Cancer incidence, mortality, and burden in China: a time-trend analysis and comparison with the United States and United Kingdom based on the global epidemiological data released in 2020

Network analysis of fatigue symptoms in Chinese patients with advanced cancer

Objective

This study was aimed at investigating the network structures of fatigue symptoms in patients with advanced cancer, with a focus on identifying the central symptom-an aspect crucial for targeted and effective fatigue symptom management.

Methods

In this cross-sectional study, patients with advanced cancer were recruited from the cancer treatment center of a tertiary hospital in China between January and December of 2022. Symptom occurrence and severity were assessed with the Cancer Fatigue Scale. Network analysis was conducted to explore the network structure and identify the core fatigue symptoms.

Results

The study included 416 patients with advanced cancer. Lack of energy (2.25 ​± ​1.24), lack of interest in anything (2.20 ​± ​1.22), and lack of self-encouragement (2.03 ​± ​1.25) were the most severe fatigue symptoms and belonged to the affective fatigue dimension. In the overall network, reluctance (r s  ​= ​5.622), a heavy and tired body (r s  ​= ​5.424), and tiring easily (r s  ​= ​5.319) had the highest strength values. All these core symptoms were classified within the physical fatigue dimension and remained stable before and after adjustment for covariates.

Conclusions

This study identified reluctance, a heavy and tired body, and tiring easily as the core fatigue symptoms in patients with advanced cancer, thus providing valuable insight to help clinical nurses formulate more effective symptom management strategies. Future interventions could assess the efficacy of targeting the central symptom cluster in alleviating other symptoms and patient burden.

Global, regional and national burden of lung cancer attributable to occupational carcinogens, 1990-2019: A study of trends, inequalities and predictions based on GBD 2019

BACKGROUND

Lung cancer, a leading cause of cancer-related mortality, is significantly influenced by occupational carcinogens. This study aimed to assess and predict global, regional and national trends of lung cancer burden attributable to occupational carcinogens.

METHODS

Data on the lung cancer burden attributable to nine occupational carcinogens were obtained from the Global Burden of Disease Study 2019. Regions were categorized by the Socio-Demographic Index (SDI). Descriptive statistics, Joinpoint regression, and Age-Period-Cohort (APC) models were employed to analyze trends in mortality and Disability-Adjusted Life Years (DALYs). Using the Slope Index of Inequality and Concentration Index, health inequalities were quantified. The ARIMA-LSTM model was developed to predict the burden from 2020 to 2030.

RESULTS

From 1990-2019, lung cancer deaths and DALYs due to occupational carcinogens increased. Global age-standardized mortality (ASMR) and DALY (ASDR) rates declined, while middle and lower SDI regions increased. Joinpoint regression and APC analysis revealed that the local drift, period, and cohort effects exhibited increasingly unfavorable trends in lower SDI regions, while they were decreasing trends in higher SDI regions. Conversely, age effects increased similarly across all SDI regions. Health inequalities worsened over time. The ARIMA-LSTM model demonstrated global ASMR and ASDR would decrease, while low-middle and low SDI regions were expected to experience substantial increases from 2020 to 2030.

CONCLUSION

Health inequality of lung cancer burden attributable to occupational carcinogens remained a critical concern, underscoring the urgent need for targeted occupational health policies for low and low-middle SDI regions.

Model of predicting fear of cancer recurrence in patients with digestive tract cancer: A cross-sectional study

AIMS

To investigate the incidence of fear of cancer recurrence in patients with digestive tract cancers analyse its influencing factors, and further establish a visual risk prediction model.

DESIGN

A cross-sectional study.

METHODS

A cross-sectional survey was conducted among 570 patients with digestive tract tumours admitted to a local hospital, from May 2023 to December 2023 by convenient sampling method. Univariate analysis and logistic analysis were performed on the influencing factors, and the risk prediction nomogram model of fear of cancer recurrence in patients with digestive tract cancer was constructed by using R 4.1.3 software. ROC curve was used to evaluate the differentiation of the nomogram model. The calibration curve and Hosmer-Lemeshow goodness of fit test were used to evaluate the consistency of the model. This study was reported using the TRIPOD checklist.

RESULTS

In this study, 272 (47.7%) patients developed fear of recurrence. The risk prediction model of recurrence fear column chart for digestive tract cancer patients incorporated six variables of gender, therapy, alimentary tract haemorrhage, pain, depression and social support. The C-statistic was (.976), and the calibration curve showed that the predicted probability was more in line with the actual probability of occurrence, and the decision curve showed that the predictive model had better practicality.

CONCLUSION

The column-line diagram prediction model constructed in this study is effective and facilitates timely intervention and management by healthcare professionals based on their risk factors.

IMPACT

Nomogram is helpful to calculate the risk probability of FCR in patients with digestive tract cancer, identify FCR patients in time, and formulate comprehensive and personalized countermeasures, to provide a good quality of life and prolong the survival cycle of patients with digestive tract cancer.

PATIENT OR PUBLIC CONTRIBUTION

Participants were hospitalized patients or patients with digestive tract cancer undergoing follow-up. First of all, before the investigation and research, a team is formed to discuss the concept, research purpose, method, significance, etc., and determine the research tools. Second, by reasonably explaining the study to patients to seek informed consent from the patient and sign it, patients filled in the questionnaire independently. For patients with low education levels who could not fill in the questionnaire, the team members made objective explanations to help them choose reasonable options.

The Burden of Severe Periodontitis in China From 1990 to 2021, With Projections to 2050: A Comprehensive Analysis From The Global Burden of Disease Study 2021

BACKGROUND

The study aims to explore the epidemiologic information related to severe periodontitis in China.

METHODS

We analyzed data from the Global Burden of Disease (GBD) 2021 study to delineate the incidence, prevalence, and disability-adjusted life years (DALYs) attributable to severe periodontitis in China, stratified by age and gender. A range of analytical methods, including comparative analysis, trend analysis, decomposition analysis, hierarchical cluster analysis, health inequality analysis, and predictive modeling, were employed to provide a comprehensive evaluation of the disease burden.

RESULTS

The GBD 2021 estimated the annual age-standardized prevalence, incidence and DALYs of severe periodontitis in China to be 0.97% (95% CI: 0.83, 1.10), 10.80% (95% CI: 8.88, 12.78), and 70.15 per 100,000 (95% CI, 27.97, 144.15), respectively. The burden was higher in males than in females, with a marked increase observed in middle-aged and elderly populations. Trend analysis revealed a general rise in the burden of severe periodontitis in China over time. Decomposition analysis identified population growth and aging as the principal drivers of the increase in disease burden. Health inequality analysis indicated a growing disparity related to the Socio-Demographic Index (SDI), with a disproportionate burden concentrated in regions with higher SDI. Projections suggest that the burden of severe periodontitis in China will remain substantial from 2022 through 2050.

CONCLUSION

Future public health initiatives should prioritize enhancing the management of middle-aged and elderly populations, while simultaneously advancing public health systems in tandem with economic growth. These efforts are critical to effectively addressing the challenges posed by population growth and aging.

Unveiling the functions of five recently characterized lncRNAs in cancer progression

Numerous studies over the past few decades have shown that RNAs are multifaceted, multifunctional regulators of most cellular processes, contrary to the initial belief that they only act as mediators for translating DNA into proteins. LncRNAs, which refer to transcripts longer than 200nt and lack the ability to code for proteins, have recently been identified as central regulators of a variety of biochemical and cellular processes, particularly cancer. When they are abnormally expressed, they are closely associated with tumor occurrence, metastasis, and tumor staging. Therefore, through searches on Google Scholar, PubMed, and CNKI, we identified five five recently characterized lncRNAs-Lnc-SLC2A12-10:1, LncRNA BCRT1, lncRNA IGFBP4-1, LncRNA PCNAP1, and LncRNA CDC6-that have been linked to the promotion of cancer cell proliferation, invasion, and metastasis. Consequently, this review encapsulates the existing research and molecular underpinnings of these five newly identified lncRNAs across various types of cancer. It suggests that these novel lncRNAs hold potential as independent biomarkers for clinical diagnosis and prognosis, as well as candidates for therapeutic intervention. In parallel, we discuss the challenges inherent in the research on these five newly discovered lncRNAs and look forward to the avenues for future exploration in this field.

HER2 regulates autophagy and promotes migration in gastric cancer cells through the cGAS-STING pathway

In gastric cancer, the relationship between human epidermal growth factor receptor 2 (HER2), the cyclic GMP-AMP synthase-stimulator of the interferon genes (cGAS-STING) pathway, and autophagy remains unclear. This study examines whether HER2 regulates autophagy in gastric cancer cells via the cGAS-STING signaling pathway, influencing key processes such as cell proliferation and migration. Understanding this relationship could uncover new molecular targets for diagnosis and treatment. Through lentiviral transfection, cell counting kit-8 assays, colony formation, transwell migration, scratch assays, and siRNA, we found that HER2 overexpression suppresses the cGAS-STING pathway, inhibits autophagy, and enhances the migratory ability of gastric cancer cells. In contrast, HER2 knockdown activates the cGAS-STING pathway, promotes autophagy, and reduces cell migration. We further observed that the inhibition of autophagy using chloroquine (CQ) increases the migration ability of HER2-overexpressing cells. Moreover, interfering with STING expression reversed the migration defects caused by HER2 knockdown, underscoring the critical role of the cGAS-STING pathway in HER2-regulated cell migration. We also revealed that high STING expression in gastric cancer is significantly associated with poor prognosis. STING expression was identified as an independent prognostic factor for survival (hazard ratio, 1.942; 95% confidence interval, 1.06-3.54; P = 0.031). These results highlight the importance of HER2-driven regulation of autophagy through the cGAS-STING pathway in gastric cancer progression and its potential as a therapeutic target.

Enhanced ZBTB10 expression induced by betulinic acid inhibits gastric cancer progression by inactivating the ARRDC3/ITGB4/PI3K/AKT pathway

BACKGROUND

Gastric cancer (GC) ranks as the fourth leading cause of cancer-related deaths worldwide, with most patients diagnosed at advanced stages due to the absence of reliable early detection biomarkers.

METHODS

RNA-sequencing was conducted to identify the differentially expressed genes between GC tissues and adjacent normal tissues. CCK8, EdU, colony formation, transwell, flow cytometry and xenograft assays were adopted to explore the biological function of ZBTB10 and betulinic acid (BA) in GC progression. RNA-sequencing and phospho-proteomic profiling were performed to analyze the signaling pathways associated with ZBTB10-inhibiting GC progression. Chromatin immunoprecipitation, Co-immunoprecipitation and luciferase reporter assay were employed to elucidate the potential molecular regulatory mechanisms of ZBTB10 in GC.

