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Chest trauma is one of the most common injuries. Venous thromboembolism (VTE) as a common complication of chest trauma seriously affects the quality of patients′ life and even leads to death. Although there are some consensus and guidelines on the prevention and treatment of VTE at home and abroad, the current literatures lack specificity considering the diagnosis, treatment and prevention of VTE in patients with chest trauma have their own characteristics, especially for those with blunt trauma. Accordingly, China Chest Injury Research Society and editorial board of Chinese Journal of Traumatology organized relevant domestic experts to jointly formulate the Chinese expert consensus on the diagnosis, treatment and prevention of chest trauma venous thromboembolism associated with chest trauma (2022 version). This consensus provides expert recommendations of different levels as academic guidance in terms of the characteristics, clinical manifestations, risk assessment, diagnosis, treatment, and prevention of chest trauma-related VTE, so as to offer a reference for clinical application.
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During the 13th Five-Year Plan period, China issued a series of policies for private hospitals, which made an important impact on the running of medical institutions by social forces. One hundred and sixty-one policy documents for private hospitals were sorted out from January 2016 to January 2020, national policies and measures in terms of access approval, comprehensive supervision, fiscal and taxation support, supporting policies, talent development, open innovation, and resource sharing were being reviewed. It found that the characteristics of China′s policies were consistent in content, comprehensive in coverage, and supported the development of traditional Chinese and Western medicine.From 2016 to 2020, the total number of private medical institutions in China maintained growth, however, there were some practical problems, such as insufficient professional and technical capacity, low coordination development with public healthcare, and incomplete supervision and evaluation system. Therefore, during the 14th Five-Year Plan period, we should realize the transformation from private hospital management to modern governance, integrate private hospital development policies, optimize the system of approval and access, standardize the supervision and evaluation system, enhance the sharing of development resources, strengthen the construction of professionals, adhere to the concept of fairness, openness, and innovation, so as to promote the sustainable development of private hospitals.
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Cancer can mediate the onset of ischemic stroke directly or through cancer-associated hypercoagulability. The clinical manifestations of cancer-associated ischemic stroke (CAIS) are very heterogeneous according to the underlying cause. Generally speaking, CAIS is manifested as multiple vascular territory ischemic lesions on imaging, and fibrinogen degradation products such as blood D-dimer are significantly increased. The treatment of CAIS is quite tricky. Given that the risk of bleeding is not higher than that of the general population, cancer is not a contraindication for intravenous thrombolysis and mechanical thrombectomy. Anticoagulant therapy of CAIS should be individualized according to the benefits and risks. Low molecular weight heparin is still the first choice, and new oral anticoagulants have good prospects. This article reviews the pathogenesis, clinical features and treatment progress of CAIS.
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Objective:To analyze features of sarcopenia and its influencing factors in hospitalized patients at our department.Methods:This was a cross-sectional study.A total of 180 patients aged 80.3±6.7 years admitted to the geriatrics department of our hospital were consecutively recruited.Patients were divided into the non-sarcopenia group(n=80, 44.4%)and the sarcopenia group(n=100, 55.6%)based on the diagnostic criteria for sarcopenia of the Asian Sarcopenia Working Group.All subjects were evaluated by using the comprehensive geriatric assessment.Differences in comorbidity, physical function, nutrition, cognitive function, psychological characteristics, geriatric syndromes, medication and other aspects were analyzed between the two groups.The correlation of the above factors with sarcopenia was analyzed.Results:Scores on the Charlson comorbidity index and the cumulative illness rating scale were higher in the sarcopenia group than in the non-sarcopenia group(2.6±1.7 vs.2.1±1.1, 11.3±4.1 vs.7.9±1.8, P<0.05). Scores on mini-nutrition assessment and mini-cog, grip, chair-rising test(five times), timed get-up and go test(3 m), walking speed, and short physical performance battery were lower in the sarcopenia group than in the non-sarcopenia group[(12.8±2.1) vs.(11.2±1.7), (2.3±1.0) vs.(4.4±0.9), (21.2±5.8)kg vs.(27.6±6.2)kg, (31.4±15.3)s vs.(13.2±4.0)s, (24.2±9.5)s vs.(12.0±2.9)s, (0.6±0.2)m/s vs.(0.9±0.3)m/s, (6.1±1.9) vs.(9.8±1.3), respectively, P<0.05]. The incidences of geriatric syndromes such as incontinence, visual impairment, hearing impairment, sleeping disorders, oral problems, chronic pain, anxiety, depression and falls were higher in sarcopenia patients than in non-sarcopenia patients.Logistic regression analysis showed that body mass index, walking speed and the number of geriatric syndromes were risk factors for sarcopenia( OR=1.401, 1.286 and 3.654, P<0.05). Conclusions:The incidence of sarcopenia is high in hospitalized elderly patients.Comprehensive geriatric assessment can be used to achieve a more complete understanding of the characteristics and influencing factors for patients with sarcopenia and will help provide a basis for appropriate treatment plans.
