Objective To investigatethe relationship between gastroesophageal reflux disease (GERD) symptoms and clinicopathological characteristics, p53 expression, and survival of Chinese patients with esophageal adenocarcinoma. Methods A total of 3882 patients with esophageal adenocarcinoma, 970 matched patients with esophageal squamous cell carcinoma, and 970 matched patients with gastric cardia adenocarcinoma were included to compare the incidence of GERD symptoms. Patients with esophageal adenocarcinoma were divided into two groups according to the presence and absence of GERD symptoms. The differences in clinicopathological characteristics and p53 expression between the two groups were compared by chi-square test, and the differences in survival between the two groups were compared by landmark analysis. Results The incidence of GERD symptoms increased successively in esophageal squamous cell carcinoma, esophageal adenocarcinoma, and gastric cardia adenocarcinoma. In patients with esophageal adenocarcinoma, the proportions of male, less than 65 years old, lower thoracic tumors, tumors without squamous cell carcinoma, poorly differentiation, early tumors (stage 0-I), and p53-positive tumors in the group with GERD symptoms were higher than those in the group without GERD symptoms; moreover, the long-term survival (≥15 years) was better. Conclusion GERD symptom is an important clinical sign of esophageal adenocarcinoma. It is closely related to specific clinicopathological characteristics, p53 overexpression, and good long-term prognosis.

Chronic hepatitis B virus (HBV) infection remains a major global public health concern. The persistent presence of intrahepatic covalently closed circular DNA (cccDNA) poses a major challenge to the complete cure of chronic HBV infection. Therefore, identifying reliable and effective serological surrogate markers for cccDNA holds great clinical significance in evaluating antiviral efficacy, predicting prognosis, and guiding the clinical management of chronic HBV-infected patients. In recent years, serum HBV RNA has emerged as a promising non-invasive alternative marker for cccDNA, offering the potential for monitoring disease progression and predicting prognosis in chronic HBV-infected patients. In this review, we summarize recent studies on HBV RNA, highlighting its ability to assess the immune and histological status of patients, and discussing its value in guiding the timing of antiviral therapy. Furthermore, we systematically summarize the clinical significance of HBV RNA in multiple domains: monitoring viral replication, evaluating antiviral treatment efficacy, predicting relapse after treatment cessation, and guiding new antiviral strategies. This review aims to provide clinicians with valuable insights for better utilizing this marker in the clinical management of chronic HBV infection.

Objective To explore the therapeutic effect of "jian pi yi qi yang xue zhi tong" for treating bone metastasis of breast cancer and the clinical effect of improving pain symptoms. Methods A total of 80 patients with bone metastases from breast cancer were admitted. They were randomly divided into an observation group and a control group according to the random-number-table method. The control group was treated with zoledronic acid, whereas the observation group was treated with jian pi yi qi yang xue zhi tong prescriptions based on the control group. We compared the differences in the effects of different treatment plans on patients' pain symptoms, physical condition, and quality of life, as well as TNF-α, IL-6, and CRP levels. Results No significant difference was found in pain scores, physical condition scores, sleep quality scores, and quality of life scores, as well as CRP, IL-6, and TNF-α levels between the two groups of patients before treatment (all P > 0.05). At one, two, and four months after treatment, the pain scores of both groups of patients decreased, with the observation group having lower scores than the control group (P < 0.05). The total pain-relief rate of the observation group was higher than that of the control group (P < 0.05). After treatment, the sleep quality scores and the levels of CRP, IL-6, and TNF-α decreased, with the observation group having lower values than the control group (P < 0.05). The physical condition scores and the quality of life scores of both groups improved, with the observation group having higher values than the control group (P < 0.05). Conclusion In patients with bone metastases from breast cancer, oral treatment with jian pi yi qi yang xue zhi tong prescription has a significant effect. It substantially improves the pain symptoms, enhances the quality of sleep and life of patients, and reduces the levels of CRP, IL-6, and TNF-α.

