Objective:To investigate the current status of occupational stress among electronic manufacturing workers in Qingdao and analyze its effect on depressive symptoms and anxiety symptoms.Methods:From July to September 2022, a cluster random sampling method was employed to select frontline workers from 14 electronic manufacturing enterprises in Qingdao as the study subjects. A total of 1134 questionnaires were distributed, with 1000 valid questionnaires collected, yielding an effective response rate of 88.18%. The Core Occupational Stress Scale (COSS), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7) were adopted to assess occupational stress, depressive symptoms, and anxiety symptoms, respectively. Binary logistic regression was employed to analyze influencing factors of occupational stress and its effects on depressive and anxiety symptoms.Results:The detection rates of occupational stress, depressive symptoms, and anxiety symptoms were 15.1% (15/1000), 7.9% (79/1000), and 13.8% (138/1000), respectively. The influencing factor analysis of occupational stress revealed that female gender ( OR=0.621, 95% CI: 0.434-0.890) and weekly working hours of 45-48 hours ( OR=0.537, 95% CI: 0.309-0.935) were protective factors ( P<0.05), while weekly working hours ≥55 hours ( OR=2.176, 95% CI: 1.290-3.670) and shift work ( OR=2.038, 95% CI: 1.412-2.940) were risk factors ( P<0.05). Spearman correlation analysis showed that the COSS score was positively related with the PHQ-9 score and the GAD-7 score ( rs=0.438, 0.289, P<0.01). Workers judged with occupational stress had 3.596 times (95% CI: 2.181-5.931, P<0.001) and 3.121 times (95% CI: 2.046-4.761, P<0.001) higher risks of detecting depressive and anxiety symptoms compared to those without occupational stress. Conclusion:Electronic manufacturing workers in Qingdao experience a certain level of occupational stress, which may increase the risk of developing depressive and anxiety symptoms. Enterprises should implement appropriate interventions to promote workers' mental health.

Objective:To investigate the effect of preoperative systemic inflammatory response index (SIRI) on prognosis in patients with resectable colorectal cancer.Methods:The clinical data of 355 colorectal cancer patients underwent radical resection from January 2018 to December 2022 in the Second Affiliated Hospital of Harbin Medical University were retrospectively analyzed. The basic information, pathological data and laboratory test results were recorded, and SIRI was calculated. The patients followed up to December 2023 or death, and the overall survival (OS) and disease-free survival (DFS) were recorded. The receiver operating characteristic (ROC) curve was drawn, the optimal critical value of SIRI in patients with colorectal cancer was determined according to the maximum Yoden index, and the patients were grouped based on this. Multivariate Cox regression analysis was used to analyze the independent risk factors of prognosis in patients with colorectal cancer. Kaplan-Meier survival curve was drawn, and the log-rank test was used for comparison.Results:ROC curve analysis result showed that the optimal critical value of SIRI was 0.99, and the area under the curve was 0.556. Among the 355 patients with colorectal cancer, SIRI<0.99 was in 229 cases (low SIRI group), and SIRI≥0.99 was in 126 cases (high SIRI group). There were no statistical difference in gender composition, age, body mass index (BMI), preoperative carcinoembryonic antigen, preoperative cancer antigen 19-9 (CA19-9), tumor location, T stage, N stage, tumor stage, degree of differentiation, tumor long diameter, lymphatic invasion, vascular invasion, operating time and intraoperative blood loss between two groups ( P>0.05). The incidence of anastomotic leakage in high SIRI group was significantly higher than that in low SIRI group: 20.6% (26/126) vs. 12.2% (28/229), and there was statistical difference ( P<0.05). The median follow-up time of 355 patients was 21.7 months. The mortality and recurrence rate in high SIRI group were significantly higher than those in low SIRI group: 28.6% (36/126) vs. 19.2% (44/229) and 13.5% (17/126) vs. 6.1% (14/229), and there were statistical differences ( P<0.05). Kaplan-Meier survival curve analysis result showed that the median OS and DFS in high SIRI group were significantly lower than those in low SIRI group (17.3 months vs. 23.3 months and 15.1 months vs. 21.9 months), and there were statistical differences ( P<0.05). Multivariate Cox regression analysis result showed that the tumor stage Ⅲ to Ⅳ, preoperative CEA>5 μg/L and SIRI>0.99 were independent risk factors of OS and DFS in patients with colorectal cancer (OS: HR = 2.447, 1.951 and 1.923; 95% CI 1.461 to 4.099, 1.266 to 3.456 and 1.003 to 2.655; P<0.05. DFS: HR = 2.982, 1.782 and 1.529; 95% CI 1.663 to 4.754, 1.147 to 2.651 and 1.198 to 2.021; P<0.05). Conclusions:The preoperative SIRI is an independent risk factor of prognosis in patients with colorectal cancer. The patients with low SIRI have longer postoperative OS and DFS. The preoperative SIRI has guiding value in the prognosis assessment and treatment selection in patients with colorectal cancer.

