Objective:To evaluate the application value of the Supply-Processing-Distribution(SPD)supply chain mode in the refined management for medical consumables in hospital on the basis of SPD supply chain mode.Methods:An integrated efficiency index system was constructed based on SPD,and the Analytic Hierarchy Process(AHP)and Entropy Method were used to determine index weights by combined weighting.Medical consumables were classified and managed according to the index weight values.A total of 63,461 types of medical consumables(included low-value medical consumables and high-value medical consumables)that was used in clinical practice at Beijing Anzhen Hospital,Capital Medical University from January to June 2021 and January to June 2023 were selected.In them,the 54,632 types of medical consumables that were used between January and June 2021 were managed by adopting conventional supply chain mode,while 56,471 types of medical consumables that were used(included 47,642 types of medical consumables that were managed by conventional supply chain made at the first stage,and 8,829 types of new medical consumables)between January and June 2023 were managed by adopting the SPD supply chain mode.The inventory amount,inventory quantity,loss rate,and return or change rate of medical consumables of the two management modes were compared.A self-designed satisfaction questionnaire was used to evaluate the satisfaction of medical staffs,who used these medical consumables,for the two kinds of management modes.Results:The inventory amount of low-value medical consumables that were managed by the SPD supply chain mode was(1,424.09±75.68)million CNY,which was lower than(2,290.79±215.93)million CNY of adopting conventional supply chain mode,with a statistically significant difference(t=8.85,P<0.05).The inventory amount of high-value medical consumables that were managed by the SPD supply chain mode was 0,which was lower than(7,692.32±360.53)million CNY of adopting conventional supply chain mode,with a statistically significant difference(Z=-2.201,P<0.05).The inventory quantities of both low-value and high-value medical consumables of adopting SPD supply chain mode were significantly lower than those of adopting conventional supply chain mode,with statistically significant differences(t=10.443,11.225,P<0.05).The average loss rates of both low-value and high-value medical consumables of adopting SPD supply chain mode were significantly lower than those of adopting conventional supply chain mode,with statistically significant differences(Z=-2.207,-2.201,P<0.05).The average return or change rates of both low-value and high-value medical consumables of adopting SPD supply chain mode were significantly lower than those of adopting conventional supply chain mode,with statistically significant differences(t=14.685,8.716,P<0.01).The satisfaction scores of medical staffs from different departments for medical consumables of adopting the SPD supply chain mode were higher than those of adopting conventional supply chain mode,with a statistically significant difference(t=7.674,P<0.05).Conclusion:The application of the SPD supply chain mode for medical consumables in hospital can reduce the inventory amount,inventory quantity,loss rate,and return or change rate of medical consumables,and improve the satisfaction of medical staffs.

Objective:To evaluate the application value of the Supply-Processing-Distribution(SPD)supply chain mode in the refined management for medical consumables in hospital on the basis of SPD supply chain mode.Methods:An integrated efficiency index system was constructed based on SPD,and the Analytic Hierarchy Process(AHP)and Entropy Method were used to determine index weights by combined weighting.Medical consumables were classified and managed according to the index weight values.A total of 63,461 types of medical consumables(included low-value medical consumables and high-value medical consumables)that was used in clinical practice at Beijing Anzhen Hospital,Capital Medical University from January to June 2021 and January to June 2023 were selected.In them,the 54,632 types of medical consumables that were used between January and June 2021 were managed by adopting conventional supply chain mode,while 56,471 types of medical consumables that were used(included 47,642 types of medical consumables that were managed by conventional supply chain made at the first stage,and 8,829 types of new medical consumables)between January and June 2023 were managed by adopting the SPD supply chain mode.The inventory amount,inventory quantity,loss rate,and return or change rate of medical consumables of the two management modes were compared.A self-designed satisfaction questionnaire was used to evaluate the satisfaction of medical staffs,who used these medical consumables,for the two kinds of management modes.Results:The inventory amount of low-value medical consumables that were managed by the SPD supply chain mode was(1,424.09±75.68)million CNY,which was lower than(2,290.79±215.93)million CNY of adopting conventional supply chain mode,with a statistically significant difference(t=8.85,P<0.05).The inventory amount of high-value medical consumables that were managed by the SPD supply chain mode was 0,which was lower than(7,692.32±360.53)million CNY of adopting conventional supply chain mode,with a statistically significant difference(Z=-2.201,P<0.05).The inventory quantities of both low-value and high-value medical consumables of adopting SPD supply chain mode were significantly lower than those of adopting conventional supply chain mode,with statistically significant differences(t=10.443,11.225,P<0.05).The average loss rates of both low-value and high-value medical consumables of adopting SPD supply chain mode were significantly lower than those of adopting conventional supply chain mode,with statistically significant differences(Z=-2.207,-2.201,P<0.05).The average return or change rates of both low-value and high-value medical consumables of adopting SPD supply chain mode were significantly lower than those of adopting conventional supply chain mode,with statistically significant differences(t=14.685,8.716,P<0.01).The satisfaction scores of medical staffs from different departments for medical consumables of adopting the SPD supply chain mode were higher than those of adopting conventional supply chain mode,with a statistically significant difference(t=7.674,P<0.05).Conclusion:The application of the SPD supply chain mode for medical consumables in hospital can reduce the inventory amount,inventory quantity,loss rate,and return or change rate of medical consumables,and improve the satisfaction of medical staffs.

