[Clinical characteristics of 272 437 patients with different histopathological subtypes of primary esophageal malignant tumors].

Objective: To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT). Methods: A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results: A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment. Conclusion: ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.

[Nursing care of esophagitis dissecans superficialis caused by acute paraquat poisoning].

The clinical data of 13 patients with esophageal dissecans superficials (EDS) induced by paraquat (PQ) in Qilu Hospital from March 2016 to April 2019 were analyzed retrospectively. EDS usually occurs on the 3rd to 9th day after taking poison, and the esophageal mucosa is different in size, color and character, in 10 cases of death, 1 case of pharyngeal pain basically disappeared on the 19th day after EDS onset, but died on the 27th day after taking poison, and 9 cases of death survived 5~19th days after taking poison, the overall cure rate was low; The pharyngeal pain symptoms of 3 surviving patients basically disappeared on day 15, 16 and 17 of EDS, and all patients had no discomfort after eating, and were cured gradually.

[The Research of Present Situation and Influencing Factors of Inflammatory Bowel Disease Nursing Competence in Gastroenterology Department of Grade A of level â ¢ Hospital in Shandong Province].

Objective: The research is to study the present situation and influencing factors of inflammatory bowel disease (IBD) nursing competency in grade A of level Ⅲ hospital in Shandong province. and provided reference for further training and education of IBD nurses. Methods: From October, 2018 to May, 2019, the research is a cross-sectional study including 17 cities, 327 IBD nurses (qualified group n=197, unqualified group n=130) based on the IBD nursing competency questionnaire. The questionnaire is self-designed on the reference of registered nurse core competence scale and the reliability and validity have been tested very well. Results: The IBD nursing competence questionnaire has 8 categories and 68 entries. The content validity index (CVI) is 0.90, while the Cronbach index is 0.992. The median score of IBD nursing competency is 70.59 and each category vary from 55.00 to 84.38. Among them, the critical thinking skills or research ability (55.00) and continuing nursing (58.33) behave not very well. According to the single factor analysis, the hierarchy (P=0.031) and the follow-up numbers of IBD patients (P=0.001) are two significant factors for the IBD nursing competency. In the Logistic multiple factors analysis, the hierarchy (N(1) and N(2)) and the follow-up numbers of IBD patients (21-50 patients) are also important factors. Conclusion: The present situation of IBD nursing competency of Shandong province is acceptable. But there is still a long way to go in the aspect of critical thinking skills, research ability, and continuing nursing. Nurse hierarchy level and follow-up of IBD patients affect nursing competence and we should reinforce the training and education of IBD nurses.

[The relationship among Psychological capital Psychological Contract and Work Engagement in Nurses].

Objective: To investigate the situation of work engagement among nurses in tertiary level 1st general hospitals and evaluated potential associations between psychological contract, psychological capital, and work Engagement. Methods: A cross-sectional descriptive study design was used. 320 nurses from three tertiary level 1st general hospitals in Jinan was included. Data were gathered with Utrecht Work Engagement Scale (UWES-9) , Psychological Capital Questionnaire, and Psychological Contract Questionnaire. Possible predictors of work engagement were analyzed using ANOVA and multivariate linear regression models with SPSS 20.0. Results: A total of 320 questionnaires were enrolled and 282 questionnaires were returned, with a response rate of 88.1%. The total mean (SD) score was 3.79 (0.91) for work engagement, 3.66 (0.72) for psychological contract and 4.39 (0.63) for psychological capital. One-way analysis of variance and post-hoc analysis showed that there was significant difference in work engagement among nurses of different gender (P<0.05) , education level (P<0.05) , department (P<0.01) and professional title (P<0.05) . Pearson correlation analysis showed that psychological contract positively associated with work engagement (r=0.253, P<0.01) and psychological capital (r=0.198, P<0.01) , and psychological capital positively associated with work engagement (r=0.575, P<0.01) . Results of multiple hierarchical regression analysis showed that work department, gender, educational background, professional title, hope, optimism and team obligation predicted work engagement and they accounted for 42.8% of the variance in work engagement. Conclusion: The work engagement of nurses is at a medium level. Work engagement of nurses is influenced by gender, professional title, educational level and department; Both psychological contract and psychological capital of nurses positively correlated with work engagement.