Objective:To compare the efficacy and safety of irradiation-incorporated and chemotherapy only-based myeloablative conditioning regimens in haploidentical hematopoietic stem cell transplantation (haplo-HSCT) for patients with high-risk myeloid malignancies.Methods:This study retrospectively collected clinical data from 63 high-risk acute myeloid leukemia/myelodysplastic syndrome (AML/MDS) patients who underwent haplo-HSCT at the Fifth Medical Center of the Chinese PLA General Hospital from January 2015 to December 2019. These patients were classified into the irradiation ( n = 17) and chemotherapy ( n = 46) groups based on different conditioning regimens. The differences between the two groups were compared in terms of hematopoietic reconstitution, cumulative incidence of acute/chronic graft-versus-host diseases (aGVHD and cGVHD), non-relapse mortality (NRM), relapse rate (RR), overall survival (OS), and disease-free survival (DFS), followed by the analysis of prognostic factors. Results:The median follow-up time for the irradiation and chemotherapy groups was 78.5 and 72.3 months, respectively. The median time for neutrophil engraftment was 14.0 days in the irradiation group and 14.5 d in the chemotherapy group, and for platelet engraftment was 15.0 and 13.0 d, respectively. As a result, the two groups showed no statistically significant differences in hematopoietic reconstitution ( P > 0.05). The cumulative incidence of aGVHD and cGVHD was higher in the irradiation group compared to the chemotherapy group, yet showing no statistically significant differences ( P > 0.05). Specifically, the cumulative incidence of grade Ⅱ-Ⅳ aGVHD within 100 d was 29.4% and 21.7% for the irradiation and chemotherapy groups, respectively. The cumulative incidence of grade Ⅲ-Ⅳ aGVHD was 23.5% and 13.0%, respectively. The cumulative incidence of severe cGVHD within five years was 11.8% in the irradiation group and 8.7% in the chemotherapy group. In terms of long-term survival, the cumulative 5\|year RR and NRM were 20.2% and 28.4% in the irradiation group, 5.9% and 23.9% in the chemotherapy group, respectively, showing no statistically significant differences ( P > 0.05). The 5-year DFS and OS rates were 73.9% and 47.7% in the irradiation group, and 81.1% and 54.4% in the chemotherapy group, respectively, without statistically significant differences ( P > 0.05). Notably, the irradiation group manifested more favorable DFS and OS survival curves compared to the chemotherapy group. The survival curves indicate that the irradiation-incorporated regimen exhibited better trends in OS, DFS, and cGVHD-free relapse-free survival (GRFS). However, multivariate analysis did not reveal that irradiation conditioning is an independent prognostic factor affecting survival [ HR = 0.532 (0.163-1.735), 0.370 (0.091-1.516), 0.683 (0.248-1.882), P > 0.05]. Conclusions:In haplo-HSCT for high-risk myeloid malignancies, the irradiation-incorporated conditioning regimen demonstrates lower RR and NRM, higher DFS and OS, and potentially superior survival outcomes compared to the chemotherapy only-based regimen. Therefore, the irradiation-incorporated conditioning regimen may be preferentially considered in haplo-HSCT.

