Objective:To explore the incidence and mortality of digestive system cancers, and the trend of the disease burden attributed to different risk factors in population in China.Methods:Data were obtained from the GLOBOCAN 2020 and the Global Burden of Disease Study in 2019 databases and only the data from the Chinese population were included. Using Excel 2019 and R 4.2.1 software, indicators including age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), age-standardized disability-adjusted life year (DALY) rate and its rate of change were used to illustrate the disease burden of digestive system cancers attributed to different factors and their trends.Results:In 2020, the ASIR of digestive system cancers in China was 83.00/100 000, and the ASMR was 63.80/100 000. The numbers of digestive system cancer cases and deaths increased with age, and more cases and deaths occurred in men than in women in all age groups. The age-standardized DALY rate of esophageal cancer, gastric cancer and liver cancers showed decreasing trends in China from 1990 to 2019 (rate of change: -45.26%, -46.87%, and -65.63%, respectively), whereas the age-standardized DALY rate of pancreatic cancer, colorectal cancer and gallbladder and biliary tract cancer showed increasing trends (rate of change: 67.61%, 30.52%, and 7.21%, respectively). The trend of the mortality rate was consistent with the DALY rate. Compared with the age-standardized DALY rate attributed to behavioral factors, the annual proportion of the age-standardized DALY rate attributed to metabolic factors to the total age-standardized DALY rate of esophageal cancer, liver cancer, pancreatic cancer, and colorectal cancer increased from 1990 to 2019. There was no significant change in the rank of age-standardized DALY rate of gastric cancer, liver cancer, pancreatic cancer, and gallbladder and biliary tract cancer attributed to different risk factors in China from 1990 to 2019, but the rank of certain attributed risk factors for the age-standardized DALY rate of esophageal cancer and colorectal cancer moved ahead (esophageal cancer: high BMI; colorectal cancer: low milk intake, and low whole-grain intake).Conclusions:The incidence and mortality of digestive system cancers was serious in China in 2020, and the annual proportion of the disease burden of digestive system cancers attributed to metabolic factors increased from 1990 to 2019. The rank of attributed risk factors for several digestive system cancers changed significantly.

Objective:To determine the total and age-specific cut-off values of total prostate specific antigen (tPSA) and the ratio of free PSA divided total PSA (fPSA/tPSA) for screening prostate cancer in China.Methods:Based on the Chinese Colorectal, Breast, Lung, Liver, and Stomach cancer Screening Trial (C-BLAST) and the Tianjin Common Cancer Case Cohort (TJ4C), males who were not diagnosed with any cancers at baseline since 2017 and received both tPSA and fPSA testes were selected. Based on Cox regression, the overall and age-specific (＜60, 60-＜70, and ≥70 years) accuracy and optimal cut-off values of tPSA and fPSA/tPSA ratio for screening prostate cancer were evaluated with time-dependent receiver operating characteristic curve (tdROC) and area under curve (AUC). Bootstrap resampling was used to internally validate the stability of the optimal cut-off value, and the PLCO study was used to externally validate the accuracy under different cut-off values.Results:A total of 5 180 participants were included in the study, and after a median follow-up of 1.48 years, a total of 332 prostate cancer patients were included. In the total population, the tdAUC of tPSA and fPSA/tPSA screening for prostate cancer were 0.852 and 0.748, respectively, with the optimal cut-off values of 5.08 ng/ml and 0.173, respectively. After age stratification, the age specific cut-off values of tPSA in the <60, 60-<70, and ≥70 age groups were 3.13, 4.82, and 11.54 ng/ml, respectively, while the age-specific cut-off values of fPSA/tPSA were 0.153, 0.135, and 0.130, respectively. Under the age-specific cut-off values, the sensitivities of tPSA screening for prostate cancer in males <60, 60-70, and ≥70 years old were 92.3%, 82.0%, and 77.6%, respectively, while the specificities were 84.7%, 81.3%, and 75.4%, respectively. The age-specific sensitivities of fPSA/tPSA for screening prostate cancer were 74.4%, 53.3%, and 55.9%, respectively, while the specificities were 83.8%, 83.7%, and 83.7%, respectively. Both bootstrap's internal validation and PLCO external validation provided similar results. The combination of tPSA and fPSA/tPSA could further improve the accuracy of screening.Conclusion:To improve the screening effects, it is recommended that age-specific cut-off values of tPSA and fPSA/tPSA should be used to screen for prostate cancer in the general risk population.

