Objective To investigate the efficacy of methylprednisolone in preventing postoperative pulmonary infections in locally advanced esophageal cancer patients undergoing neoadjuvant chemotherapy combined with immunotherapy.Methods A total of 89 patients with locally advanced esophageal cancer treated at the First Affiliated Hospital of Xinxiang Medical University from January 2022 to December 2023 were selected as the research subjects.All patients underwent thoracolaparoscopic radical esophagectomy for esophageal cancer.The patients were randomly divided into an observation group(n=45)and a control group(n=44)using a random number table method.In the observation group,one patient with intraoperative thoracotomy,two patients with extensive pleural adhesion,and one patient with preoperative upper respiratory tract infection were excluded.In the control group,one patient with extensive pleural adhesion and one patient with preoperative upper respiratory tract infection were excluded.As a result,a total of 83 patients were included in the study,with 41 in the observation group and 42 in the control group.Preoperatively,a neoadjuvant treatment regimen of paclitaxel(albumin-bound)+nedaplatin in combination with camrelizumab was given to patients in both groups for 2 cycles.Patients in the control group received conven-tional anti-infection treatment after surgery,while patients in the observation group were intravenously injected with methylpred-nisolone at a dose of 1 mg·kg-1 daily from the first to the third day after surgery.Postoperative inflammatory markers,incidence of postoperative pulmonary infections,incidence of anastomotic fistula,postoperative hospital stay,and total hospitalization costs were compared between the two groups.Results There were no statistically significant differences in leukocyte count,neutrophil ratio,procalcitonin(PCT),high-sensitivity C-reactive protein(hs-CRP),and interleukin-6(IL-6)levels of patients between the two groups before treatment(P＞0.05).On day 1 and 4 after treatment,patients in the observation group had significantly higher leu-kocyte count,neutrophil ratio,PCT,hs-CRP,and IL-6 levels compared to those before treatment(P＜0.05).On postoperative day 4,the leukocyte count,neutrophil ratio,PCT,hs-CRP,and IL-6 levels were significantly lower than those on day 1 postopera-tively(P＜0.05).On postoperative days 1 and 4,the leukocyte count,neutrophil ratio,PCT,hs-CRP and IL-6 levels of patients in the control group were significantly higher than those in the preoperative period(P＜0.05),and the leukocyte count,neutro-phil ratio and hs-CRP level were significantly lower on day 4 after surgery than on day 1 after surgery(P＜0.05);the differe-nces in PCT and IL-6 level of patients between day 4 after surgery and day 1 after surgery were not statistically significant(P＞0.05).On postoperative day 1,there were no statistically significant differences in leukocyte count,neutrophil ratio,PCT,hs-CRP,and IL-6 levels between patients in the observation group and the control group(P＞0.05).On postoperative day 4,the leukocyte count,neutrophil ratio,PCT,hs-CRP,and IL-6 levels of patients in the observation group were significantly lower than those in the control group(P＜0.05).The incidence of pulmonary infections in patients in the control group and the ob-servation group was 30.9％(13/42)and 12.2％(5/41),respectively;the incidence of pulmonary infections in patients in the observation group was significantly lower than that in the control group(x2=4.298,P＜0.05).The incidence of anasto-motic fistula in patients in the observation group and the control group was 9.76％(4/42)and 21.43％(9/42),respectively;there was no statistically significant difference between the two groups(x2=2.140,P＞0.05).The postoperative hospital stay was significantly longer in the control group than in the observation group(P＜0.05),and the total hospitalization costs were significantly higher in the control group than in the observation group(P＜0.05).Conclusion Methylprednisolone can effec-tively reduce the levels of inflammatory markers and the incidence of postoperative pulmonary infections in esophageal cancer patients undergoing neoadjuvant chemotherapy combined with immunotherapy before surgery.It is a highly safe treatment thera-py without increasing the incidence of anastomotic fistula.

