Objective To compare the refining effects between ethanol precipitation and chitosan flocculation methods on extracting solutions of Shuyu compound granules.Methods Orthogonal experiment was utilized to examine the influence of liquid concentration, alcohol concentration and standing time on refining of Shuyu compound granules extracting solution by ethanol precipitation method, and compare the impact of ethanol precipitation and chitosan flocculation methods on the contents of solids and paeoniflorin.Results The optimized condition of ethanol precipitation method was 0.8 g/mL solution concentration (crude drug) with 20% ethanol standing for 6 h. Both ethanol precipitation method and chitosan flocculation method reduced the extraction ratio of Shuyu compound granules decoction, but chitosan flocculation method caused a great loss of paeoniflorin.Conclusion Low concentration ethanol precipitation method can be used for the purification of Shuyu compound granules. Whether chitosan flocculation method is suitable requires further study.

Objective: To investigate the trends in the disease burden of leukemia in Jiangsu Province from 1990 to 2019, so as to provide insights into leukemia control in Jiangsu Province. Methods: The prevalence, incidence, death and disability adjusted life years (DALYs) of leukemia in Jiangsu Province from 1990 to 2019 were retrieved from the 2019 Global Burden of Disease Study (GBD 2019) database, and standardized by the age structure of Chinese populations in 2000. The trends in the disease burden of leukemia in Jiangsu Province from 1990 to 2019 were analyzed using average annual percent change (AAPC). Results : The average annual standardized prevalence, incidence, mortality and DALY rate of leukemia were 63.63/105, 9.76/105, 4.10/105 and 194.83/105 in Jiangsu Province from 1990 to 2019, respectively. The average annual standardized prevalence (AAPC=1.420%, t=5.644, P<0.001) and incidence (AAPC=0.806%, t=3.505, P<0.001) of leukemia appeared a tendency towards a rise, while the average annual standardized mortality (AAPC=-1.589%, t=-14.714, P<0.001) and DALY rate (AAPC=-1.849%, t=-9.046, P<0.001) of leukemia appeared a tendency towards a decline in Jiangsu Province from 1990 to 2019. Higher average annual standardized prevalence (65.27/105 vs. 62.38/105, P<0.001), incidence (10.32/105 vs. 9.29/105, P<0.001), mortality (4.69/105 vs. 3.57/105, P<0.001) and DALY rate of leukemia (216.94/105 vs. 172.80/105, P<0.001) were estimated among men than among women. The crude prevalence of leukemia peaked among patients at ages of 0 to 14 years and 60 to 74 years, and the crude incidence, DALY rate and mortality of leukemia peaked at ages of 0 to 14 years and 75 years and older. Conclusions The mortality and DALY of leukemia appeared a tendency towards a decline and the prevalence and incidence appeared a tendency towards a rise in Jiangsu Province from 1990 to 2019; however, there were high disease burdens of leukemia among men, children and the elderly.

Objective: To estimate the cancer incidence and mortality in Jiangsu, 2013. Methods: Up to June 2016, registration data in 2013 from 35 cancer registries in Jiangsu was collected by Jiangsu Provincial Central Cancer Registry. All data were checked and evaluated by the method and criteria of data quality control making by the National Central Cancer Registry, data from 34 registries' data were eligible and accepted as pooled data. Stratified by urban and rural, gender, age and cancer site, crude incidence/mortality rate, age-specific incidence/mortality rate, age-standardized incidence/mortality rate by Chinese standard population, age-standardized incidence/mortality rate by world standard population, composition, cumulative incidence/mortality rate (0-74 age years old) and the 10 leading cancers were calculated. Cancer incidence and mortality were estimated by using provincial population of Jiangsu in 2013. Chinese population census in 2000 and World Segi's population were used to age-standardize incidence and mortality. Results: All 34 cancer registries (10 in urban and 24 in rural areas) covered a total of 38 938 470 population (19 682 921 in males and 19 255 549 in females), accounted for 51.12% of whole provincial population in 2013. It was estimated that new cancer cases and cancer deaths were 232.6 thousands (136.7 thousands in males and 95.9 thousands in females) and 155.3 thousands (99.7 thousands in males and 55.6 thousands in females), respectively. The crude incidence rate in Jiangsu in 2013 was 305.22/100 000, age-standardized incidence rate by Chinese standard population and by world standard population were 184.04/100 000 and 181.16/100 000, respectively, with cumulative incidence rate (0-74 age years old) of 21.38%. The crude mortality rate was 203.94/100 000, age-standardized mortality rate by Chinese standard population and by world standard population were 116.28/100 000 and 115.12/100 000, respectively, with cumulative mortality rate (0-74 age years old) of 13.11%. Cancers of lung, esophagus, stomach, liver, colorectum and female breast were the most common cancers in Jiangsu, accounting for about 71% of all new cancer cases in 2013. Lung cancer, esophageal cancer, stomach cancer, liver cancer and colorectal cancer were the leading cause of cancer death, accounting for about 74% of all cancer deaths. Conclusion The crude incidence and mortality rate of cancer in Jiangsu Province were at a high level. For the most common cancers such as lung, esophagus, stomach, liver, colorectum and female breast cancer, effective prevention and control activities should be strengthened.