Objective:To investigate the current status of occupational stress among electronic manufacturing workers in Qingdao and analyze its effect on depressive symptoms and anxiety symptoms.Methods:From July to September 2022, a cluster random sampling method was employed to select frontline workers from 14 electronic manufacturing enterprises in Qingdao as the study subjects. A total of 1134 questionnaires were distributed, with 1000 valid questionnaires collected, yielding an effective response rate of 88.18%. The Core Occupational Stress Scale (COSS), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7) were adopted to assess occupational stress, depressive symptoms, and anxiety symptoms, respectively. Binary logistic regression was employed to analyze influencing factors of occupational stress and its effects on depressive and anxiety symptoms.Results:The detection rates of occupational stress, depressive symptoms, and anxiety symptoms were 15.1% (15/1000), 7.9% (79/1000), and 13.8% (138/1000), respectively. The influencing factor analysis of occupational stress revealed that female gender ( OR=0.621, 95% CI: 0.434-0.890) and weekly working hours of 45-48 hours ( OR=0.537, 95% CI: 0.309-0.935) were protective factors ( P<0.05), while weekly working hours ≥55 hours ( OR=2.176, 95% CI: 1.290-3.670) and shift work ( OR=2.038, 95% CI: 1.412-2.940) were risk factors ( P<0.05). Spearman correlation analysis showed that the COSS score was positively related with the PHQ-9 score and the GAD-7 score ( rs=0.438, 0.289, P<0.01). Workers judged with occupational stress had 3.596 times (95% CI: 2.181-5.931, P<0.001) and 3.121 times (95% CI: 2.046-4.761, P<0.001) higher risks of detecting depressive and anxiety symptoms compared to those without occupational stress. Conclusion:Electronic manufacturing workers in Qingdao experience a certain level of occupational stress, which may increase the risk of developing depressive and anxiety symptoms. Enterprises should implement appropriate interventions to promote workers' mental health.

