Objective To explore the safety of minimally invasive esophagectomy (MIE) with three-field lymphadenectomy (3-FL) for esophageal squamous cell carcinoma (ESCC) by comparing the short-term outcomes between the 3-FL and the two-field lymphadenectomy (2-FL) in MIE. Methods The clinical data of patients with ESCC who underwent minimally invasive McKeown esophagectomy in our hospital from July 2015 to March 2022 were collected retrospectively. Patients were divided into a 3-FL group and a 2-FL group according to lymph node dissection method. And the clinical outcomes and postoperative complications were compared between the two groups. Results A total of 257 patients with ESCC were included in this study. There were 211 males and 46 females with an average age of 62.2±8.1 years. There were 109 patients in the 3-FL group and 148 patients in the 2-FL group. The operation time of the 3-FL group was about 20 minutes longer than that of the 2-FL group (P<0.001). There was no statistical difference between the two groups in the intraoperatve blood loss (P=0.376). More lymph nodes (P<0.001) and also more positive lymph nodes (P=0.003) were obtained in the 3-FL group than in the 2-FL group, and there was a statistical difference in the pathological N stage between the two groups (P<0.001). But there was no statistical difference in the incidence of anastomotic leak (P=0.667), chyle leak (P=0.421), recurrent laryngeal nerve injury (P=0.081), pulmonary complications (P=0.601), pneumonia (P=0.061), cardiac complications (P=0.383), overall complications (P=0.147) or Clavien-Dindo grading (P=0.152) between the two groups. Conclusion MIE 3-FL can improve the efficiency of lymph node dissection and the accuracy of tumor lymph node staging, but it does not increase the postoperative complications, which is worthy of clinical application.

Objective: To investigate the trends in incidence and mortality of lung cancer in Kaihua County, Zhejiang Province from 2011 to 2022, so as to provide insights into improving lung cancer prevention and control strategy. Methods: The incidence and mortality of lung cancer in Kaihua County from 2011 to 2022 were collected through Zhejiang Provincial Chronic Disease Surveillance Information Management System. The crude incidence, standardized incidence, crude mortality and standardized mortality of lung cancer were analyzed, and the trends in incidence and mortality of lung cancer were evaluated using average annual percent change (AAPC). Results: The crude and standardized incidence of lung cancer appeared a tendency towards an increase (AAPC=5.409% and 2.957%, both P<0.05) from 2011 to 2022, with an average annual crude incidence of 75.17/105 and average annual standardized incidence of 44.37/105. Average annual crude incidence (100.16/105 vs. 48.55/105) and standardized incidence (58.03/105 vs. 30.61/105) of lung cancer was higher in males than in females (both P<0.05). The crude incidence of lung cancer in males appeared a tendency towards an increase (AAPC=2.878%, P<0.05), with no significant changing patterns seen in standardized incidence (P>0.05). The crude and standardized incidence of lung cancer in females showed a tendency towards an increase (AAPC=11.596% and 10.464%, both P<0.05). The crude incidence of lung cancer increased rapidly among residents at ages of 45 years and older, and peaked among residents at ages of 80 to 84 years (32.11/105). The crude and standardized mortality of lung cancer appeared a tendency towards a rise and decline (AAPC=1.554% and -2.491%, both P<0.05) from 2011 to 2022, with an average annual crude and standardized mortality of 52.83/105 and 29.09/105. Average annual crude mortality (77.92/105 vs. 26.10/105) and standardized mortality (43.66/105 vs. 14.33/105) of lung cancer was higher in males than in females (both P<0.05). The crude mortality of lung cancer in males appeared a tendency towards a rise, while the standardized mortality appeared a tendency towards a decline (AAPC=1.436% and -2.553%, both P<0.05). No significant changing patterns were seen in crude and standardized mortality of lung cancer in females (both P>0.05). The crude mortality of lung cancer increased rapidly among residents at ages of 50 years and older, and peaked among residents at ages of 80 to 84 years (37.26/105). Conclusions The incidence and mortality of lung cancer appeared a tendency towards an increase in Kaihua County from 2011 to 2022, and a rapid increase was seen in the incidence of lung cancer in females.

