Objectives:To investigate the imaging factors influencing the early prognosis of syrinx in patients with Chiari malformation type Ⅰ(CM Ⅰ)and syringomyelia(SM)who underwent posterior fossa decompression(PFD).Methods:Clinical data of 60 patients with CM Ⅰ and SM treated in the Department of Neurosurgery of Peking University Third Hospital from March 2013 to November 2022 were analyzed retrospectively.There were 18 males and 42 females with an average age of 48.8±9.1(range,27-65)years old.All the patients un-derwent PFD.Imaging assessments were performed preoperatively by cervical spine MRI and X-ray,and pa-rameters were collected,including maximum anterior-posterior and transverse diameters of syrinx,spinal cord anterior-posterior diameter,longitudinal distances of bulbo-pontine sulcus,fourth ventricle and cerebellar ton-sil,length of McRae line,length of clivus,clivus-canal angle,C0-C2 and C2-C7 Cobb angles as well as cervical sagittal vertical axis.The maximum syrinx/cord ratio and maximum syrinx area were calculated.With-in 1 month postoperatively,the maximum anterior-posterior diameter of syrinx was measured again by cervical spine MRI and its change rate was calculated to evaluate the early prognosis of syrinx.The patients were di-vided into improved(the change rate≥20％)and unimproved(the change rate＜20％)groups.The imaging find-ings were compared between the two groups,and a multi-variate logistic regression analysis was employed to identify significant predictors.Results:All the patients were followed up for 12.2±7.1d(range,5-31d).After PFD surgery,24 cases were improved in syrinx(the improved group),while 36 cases were not improved(the u-nimproved group).Age and gender were not significantly different between the two groups(P＞0.05).Postopera-tively,there were 2 cases with fever,2 cases with transient occipital pain,4 cases with CSF leakage,1 case with poor incision healing,and there was no significant difference of overall complication ratio between the two groups(P＞0.05).The clivus-canal angle and cervical sagittal vertical axis of CM Ⅰ patients in improved group(153.47°±9.99°,22.10±11.10mm)were significantly greater than those of unimproved patients(147.98°±9.55°,15.83±9.00mm)(P＜0.05).The maximum transverse diameter of syrinx in improved group(8.34±3.20mm)was significantly smaller than that of unimproved group(10.36±3.71mm,P＜0.05).No significant differences were found in other preoperative imaging parameters(P＞0.05).The multi-variate logisitic analysis revealed that the maximum transverse diameter of syrinx before operation was a risk factor of syrinx size reduction(OR=1.281,95％CI 1.042-1.576,P＜0.05),while the offset distance of cervical sagittal vertical axis acted as a protective factor of syrinx size reduction(OR=0.916,95％CI 0.853-0.984,P＜0.05).Conclusions:In patients with CM Ⅰand SM,preoperative maximum transverse diameter of syrinx and offset distance of cervical sagittal vertical axis are independent influencing factors for early postoperative prognosis of syrinx.

[Purpose]To analyze the compliance of liver cancer clinical screening and related in-fluencing factors in Inner Mongolia from 2016 to 2018.[Methods]The liver cancer screening pro-gram was conducted among permanent residents aged 40～74 years old in Inner Mongolia from 2016 to 2018.The risk factor assessment questionnaire was used for primary screening,and the identified high-risk subjects of liver cancer were subject to undergo clinical screening including ul-trasound examination and serum AFP test.The clinical screening rate of high-risk subjects and de-tection rate were calculated and compared among different groups.Multivariate Logistic regression model was used to analyze influencing factors related to the clinical screening rate of liver cancer.[Results]A total of 70 109 residents completed questionnaires risk assessments from 2016 to 2018,and 11 211 subjects were identified as high-risk of liver cancer with the high-risk rate of 15.99％.Among 11 211 high-risk subjects,4 998 underwent clinical screening with a screening rate of 44.58％.There were 125 cases of AFP positive(2.50％),11 cases of occupying lesions in the liver(0.22％),6 cases of cirrhosis(0.12％),and 2 303 cases of fatty liver(46.08％).Multivariate Logistic regression analysis showed that female,age of 45～54 years old,Mongolians and other ethnic minorities,individuals with vegetables intake＜2.5 kg/week and ≥2.5 kg/week,high-fat diet,history of smoking,smoking,alcohol drinking,history of tea-drinking,history of psychologi-cal trauma and stress in recent years,diseases of hepatobiliary system,and chronic hepatitis B were more likely to participate in clinical screening(all P＜0.05).[Conclusion]The screening com-pliance of high-risk population for liver cancer is low but the detection rate is high in Inner Mongo-lia from 2016 to 2018.The program mechanism should be improved to increase the liver cancer screening compliance.

