As one of the most common diseases in the elderly, chronic insomnia is often accompanied by cognitive impairment and seriously affects the quality of life of the elderly. The biological mechanism of cognitive impairment in elderly patients with chronic insomnia still remains unclear.

To investigate the correlation of cognitive function with insomnia severity, serum 25-hydroxy vitamin D₃ [25 (OH) D₃], tumor necrosis factor-α (TNF-α) in elderly patients with chronic insomnia.

A total of 105 elderly patients with chronic insomnia in the 901th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from June 2020 to June 2022 were selected as the research subjects. Pittsburgh Sleep Quality Index (PSQI), Geriatric Depression Scale (GDS-15) and Generalized Anxiety Disorder Scale (GAD-7) were tested before enrollment. The patients were divided into 32 cases in the mild insomnia group, 38 cases in the moderate insomnia group and 35 cases in the severe insomnia group according to the PSQI score. Photoplethysmography (PPG) was used to assess the objective sleep quality of patients, monitor the total sleep time, sleep latency, sleep efficiency and arousal times; the cognitive function of patients was evaluated by Mini-mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Serum levels of 25 (OH) D₃ and TNF-α were detected by enzyme-linked immunosorbent assay.

The sleep latency, arousal times and the level of TNF-α in the severe insomnia group were higher than those in the mild and moderate insomnia groups, with lower total sleep time in the severe insomnia group compared to the mild insomnia group and lower sleep efficiency compared to the mild and moderate insomnia groups (P<0.05) ; sleep latency in the moderate insomnia group was higher than that in the mild insomnia group, with lower sleep efficiency compared to the mild insomnia group (P<0.05). MMSE and MoCA scores were lower in the severe insomnia group than the mild insomnia and moderate insomnia groups, and lower in the moderate insomnia group than the mild insomnia group (P<0.05). Serum TNF-α level was higher and 25 (OH) D₃ level was lower in the severe insomnia group than the mild and moderate insomnia groups (P<0.05) ; serum TNF-α level was higher in the moderate insomnia group than the mild insomnia group, and 25 (OH) D₃ level was lower than the mild insomnia group (P<0.05). Spearman correlation analysis results showed that MMSE and MoCA scores were positively correlated with total sleep time, sleep efficiency and 25 (OH) D₃ level (P<0.05), and negatively correlated with insomnia severity, sleep latency, arousal times and TNF-α level (P<0.05) .

Cognitive impairment in elderly patients with chronic insomnia may be associated with insomnia severity, reduced serum 25 (OH) D₃ level and elevated TNF-α level.

In 2020, there were 62 000 new cases of nasopharyngeal carcinoma (NPC) in China, accounting for about 80% of the NPC cases worldwide. Analysis of the trend and projection of the incidence and mortality of NPC can provide a scientific basis for the prevention and treatment of NPC.

To evaluate the trend of incidence and mortality of NPC in Chinese residents, and explore the effects of age, period and cohort on the risk of incidence and death of NPC.

From December 2022 to January 2023, data on the ASIR (age standardized incidence rate) and ASMR (age standardized mortality rate) of NPC in China were extracted from the Global Burden of Disease 2019 database. The Joinpoint regression model was used to analyze the trends in ASIR and ASMR of NPC in China from 1990 to 2019. The age-period-cohort model was used to analyze the age effect, period effect and cohort effect affecting the risk of incidence and death of NPC in China. The ASIR and ASMR of NPC in China in the next 20 years were predicted using the R BAPC package.

There was an overall increasing trend in ASIR of NPC (AAPC=1.82, P<0.01) and decreasing trend in ASMR of NPC (AAPC=-2.45, P<0.01) among Chinese residents from 1990 to 2019. The overall risk of incidence and death of NPC generally increased with age (RR values ranged from 0.09 to 2.24 and 0.10 to 4.43 for males, 0.13 to 1.84 and 0.12 to 4.44 for females, respectively), but the incidence risk of NPC decreased after 55 years old (RR values ranged from 2.24 to 2.99 for males and 1.84 to 2.33 for females). The incidence risk of NPC increased (RR value ranged from 0.61 to 1.81 in males and 1.33 to 0.84 in females) over the years, and the risk of death from NPC decreased in females (RR value ranged from 1.42 to 0.79) and increased in males after 2005 (RR value ranged from 0.95 to 0.99). The later the birth was correlated with lower the risk of incidence and death of NPC (RR values ranged from 0.57 to 3.47 and 0.12 to 3.49 for males, 0.31 to 2.64 and 0.19 to 2.46 for females). It is predicted that the ASIR of NPC in China will continue to rise in the next 20 years, with 21.32/10⁵ in males and 4.95/10⁵ in females in 2039, the ASMR of NPC will decrease, with 1.88/10⁵ in males and 0.53/10⁵ in females in 2039.

The incidence of NPC in Chinese residents showed an increasing trend and mortality showed a decreasing trend from 1990 to 2019. Age effect and period effect dominate in terms of incidence risk of NPC, and age effect dominates in terms of the risk of death of NPC. It is predicted that the incidence of NPC will still increase and the mortality will decrease in the future.

An increasing number of studies have demonstrated that potentially inappropriate medication (PIM) occurs commonly in elderly patients with cancer, with higher prevalence of PIM than general elderly, which may lead to adverse effects on prognosis of the patients. Therefore, it is necessary to conduct a systematic and comprehensive review of previous studies to provide support and reference for future studies. PubMed, CNKI and Wanfang Data were systematically searched to summarize and analyze the screen tools of PIM, prevalence of PIM, main drugs involved, influencing factors and the relationship between PIM and adverse outcomes. The results showed that the prevalence of PIM varied when different PIM screen tools were used in older patients with cancer, and the list of medications commonly used for supportive care that are of concern in older patients provided by the NCCN Guidelines for Older Adult Oncology (2020.v2) demonstrated advantages in providing individualized medication management for elderly patients with cancer. Polypharmacy, age, and comorbidities were significantly associated with the development of PIM. Benzodiazepines and analgesics are commonly used as high-risk drugs in elderly patients with cancer. PIM may be associated with higher mortality rates, drug interaction rates, adverse event rates, emergency and hospital readmission rates in elderly patients with cancer. It is hoped that this article will provide a reference for conducting studies related to PIM in elderly patients with cancer in China and provide support for promoting the safe and rational use of medication in elderly patients with cancer.

The disease burden of esophageal cancer is high in China, more and more studies have shown that tobacco has a greater adverse effect on the development of esophageal cancer.

To understand trends in esophageal cancer deaths and burden of disease attributable to tobacco in China from 1990 to 2019, and provide data to inform the development of public health policies and interventions.

Global burden of disease 2019 (GBD 2019) data were used to extract the age-specific and sex-specific data on esophageal cancer deaths attributable to tobacco in China from 1990 to 2019. Mortality, disability adjusted life years (DALYs) , years of life lost (YLLs) , and disability adjusted life years (YLDs) were used to assess the disease burden of esophageal cancer attributable to tobacco in China. Joinpoint regression software and age-period-cohort modeling methods were applied to analyze the trends of disease burden and mortality with age, period and cohort. the Bayesian-period-cohort analysis (BAPC) was applied to predict the mortality rate of esophageal cancer attributable to tobacco in China from 2020 to 2030.

From 1990 to 2019, the number of deaths caused by esophageal cancer attributable to tobacco among Chinese residents rose from 76 400 to 123 900, with an increase of 62.17%, and the standardized mortality rate declined from 9.30/100 000 to 6.20/100 000, with a decrease of 33.33%; the DALYs rose from 1 972 500 person-years to 2 822 600 person-years, with an increase of 43.10%, and the DALYs rate decreased from 220.50/100 000 to 134.47/100 000, with a decrease of 39.02%. In terms of gender, the disease burden of esophageal cancer attributable to tobacco was mainly caused by males, with 117 700 deaths and a standardized mortality rate of 12.82/100 000 in 2019 due to tobacco-attributable esophageal cancer in males, compared to 0.62 million deaths number and a standardized mortality rate of 0.63/100 000 in females. In 2019, the number of esophageal cancer deaths attributable to tobacco among Chinese residents peaked in the age group of >69-74 years, while DALYs peaked in the age group of >64-69 years, at 23 000 and 510 300 cases, respectively. The mortality rate continued to increase with age, especially after 50 years of age. The results of Joinpoint regression analysis showed that the average annual percent change (AAPC) of esophageal cancer mortality attributable to tobacco was -1.4%〔95%CI (-1.6%, -1.2%) 〕 in China from 1990 to 2019, with -3.3%〔95%CI (-3.6%, -2.9%) 〕 for females, and -1.3%〔95%CI (-1.4%, -1.1%) 〕 for males; the AAPC for DALYs rate was -1.7%〔95%CI (-1.9%, -1.5%) 〕, with -3.7%〔95%CI (-4.0%, -3.4%) 〕 for females and -1.5%〔95%CI (-1.7%, -1.3%) 〕 for males. Analysis of the age-period-cohort model of mortality from esophageal cancer attributable to tobacco showed a negative net offset of -1.690%〔95%CI (-2.024%, -1.354%) 〕. It is expected that the number of deaths and mortality rate from tobacco-attributable esophageal cancer among Chinese residents will be relatively stable with a small decrease from 2020 to 2030, with mortality rates declining from 12.64/100 000 in 2020 to 12.63/100 000 in 2030 for males, and from 0.6/100 000 in 2020 to 0.46/100 000 for females.

Mortality rate and DALYs rate due to tobacco-attributable esophageal cancer among Chinese residents increased and then declined from 1990 to 2019. The burden of disease due to tobacco-attributable esophageal cancer is mainly caused by males in term of gender, by middle-aged and elderly people by age, which should be given sufficient attention. It is expected that the number of deaths and mortality rates from tobacco-attributable esophageal cancer will be stable and slightly decreasing from 2020 to 2030.

Microvascular invasion (MVI) is an aggressive behavior of hepatocellular carcinoma (HCC) that being an independent predictor of tumor recurrence after hepatectomy or liver transplantation. Preoperative prediction of MVI has important clinical significance.

To use non-invasive imaging and serological indicators to construct a nomogram for predicting MVI in order to provide a clinical reference.

The relevant clinical data of 284 patients who underwent radical resection of HCC in the Second Affiliated Hospital of Kunming Medical University from 2016 to 2021 were retrospectively analyzed, and HCC patients admitted from 2016 to 2020 were categorized as the model group (n=208) according to the admission time, and HCC patients admitted in 2021 were categorized as the validation group (n=76) . LASSO regression and multivariate Logistic regression analysis were performed to determine the independent risk factors for MVI in HCC, and R software was used to establish a nomogram model for predicting the risk of MVI in HCC before operation. The internal validation of the model was performed by Bootstrap method, external validation of the model was performed by using the validation group. The consistency index, calibration curve and decision curve analysis (DCA) were used to evaluate the discrimination, calibration ability and clinical application value of the nomogram.

