Objective:To investigate the clinical efficacy of superficial temporal artery-anterior temporal artery bypass combined with encephalo-duro-arterio-synangiosis in the treatment of Moyamoya disease.Methods:A total of 42 patients with moyamoya disease, admitted to our hospital from January 2016 to January 2019, were selected and divided into observation group and control group according to surgical management. The patients in the observation group were treated with superficial temporal artery-anterior temporal artery bypass combined with encephalo-duro-arterio-synangiosis, and the patients in the control group were treated with superficial temporal artery-angular gyrus artery bypass combined with encephalo-duro-arterio-synangiosis. The clinical data of these patients were analyzed retrospectively, and the differences of efficacy and safety between the two groups were compared.Results:There was no significant difference in operation time between the two groups ([189.16±21.23] min vs. [179.46±16.95] min, P>0.05). One d after the operation, the patients in both groups were re-examined with CT angiography, and the anastomotic vessels were unobligated. Two patients in the observation group had cerebral infarction in the operative region and one patient in the control group had cerebral infarction in the operative region; no significant difference was noted in the incidence of postoperative complications between the two groups ( P>0.05). The modified Rankin scale (mRS) scores in both groups one month after surgery were significantly decreased as compared with those one d before surgery ( P<0.05); one month after surgery, the mRS scores in observation group (0.13±0.346) were significantly lower than those in the control group (0.42±0.515, P<0.05). Conclusion:The superficial temporal artery-anterior temporal artery bypass combined with encephalo-duro-arterio-synangiosis has definite clinical efficacy in the treatment of moyamoya disease.

Background and purpose:The Shanghai Municipal Center for Disease Control and Prevention provides annual updates on cancer occurrence and trends in Shanghai.This study aimed to investigate the cancer incidence and mortality in 201 7 and their trends from 2002 to 2017 in Shanghai. Methods:Data of new cancer diagnoses and deaths from 2002 to 2017 were obtained from the Shanghai Municipal Center for Disease Control and Prevention population-based cancer registry and Vital Statistics System.Cancer incidence and mortality stratified by year of diagnosis or death,gender and age group were analyzed.Number,proportion,crude rate,age-specific rate,age-standardized rate and others were calculated.The number,proportion and rates of common cancers in different groups were also calculated.Trends in age-standardized rate of incidence and death rates for all cancers combined and for the common cancer types by gender were estimated by joinpoint analysis and characterized by the annual percent change(APC)and average annual percent change(AAPC).Segi's 1960 world standard population was used for calculating age-standardized incidence and mortality. Results:The new cancer cases and deaths were 79 378 and 37 186 in Shanghai in 2017.The crude rate of incidence was 546.55/105,and the age-standardized rate was 246.31/105.The age-standardized rate of incidence was higher among females than among males.The crude rate of mortality was 256.04/1 05,and the age-standardized rate was 88.41/105.The age-standardized rate of mortality was higher among males than among females.The age-specific numbers and rates of incidence and mortality increased with age.The age-specific number and rate of incidence reached the peak at the age groups of 60-64 years and older than 85 years,and those of mortality among males reached the peak at the age groups of 60-64 years and older than 85 years,and those of mortality among females reached the peak at the age groups of older than 85 years,respectively.The sites of top 10 common cancer types sorted by the number of incidence cases among males were lung,colorectum,stomach,prostate,liver,thyroid,pancreas,bladder,kidney and oesophagus,and among females were lung,breast,thyroid,colorectum,stomach,pancreas,liver,brain,central nervous system(CNS),cervix uteri and gallbladder,the sites of those sorted by the number of deaths among males were lung,stomach,colorectum,liver,pancreas,prostate,oesophagus,bladder,lymphoma and gallbladder,among females were lung,colorectum,breast,stomach,pancreas,liver,gallbladder,brain,CNS,ovary and lymphoma.The top 10 common cancer types stratified by gender and the top 5 common cancer types stratified by common age groups merged of incidence and mortality had wide variations.Overall,the age-standardized rates of incidence were stable from 2002 to 2009,and increased 2.88％on average per year from 2009 to 201 7.The age-standardized rates of mortality were stable from 2002 to 2011,and decreased 2.66％on average per year from 2011 to 201 7.The trends differed by gender and cancer type. Conclusion:Lung cancer,colorectal cancer,pancreatic cancer,thyroid cancer,female breast cancer,cervical cancer and male prostate cancer are the most common cancers in Shanghai,the appropriate screening technical scheme should be formulated according to the current situation of malignant tumors in Shanghai,promote cancer opportunistic screening,promote appropriate technologies for intervention and management of cancer patients in the community,reduce the disease burden of malignant tumors.

