Breast cancer is the leading cause of death among women worldwide, characterized by high incidence and heavy disease burden.

To assess the secular trend of breast cancer incidence and mortality in Chinese females from 1990 to 2019.

The data on breast cancer incidence and mortality in Chinese females aged ≥15 years from 1990 to 2019 were extracted from the Global Burden of Disease Study 2019. The Bayesian age-period-cohort (APC) model was used to fit breast cancer incidence and mortality trends during 1990—2019 to assess the effects of age, period and cohort on breast cancer incidence and mortality.

The crude incidence of breast cancer among Chinese females increased from 14.14/100 000 to 52.81/100 000, and the crude mortality increased from 7.22/100 000 to 13.40/100 000 during 1990—2019.The standardized incidence of breast cancer showed an increasing trend in general (17.07/100 000 in 1990, 35.61/100 000 in 2019) , while the standardized breast cancer mortality was basically stable (9.16/100 000 in 1990, 8.98/100 000 in 2019) .The results of the APC model showed that the average net drift value of breast cancer incidence in females of all age groups was 2.58%〔95%CI (2.34%, 2.83%) 〕, and the highest value of local drift was 3.46%〔95%CI (3.11%, 3.80%) 〕 in the 65-69 years old group. The average net drift value of mortality was -0.75%〔95%CI (-1.09%, -0.41%) 〕. The local drift value was stable in 15-44-year-olds, and was above 0 in age groups above 60 years old. The incidence and mortality of breast cancer increased with age. The period effect of incidence showed an increasing trend (RR: 0.79-1.47) , while the period effect of mortality showed a decreasing trend (RR: 1.08-0.90) when the period of 2000—2004 was set as the control group. The cohort effect of breast cancer incidence increased (RR: 0.27-2.48) , and the cohort effect of breast cancer mortality risk increased firstly and decreased after then (RR: 0.78-1.06-0.44) when the cohort of 1955—1959 was set as the control group.

The incidence and mortality of breast cancer in Chinese females increased continuously from 1990 to 2019, which was dominantly influenced by age and cohort.

Cervical cancer is the seventh most common cancer globally, and the fourth most common cancer in women, accounting for about 12% of all cancers diagnosed among females. Cervical cancer and liver cancer are similar with respect to high prevalent region, with about 85% of the sufferers are from less developed regions.

To assess the long-term trends of cervical cancer incidence and mortality in China.

Data about cervical cancer incidence and mortality in Chinese adult females were extracted from the Institute for Health Metrics and Evaluation. Joinpoint regression was used for analyzing the trends of cervical cancer incidence and mortality during 1993—2017. The age-period-cohort model and intrinsic estimator method were adopted for analyzing the effects of age, period, and cohort on cervical cancer incidence and mortality.

Overall, the trends of cervical cancer incidence and mortality totally experienced a significant decrease during 1993—1998, and showed an increasing trend during 2008—2015. Joinpoint regression analysis showed that from 1993 to 2017, the standardized incidence ratio of cervical cancer increased from 9.54/100 000 to 10.88/100 000〔AAPC (95%CI) =0.6 (0.3, 0.9) , P<0.05〕, while its standardized mortality ratio decreased from 4.88/100 000 to 4.48/100 000〔AAPC (95%CI) =-0.3 (-0.5, -0.1) , P<0.05〕. Moreover, cervical cancer incidence increased significantly with age before the age of 59, and the period effect exhibited a general upward trend for both incidence and mortality. The incidence and mortality risks by birth cohort showed a declining trend except for some periods and the risks all peaked in the cohort born in 1916—1920, then leveled off and slightly decreased in younger generations.

Taken together, the decrease in the cohort effect might contribute to the decrease in cervical cancer incidence and mortality rates, while the increase of age and period effects might lead to the increase in its morbidity and mortality rates.

Patients with refractory cancer pain often have dysphagia, which increases the difficulty of treatment. Patient-controlled intravenous analgesia (PCIA) is a measure that can achieve sustained, effective and safe analgesia.

To investigate the efficacy and safety of PCIA with hydromorphone, sufentanil or morphine in treatment of refractory cancer pain with dysphagia.

A total of 102 patients with refractory cancer pain and dysphagia were selected from Department of Oncology and Hospice Care Center of the Second Hospital of Wuhan Iron and Steel (Group) Corporation from May 2020 to January 2022, and equally divided into hydromorphone PCIA group, sufentanil PCIA group and morphine PCIA group single-blindly and randomly. The Numerical Rating Scale (NRS) score, the frequency of episodes of breakthrough pain, the Morphine Equivalent Daily Dose (MEDD) , Pittsburgh Sleep Quality Index (PSQI) score, Cancer Quality of Life Questionnaire Core 30 (QLQ-C30) score and the incidence of adverse reactions were compared among the three groups before and after treatment.

