OBJECTIVE To explore the correlation between drug consumption index and diagnosis related groups （DRG） overspending cases， and provide a basis for hospitals to optimize the cost structure and strengthen the refined management. METHODS Based on the data of DRG patients enrolled in a third-grade class A hospital from September to November 2023， the multivariate Logistic regression model and restricted cubic spline （RCS） model were used to analyze the correlation of drug consumption index with DRG overspending cases and its threshold effect， respectively. At the same time， rational drug use evaluation was conducted based on the drug consumption index， precise cost control and management were carried out， and the changes in the main pharmaceutical indicators of the whole hospital were analyzed before control （January-June 2023） and after control （January-June 2024）. RESULTS The results of multivariate Logistic regression analysis showed that long hospitalization days， high drug consumption index， transfer to other departments and combined diabetes mellitus were the risk factors for DRG overspending （P＜0.05）. The results of the RCS model showed that the drug consumption index had a non-linear relationship with DRG overspending. When the drug consumption index was ≥0.64， the drug consumption index was positively correlated with the risk of DRG overspending（P＜0.05）. Compared with the same period before the control， medical cost per time， drug cost per time and drug consumption index decreased significantly after the control （P＜0.01）. CONCLUSIONS The drug consumption index is a risk factor for DRG overruns， there is a non-linear relationship and threshold effect between it and DRG overruns. Each hospital can set a reasonable threshold and implement dynamic monitoring and intervention by comprehensively considering the actual drug usage， disease spectrum characteristics， and cost control targets， as well as factors such as medical quality， patient needs， and the payment capacity of medical insurance， which can effectively achieve precise control over drug usage.

OBJECTIVE To provide empirical basis for promoting the dynamic adjustment of the pharmaceutical care catalogue and the formulation of policies such as hierarchical payment of medical insurance. METHODS A multicenter cross- sectional survey method was adopted to conduct a questionnaire survey among 424 inpatients in 22 tertiary medical institutions in 12 prefecture-level cities of Hubei Province to evaluate their demand for pharmaceutical care， willingness to pay and preference for service forms. Combined with univariate and multivariate Logistic regression analysis， the influencing factors and key factors that affect patients’ willingness to pay for pharmaceutical care were identified. RESULTS Only 39.86% of the patients were aware of pharmaceutical care or pharmacists， and 89.62% of the patients hope to receive pharmaceutical care. Among the 16 types of pharmaceutical care， the patients surveyed had a relatively high recognition rate for guidance on drug usage and dosage， notification of medication precautions， and the identification， prevention and handling of adverse drug reactions. 96.70%， 95.30%， and 94.12% respectively expressed strong approval and approval. The demand for services such as insurance-related policy consultation， popular science on the mechanism of drug action， and assessment of the combined use of traditional Chinese and Western medicines was relatively low， with 61.65%， 68.47%， and 68.47% expressing strong approval and approval respectively. The positive influencing factors of willingness to pay were household monthly income ＞ 5 000 yuan （OR＝1.742）， awareness of pharmaceutical care or pharmacists （OR＝3.620）， and the desire to receive pharmaceutical care （OR＝4.686） （P＜0.05）， while self-rating health as “good” （OR＝0.390） was a negative influencing factor （P＜0.05）. Cardiovascular and cerebrovascular diseases （54.48%） and antihypertensive drugs （45.05%） were the service scenarios that the surveyed patients most hope to be covered. 85.14% of the patients preferred “service when xiaochnye@126.com needed”， with a single service duration of less than 10 minutes being appropriate （84.43%）， and the willingness to pay within 20 yuan being the main type （85.38%）. CONCLUSIONS Based on the characteristics of patients’ needs and payment behaviors， it is suggested that our country could consider establishing a hierarchical payment mechanism for pharmaceutical care， and focus on differentiated design in combination with diseases and medication situations. At the same time， the rights， responsibilities and service standards of resident pharmacists in the links such as medication reorganization and medical order review should be further clarified to comprehensively enhance the clinical value and policy operability of pharmaceutical care.

