Objective It aims to analyze the resource distribution of Chinese gradeA teritary hospitals across six regions from 2012 to 2021,so as to further understand the changes in inter-regional health resource allocation.Methods Based on the"Thirteenth Five-Year Plan"for the Establishment of National Medical Centers and Regional Medical Centers,it utilizes indicators such as the annual growth rate,coefficient of variation,agglomeration degree,and Theil index to explore the resource allocation in Chinese gradeA teritary hospitals from 2012 to 2021.Comparative and trend analyses are also conducted.Results The regional difference of high-quality medical resources in the country has continued to narrow,especially with an increased rate of reduction since 2017.The Theil index of resource allocation in grade A teritary hospitals in various regions of the country has decreased from 0.035 0 to 0.020 5,indicating a positive trend towards fairness and a gradual increase in regional development coordination.An imbalance in the geographical distribution of resources among third-class medical institutions persists across various regions of China.Conclusion The resource allocation of grade A teritary hospitals in the western region should fully consider geographical factors and change the traditional single"human-oriented"resource allocation mode.Grade A teritary hospitals in economically developed areas still need to increase resource investment,conduct proactive population monitoring,early warning,and macro resource planning.The resource allocation of third-class medical institutions should focus on both intra-regional development and inter-regional collaboration to enhance the quality and efficiency of resource distribution.

Objective To explore the efficacy of retropubic midurethral synthetic sling(RMUS)in relieving urgency and urge urinary incontinence(UUI)symptoms in patients with mixed urinary incontinence(MUI).Methods Clinical data of 44 female MUI patients treated with RMUS during Jan.2018 and Dec.2020 in Shanghai Renji Hospital were retrospectively analyzed.All patients had positive results in stress test and Marshall-Marchetti test before operation,and 27 of them completed ICIQ-FLUTS-LF questionnaire.Urodynamic(UDS)tests suggested that 9 patients(20.5％)presented detrusor overactivity(DO).During RMUS procedure,the tension of the sling was adjusted based on the anatomical landmarks.The postoperative efficacy and improvement of urinary incontinence were analyzed.Results The patients aged(58.59±9.08)years,with a body mass index of 24.71±2.77.Among the 40 patients who completed telephone interview 2 years after surgery,the subjective cure rate was 85.0％(34/40).Among the 27 patients with records of questionnaires before and after surgery,there were significant differences in the incidence of urine leakage[100％(27/27)vs.18.5％(5/27)],stress urinary incontinence(SUI)[100％(27/27)vs.18.5％(5/27)]and UUI[70.4％(19/27)vs.29.6％(8/27)](P＜0.05).However,no statistical differences were found regarding nocturia voiding episode(≥1 times),urgency,dysuria,hesitancy,strain to void,intermittent stream and enuresis(P＞0.05).Based on preoperative UDS test,there were significant differences regarding the subjective cure rate in patients with or without preoperative DO[55.6％(5/9)vs.93.5％(29/31)],incidence of SUI[66.7％(4/6)vs.4.8％(1/21)],and UUI[66.7％(4/6)vs.19.0％(4/21)](P＜0.05),while there was no statistical difference regarding urgency[66.7％(4/6)vs.33.3％(7/21)](P＞0.05).Conclusion RMUS is effective in treating MUI patients with positive stress test and Marshall-Marchetti test results,which can relieve SUI and UUI symptoms,but has no effects on urgency symptoms.DO on preoperative urodynamics results in poorer subjective outcomes.

Objective It aims to analyze the resource distribution of Chinese gradeA teritary hospitals across six regions from 2012 to 2021,so as to further understand the changes in inter-regional health resource allocation.Methods Based on the"Thirteenth Five-Year Plan"for the Establishment of National Medical Centers and Regional Medical Centers,it utilizes indicators such as the annual growth rate,coefficient of variation,agglomeration degree,and Theil index to explore the resource allocation in Chinese gradeA teritary hospitals from 2012 to 2021.Comparative and trend analyses are also conducted.Results The regional difference of high-quality medical resources in the country has continued to narrow,especially with an increased rate of reduction since 2017.The Theil index of resource allocation in grade A teritary hospitals in various regions of the country has decreased from 0.035 0 to 0.020 5,indicating a positive trend towards fairness and a gradual increase in regional development coordination.An imbalance in the geographical distribution of resources among third-class medical institutions persists across various regions of China.Conclusion The resource allocation of grade A teritary hospitals in the western region should fully consider geographical factors and change the traditional single"human-oriented"resource allocation mode.Grade A teritary hospitals in economically developed areas still need to increase resource investment,conduct proactive population monitoring,early warning,and macro resource planning.The resource allocation of third-class medical institutions should focus on both intra-regional development and inter-regional collaboration to enhance the quality and efficiency of resource distribution.

