To explore the demarcation between the normal variation and the developemental anomaly of the cardiac conduction system (CCS). Using the method of sampling CCS designed by this research group, CCS of 737 cases died of non cardiac causes of death and 149 cases died of sudden cardiac deaths were sampled, serial sections were made, stained with HE method or Masson trichrome method,and observed under the light microscope.Results:(1)There were morphological variations in size, position and structure of normal human CCS; (2) In 4 cases died of sudden cardiac deaths, developemental anomalies were found in both AVN and HB. The morphological variations observed in our cases include: displacement of the bifurcation of HB into the pars membrancea of the interventricular septum,of the HB toward the left or the left lower sides of the interventricular septum or of less than 1/2 AVN into the central fibrous body , as well as of ordinary cardiomyfibers into the HB or BB. The developmental anomalies observed in our cases include: preservation of fetal type AVN in adults, displacement of whole AVN into the central fibrous body, complete division of HB into more than 3 bundles, and the displacement of the bifurcating portion of HB into the root of tricupid valves.

Objective To approach the therapeutic effects and complication of hyperfractionated radio-therapy for nasopharyngeal carcinoma. Methods From January 2000 to November 2002,283 patients with na-sopharyngeal carcinoma were treated with hyperfraetionated radiotherapy. For hyperfractionated radiotherapy,γ-ray from 60Co was performed and two fractions of 1.2 Gy were given daily,with an interval of≥6 h,5 days per week to a median dose of 72 Gy for nasopharynx and 68.4 Gy for neck. For some patients, carboplatin or cispla-tin and 5-fluorouracil were transfused. Results The incidence rate of≥3 grade acute mueositis was 12. 4%.The complete remission rate after treatment was 93.6%. The 1,2 and 5 year survival rate was 93.6% ,82. 7%and 60. 1% respectively. Conclusion patients treated with hyperfractionated radiotherapy have good tolerance and therapeutic effect. It provids a treatment means for nasopharyngeal carcinoma. But it must be validated by the large-scale clinical trials.

Objective To evaluate the clinical features of local advanced glottic laryngeal cancer patients with beyond five years survival and to provide help for the treatment of advanced glottic laryngeal cancer patients.Methods The data of 129 cases of patients with local advanced glottic laryngeal cancer treated in our hospital from January 1999 to August 2005 were analyzed retrospectively.They were divided into two groups based on their survival time.Forty six patients with beyond five years survival were included in the first group and the other eighty three patients were in the second group.The clinical features were compared and factors associated with survival were identified.Results Compared with the group with under five years survival,the lymph node metastatic rate before treatment was lower,patients treated concurrently with operation were more,and complete remission rate after treatment were higher in the group with beyond five years survival.The differences between two groups had statistical significant.Cox regression analysis identified only operation and complete remission rate were independent prognostic factors.Conclusion For local advanced glottic laryngeal cancer,rational comprehensive treatment and complete remission after treatment and complications prevention are important.But they need to be validated by the large-scale clinical trials.

Objective To evaluate the therapeutic effects of whole course hyperfractionation radiotherapy for esophageal carcinoma. Methods Form January 2000 to December 2001,126 patients with esophageal carcinoma were treated by whole course hyperfractionation radiotherapy(120～140 cGy per fraction, 2 times per day, to a total dose of 6400～7400 cGy) in our department. Results The short-term effective rate was 99.21%. The 1, 2 and 5 year survival rate was 61.11%, 41.27%, 23.02% and the median survival time was 1.29 years. The 1, 2 and 5 year disease-free survival rates was 57.94%, 38.10%, 19.84% and the median disease-free survival time was 1.16 years. Conclusion It is promising of whole course hyperfractionation radiotherapy for esophageal carcinoma. But it must be validated by the large-scale clinical trials.

