1.Associations between usage behaviors of the artificial intelligence assistant “Xiaoyibao” and psychosocial outcomes in patients with pancreatic cancer
Jun WANG ; Yuefen SHU ; Ling ZHANG ; Changming ZHOU ; Wenjie TANG
Chinese Journal of Clinical Medicine 2026;33(5):819-826
Objective To explore the correlation between the usage intensity and functional preference of the artificial intelligence assistant “Xiaoyibao” and anxiety symptoms and quality of life among patients with pancreatic cancer. Methods A total of 140 patients who were diagnosed with pancreatic ductal adenocarcinoma in a tertiary grade A hospital from March 2024 to September 2025 and used “Xiaoyibao” were enrolled. One-off assessments were carried out from April to May 2026. Clinical data were extracted from electronic medical records. The Hamilton anxiety scale (HAMA) was adopted to evaluate anxiety, and the European organization for research and treatment of cancer quality of life questionnaire-core 30 (EORTC QLQ-C30) was used to assess quality of life past week (T1). The baseline EORTC QLQ-C30 score (T0) was obtained by asking patients to recall their status within 1 week before the first anti-tumor treatment (or within 2 weeks after diagnosis for those who had not received anti-tumor treatment). Participants were divided into a high-frequency group (cumulative usage>24 times, n=69) and a low-frequency group (cumulative usage≤24 times, n=71) based on the median cumulative usage times. They were also stratified into a psychological support group (n=70) and non-psychological support group (n=70) according to whether they used the psychological support module “Xingma Ailiao”. ANCOVA was used to compare HAMA score and EORTC_T1 score between groups. The multiple linear regression was used to analyze the dose-effect relationship between cumulative usage frequency and HAMA score. Results ANCOVA showed that after adjusting for age, sex, tumor stage, KPS score and disease duration, there was no statistically significant difference in the adjusted mean HAMA scores between the high-frequency and low-frequency groups. After adjustment for the aforementioned covariates and the baseline EORTC_T0, the difference in adjusted mean EORTC_T1 scores between the high-frequency and low-frequency groups reached marginal statistical significance (P=0.050). Compared with the non-psychological support group, psychological support group had lower adjusted mean HAMA score (P=0.024) and EORTC_T1 score (P=0.002). The multiple linear regression showed a marginally significant negative dose-effect relationship between cumulative “Xiaoyibao”usage times and HAMA score (each additional 10 usages corresponded to a reduction of approximately 0.68 points in HAMA score, P=0.050). Stratified analysis showed that this dose-effect trend was significant in the high-frequency group (Spearman ρ = −0.380, P=0.001), but not in the low-frequency group. Conclusions The use frequency of “Xiaoyibao” exceeding a certain threshold and the use of its psychological support function help reduce anxiety levels and improve quality of life in patients with pancreatic cancer. For the promotion and functional optimization of “Xiaoyibao”, the psychological support module should be prioritized.
2.Surveillance and early warning index system for schistosomiasis in the middle and lower reaches of the Yangtze River basin
Sanhong JIANG ; Yibiao ZHOU ; Shizhu LI ; Dandan LIN ; Qingwu JIANG ; Liyong WEN ; Shengming LI ; Fei HU ; Benjiao HU ; Jie ZHOU ; Chunli CAO ; Jing XU ; Jianwen XIE ; Changming WU ; Xiaolan YAN ; Weimin XU ; Jun GE ; Guanghui REN ; Xiaoli LIU
Chinese Journal of Endemiology 2025;44(4):259-264
Under the current situation of "low prevalence and low infection" of schistosomiasis in China, and to provide a basis for achieving the goal of eliminating schistosomiasis by 2030 proposed by the Healthy China Action (2019 - 2030) as scheduled, the Hunan Provincial Corps Hospital of the Chinese People's Armed Police Force established a schistosomiasis monitoring and early warning index system based on the previous studies on schistosomiasis early warning index system and the recent literature analysis, combined with the current potential risk factors affecting the transmission and prevalence of schistosomiasis, and organized two rounds of expert consultation and carried out project promotion meetings. The experts reached a consensus on the comprehensiveness and practicability of the index system, aiming to lay a solid foundation for construction of China's schistosomiasis prevention and control early warning system.