Objective:To investigate the effect of preoperative systemic inflammatory response index (SIRI) on prognosis in patients with resectable colorectal cancer.Methods:The clinical data of 355 colorectal cancer patients underwent radical resection from January 2018 to December 2022 in the Second Affiliated Hospital of Harbin Medical University were retrospectively analyzed. The basic information, pathological data and laboratory test results were recorded, and SIRI was calculated. The patients followed up to December 2023 or death, and the overall survival (OS) and disease-free survival (DFS) were recorded. The receiver operating characteristic (ROC) curve was drawn, the optimal critical value of SIRI in patients with colorectal cancer was determined according to the maximum Yoden index, and the patients were grouped based on this. Multivariate Cox regression analysis was used to analyze the independent risk factors of prognosis in patients with colorectal cancer. Kaplan-Meier survival curve was drawn, and the log-rank test was used for comparison.Results:ROC curve analysis result showed that the optimal critical value of SIRI was 0.99, and the area under the curve was 0.556. Among the 355 patients with colorectal cancer, SIRI<0.99 was in 229 cases (low SIRI group), and SIRI≥0.99 was in 126 cases (high SIRI group). There were no statistical difference in gender composition, age, body mass index (BMI), preoperative carcinoembryonic antigen, preoperative cancer antigen 19-9 (CA19-9), tumor location, T stage, N stage, tumor stage, degree of differentiation, tumor long diameter, lymphatic invasion, vascular invasion, operating time and intraoperative blood loss between two groups ( P>0.05). The incidence of anastomotic leakage in high SIRI group was significantly higher than that in low SIRI group: 20.6% (26/126) vs. 12.2% (28/229), and there was statistical difference ( P<0.05). The median follow-up time of 355 patients was 21.7 months. The mortality and recurrence rate in high SIRI group were significantly higher than those in low SIRI group: 28.6% (36/126) vs. 19.2% (44/229) and 13.5% (17/126) vs. 6.1% (14/229), and there were statistical differences ( P<0.05). Kaplan-Meier survival curve analysis result showed that the median OS and DFS in high SIRI group were significantly lower than those in low SIRI group (17.3 months vs. 23.3 months and 15.1 months vs. 21.9 months), and there were statistical differences ( P<0.05). Multivariate Cox regression analysis result showed that the tumor stage Ⅲ to Ⅳ, preoperative CEA>5 μg/L and SIRI>0.99 were independent risk factors of OS and DFS in patients with colorectal cancer (OS: HR = 2.447, 1.951 and 1.923; 95% CI 1.461 to 4.099, 1.266 to 3.456 and 1.003 to 2.655; P<0.05. DFS: HR = 2.982, 1.782 and 1.529; 95% CI 1.663 to 4.754, 1.147 to 2.651 and 1.198 to 2.021; P<0.05). Conclusions:The preoperative SIRI is an independent risk factor of prognosis in patients with colorectal cancer. The patients with low SIRI have longer postoperative OS and DFS. The preoperative SIRI has guiding value in the prognosis assessment and treatment selection in patients with colorectal cancer.

Objective To investigate the mental health status and its influencing factors among elderly hypertensive patients from Rural Areas of Chuxiong and Honghe Prefecture in Yunnan.Methods Multi-stage random sampling method was adopted to select elderly hypertensive patients from rural Yi ethnic areas in Yunnan.Questionnaires were used to collect their basic information and mental health status.Multivariate logistic regression was performed to explore the influencing factors of mental health among the elderly hypertensives.Results 21.82%(209/958)of elderly people with hypertension have poor mental health status in Chuxiong and Honghe Prefecture,Yunnan.Age of 80-89 years(OR = 2.395,P<0.05)and over 90 years(OR = 3.293,P<0.05),as well as physical disability(OR = 2.037,P<0.05),were risk factors for poor mental health.Compared with those who rated their economic situation as very difficult,rating as somewhat difficult(OR = 0.490,P<0.05),moderate(OR = 0.632,P<0.05)and relatively affluent(OR = 0.344,P<0.05),having a spouse(OR = 0.655,P<0.05),received full concern from the offspring(OR = 0.411,P<0.05)and maintain good relationships with offspring(OR = 0.339,P<0.05)were protective factors.Conclusions The mental health status of elderly people with hypertension is relatively poor in rural areas of Chuxiong and Honghe Prefecture in Yunnan Province.Special attention should be paid to the mental health of older and physically disabled elderly hypertensives.Economic and mental support from children was crucially important in improving the mental health of elderly hypertensive patients in rural areas of Chuxiong and Honghe Prefecture in Yunnan Province.

