Background: Immunotherapy is effective in treating unresectable esophageal squamous cell carcinoma (ESCC), but little is known about its role in the preoperative setting. The aim of this study was to evaluate the safety, feasibility and efficacy of neoadjuvant treatment with camrelizumab plus chemotherapy in locally advanced ESCC.Methods: Patients diagnosed with locally advanced ESCC were retrospectively included if they had received neoadjuvant camrelizumab plus nab-paclitaxel and S1 capsule followed by radical esophagectomy between November, 2019 and June, 2020 at Sun Yat-sen University Cancer Center. Primary endpoints were safety and feasibility. In addition, pathological response and the relationship between tumor immune microenvironment (TIME)/tumor mutational burden (TMB) and treatment response were also investigated.Results: Twelve patients were included and they all received three courses of preoperative treatment with camrelizumab plus nab-paclitaxel/S1. No grade 3 or higher toxicities occurred. No surgical delay or perioperative death was reported. Nine patients (75%) responded to the treatment, four with a complete pathological response (pCR) and five with a major pathological response (MPR). Neither programmed death-ligand 1 (PD-L1) expression nor TMB was correlated with treatment response. TIME analysis revealed that a higher abundance of CD56dim natural killer cells was associated with better pathological response in the primary tumor, while lower density of M2-tumor-associated macrophages was associated with better pathological response in the lymph nodes (LNs).Conclusions: Neoadjuvant camrelizumab plus nab-paclitaxel and S1 is safe, feasible and effective in locally advanced ESCC and is worth further investigation.

Objective The paper characterizes outpatient communication in a major cancer hospital in southern China with regard to the structure, style and focus of doctor–patient communication. Method Fifty‐one encounters between doctors and patients were recorded in the outpatient department of the cancer hospital and analysed inductively to identify patterns of doctor–patient outpatient communication. Results Outpatient communication in the cancer hospital is characterized by structuralized conversation, doctor domination of the conversation and a focus on technology during communication. These characteristics suggest an extreme inequality of power between Chinese doctors and patients at the individual level. They are also shaped by the institutional environment of Chinese hospitals. Discussion Measures should be taken at both the interpersonal and institutional level to improve doctor–patient communication. At the micro‐interpersonal level, public education and professional skills training are needed to improve communication and promote mutual understanding between patients and doctors. At the macro‐institutional level, changes are needed in terms of transforming the structural factors that shape doctor–patient communication. Conclusions Structuralized conversation, doctor domination of the conversation and a focus on technology during outpatient encounters present challenges to effective doctor–patient communication. These patterns are shaped by the institutional environment of Chinese hospitals and suggest the extreme power imbalance between Chinese doctors and patients.

Postoperative HRQL is restored within 6 months after discharge. Occurrence of anastomotic stricture significantly decreases HRQL after esophagectomy.

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The study explores older people's perceptions and experiences with mobile technology adoption in hospitals. Twenty nine older people were interviewed at a tertiary hospital in Guangzhou from June to December 2020. All the interviews were analyzed using thematic analysis. Older people are a diversified group. Various factors impact their readiness for technology use, including their educational level, age, past experiences, living arrangements, etc. The older people in this study in general expressed a great concern about using the new health technology and many encountered barriers to its successful adoption. Yet, the barriers and difficulties that they encountered are embedded in a changed social context in China. The findings above provide insights into the adoption of health technology, and tailored measures to facilitate older people's technology adoption are suggested.