Objective: To analyze the trends in incidence and mortality of colorectal cancer in Jinhua City, Zhejiang Province from 2016 to 2024, and to predict the incidence and mortality from 2025 to 2027, so as to provide the evidence for improving regional colorectal cancer prevention and control strategies. Methods: Data on incidence and mortality of colorectal cancer in Jinhua City from 2016 to 2024 were collected through the Zhejiang Chronic Disease Surveillance Information Management System. The crude incidence and crude mortality were calculated, and standardized using the data from the Sixth National Population Census in 2010. Trends in incidence and mortality of colorectal cancer from 2016 to 2024 were analyzed using the average annual percent change (AAPC). A grey Markov model was constructed to predict the incidence and mortality of colorectal cancer from 2025 to 2027. Results: From 2016 to 2024, the crude incidence and standardized incidence of colorectal cancer in Jinhua City were 46.90/100 000 and 30.69/100 000, respectively, showing upward trends (AAPC=4.594% and 2.051%, both P<0.05). The crude mortality and standardized mortality were 17.47/100 000 and 10.36/100 000, respectively, and the trends were not statistically significant (both P>0.05). The standardized incidence and standardized mortality of colorectal cancer in males were higher than those in females (35.38/100 000 vs. 25.68/100 000, 11.96/100 000 vs. 8.57/100 000, both P<0.05). The crude incidence and crude mortality of colorectal cancer in the ≥80 years age group were the highest, at 220.04/100 000 and 186.86/100 000, respectively. From 2016 to 2024, the standardized incidence of colorectal cancer in males and females showed upward trends (AAPC=5.069% and 3.965%, both P<0.05), while the trends in standardized mortality were not statistically significant (all P>0.05). The crude incidence in the 70-<80 years age group showed an upward trend (AAPC=1.320%, P<0.05), and the crude mortality in the 40-<50 years age group showed a downward trend (AAPC=-3.756%, P<0.05). Trends in other age groups were not statistically significant (all P>0.05). The prediction results of the grey Markov model showed that the predicted values of crude incidence and crude mortality of colorectal cancer in the whole population would increase from 58.20/100 000 and 20.04/100 000 in 2025 to 61.70/100 000 and 21.26/100 000 in 2027. Conclusions From 2016 to 2024, the incidence of colorectal cancer in Jinhua City showed upward trends, while the mortality trend was stable. Males and the elderly aged ≥80 years are high-risk populations for colorectal cancer incidence and mortality. It is predicted that both crude incidence and crude mortality will increase from 2025 to 2027.

ObjectiveTo analyze trends in the incidence and mortality of pancreatic cancer among the registered residents in Jinhua City of Zhejiang Province from 2016 to 2024, and to predict incidence and mortality rates from 2025 to 2027, thereby providing a reference for refining prevention and control strategies. MethodsData on pancreatic cancer incidence and mortality among the registered residents in Jinhua City from 2016 to 2024 were collected. The Joinpoint regression model was used to calculate the average annual percentage change (AAPC) to analyze the temporal trends of pancreatic cancer incidence and mortality. Furthermore, a GM (1,1) model was constructed using Excel 2019 to predict incidence rates and mortality rates for the years 2025 to 2027. ResultsFrom 2016 to 2024, the crude incidence and crude mortality rates of pancreatic cancer among the registered residents in Jinhua City were 8.41/100 000 and 8.19/100 000, respectively, both showing upward trends (AAPC=3.55%, 95%CI: 1.69%-5.63%; AAPC=3.35%, 95%CI: 1.08%-5.93%), while the standardized incidence and mortality rates were 5.21/100 000 and 4.93/100 000, respectively, with no statistically significant trends (AAPC=1.12% and 0.52%, both P>0.05). The incidence and mortality rates of pancreatic cancer were higher in men than in women. Both crude incidence and crude mortality rates rose steadily with increased age (both P<0.01). According to the GM (1,1) model, the crude mortality rate of pancreatic cancer among the registered residents in Jinhua City is projected to continue its upward trend from 2025 to 2027 (9.37/100 000, 9.60/100 000, and 9.83/100 000, respectively). ConclusionFrom 2016 to 2024, both the crude incidence and crude mortality rates of pancreatic cancer among registered residents in Jinhua City showed continuous upward trends, and the crude mortality rate is likely to continue rising from 2025 to 2027. Efforts to prevent and control pancreatic cancer should be strengthened, particularly among men and the very elderly.

