Objective To understand the disease spectrum of a natural village in an area with high incidence of esophageal cancer to provide a reference for precise prevention and control. Methods From 2008 to 2024, 711 asymptomatic people over the age of 35 years in a natural village with high incidence of esophageal cancer in China were surveyed, and 171 of them were subjected to gastroscopy, biopsy, and pathological examination. All participants were followed up for a long time, and their disease history was recorded. Results A total of 16 years of follow-up were performed, and 703 people were effectively followed up. In 2008, 171 people underwent gastroscopy, and 160 people had biopsy and pathological results in endoscopic screening. By 2024, 76 people had been diagnosed with malignant tumors of 12 different types, and among these people, 45 had esophageal cancer. Conclusion Esophageal cancer remains a significant cause of morbidity and mortality from malignant tumors in this region. Biopsy and pathological examination should be strengthened during gastroscopy, and follow-ups and regular check-ups should be given high importance to reduce the incidence and mortality rates of esophageal cancer.

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.

Objective To investigate the relationship between tooth loss and the occurrence of esophageal cancer in a natural village in Wenfeng District, Anyang City, Henan Province. Methods A prospective cohort study was conducted to observe the occurrence of tooth loss and esophageal cancer among the asymptomatic residents of the natural village for 16 years from January 2008 to July 2024. Data were analyzed by chi-square test, binary logistic regression, and restricted cubic spline. Results Among the total population of 711 cases, 136 cases were lost to follow-up and 575 cases were included in the final statistics, including 45 cases with esophageal cancer. Significant statistical difference was found between esophageal cancer patients with and without tooth loss (P<0.05). Logistic regression analysis showed that tooth loss was associated with the occurrence of esophageal cancer (OR=3.977, 95%CI: 1.543-10.255). After the adjustment for confounders, tooth loss remained significantly associated with the occurrence of esophageal cancer (OR=3.038, 95%CI: 1.035-8.914). A nonlinear dose-response relationship was observed between the number of teeth lost and the incidence of esophageal cancer. When the number of teeth lost was less than 12, the risk of esophageal cancer increased with the number of teeth lost. When more than 12 teeth were lost, the risk of esophageal cancer decreased as the number of teeth lost increased. Conclusion Tooth loss is a risk factor for the occurrence of esophageal cancer in this natural village. When the number of teeth lost is less than 12, the risk of esophageal cancer increases with the number of teeth lost.

As a type of experiential psychotherapy,Satir communication model can help the individual system and the family system achieve a state from dysfunction to healthy function,which can enrich the intervention connotation of family support and provide a new direction for the realization of full-life circle care.This paper aims to introduce the concept,core elements,common treatment techniques,application and effects,current challenges and relevant suggestions of Satir communication model in the nursing field from the perspective of family support,in order to provide references for the localization development and clinical integration of Satir communication model in the field of nursing in China.

