Analysis of Lymph Node Metastases of 1,526 Cases with Thoracic Esophageal and Cardiac Carcinomas: A Random Sampling Report froni the Fourth Hospital of Hebei Medical University from 1996 to 2004

OBJECTIVE To summarize the regular pattern and state oflymph node metastasis of patients with esophageal and cardiaccarcinomas,so as to analyze factors influencing lymph nodemetastasis.METHODS Clinical data collected from 1,526 thoracicesophageal and cardiac carcinoma patients who were admitted inthe Fourth Hospital of Hebei Medical University during a periodfrom January 1996 to December 2004,were randomly selectedand an Access Database of the patient's information was set up.Eight clinico-pathologic factors,including the patient's age,tumorlocation and size,pathological classification,the depth of tumorinvasion,vascular tumor embolus (VTE),the state of surroundingorgan encroachment and the status of tumor residues,wereidentified.A correlation between these factors and metastases wasstatistically analyzed using SPSS13.0 software.RESULTS Lymph node metastatic sites from esophagealcarcinomas included the thoracic and abdominal cavity.Lymphnode metastasis from the superior esophageal carcinomasmainly occurred in the neck and thoracic cavity.There was atwo-way lymph node metastasis in the patients with the middleesophageal carcinoma.The inferior esophageal carcinomas mainlymetastasized to the paraesophageal,paragastric cardia,and leftgastric artery lymph nodes.The rate and degree of the metastasisfrom the inferior esophageal carcinomas were significantly highercompared to those of the superior and the middle esophagealcarcinomas (P<0.0125).The degree of abdominal lymph node metastasis fromcarcinomas of the gastric cardia was significantly higher comparedwith that of esophageal carcinomas.In the group with carcinomaof the gastric cardia,the rate and degree of the lymph nodemetastases in the paragastric cardia and left gastric artery weresignificantly higher compared to the group with esophagealcarcinoma (P<0.05).Paraesophageal lymph node metastasis fromcarcinomas of the gastric cardia in the thoracic cavity frequentlyoccurred,too,and the degree of the metastasis was similar to thatof esophageal carcinoma.There was no significant difference inthe rate and degree of the paraesophageal lymph-node metastasisbetween the group with carcinoma of the gastric cardia comparedto those with esophageal carcinoma (P>0.05).Multifactoriallogistic regression analysis showed that the tumor size,depth oftumor encroachment,VTE,and tumor residues could all bringabout obvious impact on lymph-node metastases (P<0.05).CONCLUSION Lymph node metastasis from superioresophageal carcinomas mainly occurs in the neck and thoraciccavity.The middle esophageal carcinomas presented a two-waylymph-node metastasis (both the upwards and the downwards),and the lymph node metastasis from inferior esophagealcarcinomas mainly occurred in the thoracic and abdominal cavities.The metastases of carcinoma of the gastriccardia were most commonly found in the abdominalcavity,with frequent paraesophageal lymph-nodemetastasis.The sufficient attention should be paidto neck lymph node clearance in cases of esophagealcarcinoma.What is of the greatest concern is theclearance of the left gastric artery lymph nodes,andalso in cases of gastric cardia carcinoma,clearance,the paraesophageal lymph nodes.With an increasein the tumor size and depth of tumor encroachment,and occurrence of VTE and tumor residual cells,therisk of lymph node metastasis is significantly raised (P<0.05).

Estimated prevalence and sociodemographic correlates of mental disorders in medical students of Hebei Province,China:A crosssectional study

BACKGROUND In China,the identification rate and treatment rate of mental disorders are low,and there are few surveys on the prevalence of mental disorders among college students using diagnostic tools such as Mini-International Neuropsychiatric Interview(MINI),so the prevalence and treatment of mental disorders among college students are unclear.AIM To estimate prevalence of mental disorders among medical students in Hebei Province,and provide guidance for improving their mental health.METHODS This was a cross-sectional study based on an Internet-based survey.Three levels of medical students in Hebei Province were randomly selected(by cluster sampling)for screening.Using the information network assessment system,the subjects scanned the 2D code with their mobile phones,clicked to sign the informed consent,and answered a scale.A self-designed general status questionnaire was used to collect information about age,gender,ethnicity,grade,and origin of students.The MINI 5.0.was used to investigate mental disorders.Data analysis was performed with SPSS software.Statistically significant findings were determined using a two-tailed P value of 0.05.RESULTS A total of 7117 subjects completed the survey between October 11 and November 7,2021.The estimated prevalence of any mental disorders within 12 mo was 7.4%.Mood disorders were the most common category(4.3%),followed by anxiety disorders(3.9%);15.0%had been to psychological counseling,while only 5.7%had been to a psychiatric consultation,and only 10%had received drug therapy in the past 12 mo.CONCLUSION Although the estimated prevalence of mental disorders in medical students is lower than in the general population,the rate of adequate treatment is low.We determined that improving the mental health of medical students is an urgent matter.