Objective To observe value of thin slice CT multiple signs combined with multiplanar reformation(MPR)for diagnosing tracheobronchial tuberculosis(TBTB).Methods Data of 234 TBTB patients who underwent chest thin slice CT scanning were retrospectively analyzed.MPR was performed,the direct signs and indirect signs of TBTB were observed.The diagnostic efficacy of axial plain CT images(direct observation)and of MPR combined with the former(combined observation)were compared.Results The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of direct observation was 38.88％(201/517),98.13％(1 789/1 823),85.53％(201/235),84.99％(1 789/2 105)and 85.04％(1 990/2 340),respectively,of combined observation was 91.10％(471/517),98.85％(1 802/1 823),95.54％(471/493),97.51％(1 802/1 848)and 97.14％(2 273/2 340),respectively.Significant differences of sensitivity,positive predictive value,negative predictive value and accuracy were found(all P＜0.001),whereas no significant difference of specificity was found between 2 methods(P＞0.05).Conclusion Thin slice CT multiple signs combined with MPR could be used to effectively diagnose TBTB.

The acute combination fractures of the atlas and axis in adults have a higher rate of neurological injury and early death compared with atlas or axial fractures alone. Currently, the diagnosis and treatment choices of acute combination fractures of the atlas and axis in adults are controversial because of the lack of standards for implementation. Non-operative treatments have a high incidence of bone nonunion and complications, while surgeries may easily lead to the injury of the vertebral artery, spinal cord and nerve root. At present, there are no evidence-based Chinese guidelines for the diagnosis and treatment of acute combination fractures of the atlas and axis in adults. To provide orthopedic surgeons with the most up-to-date and effective information in treating acute combination fractures of the atlas and axis in adults, the Spinal Trauma Group of Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field of spinal trauma to develop the Evidence-based guideline for clinical diagnosis and treatment of acute combination fractures of the atlas and axis in adults ( version 2023) by referring to the "Management of acute combination fractures of the atlas and axis in adults" published by American Association of Neurological Surgeons (AANS)/Congress of Neurological Surgeons (CNS) in 2013 and the relevant Chinese and English literatures. Ten recommendations were made concerning the radiological diagnosis, stability judgment, treatment rules, treatment options and complications based on medical evidence, aiming to provide a reference for the diagnosis and treatment of acute combination fractures of the atlas and axis in adults.

Detection of serum biomarkers is an important strategy for the diagnosis of cardiovascular diseases. The roles of serum biomarker detection have become increasingly valuable in the baseline risk stratification among cancer patients in recent years. The Cardio-oncology Study Group of the Heart Failure Association and the Cardio-Oncology Council of the European Society of Cardiology newly proposed the “role of serum biomarkers in cancer patients receiving cardiotoxic cancer therapies”. By evaluating the characteristics of cardiac biomarkers in cancer patients receiving cardiotoxic cancer therapy, this statement discussed the mechanism, clinical application, value on monitoring and prognosis of the two main biomarkers,cardiac troponin and natriuretic peptide on chemotherapy induced cardiac toxic responses. The purpose of this statement is to help establish the multidisciplinary collaborative diagnosis and treatment strategies and provide a clinical framework, and guide clinicians to select appropriate serum biomarker monitoring programs based on risk stratification to prevent cardiovascular disease in cancer patients.

