Purpose: The objective of this study is to investigate the clinical efficacy of sequentially comprehensive treatment based on surgery and to furnish clinical evidence for the management of keloids.Patients and methods: The patients with keloids were retrospectively analyzed who underwent surgery-based sequentially comprehensive treatment at the Plastic Surgery Department of Shandong Provincial Hospital from January 2018 to August 2021. The recurrence rate and incidence of adverse reactions were explored for all the included patients. For patients who were followed up for more than 1 year, the clinical response rate was calculated, and the chi-square test was used to analyze which factors could influence clinical effectiveness. Binary logistic analysis was performed on the factors with statistical differences. For patients with a follow-up time of less than 1-year, paired t-test was used to evaluate their Vancouver Scar Scale (VSS) before and after treatment.Results: A total of 67 patients with 80 keloids were included. The clinical response rate was 81.5% (44/54), the recurrence rate was 15.0% (12/80) and the adverse reaction rate was 4.5% (3/67). The clinical response rate of tumor-type keloids (95.8%) was higher than that of inflammatory-type (70.0%) with a significant difference (P = 0.040). After treatment, the color, blood vessel distribution, softness, thickness, and VSS score were all decreased, and the difference was statistically significant (P < 0.001).Conclusion: The sequentially comprehensive treatment based on surgery has a significant curative effect, as well as a low recurrence rate and a low adverse effect rate. The type of keloid has a statistically significant effect on clinical efficacy, and tumor-type keloids are more suitable for sequentially comprehensive treatment based on surgery.

At the turn of the 20th century, Christian and Catholic churches in Western nations established numerous mission hospitals in non-European regions. In China, mission hospitals represent a significant category of modern architectural heritage, symbolising advancements in healthcare and medical education while also serving as historical artifacts of early cultural interactions between China and the West. With ongoing developments in medical technology, these mission hospital structures no longer meet contemporary healthcare demands; many have been repurposed or temporarily abandoned. Preserving and effectively repurposing mission hospital heritage has thus emerged as a critical issue. In the present study, the Shantung Christian University Union Medical College was examined as a case study in addressing this challenge. The site retains the original Outpatient Building, Inpatient Building, Medical Teaching Building, and other architectural heritage and has preserved the original mixed Chinese and Western architectural styles. A combination of historical research, field investigation, and historic layering was adopted in the present study, drawing primarily on data from historical maps, satellite images from different periods, aerial photography from drones, architectural drawings, and other relevant historical data. Through case studies, methods for characterising and identifying the landscape and architectural heritage of mission hospitals were explored. Principles for the preservation and regeneration of the heritage of church hospitals were also proposed, with a view to providing a reference for the study and preservation of this type of heritage.