RESULTS

ZBTB10 was one of the most significantly downregulated genes in GC tissues, and higher expression levels of ZBTB10 was correlated with better prognosis in patients with GC. Functional studies revealed that ZBTB10 overexpression and BA inhibited GC progression both in vitro and in vivo. Mechanistically, ZBTB10 enhanced ARRDC3 expression by binding to a specific response element in the ARRDC3 promoter region. Elevated ARRDC3 then directly interacted with β-4 integrin (ITGB4), leading to its ubiquitination and degradation. This cascade ultimately resulted in the downregulation of PI3K and AKT phosphorylation level. Moreover, ZBTB10 was a key target for BA in GC and BA inhibited GC progression through regulating the ZBTB10/ARRDC3/ITGB4/PI3K/AKT axis.

CONCLUSIONS

Our findings reveal that BA holds promise as an effective therapeutic strategy for GC, and the ZBTB10/ARRDC3/ITGB4/PI3K/AKT axis may serve as a novel diagnostic and therapeutic target.

What are the problems and suggestions related to cancer health education in Sichuan, China? A qualitative study of community health workers (CHWs)

BACKGROUND

Health education conducted by community health workers (CHWs) is an evidence-based strategy for promoting cancer prevention, cancer screening, and adherence to medical guidance from doctors. However, CHWs are confronted with some problems related to cancer health education in China. This study aimed to clarify CHWs' awareness of problems in cancer health education in China and the solutions that they were considering to improve the quality and efficiency of cancer health education.

METHODS

A qualitative descriptive design with purposive sampling was applied in eight primary health care sectors in Guangyuan and Chengdu in Sichuan, China. Face-to-face, in-depth, semistructured interviews were conducted, and a total of 60 CHWs were interviewed. The interviews were transcribed verbatim and imported into Nvivo12.0. Thematic analysis using the constant comparative method was used to analyze the data.

RESULTS

Uncooperative inhabitants, poor organization, low-frequency provision, and inadequate training for CHWs were problems related to cancer health education provided by CHWs in China. CHWs proposed some suggestions to improve the accessibility and acceptability of cancer health education, including combining online and offline education, health education after screening, cancer plus others, health education in the workplace, and volunteer recruitment.

CONCLUSIONS

Both the problems and suggestions described in this study may provide evidence for cancer health education and policy-making related to cancer prevention and control in China.

Utility of 131I-HLX58-Der for the Precision Treatment: Evaluation of a Preclinical Radio-Antibody-Drug-Conjugate Approach in Mouse Models

Purpose

None of the antibody-drug conjugates (ADCs) targeting Claudin 18.2 (CLDN18.2) have received approval from regulatory authorities due to their limited clinical benefits. Leveraging the radiosensitizing ability of Deruxtecan (DXd) and the internal radiation therapy of 131I for tumors, we aimed to develop the first radio-antibody-drug conjugates (RADCs) for the treatment of gastric cancer.

Methods

The CLDN18.2-specific antibody HLX58 was conjugated with the payload DXd through a cleavable maleimide glycynglycyn-phenylalanyn-glycyn (GGFG) peptide linker. HLX58-Der was labeled with 131I to produce RADC-131I-HLX58-Der. HLX58 was labeled with 125I for imaging CLDN18.2-positive tumors, providing a reference for RADC treatment in solid tumors. The antigen-binding properties and biodistribution of the RADC were studied both in vitro and in vivo. The cytotoxic effects of the RADC were evaluated in CLDN18.2-positive tumor cell lines and xenografts.

Results

HLX58 was successfully conjugated with DXd using the cleavable maleimide GGFG peptide linker and labeled with 131I to produce RADC-131I-HLX58-Der. HLX58 was labeled with 125I for imaging CLDN18.2-positive tumors. Both 125I-HLX58 and 131I-HLX58-Der exhibited significant binding affinity for the CLDN18.2-positive cancer cell line. The cytotoxic effect of 131I-HLX58-Der was observed in the CLDN18.2-positive cell line, with an IC50 of 11.28 ng/mL. In terms of cytotoxicity, 131I-HLX58-Der exhibited greater activity compared to HLX58-Der. 125I-HLX58 and 131I-HLX58-Der demonstrated similar biodistribution profiles in CLDN18.2-positive tumor models, achieving 5.72 ± 0.41%ID/g (48 h) and 5.83 ± 0.41%ID/g (72 h) in the tumor tissues postinjection, respectively. The average tumor size in groups treated with 131I-HLX58-Der and HLX58-Der was reduced by factors of 12.15 and 4.80, respectively, compared to the control group. 131I-HLX58-Der demonstrated no toxic effects on hepatorenal function, routine blood tests, or major organs in mice when compared to the control group.

Conclusion

These findings validate the potential of RADCs targeting CLDN18.2 in treating CLDN18.2-expressing solid tumors.

KHSRP promotes cancer stem cell maintenance, tumorigenesis, and suppresses anti-tumor immunity in gastric cancer

Objectives

KH-type splicing regulatory protein (KHSRP) is an RNA-binding protein involved in several cellular processes, including nuclear splicing, mRNA localization, and cytoplasmic degradation. While KHSRP's role has been studied in other cancers, its specific involvement in gastric cancer remains poorly understood. This study aims to explore KHSRP expression in gastric cancer and its potential effects on tumor progression and immune response.

Methods

KHSRP expression in gastric cancer tissues and normal tissues was analyzed using data from The Cancer Genome Atlas (TCGA) database. The correlation between KHSRP expression, patient survival, and immune response was also assessed. Immunohistochemistry was performed to evaluate KHSRP expression in gastric cancer tissues. Gain- and loss-of-function experiments were conducted to assess KHSRP's effects on gastric cancer cell proliferation, stemness, and migration. Furthermore, the impact of KHSRP silencing on tumor volume and immune cell infiltration was evaluated in a C3H/He mouse xenograft model.

Results

KHSRP was found to be overexpressed in gastric cancer tissues compared to normal tissues, with a positive correlation to tumor stage and a negative correlation with patient prognosis. Functional assays revealed that KHSRP promotes gastric cancer cell proliferation, enhances cancer stem cell properties, and increases migratory capabilities in vitro. In vivo, KHSRP silencing led to a significant reduction in tumor volume and increased immune cell infiltration in the mouse xenograft model.

Conclusions

KHSRP acts as an oncogene in gastric cancer by promoting tumorigenesis and suppressing anti-tumor immune responses. Its overexpression is associated with poor prognosis, making KHSRP a potential prognostic marker and therapeutic target in gastric cancer.

Reviewing the path to balance: mechanisms and management of hypertension associated with targeting vascular endothelium in cancer therapy

Contemporary anticancer drugs are often accompanied by varying degrees of cardiovascular toxicity, with hypertension emerging as one of the most prevalent side effects, particularly linked to inhibitors of vascular endothelial growth factor receptor (VEGFR) and tyrosine kinase inhibitors (TKIs). Hypertension induced by cancer therapies contributes to increased cardiovascular mortality in cancer patients and survivors. Given the shared common risk factors and overlapping pathophysiological mechanisms, hypertension is also a prevalent comorbidity in this patient population. The mechanisms underlying hypertension induced by therapies targeting the vascular endothelial growth factor (VEGF) signaling pathway primarily involve reduced nitric oxide (NO) synthesis, increased endothelin-1 (ET-1) production, oxidative stress, microvascular rarefaction and dysfunction, decreased natriuresis, activation of the renin-angiotensin system (RAS), and partial endothelial cell death. Research into hypertension associated with therapies targeting the VEGF signaling pathway (VSP) could facilitate the optimization of cancer treatments, improve the evaluation and management of hypertension during targeted therapy, and help to reduce cardiovascular event rates and overall patient mortality. This review aims to provide a comprehensive summary of the current advancements in this area.

Prevalence of Insomnia and Related Factors Among Cancer Outpatients in China

Background

The incidence of insomnia in cancer patients is significantly higher than in the general population. Chronic insomnia imposes pronounced physical and psychological burdens on cancer patients, affecting their quality of life and survival rate. This study aims to investigate insomnia in cancer patients and further analyze potentially related factors.

Methods

Oncology outpatients treated at Fudan University Shanghai Cancer Center were consecutively recruited. Demographic information and clinical features, such as type of cancer and treatment status, were collected. Insomnia was assessed using the Insomnia Severity Index (ISI).

Results

A total of 146 patients participated in the study, with the majority suffering from breast tumors (40.4%), gastrointestinal tract tumors (18.5%), and endocrine tumors (5.8%). Among these patients, 25 (17.1%) did not report insomnia, 69 (47.3%) had subclinical insomnia, and 52 (35.6%) reached the level of clinical insomnia. Older patients aged 41-50 years (Estimate = -3.49, 95% CI, -6.99 to 0.00, p = 0.05) and those with higher education levels (Estimate = -2.72, 95% CI, -4.88 to -0.55, p = 0.01) were less likely to have higher ISI total scores. In contrast, undergoing chemotherapy (Estimate = 3.86, 95% CI, 0.53 to 7.19, p = 0.02) was associated with higher ISI total scores. Gender, age, education, treatment modalities correlated with ISI subitem scores.

Conclusion

The prevalence of insomnia is higher in oncology patients and is associated with gender, age, education, tumor type, and treatment modality. Screening and interventions for insomnia should be emphasized in the whole-course management of oncology patients.

Modulating Treg cell activity in prostate cancer via chitosan nanoparticles loaded with si-BATF/PRDM1

Prostate cancer is a significant health issue, with regulatory T (Treg) cells playing a crucial role in its progression. This study explores the potential of chitosan-modified magnetic nanoparticles loaded with si-BATF/PRDM1 to target Treg cell activity in impeding prostate cancer development. By understanding the function of BATF and PRDM1 in Treg cells, the research demonstrates their central involvement in prostate cancer progression. Through experiments in vitro and in vivo, including single-cell sequencing and gene silencing assays, chitosan nanoparticles efficiently deliver siRNA, inhibiting BATF and PRDM1 expression. This inhibition leads to suppressed tumor growth and metastasis in prostate cancer models. The findings highlight the promise of nanoparticle-based approaches in modulating Treg cell activity for prostate cancer therapy, offering a potential avenue for precision medicine interventions in combating this prevalent malignancy.

Lovastatin-mediated pharmacological inhibition of Formin protein DIAPH1 suppresses tumor immune escape and boosts immunotherapy response

BACKGROUND

The immunosuppressive tumor microenvironment (TME) is a key characteristic of human cancer. Immunotherapy has emerged as a promising treatment strategy to overcome immune escape and has gained widespread use in recent years. In particular, the blockade of PD-1/PD-L1 interaction holds significant importance in oncotherapy. Combining anti-PD-1/PD-L1 with small molecule inhibitors targeting key pathways represents an emerging trend in therapeutic development.

METHODS

To validate our findings biologically, we employed qRT-PCR or Western blotting and immunofluorescence staining techniques to assess the expression levels of DIAPH1 and PD-L1 in cells. Additionally, CCK8 and clone formation assays were utilized to evaluate cell proliferation ability, while flow assays were conducted to detect apoptosis in T cells.

