Purpose To investigate the clinicopathological features,diagnosis,differential diagnosis and molecular charac-teristics desmoid fibromatosis the breast(DFB).Methods The clinicopathological data and prognostic information of 26 pa-tients with desmoid fibromatosis of the breast were collected.Their clinical characteristics,histological morphologies,immu-nophenotypes and molecular characteristics were analyzed.Re-sults All the 26 patients were female,with a median age of 34.5 years and an average age of 36.8 years(range from 13 to 69 years).There were 10 cases in left breast,14 cases in right breast and 2 cases in bilateral breast.Isolated and painless breast masses were found in all patients,and 3 cases were ac-companied by nipple depression.Grossly,most of them showed a poorly circumscribed tan-white to gray mass with a trabeculated appearance.Microscopically,all the tumors were composed of mild spindle cells with varying intervals of collagen fiber bun-dles.The boundary between the tumor and the surrounding breast tissue was not clear,and the tumor cells infiltrated adja-cent tissues,such as breast ducts,lobules,adipose tissue,and skeletal muscle.Uniform spindle or oval cells formed in fascicles and interwoven,without atypical or polymorphism;the nuclear chromatin was sparse or vacuolar,with small nucleoli,but mito-ses were rare or absent.Nuclear accumulation of β-catenin was present in 20 of 26 tumors,SMA was variously positive in 20 of 26,desmin was focally positive in 6 of 26;CKpan,CK5/6,p63,CD34,CD10 and S-100 were all negative.The Ki67 index was 5％-10％.The gene mutations of CTNNB1 exon 3 were found in 18 of 26 by Sanger sequencing,including T41A(83.3％),S45P(11.1％)and S45F(5.6％).Two patients also had familial adenomatous polyposis.Local resection was performed in 23 cases,mastectomy was performed in 2 cases,and one case did not require any additional treatment after core needle biopsy.20 cases were followed up for 1-108 months,and no recurrence occurred.Conclusion Desmoid fibromatosis of the breast is rare,and can mimic breast cancer clinically,ra-diologically and histologically.It should be always considered in differential diagnosis for the spindle cell proliferations of the breast.A diagnosis of DFB can be achieved basing on the typi-cal histopathology,immunohistochemistry,history and gene se-quencing.

Objective To systematically evaluate the rumination in stroke patients and identify the influencing factors.Methods A mixed-methods systematic review was carried out by searching databases,such as CNKI,WanFang Data,VIP,CBM,PubMed,Web of Science,the Cochrane Library,Embase and Scopus databases,from the inception to 27th October,2023,for literature on the influencing factors of rumination in stroke patients.The researchers evaluated quality of the literature according to the mixed methods appraisal tool developed by McGill University of Canada.Then the data were collected,analysed and integrated using the convergent integration method proposed by the JBI Evidence-Based Health Care Research Centre of Australia.Results A total of 22 studies were included with an involvement of 4 949 patients.Then a total of 45 research topics were extracted and grouped into 8 categories.The influence factors of rumination were integrated,including individual factors,external support and coping strategies.Conclusions Stroke patients have different levels of rumination.Individual factors may affect rumination in patients.Harmonious interpersonal relationships and positive thinking with coping strategies can promote deliberate rumination.However,the effects of age,place of residence and household income on rumination in stroke patients are required to be further explored.

Objective:To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT).Methods:A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ 2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results:A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment.Conclusion:ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.

Objective:To construct a scientific, effective, standardized, and practical evaluation index system for the core competence of network nurses.Methods:From December 2019 to November 2020, the evaluation index system for the core competence of network nurses was constructed through literature research, semi-structured interview methods, expert letter inquiries, and analytic hierarchy process. Based on the index system, the self-evaluation survey of 300 network nurses in four "Internet+ nursing services" pilot hospitals in Shandong Province was conducted to test the reliability and validity of the index system.Results:The final evaluation index system for the core competence of network nurses included 6 first-level indicators, 19 second-level indicators, and 54 third-level indicators. The overall Cronbach's α coefficient of the index system was 0.976, the split-half reliability was 0.895, and the content validity index was 0.974. The cumulative contribution rate of the variance of the 6 common factors reached 65.626%. The correlation coefficient between each dimension and the total questionnaire was from 0.795 to 0.883, and the correlation coefficient among each dimension was from 0.526 to 0.727.Conclusions:The evaluation index system for the core competence of network nurses constructed in this study has good reliability and validity, which can provide an effective measurement tool for the subsequent selection, appointment, training and assessment of network nurses.

