Objective To explore the feasibility, safety, and efficacy of transesophageal endoscopic surgery for mediastinal tumors. Methods A retrospective analysis was conducted on the clinical data of 17 patients who underwent transesophageal endoscopic resection for benign mediastinal tumors at the Endoscopy Center of Zhongshan Hospital, Fudan University, between January 1, 2016 and December 31, 2024. Epidemiological characteristics, surgical parameters, adverse events, and follow-up outcomes were analyzed. Results Among the 17 patients, there were 9 males and 8 females, with an average age of (42.4±14.5) years and an average tumor size of (2.6±1.6) cm. Pathological types included esophageal duplication cysts (6 cases, 35.3%), bronchogenic cysts (5 cases, 29.4%), gastroenteric cysts (3 cases, 17.6%), schwannomas (2 cases, 11.8%), and lymphangioma (1 case, 5.9%). Fourteen patients (82.4%) underwent submucosal tunneling endoscopic resection (STER), 3 patients (17.6%) underwent natural orifice transluminal endoscopic mediastinal surgery. All surgeries were successfully completed without conversion to open surgery. En bloc resection was achieved in 11 patients (64.7%), with an average operative time of (60.9±32.6) min. No intraoperative bleeding or mucosal injury occurred, and 4 patients (23.5%) experienced minor complications (pneumothorax, fever, recurrent laryngeal nerve injury), all of which resolved with conservative treatment. The average postoperative hospital stay was (3.2±1.5) days, and no recurrence was observed during the follow-up period. Conclusions Transesophageal endoscopic resection of benign mediastinal tumors is a safe, effective, and minimally invasive treatment method. Further validation of its efficacy and safety through large-scale prospective studies is warranted.

Objective To observe the correlations of pontine biological indicators on fetal brain median sagittal MRI with gestational week.Methods Data of head MRI of 226 normal fetuses without obvious abnormalities of central nervous system(normal group)and 17 fetuses with abnormalities(abnormal group)at gestational age of 23 to 38 weeks were retrospectively analyzed.Pontine biological indicators based on median sagittal MRI were obtained,including pons anteroposterior diameter(PAD),total pons area(TPA),pontine basal anteroposterior length(AP),pontine basal cranio-caudal length(CC),basis pontis area(BPA)and pontine angle of midbrain(MAP).According to the gestational week,the fetuses of normal group were divided into 8 subgroups.The distributing ranges of pontine biological indicators at different gestational weeks were analyzed,and the correlations of pontine biological indicators with gestational week in normal group were explored,and the developmental status of fetal pons in abnormal group were assessed.Results In normal group,PAD,TPA,AP,CC and BPA all showed linear positive correlation(r=0.887,0.914,0.787,0.866,0.865,all P＜0.001),while MAP was not significantly correlated with gestational week(P＞0.05).Among 17 fetuses in abnormal group,abnormal PAD or TPA was found each in 8 fetuses,abnormal AP was observed in 14,abnormal CC was noticed in 3 and abnormal BPA was found in 11 fetuses.Conclusion Fetal pontine biological indicators such as PAD,TPA,AP,CC and BPA on median sagittal MRI were positively correlated with gestational week,hence being able to be used for evaluating fetal pontine development.

Objective To explore the genetic characteristics of fetuses with congenital heart diseases(CHD)diagnosed by prenatal ultrasound.Methods Data of 613 singletons with prenatal ultrasonic diagnosed CHD were retrospectively analyzed.The cardiac structural abnormalities were classified into 8 types.Whole-exome sequencing(WES)was performed for 40 fetuses since chromosomal karyotyping analysis and/or chromosomal microarray analysis(CMA)showed benign copy number variations(CNV)or variants of uncertain significance(VUS).Results Among 613 fetuses,479 fetuses underwent both chromosomal karyotyping analysis and CMA,genomic abnormalities were detected in 60 fetuses(60/479,12.53％).Among 134 fetuses underwent only CMA,genomic abnormalities were found in 4 fetuses(4/134,2.99％).According to results of chromosomal karyotyping analysis and/or CMA,abnormalities were noticed in 40 fetuses(40/568,7.04％)among 568 fetuses with isolated CHD,while in 15 fetuses(15/45,33.33％)among 45 fetuses with non-isolated CHD,respectively.Abnormality detection rate of chromosomal karyotyping analysis and/or CMA in fetuses with complex CHD(10/41,24.39％)was higher than that in fetuses with non-complex CHD(54/572,9.44％).Among complex CHD fetuses,abnormality detection rate was the highest in fetuses with conotruncal defect(CTD)combined with malformation of venous system(4/13,30.77％),while among fetuses with non-complex CHD,situs inversus viscerum had the highest detection rate(1/4,25.00％).Among 40 fetuses chromosomal karyotyping analysis and/or CMA showed benign CNV or VUS,WES indicated pathogenic CNV/likely pathogenic CNV(P/LP)in 3 fetuses,VUS in 3 fetuses and benign CNV in 34 fetuses.Conclusion Fetuses with CHD,especially extracardiac malformations had possibilities of genomic abnormalities.Fetuses with CTD combined with malformation of venous system had higher possibilities of genomic abnormalities.Compared with CMA alone,chromosomal karyotyping analysis combined with CMA was helpful for detecting genomic abnormalities.