RESULTS

Knockdown of DIAPH1 restored the tumor-killing capacity of T cells, effectively suppressing tumor immune escape. We observed a highly positive correlation between the expression levels of DIAPH1 and 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR), which can be competitively inhibited by lovastatin. Through Sybyl analysis followed by confirmation via micro scale thermophoresis, we identified lovastatin as a potential inhibitor targeting DIAPH1. Lovastatin downregulated DIAPH1 expression both in tumor cell lines and xenograft lung cancer tissues within a mouse lung cancer model. Furthermore, we found that lovastatin degraded DIAPH1 through lysosomal degradation pathway. Treatment with lovastatin was strongly associated with improved response rates and prolonged overall survival among patients with lung adenocarcinoma. Finally, overexpression of DIAPH1 reversed the inhibitory effects mediated by lovastatin on tumor development.

CONCLUSIONS

Lovastatin downregulates PD-L1 expression by targeting DIAPH1 and restores the tumor-killing ability of T cells to block tumor immune escape. Lovastatin may become a potential drug for cancer patients to enhance immunotherapy response in the clinic.

Global temporal trends and projections of hepatitis B-related cirrhosis among adolescents and young adults from 1990 to 2035: an analysis based on the global burden of disease study 2021

Background

Chronic hepatitis B and cirrhosis pose significant global health threats. Few studies have explored the disease burden and mortality trend of cirrhosis caused by hepatitis B virus infection among adolescents and young adults (AYAs, aged 15-39 years). This study aimed to assess the disease burden and trends.

Methods

Publicly available data were obtained from the 2021 GBD database. The rates of incidence, mortality, and disability-adjusted life years were calculated at the global, regional, and national levels. Temporal trends were assessed using joinpoint regression analysis, while the Bayesian age-period-cohort model was used to predict future trends.

Results

From 1990 to 2021, the global incidence rate of hepatitis B-related cirrhosis decreased from 111.33 (95% uncertainty interval: 89.18 to 134.98) to 67.75 (54.06 to 82.71) per 100,000 with an average annual percentage change of -1.58 (95% confidence interval: -1.66 to -1.51, p < 0.001). However, between 1990 and 2021, the incidence numbers in the 30-34 and 35-39 age groups increased by 23.75 and 21.24%, respectively. The number of deaths in low and low-middle Socio-demographic Index (SDI) areas increased by 79.51 and 20.62%, respectively. Moreover, it is predicted that the numbers of incidences and deaths will continue to rise in areas with low SDI. At the regional level, Central Sub-Saharan Africa had the highest incidence and mortality rates. In 2021, Somalia and the Democratic Republic of Congo had the highest incidence rates, whereas Kiribati and Cambodia had the highest mortality rates.

Conclusion

The overall burden of hepatitis B-related cirrhosis among AYAs has decreased over the past three decades. Nevertheless, there was a slight increase in the incidence number among individuals aged 30-39 years. The substantial burden and predicted rise in the numbers of incidences and deaths in low SDI areas underscore the need for sustained and targeted public health interventions.

Analysis and comparison of the trends in burden of spinal cord injury in China and worldwide from 1990 to 2021: an analysis of the global burden of disease study 2021

Background

Spinal cord injury (SCI) is a globally prevalent neurological condition, often resulting in motor, sensory, and autonomic dysfunctions that lead to permanent disability. However, outdated epidemiological data hinder the development and implementation of effective public health policies. This study aimed to examine and compare trends in the burden of spinal cord injury-specifically incidence, prevalence, and years lived with disability (YLD)-in China and worldwide from 1990 to 2021, and to project these trends over the next 15 years.

Methods

This study analyzed the characteristics of the SCI burden in China and globally, examining changes in incidence, prevalence, and years lived with disability (YLD) using open data from the Global Burden of Disease database covering 1990 to 2021. Additionally, Joinpoint and age-period-cohort (APC) analyses were conducted to provide insights into the epidemiological characteristics of the SCI burden. The autoregressive integrated moving average (ARIMA) model was then applied to project SCI trends for the next 15 years.

Results

In 2021, the prevalence and incidence of SCI in China reached 2,766,277 and 99,363 cases, respectively, marking increases of 63.27 and 43.27% since 1990. From 1990 to 2021, the age-standardized prevalence rate (ASPR) of SCI decreased significantly, with an estimated annual percentage change (EAPC) of -0.34 (95% CI: -0.60 to-0.07). At the gender level, SCI prevalence and incidence were higher in men than in women. Joinpoint analysis revealed a significant decrease in the APC of the age-standardized incidence rate (ASIR) from 1990 to 2011 (APC = -0.98, p < 0.05), followed by a notable increase from 2011 to 2021 (APC = 2.05, p < 0.05). For ASPR, a significant decrease occurred from 2001 to 2005 (APC = -4.80, p < 0.05), while subsequent periods showed an increasing trend, particularly between 2010 and 2018 (APC = 1.43, p < 0.05) and 2018-2021 (APC = 2.84, p < 0.05). In terms of age-standardized YLD rates (ASYR), China experienced an overall downward trend from 1990 to 2010 (APC = -0.56 for 1990-2001; -5.97 for 2001-2005; -1.01 for 2005-2010, p < 0.05), followed by a slight upward trend post-2010, with fluctuations from 2010 and 2018 (APC = 0.88) and 2018-2021 (APC = 2.49, p < 0.05). Age-period-cohort analysis showed that the risk of SCI incidence increased with age in China, though both period and cohort effects demonstrated a significant downward trend. Projections indicate that by 2036, the ASIR and ASPR for SCI in China will reach 6 and 146 cases per 100,000 people, respectively.

Conclusion

The number and burden of SCI in China and globally have increased in the past. Among them, men and older people are more likely to develop SCI than women and younger people. Although the ASPR and ASIR for SCI are predicted to show a downward trend over the next 15 years, policy makers should continue to consider interventions to minimize the risk.

Awareness of lung cancer among urban residents in Sichuan Province and its impact on their willingness to choose medical institutions for cancer screening

Introduction

This study aimed to investigate the current level of knowledge about lung cancer among urban residents in Sichuan Province and to assess its influence on their willingness to choose county-level or lower-level medical institutions for cancer screening.

Methods

A total of 31,184 urban residents of Sichuan Province were included in the cross-sectional study. Binary logistic regression and propensity score matching (PSM) were used to assess the influence effect.

Results

The results showed that (1) only 23.88% of the residents self-reported having good knowledge about lung cancer. They mainly acquired knowledge from the media (43%) and medical staff (42%). Only 33.5% of the participants had undergone lung cancer screening, with the main reasons being periodic physical examinations (54%) and physician recommendations (23%). (2) Binary logistic regression analysis revealed that knowledge of lung cancer was significantly associated with the participants' willingness to undergo lung cancer screening at county-level or lower-level medical institutions [OR = 1.185, 95% CI (1.113 -1.263), p < 0.001]. (3) Using PSM, it was found that the willingness of residents who had good knowledge of lung cancer-related topics increased by 2.8% after using kernel matching, by 3.1% after using one-to-one nearest neighbor matching, and by 2.4% after using radius matching with a caliper size of 0.001. (4) After stratifying by psychological status, we found that among residents with unstable psychological status, the willingness of those who had good knowledge of lung cancer increased by 5.3% after using kernel matching, by 3.6% after using one-to-one nearest neighbor matching, and by 4.9% after using radius matching with a caliper size of 0.001.

Discussion

Improving urban residents' understanding of the disease could help improve the current situation of hierarchical diagnosis and treatment.

Systematic review registration

https://www.crd.york.ac.uk/prospero/, identifier CRD42024556625.

Genomic, transcriptomic, and T cell receptor profiling in stratifying response to first-line chemoradiotherapy or radiotherapy for esophageal squamous cell carcinoma

Introduction

Esophageal squamous cell carcinoma (ESCC) accounts for 80% of esophageal cancer (EC) worldwide. The molecular characteristics of locally advanced ESCC have been extensively studied.

Methods

In this study, we investigate the genomic and transcriptomic characteristics and try to provide the basic T-cell receptors (TCRs) dynamics and its genomic and transcriptome association during the radiochemotherapy of ESCC using multi-omics analysis.

Results

A total of 23 patients with pathologic diagnoses of locally advanced ESCC were enrolled. The median tumor mutational burden (TMB) of the 23 ESCC patients were 3.47 mutations/ Mb (mega-base). The TP53, RTK/RAS, and NOTCH pathways were concurrently prevalent in ESCC. Besides, some less prevalent pathways, including WNT and HIPPO pathways also exhibited superior frequencies in ESCC. Meantime, we found the immune-hot tumor had higher immune infiltration scores. The median TMB in the progression-free survival (PFS) low group was significantly higher than that in the PFS-high group. The chromosomal copy number variation (CNV) burden of the neutrophil-to-lymphocyte ratio (NLR)-high group appeared to be higher than that of the NLR-low group, and the StromalScore in the NLR-low group was significantly higher. Clonality score was significantly increased from pre-treat to post-treat and from on-treat to post-treat. Shannon index was significantly decreased from pre-treat to post-treat and from on-treat to posttreat. Richness was significantly decreased from pre-treat to post-treat.

Discussion

Multiomics analysis provided the basic TCRs dynamics and their genomic and transcriptome association during the radio-chemotherapy of 23 locally advanced ESCC in China, and provided a valuable insights into the heterogeneity and the tumor microenvironment and treatment responses. Meantimes, the identification of biomarkers and the exploration of their association with treatment outcomes could have important implications for clinical practice.

Efficacy and safety of multi-target tyrosine kinase inhibitor AL2846 combined with gemcitabine in pancreatic cancer

Pancreatic cancer patients urgently need new treatments, and we explored the efficacy and safety of combination therapy with AL2846 and gemcitabine in pancreatic cancer patients. This was a single-arm, single-center, open-label phase I/IIa study (NCT06278493). The dose-escalation phase was designed to evaluate the maximum tolerated dose (MTD) of AL2846 combined with gemcitabine. One or two dose levels were chosen for the dose-expansion phase. Treatment continued until disease progression, intolerable toxicity, patient withdrawal, or at the investigators' discretion. The primary study endpoint is to evaluate the safety and MTD of AL2846 combined with gemcitabine. The secondary endpoints included objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and disease control rate (DCR). Between August 2018 and July 2021, 33 pancreatic cancer patients were enrolled in the study. A total of 15 patients were enrolled in the dose-escalation phase, and the MTD was not determined. Eventually 90 mg and 120 mg of AL2846 were chosen for the dose-expansion phase, in which 11 patients (90 mg) and 7 patients (120 mg) were administered. Treatment-related adverse events (TRAEs) of any grade were reported in 30 (90.91%) patients, and those of grade ≥ 3 were reported in 16 (48.48%) patients. The most frequently reported grade ≥ 3 TRAEs were thrombocytopenia (18.18%), neutropenia (12.12%), elevated γ-glutamyltransferase (6.06%), proteinuria (6.06%), and gastrointestinal hemorrhage (6.06%).The ORR was 6.06%, and the DCR was 72.73%. The median PFS was 3.71 months (95% CI: 3.38-4.11), and the median OS was 5.59 months (95% CI: 4.11-8.71). Gemcitabine and Al2846 combination therapy exhibited tolerable safety, but there was no improvement in efficacy over standard treatment. Further evaluation of this approach is still needed.

