Abstract:Objective To analyze the early warning factors of acute radiation-induced lung injury(ARILI)in patients with esophageal cancer treated with intensity-modulated radiotherapy(IMRT).Methods 404 esophageal cancer patients who received IMRT from January 2021 to March 2024 in Shangqiu First People's Hospital were included in the study.They were divided into modeling group and verification group according to the ratio of 1∶1.According to whether ARILI occurred three months after radiotherapy,they were divided into occurrence group(108 cases,RTOG grade 1-4,including 54 cases in modeling group and 54 cases in verification group)and non-occurrence group(296 cases,RTOG grade 0,148 cases in modeling group and 148 cases in verification group).Univariate analysis and multivariate Logistic regression analysis were used to analyze the early warning factors of ARILI in the patients.Multi-factor analysis indexes were incorporated into the regression equation,the curve of receiver operating characteristics(ROC)was drawn,and their predictive value was analyzed.Results Compared with the non-occurrence group,the proportion of patients with lymph node metastasis,basic lung diseases and abnormal lung function,and the levels of V5,V10,V20,V30,whole lung mean dose(MLD),serum TGF-β1 and IL-8 in the occurrence group were higher(P＜0.05).Multivariate Logistic analysis showed that lymph node metastasis,basic lung disease,higher V5,higher V10,higher V20,higher V30,higher MLD and higher level of serum IL-8 were the early warning factors of ARILI in patients with esophageal cancer treated by IMRT,and the differences were statistically significant(P＜0.05).According to the regression equation,the ROC curve for predicting ARILI in patients with esophageal cancer treated by IMRT was drawn,which results showed that when logit(P)＞7.32,the area under the curve(AUC)was 0.891,the diagnostic sensitivity was 81.48％and the specificity was 80.41％respectively.Conclusion The early warning factors of ARILI in patients with esophageal cancer treated by IMRT are mainly higher V10,lymph node metastasis,higher V30,basic lung disease,higher V5,higher serum IL-8 level,higher V20 and higher MLD.The regression equation of influencing factors constructed based on this has good predictive value,which can be used to screen high-risk patients and adopt corresponding intervention strategies in clinical practice.

Abstract:Objective To observe the impacts of individualized nursing intervention based on the psychological state assessment scale on the psychological state,treatment compliance,and nutritional status of patients with esophageal cancer undergoing radiotherapy and chemotherapy.Methods 74 patients with esophageal cancer undergoing radiotherapy and chemotherapy in our hospital from March 2022 to August 2024 were retrospectively selected.According to different nursing methods,they were divided into a routine group(received routine nursing)and a study group(received individualized nursing intervention under the psychological state assessment scale on the basis of routine group),with 37 cases in each.The self-rating depression scale(SDS),positive and negative emotion scale,self-rating anxiety scale(SAS),positive and negative emotion and treatment compliance were compared between the two groups before intervention,10 days and 21 days after intervention.The levels of albumin(ALB),transferrin(TRF),nutritional status and quality of life score(QOL),prealbumin(PA),Hb,body mass index(BMI)and incidence complications were observed before intervention and 21 days after intervention.Results After intervention,the SAS,SDS and negative emotion scores of the study group were significantly lower than those of the routine group,and the positive emotion score,treatment compliance and QOL score of the study group were higher than those of the routine group(P＜0.05).In terms of nutritional indicators,the levels of ALB,BMI,Hb,PA and TRF in the study group after intervention were higher than those in the routine group,and the incidence of gastrointestinal reactions was lower than that in the routine group(P＜0.05).There was no significant difference in the pain,esophagitis and incidence of dermatitis between the two groups(P＞0.05).Conclusion Individualized nursing intervention based on psychological state assessment scale can alleviate negative emotions in patients with esophageal cancer undergoing radiotherapy and chemotherapy,improve treatment compliance,ensure nutritional intake,and improve psychological state and quality of life.

Abstract:Esophageal cancer is one of the common malignant tumors of the digestive tract.Lymph node metastasis(LNM)is the most common way of metastasis in esophageal cancer and,which is one of the important factors affecting the staging,treatment,and clinical prognosis evaluation of esophageal cancer.Imaging examination techniques such as CT,MRI,PET,SPECT,US and EUS are the main means for diagnosing LNM in esophageal cancer.In recent years,the emerging radiomics has shown its excellent performance in predicting LNM.This article reviews the applications of imaging and radiomics in LNM of esophageal cancer as follows.