Objective:To compare the efficacy and safety of irradiation-incorporated and chemotherapy only-based myeloablative conditioning regimens in haploidentical hematopoietic stem cell transplantation (haplo-HSCT) for patients with high-risk myeloid malignancies.Methods:This study retrospectively collected clinical data from 63 high-risk acute myeloid leukemia/myelodysplastic syndrome (AML/MDS) patients who underwent haplo-HSCT at the Fifth Medical Center of the Chinese PLA General Hospital from January 2015 to December 2019. These patients were classified into the irradiation ( n = 17) and chemotherapy ( n = 46) groups based on different conditioning regimens. The differences between the two groups were compared in terms of hematopoietic reconstitution, cumulative incidence of acute/chronic graft-versus-host diseases (aGVHD and cGVHD), non-relapse mortality (NRM), relapse rate (RR), overall survival (OS), and disease-free survival (DFS), followed by the analysis of prognostic factors. Results:The median follow-up time for the irradiation and chemotherapy groups was 78.5 and 72.3 months, respectively. The median time for neutrophil engraftment was 14.0 days in the irradiation group and 14.5 d in the chemotherapy group, and for platelet engraftment was 15.0 and 13.0 d, respectively. As a result, the two groups showed no statistically significant differences in hematopoietic reconstitution ( P > 0.05). The cumulative incidence of aGVHD and cGVHD was higher in the irradiation group compared to the chemotherapy group, yet showing no statistically significant differences ( P > 0.05). Specifically, the cumulative incidence of grade Ⅱ-Ⅳ aGVHD within 100 d was 29.4% and 21.7% for the irradiation and chemotherapy groups, respectively. The cumulative incidence of grade Ⅲ-Ⅳ aGVHD was 23.5% and 13.0%, respectively. The cumulative incidence of severe cGVHD within five years was 11.8% in the irradiation group and 8.7% in the chemotherapy group. In terms of long-term survival, the cumulative 5\|year RR and NRM were 20.2% and 28.4% in the irradiation group, 5.9% and 23.9% in the chemotherapy group, respectively, showing no statistically significant differences ( P > 0.05). The 5-year DFS and OS rates were 73.9% and 47.7% in the irradiation group, and 81.1% and 54.4% in the chemotherapy group, respectively, without statistically significant differences ( P > 0.05). Notably, the irradiation group manifested more favorable DFS and OS survival curves compared to the chemotherapy group. The survival curves indicate that the irradiation-incorporated regimen exhibited better trends in OS, DFS, and cGVHD-free relapse-free survival (GRFS). However, multivariate analysis did not reveal that irradiation conditioning is an independent prognostic factor affecting survival [ HR = 0.532 (0.163-1.735), 0.370 (0.091-1.516), 0.683 (0.248-1.882), P > 0.05]. Conclusions:In haplo-HSCT for high-risk myeloid malignancies, the irradiation-incorporated conditioning regimen demonstrates lower RR and NRM, higher DFS and OS, and potentially superior survival outcomes compared to the chemotherapy only-based regimen. Therefore, the irradiation-incorporated conditioning regimen may be preferentially considered in haplo-HSCT.

Research integrity is the foundation for ensuring the sound and orderly development of scientific and technological innovation. As the main battlefield of clinical medical research, hospitals should effectively fulfill their main responsibilities and do a good job in research integrity management. The China Hospital Research Integrity Alliance, consisting of the first batch of 43 hospitals, was established in November 2021. With the aim of " complementary advantages, resource sharing, and collaborative development", the alliance has carried out construction practices from seven aspects: construction mode, cultural system construction, organizational management, institutional construction, publicity and education, early warning and supervision, and technological empowerment. It has achieved the overall improvement of the research integrity construction ability of member units of the alliance, organic linkage between government and medical institutions, and efficient combination of internal and external resources, which can provide reference for the research integrity construction of medical institutions in China.

The performance appraisal of tertiary public hospital is the"gold standard"to test the comprehensive medical ability and level of public hospital.Discipline construction is the key to the high quality development of university affiliated hospi-tal.This study made a comparative analysis of the differences in the index system between the performance appraisal of tertiary public hospital and the subject ranking of world university and the discipline evaluation,and discussed how to guide university af-filiated hospital to strengthen discipline construction and continuously improve their comprehensive strength and international com-petitiveness through the efforts of the state,university and affiliated hospital.It provided a reference path for exploring the high-quality connotative development of world-class university affiliated hospital with Chinese characteristics.

Objective To investigate the relationship between the level of psychological stress and social support in family members of patients with accidental trauma in the emergency department. Methods A total of 96 family members of patients with accidental trauma in the emergency department were enrolled as trauma group, and 100 family members of hospitalized patients with chronic diseases were selected as chronic disease group. The differences in scores of the Family Stress Scale (RSS), the Symptom Checklist-90 (SCL-90), the Social Support Rating Scale (SSRS), and the Zarit Burden Interview (ZBI) were compared between the two groups. Simple linear correlation analysis was used to analyze the correlations of the RSS scores with SCL-90, SSRS and ZBI scores in the trauma group. Results The degree of life disruption, negative emotions, and total RSS score in the trauma group were higher than those in the chronic disease group (P < 0.05). The scores of somatization, interpersonal sensitivity, obsessive-compulsive symptoms, hostility, depression, phobia, anxiety, paranoia, psychoticism and overall SCL-90 score in the trauma group were significantly higher than those in the chronic disease group (P < 0.05). The SSRS score in the trauma group was significantly higher than that in the chronic disease group, while the ZBI score was significantly lower than that in the chronic disease group (P < 0.05). Linear correlation analysis showed that the total RSS score of family members in the trauma group was significantly positively correlated with ZBI score and SCL-90 score, but was significantly negatively correlated with the SSRS score (P < 0.05). Conclusion Family members of patients with accidental trauma in the emergency department experience significantly elevated levels of psychological stress, which is inversely related to the social support.