Comparative proteomic analysis of plasma exosomes reveals the functional contribution of N-acetyl-alpha-glucosaminidase to Parkinson’s disease

Parkinson’s disease is the second most common progressive neurodegenerative disorder,and few reliable biomarkers are available to track disease progression.The proteins,DNA,mRNA,and lipids carried by exosomes reflect intracellular changes,and thus can serve as biomarkers for a variety of conditions.In this study,we investigated alterations in the protein content of plasma exosomes derived from patients with Parkinson’s disease and the potential therapeutic roles of these proteins in Parkinson’s disease.Using a tandem mass tag-based quantitative proteomics approach,we characterized the proteomes of plasma exosomes derived from individual patients,identified exosomal protein signatures specific to patients with Parkinson’s disease,and identified N-acetyl-alpha-glucosaminidase as a differentially expressed protein.N-acetyl-alpha-glucosaminidase expression levels in exosomes from the plasma of patients and healthy controls were validated by enzyme-linked immunosorbent assay and western blot.The results demonstrated that the exosomal N-acetyl-alpha-glucosaminidase concentration was not only lower in Parkinson’s disease,but also decreased with increasing Hoehn-Yahr stage,suggesting that N-acetyl-alpha-glucosaminidase could be used to rapidly evaluate Parkinson’s disease severity.Furthermore,western blot and immunohistochemistry analysis showed that N-acetyl-alpha-glucosaminidase levels were markedly reduced both in cells treated with 1-methyl-4-phenylpyridinium and cells overexpressingα-synuclein compared with control cells.Additionally,N-acetyl-alpha-glucosaminidase overexpression significantly increased cell viability and inhibitedα-synuclein expression in 1-methyl-4-phenylpyridinium-treated cells.Taken together,our findings demonstrate for the first time that exosomal N-acetyl-alpha-glucosaminidase may serve as a biomarker for Parkinson’s disease diagnosis,and that N-acetyl-alpha-glucosaminidase may reduceα-synuclein expression and 1-methyl-4-phenylpyridinium-induced neurotoxicity,thus providing a new therapeutic target for Parkinson’s disease.

Netrin-1 signaling pathway mechanisms in neurodegenerative diseases

Netrin-1 and its receptors play crucial roles in inducing axonal growth and neuronal migration during neuronal development.Their profound impacts then extend into adulthood to encompass the maintenance of neuronal survival and synaptic function.Increasing amounts of evidence highlight several key points:(1)Diminished Netrin-1 levels exacerbate pathological progression in animal models of Alzheimer’s disease and Parkinson’s disease,and potentially,similar alterations occur in humans.(2)Genetic mutations of Netrin-1 receptors increase an individuals’susceptibility to neurodegenerative disorders.(3)Therapeutic approaches targeting Netrin-1 and its receptors offer the benefits of enhancing memory and motor function.(4)Netrin-1 and its receptors show genetic and epigenetic alterations in a variety of cancers.These findings provide compelling evidence that Netrin-1 and its receptors are crucial targets in neurodegenerative diseases.Through a comprehensive review of Netrin-1 signaling pathways,our objective is to uncover potential therapeutic avenues for neurodegenerative disorders.