3.Surveillance and early warning index system for schistosomiasis in the middle and lower reaches of the Yangtze River basin
Sanhong JIANG ; Yibiao ZHOU ; Shizhu LI ; Dandan LIN ; Qingwu JIANG ; Liyong WEN ; Shengming LI ; Fei HU ; Benjiao HU ; Jie ZHOU ; Chunli CAO ; Jing XU ; Jianwen XIE ; Changming WU ; Xiaolan YAN ; Weimin XU ; Jun GE ; Guanghui REN ; Xiaoli LIU
Chinese Journal of Endemiology 2025;44(4):259-264
Under the current situation of "low prevalence and low infection" of schistosomiasis in China, and to provide a basis for achieving the goal of eliminating schistosomiasis by 2030 proposed by the Healthy China Action (2019 - 2030) as scheduled, the Hunan Provincial Corps Hospital of the Chinese People's Armed Police Force established a schistosomiasis monitoring and early warning index system based on the previous studies on schistosomiasis early warning index system and the recent literature analysis, combined with the current potential risk factors affecting the transmission and prevalence of schistosomiasis, and organized two rounds of expert consultation and carried out project promotion meetings. The experts reached a consensus on the comprehensiveness and practicability of the index system, aiming to lay a solid foundation for construction of China's schistosomiasis prevention and control early warning system.
4.Interpretation of US cancer statistics 2025 and its implications for cancer prevention and treatment in China
Sibo MU ; Changming ZHOU ; Ying ZHENG
China Oncology 2025;35(6):523-530
In January 2025,American Cancer Society released the latest cancer statistics,projecting approximately 2 041 910 new cancer cases and 618 120 cancer-related deaths in the United States(U.S.).The cancer mortality rate in the U.S.continues to decline,with a reversal in gender disparities and an increasing cancer burden among middle-aged and young populations.Significant differences in incidence and mortality rates are attributed to variations in population characteristics,intervention screening measures,healthcare accessibility,and policy factors across different regions and populations within the U.S.Compared with the U.S.,the cancer spectrum in China is different,and the incidence rates of lung cancer and breast cancer are rapidly rising among young women,with an average annual growth rate exceeding 3%.Infection-related cancer incidence rates are relatively high,with the incidence of gastric cancer,liver cancer and cervix cancer in China being 25.4/105,26.0/105 and 21.8/105 in 2022 respectively,surpassing U.S.incidence levels.Alarmingly,the cumulative HPV vaccination coverage among eligible Chinese women during 2018-2020 was merely 2.24%,reflecting dual barriers of low screening compliance and inadequate prevention infrastructure.There is a need to further enhance primary cancer prevention and comprehensive risk factor control,prioritize cancer prevention strategies for young and female populations,formulate population-tailored prioritized prevention frameworks and strengthen multi-stakeholder financing mechanisms for personalized screening programs,with the aim of achieving the"Healthy China 2030"cancer prevention and control goals and contributing China's approach to global cancer governance.
5.Survival and cause-of-death analysis of 55 thousand thyroid cancer cases in China from a large single institution hospital-based cancer registry database
Jie SHEN ; Wanlin LIU ; Zezhou WANG ; Sibo MU ; Miao MO ; Changming ZHOU ; Jing YUAN ; Yu WANG ; Ying ZHENG ; Qinghai JI
China Oncology 2025;35(1):68-76
Background and purpose:Thyroid cancer is the most common malignant endocrine tumor,particularly prevalent among the Asian population.The overall survival for thyroid cancer patients is relatively high,but there are significant survival differences among patients.Based on long-term hospital-based cancer registry database,this study analyzed the 10-year observed overall survival(OS)rate of thyroid cancer cases and the distribution of causes of death,providing real-world evidences to further survival management of thyroid cancer in China.Methods:A total of 55343 thyroid cancer patients who underwent treatment at Fudan University Shanghai Cancer center from 2005 to 2021 were included in this study.Clinical information and the follow-up endpoint data were collected through medical records review,telephone visits and death registry data linkage.The last follow-up date was October 31,2024.Kaplan-Meier method was applied in evaluating the OS rate,and survival data were described by different subgroups as age group,gender,treatment period,tumor staging and pathological characteristics.The standardized mortality ratio(SMR)and absolute excess risk(AER)were calculated using general Shanghai population as the reference,and the mortality risk was described by gender,age at diagnosis and histological subtype.Results:With a median follow-up time of 63.01 months,the overall 1-,3-,5-and 10-year OS rates of thyroid cancer patients were 99.67%(95%CI:99.62%-99.72%),99.11%(95%CI:99.03%-99.19%),98.48%(95%CI:98.36%-98.60%)and 95.81%(95%CI:95.50%-96.11%),respectively.The 10-year OS rates of stage Ⅰ,Ⅱ,Ⅲ and Ⅳ were 97.99%(95%CI:97.70%-98.28%),89.80%(95%CI:87.24%-92.37%),77.84%(95%CI:70.76%-84.92%)and 62.95%(95%CI:55.37%-70.54%),respectively.The differences in OS among patients with different age,gender and histological classification were significant.1256(2.27%)deaths occurred,of which 18.63%,50.88%and 7.32%were attributable to thyroid cancer,other cancers and cardiovascular disease(CVD),respectively.Compared with the general population,patients with different subtypes of thyroid cancer had higher all-cause mortality rates,progressively increasing with papillary,follicular,medullary and anaplastic thyroid carcinoma/poorly differentiated carcinoma.Compared with general population,the death risk was 2.24 times higher in papillary thyroid cancer patients(95%CI:2.06-2.44),9.94 times higher in follicular thyroid cancer patients(95%CI:6.79-14.09),12.16 times higher in medullary thyroid cancer patients(95%CI:8.05-17.69),and the highest risk was observed in patients with anaplastic thyroid carcinoma/poorly differentiated carcinoma[SMR=79.67(95%CI:58.38-106.31),AER=766.01/1 000 person-years].Conclusion:The 10-year long survival data and cause of death for thyroid cancer patients with different histological types were reported in China based on a large single institution hospital-based cancer registry database.Staging and histological characteristics were the most important factors directly affected the survival.Early diagnosis and individualized treatment are crucial for improving prognosis.