Multivariate Logistic regression analysis showed that WBC>7.1×10⁹/L〔OR=3.144, 95%CI (1.301, 7.598) , P=0.011〕, tumor diameter>7.05 cm〔OR=3.836, 95%CI (1.758, 8.372) , P=0.001〕, S-Index>0.097〔OR=3.165, 95%CI (1.024, 9.779) , P=0.040〕, AAR>0.879〔OR=2.146, 95%CI (1.062, 4.337) , P=0.030〕, ANRI>24.074〔OR=2.769, 95%CI (1.175, 6.526) , P=0.020〕 were independent predictors of MVI in HCC. The consistency index of the nomogram model established using the five variables combined with AFP was 0.800〔95%CI (0.739, 0.861) 〕 and 0.755〔95%CI (0.641, 0.868) 〕 in the model group and validation group, respectively. The model fitted well with the calibration prediction curve. The optimal critical value of the nomogram calculated by Youden index was 174 points. The sensitivity, specificity, positive predictive value and negative predictive value at the critical value were 90%, 61%, 71%, and 85% in the model group, and 78%, 71%, 76% and 74% in the validation set, respectively.

The nomogram constructed with AFP>45 ng/mL, WBC>7.1×10⁹/L, tumor diameter>7.05 cm, S-Index>0.097, AAR>0.879, ANRI>24.074 can better predict the risk of preoperative MVI in HCC, the use of this nomogram can conveniently guide the clinical treatment of HCC patients by routine examination test indicators.

At present, the incidence and mortality of primary liver cancer (hereafter referred to as liver cancer) in China are high with heavy economic and disease burden. Standardized screening and health surveillance management for population as risk of liver cancer are important measures to effectively reduce the related burden of liver cancer. Currently, patients with liver cancer in primary care institutions in China lack the awareness of the necessity of liver cancer screening and surveillance with poor compliance, and the existing screening tools are less sensitive and cost-effective. This paper discusses the strategies of liver cancer screening and health surveillance management in primary care institutuons in terms of stratification of liver cancer risk assessment and screening in primary care institutions of chronic liver disease population in China, the current status of enhanced screening and long-term surveillance for population at high risk of liver cancer, to provide a reference for the standardization of screening, early diagnosis and treatment of liver cancer in China, with the aim of improving the screening coverage and control effects of liver cancer in primary care in China.

Community-based intervention is an important part of palliative care for advanced cancer patients. However, its role in the health management of advanced cancer patients remains to be supported by medical evidence.

To evaluate the efficacy of community-involved hospice care for patients with advanced cancer.

Wanfang Data Knowledge Service Platform, CNKI, VIP were searched by using Chinese keywords such as "community" "medical model" and "advanced cancer", Cochrane Library, PubMed and Web of Science were searched by using English keywords such as "Community-based" "Model of Palliative Care" "Advanced Cancer" "Quality of Life", to obtain randomized controlled trials (RCTs) related to the efficacy of community-involved hospice care from 2007-01-01 to 2022-05-10 by using Cochrane system evaluation method on 2022-05-22. The quality of RCTs meeting the inclusion criteria was evaluated, and the valid information was extracted for meta-analysis.

A total of 11 RCTs in English and 9 RCTs in Chinese were included in the study, involving 2 356 and 1 238 patients, respectively. Meta-analysis showed that compared with routine cancer care, community-involved hospice care could improve quality of life and symptom severity in patients with advanced cancer, demonstrated by increasing Functional Assessment of Chronic Illness Therapy-Palliative Care scale socre〔MD (95%CI) =3.77 (0.83, 6.71) , P=0.01〕and Quality of Life Instruments for Cancer Patients scale total score〔MD (95%CI) =12.53 (2.36, 22.69) , P=0.02〕, reducing Functional Assessment of Cancer Therapy scale total score〔MD (95%CI) =-2.61 (-3.53, -1.70) , P<0.01〕 and Edmonton Symptom Assessment System score〔MD (95%CI) =-2.45 (-4.70, -0.20) , P=0.03〕. However, the improvement of community-involved hospice care on depressive symptoms and overall survival rates of patients remains controversial, and its effect on economic indicators such as admission rates, hospitalization days/numbers needs to be further explored.

Community-involved hospice care can improve the quality of life and symptom severity of patients with advanced cancer, however, its improvement in hospice care in the depressive symptoms and overall survival rates of the patients remains controversial, and its improvement in economic indicators such as admission rate and hospital stay/inpatients admissions remains to be further explored.

Primary liver cancer (PLC) is one of the common malignant tumors and the main causes of tumor death in China. Although the diagnosis and treatment technology of PLC in China has made great progress in recent years, its morbidity and mortality have been decreasing year by year, but the low early diagnosis rate and 5-year survival rate of PLC are major public health problems that need to be solved urgently in the field of chronic disease prevention and control. Effective implementation of early screening, detection, diagnosis and treatment of PLC is an important measure to improve the rates of radical treatment and survival. The combination of serum alpha-fetoprotein (AFP) and liver ultrasound is a routine method for screening hepatocellular carcinoma (HCC) in patients with chronic liver disease; the combination of AFP and AFP-L3 and/or abnormal prothrombin can improve the early diagnosis rate of early-stage HCC; the early diagnosis rate of small hepatocellular carcinoma can be improved by Gd-EOB-DTPA-enhanced magnetic resonance imaging or its combination with computerized tomography. With the continuous promotion of hierarchical medical system and improvement of primary medical resources allocation and health service capacity in China, primary care institutions have become an important force for early screening of many cancers. Based on this context, this paper mainly discusses the development opportunities, risk challenges and future thinking of surveillance for liver cancer in primary care institutions in China, in order to provide new ideas and direction guidance for it in the future.

Traditional Chinese medicine (TCM) has become an important option for patients with advanced esophageal cancer (EC) who are not able to undergo surgery, radiotherapy, chemotherapy, or with disease progression after chemotherapy. The purpose of this study is to investigate the application effects of Dingxiang Guanshitong Hanhua Pills alone and its combination with Fugui Guanshitong Granules, in order to improve the quality of life of patients with advanced EC, and provide an effective TCM treatment schemes for EC.

To evaluate the effects of Dingxiang Guanshitong Hanhua Pills alone and its combination with Fugui Guanshitong Granules on survival rate and quality of life of patients with EC after 6 weeks of treatment.

A total of 109 patients with advanced EC admitted to nine centers such as the First Affiliated Hospital of Henan University of CM, Linzhou Hospital of Traditional Chinese Medicine and Jia County Hospital of Traditional Chinese Medicine from January 2020 to April 2021 were selected as the research objects and divided into the control group, experimental group 1 and experimental group 2 by block randomization method. The control group received Danggui Buxue Decoction and Guizhi Renshen Decoction Granules, the experimental group 1 received Fugui Guanshitong Granules and Dingxiang Guanshitong Hanhua Pills, the experimental group 2 received Dingxiang Guanshitong Hanhua Pills, with the course of 6 weeks in the above three groups. The survival rate after 6 weeks of treatment, Quality of Life (QOL) score, Karnofsky Performance Status (KPS) score, TCM syndrome score (dysphagia, poststernal chest pain, mucus vomiting, loss of appetite, fatigue) before and after treatment of the three groups were compared, and safety evaluation was conducted.

After 6 weeks of treatment, the survival rate was 72.7% in the control group, 88.6% in the experimental group 1, and 86.8% in the experimental group 2, and there was no statistically significant difference in the survival rates among the three groups after 6 weeks of treatment (χ²=4.036, P=0.133). There was no interaction effect of group and time on QOL score, KPS score, and TCM syndrome score (P_interaction>0.05). The main effect of group was not significant on QOL score, KPS score and TCM syndrome score (P_interclass>0.05). The main effect of time was significant on QOL score, KPS score and TCM syndrome score (P_time<0.05). There was an interaction effect of group and time on mucus vomiting score (P_interaction<0.05), the scores of loss of appetite and mucus vomiting in the experimental group 2 were significantly lower than the experimental group 1 (P<0.05). Adverse events in the three groups included diarrhea, fever, dry mouth, sore throat, inability to eat, lung infection, without serious complications. There was no significant difference in the incidence of adverse events among the three groups (χ²=0.063, P=0.969) .

All three treatment schemes can relieve the clinical symptoms and improve the quality of life of the patients with advanced EC. Moreover, the efficacy of Dingxiang Guanshitong Hanhua Pills alone on appetite loss and mucus vomiting was better than that of Danggui Buxue Decoction and Guizhi Renshen Decoction Granules and the combination of Dingxiang Guanshitong Hanhua Pills and Fugui Guanshitong Granules.

Esophageal cancer threatens the life and health of patients due to its complex etiology and poor prognosis, and individualized combination treatment of traditional Chinese medicine and western medicine has certain advantages.

To observe the clinical efficacy of the combination of Xiaotan Huayu Tongyi Granules, Channel Kaijie Pills and CF regimen (fluorouracil+cisplatin) on the treatment of stage Ⅲ-Ⅳ phlegm-stasis interjunction esophageal squamous cell carcinoma.

A total of 99 patients with phlegm-stasis interjunction type esophageal squamous cell carcinoma diagnosed and treated in Henan Hospital of Traditional Chinese Medicine, Anyang Cancer Hospital and Henan Cancer Hospital from February 2020 to February 2021 were selected as the study objects and randomly divided into the control group, treatment groupⅠand treatment groupⅡ, with 33 cases in each group. The control group was treated with CF regimen, the treatment groupⅠwas treated with Xiaotan Huayu Tongyi Granules combined with CF regimen, and the treatment groupⅡ was treated with the combination of Xiaotan Huayu Tongyi Granules, Channel Kaijie Pills and CF regimen. A total of 4 courses of chemotherapy were administered with 21 days as a course. The differences in TCM syndrome score, quality of life score, Karnofsky Performance Status (KPS) score, lesion remission rate, carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC) and toxic side effects among the three groups were observed.

There was no significant difference in gender, age, body mass and tumor staging among the three groups (P>0.05). Compared with pre-treatment, retrosternal chest pain, nausea and vomiting, mucus and vomit, vomitus scores and total score were reduced in the three groups, dysphagia, oligophagia and dry stool scores were reduced in the control group and treatment group Ⅱafter treatment (P<0.05) ; quality of life score and KPS score were increased, CEA and SCC levels were reduced in the three groups after treatment (P<0.05). After treatment, dysphagia, retrosternal chest pain, nausea and vomiting, vomitus, oligophagia, dry stool scores and total score in treatment groupⅡwere lower than the control group and treatment groupⅠ, and mucus and vomit score was lower than the control group (P<0.05) ; quality of life score and KPS score in both treatment groups were higher than the control group, KPS score in the treatment groupⅡwas higher than the treatment groupⅠ, CEA and SCC levels in the treatment groupⅡwere lower than the treatment groupⅠand control group (P<0.05). There was no statistically significant difference in the lesion remission rate and toxic side effects among the three groups after treatment (P>0.05) .

