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 investigate the factors influencing the decision to delivery interval (DDI) in emergency cesarean section in Guangzhou and the impact of DDI on maternal-infant outcomes.Methods:A retrospective study was conducted on clinical data of pregnant women who underwent emergency cesarean section at municipal and district maternal and child health hospitals in Guangzhou city in 2021. Per the classification method of emergency cesarean section and recommendations for DDI provided by National Institute for Health and Clinical Excellence guidelines, these subjects were classified into Category Ⅰ and Category Ⅱ cesarean sections. Each category was further divided into two subgroups based on DDI: the Category Ⅰ group into >30 min and ≤30 min subgroups, and the Category Ⅱ group into >75 min and ≤75 min subgroups. Chi-square test or Fisher's exact test, two independent samples t-test, Mann-Whitney U test, and logistic regression were used to analyze the potential factors influencing DDI and the impact of DDI on maternal-infant outcomes. Results:(1) Totally 502 women underwent urgent cesarean section, including 304 (60.6%) Category Ⅰ and 198 (39.4%) Category Ⅱ, were analyzed. Among the Category Ⅰ group, 30.3% (92/304) achieved a DDI of ≤30 min, while 37.4% (74/198) of Category Ⅱ cases had a DDI of ≤75 min. (2) For the Category Ⅰ cases, multivariate logistic regression showed that more patients under intravertebral anesthesia, than those under general anesthesia, had a DDI >30 min ( OR=14.04, 95% CI: 6.14-32.10) as well as more with ward-based emergencies than those with delivery room emergencies ( OR=3.21, 95% CI: 1.72-6.00, both P=0.001). Among the Category Ⅱ cases, logistic regression revealed that cesarean section during routine working hours was more likely to achieve DDI >75 min than that during resting hours ( OR=3.93, 95% CI: 2.03-7.63, P=0.001). The risk of DDI >75 min was higher in tertiary maternal and child health hospitals compared with secondary maternal and child health hospitals ( OR=2.45, 95% CI: 1.06-5.70, P=0.037). (3) Among the Category Ⅰ cases, compared with the DDI ≤30 min group, the DDI >30 min group had a lower risk of neonatal Apgar score ≤7 at 1 min ( OR=0.31, 95% CI: 0.14-0.69, P=0.004), but there was no significant difference in the risk of neonatal Apgar score ≤7 at 5 min ( OR=0.21, 95% CI: 0.04-1.17) or neonatal asphyxia ( OR=0.32, 95% CI: 0.07-1.44) between the two subgroups. In cases of Category Ⅱ cesarean sections, there was no significant difference in any maternal-infant outcomes between DDI ≤75 min and DDI >75 min subgroups. Conclusions:The location of emergency and types of anesthesia are the influencing factors of DDI for Category Ⅰ cesarean sections, while the operation time and level of maternal and child health hospital are the influencing factors of DDI for Category Ⅱ cesarean sections. We did not find any impact of DDI on maternal or infant outcome.

Objective:To investigate the application value of pelvic floor ultrasound in screening early postpartum stress urinary incontinence (SUI).Methods:A total of 220 postpartum women, who were admitted by the Department of Gynecology and Obstetrics of The People's Hospital of Hechi from January 2018 to June 2019, were selected for this study. These women were divided into SUI ( n = 52) and no SUI ( n = 168) groups according to whether SUI occurred within 42 days after delivery. Pelvic floor ultrasound parameters and clinical data were compared between the two groups. The effects of each ultrasound parameter on postpartum SUI were assessed. The receiver operating characteristic (ROC) curve was plotted for each parameter. The area under the ROC was calculated. The risk factors for postpartum SUI were investigated using the logistic regression analysis. Results:The number of deliveries (≥ 2 times), the proportion of women subjected to vaginal delivery, and neonatal weight in the SUI group were significantly higher than those in the no SUI group [ χ2 = 4.13, 3.30, t = 4.43, all P < 0.05]. There were significant differences in the bladder neck position and levator hiatus area in the resting state between the two groups ( t = 2.29, 3.09, both P < 0.05). There were significant differences in the bladder neck position, levator hiatus area, urethral rotation angle, and bladder neck mobility during the Valsalva movement between the two groups ( t = 13.14, 4.27, 15.64, 8.54, all P < 0.05). The areas under the ROC of bladder neck position and levator hiatus area in the resting state and the areas under the ROC of bladder neck position, levator hiatus area, urethral rotation angle, and bladder neck mobility during the Valsalva movement were 0.707, 0.725, 0.730, 0.771, 0.813, and 0.836, respectively. The area under the ROC of parameters used in combination was 0.849. Logistic regression analysis results revealed that the number of deliveries (≥ 2 times), bladder neck position (> 27.286 mm) and levator ani hiatus area in resting state (> 16.663 cm 2), and bladder neck position (< -2.774 mm), levator hiatus area (> 21.915 cm 2), urethral rotation angle (> 80.445°), and bladder neck mobility (> 30.501°) during the Valsalva movement were the risk factors for postpartum SUI. Conclusion:Combined use of pelvic floor ultrasound parameters is valuable for the diagnosis of postpartum SUI. Abnormal changes in the bladder neck position, levator ani hiatus area, urethral rotation angle, and bladder neck mobility are closely related to the occurrence of postpartum SUI. Therefore, combined use of pelvic floor ultrasound parameters can be preferred to screen early postpartum SUI.

