Objective:To investigate gait alterations in patients with rheumatoid arthritis (RA) complicated with knee joint damage and to explore the potential of using gait analysis to evaluate the effectiveness of precision medical or surgical treatments in RA patients, serving as a reference for future gait-related research.Methods:A total of 45 patients with cumulative knee joint RA and 45 healthy control subjects were recruited from May 2021 to May 2022. Gait analysis and scale scoring were performed to compare gait changes between the two groups. Statistical tests including t-test, Mann-Whitney U, and Pearson Chi-square were used to assess group differences. Results:Compared with the control group, the objective gait indexes of the knee involvement in patients with rheumatoid arthritis were double support time [(523±127)ms and (333±45)ms, t=-9.48, P<0.001], total support time [(904±137) ms and (678±101)ms, t=-8.90, P<0.001], step length [(635±81) ms and (548±56) ms, t=-5.91, P<0.001], walking cycle [(1 273±169) ms and (1 075±104) ms, t=-4.76, P<0.001], the proportion of single support cycle (0.298±0.037 and 0.334±0.015, t=6.06, P<0.001), the proportion of double support cycle (0.408±0.069 and 0.309±0.021, t=-7.90, P<0.001), total support period ratio (0.709±0.035 and 0.628±0.041, t=-10.01, P<0.001), step length [(40±5)cm and (52±4)cm, t=9.02, P<0.001], step length [(77±11)cm and (104±8)cm, t=12.71, P<0.001] and the pace [(0.708±0.168) m/s and (1.050±0.192) m/s, t=8.98, P<0.001] were significantly different. Conclusion:Gait analysis can be utilized for the quantitative evaluation of patients with rheumatoid arthritis (RA), complicated with knee darnage, enabling objective quantification of assessment indicators and offering novel ideas and methodologies for diagnosing and treating of patients with RA.

In recent years,significant breakthroughs have been achieved in the immunotherapy for Alzheimer's disease.In line with global advancements,two anti-amyloid-β monoclonal antibodies have been approved and successfully launched in China for clinical use.Lecanemab and Donanemab were officially used in June 2024 and April 2025 in China,respectively.In order to standardize the rational and safe application of anti-amyloid-β monoclonal antibodies for Alzheimer's disease in China,this article integrates recom-mendations from the clinical trials and real-world experience from the author's team and domestic peers to further update the recom-mendations for the clinical use of anti-amyloid-β monoclonal antibody based on the 2024 version.It includes indications for therapy,pre-treatment evaluation and preparation,administration protocols and safety measures during treatment,and post-treatment monitor-ing strategies.

With the extended survival period of breast cancer patients and the increasing health demands, the concomitant diseases of breast cancer have gradually attracted the attention of both doctors and patients, and it is imperative to conduct comprehensive management of these diseases, in which the general practitioners, as the more comprehensive and complex medical talents, have not yet played their due roles. In this article, we report two cases of comprehensive management of concomitant diseases of breast cancer through collaboration of general practitioners and specialists (integrated general and specialist care). The role and function of general practitioners in this process were deeply analyzed, and the establishment of a consultation-liaison general practice model to further promote the role of integrated general and specialist care in integrated oncology care was advocated.

With the extended survival period of breast cancer patients and the increasing health demands, the concomitant diseases of breast cancer have gradually attracted the attention of both doctors and patients, and it is imperative to conduct comprehensive management of these diseases, in which the general practitioners, as the more comprehensive and complex medical talents, have not yet played their due roles. In this article, we report two cases of comprehensive management of concomitant diseases of breast cancer through collaboration of general practitioners and specialists (integrated general and specialist care). The role and function of general practitioners in this process were deeply analyzed, and the establishment of a consultation-liaison general practice model to further promote the role of integrated general and specialist care in integrated oncology care was advocated.

Objective:To investigate gait alterations in patients with rheumatoid arthritis (RA) complicated with knee joint damage and to explore the potential of using gait analysis to evaluate the effectiveness of precision medical or surgical treatments in RA patients, serving as a reference for future gait-related research.Methods:A total of 45 patients with cumulative knee joint RA and 45 healthy control subjects were recruited from May 2021 to May 2022. Gait analysis and scale scoring were performed to compare gait changes between the two groups. Statistical tests including t-test, Mann-Whitney U, and Pearson Chi-square were used to assess group differences. Results:Compared with the control group, the objective gait indexes of the knee involvement in patients with rheumatoid arthritis were double support time [(523±127)ms and (333±45)ms, t=-9.48, P<0.001], total support time [(904±137) ms and (678±101)ms, t=-8.90, P<0.001], step length [(635±81) ms and (548±56) ms, t=-5.91, P<0.001], walking cycle [(1 273±169) ms and (1 075±104) ms, t=-4.76, P<0.001], the proportion of single support cycle (0.298±0.037 and 0.334±0.015, t=6.06, P<0.001), the proportion of double support cycle (0.408±0.069 and 0.309±0.021, t=-7.90, P<0.001), total support period ratio (0.709±0.035 and 0.628±0.041, t=-10.01, P<0.001), step length [(40±5)cm and (52±4)cm, t=9.02, P<0.001], step length [(77±11)cm and (104±8)cm, t=12.71, P<0.001] and the pace [(0.708±0.168) m/s and (1.050±0.192) m/s, t=8.98, P<0.001] were significantly different. Conclusion:Gait analysis can be utilized for the quantitative evaluation of patients with rheumatoid arthritis (RA), complicated with knee darnage, enabling objective quantification of assessment indicators and offering novel ideas and methodologies for diagnosing and treating of patients with RA.

