Objective To investigatethe relationship between gastroesophageal reflux disease (GERD) symptoms and clinicopathological characteristics, p53 expression, and survival of Chinese patients with esophageal adenocarcinoma. Methods A total of 3882 patients with esophageal adenocarcinoma, 970 matched patients with esophageal squamous cell carcinoma, and 970 matched patients with gastric cardia adenocarcinoma were included to compare the incidence of GERD symptoms. Patients with esophageal adenocarcinoma were divided into two groups according to the presence and absence of GERD symptoms. The differences in clinicopathological characteristics and p53 expression between the two groups were compared by chi-square test, and the differences in survival between the two groups were compared by landmark analysis. Results The incidence of GERD symptoms increased successively in esophageal squamous cell carcinoma, esophageal adenocarcinoma, and gastric cardia adenocarcinoma. In patients with esophageal adenocarcinoma, the proportions of male, less than 65 years old, lower thoracic tumors, tumors without squamous cell carcinoma, poorly differentiation, early tumors (stage 0-I), and p53-positive tumors in the group with GERD symptoms were higher than those in the group without GERD symptoms; moreover, the long-term survival (≥15 years) was better. Conclusion GERD symptom is an important clinical sign of esophageal adenocarcinoma. It is closely related to specific clinicopathological characteristics, p53 overexpression, and good long-term prognosis.

Chronic hepatitis B virus (HBV) infection remains a major global public health concern. The persistent presence of intrahepatic covalently closed circular DNA (cccDNA) poses a major challenge to the complete cure of chronic HBV infection. Therefore, identifying reliable and effective serological surrogate markers for cccDNA holds great clinical significance in evaluating antiviral efficacy, predicting prognosis, and guiding the clinical management of chronic HBV-infected patients. In recent years, serum HBV RNA has emerged as a promising non-invasive alternative marker for cccDNA, offering the potential for monitoring disease progression and predicting prognosis in chronic HBV-infected patients. In this review, we summarize recent studies on HBV RNA, highlighting its ability to assess the immune and histological status of patients, and discussing its value in guiding the timing of antiviral therapy. Furthermore, we systematically summarize the clinical significance of HBV RNA in multiple domains: monitoring viral replication, evaluating antiviral treatment efficacy, predicting relapse after treatment cessation, and guiding new antiviral strategies. This review aims to provide clinicians with valuable insights for better utilizing this marker in the clinical management of chronic HBV infection.

OBJECTIVES: To verify whether hesperetin (Hes) alleviates doxorubicin (DOX)-induced cardiotoxicity by reducing inflammation via regulating the AMPK/NLRP3 pathway. METHODS: C57/bl6 mice and H9c2 cells treated with DOX to mimic cardiotoxicity were randomly divided into Sham (or control) group, DOX group, DOX+Hes group, DOX+Hes+compound C (CC, an AMPK inhibitor) group. Cardiac function and myocardial pathologies of the mice were evaluated, and the changes in H9c2 cell morphology and viability were assessed. Lactate dehydrogenase (LDH) activity in mouse myocardial tissues and H9c2 cells was measured using ELISA, and H9c2 cell apoptosis was detected with TUNEL staining. In both H9c2 cells and the myocardial tissues of the mice, cellular expression levels of TNF-α, IL-6 and IL-1β mRNAs and cleaved caspase-3, Bcl2, Bax, IL-1β, IL-18, p-AMPK, AMPK, p-mTOR, mTOR, NLRP3, ASC and caspase-1 proteins were detected using RT-PCR and Western blotting. RESULTS: DOX treatment caused cell swelling, decreased cell viability and increased LDH activity in H9c2 cells, resulting also in significantly increased cell apoptosis and cleaved caspase-3 expression and decreased Bcl2/Bax ratio. The DOX-treated mice showed obvious myocardial fiber swelling and inflammatory infiltration, decreased cardiac function and significantly increased myocardial LDH activity. In H9c2 cells, DOX treatment significantly increased the mRNA expressions of TNF-α, IL-6 and IL-1β and protein expressions of IL-1β and IL-18, lowered the expressions of p-AMPK and p-mTOR, and increased the expressions of NLRP3, ASC and caspase-1. Hes treatment obviously reduced these toxic effects of DOX in H9c2 cells, but its protective effects were blocked by application of compound C. CONCLUSIONS Hes reduces DOX-induced cardiotoxicity by inhibiting inflammation via regulating the AMPK/NLRP3 pathway.
Animals ; Doxorubicin/toxicity* ; NLR Family, Pyrin Domain-Containing 3 Protein/metabolism* ; Mice, Inbred C57BL ; Mice ; Signal Transduction/drug effects* ; Cardiotoxicity ; AMP-Activated Protein Kinases/metabolism* ; Apoptosis/drug effects* ; Cell Line ; Myocytes, Cardiac/drug effects* ; Rats

