Objective It analyzes the current research status of the"one hospital with multiple campuses"construc-tion in public hospitals in China,focuses on research hotspots and evolution trends,and provides references for the research on"one hospital with multiple campuses"in public hospitals.Methods Using CiteSpace 6.3.R1 software,a visual analysis was conducted on 323 academic journal articles related to"one hospital with multiple campuses"in public hospitals from CNKI from 2014 to 2024.Results Over the past decade,the number of publications in this field has shown an overall upward trend;a core author group has initially formed but the density of the collaboration net-work is low;the institutions with the highest number of publications are mainly healthcare institutions and universi-ties;High-frequency keywords include public hospitals,homogenization,financial management,etc;research hot-spots generally show a trend from foundational construction to system integration,from extensive expansion to re-fined internal management,and from single-factor optimization to technology empowerment and multidimensional integration.Conclusion The research on the"one hospital with multiple campuses"construction of public hospitals in our country is clearly driven by policy,with research efforts distributed in a dual-core structure of"medical institu-tions-universities".However,interdisciplinary collaboration needs to be strengthened.Future research can focus on areas such as healthcare professionals,medical quality,the integration of business and finance systems,and inno-vation in emergency management mechanisms,providing support for the high-quality development of public hospi-tals with"one hospital with multiple campuses".

Objective To explore the development path of"one hospital with multiple campuses"in public hospitals in China,and provide a reference for promoting the healthy and high-level construction of"one hospital with multiple campuses".Methods Based on the SPO theory,an analytical framework for studying the development path of"one hospital with multiple campuses"in public hospitals in China was constructed.Taking 41 tertiary public hospitals in 20 provinces that participated in the performance assessment and carried out the construction of"one hospital with multiple campuses"as the analysis objects,the hospital performance assessment data and the development data of"one hospital with multiple campuses"were collected.Crisp-Set Qualitative Comparative Analysis was used to explore different conditional configurations for the development of"one hospital with multiple campuses"in public hospitals in China,and to reveal the development path of"one hospital with multiple campuses"in public hospitals.Results The high-quality development path of"one hospital with multiple campuses"is the result of the combined action of multiple factors.The management structure path,support and promotion path,quality and safety path,and operation performance pathare the four configurations that promote the high-quality development of"one hospital with multiple campuses"in public hospitals.Among them,quality and safety are the necessary conditions for the high-quality development of"one hospital with multiple campuses".Conclusion There are multiple paths for the high-quality development of"one hospital with multiple campuses"in public hospitals.Hospitals need to select appropriate development strategies according to their own situations,ensure the homogenization of medical quality among different hospital districts,and form a joint force for the development of multiple hospital districts.

Objective It analyzes the current research status of the"one hospital with multiple campuses"construc-tion in public hospitals in China,focuses on research hotspots and evolution trends,and provides references for the research on"one hospital with multiple campuses"in public hospitals.Methods Using CiteSpace 6.3.R1 software,a visual analysis was conducted on 323 academic journal articles related to"one hospital with multiple campuses"in public hospitals from CNKI from 2014 to 2024.Results Over the past decade,the number of publications in this field has shown an overall upward trend;a core author group has initially formed but the density of the collaboration net-work is low;the institutions with the highest number of publications are mainly healthcare institutions and universi-ties;High-frequency keywords include public hospitals,homogenization,financial management,etc;research hot-spots generally show a trend from foundational construction to system integration,from extensive expansion to re-fined internal management,and from single-factor optimization to technology empowerment and multidimensional integration.Conclusion The research on the"one hospital with multiple campuses"construction of public hospitals in our country is clearly driven by policy,with research efforts distributed in a dual-core structure of"medical institu-tions-universities".However,interdisciplinary collaboration needs to be strengthened.Future research can focus on areas such as healthcare professionals,medical quality,the integration of business and finance systems,and inno-vation in emergency management mechanisms,providing support for the high-quality development of public hospi-tals with"one hospital with multiple campuses".

