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.

Objective:To investigate the characteristics of cardiopulmonary exercise testing and risk factors for decreased aerobic capacity in children with non-acute asthma exacerbations, to assess their cardiopulmonary health and to provide a basis for improvement.Methods:A case-control study.Sixty-one children with non-acute asthma exacerbations treated at the Outpatient Department of Children′s Hospital of Soochow University from October 2022 to December 2023 and 22 control children during the same period were included.Binary Logistic regression was employed to assess risk factors for decreased aerobic capacity in children with asthma.Results:Among the included 61 children with non-acute asthma exacerbations, there were 33 cases in the chronic persistent phase (chronic persistent phase group) and 28 in the clinical remission phase(clinical remission group).There were 22 children in the control group.During the peak exercise phase of the cardiopulmonary exercise testing, the mean kilogram body weight oxygen uptake (VO 2/kg), the percentage of predicted kilogram body weight oxygen uptake, and metabolic equivalents (Met) in the chronic persistent phase group were lower than those in the control and clinical remission phase groups.The mean VO 2/kg recovery from the cardiopulmonary exercise testing in the first minute in the chronic persistent phase group was lower than that in the control and clinical remission phase groups.The median Met and ventilation per minute recovery in the chronic persistent phase group were lower than those in the control group.The median heart rate recovery in asthma children was lower than that in control children.The percentage of cardiopulmonary exercise testing abnormalities was higher in asthma children with symptoms after excise than that in asthma children without symptoms after excise.The percentage of decreased ventilation efficiency in asthma children with symptoms after excise was higher than that in asthma children without symptoms after excise.Multivariate regression analysis showed that a higher body mass index (BMI) ( OR=1.577, 95% CI: 1.113-2.235, P=0.010) and a higher peak respiratory reserve ( OR=1.103, 95% CI: 1.018-1.195, P=0.017) were risk factors of decreased aerobic capacity.The risk of decreased aerobic capacity in the chronic persistent phase was 7.949 times higher than that in the clinical remission phase ( OR=7.949, 95% CI: 1.290-48.996, P=0.025). Conclusions:The aerobic capacity is decreased and ventilatory recovery is slower in children with chronic persistent asthma than those in healthy children.The heart rate recovery in asthma children is slower than that in healthy children.A high BMI, a high peak respiratory reserve, and chronic persistence of asthma are independent risk factors for decreased aerobic capacity in children with non-acute asthma exacerbations.asthma.

Objective:To investigate the characteristics of cardiopulmonary exercise testing and risk factors for decreased aerobic capacity in children with non-acute asthma exacerbations, to assess their cardiopulmonary health and to provide a basis for improvement.Methods:A case-control study.Sixty-one children with non-acute asthma exacerbations treated at the Outpatient Department of Children′s Hospital of Soochow University from October 2022 to December 2023 and 22 control children during the same period were included.Binary Logistic regression was employed to assess risk factors for decreased aerobic capacity in children with asthma.Results:Among the included 61 children with non-acute asthma exacerbations, there were 33 cases in the chronic persistent phase (chronic persistent phase group) and 28 in the clinical remission phase(clinical remission group).There were 22 children in the control group.During the peak exercise phase of the cardiopulmonary exercise testing, the mean kilogram body weight oxygen uptake (VO 2/kg), the percentage of predicted kilogram body weight oxygen uptake, and metabolic equivalents (Met) in the chronic persistent phase group were lower than those in the control and clinical remission phase groups.The mean VO 2/kg recovery from the cardiopulmonary exercise testing in the first minute in the chronic persistent phase group was lower than that in the control and clinical remission phase groups.The median Met and ventilation per minute recovery in the chronic persistent phase group were lower than those in the control group.The median heart rate recovery in asthma children was lower than that in control children.The percentage of cardiopulmonary exercise testing abnormalities was higher in asthma children with symptoms after excise than that in asthma children without symptoms after excise.The percentage of decreased ventilation efficiency in asthma children with symptoms after excise was higher than that in asthma children without symptoms after excise.Multivariate regression analysis showed that a higher body mass index (BMI) ( OR=1.577, 95% CI: 1.113-2.235, P=0.010) and a higher peak respiratory reserve ( OR=1.103, 95% CI: 1.018-1.195, P=0.017) were risk factors of decreased aerobic capacity.The risk of decreased aerobic capacity in the chronic persistent phase was 7.949 times higher than that in the clinical remission phase ( OR=7.949, 95% CI: 1.290-48.996, P=0.025). Conclusions:The aerobic capacity is decreased and ventilatory recovery is slower in children with chronic persistent asthma than those in healthy children.The heart rate recovery in asthma children is slower than that in healthy children.A high BMI, a high peak respiratory reserve, and chronic persistence of asthma are independent risk factors for decreased aerobic capacity in children with non-acute asthma exacerbations.asthma.