Effect of cholesterol metabolism on hepatolithiasis

Surgical intervention is currently the primary treatment for hepatolithiasis;how-ever,some patients still experience residual stones and high recurrence rates after surgery.Cholesterol metabolism seems to play an important role in hepatoli-thiasis pathogenesis.A high cholesterol diet is one of the significant reasons for the increasing incidence of hepatolithiasis.Therefore,regular diet and appropriate medical intervention are crucial measures to prevent hepatolithiasis and reduce recurrence rate after surgery.Reducing dietary cholesterol and drugs that increase cholesterol stone solubility are key therapeutic approaches in treating hepato-lithiasis.This article discusses the cholesterol metabolic pathways related to the pathogenesis of hepatolithiasis,as well as food intake and targeted therapeutic drugs.

Decoding molecular mechanisms:brain aging and Alzheimer's disease

The complex morphological,anatomical,physiological,and chemical mechanisms within the aging brain have been the hot topic of research for centuries.The aging process alters the brain structure that affects functions and cognitions,but the worsening of such processes contributes to the pathogenesis of neurodegenerative disorders,such as Alzheimer's disease.Beyond these observable,mild morphological shifts,significant functional modifications in neurotransmission and neuronal activity critically influence the aging brain.Understanding these changes is important for maintaining cognitive health,especially given the increasing prevalence of age-related conditions that affect cognition.This review aims to explore the age-induced changes in brain plasticity and molecular processes,differentiating normal aging from the pathogenesis of Alzheimer's disease,thereby providing insights into predicting the risk of dementia,particularly Alzheimer's disease.

Colony-stimulating factor 3 and its receptor promote leukocyte immunoglobulin-like receptor B2 expression and ligands in gastric

BACKGROUND Colony-stimulating factor 3(CSF3)and its receptor(CSF3R)are known to promote gastric cancer(GC)growth and metastasis.However,their effects on the immune microenvironment remain unclear.Our analysis indicated a potential link between CSF3R expression and the immunosuppressive receptor leukocyte immunoglobulin-like receptor B2(LILRB2)in GC.We hypothesized that CSF3/CSF3R may regulate LILRB2 and its ligands,angiopoietin-like protein 2(ANGPTL2)and human leukocyte antigen-G(HLA-G),contributing to immunosuppression.AIM To investigate the relationship between CSF3/CSF3R and LILRB2,as well as its ligands ANGPTL2 and HLA-G,in GC.METHODS Transcriptome sequencing data from The Cancer Genome Atlas were analyzed,stratifying patients by CSF3R expression.Differentially expressed genes and immune checkpoints were evaluated.Immunohistochemistry(IHC)was performed on GC tissues.Correlation analyses of CSF3R,LILRB2,ANGPTL2,and HLA-G were conducted using The Cancer Genome Atlas data and IHC results.GC cells were treated with CSF3,and expression levels of LILRB2,ANGPTL2,and HLA-G were measured by quantitative reverse transcriptase-polymerase chain reaction and western blotting.RESULTS Among 122 upregulated genes in high CSF3R expression groups,LILRB2 showed the most significant increase.IHC results indicated high expression of LILRB2(63.0%),ANGPTL2(56.5%),and HLA-G(73.9%)in GC tissues.Strong positive correlations existed between CSF3R and LILRB2,ANGPTL2,and HLA-G mRNA levels(P<0.001).IHC confirmed positive correlations between CSF3R and LILRB2(P<0.001),and HLA-G(P=0.010),but not ANGPTL2(P>0.05).CSF3 increased LILRB2,ANGPTL2,and HLA-G expression in GC cells.Heterogeneous nuclear ribonucleoprotein H1 modulation significantly altered their expression,impacting CSF3’s regulatory effects.CONCLUSION The CSF3/CSF3R pathway may contribute to immunosuppression in GC by upregulating LILRB2 and its ligands,with heterogeneous nuclear ribonucleoprotein H1 playing a regulatory role.