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Objective An analysis of informationized multi-platform big data was conducted to learn about the quality change of health management data for hypertension and diabetes patients in Baoshan District of Shanghai since 2017.The result provided important information for further evaluation of the effect of quality control measures, and the prevention and management of chronic diseases. Methods Height, weight, blood glucose level, diagnosis and treatment information were collected from different databases of patients with hypertension and diabetes in Baoshan District from 2017 to 2019, and the consistency of the data from different sources was analyzed. Results Both the percentages of weight and height inconsistency among patients with hypertension and diabetes together were lower in 2019 than in 2017 (10.99% vs 18.72%, χ2=822.38, P < 0.001 and 0.86% vs 2.74%, χ2=347.03, P < 0.001, respectively).In 2019, the percentage of registered hypertensive patients with abnormal traceability from diagnosis was higher than that in 2017 (12.67% vs 11.72%, χ2=4.01, P=0.045).Similar results were also obtained in patients with diabetes.Analysis of glycated hemoglobin value last position in diabetic patients showed that the coefficient of variation of the last position composition ratio of the value in 2019 was significantly lower than that in 2017 (0.19 vs 0.31).The ratio in patients with the last position of glycosylated hemoglobin value of 0 was lower in 2019(4 701 cases, 12.72%) than that in 2017 (9 485 cases, 17.14%), and the difference was statistically significant. Conclusion The study result shows an improvement in quality management of hypertension and diabetes in Baoshan District of Shanghai.Information technology should be more widely used in promoting technical standardization, strengthening technical training, data quality control and effect evaluation.
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Effective supervision proves vital for the guidance of healthy development of private hospitals in China. Based on study and analysis of the current situation and problems of private hospitals supervision in China, the authors reviewed previous studies, leveraged " system+ mechanism+ technology" resources, and attempted to explore and build an integrated, omnidirectional, efficient and diversified linkage supervision system. Such a system was based on the information technology and fits the development trend of private hospitals in the Internet-plus era. The authors attempted to combine such supervision modes as government supervision, social supervision, industry self-discipline, and institutional autonomy, so as to develop a " four-dimensional supervision system" . This system works on such aspects as the supervision subject, supervision content, supervision mode and means, as well as classified supervision of private hospitals. The paper hence proposed relevant specific measures and supporting mechanisms, and provided policy suggestions, and references for improving the comprehensive and effective supervision of private hospitals.