Objective:To investigate the survival of cancer cases diagnosed during 2002-2013 in Shanghai. Methods:Data on new cancer cases with dead and follow-up information were obtained from the population-based cancer registry and vital statistics system of Shanghai Municipal Center for Disease Control and Prevention.Survival indicators stratified by year of diagnosis,gender,site and age were analyzed.Number of cases and proportion were calculated.The observed survival rates were calculated based on the life table.The probabilities of surviving from 0 to 99 years old were estimated according to the Elandt-Johnson model,and then the cumulative expected survival rates were calculated according to the Ederer Ⅱ method.Finally,the relative survival rates and average annual percent changes of their trends were calculated.The age-standardized relative survival rates adjusted by International Cancer Survival Standard weights were calculated. Results:Total 644 520 new cancer cases were diagnosed during 2002-2013 in Shanghai,accounting for 643 545(99.85％)cases included in the observed cohort for survival analysis.The 5-year observed survival rate increased from 37.61％to 46.47％.The 5-year relative survival rate increased from 42.1 8％to 51.11％.The 5-year age-standardized relative survival rate increased from 40.57％to 49.80％.Among the 5-year relative survival rates of cases diagnosed during 2011 to 2013,99.43％of thyroid cancer was the highest,followed by female breast cancer(88.35％)and corpus uteri cancer(85.56％);5.87％of pancreas cancer was the lowest,followed by gallbladder cancer(13.64％)and oesophagus cancer(17.72％).the rate of lung cancer with the largest number of cases was 23.59％,followed by colorectal cancer(59.82％)and stomach cancer(38.65％).The 5-year relative survival rate of total cases of all sites increased from 40.55％in 2002 to 52.77％in 2013,with an average annual percent change of 2.40％.13 cancer types showed increasing trends,such as liver cancer and lung cancer,while the trends of other cancer types were not statistically significant,such as pancreatic cancer and gallbladder cancer. Conclusion:The diagnostic levels and survival rates of cancer cases have been improved continuously in Shanghai.The trends of different cancer types were varied.

Objective:To investigate the lung cancer incidence and mortality in 2016 and their trends from 2002 to 2016 in shanghai. Methods:The data of incidence and death on lung cancer in shanghai from 2002 to 2016 were obtained from the Shanghai Municipal Center for Disease Control and Prevention population-based cancer registry and Vital Statistics System.Lung Cancer incidence and mortality stratified by age of diagnosis or death,gender and age-group were analyzed.The number of cases and deaths,proportion,crude rates,age-specific rates,age-standardized rates,corresponding truncated age-standardized rates(35-64 years)and cumulative rates were calculated.Segi's 1960 world standard population was used for calculating age-standardized rates of incidence and mortality as well as truncated age-standardized rates.Trends in age-standardized rates of incidence and death for lung cancer in Shanghai from 2002-2016 were estimated by Joinpoint analysis and characterized by the annual percent change(APC). Results:The new lung cancer cases and deaths were 14 395 and 9 170 in Shanghai in 2016.The crude rate of incidence was 99.41/105,and the age-standardized rate of incidence was 39.76/105.New cases of lung cancer accounted for 19.34％of all malignant tumors in shanghai,ranking the first in the incidence spectrum of malignant tumors.The crude rate of mortality was 63.33/105,and the age-standardized rate was 21.57/105.Deaths of lung cancer accounted for 24.78％of all malignant tumor deaths in shanghai,ranking the first in the mortality spectrum of malignant tumors.The age-standardized rates of incidence and mortality for males were higher than those for females.The age-specific numbers and rates of incidence and mortality increased with age.The age-specific number and rate of incidence reached the peak at the age group of 60-64 years and 80-84 years respectively,and those of mortality peaked at the age group of 80-84 years and older than 85 years respectively.The incidence of lung cancer increased from 33.70/105 in 2002 to 39.76/1 05 in 2016 in Shanghai.Joinpoint analyses showed that the age-standardized rate of lung cancer incidence remained stable from 2002 to 2010(APC=-0.79,t=-1.46,P=0.175)but showed a significant upward trend with an average annual increase rate of 5.12％from 2010 to 2016(APC=5.12,t=6.97,P＜0.001).The standardized mortality showed a downward trend with an average annual decrease rate of 0.87％from 2002 to 2016(APC=-0.87,t=-2.87,P=0.013). Conclusion:The incidence of lung cancer in Shanghai during 2002-2016 presented an upward trend while the mortality of lung cancer showed a gradual downward trend.There are differences in the incidence and mortality of lung cancer among different gender and age groups.

