With population aging and the great improvement in life following economic development, the burden (incidence and mortality) of chronic diseases, particularly malignant tumors, is becoming heavier. Carcinogenesis and tumor progression typically arise from persistent inflammation, necrosis, and proliferation in targeted tissues and/or organs on the basis of systemic low-grade chronic inflammation. Factors facilitating this process are the risk factors of cancer. Large-scale prospective cohort studies have demonstrated that regular physical exercise, especially aerobic exercise, significantly decrease the incidence of inflammation-related cancer types and the mortality of all cancer types by attenuating systemic low-grade chronic inflammation, with a dose-dependent effect. The effect of aerobic exercise at the middle level intensity for 117‒600 min per week on the reduction of cancer mortality can be more effective than that of immunotherapy combinations (50% vs 26%). The mechanisms by which regular physical exercise prevents cancer may lie in the long-term, regular physical activity increasing oxygen supply and optimizing gut probiotics, thereby reducing systemic low-grade chronic inflammation caused by immunosenescence, promoting the renewal of immune cells to enhance levels of non-specific immunity, cellular immunity and humoral immunity. Encouraging public physical exercise and other healthy lifestyles including optimizing food components to decrease systemic low-grade chronic inflammation are the most cost-effective public health strategies against cancer.

ObjectiveTo determine the association between solid fuel exposure and cancer risk among middle-aged and elderly adults in China, to investigate the underlying biological pathways through selected serological markers, and to examine whether adequate physical activity can mitigate this risk by modulating these pathways. MethodsBased on baseline characteristics, health status indicators and hematological data from the China Health and Retirement Longitudinal Study (CHARLS, 2011‒2018), multivariate logistic regression analyses were conducted to assess the association between solid fuel use and cancer risk, with stratified analyses conducted by physical activity levels. In addition, mediation analyses were performed to evaluate the role of serological markers including hemoglobin concentration and hematocrit in the association between solid fuel use and cancer incidence. ResultsSolid fuel use was significantly associated with an increased cancer risk (OR=1.344, 95%CI: 1.113‒1.615). This association remained significant among individuals with low levels of physical activity ( OR=1.344, 95%CI: 1.067‒1.673 ), but not statistically significant among those with adequate physical activity. Hemoglobin concentration and hematocrit showed a negative mediating effect between solid fuel use and cancer incidence, and this effect was stronger among those with low levels of physical activity. ConclusionIndoor solid fuel use represents an important environmental risk factor for cancer incidence in China’s middle-aged and elderly population, while regular physical activity may reduce carcinogenic risk through modulation of inflammatory levels and hematological indicators such as hemoglobin and hematocrit. Public health strategies should integrate clean energy promotion with exercise interventions to mitigate the cancer burden associated with solid fuel pollution.

China is heavily affected by cancer.In 2022,the population in Chinese mainland accounted for 18.66%of the world,but new cancer cases and cancer-related deaths accounted for 24.17%and 26.44%of the world,respectively.Lung cancer,liver cancer,gastric cancer,colorectal cancer,and esophageal cancer are the top 5 histological types,accounting for 67.50%of all cancer-related deaths.The age-standardized incidence rate(ASIR)and age-standardized mortality rate(ASMR)of liver cancer,gastric cancer,and esophageal cancer keep decreasing whereas their corresponding crude rates are increasing.The ASMR of lung cancer keeps decreasing in urban areas but increasing in rural areas.The ASIR and ASMR of colorectal cancer are increasing gradually.These data indicate that aging,movement of industrial pollution to rural areas,and alterations in lifestyle seriously affect cancer burden.Due to the rapid transformation of China's economic,modern lifestyle-related risk factors including physical inactivity,smoking and alcohol consumption,metabolic syndrome,unhealthy diet,and psychological problems continue to increase;furthermore,poverty-related risk factors including environmental pollution,food contamination,and chronic infections(including the infections with hepatitis B virus,human papillomavirus,Helicobacter pylori,and Clonorchis sinensis)still exist,both pushing up the high burden of cancers in China at this stage.These causal factors are carcinogenic either by directly interfering genetic and epigenetic mechanisms,or most frequently induce chronic inflammation to inflammation-cancer transformation.Targeted interventions to the modifiable risk factors,such as improving lifestyle and increasing physical activity can reduce systemic inflammation and improve immunity,so as to decrease cancer occurrence and cancer-related death.In addition,cancer screening is helpful in decreasing the ASMRs of several slowly progressive cancer types including colorectal cancer.Epidemiological cohort study and experimental epidemiology are key to clarify the effects of primary prophylaxis,screening,and clinical treatments on the occurrence and prognosis of cancers,which is the key for improvement of cancer tertiary prophylaxis.Optimal combination of cancer prevention and clinical diagnosis and treatment should be an effective strategy to control the cancer-caused loss of life expectancy in a cost-effective way.