Application of Saccharomyces boulardii in combination with sulfasalazine in ulcerative colitis patients demonstrates significant effectiveness

BACKGROUND Ulcerative colitis(UC)is a complex inflammatory bowel disease,and its etiology and pathogenesis remain incompletely elucidated.AIM To analyze the effects of Saccharomyces boulardii in combination with sulfasalazine on intestinal microbiota and intestinal barrier function in patients with UC.METHODS A retrospective analysis of clinical data from 127 UC patients admitted to our hospital between January 2021 and January 2023 was conducted.All patients met complete inclusion and exclusion criteria.Based on the treatment interventions received,they were divided into a control group(n=63)and an observation group(n=64).Both groups of patients received routine treatment upon admission.The control group received sulfasalazine in addition to routine interventions,while the observation group received a combination of Saccharomyces boulardii on the basis of the control group’s treatment.The clinical efficacy,improvement in symptoms,modified Baron endoscopic scores,quality of life“inflammatory bowel disease questionnaire(IBDQ)”,levels of intestinal microbial indicators(such as Lactobacillus,Bifidobacterium,Enterococcus,and Escherichia coli),intestinal mucosal barrier function indicators[diamine oxidase(DAO),lipopolysaccharide(LPS),D-lactic acid(D-LA)],and adverse reaction occurrences were compared between the two groups.RESULTS(1)Clinical efficacy:The total effective rate in the control group was 79.37%,while in the observation group,it was 93.75%,significantly higher than that of the control group(P<0.05);(2)Improvement in symptoms:The observation group showed significantly lower relief time for abdominal pain,diarrhea,rectal bleeding,fever symptoms,and mucosal healing time compared to the control group(P<0.05);(3)Baron endoscopic scores and IBDQ scores:Before treatment,there was no significant difference in Baron endoscopic scores and IBDQ scores between the two groups(P>0.05).However,after treatment,the observation group showed significantly lower Baron endoscopic scores and higher IBDQ scores compared to the control group(P<0.05);(4)Levels of intestinal microbial indicators:Before treatment,there was no significant difference in the levels of Lactobacillus,Bifidobacterium,Enterococcus,and Escherichia coli between the two groups(P>0.05).After treatment,the levels of Lactobacillus and Bifidobacterium in the observation group were significantly higher than those in the control group,while the levels of Enterococcus and Escherichia coli were significantly lower than those in the control group(P<0.05);(5)Levels of intestinal mucosal barrier function indicators:Before treatment,there was no significant difference in the levels of DAO,LPS,and D-LA between the two groups(P>0.05).However,after treatment,the levels of DAO,LPS,and D-LA in the observation group were significantly lower than those in the control group(P<0.05);and(6)Occurrence of adverse reactions:The incidence of adverse reactions in the control group was 9.52%,while in the observation group,it was 10.94%.There was no significant difference in the occurrence of adverse reactions between the two groups(P>0.05).CONCLUSION The application of Saccharomyces boulardii in combination with sulfasalazine in UC patients demonstrates significant effectiveness.Compared to sole sulfasalazine intervention,the combined application of Saccharomyces boulardii further promotes the relief of relevant symptoms in patients,alleviates intestinal mucosal inflammation,and improves the quality of life.Its action may be related to rectifying the imbalance in intestinal microbiota and improving intestinal mucosal barrier function.Moreover,the combined use of Saccharomyces boulardii does not increase the risk of adverse reactions in patients,indicating a higher level of medication safety and advocating for its clinical promotion and application.

Multiple jejunal diverticula with repeated gastrointestinal bleeding:A case report

BACKGROUND Jejunal diverticula(JD)are rare clinical conditions that are typically incidentally detected and asymptomatic.When acute complications arise,surgical exploration may be necessary for accurate diagnosis and appropriate treatment.In this report,we present a case of multiple JD complicated by gastrointestinal bleeding and review the pathogenesis,diagnosis,and treatment of JD to increase clinician awareness of this condition.CASE SUMMARY A 70-year-old male patient with multiple JD presented with repeated massive gastrointestinal bleeding.The patient did not respond to symptomatic conservative treatment.Additional diagnostic investigations,including digestive endoscopy and abdominal angiography,did not reveal any relevant abnormalities.An exploratory laparotomy was subsequently performed,during which a segment of the bowel containing numerous diverticulum-like structures was surgically removed.Following successful discharge from the hospital,the patient did not experience any further episodes of gastrointestinal bleeding during subsequent follow-up.CONCLUSION Complications caused by JD are often difficult to diagnose,and surgical exploration is sometimes the most appropriate method.

