With the continuous advancement of internet technology and the improvement of internet literacy among the general population, the concept of online-offline integration in internet hospitals has gradually gained acceptance and has been applied and developed both domestically and internationally. In thoracic surgery, the applicability of this model lies in enhancing efficiency and delivering comprehensive, diversified, and personalized medical services to address complex and severe conditions. However, challenges such as hardware limitations and diagnostic/treatment risks persist during the implementation of internet hospitals. Through future in-depth and localized research, the online-offline integration of internet hospitals is expected to undergo further development and refinement. This progress will facilitate its integration into clinical practice in thoracic surgery, ultimately providing patients with improved medical care services.

Objective To analyze the characteristics of serological prenatal screening results of pregnant women in Xinjiang,and pro-vide reference basis for the prevention and control of birth defects in Xinjiang.Methods The clinical data of 50781 pregnant women with singleton pregnancies who underwent mid-trimester serological prenatal screening at the Prenatal Diagnosis Center,Urumqi Maternal and Child Health Care Hospital from January 2022 to December 2023 were retrospectively analyzed.The levels of alpha-fetoprotein(AFP),free beta-chorionic gonadotropin(Freeβ-HCG)and free ultra Estriol(uE3)in the serum of pregnant women corresponding to different weight groups and pre-delivery age groups,and the differences in AFP,Freeβ-HCG and uE3 levels among 12 prefectures and 7 ethnic groups with the largest group of pregnant women were compared.Results The high-risk rate of serological prenatal screening in Xin-jiang was 6.00％,the prenatal diagnosis rate was 27.56％,and the positive predictive value was 1.84％.The levels of AFP,Freeβ-HCG and uE3 were inversely correlated with maternal weight and expected age before delivery.There were differences in the levels of AFP,Freeβ-HCG,uE3 in the serum of pregnant women from various prefectures and ethnic groups in Xinjiang(P＜0.05).Conclusion This study preliminarily determined the median of serological prenatal screening for AFP,Freeβ-HCG and uE3 in 12 prefectures and 7 permanent ethnic groups in Xinjiang.The prenatal screening center has revised the median system for prefectures and ethnic groups,which is of great significance for improving the service capacity of eugenics and childcare in Xinjiang.

Objective To analyze the characteristics of serological prenatal screening results of pregnant women in Xinjiang,and pro-vide reference basis for the prevention and control of birth defects in Xinjiang.Methods The clinical data of 50781 pregnant women with singleton pregnancies who underwent mid-trimester serological prenatal screening at the Prenatal Diagnosis Center,Urumqi Maternal and Child Health Care Hospital from January 2022 to December 2023 were retrospectively analyzed.The levels of alpha-fetoprotein(AFP),free beta-chorionic gonadotropin(Freeβ-HCG)and free ultra Estriol(uE3)in the serum of pregnant women corresponding to different weight groups and pre-delivery age groups,and the differences in AFP,Freeβ-HCG and uE3 levels among 12 prefectures and 7 ethnic groups with the largest group of pregnant women were compared.Results The high-risk rate of serological prenatal screening in Xin-jiang was 6.00％,the prenatal diagnosis rate was 27.56％,and the positive predictive value was 1.84％.The levels of AFP,Freeβ-HCG and uE3 were inversely correlated with maternal weight and expected age before delivery.There were differences in the levels of AFP,Freeβ-HCG,uE3 in the serum of pregnant women from various prefectures and ethnic groups in Xinjiang(P＜0.05).Conclusion This study preliminarily determined the median of serological prenatal screening for AFP,Freeβ-HCG and uE3 in 12 prefectures and 7 permanent ethnic groups in Xinjiang.The prenatal screening center has revised the median system for prefectures and ethnic groups,which is of great significance for improving the service capacity of eugenics and childcare in Xinjiang.

