Objective:To evaluate the long-term outcomes and predictors of coronary atherosclerotic lesions deemed functionally non-ischemic (quantitative flow ratio(QFR)>0.80) and deferred from intervention.Methods:This study is a post-hoc analysis of the FAVOR Ⅲ China trial, which enrolled 3 825 patients with stable or unstable angina pectoris or with myocardial infarction occurring at least 72 hours prior to screening, between December 5, 2018 and January 9, 2020 from 26 research centers in China. Coronary vessels with QFR>0.80 and without interventional treatment were analyzed in this study. The primary endpoint was 3-year target vessel revascularization. Vessels with revascularization (revascularized group) during follow-up were matched 1∶1 using propensity score matching to comparable vessels without revascularization (non-revascularized group). Multivariate Cox regression analysis was used to identify the risk factors for target vessel revascularization (TVR).Results:A total of 6 212 functionally negative vessels with deferred intervention were included in the final analysis, among which 153 vessels (2.5%) underwent TVR during a 3-year follow-up. Prior to propensity score matching, 6 059 vessels comprised the non-revascularized group. At the vessel level, compared to the non-revascularized group, the revascularized group exhibited a significantly higher proportion of males (79.1% (121/153) vs. 70.2% (4 253/6 059), P=0.018), higher body mass index ((25.6±4.0) kg/m2 vs. (24.3±5.2) kg/m2, P=0.003), and a higher prevalence of hypertension (73.9% (113/153) vs. 65.1% (3 944/6 059), P=0.025). And 152 pairs of vessels were successfully matched. Multivariate Cox regression analysis identified in-stent restenosis lesions ( HR=2.59, 95% CI 1.28-5.23, P=0.008) as an independent risk factor for target vessel revascularization. Conclusions:Coronary lesions classified as functionally non-ischemic at baseline are not entirely stable and may progress to lesions that requiring revascularization over time. In-stent restenosis emerges as a critical independent predictor of revascularization.

Objective:To evaluate the long-term outcomes and predictors of coronary atherosclerotic lesions deemed functionally non-ischemic (quantitative flow ratio(QFR)>0.80) and deferred from intervention.Methods:This study is a post-hoc analysis of the FAVOR Ⅲ China trial, which enrolled 3 825 patients with stable or unstable angina pectoris or with myocardial infarction occurring at least 72 hours prior to screening, between December 5, 2018 and January 9, 2020 from 26 research centers in China. Coronary vessels with QFR>0.80 and without interventional treatment were analyzed in this study. The primary endpoint was 3-year target vessel revascularization. Vessels with revascularization (revascularized group) during follow-up were matched 1∶1 using propensity score matching to comparable vessels without revascularization (non-revascularized group). Multivariate Cox regression analysis was used to identify the risk factors for target vessel revascularization (TVR).Results:A total of 6 212 functionally negative vessels with deferred intervention were included in the final analysis, among which 153 vessels (2.5%) underwent TVR during a 3-year follow-up. Prior to propensity score matching, 6 059 vessels comprised the non-revascularized group. At the vessel level, compared to the non-revascularized group, the revascularized group exhibited a significantly higher proportion of males (79.1% (121/153) vs. 70.2% (4 253/6 059), P=0.018), higher body mass index ((25.6±4.0) kg/m2 vs. (24.3±5.2) kg/m2, P=0.003), and a higher prevalence of hypertension (73.9% (113/153) vs. 65.1% (3 944/6 059), P=0.025). And 152 pairs of vessels were successfully matched. Multivariate Cox regression analysis identified in-stent restenosis lesions ( HR=2.59, 95% CI 1.28-5.23, P=0.008) as an independent risk factor for target vessel revascularization. Conclusions:Coronary lesions classified as functionally non-ischemic at baseline are not entirely stable and may progress to lesions that requiring revascularization over time. In-stent restenosis emerges as a critical independent predictor of revascularization.