Objective:To investigate the association between cancer fatalism and optimistic attitudes among colorectal cancer patients, and how the above linkage is moderated by the involvement of patients′ opinions, the family members′ opinions and the physicians′ opinions in treatment decision-making.Methods:A cross-sectional survey was conducted on 64 patients diagnosed with colorectal cancer and awaiting radical colorectal cancer surgery in the Department of General Surgery of Beijing Friendship Hospital Affiliated to Capital Medical University, from January 2021 to December 2021. There were 38 males and 26 females, aged (61.2±13.0) years from 30 to 84 years. Cancer fatalism, optimism attitudes, and the involvement of patients′ opinions, the family members′ opinions and the physicians′ opinions in treatment decision-making were assessed. The patients′ cancer fatalism beliefs were measured by the " Chance" subscale of the Form C of the Multidimensional Health Locus of Control (MHLC-C), optimism attitudes were assessed by the Chinese version of the revised Life Orientation Test (CLOT-R), and the influence of patients′, family members′, and physicians′ opinions in the medical decision-making process was measured by a self-designed single factor scale. Measurement data of normal distribution were expressed as mean±standard deviation ( ± s). Measurement data of skewed distribution were expressed as M( Q1, Q3). Spearman correlation analysis and Chi-square test was used to examine the association between the main outcome variable (patients′ optimistic attitudes) and demographic and clinical characteristics. Interaction was examined by hierarchical linear regression analysis combined with simple slope tests. Results:Cancer fatalism was negatively associated with patients′ optimistic attitudes ( r=-0.35, P<0.01). Optimistic attitude of patients was significantly and negatively correlated with the influence of family members′ opinions on medical decision-making ( r=-0.25, P<0.05). There were significant positive correlations between the influence of patients′ and family members′ opinions ( r=0.50, P<0.01), family members′ and physicians′ opinions ( r=0.67, P<0.01), and physicians′ and patients′ opinions ( r=0.38, P<0.01) in medical decision making. Hierarchical linear regression analysis showed a negative association between cancer fatalism and optimism ( β=-0.32, P=0.01). This association was further moderated by the involvement of family members′ opinions ( β=-0.56, P<0.01) and the involvement of physicians′ opinions ( β=-0.36, P=0.04) in medical decision-making. Simple slope tests revealed that the negative impact of fatalistic attitudes on patients′ optimism attitudes may be potentiated when family members′ opinions have high influence on medical decision-making, while the negative impact may be buffered to some extent when physicians′ opinions have high influence on medical decision-making. Conclusions:Cancer fatalism had a negative effect on patients′ optimism. The high influence of physicians in treatment decision-making buffered the negative effect of cancer fatalism on optimism; the high influence of family members in treatment decision-making potentiated the negative effect of cancer fatalism on optimism. In the process of doctor-patient communication and shared decision-making, for patients with strong fatalistic attitudes, consideration should be given to appropriately increasing direct informational communication between physicians and patients and reducing excessive family intervention in medical decision-making, so as to enhance patients′ autonomy for treatment, promote optimism, and reduce the negative effects of cancer fatalism.

Enteral nutrition plays an irreplaceable role in the nutritional treatment of critically ill patients. In order to help clinical medical staff to manage the common complications during the implementations of enteral nutrition for critically ill patients, the consensus writing team carried out literature retrieval, literature quality evaluation, evidence synthesis. Several topics such as diarrhea, aspiration, high gastric residual volume, abdominal distension, etc. were assessed by evidence-based methodology and Delphi method. After two rounds of expert investigations, Expert consensus on prevention and management of enteral nutrition therapy complications for critically ill patients in China (2021 edition) developed, and provided guidance for clinical medical staff.

Objective:To investigate the association of blood oxidative stress level with hypertriglyceridemia in the elderly aged 65 years and older in China.Methods:A total of 2 393 participants aged 65 years and older were recruited in 9 longevity areas from Heathy Aging and Biomarkers Cohort Study, during 2017 to 2018. Information on demographics characteristic, life style and health status were collected by questionnaire and physical examination, and venous blood was collected to detect the levels of blood oxidative stress and hypertriglyceridemia. The linear or non-linear association between oxidative stress and hypertriglyceridemia was described by restrictive cubic splines (RCS) fitting multiple linear regression model. The generalized linear mixed effect model was conducted to assess the association between oxidative stress and hypertriglyceridemia.Results:A total of 2 393 participants, mean age was 84.6 years, the youngest was 65 and the oldest was 112, the male was 47.9%(1 145/2 393), the triglyceride level was (1.4±0.8) mmol/L. The hypertriglyceridemia detection rate was 9.99%(239/2 393). The results of multiple linear regression model with restrictive cubic spline fitting showed that MDA level was linear association with triglyceride level; SOD level was nonlinear association with triglyceride level. MDA level had significantly association with hypertriglyceridemia, and the corresponding OR value was 1.063 (95% CI: 1.046,1.081) with 1 nmol/ml increment of blood MDA; SOD level had significantly association with hypertriglyceridemia, and the corresponding OR value was 0.986(95% CI: 0.983,0.989) with 1 U/ml increment of blood SOD. Conclusion:Among the elderly aged 65 and older in 9 longevity areas in China, MDA and SOD levels were associated with the risk of hypertriglyceridemia.