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Objective:To identify current research hotspots, research trends and future trends of point-of-care testing(POCT) in China, by means of literature review.Methods:The " point-of-care testing" and " POCT" were used as the search terms, to retrieve in CNKI database the literature on point-of-care testing published during 2010-2019 in the method of subject retrieval. CiteSpace software was used to analyze and generate the research institutions and their cooperative networks, the keyword co-occurrence network, and the burst term analysis, for an analysis of the current researches in point-of-care testing in China.Results:A total of 588 literatures were retrieved, and 485 literatures were finalized as research samples, with exclusion of those obviously irrelevant. The research found that the point-of-care testing studies in China focused on portable blood glucose meters, quality control of POCT, comparison of POCT and biochemical analyzer results, and establishment of a POCT quality system. In terms of future research tend, the hotspots fell on " total quality management system of POCT" , " POCT in cardiovascular disease application" , " POCT in battlefield operation or emergency application" .Conclusions:Given the growing number of relevant documents on point-of-care testing, and the expanding scope of researches, regional research centers have yet to be formed.
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Objective:To discuss the feasibility of prenatal MRI in evaluating fetal auricle developmental malformation and atresia of external auditory canal.Methods:Fifteen pregnant women (aged from 22 to 40 years old, mean age 31.3±5.2 years old) with fetal external ear developmental malformation suspected by ultrasound underwent MR scanning between November 2017 and May 2019. All of them were singleton. The gestational age ranged from 23 weeks to 35 weeks, with an average of (27.5±3.5) weeks. The sensitivity, specificity and accuracy of MRI and ultrasound in the diagnosis of fetal auricle malformation and atresia of external auditory canal were calculated and compared, using postnatal follow-up as the gold standard. Fisher exact test was used to compare the efficacy of MRI and ultrasound in diagnosing atresia of external auditory canal.Results:A total of 30 fetal external ears were detected in 15 fetuses, without auricle absence. Totally 19 external ears with developmental malformation were confirmed by postnatal follow-up, including 19 ears with auricle malformation and 15 ears with external auditory canal atresia. The accuracy of MRI and ultrasound in the diagnosis of auricle malformation was both 100% (19/19). For the diagnosis of external auditory canal atresia, the sensitivity, specificity and accuracy of MRI and ultrasound were 93.3% (14/15), 75.0% (3/4), 89.5% (17/19) and 33.3% (5/15), 25.0% (1/4), 31.6% (6/19), respectively. The sensitivity and accuracy of MRI in the diagnosis of atresia of external auditory canal were significantly higher than those of ultrasound, with statistically significant difference ( P=0.004, 0.001). Conclusion:MRI plays an important role in the diagnosis of fetal external ear developmental malformation, which can be used as an effective supplement to ultrasound, especially for the diagnosis of external auditory atresia.
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OBJECTIVE@#To investigate the effect of chidamide on the killing activity of NK (Natural killer cell, NK) cells targeting K562 cells and its related mechanism.@*METHODS@#K562 cells were pretreated with chidamide at different concentrations and cocultured with NK cells at different effect-target ratios. The killing effect of chidamide on K562 cells by NK cells, the expression of natural killer group 2 member D (NKG2D) ligands and apoptosis rate of K562 cells were detected by flow cytometry.@*RESULTS@#The killing sensitivity of NK cells to K562 cells could be enhanced by chidamide. The expression of ULBP2 on K562 cell surface could be up-regulate, however, the expression of ULBP1 and MICA/MICB showed no statistically difference as compared with control group. Chidamide showed no obvious cytotoxicity to K562 cells.@*CONCLUSION@#Chidamide can significantly improve killing efficiency of NK cells on K562 cells, which may be related to the up-regulation of ULBP2 expression.
