Objective The aim of this study was to analyze the incidence trend and age-specific characteristics of esophage-al cancer in cancer registration areas of Gansu Province from 2010 to 2021,and predict the incidence of esophageal cancer from 2022 to 2030.Methods Based on the incidence data of esophageal cancer in 15 cancer registries in Gansu Province from 2010 to 2021,the incidence was calculated by age,sex,urban and rural areas.The age-standardized incidence by Chinese standard population(ASIRC)was standardized using the 2000 Chinese standard population.Joinpoint regression model was used to analyze the change trend of esophageal cancer incidence,and the average annual percentage change(AAPC)was calculated to quantify the overall rate of change.A birth cohort model was constructed to analyze incidence trend of different birth groups from 1930 to 2021,and the Bayesian age-period-cohort(BAPC)model was used to predict incidence.Results From 2010 to 2021,the ASIRC of esophageal cancer in Gansu Province showed a significant downward trend(AAPC=-14.47％,95％CI:-18.72％--9.99％,P＜0.001).The ASIRC in men decreased at an annual rate of 13.02％(AAPC=-13.02％,95％CI:-17.28％--8.54％,P＜0.001),the incidence of esophage-al cancer in women at a rate of 15.80％per year(AAPC=-15.80％,95％CI:-20.69％--10.61％,P＜0.001).The ASIRC of e-sophageal cancer in urban areas decreased at an annual rate of 15.32％(AAPC=-15.32％,95％CI:-21.04％--9.18％,P＜0.001);ASIRC of esophageal cancer in rural areas decreased at a rate of 5.33％per year(AAPC=-5.33％,95％CI:-8.94％--1.58％,P＜0.001).From 2010 to 2021,the incidence of esophageal cancer in all age groups showed a significant downward trend(AAPC:-19.59％to-9.18％).The birth cohort analysis revealed that the incidence of esophageal cancer in people over 40 years old in the province,men,women,urban and rural areas showed a downward trend with increase of birth years.BAPC model predicted that that the ASIRC of esophageal cancer for the total province population,men and women would decrease from 6.47/100,000,10.02/100,000,and 2.95/100,000 in 2021 to 1.31/100,000,1.72/100,000,and 0.91/100,000 in 2030,respectively.Conclu-sions The incidence of esophageal cancer in Gansu Province showed a downward trend from 2010 to 2021,but men and rural areas were still the focus of high incidence.The prediction indicates that the incidence of esophageal cancer in Gansu Province will further decline by 2030,suggesting that the prevention and control measures have achieved results;however,it is still necessary to strengthen the intervention and long-term monitoring of high-risk groups.

Purpose To investigate the value of 18F-FDG PET/CT combined with MRI for detecting occult lymph node metastases in head and neck squamous cell carcinoma(HNSCC).Materials and Methods Eighteen patients with clinically node-negative,pathologically confirmed HNSCC were retrospectively enrolled from the Third Affiliated Hospital of Air Force Medical University from January 2022 to December 2023.All patients underwent preoperative 18F-FDG PET/CT and MRI,including 3D BRAVO high-resolution structural imaging,T2WI and diffusion-weighted imaging.Two nuclear medicine physicians qualitatively and semi-quantitatively assessed cervical lymph nodes for glucose metabolism and apparent diffusion coefficient(ADC)abnormalities.Using postoperative pathology as the gold standard,the diagnostic performance of PET,ADC and their combination for detecting occult metastases was compared.Results Among 54 dissected lymph nodes from 18 patients,12(22.2%)were pathologically confirmed as metastatic.Of 7 false-negative lymph nodes on diffusion weighted imaging,18F-FDG PET/CT correctly identified 4 as positive.18F-FDG PET/CT showed 6 false negatives and 6 false positives.The accuracies of 18F-FDG PET/CT and MRI for detecting occult metastases were 77.8%and 55.6%,respectively,while their combination achieved 91.1%accuracy(41/45).Metastatic lymph nodes exhibited higher maximum standardized uptake values(3.53±0.26 vs.2.71±0.14;t=3.17,P=0.008)and lower ADC values(0.91×10-3 mm2/s vs.1.07×10-3 mm2/s;t=4.15,P=0.001)compared with inflammatory nodes.Conclusion 18F-FDG PET/CT combined with diffusion weighted imaging improves detection of occult lymph node metastases in HNSCC and may guide surgical management.