Objective:To investigate the liver cancer incidence and mortality in 2016 and their trends during 2002 through 2016 in Shanghai. Methods:Data on new liver cancer diagnoses and deaths during 2002 through 2016 were obtained from the Shanghai Municipal Center for Disease Control and Prevention population-based cancer registry and Vital Statistics System,the numbers,crude rates and age-standardized rates of incidence and mortality of liver cancer were calculated.Segi's 1960 world standard population was used to calculate age-standardized rates.Joinpoint analysis was used to analyze the trend changes and to estimate the annual percent change of incidence and mortality rates. Results:There were 3 842 new liver cancer cases in Shanghai in 201 6,69.44％of which were males,and 3 275 deaths of liver cancer,69.44％of which were males.Mortality to incidence ratio was 0.85.The crude rate of incidence was 26.53/105,and the age-standardized rate was 10.60/105.The crude rate of mortality was 22.62/105,and the age-standardized rate was 8.65/105.The Sex ratios for age-standardized incidence and mortality were 2.91∶1 and 2.97∶1,respectively.The age-specific numbers and rates of incidence and mortality increased with age.Overall,the age-standardized rate of incidence of liver cancer was decreased 3.69％on average per year during 2002 through 2016,and the age-standardized rate of mortality of liver cancer was decreased 3.82％on average per year. Conclusion:The incidence and mortality of liver cancer in Shanghai have been remarkably decreased to a low level countrywide,while liver cancer is still one of the leading malignancies and it brings serious threat to public health,comprehensive prevention and control efforts should be strengthened according to its epidemic characteristics and risk factors.

Objective:More than half of esophageal cancer incidences and deaths occurred in China.Based on the Shanghai Tumor Registration data,this study analyzed the incidence and mortality of esophageal cancer in Shanghai in 2016 and the changing trend from 2002 to 2016,in order to provide an epidemic basis for the prevention and treatment of esophageal cancer. Methods:Data on esophageal cancer in Shanghai from 2002 to 2016 were obtained through Shanghai Municipal Center for Disease Control and Prevention Population-based Cancer Registry and Vital Statistics System.The number of cases and deaths,crude rates,composition ratios,age-specific rates and cumulative rates were counted according to the year of diagnosis or death,gender and age groups.Segi's 1960 world standard population was used to calculate age-standardized rates of incidence and mortality,and corresponding truncated age-standardized rate(35-64 years old)on esophageal cancer.Z-test and Cochran test were used to compare the differences of age-specific rates and age-standardized rates among different subgroups,respectively.Temporal trend analyses were conducted by Joinpiont 4.9.1.0 software. Results:In 2016,the proportion of morphological verification of new cases of esophageal cancer in Shanghai was 73.1 8％,the proportion of death certificate only was 0.72％,and the ratio of death to incidence was 0.84.The number of new cases and deaths of esophageal cancer in Shanghai in 2016 were 1 398 and 1 171,accounting for 1.88％and 3.1 6％of all malignant tumors,respectively.The crude incidence and mortality of esophageal cancer were 9.65/100 000 and 8.09/100000,with age-standardized incidence and mortality of 3.36/100 000 and 2.67/100,000,respectively.The age-standardized incidence and mortality were significantly higher in males than in females.The age-specific incidence and mortality increased with age,and peaked at 50.54/100 000 and 53.35/1 00 000,respectively,among people aged 85 years and older.From 2002 to 2016,both the number of new cases and deaths of esophageal cancer in Shanghai showed a downward trend,and the age-standardized incidence and mortality also showed a downward trend,with an average annual deceleration of 4.45％[annual percent change(APC)=-4.45,P＜0.001]and 4.1 7％(APC=-4.17,P＜0.001),respectively. Conclusion:The incidence and mortality of esophageal cancer in Shanghai were at a low epidemic level across China,and showed a downward trend from 2002 to 2016.Esophageal cancer screening should focus on males and subjects aged 55 to 64 years.

