Objective To analysis the current situation of clinical pathway implementation and management of 53 public general hospitals in 16 cities in Anhui Province from 2018 to 2021,so as to provide a basis for further strengthening the management of clinical pathways in Anhui Province.Methods From December 2022 to March 2023,questionnaire stars were used to conduct a questionnaire survey on the implementation status of clinical pathway management.Results In 2021,53 public general hospitals implemented an average of 23.56 clinical pathways,228.75 diseases,88.58％ of the average admission rate,69.08％ of the average coverage rate,and 92.85％ of the average completion rate,meeting the national requirements. However,the number of departments,coverage and completion rate showed a small increase over the past four years.The hospital level,the time of information system implementation,the position of the clinical pathway leader,whether it is linked to departmental and individual bonuses,and the integration of clinical pathways with DRG/DIP payment methods all have statistically significant effects on the implementation effectiveness of clinical pathways(P<0.05).Conclusion Since the establishment of the Clinical Pathway Management Center in 2015,Anhui Province has promoted the implementation of clinical pathway management in the province's second-level and above public hospitals every year,but it has entered management after 2018.It is suggested that Anhui Province should strengthen the attention of hospital leaders,information management and the integration of clinical paths and medical insurance payment methods in the future,so as to achieve a balance between cost control and reasonable diagnosis and treatment.

This article presents a case study of a patient who had Cronkhite-Canada syndrome in combination with an asymptomatic novel coronavirus infection. The patient exhibited clinical symptoms of loss of appetite, hair and nail loss, and skin pigmentation. Digestive endoscopy revealed widespread and varying-sized polypoid changes in the mucosa of the stomach, duodenum, and colon. During the course of the illness, the patient tested positive for novel coronavirus nucleic acid. Treatment with moderate doses of prednisone resulted in the patient's hair regrowth and decreased skin hypopigmentation. The article provides a summary of the patient's diagnosis and treatment and a review of relevant literature, with the aim of enhancing clinicians' understanding of the disease.

Objective To analysis the current situation of clinical pathway implementation and management of 53 public general hospitals in 16 cities in Anhui Province from 2018 to 2021,so as to provide a basis for further strengthening the management of clinical pathways in Anhui Province.Methods From December 2022 to March 2023,questionnaire stars were used to conduct a questionnaire survey on the implementation status of clinical pathway management.Results In 2021,53 public general hospitals implemented an average of 23.56 clinical pathways,228.75 diseases,88.58％ of the average admission rate,69.08％ of the average coverage rate,and 92.85％ of the average completion rate,meeting the national requirements. However,the number of departments,coverage and completion rate showed a small increase over the past four years.The hospital level,the time of information system implementation,the position of the clinical pathway leader,whether it is linked to departmental and individual bonuses,and the integration of clinical pathways with DRG/DIP payment methods all have statistically significant effects on the implementation effectiveness of clinical pathways(P<0.05).Conclusion Since the establishment of the Clinical Pathway Management Center in 2015,Anhui Province has promoted the implementation of clinical pathway management in the province's second-level and above public hospitals every year,but it has entered management after 2018.It is suggested that Anhui Province should strengthen the attention of hospital leaders,information management and the integration of clinical paths and medical insurance payment methods in the future,so as to achieve a balance between cost control and reasonable diagnosis and treatment.

Paraneoplastic neurological syndromes (PNS) are heterogeneous disorders caused by autoimmune responses of cancer, which can affect any part of the nervous system. Anti-amphiphysin antibody is one of the high-risk PNS antibodies, which is usually associated with small cell lung cancer and breast cancer. However, extrapulmonary neuroendocrine carcinoma is rare in patients with anti-amphiphysin antibody. A case of anti-amphiphysin-associated paraneoplastic brainstem encephalitis with esophageal neuroendocrine carcinoma is reported. The tumor was detected by fluorine 18 fluorodeoxyglucose positron emission tomography and pathologically confirmed by gastroscopic biopsy. The patient′s neurological symptoms were partially improved after treatment of intravenous immunoglobulin and glucocorticoids. However, the disease prognosis is closely related to the accompanying tumor.

Objective To analyze the clinical and histology characteristics of a patient with frontal lobe epilepsy diagnosed with mild malformation of cortical development with oligodendroglial hyperplasia, and to recognize the new neuropathological entity. Methods Clinical history, seizure types, neuroimaging, electroencephalography as well as macroscope, histology and immunohistochemistry characteristics were collected from a frontal lobe epilepsy patient and were compared with cases from literature. Results It was a female patient aged 16 years with 12 years history of epilepsy. The seizures manifested as episodes of conscious loss with automatism including grope and voice lasting for seconds. About 10 episodes a day were found and sometimes with secondary generalized tonic-clonic seizures. MRI showed blurring of grey-white matter interface in left orbital frontal cortex. Video-encephalography revealed left frontal lobe origin of seizures. So left prefrontal lobe was removed. Histology showed almost normal cortex neuropil and neurons. Blurring of grey-white interface in some area with patches of proliferation of oligodendrocytes in the corresponding sub-cortical white matter was found. The density of oligodendrocytes was significantly higher in sub-cortical than in deep white matter both shown in HE and Oligo-2 staining. Obvious oligodendrocytes increase and satellite phenomenon in deep cortical layer as well as increased ectopic neurons in sub-cortical white matter were found in the lesion. In proliferation area, there were some nuclei stained with Ki-67, but not as high as tumor. Subsequent follow up for two years proved the operation efficacy and benign prognosis. Conclusions There are special and undiscovered histopathological entities in epilepsy etiology. Although known as grey matter disease, white matter pathology plays an important role in epilepsy pathophysiology which needs further research.