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Due to the anatomical specificity of esophagus, esophagectomy can be carried out using different approaches, such as left transthoracic, right transthoracic and transhiatal approaches. Each surgical approach is associated with a different prognosis due to the complex anatomy. The left transthoracic approach is no longer the primary choice due to its limitations in providing adequate exposure, lymph node dissection, and resection. The right transthoracic approach is capable of achieving a larger number of dissected lymph nodes and is currently considered the preferred procedure for radical resection. Although the transhiatal approach is less invasive, it could be challenging to perform in a limited operating space and has not been widely adopted in clinical practice. Minimally invasive esophagectomy offers a wider range of surgical options for treating esophageal cancer. This paper reviews different approaches to esophagectomy.
Subject(s)
Humans , Prognosis , Lymph Node Excision/methods , Lymph Nodes/pathology , Esophageal Neoplasms/pathology , Esophagectomy/methodsABSTRACT
Objective To investigate the epidemical characteristics and analyze the incidence trend of novel coronavirus pneumonia (NCP) in Shanghai. Methods The epidemical data on NCP in Shanghai from January 20 to February 3, 2020 were collected for epidemiological descriptive analysis. Results The number of cumulative confirmed and suspected cases increased first and then decreased from January 20 to February 3, with the peak date being January 30 and January 29 respectively. The day-on-day growth rate of the suspected cases and the cumulative confirmed cases declined after January 27. Among the confirmed cases, the proportion of the exposure history of relevant confirmed cases was on the rise. The total number of confirmed cases of the resident population exceeded that of the population from other places to Shanghai, and Pudong new area had the largest number of confirmed cases. Conclusion The incidence of NCP showed a slowdown trend in shanghai, but it also faces the pressure of the peak of population returning to city, which should be paid enough attention to.
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Objective To investigate the epidemical characteristics and analyze the incidence trend of novel coronavirus pneumonia(NCP) in Shanghai. Methods The epidemical data on NCP in Shanghai from January 20 to February 3, 2020 were collected for epidemiological descriptive analysis. Results The number of cumulative confirmed and suspected cases increased first and then decreased from January 20 to February 3, with the peak date being January 30 and January 29 respectively.The day-on-day growth rate of the suspected cases and the cumulative confirmed cases declined after January 27.Among the confirmed cases, the proportion of the exposure history of relevant confirmed cases was on the rise.The total number of confirmed cases of the resident population exceeded that of the population from other places to Shanghai, and Pudong new area had the largest number of confirmed cases. Conclusion The incidence of NCP shows a slowdown trend in shanghai, but it also faces the pressure of the peak of population returning to city, which should be paid enough attention to.
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Objective To investigate the epidemical characteristics and analyze the incidence trend of novel coronavirus pneumonia(NCP) in Shanghai. Methods The epidemical data on NCP in Shanghai from January 20 to February 3, 2020 were collected for epidemiological descriptive analysis. Results The number of cumulative confirmed and suspected cases increased first and then decreased from January 20 to February 3, with the peak date being January 30 and January 29 respectively.The day-on-day growth rate of the suspected cases and the cumulative confirmed cases declined after January 27.Among the confirmed cases, the proportion of the exposure history of relevant confirmed cases was on the rise.The total number of confirmed cases of the resident population exceeded that of the population from other places to Shanghai, and Pudong new area had the largest number of confirmed cases. Conclusion The incidence of NCP shows a slowdown trend in shanghai, but it also faces the pressure of the peak of population returning to city, which should be paid enough attention to.
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Objective To investigate the spatial-temporal distribution characteristics of varicella outbreak in Jiading District in Shanghai from 2015 to 2018. Methods Varicella epidemic report data was collected from the national system of disease control and prevention and analyzed by spatial-temporal scanning statistic methods. Results There were 5 889 varicella cases reported from the year 2015 to 2018, and the annual average incidence rate was 91.68 per 100 000.The incidence rate for children below 3 years old was found to be the highest, reaching 621.45 per 100 000, which was significantly higher than that for the group of 18 years old and above (χ2=16 616.788, P < 0.001).There were 5.41% and 5.31% of the cases in September and February, respectively, which were lower than other months, and the peak incidence occurred in December and November, accounting for 13.41% and 11.95%, respectively.The highest and lowest incidence rates were 151.80 per 100 000 occurring in central urban area and 59.89 per 100 000 in rural area, respectively.The spatial-temporal scanning showed that the low population density area had a wide cluster range and a low effect value.The high population density area has small cluster range and high effect value. Conclusion The incidence of vanicella presents a trend of population, seasonal and regional clustering.Therefore, targeted measure should be taken to prevent varicella in focus population.
