Nonpharmaceutical interventions (NPIs) have been commonly deployed to prevent and control the spread of the coronavirus disease 2019 (COVID-19), resulting in a worldwide decline in influenza prevalence. However, the influenza risk in China warrants cautious assessment. We conducted a cross-sectional, seroepidemiological study in Shandong Province, Northern China in mid-2021. Hemagglutination inhibition was performed to test antibodies against four influenza vaccine strains. A combination of descriptive and meta-analyses was adopted to compare the seroprevalence of influenza antibodies before and during the COVID-19 pandemic. The overall seroprevalence values against A/H1N1pdm09, A/H3N2, B/Victoria, and B/Yamagata were 17.8% (95% CI 16.2%-19.5%), 23.5% (95% CI 21.7%-25.4%), 7.6% (95% CI 6.6%-8.7%), and 15.0 (95% CI 13.5%-16.5%), respectively, in the study period. The overall vaccination rate was extremely low (2.6%). Our results revealed that antibody titers in vaccinated participants were significantly higher than those in unvaccinated individuals (P < 0.001). Notably, the meta-analysis showed that antibodies against A/H1N1pdm09 and A/H3N2 were significantly low in adults after the COVID-19 pandemic (P < 0.01). Increasing vaccination rates and maintaining NPIs are recommended to prevent an elevated influenza risk in China.

Objective:To investigate the short-term clinical efficacy of Kamikawa anasto-mosis and jejunal interposed double channel anastomosis in laparoscopic proximal gastrectomy.Methods:The retrospective cohort study was conducted. The clinicopathological data of 68 patients with esophagogastric junctional tumors and upper gastric tumors who underwent laparoscopic proximal gastrectomy in two medical centers, including 63 cases in the Changzhi People's Hospital Affiliated to Changzhi Medical College and 5 cases in the Heji Hospital Affiliated to Changzhi Medical College, from March 2018 to December 2020 were collected. There were 57 males and 11 females, aged 62(range, 39?78)years. Of 68 patients, 35 patients undergoing Kamikawa anastomosis in laparoscopic proximal gastrectomy were allocated into Kamikawa group, and 33 patients under-going jejunal interposed double channel anastomosis in laparoscopic proximal gastrectomy were allocated into double channel group. Observation indicators: (1) intraoperative situations; (2) post-operative situations; (3) follow-up. The patients were followed up by outpatient examinations and telephone interview to detect the postoperative score of chew-wun wu special symptoms, post-operative reflux anastomotic esophagitis and anastomotic stenosis up to December 2021. Measure-ment data with normal distri-bution were represented as Mean±SD, and comparison between groups was performed by the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was conducted by Mann-Whitney U test. Comparison of ordinal data was performed by nonparametric rank sum test. Count data were expressed as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability method. Results:(1) Intraoperative situations. All the 68 patients successfully under-went laparoscopic proximal gastrectomy combined with D 