Burdens of Tracheal, Bronchus, and Lung Cancer From 1990 to 2021 in China Compared to the Global Projection of 2036: Findings From the 2021 Global Burden of Disease Study

BACKGROUND

Tracheal, bronchial, and lung cancers (TBL cancers) pose a significant global health challenge, with rising incidence and mortality rates, particularly in China. Studies from the Global Burden of Disease (GBD), 2021, can guide screening and prevention strategies for TBL cancer. This study aims to provide a comprehensive analysis of the burden of TBL cancers in China compared to global data.

METHODS

We conducted an analysis of incidence, prevalence, mortality, and disability-adjusted life years (DALYs) from 1990 to 2021. We also performed Joinpoint regression analysis and Bayesian age-period-cohort (BAPC) modeling to project future trends.

RESULTS

From 1990 to 2021, there was a substantial increase in TBL cancer indicators for all sexes in China, with the most significant rise observed in females. The female population showed alarming increases in age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR). While global efforts have managed to stabilize these rates, China's figures remain high, suggesting the impact of persistent risk factors such as smoking and air pollution, coupled with an aging population. Furthermore, we utilized the projection model in China to estimate that these indicators of TBL cancers in females will likely follow continuous and rapid upward trends, while the burden of TBL cancers among males is expected to have a steady trend.

CONCLUSION

Although global efforts have been effective in reducing the burden of TBL cancers over the past three decades, there still remains strong regional and gender heterogeneity. TBL cancers need more screening strategies and medical attention in China and in the female population.

The EORTC QLU-C10D distinguished better between cancer patients and the general population than PROPr and EQ-5D-5L in a cross-sectional study

OBJECTIVES

Health state utility (HSU) instruments for calculating quality-adjusted life years, such as the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Utility - Core 10 Dimensions (QLU-C10D), derived from the EORTC QLQ-30 questionnaire, the Patient-Reported Outcome Measurement Information System (PROMIS) preference score (PROPr), and the EuroQoL-5-Dimensions-5-Levels (EQ-5D-5L), yield different HSU values due to different modeling and different underlying descriptive scales. For example the QLU-C10D includes cancer-relevant dimensions such as nausea. This study aimed to investigate how these differences in descriptive scales contribute to differences in HSU scores by comparing scores of cancer patients receiving chemotherapy to those of the general population.

STUDY DESIGN AND SETTING

EORTC QLU-C10D, PROPr, and EQ-5D-5L scores were obtained for a convenience sample of 484 outpatients of the Department of Oncology, Charité - Universitätsmedizin Berlin, Germany. Convergent and known group's validity were assessed using Pearson's correlation and intraclass correlation coefficients (ICC). We assessed each descriptive dimension score's discriminatory power and compared them to those of the general population (n > 1000) using effect size (ES; Cohen's d) and area under the curve (AUC).

RESULTS

The mean scores of QLU-C10D (0.64; 95% CI 0.62-0.67), PROPr (0.38; 95% CI 0.36-0.40), and EQ-5D-5L (0.72; 95% CI 0.70-0.75) differed significantly, irrespective of sociodemographic factors, condition, or treatment. Conceptually similar descriptive scores as obtained from the HSU instruments showed varying degrees of discrimination in terms of ES and AUC between patients and the general population. The QLU-C10D and its dimensions showed the largest ES and AUC.

CONCLUSION

The QLU-C10D and its domains distinguished best between health states of the two populations, compared to the PROPr and EQ-5D-5L. As the EORTC Core Quality of Life Questionnaire (QLQ-C30) is widely used in clinical practice, its data are available for economic evaluation.

PLAIN LANGUAGE SUMMARY

The assessment of dimensions of health-related quality of life (HRQoL), such as physical functioning or depression, is important to cancer patients and physicians for treatment and side effect monitoring. Descriptive HRQoL is measured by patient-reported outcomes measures (PROM). The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire and the Patient-Reported Outcome Measurement Information System (PROMIS) are the most common PROM in the clinical HRQoL assessment. In recent years, multidimensional preference-based HRQoL measures were developed using these PROM as dimensions. These preference-based measures, also referred to as health state utility (HSU) scores, are needed for economic evaluations of treatments. The QLQ-C30's corresponding HSU score is the Quality of Life Utility measure-Core 10 Dimensions (QLU-C10D), and PROMIS' HSU score is the PROMIS preference score (PROPr). Both new HSU scores are frequently compared to the well-established EuroQoL-5-dimensions-5-levels (EQ-5D-5L). They all conceptualize HSU differently, as they assess different dimensions of HRQoL und use different models. Both the QLU-C10D and the PROPr have thus shown systematic differences to the EQ-5D-5L but these were largely consistent across the subgroups. Convergent and known groups validity can therefore be considered established. However, as HSU is a multidimensional construct, it remains unclear how differences in its dimensions, for example, its descriptive scales, contribute to differences in HSU scores. This is of importance as it is the descriptive scales that measure clinical HRQoL. We investigated this question by assessing each dimension's ability to distinguish between a sample of 484 cancer patients and the German general population. We could show that the ability to distinguish depended on the domain: for example, for depression, the QLU-C10D and EQ-5D-5L distinguished clearer, while for physical function, PROMIS did. Overall, the QLU-C10D and its dimensions distinguish best between cancer patients and general population.

MYST2 histone acetyltransferase promotes lung adenocarcinoma progression by regulating the p38 MAPK signaling pathway

BACKGROUND

Lung cancer, particularly lung adenocarcinoma, poses a significant health challenge due to its high incidence and mortality rates. Despite advancements in targeted therapies, treatment outcomes for lung adenocarcinoma remain unsatisfactory. This study explores the role of the histone acetyltransferase MYST2 in lung adenocarcinoma and its potential as a therapeutic target.

METHODS

An analysis using the TIMER 2.0 and TCGA databases was performed to compare the expression levels of MYST2 between lung adenocarcinoma tissues and normal tissues. Functional assays, including cell proliferation, migration, and invasion, were conducted to evaluate the effects of MYST2 overexpression and knockout in lung cancer cells. Co-immunoprecipitation and GST pull-down assays were utilized to identify interactions involving the MYST domain of MYST2 and p38, while also assessing the impact of MYST2 on the binding between MEK6 and p38.

RESULTS

The analysis revealed that MYST2 was significantly up-regulated in lung adenocarcinoma tissues compared to normal tissues and was associated with poor prognosis. Functional assays demonstrated that MYST2 overexpression promoted, whereas MYST2 knockout inhibited, lung cancer cell proliferation, migration, and invasion. Mechanistically, MYST2 enhanced the phosphorylation of p38 and ERK. Co-immunoprecipitation and GST pull-down assays identified the MYST domain of MYST2 as crucial for its interaction with p38. Additionally, MYST2 overexpression facilitated the binding of MEK6 to p38, indirectly influencing p38 activity.

CONCLUSION

These findings suggest that MYST2 acts as an oncogene in lung cancer by modulating p38 phosphorylation through the MYST domain, underscoring its potential as a prognostic marker and therapeutic target.

Spirituality and Factors Relevant to Spiritual Nursing-Care Needs Among Chinese Patients with Cancer

This study aimed to identify the factors associated with the spiritual nursing-care needs of adult Chinese cancer patients. A questionnaire survey was conducted and the 158 respondents in the total sample were classified into two groups based on the presence or absence of spiritual nursing-care needs. The group requiring spiritual nursing-care exhibited lower scores on the Meaning and Peace scales and higher scores on the Faith scale compared to the other group. The between-group difference was significant only in the case of Peace. The results indicated that the Peace score was the sole significant predictor of spiritual nursing-care needs (OR 0.83, 95% CI [0.74, 0.94]). These findings suggest that nurses should provide spiritual care to help foster Chinese patients' peace of mind.

Temporal trends in disability adjusted life year and mortality for colorectal cancer attributable to a high red meat diet in China from 1990 to 2021: an analysis of the global burden of disease study 2021

BACKGROUND

High red meat consumption is a main modifiable risk factor for colorectal cancer mortality (CRC), but its attributable disease burden remains unclear in China. We aimed to analyze the temporal trends in CRC deaths and disability-adjusted life years (DALYs) attributable to high red meat consumption in China from 1990 to 2021 and to predict the disease burden in the next 15 years.

METHODS

Data was obtained from the Global Burden of Disease (GBD) 2021 study. The Joinpoint regression model was used to calculate the annual percentage change (APC) and the average annual percentage change (AAPC). In addition, the age-period-cohort (APC) model was employed to explore the effects of age, period, and cohort on CRC mortality. The autoregressive integrated moving average (ARIMA) model was utilized to predict the disease burden in 2022-2036. We also compared the CRC burden attributed to high red meat in China with 204 countries worldwide.

RESULTS

The results showed that the number of CRC deaths in China due to high red meat consumption increased nearly 2.5 times, from 17,608 (95% UI: -3 to 36,613) in 1990 to 43,580 (95% UI: -16 to 92,083) in 2021. Male CRC deaths exhibited a more pronounced increase, rising from 9,800 in 1990 to 27,600 in 2021. Additionally, the number of DALYs increased from 518,213 (95% UI: -105,107 to 1,074,174) in 1990 to 1,091,788 (95% UI: -509 to 2,295,779) in 2021. Joinpoint regression analysis confirmed that the AAPC in ASDR and ASMR was - 0.20 (95% CI: -0.40 ∼ 0.00) and - 0.30 (95% CI: -0.40 ~ -0.10). When age, period, and cohort effects were examined as the reference group, the risk of CRC was found to increase with age. However, women experienced a marked decline in both period and cohort effects compared to men.

CONCLUSIONS

Compared to global levels, the burden in China is heavier. In terms of mortality or DALY standardized rates, Chinese women show a similar downward trend to the overall trend, while Chinese men show a striking upward trend. This study provides valuable insights into enhancing CRC prevention and improving dietary patterns in China.

Recent advances of photodiagnosis and treatment for head and neck squamous cell carcinoma

Head and neck squamous cell carcinoma (HNSCC) are the most common type of head and neck tumor that severely threatens human health due to its highly aggressive nature and susceptibility to distant metastasis. The diagnosis of HNSCC currently relies on biopsy and histopathological examination of suspicious lesions. However, the early mucosal changes are subtle and difficult to detect by conventional oral examination. As for treatment, surgery is still the primary treatment modality. Due to the complex anatomy and the lack of intraoperative modalities to accurately determine the incision margins, surgeons are in a dilemma between extensive tumor removal and improving the quality of patient survival. As more knowledge is gained about HNSCC, the increasing recognition of the value of optical imaging has been emphasized. Optical technology offers distinctive possibilities for early preoperative diagnosis, intraoperative real-time visualization of tumor margins, sentinel lymph node biopsies, phototherapy. Fluorescence imaging, narrow-band imaging, Raman spectroscopy, optical coherence tomography, hyperspectral imaging, and photoacoustic imaging have been reported for imaging HNSCC. This article provides a comprehensive overview of the fundamental principles and clinical applications of optical imaging in the diagnosis and treatment of HNSCC, focusing on identifying its strengths and limitations to facilitate advancements in this field.