The combination of Xiaotan Huayu Tongyi Granules, Channel Kaijie Pills and CF regimen in the treatment of stageⅢ-Ⅳphlegm-stasis interjunction esophageal squamous cell carcinoma can improve clinical symptoms, reduce the levels of tumor markers, and improve the quality of life of patients.

Perioperative acute ischemic stroke (POAIS) is a severe complication of surgery, which can increase surgical mortality and reduce patients' quality of life. The pathogeneses are complex and rarely explored, especially in patients with non-small cell lung cancer (NSCLC) .

To investigate the influencing factors of POAIS in NSCLC patients and the predictive value of serum uric acid (SUA) on the occurrence of POAIS in NSCLC patients.

A total of 25 NSCLC patients admitted to the Fourth Hospital of Hebei Medical University from July 2014 to April 2022, who suffered from POAIS following lung resection were selected as the case group, while 126 patients without POAIS were randomly selected as the control group after matching by age and gender. The preoperative baseline data, intraoperative data and postoperative pathology-related data of all patients were collected. Multivariate Logistic regression analysis was performed to explore the influencing factors of POAIS in the NSCLC patients, and the receiver operating characteristic (ROC) curve was plotted to evaluate the predictive value of preoperative SUA on the development of POAIS in NSCLC patients.

The average age of the 151 patients was (64±7) years, 57.62% (87/151) of whom were male. The multivariate Logistic regression analysis showed that SUA was an influencing factor of POAIS in NSCLC patients〔OR=0.990, 95%CI (0.982, 0.998) , P=0.019〕. The ROC curve indicated that the area under the curve (AUC) of SUA to predict POAIS in NSCLC patients was 0.64, with an optimal threshold value of 307.40 μmol/L, sensitivity and specificity of 58.7% and 76.0%, respectively.

Preoperative SUA level can serve as an independent predictor of POAIS incidence in NSCLC patients. Higher SUA levels at baseline may predict a lower risk of POAIS.

The improvement efficacy of consolidation chemotherapy after definitive concurrent chemotherapy and radio-therapy (CCRT) on the prognosis of patients with locally advanced esophageal squamous cell carcinoma (ESCC) remains controversial. In addition, there is a lack of nutritional risk screening tools which can consistently and accurately predict the survival of patients with esophageal cancer.

To investigate the effect of consolidation chemotherapy on the prognosis of patients with locally advanced ESCC receiving definitive CCRT.

A total of 223 patients with ESCC who received definitive CCRT in the department of radiotherapy, the Fourth Hospital of Hebei Medical University from January 2013 to December 2018 were selected as the research objects and divided into the simple CCRT group (n=87) and combined consolidation chemotherapy group (n=136) according to chemoradiotherapy regimen adopted by the patients. General data, ECOG score, tumor site, tumor length, TNM stage, radiotherapy dose, irradiation mode and chemotherapy regimen of the included patients were collected by electronic medical record system. Nutritional Risk Screening 2002 (NRS 2002) was used to score the nutritional status of the patients before chemoradiotherapy. Efficacy evaluation was performed within 1 month after CCRT, including complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD). Patients were followed up by telephone (completed by the follow-up center) and outpatient review until 2022-09-30, with overall survival (OS), local relapse-free survival (LRRFS) and distant metastasis-free survival (DMFS) collected. Survival curves of OS, LRRFS and DMFS were plotted by Kaplan-Meier method and compared by Log-rank test. Univariate and multivariate Cox risk regression models were used to explore the influencing factors of patient prognosis.

There was no significant difference in baseline data between the simple CCRT group and combined consolidation chemotherapy group (P>0.05). There was no significant difference in the rates of OS, LRRFS and DMFS between the two groups (χ²=1.942, 0.743, 1.272; P=0.163, 0.389, 0.259). There were significant differences in the rates of OS, LRRFS and DMFS between patients with NRS 2002 score <3 (n=172) and patients with NRS 2002 score≥3 (n=51) before treatment (χ²=6.585, 4.858, 7.814; P=0.010, 0.028, 0.005). Multivariate Cox proportional hazard regression analysis showed that TNM stage and NRS 2002 score were influencing factors of OS and DMFS (P<0.05), irradiation mode was an influencing factor of LRRFS and DMFS (P<0.05), and clinical efficacy was an influencing factors of OS, LRRFS and DMFS (P<0.05). Stratified analysis showed that in patients with TNM stage Ⅱ and clinical efficacy of CR, the OS rates in the combined consolidation chemotherapy group (n=74, n=33) were significantly higher than those in the simple CCRT group (n=43, n=28), with statistically significant differences (χ²=4.811, 3.932; P=0.028, 0.047) .

Consolidation chemotherapy did not improve the prognosis of stageⅡ-Ⅲ ESCC patients after definitive CCRT, but may bring survival benefits for patients with early clinical stage, good response and nutritional status. As a nutritional risk screening tool, NRS 2002 has significant predictive value for the long-term survival of patients with locally advanced ESCC after chemoradiotherapy.

Targeted therapy, represented by epidermal growth factor receptor-targeting tyrosine kinase inhibitors (EGFR-TKIs) , has significantly prolonged the survival time of patients with EGFR mutations with relatively mild adverse reactions, and become a prior choice for advanced non-small cell lung cancer (NSCLC) patients with driver genes. Dynamic monitoring of treatment progress and gene mutations in NSCLC patients by means of gene detection will help to provide a more effective, long-term and stable individualized targeted therapy for such patients.

To compare the gene mutations before and after the progression of NSCLC, and to analyze the regularities of gene mutations dynamically monitored and related prognostic value in NSCLC patients.

NSCLC outpatients and inpatients undergoing genetic tests were selected from Department of Integrated Medicine and Lung Cancer Center of China-Japan Friendship Hospital from 2007 to 2021. Their data were collected and used to establish a lung cancer genes testing database. Tissue samples or peripheral blood circulating tumor DNA (ctDNA) before and after progression were obtained for full-coding area detection of lung cancer genes, and the number of gene mutations and testing results were recorded. We divided enrolled patients into gene clearance group and non-gene clearance group, and compared baseline characteristics and survival status between the groups.

A total of 217 cases were enrolled and followed until their clinical endpoint. The total changes in gene mutations in tissue samples before and after the disease progression were as follows: the number of patients with wild type increased from 70 (32.3%) to 95 (43.8%) , the number of patients with mutant type decreased from 147 (67.7%) to 122 (56.2%) , the number of patients with 19DEL mutation increased from 64 (29.5%) to 67 (19.8%) , the number of patients with 21 L858R mutations decreased from 74 (34.1%) to 64 (24.0%) , the number of patients with T790M mutations increased from 2 (0.9%) to 45 (20.7%) , and the number of those with rare mutations or concomitant rare mutations such as TP53 increased from 20 (9.2%) to 84 (38.7%) . Gene clearance group (n=67) and non-gene clearance group (n=150) had significant differences in clinical features except the history of lung disease (P=0.032) and the history of targeted therapy (P=0.001) . The median progression-free survival (PFS) of patients in the two groups was 9.8 months and 11.8 months, respectively, with no significant difference〔HR=0.89, 95%CI (0.66, 1.20) , P=0.310〕. The median PFS of 134 patients with advanced NSCLC in two groups was 8.1 months and 9.8 months, respectively, with no significant difference〔HR=0.83, 95%CI (0.58, 1.19) , P=0.359〕. The median overall survival (OS) of patients in two groups was 50.5 months and 28.5 months, respectively, with statistically significant difference〔HR=0.56, 95%CI (0.41, 0.78) , P<0.000 1〕. The median OS of 134 patients with advanced NSCLC in two groups were 45.5 months and 24.9 months, respectively, showing statistically significant difference〔HR=0.55, 95%CI (0.37, 0.81) , P=0.000 2〕.

The gene mutation status before and after disease progression for patients with NSCLC changed dynamically. After the progression, the proportion of wild type increased significantly compared with mutant type. The proportion of classical mutation decreased, but the proportion of concomitant mutations increased. Patients with 19DEL mutations developed a higher rate of T790M after disease progression. Monitoring gene clearance could not help to predict a PFS, but the gene clearance type predicted better OS benefits. Dynamic monitoring of changes in gene status could help guide treatment promptly for optimal clinical benefits.

Lymph node metastasis is an important factor affecting the prognosis of patients with intrahepatic cholangiocarcinoma, but lymphadenectomy extent remains controversial both domestically and internationally.

To explore the current status of lymphadenectomy during radical resection of intrahepatic cholangiocarcinoma.

A retrospective analysis of the clinical data of 152 patients with intrahepatic cholangiocarcinoma who underwent radical resection at Zhejiang Cancer Hospital from 2017 to 2022 was conducted to determine the current status of lymphadenectomy during radical resection of intrahepatic cholangiocarcinoma, including the decision to perform lymphadenectomy, the extent of lymphadenectomy and the distribution of positive lymph nodes. The patients were divided into the left hemi-liver group and right hemi-liver group according to the location of the tumour in the liver.

A total of 152 patients were selected, including 83 patients in the left hemi-liver group and 69 in the right hemi-liver group. Eighty-six of them underwently mphadenectomy, accounting for higher proportion in the left hemi-liver group〔61 cases (73.5%) 〕 than the right hemi-liver group〔25 cases (36.2%) 〕 (P<0.05) . The average number of dissected lymph nodes was (7.6±6.1) , with no significant difference between the left〔7.0 (4.0, 10.5) 〕 and right hemi-liver groups 〔5.0 (1.5, 9.5) 〕 (P>0.05) . Of the 86 patients underwent lymphadenectomy, 39 (45.3%) cases showed lymph node metastasis (positive lymph nodes) on pathological examination, accounting for higher proportion in the left hemi-liver group〔34 cases (55.7%) 〕 than the right hemi-liver group〔5 cases (20.0%) 〕 (P<0.05) . Regardless of which lobe the tumour was located, lymph node stations 8, 12, and 13 accounted for a higher proportion of metastasis in routine dissection areas, among which the proportion of lymph nodes station 12 was the highest, with 79.4% (27/34) in the left hemi-liver group and 80.0% (4/5) in the right hemi-liver group.

Regardless of the location of tumour, lymph node stations 8, 12 and 13 have a higher incidence of lymph node metastasis and should be considered for routine dissection during radical resection.

Renal cell carcinoma (RCC) is characterized by insidious onset, lack of early typical clinical manifestations, metastasis or advanced stage at diagnosis in most patients and poor efficacy of radical nephrectomy. In recent years, with the broadly application of targeted therapies in tumors, the postoperative recurrence and mortality rates have been greatly reduced. However, there is a lack of evidence for the efficacy and safety of clinical treatment due to the existence of certain adverse effects and complications.

