Objective:To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for circular superficial esophageal cancer.Methods:A retrospective analysis was conducted on 74 consecutive cases of circular superficial esophageal squamous cell carcinoma treated with ESD at Nanjing Drum Tower Hospital from January 2015 to December 2019. The success rate of ESD, curative resection rate, incidence of complications, and additional treatment were mainly observed.Results:One case was transferred to surgery, and the remaining 73 cases successfully completed ESD treatment. The success rate of ESD was 98.6%. Postoperative pathology of ESD revealed that 39 cases achieved curative resection, with a curative resection rate of 53.4% (39/73). Intraoperative muscle layer injury occurred in 15 cases (20.5%), and intraoperative perforation occurred in 1 case (1.4%). Two cases (2.7%) experienced delayed bleeding, and one case (1.4%) experienced delayed perforation. Eleven cases were lost to follow-up, and the remaining 62 cases received follow-up for 36.4±19.0 months. Among the follow-up cases, 12 underwent additional surgery and 5 cases additional chemotherapy and radiotherapy. Among the 57 patients with follow-up data who did not underwent surgery, 49 developed esophageal stenosis after ESD, with an incidence rate of 86.0%.Conclusion:ESD for circular superficial esophageal cancer is generally safe, but it is prone to muscle layer injury during the operation, with a low curative resection rate, a high incidence of postoperative esophageal stenosis, and a high proportion of additional surgical procedures.

Objective:Analyzing the core position of hospital in value-based healthcare practice and designing IT platform to support value medicine practice.Methods:Based on the orchestral model and the enterprise architecture theoiy,making the hospital as the leading part of the practice of value-based healthcare,taking value-based healthcare as the business strategy,standing on the advance of value-based healthcare in China,considering fully of the existing organizational inertia on business,IT foundation and IT implementation mode based on the software prototype development method in hospital,it manages to establish an IT architecture dominated by the business operations and supplemented by business strategies.Results:The hospital IT application architecture was built around the five themes of"one-stop integrating all service,four-stream integrating to promoting business operation,reducing the cost of major supplies,scientific management and cost controlling,and evaluating the healthcare value by the total data".Conclusion:A feasible and practical hospital IT application architecture oriented to value-based healthcare is designed,which provides an reliable guidance for the hospital to push forward the value-based healthcare.

Objective:Analyzing the core position of hospital in value-based healthcare practice and designing IT platform to support value medicine practice.Methods:Based on the orchestral model and the enterprise architecture theoiy,making the hospital as the leading part of the practice of value-based healthcare,taking value-based healthcare as the business strategy,standing on the advance of value-based healthcare in China,considering fully of the existing organizational inertia on business,IT foundation and IT implementation mode based on the software prototype development method in hospital,it manages to establish an IT architecture dominated by the business operations and supplemented by business strategies.Results:The hospital IT application architecture was built around the five themes of"one-stop integrating all service,four-stream integrating to promoting business operation,reducing the cost of major supplies,scientific management and cost controlling,and evaluating the healthcare value by the total data".Conclusion:A feasible and practical hospital IT application architecture oriented to value-based healthcare is designed,which provides an reliable guidance for the hospital to push forward the value-based healthcare.

Objective:Analyzing the core position of hospital in value-based healthcare practice and designing IT platform to support value medicine practice.Methods:Based on the orchestral model and the enterprise architecture theoiy,making the hospital as the leading part of the practice of value-based healthcare,taking value-based healthcare as the business strategy,standing on the advance of value-based healthcare in China,considering fully of the existing organizational inertia on business,IT foundation and IT implementation mode based on the software prototype development method in hospital,it manages to establish an IT architecture dominated by the business operations and supplemented by business strategies.Results:The hospital IT application architecture was built around the five themes of"one-stop integrating all service,four-stream integrating to promoting business operation,reducing the cost of major supplies,scientific management and cost controlling,and evaluating the healthcare value by the total data".Conclusion:A feasible and practical hospital IT application architecture oriented to value-based healthcare is designed,which provides an reliable guidance for the hospital to push forward the value-based healthcare.

Objective:Analyzing the core position of hospital in value-based healthcare practice and designing IT platform to support value medicine practice.Methods:Based on the orchestral model and the enterprise architecture theoiy,making the hospital as the leading part of the practice of value-based healthcare,taking value-based healthcare as the business strategy,standing on the advance of value-based healthcare in China,considering fully of the existing organizational inertia on business,IT foundation and IT implementation mode based on the software prototype development method in hospital,it manages to establish an IT architecture dominated by the business operations and supplemented by business strategies.Results:The hospital IT application architecture was built around the five themes of"one-stop integrating all service,four-stream integrating to promoting business operation,reducing the cost of major supplies,scientific management and cost controlling,and evaluating the healthcare value by the total data".Conclusion:A feasible and practical hospital IT application architecture oriented to value-based healthcare is designed,which provides an reliable guidance for the hospital to push forward the value-based healthcare.