Objective Based on DRG evaluation indicators,research an evaluation method that can comprehensive-ly evaluate the medical service capacity and efficiency of clinical departments in hospitals.Methods Using the front page of inpatient medical records from a tertiary hospital in Xuzhou in 2022 as a sample,obtaining DRG related indi-cators through the China Healthcare Security Diagnosis Related Groups 1.1 grouping system.Based on the number of DRG,CMI,TEI,and CEI indicators,use TOPSIS method to comprehensively evaluate the quality of medical ser-vices in clinical departments.Results The widest coverage of medical services is in General Surgery,with a DRG group of 325;The most difficult medical service is in the Emergency Department,with a CMI value of 1.45;The best time efficiency is in Ophthalmology,with a TEI of 0.56,The Dermatology has the best cost efficiency,with a CEI of 0.36;TOPSIS comprehensive evaluation shows that the top five are Pediatrics,General Medicine,Emergen-cy Department,General Surgery,and Gastroenterology,and the bottom five are Dentistry,Burn Unit,Orthope-dics,Neurosurgery,and CCU.Conclusion The TOPSIS method based on DRG integrates two dimensions of medical service capability and medical service efficiency,and horizontally compares clinical departments.The evaluation re-sults are more objective,reasonable,and accurate,which can provide a methodological basis for hospital refined management.

Objective Based on DRG evaluation indicators,research an evaluation method that can comprehensive-ly evaluate the medical service capacity and efficiency of clinical departments in hospitals.Methods Using the front page of inpatient medical records from a tertiary hospital in Xuzhou in 2022 as a sample,obtaining DRG related indi-cators through the China Healthcare Security Diagnosis Related Groups 1.1 grouping system.Based on the number of DRG,CMI,TEI,and CEI indicators,use TOPSIS method to comprehensively evaluate the quality of medical ser-vices in clinical departments.Results The widest coverage of medical services is in General Surgery,with a DRG group of 325;The most difficult medical service is in the Emergency Department,with a CMI value of 1.45;The best time efficiency is in Ophthalmology,with a TEI of 0.56,The Dermatology has the best cost efficiency,with a CEI of 0.36;TOPSIS comprehensive evaluation shows that the top five are Pediatrics,General Medicine,Emergen-cy Department,General Surgery,and Gastroenterology,and the bottom five are Dentistry,Burn Unit,Orthope-dics,Neurosurgery,and CCU.Conclusion The TOPSIS method based on DRG integrates two dimensions of medical service capability and medical service efficiency,and horizontally compares clinical departments.The evaluation re-sults are more objective,reasonable,and accurate,which can provide a methodological basis for hospital refined management.

Objective Based on DRG evaluation indicators,research an evaluation method that can comprehensive-ly evaluate the medical service capacity and efficiency of clinical departments in hospitals.Methods Using the front page of inpatient medical records from a tertiary hospital in Xuzhou in 2022 as a sample,obtaining DRG related indi-cators through the China Healthcare Security Diagnosis Related Groups 1.1 grouping system.Based on the number of DRG,CMI,TEI,and CEI indicators,use TOPSIS method to comprehensively evaluate the quality of medical ser-vices in clinical departments.Results The widest coverage of medical services is in General Surgery,with a DRG group of 325;The most difficult medical service is in the Emergency Department,with a CMI value of 1.45;The best time efficiency is in Ophthalmology,with a TEI of 0.56,The Dermatology has the best cost efficiency,with a CEI of 0.36;TOPSIS comprehensive evaluation shows that the top five are Pediatrics,General Medicine,Emergen-cy Department,General Surgery,and Gastroenterology,and the bottom five are Dentistry,Burn Unit,Orthope-dics,Neurosurgery,and CCU.Conclusion The TOPSIS method based on DRG integrates two dimensions of medical service capability and medical service efficiency,and horizontally compares clinical departments.The evaluation re-sults are more objective,reasonable,and accurate,which can provide a methodological basis for hospital refined management.