Internal transcribed spacer sequencing to explore the intrinsic composition of fungal communities in fungal esophagitis

BACKGROUND Fungal esophagitis(FE)is caused by fungal invasion of the esophageal mucosa.Under endoscopy,the esophageal mucosa shows edema,congestion,erosion,and ulceration,and bleeds easily when touched,and the surface of the mucosa is covered with small white spots like"bean curd residue".Clinical cases showing typical FE under endoscopic imaging but negative esophageal mucosal brush(referred to as suspected FE)have increased the difficulty and challenge of clinical diagnosis and treatment.At present,the esophageal fungal flora of suspected case has not been thoroughly studied.AIM To characterize the fungal flora in FE,suspected FE,and the esophageal normal controls(NCs),and to identify marker species to improve detection of FE.METHODS This was a case-control study.A total of 19 patients with FE,16 with suspected FE,and 10 NCs were selected by endoscopy.The esophageal cell brush samples of each group were sequenced by internal transcribed spacer(ITS)1 and analyzed by bioinformatics.RESULTS In FE and suspected FE patients,species richness,species diversity and species evenness,as measured by the Chao1 index,Shannon index and Pielou index,were lower than in the NCs,and the comparison between the FE and NCs was the most significant(P<0.05).Compared with the NCs,the relative abundance of Candida in FE and suspected FE patients was significantly increased(P<0.001),while the relative abundance of Yarrowia was significantly decreased(P<0.05).Moreover,Yarrowia abundance in the FE group was significantly lower than in the NCs and suspected FE groups(P<0.001).The area under the curve for Candida in FE and suspected FE patients was 99.5%(P<0.05)and 81.3%(P<0.05),respectively.Finally,compared with FE patients,the relative abundance of Ascomycota and Candida in the esophageal flora of suspected FE patients was decreased,while the relative abundance of Yarrowia,Thermomyces and Pichia was increased.CONCLUSION ITS showed that composition of the fungal community was similar in the FE and suspected FE groups.ITS can be used as an auxiliary diagnostic method for FE and provide a theoretical basis for follow-up diagnosis and treatment.

Correction to:High expression of autophagy-related gene EIF4EBP1 could promote tamoxifen resistance and predict poor prognosis in breast cancer

This is an erratum to the published paper titled,“High expression of autophagyrelated gene EIF4EBP1 could promote tamoxifen resistance and predict poor prognosis in breast cancer.”We have removed the citations to certain articles in subsequent revisions of the manuscript.However,owing to our oversight,the citation marker in the upper right corner was not removed.We apologize for any confusion this may have caused.

Plantamajoside improves type 2 diabetes mellitus pancreaticβ-cell damage by inhibiting endoplasmic reticulum stress through Dnajc1 up-regulation

BACKGROUND Plantamajoside(PMS)has shown potential in mitigating cell damage caused by high glucose(HG)levels.Despite this,the precise therapeutic effects of PMS on type 2 diabetes mellitus(T2DM)and the underlying regulatory mechanisms require further exploration.AIM To investigate PMS therapeutic effects on T2DM in mice and elucidate its mechanisms of action through in vivo and in vitro experiments.METHODS An in vitro damage model of MIN6 cells was established using HG and palmitic acid(PA).PMS's protective effect on cell damage was assessed.Next,transcriptomics was employed to examine how PMS treatment affects gene expression of MIN6 cells.Furthermore,the effect of PMS on protein processing in endoplasmic reticulum and apoptosis pathways was validated.A T2DM mouse model was used to validate the therapeutic effects and mechanisms of PMS in vivo.RESULTS PMS intervention ameliorated cell injury in HG+PA-induced MIN6 cell damage.Transcriptomic analysis revealed that protein processing in the endoplasmic reticulum and apoptosis pathways were enriched in cells treated with PMS,with significant downregulation of the gene Dnajc1.Further validation indicated that PMS significantly inhibited the expression of apoptosis-related factors(Bax,CytC)and endoplasmic reticulum stress(ERS)-related factors[ATF6,XBP1,Ddit3(CHOP),GRP78],while promoting the expression of Bcl-2 and Dnajc1.Additionally,the inhibitory effects of PMS on ERS and apoptosis were abolished upon Dnajc1 silencing.Furthermore,in vivo experiments demonstrated that PMS intervention effectively improved pancreatic damage,suppressed the expression of apoptosis-related factors(Bax,CytC),and ERS-related factors[ATF6,XBP1,Ddit3(CHOP),GRP78],while promoting the expression of Bcl-2 and Dnajc1 in a T2DM model mice.CONCLUSION PMS intervention could alleviate pancreatic tissue damage effectively.The mechanism of action involves Dnajc1 activation,which subsequently inhibits apoptosis and ERS,ameliorating damage to pancreaticβ-cells.