Objective:To investigate the risk factors and prognostic value of the textbook outcome (TO) in patients with advanced gastric cancer (AGC) who underwent neoadjuvant chemotherapy followed by surgical resection.Methods:This is a retrospective cohort study. A total of 253 patients with AGC who underwent neoadjuvant chemotherapy combined with gastrectomy and D2 lymphadenectomy in the Department of Gastric Surgery, Fujian Medical University Union Hospital from January 2010 to December 2019 were retrospectively included. There were 195 males and 58 females, aged (60.3±10.0) years (range: 27 to 75 years). The patients were then divided into the TO group ( n=168) and the non-TO group ( n=85). Multivariate Logistic regression was used to analyze the independent predictors of TO. Univariate and multivariate Cox analysis were used to analyze independent prognosis factors for overall survival (OS) and disease-free survival (DFS). Propensity score matching was performed to balance the TO and non-TO groups, and the Kaplan-Meier method was used to calculate survival rates and draw survival curves. Results:Among the 253 patients, 168 patients (66.4%) achieved TO. The Eastern Cooperative Oncology Group score ( OR=0.488, 95% CI: 0.278 to 0.856, P=0.012) and ypN stage ( OR=0.626, 95% CI:0.488 to 0.805, P<0.01) were independently predictive of TO. Multivariate analysis revealed that TO was an independent risk factor for both OS ( HR=0.662, 95% CI: 0.457 to 0.959, P=0.029) and DFS ( HR=0.687, 95% CI: 0.483 to 0.976, P=0.036). After matching, the 5-year OS rate (42.2% vs. 27.8%) and the 5-year DFS rate (37.5% vs. 27.8%) were significantly higher in the TO group than in the non-TO group (both P<0.05). Furthermore, patients in the non-TO group benefited significantly from postoperative chemotherapy (both P<0.05), but those in the TO group did not (both P>0.05). Conclusion:TO is an independent prognosis factor in patients undergoing neoadjuvant chemotherapy and surgery for AGC and is associated with postoperative chemotherapy benefits.

Discipline construction is an important part of the high-quality development of public hospitals.Under the current single multi-district development trend of public hospitals,it is necessary to layout disciplines in a scientific and systematic way to realize the coordinated development of each district at the geographical and functional levels.From the perspective of top-level design of multi-district discipline layout and practical exploration of Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine,it is proposed to clarify the functional orientation of the hospital districts from the perspective of the concept of running the hospital,national tasks and social needs.To achieve the high-quality development of the discipline and the continuous upgrading and innovation of public hospitals,it is also suggested to clarify the current situation of the discipline and determine the classified development direction by constructing a systematic disciplinary evaluation model.The transformation of scientific and technological achievements is a breakthrough to cultivate new momentum for the development of the hospital district,so as to realise the high-quality development of disciplines and the continuous upgrading and innovation of the functions of the hospital district.

Objective:To investigate the risk factors and prognostic value of the textbook outcome (TO) in patients with advanced gastric cancer (AGC) who underwent neoadjuvant chemotherapy followed by surgical resection.Methods:This is a retrospective cohort study. A total of 253 patients with AGC who underwent neoadjuvant chemotherapy combined with gastrectomy and D2 lymphadenectomy in the Department of Gastric Surgery, Fujian Medical University Union Hospital from January 2010 to December 2019 were retrospectively included. There were 195 males and 58 females, aged (60.3±10.0) years (range: 27 to 75 years). The patients were then divided into the TO group ( n=168) and the non-TO group ( n=85). Multivariate Logistic regression was used to analyze the independent predictors of TO. Univariate and multivariate Cox analysis were used to analyze independent prognosis factors for overall survival (OS) and disease-free survival (DFS). Propensity score matching was performed to balance the TO and non-TO groups, and the Kaplan-Meier method was used to calculate survival rates and draw survival curves. Results:Among the 253 patients, 168 patients (66.4%) achieved TO. The Eastern Cooperative Oncology Group score ( OR=0.488, 95% CI: 0.278 to 0.856, P=0.012) and ypN stage ( OR=0.626, 95% CI:0.488 to 0.805, P<0.01) were independently predictive of TO. Multivariate analysis revealed that TO was an independent risk factor for both OS ( HR=0.662, 95% CI: 0.457 to 0.959, P=0.029) and DFS ( HR=0.687, 95% CI: 0.483 to 0.976, P=0.036). After matching, the 5-year OS rate (42.2% vs. 27.8%) and the 5-year DFS rate (37.5% vs. 27.8%) were significantly higher in the TO group than in the non-TO group (both P<0.05). Furthermore, patients in the non-TO group benefited significantly from postoperative chemotherapy (both P<0.05), but those in the TO group did not (both P>0.05). Conclusion:TO is an independent prognosis factor in patients undergoing neoadjuvant chemotherapy and surgery for AGC and is associated with postoperative chemotherapy benefits.