Background and objective hTe lung cancer incidence was signiifcantly increased in the past two de-cades in China. But the secular trend of lung cancer incidence difference between gender (male and female), area (urban and rural) and average age was not clear. hTe aim of this study is to analyze the trend of lung cancer incidence rate ratio between gender, area and average age in China during 1989-2008, and provide some inspiration for lung cancer prevention and control activities. Methods Cancer registry data and population data in China from 1989 to 2008 were collected by the National Cancer Registration Center. Stratiifed for gender and area, Poisson regression model was used to estimate annual lung cancer incidence rate ratio between male and female, urban and rural areas. hTe average age of lung cancer incidence was calculated. Linear regression was used to model the trend of annual incidence rate ratio and average age over time. Results Incidence rate ratios of lung cancer between male and female, urban and rural areas were signiifcantly decreased from 2.47 and 2.07 to 2.28 and 1.14 during 1989-2008, respectively. Meanwhile, the average age of lung cancer incidence among male and female dramati-cally increased from 65.32 and 65.14 to 67.87 and 68.05, respectively. Conclusion hTe difference of lung cancer incidence between male and female, urban and rural areas remarkably decreased from 1989 to 2008. hTe average age of lung cancer oc-currence gradually increased. Researches, prevention and control activities on lung cancer with consideration of new incidence pattern should be strengthened.

[Purpose]To investigate the trends of incidence and age at onset of female breast can-cer in Jiangsu cancer registration areas from 2009 to 2019.[Methods]The continuous monitoring data of female breast cancer from 2009 to 2019 were collected from 16 cancer registries in Jiangsu Province.All datasets were checked and evaluated based on data quality control criteria and were included in the analysis.Crude rate(CR),age-standardized incidence rate by Chinese standard population(ASIRC),the average annual percentage change(AAPC),crude and adjusted mean age at onset were calculated.Incidence rates stratified by regions and age groups were calculated.Age-period-cohort model was used to analyze the changes of cancer incidence and age-adjusted mean ages.[Results]The incidence CR of female breast cancer was significantly increased from 24.39/105 in 2009 to 46.72/105 in 2019 with an AAPC in CR of 6.97％(95％CI:5.26％～8.70％)and AAPC in ASIRC of 4.67％(95％CI:3.00％～6.37％).The crude mean age and adjusted mean age at onset increased from 54.10 and 52.89 years old in 2009 to 56.23 and 53.36 years old in 2019,respectively.Crude mean age at onset increased significantly over time in all registry areas(β=0.21,P＜0.001),urban(β=0.1 8,P＜0.001)and rural(β=0.25,P＜0.001)areas,while adjusted mean age at onset remained stable in all registry areas(β=0.05,P=0.024)and rural areas(β=0.09,P=0.008).From 2009 to 2019,the incidence rate of female breast cancer of all age groups showed upward trends,with an average annual growth rate of 3.26％to 7.79％(all P＜0.05),and the incidence rate in rural areas increased faster than that in urban areas.The age composition of breast cancer onset and standardized age composition of onset in women over 60 years old showed an upward trend(all P＜0.05).[Conclusion]The incidence rate of female breast cancer in Jiangsu Province in-creased from 2009 to 2019,and the mean age of onset showed a backward trend.

