Objective To investigate the screening results and factors affecting abnormal detection rates among high-risk groups of esophageal cancer and to explore effective intervention measures. Methods We investigated and collected the information on gender, education level, age, marital status, symptoms of reflux esophagitis (heartburn, acid reflux, belching, hiccup, foreign body sensation in the pharynx, and difficulty swallowing), consumption of pickled vegetables, salt use, and esophageal cancer incidence of villagers in a natural village in Wenfeng District, Anyang City, Henan Province. Changes in reflux esophagitis symptoms in the high-incidence area of esophageal cancer before and after 16 years were observed, and the relationship of such changes with esophageal cancer was analyzed. Results In 2008, 711 cases were epidemiologically investigated, including 213 cases with one of the symptoms of reflux esophagitis such as heartburn, acid reflux, belching, hiccups, foreign body sensation in the pharynx, and difficulty swallowing (sorted in accordance with the abovementioned symptoms; if there are multiple symptoms, then the former is taken); 55 cases with at least two related symptoms, among which the most symptom was heartburn in 108 cases (15.1%); followed by acid reflux, belching, etc. In 2024, the same group of people was investigated, and eight people were missing because of relocation. A total of 703 people were successfully investigated, of which 189 cases (26.8%) had one of the symptoms of reflux esophagitis, such as heartburn (sorted in accordance with relevant symptoms, if there are multiple symptoms, then the former will be selected); 167 cases (23.7%) had at least two related symptoms, among which the most symptom was heartburn in 139 cases (19.7%); followed by acid reflux. Over 16 years, among the 703 people investigated, 45 cases had esophageal cancer and they had one or more of the abovementioned symptoms. No significant differences in the reflux esophagitis-like symptoms were found between 2008 and 2024 (P=0.26); no significant differences in the composition of reflux esophagitis-like symptoms were found between 2008 and 2024 (P=0.299). Conclusion The detection rate of reflux esophagitis-related symptoms in the population in a high-risk area of esophageal cancer has not decreased in the past 16 years, and the high-risk factors still exist. Esophageal cancer is closely related to reflux esophagitis, and clinical practice can provide early diagnosis and treatment for high-risk population.

Objective To investigate the relationship between tooth loss and the occurrence of esophageal cancer in a natural village in Wenfeng District, Anyang City, Henan Province. Methods A prospective cohort study was conducted to observe the occurrence of tooth loss and esophageal cancer among the asymptomatic residents of the natural village for 16 years from January 2008 to July 2024. Data were analyzed by chi-square test, binary logistic regression, and restricted cubic spline. Results Among the total population of 711 cases, 136 cases were lost to follow-up and 575 cases were included in the final statistics, including 45 cases with esophageal cancer. Significant statistical difference was found between esophageal cancer patients with and without tooth loss (P<0.05). Logistic regression analysis showed that tooth loss was associated with the occurrence of esophageal cancer (OR=3.977, 95%CI: 1.543-10.255). After the adjustment for confounders, tooth loss remained significantly associated with the occurrence of esophageal cancer (OR=3.038, 95%CI: 1.035-8.914). A nonlinear dose-response relationship was observed between the number of teeth lost and the incidence of esophageal cancer. When the number of teeth lost was less than 12, the risk of esophageal cancer increased with the number of teeth lost. When more than 12 teeth were lost, the risk of esophageal cancer decreased as the number of teeth lost increased. Conclusion Tooth loss is a risk factor for the occurrence of esophageal cancer in this natural village. When the number of teeth lost is less than 12, the risk of esophageal cancer increases with the number of teeth lost.