As one of the common chronic bacterial infections, Helicobacter pylori (Hp) infection is a key pathogenic factor of chronic gastritis, peptic ulcer and gastric cancer. In the formation of gastric ulcer, Hp virulence factors directly damage the gastric mucosal barrier, induce the local inflammation and immune response, interfere with the regulation of gastric acid secretion, and ultimately destroy the mucosal stability. In the occurrence of gastric cancer, Hp-driven chronic inflammation is the basis of inflammation-cancer transformation, and it induces the genomic instability and epigenetic changes by interfering with key signaling pathways in host cells, thereby promoting malignant transformation. This paper systematically reviews the related mechanisms of Hp-induced gastric ulcer and gastric cancer in recent years, holding great significance for the development of new intervention strategies and the precise prevention and treatment of gastric cancer.

OBJECTIVE To develop a pharmacist-led intervention model for reducing drug-related medical insurance claim denial risks， so as to provide practical references for healthcare institutions in fulfilling their primary responsibility for medical insurance fund supervision. METHODS A risk matrix method was employed by the pharmacists to assess the risks associated with drug‑related medical insurance claim rejections in our hospital during 2024. Intervention measures were developed targeting high‑risk factors (including inappropriate indications for medical insurance coverage, exceeding the covered treatment course, and inappropriateness of gender and age) from three dimensions, namely organizational structure, technical prevention and control, and closed‑loop management. Changes in drug‑related claim rejection data were compared between 2024 (pre‑intervention) and 2025 (post‑intervention), and the interception effect of the pre‑prescription review system was evaluated after the intervention. RESULTS After the intervention, the total amount of drug‑related medical insurance claim rejections in our hospital was reduced by 57.24% compared with that before the intervention, and the number of rejected items decreased from 10 108 to 2 892. Specifically, the number of rejected items due to inappropriate indications, exceeded treatment course, inappropriate gender, and inappropriate age was reduced by 70.94%, 74.26%, 83.86%, and 96.70%, respectively. Throughout the year following the intervention, a total of 5.605 yuan million in outpatient prescription drug amounts and 4.683 million yuan in inpatient medication order amounts that did not meet the insurance‑limited payment requirements were intercepted by the pre‑prescription review system. The proportion of drug‑related claim rejection amount to the total medical service claim rejection amount of our hospital decreased to 19.7%. CONCLUSIONS The pharmacist-led multi-department collaborative， technical prevention and control， and dynamic optimization integrated full-process intervention model is highly operable and has significant practical effects. It has important promotion value in reducing drug-related medical insurance claim denial risks.

Objective To analyze the clinical and imaging features of primary anorectal malignant melanoma (ARMM) and to improve the level of its early diagnosis and clinical management. Methods A retrospective analysis was performed on the clinical data, multimodal imaging features, treatment methods, pathological results, and follow-up information of 31 patients with pathologically diagnosed ARMM at Zhongshan Hospital, Fudan University from December 2016 to October 2025. Results Among the 31 patients, there were 11 males and 20 females, with age of 65 (55, 71) years. Twenty-one patients presented with hematochezia as the initial symptom (67.7%), and four asymptomatic patients were detected incidentally by physical examination. All the patients showed negative alpha-fetoprotein, carcinoembryonic antigen, and carbohydrate antigen 19-9. All 31 cases were solitary ARMM, of which 14 (45.2%) were located in the anorectal region. CT was characterized by polypoid or fungating masses, absence of intestinal obstruction, moderate to marked enhancement; MRI was characterized by specific T₁WI hyperintensity and restricted diffusion; PET/CT is characterized by high metabolism. According to Ballantyne staging, 10 cases of stage Ⅰ, 11 cases of stage Ⅱ and 10 cases of stage Ⅲ were found. Endoscopic resection was performed in 1 patient, transanal resection in 2 patients, and abdominoperineal resection (Miles operation) with routine lymph node dissection in 17 patients. The positive rates of S-100, HMB-45 and Melan-A in 20 surgical patients were 100%, 95% and 100%, respectively, with a median Ki-67 proliferation index of 65%. Median postoperative follow-up duration of surgical patients was 34.5 (2−90) months. During follow-up, 8 patients (40%) developed recurrence and/or metastasis (median time was 11 months after surgery), with the liver and lungs being the most common metastatic sites. Conclusions Primary ARMM predominantly occurs in middle-aged and elderly women, hematochezia is the most common initial symptom. Diagnostic efficacy can be improved by combining characteristic imaging manifestations and immunohistochemical findings. ARMM is a highly malignant tumor with an overall poor prognosis, surgery remains the main therapeutic approach.