Abstract:Objective To investigate the effect and molecular mechanism of miR-4677-3p-mediated targeting of matrix metalloproteinase-2(MMP2)on the proliferation and migration of esophageal squamous cell carcinoma(ESCC)cells in vitro.Methods The GSE263647 dataset was downloaded from the GEO database,and bioinformatic analysis identified MMP2 as a key prognosis-associated gene in ESCC.Potential miRNA regulating MMP2 expression were predicted using miRWalk and miRDB databases.MMP2 expression levels were examined by qRT-PCR and Western blot in human normal esophageal epithelial cells(HEEC)and four ESCC cell lines.MMP2 was knocked down by siRNA transfection and overexpressed via lentivirus infection in two ESCC cell lines(KYSE-150 and KYSE-70).Cell proliferation was assessed using the CCK-8 assay,and cell migration ability was observed via the scratch wound healing assay.Cells were transfected with miR-4677-3p mimics or inhibitor to evaluate MMP2 expression changes.Results 467 differentially expressed genes and 89 miRNAs were identified.MMP2 showed significantly elevated expression in ESCC tissues and cell lines,and its high expression was associated with poor patient prognosis.Functional analysis showed that MMP2 knockdown significantly inhibited cellular proliferation and migration in ESCC cells,while overexpression enhanced these malignant phenotypes.miR-4677-3p mimics downregulated MMP2 expression and suppressed proliferative and migratory capacities,whereas the inhibitor had the opposite effect.Conclusion miR-4677-3p modulates proliferation and migration of ESCC cells through targeted regulation of MMP2 expression,suggesting its potential as a therapeutic target for ESCC.

Abstract:Neuraminidase-1(Neu-1),a glycosidase that cleaves terminal sialic acid residues from glycoproteins,glycolipids and oligosaccharides,belongs to the sialidase family and plays a role in cell signaling,immune regulation and intercellular interactions.Recent studies have shown that Neu-1 plays an important role in the occurrence,development,metastasis and immune escape of various tumors.This article reviews the structure of Neu-1 and its regulatory effect on sialic acid,as well as the expression regulation,related molecular mechanisms and the research progress of its inhibitors as potential targeted therapy in esophageal cancer,providing new ideas for the diagnosis and treatment of esophageal cancer.

Abstract:Objective To evaluate the predictive efficacy of Stathmin and T-lymphocyte subsets for therapeutic outcomes and prognosis in esophageal cancer patients undergoing concurrent chemoradiotherapy.Methods 110 patients with locally advanced esophageal cancer receiving concurrent chemoradiotherapy at Puyang oilfield general hospital from January 2022 to December 2023 were enrolled and divide into an ineffective group of 23 cases and an effective group of 87 cases according to the efficacy.Serum Stathmin levels and T-lymphocyte subsetswere measured before and after treatment.After a 12-month follow-up,patients were stratified into a poor prognosis group(n=29)and a good prognosis group(n=81).Associations between these markers and prognosis were analyzed.Receiver operating characteristic(ROC)curves were used to analyze the predictive power of different indicators on prognosis.Results The incidence of poor prognosis in the effective group(17.24%,15/87)was significantly lower than that in the ineffective group(60.87%,14/23)(χ2=17.840,P＜0.001).Post-treatment serum Stathmin level in the effective group was significantly lower than that in the ineffective group(P＜0.001),with more pronounced increases in CD4+and decreases in CD8+(P＜0.001).Compared to the poor prognosis group,the good prognosis group showed significantly lower Stathmin levels and CD4+/CD8+ratios(P＜0.001),but higher CD4+and CD8+proportions(P＜0.001).Multivariate logistic regression identified elevated Stathmin(OR=2.983,P＜0.001)and CD4+/CD8+ratio(OR=1.338,P＜0.001)as independent risk factors,while increased CD4+and CD8+were protective factors.ROC analysis revealed higher predictive efficacy for the combination of Stathmin and CD4+/CD8+than either marker alone.Patients with serum Stathmin＞4.50 μg·L-1 or CD4+/CD8+＞1.18 had increased risk of poor prognosis.Survival analysis showed that patients with high Stathmin expression or a high CD4+/CD8+ratio had significantly shorter progression-free survival(P＜0.001,P=0.017,respectively).Conclusion Combined assessment of serum Stathmin and CD4+/CD8+ratio provides high predictive efficacy for prognosis in esophageal cancer patients treated with concurrent chemoradiotherapy with high levels associatedwith inferior PFS.