Objective:To investigate the G/P genotypes of group A rotavirus（RVA）in the 2023 sentinel surveillance in Jiangsu Province，and to conduct a molecular characterization analysis of the whole-genome sequences of four G9P［4］genotype RVA strains identified during surveillance.Methods:A total of 212 RVA-positive specimens collected from the surveillance system in 2023 were subjected to G/P genotyping using multiplex nested RT-PCR. Whole-genome sequencing was performed on six G9P［4］strains. The resulting complete genome sequences were preliminarily genotyped using BLAST，followed by comprehensive molecular characterization analyses utilizing BioEdit 7.0.5，MAFFT，MEGA 7.0，and iTOL software.Results:The overall RVA positivity rate was 6.22%. The predominant G/P combination in both outpatient and inpatient settings was G8P［8］. Among the six G9P［4］strains，four were successfully sequenced. All four exhibited the genotype constellation G9-P［4］-I2-R2-C2-M2-A2-N1-T2-E2-H2. While the NSP2 gene belonged to the N1 genotype，all other genes corresponded to the DS-1-like genogroup. Phylogenetically，the four Jiangsu G9P［4］strains clustered within Lineage V of the VP7 gene and formed a distinct minor subclade within the N1 branch of the NSP2 gene. Unique amino acid substitutions were identified at multiple VP7 neutralization antigenic epitope sites when compared to vaccine strains.Conclusions:The predominant circulating RVA strain in Jiangsu province during 2023 was G8P［8］. Concurrently，the relatively uncommon G9P［4］-N1 strain was detected. This strain exhibited significant amino acid differences at key epitopes compared to vaccine strains. Enhancing the proportion of whole-genome sequencing in RVA surveillance is warranted to obtain more detailed genetic information，thereby providing crucial data to support future vaccine development and optimization strategies.

Objective:To investigate the G/P genotypes of group A rotavirus（RVA）in the 2023 sentinel surveillance in Jiangsu Province，and to conduct a molecular characterization analysis of the whole-genome sequences of four G9P［4］genotype RVA strains identified during surveillance.Methods:A total of 212 RVA-positive specimens collected from the surveillance system in 2023 were subjected to G/P genotyping using multiplex nested RT-PCR. Whole-genome sequencing was performed on six G9P［4］strains. The resulting complete genome sequences were preliminarily genotyped using BLAST，followed by comprehensive molecular characterization analyses utilizing BioEdit 7.0.5，MAFFT，MEGA 7.0，and iTOL software.Results:The overall RVA positivity rate was 6.22%. The predominant G/P combination in both outpatient and inpatient settings was G8P［8］. Among the six G9P［4］strains，four were successfully sequenced. All four exhibited the genotype constellation G9-P［4］-I2-R2-C2-M2-A2-N1-T2-E2-H2. While the NSP2 gene belonged to the N1 genotype，all other genes corresponded to the DS-1-like genogroup. Phylogenetically，the four Jiangsu G9P［4］strains clustered within Lineage V of the VP7 gene and formed a distinct minor subclade within the N1 branch of the NSP2 gene. Unique amino acid substitutions were identified at multiple VP7 neutralization antigenic epitope sites when compared to vaccine strains.Conclusions:The predominant circulating RVA strain in Jiangsu province during 2023 was G8P［8］. Concurrently，the relatively uncommon G9P［4］-N1 strain was detected. This strain exhibited significant amino acid differences at key epitopes compared to vaccine strains. Enhancing the proportion of whole-genome sequencing in RVA surveillance is warranted to obtain more detailed genetic information，thereby providing crucial data to support future vaccine development and optimization strategies.

