1.Mechanism of auraptene in improving acute liver injury induced by diquat poisoning in mice.
Renyang OU ; Shan HUANG ; Lihong MA ; Zhijie ZHAO ; Shengshan LIU ; Yuanliang WANG ; Yezi SUN ; Nana XU ; Lijun ZHOU ; Mei LI ; Manhong ZHOU ; Guosheng RAO
Chinese Critical Care Medicine 2025;37(6):590-594
OBJECTIVE:
To investigate whether auraptene (AUR) exerts a protective effect on acute diquat (DQ)-induced liver injury in mice and explore its underlying mechanisms.
METHODS:
Forty SPF-grade healthy male C57BL/6 mice were randomly divided into normal control group (Control group), DQ poisoning model group (DQ group), AUR treatment group (DQ+AUR group), and AUR control group (AUR group), with 10 mice in each group. The DQ poisoning model was established via a single intraperitoneal injection of 40 mg/kg DQ aqueous solution (0.5 mL); Control group and AUR group received an equal volume of pure water intraperitoneally. Four hours post-modeling, DQ+AUR group and AUR group were administered 0.5 mg/kg AUR aqueous solution (0.2 mL) by gavage once daily for 7 consecutive days, while Control group and DQ group received pure water. Blood and liver tissues were collected after anesthesia on day 7. Liver ultrastructure was observed by transmission electron microscopy. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were measured via enzyme-linked immunosorbent assay (ELISA). Hepatic glutathione (GSH), superoxide dismutase (SOD), and malondialdehyde (MDA) levels were detected using WST-1, thiobarbituric acid (TBA), and enzymatic reaction methods, respectively. Protein expression of nuclear factor-erythroid 2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1), Kelch-like ECH-associated protein 1 (Keap1), and activated caspase-9 in liver tissues was analyzed by Western blotting.
RESULTS:
Transmission electron microscopy revealed that mitochondria in the Control group exhibited mild swelling, uneven distribution of matrix, and a small number of cristae fractures. In the AUR group, mitochondria showed mild swelling, with no obvious disruption of cristae structure. In the DQ group, mitochondria demonstrated marked swelling and increased volume, matrix dissolution, loss and fragmentation of cristae, and extensive vacuolization. In contrast, the DQ+AUR group showed significantly reduced mitochondrial swelling, volume increase, matrix dissolution, cristae loss and fragmentation, and vacuolization compared to the DQ group. Compared with the DQ group, the DQ+AUR group exhibited significantly lower serum AST levels (U/L: 173.45±23.60 vs. 255.33±41.51), ALT levels (U/L: 51.77±21.63 vs. 100.70±32.35), and hepatic MDA levels (μmol/g: 12.40±2.76 vs. 19.74±4.10), along with higher hepatic GSH levels (mmol/g: 37.65±14.95 vs. 20.58±8.52) and SOD levels (kU/g: 124.10±33.77 vs. 82.81±22.00), the differences were statistically significant (all P < 0.05). Western blotting showed upregulated Nrf2 expression (Nrf2/β-actin: 0.87±0.37 vs. 0.53±0.22) and HO-1 expression (HO-1/β-actin: 1.06±0.22 vs. 0.49±0.08), and downregulated Keap1 expression (Keap1/β-actin: 0.82±0.12 vs. 1.52±0.76) and activated caspase-9 expression (activated caspase-9/β-actin: 1.16±0.28 vs. 1.71±0.30) in the DQ+AUR group compared to the DQ group (all P < 0.05).
CONCLUSION
AUR attenuates DQ-induced acute liver injury in mice by activating the Keap1/Nrf2 signaling pathway.