Objective:To calculate the normalized plan complexity scores (nPCSs), assess their correlations with dose verification pass rates, and utilize nPCSs to compare the complexity of treatment plans for various anatomical parts.Methods:A retrospective analysis was conducted for 288 patients who underwent helical tomotherapy from January 2020 to November 2022, with 13 complexity parameters being extracted from the treatment plans. Principal components were extracted using principal component analysis (PCA), and those significantly correlated with the gamma pass rate based on the 3%/2 mm (global) criterion were selected to calculate the nPCSs. The correlations between nPCSs and gamma pass rates based on different criteria were assessed using multiple linear regression, and the complexity of treatment plans for different anatomical parts was compared.Results:The four principal components, PC1, PC2, PC3, PC4, accounted for 33.5%, 24.4%, 11.4%, and 9.2% of the total variance, respectively, and 78.48% in total. PC1, PC2, and PC3 were linearly correlated with the gamma pass rate based on the 3%/2 mm (global) criterion ( β = 0.34, 0.31, 0.62; P < 0.05). The nPCSs were linearly correlated with the gamma pass rates based on both the 3%/2 mm (global) and 1%/1 mm (global) criteria ( β = 5.36, 32.51, P < 0.001). The head and neck plans and abdominal-pelvic plans exhibited similar nPCS distributions, with no statistically significant difference ( P > 0.05). Conclusions:The nPCSs based on PCA can effectively evaluate the feasibility of treatment plans and compare the complexity of different treatment plans.

Objective:To calculate the normalized plan complexity scores (nPCSs), assess their correlations with dose verification pass rates, and utilize nPCSs to compare the complexity of treatment plans for various anatomical parts.Methods:A retrospective analysis was conducted for 288 patients who underwent helical tomotherapy from January 2020 to November 2022, with 13 complexity parameters being extracted from the treatment plans. Principal components were extracted using principal component analysis (PCA), and those significantly correlated with the gamma pass rate based on the 3%/2 mm (global) criterion were selected to calculate the nPCSs. The correlations between nPCSs and gamma pass rates based on different criteria were assessed using multiple linear regression, and the complexity of treatment plans for different anatomical parts was compared.Results:The four principal components, PC1, PC2, PC3, PC4, accounted for 33.5%, 24.4%, 11.4%, and 9.2% of the total variance, respectively, and 78.48% in total. PC1, PC2, and PC3 were linearly correlated with the gamma pass rate based on the 3%/2 mm (global) criterion ( β = 0.34, 0.31, 0.62; P < 0.05). The nPCSs were linearly correlated with the gamma pass rates based on both the 3%/2 mm (global) and 1%/1 mm (global) criteria ( β = 5.36, 32.51, P < 0.001). The head and neck plans and abdominal-pelvic plans exhibited similar nPCS distributions, with no statistically significant difference ( P > 0.05). Conclusions:The nPCSs based on PCA can effectively evaluate the feasibility of treatment plans and compare the complexity of different treatment plans.