Objective:To investigate the association of blood oxidative stress level with hypertriglyceridemia in the elderly aged 65 years and older in China.Methods:A total of 2 393 participants aged 65 years and older were recruited in 9 longevity areas from Heathy Aging and Biomarkers Cohort Study, during 2017 to 2018. Information on demographics characteristic, life style and health status were collected by questionnaire and physical examination, and venous blood was collected to detect the levels of blood oxidative stress and hypertriglyceridemia. The linear or non-linear association between oxidative stress and hypertriglyceridemia was described by restrictive cubic splines (RCS) fitting multiple linear regression model. The generalized linear mixed effect model was conducted to assess the association between oxidative stress and hypertriglyceridemia.Results:A total of 2 393 participants, mean age was 84.6 years, the youngest was 65 and the oldest was 112, the male was 47.9%(1 145/2 393), the triglyceride level was (1.4±0.8) mmol/L. The hypertriglyceridemia detection rate was 9.99%(239/2 393). The results of multiple linear regression model with restrictive cubic spline fitting showed that MDA level was linear association with triglyceride level; SOD level was nonlinear association with triglyceride level. MDA level had significantly association with hypertriglyceridemia, and the corresponding OR value was 1.063 (95% CI: 1.046,1.081) with 1 nmol/ml increment of blood MDA; SOD level had significantly association with hypertriglyceridemia, and the corresponding OR value was 0.986(95% CI: 0.983,0.989) with 1 U/ml increment of blood SOD. Conclusion:Among the elderly aged 65 and older in 9 longevity areas in China, MDA and SOD levels were associated with the risk of hypertriglyceridemia.

Objective:To explore the relationship between sleep quality and occupational stress in field gas recovery workers.Methods:In October 2018, cluster sampling method was adopted to conduct cross-sectional survey on 1726 field workers in a gas production oilfield. The individual characteristics, occupational stress factors, stress regulation factors, stress response and sleep quality, social support and coping strategies were evaluated by occupational stress measurement tools and job content questionnaire. Mann Whitney U test and Kruskal Wallis H test were used to compare sleep quality scores between the groups. Spearman rank correlation analysis was used to analyze the correlation between sleep quality and occupational stress, and logistic regression analysis was used to analyze multiple factors. Results:There were significant differences in sleep quality scores among different positions, gender, marital status, age, length of service, smoking and drinking ( P<0.05) . There were no significant differences in sleep quality scores between different education levels and work shift groups ( P>0.05) . Spearman rank correlation analysis showed that sleep quality score was negatively correlated with job satisfaction, reward, job stability, promotion opportunity, positive emotion, respect, self-esteem, control strategy, support strategy and self-efficacy score ( r s=-0.361, -0.311, -0.238, -0.261, -0.248, -0.212, -0.139, -0.188, -0.152, -0.226, P<0.01) , and was positively correlated with social support, giving, daily tension, negative emotion, work monotony and depression symptom ( r s=0.312, 0.279, 0.547, 0.493, 0.429, 0.599, P<0.01) . Compared with the high sleep quality score group, the middle and low sleep quality score groups had lower giving, work monotony, daily tension, depressive symptoms, negative emotions and social support ( P<0.01) , while the scores of respect, reward, job satisfaction, positive emotion, self-efficacy, job stability, promotion opportunity, control strategy and support strategy were higher ( P<0.01) . Multiple depressive symptoms, high daily tension, high negative emotion and high work monotony were the risk factors for sleep disorders ( OR=3.417, 2.659, 2.913, 1.543) . Conclusion:Depressive symptoms, daily tension and negative emotion have great influence on sleep quality of field gas recovery workers.

Objective:To investigate the level of social support and its correlation with occupational stress among gas production workers in the field.Methods:In October 2018, the cluster sampling method was used to perform a cross-sectional survey for 1726 gas production workers in the field, and related data of these workers were collected, including age, education level, marital status, level of social support, and related factors for occupational stress. A Spearman's rank correlation analysis was used to investigate the correlation between social support and occupational stress, and the levels of occupational stress-related factors were compared between the groups with different social support scores.Results:The gas production workers in the field had a median (25th percentile, 75th percentile) social support score of 24.00 (19.00, 28.00) , and there was a significant difference in social support score between the workers with different posts or work shifts ( P<0.01) . Social support score was positively correlated with effort, daily stress, negative emotion, and job routinization ( P<0.05) and was negatively correlated with job satisfaction, reward, working stability, and promotion opportunity ( P<0.05) . The group with a high social support score had significantly higher scores of effort, job routinization, sleep disorders, and daily stress than the other two groups ( P<0.01) , and the group with a low social support score had significantly higher scores of reward, self-efficacy, positive affection, and job satisfaction than the other two groups ( P<0.01) . Conclusion:High-level social support plays an important role in alleviating occupational stress and protecting mental health among gas production workers in the field.