1+ lymph node dissection. The operation time and volume of intraoperative blood loss of the Kamikawa group were (5.15±0.31)hours and (89±11)mL, versus (4.21±0.11)hours and (142±20)mL of the double channel group, respectively, showing significant differences between the two groups ( t=2.81, ?2.34, P<0.05). The digestive tract reconstruction time and the number of lymph node dissection were (1.95±0.13)hours and 30.4±2.4 of the Kamikawa group, versus (1.69±0.76)hours and 28.0±2.4 of the double channel group, respectively, showing no significant difference between the two groups ( t=1.79, 0.73, P>0.05). (2) Postoperative situations. The time to postoperative first flatus, duration of drainage tube placement, duration of postoperative hospital stay were (3.03±0.12)days, (5.46±0.22)days, (13.00±0.50)days of the Kamikawa group, versus (4.42±0.21)days, (9.97±0.76)days, (16.46±0.92)days of the double channel group, showing significant differences in the above indicators between the two groups ( t=?5.80,?5.58, 3.40, P<0.05). Cases with or without drainage tube placement were 32 and 3 of the Kamikawa group, versus 33 and 0 of the double channel group, respectively, showing no significant difference between the two groups ( P>0.05). Cases with grade 1, grade 2, grade 3, grade 4 complica-tions of Clavien-Dindo classification were 31, 0, 4, 0 of the Kamikawa group, versus 27, 3, 1, 2 of the double channel group, respectively, showing a significant difference between the two groups ( Z=?6.28, P<0.05). Postoperative anastomotic stenous, reflux symptoms, anastomotic fistula, pancreatic fistula, pulmonary infection were found in 4, 2, 0, 0, 0 case of the Kamikawa group and 0, 1, 3, 1, 2 cases of the double channel group, respectively. There was no significant difference in the above indicators between the two groups ( P>0.05). There was no complication of incisional infection, abdominal hemorrhage, lymphatic fistula or gastroparesis in either group. Of the 4 patients with perioperative anastomotic stenosis in the Kamikawa group, 2 cases were improved after once gastroscopic balloon dilatation, 2 cases were improved after 4 times of gastro-scopic balloon dilatation. (3) Follow-up. All the 68 patients were followed up at postoperative 3, 6, 12 months. The scores of chew-wun wu special symptoms scale at postopertaive 12 months of the Kamikawa group and double channel group were 16.8±0.7 and 14.6±0.7, respectively, showing a significant difference between the two groups ( t=2.20, P<0.05). There were 2 cases of grade B reflux esophagitis and 1 case of grade B reflux esophagitis, respectively, showing no significant difference between the two groups ( P>0.05). There was no anastomotic stenosis occurred in either group. Conclusions:Laparos-copic proximal gastrectomy with Kamikawa anastomosis or jejunal interposed double channel anastomosis is safe and feasible for esophagogastric junction tumors and upper gastric tumors. The Kamikawa anastomosis has less volume of intraoperative blood loss, shorter time to postoperative first flatus, duration of drainage tube placement and postoperative hospital stay, higher quality of postoperative lfe.