Immune checkpoint blockade therapy has demonstrated remarkable efficacy in treating various malignancies; however, its clinical application remains challenged by low response rates and immune-related adverse events. Immunoglobulin superfamily member 11 (IGSF11), an inhibitory immune checkpoint molecule, serves as a specific ligand for the V-domain immunoglobulin suppressor of T cell activation (VISTA). Through the IGSF11/VISTA axis, it suppresses T cell function and represents a promising novel target for cancer immunotherapy. IGSF11 is widely expressed across multiple tumor types, though its regulatory mechanisms vary depending on the malignancy. Studies have confirmed that blocking the IGSF11-VISTA interaction or specifically inhibiting IGSF11 exerts antitumor effects. While IGSF11 is closely associated with patient prognosis, its prognostic significance differs among cancer types. This review systematically summarizes the structural characteristics of IGSF11, its regulatory mechanisms, interaction with VISTA, and functional role within the tumor microenvironment.
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Humans ; Immunotherapy ; Neoplasms/metabolism* ; B7 Antigens/chemistry* ; Animals ; Molecular Targeted Therapy ; Tumor Microenvironment

Objective:To analyze the current situation and influencing factors of work-related musculoskeletal disorders (WMSDs) among scientific researchers in a computer workstation of a high-tech aerospace enterprise, and to provide data support for the improvement of occupational health management policies in this type of enterprise.Methods:From March to April 2023, using convenient sampling method, 1398 scientific researchers using computer workstations in an aerospace high-tech enterprise in Beijing were selected as the research subjects. The incidence of WMSDs in various parts of the body was investigated by using the Musculoskeletal Disorders Questionnaire, and the influencing factors of WMSDs in neck, lower back, shoulder and upper back were analyzed by logistic regression.Results:The total incidence of WMSDs was 55.4% (774/1398) in the scientific researchers who used computer workstations. The top 4 body parts in WMSDs incidence were neck (24.3%, 340/1398), lower back (20.4%, 285/1398), shoulder (18.7%, 262/1398), upper back (12.7%, 177/1398). The results of multivariate logistic regression analysis showed that feeling slightly tired and tired after work, setting a rest/break time of 10 to 15 min before the next continuous job, and operating computer for 2 to 4 hours and >4 hours were the influencing factors for the occurrence of neck WMSDs ( OR=3.08, 1.90, 0.60, 2.00, 1.49, P<0.05). Female, 5-<10 years of working experience, feeling slightly tired, tired and very tired after work, operating computer for 6-<8 hours and 8-10 hours a day were all the influencing factors for the occurrence of WMSDs in the lower back ( OR=1.82, 0.64, 2.95, 1.80, 1.61, 1.82, 1.73, P<0.05). Female, feeling slightly tired and tired after work were the influencing factors of shoulder WMSDs occurrence ( OR=2.42, 2.09, 2.00, P<0.05). Female, 5-<10 years, 10-15 years of working age, 1-3 times of physical exercise/quarter, feeling slightly tired, tired and very tired after work were the influencing factors for the occurrence of upper back WMSDs ( OR=2.76, 2.19, 2.78, 0.48, 4.20, 2.66, 2.19, P<0.05) . Conclusion:The incidence of WMSDs among scientific researchers in computer workstations of aerospace high-tech enterprises is high, which is closely related to individual characteristics and workstation usage characteristics. Measures should be taken to prevent and improve the WMSDs status of scientific researchers.

[Objective] To review the clinical information, imaging features, pathological manifestations and prognosis of low-grade oncocytic tumor (LOT), so as to improve the clinical understanding of the disease. [Methods] The imaging, clinicopathological and postoperative follow-up data of 3 LOT cases treated in Peking University Third Hospital during Feb.2020 and Sep.2022 were retrospectively collected. [Results] All patients were male, aged 51—70 years.All tumors were single, with the maximum diameter of 14—21 mm. None of the patients had any specific clinical manifestations.The mass showed a circular isodense shadow on CT.All patients underwent nephron-sparing tumor resection.Postoperative pathology showed that the incision surface of the tumors was brownish-yellow or brown, and the tumors were solid or partially cystic.HE staining showed that the cells were uniformly eosinophilic; the nucleus was round or oval, with slight local perinuclear halo.Immunohistochemistry showed positive CK7 but negative CD117.Genetic testing in case 2 showed 1 potentially clinically significant somatic mutation TSC2.During the follow-up of 12-23 months, no recurrence occurred. [Conclusion] There were no obvious clinical symptoms and imaging features of LOT, which morphologically showed heterozygous or borderline characteristics with renal eosinophilia and renal chromophobe cell carcinoma, and the biological behavior was indolent.Nephron-sparing tumor resection promised good prognosis.