Research Progress of Buyang Yiwei Decoction in Regulating Intestinal Flora for Gastric Cancer

Intestinal flora is a complex micro-ecosystem in human body, which is called the second genome of human body. Intestinal flora imbalance plays an important role in the occurrence and development of gastric cancer through circulation, metabolism and immunity. Gastric cancer is associated with dysbacteriosis. Traditional Chinese medicine (TCM) compounds in Buyang Yiwei Decoction can reduce the clinical signs and symptoms of gastric cancer by regulating intestinal microbiota, alleviate the adverse reactions of gastric cancer after radiotherapy and chemotherapy, and improve the quality of life of patients. This article reviews whether Buyang Yiwei Decoction can reduce the risk of gastric cancer or play a therapeutic role in gastric cancer by improving the intestinal microbiota.

Comparative analysis of cancer statistics in China and the United States in 2024

BACKGROUND

Cancer patterns in China are becoming similar to those in the United States (US). Comparing the recent cancer profiles, trends, and determinants in China and the US can provide useful reference data.

METHODS

This study used open-source data. We used GLOBOCAN 2022 cancer estimates and United Nations population estimates to calculate cancer cases and deaths in both countries during 2024. Data on cancer incidence and mortality trends were obtained from the Surveillance, Epidemiology, and End Results (SEER) program and National Centre for Health Statistics in the US and cancer registry reports of the National Cancer Center (NCC) of China. Data from the Global Burden of Disease study (GBD) and a decomposition approach were used to estimate the contributions of four determinants to the change in cancer deaths.

RESULTS

In 2024, there are an estimated 3,246,625 and 2,510,597 new cancer cases and 1,699,066 and 640,038 cancer deaths in China and the US, respectively. The highest estimated cancer cases are lung cancer in China and breast cancer in the US. The age-standardized incidence rates of lung and colorectal cancer in the US, and stomach, liver, and esophageal cancer in China have decreased, but the incidence rates of liver cancer in the US and colorectal cancer, prostate cancer in men, and cervical cancer in women in China have increased. Increases in the adult population size and population aging are main reasons for the increase in cancer deaths; case fatality rates are a main reason for the decrease in cancer deaths in both countries.

CONCLUSIONS

China has made progress in cancer control but lags the US. Considering the transformation in China's pattern of cancers epidemiology, it is imperative to develop stronger policies by adopting the cancer prevention and control strategies used in the US to address population aging and curb growing cancer trends.

Epidemiological shifts in chronic kidney disease: a 30-year global and regional assessment

BACKGROUND

Chronic kidney disease (CKD) presents a growing global health challenge, with significant variability in disease burden across different regions and countries. This study aimed to analyze the trends in incidence, prevalence, mortality, and disability-adjusted life years (DALYs) for CKD from 1990 to 2019, utilizing data from the Global Burden of Disease Study.

METHODS

We conducted an in-depth study on the global and age-standardized incidence, prevalence, mortality, and DALYs of CKD, and assessed trends over a 30-year period. Additionally, we explored the associations between healthcare access and quality (HAQ), the Socio-Demographic Index (SDI), and CKD. Furthermore, we conducted a detailed analysis of six risk factors closely related to CKD, and based on these findings, provided strong evidence for enhancing the management of CKD.

RESULTS

In 2019, there were 18,986,903 cases of CKD, with an average annual percent change (AAPC) of 1.82 (95% CI = 1.8 to 1.82) in incidence since 1990. The age-standardized incidence rate increased from 192.45 per 100,000 in 1990 to 233.65 per 100,000 in 2019. Prevalence also rose, with a total of 69,729,430 cases in 2019 and an AAPC of 1.19 (95% CI = 1.19 to 1.2). Mortality and DALYs have increased correspondingly, with the mortality rate reaching 18.29 per 100,000 and total DALYs at 41,538,592 in 2019. The analysis showed that higher HAQ levels are associated with better outcomes in terms of lower mortality and DALY rates, whereas lower HAQ levels correlate with poorer outcomes. In addition, high fasting plasma glucose and high systolic blood pressure are the main contributors to CKD-related deaths, with their population attributable fraction (PAF) significantly decreasing as the SDI decreases.

CONCLUSION

The burden of CKD has significantly increased over the past three decades, influenced by demographic changes and variations in healthcare quality and access. Effective public health strategies and improvements in healthcare delivery are needed to address the disparities in CKD outcomes globally.

Different prevalence and spectrum of malignancy between Chinese patients and American patients with rheumatoid arthritis: a comparative study

Objective

To characterize the epidemiological characteristics of malignancy in Chinese patients with rheumatoid arthritis (RA) versus American patients and investigate their associated factors.

Methods

Data were collected from a real-world Chinese RA population and American patients with RA from the National Health and Nutritional Examination Survey. The prevalence and subtypes of malignancy and their potential associated factors were investigated in both populations.

Results

A total of 2,073 Chinese and 2,928 American patients with RA were included. There was a lower prevalence of malignancy in Chinese than in their American counterparts before (5.7% vs. 17.1%) and after matching (6.2% vs. 12.6%, both P < 0.001). Gender discrepancies in malignancy prevalence were observed, with a male predilection for RA with malignancy in China (8.2% vs. 5.5%), while it was the opposite in American patients (10.1% vs. 13.5%, both P < 0.05). The top type of malignancy among male patients with RA was lung cancer in Chinese (2.29%), but non-melanoma skin cancer (3.43%) in American; while among female patients was breast cancer both in Chinese (1.72%) and American (3.43%). Multivariate logistic regression analyses showed that older age (odds ratio (OR) = 1.050) and positive anti-cyclic citrullinated peptide antibody (OR = 2.752) were independently associated with malignancy in Chinese patients with RA, while female (OR = 1.395), older age (OR = 1.033), active smoking (OR = 1.580) and cardiovascular diseases (OR = 1.523) in American patients.

Conclusion

The prevalence, subtypes and risk factors of malignancy were substantially different in Chinese patients with RA and their American counterparts, which implied the importance of individualized malignancy screening strategies for patients with RA.

Elaiophylin targets EIF4B to suppress the growth of esophageal squamous cell carcinoma via the PI3K/AKT signaling pathway

Elaiophylin is known to exert antitumor effects through certain signaling pathways; however, no reports regarding its effects on esophageal cancer are available. This study explored the effects of elaiophylin in esophageal squamous cell carcinoma (ESCC) cells. Transwell and immunofluorescence assays confirmed that elaiophylin inhibited the migration and proliferation of ESCC cells, and western blotting assays showed that it affected apoptosis-related gene expression in ESCC cells. Based on RNA-seq analyses, Single-cell RNA-seq, a human cancer pathway phosphorylation antibody array, and Gene Ontology and Kyoto Encyclopedia of Genes and Genomics analyses, we found that elaiophylin was related to low expression of EIF4B and activation of the phosphoinositide 3-kinase (PI3K)/AKT signaling pathway. In both in vitro and in vivo experiments, ESCC cells treated with elaiophylin showed low EIF4B expression, which inhibited their proliferation and promoted apoptosis by activating the PI3K/AKT signaling pathway; EIF4B overexpression could reverse these effects of elaiophylin on ESCC cells. Therefore, our results indicate that elaiophylin targets EIF4B to inhibit ESCC cell proliferation via the PI3K/AKT signaling pathway. Targeting elaiophylin or the EIF4B/PI3K/AKT signaling pathway may produce new methods for ESCC treatment.

Cancer situation in China: an analysis based on the global epidemiological data released in 2024

BACKGROUND

Cancer remains a major cause of mortality and a significant economic burden in China. Exploring the disparities in cancer patterns and control strategies between China and developed countries may offer valuable insights for policy formulation and enhance cancer management efforts. This study examined the incidence, mortality, and disability-adjusted life year (DALY) burden of cancer in China, and compared these metrics with those observed in the United States (US) and the United Kingdom (UK).

METHODS

Data on cancer incidence, mortality, and DALYs for China, the US, and the UK were sourced from the GLOBOCAN 2022 online database and the Global Burden of Disease 2021 study (GBD 2021). We utilized Joinpoint regression models to analyze trends in cancer incidence and mortality across these countries, calculating annual percent changes (APCs) and determining the optimal joinpoints.

RESULTS

In 2022, China recorded around 4,824,703 new cancer cases and 2,574,176 cancer-related deaths, contributing to 71,037,170 DALYs. China exhibited a lower cancer incidence rate compared to the US and the UK. Although cancer-related mortality in China is slightly lower than that in the UK, it is significantly higher than that in the US. Additionally, China experienced significantly higher DALY rates compared to both the US and UK. The cancer landscape in China was also undergoing significant changes, with a rapid rise in the incidence and burden of lung, colorectal, breast, cervical, and prostate cancers. Meanwhile, the incidence and burden of stomach cancer continued to decline. Although the incidence of liver and esophageal cancers was decreasing, the burden of liver cancer was increasing, while the burden of esophageal cancer remained largely unchanged.

CONCLUSIONS

The cancer profile of China is shifting from that of a developing country to one more typical of a developed country. The ongoing population aging and the rise in unhealthy lifestyles are expected to further escalate the cancer burden in China. Consequently, it is crucial for Chinese authorities to revise the national cancer control program, drawing on successful strategies from developed countries, while also accounting for the regional diversity in cancer types across China.

Temporal trends of incidence, mortality, and survival of liver cancer during 2011-2020 in Fujian Province, Southeast China

BACKGROUND

Liver cancer is a common malignant tumor of the digestive system. We aimed to estimate the trend in the burden of liver cancer in Fujian Province, China, during 2011-2020.

METHODS

The population-based cancer data was collected from the cancer registry in Fujian Province during 2011-2020. Segi's world standard population was used to calculate the age-standardized incidence rates and age-standardized mortality rates. The temporal trend of liver cancer was displayed by annual percentage change and average annual percentage change (AAPC). Relative survival of liver cancer was calculated as the ratio of observed survival to expected survival. The age-standardized relative survival was calculated according to the International Cancer Survival Standards 1.

RESULTS

There were 14,725 patients diagnosed with liver cancer and 12,698 patients died between 2011 and 2020. For males, there was a downward trend in incidence and mortality (AAPC: -3.86%, -3.44%). Similarly, the downward trend was also shown in females (AAPC: -3.96%, -2.79%). The highest age-specific incidence and mortality were in the 75-79 age group (146.59/100,000 and 137.99/100,000, respectively), and there was no downward trend in this group during the period. The overall age-standardized 5-year relative survival was 10.77% in 2011-2015 and 14.54% in 2016-2020. During the study period, the percentage improvement of survival was higher in males than in females (34.75% and 25.33%). The percentage improvement of survival in urban was higher than that in rural (38.64% and 28.75%). Except for the age group over 75, the survival of patients in other age groups all has improved.