Objective:To analyze the incidence and mortality of prostate cancer in Shanghai in 2016 and trends during 2002-201 6,and to provide a basis for prostate cancer prevention and treatment. Methods:The data of prostate cancer incidence and mortality in Shanghai from 2002-2016 were obtained from the Population-Based Cancer Registry and Vital Statistics of Shanghai Municipal Center for Disease Control and Prevention.The incidence,mortality,proportion,crude rate,age-specific rate and age standardized rate of prostate cancer were calculated.Age-standardized incidence and mortality were calculated using Segi's 1960 world standard population.Trends of prostate cancer incidence,mortality,age-standardized rate and age-specific rate were estimated by Joinpoint 4.9.1.0 software. Results:In 2016,there were 3 226 cases of newly diagnosed prostate cancer and 1 067 deaths in Shanghai,crude rate of incidence was 44.91/105,crude rate of mortality was 14.85/105,age-standardized incidence and mortality were 15.47/105 and 4.34/105.Age-specific incidence and mortality increased with age,and reached the highest level in the 80-84 year-old group and 85-year-old group.Urban incidence was higher than suburb in the 50-54 year-old group,75-79 year-old group,and 80-84 year-old group,with no statistical difference in mortality.Between 2002 and 2016,incidence and mortality increased gradually,the rise of age-standardized incidence slowed down after 2012,and the age-standardized mortality in urban area declined after 2012.The age-standardized incidence in suburb increased faster than that in urban area,and the incidence rate increased faster in the younger age groups. Conclusion:The incidence and mortality of prostate cancer in Shanghai were lower than the world level but higher than the national level,and the incidence increased gradually between 2002 and 2016.Incidence and mortality were higher in urban area than in suburb,but increased faster in suburb,and the incidence increased more rapidly in younger age groups,but the proportion of early stages at diagnosis was still low,suggesting that appropriate screening strategies should be considered.

Objective:To investigate the incidence and mortality of ovarian,fallopian tube and other uterine adnexa cancer in 2016 and their trends during 2002 through 2016 in Shanghai. Methods:Data on new ovarian,fallopian tube and other uterine adnexa cancer diagnoses and deaths during 2002 through 2016 were obtained from the Shanghai Municipal Center for Disease Control and Prevention population-based cancer registry and Vital Statistics System.The incidence and mortality stratified by year of diagnosis or death,site and age-group were analyzed.The number,proportion,crude rate,age-specific rate,age-standardized rate and others were calculated.Trends in number,age-specific rate,age-standardized rate and others were estimated.Trends in age-standardized rate of incidence and mortality for the ovarian cancer were estimated by Joinpoint analysis and characterized by the annual percent change(APC).The number and proportion of selected indexes of diagnostic characteristics of new ovarian and fallopian tube cancer cases were also calculated.Segi's 1960 world standard population was used for calculating age-standardized rates. Results:The new uterine adnexa cancer cases and deaths were 813 and 440 in Shanghai in 2016.There were 751 cases(92.37％)and 419 deaths(95.23％)of ovarian cancer,and 48 cases(5.91％)and 17 deaths(3.86％)of fallopian tube cancer.The crude rate of ovarian cancer incidence was 10.29/105,and the age-standardized rate was 5.33/105.The crude rate of mortality was 5.74/105,and the age-standardized rate was 2.44/105.Overall,the age-specific rates of incidence and mortality increased with aging.They reached the peak at the age group of 55-59 years and 80-84 years,respectively.Joinpoint analyses showed a significant decreasing trend in the standardized incidence of ovarian cancer in Shanghai from 2002 to 2016,with an average annual increase of 1.78％(APC=-1.78,P＜0.001),while the increase in standardized mortality was not statistically significant.The proportion of pathological diagnosis on ovarian cancer increased to 85.02％,and the proportions of stageⅢ and Ⅳ continued to increase.The incidence of ovarian cancer in Shanghai from 2002 to 2016 showed a decreasing trend,while the mortality showed a fluctuating trend. Conclusion:In Shanghai,the age-standardized incidence rate of ovarian cancer was declined steadily,but the proportion of diagnosed advanced increased.The number of fallopian tube cancer cases increased steadily.

