Objective: To explore the effect of case management mode on self-management ability of enterostomy patients. Methods: A total of 104 cases of enterostomy patients were divided into 54 cases in control group and 50 cases in experimental group according to admission time.Used Enterostomal Therapist(ET) as the leading organization of the experimental group to establishing personal files by coordinating team psychological counselors, dietitians, specialists and nurses for individualized nursing services. Patients would receive a three-month nursing practice of case management. The control group would be given nursing intervention and health guidance according to the standardized nursing procedure for enterostomy. After discharge, the nurse-in-charge followed up patients′ treatment completion status. The incidence of enterostomy complications and self-management ability of the stoma in two groups were evaluated at 3 months after surgery. Results: In experimental group,the nursing management score of enterostomy was 33.48±4.90, the score of information management was 12.84±2.21, thesymptom observation score was 12.36±1.55, the daily life management score was 30.00±3.40, the psychological management score was 11.64±1.55. Meanwhile,in control group, the nursing management score of enterostomy was 29.74±8.34, the score of information management was 12.10±1.74, the symptom observation score was 11.25±2.56, the daily life management score was 26.59±5.22, the psychological management score was 10.74±2.59. Nursing management score of enterostomy, symptom observation, daily life management, psychological management score between two groups showed significant difference(t=1.529-2.808, P<0.01 or 0.05). The incidence of peristomal dermatitis was 8.0% (4/50) in the experimental group, much lower than that in the control group which was 27.8%(15/54).The difference was statistically significant (χ²=6.801, P<0.05). Conclusions Nursing practice of case management can improve the life quality and accelerate the social adaptability of enterostomy patients.

Objective:To investigate the safety, feasibility and accuracy of esophageal sponge cytology in esophageal carcinoma screening in high-incidence districts.Methods:Opportunistic screening for esophageal carcinoma was conducted on individuals aged 40-75 years with high-risk factors for esophageal carcinoma and visited out-patient clinic in Lianshui People's Hospital from May 2021 to June 2022. A new esophageal cell collector independently developed in China was used for esophageal sponge cytology sampling followed by cytopathological analysis. Atypical squamous cells or more severe lesions were defined as positive esophageal sponge cytology. Then gastroscopy was performed, and all suspicious areas under the endoscopy were biopsied for histopathological examination. Gastroscopy, biopsy histopathology and esophageal sponge cytology were conducted blindly in pairs. Outcome measures included adverse reactions during sampling, subject tolerability (using a visual simulation score), sampling quality, and diagnostic efficacy of esophageal sponge cytology using gastroscopy plus biopsy histopathology as the gold standard.Results:A total of 1 590 patients completed the screening program. During esophageal sponge cytology sampling, no serious adverse events were observed, and the adverse reactions were mainly manifested as vomiting during sampling [0.31% (5/1 590)] and sore throat after sampling [2.45% (39/1 590)], all of which resolved spontaneously without further medical intervention. The majority of subjects [98.62% (1 568/1 590)] reported good tolerance during the procedure. After sampling, 1 526 (95.97%) subjects had completely expanded sponge material, meeting the standard of good sampling quality. The scanning analysis of the digital pathology system showed that the number of sampled cells in 1 590 subjects ranged (2.01-4.00)×10 6, with a median of 3.48×10 6 cells, which could meet the requirements for interpreting cytological results. Using the positive esophageal sponge cytology for the diagnosis of esophageal carcinoma including high-grade intraepithelial neoplasia, esophageal squamous cell carcinoma and adenocarcinoma of esophagogastric junction, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 98.57% (69/70), 91.51% (1 391/1 520), 34.85% (69/198), 99.93% (1 391/1 392), and 91.82% (1 460/1 590), respectively. Conclusion:Esophageal sponge cytology presents promising diagnostic efficacy for esophageal carcinoma screening, offering a simple, safe, convenient, and effective approach in high-incidence esophageal carcinoma regions.