[Purpose]To analyze the trend of bladder cancer incidence and age at diagnosis in can-cer registration areas of Jiangsu Province from 2009 to 2019.[Methods]The data of bladder can-cer incidence from 2009 to 2019 were collected from 16 cancer registries in Jiangsu Province,and quality control indicators of the data were evaluated.The crude rate(CR)of incidence,age-standar-dized incidence rate by Segi world standard population(ASIRW),age-specific incidence rate,mean age at diagnosis,mean standardized age at diagnosis,and age-specific incidence composi-tion ratio were calculated.Incidence trends were analyzed using Joinpoint software and the average annual percentage change(AAPC)was calculated.Birth cohort models were constructed and can-cer incidence rates were calculated for people born from 1929 to 2019 and the incidence trends were analyzed.The linear regression models were used to analyze the relationship of average age at onset,standardized average age of onset with year of onset.[Results]The CR of bladder cancer in Jiangsu Province increased from 4.27/105 in 2009 to 7.04/105 in 2019.The CR and ASIRW showed upward trends(CR:AAPC=4.62％,ASIRW:AAPC=1.92％,both P＜0.001).Sex-specific analysis showed that the incidence rate was higher in male(AAPC=5.32％)than that in female(AAPC=1.98％).Birth cohort results indicated a significant upward trend in incidence rates among age groups of 60 years old above,and the fastest increase was in those aged 80 years old and above(AAPC=3.27％,P=0.007).From 2009 to 2019,the average age of bladder cancer onset in Jiangsu Province showed a significant rising trend,increasing by an average of 0.17 years old annually,but the standardized average age of onset showed no significant change after adjusting for age structure.[Conclusion]The incidence rate of bladder cancer showed an increasing trend from 2009 to 2019 in Jiangsu Province,with a significantly higher incidence rate in male than that in female.

Objective:To comprehensively evaluate the effects of different bolus usages in postmastectomy intensity-modulated radiotherapy (PM-IMRT) on doses.Methods:Fifty patients receiving PM-IMRT at Fudan University Shanghai Cancer Center from April to October 2021 were retrospectively studied. The planning target volume (PTV) was divided into four parts, namely chest wall (CW), internal mammary node, retained axillary lymph node, and supraclavicular node. The prescription dose was 50 Gy/25 fractions. Three PM-IMRT plans applying boluses with different thicknesses (3, 5 and 10 mm) were designed for each patient. The effects of different thicknesses and usage frequencies of boluses on PTV coverage, high dose volume of the CW skin, and dose to surrounding normal tissues were comprehensively evaluated.Results:When boluses were applied throughout the PM-IMRT, the PTV V95% of plans applying 10 mm-thick boluses was lower than that of plans applying 3 and 5 mm-thick boluses ( F=3.340, P < 0.05), the CI of plans applying 3 mm-thick boluses was higher than that of plans applying 5 and 10 mm-thick boluses ( F = 50.05, P < 0.05), and there was no statistically significant differences in the skin V105% and V110% of three plans( P > 0.05). Both PTV V95% and skin V105% were reduced with a decrease in the usage frequency of boluses. At a frequency of 20, PTV V95% decreased slightly (< 1%), while skin V105% decreased sharply to nearly half of the original values. At a frequency of 15, the PTV V95%, CI, and HI in the three plans showed no statistically significant dosimetric differences ( P > 0.05). The PTV Dmax of plans applying 3 mm-thick boluses was lower than that of plans applying 5 and 10 mm-thick boluses ( F = 9.21, P < 0.05). As for the dose to surrounding normal tissues, different bolus thicknesses and frequencies had negligible effects on doses to heart and lung, causing little different biological effects. Conclusions:For PM-IMRT, different bolus thicknesses have similar effects on doses to the PTV, skin, heart, and lung. Bolus usage frequency, rather than thickness, was the major factor determining the PTV coverage and the dose to CW skin.