This study analyzed the epidemiological characteristics and trends of respiratory syncytial virus (RSV) infections among inpatients with acute respiratory infections (ARI) in a children′s hospital in Shenzhen City inpatients from 2020 to 2023. From January 2020 to December 2023, multiple reverse transcription polymerase chain reaction (RT-PCR) combined with capillary electrophoresis fragment analysis technology was used to detect the nucleic acids of 12 respiratory pathogens, including RSV, in hospitalized children diagnosed with ARI. The patients were divided into six age groups: 0 to <6 months, 6 months to <1 year, 1 to <2 years, 2 to <5 years, 5 to <10 years, and 10 to <18 years. A total of 53 033 children were tested, including 6 830 RSV positive cases, with an overall positivity rate of 12.88%. The annual RSV positivity rates from 2020 to 2023 were 20.04%, 16.18%, 4.89%, and 13.33%, respectively, with statistically significant differences between the years ( χ2=1 185.994, P<0.001). The positive rate of RSV detection decreased with increasing age across all years (all P trend<0.05). From 2020 to 2023, the proportion of RSV-positive cases aged 2 to 5 years and older showed an increasing trend ( P trend<0.001 for all years). Compared to 2023, the median age of RSV-infected children was lower in 2020 ( Z=7.826, P<0.001) and 2021 ( Z=6.106, P<0.001). The proportion of severe infections requiring ICU admission did not change significantly across all years ( χ2=0.179, P=0.981). The RSV epidemic season in 2020 mainly occurred during 28-43 weeks, and in 2021, it spanned from 22-43 weeks. However, in 2022, the season was delayed until the 49th week and lasted for three weeks. In 2023, the seasonal epidemic appeared earlier, starting in the 14th week and lasting for 28 weeks. From 2020 to 2023, the rate of RSV co-infections with other pathogens (mycoplasma pneumoniae, human parainfluenza virus, human bocavirus, human coronavirus, human metapneumovirus, and influenza A) significantly increased (all P trend<0.01). In conclusion, the epidemiological characteristics of RSV infections in Shenzhen Children′s Hospital changed from 2020 to 2023. In 2022, there were only delayed, low-intensity and short-lived seasonal epidemics. However, in 2023, there was an earlier and prolonged epidemic, with increased infections in children aged 2 to 5 years and older and a rise in co-infections, while the proportion of severe infections requiring ICU admission remained unchanged.

Objective:To investigate lymph node metastasis(LNM)in the prostatic anterior fat pad(PAFP)of PCa patients after robot-assisted radical prostatectomy(RARP),and analyze the clinicopathological features and prognosis of LNM in the PAFP.Methods:We retrospectively analyzed the clinicopathological data on 1 003 cases of PCa treated by RARP in the Department of Urolo-gy of PLA General Hospital from January 2017 to December 2022.All the patients underwent routine removal of the PAFP during RARP and pathological examination,with the results of all the specimens examined and reported by pathologists.Based on the pres-ence and locations of LNM,we grouped the patients for statistical analysis,compared the clinicopathological features between different groups using the Student's t,Mann-Whitney U and Chi-square tests,and conducted survival analyses using the Kaplan-Meier and Log-rank methods and survival curves generated by Rstudio.Results:Lymph nodes were detected in 77(7.7％)of the 1 003 PAFP samples,and LNM in 11(14.3％)of the 77 cases,with a positive rate of 1.1％(11/1 003).Of the 11 positive cases,9 were found in the upgraded pathological N stage,and the other 2 complicated by pelvic LNM.The patients with postoperative pathological stage≥T3 constituted a significantly higher proportion in the PAFP LNM than in the non-PAFP LNM group(81.8％[9/11]vs 36.2％[359/992],P=0.005),and so did the cases with Gleason score ≥8(87.5％[7/8]vs 35.5％[279/786],P=0.009).No statisti-cally significant differences were observed in the clinicopathological features and biochemical recurrence-free survival between the pa-tients with PAFP LNM only and those with pelvic LNM only.Conclusion:The PAFP is a potential route to LNM,and patients with LNM in the PAFP are characterized by poor pathological features.There is no statistically significant difference in biochemical recur-rence-free survival between the patients with PAFP LNM only and those with pelvic LNM only.Routine removal of the PAFP and inde-pendent pathological examination of the specimen during RARP is of great clinical significance.