The participants included 51 males and 51 females, with an average age of (60.2±6.3) years. There were no statistical differences in sex ratio, average age, degree of pain, NRS score, MEDD, distribution of primary cancer type, pain type and TNM classification of cancers among the three groups (P>0.05) . The NRS score and the frequency of episodes of breakthrough pain in three groups deceased significantly after treatment (P<0.05) . The type and time of treatment had interactive effects on both the NRS score and the frequency of episodes of breakthrough pain (P<0.05) . The type of treatment produced main effect on the NRS score and the frequency of episodes of breakthrough pain, so did the time of treatment (P<0.05) . The NRS score and the frequency of episodes of breakthrough pain of hydromorphone PCIA group were significantly lower than those of each of other two groups after 24 hours or 72 hours of treatment (P<0.05) . Morphine PCIA group had higher NRS score than other two groups (P<0.05) , and had higher frequency of episodes of breakthrough pain than hydromorphone PCIA group (P<0.05) after one-week treatment. Morphine PCIA group had higher NRS score and frequency of episodes of breakthrough pain than each of other two groups after two-week or one-month treatment (P<0.05) . After one-month treatment, all groups demonstrated increased MEDD and decreased PSQI (P<0.05) . In particular, morphine PCIA group had higher MEDD than other two groups (P<0.05) . Sufentanil PCIA group had higher MEDD than hydromorphone PCIA group (P<0.05) . Morphine PCIA group had higher PSQI score than other two groups (P<0.05) . All groups demonstrated increased score of each item of the QLQ-C30 (P<0.05) . In particular, morphine PCIA group ranked bottom in terms of the score of each item of the QLQ-C30 (P<0.05) . The emotional function score of sufentanil PCIA group was significantly lower than that of hydromorphone PCIA group (P<0.05) . The incidence of adverse reactions had no significant differences among the three groups after one-month treatment (P>0.05) .

For patients with refractory cancer pain and dysphagia, hydromorphone and sufentanyl were superior to morphine for PCIA in terms of reducing pain and the frequency of episodes of breakthrough pain, improving quality of sleep and life. But hydromorphone was superior to sufentanyl in quick onset, and effective improvement of emotion with reduced dose of opioid and without increased incidence of adverse reactions.

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.

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.

As the aging population has progressed and oncology treatments have revolutionized, the clinical situation of cardiovascular disease complicating malignancy has become more common, and the field of cardio-oncology has gained much attention. When hematological malignancy is combined with coronary heart disease, the condition can be aggravated by pathological mechanisms such as imbalance of oxygen supply and bleeding coagulation abnormalities. However, the factors affecting the prognosis have rarely been reported.

To investigate the influencing factors of all-cause mortality in patients with coronary heart disease combined with hematological malignancies.

Data from the medical records of General Hospital of Southern Theater Command between January 2013 and December 2020 were retrieved to select patients whose diagnostic book homepage contained the keywords coronary heart disease or coronary atherosclerotic heart disease and hematological malignancy (leukemia or lymphoma or multiple myeloma) to establish a repository of patients with coronary heart disease combined with hematological malignancy. Patients' clinical data were collected and followed up for survival status, major adverse cardiovascular events (MACE) and the occurrence or absence and time of major bleeding events. They were divided into survival and death groups by survival status, and statistical analysis was performed for each indicator in the two groups. Multivariate Cox regression analysis was used to explore the risk factors of all-cause mortality in patients with coronary heart disease combined with hematological malignancies.

A total of 68 patients were finally included in the study, 52 died (76.47%) , the median survival time was 10.93 months, and the median follow-up time was 67.33 months. Compared with the survival group, patients in the death group were older, had faster heart rate at admission, lower body mass index, smaller body surface area, lower hemoglobin, albumin level, higher cystatin C level, higher proportion of elevated brain natriuretic peptide, and higher proportion of chemotherapy and stem cell transplantation (P<0.05) . Multivariate Cox regression analysis showed that elevated body mass index〔HR=0.841, 95%CI (0.761, 0.930) , P=0.001〕, receipt of chemotherapy〔HR=0.340, 95%CI (0.182, 0.637) , P=0.001〕, increased albumin level〔HR=0.934, 95%CI (0.889, 0.982) , P=0.008〕 were independent protective factors for death events. Elevated fibrinogen〔HR=1.635, 95%CI (1.291, 2.071) , P<0.001〕, and platelet count less than 100×10⁹/L〔HR=2.500, 95%CI (1.336, 4.678) , P=0.004〕 were independent risk factors for mortality.

Patients with coronary heart disease and hematological malignancies have poor prognosis, and the risk factors associated with all-cause mortality are elevated fibrinogen and platelet count less than 100×10⁹/L.

Helicobacter pylori (H. pylori) infection induced precancerous lesions of gastric mucosa mostly in adulthood. However, it is debatable whether these pathological changes could also occur in children.

To investigate the relationship between H. pylori infection and precancerous lesions of gastric mucosa in children hospitalized due to upper gastrointestinal symptoms in central plain area of China.

