Esophagectomy is an effective treatment for esophageal cancer,and there has been growing attention on the importance of postoperative pain management in patients undergoing the surgery.Epidural analgesia is the preferred analgesic approach for open esophagectomy.With the development of surgical technology,minimally invasive esophagectomy(MIE)has become the mainstream surgical approach.However,no conclusion has been reached concerning whether epidural analgesia is still the preferred analgesic approach for MIE.Herein,we analyzed the relevant literature published in recent years and found that epidural analgesia continued to be an important analgesic approach for MIE,offering the best analgesic effect.Epidural analgesia can reduce postoperative pulmonary complications,improve the quality of life,and reduce the stress response.Adverse effects can be minimized through accurate selection of epidural puncture segments,individualized medication,and multimodal analgesia strategies.In the future,precision-based multimodal analgesia can be achieved using emerging technologies such as big data analytics and artificial intelligence.

OBJECTIVE: To investigate the efficacy and safety of matched sibling donor allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the treatment of young patients with multiple myeloma (MM). METHODS: The clinical data of 8 young patients (median age：46 years) with MM who underwent allo-HSCT from HLA-indentical sibling donors in the First Affiliated Hospital of Chongqing Medical University from June 2013 to September 2021 were collected, and their survival and prognosis were retrospectively analyzed. RESULTS: All the patients were successfully transplanted, and 7 patients could be evaluated the efficacy after transplantation. The median follow-up time was 35.2 (2.5-84.70) months. The complete response (CR) rate was 2/8 before transplantation and 6/7 after transplantation. Acute GVHD developed in 2 cases and extensive chronic GVHD developed in 1 case. Within 100 days, 1 case died of non-recurrent events, and 1-year and 2-year disease-free survival were 6 and 5 cases, respectively. At the end of follow-up, all the 5 patients who survived for more than 2 years survived, and the longest disease-free survival time has reached 84 months. CONCLUSION With the development of new drugs, HLA-matched sibling donor allo-HSCT may be a curable treatment for young patients with MM.
Humans ; Middle Aged ; Multiple Myeloma ; Siblings ; Retrospective Studies ; Hematopoietic Stem Cell Transplantation/adverse effects* ; Graft vs Host Disease

Objective:To explore the characteristics and influencing factors of blood carnitine metabolism in premature infants.Methods:A retrospective analysis of 37 037 neonates with negative results of genetic metabolic disease screening at Guangxi Newborn Disease Screening Center from 2018 to 2021, of which 34 517 normal full-term infants were the control group and 2 520 preterm infants were the research group.According to gestational age, the preterm infants were further divided into three groups: extremely preterm group( n=232), moderately preterm group( n=324)and late preterm group( n=1 964). According to birth weight, they were divided into three groups: very low birth weight group( n=188), low birth weight group( n=1 276)and normal birth weight group( n=1 056). According to blood collection time, they were divided into three groups: 3~7 days group( n=1 990), 8~14 days group( n=342) and 15~28 days group( n=188). Tandem mass spectrometry was used to detect the levels of 31 carnitines in dried blood spots and analyze the differences in the levels of metabolic indicators in each group. Results:Carnitine levels in preterm infants are most affected by gestational age.Adjusting the physiological and pathological conditions of premature infants and other related factors, grouped by gestational age, there were differences in the levels of 31 carnitines among the groups(all P<0.05), the smaller the gestational age, the greater the difference in carnitine levels; grouped by blood collection time, there were statistically significant differences in carnitine levels between preterm infants with different blood collection age groups and full-term 3~7 days groups(all P<0.05), and showing age-related; there are differences among 31 carnitines grouped by body weight(all P<0.05), the smaller the body weight, the greater the difference in carnitine levels.Combined with the analysis of gestational age, birth weight and blood collection date, 17 indicators including C0, C2, C3, C4, C6DC, C10, C10∶1, C12, C12∶1, C14, C14∶1, C14OH, C16, C16∶1, C18, C18∶1 and C18∶1OH are important biomarkers of carnitine metabolism in premature infants. Conclusion:Carnitine in premature newborns has different metabolic differences at different gestational ages, birth weights and blood collection ages, which provides a strong basis for establishing reference standards and interpretation of preterm infants in the laboratory in this region, and provides reasonable and effective early diagnosis and treatment for clinical practice.Meanwhile, it provides an optimized program for timely detection of carnitine deficiency and carnitine supplementation to improve nutrition of premature infants.

In the original publication the labelling of Figure 1D, Y-axis is incorrectly published. The correct labeling should be read as Fragilis+/SSEA1+ and the correct figure is provided in this correction.

In the original publication the labelling on Fig. 2A and B were incorrectly published as E7.5. The correct labelling of Fig. 2A and B should be read as E17.5 which is provided in this correction.