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Humanos , Aminopiridinas , Benzamidas , Proteínas Ligadas a GPI , Antígenos de Histocompatibilidad Clase I , Péptidos y Proteínas de Señalización Intercelular , Células K562 , Células Asesinas Naturales , Alergia e Inmunología , Subfamilia K de Receptores Similares a Lectina de Células NKRESUMEN
Objective To observe the differences in T-lymphocyte subsets between patients with sepsis,non-sepsis and healthy controls with different ages,and to investigate the effect of cellular immune function on readmission rate.Methods The 337 patients with sepsis,350 patients with non-sepsis and 141 healthy controls were enrolled in this prospective study from general department and intensive care unit(ICU)of emergency department in Beijing Chaoyang Hospital during May 2017 to April 2018.The effects of ages on T lymphocyte subsets and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ)and the effects of T lymphocyte subsets and APACHE Ⅱ on 30-day rehospitalization rate were comparatively studied.Results In patients with non-sepsis,the values of CD3+T,CD4+T,CD8+ T,natural killer(NK)cell count were lower in elderly group than in the non-elderlygroup(956.0±85.8)×10-6/L vs.(1363.3±46.7)×10 6/L,(647.3±59.9)×10-6/L vs.(875.8±33.4) × 10-6/L,(288.9± 31.1)× 10-6/L vs.(451.2±21.2)× 10-6/L and (14.5±0.64)％vs.(15.4±0.6)％,respectively,P＜0.01.In patients with sepsis group,the values of CD3+ T,CD4+T,NK cells count were decreased and APACHE Ⅱ were increased in the elderly group as compared with the non-elderly group.The 30-day readmission rate was higher in elderly patients than in the non-elderly patients(74 cases vs.39 cases,P ＜0.01).Compared with the non-elderly patients,the elderly patients had decreased values of CD3+ T,CD4+ T,CD8+ T,NK cells,CD4+/CD8+ cell count and an increased APACHE Ⅱ (P ＜0.05).Conclusions The cellular immune function is decreased in elderly patients,which is more obvious in elderly patients with sepsis.Age,CD3+ T,CD4+ T,CD8+T and APACHE Ⅱ could be used as an independent predictor for 30 day readmission rate.
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Objective To investigate the surgical methods and the differences of postoperative complications in esophageal canccr patients aged 60 years and over undergoing different operation models.Methods A total of 542 elderly esophageal cancer patients who underwent thoracic surgery at our hospital between January 2010 and December 2016 were enrolled.Patients were divided into 4 groups:left thoracic incision operation group (n =202),lvor-Lewis two incisions operation group (right chest posterolateral and upper abdomen median) (n=251),three incision operation group (left neckright chest-abdominal midian (n =29),and McKneown under-endoscope minimally invasive operation group (n=60).Clinical data,including the postoperative days,numbers of lymph nodes dissection,pulmonary infection,serous membrane fluid,arrhythmia,chylous fistula,gastric emptying dysfunction and anastomotic leakage,were retrospectively compared between the four groups.Results There was no significant difference in the postoperative days,serous membrane fluid,arrhythmia,chylous fistula,gastric emptying dysfunction and anastomotic leakage (P ＞ 0.05).The number of lymph nodes dissection in Sweet group,Ivor-Lewis group,Mckeown operation group and minimally invasive Mckneown group were (12.9±7.4)、(19.3±8.6)、(14.3±6.9)and(15.4±7.3)respectively.The number of lymph nodes dissection was more in the Ivor-Lewis group than in the other three groups (F =23.915,P =0.000).Sweet group,Ivor-Lewis group,Mckeown group and minimally invasive Mckneown group were 31.7％、40.2％、24.1％ and 50.0％ respectively.The incidence of pulmonary infection was higher in the minimally invasive surgery group than in the other three groups (x2 =9.941,P =0.019).Conclusions Ivor-Lewis surgery is more effective in lymph nodes dissection and has a lower incidence of complications in elderly esophageal cancer patients.The minimally invasive surgery group has a higher incidence of pulmonary infection than in the other surgical groups,which may be related with the immaturity of endoscopic technique.
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Based on literature review and on-site investigation, this paper analyzed the current policies, regulations, supply and demand dilemma and practical mode of such a combination, as well as the feasibility from the views of current policies, service offering and the practice. It is recommended to build a service system centering on " public health services + basic medical care + community elderly/medical support" , with services enriched and supportive mechanisms supplemented, thus transforming community health centers.