Objective:To compare the effects of different positioning and puncture methods for epidural anesthesia in obese parturients undergoing cesarean section.Methods:In this prospective, randomized, controlled study, 175 obese parturients, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, with a body mass index of > 30 kg/m 2, who underwent elective cesarean section with epidural anesthesia at Henan Provincial People′s Hospital from July 2023 to April 2024, were selected and assigned into 4 groups using a random number table method: palpation positioning + median approach to puncture group (PM group, n=44), body surface marker positioning + paramedian approach to puncture group (BP group, n=43), ultrasound-assisted positioning + paramedian approach to puncture group (UP group, n=45), and ultrasound-assisted positioning + ultrasound-guided in-plane approach to puncture group (UU group, n=43). The procedures were performed by anesthesiology residents skilled in the four different epidural anesthesia positioning and puncture methods. Main observation indicators: success rate of puncture at first attempt and total success rate of puncture. Secondary observation indicators: the number of puncture, changes in puncture interspaces, positioning time, puncture time, anesthesia operation time, postoperative nausea and vomiting, sensory abnormalities at the puncture site, bleeding at the puncture site, maternal satisfaction rates, and occurrence of low back pain at day 7, 1 month, 2 months, and 3 months postoperatively. Results:In this study, 2 cases were excluded from PM group, 2 from BP group, 2 from UP group, and 2 from UU group. The total success rates of puncture were as follows: 95% (40/42) in PM group, 98% (40/41) in BP group, 93% (40/43) in UP group, and 98% (40/41) in UU group. There was no significant difference in the total success rates of puncture among the four groups ( P>0.05). Compared to PM group, the success rate of puncture at first attempt was significantly increased, the rate of changes in puncture interspaces was decreased, the positioning time was shortened, the incidence of nausea and vomiting was decreased, satisfaction rates were increased, and the incidence of low back pain was reduced at 7 days after operation in BP group; the success rate of puncture at first attempt was significantly increased, the number of puncture was reduced, the rate of changes in puncture interspaces was decreased, the positioning time, puncture time and anesthesia operation time were shortened, the satisfaction rates were increased, and the incidence of low back pain was decreased at 7 days after operation in UP group; the rate of changes in puncture interspaces was significantly decreased, and the positioning time was shortened in UU group ( P<0.05). Compared to BP group, the puncture time was significantly shortened in UP group, and the number of puncture was significantly increased, the anesthesia operation time was prolonged, the incidence of nausea and vomiting was increased, and the satisfaction rate was decreased in UU group ( P<0.05). Compared to UP group, the success rate of puncture at first attempt was significantly decreased, the number of puncture was increased, the puncture time and anesthesia operation time were prolonged, the incidence of nausea and vomiting was increased, and the satisfaction rates were decreased in UU group ( P<0.05). Conclusions:Ultrasound-assisted positioning combined with the paramedian approach to puncture can raise the success rate of puncture at first attempt, reduce the development of puncture-related complications, and increase the maternal satisfaction in obese parturients undergoing cesarean section.

Objective:To compare the effects of different positioning and puncture methods for epidural anesthesia in obese parturients undergoing cesarean section.Methods:In this prospective, randomized, controlled study, 175 obese parturients, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, with a body mass index of > 30 kg/m 2, who underwent elective cesarean section with epidural anesthesia at Henan Provincial People′s Hospital from July 2023 to April 2024, were selected and assigned into 4 groups using a random number table method: palpation positioning + median approach to puncture group (PM group, n=44), body surface marker positioning + paramedian approach to puncture group (BP group, n=43), ultrasound-assisted positioning + paramedian approach to puncture group (UP group, n=45), and ultrasound-assisted positioning + ultrasound-guided in-plane approach to puncture group (UU group, n=43). The procedures were performed by anesthesiology residents skilled in the four different epidural anesthesia positioning and puncture methods. Main observation indicators: success rate of puncture at first attempt and total success rate of puncture. Secondary observation indicators: the number of puncture, changes in puncture interspaces, positioning time, puncture time, anesthesia operation time, postoperative nausea and vomiting, sensory abnormalities at the puncture site, bleeding at the puncture site, maternal satisfaction rates, and occurrence of low back pain at day 7, 1 month, 2 months, and 3 months postoperatively. Results:In this study, 2 cases were excluded from PM group, 2 from BP group, 2 from UP group, and 2 from UU group. The total success rates of puncture were as follows: 95% (40/42) in PM group, 98% (40/41) in BP group, 93% (40/43) in UP group, and 98% (40/41) in UU group. There was no significant difference in the total success rates of puncture among the four groups ( P>0.05). Compared to PM group, the success rate of puncture at first attempt was significantly increased, the rate of changes in puncture interspaces was decreased, the positioning time was shortened, the incidence of nausea and vomiting was decreased, satisfaction rates were increased, and the incidence of low back pain was reduced at 7 days after operation in BP group; the success rate of puncture at first attempt was significantly increased, the number of puncture was reduced, the rate of changes in puncture interspaces was decreased, the positioning time, puncture time and anesthesia operation time were shortened, the satisfaction rates were increased, and the incidence of low back pain was decreased at 7 days after operation in UP group; the rate of changes in puncture interspaces was significantly decreased, and the positioning time was shortened in UU group ( P<0.05). Compared to BP group, the puncture time was significantly shortened in UP group, and the number of puncture was significantly increased, the anesthesia operation time was prolonged, the incidence of nausea and vomiting was increased, and the satisfaction rate was decreased in UU group ( P<0.05). Compared to UP group, the success rate of puncture at first attempt was significantly decreased, the number of puncture was increased, the puncture time and anesthesia operation time were prolonged, the incidence of nausea and vomiting was increased, and the satisfaction rates were decreased in UU group ( P<0.05). Conclusions:Ultrasound-assisted positioning combined with the paramedian approach to puncture can raise the success rate of puncture at first attempt, reduce the development of puncture-related complications, and increase the maternal satisfaction in obese parturients undergoing cesarean section.