Objective To explore the development path of"one hospital with multiple campuses"in public hospitals in China,and provide a reference for promoting the healthy and high-level construction of"one hospital with multiple campuses".Methods Based on the SPO theory,an analytical framework for studying the development path of"one hospital with multiple campuses"in public hospitals in China was constructed.Taking 41 tertiary public hospitals in 20 provinces that participated in the performance assessment and carried out the construction of"one hospital with multiple campuses"as the analysis objects,the hospital performance assessment data and the development data of"one hospital with multiple campuses"were collected.Crisp-Set Qualitative Comparative Analysis was used to explore different conditional configurations for the development of"one hospital with multiple campuses"in public hospitals in China,and to reveal the development path of"one hospital with multiple campuses"in public hospitals.Results The high-quality development path of"one hospital with multiple campuses"is the result of the combined action of multiple factors.The management structure path,support and promotion path,quality and safety path,and operation performance pathare the four configurations that promote the high-quality development of"one hospital with multiple campuses"in public hospitals.Among them,quality and safety are the necessary conditions for the high-quality development of"one hospital with multiple campuses".Conclusion There are multiple paths for the high-quality development of"one hospital with multiple campuses"in public hospitals.Hospitals need to select appropriate development strategies according to their own situations,ensure the homogenization of medical quality among different hospital districts,and form a joint force for the development of multiple hospital districts.

Objective:To investigate the clinical effect of the modified vertical rectus abdominis myocutaneous flap in repairing the skin and soft tissue defect after abdominoperineal resection for rectal cancer.Methods:This study was a retrospective observational study. From June 2019 to July 2022, five male patients with low rectal cancer who were conformed to the inclusion criteria were admitted to the Department of Basic Surgery of Xiangya Hospital of Central South University, with ages ranging from 65 to 70 years and the sizes of the perianal skin ulcers ranging from 5 cm×4 cm to 11 cm×9 cm, and all of them underwent abdominoperineal resection. The secondary skin and soft tissue defects in the perineum with an area of 8 cm×6 cm-14 cm×12 cm (with the depth of pelvic floor dead space being 10-15 cm) were repaired intraoperatively with transplantation of modified vertical rectus abdominis myocutaneous flaps with the skin area being 9 cm×7 cm-16 cm×12 cm, the volume of the muscle being 18 cm×10 cm×5 cm-20 cm×12 cm×5 cm, and the vessel pedicle being 18-20 cm in length. During the operation, most of the anterior sheath of the rectus abdominis muscle was retained, the flap was transferred to the recipient area through the abdominal cavity, the remaining anterior sheaths of the rectus abdominis muscle on both sides of the donor area were repeatedly folded and sutured, the free edge of the transverse fascia of the abdomen was sutured with the anterior sheath of the rectus abdominis muscle, and the donor area skin was directly sutured. After the operation, the survival of the transplanted myocutaneous flap was observed. The occurrence of complications in the perineal recipient area was recorded within 2 weeks after the operation. The recovery of the perineal recipient area and the abdominal donor area was observed during follow-up, and the occurrence of complications in the donor area of the abdomen as well as the recurrence of tumors and metastasis were recorded.Results:All transplanted myocutaneous flaps in 5 patients survived after surgery. One patient had dehiscence of the incision in the perineal recipient area 2 days after surgery, which healed after 7 d with intermittent dressing changes and routine vacuum sealing drainage treatment. In the other 4 patients, no complications such as incisional rupture, incisional infection, or fat liquefaction occurred in the perineal recipient area within 2 weeks after surgery. Follow-up for 6-12 months after discharge showed that the skin of the perineal recipient area had good color, texture, and elasticity, and was not bloated in appearance; linear scars were left in the perineal recipient area and the abdominal donor area without obvious scar hyperplasia or hyperpigmentation; no complications such as incisional rupture, incisional infection, intestinal adhesion, intestinal obstruction, or weakening of the abdominal wall strength occurred in the abdominal donor area, and the abdominal appearance was good with no localized bulge or formation of abdominal hernia; there was no local recurrence of tumor or metastasis in any patient.Conclusions:The surgical approach of using the modified vertical rectus abdominis myocutaneous flap to repair the skin and soft tissue defects after abdominoperineal resection for rectal cancer is relatively simple in operation, can achieve good postoperative appearances of the donor and recipient areas with few complications, and is worthy of clinical promotion.

