Objective:To investigate the prognosis of patients with initially resectable gastric cancer liver metastasis (GCLM) who were treated by different modalities, and analyze the influencing factors for prognosis of patients.Methods:The retrospective cohort study was conducted. The clinicopathological data of 327 patients with initially resectable GCLM who were included in the database of a nationwide multicenter retrospective cohort study on GCLM based on real-world data from January 2010 to December 2019 were collected. There were 267 males and 60 females, aged 61(54,68)years. According to the specific situations of patients, treatment modalities included radical surgery combined with systemic treatment, palliative surgery combined with systemic treatment, and systemic treatment alone. Observation indicators: (1) clinical characteristics of patients who were treated by different modalities; (2) prognostic outcomes of patients who were treated by different modalities; (3) analysis of influencing factors for prognosis of patients with initially resectable GCLM; (4) screening of potential beneficiaries in patients who were treated by radical surgery plus systemic treatment and patients who were treated by palliative surgery plus systemic treatment. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. The Kaplan-Meier method was used to calculate survival rate and draw survival curve, and Log-Rank test was used for survival analysis. Univariate and multivariate analyses were conducted using the COX proportional hazard regression model. The propensity score matching was employed by the 1:1 nearest neighbor matching method with a caliper value of 0.1. The forest plots were utilized to evaluate potential benefits of diverse surgical combined with systemic treatments within the population. Results:(1) Clinical characteristics of patients who were treated by different modalities. Of 327 patients, there were 118 cases undergoing radical surgery plus systemic treatment, 164 cases undergoing palliative surgery plus systemic treatment, and 45 cases undergoing systemic treatment alone. There were significant differences in smoking, drinking, site of primary gastric tumor, diameter of primary gastric tumor, site of liver metastasis, and metastatic interval among the three groups of patients ( P<0.05). (2) Prognostic outcomes of patients who were treated by different modalities. The median overall survival time of the 327 pati-ents was 19.9 months (95% confidence interval as 14.9-24.9 months), with 1-, 3-year overall survival rate of 61.3%, 32.7%, respectively. The 1-year overall survival rates of patients undergoing radical surgery plus systemic treatment, palliative surgery plus systemic treatment and systemic treatment alone were 68.3%, 63.1%, 30.6%, and the 3-year overall survival rates were 41.1%, 29.9%, 11.9%, showing a significant difference in overall survival rate among the three groups of patients ( χ2=19.46, P<0.05). Results of further analysis showed that there was a significant difference in overall survival rate between patients undergoing radical surgery plus systemic treatment and patients undergoing systemic treatment alone ( hazard ratio=0.40, 95% confidence interval as 0.26-0.61, P<0.05), between patients undergoing palliative surgery plus systemic treatment and patients under-going systemic treatment alone ( hazard ratio=0.47, 95% confidence interval as 0.32-0.71, P<0.05). (3) Analysis of influencing factors for prognosis of patients with initially resectable GCLM. Results of multivariate analysis showed that the larger primary gastric tumor, poorly differentiated tumor, larger liver metastasis, multiple hepatic metastases were independent risk factors for prognosis of patients with initially resectable GCLM ( hazard ratio=1.20, 1.70, 1.20, 2.06, 95% confidence interval as 1.14-1.27, 1.25-2.31, 1.04-1.42, 1.45-2.92, P<0.05) and immunotherapy or targeted therapy, the treatment modality of radical or palliative surgery plus systemic therapy were independent protective factors for prognosis of patients with initially resectable GCLM ( hazard ratio=0.60, 0.39, 0.46, 95% confidence interval as 0.42-0.87, 0.25-0.60, 0.30-0.70, P<0.05). (4) Screening of potentinal beneficiaries in patients who were treated by radical surgery plus systemic treatment and patients who were treated by palliative surgery plus systemic treatment. Results of forest plots analysis showed that for patients with high-moderate differentiated GCLM and patients with liver metastasis located in the left liver, the overall survival rate of patients undergoing radical surgery plus systemic treatment was better than patients undergoing palliative surgery plus systemic treatment ( hazard ratio=0.21, 0.42, 95% confidence interval as 0.09-0.48, 0.23-0.78, P<0.05). Conclusions:Compared to systemic therapy alone, both radical and palliative surgery plus systemic therapy can improve the pro-gnosis of patients with initially resectable GCLM. The larger primary gastric tumor, poorly differen-tiated tumor, larger liver metastasis, multiple hepatic metastases are independent risk factors for prognosis of patients with initial resectable GCLM and immunotherapy or targeted therapy, the treatment modality of radical or palliative surgery plus systemic therapy are independent protective factors for prognosis of patients with initially resectable GCLM.