Objective:To explore the association of urinary phenol concentration and blood biochemical indices in coke oven workers.Methods:From April to may 2019, we investigated 771 employing coke oven workers from a coke plant in Taiyuan city, and categorized into benzene-exposed group ( n=402) and control group ( n=369) based on their benzene exposures in workplace and urophenol concentrations. All subjects were interviewed face-to-face using a questionnaire including name, age (year) , gender, smoking and drinking habits, personal vocational history, working length (year) , and occupational protection, etc. Post-shift urine samples detected using a gas chromatography-hydrogen flame ionization detector. Fasting venous blood was drawn in the morning and centrifuged, the separated serum were detected the following items using an automatic blood biochemistry analyzer. Covariance and multiple linear regression were used to test the association of urinary phenol concentration and the levels of all the blood biochemical indices. Results:The subjects were predominantly males ( n=719, 93.3%) , with an average age of (42.3±8.2) years and an average working length of (20.6±8.2) years. Compared with the control group, the benzene-exposed group were significantly different in age, working length of years, gender, smoking and drinking habits ( P<0.05) . The median (interquartile interval) concentration of urinary phenol was 6.00 (0.00-33.00) μg/ml in the benzene-exposed group, which was significantly higher than that in the control group ( P<0.05) . Covariance analysis indicated that the fasting blood glucose, total cholesterol and high density cholesterol in the benzene-exposed group were significantly reduced compared with the control group, yet the serum creatinine, serum uric acid and triglyceride were significantly increased ( P<0.05) . Multiple linear regression showed that, an increase of each natural logarithm (Ln) transformed urinary phenol concentration was significantly associated with increases in serum uric acid level [9.82 (95% CI: 2.18-17.47) μmol/L] and cholesterol level[0.10 (95% CI:0.00-0.20) mmol/L]. An increase of each Ln-transformed accumulated benzene exposure levels was significantly associated with an increase in total cholesterol level[0.09 (95% CI: 0.01-0.17) mmol/L]. Conclusion:Occupational benzene exposure is possibly related to the variation of purine and total cholesterol metabolism in coke oven workers.

Objective:To explore the association of urinary phenol concentration and blood biochemical indices in coke oven workers.Methods:From April to may 2019, we investigated 771 employing coke oven workers from a coke plant in Taiyuan city, and categorized into benzene-exposed group ( n=402) and control group ( n=369) based on their benzene exposures in workplace and urophenol concentrations. All subjects were interviewed face-to-face using a questionnaire including name, age (year) , gender, smoking and drinking habits, personal vocational history, working length (year) , and occupational protection, etc. Post-shift urine samples detected using a gas chromatography-hydrogen flame ionization detector. Fasting venous blood was drawn in the morning and centrifuged, the separated serum were detected the following items using an automatic blood biochemistry analyzer. Covariance and multiple linear regression were used to test the association of urinary phenol concentration and the levels of all the blood biochemical indices. Results:The subjects were predominantly males ( n=719, 93.3%) , with an average age of (42.3±8.2) years and an average working length of (20.6±8.2) years. Compared with the control group, the benzene-exposed group were significantly different in age, working length of years, gender, smoking and drinking habits ( P<0.05) . The median (interquartile interval) concentration of urinary phenol was 6.00 (0.00-33.00) μg/ml in the benzene-exposed group, which was significantly higher than that in the control group ( P<0.05) . Covariance analysis indicated that the fasting blood glucose, total cholesterol and high density cholesterol in the benzene-exposed group were significantly reduced compared with the control group, yet the serum creatinine, serum uric acid and triglyceride were significantly increased ( P<0.05) . Multiple linear regression showed that, an increase of each natural logarithm (Ln) transformed urinary phenol concentration was significantly associated with increases in serum uric acid level [9.82 (95% CI: 2.18-17.47) μmol/L] and cholesterol level[0.10 (95% CI:0.00-0.20) mmol/L]. An increase of each Ln-transformed accumulated benzene exposure levels was significantly associated with an increase in total cholesterol level[0.09 (95% CI: 0.01-0.17) mmol/L]. Conclusion:Occupational benzene exposure is possibly related to the variation of purine and total cholesterol metabolism in coke oven workers.

