Truth telling for patients with esophageal squamous cell carcinoma in Henan,China

Objective: This study aims to investigate the truth-telling status and the relevant factors of esophageal squamous cell carcinoma(ESCC) patients in Henan, China.Methods: A cross-sectional study from April to June 2015 using questionnaires was given to 301 family members of hospitalized ESCC patients based in three affiliated hospitals of Zhengzhou University(i.e., The First Hospital, The Second Hospital, and Tumor Hospital) and Anyang Tumor Hospital.Results: Among the 41.9%(126/301) hospitalized ESCC patients who knew of their true diagnoses, only 4.0% patients were informed by their corresponding responsible doctors, 39.7% by their family members, and 56.3% by themselves. Univariate analyses showed that disclosure of confirmed ESCC diagnosis to patients was correlated with gender, family history of cancer(FHC), education level, vocation, hospital administrative level, and attitudes of family members(P < 0.05). Furthermore,multivariate analysis indicated that attitude of family members was the most important and an independent factor for diagnosis disclosure. Those patients with a negative FHC, under-education, manual occupation, advanced stages, and hospitalized in municipal hospitals exhibited a low rate of truth telling.Conclusions: Truth telling for ESCC patients in Henan is not prevalent and may be improved through consultation with family members, particularly for patients with a negative FHC, poor education, manual occupation, and advanced stages.

Late Tremadocian(Early Ordovician) reefs on the Yangtze Platform, South China, and their geobiological implications: a synthesis

This study provides an overview and discussion of controls on the distribution of organic reefs during the Early Ordovican Period, in the Yangtze Platform, a region of epicontinental sedimentary rocks in South China. The Yangtze Platform was located in low latitudes during the Early Ordovician and recorded rich and diverse reefs through that time. During the late Tremadocian Epoch, dolomitic and stratiform stromatolites were common in supratidal to intertidal zones of the western Yangtze Platform, while columnar stromatolites formed in deeper waters of the eastern Yangtze Platform. Skeletal-dominated reefs occurred in upper subtidal settings of the central Yangtze Platform. A transition from microbial-dominated to metazoan-dominated reefs with shallowing-upward cycles was evident, indicating that the composition of the main reef-builders was driven mainly by water depth.Increasing metazoan competition during the Great Ordovician Biodiversification Event reduced the abundance of microbial reefs. Sufficient nutrient supply is interpreted to have promoted development of skeletal-dominated reefs locally in shallow settings in the central Yangtze Platform, especially represented by the expansion of abundant solitary fossils of lithistid sponges and Calathium. High salinity environmental settings facilitated the bloom of stromatolites in near-shore locations. Low oxygen content in deep subtidal settings may have led to the absence of skeletal reefs in these habitats, so the mass occurrences of stromatolites was located in the shallower-water central and eastern platform. No keratose sponge-bearing stromatolite can be confirmed across the platform during this interval.