Objective It aims to analyze the resource distribution of Chinese gradeA teritary hospitals across six regions from 2012 to 2021,so as to further understand the changes in inter-regional health resource allocation.Methods Based on the"Thirteenth Five-Year Plan"for the Establishment of National Medical Centers and Regional Medical Centers,it utilizes indicators such as the annual growth rate,coefficient of variation,agglomeration degree,and Theil index to explore the resource allocation in Chinese gradeA teritary hospitals from 2012 to 2021.Comparative and trend analyses are also conducted.Results The regional difference of high-quality medical resources in the country has continued to narrow,especially with an increased rate of reduction since 2017.The Theil index of resource allocation in grade A teritary hospitals in various regions of the country has decreased from 0.035 0 to 0.020 5,indicating a positive trend towards fairness and a gradual increase in regional development coordination.An imbalance in the geographical distribution of resources among third-class medical institutions persists across various regions of China.Conclusion The resource allocation of grade A teritary hospitals in the western region should fully consider geographical factors and change the traditional single"human-oriented"resource allocation mode.Grade A teritary hospitals in economically developed areas still need to increase resource investment,conduct proactive population monitoring,early warning,and macro resource planning.The resource allocation of third-class medical institutions should focus on both intra-regional development and inter-regional collaboration to enhance the quality and efficiency of resource distribution.

Objective It aims to analyze the resource distribution of Chinese gradeA teritary hospitals across six regions from 2012 to 2021,so as to further understand the changes in inter-regional health resource allocation.Methods Based on the"Thirteenth Five-Year Plan"for the Establishment of National Medical Centers and Regional Medical Centers,it utilizes indicators such as the annual growth rate,coefficient of variation,agglomeration degree,and Theil index to explore the resource allocation in Chinese gradeA teritary hospitals from 2012 to 2021.Comparative and trend analyses are also conducted.Results The regional difference of high-quality medical resources in the country has continued to narrow,especially with an increased rate of reduction since 2017.The Theil index of resource allocation in grade A teritary hospitals in various regions of the country has decreased from 0.035 0 to 0.020 5,indicating a positive trend towards fairness and a gradual increase in regional development coordination.An imbalance in the geographical distribution of resources among third-class medical institutions persists across various regions of China.Conclusion The resource allocation of grade A teritary hospitals in the western region should fully consider geographical factors and change the traditional single"human-oriented"resource allocation mode.Grade A teritary hospitals in economically developed areas still need to increase resource investment,conduct proactive population monitoring,early warning,and macro resource planning.The resource allocation of third-class medical institutions should focus on both intra-regional development and inter-regional collaboration to enhance the quality and efficiency of resource distribution.

Objective It aims to analyze the resource distribution of Chinese gradeA teritary hospitals across six regions from 2012 to 2021,so as to further understand the changes in inter-regional health resource allocation.Methods Based on the"Thirteenth Five-Year Plan"for the Establishment of National Medical Centers and Regional Medical Centers,it utilizes indicators such as the annual growth rate,coefficient of variation,agglomeration degree,and Theil index to explore the resource allocation in Chinese gradeA teritary hospitals from 2012 to 2021.Comparative and trend analyses are also conducted.Results The regional difference of high-quality medical resources in the country has continued to narrow,especially with an increased rate of reduction since 2017.The Theil index of resource allocation in grade A teritary hospitals in various regions of the country has decreased from 0.035 0 to 0.020 5,indicating a positive trend towards fairness and a gradual increase in regional development coordination.An imbalance in the geographical distribution of resources among third-class medical institutions persists across various regions of China.Conclusion The resource allocation of grade A teritary hospitals in the western region should fully consider geographical factors and change the traditional single"human-oriented"resource allocation mode.Grade A teritary hospitals in economically developed areas still need to increase resource investment,conduct proactive population monitoring,early warning,and macro resource planning.The resource allocation of third-class medical institutions should focus on both intra-regional development and inter-regional collaboration to enhance the quality and efficiency of resource distribution.

Objective It aims to analyze the resource distribution of Chinese gradeA teritary hospitals across six regions from 2012 to 2021,so as to further understand the changes in inter-regional health resource allocation.Methods Based on the"Thirteenth Five-Year Plan"for the Establishment of National Medical Centers and Regional Medical Centers,it utilizes indicators such as the annual growth rate,coefficient of variation,agglomeration degree,and Theil index to explore the resource allocation in Chinese gradeA teritary hospitals from 2012 to 2021.Comparative and trend analyses are also conducted.Results The regional difference of high-quality medical resources in the country has continued to narrow,especially with an increased rate of reduction since 2017.The Theil index of resource allocation in grade A teritary hospitals in various regions of the country has decreased from 0.035 0 to 0.020 5,indicating a positive trend towards fairness and a gradual increase in regional development coordination.An imbalance in the geographical distribution of resources among third-class medical institutions persists across various regions of China.Conclusion The resource allocation of grade A teritary hospitals in the western region should fully consider geographical factors and change the traditional single"human-oriented"resource allocation mode.Grade A teritary hospitals in economically developed areas still need to increase resource investment,conduct proactive population monitoring,early warning,and macro resource planning.The resource allocation of third-class medical institutions should focus on both intra-regional development and inter-regional collaboration to enhance the quality and efficiency of resource distribution.