Objective To forecast the number of healthcare professionals at China′s primary medical institutions from 2016 to 2020 ,so as to provide the healthcare authorities with references for optimizing healthcare human resource allocation .Methods The Grey model was used to predict numbers of healthcare professionals in China from 2016 to 2020 on the base of health technicians data from 2010 to 2015 .Results The forecast results show that the number of healthcare professionals may be increased to about 600000 people a yearfrom 2015 to 2020 .The number of healthcare professionals at China′s primary medical institutions is expected to grow about 204000 people a year ,and general practitioner is increased to about 22000 people a year .The annual growth rates of medical(assistant) practitioners ,medical practitioners ,registered nurses ,pharmaceutical personnel and examiners in China are expected to be 3.20％ ,2.81％ ,6.88％ ,1.53％ and 2.16％ respectively. The annual average growth rates of postgraduates ,undergraduates and junior college graduates are expected to be 16.95％ ,12.08％ and 5.46％ respectively .Conclusions in the future ,the requirements for healthcare professionals at primary institutions will still be higher than demand in China ,with a gap to be filled and their professional makeup and academic title make to be optimized. Therefore greater efforts are required for their development to enhance their competence and professionalism ,with reasonable staffing of the human resources .

Objective To explore the influencing factors and correlation of positive surgical margin (PSM) and biochemical recurrence (BCR) in men after robot-assisted radical prostatectomy (RALP).Methods The clinical data of 190 patients with local or locally advanced prostate cancer who underwent RALP by single surgeon in the Department of Urology of Changhai Hospital from January 2016 to September 2017 were collected.Age was (67.5 ±6.9) years old;median body mass index (BMI),preoperative PSA,prostate weight were 24.2 kg/m2 (16.6-34.2 kg/m2),15.0 ng/ml (1.41-393.94 ng/ml) and 36.9 g (8.65-207.58 g) respectively.The group of surgical margin was divided into negative surgical margin,apex-only PSM,base-only PSM as well as apex and base PSM.Characteristics between patients stratified by surgical margin or BCR were compared using x2 test.The influencing factors of PSM were analyzed by logistic regression.Cox regression was used for the analysis of predictive factors of BCR.Log-rank test and Kaplan-Meier curves were used for comparing the BCR rate between the groups of surgical margin.Results Of all the 190 enrolled patients,total PSM rate was 24.7％ (47/190),apex-only PSM rate was 13.2 ％ (25/190),base-only PSM rate was 5.8％ (11/190),apex and base PSM rate was 5.8 ％ (11/190).Multivariate analysis showed the independent predictive factors influencing PSM were preoperative PSA (P =0.048) and pathological stage (P =0.004).The median follow-up period was 7.3 months (0.9-26.6months) and BCR happened in 19.5％ (37/190) patients.The rates of BCR were 15.4％ (22/143),16.0％ (4/25),27.3％ (3/11) and 72.7％ (8/11) in the patients with negative surgical margin,apexonly PSM,base-only PSM and both apex and base PSM respectively.Log-rank test revealed that the rate of BCR in patients with apex and base PSM was higher than that in patients with negative surgical margin (P ＜0.001) or patients with apex-only PSM(P =0.002).Cox analysis indicated that higher preoperative PSA (P =0.040),higher pathological stage (P =0.041) and higher pathological Gleason score (P =0.004) were the independent predictors of BCR.PSM was not a predictive factor of BCR (P =0.257).Conclusions Preoperative PSA and pathological stage are the influencing factors of PSM.Higher preoperative PSA,higher pathological stage and higher pathological Gleason Score are the predictive factors of BCR.PSM may not be a predictive factor of BCR.The relationship between PSM and BCR needs further study.

