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.

Inflammatory bowel disease (IBD) is a progressive and destructive chronic intestinal inflammatory disease. Fatigue is one of the most common symptoms of IBD patients, which has a negative impact on the quality of life of patients. Its subjectivity and complexity make it difficult for clinicians to evaluate. Fatigue is always overlooked in clinical works. The mechanism of fatigue is unclear and there is no effective therapy to alleviate fatigue in IBD for now. We mainly review the research progress of influencing factors and therapy of fatigue in IBD patients to help clinicians have better awareness of fatigue.

Inflammatory bowel disease (IBD) is a progressive and destructive chronic intestinal inflammatory disease. Fatigue is one of the most common symptoms of IBD patients, which has a negative impact on the quality of life of patients. Its subjectivity and complexity make it difficult for clinicians to evaluate. Fatigue is always overlooked in clinical works. The mechanism of fatigue is unclear and there is no effective therapy to alleviate fatigue in IBD for now. We mainly review the research progress of influencing factors and therapy of fatigue in IBD patients to help clinicians have better awareness of fatigue.

Objective:To investigate the health status, health-related behaviors and health needs of elderlies in eastern, central and western China and to understand their health experience, for exploring an efficient medical service model, and optimizing allocation of medical resources.Methods:This study used the 2008-2018 database from Chinese longitudinal healthy longevity survey organized by Peking University. It described the concentration trend of medical distance by median, compared the health status, health-related behaviors and health needs of the elderly in eastern, central and western China by χ2 tests, and analyzed time-distribution trends of the poor health status, negative health behaviors and health needs by linear relation test. Results:Among 49 611 subjects included in the study, 7 881 of them self-evaluated their health status as poor, 19 445 evaluated their recent health status as deteriorated, while 14 954 lack routine physical examination, 35 141 lack physical exercise, 8 178 smoked, 7 859 drunk, 35 814 had no access to health education services in their communities, 35 676 expressed their health education needs, and 2 637 lack adequate medical services. The difference of distribution of health status, health-related behaviors and health needs of the elderly in eastern, central and western China was statistically significant ( P<0.05). The health status, negative health behaviors and health needs of the elderly in 2008-2018 presented a linear time distribution trend( P<0.05), while the overall medical distance in eastern, central and western China was 1.02 km, 1.00 km and 1.56 km respectively, and the medical distance in the rural area further than that in the urban areas. Conclusions:The health status of the elderly in China needed to be further improved, the proportion of negative health behaviors was high, and the health needs of the elderly in central and western China were large. Promoting an active medical service mode in central and western China, strengthening the interactions between medical institutions and residential communities will contribute to health needs fulfillment and medical resource utilization.

Autoimmune gastritis(AIG) is a CD4 + T cell-mediated organ specific autoimmune disease of the stomach, characterized by the inherent gland atrophy in the stomach and intestinal metaplasia and/or pseudopyloric gland metaplasia. The diversity and nonspecificity of clinical features make the diagnosis difficult. In the past, AIG was thought to occur in the West, but in recent years, more and more studies have shown that the prevalence rate of AIG in China is not low. However, the disease has not attracted the attention of domestic clinical workers. Therefore, this paper reviews the latest research progress in the etiology, clinical characteristics, relationship with other diseases, diagnosis and treatment of AIG, so as to improve the understanding of clinical workers and improve the treatment rate and prognosis of AIG.

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 effect of the pharyngeal pressure feedback training on pharyngeal constriction in persons with swallowing disorders caused by brainstem lesions.Methods:Twenty patients with disordered swallowing caused by a brainstem lesion were randomly divided into a control group and an intervention group, each of 10. Both groups received routine swallowing training including oral sensorimotor training, neuromuscular stimulation and balloon catheter dilation, while the intervention group was additionally provided with two weeks of pharyngeal pressure feedback training. Before and after the treatment, both groups were evaluated in terms of the peak pressure of superior and inferior pharyngeal constriction, endoscopically and also using the functional oral intake scale.Results:There was no significant difference between the two groups in any measure before the intervention. Afterward, both groups had improved significantly by all of the measurements, but the average peak upper pharyngeal pressure, the average intake scale score and the endoscopy results of the intervention group were all significantly better than the control group′s averages.Conclusions:Pharyngeal pressure feedback training can significantly relieve swallowing disorders caused by brainstem lesions.

() infection is closely related to chronic active gastritis, peptic ulcer, mucosa-associated lymphoid tissue (MALT) lymphoma, and gastric cancer, and is also associated with some parenteral diseases. Eradication of can significantly improve gastric mucosal inflammatory response, prevent or delay gastric mucosal atrophy, intestinal metaplasia and its development, partially reverse atrophy, and reduce the risk of gastric cancer in varying degrees. In recent years, the eradication failure rate has increased. There are many reasons for the failure of eradication. Previous studies have suggested that resistance to antibiotics is the main cause of eradication failure, but recent studies have found that poor compliance is the main reason.
Gastric Mucosa ; Gastritis ; Helicobacter Infections ; Helicobacter pylori ; Humans

This paper reports a case of atypical cholesterol side chain enzyme deficiency caused possibly by CYP11A1p.A359V heterozygous mutation. The patient was diagnosed as congenital adrenal hyperplasia because he was born with gonadal dysplasia and there were manifestations of salt losing and pigment changing, combined with high level of plasma ACTH. Further genetic screening revealed CYP11A1p.A359V heterozygous mutations in patients with a final diagnosis of cholesterol side chain enzyme deficiency which was treated effectively to glucocorticoid.

Ohjective To explore the impact of constraint-induced aphasia therapy (CIAT) on language function and neural activity in patients with chronic Broca's aphasia.Methods Two chronic aphasics whose use of language was recovering after standard language therapy were selected to receive 1.5 h of CIAT twice daily for two weeks (30 hours in total).Before and after the CIAT they were tested using a block-designed picture-naming task,fMRIs were taken and their use of language was examined.Results The language function assessments showed relatively large improvements in the subjects' use of language after 4 weeks of conventional language training,but not much further change after 8 and 12 weeks.After the two weeks of CIAT,their language function improved further to a certain extent.fMRI showed increased activation in the left inferior frontal gyrus with or without enhanced activation in the left hemisphere,and reduced activation in the right inferior frontal gyrus.Conclusions Functional reorganization induced in the brain by CIAT was associated with up-regulation of the left inferior frontal gyrus or down-regulation of the right inferior frontal gyrus.Even the whole language network may have been modified.