Animals
;
Male
;
Mice
;
Mice, Inbred C57BL
;
Liver/pathology*
;
Chemical and Drug Induced Liver Injury/drug therapy*
;
Diquat/poisoning*
;
NF-E2-Related Factor 2/metabolism*
;
Oxidative Stress
;
Apoptosis
;
Coumarins
2.The influence of autoimmune diseases on early spontaneous abortion
Ganlu PENG ; Shuang DAI ; Man LU ; Guosheng LI ; Quan ZHOU ; Aihua CHEN
Immunological Journal 2025;41(1):44-51
Objective To systematically evaluate of the effect of autoimmune diseases(AIDs)on early spontaneous abortion(ESA).Methods Several databases such as Ovid and Web of Science were searched from January 2000 to May 2024 for retrospective analysis.Furthermore,subgroup analysis was conducted in terms of AIDs,continent and assisted reproduction.Results Total of 73 eligible studies were included in this study.There was a statistically significant difference in the risk of ESA between the population with AIDs and the population with normal pregnancy(OR=1.832,95%CI:1.619-2.073).When subgroup studies of AIDs were performed,the increased risk of ESA in patients with some AIDs was statistically significant:e.g.,thyroid autoimmunity,antiphospholipid syndrome,systemic lupus erythematosus,desiccation syndrome,antinuclear antibody positivity and rheumatoid arthritis.While the impact of some AIDs on ESA was still uncertain,e.g.inflammatory bowel disease,ulcerative colitis,Crohn's disease,autoimmune skin diseases,neuromyelitis optica spectrum disorders.In addition,patients with antiphospholipid syndrome who had underwent assisted reproductive technologies were at higher risk of ESA.Furthermore,compared to other continents,there is a difference in the risk of ESA in patients with AIDs in Africa.Conclusion AIDs are associated with the risk of ESA.
3.Predictive Value of Residual Quantitative Flow Ratio for Long-term Vessel-oriented Composite Endpoints
Rui ZHANG ; Yanpu SHI ; Changdong GUAN ; Yanyan ZHAO ; Shengxian TU ; Bo YU ; Guosheng FU ; Yujie ZHOU ; Jian'an WANG ; Yundai CHEN ; Jun PU ; Kefei DOU ; Weixian YANG ; Yongjian WU ; Shubin QIAO ; Lei SONG
Chinese Circulation Journal 2025;40(9):862-869
Objectives:To explore the predictive value of residual Murray's law-based quantitative flow ratio(μQFR)on long-term vessel-oriented composite endpoints(VoCE).Methods:This retrospective study included 3 510 patients from the FAVOR Ⅲ China trial.Offline residual μQFR analysis was performed on all vessels(diameter≥2.5 mm)with 50%-90%stenotic lesions.Patients were stratified into high-,intermediate-,and low-risk groups based on residual μQFR tertiles.The primary endpoint was 3-year VoCE,defined as a composite of cardiac death related to the target vessel,target vessel-related spontaneous myocardial infarction,and ischemia-driven target vessel revascularization.Results:Offline analysis was performed on 5 256 vessels from 3 510 patients.The mean residual μQFR was 0.92±0.75.The high-risk group(residual μQFR≤0.91)with 1 554 patients(1 958 vessels);the intermediate-risk group(residual μQFR 0.92-0.96)with 1 211 patients(1 906 vessels);and the low-risk group(residual μQFR>0.96)with 745 patients(1 392 vessels).Over 3-year follow-up,VoCE occurred in 227 vessels(4.3%).The 3-year VoCE incidence was significantly higher in the high-risk group compared to the intermediate-and low-risk groups(6.2%vs.4.1%vs.2.5%,log-rank P<0.001),primarily driven by ischemia-driven target vessel revascularization(5.0%vs.3.0%vs.1.6%,log-rank P<0.001).Hypertension(OR=0.83,95%CI:0.72-0.96),hypercholesterolemia(OR=0.84,95%CI:0.73-0.97),bifurcation lesions(OR=0.72,95%CI:0.63-0.83),moderate/severe calcification(OR=0.70,95%CI:0.57-0.84),and tandem lesions(OR=0.59,95%CI:0.47-0.75)were independent predictors of lower residual μQFR values.Conclusions:Lower residual μQFR is significantly associated with increased VoCE risk during the 3-year follow up period.
