Objective To analyze the occurrence status and influencing factors of esophageal stenosis after surgery for early esophageal cancer. Methods A total of 285 patients with early esophageal cancer with endoscopic submucosal dissection (ESD) in the hospital from January 2019 to January 2021 were selected as research objects, and they were divided into control group with 237 cases (without esophageal stenosis) and study group with 48 cases (with esophageal stenosis) according to the occurrence of esophageal stenosis after surgery. The operation time, intraoperative blood loss and quality of life were compared between the two groups. The influencing factors of esophageal stenosis were analyzed. Results Compared with the control group, the study group had longer operation time, more intraoperative blood loss, and lower scores in psychological, environmental, physiological and social dimensions, and the between-group differences were statistically significant (P<0.05). Univariate analysis showed that esophageal stenosis after ESD had no correlations with gender, clinical stage, pathological type, history of drinking, the American Society of Anesthesiologists (ASA) classification, and anesthesia method (P>0.05). Patients aged ≥60 years old, damage of the muscularis propria, circumferential extent of lesion >3/4, malnutrition, tissue infiltration depth of M3+SM1, and longitudinal length of lesion >40 mm had a higher incidence of esophageal stenosis (P<0.05). Multivariate Logistics regression analysis showed that malnutrition, age ≥60 years, circumferential extent of lesion >3/4, damage of the muscularis propria, tissue infiltration depth of M3+SM1, and longitudinal length of lesion >40 mm were the main influencing factors for esophageal stenosis after ESD (P<0.05). Conclusion The occurrence of esophageal stenosis after ESD in patients with early esophageal cancer is related to factors such as damage of the muscularis propria, malnutrition, age ≥60 years, tissue infiltration depth of M3+SM1, circumferential extent of lesion >3/4, and longitudinal length of lesion >40 mm. Based on these factors, early prevention and control can be carried out to reduce the incidence of esophageal stenosis after surgery.

[Objective]To explore the clinical efficacy of modified Yupingfeng Powder combined with western medicine in the treatment of pregnant women with mild corona virus disease 2019(COVID-19).[Methods]The pregnant women with mild COVID-19 admitted to Shanghai Public Health Clinical Center from April 2022 to June 2022 were divided into treatment group and control group randomly.The control group(52 cases)was treated with western medicine such as Vitamin C,and the treatment group(48 cases)was treated with modified Yupingfeng Powder on the basis of control group.A comparison was made between the two groups in terms of each symptoms scores,incidence of adverse pregnancy outcomes and total effective rate.Besides,the levels of laboratory indicators involving lymphocyte,C reactive protein(CRP),interleukin-2 receptor(IL-2R)and interleukin-6(IL-6)were also be compared.The negative changes of virus nucleic acid and disease outcome were observed in the two groups.[Results]Compared with control group,after treatment cessation,the total symptom score in treatment group significantly decreased(P＜0.001),and the total effective rate significantly increased(P＜0.01).The levels of inflammatory markers including CRP and IL-6 decreased significantly in treatment group(P＜0.001,P＜0.01),while the count of lymphocyte increased significantly(P＜0.001).Besides,there was no difference in the incidence of adverse pregnancy outcomes between the two groups(P＞0.05).[Conclusion]Modified Yupingfeng Powder combined with western medicine can significantly relieve the clinical symptoms of pregnant women with mild COVID-19,while shortening nucleic acid negative conversion time and does not affect the pregnancy outcome,which has certain clinical value and is worthy of clinical application.

