OBJECTIVE: To describe survival trends and global patterns of esophageal cancer (EC) using survival data from population-based cancer registries. METHODS: We systematically searched PubMed, EMBASE, Web of Science, SEER, and SinoMed databases for articles published up to 31 December 2023. Eligible EC survival estimates were evaluated according to country or region, period, sex, age group, pathology, and disease stage. RESULTS: After 2010, Jordan exhibited the highest age-standardized 5-year relative survival rates (RSRs)/net survival rates (NSRs) at 41.1% between 2010 and 2014, while India had the lowest, at 4.1%. Survival rates generally improved with diagnostic age across most countries, with significant increases in South Korea and China, of 12.7% and 10.5% between 2000 and 2017, respectively. Survival was higher among women compared to men, ranging from 0.4%-10.9%. Survival rates for adenocarcinoma and squamous cell carcinoma were similar, differing by about 4%. In China, the highest age-standardized RSRs/NSRs was 33.4% between 2015 and 2017. Meanwhile, the lowest was 5.3%, in Qidong (Jiangsu province) between 1992-1996. CONCLUSION Global EC survival rates have improved significantly in recent decades, but substantial geographical, sex, and age disparities still exist. In Asia, squamous cell carcinoma demonstrated superior survival rates compared to adenocarcinoma, while the opposite trend was observed in Western countries. Future research should clarify the prognostic factors influencing EC survival and tailor prevention and screening strategies to the changing EC survival patterns.
Humans ; Esophageal Neoplasms/mortality* ; Registries ; Male ; Female ; Survival Analysis ; Middle Aged ; Survival Rate ; Aged ; Global Health

Objective:To evaluate the impact of self-crosslinked hyaluronic acid (SCH) gel on endometrium recovery after artificial abortion.Methods:A multicenter, prospective randomized controlled trial was conducted across 18 hospitals from December 2021 to February 2023, involving 382 women who underwent artificial abortion. Participants were randomly allocated to receive either treatment with SCH gel (SCH group) or no treatment (control group) in a 1∶1 ratio. The primary outcome was endometrium thickness in 14 to 18 days after the first postoperative menstruation. Secondary outcomes included changes in menstrual volume during the first postoperative menstruation, menstruation resumption within 6 postoperative weeks, time to menstruation resumption, duration of the first postoperative menstruation, and incidence of dysmenorrhea.Results:Baseline characteristics of participants were comparable between the two groups (all P>0.05), with 95.3% (182/191) in SCH group and 92.7% (177/191) in the control group completed the study. The postoperative endometrial thickness in SCH group was significantly greater than that in the control group [(9.78±3.15) vs (8.95±2.32) mm; P=0.005]. SCH group also had significantly fewer participants with reduced menstrual volume [23 cases (12.6%, 23/182) vs 31 cases (17.5%, 31/177); P=0.038]. Although SCH group experienced less dysmenorrhea during the first postoperative menstrual period, this difference was not statistically significant [28.5% (51/179) vs 37.1% (65/175); P=0.083]. Outcomes were similar between SCH group and the control group regarding the proportion of participants who resumed menstruation within 6 weeks postoperatively, time to menstruation resumption, and duration of the first postoperative menstruation ( P=0.792, 0.485, and 0.254, respectively). No serious adverse events were observed during the study period, and no adverse events were attributed to SCH gel treatment. Conclusion:The application of SCH gel after artificial abortion is safe and might aid in the recovery of the endometrium.