4.Predictive Value of Residual Quantitative Flow Ratio for Long-term Vessel-oriented Composite Endpoints
Rui ZHANG ; Yanpu SHI ; Changdong GUAN ; Yanyan ZHAO ; Shengxian TU ; Bo YU ; Guosheng FU ; Yujie ZHOU ; Jian'an WANG ; Yundai CHEN ; Jun PU ; Kefei DOU ; Weixian YANG ; Yongjian WU ; Shubin QIAO ; Lei SONG
Chinese Circulation Journal 2025;40(9):862-869
Objectives:To explore the predictive value of residual Murray's law-based quantitative flow ratio(μQFR)on long-term vessel-oriented composite endpoints(VoCE).Methods:This retrospective study included 3 510 patients from the FAVOR Ⅲ China trial.Offline residual μQFR analysis was performed on all vessels(diameter≥2.5 mm)with 50%-90%stenotic lesions.Patients were stratified into high-,intermediate-,and low-risk groups based on residual μQFR tertiles.The primary endpoint was 3-year VoCE,defined as a composite of cardiac death related to the target vessel,target vessel-related spontaneous myocardial infarction,and ischemia-driven target vessel revascularization.Results:Offline analysis was performed on 5 256 vessels from 3 510 patients.The mean residual μQFR was 0.92±0.75.The high-risk group(residual μQFR≤0.91)with 1 554 patients(1 958 vessels);the intermediate-risk group(residual μQFR 0.92-0.96)with 1 211 patients(1 906 vessels);and the low-risk group(residual μQFR>0.96)with 745 patients(1 392 vessels).Over 3-year follow-up,VoCE occurred in 227 vessels(4.3%).The 3-year VoCE incidence was significantly higher in the high-risk group compared to the intermediate-and low-risk groups(6.2%vs.4.1%vs.2.5%,log-rank P<0.001),primarily driven by ischemia-driven target vessel revascularization(5.0%vs.3.0%vs.1.6%,log-rank P<0.001).Hypertension(OR=0.83,95%CI:0.72-0.96),hypercholesterolemia(OR=0.84,95%CI:0.73-0.97),bifurcation lesions(OR=0.72,95%CI:0.63-0.83),moderate/severe calcification(OR=0.70,95%CI:0.57-0.84),and tandem lesions(OR=0.59,95%CI:0.47-0.75)were independent predictors of lower residual μQFR values.Conclusions:Lower residual μQFR is significantly associated with increased VoCE risk during the 3-year follow up period.
5.The influence of autoimmune diseases on early spontaneous abortion
Ganlu PENG ; Shuang DAI ; Man LU ; Guosheng LI ; Quan ZHOU ; Aihua CHEN
Immunological Journal 2025;41(1):44-51
Objective To systematically evaluate of the effect of autoimmune diseases(AIDs)on early spontaneous abortion(ESA).Methods Several databases such as Ovid and Web of Science were searched from January 2000 to May 2024 for retrospective analysis.Furthermore,subgroup analysis was conducted in terms of AIDs,continent and assisted reproduction.Results Total of 73 eligible studies were included in this study.There was a statistically significant difference in the risk of ESA between the population with AIDs and the population with normal pregnancy(OR=1.832,95%CI:1.619-2.073).When subgroup studies of AIDs were performed,the increased risk of ESA in patients with some AIDs was statistically significant:e.g.,thyroid autoimmunity,antiphospholipid syndrome,systemic lupus erythematosus,desiccation syndrome,antinuclear antibody positivity and rheumatoid arthritis.While the impact of some AIDs on ESA was still uncertain,e.g.inflammatory bowel disease,ulcerative colitis,Crohn's disease,autoimmune skin diseases,neuromyelitis optica spectrum disorders.In addition,patients with antiphospholipid syndrome who had underwent assisted reproductive technologies were at higher risk of ESA.Furthermore,compared to other continents,there is a difference in the risk of ESA in patients with AIDs in Africa.Conclusion AIDs are associated with the risk of ESA.
6.Protective effect of tumor necrosis factor receptor-associated factor 6 inhibitor C25-140 on acute kidney injury induced by diquat poisoning in mice.