CONCLUSIONS

Liver cancer remains a serious public health problem in Fujian Province, China, which needs to be solved, especially in some high-risk groups such as the elderly, high-risk males, and rural populations. Early detection and treatment is the key to the prevention and treatment of liver cancer.

Awareness, attendance, and attitudes toward cervical cancer screening among HIV-positive Chinese women in Yunnan province: a cross-sectional study

BACKGROUND

Cervical cancer is a major health threat in the female population. Human immunodeficiency virus (HIV)-positive women encounter a higher risk of cervical cancer. It is significant to promote cervical cancer screening attendance among HIV-positive women. Little is known about the awareness, attendance, and attitudes toward cervical cancer screening, as well as the associated factors, among Chinese HIV-positive women.

METHODS

A cross-sectional study was conducted among 411 HIV-positive women attending a large ART clinic in Yunnan, an HIV-endemic province in China. Participants were recruited using the convenient sampling method from January 2019 to August 2020. An interviewer-administered semi-structured questionnaire was utilized to collect information on socio-demographic and behavioral characteristics, clinical characteristics related to HIV infection, awareness, attendance, and attitudes toward cervical cancer screening. Binary logistic regression analyses were used to determine factors associated with awareness, attendance, and attitude toward cervical cancer screening.

RESULTS

Some 69.8% (287) of the participants were aware of cervical cancer screening, but only 27.7% (114) had attended screening within 3 years. After receiving a brief health education, 72.3% (297) of the participants exhibited a positive attitude toward cervical cancer screening. Participants with a higher education background and longer duration of antiretroviral therapy were more likely to be aware of cervical cancer screening and have up-to-date screening. The up-to-date screening attendance was also influenced by age, smoking status, and health insurance. Single participants were less likely to show a positive attitude toward cervical cancer screening compared married or cohabiting counterparts. The main facilitators to attending cervical cancer screening were health promotion activity and well-organized programs, while the main barriers were high costs of the service and inadequate awareness.

CONCLUSIONS

Although most HIV-positive women attending a large ART clinic in Yunnan were aware of cervical cancer screening, the up-to-date attendance was low. It is crucial to conduct health education and promotion through efficient channels to improve awareness and attendance. The discrepancy between awareness and attendance also emphasized the importance of adopting appropriate screening strategies and powerful health policies that can foster the attendance of cervical cancer screening among HIV-positive women. Efforts should be devoted to constructing a comprehensive healthcare system with high accessibility in China for cervical cancer prevention and management for HIV-positive women.

High-Accuracy Positivity-Preserving Finite Difference Approximations of the Chemotaxis Model for Tumor Invasion

Numerical simulation of the complex evolution process for tumor invasion plays an extremely important role in-depth exploring the bio-taxis phenomena of tumor growth and metastasis. In view of the fact that low-accuracy numerical methods often have large errors and low resolution, very refined grids have to be used if we want to get high-resolution simulating results, which leads to a great deal of computational cost. In this paper, we are committed to developing a class of high-accuracy positivity-preserving finite difference methods to solve the chemotaxis model for tumor invasion. First, two unconditionally stable implicit compact difference schemes for solving the model are proposed; second, the local truncation errors of the new schemes are analyzed, which show that they have second-order accuracy in time and fourth-order accuracy in space; third, based on the proposed schemes, the high-accuracy numerical integration idea of binary functions is employed to structure a linear compact weighting formula that guarantees fourth-order accuracy and nonnegative, and then a positivity-preserving and time-marching algorithm is established; and finally, the accuracy, stability, and positivity-preserving of the proposed methods are verified by several numerical experiments, and the evolution phenomena of tumor invasion over time are numerically simulated and analyzed.

Orchestrated copper-loaded nanoreactor for simultaneous induction of cuproptosis and immunotherapeutic intervention in colorectal cancer

Ion interference, including intracellular copper (Cu) overload, disrupts cellular homeostasis, triggers mitochondrial dysfunction, and activates cell-specific death channels, highlighting its significant potential in cancer therapy. Nevertheless, the insufficient intracellular Cu ions transported by existing Cu ionophores, which are small molecules with short blood half-lives, inevitably hamper the effectiveness of cuproptosis. Herein, the ESCu@HM nanoreactor, self-assembled from the integration of H-MnO2 nanoparticles with the Cu ionophore elesclomol (ES) and Cu, was fabricated to facilitate cuproptosis and further induce relevant immune responses. Specifically, the systemic circulation and tumoral accumulation of Cu, causing irreversible cuproptosis, work in conjunction with Mn2+, resulting in the repolarization of tumor-associated macrophages (TAMs) and amplification of the activation of the cGAS-STING pathway by damaged DNA fragments in the nucleus and mitochondria. This further stimulates antitumor immunity and ultimately reprograms the tumor microenvironment (TME) to inhibit tumor growth. Overall, ESCu@HM as a nanoreactor for cuproptosis and immunotherapy, not only improves the dual antitumor mechanism of ES and provides potential optimization for its clinical application, but also paves the way for innovative strategies for cuproptosis-mediated colorectal cancer (CRC) treatment.

EVA1B facilitates esophageal squamous carcinoma progression and recruitment of immunosuppressive myeloid-derived suppressor cells in the tumor microenvironment

Eva-1 Homolog B (EVA1B) has been preliminarily found to be associated with prognostic outcomes and immune microenvironment in several human cancer types, but the implications of EVA1B in ESCC remain unclear. Human ESCC and paracancerous tissues were gathered in this study, and EVA1B expression was measured via immunoblotting. EC109 and KYSE-180 ESCC cells were stably infected by sh-EVA1B lentivirus, and functional experiments were subsequently implemented. Syngeneic mouse models were built, and the expansion and recruitment of myeloid-derived suppressor cells (MDSCs) were then evaluated. The results showed that EVA1B presented the notable up-regulation in clinical ESCC tissues versus controls, and was connected to more advanced stages and the abundance of MDSCs. Silencing EVA1B notably attenuated proliferation of ESCC cells and tumor growth in syngeneic mouse models. Moreover, EVA1B suppression resulted in apoptosis and cell cycle arrest, and impaired ESCC cell aggressiveness. Among ESCC patients, EVA1B was strongly correlated to EMT pathway activity. Targeted suppression of EVA1B mitigated the expression of Wnt3a, β-catenin and LRP6 in ESCC cells and tumor xenografts. Additionally, inhibition of EVA1B attenuated the expansion and recruitment of MDSCs within the immune microenvironment based upon the reduction in the percentage of CD11b+Gr-1+ immunosuppressive MDSCs as well as the expression of MDSC expansion stimulators (S100A8, S100A9, Arg-1, and VEGF). Collectively, our findings unveiled the contribution of high expression of EVA1B to ESCC progression and MDSCs expansion and recruitment, indicating that targeted suppression of EVA1B may be a potential treatment choice for ESCC patients.

RB1 Mutations Induce Smoking-Related Bladder Cancer by Modulating the Cytochrome P450 Pathway

Cigarette smoking causes multiple cancers by directly influencing mutation burden of driver mutations. However, the mechanism between somatic mutation caused by cigarette smoking and bladder tumorigenesis remains elusive. Smoking-related mutation profile of bladder cancer was characterized by The Cancer Genome Atlas cohort. Integraticve OncoGenomics database was utilized to detect the smoking-related driver genes, and its biological mechanism predictions were interpreted based on bulk transcriptome and single-cell transcriptome, as well as cell experiments. Cigarette smoking was associated with an increased tumor mutational burden under 65 years old (p = 0.031), and generated specific mutational signatures in smokers. RB1 was identified as a differentially mutated driver gene between smokers and nonsmokers, and the mutation rate of RB1 increased twofold after smoking (p = 0.008). RB1 mutations and the 4-aminobiphenyl interference could significantly decrease the RB1 expression level and thus promote the proliferation, invasion, and migration ability of bladder cancer cells. Enrichment analysis and real-time quantitative PCR (RT-qPCR) data showed that RB1 mutations inhibited cytochrome P450 pathway by reducing expression levels of UGT1A6 and AKR1C2. In addition, we also observed that the component of immunological cells was regulated by RB1 mutations through the stronger cell-to-cell interactions between epithelial scissor+ cells and immune cells in smokers. This study highlighted that RB1 mutations could drive smoking-related bladder tumorigenesis through inhibiting cytochrome P450 pathway and regulating tumor immune microenvironment.

Global burden of cancer and associated risk factors in 204 countries and territories, 1980-2021: a systematic analysis for the GBD 2021

BACKGROUND

Cancer is the second most common cause of death globally. Therefore, it is imperative to investigate cancer incidence, mortality rates, and disability-adjusted life years (DALYs) to enhance preventive measures and healthcare resource allocation. This study aimed to assess cancer burden and associated risk factors in 204 countries and territories between 1980 and 2021.

METHODS

We selected data on cancer incidence and mortality rates and associated risk factors from the global burden of disease (GBD) study tool for 204 countries and territories from 1990 to 2021 and 1980 to 2021. We estimated the age-standardized incidence (ASIR) and age-standardized deaths (ASDR) of 34 cancer types categorized as level 3 causes based on the GBD hierarchy.

RESULTS

In 2021, cancer accounted for 14.57% (95% uncertainty interval: 13.65-15.28) of total deaths and 8.8% (7.99-9.67) of total DALYs in both sexes globally. ASIR and ASDR were 790.33 (694.43-893.01) and 116.49 (107.28-124.69), respectively. Additionally, females exhibited higher ASIR than males (923.44 versus 673.09), while males exhibited higher ASDR than females (145.69 versus 93.60). This indicates that policymakers should focus on the importance of gender equality in healthcare. Non-melanoma skin cancer exhibited the highest ASIR (74.10) in both sexes, while digestive cancers accounted for 39.29% of all cancer-related deaths, and Asia exhibited the heaviest cancer burden. In females, breast cancer exhibited the highest ASIR (46.40) and ASDR (14.55). In males, tracheal, bronchial, and lung cancer exhibited the highest ASIR (37.85) and ASDR (34.32), highlighting the urgent need for targeted tobacco control measures. Different cancers in various countries exhibit unique characteristics. Therefore, policymakers should formulate specific prevention and control strategies that reflect the cancer in their country. Tobacco was the primary level 2 risk factor for cancer DALYs in males. It accounted for 29.32% (25.32-33.14) of all cancer DALYs. Dietary risks, alcohol consumption, and air pollution accounted for 5.89% (2.01-10.73), 5.48% (4.83-6.11), and 4.30% (2.77-5.95) of male cancer DALYs, respectively. Therefore, policymakers should prioritize smoking regulation and other carcinogenic risks.

CONCLUSION

Cancer is a significant public health concern globally. Understanding the common etiologies of different cancers is essential for developing effective control strategies and targeted interventions.