Objective: To estimate the incidence and mortality of lung cancer in 2021 and their trends from 2014 to 2021 within cancer registration areas of Inner Mongolia Autonomous Region, so as to provide the basis for formulating localized strategies for lung cancer prevention and control. Methods: The data on lung cancer cases in cancer registration areas of Inner Mongolia Autonomous Region in 2021 were collected from the China Cancer Registration, encompassing data from 55 registries within the region. Crude incidence and crude mortality were calculated by genders, urban/rural rareas, and ages. The Chinese population-standardized rate was calculated using the age structure of the standard population from the Fifth National Population Census in 2000, while the world population-standardized rate was calculated using Segi's world standard population. To assess the trends in Chinese population-standardized incidence and mortality of lung cancer from 2014 to 2021, data from nine qualifying cancer registries were analyzed using the average annual percent change (AAPC). Results: In 2021, within Inner Mongolia Autonomous Region, the crude, Chinese population-standardized, and world population-standardized incidences of lung cancer were 58.96/100 000, 31.58/100 000, and 31.50/100 000, respectively. The crude, Chinese population-standardized, and world population-standardized mortalities were 46.48/100 000, 24.65/100 000, and 24.36/100 000 , respectively. The Chinese population-standardized incidence and mortality of lung cancer were 1.59-fold and 1.88-fold higher in males compared to females, and 1.08-fold and 1.10-fold higher in urban areas relative to rural areas. The crude incidence and mortality of lung cancer reached their peaks at age of 80-<85 years (379.91/100 000 and 474.31/100 000, respectively). From 2014 to 2021, the Chinese population-standardized incidence of lung cancer in Inner Mongolia Autonomous Region decreased from 43.28/100 000 to 31.41/100 000, showed a downward trend (AAPC=-3.312%, P<0.05), while the Chinese population-standardized mortality decreased from 31.55/100 000 to 24.11/100 000, showed no statistical significance (P>0.05). The Chinese population-standardized incidence of lung cancer in the group aged ≥75 years and the Chinese age-standardized mortality of lung cancer in the group aged 0-<45 years showed declining trends (AAPC=-4.307%, -7.355%, both P<0.05). Conclusions The disease burden of lung cancer in cancer registration areas of Inner Mongolia Autonomous Region has decreased, showing characteristics where the burden is higher in males than in females and slightly higher in urban areas than in rural areas. The elderly population represents a key group for lung cancer prevention and control.

[Purpose]To analyze the compliance of liver cancer clinical screening and related in-fluencing factors in Inner Mongolia from 2016 to 2018.[Methods]The liver cancer screening pro-gram was conducted among permanent residents aged 40～74 years old in Inner Mongolia from 2016 to 2018.The risk factor assessment questionnaire was used for primary screening,and the identified high-risk subjects of liver cancer were subject to undergo clinical screening including ul-trasound examination and serum AFP test.The clinical screening rate of high-risk subjects and de-tection rate were calculated and compared among different groups.Multivariate Logistic regression model was used to analyze influencing factors related to the clinical screening rate of liver cancer.[Results]A total of 70 109 residents completed questionnaires risk assessments from 2016 to 2018,and 11 211 subjects were identified as high-risk of liver cancer with the high-risk rate of 15.99％.Among 11 211 high-risk subjects,4 998 underwent clinical screening with a screening rate of 44.58％.There were 125 cases of AFP positive(2.50％),11 cases of occupying lesions in the liver(0.22％),6 cases of cirrhosis(0.12％),and 2 303 cases of fatty liver(46.08％).Multivariate Logistic regression analysis showed that female,age of 45～54 years old,Mongolians and other ethnic minorities,individuals with vegetables intake＜2.5 kg/week and ≥2.5 kg/week,high-fat diet,history of smoking,smoking,alcohol drinking,history of tea-drinking,history of psychologi-cal trauma and stress in recent years,diseases of hepatobiliary system,and chronic hepatitis B were more likely to participate in clinical screening(all P＜0.05).[Conclusion]The screening com-pliance of high-risk population for liver cancer is low but the detection rate is high in Inner Mongo-lia from 2016 to 2018.The program mechanism should be improved to increase the liver cancer screening compliance.

