Objective To analyze the pollution characteristics of PM_2.5-bound polycyclic aromatic hydrocarbons (PAHs) during the non-heating period, heating period, and haze period in Harbin, and infer their possible sources, and to evaluate their impact on population carcinogenesis. Methods From 2020 to 2022, sampling points were set up in different districts of Harbin. PM_2.5 samples were regularly collected every month to analyze the contents of 10 types of PM_2.5-bound 4-6 rings PAHs. The pollution characteristics of PAHs were analyzed during different monitoring periods (non-heating period, heating period, and haze period). The excess carcinogenesis risks of PM_2.5-bound PAHs were assessed according to the Technical Specifications for Health Risk Assessment of Ambient Air Pollution and the U. S. Environmental Protection Agency (US EPA) risk assessment method. The characteristic ratio method and the positive matrix factorization (PMF) model were used to infer the sources of PAHs. Results The median mass concentrations of ambient PM_2.5-bound 4-6 rings PAHs (ΣPAHs) during the non-heating period, heating period, and haze period were 6.44 ng/m³, 37.85 ng/m³, and 106.79 ng/m³, respectively. During the heating season and haze period, the concentrations of benzo[a]anthracene, benzo[k]fluoranthene, pyrene and fluoranthene were relatively high. The excess carcinogenic risks for ASF_>16, ASF_2-16 and ASF_<2 caused by exposure to PM_2.5-bound 4-6rings PAHs during the heating season were 2.34×10^-6, 1.82×10^-6, and 0.88×10^-6, respectively, while the excess carcinogenic risks for the whole population during the heating season and haze period were 5.05×10^-6 and 1.75×10^-6, respectively. The results of the two source methods showed that the main characteristic elements during the heating season were fluoranthene, pyrene, benzo[a]anthracene, benzo[b]fluoranthene, benzo[k]fluoranthene, and benzo[a]pyrene. According to the emission source standards, it was determined that the sources were mainly coal and biomass combustion, accompanied by traffic source emissions. Conclusion In Harbin, the PM_2.5-bound 4-6 rings PAHs during the haze period is significantly higher than that during the heating period. The pollution is mainly from coal combustion emissions, accompanied by continuous traffic source pollution. The exposure to PAHs during the heating period poses a potential carcinogenic risk to the population.

Objective To investigate the prevalence of spotted fever group rickettsiae (SFGR) infections in free-living ticks and among high-risk populations in the southern margin of the Gurbantunggut Desert, Xinjiang Uygur Autonomous Region, so as to provide insights into tick-borne diseases prevention and control in this region. Methods Free-living ticks were collected from five counties (cities) in the southern margin of the Gurbantunggut Desert, Xinjiang Uygur Autonomous Region. Tick species were identified by morphology combined with mitochondrial cytochrome c oxidase subunit Ⅰ (COI) gene analysis. Four target gene fragments of Rickettsia were amplified using a nested PCR assay, including outer membrane protein B (ompB), 17-kDa common surface antigen protein (17kDa), surface cell antigen 1 (sca1), and surface cell antigen 4 (sca4) genes, to detect the prevalence of SFGR infections in tick samples. Positive PCR amplification products were purified, sequenced, and subjected to sequence alignment, and phylogenetic trees were created using the neighbor-joining (NJ) method. Serum samples were collected from individuals at a high risk of tick exposure from six counties (cities, districts) in the southern margin of the Gurbantunggut Desert, Xinjiang Uygur Autonomous Region, and serum levels of anti-R. sibirica IgG antibodies were detected among these individuals using indirect immunofluorescence assay (IFA) and statistically analyzed. Results A total of 287 free-living ticks were collected, and all were identified as Hyalomma asiaticum. The overall prevalence of SFGR infection was 78.40% (225/287) in tick samples, and five Rickettsia species were characterized, including R. sibirica, which shared 99.81% (515/516) sequence homology with the strain detected in Dermacentor sinicus from China; R. massiliae, which shared 99.80% (509/510) sequence homology with the strain detected in Rhipicephalus sanguineus from Ethiopia; R. raoultii, which shared 100.00% (516/516) sequence homology with the strain detected in Hyalomma asiaticum from Xinjiang Uygur Autonomous Region in China; R. africae, which shared 100.00% (524/524) sequence homology with the strain detected in Amblyomma splendidum from Ethiopia; and Candidatus Rickettsia barbariae, which shared 99.80% (499/500) sequence homology with the strain detected in steppe polecats from Xinjiang Uygur Autonomous Region in China, with R. sibirica (33.80% detection rate, 97/287) and R. raoultii (33.10%, 95/287) as dominant species. A total of 1 489 serum samples were collected from individuals at a high risk of tick exposure, and the seroprevalence of antiR. sibirica IgG antibodies was 30.83% (459/1 489). There were no significant differences in the seroprevalence in terms of genders (χ² = 2.23, P > 0.05) or age groups (χ² = 6.45, P > 0.05); however, there was a region-specific seroprevalence rate of anti-R. sibirica IgG antibodies (χ² = 16.05, P < 0.05). Pairwise comparisons showed lower seroprevalence rate of anti-R. sibirica IgG antibodies among high-risk individuals in Midong District of Urumqi City (22.27%, 53/238) than in Wujiaqu City (34.70%, 93/268) and Manas County(37.55%, 98/261) (both P values < 0.05); however, they were not significantly different from those in the other regions (all P values > 0.05). Conclusion Multiple SFGR species are detected in H. asiaticum ticks sampled from the southern margin of the Gurbantunggut Desert, Xinjiang Uygur Autonomous Region, where there is a potential risk of local transmission of spotted fever rickettsiosis.