Objective To compare of clinical effect between radiotherapy and chemoradiotherapy and investigate the prognostic factors in elderly patients with esophageal squamous cell cancer.Methods 229 elderly patients with esophageal squamous cell cancer who received radiotherapy and chemoradiotherapy from January 2009 to December 2013 were retrospective analyzed.The Local control rate and survival rate were calculated by Kaplan-Meier method,and the short effect and long term effect between radiotherapy and chemoradiotherapy were compared.Cox regression model was used for invariant analysis and multivariate analysis.Results The follow up time was 15.3months.The short effect of radiotherapy group was not better than that of chemoradiotherapy group,with CR 35.6％ vs 45.8％,RR 61.0％ vs 53.0％,SD 2.7％ vs 0 and PD 0.7％ vs 1.2％ (P=0.211).The 1-,2-,3-year local control rates of radiotherapy group were significantly poorer than that of chemoradiotherapy group,with 82.8 ％,60.5 ％ and 52.7％ vs 89.5％,85.4％ vs 80.9％,respectively (P=0.009).However,there were no significance difference between the 1-,2-,3-year survival rates of radiotherapy group and chemoradiotherapy group,with 66.4％,29.5％,17.1％ vs.65.9％,40.3 ％,30.8 ％,respectively (P =0.071).In invariant analysis,T stage,N stage,clinical stage and radiotherapy dose (＜ 60 Gy,60 ～66 Gy,＞66 Gy) were related with the prognosis of esophageal carcinoma.The COX regression model showed that T stage,N stage and radiotherapy dose were independent prognostic factors that effected survival rate.Conclusion In elderly patients with esophageal squamous cell cancer,chemoradiotherapy can improve the local control rates,but not benefit the survival rate.T stage,N stage and radiotherapy dose were independent prognostic factors that effected survival rate,which could provided evidence for prognosis judgement and clinical practice.

Objective To improve the non?surgical N staging system for esophageal carcinoma ( EC) . Methods A retrospective analysis was performed in 501 patients newly diagnosed with esophageal squamous cell carcinoma who received radiotherapy in our hospital from 2009 to 2013. The impacts of the supraclavicular lymph nodes and mediastinal lymph nodes on the overall survival ( OS) rate were analyzed. The original non?surgical N staging system was improved and the proposed N staging system was evaluated. The OS rates were calculated using the Kaplan?Meier method and analyzed using the log?rank test. The univariate and multivariate analyses were performed using the log?rank test and Cox regression model, respectively. Results The 3?and 5?year sample sizes were 404 and 205, respectively. In all patients, the 1?, 3?, and 5?year OS rates were 64?9%, 26?5%, and 18?3%, respectively;the 1?, 3?, and 5?year distant metastasis?free ( DMF) rates were 86?2%, 68?9%, and 67?3%, respectively;the 1?, 3?, and 5?year local control rates were 72?7%, 53?1%, and 43?6%, respectively. The univariate analysis showed that the incidence, 3?year OS rate, and 3?year DMF rate of supraclavicular lymph node metastases in patients with cervical and upper?thoracic EC were significantly higher than those in patients with middle?thoracic and lower?thoracic EC ( 25?7% vs. 14?2%, P=0?034;24?2% vs. 11?5%, P=0?016;84?8% vs. 69?2%, P=0?007) . The multivariate analysis also showed that the number of metastatic lymph nodes was an independent prognostic factor for the OS and DMF rates in patients ( P= 0?000;P= 0?007 ) . Conclusions It is reasonable to classify upper?thoracic EC with supraclavicular lymph node metastasis into stage N1 diseases. The proposed N staging system with the factor of the number of metastatic lymph nodes is more scientific and objective than the original N staging system.

Abstract Enhancing the health literacy of the entire population is a prerequisite for improving the health of the entire population, and since the health attitudes and behaviors formed during childhood and adolescence have a profound impact on the health patterns of adulthood, the enhancement of health literacy of children and adolescents is of particular importance. As the main place for children and adolescents to receive education, schools should better fulfil the function of education and promotion of health literacy. China has been carrying out the pilot and promotion of health promoting schools (HPS) since 1995, and is currently in the stage of comprehensive improvement of HPS construction. This paper introduces the background and characteristics of Health-Literate Schools (HeLit-Schools) in foreign countries and compares them with HPS in China, drawing on the advantages of HeLit-Schools to provide a new idea and a new way of thinking for the construction of HPS in China and for the practice of the "Healthy China Initiative".