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Objective To explore the mechanism of bone marrow-derived endothelial progenitor cells (EPCs)in the treatment of peripheral neuropathy of diabetic rats. Methods Rats with diabetic peripheral neuropathy (DPN)were induced by streptozotocin(60 mg/kg). Male SD rats were divided into normal control group(NC group),DPN group, DPN+saline group(DPN+S group), and DPN+ EPCs group. Sciatic nerve motor nerve conduction velocity(MNCV)was measured. The expressions of NF-κB and myelin basic protein(MBP)in sciatic nerve were detected by immunohistochemistry. Results Compared with DPN group,the expression of NF-κB was reduced in the sciatic nerve of DPN+EPCs group,while the expression of NF-κB was increased in the sciatic nerve of DPN+ S group. There was no statistical difference in the expression of MBP between DPN and DPN+ EPCs groups. Compared with DPN+S group, the expression of MBP was higher in DPN+EPCs group. Conclusion Transplantation of EPCs inhibits the expression of NF-κB and increases the expression of MBP, which might be conducive to the repairs of nerve injury.
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Objective To investigate the influence of fear of falling on clinical ,functional ,and gait variables in elderly patients with type 2 diabetes and to identify predictive factors for fear of falling in this population. Methods A total of 238 community-dwelling older persons with type 2 diabetes (aged 65 to 89 years ) were divided into two groups according to Falls Efficacy Scale-International scores.Participants with a score<23 were assigned to the no-fear group (n=118) and those with a score≥ 23 were assigned to the fear group (n= 120 ).Demographics ,anthropometrics ,number of diseases and medications ,physical activity level ,history of falls ,frailty level ,cognition ,depressive symptoms ,fasting glucose level ,and disease progression were collected. Timed Up and Go test (TUG) ,five times sit-to-stand test (5-STS) ,and tests for grip strength and pace were run. Results Participants in the fear group were more frail and presented more depressive symptoms and worse performance in the TUG and 5-STS tests than in the no-fear group.The fear group also showed a slower pace ,a shorter step length ,a longer step time ,and a longer swing time.Multivariate regression analysis revealed that the likelihood of having fear of falling increased by 1.32 times (OR :1.32 ,95％CI :1.09-1.58) for every one-point increase in the Geriatric Depression Scale (GDS-15) score and by 1.35 times (OR :1.35 ,95％ CI :1.06-1.70) for every one-second increase in TUG. Conclusions The fear of falling in community-dwelling elderly patients with type 2 diabetes mellitus is associated with frailty ,depressive symptoms ,dynamic balance ,functional mobility ,and abnormal gait. Furthermore , both GDS-15 and TUG test can predict fear of falling in this population.
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Objective To examine changes in bone mineral density,serum bone turnover markers and serum cytokines after health education intervention in elderly patients with osteoporosis.Methods Two hundred and twenty elderly patients with osteoporosis were randomly divided into two groups.The control group(n=110)was given routine treatment,including anti-osteoporosis drugs and daily supplements of calcium and vitamin D.In addition to routine drug treatment,the observation group(n=110)also underwent health education intervention,which included instructions on lifestyle,diet,and exercise.After one year follow up,levels of bone mineral density(BMD),propeptide of type Ⅰ procollagen(PINP),β crosslaps (β-CTX),parathyroid hormone (PTH),25-dihydroxyvitamin D [25(OH) VD],interleukin-2 (IL-2),and insulin-like growth factor-1 receptor (IGF-1 R) were analyzed.Results After one year follow-up,all indicators,except the β-CTX level,were significantly improved in the observation group compared with those in the control group(all P＜0.05).Mean while,compared with pre-treatment levels,both groups had significantly increased levels of BMD(both P＜ 0.05),which were markedly higher in the observation group (P ＜ 0.05).Furthermore,improvement was achieved in cognitive ability and lifestyle in the observation group (both P ＜ 0.05).Conclusions Health education intervention can effectively improve BMD in elderly patients with osteoporosis,significantly improve lifestyle,and play an important role in integrated management of osteoporosis.