Objective To explore the applicable conditions of the Cox-TEL(Cox PH-Taylor expansion adjustment for long-term survival data)method for analysis of survival data that contain cured patients.Methods The simulated survival data method based on Weibull distribution was used to simulate and generate the survival data with different cure rates,censored rates,and cure rate differences.The Cox-TEL method was used for analysis of the generated simulation data,and its performance was evaluated by calculating its type I error and power.Results Almost all the type I error of the hazard ratios(HRs)obtained by the Cox-TEL method under different conditions were slightly greater than 0.05,and this method showed a good test power for estimating the HRs for data with a large sample size and a large difference in proportions(DPs).For the data of cured patients,the type I error of the DPs obtained by the Cox-TEL method was well around 0.05,and its test power was robust in most of the scenarios.Conclusion The Cox-TEL method is effective for analyzing data of uncured patients and obtaining reliable HRs for most of the survival data with a sample size,a low censored rates,and a large difference in cure rates.The method is capable of accurately estimating the DPs regardless of the sample size,censored rates,or the cure rates.

Objective Based on DRG evaluation indicators,research an evaluation method that can comprehensive-ly evaluate the medical service capacity and efficiency of clinical departments in hospitals.Methods Using the front page of inpatient medical records from a tertiary hospital in Xuzhou in 2022 as a sample,obtaining DRG related indi-cators through the China Healthcare Security Diagnosis Related Groups 1.1 grouping system.Based on the number of DRG,CMI,TEI,and CEI indicators,use TOPSIS method to comprehensively evaluate the quality of medical ser-vices in clinical departments.Results The widest coverage of medical services is in General Surgery,with a DRG group of 325;The most difficult medical service is in the Emergency Department,with a CMI value of 1.45;The best time efficiency is in Ophthalmology,with a TEI of 0.56,The Dermatology has the best cost efficiency,with a CEI of 0.36;TOPSIS comprehensive evaluation shows that the top five are Pediatrics,General Medicine,Emergen-cy Department,General Surgery,and Gastroenterology,and the bottom five are Dentistry,Burn Unit,Orthope-dics,Neurosurgery,and CCU.Conclusion The TOPSIS method based on DRG integrates two dimensions of medical service capability and medical service efficiency,and horizontally compares clinical departments.The evaluation re-sults are more objective,reasonable,and accurate,which can provide a methodological basis for hospital refined management.

Objective Based on DRG evaluation indicators,research an evaluation method that can comprehensive-ly evaluate the medical service capacity and efficiency of clinical departments in hospitals.Methods Using the front page of inpatient medical records from a tertiary hospital in Xuzhou in 2022 as a sample,obtaining DRG related indi-cators through the China Healthcare Security Diagnosis Related Groups 1.1 grouping system.Based on the number of DRG,CMI,TEI,and CEI indicators,use TOPSIS method to comprehensively evaluate the quality of medical ser-vices in clinical departments.Results The widest coverage of medical services is in General Surgery,with a DRG group of 325;The most difficult medical service is in the Emergency Department,with a CMI value of 1.45;The best time efficiency is in Ophthalmology,with a TEI of 0.56,The Dermatology has the best cost efficiency,with a CEI of 0.36;TOPSIS comprehensive evaluation shows that the top five are Pediatrics,General Medicine,Emergen-cy Department,General Surgery,and Gastroenterology,and the bottom five are Dentistry,Burn Unit,Orthope-dics,Neurosurgery,and CCU.Conclusion The TOPSIS method based on DRG integrates two dimensions of medical service capability and medical service efficiency,and horizontally compares clinical departments.The evaluation re-sults are more objective,reasonable,and accurate,which can provide a methodological basis for hospital refined management.

Objective Based on DRG evaluation indicators,research an evaluation method that can comprehensive-ly evaluate the medical service capacity and efficiency of clinical departments in hospitals.Methods Using the front page of inpatient medical records from a tertiary hospital in Xuzhou in 2022 as a sample,obtaining DRG related indi-cators through the China Healthcare Security Diagnosis Related Groups 1.1 grouping system.Based on the number of DRG,CMI,TEI,and CEI indicators,use TOPSIS method to comprehensively evaluate the quality of medical ser-vices in clinical departments.Results The widest coverage of medical services is in General Surgery,with a DRG group of 325;The most difficult medical service is in the Emergency Department,with a CMI value of 1.45;The best time efficiency is in Ophthalmology,with a TEI of 0.56,The Dermatology has the best cost efficiency,with a CEI of 0.36;TOPSIS comprehensive evaluation shows that the top five are Pediatrics,General Medicine,Emergen-cy Department,General Surgery,and Gastroenterology,and the bottom five are Dentistry,Burn Unit,Orthope-dics,Neurosurgery,and CCU.Conclusion The TOPSIS method based on DRG integrates two dimensions of medical service capability and medical service efficiency,and horizontally compares clinical departments.The evaluation re-sults are more objective,reasonable,and accurate,which can provide a methodological basis for hospital refined management.