A total of 1 015 children under the age of 18 years old were enrolled. These children attended the People's Hospital of Zhengzhou University for upper gastrointestinal symptoms such as abdominal pain, bloating, nausea, vomiting, hiccups, and acid reflux from August 2018 to July 2021. All children underwent gastroscopy, from which gastric mucosal biopsy tissues were taken for rapid urease test and histopathological examination. The clinical and pathological data of the patients were collected retrospectively. The children were divided into infected and uninfected groups according to H. pylori infection status. The age, sex, endoscopic diagnosis, and H. pylori infection rate were compared between children in infected and uninfected groups. The incidence of precancerous lesions of gastric mucosa, inflammatory activity and the degree of inflammatory cell infiltration were compared between infected and uninfected groups, meanwhile these tests were also compared in children of different age groups.

Among the 1 015 children, 854 (84.14%) were infected with H. pylori and 161 (15.86%) were not infected. H. pylori-infected children were significantly older than those of non-infected subjects (P<0.05). Endoscopy examination revealed that the proportion of chronic superficial gastritis in H. pylori- infected group was significantly higher than that in uninfected group, while nodular gastritis was more common in H. pylori-uninfected patients (P<0.05). Among the enrolled children, 54 were 1-4 years old, 199 were 5-8 years old, 435 were 9-12 years old, and 327 were 13-18 years old. H. pylori infection rate in groups of 5-8, 9-12 and 13-18 year-old children was significantly higher than that in group of 1-4 year-old children; and the infection rate in groups of 9-12 and 13-18 year-old children was also significantly higher than that in group of 5-8 year-old children (P<0.05). Among H. pylori-infected patients, 37 out of 854 children had precancerous lesions of gastric mucosa (with incidence rate of 4.33%), of which 17 patients had atrophy, 11 patients had intestinal metaplasia and 9 patients had dysplasia, and only one of the 161 H. pylori-uninfected patients (0.62%) had atrophic gastritis. The incidence of precancerous lesions of gastric mucosa in H. pylori-infected patients were significantly more than those uninfected patients (χ²=5.178, P=0.023). The level of active inflammation and inflammatory cell infiltration of gastric mucosa in H. pylori-infected children were higher than that in non-infected children (P<0.05). In groups of 5-8, 9-12 and 13-18 year-old children, the prevalence of active inflammation and neutrophil granulocyte infiltration in gastric mucosa were significantly higher than that in uninfected patients (P<0.05). In H. pylori-infected patients, children in groups of 9-12 and 13-18 years old showed more severe lymphocyte infiltration over the uninfected patients (P<0.05) .

In children, gastric mucosal precancerous lesions occur in 4.33% of H. pylori-infected patients in central China, this include atrophic gastritis, intestinal metaplasia and dysplasia; the data revealed an obvious critical issue requiring future investigation and intervention for this group of population.

Along with the acceleration of population aging and the increase in average life expectancy, how to improve the quality of life of residents has become a social focus. Cancer is a major factor that seriously affects the health, causing increased medical burden. Therefore, it is of great significance to analyze cancer incidence in Cenxi City, Guangxi.

To perform a statistical analysis of cancer incidence in Cenxi from 2016 to 2020.

Data on cancer incidence in Cenxi from 2016 to 2020 were obtained from the Cancer Registry System of Cenxi Center for Disease Control and Prevention. Cancers were classified by the Guideline for Chinese Cancer Registration and International Classification of Disease for Oncology, Third Edition (ICD-O). Sex-specific and age-specific crude incidence rates, standardized incidence rates, and cumulative incidence rates (0-74 years), as well as truncated age-standardized incidence rate (35-64 years) were calculated. The standardized incidence rate was calculated by the 2000 Population Census of China and Segi's world population structure (Chinese age-standardized incidence rate was referred to as ASIRC, and world age-standardized incidence rate as ASIRW) .

There were 4 205 registered new cases of cancer from 2016 to 2020 in Cenxi. The crude cancer incidence rate was 98.77/10⁵. The ASIRC, ASIRW, cumulative incidence rate (0-74 years) and the truncated age-standardized incidence rate (35-64 years) were 85.48/10⁵, 82.54/10⁵, 9.08%, and 165.08/10⁵, respectively. The male crude incidence rate was higher than that in female (χ²=161.703, P<0.001). The crude cancer incidence rates for 0-34 year-old overall population, males and females were all under 34.00/10⁵, for 35-39 year-old overall population, males and females were 64.02/10⁵, 83.94/10⁵, 43.75/10⁵, respectively, and for 75-79 year-old were 437.83/10⁵, 597.17/10⁵, 292.76/10⁵, respectively, reaching the highest incidence rate. The top three cancers in terms of crude incidence rate for the overall population were liver cancer (23.47%), lung cancer (17.53%), and nasopharynx cancer (10.70%), for males were liver cancer (30.94%), lung cancer (20.84%), and nasopharynx cancer (12.51%), while for females were breast cancer (16.44%), lung cancer (12.12%), and liver cancer (11.31%) .

Compared to the Chinese average (ASIRC and ASIRW were 190.64/10⁵, 204.8/10⁵), and world average (ASIRW were 201.0/10⁵) from 2016 to 2020, Cenxi had lower overall standardized cancer incidence rates (ASIRC and ASIRW were 85.48/10⁵, 82.54/10⁵). The crude cancer incidence rate in males was higher than that of females. The crude cancer incidence rate reached its peak at the age range of 75-79 years for the overall population, males or females. The top three cancers in terms of crude incidence in the overall population were liver cancer, lung cancer and nasopharynx cancer.

