Objective:To explore the incidence and mortality of digestive system cancers, and the trend of the disease burden attributed to different risk factors in population in China.Methods:Data were obtained from the GLOBOCAN 2020 and the Global Burden of Disease Study in 2019 databases and only the data from the Chinese population were included. Using Excel 2019 and R 4.2.1 software, indicators including age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), age-standardized disability-adjusted life year (DALY) rate and its rate of change were used to illustrate the disease burden of digestive system cancers attributed to different factors and their trends.Results:In 2020, the ASIR of digestive system cancers in China was 83.00/100 000, and the ASMR was 63.80/100 000. The numbers of digestive system cancer cases and deaths increased with age, and more cases and deaths occurred in men than in women in all age groups. The age-standardized DALY rate of esophageal cancer, gastric cancer and liver cancers showed decreasing trends in China from 1990 to 2019 (rate of change: -45.26%, -46.87%, and -65.63%, respectively), whereas the age-standardized DALY rate of pancreatic cancer, colorectal cancer and gallbladder and biliary tract cancer showed increasing trends (rate of change: 67.61%, 30.52%, and 7.21%, respectively). The trend of the mortality rate was consistent with the DALY rate. Compared with the age-standardized DALY rate attributed to behavioral factors, the annual proportion of the age-standardized DALY rate attributed to metabolic factors to the total age-standardized DALY rate of esophageal cancer, liver cancer, pancreatic cancer, and colorectal cancer increased from 1990 to 2019. There was no significant change in the rank of age-standardized DALY rate of gastric cancer, liver cancer, pancreatic cancer, and gallbladder and biliary tract cancer attributed to different risk factors in China from 1990 to 2019, but the rank of certain attributed risk factors for the age-standardized DALY rate of esophageal cancer and colorectal cancer moved ahead (esophageal cancer: high BMI; colorectal cancer: low milk intake, and low whole-grain intake).Conclusions:The incidence and mortality of digestive system cancers was serious in China in 2020, and the annual proportion of the disease burden of digestive system cancers attributed to metabolic factors increased from 1990 to 2019. The rank of attributed risk factors for several digestive system cancers changed significantly.

Objective To evaluate the modified Aldrete scoring system(MASS)and the White's fast-track scoring system(WFTSS)in the context of enhanced recovery after surgery(ERAS)and to compare the effects of sevoflurane anesthesia maintenance with propofol intravenous anesthesia maintenance in the ERAS of patients undergoing laparoscopic cholecystectomy;to evaluate the MASS and WFTSS in the context of ERAS.Methods A total of 160 patients undergoing laparoscopic cholecystectomy from January 2021 to October 2023 in the First Affiliated Hospital of Ningbo University were randomly divided into sevoflurane group and propofol group,80 cases in each group.The sevoflurane group maintained on sevoflurane-remifentanil and propofol group on propofol-remifentanil.Patients ERAS were evaluated by WFTSS and MASS.Time to the recovery from anesthesia,number of patients meeting the ERAS,factors associated with non-ERAS compliance,and perioperative complications were recorded.Results The proportion of patients entering ERAS in both groups was higher in the MASS than in the WFTSS(P=0.031).In terms of extubation time,the sevoflurane group was significantly slower than propofol group(P=0.030).In terms of meeting ERAS criteria,the propofol group had significantly more patients than sevoflurane group(P=0.026),and the number of patients entering the recovery room was significantly less than in sevoflurane group(P=0.025).Regarding the factors affecting entry into ERAS,the number of cases in sevoflurane group was higher than in propofol group,with postoperative nausea being the only factor with statistical significance while others were not significantly different.Conclusion WFTSS provides a more comprehensive and effective assessment for ERAS at the time of leaving the operating room and can be considered as one of the discharge criteria for ERAS.It also concludes that compared with sevoflurane combined with remifentanil for anesthesia maintenance,the propofol combined with remifentanil maintenance can achieve the extubation requirements in the operating room more quickly and with fewer side effects.

Objective To investigate the application of the Healthcare Failure Mode and Effects Analysis ( HFMEA) system to reduce occupational exposure of HIV for surgical staff.Methods Based on the method of HFMEA system utilization, the occupational exposure prevention team for surgical medical staff had been set up to analyze the failure mode and the causes of potential risks,and to calculate the Risk Priority Number ( RPN) .In this study some improvement measures had been carried out, aiming at the failure mode and priority problems.We counted and implemented circumstances of exposure before and after the HFMEA implementation, and evaluated the appraisement of surgical staffs for the implementation of HFMEA.Results Before administration of HFMEA,twenty two HIV-infected patients were admitted in our institution,of which six patients caused occupational exposure, five cases of blood-borne exposure, and one cases of mucous membrane exposure.After administration of HFMEA,thirty HIV-infected patients were admitted, of which only one patient caused occupational exposure, for blood-borne exposed type.The exposure rate before and after HFMEA administration had statistical significance (χ2 =4.36, P <0.05 ).Surgical staffs rendered a positive appraisement for HFMEA administration and 32 (100) staffs recommended it to enhance the recognition of HIV patients contact safety protection and minimize HIV occupational exposure.Conclusions Could reduce occupational exposure rate for surgical medical staff by usage of HFMEA to evaluate and reduce occupational exposure of HIV patients, safe injection, personal protective equipment and medical waste management.