Objective To explore the application of drones in blood emergency support during the 19th Asian Games Hangzhou in Shaoxing venue,so as to provide reference for future major events.Methods A retrospective analysis of drone delivery of emergency blood to two designated rescue hospitals in Shaoxing for the Asian Games was conducted.Ten emer-gency and 30 routine land blood delivery records from two designated hospitals in 2023 were randomly selected to compare with the blood delivery using drones.The blood temperature during the drone flight were monitored,the cold chain control during drone flight was evaluated,and the application of drone flight was reviewed.Results During the Hangzhou Asian Games,a total of 14 drones were used for blood delivery.The delivery time(min)by drone from the blood station to one of the designated hospitals was 11.83±0.09,and 20.80±3.29 by emergency land delivery and 23.23±3.54 by routine land de-livery(P＜0.05),meanwhile was 17.50±0.08,24.50±3.27 and 26.57±3.23 respectively to the other hospital(P＜0.05).Compared with land emergency blood delivery and routine blood delivery,blood delivery time by drone was much shorter,demonstrating better timeliness and stability.The temperature monitoring during the drone delivering showed that the suspen-ded red blood cells and platelets were in a range of 3.8-6.8℃ and 21.8-22.8℃,with a temperature difference of 0.5-0.9℃ and 0.2-1.0℃ between takeoff and landing respectively,demonstrating that the blood cold chain was under control,and the delivery ran safely and smoothly.Conclusion During major events,the use of drones for emergency blood delivery ensures the quality of the blood,with good timeliness,feasibility and operability,and is worthy of promotion and applica-tion.

【Objective】 To explore the application of drones in blood emergency support during the 19th Asian Games Hangzhou in Shaoxing venue, so as to provide reference for future major events. 【Methods】 A retrospective analysis of drone delivery of emergency blood to two designated rescue hospitals in Shaoxing for the Asian Games was conducted. Ten emergency and 30 routine land blood delivery records from two designated hospitals in 2023 were randomly selected to compare with the blood delivery using drones. The blood temperature during the drone flight were monitored, the cold chain control during drone flight was evaluated, and the application of drone flight was reviewed. 【Results】 During the Hangzhou Asian Games, a total of 14 drones were used for blood delivery. The delivery time(min) by drone from the blood station to one of the designated hospitals was 11.83±0.09, and 20.80±3.29 by emergency land delivery and 23.23±3.54 by routine land delivery (P<0.05), meanwhile was 17.50±0.08, 24.50±3.27 and 26.57±3.23 respectively to the other hospital(P<0.05). Compared with land emergency blood delivery and routine blood delivery, blood delivery time by drone was much shorter, demonstrating better timeliness and stability. The temperature monitoring during the drone delivering showed that the suspended red blood cells and platelets were in a range of 3.8-6.8℃ and 21.8-22.8℃, with a temperature difference of 0.5-0.9 ℃ and 0.2-1.0℃ between takeoff and landing respectively, demonstrating that the blood cold chain was under control, and the delivery ran safely and smoothly. 【Conclusion】 During major events, the use of drones for emergency blood delivery ensures the quality of the blood, with good timeliness, feasibility and operability, and is worthy of promotion and application.

Objective To explore the application of drones in blood emergency support during the 19th Asian Games Hangzhou in Shaoxing venue,so as to provide reference for future major events.Methods A retrospective analysis of drone delivery of emergency blood to two designated rescue hospitals in Shaoxing for the Asian Games was conducted.Ten emer-gency and 30 routine land blood delivery records from two designated hospitals in 2023 were randomly selected to compare with the blood delivery using drones.The blood temperature during the drone flight were monitored,the cold chain control during drone flight was evaluated,and the application of drone flight was reviewed.Results During the Hangzhou Asian Games,a total of 14 drones were used for blood delivery.The delivery time(min)by drone from the blood station to one of the designated hospitals was 11.83±0.09,and 20.80±3.29 by emergency land delivery and 23.23±3.54 by routine land de-livery(P＜0.05),meanwhile was 17.50±0.08,24.50±3.27 and 26.57±3.23 respectively to the other hospital(P＜0.05).Compared with land emergency blood delivery and routine blood delivery,blood delivery time by drone was much shorter,demonstrating better timeliness and stability.The temperature monitoring during the drone delivering showed that the suspen-ded red blood cells and platelets were in a range of 3.8-6.8℃ and 21.8-22.8℃,with a temperature difference of 0.5-0.9℃ and 0.2-1.0℃ between takeoff and landing respectively,demonstrating that the blood cold chain was under control,and the delivery ran safely and smoothly.Conclusion During major events,the use of drones for emergency blood delivery ensures the quality of the blood,with good timeliness,feasibility and operability,and is worthy of promotion and applica-tion.