Objective:To explore the relationship between sleep quality and occupational stress in field gas recovery workers.Methods:In October 2018, cluster sampling method was adopted to conduct cross-sectional survey on 1726 field workers in a gas production oilfield. The individual characteristics, occupational stress factors, stress regulation factors, stress response and sleep quality, social support and coping strategies were evaluated by occupational stress measurement tools and job content questionnaire. Mann Whitney U test and Kruskal Wallis H test were used to compare sleep quality scores between the groups. Spearman rank correlation analysis was used to analyze the correlation between sleep quality and occupational stress, and logistic regression analysis was used to analyze multiple factors. Results:There were significant differences in sleep quality scores among different positions, gender, marital status, age, length of service, smoking and drinking ( P<0.05) . There were no significant differences in sleep quality scores between different education levels and work shift groups ( P>0.05) . Spearman rank correlation analysis showed that sleep quality score was negatively correlated with job satisfaction, reward, job stability, promotion opportunity, positive emotion, respect, self-esteem, control strategy, support strategy and self-efficacy score ( r s=-0.361, -0.311, -0.238, -0.261, -0.248, -0.212, -0.139, -0.188, -0.152, -0.226, P<0.01) , and was positively correlated with social support, giving, daily tension, negative emotion, work monotony and depression symptom ( r s=0.312, 0.279, 0.547, 0.493, 0.429, 0.599, P<0.01) . Compared with the high sleep quality score group, the middle and low sleep quality score groups had lower giving, work monotony, daily tension, depressive symptoms, negative emotions and social support ( P<0.01) , while the scores of respect, reward, job satisfaction, positive emotion, self-efficacy, job stability, promotion opportunity, control strategy and support strategy were higher ( P<0.01) . Multiple depressive symptoms, high daily tension, high negative emotion and high work monotony were the risk factors for sleep disorders ( OR=3.417, 2.659, 2.913, 1.543) . Conclusion:Depressive symptoms, daily tension and negative emotion have great influence on sleep quality of field gas recovery workers.

Objective:To investigate the level of social support and its correlation with occupational stress among gas production workers in the field.Methods:In October 2018, the cluster sampling method was used to perform a cross-sectional survey for 1726 gas production workers in the field, and related data of these workers were collected, including age, education level, marital status, level of social support, and related factors for occupational stress. A Spearman's rank correlation analysis was used to investigate the correlation between social support and occupational stress, and the levels of occupational stress-related factors were compared between the groups with different social support scores.Results:The gas production workers in the field had a median (25th percentile, 75th percentile) social support score of 24.00 (19.00, 28.00) , and there was a significant difference in social support score between the workers with different posts or work shifts ( P<0.01) . Social support score was positively correlated with effort, daily stress, negative emotion, and job routinization ( P<0.05) and was negatively correlated with job satisfaction, reward, working stability, and promotion opportunity ( P<0.05) . The group with a high social support score had significantly higher scores of effort, job routinization, sleep disorders, and daily stress than the other two groups ( P<0.01) , and the group with a low social support score had significantly higher scores of reward, self-efficacy, positive affection, and job satisfaction than the other two groups ( P<0.01) . Conclusion:High-level social support plays an important role in alleviating occupational stress and protecting mental health among gas production workers in the field.

Objective? To investigate the dietary sodium intake level of patients with heart failure and analyze its influencing factors, so as to provide reference for formulating dietary intervention strategies for patients with heart failure. Methods? From July 2018 to April 2019, 153 patients with heart failure in the First Affiliated Hospital of Nanjing Medical University were selected as the subject by convenient sampling. The General Questionnaire and Dietary Sodium Restriction Questionnaire(DSRQ) were collected, and 24-hour urine sodium determination was used to assess the patient's dietary sodium intake level. Results? A total of 155 questionnaires were distributed and 153 questionnaires were returned. The average dietary sodium intake of 153 patients with heart failure was (3 725.39±1 741.84) mg/d. The dietary sodium intake of 24 patients was within the recommended range (2 000-3 000 mg/d), accounting for 15.7%(24/153). The total score of the DSRQ was (54.83±9.15), and the scores of attitude and subjective normative dimension, cognitive dimension and perceptual behavior control were (23.24±3.15), (11.77±2.08), and (19.82±6.13), respectively.Univariate analysis showed different genders, tastes, dental health status, and whether the dietary sodium intake was different for patients prescribed a low-sodium diet, the differences were statistically significant (P＜ 0.05);correlation analysis showed that appetite score and sodium intake in patients with heart failure was correlated, the difference was statistically significant (r=0.174, P=0.031), and the sodium-stable diet behavioral control score was associated with sodium intake in patients with heart failure (r=-0.329, P＜ 0.001). Multiple linear regression analysis showed that the patient's gender, taste, and patient's perceptual behavioral control of sodium-restricted diet were the main influencing factors of dietary sodium intake in patients with heart failure, explaining 21.5% of the total variation in dietary sodium intake. Conclusions? The dietary sodium intake of patients with heart failure is higher than the recommended amount of the guideline, and the current situation is not optimistic. In particular, health care workers should pay attention to individualized dietary guidance and interventions in men with low salty taste and low sodium-stable dietary behavioral scores to reduce heart failure and readmission rates.