Objective:To study the influence of environmental radiation of radiotherapy workplace on the stereotactic radiation therapy(SRT) plan absolute dose verification with plastic scintillator detector Exradin W1.Methods:The computed tomography (CT) image of the stereotactic dose verification phantom (SDVP) was scanned and imported into the treatment planning system. Three schemes, including 3 cm × 3 cm to 20 cm × 20 cm square gradient field irradiation, virtual planning target volume(PTV) non-coplanar arcs irradiation and 10 cases of volumetric modulated arc radiotherapy SRT (VMAT SRT) clinical plan verification, were measured with or without a home-made shield over the photodiode. Measurements were recorded to analyze the impact of environmental radiation on dose measurement under different conditions.Results:The noise effect of the photodiode increased with the the lager open field size, and decreased with the reduced distance between the photodiode and isocenter. The contribution of photodiode noise effect increase with the lager non-coplanar arc field size, with the largest up to 4.16%. As for the clinical SRT plan verification measurement, the relative difference between the SRT plan measurements and treatment planning system(TPS) before and after shielding were (1.39±1.05)% and (0.59±1.03)%, respectively ( t=-5.343, P < 0.05). and for W1 vs. A16 microchamber was (1.22±1.56)% and (0.42±1.42)%, respectively ( t=-5.414, P < 0.05). Conclusions:The measurements of Exradin W1 are in good agreement with the TPS result and the ionization chamber measurements, but its accuracy is easily affected by the environmental radiation of radiotherapy workplace. To measure non-coplanar radiation, the photodiode should be placed as far away as possible from the isocenter and be properly shielded, which can effectively improve the accuracy and stability of the measurement and provide a strong guarantee for clinical precision radiotherapy.

OBJECTIVES: To compare the features of patients with peptic ulcer between Han and Uyghur ethnicity from 2013 to 2018 in Xinjiang and to provide the evidence of prevention and treatment for the different ethnicity. METHODS: Data of 3 586 patients with peptic ulcer (3 293 Han and 293 Uyghur) in the Karamay Central Hospital of Xinjiang, including the detection rate of peptic ulcer, () detection rate of population, season, gender, lesion location and complication, were collected from January 2013 to December 2018 and compared between 2 nationalities. RESULTS: There were significant difference in the detection rate of peptic ulcer and population's between Han and Uyghur (<0.01). The detection rates for peptic ulcer of Han were sustainable declined from 15.20% to 10.23%, while Uyghur's detective rates for peptic ulcer were raised again from 17.49% to 8.38%. The detection rate of Uyghur's population was higher than that of Han (<0.01). There were significant difference in the season's detection rate for peptic ulcer between Han and Uyghur (<0.01). The detection rate for peptic ulcer of Han was the highest in the winter, while that of Uyghur was the highest in the spring. The detective rate of Uyghur's peptic ulcer was significant higher than that of Han in the spring (<0.01). The detection rates for peptic ulcer of 2 nationality were the highest at ≤25 age groups, the detection rate for Uyghur's peptic ulcer was higher than that of Han at ≤35 age groups (<0.05). There were more men than women in peptic ulcer in the 2 nationalities. The approximate proportion was 2꞉1. The rates of multiple gastric ulcer and compound duodenal ulcer of Han were more than those of Uyghur (<0.05), but the rate for pyloric obstruction of Uyghur patient was higher than that of Han (<0.05). CONCLUSIONS There are statistical difference in detection rate of PU, detection rate of population, morbidity season, age, complication and the rate of complex ulcer between Han and Uyghur, However, there aren't statistical difference in detection rate of peptic ulcer patient, the gender, lesion location between the 2 nationalities during last 6 years.
Child, Preschool ; Duodenal Ulcer ; Ethnic Groups ; Female ; Helicobacter Infections ; Helicobacter pylori ; Humans ; Male ; Stomach Ulcer

Objective: To understand the prevalence of carotid plaque (CP) in population at high-risk for cardiovascular disease (CVD) in Jiangsu province and identify related influencing factors. Methods: Based on the China Patient-centered Evaluative Assessment of Cardiac Events Million Persons Project from 2015 to 2016, a total of 11 392 persons at high-risk for CVD were selected from six project areas in Jiangsu province for the questionnaire survey, physical measurement, laboratory test and bilateral ultrasound examination of carotid arteries. The prevalence of CP and influencing factors of abnormal carotid arteries, CP and plaque burden (CP≥2) were analyzed. Results: Among the persons surveyed, 4 821 (42.3%) were males. The age of the persons surveyed was (59.4±8.9) years. There were 5 971 abnormal carotid arteries cases (52.4%), including 1 782 carotid intima-media thickness thickening cases (15.6%), 3 811 CP cases (33.5%) and 378 carotid stenosis cases (3.3%). Older age (OR=2.253, 95%CI: 2.127-2.386), urban residence (OR=2.622, 95%CI: 2.375-2.895), hypertension (OR=1.439, 95%CI: 1.195-1.732), smoking (OR=1.441, 95%CI: 1.259- 1.650), pulse pressure difference (OR=1.270, 95%CI: 1.198-1.347), fasting plasma glucose (FPG) (OR=1.109, 95%CI: 1.059-1.161) and LDL-C/HDL-C (OR=1.225, 95%CI: 1.164-1.288) were possible risk factors of CP in population at high risk for CVD. Being women (OR=0.558, 95%CI: 0.494-0.630), high BMI (OR=0.948, 95%CI: 0.904-0.994), higher levels of education (OR=0.708, 95%CI: 0.531-0.945), and higher annual household income (OR=0.773, 95%CI: 0.669-0.894) were the possible protective factors. Conclusions Over half of the population at high-risk for CVD in Jiangsu showed abnormal carotid arteries. High blood pressure, high blood glucose, high blood lipids and smoking were the main factors that could be changed.