As an important method of systems biology, metabolomics not only plays an important role in life science but also has been increasingly widely used in radiation protection research. Based on the clinical studies of metabolomics and metabolomics methods in rodent and primate models, this article summarizes the methods and techniques of metabolomics in the diagnosis of radiation damage, the study of radiation damage mechanisms, and the development of radiation protection drugs.

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 explore the impact of function of mobile phone use on self-perceived stress and mobile phone addiction of high vocational students, and the mediating role of coping styles between different mobile phone functions and mobile phone addiction. Methods: A total of 911 participants in two vocational colleges in Wuhan and Liaocheng were investigated by using convenient sampling method. Smartphone Usage, Simplified Coping Style Questionnaire, and Stress subscale of Depression-Anxiety-Stress Scale(short version) were administered to participants. Results: Female students scored significantly higher on mobile phone social features (4.77±1.06) than males( t =2.05， P =0.04), while males scored significantly higher on MPATS and DASS-S, Negative Coping Style subscales than females( P <0.01). The social function of the mobile phone was positively related to the positive coping styles( r =0.17, P <0.01). The game features of mobile phone were positively related to negative coping styles, stress and mobile addiction( P <0.01). Negative coping style could positively predict stress and mobile phone addiction( β =0.53, 0.50, P <0.01). Negative coping styles and stress had significant chain mediation effects in nonsocial functions and mobile phone addiction(95% CI =0.06-0.24, P <0.01). Conclusion Students of vocational college who often use cellphone not for social purpose have higher self-perceived stress. The game function of mobile phones had an adverse effect on the physical and mental health of vocational students. Negative coping style is a powerful predictor of stress and mobile phone addiction.

Objective To explore the feature of embryonic communication between the carotid and vertebro-basilar system using MRA of head and neck on MR. Methods The MRA images from 7 246 consecutive patients in Liaocheng People's hospital between June 2009 and December 2015 were retrospectively reviewed. The feature of embryonic communication between internal carotid, external carotid artery and vertebro-basilar system using MRA was analyzed by two doctors. Results Forty-four cases of embryonic communication between the carotid and vertebro-basilar system were found. Thirty-nine cases of primitive trigeminal artery (PTA) and primitive trigeminal artery variants (PTAV) were detected by MRA. The prevalence of both PTA and PTAV was 0.54% (PTA, 27 cases;PTAV, 12 cases). Twenty-three cases of PTA were lateral types;four cases were medial types. All PTA originated from C4 portion of internal carotid artery, of which 27 cases connected with the basilar artery and two cases connected with the superior cerebellar artery. The region of the BA proximal to the site of convergence with the PTA was hypoplastic in seven cases and completely absent in two cases. Three cases of primitive hypoglossal artery and 2 cases of primitive proatlantal artery were detected by MRA. The prevalence of primitive hypoglossal artery and primitive proatlantal artery was 0.04% and 0.03 % respectively. Two cases of primitive hypoglossal artery were from the lateral internal carotid artery and one was from the external carotid artery. It's all on the right side. One case of primitive proatlantal artery was on the left which arises from the external carotid artery, one on the right which originated from the outer part of the internal carotid artery. Thirty-four cases were coexisted with other variants of head and neck vessels. All of the primitive hypoglossal arteries were coexisted with vertebral artery absence. One case of primitive proatlantal intersegmental artery was coexisted with vertebral artery dysplasia. Eighteen cases were associated with cerebral infarctions, and three cases with aneurysm. Conclusions MRA can accurately assess the variants of carotid-vertebasilar anastomoses and have diagnostic significance.