Objective It aims to analyze the resource distribution of Chinese gradeA teritary hospitals across six regions from 2012 to 2021,so as to further understand the changes in inter-regional health resource allocation.Methods Based on the"Thirteenth Five-Year Plan"for the Establishment of National Medical Centers and Regional Medical Centers,it utilizes indicators such as the annual growth rate,coefficient of variation,agglomeration degree,and Theil index to explore the resource allocation in Chinese gradeA teritary hospitals from 2012 to 2021.Comparative and trend analyses are also conducted.Results The regional difference of high-quality medical resources in the country has continued to narrow,especially with an increased rate of reduction since 2017.The Theil index of resource allocation in grade A teritary hospitals in various regions of the country has decreased from 0.035 0 to 0.020 5,indicating a positive trend towards fairness and a gradual increase in regional development coordination.An imbalance in the geographical distribution of resources among third-class medical institutions persists across various regions of China.Conclusion The resource allocation of grade A teritary hospitals in the western region should fully consider geographical factors and change the traditional single"human-oriented"resource allocation mode.Grade A teritary hospitals in economically developed areas still need to increase resource investment,conduct proactive population monitoring,early warning,and macro resource planning.The resource allocation of third-class medical institutions should focus on both intra-regional development and inter-regional collaboration to enhance the quality and efficiency of resource distribution.

Purpose To establish glucose metabolism patterns of Parkinson's disease(PD)at different periods,and to study the changing pattern of target region of interest(ROI)with the period of time,and then explore the relationship between ROIs and cognitive or motor in different periods.Materials and Methods A total of 42 patients with early-stage PD collected from June 2010 to September 2022 in online data from the markers of Parkinson's progression study which included clinical data,and FDG PET imaging was performed at baseline,12,24,36 and 48 months.The data of 8 healthy volunteers were also obtained from the database,and the time range was the same as that of the above-mentioned PD patients.The longitudinal changes of cerebral glucose metabolism in PD patients and the relationship between PD-associated ROI and movement disorder society-sponsored revision of the unified Parkinson's disease rating scale(MDS-UPDRS)score were evaluated.Results PD was relatively reduced activity located in frontal and parietal association areas and relatively increased activity in the cerebellum,the putamen and the cingulate gyrus.In our study of target ROIs over time,FDG uptake in the caudate nucleus,putamen,pallidum,and cerebellum of patients with PD was initially higher than in the normal group,and subsequently decreased.In contrast,the ROI of PD in the anterior cingulate gyrus,posterior cingulate gyrus,the substantia nigra pars compacta and substantia nigra pars reticulata was initially lower than that in healthy controls and subsequently increased.The putamen,pallidum and caudate nucleus metabolic activity showed a positive correlation in 36 month and MDS-UPDRS scores(r=0.659 5,0.678 7,0.716 7,all P<0.05).The caudate nucleus,putamen and pallidum metabolic activity showed a negative correlation in 24 month and baseline(r=-0.541 8,-0.878 9,-0.887 6,all P<0.05).Conclusion We provide 5-year longitudinal data on changes in 18F-FDG imaging outcomes in early PD.In addition,the glucose metabolic activity of caudate nucleus,putamen and globus pallidus are correlated with MDS-UPDRS scores.

Objective:To investigate the association of exposure to PM 2.5 and its constituents during pregnancy and fetal growth and to further identify critical windows of exposure for fetal growth. Methods:We included 4 089 mother-child pairs from the Jiangsu Birth Cohort Study between January 2016 and October 2019. Data of general characteristics, clinical information, daily average PM 2.5 exposure, and its constituents during pregnancy were collected. Fetal growth parameters, including head circumference (HC), abdominal circumference (AC), and femur length (FL), were measured by ultrasound after 20 weeks of gestation, and then estimated fetal weight (EFW) was calculated. Generalized linear mixed models were adopted to examine the associations of prenatal exposure to PM 2.5 and its constituents with fetal growth. Distributed lag nonlinear models were used to identify critical exposure windows for each outcome. Results:A 10 μg/m 3 increase in PM 2.5 exposure during pregnancy was associated with a decrease of 0.025 ( β=-0.025, 95% CI: -0.048- -0.001) in HC Z-score, 0.026 ( β=-0.026, 95% CI: -0.049- -0.003) in AC Z-score, and 0.028 ( β=-0.028, 95% CI:-0.052--0.004) in EFW Z-score, along with an increased risk of 8.5% ( RR=1.085, 95% CI: 1.010-1.165) and 13.5% ( RR=1.135, 95% CI: 1.016-1.268) for undergrowth of HC and EFW, respectively. Regarding PM 2.5 constituents, prenatal exposure to black carbon, organic matter, nitrate, sulfate (SO 42-) and ammonium consistently correlated with decreased HC Z-score. SO 42- exposure was also associated with decreased FL Z-scores. In addition, we found that gestational weeks 2-5 were critical windows for HC, weeks 4-13 and 19-40 for AC, weeks 4-13 and 23-37 for FL, and weeks 4-12 and 20-40 for EFW. Conclusions:Our findings demonstrated that exposure to PM 2.5 and its constituents during pregnancy could adversely affect fetal growth and the critical windows for different fetal growth parameters are not completely consistent.