Objective It aims to investigate the current status of patient trust in physicians among inpatients at tertiary public hospitals in China and to analyze the factors influencing this trust.The goal is to provide insights for enhancing patient trust and improving doctor-patient relationships.Methods Relying on the third"third party evaluation of national action to improve medical services"project,it surveyed inpatients from 136 tertiary public hospitals across 31 provinces(including autonomous regions and municipalities)and the Xinjiang Production and Construction Corps.A total of 21 092 inpatient questionnaires were returned.Data obtained were statistically analyzed using R software version 4.3.2.Results The trust level in attending physicians among inpatients at tertiary public hospitals in China was found to be 98.37％.Influential factors on this trust level included patient occupation,annual family income,type and region of the hospital and so on.Conclusion Overall,the level of trust in physicians among inpatients at tertiary public hospitals in China is high,though regional differences exist.It should pay attention to non-medical factors such as inpatient ward environment and hospital service quality.Improving these aspects can enhance the overall patient experience,further improve doctor-patient relationships.

Objective It aims to investigate the status quo of nurses'emotional exhaustion in tertiary public hospitals in China and analyze its influencing factors,so as to provide suggestions for formulating targeted policy measures to reduce nurses'emotional exhaustion.Methods Relying on the fifth"The Third-Party Evaluation of the China Healthcare Improvement Initiatives"project,it surveyed nurses from 143 tertiary public hospitals across 31 provinces(including autonomous regions and municipalities)and the Xinjiang Production and Construction Corps.Univariate analyses were performed using the Pearson chi-square test.Multifactorial analyses were performed using ordered multicategorical logistic regression analysis.Results The score of nurses'emotional exhaustion in tertiary public hospitals in China was 8.00(2.00～16.00),of which mild exhaustion accounted for 79.00％,moderate exhaustion accounted for 10.00％,and severe exhaustion accounted for 11.00％.Gender,age,number of children,region,type of hospital,department,employment form,assume scientific research task,excessive workload,salary and hospitals carry out psychological guidance were the influencing factors of nurses'emotional exhaustion.Conclusion Nurses in tertiary public hospitals in China are at a mild level of emotional exhaustion,but in some groups the degree is more serious.Policy makers and hospital managers should focus on special groups,implement the reform of salary system,reduce nurses'workload,reasonably arrange working hours,improve the working environment of hospitals,and strengthen nurses'psychological guidance.

Objective:To understand the epidemiology of rubella and the genetic characteristics of the virus circulating during the period 2021-2022, providing basic scientific data for rubella prevention and control in China.Methods:National rubella incidence data for the period 2021-2022 were obtained from the Infectious Disease Surveillance System module and the Surveillance Report Management module of the China′s Disease Prevention and Control Information System. Positive rubella virus(RuV)isolates were obtained from the National Measles/Rubella Laboratory Network. Two nucleotide (nt) fragments [F1-480 (8 633-9 112 nt) and F2-633 (8 945-9 577 nt)] located in the E1 gene were amplified and determined by reverse transcription polymerase chain reaction (RT-PCR), and the target gene (E1-739) was obtained after collating and splicing. The sequences obtained in this study were used to construct a phylogenetic tree with the reported reference strains for genotype and lineage identification. Additionally, the phylogenetic analysis was performed to assess their genetic relatedness of RuV strains prevalent in China during 2018-2020 from GenBank database.Results:In 2021-2022, the rubella incidence in China was 0.06/100, 000 (2021: 840 cases; 2022: 784 cases), with cases primarily concentrated in the western and southern provinces. Age distribution analysis showed that rubella cases in 2021-2022 was mainly in children under 5 years of age (2021: 34.17%, 287/840; 2022: 42.09%, 330/784), with the highest proportion in children aged 0-2 years. Further analysis of the immunization history of cases revealed that in the 8-23 months age group, a significant proportion of cases had received only one dose of rubella containing vaccine (RCV); cases in the 2-14 years age group were mainly among children who had received two or more doses of RCV; however, cases over 15 years of age were primarily found in individuals who had not received RCV or had unknown immunization history. National virological surveillance data showed that totally 22 RuV virus isolates were obtained, from 6 provinces in China during 2021-2022, which belonged to lineage 1E-L2 (11 strains) and 2B-L2c (11 strains). And these viruses displayed high genetic homology with RuV prevalent from 2018 to 2020.Conclusions:The incidence of rubella in China was maintained at a low level during 2021-2022, and the prevalent RuV strains were lineage 1E-L2 and 2B-L2c.