The prevalence of anticancer drug-induced kidney injury is increasing, but related renal pathology studies are still rare.

To analyze the clinicopathological characteristics of patients with anticancer drug-related kidney injury.

We selected 112 cancer inpatients aged 18 years or older with kidney injury (kidney injury occurred after cancer or nearly at the same time as cancer, and may be directly or indirectly associated with anticancer treatment) detected by kidney biopsy from Department of Nephrology, the Fourth Hospital of Hebei Medical University from October 2013 to August 2021. We assigned those (n=65) who were previously treated with chemotherapy, molecularly targeted drugs or immune checkpoint inhibitors and other systemic treatments to an anticancer drug group, and other cases (n=47) to a non-use anticancer drug group. We collected their demographics, laboratory examination and pathological data, and analyzed the clinical features and pathological characteristics of kidney of those with anticancer drug-related kidney injury.

In the anticancer drug group, acute kidney injury (AKI) occurred in 30 (50.8%) out of 59 cases of solid cancer, and in 4 out of 6 cases of hematological cancer. In non-use anticancer drug group, AKI occurred in 11 (31.4%) out of 35 cases of solid cancer, and in 6 (50.0%) out of 12 cases of hematological cancer. The serum creatinine level increased after treatment in the anticancer drug group (P<0.001) . Anticancer drug group and non-use anticancer drug group had significant differences in sex ratio, smoking prevalence, mean serum albumin and elevated urinary protein excretion prevalence (P<0.05) , but had no significant differences in mean age, hemoglobin, serum creatinine, urea nitrogen, uric acid, D-dimer, total cholesterol, triacylglycerol, and 24-hour urinary protein quantification, as well as prevalence of diabetes, hypertension, and AKI (P>0.05) . Solid cancer patients with anticancer drug treatment had higher prevalence of tubulointerstitial injury (P=0.023) and lower prevalence ofmembranous nephrosis (P=0.004) compared with those without anticancer drug treatment. Renal tubulointerstitial injury was the main pathological manifestations in the anticancer drug group〔34 cases (52.3%) 〕. Membranous nephropathy〔18 cases (38.3%) 〕and tubulointerstitial injury〔18 cases (38.3%) 〕were main pathological manifestations in the non-use anticancer drug group.

There are various clinical and pathological types of anticancer drug-induced kidney injury. The application of anticancer drug may cause damage to renal function, so priority should be given to the prevention of renal tubulointerstitial injury during the treatment.

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.

The presence of symptom clusters is associated with poor treatment outcomes and decreased quality of life in patients with cancer, and holistic interventions for symptom clusters can improve the management efficiency. Numerous non-pharmacologic interventions are available for symptom clusters in patients with cancer, but there is disagreement as to which interventions is the most effective.

To explore and compare the effectiveness of different non-pharmacological interventions in reducing the severity of symptom clusters in cancer patients.

In September 2021, randomized controlled trials (RCTs) about non-pharmacological interventions in reducing the severity of symptom clusters in cancer patients were searched in SinoMed, CNKI, Wanfang Data, CQVIP, the Cochrane Library, PubMed, Web of Science and Wiley Online Library databases from inception to September 2021. Two researchers independently screened studies based on the inclusion and exclusion criteria, extracted data, and performed risk of bias assessment using the Cochrane handbook for systematic reviews of interventions (version 5.1.0) . RevMan 5.3 was adopted for heterogeneity test using a traditional method and publication bias analysis. Addis 16.6 was used to make a network meta-analysis.

Twelve RCTs were finally included, involving 1 116 cases, and eight non-pharmacologic interventions: cognitive behavior intervention, mindfulness-based stress reduction, acupoint massage, multiple-modality exercise, exercise and health counseling, auricular point sticking therapy, narrative nursing, and attention control. Network meta-analysis results showed that, for reducing the severity of symptom clusters in cancer patients, acupoint massage was superior to interventions other than mindfulness-based stress reduction, mindfulness-based stress reduction was superior to usual care and narrative nursing, and cognitive behavioral intervention was superior to multiple-modality exercise, usual care and narrative nursing (P<0.05) . The surface under the cumulative ranking curve score for the interventions in reducing the severity of symptom clusters in cancer patients ranked from highest to lowest was: acupoint massage>mindfulness-based stress reduction>cognitive behavior intervention>auricular point sticking therapy/attention control>multiple-modality exercise>usual care>narrative nursing>exercise and health counseling.

Based on the results of network meta-analysis and probability ranking, acupoint massage was recommended as the clinical priority non-pharmacological intervention to alleviate the severity of symptom clusters in cancer patients, followed by mindfulness-based stress reduction. In the future, high-quality, large-sample, multicenter, double-blind RCTs are needed to further validate the effects of different non-pharmacological interventions on improving symptom clusters in cancer patients, and to provide more reliable evidence for supporting the development of interventions for symptom clusters in these patients.

