Objective To analyze the epidemic status of breast cancer globally and in China based on gender(female),age,and human development index(HDI)according to the Global cancer statistics 2022 published by the International Agency for Research on Cancer.Methods The epidemiological data of breast cancer from 185 countries and territories were sourced from the GLOBOCAN 2022 database.The HDI data were compiled based on the Human development report 2022 published by the United Nations Development Programme.The epidemiological data were stratified by age,gender,and HDI to describe the prevalence of breast cancer globally and in China.Pearson correlation analysis was used to evaluate the correlation of standardized incidence rate(SIR),standardized mortality rate(SMR)and mortality-to-incidence ratio(M/I)with HDI.Results The data of 175 countries and territories were included.The number of breast cancer incident cases worldwide was 2 297 000 in 2022,ranking the 2nd only to lung cancer,with an SIR of 46.8 per 100 000(ranking the 1st in the world).The number of breast cancer deaths globally was 666 000,ranking the 4th among all cancer deaths,with an SMR of 12.7 per 100 000(ranking the 2nd worldwide).In China,the number of breast cancer incident cases was 357 000,ranking the 6th among all cancers,accounting for 15.5％of the global breast cancers,with an SIR of 33.0 per 100 000(ranking the 2nd among all cancers in China).The number of breast cancer deaths in China was 75 000,ranking the 7th among all cancer deaths,accounting for 11.3％of the global breast cancer deaths,with an SMR of 6.1 per 100 000(ranking the 6th among all cancer deaths in China).For females around the world,the number of breast cancer incidents and deaths,SIR,and SMR ranked the 1st among all cancers.For Chinese females,both the incident number of breast cancer and SIR ranked the 2nd,while the deaths and SMR ranked the 5th and the 4th,respectively.SIR was positively correlated with HDI(r=0.76,P＜0.01),M/I was negatively correlated with HDI(r=-0.89,P＜0.01),while SMR was not correlated with HDI(r=-0.09,P=0.23).The incidence of breast cancer worldwide and in China increased with age from 25 to 29 years old.The number of breast cancer deaths in the world increased with age from 30 years old,peaked at 50-59 years old,and declined after 70 years old.The breast cancer deaths in China showed 2 small peaks at the age of 50-54 and 65-69 years old,and gradually decreased after 70 years old.The age-dependent trend of SIR varied in different countries and territories with different HDI levels,as well as globally and in China,whereas SMR continued to increase with age.Conclusion The disease burden of breast cancer is serious globally and in China.Especially in females,both SIR and SMR rank the 1st in the world;although they rank the 2nd and the 4th,respectively,in China,the number of incidents and deaths cannot be ignored.HDI is positively correlated with SIR and negatively correlated with M/I,however,with no correlation with SMR.The SIR in countries and territories with different HDI levels changes differently with age,while SMR increases with age in all.

Colorectal cancer (CRC) ranks among the most prevalent malignant tumors globally and poses a severe threat to human health. Surgical resection remains the cornerstone of CRC treatment. With the rapid advancement of minimally invasive techniques, the Da Vinci surgical robot has been increasingly adopted in CRC management. This article will systematically review the current application of the Da Vinci robotic system in minimally invasive CRC treatment, analyzes its advantages and limitations, and discusses future prospects, aiming to provide references for clinical practice and further research.