To systematically review the efficacy and safety of programmed death-1 (PD-1) /programmed death-1 ligand (PD-L1) inhibitors in the treatment of RCC.

CNKI, Wanfang Data, VIP, PubMed, Web of Science, Embase, Cochrane Library, Clinical Trials and other English databases were searched by computer and manually for the randomized controlled trials of PD-1/PD-L1 inhibitors for RCC from the inception to 2022-09-30. Two researchers independently extracted and collated the data, evaluated the quality of the included literature according to Cochrane 5.3 manual criteria, and performed meta-analysis using RevMan 5.4 software.

A total of 11 papers were finally included, involving 7 895 study subjects with 3 936 cases in the trial group and 3 959 cases in the control group. Meta-analysis results showed that the overall survival (OS) and progression-free survival (PFS) were better in the trial group than in the control group〔HR=0.87, 95%CI (0.84, 0.90), P<0.000 01; HR=0.85, 95%CI (0.78, 0.92), P<0.000 1〕; the objective response rate (ORR), partial response rate (PR), complete response rate (CR), and disease-control rate (DCR) were higher in the trial group than in the control group〔RR=1.72, 95%CI (1.39, 2.12), P<0.000 01; RR=1.56, 95%CI (1.20, 2.01), P=0.000 7; RR=3.05, 95%CI (2.39, 3.09), P<0.000 01; RR=1.12, 95%CI (1.05, 1.20), P=0.000 5〕; the rate of stable disease (SD) was lower in the trial group than in the control group〔RR=0.66, 95%CI (0.62, 0.72), P<0.000 01〕. The differences were not statistically significant when comparing the rate of PD, total rate of adverse events (AEs), rates of grade Ⅰ-Ⅱ adverse events and grade Ⅲ-Ⅴ adverse events between the trial and control groups〔RR=0.73, 95%CI (0.53, 0.99), P=0.05; RR=1.01, 95%CI (0.89, 1.04), P=0.60; RR=1.02, 95%CI (0.88, 1.17), P=0.82; RR=1.02, 95%CI (0.88, 1.19), P=0.80〕. Egger's tests resulted in P>0.05, indicating no significant publication bias among studies.

PD-1/PD-L1 inhibitors for RCC can significantly improve and enhance OS, PFS, ORR, CR, PR and DCR in patients without increasing the incidence of adverse effects in terms of safety, thus confirming the superiority of PD-1/PD-L1 inhibitors for RCC in terms of clinical efficacy and safety.

Esophageal cancer is one of the most aggressive gastrointestinal tumors. Advanced esophageal carcinoma is mainly associated with dysphagia. Most elderly patients with severe obstruction esophageal carcinomacannot tolerate anesthesia and invasive treatment due to comorbidities, while the failure to improve dysphagia in the short term will seriously affect the nutritional status, life quality and prognosis of patients.

To explore the safety and efficacy of image-guided photodynamic therapy (IGPDT) under local anesthesia for short-term improvement of obstruction and nutritional status in elderly patients with severe obstruction esophageal carcinoma.

A total of 24 elderly patients with severe obstruction esophageal carcinoma admitted to Hebei General Hospital from March 2020 to December 2021 were selected for IGPDT in the prospective, single-arm, self-control study. The upper boundary of the lesion was located by endoscopy and marked with metal tissue clips, the lower boundary of the lesion was located by CT and esophagography before treatment. During the treatment, the fiber of laser treatment was delivered to the lesion site under the guidance of X-ray fluoroscopy during treatment. The Stooler dysphagia score was evaluated before, 1 week and 1 month after operation. The nutritional status of patients was evaluated by nutritional risk screening 2002 (NRS 2002) score, hemoglobin, BMI, albumin and prealbumin before and 2 months after operation. The swallowing quality of life scale (SWAL-QOL) was used to evaluate the quality of life in patients.

All patients achieved partial response (PR) at 1 month postoperative efficacy evaluation. The Stooler dysphagia scores at 1 week and 1 month after IGPDT were significantly lower than that before operation (P<0.001). BMI, albumin and prealbumin at 2 months after operation were significantly increased than that before operation (P<0.05). The total score and scores of different dimensions in SWAL-QOL at 2 months after operation were significantly higher than those before operation, including psychological burden, appetite, eating time, fear of eating and swallowing symptoms (P<0.05). 92% (22/24) of the patients presented with grade 1-2 mild fever, and most of them could be relieved on their own. 83% (20/24) of the patients presented with grade 1-2 pain at the site of operation at 1-2 days after surgery but could be relieved by themselves. No esophageal fistula occurred in all patients during the operation, and no serious adverse effects of grade 3 or above occurred.

IGPDT has the advantages of easy operation, excellent efficacy and safety, and short-term improvement of nutritional status in patients, which can be used as a novel photodynamic therapy for patients with severe obstruction esophageal carcinoma cannot be passed by endoscopy.

The incidence of cervical and upper thoracic esophageal cancer is relatively low, with difficulties and controversies of mode in treatment, lack of convenient and accurate prognostic biomarkers, and poor overall prognosis.

To investigate the long-term prognosis of patients with cervical and upper thoracic esophageal squamous cell carcinoma under concurrent chemotherapy and radio-therapy (CCRT) .

Patients with cervical and thoracic upper esophageal cancer who received CCRT in the Department of Radiotherapy of the Fourth Hospital of Hebei Medical University from January 2013 to December 2017 were selected as the research subjects. General data, Eastern Cooperative Oncology Group (ECOG) score, tumor site, tumor length, TNM stage, radiotherapy dose, irradiation mode, chemotherapy regimen, toxic and side effects were collected by electronic medical record system, and neutrophil to lymphocyte ratio (dNLR) was calculated. The patients were divided into the dNLR<2.15 group (64 cases) and dNLR≥2.15 group (42 cases) according to dNLR. The patients were followed up, radiotherapy was reviewed once every 3 months for 1 year, once every 6 months for 2 to 5 years, and once every 1 year after 5 years, and overall survival (OS), progression-free survival (PFS), local relapse-free survival (LRRFS), and distant metastasis-free survival (DMFS) were collected. Survival curves of OS, LRRFS and DMFS were plotted by Kaplan-Meier method. The single factor analysis of OS, PFS, LRRFS and DMFS was performed by Log-rank test. Multivariate Cox proportional hazard regression model was used to explore the influencing factors of OS, PFS, LRRFS and DMFS.

As of the last follow-up, the OS rates at 3, 5 and 7 years were 55.7%, 43.0% and 37.8%, with a median OS of 47.5〔95%CI (29.4, 65.6) 〕months; the rates of PFS at 3, 5 and 7 years were 45.3%, 37.7% and 31.1%, with a median PFS of 30.7〔95%CI (21.1, 40.3) 〕months; the LRRFS rates in 3, 5 and 7 years were 50.9%, 41.4% and 33.5%, with a median LRRFS of 43.5〔95%CI (21.6, 65.4) 〕months; the DMFS rates at 3, 5 and 7 years were 49.1%, 38.6% and 34.4%, with a median DMFS of 34.7〔95%CI (20.7, 48.7) 〕months. Multivariate Cox proportional hazard regression analysis showed that TNM stage and irradiation mode were influencing factors of OS, PFS, LRRFS and DMFS (P<0.05), gender was an influencing factor of LRRFS (P<0.05), and dNLR was an influencing factor of PFS and DMFS (P<0.05). There were 10 cases, 25 cases, 32 cases, 9 cases and 11 cases of grade 2 and above acute radiation pneumonitis, acute radiation esophagitis, leukopenia, anemia and thrombocytopenia, respectively.

The long-term prognostic survival outcome of CCRT for cervical and upper thoracic esophageal squamous cell carcinoma was satisfactory and well tolerated. Local recurrence was the main failure pattern. Elective lymphatic drainage irradiation can significantly improve the prognosis of patients, which can be promoted clinically and dNLR has a predictive effect on long-term survival.

Breast cancer has become the most common malignant tumor threatening the health of Chinese women in recent years. The use of tamoxifen (TAM) has successfully reduced the recurrence and progression of estrogen receptor-positive breast cancer, however, it also increases the risk of endometrial lesions.

To explore the risk factors for endometrial lesions in breast cancer patients taking TAM, determine the optimal threshold value of endometrial thickness, and improve the positive detection rate of hysteroscopy.

Breast cancer patients taking TAM (20 mg/d) who underwent hysteroscopic endometrial biopsy admitted to the Department of Gynecology of the First Affiliated Hospital with Nanjing Medical University from January 2015 to January 2022 were retrospectively selected as the study objects and divided into the negative hysteroscopic endometrial biopsy group (normal endometrium) and positive hysteroscopic endometrial biopsy group (endometrial lesions including endometrial polyps, endometrial hyperplasia without atypia, endometrial atypical hyperplasia and endometrial carcinoma). Clinical data of the patients were collected, including age, BMI, history of hypertension and diabetes, delivery times, presence of menopause and abnormal uterine bleeding/postmenopausal bleeding (AUB/PMB), receiving of chemotherapy, duration of TAM treatment, use of gonadotropin-releasing hormone agonists (GnRH-a), endometrial thickness, echo features of intrauterine lesions. Multivariate Logistic regression analysis was used to explore the risk factors for endometrial lesions in breast cancer patients taking TAM. The receiver operating characteristic (ROC) curve of endometrial thickness for predicting endometrial lesions detected by hysteroscopy was plotted, and the area under the ROC curve (AUC) and its 95%CI were calculated to determine the optimal cut-off value of endometrial thickness for receiving hysteroscopic surgery.

The proportion of patients with AUB/PMB, duration of TAM treatment≥24 months, intrauterine hyperechoic lesions and endometrial thickness in the positive hysteroscopic endometrial biopsy group were higher than those in the negative hysteroscopic endometrial biopsy group (P<0.05). Multivariate Logistic regression analysis showed that AUB/PMB〔OR=7.731, 95%CI (1.949, 30.699), P=0.004〕, endometrial thickening〔OR=1.223, 95%CI (1.091, 1.371), P=0.001〕 and intrauterine hyperechoic lesions〔OR=13.383, 95%CI (2.751, 65.103), P=0.001〕were independent risk factors for endometrial lesions detected by hysteroscopy in breast cancer patients taking TAM. The AUC of endometrial thickness for predicting endometrial lesions detected by hysteroscopy in breast cancer patients taking TAM was 0.753〔95%CI (0.638, 0.868), P<0.001〕, with the Youden index of 0.54, optimal cut-off value of 9.15 mm, sensitivity and specificity of 0.755 and 0.786, respectively.

The risk of endometrial lesions is increased in breast cancer patients taking TAM with AUB/PMB, endometrial thickness≥9.15 mm suggested by ultrasound and intrauterine hyperechoic lesions, when the hysteroscopy and endometrial biopsy should be actively considered.