Objective In order to learn about the cognitive condition of data processing and diagram designing in medical postgraduates, and provide data for improving the teaching mode and content. Methods A self-administered questionnaire was distributed to a total of 150 medicine graduate students in three grades by cluster sampling to understand the cognitive situation and teaching requirements of data process-ing and chart making in scientific research papers by postgraduates of different levels and different cate-gories. EpiData software was used for data entry and sorting, and SPSS 22.0 was used for descriptive analysis and chi square test. Results 64.08％ (110) of the students used statistical software, but only 32.39％ (32) could use it expertly, in which graduate students were less proficient in doctoral students (P<0.05), and academic graduate students were less proficient in professional graduate students (P<0.05); in addition, 90.14％(128) of the students thought that the scientific research data processing and charting related courses were very important, while 82.39％ (117) supported the opening of related courses. Conclusion Graduate students' scientific research ability directly affects the level of scientific research. According to postgraduates' demand for data processing and chart making of research papers, it is of great significance to enhance teach-ing reform and improve teaching quality of higher medical education.

To summarize the nursing experience of a patient undergoing laryngeal transplantation due to laryngeal cancer.The case involved the development of a critical care management plan by a multidisciplinary team.By implementing nursing measures such as refined airway care,professional neck wound complication management,precise administration of immunosuppressants,ultrasound monitoring for nutritional management assurance,individualized psychological care,early rehabilitation of swallowing,speech and body function,thyroid function and hyperglycemia monitoring and other measures,the patient stayed in ICU for 23 days post-surgery and discharged after 40 days from admission.

Feeding interruption related to airway procedures is a crucial factor contributing to enteral feeding disruption in critically ill patients,and it represents a significant cause of inadequate enteral nutrition delivery.Prolonged or repeated interruptions exacerbate the insufficiency of enteral nutrition,impede patient recovery,and increase the risk of adverse complications.The absence of clear guidelines and standardized protocols has led to variations in clinical practices regarding feeding interruption during airway procedures.This article provides an overview of the clinical importance and current practices associated with feeding interruption during airway procedures in critically ill patients.Additionally,potential avenues for future research are proposed with the aim of enhancing standardization,safety,and efficacy in feeding interruption practices linked to airway procedures for critically ill patients.

Objective:To assess the cardiac autonomic nervous function in elderly patients with frailty.Methods:Patients aged ≥ 65 years old admitted in Beijing Hospital from September 2018 to August 2019 were enrolled in this study. Clinical frailty score was used to assess the frailty. The cardiac autonomic modulation was evaluated by sinus heart rate turbulence analysis through 24 h electrocardiogram recording.Results:A total of 129 elderly patients were finally enrolled in this study with a mean age of (77.5±6.4) years, 58.1% of them were male. There were 53 patients in frail group and 76 patients in non-frail group. The age of the frailty group was significantly higher than that of the non-frailty group [(80.5±5.5) vs.(75.3±6.2)]; the prevalence of hypertension [84.9%(45/53)], heart failure [32.1%(17/53)] and peripheral vascular diseases [32.1%(17/53)] in the frailty group was significantly higher than that in the non-frailty group [65.8%(50/76), 1.3%(1/76), 17.1%(13/76); t=5.001, χ 2=5.879, 24.606, 3.921; all P<0.05]. Compared with non-frailty group, turbulence onset (TO) [-0.05(-0.92, 0.82)% vs. -0.74(-1.58, 0)%; Z=2.616, P=0.009] was significantly higher in frailty group, while turbulence slope (TS) [2.34(1.30, 5.00)ms/RR vs. 4.34(2.66, 6.39)ms/RR; Z=-3.048, P=0.002] was significantly lower. The rate of TO abnormality [49.1% (26/53) vs. 26.3%(20/76), χ 2=7.038, P=0.008] and TS abnormality [34.7%(29/53) vs. 21.0%(16/76); χ 2=15.579, P<0.001] in the frailty group was significantly higher than that in the non-frailty group. Multivariate logistic regression analysis showed that TO abnormality( OR=2.970, P=0.010, 95 %CI:1.300-6.785) and TS abnormality( OR=3.618, P=0.003, 95 %CI:1.565-8.364) were correlated with frailty. Conclusion:Cardiac autonomic nerve function may be impaired in elderly frail patients, and decreased vagal nerve tension may be presented.

