The detection of minimal residual lesions represented by circulating tumor DNA can detect residual cancer lesions that cannot be displayed by traditional imaging in advance. The positive status and dynamic changes are closely related to the prognosis evaluation of various solid tumors, the effectiveness of neoadjuvant therapy, the prediction of postoperative recurrence risk, and the precise implementation of adjuvant therapy. This article summarizes the advantages and challenges faced by the application of circulating tumor DNA testing in individualized multidisciplinary diagnosis and treatment of esophageal cancer, in order to better carry out precise diagnosis and treatment of esophageal cancer under the guidance of minimal residual lesion detection.

The detection of minimal residual lesions represented by circulating tumor DNA can detect residual cancer lesions that cannot be displayed by traditional imaging in advance. The positive status and dynamic changes are closely related to the prognosis evaluation of various solid tumors, the effectiveness of neoadjuvant therapy, the prediction of postoperative recurrence risk, and the precise implementation of adjuvant therapy. This article summarizes the advantages and challenges faced by the application of circulating tumor DNA testing in individualized multidisciplinary diagnosis and treatment of esophageal cancer, in order to better carry out precise diagnosis and treatment of esophageal cancer under the guidance of minimal residual lesion detection.

Objective:To investigate the perioperative safety and survival benefits of two-stage operation in the treatment of esophageal malignancies.Methods:This is a retrospective case series study. The clinical data of 70 patients who underwent two-stage operation for esophageal malignancies from January 2015 to January 2023 in the Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine were retrospectively analyzed. There were 58 males and 12 females. The age ( M(IQR)) was 61 (22) years (range: 9 to 79 years), and 51.4% (36/70) of the patients were older than 65 years. All patients underwent the first operation to remove esophageal tumor and the second operation to complete digestive tract reconstruction. The reasons for two-stage operation were summarized, complications and treatment results were recorded, and the prognosis was calculated using Kaplan-Meier curve. Results:The interval between the two stages was 49 (35) days (range: 32 to 82 days). The follow-up perrod was 28(50) months (range: 1 to 69 months). The 30-day fatality rate after the first operation was 4.3% (3/70) and the 30-day fatality rate after the second operation was 0(0/63). The total complication rate of first operation was 55.7% (39/70), the respiratory complication rate was 10.0% (7/70) and the cardiovascular complication rate was 5.7% (4/70) The incidence of anastomotic leakage was 11.1% (9/63). The overall survival rate at 2, 3 and 5 years was 35.7%, 30.0% and 15.7%, respectively.Conclusion:Two-stage operation in the treatment of complex esophageal malignancies is feasible and yields satisfaetory results.

Objective:To investigate the perioperative safety and survival benefits of two-stage operation in the treatment of esophageal malignancies.Methods:This is a retrospective case series study. The clinical data of 70 patients who underwent two-stage operation for esophageal malignancies from January 2015 to January 2023 in the Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine were retrospectively analyzed. There were 58 males and 12 females. The age ( M(IQR)) was 61 (22) years (range: 9 to 79 years), and 51.4% (36/70) of the patients were older than 65 years. All patients underwent the first operation to remove esophageal tumor and the second operation to complete digestive tract reconstruction. The reasons for two-stage operation were summarized, complications and treatment results were recorded, and the prognosis was calculated using Kaplan-Meier curve. Results:The interval between the two stages was 49 (35) days (range: 32 to 82 days). The follow-up perrod was 28(50) months (range: 1 to 69 months). The 30-day fatality rate after the first operation was 4.3% (3/70) and the 30-day fatality rate after the second operation was 0(0/63). The total complication rate of first operation was 55.7% (39/70), the respiratory complication rate was 10.0% (7/70) and the cardiovascular complication rate was 5.7% (4/70) The incidence of anastomotic leakage was 11.1% (9/63). The overall survival rate at 2, 3 and 5 years was 35.7%, 30.0% and 15.7%, respectively.Conclusion:Two-stage operation in the treatment of complex esophageal malignancies is feasible and yields satisfaetory results.

Objective:To analyze the health development plans of the provinces in China during the " 14th Five-Year Plan" , and explore the key tasks, similarities and differences of health informatization construction in each province.Methods:Using the website of local people′s government and the official website of the provincial Health Commission, 27 copies of health development plans of various provinces during the " 14th Five-Year Plan" period were retrieved and collected from February 16 to June 5, 2022. The relevant statements of health information in the plan were extracted, content analysis was used to reveal the structural characteristics of the policy in the form of word frequency statistics, and discourse analysis was used to study the policy content.Results:The health information policies of 27 provinces during the " 14th Five-Year Plan" period could be summarized as 10 major themes, such as accelerating the construction of hierarchical diagnosis and treatment system, promoting the high-quality development of public hospitals, and deepening the reform of medical security system. The health information policy in the eastern, central and western regions was relatively clear, and there were certain differences in the construction points according to their own characteristics.Conclusions:During the " 14th Five-Year Plan" period, the policies of each province around the field of health information are well defined, and the core structure and content are similar. The distribution of key points in the eastern region is relatively balanced; the construction of health information in the central region is more prioritized and prominent; the construction of health information in the western region is focused on complementing the weak links and weaknesses.

