Objective To compare the long-term survival of elderly patients with esophageal squamous cell carcinoma (ESCC) treated with surgical versus non-surgical treatment. Methods A retrospective analysis was conducted on the clinical data of elderly patients aged ≥70 years with ESCC who underwent esophagectomy or radiotherapy/chemotherapy at Sichuan Cancer Hospital from January 2009 to September 2017. Patients were divided into a surgical group (S group) and a non-surgical group (NS group) according to the treatment method. The propensity score matching method was used to match the two groups of patients at a ratio of 1∶1, and the survival of the two groups before and after matching was analyzed. Results A total of 726 elderly patients with ESCC were included, including 552 males and 174 females, with 651 patients aged ≥70-80 years and 75 patients aged ≥80-90 years. There were 515 patients in the S group and 211 patients in the NS group. The median follow-up time was 60.8 months, and the median overall survival of the S group was 41.9 months [95%CI (35.2, 48.5)], while that of the NS group was only 24.0 months [95%CI (19.8, 28.3)]. The 1-, 3-, and 5-year overall survival rates of the S group were 84%, 54%, and 40%, respectively, while those of the NS group were 72%, 40%, and 30%, respectively [HR=0.689, 95%CI (0.559, 0.849), P<0.001]. After matching, 138 patients were included in each group, and there was no statistical difference in the overall survival between the two groups [HR=0.871, 95%CI (0.649, 1.167), P=0.352]. Conclusion Compared with conservative treatment, there is no significant difference in the long-term survival of elderly patients aged ≥70 years who undergo esophagectomy for ESCC. Neoadjuvant therapy combined with surgery is still an important choice to potentially improve the survival of elderly patients with ESCC.

Esophageal cancer is a highly prevalent and poorly prognostic malignant tumor of the digestive system worldwide. Surgical resection remains the key treatment for achieving long-term survival in patients with resectable disease. Surgical techniques are evolving from traditional open approaches to minimally invasive thoraco-laparoscopic procedures and robot-assisted surgeries. The concept of multidisciplinary comprehensive treatment has facilitated the deep integration of neoadjuvant chemoradiotherapy and immunotherapy into the perioperative setting, making the treatment model tend to attach equal importance to standardization and individualization. The continuous optimization of perioperative management and the application of enhanced recovery pathways have significantly accelerated the postoperative recovery of patients with esophageal cancer, and the prevention and control strategies for common postoperative complications have also become increasingly standardized. The choice of surgical methods for esophageal cancer is becoming increasingly precise, requiring comprehensive consideration of tumor location, histological type, and patient-specific factors. The application of new technologies such as intraoperative navigation, artificial-intelligence-assisted decision-making, biomarker analysis, and immune microenvironment integration continues to expand the scope of precision surgery. The surgical treatment of esophageal cancer is developing rapidly in the direction of minimally invasive, intelligent and systematic collaboration, with the potential to further improve the safety, standardization, and long-term efficacy of the treatment.

Objective:To investigate the degree of satisfaction with courses of postgraduates in medicine in a military medical university, and to discuss the problems existing in the offering and teaching of postgraduate medical courses as well as targeted measures.Methods:A self-made questionnaire was administered through the Questionnaire Star platform to 533 postgraduate students in a military medical university to investigate the basic situation, the types of courses offered during their study period, their opinions about and degree of satisfaction with the curriculum system, the teaching effectiveness of various courses, and suggestions for improvement in education. SPSS 23.0 was used to perform the chi-square test to analyze the relationship between variables.Results:Among the 533 students, 391 (73.32%) were satisfied with course offering ( χ2=9.64, P=0.008), and 399 (74.95%) were satisfied with course teaching ( χ2=7.60, P=0.022). Twenty-four (4.47%), 3 (6.25%), 3 (10.81%), and 2 (6.45%) students in clinical medicine, public health and preventive medicine, nursing, and pharmacy, respectively, believed that course offerings did not quite fit with their majors. The numbers of students who believed that general compulsory courses, major-specific compulsory courses, and elective courses offered were appropriate in number were 309 (57.97%), 371 (69.61%), and 409 (76.74%), respectively. For the design of the curriculum system, 399 (74.86%), 367 (68.85%), 362 (67.92%), 361 (67.73%), 355 (66.61%), 352 (66.05%), and 357 (66.98%) were satisfied with "basic theory coverage", "major-specific knowledge coverage", "research interest cultivation", "innovative thinking cultivation", "academic reporting ability cultivation", "practical ability cultivation", and "academic writing ability cultivation", respectively. The numbers of master's and doctoral students who believed that there were appropriate numbers of courses on methodology and experimental skills were 285 (71.07%) and 90 (68.18%), respectively. Conclusions:In view of the current situation of postgraduate medical courses, general basic courses should be further optimized in terms of the number and proportion of different types of courses, and major-specific required courses should pay more attention to the cultivation of postgraduates' ability and quality in addition to the coverage of basic theories. Curriculum ideology and politics for medical postgraduates should be highlighted.