Tingting HUANG ; Guosheng RAO ; Zhijie ZHAO ; Nana XU ; Manhong ZHOU ; Renyang OU
Chinese Critical Care Medicine 2024;36(12):1273-1278
OBJECTIVE:
To investigate the protective effect and mechanism of tumor necrosis factor receptor-associated factor 6 (TRAF6) inhibitor C25-140 on acute kidney injury (AKI) induced by acute diquat (DQ) poisoning in mice.
METHODS:
A total of 80 SPF grade healthy male C57BL/6 mice were randomly divided into the normal control group, DQ model group, C25-140 intervention group, and C25-140 control group, with 20 mice in each group. The DQ poisoning mouse model was established by using one-time intraperitoneal injection of 1 mL of 40 mg/kg DQ solution. The normal control group and C25-140 control group were injected with an equal amount of pure water into the peritoneal cavity. After 4 hours of model establishment, the C25-140 intervention group and C25-140 control group were given intraperitoneal injection of C25-140 5 mg/kg. The normal control group and DQ model group were given equal amounts of pure water, once a day for 7 consecutive days. After 7 days, the mice were anesthetized, eye blood was collected, and renal tissue was collected after sacrifice. The pathological changes of renal tissue were observed under a light microscope and renal tissue structure and mitochondrial changes were observed under transmission electron microscopy. The levels of serum creatinine (SCr) and blood urea nitrogen (BUN) were measured. Enzyme-linked immunosorbent assay (ELISA) was used to measure the levels of serum interleukins (IL-6, IL-1β) and tumor necrosis factor-α (TNF-α). Western blotting was used to detect the protein expression levels of TRAF6, myeloid differentiation factor 88 (MyD88), and nuclear factor-κB (NF-κB) in renal tissue. Chemical method was used to determine the content of serum malondialdehyde (MDA) and superoxide dismutase (SOD).
RESULTS:
During the observation period, there were no abnormal behaviors in the normal control group mice. The DQ model group mice gradually showed symptoms such as mental fatigue, fluffy fur, reduced activity, and low food intake after being exposed to the toxin, and severe cases resulted in death. The above symptoms were alleviated in the C25-140 intervention group compared to the DQ model group. Under light microscopy, HE staining showed infiltration of inflammatory cells, glomerulosclerosis, proximal tubular dilation, and vacuolization in the DQ model group, while the inflammatory response was reduced in the C25-140 intervention group compared to the DQ model group. Under transmission electron microscopy, the DQ model group showed relatively high levels of mitochondrial damage, severe swelling, increased volume, matrix dissolution, ridge fracture and loss. The degree of mitochondrial damage in the C25-140 intervention group was reduced compared to the DQ model group. Compared with the normal control group, the levels of serum SCr, BUN, IL-6, IL-1β, TNF-α, and MDA in the DQ model group were significantly increased, while the serum SOD level was significantly decreased. Compared with the DQ model group, the levels of serum SCr, BUN, IL-6, IL-1β, TNF-α, and MDA in the C25-140 intervention group were significantly reduced [SCr (μmol/L): 59.07±13.11 vs. 83.61±20.13, BUN (mmol/L): 25.83±9.95 vs. 40.78±11.53, IL-6 (ng/L): 40.76±7.03 vs. 83.33±21.83, IL-1β (ng/L): 53.87±7.82 vs. 91.74±12.53, TNF-α (ng/L): 102.52±32.13 vs. 150.92±31.75, MDA (μmol/L): 3.57±1.06 vs. 5.75±1.83], and the serum SOD level was significantly increased (kU/g: 162.52±36.13 vs. 122.72±22.13), and the differences were statistically significant (all P < 0.01). Western blotting results showed that the protein expression levels of TRAF6, NF-κB, and MyD88 in the renal tissue of DQ model group mice were significantly higher than those in the normal control group. The expression levels of the above-mentioned proteins in the C25-140 intervention group of mice were significantly lower than those in the DQ model group (TRAF6/β-actin: 1.05±0.36 vs. 1.74±0.80, NF-κB/β-actin: 0.57±0.07 vs. 1.03±0.75, MyD88/β-actin: 0.58±0.07 vs. 1.03±0.33, all P < 0.05).