Objective:To investigate the impacts of preoperative regional arterial infusion chemotherapy(PRAC)combined with laparoscopic surgery on the efficacy,safety,immune function,and serum levels of matrix metallopro-teinase-7(MMP-7)and human cartilage glycoprotein(YKL-40)in patients with colorectal cancer.Methods:This study retrospectively selected 164 patients with colorectal cancer(January 2014 to December 2016)as the research subjects.Patients who underwent conventional treatment and laparoscopic surgery were included into control group(81 cases);patients undergoing PRAC+laparoscopic surgery were included into observation group(83 cases).The clinical efficacy,stress response indicators,immune function related indicators,changes in serum MMP-7 and YKL-40 levels,and occurrence of adverse reactions in two groups were observed before treatment(T0)and after 4 cycles of chemotherapy(T1).Results:At T1,the total effective rate of observation group(85.54%)was greatly higher than that of control group(67.90%)(P<0.05).The levels of cortisol(Cor),neutrophile granulocyte(NE),white blood cell count(WBC),and interleukin(IL)-6 were prominently increased in both groups(P<0.05),but the levels of these indicators in observation group were greatly lower than those in control group(P<0.05).The levels of IgM and IgA in both groups were greatly reduced(P<0.05),but the levels of IgM and IgA in observation group were prominently higher than those in control group(P<0.05).The levels of MMP-7 and YKL-40 decreased in both groups(P<0.05),and the level in observation group was prominently lower than that in control group(P<0.05).There was no significant difference in the overall incidence of adverse reactions and 5-year survival rate between control group and observation group(P>0.05).Conclusion:The combination of PRAC and laparoscopic surgery has prominent healing effects and certain safety in patients with colorectal cancer.It can effectively improve immune function,reduce serum MMP-7 and YKL-40 levels.

Objective:This study aimed to explore the serum levels of soluble programmed cell death protein 1 (sPD-1) and soluble programmed cell death-ligand 1 (sPD-L1) in patients with spontaneous intracerebral hemorrhage (ICH) and their clinical value in the prognostic analysis.Methods:This prospective cohort study included patients aged ≥18 years admitted to the department of critical care medicine at the Affiliated Hospital of Zunyi Medical University between January 2022 and October 2024 with a first episode of ICH presenting within 24 hours of onset. Patients with hemorrhage caused by other causes (e.g., tumor, medication and trauma) or incomplete data were excluded. Based on 28-day all-cause mortality, patients were divided into survival group and non-survival group. According to the 60-day neurological outcome, patients were divided into good neurological outcome group and poor neurological outcome group. Clinical and imaging data were collected, along with venous blood samples obtained within 24 hours of admission to measure serum levels of sPD-1 and sPD-L1. Predictive indicators were identified using LASSO-Logistic regression analysis was used to identify predictive indicators, and a nomogram was constructed to visualize the prediction model. Model performances were evaluated using receiver operating characteristic curves, decision curve analysis, calibration curves, and the Hosmer-Lemeshow test.Results:A total of 155 patients were included: 101 in the survival group and 54 in the death group; 56 in the favorable neurological outcome group and 99 in the poor neurological outcome group. Serum sPD-1 concentrations were significantly lower in the death group and poor neurological outcome group compared to the survival group and favorable neurological outcome group, respectively. Conversely, serum sPD-L1 concentrations were significantly higher in the death group and poor neurological outcome group compared to the survival group and favorable neurological outcome group (all P < 0.05). Serum sPD-1 and sPD-L1 were identified as predictors of 28-day mortality risk. A nomogram incorporating seven indicators—brainstem hemorrhage, hemorrhage volume, obstructive hydrocephalus, surgical intervention, admission NIHSS score, and admission serum sPD-1 and sPD-L1 levels—demonstrated superior predictive performance [AUC=0.984 (95% CI: 0.968-1.000)] compared to sPD-1 alone (AUC=0.712) or sPD-L1 alone (AUC=0.753). Serum sPD-1 was a predictor of poor 60-day neurological outcome. A nomogram incorporating obstructive hydrocephalus, admission NIHSS score, and admission serum sPD-1 level [AUC=0.818 (95% CI: 0.754-0.882)] outperformed sPD-1 alone (AUC=0.637) or sPD-L1 alone (AUC=0.602). Conclusions:Serum levels of sPD-1 were significantly lower in the non-survivors and the patients with poor neurological outcomes compared to the survivors and the patients with good neurological outcomes. However, serum levels of sPD-L1 were significantly higher in the non-survivors and the patients with poor neurological outcome. Serum sPD-1 was an independent predictor of 28-day mortality risk and 60-day poor neurological outcome; serum sPD-L1 was an independent predictor of 28-day mortality risk. A nomogram prediction model incorporating sPD-1 and sPD-L1 demonstrated good predictive performance for mortality risk and poor neurological outcome.