Objective:To explore the practice of comprehensive teaching based on multiple evaluation in general surgery practice teaching.Methods:A total of 83 students were selected from the General Surgery Department, The Second Affiliated Hospital of Harbin Medical University. Among them, 40 interns used traditional teaching (control group) and 43 interns used comprehensive teaching based on multiple evaluation (experimental group). After the teaching, the assessment results of the theoretical knowledge and skill operation of the two groups of interns were evaluated, and the instructor evaluated the comprehensive ability of the interns, and evaluated the teaching satisfaction and teaching feedback results. SPSS 24.0 was used for t-test and Chi-square test. Results:After the teaching, the examination scores of interns' theoretical knowledge and skill operation in the experimental group [(94.24±2.28) points and (92.33±2.58) points] were higher than those in the control group [(90.56±2.37) points and (88.75±2.41) points]. The scores of independent learning ability, independent thinking ability, logical thinking ability, group cooperation ability, and humanistic care ability of interns in the two groups after teaching were significantly higher than those before teaching, and the scores of each ability in the experimental group were higher than those in the control group ( P<0.05). The total satisfaction rate of interns in the experimental group [95.35% (41/43)] was higher than that in the control group [75.00% (30/40)], and the difference was statistically significant ( P<0.05). The experimental group in improving the participation and learning efficiency of interns in teaching activities [97.67% (42/43), 90.70% (39/43)] was significantly higher than the control group [75.00% (30/40), 70.00% (28/40)] ( P<0.05). Conclusion:The application of comprehensive teaching based on multiple evaluation in general surgery practice teaching can help improve the interns' theoretical knowledge and skill operation performance, improve their comprehensive ability and teaching satisfaction, and improve their learning enthusiasm and efficiency, which deserves promotion and application.

Objective:To evaluate the effects of hemoclips on preventing delayed bleeding for early gastric cancer (EGC) after endoscopic submucosal dissection (ESD).Methods:Clinical data of 459 patients who underwent ESD for EGC in Beijing Friendship Hospital from June 2013 to August 2020 were collected retrospectively. Patients were divided into group A (hemoclip group, n=162) and group B (non-hemoclip group, n=297) according to whether preventive hemostatic clip treatment was performed after resection. Delayed bleeding within 2 weeks after ESD was observed. Univariate analysis and subgroup analysis were conducted for the delayed bleeding incidence and clinicopathological features. Results:Delayed bleeding incidences of group A and group B were 3.1% (5/162) and 8.1% (24/297) with significant difference between the two groups ( χ2=4.418, P=0.036). Subgroup analysis showed that there were significant differences in the delayed bleeding incidence between the two groups when the diameter of the tumor >20 mm [3.5% (2/57) VS 15.3% (13/85), χ2=5.016, P=0.025], the tumor located in the lower part of the stomach [1.0% (1/97) VS 10.4% (20/192), χ2=8.425, P=0.004], and the depth of tumor invasion was M/SM1 [3.2% (5/157) VS 8.1% (23/285), χ2=4.072, P=0.044]. There were no significant differences in the delayed bleeding incidence between group A and group B when the diameter of the tumor ≤20 mm, the tumor located in the upper/medial part of the stomach and the depth of tumor invasion was SM2 ( P>0.05). Conclusion:Hemoclips can prevent delayed bleeding after ESD for EGC, which is mainly observed in a tumor of diameter >20 mm, located in the lower part of the stomach and M/SM1 tumor invasion. It has little effect on the prevention when the tumor diameter ≤20 mm and located in the upper/medial part of the stomach.

Objective:To analyze the clinicopathological features of de novo early colorectal cancer and to evaluate the efficacy of endoscopic treatment.Methods:Patients with de novo early colorectal cancer who underwent endoscopic resection in Beijing Friendship Hospital, Capital Medical University from June 2020 to May 2022 were enrolled. The baseline data, endoscopic manifestations, treatment methods, postoperative pathological results and prognosis of the patients were collected retrospectively.Results:A total of 33 patients with de novo early colorectal cancer were enrolled with the age of 62.67 ± 8.62 years, and the male to female ratio was 7.25∶1. The long diameter of lesions was 0.96 ± 0.36 cm. The lesion morphology was mainly superficial phenotype (type 0-Ⅱ), accounting for 72.7% (24/33). Endoscopic submucosal dissection (ESD) was performed in 29 cases and endoscopic mucosal resection (EMR) was performed in 4 cases. Postoperative pathology showed that 11 cases (33.3%) were well differentiated tubular adenocarcinoma, of which the superficial submucosal layer was invaded in 2 cases. Twenty cases (60.6%) were moderately differentiated tubular adenocarcinoma, of which the superficial submucosa layer was invaded in 5 cases and the deep submucosa layer in 15 cases. Two cases (6.1%) were moderately-poorly differentiated tubular adenocarcinoma, where the deep submucosa layer was invaded in both. There was significant correlation between the depth of invasion and the degree of differentiation ( P<0.001), and moderately and moderately-poorly differentiated lesions were more likely to invade the deep submucosa layer. The en bloc resection rate was 100.0% (33/33), the complete resection rate was 97.0% (32/33), and the curative resection rate was 42.4% (14/33). Among the 19 patients who did not achieve curative resection, 13 patients received supplementary surgical treatment. No tumor residue or lymph node metastasis was found in the postoperative pathology. All patients were followed up for 3-25 months, and no signs of local recurrence or metastasis were found. Conclusion:Most de novo early colorectal cancers are superficial phenotype under endoscopy. The pathology is mainly moderately differentiated tubular adenocarcinoma. Endoscopic resection of de novo early colorectal cancer shows encouraging short-term efficacy.