Objective The aim of this study was to analyze the incidence trend and age-specific characteristics of esophage-al cancer in cancer registration areas of Gansu Province from 2010 to 2021,and predict the incidence of esophageal cancer from 2022 to 2030.Methods Based on the incidence data of esophageal cancer in 15 cancer registries in Gansu Province from 2010 to 2021,the incidence was calculated by age,sex,urban and rural areas.The age-standardized incidence by Chinese standard population(ASIRC)was standardized using the 2000 Chinese standard population.Joinpoint regression model was used to analyze the change trend of esophageal cancer incidence,and the average annual percentage change(AAPC)was calculated to quantify the overall rate of change.A birth cohort model was constructed to analyze incidence trend of different birth groups from 1930 to 2021,and the Bayesian age-period-cohort(BAPC)model was used to predict incidence.Results From 2010 to 2021,the ASIRC of esophageal cancer in Gansu Province showed a significant downward trend(AAPC=-14.47％,95％CI:-18.72％--9.99％,P＜0.001).The ASIRC in men decreased at an annual rate of 13.02％(AAPC=-13.02％,95％CI:-17.28％--8.54％,P＜0.001),the incidence of esophage-al cancer in women at a rate of 15.80％per year(AAPC=-15.80％,95％CI:-20.69％--10.61％,P＜0.001).The ASIRC of e-sophageal cancer in urban areas decreased at an annual rate of 15.32％(AAPC=-15.32％,95％CI:-21.04％--9.18％,P＜0.001);ASIRC of esophageal cancer in rural areas decreased at a rate of 5.33％per year(AAPC=-5.33％,95％CI:-8.94％--1.58％,P＜0.001).From 2010 to 2021,the incidence of esophageal cancer in all age groups showed a significant downward trend(AAPC:-19.59％to-9.18％).The birth cohort analysis revealed that the incidence of esophageal cancer in people over 40 years old in the province,men,women,urban and rural areas showed a downward trend with increase of birth years.BAPC model predicted that that the ASIRC of esophageal cancer for the total province population,men and women would decrease from 6.47/100,000,10.02/100,000,and 2.95/100,000 in 2021 to 1.31/100,000,1.72/100,000,and 0.91/100,000 in 2030,respectively.Conclu-sions The incidence of esophageal cancer in Gansu Province showed a downward trend from 2010 to 2021,but men and rural areas were still the focus of high incidence.The prediction indicates that the incidence of esophageal cancer in Gansu Province will further decline by 2030,suggesting that the prevention and control measures have achieved results;however,it is still necessary to strengthen the intervention and long-term monitoring of high-risk groups.

Hereditary diffuse leukoencephalopathy with spheroids (HDLS) is a rare case caused by a mutation in the colony-stimu-lating factor 1 receptor ( CSF1R) gene on chromosome 5. In this paper, we report a case of a young female patient with HDLS, mainly characterized by memory loss, cognitive impairment, delayed movement, and abnormal mental and behavioral states. Genetic testing revealed a missense mutation in the CSF1R gene.

BACKGROUND: Immune checkpoint inhibitors (ICIs) have been included in various neoadjuvant therapy (NAT) regimens for non-small cell lung cancer (NSCLC). However, due to the relatively short period for the use of ICIs in NAT, patients' clinical outcomes with different regimens are uncertain. Our study aims to examine the efficacy of neoadjuvant immunotherapy (NAIT) for NSCLC patients and compare the overall survival (OS) and event-free survival (EFS) of patients receiving different NAT regimens. METHODS: This study retrospectively included 308 NSCLC patients treated with different NAT regimens and subsequent surgery in National Cancer Center between August 1, 2016 and July 31, 2022. Kaplan-Meier survival analysis and Cox proportional hazards regression analysis were conducted to evaluate the prognosis of patients. RESULTS: With a median follow-up of 27.5 months, the 1-year OS rates were 98.8% and 96.2%, and the 2-year OS rates were 96.6% and 85.8% in patients of the NAIT and neoadjuvant chemotherapy (NACT) group, respectively (hazard ratio [HR], 0.339; 95% confidence interval [CI], 0.160-0.720; P = 0.003). The 1-year EFS rates were 96.0% and 88.0%, and the 2-year EFS rates were 92.0% and 77.7% for patients in the NAIT and NACT groups, respectively (HR, 0.438; 95% CI, 0.276-0.846; P = 0.010). For patients who did not achieve pathological complete response (pCR), significantly longer OS ( P = 0.012) and EFS ( P = 0.019) were observed in patients receiving NAIT than those receiving NACT. Different NAT regimens had little effect on surgery and the postoperative length of stay (6 [4, 7] days vs . 6 [4, 7] days, Z = -0.227, P = 0.820). CONCLUSIONS NAIT exhibited superior efficacy to NACT for NSCLC, resulting in longer OS and EFS. The OS and EFS benefits were also observed among patients in the NAIT group who did not achieve pCR.
Humans ; Carcinoma, Non-Small-Cell Lung/mortality* ; Male ; Female ; Lung Neoplasms/mortality* ; Middle Aged ; Immune Checkpoint Inhibitors/therapeutic use* ; Neoadjuvant Therapy/methods* ; Retrospective Studies ; Aged ; Adult ; Kaplan-Meier Estimate ; Treatment Outcome ; Immunotherapy/methods*