ObjectiveTo investigate the mechanism underlying the weight loss effect of electrothermal acupuncture （ETA） in diet-induced obese （DIO） model mice based on the hypoxia-inducible factor-1α （HIF-1α）/sphingosine-1-phosphate （S1P）sphingosine-1-phosphate receptor 3 （S1PR3） signaling pathway-mediated macrophage polarization. MethodsAn obesity mouse model was established by continuously feeding at a high-fat diet （HFD） for 8 weeks. Twenty successfully modeled obese mice were randomly divided into a model group and an electrothermal acupuncture （ETA） group with 10 mice per group， both of which continued to receive the HFD till week 12. Another 10 mice were assigned to the normal group and fed a standard chow diet continuously for 12 weeks. Starting from week 9 of the experiment， mice in the ETA group received electrothermal acupuncture stimulation at Zhongwan （CV12）， bilateral Tianshu （ST25）， and bilateral Zusanli （ST36） for 30 minutes per session， with the instrument current set at （40±0.5）mA and a constant temperature of （40±0.5）℃. Mice in the normal group and the model group were restrained in the same manner for 30 minutes without acupuncture. All interventions were performed once every other day for a total of 4 weeks. Ten hours after the final intervention， the body weight， waist circumference， and body length of mice in each group were measured， and Lee's index was calculated. Serum biochemical analysis was performed to assess fasting blood glucose （FBG）， total cholesterol （TC）， triglycerides （TG）， high-density lipoprotein cholesterol （HDL-C）， low-density lipoprotein cholesterol （LDL-C）， alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， blood urea nitrogen （BUN）， and creatinine （Cr）. Serum leptin （LEP） and adiponectin （ADPN） levels， as well as sphingosine-1-phosphate （S1P） levels in epididymal white adipose tissue （eWAT）， were detected by ELISA. Histomorphological changes in eWAT were monitored via HE staining. Flow cytometry was used to analyze macrophage subtype-related indexes in eWAT， including the total proportion of macrophages， the proportion of M1 macrophages， the proportion of M2 macrophages， and the M1/M2 ratio. Antibody array technology was used to determine the levels of differentially expressed inflammatory factors in eWAT between the model and blank groups， as well as between the ETA and model groups. Western blot and qPCR were used to detect the protein and mRNA expression levels of HIF-1α and S1PR3 in the eWAT， respectively. ResultsCompared to the normal group， the model group showed significantly increased body weight， Lee's index， waist circumference， and FBG， TC， TG， HDL-C， LDL-C， AST， and ALT levels， upgraded LEP and S1P levels， decreased ADPN level and ADPN/LEP ratio， elevated proportion of M1 macrophages and the M1/M2 ratio， reduced proportion of M2 macrophages， and upregulated protein and mRNA expression levels of HIF-1α and S1PR3 （P＜0.05 or P＜0.01）. With the exception of HDL-C， all the abovementioned indicators in the ETA group were significantly improved compared to the model group （P＜0.05 or P＜0.01）. Analysis of differentially expressed inflammatory cytokines revealed that， compared to the normal group， the levels of interleukin-1β （IL-1β）， interferon-γ （IFN-γ）， interleukin-6 （IL-6）， and interleukin-12p70 （IL-12p70） in the eWAT of the model group were elevated； conversely， the levels of interleukin-17 （IL-17）， interleukin-5 （IL-5）， IL-6， and interleukin-23 （IL-23） in the eWAT of the ETA group decreased compared to the model group （P＜0.05 or P＜0.01）. ConclusionETA exerts a weight-reducing effect in obese model mice， and the mechanism may involve inhibition of the HIF-1α/S1P/S1PR3 signaling pathway activation， which shifts macrophage polarization from the M1 to M2 phenotype， thereby alleviating chronic inflammation.