6.Interpretation of US cancer statistics 2025 and its implications for cancer prevention and treatment in China
Sibo MU ; Changming ZHOU ; Ying ZHENG
China Oncology 2025;35(6):523-530
In January 2025,American Cancer Society released the latest cancer statistics,projecting approximately 2 041 910 new cancer cases and 618 120 cancer-related deaths in the United States(U.S.).The cancer mortality rate in the U.S.continues to decline,with a reversal in gender disparities and an increasing cancer burden among middle-aged and young populations.Significant differences in incidence and mortality rates are attributed to variations in population characteristics,intervention screening measures,healthcare accessibility,and policy factors across different regions and populations within the U.S.Compared with the U.S.,the cancer spectrum in China is different,and the incidence rates of lung cancer and breast cancer are rapidly rising among young women,with an average annual growth rate exceeding 3%.Infection-related cancer incidence rates are relatively high,with the incidence of gastric cancer,liver cancer and cervix cancer in China being 25.4/105,26.0/105 and 21.8/105 in 2022 respectively,surpassing U.S.incidence levels.Alarmingly,the cumulative HPV vaccination coverage among eligible Chinese women during 2018-2020 was merely 2.24%,reflecting dual barriers of low screening compliance and inadequate prevention infrastructure.There is a need to further enhance primary cancer prevention and comprehensive risk factor control,prioritize cancer prevention strategies for young and female populations,formulate population-tailored prioritized prevention frameworks and strengthen multi-stakeholder financing mechanisms for personalized screening programs,with the aim of achieving the"Healthy China 2030"cancer prevention and control goals and contributing China's approach to global cancer governance.
7.Survival and cause-of-death analysis of 55 thousand thyroid cancer cases in China from a large single institution hospital-based cancer registry database
Jie SHEN ; Wanlin LIU ; Zezhou WANG ; Sibo MU ; Miao MO ; Changming ZHOU ; Jing YUAN ; Yu WANG ; Ying ZHENG ; Qinghai JI
China Oncology 2025;35(1):68-76
Background and purpose:Thyroid cancer is the most common malignant endocrine tumor,particularly prevalent among the Asian population.The overall survival for thyroid cancer patients is relatively high,but there are significant survival differences among patients.Based on long-term hospital-based cancer registry database,this study analyzed the 10-year observed overall survival(OS)rate of thyroid cancer cases and the distribution of causes of death,providing real-world evidences to further survival management of thyroid cancer in China.Methods:A total of 55343 thyroid cancer patients who underwent treatment at Fudan University Shanghai Cancer center from 2005 to 2021 were included in this study.Clinical information and the follow-up endpoint data were collected through medical records review,telephone visits and death registry data linkage.The last follow-up date was October 31,2024.Kaplan-Meier method was applied in evaluating the OS rate,and survival data were described by different subgroups as age group,gender,treatment period,tumor staging and pathological characteristics.The standardized mortality ratio(SMR)and absolute excess risk(AER)were calculated using general Shanghai population as the reference,and the mortality risk was described by gender,age at diagnosis and histological subtype.Results:With a median follow-up time of 63.01 months,the overall 1-,3-,5-and 10-year OS rates of thyroid cancer patients were 99.67%(95%CI:99.62%-99.72%),99.11%(95%CI:99.03%-99.19%),98.48%(95%CI:98.36%-98.60%)and 95.81%(95%CI:95.50%-96.11%),respectively.The 10-year OS rates of stage Ⅰ,Ⅱ,Ⅲ and Ⅳ were 97.99%(95%CI:97.70%-98.28%),89.80%(95%CI:87.24%-92.37%),77.84%(95%CI:70.76%-84.92%)and 62.95%(95%CI:55.37%-70.54%),respectively.The differences in OS among patients with different age,gender and histological classification were significant.1256(2.27%)deaths occurred,of which 18.63%,50.88%and 7.32%were attributable to thyroid cancer,other cancers and cardiovascular disease(CVD),respectively.Compared with the general