Discipline construction is an important part of the high-quality development of public hospitals.Under the current single multi-district development trend of public hospitals,it is necessary to layout disciplines in a scientific and systematic way to realize the coordinated development of each district at the geographical and functional levels.From the perspective of top-level design of multi-district discipline layout and practical exploration of Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine,it is proposed to clarify the functional orientation of the hospital districts from the perspective of the concept of running the hospital,national tasks and social needs.To achieve the high-quality development of the discipline and the continuous upgrading and innovation of public hospitals,it is also suggested to clarify the current situation of the discipline and determine the classified development direction by constructing a systematic disciplinary evaluation model.The transformation of scientific and technological achievements is a breakthrough to cultivate new momentum for the development of the hospital district,so as to realise the high-quality development of disciplines and the continuous upgrading and innovation of the functions of the hospital district.

Discipline construction is an important part of the high-quality development of public hospitals.Under the current single multi-district development trend of public hospitals,it is necessary to layout disciplines in a scientific and systematic way to realize the coordinated development of each district at the geographical and functional levels.From the perspective of top-level design of multi-district discipline layout and practical exploration of Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine,it is proposed to clarify the functional orientation of the hospital districts from the perspective of the concept of running the hospital,national tasks and social needs.To achieve the high-quality development of the discipline and the continuous upgrading and innovation of public hospitals,it is also suggested to clarify the current situation of the discipline and determine the classified development direction by constructing a systematic disciplinary evaluation model.The transformation of scientific and technological achievements is a breakthrough to cultivate new momentum for the development of the hospital district,so as to realise the high-quality development of disciplines and the continuous upgrading and innovation of the functions of the hospital district.

Discipline construction is an important part of the high-quality development of public hospitals.Under the current single multi-district development trend of public hospitals,it is necessary to layout disciplines in a scientific and systematic way to realize the coordinated development of each district at the geographical and functional levels.From the perspective of top-level design of multi-district discipline layout and practical exploration of Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine,it is proposed to clarify the functional orientation of the hospital districts from the perspective of the concept of running the hospital,national tasks and social needs.To achieve the high-quality development of the discipline and the continuous upgrading and innovation of public hospitals,it is also suggested to clarify the current situation of the discipline and determine the classified development direction by constructing a systematic disciplinary evaluation model.The transformation of scientific and technological achievements is a breakthrough to cultivate new momentum for the development of the hospital district,so as to realise the high-quality development of disciplines and the continuous upgrading and innovation of the functions of the hospital district.

Discipline construction is an important part of the high-quality development of public hospitals.Under the current single multi-district development trend of public hospitals,it is necessary to layout disciplines in a scientific and systematic way to realize the coordinated development of each district at the geographical and functional levels.From the perspective of top-level design of multi-district discipline layout and practical exploration of Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine,it is proposed to clarify the functional orientation of the hospital districts from the perspective of the concept of running the hospital,national tasks and social needs.To achieve the high-quality development of the discipline and the continuous upgrading and innovation of public hospitals,it is also suggested to clarify the current situation of the discipline and determine the classified development direction by constructing a systematic disciplinary evaluation model.The transformation of scientific and technological achievements is a breakthrough to cultivate new momentum for the development of the hospital district,so as to realise the high-quality development of disciplines and the continuous upgrading and innovation of the functions of the hospital district.

Discipline construction is an important part of the high-quality development of public hospitals.Under the current single multi-district development trend of public hospitals,it is necessary to layout disciplines in a scientific and systematic way to realize the coordinated development of each district at the geographical and functional levels.From the perspective of top-level design of multi-district discipline layout and practical exploration of Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine,it is proposed to clarify the functional orientation of the hospital districts from the perspective of the concept of running the hospital,national tasks and social needs.To achieve the high-quality development of the discipline and the continuous upgrading and innovation of public hospitals,it is also suggested to clarify the current situation of the discipline and determine the classified development direction by constructing a systematic disciplinary evaluation model.The transformation of scientific and technological achievements is a breakthrough to cultivate new momentum for the development of the hospital district,so as to realise the high-quality development of disciplines and the continuous upgrading and innovation of the functions of the hospital district.