As a new diagnosis and treatment decision-making model,shared decision making(SDM)can effective-ly solve the problem of patient compliance in the diagnosis and treatment of thoracic tumors,balance the status of both doctors and patients,and gradually get attention and application in the clinical practice of thoracic surgery.The application of SDM in the diagnosis and treatment of thoracic tumors is conducive to improve doctors'diagnosis and treatment level and alleviating the pressure of responsibility,reduce patients'psychological pressure and improve patients'compliance and also improve medi-cal trust and reduce doctor-patient conflict.Due to the limited medical literacy and autonomy of patients,the time for diagnosis and treatment is short due to the imbalance of doctor-patient ratio.Meanwhile,due to the limited sample size of existing stud-ies,SDM model cannot be proved to have a clear gain for the treatment of thoracic tumors,and the implementation of SDM model still faces resistance.In the future,the development of auxiliary decision-making system and the improvement of doc-tors'humanistic care ability will be conducive to promote the practical application of SDM model in thoracic surgery.

Thoracic surgery encompasses the diagnosis and treatment of various chest diseases such as lung cancer,esophageal cancer,and mediastinal tumors.The treatment plans for these diseases are complex and often involve a combina-tion of surgery,chemotherapy,and radiotherapy,each with different impacts on the patient's quality of life.Patient-reported outcomes(PRO)and shared decision-making(SDM)are becoming increasingly important in this field.PRO allows patients to directly report their health status and the effects of treatment,aiding doctors in adjusting treatment plans.SDM ensures that treatment plans align with the patient's personal values and preferences through information sharing and joint decision-making.The comprehensive application of PRO and SDM can enhance patient satisfaction and treatment outcomes,though it also faces challenges such as data collection and time management.Future research should focus on developing more efficient PRO tools and SDM processes to improve patient-centered healthcare quality.

Objective Small cell carcinoma of the bladder(SCCB)is a rare malignant tumor of the bladder.This study aims to explore its clinicopathological features and prognostic factors and to explore the role of perioperative treatment methods.Methods The clinical data of SCCB patients admitted to West China Hospital,Sichuan University over 8 years from January 2016 to January 2024 were collected.The clinicopathological features of SCCB were summarized.The survival outcomes and prognostic factors were analyzed.The effect of perioperative treatment on the improvement in prognosis was explored.Results A total of 31 confirmed cases of SCCB were enrolled.We observed a number of clinicopathologic features.All cases had advanced clinical staging,with the T staging status being above T2 in all cases,and distant metastasis was found in 23％of the newly diagnosed cases.A high proportion of the SCCB cases were combined with other histologic types,with 96％showing combination with urothelial carcinoma(UC).The SCCB patients had a poor prognosis,presenting a median survival of 12 months,1-year overall survival(OS)of 57.9％,and 3-year OS of 27.6％.Patients with extensive-stage SCCB had a significantly worse prognosis than those with limited-stage SCCB did(median OS time of 17.0 months vs.4.4 months,P＜0.05).In limited-stage SCCB,the median OS of patients who underwent radical cystectomy(RC)was 19.9 months,while that of the patients who did not undergo RC was 15.2 months(P＜0.05).The OS of patients who received perioperative therapy in combination with RC had longer OS than those who received only RC did(P＜0.05).Among these,patients recevied neoadjuvant therapy(NAT)had a significantly longer OS than patients who didn't receive NAT(P＜0.05).Subgroup analysis revealed that patients who were responsive to neoadjuvant therapy had longer disease-free survival and longer OS than those who were not responsive did(P＜0.05).Lymph node metastasis was an independent factor of poor prognosis(hazard ratio[HR]=15.21,95％confidence interval[CI]:1.732-133.912,P=0.014).NAT prior to RS was an independent protective factor,significantly reducing the risk of death compared with RC alone(HR=0.03,95％CI:0.001-0.724,P=0.031).Conclusion RC is an effective treatment that prolongs the survival of patients with limited-stage SCCB.RS combined with NAT can further improve their survival.