Lipid turbidity disease is a metabolic disease featuring lipid metabolism disorders caused by many factors such as social environment， diet， and lifestyle， which is closely related to many diseases in modern medicine， such as hyperlipidemia， obesity， fatty liver， atherosclerosis， metabolic syndrome， and cardiovascular and cerebrovascular diseases， with a wide range of influence and far-reaching harm. According to the Huangdi Neijing， lipid turbidity disease reflects the pathological change of the body's physiologic grease. Grease is the thick part of body fluids， which has the function of nourishing， and it is the initial state and source of important substances in the human body such as brain， marrow， essence， and blood. Once the grease of the human body is abnormal， it can lead to lipid turbidity disease. The Huangdi Neijing also points out the physiological relationship between the transportation and transformation of body fluids and the rise and fall of the spleen and stomach， which can deduce the pathological relationship between the occurrence of lipid turbidity disease and the abnormal rise and fall of the spleen and stomach functions. Lipid turbidity disease is caused by overconsumption of fatty and sweet foods or insufficient spleen and stomach endowments， leading to disorders of the function of promoting clear and reducing turbidity in the spleen and stomach. This leads to the transformation of thick grease in body fluids into lipid turbidity， which accumulates in the body's meridians， blood vessels， skin pores， and organs， forming various forms of metabolic diseases. The research team believed that the pathological basis of lipid turbidity disease was the abnormal rise and fall of the spleen and stomach and the obstruction of the transfer of grease. According to the different locations where lipid turbidity stays， it was divided into four common pathogenesis types： ''inability to distinguish between the clear and turbid， turbid stagnation in the Ying blood''， ''spleen not rising clear， turbid accumulation in the vessels''， ''spleen dysfunction， lipid retention in the pores''， ''spleen failure to transportation and transformation， and grease accumulation in the liver''. According to the pathogenesis， it could be divided into four common syndromes， namely， turbid stagnation in the Ying blood， turbid accumulation in the vessels， lipid retention in the pores， and grease accumulation in the liver， and the corresponding prescriptions were given for syndrome differentiation and treatment， so as to guide clinical differentiation and treatment of the lipid turbidity disease.

Objective:Given the insufficiency of current clinical biomarkers for early diagnosis of esophageal adenocarcinoma(EAC),this study developed a panel of serum protein biomarker assays using liquid-phase chip technology and preliminarily validated the detection capabilities of these markers for EAC.Methods:Collected serum samples from 48 patients with EAC and 33 age-matched healthy controls(HC).The levels of squamous cell carcinoma antigen(SCCA),human cytokeratin 19 fragment(Cyfra21-1),hepatocyte growth factor(HGF)and IL-8 in serum were analyzed by liquid chip technology.The diagnostic efficacy of a single indicator and a combination of four indicators were evaluated by receiver operation characteristic(ROC)curve.Results:The detection ranges of SCCA,Cyfra21-1,HGF and IL-8 were 0.24～1 000 ng/ml,45.72～100 000 pg/ml,21.95～16 000 pg/ml,and 0.61～10 000 pg/ml,respectively.The liquid chip technology shows a strong correlation with clinical chemiluminescence immunoassay(r=0.949 4,P<0.000 1)and ELISA technology(r=0.955 1,P<0.000 1).Compared to the HC group,serum levels of SCCA and HGF were signifi-cantly elevated in the EAC group(P<0.01),IL-8 was significantly decreased(P<0.05),while Cyfra21-1 shows no significant difference(P>0.05).In the early EAC group,serum HGF was significantly higher than in the HC group(P<0.01).ROC curve analysis shows that among individual markers,HGF exhibits the best diagnostic efficacy for early EAC with an area under the curve(AUC)of 0.761,while the AUC for the combination of the four biomarkers was 0.857,both superior to the clinical biomarkers SCCA(AUC=0.604)and Cyfra21-1(AUC=0.515).Conclusion:Liquid chip technology is used to jointly detect SCCA,Cyfra21-1,HGF,and IL-8 in human serum.In the early diagnosis of EAC,the diagnostic efficacy of the combined use of these four biomarkers is superior to that of the commonly used clinical tumor markers SCCA and Cyfra21-1.This advantage stems from the high throughput and high sensitivity characteristics of liquid-phase chip technology.Consequently,this combined detection method holds significant clinical application and is expected to provide a more accurate and reliable tool for the early diagnosis of EAC.