Abstract:Objective To analyze domestic and international literature on refractory gastroesophageal reflux disease(r-GERD)to elucidate its research history,disciplinary trends,and future directions.Methods Literature on r-GERD from 2000 to 2023 was retrieved from the China National Knowledge Infrastructure(CNKI)and Web of Science.Data analysis was conducted using Excel,VOSviewer 1.6.20 and CiteSpace 6.3.R1.A total of 376 Chinese articles and 698 English articles were included.Results After study screening,annual publication volume has shown a rising trend,with international research dominating publication volume and academic influence.Core research teams have emerged in both Chinese and English literature,yet collaborative efforts remain limited.Keyword analysis highlighted proton pump inhibitors,treatment and safety as predominant research foci.Conclusion Research interest in r-GERD remains robust,emphasizing pathogenesis,treatment modalities,medication safety,and psychological symptoms.Future research may focus on Traditional Chinese Medicine(TCM)therapies,advancements in diagnostic technologies,and enhanced international collaboration.

Abstract:Objective To analyze the effect of caffeic acid(CA)on the malignant proliferative capacity of esophageal squamous cell carcinoma(ESCC)cells and explore its underlying mechanism.Methods ESCC cells(KYSE140 and KYSE150)were treated with different concentrations of CA(10,20,and 50 μM).The experiment was divided into a control group and different CA observation groups.Oxidative stress markers(ROS,MDA,and SOD)in cells from each group were detected using assay kits.The in vitro proliferative capacity of cells in each group was assessed using CCK8 and plate colony formation assay.The expression of the endoplasmic reticulum stress marker protein GRP78 in each group was detected by Western Blot.Results Compared with the control group,cells in the CA observation groups(10,20,and 50 μM)showed a progressive decrease in ROS and MDA content,a gradual increase in SOD activity,a gradual weakening ofin vitro proliferative capacity,and a gradual decrease in GRP78 protein expression(P＜0.05).Conclusion CA can inhibit endoplasmic reticulum stress in ESCC cells through its antioxidant effects,thereby suppressing the malignant proliferation of these cells.

Abstract:Objective To investigate the effect of Porphyromonas gingivalis(Pg)infection on lung metastasis of esophageal squamous cell carcinoma(ESCC)and the role of neutrophil extracellular traps(NETs)during this metastatic process.Methods A nude mouse model of ESCC lung metastasis was established by tail vein injection of luciferase-labeled KYSE150 cells(LKC).In the direct infection group(Pg group),LKC pre-co-cultured with Pg were inoculated;in the oral exposure group(OR group),Pg bacterial suspension was applied to the oral cavity after inoculation;the control group(CON group)was not infected.At the 3rd week after inoculation,each group was further divided into two subgroups,GSK484(+)and GSK484(-),the former was intraperitoneally injected with the NETs inhibitor GSK484,and the latter was injected with drug-free solvent.In vivo fluorescence imaging was performed at the 3rd week(before intervention)and weekly from the 4th to the 8th week(experimental termination);ex vivo fluorescence imaging of the lungs was performed at the end of the 8th week.The culture supernatant of Pg-infected neutrophils was collected,and its effect on the invasive ability of KYSE30 cells was assessed using Transwell chambers.Immunohistochemistry was performed to detect Ki67 and Ly6G expression;immunofluorescence was used to detect myeloperoxidase(MPO)and citrullinated histone H3(Cit-H3)expression,and DAPI counterstaining was performed to evaluate NETs formation;flow cytometry was used to detect the proportion of CD11b+and Ly6G+neutrophils.Results Pulmonary fluorescence signals appeared in the Pg group as early as the 3rd week,gradually increased in intensity,and were the most prominent thereafter,followed by the OR group,whereas the CON group showed no obvious signals.The culture supernatant of neutrophils infected with Pg significantly enhanced the invasive ability of KYSE30 cells.Ly6G+neutrophils were significantly enriched within and around lung metastatic lesions in both the Pg and OR groups,the proportion of neutrophils in lung tissue was elevated,and MPO and Cit-H3 expression was enhanced with increased co-localization.GSK484 intervention reversed the above changes,and the proportion of neutrophils in lung tissue after intervention showed no significant difference compared with the CON group.Conclusion Pg infection promotes ESCC lung metastasis that depends on neutrophil recruitment and NETs formation in lung tissue,suggesting that targeting NETs formation may be a potential strategy to block ESCC lung metastasis.