BACKGROUND:Currently,the verification of the precision of personalized bone models is usually performed by methods such as paired t-tests or intraclass correlation coefficient,but such methods often require the production of large batches of models,which do not satisfy the need for immediate use of personalized models. OBJECTIVE:To study the feasibility of establishing the equivalent model to verify the precision of the personalized bone model rapidly. METHODS:Bone CT images of three adults were randomly obtained for reconstruction.3D printing was used to create personalized bone models,and then the personalized bone models were scanned using CT and reconstructed.Mimics was used to compare the reconstructed models of bone CT images with the bone CT images.Geomagic Studio was used to analyze the fitting deviation between the reconstruction model of personalized bone model CT image and the reconstruction model of skeletal CT image.The 3D-printed personalized bone model was measured against the measurement positions and dimensions marked on the reconstruction model of skeletal CT image,and the error was calculated. RESULTS AND CONCLUSION:(1)By comparing the reconstructed bone CT image model with the bone CT scan image,the two were compatible in terms of anatomical structure and morphology,and the contours almost overlapped.(2)By fitting bias analysis,the standard bias was 0.176,0.226,and 0.143 mm in order,and all the results were<0.25 mm.(3)By measuring and calculating the model,the mean relative errors were 0.44%,0.21%,and 0.13%,and all the results were within 5%error.(4)The constructed equivalent model was in line with the basic conditions for making personalized bone models.The established equivalent model met the clinical needs and design requirements,and it was feasible to use the method of the equivalent model to verify the precision of the personalized bone model quickly.(5)This method could provide a targeted and rapid way to verify the precision of personalized bone models.It could achieve the goal of providing immediate clinical use without the need to produce large batches of models compared to conventional methods such as paired t-tests or intraclass correlation coefficient.

Icariin,which belongs to the class of flavonoids,is the main active ingredient of the traditional tonic Chinese herb Epimedii Folium.Modern studies have shown that icariin has a wide range of effects on the male reproductive system.It has various pharmacological activities such as regulating cell proliferation and apoptosis,antioxidants,promoting testosterone secretion,improving erectile function,inhibiting prostate cancer cell migration,invasion,and regulating cell cycle.It has research value and application prospects in the field of urology and assisted reproduction.Therefore,Icariin's pharmacological effects and molecular mechanisms on the male reproductive system are reviewed in this paper combined with literature visualization analysis.It is expected to provide a theoretical basis for the therapeutic value development and application of icariin in male reproductive health.

Objective:To investigate the values of two-dimensional and three-dimensional echocardiographic parameters in predicting pulmonary vascular resistance (PVR) in chronic pulmonary thromboembolic pulmonary hypertension (CTEPH).Methods:A total of 141 patients diagnosed with CTEPH in China-Japan Friendship Hospital from November 2015 to December 2022 were included. Two-dimensional echocardiographic indicators reflecting PVR were constructed according to the calculation formula of PVR: echocardiographic estimated systolic pulmonary artery pressure (sPAP Echo)/left ventricular end-diastolic diameter (LVIDd), echocardiographic estimated mean pulmonary artery pressure (mPAP Echo)/LVIDd. sPAP Echo/left ventricular end-diastolic volume (LVEDV), sPAP Echo/left ventricular cardiac output (LVCO) were measured by three-dimensional echocardiography. The correlations between two-dimensional and three-dimensional echocardiographic ratios and invasive PVR were then analyzed using the Spearman correlation method. Using receiver operating characteristic curve analysis, cut-off values for the ratios were generated to identify patients with PVR>1 000 dyn·s -1·cm -5. Pre- and postoperative hemodynamics and echocardiographic data were analyzed, as well as the correlation between the reduction rate of the echocardiographic index and PVR in 54 patients who underwent pulmonary endarterectomy (PEA). Results:sPAP Echo/LVIDd, sPAP Echo/LVEDV and sPAP Echo/LVCO were moderately correlated with PVR( rs=0.62, 0.52, 0.63, both P<0.001). The ratio of sPAP Echo to LVEDV, when greater than or equal to 1.41, had a sensitivity of 0.800 and a specificity of 0.930 for determining PVR >1 000 dyn·s -1·cm -5 (AUC=0.860, P<0.001). Similarly, the ratio of sPAP Echo to LVIDd, when greater than or equal to 2.14, had a sensitivity of 0.647 and a specificity of 0.861 for determining PVR >1000 dyn·s -1·cm -5 (AUC=0.830, P<0.001). The sPAP Echo/LVIDd and mPAP Echo/LVIDd significantly decreased after PEA (both P<0.001). The sPAP Echo/LVIDd and mPAP Echo/LVIDd reduction rate (ΔsPAP Echo/LVIDd and ΔmPAP Echo/LVIDd) were significantly correlated with PVR reduction rate (ΔPVR), respectively ( rs=0.61, 0.63, both P<0.05). Conclusions:Two-dimensional ratio sPAP Echo/LVIDd and three-dimensional ratio sPAP Echo/LVEDV can be used to noninvasively estimate PVR in CTEPH patients. The conventional ratio sPAP Echo/LVIDd is convenient and reproducibly suitable for monitoring the improvement of PVR before and after treatment, and its ratio of 2.14 can predict the significant increase of PVR in CTEPH patients (>1 000 dyn·s -1·cm -5).