Objective:To determine the total and age-specific cut-off values of total prostate specific antigen (tPSA) and the ratio of free PSA divided total PSA (fPSA/tPSA) for screening prostate cancer in China.Methods:Based on the Chinese Colorectal, Breast, Lung, Liver, and Stomach cancer Screening Trial (C-BLAST) and the Tianjin Common Cancer Case Cohort (TJ4C), males who were not diagnosed with any cancers at baseline since 2017 and received both tPSA and fPSA testes were selected. Based on Cox regression, the overall and age-specific (＜60, 60-＜70, and ≥70 years) accuracy and optimal cut-off values of tPSA and fPSA/tPSA ratio for screening prostate cancer were evaluated with time-dependent receiver operating characteristic curve (tdROC) and area under curve (AUC). Bootstrap resampling was used to internally validate the stability of the optimal cut-off value, and the PLCO study was used to externally validate the accuracy under different cut-off values.Results:A total of 5 180 participants were included in the study, and after a median follow-up of 1.48 years, a total of 332 prostate cancer patients were included. In the total population, the tdAUC of tPSA and fPSA/tPSA screening for prostate cancer were 0.852 and 0.748, respectively, with the optimal cut-off values of 5.08 ng/ml and 0.173, respectively. After age stratification, the age specific cut-off values of tPSA in the <60, 60-<70, and ≥70 age groups were 3.13, 4.82, and 11.54 ng/ml, respectively, while the age-specific cut-off values of fPSA/tPSA were 0.153, 0.135, and 0.130, respectively. Under the age-specific cut-off values, the sensitivities of tPSA screening for prostate cancer in males <60, 60-70, and ≥70 years old were 92.3%, 82.0%, and 77.6%, respectively, while the specificities were 84.7%, 81.3%, and 75.4%, respectively. The age-specific sensitivities of fPSA/tPSA for screening prostate cancer were 74.4%, 53.3%, and 55.9%, respectively, while the specificities were 83.8%, 83.7%, and 83.7%, respectively. Both bootstrap's internal validation and PLCO external validation provided similar results. The combination of tPSA and fPSA/tPSA could further improve the accuracy of screening.Conclusion:To improve the screening effects, it is recommended that age-specific cut-off values of tPSA and fPSA/tPSA should be used to screen for prostate cancer in the general risk population.

Concurrent chemoradiotherapy (CCRT) refers to the simultaneous treatment of chemotherapy and radiotherapy, and the effect of radiotherapy is enhanced with low-dose chemotherapy, which can reduce tumor recurrence and metastasis and improve clinical prognosis of patients. At present, the main factors for the increase of radiosensitivity of concurrent chemotherapy is that concurrent chemotherapy prevents the repair of tumor cells, and chemotherapy and radiotherapy act on different cell cycles and have synergistic effects. However, even for patients with locally advanced cervical cancer (LACC) who have undergone CCRT, the 5-year survival rate is only 60%, which is still not ideal. In order to improve the efficacy, researchers have conducted a series of exploratory studies, which consist of the combination of targeted drugs and immunodrugs, and neoadjuvant regimens before CCRT, etc. Although targeted or immunologic drugs are effective treatment of LACC, in view of the lack of large-scale evidence-based medical evidence, multi-center prospective and randomized phase III clinical trials and high-level articles are needed to improve the level of evidence-based medicine. This consensus summarizes several key evidence-based medical studies published recently, especially the clinical research progress in targeted and immunological therapies, providing reference for domestic peers.