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Objective To design a simple and easy to operate new position radiography as same effect as the ordinary lateral position of the hip joint.Methods Using different angles for bone model radiography, the tilt angle of X-ray and the bone model were measured in order to obtain that the femoral head and neck was fully displayed.30 subjects with hip joint disease underwent routine and improved lateral radiography of the hip joint were enrolled, and the actual operations and image quality of the two methods were compared.Results The tilt angle of X-ray was 35°-45°,and the tilt angle of the bone model was 60°-70°, and the score was 3.The new lateral radiography of the hip joint was feasible,the display rate of the articular surface and joint space were 96.7%,the display rate of the femoral head and neck all were 100%,the display rate of the greater trochanter of femur was 80%,the display rate of the lesser trochanter was 100%.Conclusion The improved method of hip joint lateral position of X-ray can better show the femoral head, neck and the rest of the bone.
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'Social beings' model of standardized training program for residents in Shanghai is one of the important measures in the health care reform. According to the requirements of the standardized training of residents in thoracic surgery, the article preliminarily explored the standardized training model for residents from four aspects such as individualized treatment of different professional backgrounds, focus-ing on the training needs of residents with different starting point of social beings, developing training programs for different training time and combining the master's degree graduate education. And based on the characteristics of thoracic surgery, it also summed up the past experience and explored the clinical practice teaching.
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Objective To analyze the frail status and influencing factors of inpatients in geriatrics department.Methods A total of 170 patients aged ≥ 65 years in Geriatrics Department in our hospital were selected.Frailty was defined according to the Clinical Frailty Scale (CFS),and patients were divided into non-frail group and frail group.The differences in comorbidity,physical function,nutrition,cognitive,psychological,geriatrics syndromes,medication,social support and other aspects were analyzed between the two groups by using Comprehensive Geriatrics Assessment(CGA),and correlationof the factors with frailty was evaluated.Results There were 83 (49.0％)patients in frail group and 87 (51.0％)in non-frail group.In frail group versus non-frail group,Charlson comorbidity index was(2.7±2.0)vs.(1.9±1.1),and cumulative illness rating scale was(10.8±3.7) vs.(8.0±2.6) (all P＜0.05);mini-nutrition assessment was(11.2±2.3)vs.(13.0±1.3),and simple cognitive score was(2.7±1.3)vs.(4.1±0.9)(all P＜0.05).Grip,five chair rising,timed get-up and go test,walking speed,SPPB showed statistically significant differences (all P＜ 0.05) between frail group and non-frail group:(20.7±6.6)kg vs.(27.96.7)kg,(30.4±17.5)vs.(12.9±4.1),(23.7± 9.9)vs.(11.7± 3.3),(0.5 ± 0.2)m/s vs.(0.9± 0.2)m/s,(5.6 ± 2.3) vs.(10.3±1.8)respectively.The incidences of incontinence,visual impairment,hearing impairment,sleeping disorder,oral problems,chronic pain,anxiety or depression and fall history were higher in frail patients than in non-frail patients.Living alone,the widowed,nursing staff employment proportion were higher in frail group than in non-frail group.Level of education was lower in frail group than non-frail group.Logistic regression analysis showed that BMI,the walking speed and the number of geriatrics syndromes had a significant impact on frailty(OR=0.789,0.000,2.745,all P＜0.05).Conclusions Incidence rate of frailty in elderly hospitalized patients is high.To identify frailty of hospitalized patients,comprehensive geriatric assessment can be used for understanding frail characteristics and its influencing factors for hospitalized old patients,so as to provide evidence for the reasonable treatment programs.