Objective:To investigate the influencing factors and regularity of inferior mediastinal lymph node metastasis in Siewert type Ⅱ and Ⅲ adenocarcinoma of esophagogastric junction (AEG).Methods:The retrospective case-control study was conducted. The clinicopatho-logical data of 185 Siewert type Ⅱ and Ⅲ AEG patients in two medical centers (113 cases in Changzhi People's Hospital Affiliated to Changzhi Medical College and 72 cases in Heji Hospital Affiliated to Changzhi Medical College) from January 2017 to January 2022 were collected. There were 143 males and 42 females, aged (64±8)years. Patients underwent radical resection of AEG combined with inferior mediastinal lymph node dissection. Observation indicators: (1) clinicopathological charac-teristics of Siewert type Ⅱ and Ⅲ AEG patients; (2) analysis of influencing factors for inferior mediastinal lymph node metastasis in Siewert type Ⅱ and Ⅲ AEG; (3) regularity of inferior mediastinal lymph node metastasis in Siewert type Ⅱ and Ⅲ AEG. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was analyzed using the Mann-Whitney U test. Count data were represented as absolute numbers or percentages, and comparsion between groups was analyzed using the chi-square test or Fisher exact probability. Comparison of ordinal data was analyzed using the rank sum test. Univariate and multivariate analyses were conducted using the Logistic regression model. Results:(1) Clinicopathological characteristics of Siewert type Ⅱ and Ⅲ AEG patients. Pathologic staging as stage Ⅰ, Ⅱ, Ⅲ and Ⅳ, degree of tumor invasion as stage T1, T2, T3 and T4, length of esophageal invasion ≤1 cm, >1 cm and ≤2 cm, >2 cm and ≤3 cm, >3 cm and ≤4 cm were found in 30, 61, 75, 7, 3, 41, 79, 50, 101, 46, 18, 8 cases of the Siewert type Ⅱ and Ⅲ AEG patients without inferior mediastinal lymph node metastasis, respectively, versus 0, 2, 10, 0, 0, 0, 5, 7, 4, 3, 2, 3 cases of the Siewert type Ⅱ and Ⅲ AEG patients with inferior mediastinal lymph node metastasis, showing a significant differences between them ( Z=?2.21, ?2.49, ?2.22, P<0.05). (2) Analysis of influencing factors for inferior mediastinal lymph node metastasis in Siewert type Ⅱ and Ⅲ AEG. Results of univariate analysis showed that pathological staging, depth of tumor invasion and length of esophageal invasion were related factors affecting inferior mediastinal lymph node metastasis in Siewert type Ⅱ and Ⅲ AEG ( odds ratio=2.48, 3.26, 2.03, 95% confidence intervals as 1.02?6.01, 1.21?8.80, 1.18?3.51, P<0.05). Results of multivariate analysis showed that depth of tumor invasion and length of esophageal invasion were independent influening factors affecting inferior mediastinal lymph node metastasis in Siewert type Ⅱ and Ⅲ AEG ( odds ratio=4.01, 2.26, 95% confidence interval as 1.35?11.96, 1.26?4.06, P<0.05). The inferior mediastinal lymph node metastasis probability of AEG patients with the length of esophageal invasion >3 cm and ≤4 cm was 9.47 times that of AEG patients with the length of esophageal invasion ≤1 cm. (3) Regularity of inferior mediastinal lymph node metastasis in Siewert type Ⅱ and Ⅲ AEG. The number of inferior mediastinal lymph nodes including No.110, No.111 and No.112 dissected in 185 patients of Siewert type Ⅱ and Ⅲ AEG were 127, 50 and 27. The number of lymph nodes dissected and the number of metastatic lymph nodes in No.110 and No.111 of patients with length of esophageal invasion ≤1 cm, >1 cm and ≤2 cm, >2 cm and ≤3 cm, >3 cm and ≤4 cm were 69, 4, 42, 4, 4, 1, 12, 4 and 23, 0, 17, 0, 7, 2, 3, 0, respectively. There were significant differences in metastatic lymph nodes in No.110 and No.111 of patients with length of esophageal invasion ≤1 cm, >1 cm and ≤2 cm, >2 cm and ≤3 cm, >3 cm and ≤4 cm ( χ2=8.45, 7.30, P<0.05). Of the 185 patients of Siewert type Ⅱ and Ⅲ AEG, the ratio of cases with inferior mediastinal lymph nodes metastasis was 6.49%(12/185). The ratio of inferior mediastinal lymph nodes metastasis in cases with length of esophageal invasion ≤1 cm, >1 cm and ≤2 cm, >2 cm and ≤3 cm, >3 cm and ≤4 cm were 3.81%(4/105), 6.12%(3/49), 10.00%(2/20), 27.27%(3/11), respectively. The ratio of No.110 lymph nodes metastasis in cases with length of esophageal invasion ≤1 cm, >1 cm and ≤2 cm, >2 cm and ≤3 cm, >3 cm and ≤4 cm were 2.86%(3/105), 6.12%(3/49), 5.00%(1/20), 27.27%(3/11), respectively, showing a significant difference among them ( χ2=8.26, P<0.05). Conclusions:Depth of tumor invasion and length of esophageal invasion are independent influening factors affecting inferior mediastinal lymph node metastasis in Siewert type Ⅱ and Ⅲ AEG. The rate of inferior mediastinal lymph node metastasis increases with the increase of the length of esophageal invasion.