ObjectiveTo provide targeted, systematic and personalized rehabilitation guidance for orthopedic patients by building a mobile internet platform. MethodsTotally 210 orthopedic admitted in the Department of Orthopedics, Union Hospital of Tongji Medical College of Huazhong University of Science &Technology between June and September 2017 were selected using purposive sampling and divided into the treatment group (n=105) and the control group (n=105) according to the random number table. Patients in the control group received conventional guidance at discharge and telephone or home follow-up visit once every two weeks after discharge, while patients in the treatment group received conventional guidance at discharge and continued rehabilitation guidance via the mobile internet platform after discharge. Activity of daily life (ADL), compliance with continued rehabilitation guidance and patient's satisfaction were compared between the two groups 1 month and 3 months post intervention. ResultsThe ADL of the control group and the treatment group 1 month post intervention scored (66.08±3.01) and (72.00±2.66) respectively; and the ADL of the two groups 3 months post intervention scored (74.23±2.82) and (83.67±1.98) respectively (P＜ 0.05). The compliance and satisfaction were higher in the treatment group than in the control group (P＜ 0.05). ConclusionsPersonalized, targeted and visualized rehabilitation guidance for orthopedic patients via the mobile internet platform improves patient's compliance with rehabilitation exercise as well as their ADL and satisfaction.

Objective To explore the application effects of transitional care base on mobile APP for perianal abscess patients with postoperative rehabilitation. Methods A total of 97 perianal abscess patients, who were treated in the Department of Integrated Chinese and Western Medicine of West China Hospital of Sichuan University from February 2015 to February 2016, were divided into observation group (n=49) and control group (n=48) by the random number table. Patients in the control group were followed up by phone call, while patients in the observation group were given transitional care based on mobile APP with apricot trees-chart file. Wexner incontinence score, clinical recovery time and postoperative abscess recurrence rate, wound false-healing rate and the incidence of anal fistula were compared between the two groups after discharge. Results One month after discharge, the anus Wexner score of patients in observation group was (7.51±1.60) and the wound healing time was (20.71±2.48) d, which were all lower than that of the control group, and the differences were statistically significant (t=7.355,15.291; P< 0.01). The recurrence rate of abscess in the observation group was 2.0%, the rate of wound pseudo-healing was 8.2%, the incidence of anal fistula was 16.3%, and the control group was 14.6%, 27.1% and 37.5%, the two groups had statistically significant differences (χ2= 5.603, 6.005, 5.541; P< 0.05). Conclusions Transitional care base on mobile APP can effectively reduce complications and improve anal function recovery in patients with perianal abscess patients.

s] Objective To evaluate the effect of comprehensive schistosomiasis control measures with focus on total removal of cattle and sheep in Junshan District,Yueyang City. Methods The retrospective review and field survey were implemented in the pilot villages in Junshan District. The data of Schistosoma japonicum infection status of human,cattle,sheep and Oncome-lania hupensis snails,and density of snails were gathered and modeled in the period of 2006 to 2016. Results The prevalence of schistosome infection in residents in the pilot villages decreased from 3.44％ in 2006 to 0.59％ in 2012(F = 14.501,P =0.013). After removal of all the cattle and sheep in 2013,the prevalence of schistosome infection in the residents decreased to zero in 2016(F=14.148,P=0.033). The density of living snails decreased from 0.8833/0.1 m2 in 2006 to 0.3088/0.1 m2 in 2012(F=76.250,P=0.005). Conclusion The comprehensive schistosomiasis control strategy with focus on cattle and sheep removal is remarkably effective.

Objective To explore the current situation and influencing factors of knowledge-attitude-practice (KAP) on early rehabilitation among elderly patients with fracture so as to provide a reference for improving rehabilitation nursing of fracture. Methods A total of 200 elderly inpatients with fracture at Liyuan Hospital of Tongji Medical College of Huazhong University of Science and Technology were selected by convenience sampling from July 2016 to Feburay 2017. The current situation of KAP of elderly patients with fracture were investigate by the self-designed early rehabilitation KAP questionnaire for fracture patients. The simple correlation and multiple linear regression was used to analyze the influencing factors of rehabilitation among elderly patients with fracture. Results The average score of knowledge, attitude and activity behavior on early rehabilitation of elderly patients with fracture was (62.45±1.32), (85.22±1.09) and (68.90±0.78). Simple correlation showed that there were statistically significant differences in the scores of knowledge, attitude and activity behavior of elderly patients with fracture among different education background, the history of fracture, length of hospital stay and whether they received guidance related to fracture (P<0.05). Multiple linear regression revealed that the independent influencing factor of the score of knowledge,attitude and activity behavior on early rehabilitation of elderly patients was the length of hospital stay, education background and whether they received guidance related to fracture respectively (R2=0.594, 0.229, 0.587). Conclusions Elderly patients with fracture were with the low awareness rate of knowledge on early rehabilitation nursing and the low compliance of self-rehabilitation behavior. Nurses in department of orthopedics should improve the special knowledge and skills on rehabilitation and provide a multilevel and multiform guidance of early rehabilitation by combining with the charactertics of low compliance of elderly patients so as to help elderly patients improve the knowledge level of early rehabilitation and promote early rehabilitation practice.