Objective:Analyzing the core position of hospital in value-based healthcare practice and designing IT platform to support value medicine practice.Methods:Based on the orchestral model and the enterprise architecture theoiy,making the hospital as the leading part of the practice of value-based healthcare,taking value-based healthcare as the business strategy,standing on the advance of value-based healthcare in China,considering fully of the existing organizational inertia on business,IT foundation and IT implementation mode based on the software prototype development method in hospital,it manages to establish an IT architecture dominated by the business operations and supplemented by business strategies.Results:The hospital IT application architecture was built around the five themes of"one-stop integrating all service,four-stream integrating to promoting business operation,reducing the cost of major supplies,scientific management and cost controlling,and evaluating the healthcare value by the total data".Conclusion:A feasible and practical hospital IT application architecture oriented to value-based healthcare is designed,which provides an reliable guidance for the hospital to push forward the value-based healthcare.

Objective:Analyzing the core position of hospital in value-based healthcare practice and designing IT platform to support value medicine practice.Methods:Based on the orchestral model and the enterprise architecture theoiy,making the hospital as the leading part of the practice of value-based healthcare,taking value-based healthcare as the business strategy,standing on the advance of value-based healthcare in China,considering fully of the existing organizational inertia on business,IT foundation and IT implementation mode based on the software prototype development method in hospital,it manages to establish an IT architecture dominated by the business operations and supplemented by business strategies.Results:The hospital IT application architecture was built around the five themes of"one-stop integrating all service,four-stream integrating to promoting business operation,reducing the cost of major supplies,scientific management and cost controlling,and evaluating the healthcare value by the total data".Conclusion:A feasible and practical hospital IT application architecture oriented to value-based healthcare is designed,which provides an reliable guidance for the hospital to push forward the value-based healthcare.

Objective:Analyzing the core position of hospital in value-based healthcare practice and designing IT platform to support value medicine practice.Methods:Based on the orchestral model and the enterprise architecture theoiy,making the hospital as the leading part of the practice of value-based healthcare,taking value-based healthcare as the business strategy,standing on the advance of value-based healthcare in China,considering fully of the existing organizational inertia on business,IT foundation and IT implementation mode based on the software prototype development method in hospital,it manages to establish an IT architecture dominated by the business operations and supplemented by business strategies.Results:The hospital IT application architecture was built around the five themes of"one-stop integrating all service,four-stream integrating to promoting business operation,reducing the cost of major supplies,scientific management and cost controlling,and evaluating the healthcare value by the total data".Conclusion:A feasible and practical hospital IT application architecture oriented to value-based healthcare is designed,which provides an reliable guidance for the hospital to push forward the value-based healthcare.

Objective:Analyzing the core position of hospital in value-based healthcare practice and designing IT platform to support value medicine practice.Methods:Based on the orchestral model and the enterprise architecture theoiy,making the hospital as the leading part of the practice of value-based healthcare,taking value-based healthcare as the business strategy,standing on the advance of value-based healthcare in China,considering fully of the existing organizational inertia on business,IT foundation and IT implementation mode based on the software prototype development method in hospital,it manages to establish an IT architecture dominated by the business operations and supplemented by business strategies.Results:The hospital IT application architecture was built around the five themes of"one-stop integrating all service,four-stream integrating to promoting business operation,reducing the cost of major supplies,scientific management and cost controlling,and evaluating the healthcare value by the total data".Conclusion:A feasible and practical hospital IT application architecture oriented to value-based healthcare is designed,which provides an reliable guidance for the hospital to push forward the value-based healthcare.

Objective:To study the intestinal mucosal state of ulcerative colitis (UC) through UC endoscopic scores and to investigate the correlation between the endoscopic scores and clinical activity and histological scores.Methods:A retrospective analysis was performed on data of 152 patients who underwent colonoscopy or sigmoidoscopy in Nanjing Drum Tower Hospital from January 2014 to September 2019. The results were graded with 7 endoscopic scores, namely, Mayo endoscopic score(MES), modified Baron score(MBS), endoscopic activity index(EAI) , Sutherland index(DAI or UCDAI) , Rachmilewitz endoscopic index(REI), Lemann endoscopic index (LEI), and ulcerative colitis endoscopic index of severity(UCEIS). Spearman correlation coefficients between endoscopic score and partial Mayo scores, Truelove-Witts disease severity score and Nancy index (NI), Robarts index (RHI) and Geboes score (GS) were calculated respectively. Consistency of each endoscopic score among different observers was analyzed.Results:Except for the weak correlation between DAI and Truelove - Witts classification ( r= 0.469, P < 0.001), all other endoscopic scores were moderately positively correlated with clinical activity scores with significance( all P<0.001). However, the correlation between 7 endoscopic scores and histological scores was weak ( P<0.001). Except that the consistency of MBS among observers was medium, those of MES, DAI and LEI among observers were poor, and those of UCEIS, EAI and REI among observers were worse ( P<0.001). Conclusion:Endoscopic scores were moderately correlated with clinical activity indexes and weakly correlated with histological scores. However, patients with endoscopic remission may have histologic inflammatory activity, so attention should be paid to histological mucosal healing after endoscopic remission. The consistency of all 7 endoscopic scoring stystems among observers was low, and the repeatability was poor.