Objective: To analyze the association of sleep duration and emotional state with life satisfaction among upper grade primary school students in the context of the "Double Reduction" policy, so as to provide empirical evidence for improving children s sleep health and life satisfaction. Methods: From May to June 2022, a stratified random cluster sampling method was employed to recruit 3 901 primary school students in grades 4 to 6 from Bobai County, Yulin City, Guangxi, for a questionnaire survey. The questionnaire covered demographic information, sleep duration, emotion, parental homework checking frequency, after-school tutoring satisfaction and Multidimensional Students Life Satisfaction Scale. Multivariate linear hierarchical regression and the PROCESS macro were adopted for statistical analysis. Results: The score of students life satisfaction was 201.00 (184.00, 217.00). A total of 59.8% of the students slept for 9-10 hours, and 93.5% reported stable emotional state. Multivariate hierarchical linear regression analysis showed that, after controlling for variables such as gender, grade and annual family income, after-school tutoring satisfaction ( B =9.80), sleep duration ( B =3.26), frequency of parental homework checking ( B =4.06), annual family income ( B =1.99), and emotion ( B =9.35) were all positively associated with students life satisfaction (all P <0.05). Emotion played a partial mediating role between sleep duration and life satisfaction, with the mediating effect accounting for 25.8% (indirect effect=1.70, 95% CI =1.29-2.14). Gender-stratified analysis indicated that the mediating effect of emotional state between sleep duration and life satisfaction was statistically significant in both boys (indirect effect=1.40, 95% CI =0.91-1.95) and girls (indirect effect=2.08, 95% CI =1.44- 2.88 ). The proportion of mediating effect was slightly higher in girls (28.3%) than in boys (23.5%). Conclusions Emotion partially mediates the relationship between sleep duration and life satisfaction among upper-grade primary school students, and gender differences exist in the mediating mechanism. Collaborative interventions targeting sleep and emotional well-being should be promoted, and the "family-school-community" cooperative education system needs to be strengthened.

Objective To investigate the mechanism by which Shenqi Xiaozheng Decoction-medicated serum regulates c-Myc/SLC1A5/GLS1 signaling axis to inhibit glutamine(Gln)metabolism and activate immunogenic cell death(ICD)in non-small cell lung cancer(NSCLC)cells.Methods A549 cells were divided into control group,model group,Shenqi Xiaozheng Decoction-medicated serum low-,medium-and high-dosage groups and positive control group.A Gln-dependent growth model was established,and cells were treated with different concentrations of Shenqi Xiaozheng Decoction-medicated serum or the SLC1A5 inhibitor V-9302.Cell proliferation was assessed by CCK-8,EdU and colony formation assays;Cell invasion and migration were evaluated using Transwell and wound-healing assays;intracellular Gln,glutathione(GSH),and α-ketoglutarate(α-KG)contents were determined by colorimetric assay;reactive oxygen species(ROS)contents were measured with fluorescent probes;Western blot was used to detect the protein expressions of E-cadherin,N-cadherin,c-Myc,SLC1A5 and GLS1;c-Myc/SLC1A5 colocalization and high mobility group box 1(HMGB1)expression were assessed by dual immunofluorescence staining;flow cytometry was used to evaluate calreticulin(CRT)exposure on the cell surface,and ATP and HMGB1 contents in cell supernatants were quantified by ELISA.Results Compared with the control group,the model group showed significantly increased A549 cell viability,EdU-positive rate and migration rate(P<0.05),as well as higher colony counts and invasion cell numbers(P<0.05);cellular Gln,GSH and α-KG contents were significantly elevated(P<0.05,P<0.01),while ROS content were not significantly different(P>0.05),E-cadherin protein expression significantly decreased,whereas the protein expressions of N-cadherin,c-Myc,SLC1A5 and GLS1 significantly increased(P<0.05,P<0.01).c-Myc and SLC1A5 colocalization was enhanced,HMGB1 expression was significantly increased(P<0.01),CRT exposure significantly increased(P<0.01),and ATP and HMGB1 contents in cell supernatant were significantly elevated(P<0.05,P<0.01).Compared with the model group,Shenqi Xiaozheng Decoction-medicated serum at different concentrations significantly inhibited Gln-stimulated A549 cell proliferation,migration and invasion in a dosage-dependent manner.Mechanistic studies indicated that Shenqi Xiaozheng Decoction could reduce Gln uptake and synthesis of its metabolic products GSH and α-KG,induce ROS accumulation,up-regulate protein expression of E-cadherin,down-regulate the protein expressions of N-cadherin,c-Myc,SLC1A5 and GLS1(P<0.05,P<0.01),and enhance CRT exposure,ATP release and HMGB1 secretion(P<0.01).Conclusion Shenqi Xiaozheng Decoction may exert a synergistic"metabolism-immunity"antitumor effect by inhibiting c-Myc/SLC1A5/GLS1 axis-mediated Gln uptake,inducing ROS accumulation,and activating ICD signaling.