The surgical protocols and prognosis of esophageal squamous cell carcinoma (ESCC) patients influenced by the status of lymph node metastasis. It is necessary to identify risk factors that can predict lymph node metastasis to assist in clinical treatment.

To investigate the predict value of tumor budding (TB) and tumor-infiltrating lymphocytes (TILs) on lymph node metastasis (LNM) in patients with ESCC.

A total of 124 patients with ESCC who underwent radical resection and retained paraffin-embedded specimens in the Affiliated People's Hospital of Ningbo University from January 2013 to March 2022 were selected as the research subjects. The light microscopy and CK5/6 immunohistochemical staining were used to evaluate the amount of TB and density of TILs. Multivariate Logistic regression analysis was used to explore the influencing factors of lymph node metastasis in patients with ESCC and the receiver operating characteristic (ROC) curve was plotted to investigate the predictive value of TB and TILs for lymph node metastasis in patients with ESCC.

Multivariate Logistic regression analysis showed that TB〔OR=20.078, 95%CI (6.043, 66.713), P<0.001〕, TILs〔OR=0.218, 95%CI (0.071, 0.666), P=0.008〕and intravascular tumor thrombus〔OR=28.609, 95%CI (7.512, 108.946), P<0.001〕 were influencing factors for lymph node metastasis. The area under ROC curve (AUC) for TB and TILs to predict lymph node metastasis in patients with ESCC was 0.835〔95%CI (0.763, 0.907) 〕 and 0.656〔95%CI (0.558, 0.753) 〕, respectively.

High-grade TB and low-density TILs were influencing factors for lymph node metastasis, TB grade and density of TILs has good diagnostic efficacy in predicting lymph node metastasis in patients with ESCC.

Major hepatectomy for liver malignancies carries with large risks. Perioperative nutritional support plays a vital role for postoperative recovery. However, there are few studies focusing on predictions of postoperative complications and prognosis using postoperative loss of skeletal muscle mass (PLSMM) in acute stage after major hepatectomy.

To identify the change inskeletal muscle index (SMI), and to investigate risk factors for PLSMM, as well as its correlation with postoperative complications after major hepatectomy for liver cancer.

A total of 97 patients who received major hepatectomy for liver cancer from Department of General Surgery, the Second Affiliated Hospital of Soochow University between July 2018 and August 2022 were included. The preoperative and postoperative day 5 skeletal muscle area at the third lumbar vertebra level was measured, respectively, using computed tomographic images. The postoperative change rate of SMI was calculated. The PLSMM was defined as the lowest tertile of the percent change in SMI, according to which the patients were divided into PLSMM and Non-PLSMM group. Baseline data, surgical and postoperative indices were collected and analyzed.

SMI was decreased in 54 patients postoperatively. Thirty-two and 65 patients were assigned to the PLSMM group (SMI≤-3.59%) and Non-PLSMM groups (SMI>-3.59%), respectively. Compared with Non-PLSMM group, PLSMM group had longer operation time, more intraoperative blood loss and higher ratio of microvascular invasion (MVI) (P<0.05). Moreover, PLSMM group had longer postoperative hospital stay, higher levels of white blood cell and international normalized ratio and lower level of fibrinogen on postoperative day 5 (P<0.05). PLSMM group showed a lower incidence of overall complications (P<0.05). Multivariate Logistic regression analysis indicated that MVI〔OR=2.751, 95%CI (1.173, 6.642) 〕 and operation time >210 min〔OR=1.973, 95%CI (1.286, 4.936) 〕were risk factors associated with PLSMM (P<0.05). PLSMM〔OR=2.591, 95%CI (1.173, 6.977) 〕, preoperative myopenia〔OR=1.798, 95%CI (1.133, 3.792) 〕, operation time >210 min〔OR=2.958, 95%CI (0.918, 9.529) 〕 and blood loss >500 mL〔OR=1.003, 95%CI (1.001, 1.007) 〕 were risk factors associated with postoperative complications (P<0.05) .

MVI and operation time >210 min were risk factors associated with PLSMM. PLSMM was the independent predictor of postoperative complications, which negatively affected postoperative outcomes after major hepatectomy.

Breast cancer is the most prevalent malignancy in the world. Endocrine therapy reduces the level of estrogen in vivo, thus affecting the blood lipid level, which reduces the quality of life and the treatment compliance of patients.

To analyze the clinical characteristics and traditional Chinese medicine (TCM) prescription of hyperlipidemia in estrogen receptor (ER) positive breast cancer patients during endocrine therapy in real world.

Based on method of retrospective study, a total of 238 patients with ER positive breast cancer who received endocrine therapy in Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January 2012 to March 2022 were selected as the study subjects. The data including age, triglyceride, total cholesterol, low density lipoprotein, endocrine therapy drugs, TCM prescriptions of the patients were exported through the search platform of scientific research big data to establish a clinical data table of the patients. ER positive breast cancer patients with normal baseline blood lipid levels were divided into the normal group and dyslipidemia group according to the blood lipid levels during endocrine therapy, and hyperlipidemia was classified into hypercholesterolemia, hypertriglyceridemia and mixed hyperlipidemia. The exported prescriptions were analyzed for frequency, four properties, five flavors, channel tropism and medication regularity by using the "prescription analysis", an auxiliary platform for TCM inheritance, to obtain new prescriptions.

Among 238 ER positive breast cancer patients, 97 patients (40.8%) had normal baseline blood lipid levels, of whom 42 patients (205 person-time return visit) developed dyslipidemia during standardized endocrine therapy. Among the patients with dyslipidemia, 37.6% (77/205) occurred in the age group of 51 to 60 years as the highest number; 86 person-time with dyslipidemia received exemestane treatment, accounting for the highest proportion of 42.0%. Among the 42 patients with dyslipidemia (205 person-time return visit) , hyperlipidemia occurred in 99 person-time, and hypercholesterolemia occurred in 49.5% (49/99) . There was no statistically significance difference in the age of patients with three types of hyperlipidemia (P>0.05) . There were statistically significance differences in the proportion of endocrine therapy types among patients with three types of hyperlipidemia (P<0.05) . There were 189 kinds of TCM prescriptions for hyperlipidemia in ER positive breast cancer patients during endocrine treatment, licorice was the most frequently used medicine (408 times) , the highest frequency of use was tonifying qi drug (22.6%) . The channels of TCM collected by the big data platform were mainly distributed in the spleen, lung and liver channels. The properties of TCM were mainly cold, flat and warm, and the flavors were mainly sweet, bitter and pungent. The combination of "Astragalus and Licorice" had the highest frequency. Six core drug combinations and three new prescriptions were obtained through complex system entropy clustering analysis.

The highest incidence of hyperlipidemia in ER positive breast cancer patients during endocrine therapy is 51-60 years old, and hypercholesterolemia is the most common. The position of hyperlipidemia in ER positive breast cancer patients during endocrine therapy is in the spleen. The medication are maily used for invigorating spleen to remove dampness, tonifying qi and regulating stomach.

Mucinous ovarian tumors (MOT) can be divided into three types: benign〔such as mucinous cystadenoma (MCA) 〕, borderline〔such as mucinous borderline tumor (MBT) 〕, and malignant〔such as mucinous cystadenocarcinoma (MC) 〕. It is difficult to differentiate between the types preoperatively, and the final diagnosis depends on surgical pathology. So how to reduce the difficulty in making a preoperative differential diagnosis, and improve the preoperative diagnostic accuracy is particularly important for doctors to make a diagnosis and for patients to choose a treatment option.

To explore the high-risk factors associated with malignant transformation of MOT, and to evaluate the predictive value of B-ultrasound combined with tumor markers for malignant transformation of MOT.

Retrospective observational study selected surgery-treated 414 women with a histologically confirmed MCA (n=305) , MBT (n=79) and MC (n=30) from the First Affiliated Hospital with Nanjing Medical University during 2010 to 2020. Patients' data, including age, clinical symptoms, sonographic data (tumor size, properties, papilla-shaped protuberance on the cystic wall, blood flow signals, multilocular) and serum tumor markers〔carcinoembryonic antigen (CEA) , carbohydrate antigen 125 (CA125) , carbohydrate antigen 199 (CA199) , carbohydrate antigen 724 (CA724) 〕and D-dimer were collected. Multivariate Logistic regression analysis was used to explore the risk factors of malignant transformation of MOT. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of B-ultrasound with tumor markers for malignant transformation of MOT, and the area under the curve (AUC) with the corresponding 95%CI were calculated.

There were statistically significant differences in B-ultrasound manifestations and serological indicators among the three groups (P<0.05) . Maximum diameter of the ovarian tumor≥10 cm〔OR=1.947, 95%CI (1.066, 3.556) , P=0.030〕, solid tumor components〔OR=9.862, 95%CI (4.465, 21.782) , P<0.001〕, papilla-shaped protuberance on the cystic wall〔OR=2.320, 95%CI (1.100, 4.893) , P=0.027〕, blood flow signals〔OR=2.289, 95%CI (1.104, 4.747) , P=0.026〕, multilocular morphology〔OR=5.722, 95%CI (3.034, 10.789) , P<0.001〕, CA125≥35.0 U/mL〔OR=4.307, 95%CI (1.963, 9.452) , P<0.001〕and CA199≥39.0 U/mL〔OR=2.227, 95%CI (1.030, 4.816) , P=0.042〕were independently associated with increased malignant tendency of MOT. The optimal cut-off value of B-ultrasound with tumor markers〔AUC=0.868, 95%CI (0.912, 0.825) , P<0.001〕in predicting the malignant transformation of MOT was 0.354, with 72.5% sensitivity and 90.8% specificity.

It is need to consider the possibility of malignant transformation of MOT when a patient is found with an ovarian tumor with maximum diameter ≥10 cm with solid components, papilla-shaped protuberance on the cystic wall, blood flow signals, and multilocular morphology, as well as serum CA125≥35.0 U/mL and CAl99≥39.0 U/mL. B-ultrasound with tumor markers may partially predict the malignant transformation of MOT.

The research field of advance care planning (ACP) for the surrogate decision makers of advanced cancer patients in China is still at the initial stage, and the relevant researches are fragmented and poorly targeted, lacking systematic analysis of the influencing factors.

To systematically review the influencing factors of ACP participation in surrogate decision makers of advanced cancer patients, so as to provide a reference for subsequent researches in this field.

This study was a mixed-methods systematic review. In April 2022, CNKI, Wanfang Data Knowledge Service Platform, PubMed, EmBase, the Cochrane Library, Web of Science, and CBM were searched by computer for the studies related to influencing factors of ACP participation in surrogate decision makers of advanced cancer patients from the inception to 2022-07-01. After evaluating the quality of literature and extracting information from the included studies, the method of JBI Hybrid System Evaluation Guide was used to integrate quantitative studies and qualitative studies after extracting data separately, and then the themes were summarized, obtaining the influencing factors of the final ACP participation in surrogate decision makers.