Incidence and mortality rate of esophageal cancer has decreased during past 40 years in Hebei Province,China

Background： Hebei province is located in North of China with of approximately 6% of whole national population. It is known as a high-risk area for esophageal cancer in China and worldwide. The aim of our study was to estimate the esophageal cancer burden and trend in Hebei Province. Methods： Eight cancer registries in Hebei Province submitted cancer registry data to the Hebei Provincial Cancer Registry Center. All data were qualified and compiled for cancer statistics in 2011. The pooled data were stratified by gender and age group （0, 1-4, 5-9, 10-14...80＋）. Incidence and mortality rates were age-standardized to World Segi＇s population standard and expressed per 100,000 persons. In addition, proportions and cumulative incidence/mortality rates for esophageal cancer were calculated. Esophageal cancer mortality data during the periods 1973-1975, 1990-1992, and 2004-2005 were extracted from the national death surveys. Mortality and incidence rate data from Cixian and Shexian were obtained from population-based cancer registries in each county. Results： The estimated number of newly diagnosed esophageal cancer cases and deaths in 2011 in Hebei Province was 24,318 and 18,226, respectively. The crude incidence rate of esophageal cancer was 33.37/100,000 （males, 42.18/100,000 and females, 24.31/100,000）. The age-standardized rate by world standard population （ASRW） was 28.09/100,000, ranking third among all cancers. The esophageal cancer mortality rate was 25.01/100,000 （males, 31.40/100,000 and females, 18.45/100,000）, ranking third in deaths among all cancers. The mortality rates of esophageal cancer displayed a significant decreasing trend in Hebei Province from 1973-1975 （ASRW =48.69/100,000） to 2004-2005 （ASRW =28.02/100,000）, with a decreased rate of 42.45%. In Cixian, the incidence of esophageal cancer decreased from 250.76/100,000 to 106.74/100,000 in males and from 153.86/100,000 to 75.41/100,000 in females, with annual percentage changes （APC） of 2.13 and 2.16, while the mortality rates declined with an APC of 2.46 for males and 3.10 for females from 1988 to 2011. In Shexian, the incidence rate decreased from 116.90/100,000 to 74.12/100,000 in males and from 46.98/100,000 to 40.64/100,000 in females, while the mortality rates declined, with an APC of 4.89 in males from 2003 to 2011. Conclusions： Although the incidence and mortality rates of esophageal cancer remain high, an obvious decreasing trend has been observed in Hebei Province, as well as in high-risk regions, such as Cixian and Shexian, over the past 40 years.