Objective The aim of the study was to detect the mutation of Fms-like tyrosine kinase 3 internal tandem duplication (FLT3-1TD) rate in older de novo acute myeloid leukemia (AML) patients, to evaluate the role of FLT3-ITD in AML and its clinical significance. Methods The mutations of FLT3-1TD in bone marrow mononuelear cells (MNCS) from 30 cases of older AML were screened by polymerase chain reaction denaturing-high performance liquid chromatography (PCR-DHPLC). Results FLT3-1TD mutations were identified in 26.67 %(8/30) patients, while there were no mutations identified in control cases. And these kinds of mutations were likely to attend in M3 types. All mutations of FLT3-ITD were heterozygous and rearrangement fragment located in reading frame. Different karyomite groups had different FLT3-ITDmutations rate. We could see that FLT3-ITD positive patients were more prevalent in patients with normal karyotype. Clinical researches indicated that FLT3-ITD mutations had the characteristics of a higher peripheral white cell count, higher blast cells and lower complete remission rate in older AMKA Conclusion FLT3-ITD positive older AML patients conferred a poor prognosis and were likely to attend in normal karyomite group. The detection of FLT3-ITD mutations could make up for the deficiency of cytogenetics to some extent, and may become a routine examination of AML in older, which can direct their treatment and predict their prognosis.

Objective To examine the expression levels of cyclin Dl in the patients with chronic myelogenous leukemia (CML), and evaluate the pathogenesis and clinical significance of cyclin Dl in CML Methods The real-time quantitative polymerase chain reaction (RQ-PCR) was performed to detect the expression levels of cyclin Dl in the bone marrow samples of 18 patients with CML, and 16 samples of benign hemopoietic patients. The relationship between the expression levels of cyclin Dl and the progression and prognosis of patients with CML were analyzed. Results The level of cyclin Dl was higher expressed in 18 patients with CML than the control group (P <0.001). The levels of cyclin Dl was apparently higher expressed in accelerated phase /blast crisis phase than in chronic phase (P <0.05). And the RQ-PCR method showed the tendency that a significant increase was observed in the levels of cyclin Dl from 0.1980 in control group to 1.4002 in chronic phase and 5.4540 in accelerated phase /blast crisis phase. Conclusion The cyclin Dl overexpressed in CML, the roles of cyclin Dl in CML might be an oncogene expressed. The expression level is correlated with the progression and prognosis of patients with CML.

OBJECTIVEThe purpose of this study was to investigate the blood lead level of 3 - 5 year old children living in the cities in China and to provide scientific data for making policy on environmental lead pollution for children health protection.

METHODSSix thousand five hundred and two vein blood samples from 3 - 5 year old children in nineteen cities of nine provinces were sampled. Inductively coupled plasma-mass spectrometry (ICP-MS) were employed to determine lead level in whole blood after microwave digestion for sample preparation and questionnaire survey was also performed. Data were analyzed with multiple regression on factors which affecting blood lead levels.

RESULTSResults showed that mean blood lead level was 88.3 micro g/L for 3 - 5 year old children living in the cities in China and mean blood lead level of boys (91.1 micro g/L) was higher than that of girls (87.3 micro g/L). Twenty-nine point nine one per cent of the children's blood lead level exceeded 100 micro g/L. The research finding showed: (1) higher blood lead levels had negative effects on children's physical growth, language ability etc. (2) behavior of parents had certain effects on children's blood lead levels. (3) blood lead levels of children were affected by unhealthy habits.

CONCLUSIONSProblem of childhood lead poisoning in China has become more serious. During the past ten years, blood lead levels of children has been increased in China while decreasing in developed countries. Blood lead levels of children in China are higher than that of developed countries, which called for special concern by government and society.

Child, Preschool ; China ; Environmental Pollutants ; blood ; Female ; Humans ; Lead ; blood ; Male ; Mass Spectrometry ; Sex Factors ; Urban Health ; Urban Population