Objective To investigate the distribution and antimicrobial resistance profiles of clinically isolated Haemophilus influenzae and Moraxella catarrhalis in hospitals across China from 2015 to 2021,and provide evidence for rational use of antimicrobial agents.Methods Data of H.influenzae and M.catarrhalis strains isolated from 2015 to 2021 in CHINET program were collected for analysis,and antimicrobial susceptibility testing was performed by disc diffusion method or automated systems according to the uniform protocol of CHINET.The results were interpreted according to the CLSI breakpoints in 2022.Beta-lactamases was detected by using nitrocefin disk.Results From 2015 to 2021,a total of 43 642 strains of Haemophilus species were isolated,accounting for 2.91％of the total clinical isolates and 4.07％of Gram-negative bacteria in CHINET program.Among the 40 437 strains of H.influenzae,66.89％were isolated from children and 33.11％were isolated from adults.More than 90％of the H.influenzae strains were isolated from respiratory tract specimens.The prevalence of β-lactamase was 53.79％in H.influenzae strains.The H.influenzae strains isolated from children showed higher resistance rate than the strains isolated from adults.Overall,779 strains of H.influenzae did not produce β-lactamase but were resistant to ampicillin(BLNAR).Beta-lactamase-producing strains showed significantly higher resistance rates to these antimicrobial agents than the β-lactamase-nonproducing strains.Of the 16 191 M.catarrhalis strains,80.06％were isolated from children and 19.94％isolated from adults.M.catarrhalis strains were mostly susceptible to both amoxicillin-clavulanic acid and cefuroxime,evidenced by resistance rate lower than 2.0％.Conclusions The emergence of antibiotic-resistant H.influenzae due to β-lactamase production poses a challenge for clinical anti-infective treatment.Therefore,it is very important to implement antibiotic resistance surveillance for H.influenzae and guide rational antibiotic use.All local clinical microbiology laboratories should actively improve antibiotic susceptibility testing and strengthen antibiotic resistance surveillance for H.influenzae.

Objective To understand the changing composition and antibiotic resistance of bacterial species in the clinical isolates from outpatient and emergency department(hereinafter referred to as outpatients)and inpatient children over time in various hospitals,and to provide laboratory evidence for rational antibiotic use.Methods The data on clinically isolated pathogenic bacteria and antimicrobial susceptibility of isolates from outpatients and inpatient children in the CHINET program from 2015 to 2021 were collected and analyzed.Results A total of 278 471 isolates were isolated from pediatric patients in the CHINET program from 2015 to 2021.About 17.1％of the strains were isolated from outpatients,primarily group A β-hemolytic Streptococcus,Escherichia coli,and Staphylococcus aureus.Most of the strains(82.9％)were isolated from inpatients,mainly SS.aureus,E.coli,and H.influenzae.The prevalence of methicillin-resistant S.aureus(MRSA)in outpatients(24.5％)was lower than that in inpatient children(31.5％).The MRSA isolates from outpatients showed lower resistance rates to the antibiotics tested than the strains isolated from inpatient children.The prevalence of vancomycin-resistant Enterococcus faecalis or E.faecium and penicillin-resistant S.pneumoniae was low in either outpatients or inpatient children.S.pneumoniae,β-hemolytic Streptococcus and S.viridans showed high resistance rates to erythromycin.The prevalence of erythromycin-resistant group A β-hemolytic Streptococcus was higher in outpatients than that in inpatient children.The prevalence of β-lactamase-producing H.influenzae showed an overall upward trend in children,but lower in outpatients(45.1％)than in inpatient children(59.4％).The prevalence of carbapenem-resistant Klebsiella pneumoniae(CRKpn),carbapenem-resistant Pseudomonas aeruginosa(CRPae)and carbapenem-resistant Acinetobacter baumannii(CRAba)was 14％,11.7％,47.8％in outpatients,but 24.2％,20.6％,and 52.8％in inpatient children,respectively.The prevalence of multidrug-resistant E.coli,K.pneumoniae,Proteus mirabilis,P.aeruginosa and A.baumannii strains was lower in outpatients than in inpatient children.The prevalence of fluoroquinolone-resistant E.coli,ESBLs-producing K.pneumoniae,ESBLs-producing P.mirabilis,carbapenem-resistant E.coli(CREco),CRKpn,and CRPae was lower in children in outpatients than in inpatient children,but the prevalence of CRAba in 2021 was higher than in inpatient children.Conclusions The distribution of clinical isolates from children is different between outpatients and inpatients.The prevalence of MRSA,ESBL,and CRO was higher in inpatient children than in outpatients.Antibiotics should be used rationally in clinical practice based on etiological diagnosis and antimicrobial susceptibility test results.Ongoing antimicrobial resistance surveillance and prevention and control of hospital infections are crucial to curbing bacterial resistance.