Parkinson's disease(PD)is the second most common neurodegenerative disease in the world;however,it lacks effective and safe treatments.Ginkgo biloba dropping pill(GBDP),a unique Chinese G.biloba leaf extract preparation,exhibits antioxidant and neuroprotective effects and has a potential as an alternative therapy for PD.Thus,the aims of this study were to evaluate the effects of GBDP in in vitro and in vivo PD models and to compare the chemical constituents and pharmacological activities of GBDP and the G.biloba extract EGb 761.Using liquid chromatography tandem-mass spectrometry,46 GBDP constitu-ents were identified.Principal component analysis identified differences in the chemical profiles of GBDP and EGb 761.A quantitative analysis of 12 constituents showed that GBDP had higher levels of several flavonoids and terpene trilactones than EGb 761,whereas EGb 761 had higher levels of organic acids.Moreover,we found that GBDP prevented 6-hydroxydopamine-induced dopaminergic neuron loss in zebrafish and improved cognitive impairment and neuronal damage in methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced PD mice.Although similar effects were observed after EGb 761 treatment,the neuroprotective effects were greater after GBDP treatment on several endpoints.In addition,in vitro results suggested that the Akt/GSK3β pathway may be involved in the neuroprotective effects of GBDP.These findings demonstrated that GBDP have potential neuroprotective effects in the treatment of PD.

Objective:To assess the correlation between frailty and cardiac autonomic nervous system function in elderly patients.Methods:Elderly hospitalized patients aged 65 years and over were enrolled and assessed for frailty by using the clinical frailty scale.Cardiac autonomic modulation was evaluated by heart rate variability analysis through 24 h electrocardiogram recording.Results:A total of 180 elderly patients were enrolled in this study, including 66 patients with frailty and 114 patients without frailty.The mean age of the frailty group was higher than that of the non-frailty group(79.8±6.0 vs.75.0±6.3, t=5.030, P<0.001). The proportions of patients with hypertension, stroke/transient cerebral ischemia attack(TIA), heart failure and osteoarthritis were higher in the frailty group than in the non-frailty group(all P<0.05). Compared with the non-frailty group, the standard deviation of normal-to-normal intervals(SDNN)[103.0(76.0, 121.2) vs.107.5(92.0, 136.0), Z=-2.108, P=0.035], the standard deviation of the averages of NN intervals in all 5-min segments(SDANN)[86.0(67.7, 106.5) vs.97.5(78.0, 126.0), Z=-2.694, P=0.007], normalized low frequency(LFnorm)(53.1±13.0 vs.59.3±13.9, t=-3.024, P=0.003)and low frequency/high frequency(LF/HF)ratio[1.2(1.0, 1.4) vs.1.4(1.1, 1.7), Z=-3.041, P=0.002]were decreased and normalized high frequency(HFnorm)(36.8±9.2 vs.32.2±10.7, t=3.033, P=0.003)was increased in the frailty group.HFnorm in the frailty group was significantly higher than that in the non-frailty group.The incidents of SDANN<92 ms, LFnorm<50 nU, HFnorm>32 nU and LF/HF ratio<1.5 were higher in the frailty group than in the non-frailty group(59.1% or 39/66 vs.41.2% or 47/114, 42.4% or 28/66 vs.22.8% or 26/114, 72.7% or 48/66 vs.49.1% or 56/114, 84.8% or 56/66 vs.65.8% or 75/114, χ2=5.346, 7.660, 9.547, 7.664, P=0.021, 0.006, 0.002, 0.006). Logistic multivariate regression analysis showed that LFnorm, HFnorm and LF/HF ratio were correlated with frailty( OR=0.971, 1.039 and 0.333, all P<0.05), and HFnorm>32 nU and LF/HF ratio<1.5 were risk factors for frailty( OR=2.401 and 2.773, both P<0.05). Conclusions:Cardiac autonomic nerve system function is impaired in elderly frail patients, with the imbalance between the sympathetic and vagus nerves.Therefore particular attention should be paid to heart rate variability in elderly patients with frailty.