Objective To explore the relationship between impulsiveness and risky decision-making among college students with pathological internet use ( PIU),as well as the moderating role of self-control. Methods Totally 542 undergraduates anonymously completed the Internet Addiction Test (IAT),Chinese Version of Barratt Impulsiveness Scale,Risk Preference Questionnaire,Self-Control Scale. Results ( 1) In loss frames,the scores of risky decision-making with high (20. 26±4. 83) and medium (20. 40±5. 53) level of impulsiveness among college students with PIU significantly were higher than those with low ( 18. 92 ± 5. 03) level of impulsiveness ( F(2,323)= 3. 79,P<0. 05,η2=0. 02). (2) There was a significant negative correlation between impulsiveness (60. 68±10. 40) and self-control (55. 56±9. 07) (r=-0. 60,P<0. 01). And there was a significant positive correlations between impulsiveness and risky decision-making in loss frames (20. 12±5. 26)(r=0. 13,P<0. 05). The risky decision-making in gain frames ( 17. 17±4. 38) was positively correlated with that in loss frames (r=0. 52,P<0. 01). (3) Self-control played a moderating role in the association between impulsiveness and risky decision-making in loss frames (β=0. 13,t=2. 31,P<0. 05). Conclusion In loss frames,impulsiveness is positively related with risky decision-making,and self-control plays a moderating role between impulsiveness and risky decision-making in loss frames among col-lege students with PIU.

Objective: To investigate the localization of HBXIP protein over-expression in gastric adenocarcinoma, and its prognostic significance. Methods: HBXIP localization was detected by immunofluorescence in AGS gastric cancer cell line, and by immunohistochemical staining in 97 gastric adenocarcinomas, 41 adjacent non-tumor tissues and 13 gastric adenoma tissues. Correlation between HBXIP expression and clinicopathological features of gastric cancer patients was evaluated by Chi-square and Fisher′s exact tests. Overall survival rates were calculated using Kaplan-Meier method. Results: HBXIP was mainly expressed in the cytoplasm of gastric cancer. The positive and strongly positive expression rates of HBXIP protein in gastric cancers were 68.0% (66/97) and 49.5% (48/97) respectively, and were significantly higher than those in adjacent non-tumor tissues(48.8%, 20/41; 36.6%, 15/41) or gastric adenomas(2/13, 1/13; all P<0.05). HBXIP expression correlated significantly with tumor differentiation and lymph node status (P=0.007; 0.041). Kaplan-Meier survival analysis showed that the overall survival rate was significantly lower in gastric cancer patients with high HBXIP expression (P=0.015). Conclusions HBXIP expression in gastric cancer is mainly expressed in cytoplasmic, and the expression level is closely related to the prognosis. HBXIP expression status may potentially be used as an important prognostic indicator for gastric cancer.

ObjectiveTo investigate the effect of entecavir (ETV) alone or combined with interferon (IFN) on the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). MethodsA retrospective analysis was performed for 409 patients with CHB who were admitted to Beijing Ditan Hospital from January 2008 to December 2014, and according to their antiviral therapy, they were divided into ETV+IFN group with 169 patients (IFN treatment for ≥6 months) and ETV group with 240 patients (ETV treatment for ≥12 months). The patients were followed up to June 2019, and the development of HCC was the outcome event. The Mann-Whitney U test was used for comparison of continuous variables between two groups, and the chi-square test was used for comparison of categorical variables between two groups. The propensity score matching (PSM) method was used to eliminate baseline differences between groups, the Kaplan-Meier method and the log-rank test were used to compare the incidence rate of HCC between groups, and the Cox proportional-hazards regression model analysis was used to investigate the risk factors for the development of HCC. ResultsThe median follow-up time in this study was 5.4 years (IQR: 4.9-7.9). There was no significant difference in the cumulative incidence rate of HCC between the two groups before and after PSM (before PSM: 1.2% vs 2.8%, χ2=1.423, P=0.233; after PSM: 1.7% vs 4.1%, χ2=1.676, P=0.195), and the subgroup analysis also showed no significant difference in the cumulative incidence rate of HCC between the two groups in the non-high risk population (1.3% vs 1.5%, χ2=0.335, P=0.563). The Cox proportional-hazards regression model showed that age was an independent risk factor for HCC (hazard ratio=1.107, 95% confidence interval: 1.005-1.219, P=0.038). ConclusionFor CHB patients without a high risk of cancer, compared with ETV monotherapy, ETV combined with IFN for at least 6 months does not significantly reduce the risk of HCC.