Abstract:The"Conceive-Design-Implement-Operate"(CDIO)teaching model,a novel approach originated from engineering education,has gained increasing attention in medical education in recent years due to its emphasis on practicality and ability cultivation.Esophageal cancer,as one of the highly prevalent malignant tumors in the digestive tract in China,has a highly complex diagnosis and treatment process involving multiple disciplines such as surgery,medical oncology,radiation oncology,gastroenterology,pathology,and nutrition.Traditional teaching methods are insufficient to meet the actual needs of students for systematic understanding of the disease and the cultivation of clinical decision-making abilities.Therefore,exploring an effective teaching model suitable for esophageal cancer education is particularly important.This article reviews the current application status of the CDIO teaching model in esophageal cancer education,analyzes its advantages and challenges in course design,student ability cultivation,and teaching effect evaluation.Although the CDIO model shows great potential in promoting active learning and improving comprehensive qualities of students,it still faces problems such as the integration of esophageal cancer-specific knowledge,teacher training,and the allocation of clinical simulation resources in practical application.This article aims to summarize the potential value of the CDIO teaching model in esophageal cancer education and put forward targeted optimization suggestions based on esophageal cancer diagnosis and treatment cases,in order to promote the further development and application of this model.

Abstract:Objective To investigate the expression of lysosomal-associated membrane protein 2A(LAMP2a)and leucine-rich α-2-glycoprotein 1(LRG1)in esophageal cancer tissues,and to analyze their predictive value for prognosis.Methods A prospective study was conducted on 112 patients with esopha-geal cancer who were diagnosed and treated at Puyang People's Hospital hospital from March 2022 to March 2024.The cancer tissues and adjacent tissues were removed during the operation.The expressions of LAMP2a and LRG1 proteins were compared.The expressions of LAMP2a and LRG1 proteins in patients with different clinical characteristics was analyzed,and its correlation with clinical characteristics was discussed.The pa-tients were followed up for 1 a,and were divided into poor prognosis subgroup and good prognosis subgroup;the expressions of LAMP2a and LRG1 proteins in the two subgroups were compared.Cox regression was used to analyze the prognostic factors.The interaction between LAMP2a and LRG1 in the risk of poor prognosis was further analyzed,and its predictive value for prognosis was evaluated.Results The positive expression rates of LAMP2a and LRG1 protein in cancer tissues were higher than those in adjacent tissues(P<0.05).The positive expression of LAMP2a and LRG1 protein was positively correlated with TNM stage and lymph node metastasis,but negatively correlated with the degree of differentiation(P<0.05).The positive expression rates of LAMP2a and LRG1 protein in the poor prognosis subgroup were higher than those in the good prognosis subgroup(P<0.05).TNM stage,degree of differentia-tion,lymph node metastasis and positive expression of LAMP2a and LRG1 protein were independent prognostic factors(P<0.05).The OR of LAMP2a and LRG1 protein positive expression in the risk of poor prognosis was 7.023,and the interaction index was 1.405.The positive expression of LAMP2a and LRG1 protein showed a positive interaction in the risk of poor prognosis.The AUC value of combined prediction of LAMP2a and LRG1 positive expression was significantly higher than that of single index prediction(P<0.05).Conclusion The positive expression of LAMP2a and LRG1 protein in esophageal cancer tissues is closely related to clinical characteristics and prognosis,and the positive expression of LAMP2a and LRG1 protein has a positive interaction in the risk of poor prognosis.The combined detection of their levels has a higher predictive value for patient prognosis.

Abstract:Objective To explore the effects of self disclosure intervention combined with cognitive-behavioral therapy on postoperative psychological stress and hope levels in patients with esophageal cancer.Methods 82 patients with esophageal cancer who were admitted to our hospital from September 2022 to September 2024 were selected and grouped randomly,with 41 patients in each.The control group received routine nursing care,while the observation group received self-disclosure intervention combined with cognitive behavioral therapy intervention on the basis of the control group.Both groups were followed up for 8 weeks after surgery,and the psychological stress response,hope levels,and quality of life level were compared before and after intervention.Results After intervention,the psychological stress score of the observation group was lower than that of the control group(P<0.05).The positive attitude,positive action score,and overall score of the observation group were higher than those of the control group(P<0.05).The quality of life level of the observation group was higher than that of the control group(P<0.05).There was no statistically significant difference in the intimate relationship scores between the two groups(P>0.05).Conclusion Self disclosure intervention combined with cognitive-behavioral therapy can alleviate postoperative psychological stress reactions in esophageal cancer patients,improve their positive attitudes and behaviors,and enhance their quality of life.