Estimated cancer incidence and mortality in Hebei province,2012

Objective： This study estimates the numbers of new cancer cases and cancer deaths in Hebei province using incidence and mortality data from 9 population-based cancer registries in 2012. Methods： The data of new diagnosed cancer cases and cancer deaths in 2012 were collected from 9 population-based cancer registries of Hebei province in 2015. All the data met the National Central Cancer Registry of China （NCCR） criteria of data quality. The pooled data analysis was stratified by areas （urban/ rural）, gender, age group （0, 1-4, 5-9, 10-14 85＋） and cancer type. New cancer cases and deaths in Hebei province were estimated using age-specific rates and corresponding provincial population in 2012. The 10 most common cancers in different groups and the cumulative rates were calculated. Chinese population census in 2000 and Segi＇s population were used for age-standardized incidence/mortality rates. Results： All cancer registries covered 4,986,847 populations, 6.84% of Hebei provincial population （2,098,547 in urban and 2,888,300 in rural areas）. The percentage of cases morphologically verified （MV%） and death certificate-only cases （DCO%） were 76.40% and 4.72%, respectively. The mortality to incidence rate ratio （M/I） was 0.64. In 2012, it is estimated that there were about 187,900 new diagnosed cancer cases and 119,800 cancer deaths in Hebei province. The incidence rate of cancer was 258.12/100,000 （275.75/100,000 in males, 239.78/100,000 in females）, and the age-standardized incidence rates by Chinese standard population （ASIRC） and by world standard population （ASIRW） were 210.65/100,000 and 208.50/100,000, with the cumulative incidence rates （0-74 years old） of 24.46%. The cancer incidence and ASIRC were 256.99/100,000 and 211.32/100,000 in urban areas and 258.94/100,000 and 209.99/100,000 in rural areas, respectively. The cancer mortality rate was 164.63/100,000 （201.85/100,000 in males, 125.92/100,000 in females）. Age- standardized mortality rates by Chinese standard population （ASMRC） and by world standard population （ASMRW） were 137.30/100,000 and 137.39/100,000 with the cumulative mortality rate （0-74 years old） of 14.58%, respectively. The cancer mortality rate in rural areas （167.16/100,000） was higher than that in urban areas （161.16/100,000）. The most common cancers were lung cancer, stomach cancer, breast cancer, esophageal cancer, liver cancer and colorectal cancer, which accounted for 72.31% of all cancer cases. Lung cancer, stomach cancer, liver cancer, esophageal cancer and colorectal cancer were the major causes of cancer death in Hebei province, which accounted for 75.24% of all cancer deaths. The cancer spectrum differs between urban and rural, males and females in both incidence and mortality rates. Conclusions： The most common cancers were lung cancer, stomach cancer, esophageal cancer, breast cancer, liver cancer and eolorectal cancer in Hebei province.

Upper gastrointestinal cancer burden in Hebei Province, China: A population-based study

AIM To investigate the incidence and mortality rates of upper gastrointestinal cancer(UGIC) in Hebei Province, China, and to identify high-risk populations to improve UGIC prevention and control.METHODS Data for UGIC patients were collected from 21 population-based cancer registries covering 15.25% of the population in Hebei Province. Mortality data were extracted from three national retrospective death surveys(1973-1975, 1990-1992 and 2004-2005). The data were stratified by 5-year age groups, gender and area(high-risk/non-high-risk areas) for analysis. The age-period-cohort and grey system model were used.RESULTS The crude incidence rate of UGIC was 55.47/100000, and the adjusted rate(Segi's population) was 44.90/100000. Males in rural areas had the highest incidence rate(world age-standardized rate = 87.89/100000). The crude mortality rate of UGIC displayed a decreasing trend in Hebei Province from the 1970 s to 2013, and the adjusted rate decreased by 43.81% from the 1970s(58.07/100000) to 2013(32.63/100000). The mortality rate declined more significantly in the high-risk areas(57.26%) than in the non-high-risk areas(55.02%) from the 1970 s to 2013. The median age at diagnosis of UGIC was 65.06 years in 2013. There was a notable delay in the median age at death from the 1970s(66.15 years) to 2013(70.39 years), especially in the high-risk areas. In Cixian, the total trend of the cohort effect declined, and people aged 65-69 years were a population at relatively high risk for UGIC. We predicted that the crude mortality rates of UGIC in Cixian and Shexian would decrease to 98.80 and 133.99 per 100000 in 2018, respectively.CONCLUSION UGIC was the major cause of cancer death in Hebei Province, and males in rural areas were a high-risk population. We should strengthen early detection and treatment of UGIC in this population.

Predicted 10-year Cardiovascular Disease Risk and Its Association with Sleep Duration among Adults in Beijing-Tianjin-Hebei Region,China

Objective The study aims to predict 10-year cardiovascular disease(CVD)risk and explore its association with sleep duration among Chinese urban adults.Methods We analyzed part of the baseline data of a cohort that recruited adults for health screening by cluster sampling.The simplified Pittsburgh Sleep Quality Index(PSQI)and Framingham 10-year risk score(FRS)were used to measure sleep duration and CVD risk.Demographic characteristics,personal history of chronic diseases,lifestyle factors were collected using a questionnaire.Height,weight,total cholesterol(TC),and high-density lipoprotein cholesterol(HDL-C)were also measured.Multiple logistic regression models were performed to explore the association of sleep duration with the predicted CVD risk.Results We included 31,135 participants(median age 44 years,53.02%males)free of CVD,cerebral stroke,and not taking lipid-lowering agents.Overall,14.05%,and 25.55%of participants were at medium and high predicted CVD risk,respectively.Short sleep was independently associated with increased odds of medium to high risk of predicted 10-year CVD among males(OR=1.10;95%CI:1.01–1.19)and increased odds of medium to high and high risk of predicted 10-year CVD among females(OR=1.23;95%CI:1.08–1.40;OR=1.27;95%CI:1.11–1.44).In contrast,long sleep had no association with cardiovascular risk.Conclusion A substantial number of adults free of CVD were at high 10-year CVD risk.Short sleep was associated with increased odds of predicted CVD risk.