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Objectvi e To understand the correlation between the diabetes and the complications and the constitution of traditional Chinese medicine ( TCM ) in Baoshan District in Shanghai , and to provide scientific evidence for carrying out the targeted prevention and intervention measures.M ethods TCM body mass table was used to distinguish the TCM constitution of the diabetic patients and the control group .The relationship between TCM constitution and diabetes and its complications was analyzed by single factor and multiple factor logistic regression . Results There were less patients with yin-yang harmony constitution and yang deficiency constitution in the case group than in the control group , while more with qi deficiency constitution and phlegm-damp constitution than in the control group .Among a total of 879 cases of diabetic patients with1 235 physical elements , the top four biased constitution elements were identified including constitution of qi deficiency ( 15.22%), yin deficiency ( 8.42%), yang deficiency ( 8.42%) and phlegm-damp ( 8. 34%).The yin deficiency, qi deficiency and phlegm dampness constitution elements in the case group were significantly higher than in the control group .Among 875 cases in the control group with 1 129 physical elements , the top four biased constitution elements were yang deficiency (12.40 %), qi deficiency( 9.65%), yin deficiency (5.05%) and phlegm-damp (4.52%), which yin-yang harmony constitution and yang deficiency constitution elements were significantly higher than those of the case group .The incidence of complications of the diabetic patients with biased constitution was significantly higher than those with the yin-yang harmony constitution . Conclusion Phlegm dampness constitution , qi deficiency constitution and yin deficiency constitution are the main dangerous constitution of diabetes mellitus .The protective constitution of diabetes is yin-yang harmony constitution and yang deficiency constitution .The biased constitution elements are the risk factors of diabetes complications .
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<p><b>OBJECTIVE</b>To examine the relationship between gastric conduit width and postoperative early delayed gastric emptying (DGE) in patients with middle-lower esophageal carcinoma who underwent Ivor-Lewis operation.</p><p><b>METHODS</b>Clinical data of 282 consecutive patients with middle-lower esophageal cancer who underwent the Ivor-Lewis operation by same surgical team in our department from January 2013 to June 2015 were retrospectively analyzed. Patients were divided into three groups according to the width of gastric conduit: width > 5.0 cm as broad group (n=93); width 3.0-5.0 cm as moderate group (n=70); width < 3.0 cm as narrow group (n=119). The gastric conduits of patients in narrow group were completely positioned the esophageal bed and fixed to the pericardium posterior wall. None of patients received pyloroplasty or pylorotomy. Perioperative data, operation-associated complications, and postoperative upper gastrointestinal radiographic results(1 week and 4 weeks after operation) were compared among groups.</p><p><b>RESULTS</b>The baseline data among these groups were comparable in terms of age, gender, tumor TNM staging, pathological types, serum albumin level, and the rate of receiving neoadjuvant therapy(all P>0.05). There were no significant differences in operative time, blood loss, and postoperative hospital stay among groups(all P>0.05). No patients died during perioperative peried. Anastomotic leakage occurred in 2 cases, one from broad group and another from narrow group. The incidences of arrhythmia and postoperative pulmonary complications, including infection, atelectasis, pneumothorax, and pleural effusion were similar among groups (all P>0.05). The average amount of gastric juice drainage in narrow group was (98±57) ml/day, which was markedly lower than that in broad group [(157±62) ml/day, P=0.000] and in moderate group [(123±68) ml/day, P=0.008]. One week after operation, the overall incidence of DGE was 10.6%(30/282), the incidence of DGE in broad, moderate, narrow groups was 17.2%(16/93), 14.3%(10/70), and 3.4%(4/119) respectively, and broad and moderate groups had higher incidence as compared to narrow group (P=0.001 and P=0.006).</p><p><b>CONCLUSION</b>During the Ivor-Lewis operation, application of a narrow gastric conduit (width < 3.0 cm), which completely position the esophageal bed with fixation to the pericardium posterior wall, can significantly reduce the incidence of postoperative early DGE.</p>