The results of cervical cancer containment have demonstrated regional differences in China, which may be due to various socioeconomic and cultural developments across regions. Understanding cervical cancer screening results in various regions is of a great significance for developing effective cervical cancer prevention strategies.

To perform a comparative analysis of the results of two yearly cervical cancer screening (2019 and 2020) in urban areas of Shihezi, Xinjiang, to estimate the changes in high-risk human papillomavirus (hrHPV) infection and cervical lesion detection rate in women.

A retrospective design was used. Participants were 46 994 women from Shihezi urban areas who underwent initial cervical cancer screening with an HPV test〔underwent once either between December 2018 and December 2019 (the 2019 yearly screening) or between January and June 2020 (the 2020 yearly screening) 〕 in Shihezi Maternal and Child Health Hospital, Shihezi People's Hospital, and First Affiliated Hospital, School of Medicine, Shihezi University during December 2018 to June 2020. Data of the screening results, including HPV infection rate and subtypes, Thinprep cytologic test results, and pathological diagnosis of cervical biopsy samples taken during a colposcopy were collected, and those of the 2019 yearly screening were compared with those of 2020 yearly screening.

There were 18 378, and 28 616 attendees for 2019, and 2020 yearly screenings, respectively, and 44 746 of them finally completed the screening. The completion rate of cervical cancer screening in 2020 was higher than that in 2019 〔97.07% (27 779/28 616) vs (16 967/18 378) 〕 (P<0.05) . A total of 5 992 cases (12.75%) were detected with HPV infection, among them, the prevalence of HPV 16 and HPV 18 was 18.55% (1 112/5 992) , and that of other HPV subtypes was 81.45% (4 880/5 992) . The prevalence of HPV infections in participants of 2020 yearly screening〔11.09% (3 176/28 616) 〕was lower than that in participants of 2019 yearly screening〔15.32% (2 816/18 378) 〕 (P<0.05) . The prevalence of single-type HPV infections in participants of 2019 yearly screening was higher than that in participants of 2020 yearly screening 〔11.38% (2 092/18 378) vs 7.45% (2 674/28 616) 〕 (P<0.05) . The prevalence of multi-type HPV infections in participants of 2019 yearly screening was higher than that in participants of 2020 yearly screening〔3.94% (724/18 378) vs 1.75% (502/28 616) 〕 (P<0.05) . The prevalence of HPV was 10.37% (909/8 767) , 12.22% (1 916/15 677) , 13.71% (2 500/18 234) and 15.45% (667/4 316) , respectively, in four age groups of participants (30-39, 40-49, 50-59, and 60-65) in these two yearly screenings totally, showing an increase with age (P<0.05) . The prevalence of HPV showed a decrease in 30-39-year-old participants, so did it in 40-49-year-old, 50-59-year-old, and 60-65-year-old participants of 2020 yearly screening (P<0.05) . The top 5 prevalent single HPV subtypes found in 2019 yearly screening were HPV 52 (20.84%) , HPV 16 (14.48%) , HPV 53 (8.56%) , HPV 51 (7.93%) , and HPV 39/68 (7.60%) , while those found in 2020 yearly screening were HPV 52 (15.07%) , HPV 16 (12.64%) , HPV 58 (12.30%) , HPV 53 (10.25%) and HPV 66 (4.75%) . HPV 18 ranked as the 11th most prevalent single HPV subtype in both two screenings. The proportion of patients with pathological diagnosis of inflammation/condyloma and LSIL in cervical cancer screening in 2020 was lower than that in 2019 (P<0.05) . The 30-39-year-old participants of the 2020 yearly screening had lower prevalence of inflammation/condyloma detected by colposcopy than did those of the 2019 yearly screening (47.83% vs 74.36%) (P<0.05) . The 50-59-year-old participants of the 2020 yearly screening had lower prevalence of inflammation / condyloma detected by colposcopy than did those of the 2019 yearly screening (65.50% vs 77.22%) (P<0.05) . The 30-39-year-old participants of 2020 yearly screening had higher prevalence of colposcopy-detected low-grade squamous intraepithelial lesion (LSIL) than did those of 2019 yearly screening (31.30% vs 5.13%) (P<0.05) . The 40-49-year-old participants of 2020 yearly screening had higher prevalence of colposcopy-detected LSIL than did those of 2019 yearly screening (27.06% vs 16.07%) (P<0.05) . The 50-59-year-old participants of 2020 yearly screening had higher prevalence of colposcopy-detected LSIL than did those of 2019 yearly screening (23.64% vs 8.89%) (P<0.05) .

The completion rate of cervical cancer screening in 2020 was obviously better than that in 2019, but it still needs to be further improved. Compared with 2019, HPV infection rate decreased, the major prevalent HPV subtypes changed, and LISL prevalence increased in 30-39 and 50-59 age groups in 2020. Follow-up management is suggested to be strengthened in 30-39 and 50-59 age groups.