Objective To investigate the application effect of traditional Chinese medicine(TCM)in treating bone marrow suppression induced by chemotherapy for pancreatic cancer.Methods A retrospective analysis was conducted on the clinical data of 53 pancreatic cancer patients who under-went chemotherapy induced bone marrow suppression at Fudan University Shanghai Cancer Center be-tween January and August 2024.All patients developed varying degrees of bone marrow suppression during the first to third cycles of conventional chemotherapy.In the fourth cycle of chemotherapy,TCM was added,and the improvement in bone marrow suppression after TCM treatment was ob-served.Results After thefirst cycle of chemotherapy,all patients exhibited different degrees of bone marrow suppression,including leukopenia,thrombocytopenia,neutropenia,and anemia.Compared with combined TCM treatment before,among patients with bone marrow suppression of grade Ⅱ and above,the proportion of those with leukopenia decreased significantly after one month of TCM treat-ment(P=0.019),and the proportion of those with thrombocytopenia also decreased,but the differ-ence was not statistically significant(P=0.066).There was no statistically significant difference in the proportion of patients with neutropenia before and after TCM treatment(P=0.231).One month after TCM treatment,the white blood cell count,hemoglobin level,and platelet count of the patien-tsincreased comparedto before combined treatment(P=0.006,P=0.011,P＜0.001).One month after TCM treatment,the average number of use of recombinant human granulocyte colony-stim-ulating factor and recombinant human thrombopoietin were(2.8±1.9)times/cycle and(3.1±1.2)times/cycle,respectively,which were less than those before combined TCM treatment[(4.5±1.7)times/cycle and(4.5±1.3)times/cycle](P=0.002,0.038).Conclusion Combined TCM treatment can improve adverse reactions of bone marrow suppression after chemotherapy for pancreatic cancer and increase white blood cell count and hemoglobin level.

Objective:This study aimed to develop a new delivery strategy that utilized metal organic framework (MOF) loaded with small-interfering RNA (siRNA) targeting ITGAV to overcome tumor matrix barrier, and thus enhance drug penetration and immune accessibility in breast cancer.Methods:MOF@siITGAV particles were constructed and characterized. The uptake of MOF@siITGAV in breast cancer cell line 4T1 was observed by the cellular uptake assay. The toxicity of MOF@siITGAV was detected by cell counting kit 8 (CCK-8). The blank control group, naked siITGAV group and MOF@siITGAV group were set. Real-time fluorescent quantitative polymerase chain reaction (RT-qPCR) and Western blot were used to detect the expressions of ITGAV. The level of transforming growth factor β1 (TGF-β1) in the cell culture medium was detected by enzyme-linked immunosorbent assay (ELISA). The penetration of MOF@siITGAV in 4T1 cells was tested by constructing 3D spheroids. Mouse models of triple negative breast cancer were established. The effect of MOF@siITGAV on the growth of transplanted tumors and main organs was verified. Imminohistochemical (IHC) was used to test the expression of collagen and CD8.Results:MOF@siITGAV particles were constructed with sizes of (198.0±3.3) nm and zeta potential of -(20.2±0.4) mV. MOF@siITGAV could be engulfed by 4T1 cells and triggered to release siRNA. Compared to the blank control group, the expression of ITGAV in the MOF@siITGAV group [(46.5±11.3)%] and the naked siITGAV group [(109.9±19.0)%] was lower. TGF-β1 in the cell culture medium of the blank control group, naked siITGAV group, and MOF@siITGAV group was (474.5±34.4) pg/ml, (437.2±16.5) pg/ml, and (388.4±14.4) pg/ml, respectively. MOF@siITGAV could better penetrate into 4T1 spheroids and exhibit no obvious toxicity. The cell viability was (99.7±3.5)%, (98.2±5.2)%, (97.3±6.6)%, (92.1±8.1)%, and (92.4±4.1)%, respectively, after MOF@siITGAV treatment with the concentration of 0, 10, 20, 40, 80, and 160 μg/ml, respectively, for 24 h. The tumor growth in the MOF@siITGAV group was suppressed significantly. After 15-day treatment, the tumor volume of the MOF@siITGAV group was (135.3±41.9) mm 3, smaller than that of the blank control group [(691.1±193.0) mm 3] ( P=0.025). The expression of collagen and the number of CD8 positive cells of the MOF@siITGAV group were lower than those of the other two groups. No significant abnormalities were observed in the main organs of mice. Conclusions:Targeting the integrinαv on the surface of cancer cells could destroy extracellular matrix, improve drug delivery, and increase immune infiltration.

