Objective: To investigate the survival rate of female breast cancer patients in Panyu District, Guangzhou City, so as to provide the basis for improving the prognosis of breast cancer patients. Methods: Basic information including age, clinical stage and surgical treatment of female breast cancer patients registered in Panyu District and diagnosed in 2017 were collected through the Guangzhou Municipal Cancer Registration and Reporting Management System, and were followed up until December 31, 2022. The survival rate was calculated using the life table. Factors affecting survival time among female breast cancer patients were analyzed using a multivariable Cox proportional hazard regression model. Results: A total of 227 female breast cancer patients were reported in Panyu District in 2017, and had a median age of 51 (interquartile range, 17) years. There were 43 cases (18.94%) in stage Ⅰ, 55 cases (24.23%) in stage Ⅱ, 63 cases (27.75%) in stage Ⅲ, 27 cases (11.89%) in stage Ⅳ, and 39 cases (17.18%) with unknown staging. Surgical treatment was performed in 204 cases (89.87%), and chemotherapy was administered in 73 cases (32.16%). By December 31, 2022, there were 40 deaths and 14 patients lost to follow-up. The one-year, three-year and five-year survival rates were 96.44%, 87.45% and 82.87%, respectively. Multivariable Cox proportional hazard regression analysis showed that older age (HR=1.023, 95%CI: 1.002-1.046), clinical stage Ⅲ (HR=10.050, 95%CI: 1.324-76.270) or IV (HR=42.663, 95%CI: 5.588-325.742) were associated with a higher risk of mortality in female breast cancer patients, while surgical treatment (HR=0.278, 95%CI: 0.130-0.598) was associated with a lower risk of mortality. Conclusions The five-year survival rate of female breast cancer patients in Panyu District was 82.87%. Age, clinical stage and surgical treatment were the main influencing factors for the survival time of female breast cancer patients.

Purpose: Cystic duct cancers (CDCs) have been classified as extrahepatic bile duct cancers or gallbladder cancers (GBCs); however, it is unclear whether their clinical behavior is similar to that of distal extrahepatic bile duct cancers (DBDCs) or GBCs. Materials and Methods: T category of the CDCs was classified using current T category scheme of the GBCs and DBDCs, and clinicopathological factors were compared among 38 CDCs, 345 GBCs, and 349 DBDCs. We modified Nakata’s classifications (type 1, confined within cystic duct [CD]; combined types 2-4, extension beyond CD) and compared them. Results: No significant overall survival (OS) difference was observed between the patients with CDC, GBC, and DBDC. The T category of GBC staging was more accurate at distinguishing OS in patients with CDC than the DBDC staging. Patients with T3 CDC and GBC showed a significant OS difference when using the T category for GBC staging, while those with T1-T2 CDC and GBC showed no significant difference. In contrast, the T category of DBDC staging did not show any significant OS difference between patients with T1-T2 CDC and DBDC or T3 CDC and DBDC. Patients with type 1 CDC had significantly better OS than those with combined types. Conclusion Unlike GBCs and DBDCs, CDCs exhibit distinct clinicopathological characteristics. The OS is better when the CDC confines within the CD, compared to when it extends beyond it. Therefore, we propose a new T category scheme (T1, confined to CD; T2, invaded beyond CD) for better classifying CDCs.

Purpose: Cystic duct cancers (CDCs) have been classified as extrahepatic bile duct cancers or gallbladder cancers (GBCs); however, it is unclear whether their clinical behavior is similar to that of distal extrahepatic bile duct cancers (DBDCs) or GBCs. Materials and Methods: T category of the CDCs was classified using current T category scheme of the GBCs and DBDCs, and clinicopathological factors were compared among 38 CDCs, 345 GBCs, and 349 DBDCs. We modified Nakata’s classifications (type 1, confined within cystic duct [CD]; combined types 2-4, extension beyond CD) and compared them. Results: No significant overall survival (OS) difference was observed between the patients with CDC, GBC, and DBDC. The T category of GBC staging was more accurate at distinguishing OS in patients with CDC than the DBDC staging. Patients with T3 CDC and GBC showed a significant OS difference when using the T category for GBC staging, while those with T1-T2 CDC and GBC showed no significant difference. In contrast, the T category of DBDC staging did not show any significant OS difference between patients with T1-T2 CDC and DBDC or T3 CDC and DBDC. Patients with type 1 CDC had significantly better OS than those with combined types. Conclusion Unlike GBCs and DBDCs, CDCs exhibit distinct clinicopathological characteristics. The OS is better when the CDC confines within the CD, compared to when it extends beyond it. Therefore, we propose a new T category scheme (T1, confined to CD; T2, invaded beyond CD) for better classifying CDCs.

Purpose: Cystic duct cancers (CDCs) have been classified as extrahepatic bile duct cancers or gallbladder cancers (GBCs); however, it is unclear whether their clinical behavior is similar to that of distal extrahepatic bile duct cancers (DBDCs) or GBCs. Materials and Methods: T category of the CDCs was classified using current T category scheme of the GBCs and DBDCs, and clinicopathological factors were compared among 38 CDCs, 345 GBCs, and 349 DBDCs. We modified Nakata’s classifications (type 1, confined within cystic duct [CD]; combined types 2-4, extension beyond CD) and compared them. Results: No significant overall survival (OS) difference was observed between the patients with CDC, GBC, and DBDC. The T category of GBC staging was more accurate at distinguishing OS in patients with CDC than the DBDC staging. Patients with T3 CDC and GBC showed a significant OS difference when using the T category for GBC staging, while those with T1-T2 CDC and GBC showed no significant difference. In contrast, the T category of DBDC staging did not show any significant OS difference between patients with T1-T2 CDC and DBDC or T3 CDC and DBDC. Patients with type 1 CDC had significantly better OS than those with combined types. Conclusion Unlike GBCs and DBDCs, CDCs exhibit distinct clinicopathological characteristics. The OS is better when the CDC confines within the CD, compared to when it extends beyond it. Therefore, we propose a new T category scheme (T1, confined to CD; T2, invaded beyond CD) for better classifying CDCs.