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Objective To evaluate the effects of water body environments on the microbial community of Oncomelania hupensis snails in marshlands of the eastern Dongting Lake where natural extinction of O. hupensis snails are found, so as to explore the correlation between the natural extinction of O. hupensis snails and the microbial community in snails. Methods Snails were caged water bodies in the Qianliang Lake marshland (Qianliang Lake regions) where natural extinction of snails was found and in the Junshan Park marshland (Junshan Park regions) in the eastern Dongting Lake for 30 days, and then all snails were collected and identified for survival or death. DNA sequencing of the fungi and bacteria was performed in snails before and after immersion in waters, and the biodiversity and abundance were analyzed. Results The survival rates of O. hupensis snails were 28.0% (70/250) and 64.8% (162/250) in Qianliang Lake regions and Junshan Park regions 30 days after immersion in waters, respectively (χ2 = 81.365, P < 0.01). The number of the fungal community and the biodiversity of the bacterial community were both greater in snails caged in Qianliang Lake regions post-immersion than pre-immersion, and there was a significant difference in the structure of the fungal and bacterial communities. The microbial community with a significant difference included Flavobacteriaceae,which was harmful to O. hupensis snails. Conclusion The water body environment affects the composition of the microbial community in O. hupensis snails in marshlands with natural snail distinction around the eastern Dongting Lake; however, further studies are required to investigate whether the natural distinction of snails is caused by water body environments-induced changes of the microbial spectrum in O. hupensis snails.
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Schistosomiasis is a modern disease name, but it has been widespread in ancient China and exists in a specific form in traditional Chinese medicine (TCM) . The purpose of the paper is to make clear the existing form of schistosomiasis in TCM and infer the prevalence of schistosomiasis in ancient China. The paper focuses on the period when great progress was made on schistosomiasis by TCM, and sums up the understanding of TCM toward schistosomiasis in this period. By studying and analyzing the literature of schistosomiasis in this period, the paper tries to find out the representative Chinese medicine symptom description and TCM "other name" of schistosomiasis, so as to accurately judge whether the relevant description in ancient TCM books and historical documents can provide scientific basis for schistosomiasis. It is important to understand the prevalence and cognition of schistosomiasis in ancient China.
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Objective To investigate the reasons of natural extinction of Oncomelania hupensis snails by comparing the difference of the water chemical properties between the snail-breeding marshland and non-snail marshland in Eastern Dongting Lake areas. Methods Three adjoining marshlands in Eastern Dongting Lake areas were selected, one was a snail-breeding marshland, the second was a non-snail marshland, and the third was a boundary zone between them. During the periods of water-rising season, wet season and water-falling season, the water samples from the bottom of 0.5 m were collected by the systematic random sampling method (200 m × 200 m grid method). In addition, the water samples below the surface of 0.5 m were also collected in the wet season. The physicochemical indexes of the sampling water were detected. Results According to the Surface Water Environmental Quality Standard (GB 3838–2002), the water quality indicators which were less than the detection limit were Cr, Cd, Zn, Hg, Cu, S－ and CN－ during the three sampling seasons. The pollutants which were slightly higher than Grade III but lower than Grade IV (Hg ≤ 1 μg/L, TP ≤ 0.1 mg/L) were Hg and TP. The pollutants below the Grade III included As and F－. The temperature and pH values were within the Grade III. The oxygen consumption indicators covering DO, COD and BOD in the water-rising season and wet season were within the Grade III, while the value of BOD was beyond the scope of Grade III but was between Grade Ⅳ (≤ 6 mg/L) and Grade V (≤ 10 mg/L) in the water-falling season. The differences of the water pollution indexes between the snail-breeding marshland and non-snail marshland were statistically significant, and these indexes included F－, As and pH in the water-rising season (P < 0.05); pH, BOD and Fat the surface layer in the wet season (P < 0.05); F－ at the bottom in the wet season (P < 0.05); TP and F－ in the water-falling season. Moreover, the above-mentioned indexes in the non-snail marshland of Qianliang Lake were higher than those in the snail-breeding marshland of Junshan Park. Thus, F－ was the only index which had statistical differences in every sampling season, and the concentration of F－ at the non-snail marshland was also higher than that at the snail-breeding marshland. In the water-rising season, the pH value at the non-snail marshland exceeded the suitable range for the growth of snails (6.8 to 7.8). Conclusion In the Eastern Dongting Lake area, the high concentration of F－ and pH of water may be responsible for the natural extinction of O. hupensis snails.