Objective:To describe the long-term characteristics and trend changes in the incidence and mortality of female breast cancer in Shanghai from 1 973 to 2017,aiming to provide references for exploring the etiology of breast cancer and formulating strategies and measures for prevention,intervention and control. Methods:Joinpoint software was used to analyze the trend changes in the incidence and mortality of female breast cancer in Shanghai from 1 973 to 2017,and an age-period-cohort model was constructed to explore the effects of age,year of diagnosis,and birth cohort on long-term trend changes. Results:From 1 973 to 2017,there were 68 192 new cases of female breast cancer in Shanghai,with a diagnosed rate of 31.72/100 000.The incidence rate continued to rise,and the risk of the disease continued to rise from the age of 20 years,and the rise rate accelerated significantly after the age of 40 years.There were 21 535 female breast cancer deaths from 1 973 to 2017.The mortality rate was stable,with a death rate of 8.62/100 000,and the risk of death increased significantly from the age of 45 years.The effects of age,period and cohort had a significant impact on the incidence of breast cancer(P＜0.01),while the increase in mortality rate was related to age and cohort effects(P＜0.01). Conclusion:The incidence rate of female breast cancer in Shanghai is still rising rapidly,and the mortality trend is generally stable,suggesting that the treatment is effective and the quality of life is improved.However,breast cancer is still the main malignant tumor among females in Shanghai.It should be continued to implement prevention and control strategies such as lifestyle intervention and screening of high-risk individuals to further strengthen the prevention and control of breast cancer.

Objective:To describe the epidemiological features and temporal trends of colorectal cancer in urban Shanghai from 1973 to 2017. Methods:Data on colorectal cancer in urban Shanghai was obtained through Shanghai Cancer Registry and Vital Statistics System.Joinpoint analysis was used to describe the temporal trends and annual percent change(APC)and age-period-cohort analysis was used to estimate the association between age,period and birth cohort and colorectal cancer. Results:A total of 105 847 cases and 60 447 deaths of colorectal cancer were diagnosed in urban Shanghai over the 45-year study period.Both the number of new cases and the number of deaths showed an increasing trend.In the same period,the age-standardized incidence of colorectal cancer in urban areas of Shanghai increased significantly from 14.1/100 000 in 1973 to 27.7/100 000 in 2017,while the age-standardized mortality rate increased from 8.2/100 000 to 10.7/100 000.The overall average annual age-standardized incidence and mortality rates were 20.4/100 000 and 11.0/100 000,respectively.With the increase of age,the age-standardized morbidity and mortality of colorectal cancer showed an obvious upward trend.Taking 1993-1997 as reference,the risk of colorectal cancer in Shanghai reached the highest in 2013-2017,and the corresponding relative risk was 1.2(95％confidence interval:1.2-1.3),while the lowest was 0.9(95％confidence interval:0.8-1.0)during 1973-1977.Mortality risk,on the contrary,decreased with the increase of time.Before 1953-1957,the risk of colorectal cancer in urban Shanghai increased with the increase of birth cohort time,and then showed a downward trend.There was a corresponding decline in the risk of colorectal cancer death among people born after 1957. Conclusion:The incidence and mortality of colorectal cancer in Shanghai showed an increasing trend from 1973 to 2017,but the prevalence trend of colorectal cancer is still different among different populations.