A total of 11 papers were included after literature screening and evaluation of literature quality, including 5 qualitative studies and 6 cross-sectional studies. The final results were integrated into 4 categories of personal factors, external support, information access, and disease status, involving 22 influencing factors such as religious beliefs and clan culture, social network, ACP understanding, and disease development expectation after integrating the analysis results of quantitative and qualitative studies.

There are multiple influencing factors of ACP participation in surrogate decision makers of advanced cancer patients. Public perception, communication, policies and personal characteristics of surrogate decision makers can affect their ACP participation. Therefore, relevant education should be strengthened to improve public perception, an effective communication mechanism among patients, surrogate decision makers and health care providers should be established, the protection of relevant policies and regulations should be improved to strengthen guidance and intervention on variable factors.

How to implement effective and reasonable support and comprehensive services for patients with advanced cancer during chemotherapy is an issue worthy of attention in community health services at present. According to the latest data, the mortality rate of malignant tumors among residents in Shanghai has become the second place after cardiovascular and cerebrovascular diseases. The current attention to patients with advanced cancer during chemotherapy is also gradually increasing. Therefore, this study tries to understand the demand for primary care among such patients and the influencing factors.

To investigate the demand and influencing factors for community health services during chemotherapy of partial patients with advanced cancer in Shanghai, and to explore how to develop community interventions and services to address the demand of such patients.

Patients with advanced cancer during chemotherapy who regularly visited or hospitalized at Shanghai Ninth People's Hospital, Wusong Hospital and Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine from December 2021 to March 2022 were selected as the study subjects. Based on previous relevant questionnaires, government specifications and interview results, the final version of the demand for community health services of partial patients with advanced cancer during chemotherapy in Shanghai was formed, with a total of 3 demand dimensions (psychological, medical care, social support) and 38 demand items. The contents include patients' general information (demographic and sociological information: gender, age, religious beliefs, education level, marital status, source of medical expenses, disposable monthly household income, whether to participate in a patient group; tumor diagnosis: type and time of diagnosis, pain score, combining with other diseases), 6 items of psychological and psychological demand, 24 items of medical care demand, and 8 items of social support demand. A 3-point scale was adopted: 1 was unnecessary, 2 was necessary, and 3 was very necessary. The higher the score, the higher the degree of patients' demand, which was ranked according to the average score of each demand item. Univariate and multivariate Logistic regression analyses were used to explore the influencing factors of the demand for community health services of patients with advanced cancer during chemotherapy.

The average scores of each demand dimension were ranked in order of psychological demand (2.31 points), medical care demand (2.27 points) and social support demand (2.18 points). The top five average scores of all demand items were "preparation of biochemical tests such as routine blood, liver and kidney functions before chemotherapy" (2.48 points), "education on chemotherapy knowledge" (2.48 points), "care of PICC catheterization during chemotherapy" (2.45 points), "management of myelosuppression after chemotherapy" (2.43 points) " and "providing of updated information on treatment, examination and rehabilitation" (2.42 points), mainly focus on the medical care demand dimension. Multivariate Logistic regression analysis showed that education level and disposable monthly household income were influencing factors of psychological demand of patients with advanced cancer during chemotherapy (P<0.05) ; age and medical expenses were influencing factors of medical care of patients with advanced cancer during chemotherapy (P<0.05) ; age and whether to join a patient group were influencing factors of social support of patients with advanced cancer during chemotherapy (P<0.05) .

Patients with advanced cancer during chemotherapy have specific demand for community health services, with different levels of demand in psychological, medical care and social support dimensions, which are influenced by various factors such as age, education level, and household income. This study provides references for community health service centers to carry out relevant medical services. In the future, new service items with high level of demand can be piloted, community interventions such as psychological and medical care for patients with advanced cancer during chemotherapy, and their quality of survival should be followed up.

In recent years, with the aging of the population and the change of lifestyles, patients with type 2 diabetes mellitus (T2DM) have a high prevalence of malignancies, the duration of T2DM and the use of T2DM drugs may accelerate the occurrence of malignant tumor.

To analyze the risk of incidence and influencing factors of malignant tumors in patients with T2DM.

Patients with T2DM who were first treated or diagnosed at the Affiliated Hospital of Nantong University from October, 2011 to December, 2020 were prospectively included, with the follow-up termination date of September 30, 2021. The information of tumor incidence and full cause of death of patients were obtained by matching the ID information with the linkage records of the chronic disease tumor registration system and the cause of death registration system of Nantong City. The crudeincidence rate (CIR) and standardized incidence ratio (SIR) of malignant tumors among T2DM patients were calculated separately by gender. Cox proportional hazard regression model was used to explore the effects of the duration of T2DM and drug use on the incidence of malignant tumor in T2DM patients.

A total of 12 006 patients with T2DM were included in this study, involving 6 328 males (52.71%) and 5 678 females (47.29%). After 56 371 person-years of observation (29 543 person-years for males and 26 824 person-years for females), 601 patients with malignant tumor and 11 405 patients with T2DM alone were observed. The CIR of malignant tumor in T2DM patients was 1 093.24/100 000 in men and 1 032.51/100 000 in women, respectively. The top five combined tumors in T2DM patients are colorectal cancer, lung cancer, liver cancer, gastric cancer, and prostate cancer in male, while breast cancer, lung cancer, colorectal cancer, gastric cancer and pancreatic cancer in female. The incidences of colorectal cancer (SIR=2.03), prostate cancer (SIR=2.24), pancreatic cancer (SIR=1.75), kidney cancer (SIR=4.25), thyroid cancer (SIR=3.50) were higher in male T2DM patients than general population, while the incidences of lung cancer (SIR=0.61) and esophageal cancer (SIR=0.22) were lower than general population. The incidences of breast cancer (SIR=2.59), colorectal cancer (SIR=1.57), pancreatic cancer (SIR=2.10), endometrial cancer (SIR=2.83), kidney cancer (SIR=3.67), thyroid cancer (SIR=4.00) were higher in female T2DM patients than general population, while the incidence of esophageal cancer (SIR=0.27) was lower than general population. Compared with T2DM patients with disease duration of 1 to <3 years, the risk of malignant tumor was increased by 91% 〔HR=1.91, 95%CI (1.15, 3.20) 〕, 123%〔HR=2.23, 95%CI (1.37, 3.64) 〕 and 71%〔HR=1.71, 95%CI (1.04, 2.80) 〕in male with disease duration <1 year, 5 to <10 years and≥10 years, respectively, the risk of malignant tumor was increased by 79%〔HR=1.79, 95%CI (1.10, 2.92) 〕 and 99%〔HR=1.99, 95%CI (1.24, 3.19) 〕 in female with T2DM duration of 5 to <10 years and ≥10 years, respectively (P<0.05). Insulin use alone increased the risk of malignant tumor by 72%〔HR=1.72, 95%CI (1.25, 2.36) 〕and 116%〔HR=2.16, 95%CI (1.53, 3.05) 〕 in male and female, respectively (P<0.05). In addition, there was a significant interaction between insulin use and the duration of T2DM in male, the risk of malignant tumor was decreased by an average of 6% with the interaction over the years (P_interaction=0.006) .

In addition to esophageal cancer in both sexes and lung cancer in male, the risk of colorectal cancer, prostate cancer, pancreatic cancer, kidney cancer, thyroid cancer, breast cancer and endometrial cancer increase by 57%-325% in patients with T2DM, and associated with the disease duration and insulin use, with the greatest risk of malignant tumor in male with disease duration of 5 to <10 years and in female with disease duration of ≥10 years. However, there is an antagonistic interaction between insulin use and increased duration of T2DM disease on the incidence of malignant tumor.

Malnutrition is a common complication in patients with esophageal cancer, which has been validated by domestic and international studies to seriously impact the recovery of patients. While the number of patients receiving home enteral nutrition (HEN) is increasing, the effectiveness and safety of HEN for patients with esophageal cancer remains unclear.

To systematically evaluate the effectiveness and safety of HEN by meta-analysis.

RCTs on the HEN in patients with esophageal cancer were retrieved in PubMed, Cochrane Library, Embase, Web of Science, CINAHL, Scopus, Wanfang Data, CNKI, VIP and CBM from inception to December 2021. Patients in the experimental group received HEN support〔both enteral tube feeding (ETF) and oral nutritional supplement (ONS) were both acceptable〕, while patients in the control group received conventional oral diet only. Two researchers independently screened the literature and extracted data. The RoB 2.0 recommended by the Cochrane Collaboration was used to evaluate the quality of the included studies, and the RevMan 5.4.1 software was used to perform the meta-analysis.

A total of 14 articles were included, involving 1 040 patients with esophageal cancer. Meta-analysis showed that the increase values of body mass, BMI, hemoglobin, serum total protein, serum prealbumin and serum transferrin in the experimental group were higher than those in the control group〔SMD=0.63, 95%CI (0.40, 0.85), P<0.000 01; SMD=0.60, 95%CI (0.44, 0.76), P<0.000 01; SMD=1.58, 95%CI (1.37, 1.79), P<0.000 01; SMD=1.19, 95%CI (0.79, 1.58), P<0.000 01; SMD=0.97, 95%CI (0.79, 1.14), P<0.000 01; SMD=1.12, 95%CI (0.45, 1.79), P=0.001〕. The increase value of serum albumin in the experimental group was higher than that in the control group in both ETF and ONS subgroups analysis〔SMD=1.25, 95%CI (0.82, 1.68), P<0.000 01; SMD=0.61, 95%CI (0.26, 0.97), P<0.000 01〕. The incidence of malnutrition was lower in the experimental group than in the control group〔OR=0.47, 95%CI (0.33, 0.67), P<0.000 1〕. There was no statistically significant differences in the incidence of gastrointestinal complications〔RR=1.33, 95%CI (1.00, 1.77), P=0.05〕and life quality score〔MD=4.97, 95%CI (0.06, 9.87), P=0.05〕 between the two groups. The physical function score of the experimental group was higher than that of the control group〔MD=6.67, 95%CI (2.86, 10.48), P=0.000 6〕, and the fatigue symptom score was lower than that of the control group〔MD=-7.31, 95%CI (-11.85, -2.77), P=0.002〕. Sensitivity analysis showed that the combined results were stable and reliable.

HEN can significantly improve the nutritional status and physical function, reduce fatigue symptoms of discharged patients after esophageal cancer surgery, and does not increase the incidence of gastrointestinal complications, however, it has not been found to improve the global overall quality of life.

Dietary components can produce a variety of bioactive substances that maintain a low inflammatory state in the body and participate in the formation of the tumor microenvironment. The dietary inflammatory index (DII) is a new indicator to quantify the inflammatory potential of diet. High DII score is closely associated with the risk of colorectal cancer, but its relationship with upper gastrointestinal cancer (UGIC) is unclear.

This study was conducted to assess the relationship between DII and the risk of UGIC, providing a scientific basis for dietary guidance.