Objective:To guide cost control and the development of orthopedic specialty services in actual payment by thoroughly analyzing the functioning of DRG simulation in the pediatric orthopedic department of the Capital Institute of Pediatrics.Methods:A total of 736 patients from the orthopedic ward of the Capital Institute of Pediatrics were included as study subjects.The four-quadrant grouping method was employed to examine the profitability status of each diagnosis group in detail.A logistic regression model explored the key factors influencing profitability.Results:Congenital illnesses and traumas account for most pediatric orthopedic cases.Benefit groups(2 groups,4.8％),disadvantageous groups(15 groups,35.7％),key groups(8 groups,19.0％),and potential groups(17 groups,40.5％)are found using the Boston Matrix analysis.The profit group depends on the benefit groups(IF19,IH15)for 67.7％of its total revenue.No matter how profitable they are,medical consumables comprise a sizable portion(43％-45％).According to regression analysis,hospital profitability is highly impacted by age,consumable ratio,examination cost ratio,surgery cost ratio,and other cost ratios(P＜0.05).The consumable ratio is the most significant negative predictor(β=-2.238).Conclusion:Hospitals need to optimize their cost structure and increase the probability of profitability through refined management of consumables,the four-quadrant analysis method,strengthened cost accounting,and differentiated resource allocation.

Objective:To understand the epidemiological characteristics of fatal drowning in children in Zhejiang Province in 2022, analyze factors such as the swimming ability of children, the caregiver behavior at drowning site, types of first aid personnel and methods of first aid of unintentional fatal drowning and provide evidence for targeted intervention.Methods:Using the "Survey Form of Fatal Drowning Case in Children" designed by National Center for Chronic and Non-communicable Disease Control and Prevention of the China CDC, we collected case information of children aged 0-17 years who died due to drowning in Zhejiang in 2022 from medical history/death investigation records, telephone interviews, and home visits.Results:A total of 341 fatal drowning cases in children occurred in Zhejiang in 2022 and 330 cases were investigated (96.77%). The male to female of the cases was 2.33∶1, most cases were aged 15-17 years and 0-4 years, and 54.24% of fatal drowning cases occurred in children from other provinces. In the drowning cases, 83.33% were unintentional ones, and the proportion of intentional fatal drowning cases in children increased with age. Fatal drowning cases mainly occurred in open natural water bodies and public water storage facilities. More fatal drowning cases occurred in open natural water bodies in older children, while more fatal drowning cases occurred in public water storage facilities in younger children. In 275 children who died due to unintentional drowning, 73.09% could not swim, and only 1.09% were fully supervised by adults within an arm's length. First aid personnel, mainly medical staffs, bystanders and adult caregivers, were present for 47.63% fatal drowning cases. The proportion of the cases who had cardiopulmonary resuscitation as the first aid within 5 minutes was 2.18%.Conclusions:Drowning poses a serious threat to children's lives and there are differences in reasons and locations of fatal drowning in children in different age groups in Zhejiang Province in 2022. It is necessary to conduct to interventions to improve children's swimming skills, strengthen effective adult care and conduct health education about field first aid of drowning to reduce the incidence of drowning and related deaths in children.

Objective To study the efficacy of bronchoalveolar lavage(BAL)combined with prone positioning in children with Mycoplasma pneumoniae pneumonia(MPP)and atelectasis and its effect on pulmonary function.Methods A prospective study was conducted on 94 children with MPP and atelectasis who were hospitalized in Ordos Central Hospital of Inner Mongolia from November 2020 to May 2023.The children were randomly divided into a treatment group and a control group,with 47 children in each group.The children in the treatment group were given conventional treatment,BAL,and prone positioning,and those in the control group were given conventional treatment and BAL.The two groups were compared in terms of fever,pulmonary signs,length of hospital stay,lung recruitment,and improvement in pulmonary function.Results Compared with the control group,the treatment group had significantly shorter time to improvement in pulmonary signs and length of hospital stay and a significantly higher rate of lung recruitment on day 7 of hospitalization,on the day of discharge,and at 1 week after discharge(P<0.05).Compared with the control group,the treatment group had significantly higher levels of forced vital capacity(FVC)as a percentage of the predicted value,forced expiratory volume(FEV)in 1 second as a percentage of the predicted value,ratio of FEV in 1 second to FVC,forced expiratory flow at 50%of FVC as a percentage of the predicted value,forced expiratory flow at 75%of FVC as a percentage of the predicted value,and maximal mid-expiratory flow as a percentage of the predicted value on the day of discharge and at 1 week after discharge(P<0.05).There was no significant difference in the time for body temperature to return to normal between the two groups(P>0.05).Conclusions In the treatment of children with MPP and atelectasis,BAL combined with prone positioning can help to shorten the time to improvement in pulmonary signs and the length of hospital stay and promote lung recruitment and improvement in pulmonary function.