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Objective To investigate the reasons of natural extinction of Oncomelania hupensis snails by comparing the difference of the water chemical properties between the snail-breeding marshland and non-snail marshland in Eastern Dongting Lake areas. Methods Three adjoining marshlands in Eastern Dongting Lake areas were selected, one was a snail-breeding marshland, the second was a non-snail marshland, and the third was a boundary zone between them. During the periods of water-rising season, wet season and water-falling season, the water samples from the bottom of 0.5 m were collected by the systematic random sampling method (200 m × 200 m grid method). In addition, the water samples below the surface of 0.5 m were also collected in the wet season. The physicochemical indexes of the sampling water were detected. Results According to the Surface Water Environmental Quality Standard (GB 3838–2002), the water quality indicators which were less than the detection limit were Cr, Cd, Zn, Hg, Cu, S－ and CN－ during the three sampling seasons. The pollutants which were slightly higher than Grade III but lower than Grade IV (Hg ≤ 1 μg/L, TP ≤ 0.1 mg/L) were Hg and TP. The pollutants below the Grade III included As and F－. The temperature and pH values were within the Grade III. The oxygen consumption indicators covering DO, COD and BOD in the water-rising season and wet season were within the Grade III, while the value of BOD was beyond the scope of Grade III but was between Grade Ⅳ (≤ 6 mg/L) and Grade V (≤ 10 mg/L) in the water-falling season. The differences of the water pollution indexes between the snail-breeding marshland and non-snail marshland were statistically significant, and these indexes included F－, As and pH in the water-rising season (P < 0.05); pH, BOD and Fat the surface layer in the wet season (P < 0.05); F－ at the bottom in the wet season (P < 0.05); TP and F－ in the water-falling season. Moreover, the above-mentioned indexes in the non-snail marshland of Qianliang Lake were higher than those in the snail-breeding marshland of Junshan Park. Thus, F－ was the only index which had statistical differences in every sampling season, and the concentration of F－ at the non-snail marshland was also higher than that at the snail-breeding marshland. In the water-rising season, the pH value at the non-snail marshland exceeded the suitable range for the growth of snails (6.8 to 7.8). Conclusion In the Eastern Dongting Lake area, the high concentration of F－ and pH of water may be responsible for the natural extinction of O. hupensis snails.
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Schistosomiasis is one of the key diseases of surveillance and prevention in China. The elimination of schistosomiasis is of great significance to people’s health and social economy. With the development of spatial epidemiology, progress has been made in the spatial distribution of schistosomiasis, the prediction of spatial and temporal trends, and analysis of the environmental factors. This paper reviews the application of spatial epidemiology in the control and prevention of schistosomiasis and introduces the spatio-temporal distribution methods, spatial model, and application of remote sensing technology.
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Schistosomiasis is a modern disease name, but it has been widespread in ancient China and exists in a specific form in traditional Chinese medicine (TCM) . The purpose of the paper is to make clear the existing form of schistosomiasis in TCM and infer the prevalence of schistosomiasis in ancient China. The paper focuses on the period when great progress was made on schistosomiasis by TCM, and sums up the understanding of TCM toward schistosomiasis in this period. By studying and analyzing the literature of schistosomiasis in this period, the paper tries to find out the representative Chinese medicine symptom description and TCM "other name" of schistosomiasis, so as to accurately judge whether the relevant description in ancient TCM books and historical documents can provide scientific basis for schistosomiasis. It is important to understand the prevalence and cognition of schistosomiasis in ancient China.