We did a systematic search of PubMed, Web of Science, Embase and the Cochrane Library for studies on the association of DII score and UGIC published in English, and Wanfang Data, CNKI and VIP for those published in Chinese, from inception to October 10, 2022. Two researchers performed literature screening, data extraction, and quality evaluation separately. RevMan 5.4.1 was used for meta-analysis and subgroup analysis.

A total of 11 case-control studies including 9 051 participants were included in this study. Meta-analysis showed that high DII score were associated with an increase in the risk of UGIC〔OR=1.81, 95%CI (1.65, 1.97), P<0.05〕. High DII score also significantly increased the risk of esophageal and gastric cancers〔OR=2.20, 95%CI (1.69, 2.86) ; OR=1.79, 95%CI (1.44, 2.24), P<0.05〕. Subgroup analysis showed that high DII score increased the risk of UGIC by 131% in the European population〔OR=2.31, 95%CI (1.78, 3.00), P<0.05〕, and 98% in the Asian population〔OR=1.98, 95%CI (1.55, 2.53), P<0.05〕. High DII score increased the risk of UGIC by 161% in women〔OR=2.61, 95%CI (1.79, 3.79), P<0.05〕. Moreover, high DII score increased the risk of UGIC by 47% in H. pylori-negative populations〔OR=1.47, 95%CI (1.08, 1.99), P<0.05〕, and 90% in H. pylori-positive populations〔OR=1.90, 95%CI (1.33, 2.71), P<0.05〕. High DII score was associated with a 195% increased risk of UGIC in the population with interviewer-administered Food Frequency Questionnaire (FFQ) 〔OR=2.95, 95%CI (1.96, 4.43), P<0.05〕, and a 68% increased risk of UGIC in the population with self-administered FFQ〔OR=1.68, 95%CI (1.53, 1.85), P<0.05〕. High DII score was associated with a 101% increased risk of UGIC in the population with a higher number of DII components (>30) 〔OR=2.01, 95%CI (1.57, 2.57), P<0.05〕, and a 125% increased risk of UGIC in the population with a lower number of DII components (<30) 〔OR=2.25, 95%CI (1.58, 3.22), P<0.05〕. In addition, high DII score increased the risk of UGIC by 123% in the population with energy-adjusted diet〔OR=2.23, 95%CI (1.85, 2.68), P<0.05〕, and 70% in the population without energy-adjusted diet〔OR=1.70, 95%CI (1.53, 1.88), P<0.05〕. The funnel plot of the literature was asymmetric, showing that there was a certain publication bias.

A pro-inflammatory diet with higher DII score may exacerbate the risk of UGIC, especially in esophageal cancer patients and in the female population.

Cancer cachexia is a cancer-related, multi-factorial, irreversible clinical syndrome characterized by progressive nutritional consumption, which greatly reduces the survival expectation and quality of life of cancer patient. In 2010, the European Palliative Care Research Collaborative published the Clinical Practice Guideline on Cancer Cachexia in Advanced Cancer Patients, which based on clinical evidence, providing recommendations about cachexia classification and treatment in patients with advanced cancer. However, the guideline is mainly applicable to patients with advanced cancer who may present with refractory cachexia. Based on the continuously updated evidence, the European Society of Medical Oncology released the Cancer Cachexia in Adult Patients: ESMO Clinical Practice Guideline, which provides a more clear structural framework for the management of cancer cachexia, focusing on all cancer patient who may develop into cachexia, making recommendations in terms of screening, evaluation and multimodal management of cachexia. This paper interprets and summarizes the key points of the guideline in order to provide a reference for clinical management of cancer cachexia in China.

The minimum clinical importance difference (MCID) of the quality of life scale is an important parameter to explain and define the score changes of the scale, which can promote the clinical application of the quality of life scale as a tool to evaluate the effectiveness of treatment and intervention. MCID may be influenced by a variety of factors and there are few current studies on MCID of the Functional Assessment of Cancer Therapy-Generic Scale (FACT-G) .

To develop the MCID of FACT-G scale of patients with cervical precancerous lesions by a variety of methods and analyze the influence of patients' social demographic characteristics on the MCID of the FACT-G scale, so as to provide quantitative basis for clinicians to judge the clinical effectiveness of interventions.

A total of 66 patients with cervical precancerous lesions who received operation related to cervical precancerous lesions from October 2020 to November 2021 were included as study subjects in the First Affiliated Hospital of Shihezi University. The social demographic characteristics and disease-related information of the patients were collected, and the FACT-G scale was used to evaluate the quality of life of the patients before and 1 month after operation. The anchoring methods and distribution method were used to develop MCID for FACT-G scales. Multiple linear regression was used to analyze the influencing factors of MCID of the FACT-G scale.

The four anchors including Global Rating of Change Questionnaire (GRCQ) , entry 10 of Global Rating of Change Questionnaire (SF-36 scale) , utility values (UI) of the Five-level EuroQol Five-dimensional Questionnaire (EQ-5D-5L scale) and EQ Visual Analogue Scale (EQ-VAS) were selected. The MCID of the total score of the FACT-G scale developed by the anchoring method ranged from 7.048 to 12.932, the MCID of the total scores of the FACT-G scale developed by the distribution method ranged from 3.696 to 10.243. The MCID developed by the anchoring method and distribution method were inconsistent. The MCID developed by the anchor-based GRCQ was considered as an example, there were 34 patients with slight improvement after operation were screened. The results of multiple linear regression analysis showed that that single (β=15.264, P<0.001) , obesity (β=-4.830, P=0.038) , and baseline scale total scores>89.5 (β=-7.600, P=0.001) were the influencing factors of MCID of the FACT-G total score in patients with cervical precancer lesions.

The MCIDs of FACT-G scale developed by different calculation methods are inconsistent. For patients with different characteristics of cervical precancerous lesions, MCIDs of the FACT-G scale should be selected to determine the effectiveness of clinical decisions and the clinical relevance of changes in quality of life after treatment.

The incidence of colorectal cancer is high, and metastatic colorectal cancer has entered a new era of targeted immunotherapy. Due to the limited choices of effective later-line treatment and the substantial reduction of physical quality caused by long-term treatment of patients who have experienced more than three lines of treatment, the choice of later-line treatment with less adverse reactions and better clinical effect needs to be further explored.

To observe the clinical effect and safety of fruquintinib plus programmed death receptor-1 (PD-1) inhibitors in the third-line and above treatment of mCRC.

The clinical data of 75 patients with metastatic colorectal cancer admitted in the First Affiliated Hospital of Zhengzhou University from June 2020 to March 2022 were collected and analyzed retrospectively. The patients were divided into the fruquintinib alone group (n=28) and the PD-1 inhibitor plus fruquintinib group (n=47). The treatment regimen was: the patients in the fuquitinib alone group took oral furoquitinib capsules at 5 mg/d once for 3 consecutive weeks with a 1-week stop in 28-day cycles, the patients in the PD-1 inhibitor plus fruquintinib group were injected intravenously with carrilizumab/sindilizumab/pabrolizumab 200 mg and treprolizumab 240 mg from the first day in 21-day cycles, and fruquintinib was used in the same way as the fruquintinib alone group. The main observation indexes were objective response rate (ORR), disease control rate (DCR), progression-free survival time (PFS) and incidence of adverse reactions in the two groups.

As of the last follow-up (2022-05-31), the ORR of the fruquintinib alone group and the PD-1 inhibitor plus fruquintinib group were 7.1% and 14.9%, the DCR of the fruquintinib alone group and the PD-1 inhibitor plus fruquintinib group were 67.9% and 89.4%, the DCR of patients in the PD-1 inhibitor plus fruquintinib group was significantly higher than that in the furoquinitinib alone group (χ²=5.345, P=0.021). The median PFS of the PD-1 inhibitor plus fruquintinib group and fruquintinib alone group were 6.4 months (IQR: 4.0-13.1) and 4.5 months (IQR: 2.9-8.2) ; there was significant difference in PFS between the two groups (χ²=5.504, P=0.019). Most of the adverse reactions during the treatment of the two groups were grade 1-2. The incidence of hypothyroidism in the PD-1 inhibitor plus fruquintinib group was significantly higher than that in the fruquintinib alone group (P<0.05). In addition, there was no significant difference in the incidence of other adverse reactions between the two groups (P>0.05) .

Compared with fruquintinib alone, PD-1 inhibitor plus fruquintinib has prolonged survival time and reduced incidence of severe adverse reactions in patients with metastatic colorectal cancer, making it an effective and safe treatment.

In China, esophageal cancer is one of the most common cancers, and its incidence and mortality are more than twice the global average. However, most esophageal cancers in China are not detected until they are at moderate and advanced stages with poor prognosis, so early diagnosis and treatment are urgently needed. At present, the role of gut flora in the diagnosis and treatment of esophageal cancer has attracted much attention.

To explore the basic characteristics of gut flora in patients with esophageal squamous cell carcinoma.

From the Fourth Hospital of Hebei Medical University from April to August 2022, 35 patients with esophageal squamous cell carcinoma with no previous anti-cancer treatments were included as esophageal cancer group (EC group), and 35 healthy volunteers as control group. Stool samples of the two groups were collected to detect the gut flora using 16S rDNA sequence. Then an analysis was performed on the Alpha diversity, Beta diversity〔using the principal coordinate analysis (PCoA) 〕 and differential species of gut flora 〔using the linear discriminant analysis Effect Size (LEfSe) 〕 of two groups according to the species annotation of the test results.

The Alpha diversity indices, such as Shannon index, Simpson index, Chao1 index, ACE index and Goods_coverage index demonstrated no significant differences between the two groups (P>0.05), while PCoA graph showed that the Beta diversity differed significantly between the two groups on the whole, and the community structures were different (t=10.837, P<0.001). T-test results showed that there were significant intergroup differences in the abundance of 16 genera at the genus level. Among the top eight genera with relatively high abundance, the abundance of Faecalibacterium, Roseburia and Citrobacter notably decreased, while that of Lactobacillus, Romboutsia, Ruminococcus_torques_group, Intestinibacter and Turicibacter notably increased in EC group (P<0.05). LEfSe analysis showed that two groups had differences in the abundance of 14 different species of gut flora. The abundance of Faecalibacterium and Faecalbacterium-prausnitzii declined significantly, and that of Romboutsia and Romboutsia-ilealis increased significantly in EC group at the genus and species levels (P<0.05) .

Esophageal squamous cell carcinoma patients have significantly differential gut flora, among which Faecalibacterium, Faecalibacterium -prausnitzii, Romboutsia and Romboutsia-ilealis may be specific altered species of esophageal cancer, which are closely related to the occurrence of esophageal cancer.

Patient decision aids (PDAs) are essential tools to assist patients in the process of shared-decision making. However, their effects have been reported to be inconsistent in shared-decision making in the diagnosis and treatment of colorectal cancer.

To assess the core factors in the development of PADs supporting decision-making in colorectal cancer diagnosis and treatment, and their application effects using a systematic review.