Objective:To investigate the effectiveness of a tiered progressive training model in the standardized residency training of general practice in primary care institutions.Methods:A tiered progression teaching plan was applied for 26 general practice residents who attended the rotation of general practice residency training in Beijing Fangzhuang Community Hearlth Service Center from June 2022 to May 2023. The plan defined the teaching objectives and requirements for different stages, and the Leicester Assessment Package (LAP) and narrative medicine were included in the teaching methods. The effectiveness of the tiered progression training was evaluated through a questionnaire survey on the post competency of general practice residents.Results:There were 12 primary stage residents, 9 intermediate stage residents and 5 advanced stage residents. The post-training scores of general practice residents in all three stages of residents were significantly higher than the pre-training scores ( t=-3.627,-2.073,-5.277,all P<0.05). The scores of basic medical and health services, basic public health services, information utilization ability and management ability, medical knowledge and lifelong learning, interpersonal communication and teamwork, professional quality after six post competency training were significantly higher than those before training in all three stages of residents. The scores of basic medical and health services, basic public health services, medical knowledge and lifelong learning, in primary residents were significantly improved compared with those before training ( t=-3.457,-3.428,-3.063, all P<0.05);the scores of basic public health services, interpersonal communication and teamwork, and professional quality in intermediate residents were significantly higher than those before training ( t=-2.328,-2.100,-1.997, all P<0.05); the scores of basic medical and health services, basic public health services, information utilization ability and management ability, medical knowledge and lifelong learning, interpersonal communication and teamwork, and professional quality in senior residents were significantly higher than those before training ( t=-5.707,-4.542,-2.952,-1.753,-2.705,-2.805, all P<0.05). Conclusion:The application of tiered and progressive training model in the standardized residency training is helpful to improve the post competency of general practice residents.

Objective:To analyze the current status, hotspots and frontiers of pain catastrophizing at home and abroad from 2012 to 2022, so as to provide reference for research on pain catastrophizing in China.Methods:Article retrieval were conducted on the Web of Science, China National Knowledge Infrastructure, WanFang Data and VIP using the Chinese and English keywords "pain catastrophizing". The search period was from January 1, 2012 to August 24, 2022. The articles were analyzed using the CiteSpace software.Results:A total of 2036 English articles and 83 Chinese articles were included. The overall number of articles was increasing year by year, with the countries and institutions with the highest publication volume being the United States and the University of Washington. Research hotspots at home and abroad included pain, low back pain, quality of life, influencing factors, anxiety, depression, joint replacement, scale validation, kinesiophobia and so on.Conclusions:The research on pain catastrophizing abroad is increasingly receiving widespread attention, while domestic research is still in its infancy. Domestic researchers can use various methods to explore the occurrence and influencing factors of pain catastrophizing among different disease groups in China, deeply explore the mechanism of pain catastrophizing, and focus on the correlation between pain catastrophizing and exercise rehabilitation outcomes to help patients cope with pain.

Objective:To study the clinical characteristics, diagnosis, complications and prognosis of neonatal varicella.Methods:From September 2008 to December 2019, the clinical data of hospitalized neonates with varicella in our hospital were retrospectively analyzed.Results:A total of 33 cases of neonatal varicella were reviewed, including 18 males and 15 females, 32 full-term infants and 1 premature infant. The gestational age (GA) was (38.8±1.2)w and birth weight (BW) was (3 670±247)g. The onset of the disease occurred at 14.0 (8.0,19.0)d and was diagnosed at 18.0 (11.5,23.0)d. The hospital stay duration was (8.1±3.7)(2~20)d. All mothers denied varicella history or varicella vaccination. Among the 33 infants, 29 had a history of varicella/zoster exposure. All 33 infants had typical rash and 25 had fever, body temperature (38.3±0.6) ℃ and duration (2.4±1.4) d. 13 cases were congenital varicella, 20 cases were acquired varicella. 24 cases abnormality of cardiac enzymes, 11 cases skin infection, 8 cases liver damage, 4 cases pneumonia, 6 cases granulocytopenia/agranulocytosis, 9 cases anemia, 4 cases sepsis and 1 case viral encephalitis were diagnosed. 20 infants received intravenous antiviral therapy (acyclovir), 17 were treated with antibiotics, 15 were given intravenous immunoglobulin (IVIG), 8 received both antiviral therapy and IVIG and 6 were treated with recombinant human granulocyte stimulating factor. 31 infants were cured and discharged. 2 infants were discharged after improvement of rashes. All infants reported complete recovery on telephone follow-up.Conclusions:Most neonatal varicella cases have a definite exposure history. Besides rashes, complications including pneumonia, liver damage, myocardial injury, granulocytopenia/agranulocytosis, viral encephalitis are common. Intravenous antiviral therapy with acyclovir and combined treatment of IVIG and symptomatic support can often achieve a good prognosis.