Breast cancer is the most common cancer for Chinese women. Early screening is the best way to improve the rates of early diagnosis and early treatment of breast cancer. The peak ages of breast cancer in Chinese women are obviously different from those in the European and American countries. It is imperative to develop a guideline for breast cancer screening that is suitable for Chinese women. Based on the analysis and summary of breast cancer screening data in China, and the latest guidelines and consensus on breast cancer screening in Europe, the United States and East Asia, China Anti-Cancer Association and National Clinical Research Center for Cancer (Tianjin Medical University Cancer Institute and Hospital) has developed a population-based guideline for breast cancer screening in Chinese women. This guideline has provided detailed recommendations on the screening starting age, screening modalities, and screening interval in Chinese women with average risk and high risk of breast cancer, respectively. This article aims to interpret the above guideline, providing references for professionals in breast cancer screening.

Objective To analyze the genotypes and homology of MSP?1 and CSP gene of Plasmodium vivax in Shandong Province,so as to provide the evidence for case traceability. Methods A total of 12 blood samples were collected from P. vivax?infected cases in Shandong Province in 2011. Parasite genomic DNA was extracted. Primers were designed according to MSP?1 and CSP gene sequences of P. vivax. Then Nested PCR,enzyme digestion,sequencing and sequence alignment,and homolo?gous analysis were performed. Results The MSP?1 gene of all the 12 samples from P. vivax?infected cases were detected with a 470 bp PCR amplification band,and 350 bp and 120 bp enzyme digestion fragments,which were identified as type Sal?1. An analysis of phylogenetic tree of MSP?1 gene showed that the sequences of 9 indigenous case samples in Shandong Province were located in the same branch,one case sample infected from India was located in the same branch with India strains. All the 12 P. vivax?infected samples covered GDRA(D/A)GQPA sequences in CSP gene,which were identified as type PV?Ⅰ. Of the CSP gene among 12 P. vivax?infected samples,10 samples of indigenous case in Shandong Province and one sample of the case in?fected in Guangdong Province were detected with both 560-840 bp and 150-230 bp PCR amplification bands,which were iden?tified as temperate zone family strain of type PV?Ⅰ. However,one sample from the case infected in India was detected only with a 560-840 bp band,which was identified as tropical zone family strain of PV?Ⅰ. An analysis of phylogenetic tree of CSP gene showed that the sequences of 10 samples from the indigenous cases in Shandong Province and one sample from the case infected in Guangdong Province were located in the same branch,one sample from the case infected in India was located in the same branch with India and Indonesia strains. Conclusion Of all the indigenous isolates in Shandong Province,MSP?1 gene is geno?typed type Sal?1,CSP gene is genotyped temperate zone family strain of type PV?Ⅰ,with a high homology found among the in?digenous isolates.

Objective To explore the influences of intraoperative warming methods on body temperature of open abdominal surgery patients. Methods Intraoperative warming methods, which included warming of intravenous infusion or moist dressing or flushing fluids, body wrapping and used insulation blankets, were implemented to 160 elective open abdominal surgery patients from January to December of 2014. Nasopharyngeal and rectal temperatures were monitored from induction to end of surgery. In this prospective study, 5 factors 2 levels were total 25 times ( 32 groups ) combination and each combination repeated 5 times. Results The insulation effect was the best in the combination of intravenous infusion warming, flushing fluids warming and insulation blanket using group with nasopharyngeal temperature ( 36. 94 ± 0. 22 )℃ and rectal temperature (37. 32 ± 0. 13 )℃; the effect of insulation blanket followed as second with nasopharyngeal temperature (36. 90 ± 0. 37)℃ and rectal temperature (37. 26 ± 0. 26)℃; intravenous infusion warming in combination with body wrapping keeping nasopharyngeal temperature (36. 48 ± 0. 36)℃ and rectal temperatures (36. 82 ± 0. 40)℃was the third best combination in all the tested groups;the differences were statistically significant (P<0. 01). Conclusions Differences of intraoperative warming methods are compared and summarized in open abdominal surgery patients as follows: intravenous infusion & flushing fluids warming plus insulation blanket is the best choice for patient insulation during surgery. Insulation blanket and intravenous infusion warming plus body wrapping are the second and third best option for insulation. Actively maintaining intraoperative body temperature to ensure safety of patients is the necessary measure for practicing high quality surgery nursing.