Abstract:Objective To investigate the effects of vonoprazan and esomeprazole on serum levels of CGRP,5-HT,and inflammatory factors in patients with gastroesophageal reflux disease(GERD).Methods 96 GERD patients admitted to Puyang People's Hospital from July 2022 to July 2024 were randomly divided into a control group and an observation group,with 48 cases in each.Both groups were treated with itopride;while the control group received combined treatment with esomeprazole,and the observation group received combined treatment with vonoprazan.Both groups continued to receive treatment for four weeks.The clinical efficacy,serum levels of CGRP,5-HT,and inflammatory factors between two groups were compared,and the occurrence of adverse reactions was recorded.Results Compared with the control group,the total effective rate of the observation group was significantly higher;and the post-treatment levels of CGRP,5-HT,IL-6,IL-1β,and TNF-α were significantly lower(P<0.05).However,there was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Compared with itopride combined with esomeprazole,itopride combined with vonoprazan has a better therapeutic effect in reducing serum levels of CGRP,5-HT,and inflammatory factors in GERD patients,and can more effectively alleviate the body's inflammatory response;moreover,the safety of the two combined regimens is comparable.

Abstract:Esophageal cancer is one of the deadliest cancers with a specific high incidence in China,with the highest incidence and mortality in the world.The disease burden is serious.With changes in social and economic development,population size and demographic structure,and the prevalence and distribution of major risk factors,the epidemiological characteristics in China are also changing.This article summarizes epidemiological and trends of EC in China with data and reference to the latest literature on EC epidemiology at home and abroad,aiming to provide a reference for improving the prevention and control of EC.

Abstract:Esophageal cancer has a high incidence rate and poor prognosis,which is one of the major diseases endangering the national health in China.The basic method for treating esophageal cancer is to remove or destroy the tumor,including open resection,minimally invasive laparoscopic resection,as well as endoscopic resection and non-resection therapies.Choosing appropriate surgical procedures based on the size,location,type of tumor,patient's physical condition,disease staging,etc.,to prevent and reduce complica-tions,is the basic way to prolong survival,improve quality of life,and improve prognosis.This article combines domestic and international progress to summarize various esophageal cancer treatment methods currently used in clinical practice,as well as the prognosis and influencing factors of various surgical methods,for the refer-ence of clinical treatment plan selection and related researchers.

Abstract:Objective To explore the effect of ABC-X model intervention on postoperative complications and inflammatory indicators in patients with esophageal cancer(EC).Methods 92 postoperative EC pa-tients admitted to our hospital from January 2021 to December 2023 were randomly divided into a control group and an observation group,with 46 cases in each.The control group received routine nursing interven-tion,while the observation group received ABC-X model nursing intervention on the basis of the control group.After the nursing intervention,the anxiety and depression,inflammatory markers,hospitalization satis-faction,and incidence of complications in 2 groups were compared.Results Before intervention,there was no statistically significant difference between the observation group and the control group in SAS score(t=1.772,P=0.727),SDS score(t=1.637,P=0.557),NLR level(t=2.320,P=0.212),MLR level(t=6.212,P-0.338),and PLR level(t=5.621,P=0.151).After intervention,the SAS score(t=5.231,P=0.000;t=3.549,P=0.000),SDS scores(t=12.732,P=0.000;t=9.159,P=0.000),NLR levels(t=0.596,P=0.000;t=2.764,P=0.000),and MLR levels(t=2.574,P=0.000;t=1.710,P=0.000),PLR(t=2.586,P=0.000;t=1.561,P=0.000)in the control group were significantly decreased;the SAS score(t=2.412,P=0.000),SDS score(t=2.356,P=0.000),NLR level(t=5.221,P=0.000),MLR level(t=5.981,P=0.000),and PLR level(t=0.999,P=0.000)of the observation group showed a more significant decrease compared to the control group.In addition,the satisfaction rate of postoperative EC patients in the observation group was higher than that in the control group(x2=8.603,P=0.003),and the incidence of complications is lower than that of the control group(x2=9.797,P=0.002).Conclusion Nursing interventions based on the ABC-X model can significantly improve negative emotions after EC surgery,reduce the incidence of compli-cations,and improve the level of inflammation in the body.

Abstract:Esophageal cancer,one of the most common tumors in the world,has a high incidence and mortality,which is mostly in the middle and late stages when it is found,so it is still challenging to achieve effective treatment.Currently,neoadjuvant therapy strategies,including chemotherapy,radiotherapy,molec-ular targeting,immunotherapy and their combinations,have been widely recognized in clinical value,but the selection of different regimens is controversial.Based on relevant literature,this paper summarizes the re-search status and progress of neoadjuvant therapy for esophageal cancer,and analyzes its application prospects and existing problems,so as to provide references for further optimization of clinical diagnosis and treatment strategies.