Objective:To investigate the mental health status and its influencing factors in people under COVID-19 quarantine.Methods:A total of 130 people under quarantine in a centralized isolation site in Beijing from October 21 2021 to November 12 2021 were included in the study. The demographic data were collected, and the self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used for evaluation of mental health status.Results:One hundred and eleven people completed the survey; there were 10 people with anxiety (9.0%) and 34 people with depression (30.6%) among the study subjects. Multivariate logistic regression analysis showed that the number of physical diseases ≥2 was the independent risk factor for anxiety ( OR=119.76,95% CI: 5.31-2 702.08, P=0.003) and depression ( OR=41.41,95% CI:6.06- 282.75, P<0.001). Conclusions:The incidence of psychological problems among people under COVID-19 quarantine is relatively high, particularly for people with multiple physical diseases, it is necessary to carry out early intervention for vulnerable people in centralized isolation sites.

Objective:To investigate the causes of anemia in newborns delivered by human immunodeficiency virus (HIV) infected mothers.Methods:This was a retrospective study. Forty-two newborns delivered by HIV infected mothers during January 2010 and May 2019 in Beijing Ditan Hospital Affiliated to Capital Medical University were selected. According to the hemoglobin levels of newborns on the days of their birth, newborn cases were divided into two groups, anemia group and non-anemia group. The clinical data including gestational ages, birth weight, maternal anemia status during pregnancy, using of antiviral drugs during pregnancy, percentages of HIV RNA positivity in early pregnancy/pre-treatment and before delivery, maternal percentage of different CD4 + T lymphocyte counts in early pregnancy/pre-treatment and before delivery between two groups were compared. The efficacies of relative indicators for prediction of anemia in newborns were evaluated by the area under receiver operating characteristic curve (AUROC). Differences between groups were compared by chi-square test. Results:Among 42 cases of newborns, 14 cases were in anemia group and 28 cases in non-anemia group. There were no statistical differences in gestational ages, birth weight, maternal anemia status during pregnancy and positive percentage of HIV RNA before delivery between two groups ( χ2=2.211, 1.025, 1.362 and 3.783, respectively, P=0.283, 0.763, 0.181 and 0.092, respectively). In anemia group, 11 mothers took zidovudine during pregnancy, which was 12(42.86%) in non-anemia group. The difference was statistically significant ( χ2=4.359, P=0.037). Eight cases of mothers with HIV RNA positive in early pregnancy/pre-treatment in the anemia group, which was 11(39.29%) in the non-anemia group. The difference was statistically significant ( χ2=6.490, P=0.011). The number of CD4 + T lymphocyte count ≤500/μL was 13 in early pregnancy/pre-treatment in anemia group, which was 20(71.43%) in the non-anemia group. The difference was statistically significant ( χ2=16.396, P<0.01). The number of CD4 + T lymphocyte ≤0.28 was 13 in early pregnancy/pre-treatment in the anemia group, which was 19(67.86%) in the non-anemia group ( χ2=19.908, P<0.01). The number of CD4 + T lymphocyte count ≤500/μL was 14 before delivery, which was 15(53.37%) in the non-anemia group ( χ2=9.536, P=0.008). The number of CD4 + T lymphocyte ≤0.28 before delivery was 14 in anemia group, which was 15(53.37%) in the non-anemia group ( χ2=9.750, P=0.006). According to the receiver operating characteristic curve results, the AUROC, optimal cut-off value, sensitivity and specificity of CD4 + T lymphocyte count before delivery in predicting neonatal anemia were 0.708, 476.0/μL, 100.0% and 50.0%, respectively. The AUROC, optimal cut-off value, sensitivity and specificity of maternal CD4 + T lymphocyte percentage before delivery in predicting neonatal anemia were 0.719, 0.275, 100.0% and 53.6%, respectively. Conclusion:Low CD4 + T lymphocyte level in HIV-infected mothers before delivery, HIV positive in early pregnancy/pre-treatment and using of zidovudine during pregnancy may be associated with neonatal anemia.