Colorectal cancer is a common tumor, and surgery is still one of the main treatment methods. Nowadays the research on surgical treatment of colorectal cancer is very mature, but that of predicting the possibilities of postoperative complications from preoperative and intraoperative status is scarce.

To investigate the predictive value of POSSUM system and aCCI index in postoperative complications after radical resection of colorectal cancer.

Retrospective analysis was performed on the clinical data of 118 patients performed colorectal cancer operation in the First Hospital of Hebei Medical University from June 2016 to September 2020. They were divided into complication group (n=42) and non-complication group (n=76) according to the incidence of postoperative complications. Spearman rank correlation was used to explore the relationship between postoperative complications after radical resection of colorectal cancer and clinical indicators. ROC curve was used to evaluate the predictive value of POSSUM system and aCCI index.

R1, R2, aCCI levels and blood loss in the complication group were higher than those in the non-complication group, while Z and preoperative Hb levels were lower than those in the non-complication group (P<0.05) . TNM staging ratois were compared in the two groups, and the difference was statistically significant (P<0.05) . R1, R2 and Z were predicted to be 0.065 (0.039, 0.131) , 0.349 (0.220, 0.585) and 0.775 (0.214, 0.901) within 30 days. 36.1% (42/118) developed postoperative complications within 30 days after operation, and 1.7% (2/118) died of anastomotic leakage. Postoperative complications were positively correlated with TNM stage and blood loss, and negatively correlated with preoperative Hb (P<0.05) . The area under ROC curve (AUC) of R1, R2 and aCCI indexes for predicting postoperative complications after radical resection of colorectal cancer were 0.727, 0.728 and 0.638, the optimal cut-off values were 0.114, 0.516 and 3.500, the sensitivities were 57.1%, 57.1% and 52.4% respectively, the specificity was 81.6%, 80.3% and 65.8% respectively.

Both POSSUM system and aCCI index have predictive value for the occurrence of complications after radical resection of colorectal cancer and can be used in clinical decision.

Worldwide, breast cancer has become the most common malignancy, and many breast cancer survivors struggle with psychological problems in treatment and recovery. The efficacy of mindfulness-based stress reduction (MBSR) in the psychological care of breast cancer patients has been confirmed in many systematic reviews (SRs) . However, due to inconsistent outcome measures used in various SRs, the review results cannot be directly applied to clinical practice.

To perform an overview of the SRs of the efficacy of MBSR in breast cancer patients, providing a reference for the making of psychological care interventions for these patients.

PubMed, Embase, Cochrane Library, Web of Science, CINAHL, PsycINFO, JBI, CNKI, Wanfang Data, and CBM were searched from inception to July 2022 for SRs of patients with breast cancer treated with MBSR. Literature screening and data extraction were performed by two researchers independently. Methodological quality was assessed using the AMSTAR 2. The standardization of reporting quality was assessed using the PRISMA checklist. Quality of evidence and strength of recommendations were assessed using the GRADE approach. The confidence of evidence from qualitative SRs was assessed using the CERQual.

Fourteen SRs were included. The methodological quality of included SRs was generally low, with only one being of high quality and two fatally missing key items. The defects in reporting quality were mainly in study protocol registration, risk of bias assessment and funding sources. Fifteen outcomes and 73 evidence bodies (0, 31, 28 and 6 were classified as high, moderate, low, and very low quality, respectively, by the GRADE approach, and the other 8 were classified as low quality by the CERQual approach) were identified in the SRs in total. MBSR could relieve anxiety, depression, fatigue, and stress in breast cancer patients to varying degrees, whose efficacy has proven to be significant in a short-term, but is uncertain in a long-term.

Generally, SRs on MBSR improving psychological condition in breast cancer patients contain unsatisfactory quality of evidence, whose methodological quality and standardization level of reporting quality still need to be improved further. Moreover, the shorter-term effect of MBSR has been confirmed, but its long-term effect is uncertain, and requires to be evaluated by more high-quality, large-sample clinical studies.

The overall incidence of breast cancer in Chinese women is on the rise, seriously threatening their physical and mental health. Breast cancer prevention and treatment behaviors are critical to the outcomes of affected women in the community. However, these behaviors vary across individuals. And measures should be explored to improve the efficacy of such behaviors.

To perform a latent class analysis of breast cancer prevention and treatment behaviors among community-living women, and to explore the associated factors, providing evidence for individualized prevention and management of female breast cancer in the community.

A total of 1 355 community-living women were selected from in 15 towns/subdistricts of 5 counties/districts in Yinchuan and Zhongwei cities of Ningxia, China by use of convenience sampling method from November 2019 to August 2020. They were surveyed using a questionnaire consisting of baseline characteristics, and breast cancer prevention and treatment behaviors (relevant questions used are belonging to the part of breast cancer prevention and treatment in the Knowledge, Attitude and Practice of Breast and Cervical Cancer Prevention and Treatment Among Women in Ningxia) . The latent classes of breast cancer prevention and treatment behaviors were presented, and their influencing factors were identified by multivariable logistic regression analysis.