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Objective To construct sensitive,scientific,targeted index evaluation system of psychiatric nursing quality and provide basis for evaluation and surveillance of psychiatric nursing quality.Methods Based on 3-di-mension quality construction theory,literature analysis and experts group discussion were adopted to preliminarily screen indexes and compile inquiry questionnaire.Two rounds of expert consultation were performed using Delphi technique,and sensitive index evaluation system of psychiatric nursing quality was revised and finalized.Results Positive coefficients of two rounds of expert consultation were 90.63％ and 96.55％,authority coefficients were 0.81 and 0.83,and coordination coefficients were 0.136-0.335;the constructed sensitive index evaluation system of psychiatric nursing quality included 3 first-class indicators and 18 second-class indicators.Conclusion The constructed sensitive index evaluation system of psychiatric nursing quality has psychiatric characteristics.Its effects on nursing quality control and evaluation can be verified from clinical practices,then effective data sharing can be gradually realized.
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<p><b>OBJECTIVE</b>To study the clinical features and antimicrobial resistance of community-acquired pneumonia caused by Klebsiella pneumoniae in infants.</p><p><b>METHODS</b>The clinical data of 65 infants with community-acquired pneumonia caused by Klebsiella pneumoniae between 2007 and 2011 were retrospectively studied.</p><p><b>RESULTS</b>Of the 65 infants, 37 cases (57%) were aged ≤3 months, 17 cases (26%) over 4 months, 7 cases (11%) over 7 months and 4 cases (6%) between 13 and 24 months. There were no significant differences in clinical manifestations and chest X-ray features between the infants with community-acquired pneumonia caused by Klebsiella pneumoniae and those with other bacterial pneumonia. Forty strains (62%) of ESBLs-producing Klebsiella pneumoniae were detected. Klebsiella pneumoniae was 100% sensitive to imipenem, meropenem and amikacin but resistant to penicillins and cephalosporins. The resistance rates of ESBLs-producing strains to penicillins, cephalosporins, amoxicillin/clavulanic acid, ampicillin/sulbactam, compound sulfamethoxazole, gentamycin, ciprofloxacin and aztreonam were significantly higher than for non-ESBLs-producing strains. ESBLs-producing strains also showed multiple-drug resistance.</p><p><b>CONCLUSIONS</b>Community-acquired pneumonia caused by Klebsiella pneumoniae is common in infants aged ≤3 months. ESBLs-producing strains are prevalent in community-acquired pneumonia caused by Klebsiella pneumoniae and demonstrate both high rates of drug resistance and multiple-drug resistance.</p>
Subject(s)
Female , Humans , Infant , Infant, Newborn , Male , Community-Acquired Infections , Drug Therapy , Drug Resistance, Bacterial , Klebsiella Infections , Drug Therapy , Klebsiella pneumoniae , Pneumonia, Bacterial , Drug TherapyABSTRACT
<p><b>OBJECTIVE</b>To study the distribution of pathogenic microorganisms of community acquired pneumonia (CAP) in children.</p><p><b>METHODS</b>Respiratory secretion and blood specimens were collected in 1167 children with CAP within 4 hrs of admission. Mycoplasma pneumonia and Chlamydia trachomatis were detected by RT-PCR in respiratory secretion specimens. Respiratory syncytial virus (RSV-IgM) and Adenovirus (ADV-IgM) were tested using ELISA in blood samples.</p><p><b>RESULTS</b>A total of 308 strains of bacteria were isolated from the respiratory tract secretions, with gram positive strains of 53.6% and gram negative strains of 46.4%. The top five bacteria strains detected were Streptococcus pneumoniae (35.1%), Escherichia coli (11.7%), Staphylococcus aureus (8.8%), Klebsiella pneumonia (6.5%) and Moraxelle catarrhalis (5.8%) in turn. Beta-lactamase and ESBLs producing strains accounted for 30.1% in the top five bacteria strains. The non-bacteria pathogens were found in 281 specimens (24.1%). Respiratory syncytial virus accounted for the most prevalent pathogen (19.3%). The mixed infection of respiratory syncytial virus and Streptococcus pneumoniae was common (35.2%). The infection rate from most of pathogenic microorganisms among children under the age of one was higher than that in children over one year old.</p><p><b>CONCLUSIONS</b>Respiratory syncytial virus and Streptococcus pneumoniae are the major pathogens of CAP in children. The risk of pathogenic microorganism infections in children under the age of one is higher than that of children over one year old.</p>