Objective:To evaluate an intelligent voice call system in popularizing knowledge of prevention and control of Coronavirus Disease 2019 (COVID-19) for chronic disease patients in the community.Methods:An intelligent voice call system for popularization of scientific knowledge of COVID-19 and protective measures was developed in Fangzhuang Community Health Service Center of Beijing Fengtai district, in which 12 popular education modules ware designed and 3-6 core points were extracted from each module. During January 23 to January 29, 2020, the system was applied to send voice calls and text messages to all contracted chronic disease patients in Fangzhuang community with popular science education in different time points. Using equidistant sampling method, 400 participants were selected from the patients of successful voice outbound calls. The intelligent voice outbound system was used to investigate the participants′ COVID-19 knowledge levels, the main sources of knowledge and satisfaction with education. The outbound results of the above indicators were queried from the database of the intelligent voice outbound system.Results:A total of 98 487 voice outbound calls were effectively connected, the average call duration per person was 2.24 minutes, and the total call duration was equivalent to 488.5 workdays. A total of 141 201 messages were sent, with a read rate of 97.8% (141 201/144 405) . After the voice outbound education, the participants′ scores in answering the questionnaire on 12 popular science knowledge modules ware all significantly increased compared to those before the education ( t=22.4, 27.5, 24.3, 31.2, 25.6, 18.9, 22.5, 27.3, 28.1, 26.4, 15.2, 22.6, all P<0.01) ; 94.8% (235/248) of participants′ knowledge of COVID-19 mainly came from voice call. In addition, the patient′s overall satisfaction with the application of the intelligent voice call system for popularizing science education was 90.8% (225/248). Conclusions:The knowledge levels of COVID-19 and its prevention and control measures effectively have been improved among the community chronic disease patients with the application of an intelligent voice outbound system. Moreover, this mode is highly acceptable to patients, which would be introduced to other urban communities in China.

Objective To explore the status and influencing factors of the integrated service needs of medicine, pension, rehabilitation and care of the community elderly in order to provide a theoretical basis for the construction of an old-age service model in line with the national conditions. Methods A total of 330 elderly people from three communities in Tai'an were selected and investigated by self-made questionnaire of the integrated services needs for medicine, pension, rehabilitation and care of community elderly. Results Nearly 83.54％(259/310) of the elderly had moderate and above pension needs, and the first three were rehabilitation services, family beds and community public health services. Age, educational level, self-rated health and number of chronic diseases were the influencing factors of the integrated service needs of medicine, pension, rehabilitation and care(t =2.374-4.844, all P<0.05). Conclusions The majority of elderly people have the moderate and above health care integration service demand, the elderly have the highest demand for rehabilitation services. Age, education, self-rated health status and the number of chronic diseases have different influence on the needs of the elderly;government, society, education and medical treatment institutions interdisciplinary multi linkage, and strengthen the professionals training of health, rehabilitation, health care, in order to explore the best old-age service model in line with national conditions.

Objective: The purpose of the research was to draw up the questionnaire of the integrated services demand for medicine, pension, rehabilitation and care of community elderly and to provide elderly people with a effective tool for evaluating the needs of medicine, pension, rehabilitation and care. Methods: The theoretical framework of the questionnaire was based on the qualitative interview results of 12 community elderly and community health care workers. A preliminary draft was formed through two rounds of expert consultation and a preliminary survey of 102 elderly people in 3 communities in Taian. Construct validity was used to evaluate the validity of the questionnaire, and Cronbach's alpha coefficient and split half reliability were used to evaluate the reliability of the questionnaire. Results: Sixteen experts were invited to conduct two rounds of consultation on 61 items of the questionnaire. The authoritative coefficient of experts was 0.881, and the positive coefficient of experts was 100%. In the first round, items I-CVI, S-CVI/UA and S-CVI/Ave were 0.68-1.00, 0.72 and 0.83, respectively. Seven items were modified, six items were deleted and three items were added. In the second round, one item was deleted and one item was added, and a questionnaire consisting of seven dimensions and 58 items was formed.7 common factors were extracted from exploratory factor analysis, and the cumulative contribution rate was 63.078%. Finally, 7 dimensions and 51 item questionnaires were formed. Each dimension is the community public health service and general services, health education, pension services, rehabilitation services, family beds, service charges The total Cronbach's alpha coefficient was 0.919, the Cronbach' s alpha coefficient of each dimension was 0.615-0.808, the retest reliability coefficient of the total questionnaire was 0.862.and the Guttman half coefficient is 0.865. The total questionnaire CVI was 0.85 and the item CVI was 0.80-1.00. Item analysis showed that the correlation coefficients of the 7 items were lower than 0.3, and the rest were all between 0.3~0.7, and were significantly correlated at P<0.05 level. Conclusion The questionnaire of the integrated services demand for medicine, pension, rehabilitation and care of community elderly had good reliability and validity, and it could be used to evaluate the needs of medicine, pension, rehabilitation and care in the elderly.