Objective To investigate the changing antibiotic resistance profiles of E.coli isolated from patients in the 52 hospitals participating in the CHINET program from 2015 to 2021.Methods Antimicrobial susceptibility was tested for clinical isolates of E.coli according to the unified protocol of CHINET program.WHONET 5.6 and SPSS 20.0 software were used for data analysis.Results Atotal of 289 760 nonduplicate clinical strains ofE.coli were isolated from 2015 to 2021,mainly from urine samples(44.7±3.2)％.The proportion of E.coli strains isolated from urine samples was higher in females than in males(59.0％vs 29.5％).The proportion of E.coli strains isolated from respiratory tract and cerebrospinal fluid samples was significantly higher in children than in adults(16.7％vs 7.8％,0.8％vs 0.1％,both P＜0.05).The isolates from internal medicine department accounted for the largest proportion(28.9±2.8)％with an increasing trend over years.Overall,the prevalence of ESBLs-producing E.coli and carbapenem resistant E.coli(CREco)was 55.9％and 1.8％,respectively during the 7-year period.The prevalence of ESBLs-producing E.coli was the highest in tertiary hospitals each year from 2015 to 2021 compared to secondary hospitals.The prevalence of CREco was higher in children's hospitals compared to secondary and tertiary hospitals each year from 2015 to 2021.The prevalence of ESBLs-producing E.coli in tertiary hospitals and children's hospitals and the prevalence of CREco in children's hospitals showed a decreasing trend over the 7-year period.The prevalence of CREco in secondary and tertiary hospitals increased slowly.Antibiotic resistance rates changed slowly from 2015 to 2021.Carbapenem drugs(imipenem,meropenem)were the most active drugs amongβ-lactams against E.coli(resistance rate≤2.1％).The resistance rates of E.coli to β-lactam/β-lactam inhibitor combinations(piperacillin-tazobactam,cefoperazone-sulbactam),aminoglycosides(amikacin),nitrofurantoin and fosfomycin(for urinary isolates only)were all less than 10％.The resistance rate of E.coli strains to antibiotics varied with the level of hospitals and the departments where the strains were isolated,especially for cefazolin and ciprofloxacin,to which the resistance rate of E.coli strains from children in non-ICU departments was significantly lower than that of the strains isolated from other departments(P＜0.05).The E.coli isolates from ICU showed higher resistance rate to most antimicrobial agents tested(excluding tigecycline)than the strains isolated from other departments.The E.coli strains isolated from tertiary hospitals showed higher resistance rates to the antimicrobial agents tested(excluding tigecycline,polymyxin B,cefepime and carbapenems)than the strains from secondary hospitals and children's hospitals.Conclusions E.coli is an important pathogen causing clinical infection.More than half of the clinical isolates produced ESBL.The prevalence of CREco is increasing in secondary and tertiary hospitals over the 7-year period even though the overall prevalence is still low.This is an issue of concern.

