Objective To investigate the trends in incidence and mortality of esophageal cancer from 1981 to 2002 in Tianjin,China and to predict future trends and facilitate future prevention.Methods All new cancer cases registered in the Tianjin Cancer Registry between 1981 and 2002 were reviewed.Yearly age-specific,crude and age-adjusted incidence rates were calculated for males and females.Secular trends of incidence and mortality were indicated by the estimated annual percentage change(EAPC).Results A total of 8206 cases of esophageal cancer were reported in Tianjin form 1981 to 2002,with 5533 males and before 45 years,but increased rapidly after 45 years.The median age of esophageal cancer cases was 69 years,with quartile range from 62 to 75 years.The peak for age specific incidence in females was 75-80 years,which was earlier than that in males(aged 80-85).But recent data indicated that the peak age in females had increased and became similar to that of the males.The crude and age-standardized incidence rates(ASIR)of esophageal cancer decreased in last 22 years.For male and female,crude incidence decreased by 2.22% and 3.56% per year and ASIR decreased by 5.18% and 6.56% per year.The mortality of esophageal cancer decreased in the last 22 years.Conclusion The incidence of esophageal cancer decreased in the last 22 years in Tianjin,but there is little overall improvement in survival.

BACKGROUND:Artificial lumbar disc replacement is a new choice for the treatment of degenerative disc disease, and preserves lumbar vertebra’s biomechanical characteristics during pain elimination. The design of the prosthesis structure and material needs further study and validation. OBJECTIVE:To review the structure and material types of presently designed artificial lumbar discs, then to discuss the trends in the optimization design of prosthesis. METHODS:The PubMed database, China National Knowledge Infrastructure database and Chinese BioMedical Literature Database were searched for related articles concerning artificial lumbar disc and type and biomechanics of nucleus pulposus prosthesis material published from January 2005 to February 2013 by the first author. Key words were“artificial lumbar disc, principle of prosthesis design, structure, material, clinical trials”in Chinese and“artificial lumbar disc, total disc replacement, structure, material, clinical trial”in English. Repetitive and old studies were excluded. 135 articles were found, but 36 articles were included for review. RESULTS AND CONCLUSION:At present, the materials for intervertebral discs include cobalt-chromium al oy, ceramics, stainless steel, titanium al oy and ultrahigh molecular weight polyethylene. Artificial lumbar disc is commonly made by different materials. Bryan prosthesis is most commonly used in the clinic. Three-dimensional finite element analysis, in vitro trial and clinical studies verified its good biomechanical property. The successful rate of replacement was high. Nucleus prosthesis contains prefabricated type and situ polymerization type, and obtains smal injury, so it is a hot focus in present study, but it cannot achieve biomechanical function of human nucleus pulposus. To dig novel material is a future direction for designing individual prosthesis. The prosthetic structure and biomaterial design experience constant improvement and development. This study combines latest study trend and prospects the development of biomimetic design, material improvement, the optimization design of prosthesis and assisted devices.

BACKGROUND:Early clinical application of non-biological materials (bone cement) for treatment of hip joint is ineffective, due to the large fixed range, long fixation time, as wel as aging and rupture of bone cement interface causing complications such as prosthetic loosening. Thus, postoperative range of motion of the hip joint can be affected to some degree.
OBJECTIVE:To investigate the methods and progress of biological and non-biological materials for total hip replacement and to assess the features and clinical application of different hip prostheses.
METHODS:A computer-based search of PubMed and CNKI was performed by the first author to retrieve articles related to biological materials and tissue-engineered hip joint using the keywords of“carpal bone, fracture ununited”in the title and abstract. The keywords were limited to Chinese and English.
RESULTS AND CONCLUSION:Biological materials for internal fixation have good wear resistance, corrosion resistance and biocompatibility. Currently, the combination of metal joint head and polyethylene acetabulum with ultrahigh molecular weight is the most commonly used in hip replacement. However, the metal joint head exhibits an elastic modulus far from the human skeleton, resulting in stress shielding effects which are easy to cause prosthetic loosening and instability. Bio-inert ceramics has high in vivo stability and good mechanical strength;and bioactive ceramics has bone conduction characteristics and performance of the living bone integration. Composite prosthesis, because of adjustable elastic modulus and sufficient mechanical strength, shows the mechanical properties close to the human bone and has been gradual y noticed. However, there is a lack of ideal prostheses with good biocompatibility and biomechanics. Therefore, hip design and manufacturing processes should be improved to elevate wear resistance and mechanical properties, to enhance the binding between prosthesis and the host bone, and to reduce stress shielding in order to improve the biocompatibility of the implant with the host, and extend the prosthetic life.