Objective:To explore the application value of cinematic rendering reconstruction technology in laparoscopic resection of giant adrenal tumors.Methods:As many as 21 patients with large adrenal tumors who underwent laparoscopic resection in Yongchuan Hospital Affiliated to Chongqing Medical University from January 2021 to January 2024 were retrospectively analyzed, with a median age of 54.0 (40.5, 58.0) years and a median tumor diameter of 7.3 (6.8, 8.8) cm. All patients underwent preoperative cinematic rendering 3D reconstruction imaging. All patients underwent enhanced CT scans. Their CT images were three-dimensionally reconstructed on the post-processing workstation platform. By changing image perspectives, adjusting the visualization of organs or blood vessels, and using physical volume rendering, real-shadow-rendered images were obtained. With these images, surgeons can intuitively understand important preoperative information, like the relationship between the tumor and surrounding organs and the path of tumor-feeding blood vessels, for preoperative planning. Following thorough preoperative preparation, laparoscopic transabdominal resection was performed. During surgery, 20 tumors were found to be located in the adrenal gland, and 1 in the retroperitoneum, with 13 on the left side and 8 on the right side. Preoperative cinematic rendering 3D imaging was consistent with intraoperative findings.Results:All 21 patients underwent successful surgeries, with an average operation time of (199.0±95.3) minutes, a median blood loss of 220 (150, 500) ml, and a median blood transfusion volume of 200 (150, 400) ml. No significant damage of vital organs or major blood vessels occurred, and there were no case of conversion to open surgery.Conclusions:For retroperitoneal giant adrenal tumors, utilizing cinematic rendering 3D reconstruction imaging enables a comprehensive understanding of the relationship between the tumor and surrounding organs and vessels preoperatively. This approach can reduce intraoperative bleeding and collateral injuries, improve the success rate of laparoscopic resection, and enhance overall surgical safety.

Objective:To explore the application value of cinematic rendering reconstruction technology in laparoscopic resection of giant adrenal tumors.Methods:As many as 21 patients with large adrenal tumors who underwent laparoscopic resection in Yongchuan Hospital Affiliated to Chongqing Medical University from January 2021 to January 2024 were retrospectively analyzed, with a median age of 54.0 (40.5, 58.0) years and a median tumor diameter of 7.3 (6.8, 8.8) cm. All patients underwent preoperative cinematic rendering 3D reconstruction imaging. All patients underwent enhanced CT scans. Their CT images were three-dimensionally reconstructed on the post-processing workstation platform. By changing image perspectives, adjusting the visualization of organs or blood vessels, and using physical volume rendering, real-shadow-rendered images were obtained. With these images, surgeons can intuitively understand important preoperative information, like the relationship between the tumor and surrounding organs and the path of tumor-feeding blood vessels, for preoperative planning. Following thorough preoperative preparation, laparoscopic transabdominal resection was performed. During surgery, 20 tumors were found to be located in the adrenal gland, and 1 in the retroperitoneum, with 13 on the left side and 8 on the right side. Preoperative cinematic rendering 3D imaging was consistent with intraoperative findings.Results:All 21 patients underwent successful surgeries, with an average operation time of (199.0±95.3) minutes, a median blood loss of 220 (150, 500) ml, and a median blood transfusion volume of 200 (150, 400) ml. No significant damage of vital organs or major blood vessels occurred, and there were no case of conversion to open surgery.Conclusions:For retroperitoneal giant adrenal tumors, utilizing cinematic rendering 3D reconstruction imaging enables a comprehensive understanding of the relationship between the tumor and surrounding organs and vessels preoperatively. This approach can reduce intraoperative bleeding and collateral injuries, improve the success rate of laparoscopic resection, and enhance overall surgical safety.