Objective:To investigate the diagnostic efficacy of ultrasound in pregnancy associated breast cancer (PABC) under different breast ultrasound background echotextures.Methods:The ultrasonic images of 269 female patients with breast diseases who underwent breast surgery in Fudan University Shanghai Cancer Center from January 2016 to September 2023 and were pregnant or within one year postpartum at the time of onset were retrospectively reviewed. Breast ultrasound background echotextures were classified according to two criteria: the first classification was homogeneous-fat, homogeneous-fibroglandular, and heterogeneous; the other classification was hypoechoic dominated and hyperechoic dominated. The comparison of the diagnostic value of ultrasound in PABC under different backgrounds was conducted by the receiver operating characteristic(ROC) curves.Results:Among 269 patients, 67 patients(24.91%)were during pregnancy and 202 patients(75.09%) were within one year postpartum. Pathologically, 47 patients (17.47%) were confirmed as benign, 222 patients (82.53%) were malignant. According to the first classification, 138 patients were homogeneous-fibroglandular and 131 patients were heterogeneous, with the diagnostic sensitivity of ultrasound in PABC were 88.70% and 59.81% respectively, and the specificity were 91.30% and 83.33% respectively, the areas under the ROC curves were 0.940 and 0.826 respectively ( P=0.022). According to the second classification, 119 were hypoechoic dominated and 150 patients were hyperechoic dominated, the sensitivity were 60.21% and 85.27% respectively, the specificity 84.62% and 90.48% respectively, the areas under the ROC curves were 0.826 and 0.925 ( P=0.042). Conclusions:The heterogeneous background echotextures of the breast may cause decrease of the diagnostic efficiency of ultrasound in PABC, and hypoechoic dominated background was more unfavorable for the diagnosis of PABC compared to the hyperechoic dominated background.

Objective Under the background of building age-friendly hospitals,it aims to explore the satisfaction and influencing factors of elderly patients in Shanghai City,which has the highest degree of aging in China,in order to provide reference for improving the age-friendly hospitals.Methods According to the framework of building age-friendly hospitals,a survey questionnaire is designed around friendly services and friendly environment,and the Likert 5-level rating is used.Select one medical institution in the central urban area and one in the suburbs of Shanghai City,both of which are grade-A tertiary age-friendly hospitals,and outpatient patients were randomly selected to participate in the questionnaire survey.A total of 2 418 elderly patients(≥60 years old),were ultimately surveyed.Results Elderly patients'overall satisfaction with medical care,with an average score of 4.77,is very satisfactory;the ratings of friendly service and friendly environment are very good,but relatively speaking,the friendly service is better and the friendly environment is weaker.Among elderly patients,younger(60～74 years old),male,and those living in other places have higher satisfaction.Friendly service and friendly environment are both influencing factors of satisfaction,with friendly service having a greater impact weight.Conclusion Good friendly service should be maintained,and weak friendly environment should be strengthened.Continuously improve age-friendly hospitals and enhance the medical experience of elderly patients.

Objective Under the background of building age-friendly hospitals,it aims to explore the satisfaction and influencing factors of elderly patients in Shanghai City,which has the highest degree of aging in China,in order to provide reference for improving the age-friendly hospitals.Methods According to the framework of building age-friendly hospitals,a survey questionnaire is designed around friendly services and friendly environment,and the Likert 5-level rating is used.Select one medical institution in the central urban area and one in the suburbs of Shanghai City,both of which are grade-A tertiary age-friendly hospitals,and outpatient patients were randomly selected to participate in the questionnaire survey.A total of 2 418 elderly patients(≥60 years old),were ultimately surveyed.Results Elderly patients'overall satisfaction with medical care,with an average score of 4.77,is very satisfactory;the ratings of friendly service and friendly environment are very good,but relatively speaking,the friendly service is better and the friendly environment is weaker.Among elderly patients,younger(60～74 years old),male,and those living in other places have higher satisfaction.Friendly service and friendly environment are both influencing factors of satisfaction,with friendly service having a greater impact weight.Conclusion Good friendly service should be maintained,and weak friendly environment should be strengthened.Continuously improve age-friendly hospitals and enhance the medical experience of elderly patients.