Objective To compare the association of the incidence and mortality of leukemia and the human development index(HDI)in different countries or regions in 2022,and the trend of leukemia incidence and mortality with age in countries with different HDI levels.Methods GLOBOCAN 2022 data related to leukemia incidence and mortality in different countries or regions worldwide and HDI were evaluated by Pearson correlation analysis and Kruskal-Wallis test.The incidence and mortality rates of each age and the age change trend were analyzed using the Joinpoint Regression model.Results Age-standardized incidence rate(ASIR),age-standardized mortality rate(ASMR),and mortality to incidence ratio(M/I)were statistically significantly different among the four groups of HDI countries(P<0.001).HDI was positively correlated with ASIR and ASMR and negatively correlated with M/I.Among all ages,ASIR and ASMR of leukemia of the four groups had similar trends with age,and the risk of leukemia was high at ages less than 15 and more than 40.The incidence of leukemia in all age groups in China differed from those in other countries with high HDI,while the mortality rate was lower than those in other countries with high HDI.Conclusion Countries or regions with higher HDI have higher ASIR and ASMR and lower M/I because of their better medical condition.

Statistics plays an important role in medical research， and the selection of appropriate statistical methods is crucial for drawing reliable and valuable conclusions. This paper provides a brief introduction to commonly used statistical analysis methods for medical data， covering descriptive analysis， parametric test， nonparametric test， correlation analysis， regression analysis， and analysis of survival data. It focuses on discussing the assumptions of multiple linear regression， logistic regression and Cox proportional risk regression， as well as how to choose the appropriate statistical methods for analyzing and interpreting medical data based on different research objectives and data types.

Clinical research reports serve as the presentation of scientific research findings and directly reflect the quality of the research. This article describes the writing of different types of clinical research reports， such as observational studies and randomized controlled trial studies， with a particular focus on randomized controlled trials. Each scientific research design has its reporting focus， and the writing of scientific research papers has uniform requirements and a specific writing format. Mastering the proper format of drafting research reports is of practical value and significant importance for conduction high-quality clinical research.

Chronic diseases have become an important public health problem for people under 70 years of age worldwide， while also causing a great economic burden. The establishment of clinical prediction models can help to predict the risk of a disease or the prognostic effect of a study subject in advance by means of index testing at the early stage of chronic diseases， and plays an increasingly important role in clinical practice. This study introduces clinical diagnostic prediction models and clinical prognostic prediction models， and reviews clinical data processing， clinical prediction model building， visualization methods and model evaluation from the perspective of the application of clinical prediction models， which contribute to the correct and reasonable use of prediction models in clinical research.

The continuous development of high-throughput and single-cell sequencing technologies and the emergence of spatial transcriptome sequencing have allowed the continuous discovery of temporal and spatial molecular events in the progression of colorectal cancer (CRC) to better understand its mechanism of malignant progression. Genetic variations (mutation of APC and P53, etc.) and mismatch repair of DNA, posttranscriptional regulation, such as epigenetic alteration, and dynamic alteration of complex molecular networks have their own special molecules that play key roles. Drug resistance and metastasis in the late stage of CRC progression are closely related to these key molecular events. This article reviews the research progress and explores key molecular events in the malignant progression of CRC to provide scientific basis and ideas for elucidating the regulatory mechanism of CRC and evaluating its prognosis prediction and treatment.

Hepatocellular carcinoma (HCC) is a kind of primary liver cancer with a high mortality rate. In China, the incidence ratio in males to females with HCC is 2:1–5:1. The difference in sex hormone pathways between males and females and the interaction between androgen/androgen receptors and HBV can lead to an incidence difference between males and females with HCC. Hence, the androgen/androgen receptor oncogenic pathway in hepatocellular carcinoma has received considerable attention. This review mainly summarizes the recent research progress on the androgen/androgen receptor oncogenic pathway in hepatocellular carcinoma.

ObjectiveTo identify causal factors of a case of severe Chlamydia psittaci pneumonia in Yangpu District and provide a scientific basis for effective prevention and control. MethodsBasic information and epidemiological data of the patient were collected through telephone interviews and field epidemiological surveys. Specimens from the patient， close contacts and the environment were collected for pathogen detection. Metagenomics next-generation sequencing （mNGS） was used to identify unknown pathogens. ResultsA 65-year-old male patient with a history of hypertension and diabetes was admitted to the hospital with symptoms of fatigue， poor appetite for a week， fever and cough for four days. A chest computer tomography （CT） scan showed scattered inflammation in the left lung with infiltration of multiple lobes. Blood gas analysis showed type I respiratory failure. The results of mNGS on the bronchoalveolar lavage fluid of the patient indicated that he was infected with Chlamydia psittaci. Epidemiological investigation showed a clear history of avian exposure， with an incubation period of 30 days. ConclusionThis serious pneumonia is a zoonotic disease caused by Chlamydia psittaci. A clear history of avian exposure and the use of mNGS technology can help in the timely diagnosis of this disease.