Objective: To analyze the incidence and mortality of colorectal cancer in Jiangsu province in 2015. Methods: Based on the method and criteria of data quality control from the National Central Cancer Registry, data in 2015 from 42 cancer registries in Jiangsu were evaluated by the Jiangsu Provincial Center for Disease Control and Prevention. Data from 35 registries were qualified after assess-ment and accepted as pooled data. Stratified by urban-rural, gender, and age groups, the crude rates of colorectal cancer incidence and mortality, age-standardized incidence/mortality rates, age-specific incidence/mortality rates, cumulative incidence/mortality rate (0-74 years old), and truncated age-standardized incidence/mortality rate (35-64 years old) were calculated. The Chinese population census in 2000 and Segi's standard world population were used for age-standardized incidence/mortality rates. Results: The 35 cancer registries covered a population of 38,761,144 (15,168,594 in urban areas, 23,592,550 in rural areas) in Jiangsu province in 2015. The number of new cases of colorectal cancer were 11,051, with a crude incidence rate of 28.51/105. The age-standardized incidence rates by the Chinese Standard Population (ASRC) and World Standard Population (ASRW) were 15.43/105 and 15.20/105, respectively. The cu-mulative incidence rate (0-74 years old) was 1.81%, with a truncated age-standardized incidence rate (35-64 years old) of 23.71/105. The crude and ASRC incidence rates in urban areas were 33.87/105 and 18.44/105, respectively, whereas those in rural areas were 25.06/105 and 13.54/105, respectively. The number of deaths due to colorectal cancer was 5,436, with a crude mortality rate of 14.02/105. The ASRC, ASRW, cumulative (0-74 years old), and truncated (35-64 years old) mortality rates were 6.92/105, 6.81/105, 0.70%, and 8.08/105, respectively. The crude and ASRC mortality rates in urban areas were 16.57/105 and 8.27/105, respectively, whereas those in rural areas were 12.39/105 and 6.07/105, respectively. Conclusions: There remains a heavy burden of colorectal cancer in Jiangsu. The incidence and mortality of colorectal cancer show a rising trend in Jiangsu in 2015. The burden and patterns of colorectal cancer show urban-rural differences. Preventative and control strategies should be implemented.

Objective:To evaluate the associations between CYP24A1 genetic polymorphisms and related risks on breast cancer among postmenopausal women.Methods:We carried out a population-based case-control study to include 1 134 postmenopausal women (589 cases and 545 controls) from Wuxi, Jiangsu province and to explore the association between CYP24A1 polymorphisms and related risks on breast cancer. Seven CYP24A1 variants (rs2209314, rs2585428, rs2762941, rs3787555, rs4909959, rs912505 and rs927650) were genotyped by Sequenom MassARRAY platform. Logistic regression method was used to estimate the CYP24A1 genetic variants and susceptibility of breast cancer. Loci-loci interactions were evaluated by a generalized multifactor dimensionality reduction (GMDR) method.Results:Result showed that rs2209314, rs2585428, rs2762941, rs3787555, rs4909959, rs912505 and rs927650 of CYP24A1 were not associated with breast cancer under the codominant, dominant, recessive or additive models. Among the population with <80 cm waist circumstance, rs2585428 was associated with the reduced risks on breast cancer ( OR=0.64, 95 %CI: 0.42-0.96). Similar negative association was observed for rs3787555 ( OR=0.58, 95 %CI: 0.38-0.87). The genotypes of rs2585428, rs3787555 and rs4909959 showed significant interactions with waist circumstance on the risk of breast cancer. Also, rs2209314, rs3787555 and rs912505 in CYP24A1 could alter the risk of breast cancer by way of loci-loci interaction. Conclusion:CYP24A1 variants rs2585428 and rs3787555 were associated with risks of susceptibility on breast cancer, among postmenopausal women.