Objective To explore the application of drones in blood emergency support during the 19th Asian Games Hangzhou in Shaoxing venue,so as to provide reference for future major events.Methods A retrospective analysis of drone delivery of emergency blood to two designated rescue hospitals in Shaoxing for the Asian Games was conducted.Ten emer-gency and 30 routine land blood delivery records from two designated hospitals in 2023 were randomly selected to compare with the blood delivery using drones.The blood temperature during the drone flight were monitored,the cold chain control during drone flight was evaluated,and the application of drone flight was reviewed.Results During the Hangzhou Asian Games,a total of 14 drones were used for blood delivery.The delivery time(min)by drone from the blood station to one of the designated hospitals was 11.83±0.09,and 20.80±3.29 by emergency land delivery and 23.23±3.54 by routine land de-livery(P＜0.05),meanwhile was 17.50±0.08,24.50±3.27 and 26.57±3.23 respectively to the other hospital(P＜0.05).Compared with land emergency blood delivery and routine blood delivery,blood delivery time by drone was much shorter,demonstrating better timeliness and stability.The temperature monitoring during the drone delivering showed that the suspen-ded red blood cells and platelets were in a range of 3.8-6.8℃ and 21.8-22.8℃,with a temperature difference of 0.5-0.9℃ and 0.2-1.0℃ between takeoff and landing respectively,demonstrating that the blood cold chain was under control,and the delivery ran safely and smoothly.Conclusion During major events,the use of drones for emergency blood delivery ensures the quality of the blood,with good timeliness,feasibility and operability,and is worthy of promotion and applica-tion.

Objective To explore the application of drones in blood emergency support during the 19th Asian Games Hangzhou in Shaoxing venue,so as to provide reference for future major events.Methods A retrospective analysis of drone delivery of emergency blood to two designated rescue hospitals in Shaoxing for the Asian Games was conducted.Ten emer-gency and 30 routine land blood delivery records from two designated hospitals in 2023 were randomly selected to compare with the blood delivery using drones.The blood temperature during the drone flight were monitored,the cold chain control during drone flight was evaluated,and the application of drone flight was reviewed.Results During the Hangzhou Asian Games,a total of 14 drones were used for blood delivery.The delivery time(min)by drone from the blood station to one of the designated hospitals was 11.83±0.09,and 20.80±3.29 by emergency land delivery and 23.23±3.54 by routine land de-livery(P＜0.05),meanwhile was 17.50±0.08,24.50±3.27 and 26.57±3.23 respectively to the other hospital(P＜0.05).Compared with land emergency blood delivery and routine blood delivery,blood delivery time by drone was much shorter,demonstrating better timeliness and stability.The temperature monitoring during the drone delivering showed that the suspen-ded red blood cells and platelets were in a range of 3.8-6.8℃ and 21.8-22.8℃,with a temperature difference of 0.5-0.9℃ and 0.2-1.0℃ between takeoff and landing respectively,demonstrating that the blood cold chain was under control,and the delivery ran safely and smoothly.Conclusion During major events,the use of drones for emergency blood delivery ensures the quality of the blood,with good timeliness,feasibility and operability,and is worthy of promotion and applica-tion.

Objective To explore the application of drones in blood emergency support during the 19th Asian Games Hangzhou in Shaoxing venue,so as to provide reference for future major events.Methods A retrospective analysis of drone delivery of emergency blood to two designated rescue hospitals in Shaoxing for the Asian Games was conducted.Ten emer-gency and 30 routine land blood delivery records from two designated hospitals in 2023 were randomly selected to compare with the blood delivery using drones.The blood temperature during the drone flight were monitored,the cold chain control during drone flight was evaluated,and the application of drone flight was reviewed.Results During the Hangzhou Asian Games,a total of 14 drones were used for blood delivery.The delivery time(min)by drone from the blood station to one of the designated hospitals was 11.83±0.09,and 20.80±3.29 by emergency land delivery and 23.23±3.54 by routine land de-livery(P＜0.05),meanwhile was 17.50±0.08,24.50±3.27 and 26.57±3.23 respectively to the other hospital(P＜0.05).Compared with land emergency blood delivery and routine blood delivery,blood delivery time by drone was much shorter,demonstrating better timeliness and stability.The temperature monitoring during the drone delivering showed that the suspen-ded red blood cells and platelets were in a range of 3.8-6.8℃ and 21.8-22.8℃,with a temperature difference of 0.5-0.9℃ and 0.2-1.0℃ between takeoff and landing respectively,demonstrating that the blood cold chain was under control,and the delivery ran safely and smoothly.Conclusion During major events,the use of drones for emergency blood delivery ensures the quality of the blood,with good timeliness,feasibility and operability,and is worthy of promotion and applica-tion.