Objective Under the background of building age-friendly hospitals,it aims to explore the satisfaction and influencing factors of elderly patients in Shanghai City,which has the highest degree of aging in China,in order to provide reference for improving the age-friendly hospitals.Methods According to the framework of building age-friendly hospitals,a survey questionnaire is designed around friendly services and friendly environment,and the Likert 5-level rating is used.Select one medical institution in the central urban area and one in the suburbs of Shanghai City,both of which are grade-A tertiary age-friendly hospitals,and outpatient patients were randomly selected to participate in the questionnaire survey.A total of 2 418 elderly patients(≥60 years old),were ultimately surveyed.Results Elderly patients'overall satisfaction with medical care,with an average score of 4.77,is very satisfactory;the ratings of friendly service and friendly environment are very good,but relatively speaking,the friendly service is better and the friendly environment is weaker.Among elderly patients,younger(60～74 years old),male,and those living in other places have higher satisfaction.Friendly service and friendly environment are both influencing factors of satisfaction,with friendly service having a greater impact weight.Conclusion Good friendly service should be maintained,and weak friendly environment should be strengthened.Continuously improve age-friendly hospitals and enhance the medical experience of elderly patients.

Objective Under the background of building age-friendly hospitals,it aims to explore the satisfaction and influencing factors of elderly patients in Shanghai City,which has the highest degree of aging in China,in order to provide reference for improving the age-friendly hospitals.Methods According to the framework of building age-friendly hospitals,a survey questionnaire is designed around friendly services and friendly environment,and the Likert 5-level rating is used.Select one medical institution in the central urban area and one in the suburbs of Shanghai City,both of which are grade-A tertiary age-friendly hospitals,and outpatient patients were randomly selected to participate in the questionnaire survey.A total of 2 418 elderly patients(≥60 years old),were ultimately surveyed.Results Elderly patients'overall satisfaction with medical care,with an average score of 4.77,is very satisfactory;the ratings of friendly service and friendly environment are very good,but relatively speaking,the friendly service is better and the friendly environment is weaker.Among elderly patients,younger(60～74 years old),male,and those living in other places have higher satisfaction.Friendly service and friendly environment are both influencing factors of satisfaction,with friendly service having a greater impact weight.Conclusion Good friendly service should be maintained,and weak friendly environment should be strengthened.Continuously improve age-friendly hospitals and enhance the medical experience of elderly patients.

Objective Under the background of building age-friendly hospitals,it aims to explore the satisfaction and influencing factors of elderly patients in Shanghai City,which has the highest degree of aging in China,in order to provide reference for improving the age-friendly hospitals.Methods According to the framework of building age-friendly hospitals,a survey questionnaire is designed around friendly services and friendly environment,and the Likert 5-level rating is used.Select one medical institution in the central urban area and one in the suburbs of Shanghai City,both of which are grade-A tertiary age-friendly hospitals,and outpatient patients were randomly selected to participate in the questionnaire survey.A total of 2 418 elderly patients(≥60 years old),were ultimately surveyed.Results Elderly patients'overall satisfaction with medical care,with an average score of 4.77,is very satisfactory;the ratings of friendly service and friendly environment are very good,but relatively speaking,the friendly service is better and the friendly environment is weaker.Among elderly patients,younger(60～74 years old),male,and those living in other places have higher satisfaction.Friendly service and friendly environment are both influencing factors of satisfaction,with friendly service having a greater impact weight.Conclusion Good friendly service should be maintained,and weak friendly environment should be strengthened.Continuously improve age-friendly hospitals and enhance the medical experience of elderly patients.