Objective: To investigate the prevalence, awareness, treatment and control of hypertension in adult residents in Jiangsu province and provide evidence for the prevention and control of hypertension. Methods: A population-based cardiovascular disease screening project was conducted during 2015-2018 in Jiangsu, a total of 95 348 community-dwelling adults aged 35-75 years from 6 project areas were included in the study. The prevalence rate of hypertension and rates of awareness, treatment and control of hypertension in the adults with different characteristics were analyzed. Multilevel model was applied to identify the influencing factors. Results: Among 95 348 adults surveyed, 54 407 were hypertensive, the standardized prevalence rate was 48.1%. The prevalence rate was significantly higher in males than in females (62.1% vs. 54.0%, P<0.05). Among the hypertension patients, the rates of awareness, treatment and control of hypertension were 56.6%, 45.3% and 12.0% (standardized rates: 52.2%, 41.0% and 11.2%), respectively, and all the rates were positively associated with age (all P<0.05). Multilevel model analysis showed that those who were males, at older age, lived in rural area, suffered from diabetes, had frequent alcohol drinking and those who were overweight/obese had higher risk for hypertension (all P<0.05). Among people with hypertension, those who had younger age, lower education level, lower household income level and those who had frequent alcohol drinking had lower awareness, treatment and control rates of hypertension (all P<0.05). Conclusions The prevalence rate of hypertension was high, but related awareness, treatment and control rates were low in adult residents in Jiangsu province. Comprehensive measures should be taken to improve awareness, treatment and control of hypertension in whole population, especially in young adults, and those with low education or income levels.

Objective To analyze the safety and efficacy of autogenous femoral lateral iliotibial fascia(autologous fascia lata) in the treatment of female stress incontinence.Methods The clinical data of 7 female patients with stress incontinence admitted from January 2016 to June 2017 were retrospectively analyzed.The mean age was 58.2 years (range 45-72 years).The mean disease duration was 10.7 years (range 5-21 years).The mean Body mass index (BMI) was 24.1 kg/m2 (range 20.3-31.4 kg/m2).7 patients had severe subjective scores according to clinical symptoms.The average score of urinary incontinence questionnaire-simple form (ICIQ-SF) of international urinary incontinence advisory committee was 14.3 ± 1.1,the score of incontinence-quality of life (I-QOL) was 24.3 ± 4.8,respectively.During general anesthesia,the patient was placed in a half-recumbent position with the right leg straight down and the left leg bent over.The position of patella as well as the iliotibial band of the lateral femoral muscles were marked on the body surface.The iliotibial fascia of the lateral femoral muscle was exposed through a transverse incision 4-6 cm perpendicular to the iliotibial fascia of the lateral femoral muscle.The fascia of the lateral iliac tibial fascia of the lateral vastus with a width of 1.5 to 2.0 cm and a length of 12 to 14 cm was cut.The fascia was immersed in physiological saline and sutured with two 2-0 CT1PDS absorbable sutures or 2-0 vascular sutures at both ends of the fascia for 3 consecutive needles to form a sling.Then the urethral catheter was placed in the position of lithotomy,and then urethral suprapubic suspension was performed using autologous fascia through bilateral paravaginal incisions.The duration of surgery,intraoperative blood loss,intraoperative complications,postoperative catheter indwelling time,the length of hospital stay and postoperative complications were recorded.The situation of urinary incontinence as well as life quality before and after surgery were compared respectively.Results The operation was successfully performed.The mean operative time was 117.6 min(range 95-140 min).The mean intraoperative blood loss was 70.3 ml (range 50-90 ml).No complication was observed during the operation.The mean postoperative indwelling catheterization was 5.8 days (range 5-7 days).The mean postoperative hospital stay was 6.3 days (range 5-8 days).All 7 patients were cured after surgery,2 patients experienced urinary retention after removal of the catheter.The mean follow-up time was 18.2 months(range 13-24 months).No urinary incontinence or complications was observed postoperatively in all cases.Patient ICIQ-SF urinary incontinence questionnaire summary score and quality of life score of I-QOL questionnaire of 1 year post operation were 0.6 ± 0.5 and 96.1 ± 4.3,which were significantly improved compared with that before surgery(P ＜ 0.01).Conclusion It is safe to use autologous femoral lateral muscle iliotibial fascia in the middle segment of urethra suspension for the treatment of female stress incontinence,and the curative effect is affirmative through one-year observation.