Objective To understand the relationship of anxiety and depression with AIDS knowledge,cognition of risk and sex behavior among young men who have sex with men(YMSM).Methods The study was conducted by the snowballs sampling method for the recruitment and serological examination of YMSM aged 15-24 in Mianyang city,Sichuan province.The anxiety and depressive symptoms were assessed by the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS).Chi-square test was used to implement single-factor analysis and non-conditional logistic regression for multiple-factor analysis.Results Totally 356 cases completed the SAS and 355 cases completed the SDS.And the total scores of SAS and SDS were (42.96± 10.81) and (45.63± 12.40).The detection rates of anxiety and depressive symptoms were 23.60％ and 33.24％ respectively.There was no statistical difference in the incidence of HIV infection with or without anxiety and depression (x2=2.235,1.718,both P＞0.05),and there was a statistical difference in the incidence of syphilis infection (x2 =6.840,P＜0.05).Multi-factor analysis results showed that HIV infection risk awareness(β=1.101,P=0.015),number of anal sex in nearly 1 week (β=1.111,P=0.005),and the diagnosis of STD in nearly 1 year(β=1.996,P=0.010) were independent factors influencing anxiety symptoms,meanwhile occasional sex in nearly six months (β=0.692,P=0.037),and the number of anal sex in nearly one week (β=0.969,P=0.012) were independent factors in depressive symptoms (P＜0.05).Conclusion The detection rate of anxiety and depressive symptoms among YMSM is high.Anxiety and depressive symptoms are related to AIDS related factors,which has certain characteristics to the YMSM sex behavior and is of great health risk.AIDS prevention should combine behavior with psychological intervention.

China ; HIV Infections ; Homosexuality, Male ; Humans ; Incidence ; Male ; Risk Factors

Objective:To compare the efficacy and safety of tubeless percutaneous nephrolithotomy ( tubeless-PCNL) and ureteroscopic lithotripsy ( URL) in treatment of impacted upper-ureteral calculi ≥1.5 cm in size.Methods:Patients with ureteral stones sized ≥1.5 cm and lodged above the fourth lum-bar vertebra who were treated between September 2009 and July 2013 in Peking University People ’ s Hos-pital were retrospectively analyzed .In the study , 182 patients underwent tubeless-PCNL or URL treat-ment respectively , and the operation success rates were compared .The duration of operation , intraopera-tive blood loss ( average hemoglobin decrease ) , complications , mean hospital stay and residual stone rates were also compared.Results: Fifty-four patients underwent tubeless-PCNL treatment,the average stone size was (1.9 ±0.4) cm,nephrostomy tubes were placed in two patients ,and the operation success rate was 96.3%(52/54).In the rest of the 52 patients,and the mean operation time was (30.1 ±14.8) minutes with an average postoperative hemoglobin decrease of (10.2 ±6.1) g/L, and the mean hospital stay was (3.0 ±1.4) days.Only one of the patients had residual fragments (2%).The main complica-tions included minor perirenal hematoma in 1 patient, fever in 2 patients, elevated blood WBC in 11 patients,and analgesics requirement in 3 patients.In the study, 128 patients were treated with URL,the average stone size was (1.7 ±0.3) cm.19 procedures failed,and 10 patients were converted to PCNL, extracorporeal shock wave lithotripsy was executed subsequently after double -J stent placement in 5 patients,and migration of calculi or stone fragments happened in 4 patients.The mean operative time was (51.3 ±25.5) minutes for the remaining 109 patients with a hemoglobin reduction of (5.2 ±7.2) g/L. The mean hospital stay was (2.9 ±1.3) days, and residual stones were found in 13 of the 109 patients (11.9%).The main complications included fever in 3 patients, elevated blood WBC in 42 patients, an-algesics requirement in 13 patients because of pain in the urethra or flank .The size of the stones between the two group didn ’ t show significant difference ,but the success rate of the tubeless-PCNL procedure was significantly higher .Except that hemoglobin decrease was slightly higher in the tubeless-PCNL group ,the mean operative time , the rate of residual stones and rate of complications of the tubeless-PCNL group were lower significantly.Conclusion:Treating stones above 4th lumbar vertebra larger than 1.5 cm were challenging .It is difficult to treat these stones with URL because of a high probability to fail , but on the contrary, tubeless-PCNL was more likely to be performed successfully .For surgeons experienced with the PCNL technology, treating stones≥1.5 cm with tubeless-PCNL procedure may turn out to be more effi-cient and with a higher operation success rate , and the risk of complications was lower without lengthe-ning the postoperative hospital stay .

Objective:To understand the relationship of personality characteristics,self-esteem and social sup-port between men who have sex with men (MSM).Methods:Totally 402 cases aged 18-77 years were selected by snowball sampling method in Mianyang City and evaluated with the Chinese version of Eysenck Personality Ques-tionnaire short form scale (EPQ-RSC),Self-Esteem Scale (SES)and Social Support Rating Scale (SSRS).Re-sults:Objective support score was negatively correlated with psychoticism and neuroticism score (standard β=-0.18,-0.28),and positively correlated with introversion-extroversion score (standard β=0.14).Subjective sup-port score was negatively correlated with introversion-extroversion score (standard β=-0.15),and positively cor-related with lie score (standard β=0.22).The utilization degree of social support score was negatively correlated with psychoticism and neuroticism score (standard β=0.16,0.15),and positively correlated with lie score (stand-ard β=-0.15).Self-esteem score was negatively correlated with psychoticism and neuroticism score (standard β=0.10,0.21),and positively correlated with the utilization degree of social support score (standard β=-0.26). Conclusion:The relationships of personality,self-esteem and social support in MSM may be close.