Objective:To investigate the degree of satisfaction with courses of postgraduates in medicine in a military medical university, and to discuss the problems existing in the offering and teaching of postgraduate medical courses as well as targeted measures.Methods:A self-made questionnaire was administered through the Questionnaire Star platform to 533 postgraduate students in a military medical university to investigate the basic situation, the types of courses offered during their study period, their opinions about and degree of satisfaction with the curriculum system, the teaching effectiveness of various courses, and suggestions for improvement in education. SPSS 23.0 was used to perform the chi-square test to analyze the relationship between variables.Results:Among the 533 students, 391 (73.32%) were satisfied with course offering ( χ2=9.64, P=0.008), and 399 (74.95%) were satisfied with course teaching ( χ2=7.60, P=0.022). Twenty-four (4.47%), 3 (6.25%), 3 (10.81%), and 2 (6.45%) students in clinical medicine, public health and preventive medicine, nursing, and pharmacy, respectively, believed that course offerings did not quite fit with their majors. The numbers of students who believed that general compulsory courses, major-specific compulsory courses, and elective courses offered were appropriate in number were 309 (57.97%), 371 (69.61%), and 409 (76.74%), respectively. For the design of the curriculum system, 399 (74.86%), 367 (68.85%), 362 (67.92%), 361 (67.73%), 355 (66.61%), 352 (66.05%), and 357 (66.98%) were satisfied with "basic theory coverage", "major-specific knowledge coverage", "research interest cultivation", "innovative thinking cultivation", "academic reporting ability cultivation", "practical ability cultivation", and "academic writing ability cultivation", respectively. The numbers of master's and doctoral students who believed that there were appropriate numbers of courses on methodology and experimental skills were 285 (71.07%) and 90 (68.18%), respectively. Conclusions:In view of the current situation of postgraduate medical courses, general basic courses should be further optimized in terms of the number and proportion of different types of courses, and major-specific required courses should pay more attention to the cultivation of postgraduates' ability and quality in addition to the coverage of basic theories. Curriculum ideology and politics for medical postgraduates should be highlighted.

Objective:To construct a scientific and systematic indicator system for the ideological and political construction of medical professional courses in military medical universities, and to provide a reference for the teaching management department of military medical universities to guide and manage the ideological and political construction of courses, as well as for medical professional course instructors to carry out the ideological and political teaching of courses.Methods:On the basis of literature research and case studies, a framework of the indicator system was established for the ideological and political construction of medical professional courses in military medical universities, and six experts in the field of military medical education were invited for pre-consultation. A preliminary draft of the indicator system was formed after discussion within the research group. A total of 25 experts, who had intermediate or above professional titles and long-term experience in military medical education, teaching and management, military academy education management, and military ideological and political education in military academies, were invited to conduct two rounds of Delphi expert consultation, and a statistical analysis was performed for the consultation results to determine the indicator system for the ideological and political construction of medical professional courses in military medical universities. The percentage weight method and the product method were used to calculate the weight coefficient of each indicator and combined weight coefficient.Results:In the two rounds of expert consultation, the expert positivity coefficient was 100%, the expert authority coefficient was 0.883, and the Kendall harmony coefficients were 0.254 and 0.268, respectively ( P<0.05). Finally, an indicator system was established for the ideological and political construction of medical professional courses in military medical universities, which consisted of 5 primary indicators, 12 secondary indicators, and 31 tertiary indicators. The 5 primary indicators were the teaching objectives, teaching team, teaching resources, teaching implementation, and teaching effect of curriculum ideology and politics, with a weight coefficient of 0.210, 0.202, 0.197, 0.202, and 0.189, respectively. Conclusions:The indicator system constructed in this study is scientific, reliable, systematic, and comprehensive and has a certain guiding significance for the ideological and political construction of medical professional courses in military medical universities.

This paper mainly discusses the practical significance of the internal quality assurance system of graduate students in a military medical university based on training process management. The integrated internal quality assurance system follows the direction of three core steps—course learning, scientific research practice training, and dissertation writing, and highlights nine key points—learning foundation in admission education and training, knowledge acquisition in course learning, application ability in teaching and scientific research practice, innovation ability in academic activities and innovation competitions, topic selection quality in thesis proposal, training quality in mid-term assessment, paper quality in dissertation writing, output quality in thesis defense, and comprehensive quality in diploma awarding. Our exploration and practical experience is shared in this article.