OBJECTIVE: This study aimed to investigate the impact of glycemic control and diabetes duration on subsequent myocardial infarction (MI) in patients with both coronary heart disease (CHD) and type 2 diabetes (T2D). METHODS: We conducted a retrospective cohort study of 33,238 patients with both CHD and T2D in Shenzhen, China. Patients were categorized into 6 groups based on baseline fasting plasma glucose (FPG) levels and diabetes duration (from the date of diabetes diagnosis to the baseline date) to examine their combined effects on subsequent MI. Cox proportional hazards regression models were used, with further stratification by age, sex, and comorbidities to assess potential interactions. RESULTS: Over a median follow-up of 2.4 years, 2,110 patients experienced MI. Compared to those with optimal glycemic control (FPG < 6.1 mmol/L) and shorter diabetes duration (< 10 years), the fully-adjusted hazard ratio ( HR) (95% Confidence Interval [95% CI]) for those with a diabetes duration of ≥ 10 years and FPG > 8.0 mmol/L was 1.93 (95% CI: 1.59, 2.36). The combined effects of FPG and diabetes duration on MI were largely similar across different age, sex, and comorbidity groups, although the excess risk of MI associated with long-term diabetes appeared to be more pronounced among those with atrial fibrillation. CONCLUSION Our study indicates that glycemic control and diabetes duration significant influence the subsequent occurrence of MI in patients with both CHD and T2D. Tailored management strategies emphasizing strict glycemic control may be particularly beneficial for patients with longer diabetes duration and atrial fibrillation.
Humans ; Diabetes Mellitus, Type 2/blood* ; Male ; Female ; Middle Aged ; Aged ; Coronary Disease/complications* ; Myocardial Infarction/etiology* ; Retrospective Studies ; China/epidemiology* ; Glycemic Control ; Blood Glucose ; Adult ; Risk Factors ; Time Factors

Objective:To investigate the impacts of preoperative regional arterial infusion chemotherapy(PRAC)combined with laparoscopic surgery on the efficacy,safety,immune function,and serum levels of matrix metallopro-teinase-7(MMP-7)and human cartilage glycoprotein(YKL-40)in patients with colorectal cancer.Methods:This study retrospectively selected 164 patients with colorectal cancer(January 2014 to December 2016)as the research subjects.Patients who underwent conventional treatment and laparoscopic surgery were included into control group(81 cases);patients undergoing PRAC+laparoscopic surgery were included into observation group(83 cases).The clinical efficacy,stress response indicators,immune function related indicators,changes in serum MMP-7 and YKL-40 levels,and occurrence of adverse reactions in two groups were observed before treatment(T0)and after 4 cycles of chemotherapy(T1).Results:At T1,the total effective rate of observation group(85.54%)was greatly higher than that of control group(67.90%)(P<0.05).The levels of cortisol(Cor),neutrophile granulocyte(NE),white blood cell count(WBC),and interleukin(IL)-6 were prominently increased in both groups(P<0.05),but the levels of these indicators in observation group were greatly lower than those in control group(P<0.05).The levels of IgM and IgA in both groups were greatly reduced(P<0.05),but the levels of IgM and IgA in observation group were prominently higher than those in control group(P<0.05).The levels of MMP-7 and YKL-40 decreased in both groups(P<0.05),and the level in observation group was prominently lower than that in control group(P<0.05).There was no significant difference in the overall incidence of adverse reactions and 5-year survival rate between control group and observation group(P>0.05).Conclusion:The combination of PRAC and laparoscopic surgery has prominent healing effects and certain safety in patients with colorectal cancer.It can effectively improve immune function,reduce serum MMP-7 and YKL-40 levels.