Abstract: Objective To elucidate the potential mechanism of Jindanjiangan Capsule in the treatment of liver fibrosis by network pharmacology and molecular docking. Methods Active ingredients and targets of Jindanjiangan Capsules were searched by Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and HERB databases, and the disease targets were screened by DisGeNET and Therapeutic Target Database (TTD) databases. The targets of the active ingredients of Jindanjiangan Capsule were matched with the disease targets, and the common targets were imported into the String database platform to construct a protein-protein interaction network (PPI) network. CytoNCA tool of Cytoscape 3.9.1 software was used for topological analysis to screen key targets. Traditional Chinese Medicine-Key Active IngredientsKey Target Network was constructed by Cytoscape 3.9.1 Software. KEGG enrichment analysis of key targets was performed through the DAVID platform. The molecular docking of active ingredients and targets was performed to verify the above results using LeDock software. Results By screening, 180 potential active ingredients and 1 340 targets of Jindanjiangan Capsule and 1 060 targets of liver fibrosis, and 273 common targets were obtained. 29 key targets related to liver fibrosis were screened out by PPI network interaction, and verified by KEGG analysis and molecular docking. Jindanjiangan capsule acts on key targets such as EGFR, MMP9, PTGS2, ESR1, PIK3CA, F2, PPARG, and PTPN11 through active components such as isovitexin, quercetin 7-O- β -D-glucoside, (3S, 6S) -3- (benzyl) -6- (4-hydroxybenzyl) piperazine-2, 5-quinone, 6-Osyringoyl-8-O-acetylshanzhiside methyl ester, tanshinone II, nortanshinone, capillaris chromone, and etanone. The specific mechanism may be related to HIF-1 signaling pathway, C-type lectin receptor signaling pathway, Toll-like receptor signaling pathway, tumor necrosis factor signaling pathway, relaxin signaling pathway, FoxO signaling pathway and so on. Conclusion Jindanjiangan capsule can effectively treat hepatic fibrosis through multi-component, multi-target and multi-pathway.

Objective:To evaluate the safety and efficacy of ciprofol and propofol for gynecological surgeries with general anesthesia through a meta-analysis.Methods:Electronic databases including PubMed, Embase, Cochrane, Web of Science, China National Knowledge Infrastructure, Wanfang Data, China Biomedical Literature Database, and China Science and Technology Journal Database were searched for randomized controlled trials comparing the safety and efficacy of ciprofol and propofol in gynecological surgeries with general anesthesia from inception to May 2023. Meta-analysis was performed using Revman 5.4 software.Results:Six randomized controlled trials were included, involving 741 patients, of which 371 received ciprofol and 370 received propofol. Compared with propofol group, the emergence time was significantly prolonged, the difference in mean arterial blood pressure, systolic blood pressure and diastolic blood pressure before and after anesthesia induction was decreased, and the incidence of injection pain, respiratory depression, body movement and hypotension was decreased in ciprofol group ( P<0.05). There were no significant differences between the two groups in terms of time of successful anesthesia induction, difference in BIS values and heart rate before and after anesthesia induction, and incidence of tachycardia, bradycardia and hypertension ( P>0.05). Conclusions:Ciprofol is comparable to propofol in terms of efficacy and has better safety than propofol when used in gynecologic surgeries with general anesthesia.

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:Investigate the relationship between dietary patterns and sarcopenia in a Chinese elderly population.Methods:Participants in this cross-sectional study were recruited from the Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study. The study population comprised 2 423 participants, with mean age of (67.6±5.2) years. Sarcopenia was defined based on the guidelines of the Asian Working Group for Sarcopenia. Three dietary patterns were derived by factor analysis: fruit and sweet pattern, traditional oriental pattern, and animal food pattern. The association between quartile categories of dietary pattern scores and the presence of sarcopenia was analyzed using multiple logistic regression models. Odds ratios ( OR) and 95% confidence interval ( CI) were calculated. Results:The prevalence of sarcopenia was 16.1%. After adjusting for confounding factors, compared with the lowest quartile, the adjusted OR ( 95%CI) of sarcopenia for the highest quintile of Fruit and sweet pattern score, Traditional oriental pattern score and Animal food pattern score were 1.06 (0.74, 1.50), 0.54 (0.34, 0.86), and 0.50 (0.33, 0.74), ( P for trend were 0.87,<0.01, and<0.001), respectively. Conclusions:The current study found that the traditional oriental pattern and animal food pattern has a protective relation for sarcopenia in elderly adults, which suggests its potential to attenuate or prevent the progression of sarcopenia.