Objectives:To investigate the imaging factors influencing the early prognosis of syrinx in patients with Chiari malformation type Ⅰ(CM Ⅰ)and syringomyelia(SM)who underwent posterior fossa decompression(PFD).Methods:Clinical data of 60 patients with CM Ⅰ and SM treated in the Department of Neurosurgery of Peking University Third Hospital from March 2013 to November 2022 were analyzed retrospectively.There were 18 males and 42 females with an average age of 48.8±9.1(range,27-65)years old.All the patients un-derwent PFD.Imaging assessments were performed preoperatively by cervical spine MRI and X-ray,and pa-rameters were collected,including maximum anterior-posterior and transverse diameters of syrinx,spinal cord anterior-posterior diameter,longitudinal distances of bulbo-pontine sulcus,fourth ventricle and cerebellar ton-sil,length of McRae line,length of clivus,clivus-canal angle,C0-C2 and C2-C7 Cobb angles as well as cervical sagittal vertical axis.The maximum syrinx/cord ratio and maximum syrinx area were calculated.With-in 1 month postoperatively,the maximum anterior-posterior diameter of syrinx was measured again by cervical spine MRI and its change rate was calculated to evaluate the early prognosis of syrinx.The patients were di-vided into improved(the change rate≥20％)and unimproved(the change rate＜20％)groups.The imaging find-ings were compared between the two groups,and a multi-variate logistic regression analysis was employed to identify significant predictors.Results:All the patients were followed up for 12.2±7.1d(range,5-31d).After PFD surgery,24 cases were improved in syrinx(the improved group),while 36 cases were not improved(the u-nimproved group).Age and gender were not significantly different between the two groups(P＞0.05).Postopera-tively,there were 2 cases with fever,2 cases with transient occipital pain,4 cases with CSF leakage,1 case with poor incision healing,and there was no significant difference of overall complication ratio between the two groups(P＞0.05).The clivus-canal angle and cervical sagittal vertical axis of CM Ⅰ patients in improved group(153.47°±9.99°,22.10±11.10mm)were significantly greater than those of unimproved patients(147.98°±9.55°,15.83±9.00mm)(P＜0.05).The maximum transverse diameter of syrinx in improved group(8.34±3.20mm)was significantly smaller than that of unimproved group(10.36±3.71mm,P＜0.05).No significant differences were found in other preoperative imaging parameters(P＞0.05).The multi-variate logisitic analysis revealed that the maximum transverse diameter of syrinx before operation was a risk factor of syrinx size reduction(OR=1.281,95％CI 1.042-1.576,P＜0.05),while the offset distance of cervical sagittal vertical axis acted as a protective factor of syrinx size reduction(OR=0.916,95％CI 0.853-0.984,P＜0.05).Conclusions:In patients with CM Ⅰand SM,preoperative maximum transverse diameter of syrinx and offset distance of cervical sagittal vertical axis are independent influencing factors for early postoperative prognosis of syrinx.

Established in 2017, the Screening Cohort for Asian Nomadic descendants in China (Scan-China) has benefited over 180,000 members of a multi-ethnic population, particularly individuals of Mongolian descent compared with the general population (Han ethnicity), in the Inner Mongolia Autonomous Region, China. This cohort study aims to evaluate the effectiveness of cancer screening and serve as a real-world data platform for cancer studies. The 6 most prevalent cancers in China are considered—namely, breast, lung, colorectal, gastric, liver and esophageal cancer. After baseline cancer risk assessments and screening tests, both active and passive follow-up (based on the healthcare insurance database, cancer registry, the front page of hospital medical records, and death certificates) will be conducted to trace participants’ onset and progression of cancers and other prevalent chronic diseases. Scan-China has preliminarily found a disproportionately lower screening participation rate and higher incidence/mortality rates of esophageal and breast cancer among the Mongolian population than among their Han counterparts. Further research will explore the cancer burden, natural history, treatment patterns, and risk factors of the target cancers.