Purpose To investigate the value of 18F-FDG PET/CT combined with MRI for detecting occult lymph node metastases in head and neck squamous cell carcinoma(HNSCC).Materials and Methods Eighteen patients with clinically node-negative,pathologically confirmed HNSCC were retrospectively enrolled from the Third Affiliated Hospital of Air Force Medical University from January 2022 to December 2023.All patients underwent preoperative 18F-FDG PET/CT and MRI,including 3D BRAVO high-resolution structural imaging,T2WI and diffusion-weighted imaging.Two nuclear medicine physicians qualitatively and semi-quantitatively assessed cervical lymph nodes for glucose metabolism and apparent diffusion coefficient(ADC)abnormalities.Using postoperative pathology as the gold standard,the diagnostic performance of PET,ADC and their combination for detecting occult metastases was compared.Results Among 54 dissected lymph nodes from 18 patients,12(22.2%)were pathologically confirmed as metastatic.Of 7 false-negative lymph nodes on diffusion weighted imaging,18F-FDG PET/CT correctly identified 4 as positive.18F-FDG PET/CT showed 6 false negatives and 6 false positives.The accuracies of 18F-FDG PET/CT and MRI for detecting occult metastases were 77.8%and 55.6%,respectively,while their combination achieved 91.1%accuracy(41/45).Metastatic lymph nodes exhibited higher maximum standardized uptake values(3.53±0.26 vs.2.71±0.14;t=3.17,P=0.008)and lower ADC values(0.91×10-3 mm2/s vs.1.07×10-3 mm2/s;t=4.15,P=0.001)compared with inflammatory nodes.Conclusion 18F-FDG PET/CT combined with diffusion weighted imaging improves detection of occult lymph node metastases in HNSCC and may guide surgical management.

Hereditary diffuse leukoencephalopathy with spheroids (HDLS) is a rare case caused by a mutation in the colony-stimu-lating factor 1 receptor ( CSF1R) gene on chromosome 5. In this paper, we report a case of a young female patient with HDLS, mainly characterized by memory loss, cognitive impairment, delayed movement, and abnormal mental and behavioral states. Genetic testing revealed a missense mutation in the CSF1R gene.

Objective To analyze the differential metabolites in the seminal plasma of different types of male infertility based on untargeted metabolomics and explore new biomarkers. Methods Seminal plasma samples were collected from 85 men,and divided into oligospermia (n=20),azoospermia (n=20),asthenozoospermia (n=10),high sperm DNA fragmentation index (n=15),and healthy control (n=20) groups. Seminal plasma metabolites were detected using liquid chromatography-mass spectrometry (LC-MS). Differential metabolites were identified after data processing and statistical analyses. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis was used to identify key metabolic pathways. Area under the curve (AUC) was used to evaluate the diag-nostic efficacy of differential metabolites. Results We identified 1431 differential metabolites. KEGG enrichment analysis showed that differential metabolites mainly participated in pathways,such as amino acid biosynthesis,protein digestion and absorption,and nucleotide metabolism. The AUC of the top 10 upregulated and downregulated metabolites in each group were>0.7,indicating good diagnostic effi-cacy. Conclusion Untargeted metabolomics of seminal plasma can detect differential metabolites between different types of male infer-tility and healthy men,providing new ideas for exploring biomarkers and metabolomics-related mechanisms of male infertility.