Objective:To explore the relationship between the long-term dynamic change in alanine aminotransferase(ALT) level and metabolic associated fatty liver disease(MAFLD).Methods:A retrospective study was conducted on 6 864 subjects who underwent four consecutive physical examinations from 2017 to 2020 in a cohort study of physical examination population in Henan Province. The relation between ALT level and the shift of MAFLD risk was analyzed using a multi-state Markov model, and the bidirectional relationship between ALT level and MAFLD was explored using a random intercept cross-lagged model.Results:Multi-state Markov model after adjusting for confounding factors showed that the risk of MAFLD in ALT Q2, Q3, Q4 group was gradually higher than that in Q1 group; Compared with health status, non-alcoholic fatty liver disease and MAFLD status gradually increased the risk of ALT shifting from normal to abnormal. The random intercept cross-lagged model after adjusting for confounding factors showed that there was a significant positive bidirectional relationship between MAFLD and ALT level. The cross-lag effect of MAFLD→ALT level was 0.083(95% CI 0.078-0.087), and the cross-lag effect of ALT→MAFLD was 0.044(95% CI 0.039-0.050). And with the extension of time, the cross-lag effect gradually decreased. Conclusions:There is a significant bidirectional relationship between the long-term dynamic change of ALT level and MAFLD. The occurrence of MAFLD is more likely to increase the risk of elevated ALT level, emphasizing the need for enhanced early prevention and treatment of MAFLD.

Chronic disease management is a challenging issue in China. To address the needs of talents and mature innovation ecosystem related to chronic disease management, The First Affiliated Hospital of Sun Yat-sen University(FAH-SYSU) actively responds to the national strategy to promote the high-quality development of the hospital through strengthening strategic planning, top-level design, and systematic consideration. Precise management of chronic diseases was taken as key measure for the construction of a national medical center. With continuous exploration in establishing talent pool, innovation center and application platform, and chronic disease management system that focuses on core elements of talent and innovation, the FAH-SYSU Model for the precise management of chronic diseases has been initially formed.

Objective:Through the analysis of the evaluation index system of the major rankings of universities and hospitals, this paper aims to provide a reference for the discipline construction of affiliated hospitals in universities.Methods:This paper comprehensively analyzes and compares the evaluation objectives and indicators of the five major rankings of universities and the three major rankings of hospitals in China and abroad.Results:Each main rankings have its own characteristics that both positive and with possible limitations.Conclusions:Hospital management departments can refer certain indicators in order to identify possible gaps of the hospital discipline development. Also, tailored corresponding measurements for discipline development can be developed in combination with real-needs.

Objective:To investigate the journals and research directions of SCI papers published by the first affiliated hospital of Sun Yat-sen university from 2007 to 2016. To further study the trend of published journals, as well as the relationship between the research directions and departments.Methods:According to the data from Institute of Scientific and Technical Information of China and the Web of Science, SCI papers of our hospital from 2007 to 2016 were searched and collected, detailed information on published journals and research directions of the papers were analyzed.Results:From 2007 to 2016, scientists of our hospital published 2 999 SCI papers in 897 kinds of journals in total, among which almost 60% papers were published in 166 kinds of journals. PLoS One published the largest number, counted as 125 papers. There were 16 kinds of journals with impact factor (IF)> 10, published 25 papers from 12 departments. A total number of 76 research directions were involved in all these papers, and the largest number of papers was in oncology, accounted for 10.3%. There were 1 647 papers in the top 10 research directions, accounted for 54.92%. Among the 76 research directions, 62 research directions involved more than 2 departments.Conclusions:The distribution of SCI journals published by the first affiliated hospital of Sun Yat-sen university is centralized, with few high-impact achievements. Interdisciplinary research is common and widespread, but the degree of concentration is not enough.

Objective This article conducted the statistical analysis of SCI papers published during 2013-2017 at the first affiliated hospital of Sun Yat-sen university ,to understand the SCI paper outcomes as to provide reference for future policy making and research administration development .Methods We analyzed the SCI papers published by the First Affiliated Hos-pital of Sun Yat-sen University from 2013 to 2017 ."Article" and"Review" type SCI papers published by the hospital as the first completion unit were statistically analyzed from the aspects of quantity ,impact factors ,journals and discipline distribu-tion .Results A total of 2268 SCI papers were published in 5 years ,distributed in 1162 journals .The quantity and the average impact factor both increased year by year ,but mainly concentrated in traditional dominant disciplines .Conclusions The SCI papers were increasing annually since 2013 .However ,we still need to improve the quantity and quality of high-level articles ,to promote the development of disciplines ,to strengthen the construction of public experimental platforms ,to continue building talent teams ,to improve the reward and evaluation system ,and to further enhance the overall scientific research level of the hospital .