In recent years, the overall incidence of gastric cancer has been decreasing worldwide, while the incidence of the esophagogastric junction tumor is increasing year by year. With the progress of the diagnostic technology of upper gastrointestinal tumors and the gradual popularization of early cancer screening, the detection rate of early esophagogastric junction tumor keeps increasing. Therefore, in recent years, the clinical application of gastric function preserving surgery is gradually increasing. As an important part of the surgical treatment strategy of esophagogastric junction tumors, proximal gastrectomy has attracted more and more attention with the confirmation of oncological safety. Compared with total gastrectomy, patients after proximal gastrectomy have better nutritional status and quality of life. However, the high incidence of reflux esophagitis after traditional proximal gastrectomy has seriously affected the quality of life of patients, and also hindered the application of proximal gastrectomy in esophagogastric junction tumors. How to reduce the occurrence of reflux esophagitis after proximal gastrectomy by optimizing the method of digestive tract reconstruction has been a big challenge in clinical practice. This article reviews the current methods of anti-reflux surgery for proximal gastrectomy for esophagogastric junction tumors, aiming to provide a reference for choosing a reasonable anti-reflux surgery.

In recent years, the overall incidence of gastric cancer has been decreasing worldwide, while the incidence of the esophagogastric junction tumor is increasing year by year. With the progress of the diagnostic technology of upper gastrointestinal tumors and the gradual popularization of early cancer screening, the detection rate of early esophagogastric junction tumor keeps increasing. Therefore, in recent years, the clinical application of gastric function preserving surgery is gradually increasing. As an important part of the surgical treatment strategy of esophagogastric junction tumors, proximal gastrectomy has attracted more and more attention with the confirmation of oncological safety. Compared with total gastrectomy, patients after proximal gastrectomy have better nutritional status and quality of life. However, the high incidence of reflux esophagitis after traditional proximal gastrectomy has seriously affected the quality of life of patients, and also hindered the application of proximal gastrectomy in esophagogastric junction tumors. How to reduce the occurrence of reflux esophagitis after proximal gastrectomy by optimizing the method of digestive tract reconstruction has been a big challenge in clinical practice. This article reviews the current methods of anti-reflux surgery for proximal gastrectomy for esophagogastric junction tumors, aiming to provide a reference for choosing a reasonable anti-reflux surgery.

Objective To investigate the laparoscopic feature and its relationship with clinical manifesta-tions in infertile patients with endometriosis. Methods From Jan.2013 to Jan.2017,infertile patients who received hysteroscopy and hysteroscopy combination surgery in Ganzhou People′s Hospital were enrolled in this ret-rospective study.The basic clinical data and the distribution of endometriotic lesions were recorded and analyzed in patients with endometriosis simultaneously. Analysis was performed about the clinical manifestations and the rAFS stage of the patients. Results 204 patients are totally enrolled in the study. Among them,120 patients(58.8%) had endometriosis. The presence of menorrhea,dyspareunia,tenesmus,chronic pelvic pain,hypermenorrhea, adnexal mass,restricted uterine mobility,tenderness of adnexa,and tenderness nodules of posterior vaginal fornix are clinically statistically significant.In addition,the presence of ovarian endometrioma is also a significant clinical factor that is close related with the rAFS stage of infertile patients with endometriosis. Moreover,uterosacral liga-ment,rectovaginal septum,vagina and bowel were more common infiltrated in stage Ⅲ and stage Ⅳ endometrio-sis. Conclusions For infertile patients,detailed case history,overall bimanual examination and trans-vaginal ultrasound examination are very important to help diagnosis endometriosis preoperatively and provide evidence for the selection of individualized treatment strategies.

Objective To explore the influencing factors of sub-health status among the migrant workers in Dongguan City.Methods A total of 740 migrant workers in Dongguan city were extracted by the stratified random sampling method.The SubHealth Measurement Scale Version 1.0(SHMS V 1.0) was adopted to test the health status.The data were analyzed by Logistic regression analysis.Results The univariate analysis showed that the marital status,average daily working time,monthly family per capita income,living conditions,drinking,breakfast,nutritional status,vigils,living conditions satisfaction,sedentary desk operation and experiencing negative events had statistical significance(P＜0.05).In the Logistic regression analysis:average daily working time,vigils and experiencing negative events were the risk factors of sub-health status occurrence,their odds ratio(OR) and 95 ％ confidence interval(CI)were 1.971(1.211,3.205),2.183(1.378,3.459) and 2.135(1.353,3.369),respectively.Breakfast and nutritional status were the protective factors of sub-health status occurrence,their OR and 95 ％ CI were 0.706 (0.526,0.947) and 0.386(0.239,0.625),respectively.Conclusion The unhealthy living habits and experiencing negative events affect the health of migrant workers in Dongguan City.