population,patients with different subtypes of thyroid cancer had higher all-cause mortality rates,progressively increasing with papillary,follicular,medullary and anaplastic thyroid carcinoma/poorly differentiated carcinoma.Compared with general population,the death risk was 2.24 times higher in papillary thyroid cancer patients(95%CI:2.06-2.44),9.94 times higher in follicular thyroid cancer patients(95%CI:6.79-14.09),12.16 times higher in medullary thyroid cancer patients(95%CI:8.05-17.69),and the highest risk was observed in patients with anaplastic thyroid carcinoma/poorly differentiated carcinoma[SMR=79.67(95%CI:58.38-106.31),AER=766.01/1 000 person-years].Conclusion:The 10-year long survival data and cause of death for thyroid cancer patients with different histological types were reported in China based on a large single institution hospital-based cancer registry database.Staging and histological characteristics were the most important factors directly affected the survival.Early diagnosis and individualized treatment are crucial for improving prognosis.
8.Efficacy of anlotinib in the treatment of advanced radioactive iodine-refractory differentiated thyroid cancer and the effect on iodine uptake of lesions
Fanglei ZHANG ; Hongyan ZHAI ; Ruihong YAN ; Changming ZHANG ; Zhenhu ZHOU
Chinese Journal of Nuclear Medicine and Molecular Imaging 2024;44(10):592-596
Objective:To study the efficacy and safety of anlotinib in the treatment of advanced radioactive iodine-refractory differentiated thyroid cancer (RAIR-DTC) and the effect of anlotinib on iodine uptake of lesions.Methods:A retrospective analysis was performed on 23 patients (10 males and 13 females, age (59.1±8.7) years) with advanced RAIR-DTC who were treated with anlotinib in Liaocheng Hospital Affiliated to Shandong First Medical University between January 2019 and February 2023 and met the enrollment criteria. Thyroid function, serum thyroglobulin (Tg) and Tg antibody (TgAb) were determined every 6 weeks during the treatment with anlotinib, and maximum diameter of target lesion (TL) was monitored by CT every 12 weeks, in order to evaluate the therapeutic efficacy, and treatment-related adverse reactions were observed. Diagnostic 131I whole body scan (Dx-WBS) was performed in some patients to evaluate the changes in iodine uptake of lesions after anlotinib treatment. In this study, the posttreatment changes of patients within 24 weeks during the treatment were analyzed. The maximum diameter of TL and Tg at different time points were compared by Friedman test, and were further compared in pairs with P values corrected by Bonferroni method. Results:After 24 weeks of treatment with anlotinib, 8 of 23 patients achieved partial response, 15 had stable disease, and no patients achieved complete response. Serum Tg levels at 6, 12, 18, 24 weeks after anlotinib treatment were 189.5(85.0, 483.3), 127.7(52.4, 319.8), 82.0(40.2, 213.5) and 80.1(39.9, 205.0) μg/L, all of which were lower than the baseline level of Tg (384.5(210.9, 1 605.0) μg/L; χ2 values: 4.23-7.86, all P<0.001). Tg level at 18 weeks after treatment was statistically different from that at 12 weeks after treatment ( χ2 =3.06, P<0.001), but was not statistically different from that at 24 weeks after treatment ( χ2 =12.57, P=0.059). The maximum TL diameters of lung and cervical lymph nodes were significantly reduced at week 12 and 24 of anlotinib treatment compared with baseline ( χ2 values: 14.76-31.12, all P<0.001), while there was no significant difference in TL maximum diameter at 12 and 24 weeks of treatment ( χ2 values: 5.65, 9.02, P values: 0.314, 0.070). Common adverse reactions included hypertension, hand-foot syndrome, hyperacylglyceremia and proteinuria. No adverse reactions above grade 4 or death related to adverse reactions occurred. Dx-WBS evaluation was performed in 7 patients after anlotinib treatment, and no change in iodine uptake was found. Conclusions:Anlotinib has a clear effect on advanced RAIR-DTC with less adverse reactions. The efficacy of anlotinib reaches the strongest at around 12-18 weeks and becomes stable at 24 weeks. No effect of anlotinib on inducing redifferentiation of RAIR-DTC cells and enhancing iodine uptake is found.