OBJECTIVE To provide a reference for safe drug use in clinic. METHODS ADE reports related to nilotinib from the first quarter of 2007 to the fourth quarter of 2022 were collected from the US FDA adverse event reporting system database. The reporting odds ratio （ROR） and proportional reporting ratio （PRR） of disproportionality measures were used to mine potential ADE signals，which were compared with drug instruction and related case report， and were screened and analyzed according to the designated medical events （DME） list formulated by the European Medicines Agency. RESULTS Totally 23 332 cases of ADE with nilotinib as the primary suspected drug were reported. A total of 359 positive signals were obtained，involving 24 system organ classes （SOC），mainly concentrated in various examinations，heart organ diseases，vascular and lymphatic diseases，all kinds of nervous system diseases，etc. Among them，ADEs such as vertebral artery stenosis，coronary artery stenosis，arterial disease，liver infection and the second primary malignant tumor were not mentioned in the instructions. Seven DMEs were detected，of which bone marrow failure，pulmonary hypertension and deafness were not mentioned in the drug instruction. CONCLUSIONS The common ADE signals of nilotinib excavated in this study are consistent with the instructions. In clinical use，special attention should be paid to DME not mentioned in the instructions such as bone marrow failure，pulmonary hypertension and deafness； cardiac function， blood glucose and blood lipid indexes should be monitored closely.

Objective:To explore an efficient method of practical teaching for ultrasonography.Methods:There were 41 five-year clinical medical students intending to learn ultrasonography in the spring semester of 2019. After completing common theory courses, they were divided into two groups randomly for practice courses, which consisted of two modules: Lecture and Hands-on. Lecture included case-based learning while Hands-on included pictures reading. Each group followed different sequence of modules. There were assessments of ultrasound theory, practice or the combination of both before, during and after practice courses.Results:The theory and practice ability of each group improved significantly after practice courses ( P < 0.05). Moreover, the group whose Hands-on module preceded Lecture module got the higher scores in the evaluation of the combined ability of theory and practice ( P < 0.05). Conclusion:The theory was as important as the practice during the clerkship of ultrasonography. The clinical practical teaching pattern that Hands-on precedes Lecture has achieved better teaching effects.

We conducted a randomized, open-label, parallel-controlled, multicenter trial on the use of Shuanghuanglian (SHL), a traditional Chinese patent medicine, in treating cases of COVID-19. A total of 176 patients received SHL by three doses (56 in low dose, 61 in middle dose, and 59 in high dose) in addition to standard care. The control group was composed of 59 patients who received standard therapy alone. Treatment with SHL was not associated with a difference from standard care in the time to disease recovery. Patients with 14-day SHL treatment had significantly higher rate in negative conversion of SARS-CoV-2 in nucleic acid swab tests than the patients from the control group (93.4% vs. 73.9%, P = 0.006). Analysis of chest computed tomography images showed that treatment with high-dose SHL significantly promoted absorption of inflammatory focus of pneumonia, which was evaluated by density reduction of inflammatory focus from baseline, at day 7 (mean difference (95% CI), -46.39 (-86.83 to -5.94) HU; P = 0.025) and day 14 (mean difference (95% CI), -74.21 (-133.35 to -15.08) HU; P = 0.014). No serious adverse events occurred in the SHL groups. This study illustrated that SHL in combination with standard care was safe and partially effective for the treatment of COVID-19.
COVID-19 ; Humans ; Medicine, Chinese Traditional ; Research ; SARS-CoV-2 ; Treatment Outcome

Objective:To investigate the clinicopathological features, immunohistochemical characteristics, differential diagnosis and prognosis of gastric SWI/SNF-complex deficient undifferentiated/rhabdoid carcinomas.Methods:Two cases of gastric SWI/SNF-complex deficient undifferentiated/rhabdoid carcinoma were collected at Fudan University Shanghai Cancer Center, Shanghai, China from 2017 to 2018. The clinicopathological characteristics were analyzed. Hematoxylin and eosin, and immunohistochemical stains were performed, and the relevant literatures were reviewed.Results:The two patients were both male, aged 60 and 74 years, respectively. Their symptoms were both abdominal pain. The tumor arose in the esophagogastric junction in case 1, and the cardia to the fundus and the posterior wall of the upper part of gastric body in case 2. Both tumors were present as an ulcerative mass. The patients died of tumor 11 months and 8 months after surgery, respectively. Histologically, the tumor cells arranged in sheets, nests, cords or trabecular patterns, and pseudoavleolar structure. The tumor cells were epithelioid with uniform morphology, while the tumors showed scant stroma and massive necrosis. Variable rhabdoid cells and multinucleated giant cells were seen in both cases. SMARCA4 encoding protein BRG1 was undetectable in both tumors, while SMARCB1 encoding protein INI1 was detected. The tumor cells were diffusely positive for vimentin and negative for epithelial marker (CKpan), gastrointestinal stromal tumor markers (CD117 and DOG1), myogenic markers (desmin and myogenin), melanoma markers (S-100 protein, SOX10 and HMB45), and lymphohematopoietic markers (LCA and CD20).Conclusions:Gastric SWI/SNF-complex deficient undifferentiated/rhabdoid carcinoma is a rare and highly aggressive tumor with poor prognosis. The detection of subunits protein expression of SWI/SNF complex is important for diagnosis of the tumor.

