The incidence, mortality and survivorship of female breast cancer in China, and the distribution of its several key characteristics were described brielfy in this article. The breast cancer incidence and mortality rates among Chinese women were increasing rapidly, especially in rural area during the recent 10 years, though they were still in low level worldwidely. The distribution of breast cancer incidence and mortality among Chinese women by age and district were showing signiifcant characters. The total survival rate was estimated to be closed to the average level of developing countries, while disparity between urban and rural area was recognized. Because of lacking population data, it is dififcult to describe the characteristics on histological subtypes, stages on diagnosis and molecular subtypes nationwide. The national strategies on breast cancer prevention and control should be focused on disease surveillance, etiological research and survival study. Moreover, measurement should be taken to improve the capacity on breast cancer prevention, screening and clinical services in rural area, in order to narrow the gap of survivorship between urban and rural area and control the rapid increase of mortality in rural area.

OBJECTIVE:To explore the effect and mechanism of ulinastatin on blood coagulation dysfunction of ICU sepsis pa-tients. METHODS:64 ICU sepsis patients were randomly divided into treatment and control groups,with 32 cases in each group. Control group received routine treatment,while treatment group was additionally given Ulinastatin injection on the basis of control group,100 000 u dissolved in 500 ml 15% Glucose injection or Sodium chloride injection intraveously,3 times/d,for consecutive 7 days. The mechanical ventilation time,ICU length of stay and survival rate within 30 d were analyzed statistically in 2 groups. The platelet count (PLT),prothrombin time (PT),activated partial thromboplastin time (APTT),fibrinogen (FIB),D-dimer (D-D), white blood cell count (WBC) and IL-6 were detected before treatment and on first,third and seventh day after treatment. RE-SULTS:After treatment,mechanical ventilation and ICU length of stay in treatment group were significantly shorter than in control group,and survival rate was significantly higher than control group,with statistical significance (P<0.05). The peripheral blood WBC and IL-6 level of treatment group were significantly lower than those of control group,with statistical significance(P<0.05). There was a significant difference in blood coagulation indicators between treatment group after 7 days of treatment and before treat-ment,control group after treatment(P<0.05). The blood coagulation indicators recovered to normal level after 7 days of treatment. CONCLUSIONS:Ulinastatin can improve blood coagulation of ICU sepsis patients by a mechanism of inhibiting the release of in-flammatory cytokines and corresponding blood coagulation factor function.

[ ABSTRACT ] AIM: To investigate the effect of advanced oxidation protein product-human serum albumin ( AOPP-HSA) at different concentrations on the permeability of human umbilical vein endothelial cell ( HUVEC) monolayer and the protective effect of NADPH oxidase inhibitor diphenyleneiodonium ( DPI ) against AOPP-HSA exposure. METHODS: Cultured HUVECs were exposed to 200 mg/L HSA (control) or AOPP-HSA (50, 100 and 200 mg/L).The permeability of the endothelial monolayer was assessed by measuring CMFDA-labeled THP-1 cells across the endothelial cells.The cultured HUVECs were treated with HSA (200 mg/L), AOPP-HSA (200 mg/L), or AOPP-HSA (200 mg/L)+DPI (100 μmol/L), and the activation of NADPH oxidase, endothelial monolayer permeability and cytoskeleton rear-rangement were evaluated.RESULTS: AOPP-HSA increased the permeability of the endothelial cell monolayer, and AOPP-HSA at 200 mg/L significantly increased the phosphorylation level of NADPH oxidase in the cells.Treatment with 100 μmol/L DPI obviously attenuated AOPP-HSA-induced NADPH oxidase activation, the increase in the permeability of the cell monolayer and the cytoskeleton rearrangement.CONCLUSION: AOPP-HSA increases the hyperpermeability of HUVEC monolayer via the phosphorylation of NADPH oxidase, and the NADPH oxidase inhibitor DPI reverses such effects.

Gastrointestinal malignant tumors are the most common malignant neoplasms among the elderly people over 75 years old in China. There are 122.1 thousand new gastric cases and 78.2 thousand new colorectal cancer cases diagnosed each year in China, which accounts for 42.73% and 18.08% respectively of the cases with same age in the world. The gastric cancer accounts for 25.13% and colorectal cancer accounts for 28.86%of all the malignancies in the elderly. The gastric cancer death accounts for 36.38% and colorectal cancer death accounts for 44.68% in those people over 75 years old in China. It was estimated that the risk of developing gastrointestinal malignant tumors of these elderly people was about 5-6 times and the risk of death of gastrointestinal malignant tumors was about 7-8 times of the general population. Compared with the general population and the people of 55-74 years old, the incidence of gastric cancer in the elderly decreased more slowly and the incidence of colorectal cancer increased more quickly over the past 40 years, which brought significant double burden. The survival rate of gastrointestinal malignant tumors in these elderly was lower than that of the general population. We summarized the incidence, mortality, survival and trend of gastrointestinal malignant tumors in the Chinese elderly, in order to provide data for predicting the age distribution and disease burden in the future, to improve the awareness for cancer prevention and control among these elderly, and to call attention to epidemiology, preclinical and clinical medicine for the elderly, especially in the field of study on the influence between comorbidity and cancer treatment, with the aim of improving survival and quality of life among the elderly.
Age Distribution ; Aged ; China ; epidemiology ; Colorectal Neoplasms ; epidemiology ; Gastrointestinal Neoplasms ; epidemiology ; Humans ; Incidence ; Prevalence ; Quality of Life ; Stomach Neoplasms ; epidemiology ; Survival Rate

