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.

Objective:To evaluate the effect of job-transfer training for psychiatrists in Henan province in 2018 and to compare them with the results of 2016.Methods:Data of the trainees were collected through questionnaires in 2017 and 2019 respectively. The influencing factors of knowledge and skills were determined by Multiple linear regression analysis; baseline data, training intention, training feedback and the proficiency of knowledge and skills were compared by independent sample t test and chi-square test. Results:The overall satisfaction rate for training was 98.3%, and the overall mastery rate of training knowledge and skills was 59.2% in year 2018. Compared with 2016, the willingness to participate in training, the satisfaction rate, the recognition degree of " 1+ 10+ 1" training mode, the degree of mastery and practical application of training knowledge and skills increased( P<0.05). There were statistically significant differences in the distribution of the primary reasons for participating in the training, factors hindering their participation in the training, and the causes for their failure to fully apply their learning to practice( P<0.01). The results showed that scope of practice, title, intention, and interest in psychiatry was related to the mastery of training knowledge and skills( P<0.05). Conclusions:The effect of training in 2018 is better than 2016, and the degree of mastery and practical application of training knowledge and skills should be increased.

Objective: To survey mental health knowledge and its influence factors among undergraduates in Henan provenience and to provide a scientific evidence for further formulating the targeted strategies. Methods: Totally 840 agriculture and forestry college students, literature and history students, science students and medical students were selected with stratified multistage random sampling from 45 colleges and universities in Henan provenience,investigation of Mental Health related knowledge by self-designed questionnaire. Results: The awareness rate of mental health knowledge was 75.86%(32 806/43 248). Multivariate linear regression analysis showed that score of mental health knowledge of femal students was 1.03 of the of male students; score of medical students was 5.19,3.65,2.65 of that of students in the other majors; score of students who obtained mental health knowledge through other channels(television/movie/network/talking) was 1.42 of that of than those who obtained through formal approaches(slogans/manuals/broadcast/cathedra)(P<0.05). Conclusion The awareness rate of mental health knowledge among undergraduates in Henan provenience need to be improved, the education of male, senior students, non-medical students and the explore of diversified forms should be strengthened.

Objective: To explore the effectiveness and cost of breast cancer screening strategy that is suitable for the current econom-ic conditions in China. Methods: We collected clinical and cost information of breast cancer screening for Chinese women based on previous screening programs conducted from February 2008 to December 2011 and collected the same information about breast can-cer cases diagnosed in hospitals at the same time. Markov models were developed to analyze the incremental cost-effectiveness ratios (ICER) for 132 breast cancer screening strategies compared to no screening for Chinese women. Results: In 2010, as compared to no screening, the most cost-effective breast cancer screening strategy was biennial screening with clinical breast examination (CBE) and breast ultrasound, in parallel, for women aged between 40 to 64. This screening strategy could save 1,394 quality-adjusted life years (QALY) per 100,000 women, and the cost of saving breast-cancer related QALY would be 91,944 RMB. Sensitivity analysis indicated that in 2016, the most cost-effective breast cancer screening strategy was biennial screening with CBE and mammography (MAM), in parallel, for women aged 40 to 64, with ICER of 159,637 RMB per QALY. Conclusions: Population-based breast cancer screening would be acceptable in the current conditions in China. As the Chinese economy and level of medical care improve, breast cancer screening would be more cost-effective.

AIM: To investigate the influences of microRNA-126 on the curative effect of chemoradiotherapy and radiosensitivity of SGC-7901 cells.METHODS: The patients of gastric cancer (n=60) were selected in this study including 32 males and 28 females with the average age of (51±7) years.All patients received similar chemoradiotherapy strategy.The tissue and blood samples were collected during treatment.The short-term curative effect was evaluated by the Response Evaluation Criteria in Solid Tumors (RECIST), and the patients were divided into sensitive group and insensitive group.The microRNA-126 levels were detected by RT-qPCR.The SGC-7901 cells were maintained in vitro and transfected with microRNA-126 mimic.The plate colony formation assay was used to determine the enhancement effect of microRNA-126 on radiosensitivity of the SGC-7901 cells.The apoptotic rate of the SGC-7901 cells induced by microRNA-126 was analyzed by flow cytometry.RESULTS: According to the RECIST, 28 cases were defined as sensitive patients and 32 cases were the insensitive patients.Compared with the sensitive patients, the microRNA-126 levels both in blood and tissue samples were lowered in the insensitive patients, and the relative fold changes were 0.72±0.04 and 0.48±0.03, respectively (P<0.05).After transfection with microRNA-126 minic, the SF2 and D0 in the SGC-7901 cells were decreased with the SER of 1.74.Furthermore, microRNA-126 induced apoptosis of SGC-7901 cells and enhanced their radiosensitivity.CONCLUSION: The patients with low microRNA-126 level may suffer a poor curative effect of chemoradiotherapy on the gastric cancer.MicroRNA-126 has an enhancement effect on the radiosensitivity to the SGC-7901 cells.

By reviewing the latest published papers on palliative care, the article discussed the development and research progress of palliative care for people with advanced cancer, so as to provide reference for the development of palliative care specialty. According to the analysis, it suggested that by means of striving for more government support in both economic and education, raising funds through various channels, perfecting the social insurance system and volunteer′s regimen, promoting group working model, establishing standardized policies and regulations, increasing the publicity of palliative care, palliative care would move forward to a professional and normalized road, so that the people with incurable disease will receive better palliative care to improve the quality of life to the most.

Objective To evaluate the different statins in the treatment of elderly patients with primary hyperlipidemia. Methods A total of 76 patients with primary hyperlipidemia admitted in our hospital from January 2013 to November 2014 were randomly divided into two groups. For 39 cases in the observation group, chose rosuvastatin treatment; for 37 cases in the control group, chose the atorvastatin treatment. Two groups of patients were observed and compared in the clinical efficacy, the degree of improvement in various lipid levels and the incidence of adverse reactions. Results The rate of excellent clinical efficacy in the observation group was 92.3%, significantly better than that was the 70.3%in the control group,the difference was statistically significant(P<0.05);The degree of improvement in lipid levels in the observation group was bigger than that in the control group,the difference was statistically significant(P<0.05);inflam-mation factor of the observation group was lower than that in the control group, the difference was statistically signifi-cant(P<0.05). Conclusion The clinical efficacy of rosuvastatin treatment of primary hyperlipidemia is good,can effec-tively improve lipid levels in patients, reduce inflammation in the body concentration factor, deserves in clinical prac-tice.