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.

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 investigate the effect of Xuanfei-Liyan patch on T lymphocyte subsets in recurrent respiratory tract infection children. Methods:One hundred twenty recurrent respiratory tract infections children who met the inclusion criteria in the Health service Center of Youyi Street community of Shanghai Baoshan District from January 2017 to January 2019 were selected as the study subjects. A random number table method was used to divide them into observation group and control group with 60 cases in each group. The control group was given with conventional treatment measures. On the basis of treatment in the control group, the observation group was treated with Xuanfei-Liyan patch once every other day. Two groups were treated for 2 months. The forced expiratory volume (FEV1) and maximum peak flow rate (PEF) were measured with a pulmonary function meter, the recovery time of symptoms and signs were recorded, the levels of CD3 +, CD4 +, and CD8 + were detected by flow cytometry, and clinical efficacy was evaluated. Results:The total effective rate of the observation group and the control group was 98.33% and 86.67%, respectively, and the difference was statistically significant ( χ2=4.324, P=0.038). After treatment, FEV1 (1.61 ± 0.22 L vs. 1.30 ± 0.19 L, t=8.261) and PEF (122.93 ± 14.49 L/min vs. 103.05 ± 12.06 L/min, t=8.168) in the observation group were significantly higher than those in the control group ( P<0.01). The time of temperature recovery, cough relief, ralogue disappearance, and pharyngeal normalcy in the observation group were significantly shorter than those in the control group ( t value were 16.851, 15.667, 12.387, 8.746, respectively, all Ps<0.001). After treatment, the levels of CD3 + and CD4 + were significantly higher than those in the control group ( t=3.656 and 4.667, respectively, all Ps<0.01), and level of CD8 + was significantly lower than that of the control group ( t=5.149, P<0.01). Conclusions:The Xuanfei-Liyan patch sticking point application can improve the pulmonary function and immunity of children with recurrent respiratory tract infection, improve clinical symptoms and curative effect.

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 understand the status quo of continuing rehabilitation nursing needs of orthopaedic patients after discharge, and to analyze the influencing factors of their rehabilitation needs. Methods? Using convenience sampling method, 210 orthopaedic inpatients from March to June 2017 in a ClassⅢ Grade A hospital in Wuhan were selected. The status quo and influencing factors of patients' rehabilitation needs after discharge were investigated by self-made Questionnaire of Orthopaedic Patients' Continuing Rehabilitation Nursing Needs. Results? The total score of continuing rehabilitation instruction needs of 210 patients was (46.35 ±13.20), 47.2% of them hoped to continue rehabilitation through network communication, 85.9% chose to do rehabilitation at home, 84.8% hoped that the former medical staff would provide continuing rehabilitation instruction, and 83.3% accepted rehabilitation exercises with the help of Wechat public account. Multivariate linear regression analysis showed that education level, disease diagnosis, knowledge of rehabilitation and willingness to guide rehabilitation were independent influencing factors (β=-3.138, 3.162,-3.985,-3.786; P＜ 0.01). Conclusions? Orthopaedic patients have a strong demand for rehabilitation knowledge and exercise. It is suggested that medical staff strengthen continuing rehabilitation nursing exercise and knowledge instruction for orthopaedic patients through the internet Wechat platform.

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.