Background and purpose:The incidence and mortality of colorectal cancer increased gradually in China, cancer survival rate plays an important role in guiding cancer prevention and treatment.Methods:Data of colorectal cancer cases diagnosed during 2002-2006, follow-up information and death report were from Shanghai Cancer Registry, Life Table and EdererⅡ were used to calculate observed survival (OS) and relative survival (RS), the related demographic characteristics and status were also analyzed to relfect the survival situations of the colorectal cancer survivors in major areas in Shanghai.Results:In this study, 16 682 colon cancer cases and 11 906 rectum cancer cases were included in analysis, 5-year OS rates for colon cancer and rectum cancer were 48.84% and 51.65%, RS rates were 70.50% and 71.31%. Signiifcant difference in survival had been found among the various diagnostic stages, the survival rate in stageⅠ was much higher than those in stageⅢ and stageⅣ. The survival of colorectal cancer patients with different gender, age, tumor histological and residential areas were also found with differences, female was higher than male, age ranged from >44-54 years had the highest survival rates than other age groups. The survival of epithelial tumors was higher than other histologic types in colon cancer, and the survival of non-epithelial tumors was higher than other histologic types in rectum cancer. Over the past 3 decades, the 5-year OS increased dramatically in Shanghai. Conclusion:The level of survival of colorectal cancer in Shanghai is similar with it in developed counties. Colorectal cancer survival rate with different population characteristics may provide suggestions and evidence for further improvement of early screening, diagnosis and treatment.

Background and purpose:Incidence and mortality of gastric cancer have increased gradually in China. Population-based cancer survival rate can relfect improvements in cancer diagnosis and treatment, as well as provide evidence for gastric cancer prevention and control.Methods:Data from gastric cancer incidence and follow-up between 2002 and 2006 were collected by the Shanghai Cancer Registry. Life table and EdererⅡ were used to calculate observed survival (OS) and relative survival (RS).Results:A total number of 28 243 gastric cancer cases were documented between 2002 and 2006 in Shanghai. The 5-year OS and RS of gastric cancer were 32.15% and 45.81%, respectively. Survival rates of gastric cancer varied by age, residence, diagnostic stage, and tumor histological type, but not by gender. Patients aged 35-44 years who were diagnosed at stageⅠ or with tubular adenocarcinoma, had the highest survival rates. Moreover, patients in rural areas had higher 5-year OS than those in urban areas. During the period 2002-2006,both 5-year OS and RS of gastric cancer increased dramatically, as compared with 1972-1976. Conclusion:Survival rates of gastric cancer varied by age, residence, diagnostic stage, and tumor histological type. The 5-year OS and RS signiifcantly increased in Shanghai over the past three decades, but are still far below developed countries. Early diagnosis of gastric cancer would be an effective strategy to improve survival and prognosis of patients with gastric cancer.

Background and purpose:Head and neck cancer is common worldwide. This article aimed to describe the patterns of incidence of head and neck cancer and their changes in Shanghai from 2003 to 2012, in order to provide reference for prevention programs, research and control strategies on cancer.Methods:The data of lip, oral cavity and pharynx cancer cases were collected by the Shanghai Cancer Registry. The distributions of Shanghai lip, oral cavity and pharynx cancer incidences from 2003 to 2012 were described. The patterns were described according to gender, age, basis of diagnosis, histological type, diagnostic stage in detail. We compared incidences of recent 5 years (from 2008 to 2012) with those of previous 5 years (from 2003 to 2007).Results:On average from 2003 to 2012, 1105 new cases of head and neck cancer were diagnosed in Shanghai each year, with 2.08% among the total cancer cases. The crude rate was 8.01 per 100000 and the age-standardized rate was 4.45 per 100000. Nasopharyngeal cancer was the major subtype of the head and neck cancer, with 50.81% among the total head and neck cases. The crude and age-standardized rates among males were higher than those among females. The histologically verified percentage was 85.77%. The squamous carcinoma was the major histological type, with 57.58% among the total cases. The age-stan-dardized rate of nasopharyngeal cancer was in decline.Conclusion:The incidence of head and neck cancer was low in Shanghai during the past 10 years. Male cases were more than female cases. The major histological type was squamous carcinoma. Half of new cases were nasopharyngeal cancer which appeared to affect patients at a relatively young age. Patients with nasopharyngeal cancer were diagnosed at relatively advanced stages.