Objective It aims to investigate the current status of patient trust in physicians among inpatients at tertiary public hospitals in China and to analyze the factors influencing this trust.The goal is to provide insights for enhancing patient trust and improving doctor-patient relationships.Methods Relying on the third"third party evaluation of national action to improve medical services"project,it surveyed inpatients from 136 tertiary public hospitals across 31 provinces(including autonomous regions and municipalities)and the Xinjiang Production and Construction Corps.A total of 21 092 inpatient questionnaires were returned.Data obtained were statistically analyzed using R software version 4.3.2.Results The trust level in attending physicians among inpatients at tertiary public hospitals in China was found to be 98.37％.Influential factors on this trust level included patient occupation,annual family income,type and region of the hospital and so on.Conclusion Overall,the level of trust in physicians among inpatients at tertiary public hospitals in China is high,though regional differences exist.It should pay attention to non-medical factors such as inpatient ward environment and hospital service quality.Improving these aspects can enhance the overall patient experience,further improve doctor-patient relationships.

Objective It aims to investigate the status quo of nurses'emotional exhaustion in tertiary public hospitals in China and analyze its influencing factors,so as to provide suggestions for formulating targeted policy measures to reduce nurses'emotional exhaustion.Methods Relying on the fifth"The Third-Party Evaluation of the China Healthcare Improvement Initiatives"project,it surveyed nurses from 143 tertiary public hospitals across 31 provinces(including autonomous regions and municipalities)and the Xinjiang Production and Construction Corps.Univariate analyses were performed using the Pearson chi-square test.Multifactorial analyses were performed using ordered multicategorical logistic regression analysis.Results The score of nurses'emotional exhaustion in tertiary public hospitals in China was 8.00(2.00～16.00),of which mild exhaustion accounted for 79.00％,moderate exhaustion accounted for 10.00％,and severe exhaustion accounted for 11.00％.Gender,age,number of children,region,type of hospital,department,employment form,assume scientific research task,excessive workload,salary and hospitals carry out psychological guidance were the influencing factors of nurses'emotional exhaustion.Conclusion Nurses in tertiary public hospitals in China are at a mild level of emotional exhaustion,but in some groups the degree is more serious.Policy makers and hospital managers should focus on special groups,implement the reform of salary system,reduce nurses'workload,reasonably arrange working hours,improve the working environment of hospitals,and strengthen nurses'psychological guidance.

Objective It aims to investigate the current status of patient trust in physicians among inpatients at tertiary public hospitals in China and to analyze the factors influencing this trust.The goal is to provide insights for enhancing patient trust and improving doctor-patient relationships.Methods Relying on the third"third party evaluation of national action to improve medical services"project,it surveyed inpatients from 136 tertiary public hospitals across 31 provinces(including autonomous regions and municipalities)and the Xinjiang Production and Construction Corps.A total of 21 092 inpatient questionnaires were returned.Data obtained were statistically analyzed using R software version 4.3.2.Results The trust level in attending physicians among inpatients at tertiary public hospitals in China was found to be 98.37％.Influential factors on this trust level included patient occupation,annual family income,type and region of the hospital and so on.Conclusion Overall,the level of trust in physicians among inpatients at tertiary public hospitals in China is high,though regional differences exist.It should pay attention to non-medical factors such as inpatient ward environment and hospital service quality.Improving these aspects can enhance the overall patient experience,further improve doctor-patient relationships.

Objective It aims to investigate the status quo of nurses'emotional exhaustion in tertiary public hospitals in China and analyze its influencing factors,so as to provide suggestions for formulating targeted policy measures to reduce nurses'emotional exhaustion.Methods Relying on the fifth"The Third-Party Evaluation of the China Healthcare Improvement Initiatives"project,it surveyed nurses from 143 tertiary public hospitals across 31 provinces(including autonomous regions and municipalities)and the Xinjiang Production and Construction Corps.Univariate analyses were performed using the Pearson chi-square test.Multifactorial analyses were performed using ordered multicategorical logistic regression analysis.Results The score of nurses'emotional exhaustion in tertiary public hospitals in China was 8.00(2.00～16.00),of which mild exhaustion accounted for 79.00％,moderate exhaustion accounted for 10.00％,and severe exhaustion accounted for 11.00％.Gender,age,number of children,region,type of hospital,department,employment form,assume scientific research task,excessive workload,salary and hospitals carry out psychological guidance were the influencing factors of nurses'emotional exhaustion.Conclusion Nurses in tertiary public hospitals in China are at a mild level of emotional exhaustion,but in some groups the degree is more serious.Policy makers and hospital managers should focus on special groups,implement the reform of salary system,reduce nurses'workload,reasonably arrange working hours,improve the working environment of hospitals,and strengthen nurses'psychological guidance.