The survey achieved a response rate of 97.93% (1 327/1 355) .By use of latent class analysis, breast cancer prevention and treatment behaviors of the respondents were classified into four latent classes, including positive prevention and treatment (n=522, 39.34%) , high-risk behaviors plus positive treatment (n=449, 33.83%) , high-risk behaviors plus negative treatment (n=229, 17.26%) , and general prevention and treatment (n=127, 9.57%) . The overall median score of breast cancer prevention and treatment behaviors was 9.00 (7.00, 11.00) points for all respondents. The median score of breast cancer prevention and treatment behaviors was 11.00 (11.00, 12.00) points for respondents with positive prevention and treatment behaviors, 9.00 (8.00, 10.00) points for those with high-risk behaviors plus positive treatment behaviors, 6.00 (5.00, 6.00) points for those with high-risk behaviors plus negative treatment behaviors, and 8.00 (6.00, 9.00) points for those with general prevention and treatment behaviors, with significant difference across the groups (H=1 008.493, P<0.001) . Multivariable Logistic regression analysis showed that, compared with general prevention and treatment behaviors, living in Zhongwei and having a history of childbirth were associated with increased possibility of being classified into positive prevention and treatment behaviors, having health insurance〔urban resident basic medical insurance (URBMI) , commercial health insurance, or other types〕, self-pay treatment, and a history of hormone replacement therapy were associated with increased possibility of being classified into general prevention and treatment behaviors (P<0.05) , having a history of childbirth were associated with increased possibility of being classified into high-risk behaviors plus positive treatment behaviors, having health insurance (URBMI or commercial health insurance) , as well as a history of hormone replacement therapy were associated with increased possibility of being classified into general prevention and treatment behaviors (P<0.05) , and primary education or below, household monthly income per person of 1 000-2 999 yuan were associated with increased possibility of being classified into high-risk behaviors plus negative treatment behaviors, and having URBMI were associated with increased possibility of being classified into general prevention and treatment behaviors (P<0.05) .

In general, breast cancer prevention and treatment behaviors in this group could be definitely classified, all being performed at a moderate level. To improve the level of breast cancer prevention and treatment behaviors of Ningxia's community-living women, focus should be on those who have high-risk behaviors and negatively seek for treatment. Moreover, the problems in positive breast cancer prevention and treatment behaviors in women with other three classes of behaviors should also be intervened and corrected to improve the outcomes of them.

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.

Preoperative frailty is a severely unhealthy status that reflects the reduction of overall physiological reserve, which is highly prevalent in elderly patients with gastric cancer. Understanding the perceived influencing factors of preoperative frailty can provide an important basis for developing individualized intervention plans.

To perform a qualitative descriptive study to identity the perceived influencing factors of preoperative frailty among elderly gastric cancer patients using the theory of health ecology.

A qualitative descriptive study was conducted based on health ecology theory. Purposive sampling method was used to select 29 frail elderly patients who would undergo gastric cancer surgery in the First Affiliated Hospital with Nanjing Medical University from February to June 2021 for semi-structured interview. Directed content analysis was used for data analysis.

Five themes and thirteen sub-themes were extracted: physiological traits, including accumulated aging-related losses, obvious gastrointestinal symptoms, and successive attacks of multiple diseases; behavioral characteristics, including lack of exercise behavior and overexertion; interpersonal networks, including insufficient peer social interaction, lack of parent-child interaction, and lack of communication and self-disclosure between couples; living and working conditions, including heavy individual financial burden, heavy unplanned family care tasks, insufficient information resources for health and disease management; macro factors, including limited medical services and medical insurance support.

This study described the effects of different perceived factors on preoperative frailty among elderly gastric cancer patients from the perspective of health ecology. Medical workers should formulate and implement systematic prehabilitation programs based on the above factors to improve the patients' preoperative anti-stress capacity and postoperative outcomes.

In China, elderly patients with non-small cell lung cancer (NSCLC) accounts for the highest percentage of lung cancer patients, and most of them are found to have no surgical possibilities at the time of diagnosis. Moreover, these patients are increasing as aging advances. Increasing their survival rate will help to reduce the overall mortality of lung cancer patients. So identifying effective prognostic indicators in NSCLC patients with non-surgical treatment is of great significance in prognostic stratification, which also contributes to clinical studies aiming at improving the survival rate of such patients via prognostic stratification-based treatments.

To investigate the relationship between systemic immune-inflammatory-nutritional index (SIINI) and survival in non-surgically treated elderly patients with NSCLC.