【Objective】 To investigate the predictive value of regional cerebral oxygen saturation (rScO2) monitoring during total aortic arch replacement and stent trunk surgery for perioperative neurocognitive disorders (PND) and changes in plasma S100β protein and neuron-specific enolase (NSE) concentrations and their relationship with PND. 【Methods】 Sixty-five Stanford type A aortic dissection patients who planned to undergo total aortic arch replacement and trunk stenting were selected. Their rScO2 values were monitored throughout the operation and recorded after induction (T1), the beginning of CPB (T2), during deep hypothermic circulatory arrest (T3), rewarming to 36℃(T4), CPB stop for 1 hour (T5), and post-operation (T6). After induction (Ta), rewarming to 36℃ (Tb),1 h (Tc), 6 h (Td) and 24 h (Te) after cessation of cardiopulmonary bypass, central venous blood was collected from patients, and the concentrations of S100β protein and NSE in plasma were detected by ELISA. The patients were divided into PND group and non-PND group by the evaluation of MMSE scale at time of before operation, on the day of extubation, and 7 days after operation. 【Results】 The incidence of PND was 44.6%. The rScO2 value at T2 was significantly lower than that at T1 (P<0.05). The rScO2 value of PND group at T3 and T6 was significantly lower than that at T1 and non-PND group (P<0.05). The mean value of rScO2 and the minimum value of rScO2 in PND group were significantly lower than those in non-PND group, while rScO2 %max in PND group was significantly higher than that in non-PND group (P<0.05). The intraoperative critical value of rScO2 %max was >9.89%, the area under curve (AUC) was 0.658 (95% CI: 0.525-0.791, P<0.05), and sensitivity and specificity were 48.3% and 75.0%, respectively. The concentrations of S100β protein and NSE protein in PND group were significantly higher than those in non-PND group at Tc and Td (P<0.01). Compared with Ta, the concentration of S100β protein in PND group was significantly increased at Tc and Td (P<0.001), and the concentration of NSE protein was significantly increased at Tb-Te (P<0.01). CPB time was an independent risk factor for PND. 【Conclusion】 The occurrence of PND after total arch replacement and stenting may be related to the decrease of rScO2 and the increase of S100β protein and NSE protein. Intraoperative rScO2 %max >9.89% can be a potential predictor of PND.

To explore the effect of doctor-patient relationship perception on work performance among medical staff in public hospitals and its mechanism. The convenient sampling method was used to select 380 medical staff working in four public tertiary hospitals in Sichuan Province, Zhejiang Province, and Fujian Province from August 2022 to October 2022 as the research objects, and the General Information Questionnaire, Doctor-Patient Relationship Scale, General Self-Efficacy Scale, Perceived Organizational Support Scale, Work Performance Questionnaire were used. This paper showed that the doctor-patient relationship perception of medical staff was negatively correlated with self-efficacy (r=-0.392, P<0.01) and work performance (r=-0.286, P<0.01), self-efficacy was positively correlated with perceived organizational support (r=0.538, P<0.01) and work performance (r=0.507, P<0.01), perceived organizational support was positively correlated with work performance (r=0.510, P<0.01). Self-efficacy played a partial mediating role between doctor-patient relationship perception and work performance, and its effect value was -0.241, accounting for 64.78% of the total effect. Perceived organizational support weakened the negative predictive effect of doctor-patient relationship perception on self-efficacy, which moderates the first half path of the mediating model that doctor-patient relationship perception affects work performance through self-efficacy. It indicated that the doctor-patient relationship perceived by medical staff in public hospitals is poor. Measures should be taken from the aspects of policy support, hospital and society levels to alleviate the doctor-patient relationship, play the mediating role of self-efficacy and the moderating role of organizational support, minimize the negative impact of doctor-patient relationship on the work performance among medical staff, and improve the work performance of medical staff, so as to improve the overall quality of medical services.