Objective To investigate the cognition and implementation situation of perioperative nursing care of temperature among nurses of Operating Room in second-class or third-class hospitals in Xinjiang region so as to provide evidence for improving the training of professional nurses and perioperative nursing care in Operating Room.Methods A self-designed questionnaire was applied to investigate and analyze the cognition of perioperative nursing care of temperature among 209 nurses of Operating Room.Results There were statistically significant differences in the level of knowledge on perioperative heat preservation,the rate of taking part in training,temperature monitoring,prevention of hypothermia and so on among nurses of Operating Room in thirdclass hospitals and second-class hospitals (P ＜0.01).The body temperature detector was 100.00％ equipped in Operating Room in third-class hospitals,while only 48.33％ in second-class hospitals with a statistical significance (P ＜ 0.01).Conclusions Second-class hospitals in Xinjiang region may gradually improve being equipped with the body temperature detector and nursing equipment of heat preservation.Third-class hospitals may take measures on special lecture,training course of continuing education,remote network and so on combined with the training of professional nurses of Operating Room to improve the integration level of perioperative nursing care of body temperature among in nurses of Operating Room in Xinjiang region.

Objective To study effects of 5 kinds of thermal insulation methods on anabiosis time and postoperative recovery of patients with laparotomy.Methods From January 2015 to December 2015,a total of 150 patients with laparotomy were randomly divided into transfusion +flushing fluid warming +blanket heating group (Group A),transfusion +body package group(Group B),blanket heating group(Group C),body package group (Group D)and conventional heat preservation group(Group E).Anabiosis time,drainage,surgical site infection and postoperative hospital stay were observed and compared.Results No difference of drainage 1 day after operation, hospital stay and surgical site infection were found(P >0.05);however,conventional heat preservation group had the longest anabiosis time,comparing with transfusion +flushing fluid warming +blanket heating the shortest(P <0.05).Conclusions Implementing active measures on temperature management aiming at controllable factors of hypothermia can shorten anesthesia time and patients′families waiting time after operation positively and help patients undergo anesthesia recovery period more smoothly.

Objective To explore the current status and influence factors of intraoperative hypothermia nursing intervention .Methods A total of 617 nurses in operation room from 17 hospitals were randomly selected by stratified cluster sampling method .The current status and influence factors of intraoperative hypothermia nursing intervention were analyzed with 6 scales.Results A total of 617 questionnaires were issued , and there were 607 valid questionnaires collected , with 98.4% recovery rate.The scores of cognition status scale , self-efficacy scale , safety culture assessment scale , Maslach Burnout Inventory , management status scale and behavior status scale were (77.02 ±8.40), (59.96 ±7.84), (87.84 ±9.67), (61.05 ±15.68), (38.28 ± 5.97) and (45.97 ±8.66), respectively.The single factor correlation analysis showed that job burnout was only related to behavior status (P<0.05), and there were correlations among all the other factors (P<0.05). The multiple linear regression analysis showed that the cognition status , safety culture, job burnout and management status were influence factors of behavior status of intraoperative hypothermia nursing intervention (P<0.05).Conclusions Besides providing cognitive training and belief intervention , the nursing managers should enhance the humanistic care for nurses in order to improve the implementation of intraoperative hypothermia nursing intervention and nursing service quality .