Objective:To investigate the impact of body mass index (BMI) on delayed extubation of patients with acute Stanford type A aortic dissection (ATAAD).Methods:A total of 400 ATAAD patients who were admitted to our hospital from October 2021 to October 2023 and underwent surgical treatment were selected as the research objects. According to BMI, they were divided into obese group (BMI≥28 kg/m 2, 119 cases) and non-obese group (BMI<28 kg/m 2, 281 cases). The differences of preoperative clinical characteristics, intraoperative and postoperative data between the two groups were compared. Starting from transferring to the ICU and ending with the first successful extubation, The risk factors of postoperative invasive mechanical ventilation time ≥ 48 h in ATAAD patients were analyzed, and the predictive efficacy of related factors for postoperative invasive mechanical ventilation time ≥ 48 h in ATAAD patients was evaluated. Results:Compared with the non-obese group, the proportion of hypertension, diabetes, admission heart rate, admission systolic blood pressure, admission diastolic blood pressure and preoperative white blood cell count in the obese group were significantly increased, and the differences were statistically significant ( P<0.05). The cardiopulmonary bypass time, aortic cross-clamp time, operation time, red blood cell transfusion volume, invasive mechanical ventilation time, secondary operation rate and total hospitalization cost in the obese group were significantly higher than those in the non-obese group, and the differences were statistically significant ( P<0.05). Univariate logistic regression analysis showed that BMI, cardiopulmonary bypass time, ascending aortic cross-clamp time, operation time, age, hypertension, and red blood cell transfusion were related factors for postoperative invasive mechanical ventilation time ≥48 h in ATAAD patients ( P<0.05). Logistic multivariate regression analysis showed that increased BMI ( OR=1.213, P<0.05) and increased age ( OR=1.020, P<0.05) were independent risk predictors of postoperative invasive mechanical ventilation time≥48 h in ATAAD patients. Receiver operating characteristic curve ( ROC) analysis showed that the area under the ROC curve ( AUC) of BMI for predicting the duration of postoperative invasive mechanical ventilation in ATAAD patients≥48 h was 0.682 ( P<0.05), and the best predictive cut-off value was 25.64 kg/m 2. Conclusion:BMI≥28kg/m 2 increases the difficulty of surgery and the duration of invasive mechanical ventilation in ATAAD patients. BMI has a high predictive value for the duration of invasive mechanical ventilation in ATAAD patients after surgery ≥48 h, and effective intervention measures can be formulated to improve the treatment effect of patients.

[Purpose]To analyze the incidence and mortality of gastric cancer in 2019 in Gansu cancer registration areas and the trend from 2010 to 2019.[Methods]The data of gastric cancer reported by 23 cancer registries in Gansu Province were collected.The crude incidence and mor-tality rates,standardized incidence and mortality rates by Chinese and world standard population(ASIRC,ASIRW and ASMRC,ASMRW)and cumulative rate were calculated.The annual percentage change(APC)and the average annual percentage change(AAPC)were calculated with Joinpoint regression model.[Results]In 2019,the crude incidence of gastric cancer was 48.54/105,the ASIRC was 31.30/105,and the ASIRW was 34.40/105.The cumulative rate(0～74 years old)was 3.95％.The crude mortality rate of gastric cancer was 29.12/105,the ASWRC was 18.29/105,the ASMRW was 20.74/105,the cumulative rate(0～74 years old)was 2.13％.Gastric cancer accounted for 17.93％of all cancer new cases in Gansu Province in 2019,and accounted for 21.52％of all cancer deaths,both ranking the first of all cancers in the province.The AAPC of ASIRC was-5.85％(95％CI:-7.94％～-3.20％),and the AAPC of ASMRC was-6.12％(95％CI:-7.32％～-4.73％).For regional distributions,Lintan County had the highest incidence rate,Ganzhou District had the highest mortality rate,Qingcheng County had the lowest incidence rate and Baiyin District had the lowest mortality rate.[Conclusion]The incidence and mortality of gastric cancer in Gansu Province have been decreasing,however,the prevention and control strategies of gastric cancer should be continuously earried out in the province and strengthened screening for high risk population.