Liver cancer is a significant contributor to the world's cancer burden. In order to comprehend the variations in its regional, age, gender, and histological subtype distributions as well as its temporal trend, this paper analyzes the worldwide statistical data of liver cancer, including the incidence, mortality, and survival. The findings indicated that the stages of liver cancer control and prevention are heterogeneous among countries and regions. The successful experience of liver cancer control and prevention in some countries should be promoted and disseminated. According to the various national conditions, comprehensive intervention measures, including reducing aflatoxin exposure, promoting vaccination, improving the treatment of chronic hepatitis infection, and implementing early diagnosis and treatment of liver cancer, should be developed.

Objective:To assess the influence of extreme temperature events on the mortality risk of nervous system diseases in residents of Jiangsu Province and identify patients with nervous system diseases who are susceptible to extreme temperature events.Methods:Acase-crossover design was used to investigate the cumulative lagged effects of extreme temperature events on the mortality risk of nervous system disease in local residents by using the data on causes of death from nervous system diseases in Jiangsu from 2014 to 2020 with conditional logistic regression model. The final definition of extreme temperature events was established using Akaike information criterion. The heat wave was defined as 4 or more consecutive days with daily mean temperatures above the 92.5 th percentile of annual daily mean temperatures, and the cold spell was defined as 2 or more consecutive days with daily mean temperatures below the 10 th percentile of annual daily mean temperatures. Furthermore, stratified analyses was conducted to compare the effects of extreme temperature events on mortality risk in populations in different gender, age and marital status groups to identify susceptible populations to extreme temperature event. Results:Statistical results showed that the effect values of heat wave and cold spell on the mortality risk of nervous system diseases all peaked at the 7 th day of the cumulative lag, with OR of 1.60 (95% CI: 1.44-1.76) and 1.33 (95% CI: 1.13-1.56), respectively. Heat wave exposure increased mortality risk for individuals with Alzheimer's and Parkinson's diseases, while cold spell exposure increased the mortality risk for those with Alzheimer's disease. Stratified analyses showed that the mortality risk for nervous system disease and Alzheimer's disease was higher in partnerless population after heat wave exposure. Conclusions:Heat wave and cold spell were associated with increased mortality risks for nervous system disease, highlighting the need for improved early warning systems for extreme temperature event. In the context of heat wave, interventions to protect individuals with nervous system disease should prioritize partnerless population.

[Purpose]To analyze the trend of gastric cancer incidence and age characteristics in Jiangsu cancer registration areas from 2009 to 2019.[Methods]Cancer registration data from 2009 to 2019 meeting quality control requirements were collected from 16 cancer registries in Jiangsu Province.The crude incidence rate and age-standardized incidence rate by Chinese standard population in 2000(ASIRC)were calculated by gender,urban/rural areas and age groups.The inci-dence trends were analyzed by Joinpoint.A birth cohort model was constructed to calculate the in-cidence rate of gastric cancer for men and women born between 1929 and 2019.The age composi-tion of gastric cancer incidence in Jiangsu Province between 2009 and 2019 was calculated and compared.[Results]The crude incidence rate and ASIRC of gastric cancer in Jiangsu cancer regi-stration areas from 2009 to 2019 showed a significant decreasing trend in both male and female or urban and rural areas,in which the decrease in male(AAPC=-1.28％,P＜0.001)was higher than that of female(AAPC=-1.17％,P=0.030),and the decrease in urban(AAPC=-1.66％,P＜0.001)was higher than that of rural(AAPC=-0.72％,P＜0.001).The incidence rates of gastric cancer in age groups of 40～79 years old showed a significant decreasing trend from 2009 to 2019 with the AAPC ranging from-6.75％to-3.54％(all P＜0.05).In age groups of 40～79 years old,the inci-dence rates of gastric cancer among people with different years of birth showed a decreasing trend with the increase of the birth year.For ASIRC,the composition of patients aged 60 years old above increased by 0.63％(95％CI:0.46％～0.81％)per year from 2009 to 2019.[Conclusion]The inci-dence rate of gastric cancer in cancer registration areas of Jiangsu Province from 2009 to 2019 showed a decreasing trend,the average age of incidence showed a trend of backward moving,and for age-standardized incidence the proportion of patients over 60 years old was increased.