77) μg/L, which was significantly lower than that in the healthy control group ((17.93±6.93) μg/L). The difference was statistically significant ( t=4.044, P<0.001). The serum 25(OH)D concentrations of subtypes I, II and III in patients with Meige syndrome were (14.7±8.14), (11.4±5.02), (8.38±4.99) μg/L, respectively. There was no significant difference among the three types ( F=1.892, P=0.231). Logistic regression results showed that serum 25(OH)D levels were correlated with Meige syndrome ( OR=0.938, 95% CI: 0.885-0.995, P=0.034). Conclusion:The serum 25(OH)D expression level in patients with Meige syndrome is low, suggesting that vitamin D deficiency may be involved in the pathogenesis of Meige syndrome.

Objective:To investigate the levels and the clinical signficance of matrix metalloproteinase 3 (MMP-3) in different activities of rheumatoid arthritis (RA).Methods:Case-control study. A total of 130 patients [24 cases of male, 106 cases of female, age (52.98±13.24)years, the median age was 51 years] with RA diagnosed in the Department of Rheumatology from the Second Affiliated Hospital of Soochow University, Suzhou Hospital of Traditional Chinese Medicine and Suzhou Ninth People′s Hospital from 2017 to 2018, and 100 healthy controls [28 cases of male, 72 cases of female, age (45.04±11.55) years, the median age was 44 years] from the physical examination center of the Suzhou Ninth People′s Hospital. The basic clinical data was used to determine the MMP-3 on groups of RA patients and healthy controls by immunoturbidimetry. The discriminating validity of MMP-3 in disease was evaluated using receiver operating characteristic (ROC) curve analysis.Results:Compared with that in healthy controls[28.0 (21.7-36.1)ng/mL], the MMP-3 in the low groups [51.8(41.8-73.1)ng/mL] increased dramatically ( Z=2.942, P<0.01). However, there was no significant difference between the MMP-3 in remission patients [28.8 (21.9-38.7)ng/mL] compared with the healthy controls ( Z=1.09, P>0.05). The area under the curve (AUC) of MMP-3 for diagnosis of RA was 0.877. the sensitivity was 73.1%, and the specificity was 93%.The AUC of MMP-3 diagnosis of low groups was 0.906, the sensitivity was 77.8%, and the specificity was 88%. In addition, the MMP-3 level was correlated with CRP and ESR ( r=0.242, r=0.243), and it was significantly correlated with DAS 28 ( r=0.361). Conclusions:It was indicated that the level of MMP-3 increased with the severity of rheumatoid arthritis. And the clinically low level of MMP-3 in RA patients could be used to indicate the remission condition. Meanwhile, the serum MMP-3 was closely related to DAS28.