Objective It aims to investigate the current status of patient trust in physicians among inpatients at tertiary public hospitals in China and to analyze the factors influencing this trust.The goal is to provide insights for enhancing patient trust and improving doctor-patient relationships.Methods Relying on the third"third party evaluation of national action to improve medical services"project,it surveyed inpatients from 136 tertiary public hospitals across 31 provinces(including autonomous regions and municipalities)and the Xinjiang Production and Construction Corps.A total of 21 092 inpatient questionnaires were returned.Data obtained were statistically analyzed using R software version 4.3.2.Results The trust level in attending physicians among inpatients at tertiary public hospitals in China was found to be 98.37％.Influential factors on this trust level included patient occupation,annual family income,type and region of the hospital and so on.Conclusion Overall,the level of trust in physicians among inpatients at tertiary public hospitals in China is high,though regional differences exist.It should pay attention to non-medical factors such as inpatient ward environment and hospital service quality.Improving these aspects can enhance the overall patient experience,further improve doctor-patient relationships.

Objective It aims to investigate the status quo of nurses'emotional exhaustion in tertiary public hospitals in China and analyze its influencing factors,so as to provide suggestions for formulating targeted policy measures to reduce nurses'emotional exhaustion.Methods Relying on the fifth"The Third-Party Evaluation of the China Healthcare Improvement Initiatives"project,it surveyed nurses from 143 tertiary public hospitals across 31 provinces(including autonomous regions and municipalities)and the Xinjiang Production and Construction Corps.Univariate analyses were performed using the Pearson chi-square test.Multifactorial analyses were performed using ordered multicategorical logistic regression analysis.Results The score of nurses'emotional exhaustion in tertiary public hospitals in China was 8.00(2.00～16.00),of which mild exhaustion accounted for 79.00％,moderate exhaustion accounted for 10.00％,and severe exhaustion accounted for 11.00％.Gender,age,number of children,region,type of hospital,department,employment form,assume scientific research task,excessive workload,salary and hospitals carry out psychological guidance were the influencing factors of nurses'emotional exhaustion.Conclusion Nurses in tertiary public hospitals in China are at a mild level of emotional exhaustion,but in some groups the degree is more serious.Policy makers and hospital managers should focus on special groups,implement the reform of salary system,reduce nurses'workload,reasonably arrange working hours,improve the working environment of hospitals,and strengthen nurses'psychological guidance.

Objective It aims to investigate the current status of patient trust in physicians among inpatients at tertiary public hospitals in China and to analyze the factors influencing this trust.The goal is to provide insights for enhancing patient trust and improving doctor-patient relationships.Methods Relying on the third"third party evaluation of national action to improve medical services"project,it surveyed inpatients from 136 tertiary public hospitals across 31 provinces(including autonomous regions and municipalities)and the Xinjiang Production and Construction Corps.A total of 21 092 inpatient questionnaires were returned.Data obtained were statistically analyzed using R software version 4.3.2.Results The trust level in attending physicians among inpatients at tertiary public hospitals in China was found to be 98.37％.Influential factors on this trust level included patient occupation,annual family income,type and region of the hospital and so on.Conclusion Overall,the level of trust in physicians among inpatients at tertiary public hospitals in China is high,though regional differences exist.It should pay attention to non-medical factors such as inpatient ward environment and hospital service quality.Improving these aspects can enhance the overall patient experience,further improve doctor-patient relationships.

Objective It aims to investigate the status quo of nurses'emotional exhaustion in tertiary public hospitals in China and analyze its influencing factors,so as to provide suggestions for formulating targeted policy measures to reduce nurses'emotional exhaustion.Methods Relying on the fifth"The Third-Party Evaluation of the China Healthcare Improvement Initiatives"project,it surveyed nurses from 143 tertiary public hospitals across 31 provinces(including autonomous regions and municipalities)and the Xinjiang Production and Construction Corps.Univariate analyses were performed using the Pearson chi-square test.Multifactorial analyses were performed using ordered multicategorical logistic regression analysis.Results The score of nurses'emotional exhaustion in tertiary public hospitals in China was 8.00(2.00～16.00),of which mild exhaustion accounted for 79.00％,moderate exhaustion accounted for 10.00％,and severe exhaustion accounted for 11.00％.Gender,age,number of children,region,type of hospital,department,employment form,assume scientific research task,excessive workload,salary and hospitals carry out psychological guidance were the influencing factors of nurses'emotional exhaustion.Conclusion Nurses in tertiary public hospitals in China are at a mild level of emotional exhaustion,but in some groups the degree is more serious.Policy makers and hospital managers should focus on special groups,implement the reform of salary system,reduce nurses'workload,reasonably arrange working hours,improve the working environment of hospitals,and strengthen nurses'psychological guidance.