Evaluating the diagnostic performance of [18F]ALF-NOTA-FAPI-04 PET/CT in gastric cancer: a comparative study with [18F]FDG PET/CT

PURPOSE

To compare the diagnostic value of [18F]ALF-NOTA-FAPI-04 positron emission tomography/computed tomography (PET/CT) and 18F-fluorodeoxyglucose (FDG) PET/CT in gastric cancer.

METHODS

This single-center retrospective analysis included 65 patients with gastric cancer who received both [18F]FDG and [18F]ALF-NOTA-FAPI-04 PET/CT for initial staging or restaging. Histopathological manifestations, typical imaging manifestations, follow-up imaging, and comprehensive clinical assessment were used as reference criteria. The uptakes of [18F]FDG and [18F]ALF-NOTA-FAPI-04 PET were compared using the Wilcoxon signed-rank test. McNemar's test was employed to compare the diagnostic performance of the two imaging techniques.

RESULTS

A total of 65 patients were included (26 male and 39 female; mean age, 54.03 ± 10.41 years), Among them, 10 were newly diagnosed, 46 underwent radical gastrectomy, and 9 received only chemotherapy prior to the study. Compared with [18F]FDG PET/CT, [18F]ALF-NOTA-FAPI-04 PET/CT showed higher sensitivity in primary or recurrent tumors (100% vs. 64.52%, p < 0.001)), lymph node metastases (88.89% vs. 38.89%, p = 0.006), distant metastases (91.18% vs. 50%, p < 0.001). From the semi-quantitative evaluation, the Maximum standardized uptake value (SUVmax) and target-to-background ratio of [18F]ALF-NOTA-FAPI-04 PET/CT were significantly higher than that of [18F]FDG PET/CT in primary or recurrent tumors, lymph node metastases, and distant metastases (all p < 0.001).

CONCLUSION

Our study results indicate that [18F]ALF-NOTA-FAPI-04 PET/CT outperforms [18F]FDG PET/CT in the detection of primary or recurrent tumors, lymph node metastasis, and distant metastasis in gastric cancer.

KEY POINTS

Question Early diagnosis and precise staging of gastric cancer are crucial for patient prognosis; however, current imaging techniques still face significant limitations. Findings [18F]ALF-NOTA-FAPI-04 PET/CT demonstrated significantly higher sensitivity than [18F]FDG PET/CT in detecting primary or recurrent tumors and metastases in patients with gastric cancer. Clinical relevance [18F]ALF-NOTA-FAPI-04 PET/CT is an advanced imaging diagnostic technique that significantly enhances the diagnostic accuracy for gastric cancer and its metastatic lesions. This technology provides robust support for clinical decision-making, thereby improving the management of patients with gastric cancer.

Prevotellaceae Modulates Colorectal Cancer Immune Microenvironment to Assist Anti-PD-L1 Immunotherapy

Background/Aims

Colorectal cancer (CRC) stands as the third most prevalent cancer on a global scale. In recent years, immunotherapy, such as anti-PD-L1 treatment, has demonstrated promising therapeutic outcomes in CRC. However, studies have suggested that intestinal microbiota may influence the efficacy of anti-PD-L1 immunotherapy. This study aimed to investigate the linkage between intestinal bacteria and anti-PD-L1 therapy.

Materials and Methods

Bioinformatics analysis was employed to study the correlation between the intestinal microbiota of CRC patients and immune infiltration. The study delved into the relationship between Prevotellaceae and immune-related genes in CRC. Mouse experiments were conducted to validate the association between Prevotellaceae abundance and the efficacy of anti-PD-L1 tumor treatment. Prevotellaceae abundance in mouse feces was assayed by 16S sequencing. Flow cytometry was utilized to assay immune cell infiltration in patient tumor tissues, while western blot and quantitative polymerase chain reaction (qPCR) assays measured IFN-γ, IL-2, and PD-L1 levels in tumor tissues.

Results

The high immune cell infiltration group demonstrated reduced tumor purity when compared with the group displaying low immune cell infiltration. Substantial variances were discerned in the Stromal Score, Immune Score, ESTIMATE Score, and Tumor Purity among the 3 distinct subtypes. The community evenness in the gut microbiota of CRC patients from cluster 2 and cluster 3 subtypes displayed significant differences. Members of the Prevotellaceae family were significantly enriched in the gut microbiota of cluster 3 subtype patients. In vivo experiments ascertained the supportive role of Prevotellaceae in anti-PD-L1 immunotherapy.

Conclusion

The facilitating effect of Prevotellaceae on anti-PD-L1 treatment was demonstrated in CRC. The findings suggest that elevating Prevotellaceae abundance may offer a new direction for assisting in CRC immunotherapy and provide a foundation for devising more effective CRC immunotherapeutic strategies.

PCBP2 stabilizes TROAP to promote the malignant progression of gastric cancer

Gastric cancer (GC) is a leading cause of cancer-related deaths worldwide. Poly(rC) binding protein 2 (PCBP2), an RNA binding protein, has been reported to be involved in the progression of various cancers. However, the role of PCBP2 in GC and its underlying mechanisms remain elusive. Quantitative real-time polymerase chain reaction (qRT-PCR) was performed to detect mRNA expression, whereas western blotting and immunohistochemistry assays were used to detect protein expression levels. Cell proliferation, migration, and invasion were assessed by EdU assay, wound-healing assay, and transwell assay, respectively. The levels of reactive oxygen species (ROS), malondialdehyde (MDA), glutathione peroxidase (GSH-Px), and iron (Fe2+) were detected using commercial assay kits. RIP assay was conducted to analyze the relationship between PCBP2 and trophinin-associated protein (TROAP). Actinomycin D assay was performed to investigate the effect of PCBP2 depletion on TROAP mRNA stabilization. Finally, a subcutaneous xenograft mouse model was established to validate the effect of PCBP2 depletion on tumor formation. PCBP2 expression was upregulated in GC tissues and cells, and its depletion inhibited GC cell proliferation, migration, and invasion. Additionally, PCBP2 depletion promoted ferroptosis, a novel form of cell death mediated by iron. TROAP expression was also upregulated in GC tissues and cells, and PCBP2 stabilized TROAP mRNA expression in GC cells. Knocking down PCBP2 regulated GC cell proliferation, migration, invasion, and ferroptosis by reducing TROAP expression. Furthermore, PCBP2 knockdown repressed aggressive behavior of GC cells in vivo. Our study demonstrated that PCBP2 stabilized TROAP to promote the malignant progression of gastric cancer. Targeting PCBP2 and its downstream target TROAP may provide a novel therapeutic strategy for the treatment of gastric cancer.

Investigating the Potential of X-Ray-Based Cancer Treatment Equipment for the Sterile Insect Technique in Aedes aegypti Control Programs

The sterile insect technique (SIT) stands as an eco-friendly approach for mosquito control, but it is impeded by the limited availability of γ-ray radiation source. This research sought to investigate a different radiation source-the Varian Clinac 23EX linear accelerator, which is frequently used for X-ray therapy in cancer treatment. Evaluation parameters including emergence rate, average survival time, induced sterility (IS), male mating competitiveness of irradiated males and fecundity (the number of eggs per female per batch), and the egg hatch rate of females mated with irradiated males were assessed to gauge the application potential of this cancer treatment equipment in the realm of the SIT. The results indicated that X-rays from radiation therapy equipment can effectively suppress the hatch rate of offspring mosquitoes without adversely affecting the emergence rate of irradiated males or the fecundity of females. In addition, at an X-ray dose of 60 Gy, the induced sterility in Ae. aegypti was comparable to the sterility induced by 40 Gy of γ-rays with both treatments resulting in 99.6% sterility. Interestingly, when a release ratio of 7:1 (irradiated males:unirradiated males) was used to competitively mate with females, the IS results resulted by 60 Gy X-rays and 40 Gy γ-rays were still at 70.3% and 73.7%, respectively. In conclusion, the results underscored the potential of the Varian Clinac 23EX linear accelerator as an X-ray source in SIT research.

Research focus and emerging trends of cancer-related fatigue in nursing arena: A bibliometric analysis from 2012 to 2021

BACKGROUND

To explore distributed characteristics and identify research focus and emerging trends related to cancer-related fatigue (CRF) in the nursing field.

METHODS

Data were collected from the Web of Science Core Collection database between January 2012 and December 2021 using an advanced search strategy. Data were extracted and analyzed using CiteSpace and Microsoft Excel.

RESULTS

A total of 967 articles were included in this study. The number of published nursing studies on CRF has increased with slight fluctuations. Keyword co-occurrence analysis and timeline view indicated that CRF is closely related to quality of life, and there is a correlation between CRF and other symptoms. Moreover, increasing attention has been paid to CRF nursing interventions. The assessment tools and their different language versions, risk factors and reviews of CRF were the research frontiers in recent years with citation bursts.

CONCLUSIONS

In the field of nursing, the focus of CRF research is still on risk factors, adverse outcomes and nursing management. Assessment tools will continue to be developed and additional risk factors will be studied in the future.

Influence of Blood Sampling Service Process Reengineering on Medical Services Supply: Quasi-Experimental Study

BACKGROUND

Tertiary hospitals in China are confronted with significant challenges due to limited spatial capacity and workforce constraints, leading to saturated allocation of medical resources and restricted growth in medical service provision. The incorporation of digital health into medical service process reengineering (MSPR) marks a pivotal transformation and restructuring of conventional health service delivery models. Specifically, the application of MSPR to blood sampling services processes reengineering (BSSPR) holds promise for substantially enhancing the efficiency and quality of medical services through streamlining and optimizing these procedures. However, the comprehensive impact of BSSPR has been infrequently quantified in existing research.

OBJECTIVE

This study aims to investigate the influence of BSSPR on the efficiency and quality of medical services and to elucidate the key informative technological support points underpinning BSSPR.

METHODS

Data were collected from both the new and old laboratory information systems from August 1, 2019, to December 31, 2021. A combination of statistical description, chi-square test, and t test was used to compare check-in time and waiting time of outpatients before and after the implementation of BSSPR. An interrupted time-series design was used to analyze the impact of BSSPR on medical service efficiency and quality, enabling the control of confounding variables, including changes in medical human resources and both long- and short-term temporal trends.

RESULTS

BSSPR had an impact on the efficiency and quality of medical services. Notably, there was a significant increase in the number of patients receiving blood sampling services, with a daily service volume increase of ~150 individuals (P=.04). The average waiting time for patients decreased substantially from 29 (SD 36) to 11 (SD 11) minutes, indicating a marked improvement in patient experience. During the peak period, the number of patients receiving blood sampling services per working hour statistically increased from 9.56 to 16.77 (P<.001). The interrupted time-series model results demonstrated a reduction in patients' waiting time by an average of 26.1 (SD 3.8; 95% CI -33.64 to -18.57) minutes. Although there was an initial decline in the number of outpatients admitted following BSSPR implementation, an upward trend was observed over time (β=1.13, 95% CI 0.91-1.36).