Objective: To explore influence of ginsenoside Rg1 on coronary artery angiogenesis in rats with acute myocardial infarction (AMI) and its mechanism.Methods: A total of 120 Wistar rats were randomly and equally divided into sham operation group (only received thoracotomy to expose heart without coronary ligation),AMI group (no treatment after model development with ligating left coronary artery) and ginsenoside group (received ginsenoside Rg1 injection on 3h after AMI model development).Infarct area, expressions of vascular endothelial growth factor (VEGF) and its receptor (Flk-1), and VIII factor expression were respectively measured on 24h, one week and five weeks after model development.Results: Compared with sham operation group after five weeks, there were significant rise in myocardial infarction area, number of new blood capillaries and expression levels of VEGF and its receptor Flk-1 in ginsenoside group and AMI group, P<0.05 or <0.01;compared with AMI group, there was significant reduction in myocardial infarction area [(51.31±9.67)% vs.(29.33±6.70)%], and significant rise in number of new blood capillaries [(18.31±5.07) vs.(46.79±13.67)], expressions of VEGF [greyscale value: (84.3±8.7) vs.(32.9±16.7), greyscale value was inversely proportional to expression] and Flk-1 [(17.6±8.7) vs.(59.9±16.2)] in ginsenoside group, P<0.05 or <0.01.Conclusion: Application of ginsenoside Rg1 in AMI rat model can mobilize marrow stem cells gather in ischemic myocardium, upregulate expressions of VEGF and its receptor Flk-1, effectively promote angiogenesis of blood capillaries, and reduce myocardial infarction area.

Objective To investigate the prevalence and influencing factors of sub-health status of the migrant workers in Dongguan City,in order to provide scientific preferences for preventing sub-health status.Methods Using the stratified random sampling method,740 migrant workers from ten towns(disetricts) in Dongguan city from August 2015 to August 2016 were recruited in this study.The sub-health measurement scale version 1.0 (SHMS V1.0) was applied to evaluate the sub-health status of migrant workers.The SHMS V1.0 scores were compared among migrant workers with different demographic characteristics,and the multivariate linear regression analysis was utilized to explore the influencing factors.Results A total of 718 valid questionnaires were collected,and the effective recovery rate was 97.03％.The sub-health status was detected in 483 migrant workers,and the prevalence rate of sub-health status was 81.6％.The migrant workers' subscale scores of physical sub-health (PS),mental subhealth (MS),social sub-health (SS) and total scale (TS) were (70.25-4-12.25),(64.21± 13.83),(62.21-4-13.87) and (66.114-11.15),respectively.The PS scale scores among migrant workers with different monthly household incomes per capita,and different inhabit situations;the MS scale scores among migrant workers with different ages,educations,marital status,monthly household incomes per capita,and inhabit situations;the SS scale scores among migrant workers with different genders,educations,and inhabit situations;and TS scores mong migrant workers with different educations,monthly household incomes per capita,and inhabit situations were statistically significant different (P＜0.05).The multivariate linear regression analysis showed that educations and inhabit situations were the influencing factors for TS score (P＜0.05).Conclusion The sub-health status of migrant workers in Dongguan City is serious,and the influencing factors are educations and inhabit situations.

Objective To investigate the changes of peripheral blood tacrolimus concentration and lymphocyte subsets in the uterus transplant recipient,and provide the evidence for monitoring the immune status after uterus transplantation.Methods The peripheral blood tacrolimus concentrations of the uterus transplant recipient during 1 year after transplantation were measured with the microparticle enzyme immunoassay (MEIA).Meanwhile,the whole blood cell counts and lymphocyte subsets were determined by the blood analyzer and flow cytometer,respectively.Results The blood tacrolimus concentrations of the uterus transplant recipient in the first month and second month after transplantation were (13.51 ± 3.92) ng/mL and (15.58 ± 1.19) ng/mL,respectively.The lymphocyte absolute counts were normal before transplantation.At the fifth day after transplantation,the counts of CD3 + T lymphocytes,CD4 + T lymphocytes,CD8 + T lymphocytes and NK cells and the ratio of CD4/CD8 were significantly decreased.One week after transplantation,the counts of CD4 + T lymphocytes were recovered to the normal range and maintained,but its recovery was slower than that of CD8 + T lymphocytes.The ratio of CD4/CD8 ranged from 0.4 to 0.8 during 10 days after transplantation,and increased and maintained between 0.8 and 1.1 after that.The counts of NK cells increased gradually from the 10th day after transplantation,but still did not recover to the level before transplantation even at the 20th day after transplantation.However,the counts and percentages of B lymphocytes did not decrease but increased at the fifth day after transplantation,and recovered to normal gradually from the 10th day after transplantation.There was no significant correlation between the CD3 + T lymphocyte count and blood tacrolimus concentration.Conclusion The dynamic changes of blood lymphocyte subsets and tacrolimus concentration exist in the uterus transplant recipient,which need to be further verified by a large amount of clinical data.