Objective To develop a convolutional neural network （CNN） that can identify isokinetic knee exercises moment of force-time diagrams under different levels of efforts. Methods The 200 healthy young volunteers performed concentric isokinetic right knee flexion-extension reciprocating exercises with maximal effort as well as half the effort at angular velocities of 30°/s and 60°/s twice, respectively, with an interval of 45 min. The moment of force-time diagrams were collected. The 200 subjects were randomly divided into the training set （140 subjects） and the testing set （60 subjects）. The moment of force-time diagrams from subjects in the training set were used to train CNN model, and then the fully trained model was used to predict types of curves from the testing set. Random sampling of subjects along with subsequent development of models were performed 3 times. Results Under the circumstances of isokinetic knee exercises with maximal effort and half the effort, 2 400 moment of force-time diagrams were produced, respectively. Classification accuracy rates of the CNN models after the 3 trainings were 91.11%, 90.49% and 92.08%, respectively, and the average accuracy rate was 91.23%. Conclusion The CNN models developed in this study have a good effect on differentiating isokinetic moment of force-time diagrams of maximal effort exercises from those made with half the effort, which can contribute to identifying levels of efforts exerted by subjects during isokinetic knee exercises.
Humans ; Knee ; Knee Joint ; Muscle Contraction ; Muscle, Skeletal ; Neural Networks, Computer

Objective To observe the changes in tear quantity and tear break-up time(BUT) before and after wearing overnight orthokeratology (OK),and investigate the influence of OK on tear film in young adolescents.Methods Prospective clinic study was conducted in 60 adolescents,aged 8-16 years,who met the inclusion criteria during November 2016 and May 2017 in the Second Hospital of Dalian Medical University were chosen and fitted with OK (OK group).At the same time,60 adolescents who met the same requirement were fitted with spectacle (spectacle group).The two groups were both divided into three subgroups according to the age (subgroup of 8-10 years old,11-13 years old,and 14-16 years old).The BUT,Schirmer' s I test score,and corneal fluorescent (FL) were measured and recorded before wearing and 1 week,1 month,3 months,6 months and 12 months after wearing.Results Totally 57 patients in the OK group (114 eyes) and 59 patients in the spectacle group (118 eyes) completed the follow-up study.No significant difference in Schirmer' s Ⅰ test scores was observed between the OK group and spectacle group (all P＞0.05).The BUT in OK group was significantly lower than that in the spectacle group at all the time points (all P ＜ 0.05).Of all subgroups,the subgroup aged from 8-10 years exhibited the sharpest and most rapid reduction in BUT.Conclusion Based on our findings,long-term OK wearing has no effect on tear volume but reduces the stability of tear film.The results suggest that OK should be considered to be a good alternative for children and adolescents with spectacle;however,it may influence the quality of tear film.In addition,special attention should be paid to younger adolescents,and regular follow-up is needed.