This study aimed to investigate the efficacy and safety of apatinib plus programmed cell death protein 1 (PD-1) blockades for patients with metastatic colorectal cancer (CRC) who were refractory to the standard regimens. In this retrospective study, patients with metastatic CRC who received apatinib plus PD-1 blockades in clinical practice were included. The initial dosage of apatinib was 250 mg or 500 mg, and PD-1 blockades were comprised of camrelizumab, sintilimab and pembrolizumab. Efficacy and safety data were collected through the hospital’s electronic medical record system. From October 2018 to March 2022, a total of 43 patients with metastatic CRC were evaluated for efficacy and safety. The results showed an objective response rate of 25.6% (95% CI, 13.5%-41.2%) and a disease control rate of 72.1% (95% CI, 56.3%-84.7%). The median progression-free survival (PFS) of the cohort was 5.8 months (95% CI, 3.81-7.79), and the median overall survival (OS) was 10.3 months (95% CI, 5.75-14.85). The most common adverse reactions were fatigue (76.7%), hypertension (72.1%), diarrhea (62.8%), and hand-foot syndrome (51.2%).Multivariate Cox regression analysis revealed that Eastern Cooperative Oncology Group (ECOG) performance status and location of CRC (left or right-side) were independent factors to predict PFS of patients with metastatic CRC treated with the combination regimen. Consequently, the combination of apatinib and PD-1 blockades demonstrated potential efficacy and acceptable safety for patients with treatment-refractory metastatic CRC. This conclusion should be confirmed in prospective clinical trials subsequently.

Purpose: This study aimed to evaluate the efficacy and safety of neoadjuvant programmed cell death-1 (PD-1) inhibitors plus apatinib and chemotherapy (PAC) in patients with locally advanced gastric cancer (LAGC). Materials and Methods: Seventy-three patients with resectable LAGC were enrolled and named the PAC group (n=39) or apatinib plus chemotherapy (AC) group (n=34) based on the treatment they chose. Neoadjuvant therapy was administered in a 21-day cycle for 3 consecutive cycles, after which surgery was performed. Results: The PAC group exhibited a higher objective response rate than the AC group (74.4% vs. 58.8%, P=0.159). Moreover, the PAC group showed a numerically better response profile than the AC group (P=0.081). Strikingly, progression-free survival (PFS) (P=0.019) and overall survival (OS) (P=0.049) were prolonged, whereas disease-free survival (DFS) tended to be longer in the PAC group than in the AC group (P=0.056). Briefly, the 3-year PFS, DFS, and OS rates were 76.1%, 76.1%, and 86.7% in the PAC group and 46.9%, 49.9%, and 70.3% in the AC group, respectively. Furthermore, PAC (vs. AC) treatment (hazard ratio=0.286, P=0.034) was independently associated with prolonged PFS in multivariate Cox regression analyses. The incidence of adverse events did not differ between the two groups (all P>0.05), where leukopenia, anemia, hypertension, and other adverse events were commonly observed in the PAC group. Conclusions Neoadjuvant PAC therapy may achieve a preferable pathological response, delayed progression, and prolonged survival compared to AC therapy with a similar safety profile in patients with LAGC; however, further validation is warranted.