One of the major responsibilities for medical students is to save lives and to popularize emergency medical treatment knowledge for the masses of society.Based on research analysis,systemic training of cardiopulmonary resuscitation program including lectures,simulation education and social practice were performed for medical students.After practice activities,these students could proficiently apply the basic knowledge and skills of cardiopulmonary resuscitation in practical work and spread what they have learned to the public.Furthermore the program could improve students' abilities in social practice and team spirit and it is of great social significance.

Objective To investigate the different characteristics of gastrointestinal migrating myoelectrical complex (MMC) of different origin in fasting state and the effects of motilin (MTL) and ursodeoxycholic acid (UDCA) on the MMC of the gastrointestinal tract of different origin in rats. Methods Three bipolar silver electrodes were chronically implanted on the antrum, duodenum and jejunum. Seven days later twenty-four experimental rats were divided into two groups. One group were injected with porcine MTL via sublingual vein, while the other group was perfused with UDCA into the stomach. The gastrointestinal myoelectrical activity was recorded one hour before and two hours after the test substances infusions on these conscious fasting rats. Results Among the total sixty-eight MMCs recorded in fasting rats under control, 67% started in the duodenum, and 33% started in the antrum. The MMC cycle duration and duration of phase Ⅲ of antral origin were longer than those of duodenal origin. Administration of porcine MTL could induce a premature antral phase Ⅲ of antral origin. However, perfusion into the stomach with UDCA resulted in a shorter MMC cycle duration and longer duration of phase Ⅲ of duodenal origin. Conclusion In fasting rats, MMC may originate from the antrum and duodenum, respectively. The different characteristics of MMC of different origin may contribute to the large variations within subjects. Pocrine MTL and UDCA can affect the MMC of different origin of the gastrointestinal tract in fasting state.

Objective To assess the long-term outcome of transurethral resection of the prostate (TURP) in men with different maximum detrusor pressure (Pdet.max).Methods 113 neurologically intact men diagnosed with BPH and undergone surgical intervention in our department were enrolled between Feb.2009 and May 2012.All patients had completed the International Prostate Symptom Score (IPSS) and quality-of-life (QOL) questionnaires and had undergone a full urodynamic analysis before surgery.The outcomes were assessed at 24 months postoperatively using the IPSS score,QOL score,and maximum urinary flow rate (Qmax).Results After 24 months follow-up,3 cases in the poor symptom improvement group could not void.The average Pdet.max of these three patients was (15.7±5.1) cmH2O,which was statistically significantly lower than that of the other three groups [(102.7±39.3),(95.9±42.8),(77.0±27.4) cmH2O] (P＜0.05).Nine cases in the poor functional improvement group whose average Pdet.was (32.5± 16.6) cmH2O,which was statistically significantly lower than that of the other three groups [(115.2±36.3),(87.5±28.7),(75.5±46.9) cmH2O] (P＜0.05).Conclusions Urodynamic analysis plays an important role in judging the efficacy of TURP.Patients with a Pdet.max less than 32.5 cmH2O may not have an objectively successful result from surgery treatment.