Objective:To investigate the contamination status of SARS-CoV-2 in imported frozen seafood from a Russia cargo ship in Qingdao and to analyze the risk factors for infection in local stevedores.Methods:The method of "two-stage, full coverage and mixed sampling" was used to collect the seafood packaging samples for the nucleic acid detection of SARS-CoV-2 by real-time fluorescent quantitative RT-PCR. A unified questionnaire was designed to investigate 71 stevedores in two shifts through telephone interview. The stevedores were divided into two groups, with 23 in the shit with two infections was group A and 48 in the shift without infection was group B. Software Epi Info7.2 was used to identify the risk factors for SARS-CoV-2 infections in the stevedores.Results:In the frozen seafood from a Russia cargo ship, the total positive rate of SARS-CoV-2 nucleic acid in the frozen seafood was 11.53% (106/919). The positive rate of SARS-CoV-2 nucleic acid in the frozen seafood unloaded by group A (14.29%,70/490) was significantly higher than that in the frozen seafood unloaded by group B (8.39%,36/429)( χ2=7.79, P=0.01) and the viral loads detected in the frozen seafood unloaded by group A were higher than those detected in the frozen seafood unloaded by group B. The scores of personal protection and behaviors in the stevedores in group A were significantly lower than those in group B ( P<0.05), and toilet use, smoking and improper hand washing before meals were the risk factors for the infection. Conclusions:The imported frozen seafood was contaminated by SARS-CoV-2 and the contamination distribution was uneven. Supervision and management of personal occupational protection and behaviors of workers engaged in imported frozen food transportation should be strengthened. It is suggested that a closed-loop monitoring and management system for the whole process of "fishing-transport- loading/unloading" should be established by marine fishery authority.

Cardio-oncology has developed into a new subspecialty of modern cardiology, and the clinical mentors usually need to guide students to focus on this frontier field. However, there are many deficiencies in the field of cardio-oncology training in China, and there is a lack of perfect teaching and training objectives and evaluation system. In order to adapt to the goal and orientation of talent training in cardio-oncology, the First Affiliated Hospital of Dalian Medical University adopts a multi-disciplinary teaching mode. Corresponding teaching contents and training objectives are set according to the trainees at different levels of training, and various teaching methods and assessment forms are cooperated to explore and establish the training and assessment system of cardio-oncology for doctors at different levels. The system is put into practice, and the teaching effect is outstanding which has been widely recognized by teachers and students.

According to the pathological characteristics of symptomatic chronic thoracic and lumbar osteoporotic vertebral fracture (SCOVF), the different clinical treatment methods are selected, including vertebral augmentation, anterior-posterior fixation and fusion, posterior decompression fixation and fusion, and posterior correction osteotomy. However, there is still a lack of a unified understanding on how to choose appropriate treatment method for SCOVF. In order to reflect the new treatment concept and the evidence-based medicine progress of SCOVF in a timely manner and standardize its treatment, the clinical guideline for surgical treatment of SCOVF is formulated in compliance with the principle of scientificity, practicability and advancement and based on the level of evidence-based medicine.