CONCLUSIONS
TRAF6 inhibitor C25-140 can alleviate AKI induced by DQ poisoning in mice by regulating the Toll-like receptor 4 (TLR4)/TRAF6/NF-κB signaling pathway and downregulating the levels of inflammatory cytokines IL-1β, IL-6, and TNF-α.
Animals
;
Male
;
Acute Kidney Injury/prevention & control*
;
Mice
;
Mice, Inbred C57BL
;
Diquat
;
TNF Receptor-Associated Factor 6/metabolism*
;
Interleukin-6/blood*
;
Kidney/pathology*
;
NF-kappa B/metabolism*
;
Peptide Fragments
7.Protective effect and mechanism of quercetin on acute liver injury induced by diquat poisoning in mice
Shan HUANG ; Jianhong WANG ; Renyang OU ; Guosheng RAO ; Zhijie ZHAO ; Nana XU ; Manhong ZHOU
Chinese Critical Care Medicine 2024;36(6):604-608
Objective:To investigate the protective effect of quercetin (QR) on acute liver injury induced by diquat (DQ) poisoning in mice and its mechanism.Methods:Eighty healthy male C57BL/6 mice with SPF grade were randomly divided into control group, DQ model group, QR treatment group, and QR control group, with 20 mice in each group. The DQ poisoning model was established by a one-time intraperitoneal injection of DQ solution (40 mg/kg); the control and QR control groups received equivalent amounts of distilled water through intraperitoneal injection. Four hours after modeling, the QR treatment group and the QR control group received 0.5 mL QR solution (50 mg/kg) through gavage. Meanwhile, an equivalent amount of distilled water was given orally to the control group and the DQ model group. The treatments above were administered once daily for seven consecutive days. Afterwards, the mice were anesthetized, blood and liver tissues were collected for following tests: changes in the structure of mice liver tissue were observed using transmission electron microscopy; the levels of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were detected using enzyme linked immunosorbent assay (ELISA); the levels of glutathione (GSH), superoxide dismutase (SOD), and malondialdehyde (MDA) in liver tissues were measured using the water-soluble tetrazolium-1 (WST-1) method, the thiobarbituric acid (TBA) method, and enzymatic methods, respectively; the protein expressions of nuclear factor erythroid 2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1), Kelch-like ECH-associated protein 1 (Keap1), and activated caspase-9 in liver tissues were detected using Western blotting.Results:Severe mitochondrial damage was observed in the liver tissues of mice in the DQ model group using transmission electron microscopy, yet mitochondrial damage in the QR treatment group showed significant alleviation. Compared to the control group, the DQ model group had significantly increased levels of MDA in liver tissue, serum AST, and ALT, yet had significantly decreased levels of GSH and SOD in liver tissue. In comparison to the DQ model group, the QR treatment group exhibited significant reductions in serum levels of ALT and AST, as well as MDA levels in liver tissue [ALT (U/L): 52.60±6.44 vs. 95.70±8.00, AST (U/L): 170.45±19.33 vs. 251.10±13.09, MDA (nmol/mg): 12.63±3.41 vs. 18.04±3.72], and notable increases in GSH and SOD levels in liver tissue [GSH (μmol/mg): 39.49±6.33 vs. 20.26±3.96, SOD (U/mg): 121.40±11.75 vs. 81.67±10.01], all the differences were statistically significant (all P < 0.01). Western blotting results indicated that the protein expressions of Nrf2 and HO-1 in liver tissues of the DQ model group were significantly decreased compared to the control group. On the other hand, the protein expressions of Keap1 and activated caspase-9 were conspicuously higher when compared to the control group. In comparison to the DQ model group, the QR treatment group showed a significant increase in the protein expressions of Nrf2 and HO-1 in liver tissues (Nrf2/β-actin: 1.17±0.08 vs. 0.92±0.45, HO-1/β-actin: 1.53±0.17 vs. 0.84±0.09). By contrast, there was a notable decrease in the protein expressions of Keap1 and activated caspase-9 (Keap1/β-actin: 0.48±0.06 vs. 1.22±0.09, activated caspase-9/β-actin: 1.17±0.12 vs. 1.59±0.30), the differences were statistically significant (all P < 0.01). Conclusion:QR may reduce acute liver injury induced by DQ poisoning in mice via activating Keap1/Nrf2 signaling pathway.