A 54-year-old male patient with chronic hepatitis B and liver cirrhosis with upper gastrointestinal hemorrhage was treated with the percutaneous transhepatic embolization of gastroesophageal varices and partial splenic embolization.He received an intravenous ioversol injection 160 ml.About 6.5 hours after intervention, the patient became blind in both eyes.Magnetic resonance imaging (MRI) showed widely fresh brain infarction, but nothing abnormal was found in brain computed tomography.He was given oxygen and dexamethasone, sodium aescinate, mannitol, alprostadil, vinpocetine, ligustrazine,monosialotetrahexosyl ganglioside sodium.Fifty-eight hours after blindness, the eyesight was completely resumed.Two weeks later, MRI showed that the range of cerebral infarcts became smaller, signal intensity was reduced.Fourteen months later, the gastrointestinal hemorrhage did not occur and the eyesight was normal.

A 54-year-old male patient with chronic hepatitis B and liver cirrhosis with upper gastrointestinal hemorrhage was treated with the percutaneous transhepatic embolization of gastroesophageal varices and partial splenic embolization.He received an intravenous ioversol injection 160 ml.About 6.5 hours after intervention, the patient became blind in both eyes.Magnetic resonance imaging (MRI) showed widely fresh brain infarction, but nothing abnormal was found in brain computed tomography.He was given oxygen and dexamethasone, sodium aescinate, mannitol, alprostadil, vinpocetine, ligustrazine,monosialotetrahexosyl ganglioside sodium.Fifty-eight hours after blindness, the eyesight was completely resumed.Two weeks later, MRI showed that the range of cerebral infarcts became smaller, signal intensity was reduced.Fourteen months later, the gastrointestinal hemorrhage did not occur and the eyesight was normal.

Objective To study the effects of ?2-adrenergic receptor gene Arg16Gly polymorphism on blood lipid and apolipoprotein ratio and its role in blood lipid and apolipoprotein ratio mediated by high carbohydrate/low fat (HC/LF) diet in healthy young persons.Methods Fifty-six healthy young volunteers had regular diet for 7 d followed by HC/LF diet for 6 d.Twelve-hour fasting venous blood samples were collected on days 1,8 and 14 to measure blood lipid and apolipoprotein (apo) AI and B100 levels,and to calculate ratios of TG/HDL-C,log (TG/HDL-C),TC/HDL-C,LDL-C/HDL-C and apoAI/apoB100.DNA was isolated from genome.Arg16Gly polymorphism was analyzed by PCR-RFLP.Results No significant difference was found in the baseline lipid and apolipoprotein ratio in subjects with AA genotype and G carriers before and after regular or HC/LF diet.The ratios of TG/HDL-C (P=0.017),log (TG/HDL-C) (P=0.031),and apoAI/apoB100 (P=0.006) were significantly higher,while those of TC/HDL-C (P=0.001) and LDL-C/HDL-C (P

Objective To evaluate the effects of time selection and immediate percutneous transluminal coronary angioplasty (PTCA) in refractory unstable angina pectoris.Methods PTCA was performed in 27 RUAP patients,among which 16 underwent emergency PTCA and 11 patients experienced PTCA after controlling with medicine.ECG and recurrence of symptoms were observed immediately and 6 months after PTCA.Results The procedural success rate was 100%.The immediate relieving rate was 96.3%.The recurrence rate of 11 cases within 6 months (18.2%)was significantly lower than that of 16 cases(37.5%).Conclustion The PTCA for RUAP is relatively safe and effective,but PTCA should be performed after situation is unchanged by use of medicine and PTCA shoulde be carried out immediately if the symptoms can not be controlled by medicine.

Objective To evaluate the safety and efficacy of low-molecular weight heparin on the prevention of acute closure after percutaneous intracavitary coronary angioplasty.Methods 73 patients were randomly assigned to LMWH and SH groups.All patients underwent SPECT or CAG.Myocardial ischemia and hemorrhage complication were analyzed.Results In Group LMWH,no case of hemorrhage complication occurred,and in 3 cases angina occurred within 24h after the operation,which was proved by CAG to be acute closure of target vessel (the incidence rate 8.6%) .In Group SH,gum and subcutaneous hemorrhage occurred to 2 cases within 7h after the operation,hematuria occurred to 2 cases within 12h and one case died from cerebral hemorrhage,which was confirmed by CT (the total hemorrhage incidence 13.2%).Another 4 cases in Group SH suffered from re-occurrence of angina,which was confirmed by CAG to be acute closure of target vessel (10.5%).There was significant difference in hemorrhage complication between the two groups (P0.05)。Conclusion The results suggest that LMWH is safe and effective in the prevention of acute closure after native vessel coronary angioplasty.