A Genetic Epidemiological Study on Esophageal Cancer and Carcinoma of the Gastric Cardia in Cixian County of Hebei Province

OBJECTIVE To investigate the role of family aggregation and genetic factors of esophageal cancer （EC）, including carcinoma of gastric cardia （CGC）, in Cixian county, and to calculate the segregation ratio and heritability of first-degree relatives （FDR） in EC cases.METHODS A case control study was conducted, and each of 285 esophageal cancer cases and FDR＇s case history and family medical history of EC in 1415 controls was carried by home visits to compare the incidence of EC in the crowds. The family aggregation of EC was found by X2 test for goodness of fit test according to binomial distribution. Li-Mantel-Gart method was used to calculate the segregation ratio and Falconer method was employed to compute the heritability （h2）.RESULTS The incidence rate of the FDR in the index case of EC （12.80%） was higher than that in the controls （7.52%）. There were significant differences between the 2 groups （X2= 44.34, P = 0.000）. The distribution of EC in the family did not agree with the binomial distribution, which presented a conspicuous familial aggregation （X2= 288.19, P 〈 0.0001）. The heritability of EC was （29.67 ±4.32）%, and segregation ratio was 0.1814 （95%CI = 0.1574-0.2054）, which is lower than 0.25, and can be regarded as a disease of multi-factorial inheritance.CONCLUSION The occurrence of EC in the Cixian County is the outcome of the mutual effect of genetic and environmental factors. The family history of upper gastrointestinal cancers increases the risk of EC in late generations.

Clinical diagnosis,treatment,and medical identification of specific pulmonary infection in naval pilots:Four case reports

BACKGROUND Specific pulmonary infection could seriously threaten the health of pilots and their companions.The consequences are serious.We investigated the clinical diagnosis,treatment,and medical identification of specific pulmonary infections in naval pilots.CASE SUMMARY We analyzed the medical waiver and clinical data of four pilots with specific pulmonary infections,who had accepted treatment at the Naval Medical Center of Chinese People’s Liberation Army between January 2020 and November 2021,including three cases of tuberculosis and one of cryptococcal pneumonia.All cases underwent a series of comprehensive treatment courses.Three cases successfully obtained medical waiver for flight after being cured,while one was grounded after reaching the maximum flight life after being cured.CONCLUSION Chest computed tomography scanning should be used instead of chest radiography in pilots’physical examination.Most pilots with specific pulmonary infection can be cured and return to flight.

PRELIMINARY EXPLORATION OF NORMAL VALUE OF BA ON ADULT IN HEBEI REGION

目的:探讨河北省地区成年人的脑电地形图的正常值。方法:对60例正常成人通过BA-Ⅲ型脑电地形图仪进行了检查。结果:60例成年人的脑电地形图各频段的正常平均值被初步确定。结论:60例成年人的脑电地形图的正常值是有参考价值的。

Using the Delphi method to propose foods for special medical purposes health effect evaluation indicators

Objective:The Delphi method was used to propose health effect evaluation indicators to assess foods for special medical purposes(FSMPs).This lays the foundation for the formation of a big data model for human health testing,as well as a big data platform for the health and safety evaluation of special medical foods.Methods:The Delphi method was used to conduct two rounds of expert consultation on the constructed FSMP health effect evaluation indicators.Results:Ten major items were identified after two rounds of expert consultation.Among these,there were 10 primary entries,32 secondary entries,50 tertiary entries,and 28 quaternary entries.Conclusion:The complete list of evaluation indicators contains 10 entries,which can comprehensively and systematically monitor adverse reactions to the use of FSMPs.The present findings lay the foundation for a big data platform to evaluate the health and safety of special foods.