8.Analysis of short-term efficacy of one-stage posterior sparing laminectomy for single level thoracolumbar tuberculosis
Wei ZENG ; Guosheng ZHAO ; Lu LIN ; Yang LIU ; Yang WANG ; Wenyi ZHOU ; Zhenyong KE
Chongqing Medicine 2024;53(4):508-511,516
Objective To explore the feasibility and short-term clinical efficacy of single segment thora-columbar tuberculosis treated with one-stage posterior approach lamina-sparing decompression.Methods A total of 11 patients with single segment thoracolumbar tuberculosis who underwent one-stage posterior ap-proach preservation of vertebral plate lesion removal,bone graft fusion,and internal fixation treatment in this hospital from September 2021 to June 2022 were selected.C-reactive protein(CRP)and erythrocyte sedimen-tation rate(ESR)were monitored to evaluate tuberculosis bacteremia and activity control,visual analogue scale(VAS)score and Oswestry disability index(ODI)were followed up to evaluate the improvement of clin-ical function,and the American Spinal Injury Association(ASIA)injury scale was used to evaluate neurologi-cal function,and the correction of kyphosis was followed up.Results All 11 patients were fully followed up.The average surgical duration is(270.91±45.98)minutes,and the average surgical bleeding is(522.72± 194.11)mL.During the follow-up period,none of the 11 patients experienced tuberculosis recurrence,and all 11 patients achieved bone graft fusion.The fusion time was 6-9 months after surgery with an average of(7.36±1.12)months.Two patients with preoperative nerve damage recovered after surgery.During the fol-low-up period,11 patients did not experience any complications related to surgery.The average CRP,ESR,ODI score,and VAS score of postoperative patients decreased compared to preoperative levels,and further de-creased at 12 months after surgery;The patient's kyphosis caused by thoracolumbar tuberculosis was correc-ted,and no obvious angle loss was found at the last follow-up(P>0.05).Conclusion One-stage posterior ap-proach lamina-sparing decompression is a safe and effective method for treating single segment thoracolumbar tuberculosis.
9.Analysis of the current situation of model research wards construction in Beijing
Ying ZHOU ; Wei SHI ; Gang LI ; Jianting SU ; Lihong LIU ; Wenbin LI ; Jiamin WANG ; Guosheng FENG
Chinese Journal of Hospital Administration 2023;39(9):651-655
Objective:To understand the construction status of research wards in the first model research wards in Beijing, and provide reference for promoting their high-quality development.Methods:From July to September 2022, a questionnaire survey was conducted on the setting mode, facility deployment, operational efficiency, and implementation of supportive policies of the research wards among the first batch of model research wards in Beijing. Descriptive analysis was used to analyze the questionnaire data.Results:The 8 hospitals surveyed had all set up specialized research wards; 5 of them had shared research wards, including 4 general hospitals and 1 specialized hospital. The number of research ward beds in each hospital ranged from 31 to 120, with only 1 hospital having research ward beds accounting for 11.3% of the hospital′s beds, while the other 7 hospitals were less than 10.0%. Compared with 2020, the number of clinical research projects carried out in the research wards of 8 hospitals in 2021 have increased by a total of 403, while the ethical review time was less than or equal to 14 working days, 2.5 working days shorter than 2020; 4 hospitals could complete the experimental project approval within 60 working days and the first visit within 22 working days, while 5 hospitals could complete the research conclusion within 14 working days. There were 2 hospitals that link the performance evaluation of research wards with salary distribution, and 3 hospitals link it with professional title evaluation and employment.Conclusions:The model research wards in Beijing have adopted different setting modes for the construction of research wards, all operating well. It is recommended to further improve such areas as selecting a research ward setting mode to fit the needs of the hospital, optimizing and integrating the resource allocation of research wards, improving operational efficiency to increase market competitiveness, and effectively implementing supportive policies related to human resource management. These practices can better promote the high-quality construction of research wards and comprehensively enhance the supportive role of clinical research in pharmaceutical and healthcare collaborative innovation.