CONCLUSIONS

BSSPR implementation for outpatients not only reduced waiting time and improved patients' experience but also augmented the hospital's capacity to provide medical services. This study's findings offer valuable insights into the potential advantages of BSSPR and underscore the significance of harnessing digital technologies to optimize medical service processes. This research serves as a foundational basis and provides scientific support for the promotion and application of BSSPR in other health care contexts. By continuing to explore and refine the integration of digital technologies in health care, we can further enhance patient outcomes and elevate the overall quality of medical services.

Smad4 Deficiency in S100A4+ Macrophages Enhances Colitis-associated Tumorigenesis by Promoting Macrophage Lipid Metabolism Augmented M2 Polarization

S100A4 is primarily expressed in intestinal macrophages, and promotes colonic inflammation and colitis-associated colon tumorigenesis. Smad4 is also expressed in the colon; however, it inhibits colitis-associated cancer (CAC) development. The specific role of Smad4 in S100A4+ cells in CAC remains unknown. In this study, an azoxymethane (AOM)/dextran sodium sulfate (DSS)-induced CAC model was established in mice with S100A4+ cell-specific Smad4 deletion (S100A4 Smad4-/-). Smad4 deficiency in S100A4+ cells exacerbated DSS-induced colitis and promoted colorectal tumorigenesis. In addition, S100A4+ cell-specific Smad4 ablation promoted the M2 polarization of macrophages in CAC. Mechanistically, Smad4 depletion in macrophages enhanced lipid metabolism by activating the FA binding protein 2 (Fabp2)/STAT6 pathway. Furthermore, Smad4 deficiency in macrophages promoted MC38 tumor growth in myeloid-specific Smad4 deficient (Lyz Smad4-/-) mice, whereas blocking Fabp2 expression reversed the tumor growth. Additionally, high Smad4 expression was associated with prolonged survival in patients with colorectal cancer. Thus, Smad4 in S100A4+ macrophages plays a tumor-inhibiting role in CAC development and supports its use as a prognostic marker in CRC patients.

The Mechanism by Which Hedgehog Interacting Protein (HHIP) in Cancer-Associated Fibroblasts Regulate the Secretion of Inflammatory Factors Through the JAK1/STAT3 Pathway Affecting Prostate Cancer Stemness

Purpose

Prostate cancer (PCa) is seriously affecting men's health and quality of life. Existing studies indicate that PCa stem cells are responsible for promoting the growth and contributing to the high recurrence rate of PCa.

Methods

We retrieved and downloaded PCa-related datasets from both the GEO and TCGA database. These datasets were subsequently analyzed using single-cell analysis, difference analysis, WGCNA, and machine learning algorithms. WB was performed to detect the expression of Hedgehog interacting protein (HHIP), JAK1/STAT3 pathway-related protein, CD133 and CD44. Immunohistochemistry was conducted to assess the distribution of HHIP and Ki67. The levels of inflammatory factors were measured using ELISA. The tumor cell stemness was evaluated through spheroid formation assay and flow cytometry.

Results

Through bioinformatics analysis, we identified eight genes (ARHGAP24, HHIP, MITF, CBX7, PPP1R12B, PLEKHA1, ADGRA2, and PGR). Among these genes, we selected HHIP for follow-up experiments and confirmed its low expression in PCa tumor tissues. Primary cancer-associated fibroblasts (CAFs) were extracted, and to further explore the mechanism of HHIP, we overexpressed or knocked down HHIP in CAFs. Overexpression of HHIP was found to inhibit the JAK1/STAT3 pathway and the secretion of inflammatory factors, thus suppressing both the proliferation and stemness of PCa cells. Treatment of CAFs with the JAK1/STAT3 pathway inhibitor AG490 led to a decrease in inflammatory factor secretion, along with inhibition of PCa cell proliferation and stemness. On this basis, knockdown of HHIP partially reversed the inhibitory effects of AG490 on PCa cells. Finally, we constructed a mouse subcutaneous tumor model and found that HHIP inhibited tumor proliferation and densification.

Conclusion

In summary, HHIP in CAFs can regulate the JAK1/STAT3 pathway and affect the secretion of inflammatory factors, thus affecting the proliferation of PCa.

Fuzheng-Buyi formula for treating castration-resistant prostate cancer: A systematic review and meta-analysis

BACKGROUND

The study was designed to systematically evaluate the efficacy and safety of Fuzheng-Buyi formula in treating castration-resistant prostate cancer (CRPC).

METHODS

A computer-based search were conducted in the databases, including CNKI, WanFang Data, VIP, CBM, PubMed, EMbase, and the Cochrane database to identify all randomized controlled trials. The studies investigating the efficacy and safety of Fuzheng-Buyi formula combined with Western medicine for the treatment of CRPC were included from January 1st, 2010 to December 31st, 2023. The quality of the included studies was evaluated according to the Cochrane Handbook manual, and meta-analysis was performed using Review Manager 5.3 and R Studio 4.2.3 software.

RESULTS

In this study, a total of 18 trials were included, encompassing a population of 1093 patients diagnosed with CRPC. The results of the meta-analysis showed that the combination of Fuzheng-Buyi formula and Western drugs was more effective in increasing the overall efficacy rate (risk ratio = 1.31, 95% confidence interval [CI] [1.17, 1.46], P < .00001), decreasing Traditional Chinese Medicine syndrome score (mean difference [MD] = -4.40, 95% CI [-6.10, -2.70], P < .00001), and quality of life scale (physiological condition MD = -2.31, 95% CI [-3.13, -1.48], P < .00001; social well-being MD = 1.26, 95% CI [0. 59, 1.94], P = .0002; emotional well-being MD = -2.04, 95% CI [-2.96, -1.12], P < .00001; functional well-being MD = -3.18, 95% CI [2.11, 4.26], P < .00001; others should be paid to MD = -3.15, 95% CI [-4.93, -1.37], P = .0005) compared with the Western medicine alone. And the incidence of adverse events was significantly lower in the combination treatment group compared with Western medicine group (risk ratio = 0.58, 95% CI [0.46, 0.73], P < .00001).

CONCLUSION

The combination of Fuzheng-Buyi formula and Western medicine was more effective in improving the clinical efficacy and quality of life of CRPC patients, with lower incidence of adverse events compared with Western medicine alone.

TRIM47 drives gastric cancer cell proliferation and invasion by regulating CYLD protein stability

The expression of TRIM47, a member of the TRIM protein and E3 ubiquitin ligase families, is elevated in various cancers, such as non-small cell lung cancer and colorectal cancer, and is linked to poor prognosis. This study aimed to investigate the role of TRIM47 in gastric cancer development. Using The Cancer Genome Atlas-Stomach Adenocarcinoma (TCGA-STAD) dataset and analysis of 20 patient samples from our center, TRIM47 was found to be significantly up-regulated in gastric cancer tissues and associated with advanced N-stage and poor prognosis. We constructed stable TRIM47 knockdown and overexpressing gastric cancer cell lines. CCK8, EDU, colony formation, wound healing, and Transwell tests were used to evaluate the effects on cell proliferation, invasion, and migration. The results showed that TRIM47 knockdown inhibited the proliferation, migration and invasion of gastric cancer cells, while TRIM47 overexpression promoted these behaviors. These results were further confirmed in vivo. In the mechanism part, we found that TRIM47 interacts with CYLD protein. Moreover, TRIM47 promotes K48-linked ubiquitination, leading to the degradation of CYLD by the proteasome, thereby activating the NF-κB pathway and regulating the biological behavior of gastric cancer cells. Taken together, our study demonstrated that TRIM47 is involved in the proliferation and metastasis of gastric cancer through the CYLD/NF-κB pathway.

Burden of major cancers in China attributable to modifiable risk factors: Predictions from 2012 to 2035

The cancer burden continues to escalate in China. This study was designed to quantify the burden of deaths attributable to modifiable risk factors for major cancers in China from 2012 to 2035, and to provide evidence-based recommendations for cancer management. Using nationally representative data on risk factors and cancer mortality, a comparative risk assessment approach was employed to calculate the temporal trend of population-attributable fractions (PAFs) for 15 modifiable risk factors associated with major cancers in China. The PAF for modifiable risk factors decreased from 64.5% (95% uncertainty interval [UI]: 46.2%-75.3%) in 2012 to 59.3% (95% UI: 40.6%-71.2%) in 2035. Attributable deaths increased from 1,309,990 (95% UI: 938,217-1,529,170) in 2012 to 1,313,418 (95% UI: 898,411-1,577,189) in 2035, while attributable disability-adjusted life years (DALYs) rose from 28,488,120 (95% UI: 20,471,859-33,308,237) to 33,017,705 (95% UI: 22,730,814-39,564,735). Between 2012 and 2035, the top three risk factors contributing to cancer burden shifted from smoking, insufficient fruit intake and particulate matter <2.5 μm in diameter (PM2.5) exposure to smoking, physical inactivity, and inadequate fruit intake. Controlling modifiable risk factors at recommended levels by 2020 could have prevented around 890,000 deaths and 2.2 million DALYs by 2035. The proportion of cancer burden due to modifiable risk factors is projected to decrease, but the absolute number continues to rise. Adhering to an optimal lifestyle could prevent ~40% of cancer deaths by 2035. Key modifiable risk factors including smoking, physical inactivity, and insufficient intake of fruits require high attention.

Global burden of lung cancer in 2022 and projected burden in 2050

BACKGROUND

Lung cancer is the most common cancer and a leading cause of cancer-related deaths globally. The aim of this study was to evaluate the incidence and mortality of lung cancer worldwide in 2022 and to project the number of new cases and deaths due to lung cancer in China and the United States in 2050.

METHODS

In this study, data from the GLOBCAN 2022 database were used to analyze lung cancer incidence and mortality. The current status of lung cancer incidence and deaths was described by country/region, sex, age, and the human development index (HDI), and future lung cancer incidence and deaths in China and the United States were projected for 2050.

RESULTS

Globally, an estimated 2,480,675 new lung cancer cases and 1,817,469 lung cancer-related deaths occurred in 2022, with age-standardized incidence rates (ASIRs) and age-standardized mortality rates (ASMRs) of 23.6/100,000 and 16.8/100,000, respectively. In China, the ASIR and ASMR for male lung cancer patients were approximately 1.7 times and 2.7 times greater than those for female lung cancer patients, respectively. The ASIR and ASMR in high-HDI countries were approximately 8.5 times and 6.5 times those in low-HDI countries, respectively. It is estimated that in 2050, there will be approximately 1120 thousand new cases and 960 thousand deaths among Chinese men, 680 thousand new cases and 450 thousand deaths among Chinese women, approximately 170 thousand new cases and 110 thousand deaths among American men, and 160 thousand new cases and 90 thousand deaths among American women.

CONCLUSIONS

There are significant differences in the incidence and mortality of lung cancer among different regions and sexes. Therefore, sex factors need to be considered in the prevention, screening, and treatment strategies of lung cancer, and the implementation of tertiary prevention measures for lung cancer, especially primary and secondary prevention, needs to be actively promoted.