In February 2022, randomized controlled trials (RCTs) on PDAs supporting decision-making in colorectal cancer care were searched in databases including PubMed, Web of Science, CIHNAL, Cochrane Library, EmBase, PsycINFO, JBI, Scopus, CNKI, WanFang, CQVIP and SinoMed from inception to January, 2022. Two researchers performed literature screening and data extraction separately. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials (5.1.0) was used to assess the risk of bias. A descriptive analysis was conducted to describe the core factors used in the development of PDAs and to summarize the effect of PDAs.

A total of 11 RCTs were included, involving PDAs for supporting decision-making in colorectal cancer screening, systemic therapy and supportive care for advanced colorectal cancer, chemotherapy for metastatic colorectal cancer, and genetic testing for hereditary nonpolyposis colorectal cancer. The quality was moderate on the whole. Specifically, the quality of one RCT was rated as level A and that of the other 10 was level B. The analysis found that: (1) currently, the development of PDAs for supporting decision-making in colorectal cancer is mainly under the guidance of the quality criteria framework published by the International Patient Decision Aids Standards Collaboration, and the core content of the tool include providing information about options, balanced presentation of options, clarifying and expressing values; (2) The use of PDAs increased patient knowledge (six RCTs) , reduced patient decisional conflicts (eight RCTs) and promoted informed choice (two RCTs) .

The use of PDAs has proven to be effective in improving patient decision-making behavior and results in colorectal cancer. Although the evidence is still insufficient, they have broad prospect in clinical practice. In the future, the PDAs that are applicable to Chinese patients in different stages of colorectal cancer can be developed with the support of foreign theoretical achievements about decision-making and in accordance with the conditions of Chinese population, and the application effects of them need to be assessed further.

As with other chronic diseases, cancer presents a multidimensional state. And many chronic diseases share common risk factors with cancers. The association between a single chronic disease indicator and the risk of cancer is weak, so it is significant to construct a risk score composed of multiple chronic disease indicators and analyze its association with the risk of cancer.

To investigate the association between chronic disease risk score and cancer risk.

This study selected a total of 18 009 eligible individuals who had participated in Tianjin Chronic Disease Risk and Health Management Cohort Study and undergone physical examination in Health Management Center, Tianjin Medical University General Hospital from January 2015 to December 2019. All subjects completed the health risk assessment questionnaire, physical examination, and laboratory examination. Follow-up ended on the day of cancer occurrence or the day of follow-up termination (December 31, 2019) . Multivariate Cox regression model was used to evaluate the relationship of the risk of cancer (used as the dependent variable) with each of the chronic disease related indicators〔consisting of BMI, waist circumference, blood pressure, blood glucose, total cholesterol, triglyceride, uric acid, total bilirubin, heart rate, and estimated glomerular filtration rate (used as independent variables) 〕. And then the comprehensive score of chronic disease risk was calculated, and the cancer risk in tertile groups of the score 〔low-score group (<6 points) , medium-score group (6-8 points) , and high-score group (≥9 points) 〕 was assessed by Cox regression analysis.

A total of 71 835 person-years (median 4.00 years) were followed up, and 91 cases (33 males and 58 females) were diagnosed with cancer. Compared with low-score group (n=6 403) , the HR value (95%CI) of cancer risk was 2.16〔95%CI (1.20, 3.90) , P=0.011〕in medium-score group (n=6 459) , and 3.08〔95%CI (1.72, 5.50) , P<0.001〕 in high-score group (n=5 147) (P_trend<0.001) , which satisfied the proportional hazards hypothesis test (χ²=1.98, P=0.371) . For per point increase in the chronic disease risk score, the risk of cancer increased by 17%〔95%CI (9%, 25%) , P<0.001〕, which satisfied the proportional hazards hypothesis test (χ²=0.31, P=0.579) . Compared with females in low-score group, the females in high-score group had an increased risk of cancer, with HR value (95%CI) of 3.00〔95%CI (1.32, 6.82) , P=0.009〕, which satisfied the proportional hazards hypothesis test (χ²=1.24, P=0.538) . For per point increase in the chronic disease risk score, the risk of cancer in females increased by 21%〔95%CI (10%, 33%) , P<0.001〕.

The higher the chronic disease risk score, the higher cancer risk, and the association was significant in females, but not in males.

Breast cancer has become the most prevalent cancer worldwide, which leads to both physical symptom burden and psychological distress among patients. Although available literature has demonstrated the effect of physical activity in improving psychological health among breast cancer survivors, the underlying psychosocial mechanism is relatively understudied.

To investigate the association of walking with positive and negative affect among breast cancer patients, and examine the potential mediating effects of different dimensions of posttraumatic growth between them.

From April to July, 2019, 256 breast cancer patients receiving community-based management were recruited using convenience sampling from Shanghai Pengpuxincun Community Health Center to attend a household survey. Two hundred and thirty-five of them who completed the survey were included as final participants (achieving a response rate of 91.8%) . Levels of walking were measured using International Physical Activity Questionnaire-Long Form (IPAQ-long) , posttraumatic growth was assessed using Posttraumatic Growth Inventory-Short Form (PTGI-SF) , emotional health was assessed using the 20-item Positive and Negative Affect Scale (PANAS) . Structural equation modeling was conducted to test the parallel mediating effects of different dimensions of posttraumatic growth between walking and positive and negative affect.

The result of intermediary effect analysis show that, walking was associated with greater positive affect through facilitating the personal strength dimension of posttraumatic growth among breast cancer patients, with an indirect effect of 0.07〔95%CI (0.02, 0.13) 〕. Moreover, walking was associated with lower level of negative affect through facilitating the appreciation for life dimension of posttraumatic growth, with an effect size of -0.13〔95%CI (-0.21, -0.05) 〕. The result of the intermediary model show that, the level of walking activity promoted positive emotions (β=0.34, P<0.01) by promoting the personal strength dimension of post-traumatic growth (β=0.21, P<0.01) . In addition, walking activity decreased negative mood (β=-0.37, P<0.01) by promoting the life appreciation dimension of post-traumatic growth (β=0.35, P<0.01) .

Posttraumatic growth plays an important role as a mediator between walking and emotional health in breast cancer patients. In view of this, physicians from community health centers, the institutions responsible for long-term health management of cancer patients, should value walking as a potential intervention for improving psychological health of breast cancer patients in the future community health management. In addition, it is recommended to use both physical activity and psychological interventions to improve posttraumatic growth, in order to further enhance the intervention efficacy.

The relationship between aurora kinase A (Aurora A) expression level in the medullary thyroid carcinoma (MTC) tissue and the clinicopathological characteristics and biochemical cure of patients remains unclear.

To analyze the relationship between Aurora A expression level in medullary thyroid tissue and the clinicopathological characteristics of patients, to further analyze the risk factors for biochemical cure and clarify the correlation between Aurora A expression and biochemical cure.

A total of 90 patients with MTC who were hospitalized with MTC resection in the Department of Head and Neck Oncology, Tianjin Medical University Cancer Institute and Hospital from February 2011 to July 2019 were enrolled, the clinical data of the patients were collected, and Aurora A expression level in the tissues was detected by immunohistochemical detection, and the influencing factors of biochemical cure of MTC patients were explored by multivariate Logistic regression model.

62 patients with high Aurora A expression level and 28 patients with low Aurora A expression were included, 40 patients achieved biochemical cure and 18 patients experienced recurrence. There were significant differences in gender, maximum tumor length, T stage, N stage, AJCC8th clinical stage, biochemical cure, and recurrence between patients with high Aurora A expression level and low Aurora A expression level (P<0.05). There were significant differences in gender, number of lesions, T stage, N stage, AJCC8th clinical stage, and Aurora A expression level between biochemically cured patients and those who were not biochemically cured (P<0.05). Multiple lesions〔OR=3.18, 95%CI (1.01, 9.97), P=0.047〕, T staging as T₃/T₄〔OR=3.69, 95%CI (1.05, 12.93), P=0.042〕, and high Aurora A expression level〔OR=3.22, 95%CI (1.07, 9.74), P=0.038〕were the influencing factors of biochemical cure in patients with MTC.

High Aurora A expression level is associated with tumor invasion of MTC, and the expression level of Aurora A can influence the biochemical cure in patients with MTC.

Frailty is common in cancer patients, which seriously affects their prognosis. However, the factors associated with frailty in cancer patients are not clear at present.

To identify the factors associated with frailty in cancer patients by a meta-analysis, to provide a scientific basis for the development and implementation of related interventions.

The databases of China National Knowledge Infrastructure (CNKI), CQVIP, WanFang Data, PubMed, Web of Science, Cochrane Library, CINAHL and Embase were comprehensively and systematically searched from inception to August 2022 for included cross-sectional studies, cohort studies or case-control studies reporting associated factors of frailty in cancer patients. Two researchers screened the literature and performed quality evaluation and data extraction. Stata 17.0 and RevMan 5.4 were used for meta-analysis.

Eleven studies were included, among which nine were cross-sectional studies and the other two were cohort studies. Altogether, 2 898 cancer patients were studied, among whom 1 025 were frail, and 12 associated factors of frailty were reported. Meta-analysis showed that the prevalence of frailty in all cancer patients, lung cancer patients, digestive cancer patients, and other cancer patients was 34%〔95%CI (23%, 45%) 〕, 31%〔95%CI (25%, 36%) 〕, 42%〔95%CI (26%, 59%) 〕, and 12%〔95%CI (9%, 16%) 〕, respectively. The risk of frailty in cancer rose with advanced age〔OR=1.16, 95%CI (1.05, 1.27) 〕, combined with other diseases〔OR=1.46, 95%CI (1.28, 1.67) 〕, high BMI〔OR=1.13, 95%CI (1.05, 1.21) 〕, poor nutritional status〔OR=2.77, 95%CI (1.27, 6.06) 〕, high syndrome group scores〔OR=1.07, 95%CI (1.04, 1.09) 〕and depression〔OR=1.27, 95%CI (1.12, 1.44) 〕, but decreased with high education level〔OR=0.78, 95%CI (0.68, 0.90) 〕, albumin level≥35 g/L〔OR=0.33, 95%CI (0.12, 0.90) 〕and high level of instrumental activities of daily living (IADL) 〔OR=0.50, 95%CI (0.42, 0.59) 〕. Egger's test assessing the potential publication bias in 11 studies via funnel plot asymmetry showed that there was a certain publication bias (t=-4.12, P=0.003) .

This meta-analysis revealed that age, education level, comorbidity, BMI, albumin, nutritional status, syndrome group, depression and IADL were the associated factors of frailty in cancer patients. It is necessary for health professionals to pay more attention to cancer patients with advanced age, low education level, combined with other diseases, high BMI, albumin level <35 g/L, poor nutritional status, with syndrome group, depression or low-level activities of daily living, so as to prevent the occurrence of frailty.