[Purpose]To analyze the trends of incidence and age at onset of leukemia in Jiangsu cancer registration areas from 2009 to 2019.[Methods]The continuous monitoring data of leukemia 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 incidence rate(CIR),age-standardized incidence rate by Chinese standard population(ASIRC),the average annual percentage change(AAPC),the standardized average age at onset,the changes in the age structure of incidence and the changes in the birth cohort by year were calculated.[Results]The incidence rate of leukemia significantly increased from 5.22/105 in 2009 to 7.88/105 in 2019,with a significant upward trend(for CIR,AAPC=4.95％,95％CI:3.82％～6.09％;for ASIRC,AAPC=2.97％,95％CI:1.52％～4.43％).The incidence rates were in-creased in all age groups and increased with the birth cohort by years.There was a tendency of backward shift for the age composition of the population,with the increasing of composition for those over 60 years old.The mean age at onset increased from 48.62 years old in 2009 to 57.96 years old in 2019,with a backward shift in the mean age(β=0.773,P＜0.001),and the mean age at onset increased with the year only in rural areas after standardization(β=0.428,P=0.017).[Conclusion]Leukemia incidence rate in Jiangsu Province increased from 2009 to 2019,and the age at onset has shifted backwards.It's important to strengthen the early prevention and control of leukemia.

BACKGROUND: Children's respiratory health demonstrates particular sensitivity to air pollution. Existing evidence investigating the association between short-term ozone (O₃) exposure and childhood pneumonia remains insufficient and inconsistent, especially in low- and middle-income countries (LMICs). METHOD: To provide more reliable and persuasive evidence, we implemented a multi-city, time-stratified case-crossover design with a large sample size, using data from seven representative children's hospitals across major geographical regions in China. To avoid the impact of the COVID-19 pandemic, individual-level medical records of inpatient children under 6 years of age diagnosed with pneumonia during 2016-2019 were collected. Conditional logistic regression models were fitted for each city, and city-specific estimates were pooled through a meta-analysis using a random-effects model. RESULTS: In total, the study included 137,470 pediatric pneumonia hospital admissions. The highest pooled estimate for O₃ occurred at lag0-1, with a 10 µg/m³ increase in O₃ associated with a 1.57% (95% CI: 0.67%-2.48%) higher risk of pediatric pneumonia hospital admissions. Stratified analyses indicated that the effects of O₃ were robust across different sexes, age groups, and admission seasons. We also observed a statistically significant increase in risk associated with O₃ concentrations exceeding the World Health Organization Air Quality Guidelines (WHO-AQGs). CONCLUSIONS This study revealed a significant positive association between O₃ and pediatric pneumonia hospital admissions. Our findings substantially strengthen the evidence base for the adverse health impacts of O₃, underscoring the importance of O₃ pollution control and management in reducing the public health burden of pediatric pneumonia.
Humans ; Ozone/analysis* ; China/epidemiology* ; Pneumonia/chemically induced* ; Child, Preschool ; Male ; Female ; Infant ; Cross-Over Studies ; Air Pollutants/analysis* ; Hospitalization/statistics & numerical data* ; Child ; Cities/epidemiology* ; Air Pollution/adverse effects* ; Infant, Newborn ; Environmental Exposure/adverse effects*

Objective:To explore the latent trajectory class of perioperative pain catastrophizing in patients undergoing lumbar internal fixation surgery and analyze the influencing factors of these latent classes.Methods:A total of 180 patients who underwent lumbar internal fixation surgery at Xinxiang Central Hospital from January to December 2023 were selected using convenience sampling. The Pain Catastrophizing Scale (PCS) was used to assess pain catastrophizing at 1 day preoperatively and on postoperative days 3, 7, and 14. Latent Class Growth Modeling (LCGM) was employed to identify trajectory classes of pain catastrophizing, and Logistic regression analysis was used to examine their influencing factors.Results:A total of 177 patients completed the follow-up, with a follow-up rate of 98.33% (177/180) . The overall perioperative PCS score was (30.39±10.86) . PCS scores at 1 day preoperatively and on postoperative days 3, 7, and 14 were (37.63±6.23) , (33.27±6.00) , (28.55±9.02) , and (23.81±9.33) , respectively. The proportions of patients with PCS≥38 at the four times were 42.94% (76/177) , 23.16% (41/177) , 22.60% (40/177) , and 12.43% (22/177) , respectively. LCGM identified three latent trajectory classes of perioperative pain catastrophizing: "high-level declining group" (55.93%, 99/177) , "high-level fluctuating group" (28.81%, 51/177) , and "persistent high-level group" (15.25%, 27/177) . Logistic regression analysis showed that payment method, surgical duration, and preoperative PCS score were significant influencing factors of pain catastrophizing trajectory classes ( P<0.05) . Conclusions:Pain catastrophizing levels in patients undergoing lumbar internal fixation surgery peaked preoperatively. While most patients showed a declining trend postoperatively, a subset exhibited fluctuating or persistently high levels. Payment method, surgical duration, and preoperative pain catastrophizing levels significantly influenced the trajectory of pain catastrophizing, warranting attention from clinical nursing staff.