Objective To evaluate the safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) for the diagnosis and treatment of pancreas divisum(PD) associated with recurrent acute pancreatitis(RAP) in children and teenagers. Methods Data of patients with symptomatic PD associated with RAP under 18 years old who were diagnosed and treated with ERCP from January 2011 to January 2015 were retrospectively analyzed. Patients with complete pancreas divisum underwent endoscopic minor sphincterotomy combined with dorsal duct stenting ( ESCS ) , and those with incomplete pancreas divisum underwent bi?papilla endoscopic sphincterotomy combined with dorsal duct stenting ( Bi?ESCS ) . ERCP?related data, complications were recorded. Long?term follow?up was conducted for procedure related complications. Results Nine patients with symptomatic PD associated with RAP were firstly diagnosed. A total of 18 ERCP procedures were performed in these patients, with success rate of 100. 0% ( 18/18) in the minor papilla cannulation, and mild ERCP?related complication rate of 11. 1% ( 2/18) . One was acute mild pancreatitis and the other was hyperamylasemia. During follow?up from 3 to 60 months, all patients had pain relief, among whom 7 were asymptomatic, with no onset of acute pancreatitis. Dorsal ducts of all patients were not obviously dilated in MRCP or CT scan. All patients gained weight and presented normal physical and intelligence development. Conclusion Symptomatic PD associated with RAP can be completely diagnosed with ERCP . ESCS and Bi?ESCS are safe and effective endoscopic treatment techniques for pediatric cases.

[ABSTRACT]AIM:ToinvestigatetherolesofthecanonicalWntpathwayinautism.METHODS:Usinganau-tistic model induced by prenatal exposure to valproic acid ( VPA) , we detected the expression of the signaling molecules of the canonical Wnt pathway in the prefrontal cortex (PFC) and hippocampus formation (HF) of autistic rats.The expres-sion levels of glycogen synthase kinase 3β( GSK-3β) , phosphorylated GSK-3β, β-catenin and phosphorylated β-catenin were observed by Western blotting .The mRNA expression of GSK-3β, β-catenin, c-Myc and cyclin D1 was assessed by semi-quantitative RT-PCR.RESULTS:The results of Western blotting showed that inactivated GSK-3β(Ser9) phospho-rylation was significantly increased , and inhibitory β-catenin ( Ser33/37/Thr41 ) phosphorylation was obviously decreased compared with control group .The results of RT-PCR showed that the mRNA levels of β-catenin, c-Myc and cyclin D1 in-creased, and GSK-3βwas significantly enhanced in VPA-exposed rats compared with the controls .CONCLUSION: In-creased activity of canonical Wnt pathway in the PFC and HF of autistic rats may contribute to the susceptibility to autism .

[ ABSTRACT] AIM:To investigate the effects of sulindac on oxidative stress in autism.METHODS:With an au-tistic model induced by prenatal exposure to valproic acid ( VPA) , we detected the expression of the signaling molecules of canonical Wnt pathway in the prefrontal cortex ( PFC) and hippocampus ( HC) of autistic rats treated with sulindac.The protein expression levels of glycogen synthase kinase 3β(GSK-3β), β-catenin and 4-hydroxynonenal (4-HNE) were ob-served by Western blotting.The mRNA expression of thioredoxin(Trx)1 and Trx2 was assessed by semi-quantitative RT-PCR.RESULTS:The protein level of GSK-3βand mRNA levels of Trx1 and Trx2 were lower, whereas the protein expres-sion levels ofβ-catenin and 4-HNE were higher in VPA group than those in control group.In contrast, the protein levels of GSK-3βwere significantly higher in the animals treated with both VPA and sulindac than those in VPA group, while the lev-els ofβ-catenin and 4-HNE were decreased.CONCLUSION:Sulindac attenuates oxidative stress in the pathogenesis of au-tism, suggesting the up-regulation of the Wnt/β-catenin signaling pathway disrupts oxidative homeostasis and further facili-tates susceptibility to autism.