Objective:To analyze the current situation and influencing factors of work-related musculoskeletal disorders (WMSDs) among scientific researchers in a computer workstation of a high-tech aerospace enterprise, and to provide data support for the improvement of occupational health management policies in this type of enterprise.Methods:From March to April 2023, using convenient sampling method, 1398 scientific researchers using computer workstations in an aerospace high-tech enterprise in Beijing were selected as the research subjects. The incidence of WMSDs in various parts of the body was investigated by using the Musculoskeletal Disorders Questionnaire, and the influencing factors of WMSDs in neck, lower back, shoulder and upper back were analyzed by logistic regression.Results:The total incidence of WMSDs was 55.4% (774/1398) in the scientific researchers who used computer workstations. The top 4 body parts in WMSDs incidence were neck (24.3%, 340/1398), lower back (20.4%, 285/1398), shoulder (18.7%, 262/1398), upper back (12.7%, 177/1398). The results of multivariate logistic regression analysis showed that feeling slightly tired and tired after work, setting a rest/break time of 10 to 15 min before the next continuous job, and operating computer for 2 to 4 hours and >4 hours were the influencing factors for the occurrence of neck WMSDs ( OR=3.08, 1.90, 0.60, 2.00, 1.49, P<0.05). Female, 5-<10 years of working experience, feeling slightly tired, tired and very tired after work, operating computer for 6-<8 hours and 8-10 hours a day were all the influencing factors for the occurrence of WMSDs in the lower back ( OR=1.82, 0.64, 2.95, 1.80, 1.61, 1.82, 1.73, P<0.05). Female, feeling slightly tired and tired after work were the influencing factors of shoulder WMSDs occurrence ( OR=2.42, 2.09, 2.00, P<0.05). Female, 5-<10 years, 10-15 years of working age, 1-3 times of physical exercise/quarter, feeling slightly tired, tired and very tired after work were the influencing factors for the occurrence of upper back WMSDs ( OR=2.76, 2.19, 2.78, 0.48, 4.20, 2.66, 2.19, P<0.05) . Conclusion:The incidence of WMSDs among scientific researchers in computer workstations of aerospace high-tech enterprises is high, which is closely related to individual characteristics and workstation usage characteristics. Measures should be taken to prevent and improve the WMSDs status of scientific researchers.

Cryoablation therapy with explicit anti-tumor mechanisms and histopathological manifestations has a long history.A large number of clinical practice has shown that cryoablation therapy is safe and effective,making it an ideal tumor treatment method in theory.Previously,its efficacy and clinical application were constrained by the limitations of refrigerants and refrigeration equipment.With the development of the new generation of cryoablation equipment represented by argon helium knives,significant progress has been made in refrigeration efficien-cy,ablation range,and precise temperature measurement,greatly promoting the progression of tumor cryoablation technology.This consensus systematically summarizes the mechanism of cryoablation technology,indications for oral mucosal melanoma(OMM)cryotherapy,clinical treatment process,adverse reactions and management,cryotherapy combination therapy,etc.,aiming to provide reference for carrying out the standardized cryoablation therapy of OMM.

Objective:To summarize the clinical characteristics of patients with renal angiomyolipoma(RAML)combined with inferior vena cava(IVC)tumor thrombus,and to explore the feasibility of par-tial nephrectomy and thrombectomy in this series of patients.Methods:The clinical data of patients diagnosed with RAML combined with IVC tumor thrombus in the Department of Urology of the Peking University Third Hospital from April 2014 to March 2023 were retrospectively analyzed,and demographic and perioperative data of RAML patients with IVC tumor thrombus were recorded and collected from Elec-tronic Medical Record System,including age,gender,surgical methods,and follow-up time,etc.The clinical characteristics between classic angiomyolipoma(CAML)patients with IVC tumor thrombus and epithelioid angiomyolipoma(EAML)patients with IVC tumor thrombus were compared to determine the clinical characteristics of these patients.Results:A total of 11 patients were included in this study,in-cluding 7 patients with CAML with IVC tumor thrombus and 4 patients with EAML with IVC tumor thrombus.There were 9 females(9/11,81.8％)and 2 males(2/11,18.2％),with an average age of(44.0±17.1)years.9 patients(9/11,81.8％)experienced clinical symptoms,including local symp-toms including abdominal pain,hematuria,abdominal masses,and systemic symptoms including weight loss and fever;2 patients(2/11,18.2％)with RAML and IVC tumor thrombus did not show clinical symptoms,which were discovered by physical examination.Among the 11 patients,10 underwent radical nephrectomy with thrombectomy,of whom,3 underwent open surgery(3/10,30.0％),2 underwent laparoscopic surgery(2/10,20.0％),and 5 underwent robot-assisted laparoscopic surgery(5/10,50.0％).In addition,1 patient underwent open partial nephrectomy and thrombectomy.The patients with EAML combined with I VC tumor thrombus had a higher proportion of systemic clinical symptoms(100％vs.0％,P=0.003),more intraoperative bleeding[400(240,3 050)mL vs.50(50,300)mL,P=0.036],and a higher proportion of tumor necrosis(75％vs.0％,P=0.024)compared to the patients with CAML combined with I VC tumor thrombus.However,there was no statistically significant difference in operation time[(415.8±201.2)min vs.(226.0±87.3)min,P=0.053]between the two groups.Conclusion:Compared with the patients with CAML and IVC tumor thrombus,the patients with EAML and IVC tumor thrombus had a higher rate of systemic symptoms and tumor necrosis.In addi-tion,in the selected patients with CAML with IVC tumor thrombus,partial nephrectomy and tumor thrombectomy could be performed to better preserve renal function.