Objective:To investigate the clinical effectiveness of tumor lesion curettage and allogeneic bone grafting via the fovea of femoral head through the surgical hip dislocation approach in children and adolescents with femoral head chondroblastoma (FHCB).Methods:Case series study.The clinical data of 7 FHCB patients [3 males and 4 females with a mean age of 13.7 years (11-19 years)] treated at the Department of Pediatric Orthopedics, Zhengzhou Orthopedic Hospital from January 2016 to March 2023 were retrospectively analyzed.All patients underwent lesion curettage and allogeneic bone grafting via the fovea of femoral head through the surgical hip dislocation approach.The healing, local recurrence and complications were assessed via clinical and radiological tests.Functional outcomes were evaluated using the Musculoskeletal Tumour Society (MSTS) scoring system.A paired t-test was used to compare the MSTS scores before the operation and at the final follow-up. Results:All patients were followed up for 30 months on average (18-48 months).The average healing time for bone grafting was 4.9 (3-8) months.Local recurrence and serious postoperative complications such as avascular necrosis of femoral head, secondary osteoarthritis, ectopic ossification and nonunion of greater trochanter osteotomy end were not observed in all patients up to the last follow-up.The average MSTS score at the last follow-up was (29.14±0.45) points.Conclusions:Curettage and bone grafting via the fovea of femoral head through the surgical hip dislocation approach is effective and safe in the treatment of FHCB in children and adolescents.This method can maintain the integrity of the articular surface and growth plate, and also preserve the blood supply of the femoral head and the normal function of the hip joint, with satisfactory short-term effects.

Objective:To construct an esophageal language rehabilitation program for patients after total laryngectomy (TL) based on the behavioral change wheel theory and exploring its application effects.Methods:The multidisciplinary team constructed the first draft of the esophageal language rehabilitation program for patients after TL based on the behavioral change wheel theory, combined with a literature review, and used an expert meeting to revise the rehabilitation program to form the final draft of the program. Adopting experimental research, 35 patients after TL who attended the nursing outpatient clinic of Beijing Tongren Hospital, Capital Medical University from February 2023 to May 2023 were selected as the control group by convenience sampling method, and 35 patients after TL who attended the nursing outpatient clinic from June 2023 to September 2023 were selected as the experimental group. The experimental group applied the TL postoperative patients′ esophageal language rehabilitation program based on the behavioral change wheel theory on the basis of conventional nursing measures, and the control group received conventional nursing care. The status of language rehabilitation training, quality of life, social behavioral status, and anxiety and depression status before intervention, 1, 3, 6 months after intervention were compared between the two groups.Results:Both groups of patients completed the study. There were 29 males and 6 females in the control group, with an age of (54.63 ± 10.44) years old. There were 34 males and 1 female in the experimental group, with an age of (55.17 ± 10.67) years old. There was no statistically significant difference in the language rehabilitation training status, quality of life, social behavior status, and anxiety and depression status between the two groups before intervention (all P>0.05). The total scores of speech rehabilitation training in the experimental group at 1, 3, and 6 months after intervention were (32.80 ± 2.49), (39.80 ± 2.75), (51.91 ± 4.20) points, respectively, which were higher than those in the control group (23.40 ± 3.42), (24.40 ± 3.42), (25.80 ± 3.42) points, and the differences were statistically significant ( t=14.53, 23.44, 32.70, all P<0.05). The total scores of quality of life in the experimental group at 1, 3, and 6 months after intervention were (98.91 ± 8.49), (134.66 ± 11.31), (157.97 ± 13.97) points, respectively, which were higher than those in the control group (67.06 ± 7.64), (72.16 ± 7.64), (99.46 ± 8.09) points, and the differences were statistically significant ( t=17.53, 30.16, 21.45, all P<0.05). The scores for social occasion diet and language comprehension in the experimental group at 1, 3, and 6 months after intervention were (40.41 ± 13.94), (40.43 ± 24.08), (40.60 ± 18.56), and (43.71 ± 12.26), (47.40 ± 17.09), (52.50 ± 13.82), respectively, which were higher than those in the control group (30.59 ± 15.98), (30.57 ± 18.28), (27.21 ± 15.27), and (27.29 ± 15.13), (23.60 ± 14.78), (19.50 ± 12.78), and the differences were statistically significant ( t values were -6.88-2.16, all P<0.05). The total scores of anxiety and depression in the experimental group at 1, 3, and 6 months after intervention were (23.74 ± 2.73), (14.89 ± 3.89), (12.11 ± 3.14) points, respectively, which were lower than those in the control group (32.63 ± 1.85), (30.63 ± 1.85), (24.80 ± 2.75) points, and the differences were statistically significant (t=-19.55, -27.10, -17.97, all P<0.05). Conclusions:The esophageal language rehabilitation program for patients after TL based on the behavioral change wheel theory in this study is scientific, feasible, and can improve the patients′ esophageal language expression, quality of life, anxiety and depression, and social behavioral status, which can provide a reference for clinical care.