Patients (n=231, ≥65 years old) with first treatment for NSCLC were retrospectively recruited from Hebei General Hospital from January 1, 2014 to June 30, 2018. Clinical characteristics were collected, mainly including age, sex, prevalence of smoking, baseline diseases, BMI, pathology, differentiation, and clinical stage of NSCLC. Some calculated data based on baseline routine blood test parameters, and/or serum albumin, and/or BMI using different approaches were also collected, including neutrophil to lymphocyte ratio (NLR) , derived NLR (dNLR) , platelet to lymphocyte ratio (PLR) , prognostic nutrition index (PNI) , systemic immune-inflammation index (SII) , advanced lung cancer inflammatory index (ALI) and SIINI 〔using a formula proposed in clinical retrospective studies, in which all variables are measured before treatment: (neutrophil count×platelet count×hemoglobin level) / (lymphocyte count×BMI×serum albumin level) 〕. Post-treatment follow-up was conducted till February 1, 2020 through outpatient reexamination, telephone or text messages with death as the endpoint. For assessing prognostic values of NLR, dNLR, PLR, PNI, SII, ALI and SIINI, ROC analysis was performed with defined optimal cut-off value and the area under the curve (AUC) for each indicator (if the AUC value is less than 0.5, then the optimal cut-off value is defined using the median value, by which the AUC value is defined as large or small when it is greater or less than the value) . The survival curves were comparatively analyzed by different patient characteristics. Cox regression analysis was applied to identify the influencing factors of survival. The survival rate curve was visualized using GraphPad Prism 8.0.2.

The optimal cut-off values using NLR, dNLR, PLR, PNI, SII, ALI and SIINI in assessing the prognosis were 3.30, 2.51, 179.99, 273.65, 736.54, 46.05 and 102.89, respectively. The survival curves varied significantly by age, sex, prevalence of smoking, pathology, differentiation, and clinical stage of NSCLC, NLR, dNLR, PLR, ALI, SII, PNI and SIINI (P<0.05) . Further analysis indicated that the difference between the survival curves of 65-70-year-olds and 76-and-over-year-olds was statistically significant (P<0.05) . The survival curves between those with low or moderate differentiation and those with high differentiation were significantly different (P<0.05) . The survival curves of patients with stageⅠ NSCLC were different from those of patients with stage Ⅱ, Ⅲ or Ⅳ NSCLC (P<0.05) . Cox regression analysis revealed that ≥76 years old (P<0.001) , highly differentiated NSCLC (P<0.001) , stage Ⅲ NSCLC (P=0.012) and Ⅳ NSCLC (P<0.001) and SIINI (P=0.001) were prognostic factors of patients. Moreover, there existed significant differences in survival curves by NLR, dNLR, PLR, ALI, SII, PNI, and SIINI (P<0.05) .

We found that SIINI, a new indictor calculated based on immunity, inflammation and nutrition factors, is effective in predicting the overall survival in non-surgically treated elderly patients with NSCLC, and it may be superior to NLR, dNLR, PLR, PNI, SII, ALI in terms of survival prediction-related application and in-depth research.

The past nearly 20-year period has seen a sudden increase in the use of artificial intelligence (AI) in esophageal cancer research, and an emergence of many systematic reviews and meta-analyses of the research. However, most of the reviews and meta-analyses only address a single aspect in summary, making it difficult for researchers to gain a comprehensive understanding of the latest developments and research hotspots in the field.

To perform a bibliometric analysis of the use of AI in esophageal cancer research, and the development, hotspots and emerging trend in this field.

All literature in English regarding esophageal cancer research using AI included in the Science Citation Index Expanded database of the Web of Science Core Collection was searched from 2000-01-01 to 2022-04-06. Microsoft Excel 2019, CiteSpace (5.8R3-64bit) and VOSviewer (1.6.18) were used to analyze the literature for annual number of publications, country, author, institution, co-citation and keywords.

Nine hundred and eighteen studies were retrieved, with a total of 23 490 times of being cited. The number of studies published between 2000 and 2016 grew slowly (from 6 to 40), but increased rapidly between 2017 and 2022 (from 62 to 216). Sixty countries, 118 institutions and 5 979 authors were involved in the studies. China (306 articles), the United States (238 articles) and the United Kingdom (113 articles) ranked the top three in terms of number of studies published. The top three institutions in terms of intensity of cooperation were University of Amsterdam (TLS=72), Catherine Hospital (TLS=64) and Eindhoven University of Technology (TLS=53). The top three authors in terms of number of publications were Jacques J G H M Bergman from the Netherlands (n=16), Tomohiro Tada from Japan (n=12), and Fons Van Der Sommen from the Netherlands (n=12). There were 39 962 co-cited authors and 42 992 co-cited studies. Thirty-three burst keywords were identified: the major burst keywords were p53 and mutations in 2001-2008 (early stage), and were esophageal cancer classification, new examination techniques (tomography), differentiation, identification and comparison between esophageal cancer and other cancers in 2013-2018 (middle stage), and were deep learning, convolutional neural network, and machine learning in esophageal cancer examination and diagnosis applications in 2019-2022 (late stage). Among which deep learning had the highest burst intensity (burst intensity of 13.89) .

AI application in esophageal cancer research has entered a new phase, moving gradually from genes and mutations toward accurate examination, diagnosis, and treatment. The latest major burst keywords in recent years (2019-2022) are deep learning, convolutional neural network, and machine learning in esophageal cancer examination and diagnosis. The future challenges to the use of AI in esophageal cancer research may include individual data collection, data quality assurance, data processing specifications, AI code reproduction, and reliability assurance of AI-assisted diagnostic decision-making.