9.Relationship between serum sCD40L,ADAMTS13 and postoperative lower extremity deep vein thrombosis in elderly patients with hip fractures
Guangyu FU ; Changming ZHOU ; Jianmin LIU ; Yan LI
International Journal of Laboratory Medicine 2024;45(24):2951-2955
Objective To explore the relationship between serum soluble cell surface differentiation antigen 40 ligand(sCD40L),a disintegrin-like and metalloproteinase with thrombospondin type-1 motif 13(ADAMTS13)levels and postoperative lower extremity deep vein thrombosis(DVT)formation in elderly pa-tients with hip fractures.Methods A total of 192 elderly patients with hip fractures who visited the hospital from June 2022 to June 2023 were selected and separated into non DVT group(120 cases)and DVT group(72 cases)based on whether they experienced lower extremity DVT after surgery.Enzyme-linked immunosorbent assay was applied to detect serum sCD40L and ADAMTS13 levels in each group.Pearson method was applied to analyze the correlation between serum sCD40L and ADAMTS13 levels in patients.Multivariate Logistic re-gression model was applied to analyze the factors affecting postoperative lower extremity DVT in elderly pa-tients with hip fractures.Receiver operating characteristic(ROC)curve was applied to evaluate the predictive value of serum sCD40L and ADAMTS13 levels for postoperative lower extremity DVT in elderly patients with hip fractures.Results There were statistically significant differences in the proportion of hyperlipidemia and the time from fracture to surgery between the two groups(P<0.05).Compared with the non DVT group,the serum sCD40L level in the DVT group increased(P<0.05)and the ADAMTS13 level decreased(P<0.05).Pearson method results showed that the serum sCD40L level was negatively correlated with ADAMTS13 level in patients(r=-0.457,P<0.001).Multivariate Logistic regression model analysis showed that hyperlipi-demia,long time from fracture to surgery,increased level of serum sCD40L were risk factors for postoperative lower extremity DVT in elderly patients with hip fractures(P<0.05),and the increased level of serum AD-AMTS13 was a protective factor for postoperative lower extremity DVT in patients with hip fractures(P<0.05).The area under the curve of the combined prediction of serum sCD40L and ADAMTS13 for postopera-tive lower extremity DVT in elderly patients with hip fractures was 0.812,which was larger than that of sCD40L and ADAMTS13 alone(P<0.05).Conclusion Serum sCD40L level increases and ADAMTS13 level decreases in elderly patients with hip fracture who had lower extremity DVT after surgery,the two could re-flect the risk of DVT and have predictive value for the occurrence of lower extremity DVT in elderly patients with hip fracture.
10.Survival analysis of 6 737 surgically resected gastric cancer cases in China from a large single institution hospital-based cancer registry database
Jie SHEN ; Jiangli WANG ; Zezhou WANG ; Miao MO ; Changming ZHOU ; Jing YUAN ; Dazhi XU ; Ying ZHENG
China Oncology 2024;34(3):268-277
Background and purpose:Follow-up data of 6 737 patients undergoing surgery for gastric cancer were collected based on hospital registration,and the 1-,3-and 5-years observed overall survival(OS)rates and disease-free survival(DFS)rates were analyzed to provide real-world research evidence for the prevention and control of gastric cancer and policy making in China.Methods:A total of 6 737 gastric cancer patients who underwent surgical treatment at Fudan University Shanghai Cancer center from 2015 to 2020 were included in this study.Clinical information and the follow-up endpoint data were collected through medical records review,telephone visits and death registry data linkage.The last follow-up date was November 30,2023.Kaplan-Meier method was applied in evaluating the 1-,3-and 5-year OS rate and DFS rate,and survival data were described by different subgroups including age group,gender,treatment period,tumor staging,and pathological characteristics.Results:With a median follow-up time of 50.99 months,the 5-year OS rate of surgically resected gastric cancer patients was 70.37%,and 5-year DFS rate in Ⅰ-Ⅲ stage cases was 69.46%.The 5-year OS rates of stage Ⅰ,Ⅱ,Ⅲ and Ⅳ were 94.32%,82.56%,51.01%and 23.97%,respectively.The differences in survival among patients with different age,tumor location,gross classification,Borrmann classification and Laurence classification were significant.Conclusion:Staging is an important factor directly affecting the survival of gastric cancer patients.Screening and early diagnosis and treatment in large population,especially high-risk group,should be strengthened to further improve the patients'survival.

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