10.A comparative study of breast cancer mass screening and opportunistic screening in Chinese women
Songjie SHEN ; Yali XU ; Yidong ZHOU ; Guosheng REN ; Jun JIANG ; Hongchuan JIANG ; Jin ZHANG ; Bo LI ; Feng JIN ; Yaping LI ; Fengming XIE ; Yue SHI ; Zhendong WANG ; Mei SUN ; Shuanghu YUAN ; Jingjing YU ; Yue CHEN ; Qiang SUN
Chinese Journal of Surgery 2021;59(2):109-115
Objective:To compare the population characteristics, the positive rate of screening, the detection rate of breast cancer, early diagnosis rate and the cost between the mass screening group and opportunistic screening group of breast cancer.Methods:This study is a prospective multicenter cohort study conducted from January 1, 2014 to December 31, 2016. The participants were enrolled for mass screening or opportunistic screening of breast cancer. After completing the questionnaire, all the participants received breast physical examination and breast ultrasound examination every year for 3 rounds by year. The participants′ characteristics and screening results of the two groups were compared by χ 2 test, Fisher exact test or Wilcoxon rank-sum test. Results:A total of 20 080 subjects were enrolled. In the mass screening group, 9 434 (100%), 8 111 (85.98%) and 3 940 (41.76%) cases completed the 3 rounds of screening, and 10 646 (100%), 6 209 (58.32%) and 2 988 (28.07%) cases in the opportunistic screening group, respectively. In the opportunistic screening group, the proportions of less than 3 months lactation (1 275/9 796 vs. 1 061/8 860, χ2=4.597, P=0.032), non-fertility (850/10 646 vs. 574/9 434, χ2=27.400, P<0.01), abortion history (6 384/10 646 vs. 5 062/9 434, χ2=81.232, P<0.01), postmenopausal (2 776/10 646 vs. 2 217/9 434, χ2=17.757, P<0.01), long-term oral contraceptives(>6 months) (171/10 646 vs. 77/9 434, χ2=25.593, P<0.01) and family history of breast cancer in first-degree relatives (464/10 646 vs. 236/9 434, χ2=51.257, P<0.01) were significantly higher than those in mass screening group. The positive rate of screening (514/10 646 vs. 128/9 434, χ2=194.736, P<0.01), the detection rate of breast cancer (158/10 646 vs. 13/9 434, χ2=107.374, P<0.01), and positive rate of biopsy (158/452 vs. 13/87, χ2=13.491, P<0.01) in the opportunistic screening group were significantly higher than those of the mass screening group. The early diagnosis rate of the mass screening group was significantly higher than the opportunistic screening group (10/12 vs. 66/141, χ2=5.902, P=0.015). The average cost for detecting each breast cancer case of the mass screening group was 215 038 CNY, which was 13.6 times of the opportunistic screening group (15 799 CNY/case). In the opportunistic screening group, the positive rate of biopsy in primary hospitals was significantly lower than that in large-volume hospitals (79/267 vs. 79/185, χ2=8.267, P=0.004), but there was no significant difference in the mass screening group (6/37 vs. 7/50, χ2=0.082, P=0.774). Conclusions:Breast cancer screening can improve early detection rate. Compared with the mass screening mode, the opportunistic screening mode has the advantages of higher proportion of high-risk factors, higher positive rate of screening, higher detection rate of breast cancer, higher positive rate of biopsy, and lower cost of screening. However, the early diagnosis rate of breast cancer of opportunistic screening is lower than that of mass screening. The positive rate of opportunistic screening in primary hospitals is lower than that of large-volume hospitals. The two screening modes have their own advantages and should be chosen according to local conditions of different regions in China.

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