Objective To evaluate the efficacy of a new pelvic muscle gymnastic exercise in the treatment of stress urinary incontinence (SUI).Methods Prospectively,we randomly recruited 60 cases with mild and moderate SUI.We use ICI-Q-SF,pad Test and urodynamics to assess the degree of incontinence,volume of leakage,maximum urethral pressure and functional urethral length before and after intervention.Results The ICI-Q-SF score,volume of leakage,maximum urethral closure pressure and functional urethral length in study group before treatment were 11.6 ±4.2,(5.9 ±2.2) ml,(39.4 ± 12.5) cm H2O and (2.5 ±1.2) cm.The indicators in control group were 10.3 ±2.2,(5.8 ±1.3) ml,(41.3 ±8.9) cm H2O and (2.1 ± 0.5) cm respectively.There was no significant difference between the 2 groups (P ＞ 0.05).The ICI-Q-SF score,volune of leakage and maximum urethral closure pressure in study group after treatment were 7.7 ± 2.7,(1.8 ± 1.2) ml and (65.9 ± 8.9) cm H2O,which were significantly improved than the values of10.1 ±2.1,(5.7 ± 1.1) ml and (44.6 ±9.5) cm H2O in control group (P ＜0.05).Conclusions The new pelvic muscle exercise may play an important role in the treatment of mild and moderate SUI.Therefore,it could be recommended to the patients with mild and moderate SUI.

Objective To study the CT findings of ovarian sertoli-leydig cell tumor (SLCT),to improve the understanding of SLCT imaging features.Methods CT images of 6 cases were reviewed retrospectively.CT plain scan was performed in 6 patients;CT enhancement scan was performed in 4 patients.Results All tumors were unilateral.On non-enhanced CT,5 cases showed cystic-solid masses with clear margin,and 1 case showed solid mass.After contrast administration,the cystic walls,septum and solid portions showed progressively obvious enhancement.Of these 6 cases, 3 cases showed increased testosterone levels,2 cases had high prolactin level,and 1 case was with raised AFP in plasma.Positive expressions of immunohistochemical markers were as following:Inhibin-α (6 cases),Vimentin (4 cases),Calretinin (2 cases), CD99 (1 case), Ki-67 (1 case), CK20 (1 case).Conclusion CT findings of SLCT have some certain characteristics, especially a unilateral, cystic-solid and well-defined mass, and marked solid part enhancement on contrast CT.Combined with clinical findings, especially increased plasma testosterone levels, SLCT should be included in the differential diagnosis of regional tumors.

OBJECTIVETo observe the trend in the change of incidence and mortality of female breast cancer in Tianjin and evaluate its effect of prevention.

METHODSMethod of descriptive epidemiology was used to study the epidemic situation of female breast cancer in Tianjin.

RESULTSThe incidence of breast cancer in Tianjin had increased by 39.7% from 1981 to 1997, as compared with the other cities in China. Especially, compared with the developed countries the world over, the incidence of breast cancer in Tianjin is much lower. The mortality rate of breast cancer had lowered by 31.0% from 1981 to 1997 and the 3-year and 5-year survival rates increased to various degrees.

CONCLUSIONEarly detection and diagnosis of breast cancer are very important to both increase of survival and lowering of mortality of breast cancer. Preventive efforts should be made to the high risk people of breast cancer.

Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; epidemiology ; mortality ; China ; epidemiology ; Female ; Humans ; Incidence ; Middle Aged ; Survival Rate

Purpose: This study was to investigate the work experience of newly recruited male nurses during the COVID-19 pandemic. Methods: With a phenomenological approach, this qualitative study was adopted semistructured interviews by phone or video calls. A total of 9 male nurses newly recruited for the COVID-19 wards in Chinese hospitals were interviewed for this study. And Colaizzi's method was applied for evaluation in the data analysis. Results: Based on our findings, three themes were extracted. First, the newly recruited male nurses showed negative emotions at the beginning of COVID-19 epidemic, which was caused by changes in working conditions and content, but also prompted the nurses to change the way of coping with the crisis. Second, they gradually mastered the working skills and psychological training to cope with COVID-19 and developed a positive attitude toward life and a high sense of professional responsibility. Finally, we learned about their needs to respond to public health emergencies such as the COVID-19 pandemic. Conclusion COVID-19 is a disaster for all of humanity. The newly recruited male nurses are an important force in emergency rescue. Although they suffered from short-term negative emotions, they quickly adapted to the crisis. In order to better prepare for future emergencies, the disaster response capacity of newly recruited male nurses needs to be further improved. In addition, newly recruited male nurses have a strong demand for timely and personalized career development guidance.