Background and purpose: The incidence and mortality of lung cancer ranked first in China. This study aimed to describe lung cancer survival in Shanghai, and provide background information for cancer prevention and treatment evaluation. Methods: Data of lung cancer cases diagnosed during 2002-2006, follow-up information and death report were collected from Shanghai Cancer Registry. Life table method and Ederer Ⅱ were used to calculate observed survival (OS) and relative survival (RS) respectively. Related demographic characteristics and status were also analyzed to present the survival situations of the lung cancer survivors in Shanghai. Results: In this study, 41802 lung cancer cases were included in analysis. The 5-year OS and RS for lung cancer were 13.75% and 20.23% respectively, and median survival time was 318 days. Survival rate was higher among females than males, with the 5-year OS of 15.49% and 13.00% respectively. The 5-year OS was higher among suburban residents (14.25%) than urban residents (13.23%). Survival rates decreased with increasing age and advanced stage. Patients aged 0-34 had a 5-year OS of 38.21%, while patients aged above 75 had a 5-year OS of 5.48%. Patients diagnosed with stage Ⅰ had a 5-year OS of 55.47%, while patients diagnosed with stage Ⅳ had a 5-year OS of 5.27%. Survival of lung cancer patients differed by tumor histological subtype. The 5-year OS of squamous lung cancer (24.40%) was higher than other histological types, followed by adenocarcinoma (22.26%), large cell (20.27%) and small cell lung cancer (12.22%). From 1972-1976 to 2002-2006, the 5-year OS of urban male patients increased from 6.8% to 12.4%, and 5-year OS of urban female patients increased from 7.3% to 14.9%. Analysis of RS gave the similar results. Conclusion: During the past 30 years, survival rate of lung cancer patients in Shanghai improved steadily, and the survival condition is above average among different countries and areas. However, survival rate of lung cancer is still low compared with other types of cancer. Future focus should be placed on the control of tobacco smoking, early detection by low-dose helical computed tomography and targeted therapy to further improve lung cancer survival.

Background and purpose:China is a high incidence area of liver cancer. The latest monitoring data in Shanghai show that liver cancer is one of the most common cancers with very high disease burden. This study aimed to describe and analyze the population-based survival rates of patients with liver cancer in Shanghai.Methods:Data of liver cancer cases diagnosed between 2002 and 2006, including follow-up information and death report, were collected from Shanghai Cancer Registry. Life table and Ederer Ⅱ were used to calculate observed survival (OS) and relative survival (RS). The related demographic characteristics and status were also analyzed to relfect the survival situations of the liver cancer survivors in major areas of Shanghai.Results:In this study, 20 702 liver cancer cases were included in analysis. Five-year OS rate for liver cancer was 11.72%, whereas RS rate was 15.45%. The OS of male liver cancer patients was higher than that of female patients. Patients whose age ranged from 0-34 years had the highest survival rates than patients from other age groups. The survival of patients with hepatocellular carcinoma was higher than that of patients with other histologic types of liver cancer. Signiifcant difference in survival had also been found among patients with various stages of liver cancer. The survival rate of patients with stageⅠliver cancer was much higher than that of patients with stageⅢ andⅣ liver cancers. There was no signiifcant difference in the survival of liver cancer patients between urban and rural residents. Over the past 3 decades, the 5-year OS increased dramatically in Shanghai. Conclusion:The survival of patients with liver cancer in Shanghai is improved signiifcantly. The prognosis is poor compared with other common malignant tumors. It is necessary to strengthen the risk factors and high-risk population control and intervention in the future.

Objective:To investigate the understanding of cancer pain by medical doctors and its therapeutic status in Shanghai. Methods:We recruited 1 982 medical physicians from 106 secondary and tertiary hospitals in Shanghai city from January to March in 2007. The understanding and the therapeutic status of cancer pain were investigated by conducting a questionnaire survey and the results were statistically analyzed.Rusults:There were 52.3% physicians who believed that they understand the treatment protocol of the Three-step Analgesic Ladder regimen. The rate increased by 21.6 percentage point compared with the results in 1999. The understanding degree of oncologists was significantly better than non-oncologists. There were 16.8% physicians giving the correct answers on the three main principles of the dosage titration in analgesic management. The correct rate of oncologists was significantly higher than that of non-oncologists. Opium with strong analgesic effect had become the first choice for severe cancer pain, and the use of pethidine (Dolantin) for severe cancer pain decreased significantly.The pain was significantly relieved in 74.8% patients. The pain-relieving rate increased by 25.4 percentage point compared with the results in 1999. There were 81.1% medical doctors confirming the effect of pain treatment and among them oncologists were more optimistic to therapeutic outcome than others. There were 93.3% physicians who agreed that it was necessary to carry out the standardized training of cancer pain treatment and the requirement of non-oncologists were much emergent. The over-strict controls by the hospitals and the regulations were the main obstacles for using analgesic drugs.Conclusion:The understanding of medical doctors and the diagnostic and therapeutic levels of cancer pain were improved significantly compared with those in 1999. But more training of cancer pain treatment are still required to publicize the standardized therapy and overcome the obstacles of using analgesic drug.