Objective To explore the application of drones in blood emergency support during the 19th Asian Games Hangzhou in Shaoxing venue,so as to provide reference for future major events.Methods A retrospective analysis of drone delivery of emergency blood to two designated rescue hospitals in Shaoxing for the Asian Games was conducted.Ten emer-gency and 30 routine land blood delivery records from two designated hospitals in 2023 were randomly selected to compare with the blood delivery using drones.The blood temperature during the drone flight were monitored,the cold chain control during drone flight was evaluated,and the application of drone flight was reviewed.Results During the Hangzhou Asian Games,a total of 14 drones were used for blood delivery.The delivery time(min)by drone from the blood station to one of the designated hospitals was 11.83±0.09,and 20.80±3.29 by emergency land delivery and 23.23±3.54 by routine land de-livery(P＜0.05),meanwhile was 17.50±0.08,24.50±3.27 and 26.57±3.23 respectively to the other hospital(P＜0.05).Compared with land emergency blood delivery and routine blood delivery,blood delivery time by drone was much shorter,demonstrating better timeliness and stability.The temperature monitoring during the drone delivering showed that the suspen-ded red blood cells and platelets were in a range of 3.8-6.8℃ and 21.8-22.8℃,with a temperature difference of 0.5-0.9℃ and 0.2-1.0℃ between takeoff and landing respectively,demonstrating that the blood cold chain was under control,and the delivery ran safely and smoothly.Conclusion During major events,the use of drones for emergency blood delivery ensures the quality of the blood,with good timeliness,feasibility and operability,and is worthy of promotion and applica-tion.

Objective To explore the application of drones in blood emergency support during the 19th Asian Games Hangzhou in Shaoxing venue,so as to provide reference for future major events.Methods A retrospective analysis of drone delivery of emergency blood to two designated rescue hospitals in Shaoxing for the Asian Games was conducted.Ten emer-gency and 30 routine land blood delivery records from two designated hospitals in 2023 were randomly selected to compare with the blood delivery using drones.The blood temperature during the drone flight were monitored,the cold chain control during drone flight was evaluated,and the application of drone flight was reviewed.Results During the Hangzhou Asian Games,a total of 14 drones were used for blood delivery.The delivery time(min)by drone from the blood station to one of the designated hospitals was 11.83±0.09,and 20.80±3.29 by emergency land delivery and 23.23±3.54 by routine land de-livery(P＜0.05),meanwhile was 17.50±0.08,24.50±3.27 and 26.57±3.23 respectively to the other hospital(P＜0.05).Compared with land emergency blood delivery and routine blood delivery,blood delivery time by drone was much shorter,demonstrating better timeliness and stability.The temperature monitoring during the drone delivering showed that the suspen-ded red blood cells and platelets were in a range of 3.8-6.8℃ and 21.8-22.8℃,with a temperature difference of 0.5-0.9℃ and 0.2-1.0℃ between takeoff and landing respectively,demonstrating that the blood cold chain was under control,and the delivery ran safely and smoothly.Conclusion During major events,the use of drones for emergency blood delivery ensures the quality of the blood,with good timeliness,feasibility and operability,and is worthy of promotion and applica-tion.

Objective To explore the application of drones in blood emergency support during the 19th Asian Games Hangzhou in Shaoxing venue,so as to provide reference for future major events.Methods A retrospective analysis of drone delivery of emergency blood to two designated rescue hospitals in Shaoxing for the Asian Games was conducted.Ten emer-gency and 30 routine land blood delivery records from two designated hospitals in 2023 were randomly selected to compare with the blood delivery using drones.The blood temperature during the drone flight were monitored,the cold chain control during drone flight was evaluated,and the application of drone flight was reviewed.Results During the Hangzhou Asian Games,a total of 14 drones were used for blood delivery.The delivery time(min)by drone from the blood station to one of the designated hospitals was 11.83±0.09,and 20.80±3.29 by emergency land delivery and 23.23±3.54 by routine land de-livery(P＜0.05),meanwhile was 17.50±0.08,24.50±3.27 and 26.57±3.23 respectively to the other hospital(P＜0.05).Compared with land emergency blood delivery and routine blood delivery,blood delivery time by drone was much shorter,demonstrating better timeliness and stability.The temperature monitoring during the drone delivering showed that the suspen-ded red blood cells and platelets were in a range of 3.8-6.8℃ and 21.8-22.8℃,with a temperature difference of 0.5-0.9℃ and 0.2-1.0℃ between takeoff and landing respectively,demonstrating that the blood cold chain was under control,and the delivery ran safely and smoothly.Conclusion During major events,the use of drones for emergency blood delivery ensures the quality of the blood,with good timeliness,feasibility and operability,and is worthy of promotion and applica-tion.