Objectives:To observe the anatomical location and mechanism of axis ring fractures (ARF) using 3-D CT scans, and propose a new classification for such fractures.Methods:By reviewing prospectively maintained database collecting ARF from 7 medical centers in China, 202 patients were included in this study. According to anatomical location, ARFs were classified into axis arthrosis fracture (AAF) and axis bony damage (ABD). The axis ring was divided into anterior, middle, and posterior rings, based on the border of the pars interarticularis (or pedicle) of axis. According to the features of ARF and previous study, a new classification was proposed based on the anatomical features of different fracture patterns, which was divided into three types and six subtypes (A1, A2, B1, B2, C1 and C2). The incidence of AAF and ABD and their distribution in different location of axis ring and the new classification, were observed.Results:In 202 patients with ARF, 501 anatomical structures were involved. 288 AAFs were found in 178 patients (288/501, 57%), while 213 ABDs were found in 149 patients (213/501, 43%). In anterior ring, 304 structures (304/501, 61%) were involved in injury, with 225 AAF and 79 ABD. In middle ring, 99 structures (99/501, 20%) were involved in injury, and all of them were ABD. In posterior ring, 98 structures (98/501, 19%) were involved in injury, with 63 AAF and 35 ABD. The anterior ring injuries (61%) were more common than middle (20%) or posterior ring (19%). In anterior ring, AAF (84%) were morecommon than ABD (16%); In middle ring, all the injuries were ABD; In posterior ring, AAFs (64%) were more common than ABD (36%). Type A fractures were featured with pedicle fractures and were identified in 30 patients (30/202, 15%). Type A1 fractures were bilateral pedicle fracture lines symmetrically or asymmetrically and identified in 12 (6%) patients; Type A2 fractures were pedicle fracture lineson one side and inferior articular facet injuries or lamina fractures on the otherside and identified in 18 (9%) patients. Type B fractures were featured with superior articular facet injuries or posterior wall of C2 body fractures on one side and identified in 136 patients (67%). Type B1 fractures were superior articular facet injuries or posterior wall of C2 body fractures on one side and pedicle fracture on the other side and identified in 57 (28%) patients; Type B2 fractures were superior articular facet injuries or posterior wall of C2 body fractures on one side and inferior articular facet injuries or lamina fractures on the otherside and identified in 79 (39%) patients. Type C fractures were featured with bilateral superior articular facet injuries or posterior wall of C2 body fractures and identified in 36 patients (18%). Type C1 fractures were bilateral superior articular facet injuries or posterior wall of C2 body fractures symmetrically and identified in 22 (11%) patients; Type C2 fractures were bilateral superior articular facet injuries or posterior wall of C2 body fractures asymmetrically and identified in 14 (7%) patients.Conclusion:ARF could occur in different anatomical locations, and most of these fractures were caused by hyperextension and axial load on superior articular facet on one or two sides. The new CT classification of ARF with three types and six subtypes might provide all fracture patterns, which could be useful for the choice of proper diagnosis and treatment for such fractures.

Objective To investigate the experience in management of the high risk benign prostatic hyperplasia (BPH) patients in order to improve the safety of the operation.Methods The high-risk factors of 115 patients with BPH who had been treated with transurethral resection of prostate (TURP) were analyzed.The blood pressure of hypertensive patients should be controlled below 140/90 mm Hg.The patients with myocardial infarction should be in stable condition for more than 6 months.Smoking cessation,oxygen inhalation,and pulmonary function training should be carried out during the perioperative period in patients with chronic obstructive pulmonary disease,correct expectoration methods and rational use of antibiotics were also needed to improve the maximum amount of pulmonary ventilation to more than 70％.The blood-glucose of diabetic patients should be controlled below 8 mmol/L by insulin.Catheter was indwelled in patients with chronic obstructive renal insufficiency for more than 2 weeks so that the blood Cr could be below 130 μmol/L.Anticoagulant therapy should stop at least 5 days before surgery.Patients were encouraged to have physical training early after surgery and to have ankle stretch movement when they recovered form anesthesia,and pressure cycle drive therapeutic apparatus were also used to prevent deep venous thrombosis.Results All the patients tolerated TURP safely.Operation time was 30 to 60 min,the weight of the resection prostate tissue was 12 to 37 g,blood loss was 80 to 150 ml,and catheterization time was 3 to 7 days.The overall incidence of complications was 1.7％.There were 2 cases with deep venous thrombosis,who recovered after anticoagulant therapy.There were no pulmonary infection,bleeding,TUR syndrome,and other complications.Conclusion Correct analysis and effective management of the perioperative risk factors in high-risk BPH patients treated with TURP can improve the safety of the operation and reduce the complications.