Objective:To explore the application of a scenario-based onsite first-aid skills station in objective structured clinical examination (OSCE).Methods:Based on common scenarios and cases in medical practice, an evaluation framework of the OSCE onsite first-aid skills station—containing assessment indicators, exam room setting, examiner training, and assessment process—was designed to evaluate the onsite first-aid competencies of medical graduates of the five-year program for three consecutive years. SPSS 24.0 was used to perform the Kruskal-Wallis test and Pearson correlation analysis to calculate the correlation between course examination scores and OSCE onsite first-aid skills station assessment scores. Excel was used to calculate the difficulty index and discrimination index of test items.Results:The graduates' OSCE onsite first-aid skills station assessment scores were improved year by year, with a mean score of about 80 points. The station assessment items showed a moderate difficulty level (0.7-0.8), a good discrimination level (>0.4), and good internal consistency (Cronbach's α>0.7). The examiners and examinees had a high recognition of the design and effectiveness of this station assessment method. There was a positive correlation between the OSCE scores and corresponding course scores (2016, r=0.245, P=0.001; 2017, r=0.108, P=0.026; 2018, r=0.198, P=0.006). Conclusions:Through scientific scoring and strict examination management, the OSCE scenario-based onsite first-aid skills station can effectively evaluate examinees' injury treatment competencies in different situations, which can provide a reference for course teaching.

Objective To investigate the influence of changes in blood flow parameters on pulse rate characteristics by taking the advantage of controllable parameters in an experimental cardiopulmonary bypass system.Methods A set of human circulatory system equipped with an in vitro wrist model was established.By changing parameters such as the heart rate,wrist flow,pressure,and system compliance,a photoplethysmography pulse wave signal was obtained from the wrist model,and the time-and frequency-domain indices of pulse rate variability were extracted.Results Changes in heart rate,pressure,and system compliance caused a change in pulse shape,but the time domain indices NN50 and PNN50,which indicate pulse rate variability,were zero,and the other indices and frequency domain indices were in the very low value category.Conclusions In the absence of heart rate variability,hemodynamic changes in heart rate,wrist flow,blood pressure,and system compliance did not produce significant pulse rate variability.This study can provide a reference for studies on pulse rate variability and heart rate using more convenient wrist acquisition equipment.

Objective:To investigate the incidence of venous thromboembolism (VTE) in patients with esophageal cancer (EC).Methods:The retrospective cohort study was conducted. The clinicopathological data of 8 458 EC patients who were admitted to Sichuan Cancer Hospital from January 2017 to December 2021 were collected. There were 6 923 males and 1 535 females, aged (64±9)years. There were 3 187 patients undergoing surgical treatment, and 5 271 cases undergoing non-surgical treatment. Observation indicators: (1) incidence of VTE in EC patients; (2) treatment and outcomes of patients with VTE. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was analyzed using the nonparameter rank sum test. Count data were expressed as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Comparison of ordinal data was analyzed using the nonparameter rank sum test. Results:(1) Incidence of VTE in EC patients. Of 8 458 EC patients, 175 cases developed VTE, with an incidence rate of 2.069%(175/8 458). Among 175 VTE patients, there were 164 cases of deep venous thrombosis (DVT), 4 cases of pulmonary embolism (PE), 7 cases of DVT and PE. There were 59 surgical patients and 116 non-surgical patients. There was no significant difference in thrombus type between surgical and non-surgical EC patients with VTE ( χ2=1.95, P>0.05). Of 3 187 surgical patients, the incidence of VTE was 1.851%(59/3 187), including an incidence of 0.157%(5/3 187) of PE. PE accounted for 8.475%(5/59) of surgical patients with VTE. Of 5 271 non-surgical patients, the incidence of VTE was 2.201%(116/5 271), including an incidence of 0.114%(6/5 271) of PE. PE accounted for 5.172%(6/116) of non-surgical patients with VTE. There was no significant difference in the incidence of VTE or PE between surgical patients and non-surgical patients ( χ2=1.20, 0.05, P>0.05). (2) Treatment and outcomes of patients with VTE. Among 175 EC patients with VTE, 163 cases underwent drug treatment, and 12 cases did not receive treatment. Among 163 cases with drug therapy, 158 cases underwent anticoagulant therapy, 5 cases were treated with thrombolysis. All the 163 patients were improved and discharged from hospital. Conclusions:The incidence of VTE in patients with EC is relatively low, as 2.069%. There is no significant difference in the incidence of VTE or thrombus type between surgical EC patients and non-surgical EC patients.

The ideological and political construction of medical courses reveals the educational essence of "truth, goodness, and beauty" in medicine. Scientificity and humanity are the embodiment of "seeking truth" and "advocating goodness" in medicine, and the unity of their content and form reaches the highest level of "advocating beauty". Studying the ideological and political construction of medical courses plays an important role in implementing the fundamental task of fostering virtue through education, and carrying out the Healthy China initiative. In terms of teaching objectives, the goals of ideological and political education in medical courses should not only include the goals of basic literacy goals, such as political literacy, cultural literacy, legal literacy, and moral cultivation, but also include professional literacy goals, such as medical humanistic cultivation. Thus, a "five in one" model of ideological and political education in medical courses will be established. In the practical path, it is suggested to explore from five aspects that changing the educational concept and strengthening the educational awareness, establishing teaching objectives and clarifying education direction, digging deeply into the ideological and political elements and clearing teaching content, innovating teaching methods and improving teaching effectiveness, and constructing evaluation indicators and evaluating teaching effectiveness scientifically.