Objective:To introduce the formulation and implementation of exercise prescription for military flying personnel.Literature resource and selection:The related literature on exercise prescription of military flying personnel published at home and abroad.Literature quotation:Fifty-eight references were cited, including 46 articles, 6 reviews, 5 dissertations and 1 conference paper.Literature synthesis:Exercise prescription plays an important role in improving the physical function, physical quality, psychological stress and flight ability of flying personnel. The formulation of exercise prescription for flying personnel needs to focus on such aspects as anti-acceleration endurance, muscle strength, exercise ability and cardiopulmonary exercise function. This paper analyzes the elements of exercise prescription for flying personnel, including the selection of exercise type, the control of exercise intensity, the arrangement of exercise time and the setting of exercise frequency.Conclusions:Under the mode of flying personnel′s robust promotion and support, the formulation of individualized moderate intensity exercise prescription according to different types of aircraft, models of aircraft, types of personnel, ages and physical and mental conditions can help flying personnel to improve the physical and mental health and military operation ability.

Objective:To introduce the formulation and implementation of exercise prescription for military flying personnel.Literature resource and selection:The related literature on exercise prescription of military flying personnel published at home and abroad.Literature quotation:Fifty-eight references were cited, including 46 articles, 6 reviews, 5 dissertations and 1 conference paper.Literature synthesis:Exercise prescription plays an important role in improving the physical function, physical quality, psychological stress and flight ability of flying personnel. The formulation of exercise prescription for flying personnel needs to focus on such aspects as anti-acceleration endurance, muscle strength, exercise ability and cardiopulmonary exercise function. This paper analyzes the elements of exercise prescription for flying personnel, including the selection of exercise type, the control of exercise intensity, the arrangement of exercise time and the setting of exercise frequency.Conclusions:Under the mode of flying personnel′s robust promotion and support, the formulation of individualized moderate intensity exercise prescription according to different types of aircraft, models of aircraft, types of personnel, ages and physical and mental conditions can help flying personnel to improve the physical and mental health and military operation ability.

With the increasing popularity of chest spiral CT screening, the detection rate of lung cancer in China is increasing. According to the characteristics of lung cancer in China and the progress of lung cancer researches at home and abroad, Chinese Medical Association guidelines for clinical diagnosis and treatment of lung cancer are updated once a year. It is of great guiding significance to standardize and improve the clinical diagnosis and treatment of lung cancer for thoracic surgeons. The surgical diagnosis and treatment of lung cancer in the guidelines mainly include: (1) surgical treatment of stage Ⅰ-Ⅱ non-small cell lung cancer (NSCLC); (2) surgical treatment of resectable stage Ⅲ NSCLC; (3) surgical treatment of multiple primary lung cancer; and (4) surgical treatment of locally resectable small cell lung cancer. Based on the Chinese Medical Association guidelines for clinical diagnosis and treatment of lung cancer (2019 edition), this paper interprets the hot issues related to the surgical treatment of lung cancer.

Objective To provide an index system and model for evaluating the development strategies of military preventive medicine (MPM).Methods SWOT was used to analyze the internal and external conditions of the development strategies of MPM,and the evaluation index system was constructed.The weight of each evaluation index was determined based on the analytic hierarchy process (AHP) and expert consultation.The evaluation model of MPM development strategies and confrontation matrix were constructed based on SWOT analysis.The effectiveness of the index system and model was evaluated through empirical research.Results The evaluation index system was constructed,which included four grade-one indexes (R&D quality,difficulty,requirement and support) and sixteen grade-two indexes (research level,academic status,etc.).The advantage and disadvantage models,opportunity threat model and SWOT evaluation model were established.The confrontation matrix of development strategies for MPM was developed.Conclusion This evaluation index system and model can accurately evaluate MPM development strategies and provide reference for formulating development strategies of MPM.

Objective To investigate the expression of phosphorylated RB (pRB) in the invasion front of papillary thyroid carcinoma and the clinical pathological implications. Methods Immunohistochemistry was ap-plied in analyzing pRB expression feature and the clinical pathological implications in a total of 82 patients who underwent total or subtotal thyroidectomy and neck lymph node dissection for papillary thyroid carcinoma. Results The displacement of pRB proteins from the nucleus to the cytoplasm was observed in the invasive front of papil-lary thyroid carcinoma , which was an independent predictor of lymph node metastasis in papillary thyroid carci-noma. Conclusion Nuclear-cytoplasmic transport of pRB in the invasive front was an independent predictor of lymph node metastasis in papillary thyroid carcinoma.