Objective:To analyze the clinicopathological characteristics and prognosis of patients with multilocular cystic renal neoplasm of low malignant potential and compare the clinicopathological charac-teristics of patients with multilocular cystic renal neoplasm of low malignant potential who underwent different surgical methods.Methods:Clinicopathological data and prognosis of patients admitted to Peking University Third Hospital from January 2010 to September 2023 were collected.Patients who underwent radical nephrectomy or nephron-sparing surgery and were pathologically diagnosed with multilocular cystic renal neoplasm of low malignant potential were identified.Based on the surgical methods,the patients were divided into radical nephrectomy group and nephron-sparing surgery group.The clinicopathological characteristics of the two groups were compared.Results:A total of 35 patients were enrolled in this study.The median age at diagnosis was 53.0(39.0-62.0)years.Among the 35 patients,23 were males(65.7％)and 12 were females(34.3％).Nine patients underwent radical nephrectomy(25.7％),while 26 patients underwent nephron-sparing surgery(74.3％).The clinical T-stage of 35 patients did not exceed T2a stage.The median operation time was 145.0 min,and the median estimated intraoperative blood loss was 20.0 mL.The median postoperative hospitalization days was 6.0 d.The postoperative pathological results did not indicate renal sinus invasion,sarcomatous change,adrenal invasion or lymph node invasion.Based on the surgical methods,the patients were divided into a radical nephrectomy group and a nephron-sparing surgery group.There was no significant difference in clinicopathological charac-teristics between the two groups.Except for one patient who was lost to the follow-up,all the other patients were followed up for 8-111 months,with a median follow-up time of 70.5 months.Only one patient died from non-cancer-specific reasons,other patients had no tumor metastasis or recurrence.Conclusion:Patients with multilocular cystic renal neoplasm of low malignant potential have a good prog-nosis.There is no significant difference in clinicopathological characteristics of patients between nephron-sparing surgery group and radical nephrectomy group for multilocular cystic renal neoplasm of low malig-nant potential.

Objective:To investigate the postoperative renal function and oncologic outcomes of cystic renal cell carcinoma with partial nephrectomy,and to compared the single-center data on surgical out-comes with the Surveillance,Epidemiology,and End Results(SEER)database.Methods:This was a retrospective study that included the patients with cystic renal cell carcinoma who underwent partial ne-phrectomy in the Department of Urology,Peking University Third Hospital(PUTH)from 2010 to 2023.The clinical data and depicting baseline characteristics were collected.Renal dynamic imaging and the Chinese Coefficients for Chronic Kidney Disease Epidemiology Collaboration(C-CKD-EPI)formulae were used to calculate the estimated glomerular filtration rate(eGFR).The renal function curves over time were then plotted,and the patients were followed-up to record their survival status.Cases of cystic renal cell carcinoma in the SEER database between 2000 and 2020 were included,propensity score matching(PSM)was performed to balance the differences between SEER cohort and PUTH cohort,and the cancer-specific survival(CSS)curves for both groups were plotted and statistical differences were calcu-lated by the Kaplan-Meier method.Results:A total of 38 and 385 patients were included in the PUTH cohort and SEER cohort,respectively,and 31 and 72 patients were screened in each cohort after PSM.Of the baseline characteristics,only tumor size(P=0.042)was found to differ statistically between the two groups.There was no statistically significant difference between the two cohorts in terms of CSS after PSM(P=0.556).The median follow-up time in the SEER cohort was 112.5(65,152)months and a 10-year survival rate of 97.2％,while the PUTH cohort had a median follow-up of 57.0(20,1 172)months and a 10-year survival rate of 100.0％.There was no statistically significant difference between eGFR determined by preoperative renal dynamic imaging and the results of the C-CKD-EPI formulae based on creatinine estimation(P=0.073).There was a statistically significant difference in eGFR among the preoperative,short-term postoperative,and long-term postoperative(P＜0.001),which was characterized by the presence of a decline in renal function in the short-term postoperative period and the recovery of renal function in the long-term period.Conclusion:Partial nephrectomy for cystic renal cell carcinoma is safe and feasible with favorable renal function and oncologic outcomes.