Background: It is known that short sleep duration adversely affects children's behavior and physical development. This study aimed to investigate the status of sleep duration in 3-14-year-old children in Beijing and explore the related factors of sleep loss with them. Methods: In this study, a cross-sectional study of random stratified cluster sampling was conducted on 3-14-year-old children and adolescents in Beijing. According to the proportion of children in each district and school, the final cohort included a total of 11 kindergartens, 7 primary schools, and 8 junior high schools from 7 districts of Beijing. Children of sampled classes were included, and their parents were invited to fill a series of questionnaires including the simplified Chinese version of Pediatric Sleep Questionnaire, Sleep Questionnaire Scale, and Hong Kong-Children Sleep Questionnaire about the performance of the last 6 months. Results: Out of the total 11,420 questionnaires, 9198 questionnaires were valid and effective with the response rate of 80.54%. The age of the investigated children was 8.8 ± 3.8 years, including 4736 males and 4462 females. The daily sleep duration of children in Beijing was 9.7 ± 0.7 h. The prevalence of sleep loss (<9 h/day) of children in Beijing was 11.8%. The daily sleep duration of children aged <6, 6 ≤ age <11, and ≥11 years was 9.7 ± 0.6 h, 9.6 ± 0.6 h, and 9.5 ± 0.8 h, respectively. The sleep duration reduced significantly in children aged ≥11 years as compared to younger children in Beijing which was mainly contributed by the variation tendency of sleep duration on weekdays. The multivariate logistic regression analysis identified factors associated with sleep loss (P < 0.05): male (odds ratio [OR] = 1.32, 95% confidence interval [CI]: 1.15-1.51), age ≥11 years (OR = 2.37, 95% CI: 1.92-2.93), overweight (OR = 1.34, 95% CI: 1.17-1.54), family history of snoring (OR = 1.35, 95% CI: 1.13-1.61) and activities before bedtime with watching TV (OR = 1.24, 95% CI: 1.08-1.43), sports (OR = 1.22, 95% CI: 1.01-1.48), playing cellphone (OR = 1.91, 95% CI: 1.31-2.73) and surfing the Internet (OR = 1.27, 95% CI: 1.06-1.52) and among them age ≥11 years and playing cellphone before bedtime had greater impact on children's short sleep duration than that of other factors. Conclusions Sleep loss was common among 3-14-year-old children in Beijing. Sleep duration decreased with age, especially among children over 11 years old. Factors associated with sleep loss covered sociodemographic characteristics, family sleep habits and routine activities before bedtime, and among those variables, age ≥11 years and playing with cellphones before bedtime had a greater impact on sleep duration, indicating that existing sleep loss in 3-14-year-old children could be, at least partly, improved by paying more attention to children aged of 11 years or entering Grade 5 and Grade 6 and to children with a family history of snoring; by reducing the use of electronic products before bedtime, especially cellphones; by managing weight and keeping fit; and by improving the bedtime routine.
Adolescent ; Beijing ; Child ; Child, Preschool ; Cross-Sectional Studies ; Female ; Humans ; Male ; Sleep ; Sleep Deprivation ; Surveys and Questionnaires

Objective· To investigate the prevalence of low triiodothyronine syndrome (LT3S) in peritoneal dialysis (PD) patients and to evaluate the predictive value of long-term prognosis. Methods · From Jan. 2009 to Dec. 2015, all patients who started PD for 3 months were enrolled. According to thyroid hormone levels, there were classified into LT3S group (218 cases) and normal T3group (259 cases). The association between FT3and mortality in PD patients was estimated using Cox risk regression model. Results · Compared to the patients in normal T3group, patients with LT3S had lower hemoglobin[(97.90±23.71)g/L vs(105.54±22.94)g/L],adjusted serum calcium[(2.06±0.35)mmol/L vs(2.17±0.27)mmol/L](all P<0.01).Patients with LT3S had higher BNP{[311.00(134.59,776.00)pg/mL]vs[159.00(58.28,378.75)pg/mL]},hrCRP{[2.85(0.95,6.81)mg/L]vs[1.34(0.54,3.32)mg/L]}and serum total cholesterol[(3.18±1.29)mmol/L vs(2.76±0.93)mmol/L]than that in patients with normal T3group(all P<0.01).LVMI of LT3S group [(154.16±58.15)g/m2] vs (125.24±42.67)g/m2] was much higher than that of normal T3group (P<0.01). Cox risk regression model indicated that FT3 was significantly associated with all-cause mortality(HR 0.51,95% CI 0.41-0.63;P<0.01)and cardiovascular mortality(HR 0.60,95% CI 0.45-0.81;P<0.01). Conclusion·LT3S is common in PD patients.Lower FT3was an independent risk factor of all-cause and cardiovascular mortality in PD patients.