Objective To explore the efficacy and safety of lung recruitment maneuver(LRM)on postoperative hypoxemia in patients with acute type A aortic dissection(ATAAD).Methods A total of 56 ATAAD patients with postoperative hypoxemia in the First Affiliated Hospital of Guangxi Medical University from November 2019 to May 2022 were selected and randomly divided into LRM group(n=36)and conventional treatment group(n=20).Patients in conventional treatment group received routine mechanical ventilation on the basis of lung protective ventilation.The patients in LRM group were treated with incremental positive end expiratory pressure(PEEP).Arterial blood gas analysis,respiratory parameters,hemodynamics parameters and serum interleukin(IL)-6 and IL-10 levels were compared between two groups before and after treatment.Results At 12h and 24h after treatment,arterial partial pressure of oxygen(PaO2),oxygenation index(OI),static compliance(Cstat)and dynamic compliance(Cdyn)in two groups were significantly higher than before treatment,the alveolar-arterial gradient of oxygen[PO2(A-a)],respiratory index(RI),peak inspiratory pressure(Ppeak)and plateau pressure(Pplat)were significantly lower than before treatment(P<0.05).PaO2,OI,Cstat and Cdyn in LRM group were significantly higher than those in conventional treatment group,PO2(A-a),RI,Ppeak and Pplat were significantly lower than those in conventional treatment group(P<0.05).Systolic blood pressure and mean arterial pressure decreased and central venous pressure increased during pulmonary reexpansion in LRM group(P<0.05),and all patients returned to baseline level after pulmonary reexpansion.At 12h after treatment,serum IL-6 and IL-10 levels in both groups were significantly lower than before treatment(P<0.05).Conclusion Incremental PEEP can improve oxygenation and lung compliance in patients with hypoxemia after ATAAD surgery,but it has transient effects on hemodynamics,and should be closely monitored during treatment.

Objective:To analyze the experiences and practice in the reform of public hospital salary system in Sichuan province, summarize the typical modes of such reform in the province, and provide references for further reform.Methods:As of October 29, 2021, the research group received 77 sets of typical experience materials submitted by the health commissions and public hospitals in Sichuan province on enforcing the reform of the public hospital salary system. The analysis framework was based on the five main elements proposed in the Guidance to Deepening the Reform of the Salary System of Public Hospitals for the purpose of furthering the reform. These five elements refer to " reasonably determining the level of salary in public hospitals" " fully implementing the autonomy of internal distribution in public hospitals " " establishing and improving the incentive and restraint mechanism for the remuneration of public hospital leaders" " improving the assessment and evaluation mechanism oriented to public welfare" and " funding sources ". A quantitative analysis was made on the typical experience materials using the social network analysis method, while a qualitative analysis was made on the typical experience materials using the content analysis method. Results:The results of social network analysis showed that the network density was 0.272; the highest point centrality was " fully implement the autonomy of internal distribution in public hospitals" (0.935), and the highest intermediary centrality was " improving the assessment and evaluation mechanism oriented to public welfare" (0.870), while the closeness to centrality of " establishing and improving the incentive and constraint mechanism for the salary of public hospital leaders" (0.434) and " funding sources" (0.421) were relatively low. The results of content analysis showed that the ones with higher frequency among all the typical experience materials were " fully implementing the autonomy of internal distribution of hospitals" (72 times) and " improving the assessment and evaluation mechanism oriented to public welfare" (67 times), while the ones with lower frequency were " establishing and improving the salary incentive and constraint mechanism for public hospital leaders" (17 times) and " funding sources" (14 times). In terms of unity and synergy, the typical models of public hospital salary system reform in the province could be categorized as the fine standard mode, the fair value mode, the autonomous synergy mode and the circular symbiosis mode.Conclusions:Deepening the reform of the salary system of public hospitals should unify the standards and improve the fair and refined assessment and evaluation mechanism; explore various forms of distribution and build an internal autonomous and synergistic incentive mechanism; pay attention to the weak remuneration incentive mechanism for hospital leaders and the problem of a relatively single source of funding.

Research of healthy life expectancy (HLE) is needed in an aging society and by the Healthy China Initiative. However, China has not developed the HLE policy goal nor published HLE values. Therefore, it is essential to construct the HLE indicator system to guide HLE estimation and research. Based on the definition of health from the WHO and the concepts from the United Nations Sustainable Development Goal, One Health and Active Health, we systematically reviewed the existing international HLE indicators, and initially proposed a novel multi-dimensional HLE conceptual framework and indicator structure according to international function, disability and health classifications and international disease classification framework of WHO. The conceptual framework includes five dimensions-physical, mental, behavioral, social, and environmental health, and the comprehensive indicator for disability-disability index is added. Furthermore, we proposed the HLE indicator structure, including behavioral factors, physiological and pathological reasons, impairment, functional limitation, disability and death. Then we discussed the approaches, types of data, and potential data sources for such research. The results of this study would facilitate HLE research and contribute to the aging society and Healthy China Initiative.

【Objective】 To compare the effectiveness of the old mode of blood isolation and batch release (the old mode) and the new mode in Chengdu, so as to provide basis for optimizing working strategy. 【Methods】 1) The blood testing report was released one by one in the old mode but released uniformly in accordance with the blood batches classified by blood storage and supply department in the new mode. 2) In the old mode, apheresis platelet samples were detected by serological testing first and nucleic acid testing(NAT) later, and whole blood samples were reasonably arranged according to blood inventory and detection workload. In the new mode, platelets samples collected within our center headquarters were detected by serological test and NAT simultaneously, while those collected outside the center complied with the old strategy. As for whole blood, the same batch samples classified by blood storage and supply department should be arranged to the detection line with the fewest samples.3) The turnaround time(TAT) in the laboratory (referred to as sample TAT) and the TAT in the blood to-detect stock (referred to as blood TAT) in two phases(year 2016 vs 2018, pre- and post- the new mode), involving 164 748 and 179 488 blood samples, were compared by SPSS25.0 software. The constituent ratio of the TATs were compared with Chi-square test, and the difference of blood TAT between old and new mode were compared with Mann-Whitney U test. 【Results】 1) Significant difference was noticed in constituent ratio of TATs between old and new mode (P<0.05). 2)The blood TATof apheresis platelets using the new mode was 0.95(QR: 0.22)days, with the median 0.20 days shorter than that the old mode.. The blood TAT of whole blood in the new mode was 3.77 (QR: 1.99) days, with the median 0.90 days shorter than that in the old mode, and the difference was statistically significant (P<0.05). 【Conclusion】 Compared with the old mode, the new mode showed the following advantages: 1) It can realize the unified issuing of testing reports of blood with the same batch, contribute to the early discovery of errors that occurred during blood donation process, and located the errors wihin intra-batches for investigation. 2) It can advance the issuing of blood testing reports of the same batch. 3) It can make the flow of samples and blood with the same batch between different departments more standardized and orderly, and optimize the process of blood sorting thus shortening blood TAT. 4) It can realize the counting and checking of samples, within the same batch, at different states, so as to minimize the error issuing of unqualified blood and to-detect blood, and is more conducive to ensure the quality, safety and timely supply of blood.

Objective:To analyze the salary characteristics of medical institutions and the influencing factors of personnel expenditure as found in the salary system reform of public hospitals in Sichuan province, for reference in furthering such reform in public hospitals.Methods:The data of personnel expenditure, business operation and medical services came from 96 medical institutions in 21 cities(prefectures)of Sichuan province from 2017 to 2020 by means of institutional survey. The average salary level and salary structure of medical staff were used to describe the salary characteristics, and the total salary was presented by the level of personnel expenditure. The measurement data was represented by M(IQR), the counting data was described by frequency and constituent ratio, and the influencing factors of personnel expenditure were analyzed by generalized linear mixed model. Results:From 2017 to 2020, the personnel expenditure of medical institutions increased by 13.04% annually. In 2020, the per capita salary level of medical staff was 151 900 yuan, while the basic salary and performance salary accounted for 16.20% and 54.60% of personnel expenditure respectively. The analysis results of the generalized linear mixed model showed that the average cost of patients per visit( β=0.596), the level of drugs and sanitary materials consumed per 100 yuan medical income( β=0.286), the number of medical visits( β=0.328), and the years [(2018, 2019, 2020) β=0.025, 0.052, 0.066] were positively correlated to personnel expenditure, while the average length of stay( β=-0.693), the proportion of medical service income( β=-0.392), and the balance rate of income and expenditure( β=-0.062)were negatively correlated to personnel expenditure( P<0.05). The proportion of fiscal subsidy revenue, regional GDP and asset-liability ratio were not the influencing factors of personnel expenditure( P> 0.05). Conclusions:In the reform of the salary system of the province, its salary level of medical institutions has surpassed the current wage ceiling of these institutions. As the salary distribution was mainly made based on the workload, the " baton" role of the salary system reform has begun to pay off. However, the basic guarantee role of compensation has not yet been fully leveraged.Further reform is needed in upgrading refined management, and timely dynamic adjustment of personnel expenditure in combination with the hospital's financial performance and cost analysis, and reasonably optimizing the level of medical staff compensation.